Welfare Reform and Work Bill

Lord Ramsbotham Excerpts

Monday 25th January 2016 Lords Chamber

Moved by

[Lord Ramsbotham]

3: Clause 4, page 4, line 31, at end insert—
“Maternal nutrition: reporting obligationA1ZA Maternal nutrition and poverty: reporting obligation
(1) The Secretary of State must publish and lay before Parliament a report containing data on—
(a) maternal nutrition in workless households in England;(b) maternal nutrition in long-term workless households in England.(2) The report must set out how the Secretary of State has interpreted the following terms for the purposes of the report—
(a) maternal nutrition;(b) household;(c) worklessness;(d) long-term worklessness.(3) The data contained in the report, and the provision about how the terms used in it are to be interpreted, must, so far as practicable, be derived from any relevant official statistics.
(4) The first report must be published before the end of the financial year ending with 31 March 2017.
(5) Later reports must be published before the end of each subsequent financial year.
(6) In this section “official statistics” has the meaning given by section 6(1) of the Statistics and Registration Service Act 2007.”

--- Later in debate ---

[Lord Ramsbotham (CB)]

My Lords, in moving Amendment 3 I shall speak also to Amendments 4, 5, 6, 7, 9, 10, 12, 13 and 14, which are all to Clause 4 of the Bill. Indeed, they are all amendments in effect to the Child Poverty Act 2010. They represent a repetition of amendments that I tabled in Committee about the annual reporting on health and well-being and on children aged five, as opposed to at key stage 4. For very logical reasons, the Public Bill Office has put Amendment 3 before my old amendment, which is now Amendment 5, because maternal nutrition obviously comes before children who have already been born. Therefore, I shall speak first to Amendments 5 and 6 to amplify what I said in Committee, on which I had a discussion with the Minister before Christmas following the rather inconclusive conclusion to our debate that evening, following timing problems in the House. I particularly want to talk about the link between extreme poverty and mental health, particularly of children, which was highlighted in the previous amendment.

In any situation, it is grossly inefficient to tax people who cannot pay. Local government has been quite right to draw the Government’s attention to the inability of councils in England and Wales to collect the £1 billion in three years that they were instructed to start taxing in April 2013. Of course, as has been said many times during the passage of the Bill, there is a cumulative impact on the health and well-being of residents when the benefits provided by central government for survival are being reduced in value as the rents that they have to pay rise. Therefore, in fact, we are talking about the cumulative effects of a great number of issues that are not in themselves all the responsibility of the Department of Health, or, indeed, the Department for Communities and Local Government, which have to deal with the outcomes.

The economic and social costs of mental health provision, which is the subject of this amendment, have been calculated by the Centre for Mental Health, in which I declare an interest as a vice president, as being £105 billion in 2009-10, which is reckoned to be an underestimate. That is a huge amount of money and a great deal of that is caused by the conditions that we have been discussing in this Bill. It is of interest that Dr Angela Donkin, who is a deputy director at the Institute of Health Equity, has said that the national audit in 2010 found that 82% of homeless people had at least one physical health problem, and 72% had at least one mental health problem. So there is a huge cost to all this poverty.

Some 10.4% of those in fuel poverty, living therefore in extremely cold houses, showed higher levels of respiratory conditions, cardiovascular disease and poor mental health as the result of the conditions in which they lived. You then add food poverty, which has been mentioned—and, again, the lack of proteins, iron and the correct vitamins, minerals and fatty acids leave a higher susceptibility to illness and infection and heart and lung complications. It is said that preventing low birth weight should be an absolute must for all public health officials, but all their efforts will be hampered by inefficient incomes, which mean that people cannot buy what is required to produce that high birth weight. Finally, there are many mental disorders, particularly evident in women who, in addition to handling the family budget, suffer from maternal depression, which is bound to impact on the children and their social development.

As I mentioned before, we have a situation here where the Chancellor is apparently directing, without ever taking evidence from such as the Barrow Cadbury Trust, whose evidence was used by the Mayor of London to calculate the London living wage—and also, I fear, there is a lack of tie-up between the Treasury, the Department of Health and the Department for Work and Pensions as well as the Department for Communities and Local Government. There is too much silo working. My amendments aim collectively to ensure that the collection of evidence by one ministry or another should be made available to all the others so that they have an aggregated picture on which to make their judgments.

Amendment 3 would introduce reporting on maternal nutrition—an addition to what I tabled in Committee. Also, it has been taken forward considerably since we debated it in December, particularly in a speech by the Prime Minister on 11 January, when he announced his life chances strategy. In addition to maternal nutrition, he also endorsed what was in my previous Amendment 4: the suggestion that reporting on children should not be left until key stage 4, at the end of schooling, but should be done at the age of five, because we would then have some chance of taking remedial action based on something that we had found early, thus increasing life chances. It is interesting that in his speech on 11 January, the Prime Minister said that,

“we must think much more radically about improving family life and the early years”.

He called that a “life cycle approach”—one that takes people from their earliest years through schooling and through adolescent and adult life.

This strategy clearly points to the importance of early child development and getting children ready for school, thus endorsing the assessment currently done of every child by the age of two, which I mentioned in Committee. Without measuring a child’s progress at the age of five, the Government cannot know how successful or otherwise any remedial treatment initiated following the health visitor assessment at two has actually been in preparing children for school.

I also mentioned in Committee that the All-Party Group on Speech and Language Difficulties, which I co-chair, in a report on the links between disadvantage and speech, language and communication needs, found that children with a low IQ from advantaged families overtook children with a higher IQ from disadvantaged families by the age of five. That is a terrible factor to consider: that overtaking will happen unless remedial action is taken. Therefore, I strongly believe that tackling child poverty and improving children’s life chances—the right reverend Prelate has just spoken about this, and we have just voted on it—is a national endeavour and responsibility. My amendment is designed to present the Government with the opportunity, through the evidence produced every year, to learn about what is actually happening to our children, and then to enable all the departments involved, not just the Department for Work and Pensions, to use the information to improve life chances, and thus to invest the nation’s money in its future—our children—more wisely.

My other amendments—Amendments 7, 9, 10 and 12 to 14—are textual adjustments to reflect the content of Amendments 3 to 6. I beg to move.

[Baroness Meacher (CB)]

My Lords, I strongly support the amendments tabled by my noble friend Lord Ramsbotham. The main amendments in this group are of fundamental importance if the Government are to make a success of their own DWP policy. The Government want to focus upon the life chances of children rather than upon poverty alone—but I do not believe we should lose sight of the significance of poverty, particularly when the levels of poverty will worsen so severely in the coming years. I was relieved to hear the Minister assure the House that the Government will continue monitoring poverty as before, whatever becomes of the amendment on which the House has just voted when it gets to the other place.

Of course, there is a lot more to successful parenting and the life chances of children than income alone. As we all know, sufficient income is a necessary but certainly not a sufficient condition for a successful childhood. Parents’ mental and physical health and well-being are essential to successful parenting. If a mother is malnourished, she is most unlikely to provide for her child’s mental and physical needs. If she is depressed, she may not be able to look after her child at all until her mental health improves.

As my noble friend Lord Ramsbotham reminded us, the Prime Minister himself has highlighted the early years as one of four areas in which to anchor the Government's approach to life chances. The Government’s life chances strategy can, in my view, set a course for improving school readiness for the poorest and most disadvantaged children—but only, of course, if it is introduced across the country and is adequately funded. But only by monitoring progress in improving the health and well-being of children in workless households, particularly during the early years, is there any hope that policies will be developed and adjusted over time to ensure that they help rather than hinder the life chances of those children. Any Government will need to learn from their mistakes over time—and as we all know, Governments certainly make mistakes.

--- Later in debate ---

[Lord Freud]

As the noble Baroness knows, we have a lot of information about how pupils progress. The point is that it is necessary to have something that absorbs all that rather than having detailed measures at each point. The earlier processes have to be right to attain the achievements at the key target date. I have spoken in this House before about “targetitis”. If you give hospitals 220 different targets, for instance, which is what happened a decade ago, nobody knows what on earth they are looking at, whereas if you focus on the two things that really matter and not on the culmination of a lot of measures, you drive coherent behaviour through the targets that are set, and that is exactly what this strategy does.

I have already made the House aware that the measures that we have include key stages 1 and 2. Annual reporting at different stages of primary schooling already provides significant detail of the progress and attainment of disadvantaged pupils. Monitoring personal development in the way that the noble Lord suggests—

[Lord Ramsbotham]

My Lords, these reports include the Department for Education and the Department of Health, as well as the Department for Work and Pensions. Who is making these reports and to whom are they going?

[Lord Freud]

The whole point is that these reports are published. It is a forcing mechanism to make sure that the relevant Secretaries of State and the relevant departments of government work together to tackle the fundamentals that produce these outcomes.

Returning to the educational issue, if we made this change to the Bill, it would increase the burden on primary schools and send a signal to schools that Parliament does not trust them to carry out their core functions. That is why I cannot support this amendment.

Amendments 5 and 6 look to expand the reporting duty placed on the Secretary of State so that his annual report containing data on children living in workless households and long-term workless households in England must include data on the health and well-being of these children.

It goes without saying that the Government want the best for our children. We want all children to have the opportunity to have fulfilling lives and to realise their potential, and clearly their health and well-being is an integral part of that. However, we can achieve this aim, which is one that we all share, only by tackling the root causes of child poverty, and I will not parrot what I have already said on this point. Our evidence review shows clearly that worklessness and educational attainment are the two factors that have the biggest impact.

We recognise that, as the evidence review pointed out, child ill-health is also a driver of poverty. We are absolutely committed to reducing health inequalities in terms of access and outcomes, and we are working across government to ensure that ill health does not hold our children back from fulfilling their potential. The Government have already put in place a well-developed reporting framework—the public health outcomes framework—that supports health improvement and protection at all stages of life, especially in the early years. The framework includes a large number of indicators on children and young people’s health and, along with the NHS outcomes framework, sets a clear direction for children’s health that allows anyone to hold us to account.

We are committed to improving access to better services and to promoting early intervention to address children and young people’s mental health issues before they worsen. We are investing £1.4 billion in that over the next five years, and we have invested more than £120 million to introduce waiting time standards for mental health services—the first time that we have done that.

If we concentrate our actions and resources on the root causes of child poverty, such as worklessness and education, that will be the springboard from which everything else will follow. While the Government recognise the importance of tackling child ill-health, these amendments would ultimately distract the Government’s focus and finite resources from what is most important for our children’s future life chances. For these reasons, I cannot support the amendments of the noble Lord and the noble Baroness.

Amendment 7, tabled by the noble Lord, Lord Ramsbotham, would require separate reports for measures of worklessness and educational attainment. We are already committed to reporting on these measures and believe that it is sensible to deal with them together as they are jointly fundamental to improving life chances.

Amendments 9, 10, 12, 13 and 14 are consequential on Amendment 7 and therefore, in the Government’s view, unnecessary.

Once again, I thank noble Lords for their contributions but, on the basis of what I have said, I urge the noble Lord to withdraw his amendment.

[Lord Freud]

I shall be happy to write.

[Lord Ramsbotham]

My Lords, I am very grateful to all those who have contributed to this short debate. I am particularly grateful to the noble Lord, Lord McKenzie, for summing up what people said.

I listened very carefully to what the Minister said, and I am grateful to him for repeating what he has said before about the Government’s concentration on worklessness and educational achievement as being the main causes. However, I do not think that they are unique causes. The health and well-being, not just of the children but also of the families, and particularly the mother, is something that is a huge cause of the subject that we are looking at, and it ought to be added to worklessness and educational attainment.

It is all very well saying that we are going to do a great deal and going to improve the child mental health treatment processes in the National Health Service, but that comes at an enormous cost. The National Health Service cannot afford to do all this at present; otherwise, it would already have done it. I am very concerned that health and well-being in particular are being excluded from the terms of the Bill. They ought to be before everyone who is considering the issues of which the Bill is made up, particularly tackling the problems of worklessness and educational attainment, both of which have mental health as one reason—not the only reason—that they are there.

I am in something of a quandary. In many ways, I would like to test the opinion of the House on each of these three amendments, because I think that they are each important. However, if I may, I would like to withdraw Amendment 3 and not move 4 and test the opinion of the House on Amendments 5 and 6, which deal with health and well-being, which are, I think, the guts of all this issue.

Amendment 3 withdrawn.

--- Later in debate ---

Moved by

[Lord Ramsbotham]

5: Clause 4, page 4, line 36, at beginning insert “the health and wellbeing of”

[Lord Ramsbotham]

My Lords, I wish to test the opinion of the House.