Equality Act 2010 (Age Exceptions) Order 2012

Debate between Baroness Thornton and Baroness Howe of Idlicote

Tuesday 17th July 2012 Grand Committee

[Baroness Thornton]

My Lords, I thank the Minister for her very good explanation of this rather straightforward order. The order arises out of the Equality Act 2010, which my noble friend Lady Royall and I took through the House before the general election. There are two areas that I want to explore.

We welcome the implementation at last of Labour’s age discrimination legislation and the fact that that the Act will come into force in October. What preparatory work is being undertaken to explain and publicise this important legislation and which government departments are involved in its implementation and rollout? Is it, for example, BIS or the DWP? Is support being given to employers and employees? Perhaps the Department of Health—to which I will return—is involved as well. Who is leading on the preparation for rollout of the legislation in October? Is it the Government Equalities Office or the EHRC? What quantum of resources might be applied to it? The impact assessment, which came with the helpful notes accompanying the order, explains what the impact might be on businesses, charities and voluntary and public sector bodies; it does not say what resources might be put into explaining and promoting the legislation.

I welcomed the Minister’s mentioning the Government’s awareness of issues relating to discrimination in health services, because, even at Question Time today and as the Minister will know, a noble Baroness mentioned that older people with depression are not being offered talking therapies because of their age. The breast cancer charities produce enormous amounts of evidence that suggests that older women with breast cancer are routinely undertreated.

Are the Government still refusing to implement the dual discrimination provisions in the Equality Act which will make it easier to challenge the multiple layers of discrimination that older people face, such as the toxic combination of ageism and sexism? The Secretary of State said on 15 May that there would be a delay to the commencement of the dual discrimination provisions. What does that mean? How long is that delay going to be? When can we see orders which implement those provisions, or an intention to do so?

During the passage of the Bill in another place, the Minister’s colleague, Lynne Featherstone, put down an amendment which suggested that the Bill be implemented within six months of its passage, because she did not trust what might happen after the general election and she feared that the party elected, if it was not sympathetic, might not implement it. The Minister will be pleased to know that a combination of my then right honourable friend Vera Baird and her honourable friend Mr Harper persuaded Ms Featherstone that this was not necessary and that the Bill would be implemented, albeit perhaps with a delay—as is the case.

I turn to the orders in front of us today. Of course we welcome them; why would we not? They directly arise from commitments given during the course of the Bill in February and March 2010. There were serious discussions during that period with Saga, Age UK and organisations that provide financial services about what those exceptions should be. The continuing consultation seems to have covered most of those points. My only question about the consultation arises from the fact that Age UK mounted a campaign objecting to the proposed specific extension of financial services, because in its view that would continue to perpetuate the culture of ageism. What is the Government’s view of that campaign? The 17 campaign letters received from Cornish self-catering holiday home workers seeking a specific exception to ban young people from their accommodation have my total sympathy, when one hears about what young people get up to in Cornwall after their exams.

We welcome this measure. We think it is important, and I hope that the Government are going to put resources into supporting organisations and people during its implementation in October. During the debate in March 2010 there was cross-party agreement in the House about these exceptions, and I think that the Government have covered all the issues that needed to be covered. My only questions are about its implementation, resources and publicisation, and ensuring that all the people who should know about this will know about it.

[Baroness Howe of Idlicote]

My Lords, I, too, congratulate the Government on the great deal that has been achieved. I have memories of the heavy support for Saga initiatives and so on, which clearly have been very well handled subsequently.

I have a specific question about the Equality and Human Rights Commission. I happen to have been seeing the commission about another matter today, and as a result have received some comments about the articles that we are discussing. My general question, and I will back this up in a minute with a specific one, is whether the Government have had more recent detailed discussions with the EHRC and made certain that it is satisfied. I am thinking particularly about Article 4, “Exceptions for concessionary services”. The commission says:

“In its 2011 consultation response, the Commission noted that the exception for general beneficial concessions was limited by a test of reasonableness. The exception also contained a requirement that the concession (or more favourable term) did not have the effect of preventing persons of other age groups from requiring the services. However, in the version of the Order currently before Parliament”,

apparently,

“both these limitations have been removed”.

The commission, having analysed Article 4, advises that,

“as currently drafted, the exception may fail to meet the policy intention of the exception, as stated by the Government Equalities Office in its 2011 consultation paper: ‘The exception will not, however, allow concession to be a deterrent to people who do not qualify for them or unreasonably to inhibit access to the service concerned by those outside the target age group’”.

The commission says that:

“There is a risk that, as currently drafted, the exception could be used to create artificial pricing structures designed to exclude older (or younger) people from access to particular services”.

A number of examples are given, including a fashion retailer which wishes to maintain a younger customer profile. It inflates its prices for clothing while offering a 50% discount for the under-30s, thereby allowing them still to pay reasonable prices.

As regards my main point, have the Government had discussions? Is the Commission reasonably satisfied, from its independent perspective of not being part of a government department—its independence is crucial to the way in which it operates—with what the Government are doing? Have the Government at least explained why they are doing things in a specific way? Has the Commission accepted that as the Government’s right?

Health and Social Care Bill

Debate between Baroness Thornton and Baroness Howe of Idlicote

Wednesday 30th November 2011 Lords Chamber

[Baroness Howe of Idlicote]

My Lords, I have listened to what has been said by all these expert professionals and I am very much persuaded in favour of something along the lines of this amendment. I think that one of the most worrying things from the public viewpoint has been the sheer number of concerns about nursing that we have had in the press—not least, I may say, about the mortality rates et cetera going up during weekend staffing. Quite clearly there is a need for better reorganisation.

I go back quite a long way, to the time when I sat on the Briggs committee on the future of the nursing profession, and will never forget one of the nurses saying to me at the time: “I’ve been nursing for”—however long it was; she had just got her qualification—“and now I’m going to have a rest”, which was roughly what she was up to. I had a great deal of sympathy with her from that viewpoint.

I hope the Minister will bear in mind—I am sure that he must be more than aware of it—that the number of cuts in nursing staff are considerable in the present plan. Something like 8.3 per cent of qualified nursing jobs are to be lost. As the Royal College of Nursing pointed out in its briefing, that is on top of something that was done no less than about 18 months ago and is more than 10 times the original figure. Axing up to a quarter or a third of nursing posts will undoubtedly have a deep and potentially dangerous impact on patient care. Of course the training of the nurses—the experts in the really expert places—is essential. The training and up-skilling of those nurses on the real needs of patients is vitally important, but so are the numbers.

[Baroness Thornton]

My Lords, I thank the noble Baroness, Lady Emerton, the noble Lord, Lord Patel, and my noble friend Lord MacKenzie and other noble Lords for bringing these important amendments into Committee. Amendments 138 and 139 make provision for the NHS Commissioning Board to mandate safe nursing staffing levels and the number of patients a registered nurse is designated to care for. At the risk of stating the absolutely obvious about safe and effective staffing levels and patient ratios, where there are insufficient nurses and too many patients allocated to care for, then the level of care that can be administered will be affected. These amendments are about patient safety and well-being and the noble Baroness, Lady Murphy, hit the nail on the head. In response to her remark about speeches and the length of speeches, my observation, which is shared on these Benches, is that the Cross-Benchers are not the problem. They have been making admirably short and speedy comments. I hope that mine will be also. Other noble Lords might think about that.

This is a current problem as well as a long-term problem. As my noble friend Lord MacKenzie said, it has been with us for a long time, but it is current at the moment. The Royal College of Nursing tells us that some NHS trusts are diluting the skill mix on wards and in other care environments. This dilution is when non-registered healthcare support workers are employed in the place of a registered nurse. Healthcare support workers are paid—as one might guess—significantly less than registered nurses due to their comparative lack of vocational qualifications, so are seen by employers as a cheaper option. We think that that potentially puts patient safety at risk. Recent research by the Nursing Times has highlighted a significant variation in skill mixes between different hospitals in different regions. It seems to us that when cost becomes the overriding factor at the expense of the quality of service, patient outcomes and even patient safety become endangered. The most high-profile recent example of this was the care failings of the Mid-Staffordshire NHS Trust. Sadly, due to a range of factors—including financial pressures—costs were cut, nursing staffing levels were reduced and patient safety declined. It is vital, therefore, that stakeholders, including the RCN, work together with the national Commissioning Board to set the appropriate staffing levels and standards. There is some evidence from the NHS Information Centre that there is an accumulating problem here. Between January and August, the decline in terms of full-time equivalents in nursing, midwifery and health visiting staff in England fell by 1.6 per cent, from 310,989 to 306,028. There is evidence of a growing problem.

I would like to ask the Minister about an exchange in October when the Secretary of State gave evidence to a Select Committee. He stated that he was not aware of the down-banding, which is the issue at stake here, relating to the ratio. He was not aware that this was a problem or that the Royal College of Nursing had raised it with him. The Director of Nursing at the Royal College of Nursing then gave evidence to the same Select Committee the following day. She claimed that the Secretary of State was aware of down-banding practices; that the Royal College of Nursing, among others, had drawn it to his attention; and that it was a matter of some concern. I ask the Minister whether the department is aware that this is a problem and what it is intending to do about it.

These Benches support the amendments, and we are keen that this issue should be addressed robustly.