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Baroness Barker: My Lords, I thank the noble Baroness for her response. I accept some of the limitations in the drafting, which she pointed out. However, I hope that she will accept that perhaps one of the reasons that the existing scheme has done so well for over 50 years—some of us are living proof of that—is precisely that it was a universal scheme. It was there to pick up those children and mothers who might be in obvious need. That was the concern behind the amendment.

Perhaps the noble Baroness has rather more faith than me in the new scheme, not only to determine who will be eligible at the beginning but to continue to pick up the children who would be eligible. One of the great aspects of the existing scheme was the general monitoring of healthcare that was carried on throughout.

I note what the noble Baroness says. I shall take this away and read her comments. In the mean time I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendment No. 404B not moved.]

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The Deputy Speaker (Baroness Cox): My Lords, before calling Amendment No. 405, I must inform the House that if that amendment is agreed to, I cannot call Amendments Nos. 405ZA to 405ZD standing in the names of the noble Lord, Lord Clement-Jones, and the noble Baroness, Lady Barker.

Earl Howe moved Amendment No. 405:

    Page 99, leave out lines 23 to 37.

The noble Earl said: My Lords, following the Minister's most welcome concession on the regulations, there can be one line only of "A Midsummer Night's Dream" with which to respond—

    "Merrily, merrily, shall I live now".

In moving Amendment No. 405, I am able to repeat that line with even greater vigour because we have the happy circumstance of the Minister's name alongside our own. I shall not labour our objections to subsection (4) of new Section 13 of the Social Security Act 1988. Suffice it to say that I am very glad the Minister has taken on board our concerns and is prepared to join with us in deleting the subsection. I beg to move.

Baroness Andrews: My Lords, merrily indeed. I am very pleased that we were able to meet the concerns of noble Lords in this respect.

There was widespread agreement in Committee to our main aim of bringing the Welfare Food Scheme closer to the NHS, precisely in order to help its beneficiaries to make the best use of the NHS primary care services aimed at pregnant women and families with young children. This is a clear and strategic aim. We want very much to make clear that this is part of our strategy for defeating inequalities and improving nutrition as a whole. I think we have done that. Making a direct link between that and the Welfare Food Scheme is part of the national objective.

That method is particularly useful because it gives us a way to help young families at the earliest and most vulnerable time of their lives. That is when the lifelong understanding of good nutrition and habits will be laid down. It is timely. This week we had the report of the FSA on the consequences of poor nutrition.

We are very positive about this. Introducing a mechanism for families to register for the reformed scheme through a health professional is a key means of bringing about contact. This is not new. I remind noble Lords that our plans are entirely consistent with other existing arrangements. In later pregnancy women on a low income already have to visit a health professional and receive advice on maternal and infant health in order to claim their Surestart Maternity grant. Women on jobseeker's allowance must also visit a health professional at a similar time to obtain proof of pregnancy and estimated date of delivery before they can make themselves unavailable for work without losing benefits. Both appointments can be rolled into

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one and evidence suggests that many of our current beneficiaries choose this time to notify DWP of their pregnancy and thus do not get their tokens until late. Our plans propose to link into existing arrangements but significantly to give women the encouragement to access healthcare earlier to get advice and benefit.

However, the detailed requirements that may be specified in order for families to gain and retain access to the benefits of the reformed schemes set out in subsection (4) have given rise to much debate. I offered reassurances in Committee about the nature and purpose of the subsection. I made it clear that our intention was that the requirements would be defined in regulations in a way that is proportionate and reasonable for both health professionals and beneficiaries. I stressed that there would be nothing onerous required of either mothers or NHS staff. I stand by those assurances.

However, I respect that many noble Lords were uncomfortable with the inclusion of some of the requirements in subsection (4). I listened to the range of opinions expressed and we have decided to delete the subsection.

We still intend that regulations under Clause 181 will make it a requirement for a person to apply for the scheme. That is necessary simply because the introduction of tax credits will affect how information on pregnant women is collected. Currently, the Department of Health obtains information on who is eligible for the scheme from the Department for Work and Pensions. From October 2004, that will cease when the Inland Revenue takes over. We have no way of knowing who is eligible. So the simpler registration will enable eligible persons to access the welfare food benefit. I am very pleased that noble Lords are pleased that we have acceded to this and I am grateful for their support this evening.

Earl Howe: My Lords, I once again thank the Minister not only for seeing the matter from our point of view but for going as far as she has done and for her full explanation.

On Question, amendment agreed to.

[Amendment No. 405ZE not moved.]

10.30 p.m.

Baroness Barker moved Amendment No. 405ZF:

    Page 99, line 41, leave out "person" and insert "qualified health care professional"

The noble Baroness said: My Lords, I move the amendment to ask the noble Baroness if she might elucidate a little more on how access to healthcare professionals will work under the new system as she has just described it. I know that she stressed that she has taken on board those concerns, but I was not exactly sure how people who register for the scheme will have direct access to a healthcare professional. If she could just give me some assurances about how that will happen, I shall be as happy as is the noble Earl, Lord Howe. I beg to move.

11 Nov 2003 : Column 1345

Baroness Andrews: My Lords, I shall answer the question by dealing with the amendment, if I may.

We see no reason to insist that the beneficiaries of the scheme can collect the foods to which they are entitled only from health professionals or health service bodies—which is what the amendment would provide. Some voluntary schemes exist where food is provided through co-operatives facilitated by health professionals. They work well, but they work precisely because they are voluntary and responsive to local need. To place the burden of such a role on health professionals without regard to the other pressures that they face would not be a good use of valuable skills and expertise.

Our proposals were criticised in Committee for being intrusive and prescriptive in their requirements on beneficiaries. When we read the amendment, we thought that to introduce such a requirement would be prescriptive to the utmost degree and would remove beneficiaries' right to exercise choice. We now envisage that, for example, when a woman finds herself pregnant, she will as a matter of course in the process of confirming her pregnancy meet the health professional—the health visitor, the practice nurse, or whatever—and, as I understand it, will then simply be required to sign to say that she is pregnant and would therefore like to claim her entitlement to the welfare voucher.

That is one matter on which we will consult, because we want—as we have done—to talk to beneficiaries about how they would feel most comfortable and confident about making that connection. If I may, I shall write to the noble Baroness about some responses that we have so far received to our consultation. That has not yet been published, but I should be happy to let her have sight of what women have said about how they think that the scheme could be improved in that respect. As I remember, there was certainly no objection to registration, but those women made some interesting comments about how they saw the scheme working. I should be happy to circulate that letter.

Another point implicit in the amendment is that to remove the dairy industry from the scheme altogether—which, as the noble Earl said, is rather concerned about the impact of reforms on the viability of small businesses—would have a definite negative impact. That is another reason why we cannot accept the amendment. As I said in Committee, we are concerned to continue the dialogue with the dairy industry to ensure that it will continue to play a part in the scheme, as appropriate, and, indeed, to extend the number of suppliers involved so that families and women have the widest choice.

On those grounds, I hope that the noble Baroness will withdraw her amendment.

Baroness Barker: My Lords, I thank the noble Baroness for that extremely helpful reply. We are seeking to strike a balance on this matter which has not

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yet been fully and satisfactorily determined. I say that for the best of reasons. One could be quite cynical about these amendments, but the motives behind them are extremely good.

The first point of concern was that, given that this work may be undertaken in places other than the standard clinics that we all know—for example, it may take place in pharmacies—we might see a gradual smoothing away from healthcare professionals to product salesmen. Secondly, as I indicated earlier, one of the great advantages of the current scheme is the contact between pregnant women, mothers of infants and healthcare professionals. Clinics often provide an opportunity for other issues to be picked up and discussed. I cite, for example, the onset of postnatal depression, mastitis and other conditions. We are concerned to retain what is best about the involvement of healthcare professionals.

I understand that the settings and the role that voluntary organisations may play in making services accessible may change, but I have to say that I was not wholly convinced by the answer given by the noble Baroness. However, I shall pay great attention to the letter that she has said she will write to me. We are not that far apart on this, I believe, but perhaps we have a little more work to do before we reach a union of agreement with which we are both satisfied. For the moment, I beg leave to withdraw the amendment.

Amendment, by leave, withdrawn.

[Amendments Nos. 405ZG, 405ZH and 405ZJ not moved.]

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