(4 years, 1 month ago)
Grand CommitteeMy Lords, as this is my first intervention, I remind the Committee of my presidency of the Health Care Supply Association. I have Amendments 82, 92 and 141 in this group, none of which have much to do with each other, but that is part of the mysteries and delights of grouping.
Amendment 82 is particularly concerned with the challenges facing charities seeking to obtain contracts from public authorities. I am very grateful to NCVO and Lloyds Bank for their briefing on this matter. While all types and sizes of charities experience challenges relating to the commissioning and procurement of public service contracts, smaller organisations often face considerable barriers. Yet a large proportion of the voluntary sector is actually fundamental to the delivery of public services. There are many examples, but we know, for instance, that the voluntary sector is the leading provider of services—according to research commissioned by DCMS—in relation to homelessness, and there are many other services where we are absolutely reliant on the voluntary sector.
However, there is a real problem in the huge amount of work that needs to be done to assemble information and make bids. Advance notice of tender opportunities is important for charities. We know that many of them have far fewer resources than private companies to support bid-writing, so they need time to plan. They also want to take time to work with service users or other charities to develop an offer, and that cannot be rushed. When commissioning services for people, especially those experiencing a range of intersecting challenges, a market does not often exist, so preliminary market engagement is critical for understanding what people need and how those needs could be met.
All my amendment seeks to do is create a presumption that contracting authorities should have ample notice through a planned procurement notice, unless there is a very good reason not to do so. This would allow the necessary time, particularly for smaller charities, to prepare bids.
My Amendment 92 is about the need for rigour and accountability in procurement. It starts from the requirement set by Her Majesty’s Treasury to ensure that the investment of public money, especially large sums, is done objectively and in a way that those who have to authorise the investment can rely on. It also deals with the principle of transparency and would ensure that business cases are routinely published.
My understanding is that it is already required under Green Book guidance from Her Majesty’s Treasury, particularly for major projects managed in the government portfolio, that at least a summary of the business case has to be published within four months of contract award. The Green Book, which has been regularly updated by the Treasury as circumstances require, describes in great detail the rigorous process that needs to be followed. The principle is that if you do not abide by this, you will not get approval for the expenditure of resources. Much in the Green Book is based on the need for a proper business case and I believe it was also envisaged that the business case would be published.
The problem is that regulation and good practice are too often ignored in the public sector. I think athere is less appetite for proper enforcement of that guidance. All campaigners can do to raise concerns about a particular tender process is go for judicial review, which, as we all know, can be very expensive.
My particular interest is the NHS. When I was a Health Minister, which seems a very long time ago, there were very strict rules about spending and investment by trusts. If public money was sought for a major procurement or programme then a strong authorisation path led from region to department, and often to the Treasury itself. Some of that remains, but what is missing is that the former strategic health authorities ensured that the required processes were followed properly and intervened when they were not. They also ensured that the public were consulted, but much of that has foolishly been thrown away. That means that it has become much harder for the public to hold decision-makers to account.
It is very noticeable that, last month, the Public Accounts Committee published a report on the Department of Health’s 2020-21 annual report. It commented that the department
“has regularly failed to follow public spending rules and across the Departmental Group there is a track record of failing to comply with the requirements of Managing Public Money. The Department is required to obtain approval from the Treasury before committing to expenditure where such authority is needed. The Treasury has confirmed that £1.3 billion of the Department’s spending in 2020–21 did not have HM Treasury consent and was therefore ‘irregular’. The Treasury has stated that ‘in the vast majority of cases’ this was because either the Department and/or the NHS had spent funds without approval or in express breach of conditions.”
If the noble Baroness, Lady Noakes, was still in the position she held on financial management in the Department of Health, that would not be happening.
My amendment would ensure that there is a proper business case and that it should be publicly available before crucial decisions are taken. If the Minister says that it is already required, the fact is that parts of the public sector are not listening. I hope that this debate will be helpful in ensuring that the Treasury and government departments look at this very closely in the future.
My third amendment follows a briefing from the RNIB and concerns the fact that, in replacing the existing legislation, the Bill overwrites requirements that are of particular significance to 14 million disabled people in the UK because they ensure that publicly procured goods and services are accessible to everyone. It is pretty unclear at the moment how the current Bill will replace that regulatory framework, and my Amendment 141 seeks to re-establish a requirement that contracting authorities have due regard to accessibility criteria for disabled people.
In June last year several organisations, including the RNIB, wrote to the Cabinet Office seeking assurances that accessibility for disabled people would be maintained in public procurement legislation. Responding, the then Minister, the noble Lord, Lord Agnew—who has certainly shown how you should resign, in style and with full transparency and visibility to your Lordships’ House, although I do not think he quite managed the grace of the noble Lord, Lord True, in his very perceptive remarks yesterday—said that the Government are committed to ensuring that accessibility for disabled people is maintained as part of public procurement legislation, and that the new regime will ensure that specifications take into account accessibility criteria and design for all users. Despite that, the only reference we can find to accessibility is in Clause 87(2), which states that any electronic communications utilised as part of the public procurement exercise must be
“accessible to people with disabilities.”
This is partly probing—finding out the government response to it. If the Minister argues that the public sector equality duty under the Equality Act is sufficient, we will argue that it is not sufficient because we have seen contracting authorities failing to consider their obligations and procuring inaccessible products. This amendment is only a start, but I hope the Minister will be sympathetic to the issue.
My Lords, before I speak to my Amendments 84 and 88, I will just say that, while I do not think it is a registrable interest or a conflict of interests, my experience in these things is largely derived from my work, over a number of years now, advising LOW Associates SRL in Brussels, which has a number of contracts with the European Commission and other European agencies. We have participated in procurements on a number of occasions each year in the European context. That gives one quite a lot of experience of the system we are moving from and some of the ways it can be improved. I put that on the record.
My noble friend and other noble Lords may recall that at Second Reading the most important point I made—it is one I will return to on a number of occasions, including when we talk about the procurement objectives and the national procurement policy statement —is that procurement by the public sector is a very large element of economic activity. The way in which it is conducted can have a significant and beneficial impact on productivity in the economy if the issues of innovation are properly incorporated into the consideration of how procurement is undertaken and who the suppliers to public authorities are.
In a sense, the noble Baroness, Lady Worthington, is trying to do the same kinds of things in Amendments 85 and 87. We are maybe trying to approach it in slightly different ways. The same will be true in relation to the procurement objectives.
I hope that in responding to this debate my noble friend can at least give us a sense that we can work together to try to ensure that the promotion of innovation is one of the central aspects of how contracting authorities go about their process of delivering best value, and that the broader externalities of procurement, through promoting innovation in the economy, are realised. They are significant.
I am grateful to the noble Lord for considering my amendment. Does he accept part of my premise, which is that some public authorities are really not doing the right thing at the moment, despite Treasury rules and guidelines? In fact, the qualification the PAC made to the DH report is some evidence of that in relation to the NHS.
My Lords, I could not possibly be tempted, particularly at 8.04 pm when the Committee needs to finish shortly and I already have a very long response to a large number of amendments. The Bill does have pipeline notices, which I have discussed: I will engage with the noble Lord on that before Report and I welcome that.
Amendment 141 is about a hugely important issue to which so many noble Lords spoke. The noble Baroness seeks to amend Clause 24 to require contracting authorities to take account of accessibility and design for all principles when drawing up their terms of procurement, except in duly justified circumstances. This is an issue of fundamental importance. It is of concern for disabled people, and I know that your Lordships hold concerns about accessibility very close to their hearts; it comes up in every piece of legislation.
As part of our broader goal of a simpler regulatory framework and increased flexibility to design efficient, commercial and market-focused competitions, the Bill does not dictate how terms of procurement including technical specifications are to be drawn up, which is the issue around Clause 24. It simply contains what is prohibited by international agreements and applies to all “terms of a procurement” as defined in Clause 24(5). We believe that this approach is better than the existing approach, as buyers are forced to truly analyse and develop the content of their specifications to address the needs of all those the public contract should support.
The UK has legal obligations, which we readily own and which will dictate how terms of procurement are drawn up, with accessibility covered by Section 149 of the Equality Act 2010, as mentioned by the noble Lord opposite. We consider that helps deliver the intended outcomes of both the current duties in this area contained in Regulation 42 of the Public Contracts Regulations 2015 and of this amendment.
I have heard the very strong speeches made by noble Lords on all sides, and I have seen the submissions from the RNIB and others. It is very important that we should have constructive discussion to test whether the Bill delivers the accessibility that your Lordships hope for. The Government remain absolutely committed to ensuring that public procurement drives better outcomes for disabled people. In our contention, there is no dilution of the commitment to accessibility under the Bill. The Government are clear that accessibility criteria should always be taken into account in every procurement, and the existing legislation ensures that that is the case.
However, we will engage further on this and on the other themes and points put forward by so many noble Lords in this wide-ranging debate. In those circumstances, I respectfully request that the amendments are withdrawn and not pressed.
(4 years, 2 months ago)
Lords ChamberMy Lords, it is a great pleasure to follow the noble and learned Lord, who showed how much more interesting a debate on a procurement Bill can be than we thought when we started out on this journey. I declare an interest as president of GS1 and of the Health Care Supply Association, and I pay tribute to NHS procurement officials for the fantastic work that they did during Covid.
Like most other noble Lords,I support the intent of the Bill to make public procurement quicker, simpler and more transparent. However, there is a balance to be struck. I take on board the comments of the noble Lord, Lord Maude, that outcome is more important than process, particularly in relation to the public sector’s poor record in supporting innovation and the perennial UK problem that we are a country great at innovation but very slow to adopt it, particularly in the public sector.
We must, however, have some process and tracking of what happens. We saw with Covid what happens when you do not have it. The PAC’s report readily acknowledged the challenge faced by the Government, but the failure to be transparent about decisions, publish contracts in a timely manner and maintain proper records left them open to accusations of cronyism and waste. Somehow, the Minister, through the passage of this Bill, must convince us that in moving to a quicker and more efficient system, proper process will continue while also allowing SMEs and innovative companies to take part and win tenders. The state of our economy suggests that unless we invest in innovation, we will be in very challenging times in the years ahead.
On defence, the noble Baroness, Lady Smith, made very trenchant points. Reading the PAC’s report this month on the MoD’s worrying inability to control costs was sobering. The report said that the MoD’s reliance on billions of pounds of future cost reductions to keep within its budget looks like a lot of trouble to come. It currently has no plans to support how these might be delivered and rising inflation will make pressure on affordability worse. The Government, however, are saying that they have done sufficient to ensure that our Armed Forces are in a state of preparedness for many of the challenges to come. That does not add up. The MoD has rejected the PAC’s general point, but I know who I would trust more in relation to defence contracts.
I principally wanted to mention the NHS, which the Minister kindly mentioned in his opening speech. We have just had the passage of what is now the Health and Care Act. There was quite a debate about procurement because that Act takes out the enforced tendering of clinical services from the Health and Social Care Act 2012. There is concern that in the Act there is now an all-catching clause which effectively gives the Secretary of State power, through regulations, to change the whole NHS procurement process. This was in anticipation of this Bill.
The noble Lord was very clear in his opening speech that this Bill is not going to be used to turn the clock back and allow for the tendering out of clinical services where it is not required to do so. It would be good to get his confirmation, and also for him to spell out what Clause 108 of this Bill means, which gives the power to Ministers, through regulations, to disapply provisions of this Bill in relation to procurement by the NHS in England. I hope that the two things go together, but it would be good to get some clarification.
I support what the noble Lord, Lord Alton, said very strongly. The noble Lord, Lord Stevens of Birmingham, has also mentioned this. In the Health and Care Act, there was an insertion of Section 81, which provides that:
“The Secretary of State must … make such provision … with a view to eradicating the use in the health service in England of goods or services that are tainted by slavery and human trafficking.”
Will this be replicated in this Bill? Does the Minister further accept—this was raised in the Answer on Xinjiang today—that this Bill should be amended to include at least a discretionary exclusion ground for companies closely associated with serious human rights abuses? I am sure there will be a number of amendments in this field, and past history would suggest that the Government would be advised to accept them, or at least accept the principle.
My final point, which a number of noble Lords have also made, is on the post-award contract management that the noble Lord, Lord Maude, talked about. The monitoring of public procurement contracts has been very poor. Many PFI deals were poorly procured. Many recent deals involving the use of private providers through centrally awarded contracts or frameworks have not proven to be good value for money. We seem to have in the public sector a bureaucratic edifice where huge energy goes into the agreement of a contract, but once that is done, people move on to looking at a new contract. Monitoring and managing the contract is simply not done effectively. In our meeting with the noble Lord, Lord True, a week ago, which was very helpful, he talked about his department, or the Government, engaging in development and training support programmes for procurement professionals, with a particular focus on contract management. That is very welcome. I ask the noble Lord, Lord True, whether that will be extended throughout the public sector. Although we are much concerned here with central government contracts, the principles must be enunciated throughout the public sector. In terms of value for money and for our future confidence in public procurement, it is essential that we up our game in relation to contract management.
(4 years, 4 months ago)
Lords ChamberI am delighted that I am not in a department where I have to defend the DVLA. I take note of what my noble friend says, and I think people will have heard the sentiment on that subject across the House.
My Lords, has the Minister noted reports that the number of Russian speakers in the Foreign Office staff has been reduced quite drastically over the past few years? Is he satisfied that the reductions in funding and staff for the Foreign Office, particularly in eastern Europe, have prepared it for the huge challenges that it now faces?
My Lords, I cannot claim to be an expert on the linguistic training policies of the foreign service. I would say that we wish to have a Civil Service that is adaptable, nimble and responds to challenge, and that should involve a better awareness of future as well as present challenges, and that is certainly one of the things that the efficiency programme will look at.
(4 years, 10 months ago)
Lords ChamberMy Lords, for decades, social care has proved to be an intractable problem. After numerous reviews and failed reforms, the level of unmet need rises, the pressure on unpaid carers grows, the supply of care providers diminishes and the strain on the undervalued care workforce ever increases. So, it is welcome that at last we have a proposal before us and, as the noble Lord, Lord Macpherson, has said, a recognition that taxes will have to rise to pay for it.
The problem is that these are the wrong proposals. What the Minister has brought to us today, is essentially a tax increase on younger and low-paid workers so the wealthy can retain more of the value of their properties to pass on to their children. As we have heard, it is a tax on employment that will hit businesses. It will not, as yet, solve the underlying pressures in social care.
What a flimsy Bill it is. It is treated—remarkably—as emergency legislation, despite the fact that the Government have had 11 years to bring forward proposals to Parliament. There have been no cross-party talks about this and no consultation, and no Select Committee was allowed to scrutinise the Bill before it was brought before Parliament. Clause 4, as my noble friend Lord Eatwell said, is remarkable in the power it gives to the Treasury to make any change it seems to want to in relation to the proposals before us. If this Bill were to receive proper parliamentary scrutiny, it would be torn to bits. No wonder the Minister spoke for less than five minutes.
My noble friend Lord Eatwell has already referred to the remarkable commentary from HMRC on this tax rise. I will repeat one comment that he made. HMRC said:
“There may be an impact on family formation, stability or breakdown as individuals, who are currently just about managing financially, will see their disposable income reduce.”
As my noble friend said, how can the Minister justify that? What does he say to the CBI, which commented that a national insurance increase
“will directly hurt a business’s ability to hire staff, at a time when businesses have faced a torrid 18 months and are now fighting crippling labour shortages”?
Indeed, having listened to the Prime Minister and Ministers last week, I might ask whether the Government have any interest at all in the future health of our business sector. It seems not.
Unfair as it is, will this levy be sufficient? In his opening remarks the Minister remarkably claimed, without any evidence whatever, that this will put social care on a long-term sustainable footing. But we have already heard that the levy is projected to raise £36 billion over the next three years, that all the money raised in 2022 will go to the NHS and that for the remaining two years £5.4 billion will be invested in social care. This money is not designed to alleviate existing funding pressures on the system, yet these are immense. The committee chaired by the noble Lord, Lord Forsyth, published an excellent report which estimated that an £8 billion yearly increase would be needed to restore care provision to 2010 levels—he has already referred to that. But the £5.4 billion, one assumes, is to be allocated primarily to implementing the cap.
The Health Foundation, following up on the Select Committee report, set out at the beginning of this month what it may cost the Government to fund the NHS and social care system in England, along with workforce requirements, over the next 10 years. It looked at two projections, stabilisation and recovery, and stated that both of them would need much higher growth than in recent years. It said that
“an additional £8.9bn and £14.4bn is needed in 2030/31 over 2019/20 for the stabilisation and recovery scenarios respectively.”
Does the Minister really think that the levy is the answer to that, when most commentators reckon that, in the end, the NHS is going to need almost all of the levy and is likely to get it?
The claim that no one will be forced to sell their own home is surely questionable. My estimate is that on average a person will have to spend at least £160,000 before they get to the £86,000 cap. This takes account of a modest calculation of living costs at about £12,000 per annum, and the fact that the £86,000 cap, as the noble Lord, Lord Forsyth, who is surely right, said, will be calculated on local authority rates—despite the fact that the self-funders subsidise those local authority rates. Even when a person reaches the cap, they will still have to find living costs on an annual basis, and it is quite likely that the local authority will still pay only at the local authority rate, so many people will have to pay top-ups as well. Melissa Lawford in the Sunday Telegraph put the estimate much higher. She thought a self-funder would receive government support only after five years, having spent £296,000. The puzzle to me is that no effort at all has been made to encourage and incentivise the insurance market to provide a more effective way of support for self-funders.
The ABI, in a commentary it set out over the weekend, said that the cap should be viewed as a solution to avoid catastrophic care costs and not as a way to enable a private market to develop. A cap, in itself, would not prompt a market to develop. Why on earth are the Government not seeking to incentivise a private market to develop to help self-funders, allowing the Government to concentrate on the proper provision of social care for those who cannot afford to pay above any insurance prospect?
Why have the Government spent so long dithering about implementing Dilnot when they should have been thinking about a much more concerted approach to dealing with these issues, to encourage as many people as possible to support themselves while shoring up the pitiful state of our social care system at the moment? There is no plan. We are promised a White Paper in December. Does any noble Lord think that this is going to be well thought through in a way that will deliver a good social care system for us going forward?
What about carers? The right reverend Prelate asked what this would mean for carers. I would just say to him, as Carers UK has said, that carers have been propping up a chronically underfunded healthcare system at huge cost to their own personal health, finances and ability to stay in work. It is very telling that nothing, in all the claims the Government have made, has been said about how carers will be helped.
Paul Johnson of the IFS recently described our social care system as the unfinished business of the National Assistance Act 1948. It enshrined, he said, a Poor Law philosophy of both needs-tested and then means-tested moving into the social care system, to be run in parallel with the free at point of use NHS.
This Bill is not the answer to that. It will not transform social care; it will not help care workers get the pay, terms and conditions they deserve; it will not help unpaid family carers. Instead, we have a huge, missed opportunity and a tax on the youngest and lowest-paid workers for the benefit of the better off. This Bill will not do.
Lord Agnew of Oulton (Con)
My Lords, this has been an interesting debate. The quality of speakers has been very high, and I am aware that most of them know far more about these issues than I do—so it is with a certain humility that I attempt to reply. Also, as someone who does not appear that often, even I have noticed that I do not necessarily have the mood of the House with me on this Bill. However, I will spend longer in summing up than I spent in opening, to try to address some of the concerns and at least put the Government’s point of view on the many challenges that have been raised.
I will start with my noble friend Lord Forsyth, the noble Lords, Lord Eatwell and Lord Shipley, and the noble Baronesses, Lady Tyler and Lady Kramer, on the fundamental issue of the use of national insurance as the linchpin for this tax raising. We need a broad-based tax, such as income tax, VAT or national insurance, to raise the sums needed for such a significant investment. There is a precedent here. In 2003, the Labour Government increased the same NIC rates by 1%, specifically to increase funding for the NHS. There is an existing NIC ring-fence for the NHS. The NIC system already directs a ring-fenced proportion of receipts to the NHS. This ring-fence was established in 1948 and expanded by the Labour Government in 2003. I cannot provide the noble Lord, Lord Eatwell, with a cast-iron guarantee that the hypothecation will remain in perpetuity, but we see the principles here and, as my noble friend Lord Hannan said earlier, rarely do these taxes, once created, go away—so I hope to give some reassurance on that.
This also ensures that businesses contribute to the NHS. That is fair and reasonable, because they need a workforce that benefits from the NHS. Lastly, NICs apply on a UK-wide basis.
The noble Lords, Lord Macpherson and Lord Sikka, asked why we have not included rental income in the widening of the net. We have included dividends while excluding modest amounts of dividend, up to £2,000 a year. With regard to income from property, tax is currently levied at the same rates as income tax on earned income. Divergence in these rates would add complexity and create opportunities for avoidance. Those who earn their income from property have made a contribution to public finances. The property allowance has been frozen, as have the personal allowance higher rate and additional rate thresholds.
The Government are making sure that landlords continue to make a contribution. For example, we have restricted tax reliefs available to landlords. Over the past four years we have restricted relief for finance costs: it can now be claimed only at the basic rate, not at 40% or 45%. That has raised more than £1 billion. The higher rate of stamp duty for additional residential dwellings means that landlords now pay between 3% and 15% extra tax on those properties.
The noble Baroness, Lady Tyler, raised the issue of people over the state pension age, and noble Lords asked about the whole issue of intergenerational fairness. If we were to raise the sums required just for those over 40, the levy would need to be 60% higher, at around 2%. This would be a much larger burden on working people. Furthermore, around half of all the funding raised by the levy will go towards health and social care services that benefit working-age people, such as general NHS funding and vaccines. Working-age people will also benefit from limits on what they would need to pay if they themselves needed care in later life, and they will gain the peace of mind that comes from protecting their family members from substantial costs.
The noble Lords, Lord Eatwell and Lord Sikka, my noble friend Lord Forsyth and the noble Baroness, Lady Tyler, asked about the impact on the lowest paid. In relation to individuals, NICs are a progressive way to raise money: the highest-earning 14% will pay about half the revenues raised, while 6.2 million people who earn less than the NIC threshold of £9,500 will be kept out of the levy. I accept the points raised by two noble Lords about the cliff-edge nature of NIC contributions for higher earners, but the brutal reality is that, in the round, that top 14% will be paying around half of the total. That goes to the crux of this whole debate: we have tried very hard to ensure that this is a broad-based tax—as broad as possible.
Lower-income households will be large net beneficiaries from the package, with the poorest households gaining the most as a proportion of income. As was noted by one noble Lord, the highest 20% of households by income will contribute 40 times as much as the poorest 20%. One can make arguments about how much the bottom and top earn; nevertheless this is a highly redistributive approach to a difficult tax and an issue that all parties have dodged for 20 years. It is a genuinely progressive policy, and the distributional analysis published by the Treasury makes that clear.
Going beyond that, since 2010, Conservative Governments have consistently kept lower-paid people out of tax and kept the cost of living down. The income tax personal allowance threshold has increased by over 90%, meaning that a typical basic rate taxpayer now pays £1,200 a year less than they would have done otherwise. We also increased the NIC primary threshold by over £800, in April of last year, with a typical employee saving just over £100. In April of this year, we increased the national living wage to £8.91—an annual pay rise of £350 for someone working full time on the national living wage. Taken together, our changes to national insurance mean that someone working full-time on the minimum wage is currently £5,400 better off than in 2010.
The noble Lords, Lord Eatwell and Lord Macpherson, asked about the impact on employers. Some 70% of the money raised from businesses will come from the largest 1% of employers, and some 640,000 employers are excluded through the assistance at the bottom end. Again, as a Conservative Minister myself, I do not like raising taxes for anybody, but we have tried to broaden this tax as much as possible. Around 40% of businesses will not be affected by the levy. The noble Lord, Lord Macpherson, and my noble friend Lord Hannan, are not happy about a tax on jobs. The OBR will consider the economic effects of the levy in the light of its updated economic and fiscal forecasts, which will be published in the next couple of weeks alongside the Budget.
The noble Lord, Lord Eatwell, asked about the tax bill on the UK. We have had to take these difficult decisions because, as I said in my opening comments, this is a permanent increase in taxation for a permanent challenge that we face in a country with aging demographics. Our tax system remains competitive, with our tax take as a share of GDP lower than major international competitors, and broadly in the middle of the G7.
My noble friend Lord Forsyth asked about anti-avoidance rules, which is a very important question. I suspect, pragmatically, that there will be some fiddling around at the edges in the March/April threshold, but this whole piece of legislation will be subject to the full anti-avoidance rules that apply to NICs. Indeed, the recent work on IR35 would probably have been the biggest area of weakness had we not engaged in those reforms. The noble Lord might be interested to hear that even government departments are being threatened with fines by HMRC for non-compliance with IR35, so HMRC is out there already.
The noble Lord, Lord Eatwell, and the noble Baronesses, Lady Brinton and Lady Kramer, asked about hypothecation. I touched on this earlier. In 2022-23, all revenue from the health and social care levy will be directed to NHS England and equivalent bodies in Scotland, Wales and Northern Ireland through the existing NHS allocation. From 2023-24 onwards, levy revenue will be ring-fenced in law for health and social care. HMRC will pay the proceeds to those responsible for health and social care in all four parts of the UK, including NHS Scotland, NHS Wales and the equivalent in Northern Ireland.
The noble Baroness, Lady Fraser, asked about devolution and our way of handling that. This is absolutely a UK-wide problem. We have taken the decision to act on a UK-wide basis for the benefit of citizens across the UK. Scotland, Wales and Northern Ireland will receive Barnett consequentials on the additional health and social care funding in the usual way, with exact totals to be confirmed in the SR. Early indications are that, pro rata, the populations of the devolved authorities will receive more money from this approach.
The noble Baroness, Lady Brinton, asked about the funding specifically for social care. The Government are committed to spending £5.4 billion across three years on adult social care from this levy. This funding will end unpredictable care costs and include over £0.5 billion to support the adult social care workforce, in recognition of their efforts over this terrible pandemic. It includes funding to enable all local authorities to move towards paying providers a fair rate for care, which should drive up the quality of adult social care services, improve workforce conditions and increase investments.
Several noble Lords asked about funding for local authorities. We are committed to ensuring that local authorities have access to sustainable funding for core budgets at the spending review. We will ensure that every council has the resources they need to deliver these reforms.
The noble Lord, Lord Griffiths, spoke movingly and clearly understands this sector very well. I would like to reassure him that substantial support has been provided to the social care sector through the pandemic—for example, billions of items of free PPE prioritised to care workers, residents and unpaid carers for vaccination. We have made available £2.4 billion in specific funding for adult social care. This is made up of £1.75 billion for infection prevention and control, £522 million for testing, and £120 million to support workforce capacity. This funding is additional to the £6.1 billion for local authorities to deal with the impact of the pandemic on their services, including adult social care.
I turn to some specific questions on social care spending. First, on the size of the cap, the new £86,000 cap will end unpredictable care costs so that more people can preserve their savings and assets. Andrew Dilnot’s report was published 10 years ago and reflected the circumstances in 2011. Clearly, levels of wealth and asset prices have increased since then. We think that we have set the cap broadly at the right balance of achieving personal responsibility for planning for old age but putting in place a safety net where exceptional costs or periods of care are needed.
On domiciliary care, I think my noble friend—
Would the noble Lord give the House an estimate of how much a person would really have to spend before they reach the £86,000 cap? Does he agree that it will be at least double?
(4 years, 11 months ago)
Lords ChamberMy Lords, I am grateful to my noble friend Lord Blunkett for instituting this debate and for the measured terms in which he introduced it. I agree with the noble Baroness, Lady Stowell, about the collective and individual responsibility for leadership in standards. Of course, one has to reflect that standards at Westminster can permeate the whole of public life. Therefore, we need to be very cautious about how we conduct ourselves here as well as in government as a whole.
We know that concern about public standards is not new. Lord Nolan’s committee was a response in part to the cash for questions affair, and we know that party funding and expenses were a major concern in the 2000s. However, I have to say that, since 2010, the litany of poor behaviour by Ministers and ex-Ministers seems to be have been off the scale. Rather like the noble Lord, Lord Kerr, I have deplored the near-contempt that many Ministers have shown towards their officials in failing to understand that constructive criticism is partly what they are there to do to enhance the quality of decision-making.
I pay tribute to all those members of the various regulatory bodies that have been established over the past 30 years, but I am afraid that they have proved flimsy in the face of the behaviour of some Ministers and former Ministers. My noble friend Lord Blunkett referred to the “good chap and chapess” theory. The problem is, what happens if the Prime Minister is not a good chap? How far can we have confidence in a system where the Prime Minister himself, who has overall responsibility for standards in public life, is clearly a man who over the years has had a default position of carelessness with the truth and no concern whatever about upholding standards? This is the problem we have with all the recommendations that I have seen so far for improving the situation.
I pay tribute to the noble Lord, Lord Evans, and his committee and to the other committees. I think the recommendations that have been put forward should be implemented, beefing up the current system, with the independent adviser being able to initiate investigations and publish the outcome of those investigations. The Institute for Government has suggested that the Ministerial Code should set out the sanctions that might be applied for different breaches. We are going to hear from the Committee on Standards in Public Life shortly, but there are other very useful recommendations on business appointments, transparency, and lobbying and public appointments where it said that the commissioner ought to be given more powers to uphold the integrity of the process. The scandal of the Government’s determination to put one person into Ofcom to do over the BBC and completely traduce the system of appointments is one of the most disgraceful acts I have ever seen any Government do.
Next week we have another debate, in the name of the noble Lord, Lord Norton, on the training of Ministers, which I think will be interesting. He wants it to be training in decision-making; I am afraid I think it has to be training in integrity, ethics and understanding what the Ministerial Code means and how they ought to behave, including their attitude towards officials. Will this do in the face of a Prime Minister who has no concern whatever about those standards? I doubt it.
I am afraid that, in the end, I reach the conclusion that, while it may be against our political tradition, if it goes on like this, it will have to be outsourced to the courts or an independent body. We cannot trust the person who is responsible for the Ministerial Code to oversee it properly and effectively, and our democratic institutions and public life generally suffer hugely because of it.
(5 years ago)
Lords ChamberMy Lords, I am delighted to take part in this debate. I too congratulate my noble friend Lady Armstrong on her skilled chairing of the Select Committee and the clerk and his staff for their excellent work.
As the report says, the pandemic represented an unprecedented challenge to the United Kingdom’s public services. I take the positives from it: many of them rose to that challenge. Many public service providers developed remarkable innovations, as the noble Baroness, Lady Fox, just referred to. Decisions which before the pandemic took months were made in minutes. Good personal and organisational relationships broke down long-standing barriers between the statutory and voluntary sectors. New ways to deliver services flourished. I agree with the noble Baroness, Lady Fox, that we do not want to lock in certain behaviours, and we need to tackle the issue of the difficulty of face-to-face interventions. Yes, the NHS does have its challenges. I agree about the issues around “do not resuscitate” and the transfer of patients with Covid into care homes. But I would say to the noble Baroness that, when you look at the comparative statistics, the NHS has fewer beds, doctors and nurses than any comparable healthcare system, and we have to consider that in terms of funding decisions for the future.
Of course, it is not all good. We heard as a committee that the overall public health response was at times hampered by overcentralised, poorly co-ordinated and poorly communicated policies that were designed and delivered by central government, even though local-level providers were often better equipped. One of the key questions the committee poses is: how do we hold on to the positive behaviours we saw during the pandemic? I want to concentrate on just one issue: the over- centralisation of public services.
My noble friend Lord Liddle asked if our politics is up to the challenge of tackling this centralisation. The Government’s response was pretty wet, although the Prime Minister’s recent speech on levelling up did at least cover some of the ground. He spoke about the country being the most centralised of all the developed countries. He acknowledged that the big metro mayors were championing their hometowns, and that in the rest of the country, including the counties, local leaders needed to be given the tools to make things happen. Does this suggest a possible big move to decentralisation or even devolution? Well, up to a point, because I wonder whether the Government have themselves taken note. Last week in the Commons, the Health and Care Bill had its Second Reading. It did not show much commitment to devolving or decentralising power. Indeed, it faces the other way, with a power grab by Ministers and an imposition of powers of direction for the Secretary of State on the NHS. This suggests that there is a little way to go before government and Whitehall understand that devolution requires a huge shift in thinking.
In a really interesting paper about this, the Institute for Government has pointed out that, in recent decades, UK parties of all political persuasions have made commitments to decentralise power but in reality, coming into government, have found it very hard to do so. The institute’s analysis suggests that decentralisation requires at least three main groups to either support or acquiesce to reforms: national politicians, local politicians and, of course, the public. These groups often have different interests, are not internally cohesive and have different priorities and values—all factors which make securing sufficient support difficult. As important, all these groups have considerable, and not to be underestimated, power to block or undermine reforms they dislike.
Each of the obstacles the institute identifies is linked to one of these groups: national government lacks trust in regional or local government competence; those leading decentralising reforms are often unsuccessful at persuading other departments or Ministers to give away powers; taking powers from existing local politicians to give to a new sub-national government layer creates opposition; and the public generally lack interest in regional and local government reform and are sceptical of the value of more politicians. This goes perhaps some way to explaining why the bold talk of decentralisation is not always matched by deeds—and yet you come back to the conclusions of our report and to the argument that decentralisation could boost economic growth, better reflect differences in local identities and preferences and allow more variation and innovation in public services.
This, in the end, is the challenge for the noble Lord, Lord True, and the Government. Are they really serious about levelling up? If they believe that decentralisation and devolvement of powers is the way forward, if they want to build on the fantastic local innovation in evidence over the last 16 months, their forthcoming White Paper must be ambitious. I hope it will be.
(5 years, 2 months ago)
Lords ChamberThe Government always seek to engage positively with the House; the House does not necessarily always engage positively with the Government. The Government did not accept the cap when it was proposed to come in by 2027 in the first report, and they do not accept it in the latest report, when it is due by 2024.
My Lords, I think the House has been freshened up rather enough, and we hope that the Government might pause for a little time. Have the Government now set themselves against substantive reform of the House? If they have, why not at least engage with your Lordships’ House to see what incremental change could be agreed?
My Lords, as the noble Lord knows, there have been a number of changes in your Lordships’ House over recent years. The Government have made their position clear: we are committed to looking at the role of the House of Lords, but we do not want to do so in a piecemeal way.
(5 years, 5 months ago)
Lords ChamberMy Lords, the Chancellor’s claim that the Budget will support business and build our future economy seems somewhat fanciful with the raising of corporation tax, the collapse of exports to the EU, precious little action to improve our low productivity levels and the axing of the industrial strategy. I hope the Minister will explain the extraordinary decision to abolish the Industrial Strategy Council. Make UK, which represents manufacturers, says it raises a genuine fear that the critical part that companies can play in the economic recovery is no longer regarded as important. What does the Minister have to say to that?
On public finances, the Government say they cannot afford to give nurses a decent pay rise, yet they have managed to squander billions of pounds on management consultants, fly-by-night companies and friends of Ministers. This week’s PAC report on test and track is illuminating: hugely costly, with an overreliance on consultants and temporary staff, and no clear evidence with which to judge its overall effectiveness. One figure that we do know is that we have the highest death rate per million of population of any country in the world. Meanwhile, there is no decent pay rise for nurses, nor any plans for the NHS to treat the huge backlog of patients.
As for social care, the Chancellor’s complacency is quite extraordinary. There is no lifeline for our struggling social care sector, with the long-promised White Paper yet to surface. So the level of unmet need increases, the pressure on unpaid carers grows stronger, the supply of care providers diminishes and the strain on the care workforce continues, yet the Chancellor is silent. Will the Minister respond?
I call the noble Lord, Lord Mair. Can the noble Lord please unmute?
(5 years, 5 months ago)
Lords ChamberMy Lords, with the leave of the House, I thought it might be helpful if I made a brief statement at this early stage. The Government have listened carefully throughout Second Reading and in the various discussions I have had with noble Lords of differing opinions outside the Chamber. The Government recognise the strength of feeling on this issue and the desire of your Lordships’ House to give effect to this strength of feeling. The Government recognise the concerns that have been expressed, articulated today by my noble friend in his remarks when moving Amendment 1 and by many others in the debate on Monday, that in meeting the legal requirements of legislative drafting there may be more than one acceptable approach.
The amendments tabled in the name of the noble Lord, Lord Lucas, seek to change the drafting of the Bill to substitute the words “mother or expectant mother” in lieu of the word “person” in various places in Clauses 1 to 3. The Government accept that such an approach to the drafting of the Bill would be legally acceptable and that the intention and meaning of the Bill would be unaffected by such a change. As a result, the Government will accept the amendments tabled in the name of the noble Lord, Lord Lucas.
My Lords, in speaking to my amendments, I very much welcome the Minister’s announcement, as well as his willingness to talk to noble Lords on numerous occasions over the last four days. I also welcome the review he is announcing alongside the amendments tabled by the noble Lord, Lord Lucas. I had already decided to put my support behind the noble Lord, Lord Lucas. I prefer the term “woman” but, as he said, I am very happy with the substitution of “mother” for “person”.
I always wanted to see the Bill delivered so that the Minister can get her maternity leave, but I also wanted it to be clear and respectful to women. I am delighted that we have come to this outcome. There is no doubt that the use of the word “person” rather than “woman” or “mother” is not a technical issue that should ever have been decided by parliamentary counsel. It goes right to the heart of the Government’s attitude towards women, their rights and their ability to speak clearly about situations where their sex matters. In recent months we have increasingly heard about the Government’s concerns about free speech in this country. However, when it comes to issues to do with sex and gender, they have been remarkably silent.
I know that many noble Lords have received countless messages, mainly from women, since our debate on Monday—I have had over 200 messages. What comes through is their fear about the hard-won rights of women and their marginalisation in recent years. I was struck by the comments of one senior NHS consultant, who said:
“Language matters and sex-based rights depend upon that language … You are … aware of what happens when women have … tried to express similar concerns”
to those that noble Lords expressed on Monday. She continued:
“What happened to Rosie Duffield was disgusting, but the silence from her colleagues was also chilling and very disturbing.”
Other comments I received were:
“If we can’t speak meaningfully about sex, we will never end sexism, violence against women and girls, or misogyny”,
and:
“I have campaigned for equality across the board all my life and yet now I’m dismissed as a bigot and a transphobe for even trying to raise concerns at all.”
I too find it chilling that those who speak up for women’s rights can find themselves accused of trans hate and subject to horrific abuse, particularly if they are women. That really is a sign of free speech under threat.
At Second Reading, I listened very carefully to the noble Baroness, Lady Brinton, because she was one of the two speakers who disagreed with the general theme of our debate. She referred to the importance of the language used in legislation remaining inclusive and referred to trans men believing that using the word “woman” excludes them and therefore removes their rights.
As Louise Perry pointed out in this week’s edition of the New Statesman—actually, in relation to the Brighton NHS trust’s adoption of gender-inclusive language—one risk is that if you exclude one group to include another, you impact on their rights. It goes much wider than health, of course. How is erasing women from the language of the law somehow inclusive? Where is the equivalent pressure to change references to men in public health campaigns? Prostate Cancer UK does not come under fire for transphobia for talking about it as a men’s health issue.
It is women’s safety, dignity and inclusion that are compromised when organisations do not feel confident in maintaining the ordinary privacy of separate spaces for changing and washing. It is women’s specialist services, such as rape crisis centres, that are being replaced by mixed-sex services—the latest example being very recently in Brighton, with the contract being withdrawn from Brighton Women’s Aid.
It is women’s specialist services and charities where the staff are afraid to speak up for fear of losing funding. It is the women in the workplace who feel threatened if they speak up for their rights under the Equality Act. It is female academics who are being no-platformed and silenced because they are seen as “the wrong kind of feminist”. It is the women MPs in the other place who get the hate and abuse. That is not inclusion.
I support trans rights, and I support women’s rights. Sometimes, there can be a tension between them. That is why the Equality Act 2010 was so carefully drafted to recognise that, with separate characteristics and principles for reconciling and balancing rights when they come into conflict. The legislation uses the word “woman” not just in terms of defining the protected characteristic of sex, but throughout the Act in all sections related to pregnancy, maternity and lactation.
All institutions have a responsibility to avoid discrimination in relation to each of the nine protected characteristics as laid out in that Act, but it is increasingly common to find in the equality policies of many public bodies that the Equality Act characteristics of “sex” and “gender reassignment” have been replaced by a single word: “gender”. The protected characteristics of pregnancy and maternity are often forgotten. How can those organisations then assess how their policies impact on people in relation to sex and gender reassignment, when they collapse the two categories into one?
Furthermore, many are advised by organisations that tell them that even thinking about the possibility of a conflict of rights is transphobic. The result, of course, is that single and separate-sex services, which are enshrined in the Equality Act 2010, are coming under increasing attack, not least from the misleading guidance issued by many government bodies, local authorities and the EHRC.
I am very grateful to the Minister. This is a turning point and an important moment, but there is much more to do to protect women’s rights and the other rights enshrined in the Equality Act. I will certainly not move my amendment, but I thank all noble Lords who have given enormous support to this cause; I am very grateful.
My Lords, I had expected to speak to my Amendment 13 but, in view of what the Minister said, it would be detaining the House unnecessarily to go into a long explanation. I had thought to define the word “person” as either an expectant mother within 12 weeks of the expected week of childbirth or, as a mother, a person who has given birth to a child within the previous four weeks. In view of the Minister's acceptance of the word “mother”, however, I see no further need to proceed with my amendment and will not move it.
(5 years, 5 months ago)
Lords ChamberMy Lords, I too support the intent of the Bill and certainly wish the Attorney-General well. As other noble Lords have said, it is disappointing that the Bill provides for only a small number of what might be described as very privileged women when we know that in the workplace many thousands of pregnant women or new mothers face discrimination and risk losing their jobs. In fact, one of the striking facets of the debate in the House of Commons was the number of comments made by Members of Parliament about the impact on women of pregnancy and the insecurities in the workplace. The noble Lord, Lord True, acknowledged that the Bill could have been so much more. It is a missed opportunity. I accept what the Government have said about the work being done, but we are being asked to set up a two-tier system for maternity leave in this country and there is a feeling of discomfort about that.
This has been a very good debate so far and I listened with great attention to the comments of the noble Lord, Lord Randall. I must say I disagree with him about the issue of language; I do not see it as a technical issue. Fundamentally, a much more important set of principles lie behind the way language is used in the Bill. A colleague of mine counted the number of times “women” was used in the Commons debate and it came to over 300, yet the Bill makes no mention of women. Instead, we heard the rather inelegant terms “person who is pregnant” and “person who has given birth to a child”, which do not seem to add to what we understand as good English.
I have supported trans rights and gay rights over many years. I fought the iniquities of Section 28 and, as a Minister, I took the legislation through this House to allow for gay adoption. I have to say to the noble Baroness, Lady Noakes, whose speech I enjoyed, that, working in London and living in Birmingham, I am a fully paid up member of the metropolitan bubble and proud of it. However, I have become increasingly concerned that the hard-won rights of women over many decades are at risk of being watered down and marginalised as the single-sex spaces enshrined in the Equality Act 2010 come under increasing attack.
That is why this language is so important. Many public bodies are misinterpreting the Act, and many women’s sector organisations, especially those that seek to end violence against women and girls, fear loss of funding and commissioning if they want to provide single-sex exemptions. I am afraid that various government departments have weaselled down the words of the Equality Act in the guidance they have issued to public bodies. Local authorities have misinterpreted the Act and are threatening many small charities trying to provide these services at local level, and people there are frightened to speak up because they believe that they will be attacked and, if they are not careful on social media, accused of transphobia. The Government have remained silent because they themselves have a lot of this philosophy embedded in their advisory system. That is why the wording of the Bill is so important.
Work by Jane Clare Jones and Lisa Mackenzie has described the pattern of erasing sex in data collection and other areas of public policy. The ONS has caved into bullying—pathetic. The head of the ONS was interviewed, I think on the “Today” programme, and said that it was not going down the path it has now chosen. However, it has caved in, as many public bodies do, because they come under aggressive attack on social media and are accused of transphobia. The Government remain absolutely silent.
On the language, in her thoughtful contribution my noble friend Lady Gale talked about the fact that gender-neutral terms will often be appropriate. I agree with that. However, do we really want to see demeaning terms such as “menstruators”, “individuals with a cervix”, “birthing bodies” or even “chest feeders”? When the Brighton trust announced the use of the latter term, where was the Department of Health? It was absolutely silent, because it is cowed and frightened to speak up against this kind of absolute nonsense.
There are many parliamentarians who know that this is nonsense but they are frightened to speak up because of the abuse they will receive. Look at my honourable friend Rosie Duffield. What support has been given to her? Hardly anything, except from a few brave, dedicated people. It is shameful that we have allowed this situation to arise. That is why the Bill and its drafting are so important.
The justification was of course Jack Straw’s change in the convention and revised guidance. However, as the noble Baroness, Lady Noakes, said, that was designed to promote the rights of women because previously, “he” was always taken to mean “he and she” in legislation. For that to be used against women in this Bill is extraordinary.
I have looked up the parliamentary counsel guidance. The latest version was produced by the Drafting Techniques Group in 2020. This is a most worthy body but it is not one that should be at the heart of government decision-making. I noted the advice on page 2, which says:
“Clarity is helped by the use of short sentences … Tell your story in a moderate, level tone. Legislation should speak firmly but not shout … While brevity may be good, brusqueness is not.”
That is good advice but is it slavishly followed in all legislation? I very much doubt it. We understand that six pieces of legislation since the original guidance was issued have used the word “women”, including the seminal Equality Act 2010.
I have to say that six minutes is a guide; it is not something that can be enforced by anybody in your Lordships’ House.
I will carry on. This is a Second Reading debate. We do not have time limits.
Thank you very much—I do not usually get this support. After 23 years here it makes quite an unusual change.
My Lords, the six-minute limit is advisory but we have to get through this debate in a certain time.
With respect, we do not have to take the privileges committee report tonight. This is a Second Reading debate and I am afraid that advisory guidance on a Second Reading debate is highly inappropriate. But I shall not go on much longer.
The noble Lord, Lord True, was very helpful in arranging a meeting last week—we are meeting him again—and I am grateful to him. He must know that the Bill in the way it is worded is indefensible. If this had been a normal Second Reading, the Minister would have observed this debate, gone back and said, “We’re going to get an amendment and we’ve got to change it.” I know we have only four days to go but I urge him to think again. He should also say that this will never be used as a future precedent in legislation. He should ensure that parliamentary counsel changes the guidance, because it is not up to the mark.
Finally, this is my great appeal. Please will the Government defend women who speak up for the protection of women’s rights based on sex? I come again to the outrageous abuse that some of my parliamentary colleagues have received by stating in perfectly reasonable terms that they are not transphobic, just reasonable people seeking to do their job, yet they do not get support from the people who know that what is happening to them is wrong. Above all else, I hope the Minister will say something about that.