Queen’s Speech — Debate (4th Day)

Part of the debate – in the House of Lords at 10:34 pm on 14th May 2013.

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Photo of Earl Howe Earl Howe The Parliamentary Under-Secretary of State for Health 10:34 pm, 14th May 2013

My Lords, it is one of the glories of the debate on the gracious Speech that it engenders a wealth of varied and expert contributions from all quarters of the House. Correspondingly, it falls to the lot of the responding Minister to try to do justice to those contributions. Because of the large number of speakers today and the limited time available to me, I hope that noble Lords will understand if the justice that I do is of a rather rougher nature than I would ideally like, but I undertake to respond in writing to those noble Lords whose questions I have been unable to cover.

I cannot, however, omit to compliment our three maiden speakers on their contributions, which so lit up this debate—the noble Lord, Lord Berkeley of Knighton, on the economic and wider societal benefits of music and the arts; my noble friend Lord Ridley on the importance of affordable energy to economic growth; and the right reverend Prelate the Bishop of Winchester on religious education and social well-being. The right reverend Prelate has asked me to say that he has been called back to his diocese on a very urgent matter. The House listened with admiration to all three, and we look forward to their participation in our proceedings in future.

It is perhaps natural for me to begin with the Care Bill. I was grateful for the welcome accorded to the Bill by a number of speakers. As those noble Lords have highlighted, the Care Bill is essential to achieve a modern, clear and fair legal framework for care and support. There are issues which we shall doubtless debate in Committee. The noble Lord, Lord Hunt, questioned why the cap on care costs in the Bill was set at £72,000. Of course, that is the equivalent of £60,000 in 2010-11 prices, when the Dilnot commission reported. Simply, the cap is set at that level to strike a balance between protecting social care users and public affordability. The same principle will apply to national minimum eligibility criteria, which were raised by several noble Lords, including the noble Lord, Lord Northbourne, and the noble Baroness, Lady Greengross, and which will be published in draft following the announcement of the spending review settlement on 26 June.

The noble Baroness, Lady Wheeler, raise the issue of overall funding of social care. I would like to believe that she does not begrudge what we have done. We have sought to prioritise adult care and support. This year, the NHS is transferring funds of £859 million to support adult social care services, which also have a health benefit. Alongside that, we have seen examples of local authorities redesigning services to find more efficient ways of using scarce resources.

A number of noble Lords, including my noble friend Lady Jolly and the noble Lord, Lord Hunt, raised the issue of young carers. Both departments—of health and for education—are working closely with carer organisations and young carers themselves to consider how they can best be supported through legislation and other means. We do not, however, believe that the adult statute is the right place to make provision for children. The boundary between legislation for children and for adults ensures an appropriate distinction between what is expected of adults and of children.

The noble Lord, Lord Patel, raised the issue of free social care at the end of life. I hope that he will understand if I say simply at this juncture that I note that that idea has merit, as the Joint Committee on pre-legislative scrutiny concluded. The noble Lord, Lord Morris of Handsworth, and the noble Baroness, Lady Pitkeathley, both raised the Ready for Ageing? report by the Select Committee on Public Service and Demographic Change. I thank the Select Committee for its thorough report, and the Government will respond in due course.

The Care Bill also sets out critical elements of the Government’s response to the findings of Robert Francis QC, which are vital to delivering our commitment to ensuring that patients are,

“the first and foremost consideration of the system and everyone who works in it”.

In that context, the noble Lord, Lord Hunt, questioned why we are not merging Monitor and the Care Quality Commission. The answer is that those bodies have different functions. The Care Quality Commission’s need to address quality and highlight features of care should not be conflated with Monitor’s responsibility to oversee the turnaround of failing NHS providers.

The criminal offence of providing false and misleading information was also raised. Perhaps I need to make clear that it applies to all care providers. However, as the Francis report identified that distortions to mortality rates are most significant, we plan to limit the application of the offence through regulations to provision of this kind of information.

On the issue of criminal sanctions for individuals, there are already existing routes for prosecution through the Health and Safety Executive, the corporate manslaughter Act and the laws of negligence. In future, when the new Chief Inspector of Hospitals identifies criminally negligent practice, they will refer the matter to the Health and Safety Executive to consider whether prosecution is necessary.

The lack of reference to minimum alcohol pricing and standardised tobacco packaging in the Care Bill has been mentioned by a number of noble Lords, including the noble Baronesses, Lady Jones of Whitchurch and Lady Morgan of Drefelin, and the noble Lords, Lord MacKenzie of Culkein and Lord Patel. Introducing either of these measures would be very significant. We are actively looking at them both but we are determined to take the time to consider all the available evidence, rather than rushing to legislate. I look forward to further debates on the issues covered by the Care Bill with the many noble Lords who are expert in these areas.

On other health issues, my noble friend Lord Colwyn raised dental foundation training. My figures are that in this year’s recruitment, only 33 out of 1,000 applicants failed to secure dental foundation training places. We are committed to improving the process but this is a competitive process open to others including, noticeably, EU graduates. The noble Lord, Lord Turnberg, raised the issue of early identification of dementia. The

Government are introducing a new enhanced service as part of the GP contract for 2013-14, rewarding practices for early identification of dementia. My noble friend Lady Barker asked about social enterprises. The Department of Health’s Social Enterprise Investment Fund has invested almost £110 million in 650 organisations, while over 10% of community health services are now provided by social enterprises through the “right to provide” programme.

The noble Lord, Lord Patel of Bradford, spoke powerfully about mental health. We are investing over £400 million to give thousands of people, in all areas of the country, access to NICE-approved psychological therapies. The mandate to NHS England makes clear that “everyone who needs it” should have,

“timely access to evidence-based services. This will involve extending and ensuring more open access to the Improving Access to Psychological Therapies … programme, in particular for children and young people, and for those out of work”.

Finally on health, the issue of charges for migrants was raised by a number of noble Lords, including the noble Lord, Lord Hunt. Such charging was actually welcomed by the shadow Secretary of State for Health in yesterday’s debate in the other place. Our approach is simply to ensure that everyone who uses NHS services contributes. We are seeking to do that in a way that will be simple for services to be provided and will be consulting on the details in the summer.

Just as care and support needs reforming, so fundamental reform to state pensions is vital in order to have a system fit to meet future challenges. This is taken forward by the Pensions Bill. The single-tier pension will deliver simplicity, introducing a flat-rate state pension for future pensioners that is set above the basic means test to provide a clear foundation for retirement. I thank the noble Baronesses, Lady Hollis and Lady Drake, and my noble friend Lord Stoneham for their words of support for these crucial reforms. The noble Baroness, Lady Hollis, stressed the need to consider healthy life expectancy when looking at state pension age. The Pensions Bill introduces a regular review of the state pension age. The guiding principle of that review will be that individuals should spend a given proportion of their lives drawing a state pension but other factors are important. An independently-led body will consider and report on other relevant factors, which could include variations in healthy life expectancy and regional variations in life expectancy.

My noble friend Lord Stoneham remarked on the difficulty of the ending of contracting-out for defined benefit schemes as a consequence of these reforms. The Government recognise that this is the case; that is why the Pensions Bill contains a statutory override to help employers make any necessary changes. The noble Baroness, Lady Drake, spoke of the importance of the single-tier pension in a world where employees will be automatically enrolled into workplace pension schemes. She mentioned the importance of the single-tier pension retaining its value relative to earnings. The Pensions Bill includes provisions which mean that the single-tier pension will be annually uprated by at least earnings.

I shall turn briefly to the water Bill. The water industry has come a long way since privatisation, using private sector investment to deliver major improvements in infrastructure and the environment, but we are now facing unprecedented pressures on our water resources as a result of growing population and changing weather patterns. Doing nothing is not an option. The noble Lord, Lord Hunt, suggested that the water Bill fails to deal with public affordability. However, the Bill will increase resilience, efficiency and innovation in the water sector, which will keep customer bills affordable. My noble friend Lord Redesdale raised sustainability. Ofwat has had a statutory duty to contribute to the achievement of sustainable development since 2003. We are supplementing this by introducing a new primary duty to secure the long-term resilience of our water services.

On issues around culture and media, I agree with my noble friend Lord Clement-Jones regarding the importance of creative industries and the contribution of arts and culture to our society. The noble Lord, Lord Berkeley of Knighton, talked of the excellent returns of investment in the arts. The Government are committed to the creative industries as a vital part of our strategy for growth.

I shall conclude with remarks on two Bills carried over from the previous Session. The Children and Families Bill will transform the system for children and young people with special educational needs, reduce delay in the adoption system and reform childcare to ensure the system focuses on providing safe, high-quality care and early education for children. A number of noble Lords, including my noble friends Lady Barker, Lady Jolly and Lord McCall and the noble Baroness, Lady Massey, raised issues which demonstrate their real expertise in this area. The noble Earl, Lord Listowel, my noble friends Lord Storey and Lady Walmsley and other noble Lords raised the important issue of childcare. We strongly agree that we need to do more to encourage high-quality, better paid professionals in the sector. Our proposals will help to attract more talented people into the profession by making it easier for providers to pay better wages. I hope I can offer some reassurance. The Government’s proposed new ratios bring us into line with practice in countries such as France and the Netherlands, both of which operate with less restrictive ratios combined with better qualified and better paid professionals. We want to give providers in this country these same freedoms to improve the quality of staff. The new ratios will be available only to those providers who employ highly qualified staff. We have consulted on the qualification thresholds and are considering the responses. We will be publishing the response soon.

As the noble Lord, Lord Puttnam, so rightly said, nothing has more impact on children’s achievement than the quality of teaching they receive. My right honourable friend the Secretary of State for Education is raising the bar for new teachers, supporting existing teachers to improve and creating teaching schools which model and share outstanding practice. In response to the noble Lord, Lord Griffiths, I must stress that our ambitions and these critical improvements are for all children and all schools. The steady stream of applications to set up new free schools demonstrates the continuing demand from parents for a greater choice of schools within their communities. The success of the academies programme is something for which the Government do not apologise. We make no apology for our investment in a programme which is proven to drive up standards and make long-term school improvements. We want as many as possible to take advantage of the significant benefits that academy status brings.

The noble Baroness, Lady Billingham, and the noble Lord, Lord Hunt, spoke of the importance of the Olympic legacy in schools. We entirely agree that we must harness the sporting spirit of 2012 for all our young people. That is why the Department for Education is providing £150 million per year and reintroducing competitive sport into the heart of the curriculum. By doing that, we can achieve an Olympic legacy in our schools of which we can be proud.

A number of noble Lords spoke about the review of the national curriculum. The noble Lord, Lord Northbourne, and the noble Baroness, Lady Massey, are concerned that the breadth of education is important. The right reverend Prelate the Bishop of Winchester raised the importance of religious education in schools, my noble friend Lady Miller asked about the teaching of nutrition and my noble friend Lady Benjamin highlighted the importance of Shakespeare. The aim of the curriculum review is to enable a focus on the essential subject knowledge that all young people should acquire to be educated citizens while freeing up teachers to use their professional judgment about what to teach beyond that core and how to teach in a way that will inspire and challenge their pupils.

Finally, the Energy Bill seeks to reform the electricity market by ensuring security of supply, reducing our emissions by transition to low-carbon generation and doing all of this at the lowest cost to the consumer. I am grateful for the contributions of many noble Lords more expert than me in this area, including my noble friend Lord Jenkin of Roding. The noble Lord, Lord Oxburgh, and my noble friend Lord Crickhowell raised the slow progress of energy reforms. These reforms are complex and it takes time to work through them with stakeholders. Therefore I hope that the Energy Bill will progress quickly through your Lordships’ House.

The issue of shale gas was raised by a number of noble Lords, including my noble friend Lord Ridley. The Government have set up the Office for Unconventional Gas and Oil. In the Budget, the Chancellor announced plans to incentivise shale gas development in the UK.

The noble Lord, Lord Donoughue, questioned the scientific orthodoxy on climate change. The Government are committed to implementing the Climate Change Act 2008. This commits us to reducing greenhouse gas emissions by 80% by 2050. It also sets the long-term framework for planning about which my noble friend Lord Redesdale is rightly concerned.

It is a pity that I do not have time to respond to many of today’s excellent contributions, including those of my noble friend Lord Bridgeman, the noble Lord, Lord MacKenzie, on nursing, the noble Lord, Lord Touhig, on autism, the noble Lord, Lord Noon, on higher education, and the noble Lord, Lord Best, and my noble friend Lord Kirkwood on housing. I could name many more. However, in such a relatively short speech, it is challenging to do justice to a debate of this diversity and length. As I mentioned, where possible I will write in response to other questions that were put today. I look forward to future debates on all the measures announced in the gracious Speech and I commend the programme to the House.

The debate adjourned until Wednesday 15 May.