Environmental Targets (Fine Particulate Matter) (England) Regulations 2022

Debate between Lord Stevens of Birmingham and Baroness Jones of Moulsecoomb

Monday 30th January 2023 Lords Chamber

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I congratulate the noble Baroness, Lady Hayman of Ullock, because I thought her analysis of this statutory instrument was excruciatingly thorough and coruscating, quite honestly. It was possibly her finest hour, but I am sure she is going to have many more.

I would have liked to have stopped the Minister several times during his opening remarks because, quite honestly, I would have liked to refute things or challenge them because they were so off-beam at times with some of the language he used. He said things such as “What would we want to snuff out?” I can give him a list and explain very clearly how we could achieve much tougher targets.

These targets make exactly the same mistakes as the targets on water that we argued over last week, which is that they are too little, too late. The Government have had the opportunity to show the public that they care about the quality of our water and air. They say they want to improve human health and reduce environmental pollution and that there is some urgency to their actions but that is absolute nonsense. I have seen no ambition in these proposed targets to reduce the thousands of premature deaths due to air pollution that this country suffers from.

The Minister said that we would restrict freedoms. What about the freedom to breathe clean air and not be ill from breathing the air in our urban spaces? That is absolutely a human right and something we could deal with. The Minister talks about restrictions but what we can do is make it easier for people to do the right thing. We can make it easy for them not to use their cars by giving them decent public transport. This is something that the Government do not seem to be able to tie up at all. They cannot see any relationship between a carrot and a stick. I know that Ken Livingstone is not held in the highest esteem any more but he really understood that and when he brought in the congestion charge, he massively improved public transport. It made a huge difference to travel patterns in London.

The noble Baroness, Lady Hayman, said she was looking for ambition. She has certainly failed to find any ambition in these targets. It is totally unacceptable that the Government are proposing to delay compliance with the World Health Organization’s air quality guideline for fine particulate matter. Of course it is a complex problem but, as the noble Lord, Lord Tope, pointed out, not only road traffic but plant is responsible. We could insulate buildings, which would mean that people used less energy, for example, and therefore polluted less.

A target was published in 2005 that this country will not now hit until 2040. That is appalling, isn’t it? It is the same as with the sewage targets: putting everything back a couple of decades means that most of us will not live to see a country where we have clean air and clean water. I have no problem making sacrifices for the next generation—I do so on a daily basis—but I prefer to make sacrifices that deliver improvements while I am alive, if possible. And I am saying that it is possible, but this Government choose not to do it.

The World Health Organization has halved its guideline for PM2.5 to 5 micrograms per cubic metre. That happened over a year ago. So not only are we delaying targets; the targets we are using are already out of date. The science has moved on but this Government and this country have not.

I have a few questions. I realise that they will not be answered today but I would like them answered. I am happy to write to the Minister, but I will now read them into the record. First, are the Government taking literally the wording of Section 4(2) of the Environment Act 2021:

“Before making regulations under sections 1 to 3 which set or amend a target the Secretary of State must be satisfied that the target, or amended target, can be met”?


Doing so would mean the Government not protecting anyone until the last person in the entire country was protected from air pollution standards set in 2005. I would like clarity on that.

Secondly, what computer modelling can the Government possibly be using that shows that the UK cannot or will not achieve the WHO’s old air quality guideline until 2040? That modelling has to be out of date; it cannot possibly be anything that any of us on this side of the Chamber could have come up with.

Thirdly, are the Government aware that official modelling done for the revision of the Gothenburg protocol shows that less than 5% of the UK population would be exposed to more than 6 micrograms per cubic metre of PM2.5 by 2030, and only 8,000 people above 7 micrograms per cubic metre? That is the baseline case.

Fourthly, are the Government aware—actually, I think the Minister did mention this—that the European Commission is proposing to comply with the old air quality guideline for PM2.5 by 2030, 10 years earlier than this Government, and that it is proposing to halve the current level for nitrogen dioxide by the same date? Where is our Brexit dividend? People will say, “I voted for Brexit. I want my dividend. Where is it in this SI?”

Instead of this nonsense and all the flannel we keep being given about targets, I ask the Government to support Ella’s Law—my Bill that would make clean air a human right. It is in the other place at the moment, and I suggest that all noble Lords on the opposite side of the Chamber lobby their friends and family to sign up to the Bill and say, “This is what would actually fix the problem we are facing.”

These targets will not fix the problem. People will suffer and die, and the Government will never hear the end of it while we few are on this side of the House.

[Lord Stevens of Birmingham (CB)]

My Lords, it is unusual, I suggest, in public policy to find an area where the case for faster action is as barn-door obvious as it is in this instance. We have a set of impacts with strongly negative consequences. We have a set of practical actions that would enable us to do something about that, and the benefits of so doing would be rapid—in some cases, almost immediate. That is not my judgment but that of Professor Chris Whitty, the Chief Medical Officer, whose 2022 annual report—published just before Christmas and which, unfortunately, did not get the scrutiny and focus it deserved—concentrates on air pollution.

Health and Care Bill

Debate between Lord Stevens of Birmingham and Baroness Jones of Moulsecoomb

Lords Hansard - Part 1 & Report stage
Thursday 3rd March 2022 Lords Chamber

[Baroness Jones of Moulsecoomb (GP)]

I shall speak to Amendment 82 in the name of my noble friend Lady Bennett of Manor Castle. I attended Second Reading and made my views felt then, but I have not been able to join the deliberations on the Bill since then because of the pressure of other Bills in your Lordships’ House.

Even I, as someone who does not know very much about medicine, know that the most urgent challenge currently facing our health service is a shortage of nurses. I have been lobbied very heavily by the Royal College of Nursing, because Amendment 82 is its number one priority. It feels that, without a co-ordinated work plan, a coherent forward view and knowledge of exactly how the situation is at the moment, it cannot possibly achieve the sorts of numbers that are needed. There were almost 50,000 vacancies before Covid, and you can imagine the pressure that Covid has put on to the NHS—extreme pressure at completely unsustainable levels, and with staff numbers that are actually unsafe. We all know this, yet Boris Johnson and the Conservatives made big promises at the last election—their manifesto made a promise of 50,000 more nurses—and instantly that number began to unravel, as it included existing nurses who do not quit. That is unclever and unsophisticated number crunching.

I do not understand why this Government will not live up to their manifesto commitments. One reason why I have not been able to speak on this Bill since Second Reading is because of all the other Bills coming through, on which the Conservatives have said that they are aiming to achieve their manifesto commitments. They are actually going rather beyond their manifesto commitments in lots of areas—but the fact is that they are picking and choosing as if from a box of sweets the ones that they prefer.

The Royal College of Nursing represents over 480,000 nurses in health and social care. These are people whose pay requests are constantly ignored—and who constantly have their pay cut; in real terms, it has reduced. Just at the point when MPs are getting very welcome extra pay, nurses hang on by their fingertips. We know that vacancies are also a huge problem, with retirement age approaching for a lot of nurses. Nurses need the certainty of planning, and I do not hear those plans coming from the Government, although this is really their job—to manage the economy and manage society in a way that benefits everybody. Clearly, if the NHS fails in any area, that does not benefit anybody at all.

I argue very strongly for Amendment 82, and I just hope that the Government wake up in time to see how necessary it is.

[Lord Stevens of Birmingham (CB)]

My Lords, I am very pleased to co-sponsor the amendment proposed by the noble Baroness, Lady Cumberlege, Amendment 80, and to speak in support of a number of the other amendments in this group. I declare my honorary fellowship of the Royal College of Physicians and the Royal College of GPs, and thank them and the 100 other organisations across the health and social care sector that have joined in the cross-party support that this amendment is likely to generate.

In considering how to vote on this amendment, I think it really boils down to two very straightforward questions. First, do we need regular, rigorous and independent workforce planning for health, social care and public health? The social care point, as the noble and learned Lord, Lord Mackay of Clashfern, has just reminded us, is so crucial here. The second question is: if so, will we get it, with appropriate rigour and independence, without this amendment? I suggest that the answer to that question is, unfortunately, no.

The first question is self-evident to most people. We discussed it throughout Committee: workforce pressures mean that it is obvious that we need regular workforce planning. The very long lead times make it critical. Earlier this week, your Lordships were debating pressures in young people’s mental health services and eating disorder services. It is worth reminding ourselves that a new consultant psychiatrist specialising in eating disorders, starting work in NHS mental health services this morning, will have entered medical school 15 years ago. It is worth reminding ourselves, too, at a time when the NHS is confronting long waits for routine operations and needs to deal with a backlog of care, that the new medical student starting undergraduate medicine in September will report for duty as a consultant orthopaedic surgeon in 2037.

So the lead times are clear, yet we have a paradox: more young people and, indeed, mid-career people, would like to join this great campaign, this social movement—the health service, social care and public health—but we are turning them away. In 1945, Nye Bevan said:

“This island is made mainly of coal and surrounded by fish. Only an organising genius could produce a shortage of coal and fish at the same time.”


I suggest that, if Bevan were recasting his aphorism for today, he would say that, at a time when the NHS and social care have such a clear need for more staff, only a workforce planning system of organisational genius could turn away bright and committed young people from undergraduate medicine and other oversubscribed university places for health and other professions.

We have to accept that there will be extra costs from getting this right. The noble Baroness, Lady Cumberlege, was quite right to draw attention to the fact that there will be savings, including from the £6.2 billion spent in 2019-20 on agency and bank staffing across the health service. But there will be extra costs: the Royal College of Physicians has estimated that doubling undergraduate medicine places would cost perhaps £1.85 billion, which is about one-seventh of the amount that the House of Commons Public Accounts Committee identified last week as being likely to be lost from fraud and waste through the various furlough and other schemes introduced during Covid. So I think we need to put these costs in perspective.

The fact that there will be those costs gives us the answer to our second question. Of course, we need workforce planning, but are we going to get it without this amendment? I am afraid that I do not think we are. In Committee—although I shall not rehearse it—using publicly available materials, I set out the sorry history of what I described as the “wilful blindness” that has been inflicted on the health and social care sector and, indeed, on health Ministers and the Department of Health and Social Care itself, as they have sought to go about this task down the years.

The question before your Lordships is: has the leopard changed its spots? I suspect—and I genuinely sympathise with the Minister’s predicament—that he will tell us that the baton has now been passed from the Department of Health and Social Care to NHS England, so that for the first time it has the responsibility for undertaking this task, and we should be reassured by that fact. In that case, I ask him to give clear guarantees at the Dispatch Box that the proposed new powers of direction for the Secretary of State will never be used to veto or censor any independent estimates that NHS England itself puts forward, including those with a financial consequence. Indeed, I ask that he goes further than that and gives us a Dispatch Box guarantee that NHS England will be entirely free to publish, every two years, without approval, veto or censorship from either the Department of Health or the Treasury, the workforce need, demand and supply models implied in Amendment 80. If those guarantees are not forthcoming from the Dispatch Box, I think your Lordships will be entitled to draw your own conclusions.