King’s Speech

Baroness Merron Excerpts

Friday 19th July 2024 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, it is a tremendous honour to be closing today’s debate on behalf of His Majesty’s Government. I extend my thanks to His Majesty for his gracious Speech, and to all noble Lords for their thoughtful contributions and questions. On behalf of myself and my noble friend Lady Smith—this one, of Malvern—I also say how much we have appreciated such generous words of welcome and encouragement from across the House. I assure your Lordships’ House that we will always do our best. My noble friend Lady Smith made a fine maiden speech, exhibiting her characteristic intelligence, warmth and skill, which the House will continue to see in her new position on the Front Bench. I served in the other place with my noble friend—it does feel rather like we are getting the band back together.

I pay tribute to my predecessor, the noble Lord, Lord Markham. He was unfailingly collegiate, professional and caring. I know that I, and all other noble Lords, really valued that. It is a great pleasure to see the noble Lord, Lord Evans, and the noble Baroness, Lady Barran, in their places. I have never doubted their commitment to making things better for people. I share in the assessment of the noble Baroness, Lady Barran, that she has indeed earned herself a gold star.

I was glad to see the noble Lord, Lord Storey, in his place. I look forward to working with the noble Baroness, Lady Tyler, and give special thanks from these Benches to the noble Lord, Lord Allan, for being such a constructive colleague.

I congratulate the noble Baroness, Lady Monckton, on her maiden speech, and I know that we very much look forward to hearing more from her with her great life experience, as well as her business experience. To the noble Baroness, Lady Jolly, we will certainly miss her wisdom and experience, and I wish her and her family many years of happiness and good health.

When I closed this debate the last time on behalf of the Official Opposition, I said:

“I can only hope that the next gracious Speech will be different and will grasp every opportunity for change”.—[Official Report, 9/11/23; cols. 253-55.]


Well, different it is and change there will be. All that we speak of today is against the backdrop of the most challenging circumstances since the Second World War. With no time to waste, therefore, the Chancellor is carrying out an urgent assessment of our spending inheritance and will be presenting the results to Parliament before the Summer Recess, so that the findings can inform every spending decision we make.

It is, like for many others, some 14 years since I served as a Health Minister in the other place. In that time, the challenges before us have widened and deepened. We now have the highest waiting lists and the lowest patient satisfaction, and we have an education system struggling to cope and employers struggling to find the skills they need. All of this is despite the best efforts of the workforce, to whom we owe a debt of gratitude. This gracious Speech gives the hope and the means that the next generation will be healthier and better educated than any that has come before.

This has been a debate rich in constructive proposals and comment. It was absolutely marked by the amount of good will towards this new Government from across the Chamber, as people want to see change. Although I am buoyed up by that—in fact, I am rather touched by it—I must say to noble Lords that I promise I will not get used to it. I have also heard the points about what more could be done and what was not in the gracious Speech; I have heard the many valuable questions and challenges. I will reflect on those. Even though I will be unable to refer to all the points in my response today, I hope noble Lords will understand that that nevertheless means that I take their points extremely seriously.

Turning to the two health Bills, like many noble Lords, I am delighted that we are bringing forward a Bill to modernise the Mental Health Act. Through it, patients will be given greater choice, autonomy, enhanced rights and support and we will ensure that everyone is treated with dignity and respect. As the gracious Speech confirmed and the noble Baroness, Lady Hollins, highlighted, we will ensure that mental health is given the same attention and focus as physical health. Let me tell your Lordships’ House that this was music to the ears of the service users, campaigners and advocates with whom I met and spoke in my first few days in post.

Since the Mental Health Act was introduced in 1983, rates of detention have nearly doubled. Black people are three and a half times more likely to be detained under the Act, while four in 10 people with a learning disability who are cared for in hospital could be cared for in the community. This Act has been languishing on a 40-year waiting list, shaping the lives of people decades after it became law. So I commend the detailed work of the pre-legislative scrutiny Joint Committee, as well as the invaluable contributions by many noble Lords and others to develop this Bill through both the independent review and their absolute persistence and focus. Reform of the Act is long overdue, and we want to legislate as soon as possible while getting the details right.

The tobacco and vapes Bill will give a once-in-a-generation opportunity to end the vicious cycle of addiction to tobacco, which is the number one cause of death, disability and ill health. We will save the next generation from becoming hooked on tobacco and nicotine. Through this legislation, we will introduce a progressive smoking ban to gradually end the sale of tobacco products to those currently aged 15 and below. I say to the noble Lord, Lord Patel, that our primary focus will be protecting our children by banning vapes being deliberately branded for and targeted at them.

I turn to the education and skills Bills in the gracious Speech. As my noble friend Lady Smith said, we will transform the life chances for millions of children through not just the health measures in the gracious Speech but the children’s well-being Bill, which will raise school standards and open the doors of opportunity to every child. In bringing free breakfast clubs to every primary school, we want to see hungry minds, not hungry bellies. Breakfast clubs and school meals are about so much more than just food: I have seen them be a magnet for children to play and to learn, including learning how to be with others.

Barriers have stood in the way of young people achieving their potential, holding back individuals, society and economic growth. Skills shortage vacancies have more than doubled between 2017 and 2022 to more than 500,000, and the number of work visas granted increased by almost 80% between March 2022 and March 2024. Setting up Skills England will help us to close both these gaps. Uniting businesses, unions, combined authorities and government will make sure that training programmes are well designed and properly delivered to simplify the skills landscape for businesses and learners alike, ensuring that programmes can deliver the skills that businesses need to drive that all-important economic growth that so many noble Lords referred to. It will also create a formal link between migration data and skills policy, so that we can develop a homegrown, highly skilled workforce and reduce our reliance on migration.

A number of noble Lords raised several questions about T-levels and, more broadly, how we will support the many young people who leave education without the qualifications they may need to get on in life. To my noble friends Lord Knight, Lord Watson and Lady Morris, and the noble Baroness, Lady Garden, I say that qualifications are needed to deliver our mission to boost opportunity for everyone and to make sure that there are no glass ceilings holding back young people in our country. Our priority is to ensure that there are high-quality, accessible qualifications for all young people. T-levels provide a respected qualification for many, and we support their development, but we will be saying more about that soon and about how we will ensure that, where T-levels do not currently provide the necessary access, we do not leave leavers with no viable option.

On the points raised by the noble Lords, Lord Baker and Lord Aberdare, the Government have indeed already established an independent review of the curriculum. That will seek to ensure that the curriculum provides an excellent foundation, including those necessary digital, oracy and life skills that noble Lords referred to in this debate. It will ensure that it is a broad curriculum, with access to music, art, sport and drama, as well as vocational subjects.

The noble Baronesses, Lady Monckton, Lady Fraser and Lady Finlay, and the noble Lord, Lord Lexden, along with other noble Lords, raised the question of support for children, including those with special educational needs, and related that to ending tax breaks for private schools. We are committed to making VAT apply to school fees and ending charitable business rates relief for private schools. These changes will not impact those with a necessary place at an independent school that is funded by a local authority to meet a special educational need. I add that all children of compulsory school age are entitled to a state-funded school place if they need one, and the department will ensure that the state-funded sector has the resources it needs to manage any impact of these tax changes affecting independent schools.

It is important that I remind your Lordships’ House that, in our view, these changes are important to enable investment in the public sector, including for 6,500 more teachers and improved nursery provision. I know that both of those are very much in the hearts and minds of noble Lords across your Lordships’ House. We will engage constructively with the independent schools sector, and we want to see it thrive in this new context. We will work with the Treasury, and I can say to noble Lords that there will be further details in due course.

Turning to the points raised on health and social care, let me openly acknowledge the feeling expressed by this House, including by the noble Lords, Lord Patel and Lord Evans, the right reverend Prelate the Bishop of London, my noble friend Lady Pitkeathley and the noble Baronesses, Lady Walmsley and Lady Tyler, who all spoke of the need to address the challenges in adult social care and asked that it be given the priority it requires. They made the point well that after decades of neglect, these challenges are significant and urgent. We will work with the sector to build consensus on the longer-term reforms needed to create a sustainable national care service. We will make a start by delivering a long-overdue new deal for care workers, ending the constant churn in social care and recruitment challenges. I hope that the noble Lord, Lord Prentis, and other noble Lords will be pleased to know that we will engage with workers and trade unions to develop the first ever fair pay agreement for care professionals, taking lessons from other countries where that already operates successfully.

On charging reforms, noble Lords will be aware of the commitment that this Government inherit to implement these reforms in October 2025. It has become clear that the health and care systems are going through a more severe crisis than we first thought. The Health Secretary has asked officials to report to him on progress against this as a key priority. I look forward to keeping your Lordships House updated.

To the noble Baroness, Lady Finlay, on palliative care, I can give the assurance that this Government understand the vital role of hospices and we will ensure that palliative care is both considered and prioritised.

When it comes to the issue of puberty blockers, the decisions this Government take will always be based on evidence and not on politics. The Cass review made it categorically clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence to know whether they are safe or beneficial. In response to the Cass review, we are acting to ensure that evidence and safety come first, and that puberty blockers and drugs are available only to those for whom they have been proven to be medically necessary. To ensure that safety is prioritised, we will launch with NIHR and NHS England a clinical trial to ensure that we fully understand the effects of puberty blockers to treat gender incongruence.

I thank noble Lords for their words and their thoughtfulness in emphasising the support that must be provided to individuals who are struggling, and reiterate the sentiment that we must protect safety and act according to the evidence. I also acknowledge that several questions were raised on the conversion therapy ban by the noble Baroness, Lady Meyer, and the noble Earl, Lord Leicester. I can say that a draft Bill will be brought forward to deliver on our manifesto commitment and we will consult all relevant groups.

Many noble Lords, including the noble Baroness, Lady Walmsley, my noble friend Lord Brooke and the noble Earl, Lord Effingham, rightly highlighted the urgent need to tackle obesity. I can certainly assure my noble friend Lord Brooke that our Government’s approach will be very much about bringing key players around the table to make progress. We know that the NHS spends £11.5 billion every year on illnesses caused by obesity, while costing our society a staggering £74 billion. It is a particular scourge on the poorest in our society and holds back the life chances of children from deprived communities. We will bring forward restrictions on TV and online advertising of unhealthy food to children and we will ban the sale of high-caffeine energy drinks to under-16s.

This alone could bring down the number of children living with obesity by some 20,000 and I very much welcome the focus of noble Lords on ensuring we have a preventive approach to obesity. We will ensure that schools can provide a range of different sports and activities in addition to PE lessons, to help more pupils meet the Chief Medical Officer’s guidelines of 60 minutes of physical activity per day.

The gracious Speech marks the beginning of a decade of national renewal. It will break the pernicious link between background and success that has defined this country for far too long, so that the next generation can grow up in a Britain where chances in life are defined not by where you have come from but by the possibilities you can receive. The road to get there will be long and doubtless bumpy, but this is a journey on which I hope noble Lords will join us, with their expertise and insight, to improve the quality of people’s lives. In my view, the gracious Speech marks a turning point. I hope we can embrace it and bring about the change we seek.

Debate adjourned until Monday 22 July.