Health and Care Bill

Baroness Bennett of Manor Castle Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

Moved by

[Baroness Bennett of Manor Castle (GP)]

237: Clause 141, page 119, line 17, at end insert—
“(c) after subsection (2) insert—“(3) No financial assistance provided under this section may be used for the purposes of—(a) repaying debt;(b) paying interest on debt;(c) making distributions to shareholders.””Member’s explanatory statement
This amendment ensures that financial assistance given by the Secretary of State is not distributed to shareholders or used to repay debt obligations.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I will also speak to Amendments 238 and 239 in my name. Predatory and rent-seeking financial practices by investment firms and hedge funds, which are often based in tax havens and have extremely complex ownership structures, have placed unmanageable financial and human costs on the UK care sector. I first learned about this issue in 2016 from the brilliant Centre for Research on Socio-Cultural Change, which was then based in Manchester but is sadly no longer extant. Since then, the issue has become a staple on the pages of the Financial Times. If any noble Lord does not know about this issue, I urge them to look up “UK social care” on ft.com. They will see there a long string of stories from a publication that does not generally represent my side of politics saying how much of a problem this is.

I also note that, last week, the noble Lord, Lord Sikka, not currently in his place, initiated an Oral Question that highlighted some of the worst abuses in financialised care homes, from HC-One siphoning off 20% of its revenues to offshore affiliates through intra-group transactions to—as was highlighted by the noble Baroness, Lady Brinton, who may raise this again later—the industry average of 16% of the money going not to care but to the financial sector. The crisis is here and was further highlighted by the recent “Panorama” report.

What is lacking, however, and I have been looking for them since 2016, is solutions. How do we change this situation? It is worth pointing out that this is not how things have always been. Back in the 1980s, the NHS was generally known as a world leader for geriatric care, as it was then known, picking up half of the care sector for older people. In 1982, there were only 44,000 private care home beds. By 1994, there were 164,000. The number of charity, non-profit, local authority beds plummeted and the private sector came in or displaced the public.

The amendments to the Health and Care Bill that I am presenting today rely on the work of the All-Party Parliamentary Group on Limits to Growth. Its excellent report covers these issues in much more detail than I have time to do today and I urge noble Lords to look at it. The group worked on and produced these amendments.

Amendment 237 takes what I think could be a deeply dangerous element of the Government’s Bill, which has received little attention thus far. It is the provision allowing for government support of private care facilities. This is not possible now. Amendment 237 would add the provision that these funds cannot be used to make payments on debt obligations for for-profit bodies or in distributions to shareholders—huge payouts that were highlighted in last week’s debate.

However, that takes us further, and it is interesting that the government amendment—I suspect unintentionally—actually gives us a way forward to start to unwind the privatisation, as there is a potential problem. We have already seen two major private care home crashes: Southern Cross in 2011 and Four Seasons Health Care in 2019. When—I will not say if—more crash, how do we start to move towards worker co-operatives, social enterprises, local authority homes and charity-run homes? How do we ensure that people can stay in those homes safely and be cared for, and not see the money siphoned off into offshore tax havens? We can use Clause 141 with this amendment for potentially very positive, even revolutionary, purposes.

Amendment 238 picks up a point that I often make that a foundation for tackling our out-of-control financial sector and ensuring that fair taxes are paid by companies is country-by-country reporting. The amendment requires any related companies within the same corporate group that are registered offshore to be under the same financial reporting and publication requirements as those bodies registered in the UK. That means that expenditure on dividends, directors’ fees, interest payment and similar would have to be fully and transparently declared. I have to ask the Minister: what does he have against transparency in the financial sector? What could the Government possibly have against seeing exactly where the money goes—whether it is the money of older, vulnerable people in our society or the state money that is supporting them? That is all that this amendment does; it demands that transparency.

These two amendments are not a total solution—I do not have a panacea for the situation—but they are a start, and that is why they combine with the third amendment in this group, Amendment 239, which calls for a review. It is a very simple, obvious amendment of a type often seen in your Lordships’ House. I note that I am joining the former Conservative Health Secretary Jeremy Hunt, who also recently called for a review of the funding. We see some unusual alliances in this House; this is an unusual alliance between the two Houses.

As we all know and has just been highlighted, the many hours of this debate have focused on what a mess the care sector is. These are the most vulnerable members in our society, and a significant part of that mess is because money is being siphoned away from their care. We can use the Bill, with these three modest amendments, to start to turn around that situation. I beg to move.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite her to speak.

--- Later in debate ---

I am afraid I cannot provide the noble Baroness, Lady Bennett, with any comfort on these amendments. However, I hope I have been of some help to her and the Committee in explaining the Government’s position and what we are doing to address some of the important priorities associated with the adult social care agenda.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I thank the Minister for his courteous and comprehensive response, which was very useful. I very much thank all noble Lords who took part in this debate, which was a powerful exploration of the issues.

The noble Baroness, Lady Brinton, talked about assets being milked. If we think about what we are actually talking about here—some of our most vulnerable citizens—and what is happening to them, that is a really crucial point. The noble Baroness, Lady Tyler, talked about a stunning figure: £40,000 of debt per bed. If you think of that physically, visually, that is just unsustainable—a word the Minister himself used.

I particularly thank the noble Baroness, Lady Altmann; I hope the Government will listen to their noble friend. She made a comparison with the insurance sector and stressed that this is about people’s most basic security. These care homes—people’s homes—being ladened with debt in the circumstances we are talking about is supremely insecure.

I thank the noble Lord, Lord Blunkett, for raising the plight of workers. These are people who, both through the pandemic and just in their everyday lives, have gone above and beyond the call of duty to care for people. They do really difficult jobs paid at the absolute base level.

I actually take some comfort from the Minister’s response. I take his point about how Amendment 237 is worded on debt. It is meant to address the kind of debt held in hedge funds, not debt to the local linen washing service or something, and I will think about how that might be addressed in different terms.

I pick up what the Minister said about dividends. I suggest that, should a care home chain be rescued by the Government in a state of great financial crisis, it should pay that rescue money back before it pays out any dividends. The Minister talked about the use of public funds, and I could almost feel the House restraining itself, since we are in constructive Committee form, from giving any reaction at that point. If the Government wish to avoid future scandals, the transparency offered by these amendments or something like them would be an ideal way for them to do that.

We were discussing yesterday in Grand Committee the Registration of Overseas Entities Bill—how long it has taken, how much we have been waiting for it and how crucial it is. This is picking one sector, producing a trial run to see how it works and taking it forward immediately in an emergency situation where we cannot wait many years for change.

This has been a very useful debate. I note the expressions of support from all sides of the House, and I reserve the right to take this issue forward on Report. In the meantime, I beg leave to withdraw the amendment.

Amendment 237 withdrawn.

--- Later in debate ---

[Baroness Stowell of Beeston (Con)]

I will be very brief. I declare my chairmanship of the Communications and Digital Committee. A lot of powerful speeches have been made all around the House today and clearly, we are all united in our care and concern for the issue of child obesity. The complexity of what is proposed in this legislation has been illustrated to such an extent that there is a case for delaying implementing these measures so that it is got right.

But the main reason for my decision to speak in this debate is the issue of fairness, equal treatment and the difference in the way these regulations apply to broadcasters and to the online platforms. The noble Viscount, Lord Colville, and my noble friend Lord Black of Brentwood have already spoken in some detail about the inequality of treatment between broadcasters and news publishers, and the online platforms.

I spell out clearly that what we are talking about here is that responsibility for the control and compliance of advertising that appears on television or radio rests with broadcasters, which can be sanctioned severely with huge fines by regulators if they allow anything that is non-compliant to air. But responsibility does not rest with the online platforms, which take far more in profit from the advertising they publish on their sites than any broadcaster is able to. They are equally able to control what appears on their platforms, as the noble Viscount powerfully described. Could my noble friend the Minister therefore explain why the Government are not ensuring parity between broadcasters and the likes of Google and Facebook at the point of legislation, to ensure parity in the way this will be applied?

Also under the heading of fairness, I say that, in the case of the small manufacturers of the products affected by the advertising ban, I support the amendment tabled by the noble Lord, Lord Clement-Jones, which ensures that the definition of “SME” in the Bill does not provide a loophole exempting large international manufacturers from these advertising restrictions just because they have a small workforce in this country.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I feel the need to balance the sides of this debate. I attached my name to Amendment 244 in the name of the noble Baroness, Lady Finlay. I associate myself with everything said by her and the noble Baroness, Lady Boycott, in particular, as well as the noble Lord, Lord Krebs, who gave powerful and well-evidenced presentations of why we need to see action here. Given the time and the fact that I have a train to catch, I will be brief.

The noble Lords, Lord Black and Lord Moylan, talked about freedom of speech—the freedom of the advertisers to push on to children whatever they want to push. I put against that the freedom to flourish and live a healthy life with a decent lifespan. The figures quoted by the noble Lord, Lord Stevens, illustrated that that is not being achieved and there is a deep inequality in our society.

The noble Lord, Lord Lansley, talked about how difficult it would be to measure or separate out the impact of these measures. We are in a hugely obesogenic environment. We have this huge problem with obesity not because human nature has suddenly changed and people have lost self-control, but because they are bombarded and barraged from all sides with ultra-processed pap, which we should stop all advertising of. I do not think that “High in fat, sugar and salt” goes far enough. There is evidence that under-11s—primary school kids—cannot distinguish between adverts and editorial content, so we have to protect them.

Finally, the noble Lord, Lord Black, asked about the international comparisons. Perhaps one of the most obvious ones is Norway, which brought in a ban somewhat similar to this in 2012. It has struggled for the reasons outlined by many noble Lords. Indeed, a study was produced by Oslo Metropolitan University last year, using the categorisation of the WHO European Office for Prevention and Control of Noncommunicable Diseases. Eight out of 10 adverts that young people in Norway were seeing online were for unhealthy food. That is a problem, but it is an argument not for doing nothing but for tackling the whole obesogenic environment that our young people are growing up in, with demonstrable effects. Norway, which has taken similar action to that which we are talking about today, as have Spain, Portugal, Slovenia, Latvia and Lithuania—that is just a shortlist—has half the level of childhood obesity that we do, and it regards it as a serious problem.