My Lords, I declare my interests listed in the register. I, too, congratulate the noble Lords who have made such wonderful maiden speeches today.
The noble Lord, Lord Griffiths of Burry Port, in welcoming a maiden speech, resorted to talking about music. I will, too, because Queen’s Speeches, which are debated over several days, with different subjects weaving in and out, always bring to mind Eric Morecambe’s great sketch with André Previn and the moment where he squares up to him and says, “I am playing the right notes but not necessarily in the right order”. That is quite often how these Queen’s Speech debates appear to me.
In times of social hardship and economic uncertainty there are two common political reactions. The first is retrenchment, a harkening back to a previous golden age when things were much more certain. Quite often it involves the scapegoating of minorities and different people. It is a populist strategy but very divisive. The second reaction, which is much more difficult, is to maintain an inclusive world view and to use it to build social cohesion and find new solutions to problems. It is much more difficult but it is what responsible politicians should do.
The gracious Speech should be judged against those criteria and the extent to which they are fulfilled. In his speech last Thursday, the right reverend Prelate the Bishop of Exeter spoke movingly about the extent to which the Church, the Government and the voluntary sector have a duty to strengthen people’s sense of community, place and identity during times of uncertainty. He is absolutely right.
I always end up speaking on this day during the Queen’s Speech debate and I always think about it as being stuck in the big spending departments. However, today we need to take a radically different approach. I have spent some time reading a number of works by futurologists who have been looking at the future of work. The other week I came across some interesting arguments by two futurologists, Pearson and Maloney, who said:
“As computers get more intelligent, the work that will take over will require human skills like leadership, motivation and compassion”.
As machines manufacture things much more easily, the future of work will change. The important work in the future will be the work that cannot be done by computers. In their list of future jobs they have some interesting examples: vertical farmers; climate controllers, who manage and modify weather patterns; and nano-medics, who create small implants for health monitoring. Also in their list are home carers, who help care for elderly people in their homes.
The future of social care as a stimulant to employment is extremely important and is a different way of looking at the issue. We need to think radically about the future of communities. There are many communities in this country where, now and in the future, health and social care will be the main form of employment. I ask the Minister: does the commitment the Government made in July 2010 to extend social enterprise within health remain, and what progress has been made on it? In some communities, by using legislation such as the social value Act, the extent to which we can create employment around care will be important.
As to the Care Bill, I listened to the speech of the noble Lord, Lord Hunt, with some depression. We have come so far together and got so near to building a consensus around what we think should be the future architecture for social care in this country. We now have a Bill that addresses problems that have been outstanding and addressed in every debate on the Queen’s Speech in which I have taken part in this place since 1999. I agree with him that the questions of eligibility and resources are critical. We will never have enough resources to address all the needs that there are but we can, by using this Bill, move a long way towards removing a number of the structural problems that have bedevilled the integration of health and social care for all our lifetimes. It is important that we do that in future to provide services of an acceptable quality and to cut down on some of the inefficiencies, which we know are costly. We must have a social care system that can integrate more easily with health and housing. I hope that the noble Lord and the Opposition will stay with the process of seeing the Care Bill through—at least until the point when we debate eligibility, which I understand is due to be in late June. I think that a lot of people who are involved with voluntary organisations, and among the general public, would not appreciate it if the Opposition were to give up on this process now.
I want to address one more health matter and talk briefly about the immigration Bill. I do not know on what basis the Ministry of Justice put together this legislation but I hope it has looked at the evidence of Médecins sans Frontières, which runs a project in London and produced a report in 2008. The organisation sees people from all over the world and noted that their needs are broadly reflective of the conditions seen among the general public. Less than a third required prescriptions. Indeed, the majority just needed help to access primary care or, rather worryingly, antenatal care. They were not turning up in this country asking for expensive surgical procedures to be done for free on the NHS. When we look at this issue, by all means let us ensure that the NHS is not being taken for granted by people who should not be accessing it, but let us not deny healthcare to pregnant women, those who have survived torture, or those who may have communicable diseases. Frankly, that is inhumane and presents a threat to our public health system. We would not be doing our fellow citizens a favour if we were to do that.
We might also look at the work being done at West Middlesex University Hospital, which is close to Heathrow Airport. It has adopted a policy of stabilising people who turn up in A&E and then talking to them quickly about what the cost of their care is likely to be. It has managed to reduce radically the number of people who do not pay for their health services. Let us look at whether the legislation is necessary.
Unfortunately, I will not be taking part in the Children and Families Bill because I have the privilege to lead from these Benches on the Marriage (Same Sex Couples) Bill, so I shall be rather busy doing that. However, if I were taking part, I would want to address a question that the noble Earl, Lord Howe, and I thought about during consideration of the Adoption and Children Bill and the Human Fertilisation and Embryology Bill: the fact that our birth registration system is becoming increasingly out of date in a world in which families are very different and digital technology is bringing about change. It is not a subject that I can go into at any great length, but I hope to return to it at some point later in the year.
These are tough times. We need to strengthen communities, and we will do that only by looking forward in a radical way, not by looking into the past.