NHS Dentistry: Recovery and Reform
Earl of Courtown Excerpts(9 months, 1 week ago)
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The Earl of Courtown (Con)
My Lords, with apologies to the House, I am afraid that the noble Lord, Lord Young, was not in his place at the start of the Statement and, with the greatest apologies, it is the custom of the House that a noble Lord should be here for the start of the Statement before they ask a question.
Smoking
Earl of Courtown Excerpts(9 months, 3 weeks ago)
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Noble Lords
The Earl of Courtown (Con)
My Lords, I think the House would like to hear from my noble friend Lord Young.
Lord Young of Cookham (Con)
I am grateful to my noble friend for giving way.
Independent Medicines and Medical Devices Safety Review
Earl of Courtown Excerpts(4 years, 4 months ago)
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Baroness Kennedy of The Shaws (Lab) [V]
Does the Minister agree that this scandal is about something much deeper than damaging medicines and inadequate healthcare products? Just as the law for generations dismissed the experience of women who were abused and raped and gave little credibility to their testimonies, the medical profession too has to examine its own culture, which as this report shows—
The Earl of Courtown (Con)
My Lords, the noble Baroness, Lady Kennedy, has very bad connectivity at the moment. Can we come back to her later in the Question, if possible?
The Deputy Speaker (Lord Duncan of Springbank) (Con)
Yes. The next speaker is the noble Baroness, Lady Brinton.
Queen’s Speech
Earl of Courtown Excerpts(5 years ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)
My Lords, I am honoured to close this final day of debate in support of the gracious Speech. As ever, debate has been robust, largely courteous, but underpinned by the extensive expertise of this House. In this age of partisan rancour, our debate has been informed by a deeply held belief that in this place, regardless of political persuasion, we are bound together by a collective responsibility to use our roles here to improve the lives of our fellow citizens. That is something to be proud of.
The topics we have debated today—education, work and pensions, culture and health—make more difference than any others to the lived experience of people across this country. That is why the past seven hours have flown by for me as I have listened with pleasure to the important contributions of 61 noble Lords. It is because of the importance of these issues and the consensus on the need for action that the Prime Minister and his Government have prioritised them over recent months and, of course, in the gracious Speech, investing £14 billion in schools over the next three years, supporting the modernisation of pensions, accelerating access to broadband—perhaps even to the home of the noble Lord, Lord Aberdare—and three new health Bills, with a commitment to work towards a further two. It is an ambitious agenda and has been fully reflected in today’s wide-ranging debate.
I will now do my best to respond to the many important points raised today, but it will be necessary, I am afraid, that the relevant Minister might have to write on a few issues that I am not able to cover in the time that is available. I begin by focusing on education. I know that the whole House is passionate about supporting investment in education and the importance of ensuring, as the noble Baroness, Lady Massey, so clearly put forward, that all children, no matter their background, can benefit from an outstanding education. As the noble Lords, Lord Storey and Lord Berkeley, and the noble Baronesses, Lady Bull and Lady McIntosh, noted, there should be a broad and varied education. As a former musician myself, noble Lords are preaching to the choir when they emphasise the value of creativity to society and its role in preparing children for the future—even its role in preparing a recalcitrant Health Minister.
As has been mentioned, the Government have announced welcomed investment in schools. I can confirm to the noble Lord, Lord Watson, that, following the funding allocation statements issued by DfE last week, all schools will be better off in three years’ time.
The noble Lord, Lord Addington, raised very important issues around special educational needs, and the Government have announced an additional £770 million of investment in 2021 for SEND education. But the whole House will appreciate that providing the best possible education is not just about money. That is why the DfE has commissioned a review of SEND education to assess what further we need to do in order to support pupils with special educational needs, so I will put forward the specific points that he raised in order to ensure they are properly considered.
The Government have also set up a cross-government hub for all disability issues in the Cabinet Office to draw together a catalysed, more effective cross-government action on these points. The DWP has increased the size of Access to Work grants by £15,000 in the last year, driving forward a 7% increase in the volume of grants made in recognition of their importance. This will support those with disabilities and special educational needs in the workplace.
A wide range of noble Lords noted the critical role of further education, with my noble friends Lord Lingfield and Lord O’Shaughnessy, and the noble Lord, Lord Aberdare, and the noble Baronesses, Lady Blackstone and Lady Garden, all drawing attention to it. Further education is at the heart of the Government’s plans for an education system that works for everyone. That is why we have announced—as has been noted—an additional £400 million of funding and a focus on improving not only the quality of teaching and learning but also its status.
Many noble Lords have welcomed an investment as well of £290 million in 20 institutes of technology to deliver higher technical education as a clear route to high-skilled, high-wage employment, but they also sought more clarity on how this will work in practice. I shall ask for those points to receive an individual response as I cannot get through all of those right now.
The noble Lord, Lord Storey, and others also raised the response to the Augar review, which is awaited. I confirm that Ministers are considering this very carefully and will respond shortly. This is a policy area that would clearly benefit from close attention in the spending review that is coming up next year.
On essay mills, I can confirm that, in the first instance, the Office for Students will engage the sector in order to eliminate the use of such organisations, but the Government do not rule out further action.
Clearly, more progress needs to be made on apprenticeships, but much progress has been made: over 1.8 million apprenticeships have started since 2015, investment annually is over £2.5 billion and over 60% of apprenticeships are of the highest industry-desired standards. I recognise the need for progress, and we are working hard on it. That is why the Secretary of State has taken the portfolio of apprenticeships as his personal responsibility, in response to the point made earlier.
I turn to work and pensions. The noble Baronesses, Lady Donaghy, Lady Watkins and Lady Sherlock, and the noble Lord, Lord Willetts, all raised universal credit and concerns about in-work poverty. I think there is a consensus that work should always pay. Universal credit is a welfare system designed to help people into work, to support those who need help and to be fair to everyone who pays for it. The DWP recognises, however, the need to continually review and improve universal credit. This year alone, the DWP has committed to running a pilot on moving to universal credit to ensure the further and safe rollout of the advantages of universal credit. I noted the question about an update on that progress and I will ensure that a note comes to the noble Baroness about that. The department has announced that it will reduce the maximum single sanction that a claimant can face from three years to six months, and the number of those sanctions has also fallen. The department has instructed work coaches to use the flexible support fund to support parents with childcare costs. It is also providing £3 billion to support transitional arrangements for claimants moving over from other benefits. Noble Lords also raised concerns about the benefits freeze being extended. I can confirm now that it will come to an end by 2020.
The noble Baroness, Lady Bryan, and a number of noble Lords mentioned the pensions Bill. I genuinely feel that pensions is an area where there has been positive progress over the past decade. The Bill now goes a step further to improve both the options available to employers and accessibility for employees, so that they can track their pension as they would their bank account.
Our debate on DCMS was particularly robust, it is fair to say. I begin with broadband rollout, which was mentioned by the noble Lords, Lord Clement-Jones and Lord Aberdare. The Government have been clear in their commitment to delivering nationwide, gigabit-capable, reliable and resilient broadband—that is not easy to say at the end of a long debate—as soon as possible. That is why the gracious Speech included the telecommunications Bill, to ensure that millions of leaseholders are not left behind as we upgrade our communications network. I am conscious of the time but I am also aware that the Second Reading is imminent, so I am sure that many of the points made by your Lordships will be answered in letter form and that there will be ample time for detailed debate and robust scrutiny, which I am sure this House will provide.
The noble Lords, Lord Clement-Jones and Lord Griffiths, and a range of Peers noted the challenge of online harms and how to regulate and respond to digital technologies that can change and evolve rapidly. The online harms White Paper was published in April. It set out the Government’s plan for world-leading legislation to make the UK the safest place in the world to be online. The public consultation has closed and the Government’s response will be published in the coming months. We will then publish a draft Bill for pre-legislative scrutiny. Let me be clear: the Government recognise that this is one of the fundamental challenges facing our society in the coming years and they are determined to address it.
I want explicitly to recognise the strength of feeling expressed by the noble Baronesses, Lady Benjamin and Lady Howe, the noble Lords, Lord Clement-Jones and Lord McNally, and other noble Lords on the issue of age verification and the pace of reform. I will confer that back to the department. The Government are clear that protecting children is at the heart of our online reform agenda and is key to wider government priorities. The issue here is making sure that those reforms are as effective as possible and do the job that they are intended to do.
Moving on to health and social care, my department was delighted to begin the year by publishing the clinically led NHS long-term plan and by securing £33.9 billion to support its implementation. On the point made by the noble Lord, Lord Smith, the plan focuses not on funnelling ever-greater funding into the health service but on ensuring sustainable and substantive reform that can support what we all want to see in the health service. As my noble friend Lord O’Shaughnessy noted, there are delicate balances to be struck on integration versus accountability, which the upcoming NHS long-term plan Bill is intended to address. That has also been clinically and NHS-led.
I follow the noble Lord, Lord Hunt, who is not in his place—
Baroness Blackwood of North Oxford
Sorry, he is in a different place. I follow the noble Lord in paying tribute to the noble Lord, Lord Patel, and his colleagues on the Long-Term Sustainability of the NHS Committee, which he chaired, because many of its proposals were replicated in the long-term plan.
The noble Baronesses, Lady Greengross, Lady Walmsley and Lady Massey, and my noble friend Lord Young raised the importance of prevention, primary care and tackling inequalities. These are all important agendas for the Government and for my department, which is why the Government have committed more than £4.5 billion of additional funding to support GP services and will recruit an additional 20,000 staff to work in practices.
It is also why the Government have published their prevention vision, which sets out an ambitious agenda in order to put public health at the heart of everything the department and the NHS do, including aggressive action to tackle obesity such as the sugar tax, which has proved to be a great success. I am happy to reassure my noble friend Lord Young of Cookham that this will continue to be right at the heart of our agenda. Moreover, the department is addressing the real and valid concerns about health inequalities. We have just recently finished consulting on how to improve the health of people living in the poorest communities. Reducing inequalities is a key part of the long-term plan and will be a requirement as part of our PCMs.
We have also worked closely with Defra on the introduction of the clean air strategy, which was noted by the noble Baroness, Lady Walmsley, and on antimicrobial resistance, which no one noted but I do so now, and with Henry Dimbleby on his food strategy. On this last point, while I cannot commit the Leader of the Opposition to continuing commitment on this agenda, I can certainly reassure the noble Baroness, Lady Boycott, of the Government’s ongoing commitment and I thank her for both her expertise and her work on this agenda because it is essential.
The noble Baronesses, Lady Greengross, Lady Meacher, Lady Hollins, Lady Watkins, Lady Sherlock, Lady Campbell, Lady Wheeler and Lady Bakewell, along with my noble friend Lord Young, the noble Lord, Lord Hunt, and the right reverend Prelate the Bishop of London also raised the critical issue of social care. As my noble friend Lord Willetts said, we must just get on with it, and I do not think that I can improve on what the noble Baroness, Lady Bakewell, said: “Ageing is not an option”, and nor is substantial reform in this area.
The Prime Minister was clear on the steps of Downing Street about this Government’s determination to fix the crisis in social care to ensure that every older person has dignity and security and that no one needs to sell their home to fund their care. He wants this to be a bold, once-in-a-generation reform and I can reassure the House that officials across government are working, probably at this moment, on developing ambitious proposals on top of the £17.1 billion invested in the past financial year. However, I will strongly reiterate to the Secretary of State and to the Prime Minister, as I often do, the very strong mood in this House that the time for action is now. I will also confirm that the department will consider carefully the recommendations set out by the Independent Living Strategy Group, led by the noble Baroness, Lady Campbell, and those of the Intergenerational Fairness Committee, of which the noble Baroness, Lady Greengross, is a member, as part of those considerations.
The noble Baronesses, Lady Jolly, Lady Donaghy, Lady Janke and Lady Watkins, along with the noble Lord, Lord Patel, raised the issue of NHS staffing. Having the right staff is crucial to delivering the aims and objectives of the long-term plan. To address this, we are recruiting more staff than ever before with, for example, a 25% increase in training places for medical students. We have also given a significant pay rise to more than 1 million staff and my noble friend Lady Harding is currently preparing for publication the people plan, which will set out a range of ambitious options for what more we can do to improve the situation. In answer to the noble Baroness, Lady Watkins, this will specifically consider the whole range of potential financial incentives which could support recruitment and retention. At this point I will follow other noble Lords in putting on the record my department’s deep appreciation of the noble Baroness, Lady Emerton, for her wonderful work as a champion of the nursing profession.
The noble Baronesses, Lady Jolly, Lady Hollins, Lady Sherlock, Lady Featherstone, and Lady Tyler, and my noble friends Lady Verma and Lord Kirkhope, along with the noble Lord, Lord Watson, noted the importance of getting mental health right, the reform of the Mental Health Act and the care of those with disabilities. This is not only a crucial issue but a complex area, so it is important that we get the reform right. I recognise the impatience of noble Lords to go further faster, but there is real progress to report. The Government have already accepted a number of the recommendations made in the independent review. We will publish a White Paper by the end of the year and we will set out in detail our legislative and non-legislative response. To address the immediate service challenges, the Government are also investing record amounts in NHS mental health care as well as in care for those with learning disabilities and autism. I can also report that capital will not be overlooked. Since 2017, we have recruited more than 3,000 additional staff to put in place a wide range of measures to ensure that care is provided closer to home.
The noble Lord, Lord Rennard, and my noble friend Lord O’Shaughnessy raised Brexit and the health service. In any Brexit scenario my department is committed to maintaining the very highest standards of regulation and I can assure the noble Lord, Lord Rennard, and my noble friend Lord Young of Cookham that we will remain a world leader in the regulation of tobacco and of prevention, as we have laid out in our prevention vision. Our preference remains close co-operation with the EMA as well as with our other long-term friends and partners such as the Commonwealth, as my noble friend Lord Howell mentioned.
The importance of patient safety was also raised by a number of Peers in relation to the upcoming Health Service Safety Investigations Bill. I am very much looking forward to its Second Reading next week, when I am sure we will have plenty of time to debate it and I will be held to account in every possible way—so I shall not go into detail on that now.
I will say just a word about innovation, raised by the noble Lords, Lord Patel, Lord Kakkar and Lord Bassam, who raised the importance of life sciences and innovation. We have a very strong record in this area. I am afraid I do not recognise the picture presented in the IPPR’s recent report. Turnover and employment in UK life sciences have grown notably over the last decade, and the life sciences strategy sets out a powerful vision for action, which we are delivering against assiduously. This has included £1 billion of government investment and £3 billion of leveraged industry investment. We now have substantially better partnership between the NHS, academia, government and industry, but I agree with the noble Lord, Lord Kakkar, that we have to improve on our rate of progress between ideation and adoption. Part of that is better working between all those agencies engaged in trying to deliver against that objective.
I also noted strong support from the noble Lord, Lord Patel, and others on the fast-track visa for top scientists. I will take away the sensible suggestion from the noble Baroness, Lady Bull, that this be expanded to include the cultural and creative sectors.
Finally, the noble Baroness, Lady Deech, raised the storage of gametes. I agree on the importance of this, as I think she knows, and have continued to push this matter within my department. To that end, I hope to have a positive update in the coming weeks.
I am mindful that I have only a short amount of time and the clock is counting down. In closing, I reiterate my thanks to noble Lords for their many and varied insightful contributions. Responding to a debate such as this is a challenge, given the breadth of issues we have covered, but it is also a pleasure, giving me the opportunity to engage on many issues that I do not regularly come across in my brief. As has been pointed out, we debate the gracious Speech in unprecedented political times, but my commitment to this place on behalf of the Government and the departments for whom I speak today is that we will continue to strive day in, day out to improve the lives of and the services available to people right across the United Kingdom. I know that is an ambition to which all your Lordships here today will join me in being committed.
Winterbourne View
Earl of Courtown Excerpts(12 years ago)
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Earl Howe
Yes, my Lords, I agree with that. We must not take our eye off the ball. Once this report comes out, we have to ensure that its recommendations are carried through and constantly monitored. It will be, in part, the job of the NHS Commissioning Board to hold the ring and ensure that local commissioners are supported with the proper guidance, and held to account for the outcomes that they achieve, across the whole NHS but particularly in this area. That focus on outcomes is important when we consider how the service is held to account. We will be publishing very shortly the final version of the mandate that the Secretary of State gives to the NHS Commissioning Board as the means by which the board will be held to account by Parliament and the public.
The Earl of Courtown
My Lords, I declare an interest as a patron of a home providing residential care for adults with autism spectrum disorder. What we have all heard, read and seen about the Winterbourne View care home has been quite terrible. Does my noble friend the Minister agree that there are many homes out there providing a very good service to people suffering from these problems?
Earl Howe
My Lords, I am very grateful to my noble friend because it is all too easy to sink into a state of despair over these services. He is absolutely right: many, many good examples of excellent care are being delivered to those with learning disabilities. The challenge is to ensure that best practice is spread, but I am grateful to him for reminding the House of that important fact.
Health: Diabetes
Earl of Courtown Excerpts(12 years, 9 months ago)
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Earl Howe
My Lords, we know that insulin pump therapy can make a huge difference to glycaemic control and the quality of life in some people. It is not appropriate for everyone, as the noble Baroness will, I am sure, recognise. We know that much more has to be done to improve the uptake of insulin pumps in line with NICE recommendations. The NHS operating framework for this year highlights the need to do more to make these devices available. The NHS Technology Adoption Centre has published guidance to support NHS organisations in the adoption of these devices and I know that the National Clinical Director for Diabetes, Dr Rowan Hillson, chairs a working group focusing on the uptake of insulin pumps.
The Earl of Courtown
Does my noble friend agree that one of the greatest problems for those suffering from diabetes—particularly type 2 diabetes—and for those looking after them, is that they are not actually taking up the education that is available so that they can learn how to live their lives to get a better result from their illness?
Earl Howe
I agree with my noble friend. We are firmly of the view that education is a major action area for primary care clinicians, and for those in secondary care too, if we are to avoid unplanned admissions to hospital, which are unpleasant for patients and very costly for the NHS.