Mental Health (Discrimination) (No. 2) Bill

Lord Low of Dalston Excerpts

Friday 18th January 2013 Lords Chamber

[Lord Low of Dalston]

My Lords, I rise to give my enthusiastic support to this measure. Given the conditions outside and what I am sure is the desire of noble Lords to get home as soon as possible, I can probably signify my support fairly formally—or, at any rate, briefly.

As someone who has had a bit to do with anti-discrimination and equality legislation in my time, I am a bit embarrassed that it should be necessary to bring a Private Member’s Bill to remedy the injustices this Bill seeks to correct. I suppose any piece of generic, comparatively unfocused legislation like the Disability Discrimination Act, and now the Equality Act, is bound to miss a few specific provisions—pockets of discrimination, which, to our shame, remain hidden away in the interstices of the statute book. We should be grateful to the noble Lord, Lord Stevenson, for winkling them out and bringing them to us today so that we can root out once and for all these anomalies, which, inappropriately in the 21st century, continue to disfigure our legislation and have unaccountably escaped the consolidator’s pruning knife.

Perhaps we should not be altogether surprised that these anomalies should have survived, because of course they reflect the particular stigma that mental illness has traditionally attracted, and still attracts—greater even that that attaching to physical disability. For that very reason, we should warmly welcome this Bill as sending a strong message that the outdated attitudes reflected in the discriminatory provisions that the Bill sweeps away are no longer regarded as appropriate in a civilised society.

Like other noble Lords, I do not propose to say anything about the specific provisions of the Bill, which, as the noble Lord, Lord Stevenson, pointed out, are fully covered in the briefing which has been provided. Rather, I will simply give the Bill a warm welcome, thank and commend the noble Lord for bringing it before us today and express the hope that your Lordships will give it an enthusiastic Second Reading and speed it on its way.

Of course, that will not be the end of the story. As the noble Lord said, the Bill makes just an inroad in the problem of discrimination which still attends those who suffer from mental illness. Mind, Rethink Mental Illness and the Royal College of Psychiatrists point out that there is still a good deal to do before parity of esteem between physical and mental health is achieved. That means valuing those who suffer from mental illness equally with those who suffer from physical illnesses.

They say that several things need to be done to improve outcomes for those who suffer from mental illness. The notion of parity needs to be embedded in the NHS constitution. Mental health services should be funded to a level which accords with the scale of mental illness. Currently, mental illness accounts for 23% of all illness, but receives only 13% of the NHS budget. Waiting times for mental health treatments need to be comparable with those for physical illnesses. They recommend annual health checks for people with mental health problems, and enhanced training on co-morbidity to avoid people with severe and enduring mental health problems dying 20 years younger than the general population.

The Bill can be a springboard to end wider discrimination, which is still endemic in the delivery of mental health services, and to move towards the parity of esteem which the advocates for those who suffer from mental illness desire. Given that, this time around, the Bill has already passed all its stages in the Commons before reaching us, I trust that, with a fair wind and a helping hand from the Government, it will now reach the statute book with the minimum of delay.

EU: Scottish Independence

Lord Low of Dalston Excerpts

Wednesday 28th November 2012 Lords Chamber

[Lord Wallace of Saltaire]

My Lords, we do not know. That is one of the things that everyone is longing to discover.

[Lord Low of Dalston]

My Lords, would the UK have a veto on a Scottish application for membership such as General de Gaulle exercised in respect of British membership in former times?

[Lord Wallace of Saltaire]

My Lords, we are all mongrels. My father was a Scot; there are many of us here who have mixed Scottish, English, Irish and Welsh antecedents so we all hope that this question will not come up. If it did ever lead to separation, we would, of course, have to consider it. The Irish Free State seceded from the United Kingdom in 1922. Incidentally, that was relatively peaceful—although not within Ireland itself—and Ireland had to reapply to join international organisations.

Voluntary Sector and Social Enterprise

Lord Low of Dalston Excerpts

Thursday 21st June 2012 Lords Chamber

[Lord Low of Dalston]

My Lords, a couple of years ago we had a couple of good debates about the role of the voluntary sector. The subjects for debate referred more to civil society than the voluntary sector but people seemed to take the view that we were free to talk about more or less whatever we liked. That was a couple of years ago, so the noble Baroness, Lady Scott, is to be greatly congratulated on bringing us back to the subject, especially considering the prominent place that the voluntary sector has assumed in the Government’s thinking about the direction of society. I am taking it that the subject for debate today gives us a similarly free hand as to what we talk about.

ACEVO, the Association of Chief Executives of Voluntary Organisations, says that a social enterprise is an organisation that trades for a social and/or environmental purpose and reinvests its profits in support of that social or environmental aim. As we have heard, a well known example is the Big Issue, the magazine that is sold for £1.25 to homeless vendors who then sell it for £2.50, achieving the social return of increased income and independence. The Annual Survey of Small Businesses UK 2010 estimated that there are approximately 68,000 social enterprises in the UK, which contribute at least £24 billion to the economy and employ an estimated 800,000 people. ACEVO would argue that it is unhelpful to draw a hard and fast distinction between charity and social enterprise. All charities need to be enterprising in their outlook, particularly in challenging economic times, and many pursue social enterprise models.

In a sense, social enterprise is something that an organisation does, rather than something that it is. For example, the charities Catch22 and Turning Point work with the private company Serco to deliver an anti-reoffending pilot at Doncaster prison on a payment-by-results basis, in which payment levels depend on the extent to which reoffending is reduced. This is replicating a social enterprise model in which investors are rewarded when a programme achieves targets. If this is what a social enterprise model is, I would have to flag up dangers. Just to be clear about my own position, institutional and ideological, I have 40 years’ experience of working in charities, great and small, ending up as a vice-president of RNIB, having been chair for nine years at the beginning of this century. I am also president of a number of others, declared in the register of interests, and have been president of others that I helped to found back in the 1970s but which have recently either merged or, sadly, folded.

I am thus a great believer in the big society, pace the noble Lord, Lord Giddens, as an expression of the voluntary effort that goes to make it up. The voluntary sector can add much in specific expertise and commitment to the comparatively blunt instruments that the state often has at its disposal, but it should not be contingent on a rolling-back of the state. We need them both; they are interdependent, as the noble Baroness, Lady Scott, made clear. We need the state to remedy the deficiencies of civil society in caring for the vulnerable and providing basic health, education and other services for the population at large. Some Ministers seem to base their view of what constitutes a healthy society—or a healthy economy anyway—on such a rolling-back. Thus the noble Lord, Lord Sassoon, said:

“As the Government, we have to continue to reduce the burden of the state. If we do that, the economy will flourish”.—[Official Report, 22/3/12; col. 1031.]

We have to be careful that the payment-by-results model does not turn into exploitation. Volunteering is a wonderful thing—but there is also exploitation, as the noble Lord, Lord Prescott, reminded us. It is the exploitation of organisations rather than individuals that I want to talk about. Small and medium-sized charities such as Action for Blind People or the Shaw Trust may have the specialist expertise that is crucial to get those farthest from the labour market into work, but they can find it hard to compete with large private-sector organisations with deep pockets that can bear the upfront costs and uncertainty of the final outcome for the length of time that it can often take to get such people into work. Prime contractors, whose aim is to maximise profit by cherry-picking those who are easiest to place, are also failing to refer to the more specialised organisations those who need the specialist support that is far beyond their capacity. For reasons such as these, the Work Programme—the noble Lord, Lord Shipley, also touched on this—by which the Government set such store to support for getting into work those whom they have thrown off benefit, is just not working, at least for those whose disabilities have placed them at a particularly severe competitive disadvantage.

During the spring, ACEVO held a series of round tables and spoke with over 100 charity chief executives to hear their thoughts and concerns about the future across the different sectors and beneficiary groups. Common themes emerging included the point that cuts are significantly affecting the vulnerable beneficiary groups that voluntary organisations serve. These cuts are being implemented in a climate of little or no public scrutiny and a local democratic deficit. The devolution of power to a local level is not accompanied by greater accountability. With the scrapping of scrutiny mechanisms such as comprehensive area assessments in the Audit Commission and low levels of public engagement with local politics, there is a lack of accountability for local spending decisions. Charities would love to act as the armchair auditors envisaged by Eric Pickles, scrutinising local decision-making on behalf of their beneficiaries, but local authorities do not make the necessary data and information available. For example, Rethink Mental Illness recently attempted to ask local authorities how much of their social care budgets were dedicated to mental health and received incomplete information, or none, which made it mostly impossible to determine what funding had been allocated to social care of different groups, what evidence lay behind funding decisions and whether, and how, funding had changed year on year. Fewer than 50% of local authorities contacted provided the budgetary information requested.

Consequently, there is the danger of a forgotten Britain developing—a marginalised and underprivileged section of society that will be increasingly affected by cuts but goes largely unnoticed by much of society. ACEVO argues that the scrutiny deficit must be plugged. The Government have undertaken to evaluate the impact of cuts as several of their Bills have passed through Parliament. Charities can help to fulfil that role, but it requires genuine co-operation and engagement from the public sector.

Government: Commercial Lobbying of Ministers

Lord Low of Dalston Excerpts

Tuesday 25th October 2011 Lords Chamber

Asked By

[Lord Low of Dalston]

To ask Her Majesty’s Government whether they will set up an inquiry into the nature and extent of commercial lobbying of Ministers, outside the normal processes of Government.

[Lord Wallace of Saltaire]

My Lords, the Ministerial Code sets out the ways of working for Ministers. On taking office, the Prime Minister committed to the quarterly publication of Minister’s meetings with external organisations and the hospitality received. He also strengthened the code in relation to former Ministers to include a two-year ban on lobbying Government and a requirement for former Ministers, for two years after leaving office, to obtain the advice of the independent Advisory Committee On Business Appointments about any job or appointment they wish to take up, and to abide by the committee’s advice, which is made public.

[Lord Low of Dalston]

My Lords, following the Prime Minister’s request to him to investigate the former Defence Secretary’s conduct in relation to the Ministerial Code, the Cabinet Secretary wrote in his report that more allegations had arisen,

“which will be the responsibility of others to answer”.

If the Government do not intend to set up an inquiry, how do they propose to go about getting those answers, which I am sure both Parliament and the country will be anxious to hear?

[Lord Wallace of Saltaire]

My Lords, there has been an inquiry on the Werrity affair, and I was not aware that we needed a further inquiry on it. The Government are committed to as much transparency as possible, not only in ministerial meetings—I assure the noble Lord that it relates to people as far down the food chain as me, in terms of what is required about my diary being published—but in the funding that is provided for various activities.

Social Policy

Lord Low of Dalston Excerpts

Wednesday 16th June 2010 Lords Chamber

[Lord Low of Dalston]

My Lords, I, too, congratulate the right reverend Prelate the Bishop of Leicester on securing this debate. It could not be more timely, as the new Administration begin to put in place a new strategy for shaping and delivering social policy. I apologise for missing the first minute or two of his introduction, but the quality of the greater part which I did hear was sufficient to show what an impressive introduction it was. I also welcome the Minister to her position on the Front Bench and, like the rest of us, I look forward to the maiden speech of the noble Lord, Lord Wei.

The current fiscal environment demands that social policy and public services are recast to take account of the new economic reality, but the questions and challenges that that poses are immense. Not only is the scale of these issues already very significant, but, as the full effects of the recession play out, it will continue to grow. The Government are now looking at a situation where they will have to do much more with far less. Speaking as an advocate for the voluntary sector, I believe that must ensure value for money, efficiency and effectiveness of services in order to extract the maximum utility that we can from each pound of public spend. As a result, we must ensure that the policy frameworks around which those services are constructed are as focused and as appropriate as we can make them. I believe that civil society is in a unique position to help the Government to create those frameworks. The expertise and knowledge of the sector, whose strengths need to be harnessed, are an invaluable resource for the Government.

The Government’s big society agenda may well be able to provide at least a partial answer in meeting those problems. However, doing so requires recognition of the fact that building the big society needs not just civic action but organised civic action; that is to say, civil society organisations with business nous and financial capacity and a smart, strategic state working in genuine partnership with the sector. The danger that we face is a state that simply retrenches and leaves the big society to pick up the pieces.

There are two clear planks in the Government’s vision for a big society: empowered communities and more public services delivered by citizen-focused civil society organisations. Those ambitions are not without their history. The boundaries between what is done by the state and what is done by the voluntary sector have shifted backwards and forwards over the centuries. The state made a major advance in the 20th century, but it is now definitely in retreat. How headlong that retreat will prove to be is perhaps under negotiation, even as we speak. Over the past decade, there has been a growing political consensus on the strengths that civil society organisations bring to public services. Increasing levels of impact reporting are now formally demonstrating the immense value that the sector brings to shaping social policy and delivering services.

The key strength that the sector provides in shaping policy is in the role of the provider advocate. Due to the close nature of their relationship with their beneficiaries, civil society organisations are able to shape their services around individual need, and can then translate the lessons learnt from practice into policy. That exercise can be successful only when relationships of trust and mutuality exist—something which civil society is streets ahead of other sectors in creating. That knowledge must be used and applied by government in the design of effective social policy.

A major question is: how do we get from where we are today to where we want to be? How, practically, is the big society to be built, especially at a time when the state’s capacity will be hampered by massive public spending cuts? One thing is clear: success will depend to a large degree on the extent to which civic action can organise itself. Informal civil action—mutual support between family members and friends, for example—is the bedrock of our society, but clearly there are limits to what can be done through such informal activity

If you want volunteers helping children to read in school, reformed ex-offenders mentoring those released from prison to prevent reoffending or volunteers providing the elderly with company and conversation, you will need civil society organisations to manage and organise those volunteers. You will need those organisations to be efficient, professional and well led. If you want civil society organisations to deliver more public services, especially at a time when spending cuts mean that you also want efficiencies of scale and to pay providers only once they have achieved results, you will need those organisations to be businesslike, capable of scaling up and able to access working capital.

Furthermore, if you want civil society to shape policy, there will need to be formal conduits through which information and evidence of the impact of civic action can be collected, analysed and evaluated. Formalised organisations and networks are not necessarily a sign of inefficiency or waste. Infrastructure, both capital and organisational, is an important way of gaining efficiency, collating data and sharing best practice. It is imperative that that aspect is not ignored by the Government if they are truly keen on a big society.

How is civil society meeting those challenges? Consolidation is an obvious response to the need for greater cost-effectiveness. That is beginning to happen, still too tentatively, in a sector deeply imbued with traditions of organisational pride, but I predict that it will grow. Diversity is a good thing, but you can have too much of it. In the world of the visually impaired, which, as vice-president of the RNIB, I know a bit about, there are no fewer than 733 charities. The RNIB thus performs an invaluable service for government by bringing together the entire impairment sector—not just charities but the statutory sector as well, eye health and social care professionals and users of eye care services—around a UK vision strategy. That sets out a shared agenda which gives government and others a coherent and expert view of what the sector needs.

That both points to and facilitates a second requirement: partnership from the state. As David Cameron has said, building a big society will require a smart, strategic state, not one that simply retrenches. It will require a state that is proactive in supporting civil society—for instance, by acting fast to set up a big society bank. It will require a state that works with us in the sector to define the contours of the big society. Above all, it will require a state that does not think, even at the back of its mind, that the sector can simply pick up the pieces for free when the state decides to do less. It cannot, it will not, and in every sense the Government would pay a heavy price for believing the opposite.

Civil society organisations such as the Association of Chief Executives of Voluntary Organisations have campaigned vigorously for the Government to take a mature partnership approach in policy formation. I believe that this is an offer that we should seize with both hands, particularly over the coming months when it will be critical to bring out the best in both sectors. Already the Government have courted controversy by ending the future jobs fund, an effective scheme devised by the third sector for producing real, long-term jobs, and the perverse decision to replace futurebuilders loans with grants. Dangerously, backward-looking councils have already started cutting grants to voluntary organisations. The sector and government must do more to work together in creating more positive social outcomes. Both sides are realistic and know that cuts in spending are coming, but a partnership approach in policy and delivery can ensure the least damage to vital front-line services. We should not underestimate this challenge, and now is no time to be romantic. However, I believe that a meaningful partnership between government and civil society is a vital plank in developing a more effective and appropriate social policy.