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I have received powerful representations
that in the last months of pregnancy, when nutrition is most important
and in the first weeks after birth, the extra costs borne by parents could be better recognised if we did more to help through our universal benefitchild benefit[ Official Report, 6 December 2006; Vol. 454, c. 308.]
The Treasury has repeatedly refused to make those powerful representations available; it has been asked, but repeatedly refuses to do so. I have asked, but I have had no response, despite a raft of parliamentary questions perfectly properly asking for the evidence that the Prime Minister has specifically and explicitly relied on. Both the Treasury and the Department of Health have failed to provide any evidence that nutrition is most important at those times.
During the oral evidence sitting, as I am sure the Minister and my hon. Friend the Member for Tiverton and Honiton (Angela Browning) will remember, the Minister admitted, in contradiction to what the Prime Minister said, that the evidence suggested that the nutritional benefits specifically to the unborn child were more important earlier in the pregnancy. We agree with the Minister about that.
Angela Browning: Does my hon. Friend recall, as I do, that it was openly acknowledged in Committee that the money may not go on food and nutrition, even in the latter stages of pregnancy. It was suggested that the money could be used to pay off debts or buy other household items, so there is no guarantee at all that this money will benefit the unborn child.
Mr. O'Brien: I am again grateful to my hon. Friend, whose memory serves her well. I recognise, Mr. Deputy Speaker, that I must remain in order in speaking to amendments Nos. 48 and 49, but it is vital to try to find the basis on which this approach and the relevant amendments have been brought before the House, to explain where we are today. I recall what I thought was a rather inelegant parallel when it was said in Committee that Australia had had a similar scheme, which had perhaps rather unfairly been called the plasma payment. It was being paid in the later stages of pregnancy, and rather than being spent on food and nutrition or vitamin supplements, it was used to buy wide-screen TVs. That was a most inappropriate use of something which was introduced for the ends that the Prime Minister is seeking to achieve. It was referred to when we were trying to understand the purpose of the health in pregnancy grant.
Kelvin Hopkins (Luton, North) (Lab):
I cannot accept that giving additional money to expectant mothers will simply be wasted. A high proportion of them will be
caring people who want the best for their imminent child, and they will do their best to provide the right nutrients for themselves. Undoubtedly some people will be in debt, but for most mothers, additional money will inevitably spill over into a diet that is a bit better. The hon. Gentleman is rightly saying that there should be a much more substantial increase for expectant mothers and for mothers after the child is born. I certainly agree with the need for much higher child benefit.
Mr. O'Brien: I am grateful to the hon. Gentleman for helping us to recall what happened in Committee. Some of us who were a touch sceptical about the evidence sessions before they took place found that they helped a lot of us understand where the evidence that had inspired the Government to introduce the provisions might lie. That was particularly so in the case of the health in pregnancy grant. We all approached the grant in a benign way, with good will, because we wanted to see it happen.
The hon. Gentleman is entirely right that the grant must be appropriate. Where there are scarce resources, and in particular where extra resources are being made available, they should be targeted at those who can benefit most from that support. Pregnant women are clearly in that category. It is best that resources are well targeted to deliver the best benefit. The evidence we were seeking was where that best benefit would lie.
Rather than castigating those who might be presumed to misuse the money, on the contrary, I said to my hon. Friend the Member for Tiverton and Honiton (Angela Browning)I hope that the hon. Gentleman heard methat I thought it rather rough and unfair for the payment in Australia to be termed the plasma payment. This country should be better able to trust people to do the best for themselves if they are given the opportunity to do so with extra resources. That is precisely what I was seeking to ensure was being said in response to my hon. Friend.
The big issue is that if there are scarce resourcesif it is not possible to augment the payment proposed by the Government, who have identified what resources they are prepared to devote to the grantwe need to target them in the best way. The evidence does not suggest that it is best to put a nutritional opportunity at the tail end of a pregnancy, which is what the Prime Minister seemed to say when he was Chancellor of the Exchequer and that was announced, in effect, by voting the money, or the intended money. Rather, the evidence suggests that it should be provided in the early weeks, and prior to conception. That is the beef; that is the argument. We are all trying to achieve nutritional and health improvements.
I do not think that the hon. Gentleman and I are at odds on that. It was helpful that he intervened, because I have been able to make it clear that we are not in the business of castigating people. On the contrary, we want them to derive the best benefit from a potential opportunity. However, in the light of all the discussion, and the evidence to the contrary of what the Prime Minister sought to pray in aid, we believe that what is delivered in the Bill is still based on a false premise. We would be far better off using the evidence sessions, which were designed to help the Committee, to ensure that the best benefit is delivered in the early years and prior to conception.
Angela Browning: The point was made in CommitteeI think that it was borne out by the evidence sessionthat there are fundamentals in the nutrition of the unborn child, particularly in the early months. They include when nutrients, particularly calcium, phosphorous and vitamin D, are needed to lay down the skeletal frame. By the 25th week the internal organs will be well formed, although one would hope that the foetus would gain in weight thereafter. Many of the deficiencies in underweight babies result from lack of nutrient in the early stages. That was clearly stated, yet the Government appear not to have taken any notice of it.
Mr. O'Brien: I bow to my hon. Friends experience and knowledge. I think that those of us who are men should trespass rather carefully on this area, as much of the expertise is clearly on her side. There is no doubt that the evidence entirely supports what she has said. It would have been better if the Government had had the grace to accept that on this occasion the Prime Minister misspokelet us be kindand that there was no evidence to support what he had said was the genesis of this part of the Bill.
It is vital for future health that we consider this issue while discussing Lords amendments Nos. 48 and 49, because we shall not have a further opportunity to do so at this stage of the Bills passage. I hope that the Minister will respond, and will not choose to remain in his seat as he did when we debated the last group of amendments. Those who must implement the Bill will then be able to argue for a health in pregnancy grant to be made at the time when it will be of most value. As my hon. Friend will be the first to remember, a series of amendments were tabled in Committeeunder both chairmanshipsrelating to the number of weeks involved. The issue was not whether the grant should be paid when a woman was 25, 24, 23, 21, 16 or even 12 weeks pregnant; it was to do with the pre-conception stage and the very early weeks of pregnancy, the fact that nutritional information was vital, and the benefit that could be derived from it.
Kelvin Hopkins: I have every sympathy with what the hon. Gentleman is saying, and I think we are all trying to move in the right direction. I entirely agree that the earliest stages of pregnancy, immediately after conception, are crucial. It is vital that alcohol abuse, for instance, is avoided at that stage. The difficulty for the Government, however, is that it is not really feasible to award a grant to someone on the basis that she is hoping to become pregnant. I think the best that the Government can do is ensure that expectant mothers are advised to eat properly and not to abuse their bodies, and told that they will receive a grant later which will help them out once their pregnancies are confirmed. The Government cannot seriously provide a grant just because someone is trying to become pregnant.
The hon. Gentleman is right to highlight the practical difficulty, although I do not think it is an impossibility. After all, the NHS funds infertility treatment. That has quite an extensive scientific base. It involves diagnosis, and the assessment of people on the grounds of their wish to start a family, at the pre-conception stage. It is, however, more important for us to recognise thatas the hon. Gentleman also saidit is vital for good-quality assistance and advice to be given to women who seek to become or have just become pregnant, and
who are abusing alcohol or drugs either on binges or on a regular basis. Nutritional impetus is crucial at that stage, because it may just provide an opportunity for the surmounting of what could otherwise be a much more serious health hurdle for both mother and unborn child.
The Treasury has repeatedly refused to provide me with the evidence that I requested, despite the raft of parliamentary questions to which I have referred, and the Department too has provided no evidence that nutrition is most important during the later stages of pregnancy. The Minister admitted that during the oral evidence session.
Given those policy shifts, I hope that the Minister will now explain exactly what stake Her Majestys Revenue and Customs and the Department for Work and Pensions have in the grant. In view of HMRCs recent record on data handling, I am surprised that the Government are presenting any proposals that would help it to share data. That seems to be adding fuel to the fire, given its recent reputation and performance.
What guarantees can the Minister give that this is not simply a power to allow tax inspectors and the DWPs spiesthat may sound pejorative, so I shall say its operativesto harass pregnant women and new mothers? We need to be very careful that people do not feel oppressed by requests for information at what is often a sensitive and vulnerable time in their lives.
Lords amendments Nos. 50, 63, 64, 65, 90 and 91 make the nationally negotiated elements of the pharmacy contractabout which the hon. Member for Romsey (Sandra Gidley) knows a great deal on the basis of experiencesubject to regulations rather than local determination. They result from an amendment tabled by Earl Howe on Report, and they will give pharmacists business confidence. I hope that the hon. Lady will tell us how she feels that the proposals can be reconciled with the need for a more devolved NHS, particularly in relation to pharmaceutical services.
I must come clean about Lords amendments Nos. 48 and 49. When I first read them, I thought, This is a bit worrying: it effectively allows the Department for Work and Pensions and HMRC to share information. Then I realised that that provision was already in the Bill. It is probably remiss of usI hold up my hand as guiltynot to have examined that in Committee. I share the concern expressed by the hon. Member for Eddisbury (Mr. O'Brien). As the matter was not discussed in Committee, it would be helpful if the Minister could clarify the nature of the information likely to be shared, and the mechanisms that exist for the limiting and auditing of information sharing so that the health in pregnancy reason is not given when some other purpose is being served. That would be reassuring, in the light of the public interest in data sharing and data security. If the Minister does not have the details to hand, I am sure that many of us would like to be given the information at some stage.
I welcome Lords amendment No. 50 and the consequential amendments relating to pharmaceutical services. I should record the fact that I am on the
register of practising pharmaceutical chemists, and therefore have a potential interest. I welcome the reassurance that pharmacists will not necessarily find after investing in their businesses that local decisions will not support the services in which they have invested. It is difficult for companies to develop a strategy if numerous different provisions exist.
We need to be reassured that plans to devolve the arrangements further will be subject to further scrutiny, because the issue is not straightforward. However, people to whom I have spoken who were concerned about the original provision in the Bill are pleased about the amendment, and I thank the Minister for it.
Mr. Bradshaw: Like the hon. Member for Romsey (Sandra Gidley), I do not intend to repeat our lengthy discussions on the principle of the health in pregnancy granta principle that the Opposition opposed so strongly that they did not even bother to divide the Committee. I will, however, speak to Lords amendments Nos. 48 and 49.
Clauses 126(6) and 129(6) amend section 122 of the Social Security Administration Act 1992 and section 116 of the Social Security Administration (Northern Ireland) Act 1992. Those were included in the Bill with the express intention of ensuring that both the Department for Work and Pensions and the Department for Social Development in Northern Ireland could verify that a woman had been given the appropriate health advice by an appropriate health professional, in order to be entitled to the health in pregnancy grant. Work to develop the arrangements for administering the grant subsequently established that both the Department for Work and Pensions and the Department for Social Development in Northern Ireland in fact already had sufficient access to information under the existing provisions to verify whether the necessary advice had been given. Accordingly, clauses 126(6) and 129(6) are no longer necessary, so amendments Nos. 48 and 49 will remove those provisions from the Bill.
Mr. Graham Stuart (Beverley and Holderness) (Con): The Minister himself has said that, from a nutritional point of view, money would be best spent earlier in the pregnancy. Can he explain why the grant is being given so late in the pregnancy?
The work also established that there was no information-sharing system that would permit the disclosure of health in pregnancy grant data for the purpose of further developing social security policy for supporting expectant mothers. In order to facilitate policy development, Government amendments Nos. 48 and 49 add references to the health in pregnancy grant to existing information systems which permit information to flow for a broad range of Department for Work and Pensions activities, including social security policy development. That data would include statistical information such as the number of claims, regional distribution and the stages when claims are made.
Mr. Bradshaw: Members will recall that the previous time this Bill was before the House we undertook to address the issue of the application of the Human Rights Act 1998 following the decision in YL v. Birmingham city council. The effect of that decision is that residents whose care is publicly arranged do not have those rights we intended to put in place when we introduced the Human Rights Bill into Parliament. These amendments seek to address the immediate impact of the YL case for people receiving publicly arranged care in care homes.
It remains the Governments view that in general the provision of publicly arranged health and social care should be considered a function of a public nature. The Government will therefore continue to treat those exercising such functions as subject to the Human Rights Act. In particular, it remains the Governments firm view that independent providers of NHS care under the National Health Service Act 2006 are, as the law currently stands, exercising a function of a public nature.
The Minister with responsibility for human rights has committed to consulting in the near future on how to address the general issue of the definition of public authority in future, perhaps by means of legislation. The consultation process is the place and time to work out which functions should be subject to the Human Rights Act, and to work out how that can best be achieved. I am grateful to all those who have worked with the Government in preparing the amendment. I would particularly like to note the contributions of the British Institute of Human Rights and the Equality and Human Rights Commission. The amendment is a step along the road to addressing the issues around the scope of the Human Rights Act, but it is a very important step. It will provide the additional protection of the Act to some of the most vulnerable people in our society. I commend it to the House.
Mr. Stephen O'Brien: Lords amendment No. 51 makes local authority-funded private or voluntary sector care a function of a public nature under section 6(3)(b) of the Human Rights Act. It is important to note that privately funded individuals will still fall outside the scope of the Act. I would be grateful if the Minister also clarified the position of part-funders, which remains very unclear and therefore of grave concern to many who find themselves in that position.
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