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Address in Reply to Her Majesty's Most Gracious Speech

Debate resumed on the Motion moved on Tuesday last by the Baroness Lockwood—namely, That an humble Address be presented to Her Majesty as follows:

"Most Gracious Sovereign—We, Your Majesty's most dutiful and loyal subjects, the Lords Spiritual and Temporal in Parliament assembled, beg leave to thank Your Majesty for the most gracious Speech which Your Majesty has addressed to both Houses of Parliament".

The Parliamentary Under-Secretary of State, Department of Health (Lord Warner): My Lords, I am glad to have the opportunity to explain next year's programme on education, environmental and rural affairs, and work and pensions and to outline my department's continued reform of the NHS.

The measures that we propose for the coming Session will continue the reform of public services to ensure that they provide more security and opportunity for all. They extend educational opportunity so that all individuals can realise their full potential and help us all to live in clean and safe neighbourhoods. We will continue to improve access to the NHS, take forward further investment and pursue the extension of choice for patients, all in an NHS free at the point of use and available to all.

Under this Government, there have been radical changes in public services, nowhere more so than in education and skills. We are proud of our record since 1997. Education spending has risen from 4.7 per cent of GDP in 1996–97 to 5.4 per cent in 2004–05 and is forecast to rise to 5.6 per cent in 2007–08. In real terms, since 1997–98, schools recurrent funding has risen by £870 per pupil to £3,740 in 2004–05. Every three and four year-old is now entitled to a free part-time nursery place and 1.2 million new childcare places have been created since 1997. We have smaller classes, 28,500
 
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extra teachers, 105,000 more support staff, 99 per cent of schools connected to the Internet and the best ever results at all the key stages. The past two years have seen the highest ever test results for 14 year-olds, with 69 per cent reaching the expected level in English in 2003 and 73 per cent in maths in 2004. The proportion of pupils getting five or more GCSEs in 2004 is up 0.5 percentage points. There are increased entries for A-level up two percentage points on 2003 and the best ever results.

Apprenticeships are becoming a popular and mainstream option. Now, 25,000 young people are on the various programmes, which is the highest number ever. Specialist and inner city schools are improving fast, with specialist schools achieving an above average improvement at grades A* to C at GCSE. London schools are improving one-and-a-half times faster than the national average, with no London borough now below 40 per cent of pupils achieving 5 GCSEs at grades A* to C. More people than ever before are entering higher education and increasing numbers of the population are gaining a qualification in literacy or numeracy, with the figure now exceeding 750,000.

Some 3 million of the 12 million children in this country have experienced the separation of their parents, and it is important that we take steps to offer that large and vulnerable group the best opportunities to achieve the outcomes that children have told us are most important to them: being healthy; staying safe; enjoying and achieving; making a positive contribution; and achieving economic well-being.

To support that group, we will publish in draft for pre-legislative scrutiny a Bill on child contact and intercountry adoption. The judiciary has told us that it needs more flexible powers to underpin and enforce contact orders in cases of parental separation. The Bill will give the courts more options in facilitating the making of contact arrangements and, where necessary, enforcing contact orders. It will help to support positive contact arrangements in the best interests of the child and underpin the Government's firm belief that after separation, both parents should have responsibility for, and a meaningful relationship with, their children, so long as it is safe. The Bill will provide a clear and transparent statutory framework which makes express provision for the suspension of intercountry adoptions from a specified country where there are concerns about child welfare and the intercountry adoption process in that country.

Our Education Bill, which is being introduced today, will be a key part of the Government's commitment to developing a new relationship with schools as well as the first piece of legislation to take forward our five-year strategy for children and learners, which we launched in the summer. The reforms to inspection will ensure that all schools experience more frequent inspections, but these events will be shorter, sharper and more tightly focused on school improvement. Inspection reports will provide clearer information for parents, enabling them to understand what their children actually experience in school. Where schools require additional support, either as a result of an inspection or as part of their own drive
 
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to raise standards, we will look to the new school improvement partners to make those links between the school, the local authority and those who can meet the individual needs of each school.

However, the new relationship is not just about inspection. We want to free our teachers and school leaders from the unnecessary burdens that they currently face to enable them to focus on delivery of high quality education, learning and care. Hence, we will repeal the requirements on governing bodies that they hold a meeting each year with parents and that they produce a governors' annual report. Instead, we will take advantage of the technology available to ensure that each school produces a school profile containing a range of statistical information on each school—for example how well examination results have improved, absence rates and the latest Ofsted summary report.

The profile will enable schools to combine performance and other statistical information within their specific localised context in a simple, online system, or to be made easily available to parents in printed form where that is more appropriate. That will provide parents with a clearer, more accessible set of information on their child's school.

The Bill will also provide the basis for all schools in England and Wales to receive guaranteed three-year budgets, allowing them to plan for the future with greater confidence. The Secretary of State for Education and Skills intends a major consultation exercise with our key stakeholders on the school funding arrangements to begin in the new year, ensuring that the policy is developed in a way which is supportive of local needs.

The large increase in the number of teachers and support staff of the past few years, coupled with our work to remodel the school workforce, has meant that there is a range of new roles for staff in schools. All of those will need to be supported and developed over the next few years. We shall look to the remodelled Teacher Training Agency to lead on developing those new arrangements and will legislate to enable that.

We will also reform the way in which we collect information on the school workforce by removing the surveys which currently collect overlapping data and introducing a single collection to create the school workforce database. As a result, we will have a much better picture of our school workforce and its needs.

Although much of the Bill covers England and Wales, there are number of Wales-only provisions that further the aspirations set out in the National Assembly for Wales' document, The Learning Country. It will provide an enabling framework of legislation that will give the National Assembly powers on a range of issues. In line with the devolution settlement, the National Assembly will be able to determine for itself whether the changes proposed for England are appropriate for Wales.

We will also introduce a School Transport Bill to support our policy of promoting greener, healthier, safer journeys to school. We have already put in place a network of school travel advisers in every local authority in England, and in June distributed additional capital
 
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funds worth £14 million to about 2,400 schools with travel plans that promote more sustainable home to school travel. The Bill is part of that wider picture.

The current school transport legislation dates back to 1944 and does not reflect modern day lifestyles or road safety conditions. Around twice the proportion of children are now arriving at school by car, compared with 20 years ago, with a corresponding reduction in the number walking to school. Although more and more parents are driving their children to school, research published by the Department for Transport in 2001 found that 44 per cent of parents who drove their children to school would consider switching to existing standard school buses and as many as 76 percent would consider switching to an improved service.

The School Transport Bill is deregulatory. It will give a small number of local education authorities in England and Wales additional flexibilities to tackle those issues at a local level. They can put forward innovative proposals for travel schemes that offer a range of good quality, cost-effective alternatives to the family car on the school run and make walking, cycling and bus use more attractive to pupils and parents.

Scheme authorities will be required to address the travel needs of all pupils, not just the small minority—around 10 per cent in England and 20 per cent in Wales—who benefit from the current arrangements, many of whom are not from the most needy homes. Participation in schemes will be voluntary in both the short and longer term. Those authorities that wish to develop innovative schemes will have the flexibility to do so. Those that wish to remain with the status quo, for whatever reason, will be able to do so.

Depending on the number of pupils covered by a scheme, pump-priming money of up to £200,000 will be provided to the initial tranche of pilot local education authorities in England with approved schemes. All schemes must aim to reduce car dependency on the home to school journey. Beyond that, they must focus on local priorities. The Bill will give local education authorities additional flexibilities to tackle rising car use on the school run. That use contributes to lack of exercise, which is damaging the health of our children. It also causes congestion and pollution, especially around schools.

I now turn to cleaner neighbourhoods and the environment. There is an important link between the state of the local environment, anti-social behaviour and the fear of crime. The clean neighbourhoods and environment Bill will form an important element of the cross-cutting Cleaner, Safer, Greener agenda. The measures in the Bill were developed after extensive consultation of stakeholders, including local authorities, and many respond to requests for action. The Bill will be an important part of delivering more security in many communities, particularly some of the most deprived ones, by making the link between poor local environmental quality and anti-social behaviour.

The Bill will extend the objectives of crime and disorder reduction partnerships, led by police and local authorities, to consider specifically the quality of
 
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their local environment. The Bill also gives local authorities and others, including parish and town councils, more powers to tackle local environmental quality and anti-social behaviour, including litter, fly-posting, abandoned vehicles, fly-tipping, nuisance—including night-time noise and artificial light—and nuisance alleyways.

We all know that neglecting the local environment creates unease and a "nobody cares around here" mentality. That can quickly lead to escalating problems of anti-social behaviour. Powers available to local government and other agencies will be significantly enhanced, with local residents and business engaged in a powerful alliance to improve their neighbourhoods. Some of the powers in the Bill will enable parish and town councils to deal with environment issues at a very local level.

Dealing with problems arising from local environmental quality and anti-social behaviour costs agencies around £3.4 billion every year. Abandoned vehicles, for example, cost local authorities £26 million in 2002–03, while vehicle arson costs society about £230 million a year. The Bill will reduce all those costs—in the case of abandoned vehicles, by enabling local authorities to remove abandoned vehicles immediately from the streets.

The illegal disposal of waste, or fly-tipping, is also a major anti-social problem that can lead to serious pollution and harm to human health. Dealing with it costs local authorities, the Environment Agency and landowners around £100 million a year. The measures in the Bill were developed following Defra's recent fly-tipping strategy consultation and will develop stronger and more effective enforcement powers to deal with fly-tipping. Local economies suffer where the local environment is poor. By driving up the standards of our public space and living environment, the measures will bring a much-needed boost to local neighbourhoods and businesses.

We welcome the opportunity to bring forward the draft Animal Welfare Bill, which reflects the Government's concern to improve animal welfare further. The Bill covers all animals for which man is responsible or which come under man's control. The sole exceptions are animals used in scientific experimentation, which will continue to be protected by the Animals (Scientific Procedures) Act 1986. Most importantly, it extends to companion animals the principles of responsibility and care that have long been commonplace for farm animals. The current rules for animals not in farms require suffering to occur before action can be taken. Under the Bill, an offence occurs as soon as an animal is treated in a way that may lead to suffering, so it will be possible to take action sooner.

The Bill also extends to companion animals the use of welfare codes, agreed by Parliament, which are currently used to underpin the welfare of farm animals. The measure has broad support and will significantly improve animal welfare. The draft Animal Welfare Bill will apply to England and Wales. Scotland and Northern Ireland are reviewing their existing animal welfare legislation.
 
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We will publish in draft a modernising rural delivery Bill. It will ensure better management and protection of our natural resources, with a new integrated agency. It will be a strong independent body, integrating and building on the excellent work done by English Nature, the Countryside Agency and the Rural Development Service. It will establish a powerful independent voice for rural people in the new Countryside Agency and improve our ability to deliver benefits by removing legislative, organisational and administrative barriers.

We will also publish in draft a commons Bill. It will facilitate the long-term protection and conservation of valuable habitats by enabling the registration of common land which is currently unregistered and enable the deregistration of wrongly registered land. The Bill will enable the existing commons registers to be brought up to date. It will also enable local councils or national park authorities to assume ownership of unclaimed common land to improve its management. The Bill will deliver benefits through sustainable farming, public access and biodiversity. Statutory commons associations will enable the majority of responsible commoners to regulate grazing so that the actions of a small minority can no longer prevent sustainable management.

The Disability Discrimination Bill was introduced to this House on 25 November following pre-legislative scrutiny. Together with changes since 1997, it will completely transform civil rights for disabled people. It is the final step in delivering the Government's 2001 manifesto commitment to legislate for the full civil rights of disabled people, which strengthens and broadens civil rights in the workplace in providing greater access to shops, leisure facilities and public transport, and in the letting of premises.

Our package of reforms means that disabled people will be empowered as never before. Millions will benefit from greater opportunities to get a decent education, a decent job and access to goods and services—in short, to play a fuller and more active role in our society. An additional 175,000 people will benefit from civil rights protection. Public bodies will have a new positive duty to promote equality of opportunity for disabled people. All aspects of public transport will be covered by anti-discrimination law, and we will set an end date by which all rail vehicles must be accessible to disabled people. Public functions such as planning decisions will be covered for the first time. Landlords will be required, for the first time, to make "reasonable adjustments" to allow disabled people to enjoy their home.

We remain committed to reforming the law on mental health. A draft Bill is undergoing pre-legislative scrutiny. It modernises the law on treating people with a mental disorder without their consent when that is necessary to protect them or others. It brings the law more in line with modern, community-based patterns of services. It also introduces new safeguards for patients; for example, the introduction of a choice of nominated person to represent their
 
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view; improved access to advocacy; and independent tribunal authorisation of compulsion after 28 days. We will introduce the Bill as soon as parliamentary time allows. In producing the draft Bill, we have taken full account of the comments received during the 2002 consultation exercise. We look forward to receiving the recommendations of the pre-legislative scrutiny committee in March 2005.

We will continue our reform of the NHS and social care. The NHS still needs to be rooted in the same important core values of high-quality care on the basis of need and not the ability to pay—a clear dividing line between us and some other parties. But increased emphasis is needed on the NHS becoming a more personalised service that fits individual needs better and provides more choices and even faster access. The NHS is being transformed under this Government by record levels of investment: more doctors, more nurses, new equipment and many new hospitals. Spending has increased from £33 billion in 1996–97 to £69 billion in 2004–05. By 2007, we will spend £92 billion a year. That will mean even more staff, even faster treatment, better patient care and more choice.

We have consulted patients and are responding to what they say is important. The improvements that this Government have delivered have been made possible by steady increases in the number of NHS staff and their hard work and commitment, to which I pay tribute. For example, over 97 per cent of patients can now see a GP within two days. The maximum waiting time for an outpatient appointment has fallen from 26 to 17 weeks. The maximum waiting time for an operation has fallen from 18 months to fewer than nine months.

Understandably, people want action on the biggest killers, especially cancer and heart disease. We have the fastest falling death rates from cancer in Europe. The latest figures show that cancer mortality in under 75 year-olds has fallen by over 12 per cent in the past six years. That equates to around 33,000 lives saved over this period. We have seen a one-quarter reduction in premature deaths from heart disease.

There will be a sustained drive to reduce inequalities in health with further progress in tackling the biggest killer diseases so that by 2010 there will be a 40 per cent fall in premature death rates from heart disease and stroke and a 20 per cent fall in premature death rates from cancer—all compared with 1995-97 figures.

We understand fully public concern about healthcare-acquired infections, especially MRSA. That is why it is one of the few new targets that we have set for the NHS at a time when we have reduced the number of new national targets overall from 62 to 20.

NHS hospital cleanliness is at the heart of the new NHS inspection regime led by the Healthcare Commission. We will be debating many of those issues a little further tomorrow. It is quite clear that we are committed to achieving our new target of halving the number of MRSA bloodstream infections identified in NHS hospitals by March 2008.
 
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Growing numbers of patients are taking advantage of new services such as NHS Direct, NHS Direct Online and NHS walk-in centres, and that will continue. For example, NHS Direct has handled more than 26 million calls since its launch in March 1998. NHS walk-in centres have treated more than 5 million people since they were introduced in 2000. We are continuing to expand those centres.

We are building more modern facilities and buildings. Since May 1997, 48 new hospital schemes have become operational, with a further 31 under construction. In total, the hospital building programme in England is now worth more than £17 billion. We are also modernising and replacing large numbers of GP surgeries.

But what we have done so far is far from the end of the story. By 2008, the NHS will offer improved access and choice. Patients will be admitted for treatment within a maximum of 18 weeks—I repeat, 18 weeks, not 18 months—of referral by their GP. Those with urgent conditions will be treated much faster. For the first time, the maximum waiting time guarantee of 18 weeks will include the whole patient journey—from GP referral through outpatient consultation to inpatient treatment. Furthermore, NHS patients will be able to choose the time and place for their treatment. Patients will have access to a wider range of services in GP surgeries, pharmacies and other parts of primary care. Electronic prescribing will improve the efficiency and quality of prescriptions.

As we announced today, we are cutting bureaucracy further in order to redistribute money to the NHS front line. Today's announcement on the reduction in NHS arm's-length bodies means that by 2008 at least £0.5 billion a year extra, year on year, will go into front-line services from the ALB sector's reduction in scale and improvements in efficiency. There is now a thought-through plan for doing that, which will deliver a big change for the front line.

Inspection and data demands from the centre are also being cut. Fewer national requirements will create more scope for local priorities so that the NHS and social care have much more flexibility to deliver personalised services for patients and to recognise local needs and priorities. The quality of care will continue to improve with the new Healthcare Commission providing an independent assurance of standards and patient safety continuing to be a top priority.

We are now moving to developing the NHS into more of a health service rather than one that focuses on sickness. We will do that by working with others to make further inroads into levels of smoking, obesity and other major causes of disease. The Government's Choosing Health: making healthy choices easier White Paper published this month sets out proposals for health improvement and tackling health inequalities across the whole population. It presents a formidable forward agenda for better health in this country, with £1 billion of commitment up to the period 2007–08. We want people to be able to make informed and healthy choices so that we can all benefit from living in
 
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a healthier society. We will publish a delivery plan on the White Paper early in 2005 to set out in detail how we will implement each of the White Paper's commitments.

In conclusion, this is a reforming Government that want their public services to continue to improve and to provide even better services to the British people. Our continuing commitment to investment and reform in the NHS, social care and education services is one of our great commitments to the British people. The new programme of legislation that I have outlined in education, environmental and rural affairs, and disability rights is further strong evidence that this Government's commitment is to provide more security and more opportunity to all our people.

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