(2 years, 10 months ago)
Lords ChamberMy Lords, I rise to speak on behalf of my noble friend Lady Jones of Moulsecoomb, who signed both Amendments 46 and 54, in the names of the noble Baroness, Lady Lister, and others, about no recourse to public funds. The question has been clearly set out by the noble Baronesses, Lady Lister, and the noble Baroness, Lady Stroud, added a great deal to this debate, which has been very rich thus far.
I must admit to a certain sense of déjà vu, in that we have had much the same cast as in debates on the Domestic Abuse Act, discussing much the same issues around the absolute horror of no recourse to public funds. We are talking about a particular group of people in that situation now, but I state loudly and clearly: no one who is here as part of UK society should have no recourse to public funds. That is inhumane, unjust and damaging to our society for some of the reasons that the noble Baroness, Lady Stroud, just set out.
It is interesting that it is almost two years since Boris Johnson claimed not to know that this status existed—that he did not know that there was such a thing as no recourse to public funds. At that time, he promised to review the policy, but I understand that there has been no overall review of no recourse to public funds, although I would be very pleased if the Minister could tell me that I am wrong about that.
But I want to add one point, which goes back to the group that we discussed before the dinner break. The Minister tried to clearly draw a line between differentiation and discrimination. I think that no recourse to public funds is very clear cut and obvious: you either have access to money, as the noble Baroness, Lady Stroud, said, if you are in work and need extra support to survive and feed yourself, or you do not. How can it be anything but discrimination if you do not have access to that money, despite being in exactly the same situation as the person beside you, doing the same job?
My Lords, I will respond to my noble friend Lady Stroud’s request to know the policy intent. Declaring my interests as set out in the register, as noble Lords may know, I have a lot of interest in what happens in our neighbouring country of France. I have been following the debates there reasonably closely over the last few weeks. In recent months, we have received more than our fair share of criticism from our French friends, who say that our asylum system is so much easier to navigate because there are so many pull factors—I recall my noble friend talking about these in her speech at Second Reading. This means that, in effect, we are a more attractive country to apply for asylum in than France, and this generates a huge amount of criticism.
My question to my noble friend the Minister is: when you look at no recourse to public funds, is that not one of the pull factors that is causing so much of this problem? I think that Clause 11 is designed to reduce those very pull factors that the French suggest are in fact causing the problem, so those of us who are for open borders should try to work this out. I always have been for open borders; I rejoice that we probably have one of the finest global multiracial societies in the world. Sadly, we do not appear to be proud of it. As the noble Lord, Lord Alton, knows, I was brought up in Toxteth and went to school in Penny Lane. I love Toxteth and I am so proud of the community there, which he will know very well, because it is a viable, strong, multiracial society.
Well, I agree with every word that my noble friend has just said. What I am seeking to persuade colleagues to focus on is that surely the objective—the policy intent to which she referred—is to focus our efforts on helping people via safe and legal routes. If we can deter people from coming here in small boats and by other illegal means, we can instead focus our efforts on those people who are genuinely in need. Okay, if we are not prepared to countenance NRPF, what is our answer to reducing deterrent factors—or do noble Lords simply think that this is not an issue? If that is the case, what do we say to the French, who really do strongly believe that it is a problem?
The noble Lord talked about focusing on people genuinely in need and compared them with people coming by irregular routes, such as across the channel. Does the noble Lord acknowledge that more than 70% of people coming across the channel have been granted refugee status, therefore they clearly are in genuine need?
I am not disagreeing with the noble Baroness; I am just trying to get us to focus on what the Government are now putting forward as a policy intent, which is to reduce pull factors, push factors or whatever we call them. Surely, our whole objective in all this must be to help those who are really in need and to encourage them to come by safe and legal routes. That is surely what Clause 11 is all about.
(2 years, 10 months ago)
Lords ChamberMy Lords, it is my pleasure to support all the amendments in this group, so ably introduced by the noble Baroness, Lady Thornton. I thank her for tabling this amendment and Amendment 28, to which I was pleased to attach my name.
I agree with pretty well everything that has been said but want particularly to highlight the contribution of the noble Baroness, Lady Hollins. As she was talking, I was thinking about testimony that I heard earlier this week at the All-Party Parliamentary Group for Art, Craft and Design in Education. A teacher was saying that if their educational provision caters to the most vulnerable and disadvantaged pupil in their school, that means that it is catering the best for everyone. It might be thought that having a representative for the interests of those with autism and learning difficulties will affect the care that they receive but it would actually greatly improve the care that everyone would receive. That is not often adequately understood.
As the noble Baroness, Lady Thornton, said in her introduction, there are really two sub-groups here. Going from consideration of Amendment 18 to Amendment 30, we are essentially talking about, as the noble Baroness, Lady Bakewell, was saying, the need to avoid corporate capture of our NHS, although the corporate sector has already won many battles and taken over a great deal of the NHS. If the need for profit is the way in which things are being run, care must suffer. Care is the second priority and that is an unavoidable fact. When one considers privatisation—I have later amendments that will address the care sector in particular—we see where this has been allowed to extend to extremes, whereby the private equity sector has taken over our care system at enormous cost to the quality of care for public and private pockets. The system is in a state of near-continual collapse. We have to make sure that ICBs do not go down the route that our care sector has already gone down.
I am thinking about this matter for Report. There is also a further issue whereby although these amendments address people’s current employment and roles, we also need to think about the revolving door situation, about which, I see from social media, the public are increasingly concerned. We see people flipping between the private and public sectors and taking the interests, direction of travel and thinking of one to the other—and not for positive purposes.
I am aware of the hour but I am looking at the second sub-group of amendments, Amendments 37 to 41, and at who should be there. The issue relates to my comments on the previous group. We cannot just say, in terms of managing the NHS, “Just leave it to the doctors and the experts. They know about care.” Of course they do in terms of running services but in making choices and allocations and in ensuring that the ICB meets the needs of its community, it is the community that knows what the needs are and should tell the medical people what needs to be delivered, and the shape of that delivery. The technical details will come down to the medical people.
It is therefore crucial that we do not see the ICBs as technocratic places for people with MBAs and doctors but that we should include trade unionists, patients and carers. Carers are particularly important because our current system does so poorly in meeting their needs and supporting them. We need bodies that truly serve to represent the community.
My Lords, in declaring my interests as set out in the register, I want to press my noble friend the Minister on conflicts of interest.
Paragraph 8 of Schedule 2 to the Bill provides that local NHS trusts and GPs are to appoint members of the integrated care board. Organisations that provide the bulk of NHS services will therefore be co-opted into the work of commissioning. It is currently the work of commissioners to hold providers to account, objectively determining whether they are best placed to provide a service and assessing their performance. The new integrated care boards must continue to perform that role.
Clause 14 introduces into the 2006 Act new Section 14Z30, subsection (4) of which provides, rightly:
“Each integrated care board must make arrangements for managing conflicts and potential conflicts of interest in such a way as to ensure that they do not, and do not appear to, affect the integrity of the board’s decision-making processes.”
Reference has already been made to amendments that seek to exclude individuals involved with independent healthcare provision from joining the ICBs. Does my noble friend the Minister agree that the membership of provider appointees on integrated care boards may at least risk creating a perception of a conflict of interest between the roles of those individuals on the board and any roles they may hold with provider organisations? How can the benefit of provider input into the work of an ICB be reconciled with the task of objectively assessing both the suitability and performance of providers? I believe that greater clarity from the very outset on the extent of the role that provider appointees will be expected to play will surely assist ICBs in developing robust governance arrangements, which would then enjoy public confidence.