My Lords, I declare my interests as a vice-president of the Local Government Association and as a vice-chair on the All-Party Group on Adult Social Care. I start by echoing the Minister’s tribute to Her Majesty the Queen and will add how good it was to see her using her Oyster card today on the new Elizabeth line.
A Queen’s Speech is obviously about legislation, the economy and finances, and the priorities of a Government. But it is also an indicator of the attitude and approach of a Government to how they are going to govern. The last five years have meant that they have had to face some extreme challenges; some of this Government’s own making—Brexit—and some external ones—Covid and Russia’s invasion of Ukraine—to which our Government have had to respond. The cost of living crisis, energy costs, food costs: millions of people are struggling to pay their bills, and with inflation currently at 7%, a 30-year high, this is likely to increase. Public services become even more critical when individuals and families are struggling, and they, too, are finding it difficult.
The Minister referred to the managed migration to universal credit, which has caused real problems for claimants. The Government’s own documents say that of the 2.6 million households still on legacy benefits,
“we estimate around 1.4 million (55%) would have a higher entitlement on UC, 300,000 would see no change and approximately 900,000 households (35%) would have a lower entitlement.”
But the poorest in our society already face impossible pressures on their costs, and for nearly 1 million households to face a lower entitlement because of a migration to a new benefit is a disgrace.
The Government say they understand the problem, but unfortunately there is no real offer of help for the people who are already having to choose between heating and eating, and who are not in a position to take on extra work, as one MP suggested yesterday, or to cook better. Instead, this Government will raise an additional £13.8 billion through personal taxes this year. That is why from the Liberal Democrat Benches we say that VAT should be reduced immediately, saving the average family £600 a year, and there should be an emergency Budget: these families need action right now.
The Social Security (Special Rules for End of Life) Bill, extending the period of terminal illness from six to 12 months to be eligible for special provisions, is also very welcome, but I hope that Ministers will also guarantee a speedy decision within a few days of notification, rather than using the extra time to delay implementation.
I am looking forward to my noble friend Lord Storey’s contribution on the Schools Bill, but I want to make a brief point on Part 3, to do with the register of children out of school. While it is absolutely vital that there is a record of where school-age children are, the Secretary of State announcing the naming and shaming of children not in school and their parents, as well as increasing the criminal penalties for parents, is very worrying, including for those parents who wish to home school.
Criminalising parents and naming and shaming children is completely inappropriate when a child, for example, has been so severely bullied that they are traumatised and waiting for a CAMHS appointment to start therapy, which currently can take 18 months to two years. It is also completely inappropriate that children who are immunocompromised, for example on chemotherapy, are currently forced to go into school without special measures and ventilation, even though their consultants say that these children cannot live with Covid. Parents of some of these children are currently being taken to court and fined.
Any register must record why a child is absent, and specialist advice, such as that of a hospital consultant, should be followed. This means alternative provision online may be needed and should be both provided and fully funded. Covid has also laid bare the inadequacies of too many school buildings, whether in terms of ventilation, appropriate space to learn in, or safety features, so we need an urgent investment in our school estate.
I have talked already about the increase in living costs, but many disabled people need much more heating than most families, and there are some who need to run life-saving equipment, such as ventilators and heart monitors, overnight. I have had family experience of this with my granddaughter. People in this particular group are very easy to help, because they are registered with their local energy supplier for emergency help in the event of a sustained power cut—so why cannot these disabled people be given grants to cover the extra costs that they face through no fault of their own?
More generally, disabled children cannot access the healthcare and other services that they have a right to. Forty-three per cent of families with disabled children have waited more than a year to get respite care, and more than four in 10 disabled children have waited more than a year for an operation.
The lack of funding available in local councils means that more parents of disabled children have had to take their local authority to tribunal to get the support they are entitled to. Lest you do not believe me, in 96% of hearings, the tribunal supports the parents. These children deserve that support, and frankly our local authorities deserve the funding that they need to deliver it.
Disabled people still face problems with transport and I am grateful to the noble Lord, Lord Borwick, who in his speech last week reminded us that when the Disability Discrimination Bill of 1995 was in Committee, the Minister said that
“taxis newly licensed must, as a condition of licence, be accessible to all disabled people, including those who use wheelchairs.”—[
In addition to that, we heard only two days ago of BBC correspondent Frank Gardner being stuck yet again on a plane because Heathrow’s disabled service had failed. There are many other problems. Nearly three decades after the Disability Discrimination Bill was passed, our taxi service can still opt out of carrying wheelchair users, and people can still just sit and wait on aeroplanes.
I turn now to working disabled people. NHS England has just reported that, even in the NHS, disabled staff are nearly twice as likely to face formal capability questions about whether they can do their job properly. NHS England is now asking trusts to look at whether they are doing that unfairly.
From these Benches, we have concerns about the Bill of Rights. We believe that it will further take away the rights of those with protected characteristics, including disabled people, who can currently rely on the positive obligations placed on public authorities by the European Convention on Human Rights. The Bill of Rights will cut those positive obligations and severely weaken people’s ability to access their rights under the convention.
Banning conversion therapy is absolutely the right thing to do. However, it is not right to exclude trans and non-binary people from the ban, thereby allowing conversion abuse to continue to take place against two groups of people with protected characteristics.
I am pleased that the mental health reform Bill is coming into the process this year. It is a very important Bill and the Minister was right to say that. People definitely need a stronger say in their treatment. However, the Royal College of Psychiatrists, the Local Government Association and many other stakeholders make the vital point that mental health reform must also include fully resourced funding for mental health services on the front line, training mental health professionals, workforce planning and community services. It is also vital that those with learning disabilities are not kept in secure accommodation. This is a scandal of which we should all be ashamed and which I hope will be ended by the Bill.
Mental health is part of a wider health crisis. This is undoubtedly partly as a result of Covid, but many of the current problems are long-standing and point to a lack of investment over the last 10 years and an unwillingness in Ministers to tackle them honestly. The NHS is undoubtedly in crisis and doing the best that it can, as it always does, while its staff is exhausted, understaffed and demoralised. The most visible points are the ambulance crisis leading to an A&E crisis, the lack of clinical staff and the cuts in capital spend, resulting in too many NHS trusts delivering services in poor buildings.
Today, a paramedic noted that her first patient of the day in her ambulance was now in a queue at the local A&E department. She commented that if today was like her last shift, she would spend the entire shift with this one patient in this one car park. This is not a one-off; it is happening all over the country every day. A&E departments are stuck because beds cannot be freed up, since patients cannot be sent from other wards into residential or nursing care—or even to their own homes—if there are no carers to look after them. The social care sector continues to see staff leaving for better paid jobs, including in the NHS, without being in a position to charge more for their services. Instead of real help, Ministers and the press continue to attack the NHS and the care sector. They attack the NHS for having too many managers, but the NHS’s 2% compares well to the German and French healthcare systems, which have more than double that figure.
From these Benches, we hoped to see more about tackling the inequalities in our health system. Whether they are based on deprivation, ethnicity or disability, we need to address the social determinants of health. Instead of cutting public health budgets, as happened to the UKHSA last month, we should be investing in food reformulation, tobacco bans and social prescribing. Until this happens, the focus will be on those already ill, rather than preventing them becoming ill.
Above all, everyone involved in the health and social care sector is looking to the Government to plan and invest in the workforce. The NHS staff survey published as recently as March found that 52% of staff said that they cannot do their jobs properly because of staff shortages. Vacancies across the NHS are now back to their pre-pandemic levels, with over 110,000 full-time-equivalent empty posts. Some 48% of advertised consultant posts are unfilled; this needs to be addressed urgently.
Finally, I ask the Minister why unpaid carers’ leave is once again not in the Queen’s Speech, despite it being a Conservative Party manifesto commitment. Over half of working carers say that they needed unpaid carers’ leave to help them juggle work and care. Despite commitments to help carers at the end of the passage of the Health and Care Bill, the Government have once again let carers down. Ministers talk of levelling up, but I fear that the Government are not listening to the evidence of how the current cost-of-living crisis and the cuts to our public services are affecting the most vulnerable in our country.