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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.
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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.
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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.
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