Wednesday 12th May 2021

(2 years, 10 months ago)

Lords Chamber
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Baroness Thornton Portrait Baroness Thornton (Lab)
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It is our first day discussing the gracious Speech and we have had almost 90 speakers, so the first thing I need to say is “good luck” to the Minister responding to the outstanding contributions and pertinent questions that have been put to him.

I welcome the two maiden speakers. As I expected, my noble friend Lady Blake drew on her huge experience. We are confident that my noble friend will be a huge asset to our Benches and to the House. I am sure that the noble Lord, Lord Lebedev, speaking from the Cross Benches, will gain much from joining the distinguished ranks of outstanding expertise and independence of party alignment that he will find there. I am sure that we will also miss the right reverend Prelate the Bishop of Portsmouth, whose forthright and—if I might say—sometimes progressive views have been greatly appreciated in your Lordships’ House. I wish him all the very best in his retirement.

I am grateful to my noble friend Lord Watson and other noble Lords—my noble friends Lord Winston, Lord Bassam, Lord Monks, Lady Morris, Lady Blower and Lady Massey—for their high-quality and comprehensive questioning of the Government’s education and training proposals, apprenticeship schemes and the lack of an employment Bill in the Queen’s Speech.

I realise that lumping together the economy, business, health and education in this debate is the Government’s idea of playing to their theme of levelling up, mentioned by many noble Lords. The problem is that the levelling-up agenda seems to be faltering and to be inconsistent; it is jargon without substance. Will it really tackle the inequalities of our country—the inequalities of race, poverty, distribution of wealth, and gender—and the sorts of problems that my noble friend Lady Lawrence outlined? Is it the case that Downing Street briefings suggest that financial constraints mean that it will be impossible to deliver?

Indeed, there is no doubt that this crisis has pulled back the curtain on the Conservatives’ insecure economy. It did not create opportunities for people across the country and left us badly exposed to the virus. We have had one of the worst death tolls in Europe and, while Covid has closed much of our economy, as my noble friend said, the Conservative Government have crashed it. This has been recognised by the OBR, which believes that a short-term initial recovery will quickly revert to the sluggish GDP growth of recent years, with an unemployment level that might reach 6.5%.

I was confident when I saw that my noble friends Lord Davies, Lord Eatwell, Lord Haskel, Lord Triesman and Lord Hain were all speaking today that they would be putting the important questions to the Minister. They certainly have, by saying that the only way to get the public finances back on to a firm footing is to secure the economy and get Britain on the road to recovery. I think my noble friend Lord Eatwell summarised in five minutes what the Government need to do.

Does the Minister agree that transforming social care must be treated as an economic priority, because the sector is as much a part of the economic infrastructure as roads and railways? The Labour Party recognises this, as does the US President, Joe Biden, who has included an investment in home care as part of his post-pandemic infrastructure plan. Will the Government do the same?

The Government’s sticking-plaster approach to supporting businesses has left firms hanging by a thread. Will the Government stand by their commitment to do “whatever it takes” to help businesses and workers through this next phase and recovery? Part of doing so involves the contents of the public procurement reform Bill: reforms to public procurement to help SMEs get better access to government procurement, which is absolutely right. Can the Minister guarantee that social enterprises, mutuals and co-operatives will not be excluded from this legislation and that due regard to social value regimes will be there?

I will pick up on a point made by my noble friend Lord Haskel about free ports. It appears that the Government have made a catastrophic blunder by signing trade agreements with 23 countries which include clauses that prohibit manufacturers in free-port zones from securing these perceived benefits. Is this indeed the case? What are the Government going to do about it?

I turn to health and social care—on International Nurses Day. I have, at least once a week while your Lordships’ House has been sitting in the last year, praised and thanked our NHS for getting us through the last 14 to 16 months of the pandemic. To our scientists, the volunteers, the auxiliary staff, the porters and those who have delivered the vaccine, we have all registered our thanks. This has been the public sector delivering what we needed it to deliver, in sharp contrast to the appalling waste of public money in the early days of track and trace. I welcome the Prime Minister’s commitment to a public inquiry into Covid.

The test of whether this Queen’s Speech genuinely delivers for the people of Britain is whether it brings forward a proper rescue plan for the NHS and delivers a social care solution, as the Prime Minister promised on the steps of 10 Downing Street almost two years ago. What is the timetable?

I was very dispirited reading the blurb the Government published alongside the gracious Speech, which says:

“The Bill will include provisions to allow us to get much better data and evidence about the care that is delivered locally.”


What nonsense! What evidence? What more evidence do we need that social care needs to be reformed? It sounds like kicking it into the long grass again.

Can the Minister confirm that we will see a draft mental health Bill very soon and it will go into pre-legislative scrutiny? Perhaps he could tell us what the timetable for that will be.

There are so many neglected areas in our health system—for example, dentistry. Millions of people have struggled to access NHS dentistry as the pandemic hit. Will the proposed reforms ensure that both primary and secondary care dentistry will be protected?

Public health, where we need a focus on tackling health inequalities, has been alluded to, but, with the creation of a new body in the middle of the pandemic and the previous 10 years of funding starvation and neglect of what were very effective public health services, can the Minister confirm how much the Government intend to invest to support public health services in the UK? How will they be integrated into the new proposals for health and social care?

Ten years ago, many of us attempted to persuade the Government that the then Health and Social Care Bill—the Lansley Bill—was a bad idea. I was very pleased to see that the noble Lord, Lord Owen, was in his place today, because he joined us in trying to persuade the Government to change their mind on that Bill. Well, we told you so. The promised NHS Bill has at its core the reversal of key aspects of the Lansley Act. The cost, both monetary and in terms of wasted opportunity, runs to many billions. The NHS must not repeat this waste—so why a Bill now? The noble and gallant Lord, Lord Stirrup, and my noble friend Lady Donaghy said it. Why is the NHS Bill being presented when recovery from the pandemic must have priority? It is far more important that the NHS recovers from Covid, that there is a solution to social care, that we invest in mental health, that we repair the destructive break-up of public health and that we have a sensible long-term workforce plan—to name just five priorities that must be ahead of reorganising the NHS. However, we can agree that competition for care services does not work and has not worked in the interests of patients, staff and often even the providers of care—so good riddance to that.

As my noble friend Lord Hunt said, there are some serious challenges in the White Paper proposals, with a complexity and multiplicity of bodies involved in planning and commissioning. Almost nothing is said about the vital role of patients, carers, families, voluntary organisations and communities in shaping how services are provided. This is a major weakness.

We can all agree that integrated care is better than disintegrated care, but structures alone do not produce integrated care. A culture change, robust accountability and strong governance—these will be what we examine when the Bill reaches your Lordships’ House. We will be strong in our scrutiny of how the new provider selection regime is set out in statute and guidance. It must eliminate pointless competition while not making crony contracts and outsourcing easier.

The new regime must bring total transparency, with no commercial confidentiality nonsense. The cost of doing business with the NHS should be to be a decent employer and a taxpaying and honest organisation. My noble friend Lady Bakewell flagged up in her speech the dangers we face here.

I look forward to the Minister’s response, but I ask that his noble friend the noble Lord, Lord Bethell, might address some of the questions he might not be able to.