King’s Speech

Debate between Lord Markham and Lord McInnes of Kilwinning

Thursday 9th November 2023 Lords Chamber

[Lord McInnes of Kilwinning]

That an humble Address be presented to His Majesty as follows:

“Most Gracious Sovereign—We, Your Majesty’s most dutiful and loyal subjects, the Lords Spiritual and Temporal in Parliament assembled, beg leave to thank Your Majesty for the most gracious Speech which Your Majesty has addressed to both Houses of Parliament”.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, on behalf of all noble Lords, I thank His Majesty for his gracious Speech. I am truly honoured to be a Minister in his Government and to open this debate.

I always said that I wanted to be a different kind of Minister, and today is no different. Over the past few days, I have thought a lot about the sort of speech that I wanted to give. I could not quite make up my mind, but it finally clicked late last night, as I leaned over my five year-old son, Xavi, as he slept in his bed. I thought that, if I am making a speech about the long-term changes that this Government want to make in health, education, housing and welfare, I need to explain what kind of country we want to build for Xavi and his generation—so forgive me if this is a bit unconventional.

As I have told Xavi when he asks me about work, the National Health Service is probably our country’s most beloved institution. It represents how we think of ourselves as a nation: caring, compassionate, and a place where everyone will have their needs cared for at no cost, according only to need. It touches so many lives every day. It saved Xavi’s brother, Sam, when he was born more than 20 years ago and, more recently, it saved Xavi’s grandfather with an emergency operation.

However, it is a health service that faces huge challenges. It is a health service that must care for an ageing population that is growing rapidly and has rapidly growing needs, where it costs five times more to care for 70 year-olds than for 20 year-olds. It is a health service that is still recovering from a once-in-a-generation pandemic, which stretched it more than ever before and created health needs both physical and mental, which even now we are only just beginning to understand. So it is a health service where we need to make decisions for the long-term, to change how it operates and how we approach it, so that it is there for Xavi’s generation and the one after, just as it has been for ours.

That means we will all have to have to take more responsibility over our health, and that government must empower us all to make long-term decisions that benefit our health. That means diagnosing and treating conditions faster, but it must start with prevention. The single biggest thing that Xavi and his generation can do to protect their health is to never start smoking, and this Government are going to help them do that. We are making it illegal for Xavi and his friends, and anyone who is 14 or younger, to ever be sold tobacco. This will save thousands of lives and prevent thousands more people suffering from cancer. Vaping is, of course, much safer than smoking, and it helps many smokers to quit for good, but that does not mean that Xavi and his friends should ever take up vaping. That is why, following a consultation, we will bring forward measures to restrict the availability of vapes to our children, targeting sweet flavours, colourful packaging, eye-catching displays and disposable vapes, making sure that we do not replace a generation of nicotine addicts who smoke with another who vape.

We are not only taking steps to prevent Xavi’s generation suffering major illnesses but steps that will allow them to take more responsibility for their health. Just as we use apps and technology to manage our finances, retail preferences and social lives, they will be able to manage their health using technology, through the NHS app. As we speak, we are loading more features which will allow patients to understand their health needs through accessing their health records, and to navigate and decide whether they are best served by seeing a pharmacist through our Pharmacy First programme, seeing a nurse or a doctor, or referring themselves straight to a specialist at one of our 160 new community diagnostics centres. Patients will be able to make appointments from the app and then get their results directly to their phones. If they need follow-up treatment with a specialist, at a hospital or at a CDC, they will be able to exercise choice to find an appointment that suits them, whether that is seeing a particular doctor, getting care closer to home, or getting a shorter waiting time.

Artificial intelligence and technology are already allowing us to do great things. AI is allowing us to halve the time that it takes to treat people with strokes, making it more likely to recover completely. It is allowing radiologists to read lung and breast scans to detect cancers more quickly and more accurately than ever before. For Xavi’s generation, AI can do so much more. It could help us to discover medicines and cures that have defeated us so far, and it could analyse health records, helping us to join the dots between what links different generations and different conditions, to allow scientists to develop medicines and treatments to target the causes of major diseases.

All the work that we are doing to improve the nation’s health is underpinned by our long-term workforce plan—ground-breaking in its purpose—ensuring that we have the right numbers of nurses, doctors and specialists, and the right training and pathways into the profession, whether that is by expanding degrees, apprenticeships, or more on-the-job development. Underlying all our work is the need to focus our most precious resource, our people, on getting upstream of the problem. Rather than just focusing on hospital treatment centres and primary care, we are focusing resources on prevention and increasing the use of technology.

At this stage, I want to emphasise the Government’s commitment to creating parity between mental and physical heath and to introducing the mental health Bill in the future, when parliamentary time allows. In the meantime, we are taking decisive action. We are eliminating dormitory accommodation, so that people with mental health conditions are treated where they can be best cared for—in the community. We are making sure we have mental health ambulances available to answer 999 calls where we need a mental health response. We are also investing an additional £2.3 billion to support 2 million more people to receive mental health treatment.

As well as building a sustainable future for the NHS for our children, we are making sure it is ready for winter. Average category 2 ambulance response times were over 10 minutes faster in September than in the same month last year—and we are going further. This year, we are investing an additional £600 million into our discharge fund, supporting hospitals to discharge patients when they are ready, with the right support, and stopping patients who do not medically need to be in hospital from taking up important beds and delaying ambulance handovers. We are also providing 5,000 additional permanent staffed beds, introducing 800 new ambulances and using our 10,000 hospital-at-home beds to keep thousands of patients out of hospital.

As well as protecting the health of Xavi and the next generation, we are getting them ready for their futures. We are proud of our education record to date. Xavi and his friends are far more likely to go to a school rated good or outstanding. When we took office, just 70% of schools met this standard; today, that figure is 90%. Our nine and 10 year-olds lead the western world in reading, and our 15 year-olds perform significantly above the OECD average for reading, maths and sciences. However, the parallel nature of A-levels and technical qualifications limits the breadth of young people’s education, stops progression in maths and English far too early and prevents parity of esteem between academic and technical qualifications. Furthermore, we are an international outlier from 16 to 19 in terms of subjects taken and the number of hours taught. The advanced British standard will ensure that, when Xavi and his friends turn 16, they will face a world-class system, placing equal value on technical and academic knowledge, giving them depth and breadth of knowledge to succeed in further study and the world of work.

I now turn to housing and the world that we want to create for Xavi’s generation and those that follow. First, we understand the vital role of housing supply. Since 2010, we have delivered nearly 2.3 million homes, realising dreams of home ownership and delivering decent rented accommodation. We are on track to deliver our manifesto commitment of building 1 million more homes over this Parliament. At some point, all of us, including Xavi, are likely to rent their home, maybe as a stepping stone to home ownership, or maybe for the long term. Whatever the circumstance, we have acted to make renting better and fairer by cracking down on those 400,000 non-decent homes and banning tenant fees. With the Renters (Reform) Bill, we are going further. We will ban no-fault evictions that carry just two months’ notice, empower tenants to raise concerns about the quality of their property and give them greater security. At the same time, we want to be fair to landlords, making it easier for them to evict tenants who display anti-social behaviour or wilfully do not pay their rent.

We also want to help people like Xavi and young people today into home ownership. For some of us, that will mean buying a leasehold property. This Government are committed to improving the experience of the owners of the 5 million leasehold dwellings in England and Wales. We have already capped ground rents in most new leases at very low rates and we will deliver further leasehold reform with the leasehold and freehold reform Bill, which will ban the sale of new leasehold houses. Where leaseholds are required for practical purposes, such as in flats and apartments, we will extend their lease to 990 years and cap new ground rents, with the intention of giving future leaseholders the equivalent experience as if they owned the freehold on their home. We will also launch a consultation to see how we can further improve leaseholder rights. This legislation will fundamentally reform the leaseholder system, ensuring that families have the right fully to enjoy their homes and giving them increased opportunities to pass them on to their children.

While this Government are committed to supporting our society in health, education, housing and living and working independently, I want Xavi to know that we take care of those who need our support—now more than ever with the heightened cost of living. We spend £31 billion on supporting renters with housing costs and £276 billion in total through the welfare system in 2023-24, including providing more than 8 million low-income households with cost of living payments totalling up to £900. For those who need it most, we have increased benefits and the state pension by 10%, in line with inflation. We have made strong progress towards halving inflation by the end of the year, thereby reducing cost of living pressures. I am proud to say there are 1.7 million fewer people in absolute poverty than in 2010, including 200,000 fewer pensioners and 400,000 fewer children.

While we must support people who cannot work, it is vital that we give a leg up to those who can. As well as bringing economic benefits to a person, work boosts their confidence and well-being. The Government have made work pay with the introduction of a national living wage and by ensuring that those earning £12,570 or less pay no income tax or national insurance. These steps led to record employment rates before the pandemic and, last year, the lowest level of unemployment for 50 years. At the same time, there are 2.6 million people who are economically inactive due to disability or long-term sickness. Over a quarter of those who are long-term sick want to work, to the benefit of themselves and the economy. With flexible working and the ability to work from home, we want to help these people into the types of work that they can do, while understanding their conditions. That is why we have launched a consultation to change the work capacity assessment to come into force by 2025 and to provide tailored support for people to safely move into employment, to benefit them, their health, well-being and confidence and, of course, our economy.

I finish by addressing an issue of utmost importance, given the ongoing events in the Middle East. The aftermath of Hamas’s attack on Israel on 7 October demonstrates a clear link between anti-Israel sentiment and anti-Semitism. In the 21 days following this attack, the Community Security Trust recorded more than 800 anti-Semitic incidents—the highest ever recorded in a 21-day period. We know that boycotts and sanctions are divisive and undermine community cohesion. Many target Israel, under the banner of the Boycott, Divestment and Sanctions—or BDS—movement. There is evidence that this movement has contributed to the horrific rise of anti-Semitism in the UK. Yet we have seen taxpayer-funded bodies attempt such boycotts. In 2014, Leicester City Council passed a BDS motion on boycotting goods from Israeli settlements; that same year, Gwynedd Council passed a BDS motion calling for a trade embargo with Israeli settlements; and, in 2021, Lancaster City Council passed a motion in support of the BDS movement.

Taxpayer-funded public bodies should never interfere in foreign policy. That is why this Government have carried over the Economic Activity of Public Bodies (Overseas Matters) Bill into this parliamentary Session. It will deliver on our 2019 manifesto commitment to ban public bodies from imposing boycotts, divestments or sanction campaigns against foreign countries. It will prevent them pursuing divisive policies that undermine community cohesion and stoke anti-Semitism, ensure that the UK speaks with one voice internationally and guarantee that taxpayers only pay for foreign policy once.

Across housing, welfare, health and employment, this Government are taking the long-term decisions to help give Xavi and young people across the country a brighter future. We will create a health system that puts patients first, give more families a quality home, get more people into work and grow our economy. My noble friend Lord Younger and I look forward to hearing noble Lords’ valuable reflections on the measures that I have outlined today on how we can all take the long-term decisions needed to create brighter future for Xavi and all our young people.