The
Chairman: Order. Before the hon. Gentleman moves on to his
third point, I want to remind the Committee that we are debating
regulations, not alternative proposals or related issues that might be
of interest. I should be grateful if the hon. Gentleman and others
would bear that in
mind.
Mr.
Breed: Thank you, Lady Winterton. As I understand it, we
are members of a finance Committee that is considering the spending of
money. To my mind and that of many others, the spending of money in
respect of the regulations is wholly inappropriate when so many other
issues need to be addressed. That is why we are against it, and as the
hon. Member for South-West Hertfordshire said, we always need to
consider how we are spending money, particularly public money, but when
the public purse has been so depleted for whatever reason, we have to
be even more careful with our spending. I certainly have no hesitation,
on behalf of my constituents, in voting against a pregnancy grant in
this finance Committee because far more important things can be
contributed to the health of expectant
mothers. Finally,
intensive care beds are important, particularly when twins have had to
be separated to go to different hospitals because there was
insufficient care in the same hospital to look after them. To think of
the regulations as a measure to improve the health of expectant mothers
and, indeed, their babies is ludicrous.
I want to
mention Cornish babies. A lot of people in Cornwall would like their
babies to be born in Cornwall and their ability to do so is limited
because there are insufficient maternity services in Cornwall, as a
result of which they have to go to
Devon. 2.53
pm Mr.
Peter Lilley (Hitchin and Harpenden) (Con): I am disposed
to support the measure. I am a natalist. I can think of no better way
of spending money than to improve the health of pregnant mothers and
their children. Like Winston Churchill, who said that he could see no
better use of money than to use it pouring milk down babies’
mouths, I think that healthy mothers and children are a good
thing. However,
in the light of the questions posed by my hon. Friend the Member for
South-West Hertfordshire and the objections raised by the Liberal
Democrats, I was forced to think again about the matter and the more I
do so, the more extraordinary I think it is that we are proposing to go
ahead with the regulations. They are manifestly badly targeted. The
point in pregnancy at which they will come in is self-evidently badly
timed. They are virtually unconditional in that there is no reason to
suppose that the money will be used, as we would like it to be used, to
improve the health of mothers and their children. It is clear that far
more important would be enhancing the provision of health visitors and
midwives. Even
if we could overcome those objections, I cannot help harking back to
the debate in which many of us participated yesterday. We face a
deficit in this country greater than the entire education budget
together with the entire defence budget and the entire budget for law
and order. We face a national crisis. We cannot afford those major
services of the state without resorting to
borrowing. Now we are proposing yet more expenditure. Have the
Government no sense of the national emergency that we
face? From
my experience in government, the only way that a deficit can be
controlled—the only way to avoid an unwanted pregnancy or
becoming dependent on drugs—is to take Nancy Reagan’s
advice and learn to “Just Say No”. There comes a point
when we have to say no to proposals for further expenditure. If we do
not have Ministers who can say no to things, we shall not get out of
the problems that we face of expenditure far exceeding the ability to
raise taxes to finance
it. I
very much hope that the Committee will require the Government to look
again at whether we should be going ahead and spending £130
million—not very much to a lot of people in this room, but eight
such measures and we are at £1 billion. I found it difficult
when I was a hard-faced, hard-nosed Secretary of State for Social
Security to save a couple of billion every year. It is only by learning
to say no and stopping every small programme that is not essential that
we shall get out of the financial crisis that we face. It is the duty
of the Committee to think long and hard, and to force the Government to
think long and hard about whether they should be going ahead with
expenditure that clearly does not command widespread support, is not
well targeted and cannot be afforded by the nation at this
time. 2.56
pm
The
Financial Secretary to the Treasury (Mr. Stephen
Timms): I bid you a warm welcome to the Chair of our
Committee, Lady
Winterton. I
am glad that we have the opportunity to discuss the grant. Its aims
were discussed extensively during the passage through its parliamentary
stages of the Health and Social Care Act 2008. I understand that there
were no Divisions—it was broadly supported—and I reaffirm
what the Secretary of State for Health said at the time about the
purposes and principles of the
grant. The
purpose of the payment is to extend financial support to all women
during pregnancy, enhancing the existing help available. Those with
lower incomes and greater needs, as we were reminded, receive support
through the existing lump sum payment provided by the Sure Start
maternity grant and the Healthy Start voucher scheme. However, for many
women, particularly those less well-off, the grant will provide a
welcome addition to their income at what all of us would acknowledge is
a difficult and stressful time. We know that life chances are
influenced before birth and that the support provided to the expectant
mother during pregnancy has an impact on those chances. We also know
that maternal health and well-being are affected by a wide range of
factors, from the behaviour of the individual expectant mother to her
financial circumstances and the support that she receives from
professionals, family and
friends. I
suggest to the Committee that the grant is a good example of the early
intervention approach, which is increasingly supported across the
House. Many of us have seen the booklet jointly written by my hon.
Friend the Member for Nottingham, North (Mr. Allen) and the
right hon. Member for Chingford and Woodford Green (Mr.
Duncan Smith), “Early Intervention: Good Parents, Great Kids,
Better Citizens”, jointly published by the Smith Institute and
the Centre for Social Justice.
They recognise, as Members across the House are increasingly
recognising, that experience and well-being before birth and in the
very earliest years of life can indeed have a significant impact on
future life
chances. Although
only Labour and Conservative Members put their names to the report, I
note that the leader of the Liberal Democrats went on record as
favouring the early intervention approach. He welcomed the work that
those two Members of the House had done, saying in response to the
report: “This
is a welcome wake up
call”. We
have in the regulations a good example of early intervention being
implemented. We are making the health in pregnancy grant available to
all pregnant women, in recognition of the costs that all face in the
weeks leading up to a baby’s birth and to support the well-being
of the women at that important time. We are committed to improving the
range of maternity support for the benefit of both women and their
soon-to-be-born children. The “Maternity Matters”
document published in April 2007 sets out a comprehensive programme for
improving choice, access and continuity in care. It is a strategy that
puts women and, indeed, parents at the centre of local maternity
provision. It
is worth emphasising that the Royal College of Midwives, to which I
know you are connected, Lady Winterton, strongly supported this measure
and helped us to prepare for its introduction. It has not called for
the abandonment of the grant and for the funds to be diverted
elsewhere. Its deputy general secretary, Louise Silverton,
said: “The
Royal College of Midwives is pleased that the financial costs of
pregnancy for women and their families has been recognised. This will
help women to make essential purchases before the baby’s
arrival.” The
measure has also been supported by the Royal College of Nursing and the
Daycare Trust, among others.
The health
and pregnancy grant fits into the wider strategy that we have set out
for support during pregnancy and during a child’s early years.
We have seen maternity pay extended from 26 to 39 weeks and the
extension of the right to request flexible working to carers of
children under six; now, we are providing additional financial support
during pregnancy. By linking grant entitlement to the provision of
advice from midwives, the grant provides an important incentive to all
women to access the services available to them sooner rather than
later. To
pick up the point on which the hon. Member for South-West
Hertfordshire—perfectly fairly—pressed me, it is true
that a large proportion of women are in touch with midwives during
their pregnancy. However, we need to encourage them to access those
services earlier rather than later. By setting the 25-week timing for
applications, we are pretty confident that we will be able to encourage
more women to get in touch earlier. By the way, I should tell the hon.
Member for Solihull that her daughter will be eligible to benefit from
this grant. In fact women who have reached 25 weeks since 1 January
this year are able to apply for the grant. I hope that she will pass on
that good news to her daughter. We all wish her daughter well in the
weeks ahead.
Mr.
Gauke: I take the Minister’s point that the
Government are pretty confident that they will increase the number of
expectant mothers who get in contact
earlier, but can he be more precise? How many are in contact with
midwives by the 25th week now, and how many does he envisage will be as
a consequence of these
measures?
Mr.
Timms: I am afraid I am not able to announce a target for
such activity; however, it is important to encourage women to access
those services early. That is the point that I am making. The fact that
there is a very tangible advantage now in being in touch earlier in
pregnancy should help. We will need to see what the impact of the
measure
is. Fiona
Mactaggart (Slough) (Lab): My right hon. Friend has
explained that one target of the measure is to engage pregnant women
earlier with maternity services, but does he accept that, in contrast
to some of the things that we have heard from the Opposition, targeting
money on women for their children and for the future health of their
children is extremely effective? For example, we know that women who
receive child benefit are much more likely to spend the money on their
children than men who receive child tax allowances. Simply because the
grant is going to mothers, it is an effectively targeted
benefit.
Mr.
Timms: I agree with my hon. Friend and I am grateful to
her for making that point. We will see this resource effectively used
for that
reason. The
two sets of regulations set out the detailed measures for the grant.
Shortly before the Bill providing for the grant started its Commons
Committee stage, the Treasury published an indicative set of draft
regulations to flesh out how the provisions would work in practice. The
final versions do not vary much from
those. The
Health in Pregnancy Grant (Entitlement and Amount) Regulations 2008
provide for women to receive a lump sum of £190 from the 25th
week of pregnancy. That sum will be payable from next Monday, 6 April.
As with the Sure Start maternity grant entitlement, the health in
pregnancy grant is conditional on a woman receiving advice from her
midwife or
doctor.
Lorely
Burt: The hon. Member for South-West Hertfordshire asked
an interesting question and I do not want the Minister to sit down
before he has a go at answering it. He asked why the figure is
£190, what its significance is and how it was arrived
at.
Mr.
Timms: I assure the hon. Lady that I am not planning to
sit down imminently. There are a number of matters that I want to go
through before that
stage. To
be entitled, a woman must be ordinarily resident in the UK. The hon.
Member for South-West Hertfordshire queried the special provision that
is made for Crown servants posted abroad and for partners and daughters
who accompany them. The treatment for Crown servants will affect the
armed forces primarily and is consistent with commitments on access to
benefits in the service personnel Command Paper that was published last
year. I think that Members on both sides of the Committee will
recognise that, although it is appropriate to restrict
the payment to those who are resident in the UK, an exception should be
made for those serving in the armed forces
overseas. The
administration regulations provide for how and when claims should be
made, the evidence required to support a claim, the manner and timing
of payments and for others to be able to act for those who are unable
to act on their own behalf. The payment is a single lump sum, but
otherwise the administration regulations are broadly the same as
measures that apply across social security
payments. Both
the entitlement regulations and the administration regulations came
into effect on 1 January. Payments of the grant cannot be made until 6
April, as I have said. The regulations were brought into force early so
that pregnant women who were not expected to give birth before 6 April
but who had reached the 25th week of their pregnancy since 1 January
satisfied the remaining conditions and could make their claims at the
appropriate time. So far, more than 103,000 women have made a claim,
and Her Majesty’s Revenue and Customs is receiving more than
3,000 claims every day. From next Monday, it will start to process the
claims so that payments are made as quickly as
possible. I
have referred to the strong support from the Royal College of Midwives,
the Royal College of Nursing, the Daycare Trust and
others. To
respond to the hon. Member for Solihull, we have increased funding
significantly for maternity services nationally. We have more than
25,600 midwives and achieved our aim of recruiting 1,000 more by last
September. We will continue to build on that progress, with 4,000 more
midwives by 2012. It is not a question of doing one or the other; we
are committed to doing
both. The
latest estimate of the cost of the grant is £145
million. It will be more in year one because of those who have applied
since 1 January. That is the figure that has been published and it is
reflected in the Red
Book.
Mr.
Gauke: Will the Minister elaborate on why the costs have
increased? Is it because a higher birth rate is anticipated in the next
few years or is there another
reason?
Mr.
Timms: My advice is that that was the figure published in
2006. I will have to look whether there has been a change.
The Prime
Minister made the point when he was Chancellor, as the hon. Gentleman
mentioned, that the extra cost borne by parents in the latter months of
pregnancy ought to be recognised and that nutrition is important
throughout pregnancy. That is the point: nutrition is important not
only at the beginning, but throughout pregnancy.
The hon.
Member for Solihull asked me to spell out how we came up with the
figure of £190. Clearly, there is a judgment to be made, but we
set the grant at a high enough level to provide worthwhile financial
support towards the additional costs incurred in pregnancy and in
making preparations for a new baby. It is a lump sum to provide
flexibility for expectant mothers and it is set, as has been mentioned,
at the same level irrespective of whether this is the first or
subsequent baby. I suggest to
the Committee that a £190 one-off payment is sufficiently large a
sum to make a genuinely worthwhile contribution to those
costs. Lady
Winterton, I have just been corrected. In fact the Red Book in 2006
gave a figure of £135 million, but it was revised in 2007 to
reflect, as the hon. Member for South-West Hertfordshire suggested,
Office for National Statistics data on birth rates. That figure has
been used for projections for subsequent
years. I
hope that, despite the caution expressed by Opposition Members, they
will welcome the measure. It is an important step in supporting women
at an important time for them and for their babies. I commend the
regulations. Question
put:
The
Committee divided: Ayes 8, Noes
3.
| 
