Health: Dementia
Baroness Thornton Excerpts(14 years, 5 months ago)
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Earl Howe
My Lords, my noble friend has raised an important issue, and one which we are giving consideration to. We recognise fully that breaks from caring are one of the top priorities for carers in terms of the sort of help they want. Supporting the physical and mental well-being of carers by giving them breaks obviously enables them to do their job more safely and effectively, and can keep families together. But where violence intrudes, it is often an intractable problem. I hope to be able to give my noble friend more details once we have given this area the thought that it deserves.
Baroness Thornton
My Lords, we are at the beginning of the second year of what is in fact a five-year dementia strategy, which is what the noble Baroness, Lady Greengross, referred to in her Question. Some £150 million was earmarked for the first two years of the strategy. Is that £150 million safe, particularly the £90 million for 2010-11, and do the Government have plans to implement the rest of the five-year strategy?
Earl Howe
My Lords, the answer to the specific question about whether the money is safe this year is yes, but we want to ensure that the strategy is sustainable over the following three years. We will do that principally by driving up quality standards through a tariff for dementia patients, by better regulation of providers and by better commissioning of services, including public health interventions. Alongside that, as I said to the noble Baroness, Lady Greengross, we plan to provide better information to people with dementia so that they have a good understanding of their local services, and local organisations will be expected to publish how they are delivering on those standards.
Queen's Speech
Baroness Thornton Excerpts(14 years, 5 months ago)
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Baroness Thornton
My Lords, I apologise to the House and to the noble Lord, Lord Hill, for listening to his maiden speech from below the Bar. I begin by offering my congratulations to the new Government and Ministers. Like my noble friend, I wish that the noble Earl, Lord Howe, had got the top job in his department. I congratulate the noble Lord, Lord Hill, welcome him to his place on the Government Front Bench and congratulate him on his outstanding maiden speech. I also extend my congratulations to the noble Baroness, Lady Northover, who is now health whip—a job that I filled happily for a year or so.
It is a rum old world: many noble Lords from both parties opposite, and on this side, will share that sentiment. I was thinking about the rumness of it all and wondering how the conversations are progressing between the Minister and his new whip with regard to tobacco regulations. About a year ago, the noble Baroness and I made common cause against the noble Earl: so we shall see where that ends up.
We have had an excellent and wide ranging debate, with four maiden speeches of great quality. In all cases, I am happy to agree with noble Lords that we can look forward to all the maidens’ future contributions of distinction to the work of this House. The noble Lord, Lord Hall of Birkenhead, is a long-standing friend whose speech made me think what a great champion he will be in discussions about the arts and heritage in this place. The right reverend Prelate the Bishop of Guildford, in his evocative descriptions of his diocese, made me realise that we need to organise a charabanc trip there. The presentation of the noble Lord, Lord Kakkar, showed that he will add greatly to the medical expertise of this House. I am also very pleased to learn that the noble Lord will join the Lord Speaker's outreach programme, of which I can modestly claim to be a veteran. It is an invigorating and humbling experience on every occasion when I go to speak to children and young people in their schools. I wish the noble Lord well and hope that he will enjoy it as much as I do.
My noble friend Lady Morgan spoke to the parts of the gracious Speech that addressed education and welfare. She was amply supplemented in her remarks by our noble friend Lord McKenzie of Luton. It remains for me to say only that I agree with every word that both of them said. I commend the contributions both of my noble friend Lady Hollis, who has given the noble Lord a brilliant pension scheme—we look forward to his comments on that—and of the noble Lord, Lord Kirkwood, who I sense will make a career of keeping his Government on their toes in these matters. It remains for me only to add a word of advice to the noble Lord, Lord Hill. The Government insist that they are about fairness, about closing the gap in achievement and about raising standards. All that they have to do to achieve this is to listen to the wise words of my noble friend Lady Morris of Yardley. Instead of relegating failing schools that need extra help and resources to the bottom of the list for attention and help, they should put them first, before outstanding schools that are doing well under present circumstances.
I turn to culture, media and sports. The gracious Address was largely silent about this important area of national activity, except for the commitment to high-speed broadband internet connections. That subject was well addressed by the noble Lord, Lord Elis-Thomas. My noble friend Lady Andrews added her voice to the championship in this House of heritage, tourism and the arts. The noble Lords, Lord Hall and Lord Macdonald, illustrated well the national benefits of the media, arts and heritage in creating wealth and jobs and in enriching the quality of life for millions of people. The arts and heritage play an important part in our economy, accounting for 10 per cent of our national economic activity. My right honourable friend Ben Bradshaw and his team—Margaret Hodge, Gerry Sutcliffe and Tessa Jowell—left this area in very good shape.
It is clear to me that this Government intend to turn the clock back in their approach to the arts. It is disappointing that—I am sorry to say this to the noble Lord, Lord Hall—the arts institutions have already had a budget cut of 3 per cent this year, despite promises from the Government during the election campaign. It is particularly disappointing that the Arts Council was singled out for a bigger cut of 4 per cent this year. As the BBC’s respected arts editor, Will Gompertz, has pointed out, this creates a precedent that could see arts institutions across the land being asked to realise assets such as bank savings and buildings to fund their activity in lieu of government grants. Responsible saving and budgeting are being punished and to date the Secretary of State has refused to rule out taking the same approach to other arts institutions, so watch out Royal Opera House. I ask the Minister when we will know about this.
While we welcome the Government’s commitment to increase philanthropy, they have gone quiet on moves to encourage philanthropy through the tax system. I am depending on the noble Lord, Lord Inglewood, to chase them on this matter. The Secretary of State has said that he intends to write to the 200 biggest philanthropic donors thanking them for their contributions. I am sure that they will be grateful and perhaps even flattered by this attention, but I suggest that the message might be seen as a little hollow when the Secretary of State’s first contribution to the nation’s great arts heritage has been to cut funding.
On the Olympic Games, the brilliant custodianship of my right honourable friend Tessa Jowell has ensured that this month’s report on progress says that the 2012 London Olympics are on time and on budget. The Government have inherited much in arts and culture; they have inherited something that was working and working well. They need to provide reassurance that the budget cuts that they have proposed will not have an impact on the London Olympic Games in 2012.
I now turn to health. The House would expect me to look at the manifestos of the partners in the coalition Government, the coalition agreement and the gracious Speech, as well as, of course, the words of the partners in the past, to see how the Government will attempt to reconcile some interesting and occasionally diametrically opposed points of view. Let us start with the name of the Department of Health. The Conservatives said:
“We will turn the Department of Health into a Department for Public Health”.
It is a small and relatively unimportant promise to break immediately, but what does it presage?
Here are some of the Conservative promises that do not appear to have survived the coalition negotiations. The Conservatives promised to scrap all central NHS targets relating to clinical processes, but now they do not seem so sure. They promised to end “pointless” reorganisations of the NHS, but now they are about to embark on a massive new NHS reorganisation. They promised to reduce the number of unaccountable quangos, but they are turning the NHS into a new quango. They promised a voluntary insurance scheme to pay for residential care, but they have dropped that. They promised to protect the disability living allowance and the attendance allowance, but they have suddenly gone very quiet on that. I know that government involves compromises—it is a lesson that the Conservatives and the Liberal Democrats are perhaps only just beginning to learn—but who would have thought that one of the benefits of coalition government was that you never needed to look at your manifesto again?
It is important to put on the public record at the start of this Parliament that Labour has left the NHS in its strongest ever position. In 1997, the discussion was about whether the NHS would survive at all; today in 2010, the NHS is substantially rebuilt and renewed. I do not apologise for repeating the figures: waiting times are at an all-time low; infection rates are right down; patient satisfaction with the NHS is at an all-time high; there are 44,000 more doctors and 89,000 more nurses; waiting lists are down by over half a million; and 3 million more operations are done per year. Also, we have seen the biggest hospital-building programme in the history of the NHS, with 118 new hospital schemes completed. As George Osborne might say, we did fix the roof while the sun was shining.
That did not happen by chance. In the teeth of opposition—from some, if not all, of the Benches opposite but particularly from the new Secretary of State—we took the decisions that have left the NHS in this position. I put the Minister on notice that we shall be watching closely the Government’s decisions and the effect that they have on the NHS. I urge the Minister’s Liberal Democrat colleagues to do the same, because they supported many of our changes and they, too, will be held to account for what happens next.
Of course, where we support the work of the Government, the noble Earl can expect my support. He and I have a history of co-operation and friendship, which, for my part, I intend to continue.
I read the new Government’s coalition agreement with great interest. I am astonished that the document seems to have been signed off by the now Secretary of State, who, in opposition, promised over and over again to,
“scrap all centrally-imposed targets relating to clinical processes”.
Perhaps one of the Secretary of State’s new officials told him that his plan to remove targets which have helped to deliver so many improvements for so many patients was “very bold, Minister”—but perhaps not.
Therefore, we await the detail, and of course we have no doubt that any detail will be presented to Parliament before it is published elsewhere. Reports have already suggested that the four-hour accident and emergency target and the 18-week referral to treatment target will be scrapped. I think that the Minister needs to come clean with this House. Are his Government going to change those standards? Are they going to keep the 18-week target? Are they going to back down or keep the two-week target for cancer and the four-hour accident and emergency target? Not only does this House need a direct answer; so, too, do millions of patients.
However, not everyone will be unhappy about the ditching of targets. The Financial Times has already reported, on 18 May, that:
“Private hospitals are expecting a rise in business if, as expected, the Conservatives go ahead with their promise to scrap Labour’s waiting-time targets”.
That choice of going private is one that many patients will remember. Before targets were in place, patients had a choice: wait in the NHS or pay and go private. It is something that we changed, and I am proud of that. I ask the Minister what mechanism the Government are going to use to ensure that waiting lists do not rise. With hospitals encouraged to make savings, what will the mechanism be to ensure that savings are not made by making people wait, as the party opposite has done in the past?
Can the Minister also tell us what will happen to NICE? What will happen to the investment that we proposed for cancer diagnosis? Just before our Government left office, we announced £200 million a year in funding for new diagnostic equipment for cancer. Can the noble Earl tell me whether that target will be met, or has this money been diverted into the Secretary of State’s cancer drugs fund? Can he tell me which is most likely to save more lives: investing in early diagnosis or investing in cancer drugs unapproved by NICE? Can he also explain what relationship the new cancer drugs fund will have with NICE?
The Government have promised that the health budget will rise but they have also promised to make savings. Can the Minister say by how much the budget will rise? In opposition, the new Secretary of State managed to do two things. He complained that deprived areas did too well out of the NHS budget at the expense of areas with less deprivation but more older people, and he called for a change in the funding formula. At the same time, he called for more of the health budget to go to deprived areas in the form of a health premium. It was impressive, to say the least, to complain that deprived areas were overfunded and underfunded at the same time, but I wonder how that feat might roll out in government. If we take the Secretary of State’s words at face value, which PCTs will gain and which will lose?
Another promise that seems to have been forgotten is the one made repeatedly by the Prime Minister, when he was leader of the Opposition, that he would have “no more pointless reorganisations” in the NHS. It now seems that the Government are planning one of the biggest reorganisations in the history of the NHS, with not only a new independent NHS board but, according to the Health Service Journal, the abolition of strategic health authorities. I am not sure that the Secretary of State is adopting the right way to deliver a reduction of costs by encouraging members of strategic health authorities to resign in protest. On that basis, it could take some time. The new Prime Minister once asked the question: are serious political issues too important to be left to unaccountable quangos? He has given his answer. The job of allocating the NHS budget is too important to be left with his Health Secretary. My noble friend Lord Morris hit the nail on the head with his analysis on this matter.
I turn to social care. Noble Lords will not be surprised to learn that I was disappointed to see that the Government have decided not to take forward free personal care at home for those with the highest needs. I am sure that I am not as disappointed as the elderly and disabled people and their families and carers who stood to benefit from the legislation. I should like to join with Carers UK in asking the noble Earl what has happened to the £420 million of funding and what is it now being used for. What about the £130 million that was earmarked for reablement and what has happened to the commitment, supported across the House, for the delivery of portability of care packages to those most seriously disabled?
I was less disappointed that the Conservative proposal to create a new private insurance system to cover the costs of residential care has been dropped. It seems to have bitten the dust. That was a policy whose sums never added up.
The Government's new proposal of a commission on long-term care is certainly better than the old Conservative policy, and we will be happy to support that commission's work. I hope the Minister took note of the job application of my noble friend Lord Warner to serve on the commission, as he is definitely very well qualified to do so. I recommend the White Paper which we launched just before the election as a blueprint that that commission might consider.
At the end of this Queen’s Speech debate, I wish to make some general remarks. I want to mention the economy because it is important to put such general remarks on the record. Our Government made the Bank of England independent and that was opposed by the Conservatives. We took tough decisions to get our national debt lower than that of France, Germany, America or Japan before this global financial crisis began. Our Government led the worldwide effort to stop global financial collapse into recession and into depression, in the face of bitter and wrong-headed opposition from the party opposite. Although the Government may now pray in aid the loyal support of the Governor of the Bank of England and the German finance ministry in advocating immediate and deflationary spending cuts to reduce the deficit faster this year, he and his Chancellor are out of step with worldwide opinion and run grave risks with our recovery, our jobs and our vital public services.
We shall be holding this new coalition to account, make no mistake about it. We shall take our responsibilities as a loyal Opposition seriously to probe, to question and to challenge and we shall use the tools at our disposal to do so. I disagree with the noble Lord, Lord Hill, when he said that he felt nothing much had changed since the last time he was in his position. Government in 2010 is not the same as the Government which the Conservative Party left in 1997. There are different terms of engagement these days. I have no fears for the noble Earl, Lord Howe, as a model of transparency and accountability, but he may need to have a quiet word with some of his fellow Ministers.
We have had four days of wonderful, illuminating and considered debate. In closing, I congratulate all noble Lords on their contributions today and on the other days of this debate, particularly the maiden speeches that we have heard from new Members of your Lordships’ House and the speeches by the maidens at both Dispatch Boxes. Your Lordships’ wisdom and eloquence bodes well for our future debates.
Health: Contaminated Blood Products
Baroness Thornton Excerpts(14 years, 5 months ago)
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Baroness Thornton
My Lords, I join my noble friend in welcoming the noble Earl to his new position and wish him all the very best. Not so long ago, during the passage of my noble friend’s Bill last November, the noble Lord, Lord Thomas of Gresford, and the noble Baroness, Lady Barker, were very keen on a full compensation package for those affected by contaminated blood products. Has this commitment been translated into the coalition Government’s policy? If so, how and in what timescale?
Earl Howe
My Lords, I thank the noble Baroness for her kind remarks. We are in a coalition Government. Not every pledge in either the Conservative or the Liberal Democrat manifesto can be honoured. That is the nature of coalitions. In fact, the specific Liberal Democrat proposal which she referred to was not included in the programme for government which we published.