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Local democratic accountability is different from patient and public involvement. I was slightly confused when the Secretary of State intimated that the Department was seeking legislative time to legislate on patient and public involvement. Do I infer from that that she has not been successful in getting that time? I would be grateful for clarification. From the fact that
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such a measure was not mentioned in the Queen’s Speech, may I infer that she failed to get legislative time? Does she hope to get it, but is not sure of doing so?

It is indicative of the importance that the Government attach to patient and public involvement that they abolished first the community health councils, and then the newly created patient and public involvement forums—a putative new scheme, but the Government cannot even find time for the legislation that might put it in place. There has been a complete failure of local democratic accountability, and a failure to find parliamentary time for patient and public involvement, and the reason is that the Government think that they know best. They have decided what they want done with the health service, but the public have an inconvenient way of saying something different. That is the problem, and that is why we need greater democratic accountability.

Another area in which we would like to change the direction of travel is health and social care; we want those two services to work together much more closely. The Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), who has responsibility for social care, today made a statement headed “Dignity in Care”, which says that there is to be extra money for care homes next year, which is obviously welcome. The money will “further the dignity agenda”, and there will be “dignity tests” and “champions of dignity”. Who could be against any of that? However, the reality is that, in social services departments across the land, people’s serious home-care needs are not being met, because local authorities are up against it and have to restrict the availability of social care. The Secretary of State, in her “It’s nothing to do with me, guv,” mode, would say, “Well, that’s down to councils.” Does she accept any responsibility for the fact that growing numbers of elderly and frail people cannot get the care that they need? That is clearly happening, and the restriction is getting tighter.

Sarah Teather: Does my hon. Friend agree that part of the problem is that, in an effort to make cost savings, many primary care trusts are shunting their debts on to councils? They are renegotiating the partnership arrangements between health and social care, and are telling councils, “Well, we can’t meet our budgets, so you can have my debt.”

Steve Webb: My hon. Friend is absolutely right, and that is another reason why budget pooling, and greater co-ordination between health and social care, would mean that money was not shunted from one pot to another, and people were not shunted from one part of the system to another. Instead, the system would be seen as an integrated whole, and the service would be delivered in the way that was best for the individual, not in a way that enabled one organisation to balance its books at the expense of another, as that is not the way to run services. That has to be the direction of travel.

Two pieces of health legislation were mentioned in the Queen’s Speech. One was the draft legislation on embryology. I assume that the Secretary of State for
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Education and Skills will respond to the debate, and it is only fair to forewarn him that I have a question for him about sperm donation. I do not know whether that is a specialist subject of his, but there is a serious issue to discuss. The legislation on the anonymity of sperm donors is causing real problems. I visited—in a professional capacity—the infertility services department at one of my local hospitals, and constituents have come to see me about the issue.

Although I fully understand the thinking behind removing anonymity, it has had serious, practical results. The supply of donated sperm has fallen substantially, because now that they can be named, donors realise that, as each donation can serve 10 families, each of which can have two children, one donation of sperm can generate a maximum of 20 children and, in principle, all 20 could turn up on the donor’s doorstep in 18 years’ time and say, “Hello, dad.” It is hardly surprising that in those circumstances, the supply of donated sperm has fallen.

A further problem resulting from the loss of donor anonymity is that we do not know whether the child born was created by the donated sperm. If the mother continued to have other partners, perhaps including a spouse or regular partner, we could not always be sure that the donor was the father. It is not yet clear how the Government will ensure—

Judy Mallaber: DNA tests?

Steve Webb: Well, DNA has been mentioned, but such tests are not carried out. What reassurances does a donor have that the people who turn up on the doorstep in 18 years’ time and say, “Hello, dad” are actually his children? What will be the consequences? The theory behind getting rid of anonymity is that children have a right to know who their parents are, but the reality is that people are buying sperm off the internet, or are going abroad to get donated sperm, and in those circumstances they have no idea who the donors are.

I understand that there is a good flow of trade from Bristol International airport to Barcelona, where there are clinics with good, English-speaking nurses, and where there is a ready supply of sperm. In other words, to get around the problems in this country, people simply go abroad. Generally—but not in that particular case—there are issues about the quality of donated sperm, too. I have repeatedly written on the subject to the Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint), who has responsibility for public health, but she simply tells me that there is no problem, and that there should just be more effort made on recruitment. There is a serious problem, and I hope that the Government will take it seriously and will think again about the consequences of legislation that was well-meaning, but that is causing practical problems.

I want to make a final remark about the provisions in the Queen’s Speech for a mental health Bill. We have already heard about the history of an earlier mental health Bill, and how it went through various consultation phases and drafts, and was trashed by a Joint Committee of both Houses. The proposed mental health Bill is classic new Labour, because the Government neglect prevention and then legislate in an
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authoritarian way. Across the country, mental health services are being cut back, because they are always the easiest thing to cut. Everywhere I go, when hospitals and local primary care services are struggling, I hear of mental health services being cut.

On one level, we are struggling to provide support for people with mental health problems—day centres are closing, and services and access are being reduced—yet we are to have a Bill that really ought to be brought forward by the Home Office, because it is essentially criminal justice legislation. It does not offer real entitlement to treatment. It is all about detaining people, and it is almost a response to tabloid scare stories. When there are isolated problems, the Government’s reaction is to legislate. Unless the Bill looks very different to the draft forms that we have seen, my colleagues in the other place and I will have great difficulty supporting it.

The Queen’s Speech had relatively little legislation on health, but that legislation gives us serious cause for concern. We do not need masses of reform; we need a period of stability. The health service needs to know its long-term direction of travel. That direction of travel should not be about the independence of public scrutiny, but real, local, democratic accountability in the NHS. It should be about integrated services that serve the whole person, and those services should have that person at their centre, and not the financial crisis in the NHS.

1.7 pm

Helen Jones (Warrington, North) (Lab): I am pleased to contribute to this debate on the Queen’s Speech, which continues much of the work that the Government have already begun, and which addresses critical problems that we must face, such as climate change, organised crime and the security of our people. A number of my remarks will be about security, because despite our economic successes, we all know that there is a feeling of insecurity in society. One of the great paradoxes of our time is that although prosperity has risen, and although many people have more material goods than was imaginable just a couple of generations ago, they still feel under threat. That threat may be real, as the terrorist threat is, or it may be a matter of perception. Those kids at the end of the street may be up to no good, but they may just be hanging around with their mates.

The difficulty for us politicians is that it is often hard to get people to believe in the real threats, such as the terrorist threat that everyone in the House knows exists. Sometimes people may sincerely feel, even in a safe and secure community, that they are not safe in their own homes. Much of the legislation in the Queen’s Speech aims to deal with external threats, such as organised crime, antisocial behaviour and so on, but I want to consider some of the other reasons why people may feel insecure, and how we can deal with them. Although that insecurity often manifests itself expressly in a fear of crime, the roots of people’s insecurity go much deeper. They relate to the profound changes that society has undergone.

The world that my parents knew has vanished, and even the world in which I grew up has gone. It was a world where we knew our neighbours, and we often
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went to school with people we had known since we were born. We might even work with them later, or at least live close to them. When I was growing up, my family did not consist of just my parents and me; my grandparents, aunties and cousins all lived around us. My family, like many others, is scattered around the country, and the sense of security that derived from having one’s extended family nearby has gone. People often have to work irregular hours to cope with the demands of a 24/7 society. Having grown up in a household where my father worked shifts, however, I know that some people have always had to put up with that.

People no longer start a job and expect to do it until they retire—they will change jobs several times. Many communities have altered beyond recognition. That has given us a much wider outlook on the world and enriched our lives, but it has challenged us to learn to live together. It is no use politicians lamenting those changes—they have taken place, and we have to cope with them. The question for us is how we build a society that is sufficiently secure in its beliefs and confident of its values to be able to cope with change and regard it as an opportunity, not a threat. An insecure society, like people who feel insecure, cannot cope with change. Security has an economic foundation, and the Government have achieved a great deal in that regard. In 1997, families in some parts of my constituency were suffering from third-generation unemployment. Children were growing up not knowing what it was like for someone in the family to go out to work. Now, however, the number of people in employment is greater than the proportion in Beveridge’s definition of full employment, and we expect another 12,000 jobs to be generated once the biggest industrial development in the region comes on stream. However, people not only need to believe that they are doing well now to feel secure but that they will continue to do so in future. Many people who are in work grew up in a period of recession, and they worry about what will happen to their jobs in future. Some people who are in work suffer as a result of low skills and, certainly in my area, low-paid employment.

The challenge for us is to assure people that if they lose their job and they have to change work in future they can reskill or improve their skills to move on, so I am glad that the Gracious Speech makes provision for a further education Bill. The Government are the first in a long time to take further education seriously, but may I point out to the Secretary of State for Education and Skills that many of our efforts, for understandable reasons, have been directed at young people? We must think about adults, too, because over the next 20 years, the economy will need an estimated 2 million more workers, only a quarter of whom will be school leavers. The needs of the economy and the individual for security and upskilling must mesh if we are to achieve a greater emphasis on adult skills.

The Government have done a great deal in that regard, as there are 670,000 more people in FE than there were in 1997. The employer training pilots have given 18,000 people an opportunity to raise their skill levels, but we must do more. We must concentrate on people who are hard to reach and do not have many skills. In doing so, we should learn from what has been successful. Adult and community education are
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extremely good in bringing back into the system people who have had bad educational experiences in the past; so, too, is the trade union learning reps scheme, which is one of the Government’s great unsung successes. We must learn from that success, and pay attention to a sector that enables people to learn things that may not be directly relevant to their employment. The question for us is how we build on that engagement with the education system so that they can move on. We must remember, however, that without that system, those people would never go through the door of a college. We must work with them where they are.

Another problem is to upskill our existing work force. I hope that the Government will look carefully at the pilots in the north-west and the midlands to allow people to achieve level 3 skills in work. As the number of unskilled jobs declines, we will require the work force to have a much higher level of skill, so people’s future economic security will depend on such skills. Economic security is not an end in itself—it is a means to an end. Unless we enable people to use that economic security to build good lives for themselves in decent, stable communities, we will fail. As politicians, we face two problems. First, how do we reconcile the needs of the community with growing individualism in society? Secondly, on a related point, how do we build and promote a system of values by which we can all abide?

Politicians are very good at talking about individuals. We all fight election campaigns on the platform, “What we can do for you and what will happen to you in future”. Life, however, is more complicated. The rise of individualism has many benefits, because it allows people to live as they wish and to defy convention, but we need to find a language to talk about the meshing of the individual and the community. Our lives do not proceed along parallel lines—it is not a question of me and everyone else—as our paths cross or merge for a time. Unless I as an individual or anyone else live in a secure community, my life will not be as secure, safe and prosperous as it could be. It used to be easy to explain such things when there were many big institutions, but those institutions have declined, so we must find a new language to talk to people about the things that we need to do for the benefit of all.

The Government have made several efforts in that direction, but I want to touch on a few issues that need to be addressed if people are to feel secure. First, in the inner cities and areas such as mine where house prices are much higher than in surrounding areas, it is difficult for young people to get a foot on the housing ladder. There is not enough rented accommodation, and the available housing is often of poor quality. I admit that we are schizophrenic about that—we all want our children to have access to good, affordable housing, but we do not want it to be built near us. We must address that problem, because many families fear that their children will not be able to do as well as they did, and they will not get their foot on the ladder because of housing problems. I commend the Government on encouraging more forms of home ownership and on their investment to bring housing up to a decent standard. However, those new forms of home ownership must be spread more widely if we are to tackle the problem.

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We must look carefully at the provision of affordable housing. Quite simply, developers often wriggle out of their obligation to provide affordable housing on developments, but they should not be allowed to do so. We must consider, too, the development of housing tenure, as it has split communities. I grew up on a council estate with mixed communities, but that is no longer the case in many areas, where social housing has become the preserve of the old and the poor. That is a recipe for problems further down the line. We need many more mixed developments of houses for sale and for rent, whether through social landlords, housing associations, private developers or, dare I tell Ministers, local authorities.

A local government Bill was announced in the Queen’s Speech, but it is not simply by changing the structure of local authorities that we will reinvigorate local government. What matters is what they are able to do. When I grew up, the local authority built housing for sale, as well as for rent, and built it where I lived. There is no reason why local authorities should not do that in future.

Mr. Stephen O'Brien (Eddisbury) (Con): That was Chester.

Helen Jones: Indeed. We must stop weighting the system against action by local authorities. If there is to be real local democracy, we must accept that sometimes people make decisions that we may not want. With regard to housing, in many cases people want to stay with the local authority rather than transfer to other registered social landlords or arm’s length organisations.

Another issue that we need to face is the environment in which many people live. We talk a lot about the environment in general terms, but what people see is what is outside their front door every day. Although the Government have done a great deal through the single regeneration budget, there are still areas, particularly in authorities like mine, where not enough effort has been put into improving the general environment in which people live. Authorities like mine, which include very prosperous areas and very deprived areas, do not come high on the scale of deprivation when they are measured overall. We need to get much more realistic and much cleverer about how we target funding for these matters.

Environmental problems—litter, graffiti and vandalism—need to be improved quickly, because they take an area downhill. Although the Government have done much to enact legislation to allow such problems to be sorted out, it is often not enforced locally. That is what we need to focus on—not just on environmental factors, but on antisocial behaviour in general.

I fully support the Government’s agenda on antisocial behaviour. I support it because I am sick of decent, hard-working people having their lives made a misery by a minority around them. I am sick of seeing people in my surgery who cannot get action on it. I am sick of passing legislation in the House which is not being used. I have seen examples of people who have waited two years to get anything done about their antisocial neighbours. I have seen people who have filled in nuisance neighbour diaries, which have been lost. I have seen people who had monitoring equipment installed, which failed.

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When I addressed a conference organised by Golden Gates Housing the other week, those were the issues that I raised. I urge the Government not merely to get tough on antisocial behaviour, but to get tough on those who refuse to act on antisocial behaviour. My constituents are fed up with people having tea and biccies and discussing the respect agenda. What they want is the people who make their lives a misery to be removed from their estates. They would like their lives back. So let us send in the respect squad if we must, but let us penalise local authorities or registered social landlords which do not act, because my constituents cannot wait any longer for them to act.

As well as dealing with the negatives in our society, we need to encourage the positives. We need to be clear about the values that we stand for. That does not mean resorting to nostalgia or bringing back jingoism. There are values clearly rooted in our history which we all ought to abide by—respect for the rule of law and for democracy, fairness and tolerance. In some parts of the country, though not, perhaps, all, there is a built-in respect for the value of learning.

Many politicians have made a mistake in the past by believing that those values were somehow the preserve of the few. They are entrenched in the sort of community that I come from. When Lancashire and Cheshire women in the mills fought for the vote, for instance, and—a story that has long been forgotten—when the cotton workers welcomed Gandhi, what were they doing but expressing their belief in the values of fairness and democracy? When the Welsh miners, who are my ancestors on my father’s side, put aside pennies from their meagre wages to fund libraries, what were they doing but expressing a belief in the value of learning? Those are the values that we must pass on to our young people. We do it in the home, but we must also be clear about doing it through education.

The Government have made huge advances in education, but if I have one comment to make, it is this: we should not talk about education only in economic terms. Of course, a good education system must equip people to earn their own living. If it does not do that, it has failed, but it has to do much more than that. It must equip our young people to behave, to learn, to live in a society that encapsulates respect for those values. There are things that money cannot buy, such as respect for other people, a commitment to the service of others, the ability to discuss the great issues of the day, the ability to use leisure.

Mr. Nick Gibb (Bognor Regis and Littlehampton) (Con): The hon. Lady is making a wonderful speech, to which I, like other hon. Members, am listening with great interest. Why does she think we have lost the value of education in too many communities over the past 40 years? What does she see as the fundamental cause of that?

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