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House of Lords

Wednesday, 9 May 2007.

The House met at three o’clock: the LORD SPEAKER on the Woolsack.

Prayers—Read by the Lord Bishop of Salisbury.

NHS: Hospital Telephones

asked Her Majesty’s Government:

What is the cost to hospital in-patients of making and receiving landline telephone calls.

The Minister of State, Department of Health (Lord Hunt of Kings Heath): My Lords, patients make telephone calls by using the bedside telephone system or hospital payphones. Bedside telephones are managed by three major service providers. Two providers charge 10 pence per minute for making an outgoing call and the other charges 26 pence per minute. Payphone charges vary at trust level according to local agreements with the chosen service provider.

Lord Dubs: My Lords, I am grateful to my noble friend for that Answer. Will he confirm that the company that charges 26 pence per minute for patients to make calls covers 75 per cent of all calling opportunities for patients? Given those high costs and given that telephone calling is an important link for people who are going through a stressful time while they are ill in bed, why can they not use mobile phones in the same way that doctors can?

Lord Hunt of Kings Heath: My Lords, my noble friend is absolutely right to draw attention to the issue. I am sure that there has been general concern about the very large increase in call costs in relation to the company that he mentioned. He is right that it has a large proportion of the units in NHS hospitals, but these have brought a great deal of benefit to patients. New guidance issued by the department this month makes it clear that mobile phones can be used in certain areas but not in clinical areas. One must feel for patients who want peace and quiet if there is huge use of mobile phones on a ward. However, I agree with my noble friend’s point about doctors.

Baroness Oppenheim-Barnes: My Lords, do the trusts that award the contracts to specific firms get any benefit from doing so?

Lord Hunt of Kings Heath: No, my Lords. The benefit comes to the patients in using the units and having access to television channels and the radio. The trust gets no financial benefit. However, surveys show a very high satisfaction rate among patients who use the units, as they bring an additional service.

Lord Winston: My Lords, is my noble friend aware that research has been done in Melbourne Australia and at the Mayo Clinic in the United States? The latest

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paper from the Mayo Clinic published in March clearly shows that in 300 tests of mobile phones in 75 patient areas there was no evidence at all of any interference with medical equipment. Interference had occurred previously only when phones had been used within one metre of equipment, but, with modern technology, that no longer applies.

Lord Hunt of Kings Heath: My Lords, my noble friend raises a very fair point. I understand that the MHRA, the regulatory body, has looked at this and has suggested that individual trusts undertake their own risk assessments, taking account of the research that my noble friend has mentioned.

Baroness Neuberger: My Lords, the Minister has already told us that the Government say there is no reason not to use mobile phones in hospitals. Can he comment on the accuracy of BBC reports that some hospitals have nevertheless banned the use of mobile phones because they are tied to contracts with pay-as-you-go phone companies?

Lord Hunt of Kings Heath: My Lords, I have seen the standard documentation that related to the original licensing and there was no blanket ban on the use of mobile phones, although there were qualifications around it. Some trusts may have gone further than they needed to, but they will be absolutely clear from the guidance issued this month by my department that there is no reason for a total prohibition. However, a balance has to be struck here. Patients on wards—rather like passengers in railway carriages—do not want to be bombarded with very noisy people using mobile phones. Mobile phones can also be used to take pictures and it is not appropriate for them to be used in clinical areas. It is better that mobiles are used in non-clinical areas, where their use is entirely appropriate.

Lord Brookman: My Lords, everyone has telephones at home and everyone rings everywhere—gas, electricity and so on. In hospitals, if a phone rings and one is ill, will there be an answering message saying, “Press button 1; press button 2; if you are dying press button 3”? Are we really getting into that mode in the health service?

Lord Hunt of Kings Heath: My Lords, there is probably a contrast between a general switchboard and the phone number of the individual ward. Of course, the whole point about these individual patient units is that relatives and friends can ring a patient directly. That is why, overall, this has been a very successful project. It has brought much benefit to patients. I understand the concern about the huge increase in price, but overall patients have very much enjoyed the new facility.

Baroness Murphy: My Lords, is the Minister aware that one can pay in advance by credit card for these patient lines, but one cannot get the money back again? Over the past two weeks, I have paid, in advance, £10 on one ward and £10 on another ward for a patient line for my mother to use. She was then

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transferred to another ward but there is no way of getting back that money. It is money down the drain. For me, that does not matter, but for many others it would matter. Is that a convenience for patients? I have seen the phones used in many hospitals around east London, but I had no idea, until I had to use one myself, how expensive they are for patients to use.

Lord Hunt of Kings Heath: My Lords, I am very sorry to hear of the financial loss to the noble Baroness. I am sure we all express our deep concern to her. The phones have brought a great deal of advantage to many patients and patients do not have to use the system if they do not want to. Pay phones are still available in hospitals and in some cases the old trolley phones can be rolled out. There has to be a balance. The introduction of the system has come at no cost to the National Health Service and it has brought great advantages to many patients. Noble Lords are understandably concerned about the huge increase in prices. That is a matter for individual trusts to discuss with the company concerned. Overall, surely it is best that patients have much greater access and immediate access to phones and television and radio services.

Lord Soulsby of Swaffham Prior: My Lords, despite the criticism of this service, I, as a user of it some time ago, have nothing but the greatest of praise for it. It provides access to a patient in hospital that is, to my mind, unique. I thank the Government for agreeing to this service.

Lord Hunt of Kings Heath: My Lords, we should listen to the voice of the patients.

Homelessness

3.15 pm

Lord Roberts of Llandudno asked Her Majesty’s Government:

Whether they provide guidance and help for people of all ages in stressful situations who might become homeless and destitute.

The Parliamentary Under-Secretary of State, Department for Communities and Local Government (Baroness Andrews): My Lords, under the Homelessness Act 2002, all local housing authorities in England and Wales are required to have a strategy for preventing, as well as tackling, all forms of homelessness. This approach involves promoting a range of practical measures to help people who might become homeless, particularly early intervention and the provision of housing advice.

Lord Roberts of Llandudno: My Lords, I thank the Minister for that Answer. I am particularly worried. What arrangements are there for those from other countries who come to the United Kingdom to alert them to difficulties regarding accommodation, jobs and other benefits? Secondly, when they have arrived

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here, perhaps near destitution and rooflessness, what co-ordinated arrangements are there to help them in their difficulties?

Baroness Andrews: My Lords, I shall answer the question in terms of people coming from A8 and A2 countries, who I think are at the back of the noble Lord’s mind. The Government have invested in an extensive information campaign in those countries to ensure that prospective migrants are aware of their rights and their obligations, particularly their rights to seek work and to access social benefits. We are trying to ensure that at the very beginning people know what the prospects are when they come and their rights. The message is essentially, “Think before you leave”.

It is important to point out that, of the people who come here, 97 per cent of the A8 nationals are in full-time employment. They contribute to the economy. We know that in areas such as Westminster, which is traditionally the part of the city that has the highest levels of rough sleeping, there are people who find themselves destitute. I visited the Passage recently, which is a place to which many A8 migrants go and where they are helped. It is under pressure, like many other places. We have recently made available over £600,000 to central London local authorities to support intervention to work with those nationals who are rough sleepers. There is quite a lot of assistance and charitable help as well.

Baroness Turner of Camden: My Lords, is my noble friend aware that the well respected charity, Shelter, has repeatedly drawn attention to the overcrowded condition in which numbers of children are now having to live, owing to the shortage of housing accommodation? It is concerned that children’s welfare and future development is being damaged by these sorts of conditions. Are the Government doing anything about this?

Baroness Andrews: Yes, my Lords. We know that it is a particular issue in London. We recently provided £19 million for local authorities to look at ways of increasing accommodation for children living in overcrowding. We have five co-ordinators working on overcrowding in London, and we have another £700,000 for the five London boroughs worst affected to develop better policies.

The Earl of Listowel: My Lords, does the Minister agree that it makes good sense to support vulnerable families so that their children do not run away or go on to the streets and become homeless? Does she see an important role, in terms of stopping youth homelessness, for the parenting academy that the Government have introduced and the new support for social work that they have been developing?

Baroness Andrews: Absolutely, my Lords. One of the main causes of homelessness is parents or relatives who are unwilling to provide accommodation for young people. We have to work hard at mediation services, and there is much more investment going into those

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services. For example, we have a supported lodging scheme for young people that is making a difference, and we have a commitment that by 2010 no 16 or 17 year-old will be in the same position. It is absolutely right that parenting schemes have a large role to play in that.

Baroness Gardner of Parkes: My Lords, while I have every sympathy with the families and young people whom we have heard about so far, is the Minister aware that there are a great many single women who have been renting rooms, particularly in London, who now find that the people who were letting rooms to them do better by selling the properties so are giving them notice? If they have only a weekly tenancy, they have nothing to go to and no claim to remain where they are. As far as I know, there are no council facilities for homeless women. Is the Minister able to tell us about that?

Baroness Andrews: My Lords, the noble Baroness raises an important point. Since 2003, all local authorities have had to develop a homelessness strategy. They should certainly be looking at people like that, identifying people who are vulnerable and providing the sort of housing advice services which can set out the housing options, pointing people in the direction of, for example, supported or key-worker housing. I will think about what the noble Baroness has said, in particular relation to that group.

Baroness Masham of Ilton: My Lords, young girls who run away from home and are sleeping rough are at great risk of rape and assault. Sometimes they have run away to get away from assault. Does the Minister agree?

Baroness Andrews: My Lords, yes, one of the primary feeders of homelessness is domestic violence. Much of the work we are doing with local authorities in setting up sanctuary schemes and so on is about ensuring that people are safe and that, if they leave home, they are picked up on the streets by outreach teams working with the police and given appropriate accommodation as safely as possible.

Lord Cotter: My Lords, the Minister has spoken a lot about young people. Young offenders frequently have difficulty finding suitable housing. If they are not looked after they are at risk of reoffending. What signposting is given to direct them to where they can find the housing?

Baroness Andrews: My Lords, that is a terribly important question. The housing advice provision now being made in prisons to give early advice on accommodation is absolutely vital. We are working in partnership with the Home Office on reducing reoffending by creating pathway programmes into housing. We have some extremely interesting pilots, working in Holloway with women offenders, for example, which I would be pleased to write to the noble Lord about.

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Wealth Distribution

3.22 pm

Lord Giddens asked Her Majesty’s Government:

Whether they are concerned about the level of inequality in the distribution of wealth in the United Kingdom.

Lord Davies of Oldham: My Lords, the Government aim to tackle poverty and asset exclusion by supporting the most vulnerable without blunting incentives for enterprise or penalising success. To spread wealth more widely, the Government seek to make saving and assets accessible to all: the child trust fund will ensure that all children enter adulthood with that financial asset; individual savings accounts have extended saving opportunities more widely; and the saving gateway is exploring ways to encourage saving further among low earners.

Lord Giddens: My Lords, I thank my noble friend for that Answer. Just before coming into your Lordships’ Chamber, I trawled through some websites, many of which said, “Pay no tax at all! Transfer your wealth abroad”. Does the Minister support the OECD’s programme for regulating tax havens, especially those that the OECD calls “unco-operative”?

Lord Davies of Oldham: My Lords, I can certainly give my noble friend a positive response to that. The Government have played a full part in the OECD to tackle this problem. The House will recognise that it is an international issue, but there is a drive towards requiring some of these areas that my noble friend called tax havens to produce standards of transparency with regard to tax accounts that are held in their area. We are making progress, but not as quickly as the Government would wish.

Lord Barnett: My Lords, I may have overlooked it, but my noble friend asked a direct question: whether the Government are concerned about inequality. The Minister could have answered, “Yes”, “No” or “Just a little bit”, but he did not say any of those three. He has given a virtual assurance that he has no intention of taking any money from the wealthy, so, if he is going to help the poorest just a little bit, does that mean that he—or a future Chancellor—has it in mind to use any future economic growth to help primarily those without any wealth?

Lord Davies of Oldham: My Lords, I am sorry that my noble friend was not happy with my original Answer. I could certainly have answered, “Yes”, but I thought that the House required the Government to demonstrate areas in which they are active, which is what I sought to do. As far as my noble friend’s second question is concerned, the answer is, “Yes”.

Baroness Noakes: My Lords, the Minister’s Answer gave a lot of examples of how the Government say that they are encouraging saving, but the plain fact is

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that the saving ratio has virtually halved since 1997. If anything, wealth inequality has increased in the past few years. Do the Government’s policies have any credibility in this area?

Lord Davies of Oldham: My Lords, on the overall position on inequality, we have seen progress in its reduction. The noble Baroness is right to say that in 2003 there was a blip in progress, but we have made progress. The most crucial aspect of the Government’s strategy is to give greatest support to those most in need. I enumerated ways in which we intend to pursue and are pursuing policies that help those people.

Lord Newby: My Lords, is it not a fact that if you are to reduce inequality, as the Minister seeks to do, you must tackle the problem at both ends and deal with the wealthy as well as the poor? Will he consider abolishing some of the tax reliefs for the wealthy, such as capital gains tax taper relief?

Lord Davies of Oldham: My Lords, the Government review our position in every Budget but, as I said in my original reply, we must balance such measures against the obvious advantages of increased investment in our society, which supports the development of growth in wealth overall. The noble Lord will recognise that that is a balance that the Chancellor has struck with considerable success during the past decade.

Lord Sheldon: My Lords, does my noble friend accept that the proportion of wealth held by the richest 10 per cent rose in the 1990s from 47 per cent to 54 per cent? What has happened is that home ownership has given a great deal of wealth to a number of people, so it is not just what you earn, but what you own.

Lord Davies of Oldham: My Lords, that is certainly an important factor, but my noble friend will recognise that an increase in home ownership has also occurred: it has risen from 67 per cent to 70 per cent. My noble friend is right. One of the striking factors has been the very rapid rise in house prices recently. Of course, there is no guarantee that the rate of rise in recent years will necessarily continue.

The Earl of Listowel: My Lords, does the Minister agree that by raising the status of those working in social care, the majority of whom by far are women—for instance, in early years care—as the Government are doing, and improving their pay and conditions, one is not only lifting them out of the poorest percentile of the nation but benefiting their children in the process?

Lord Davies of Oldham: My Lords, I agree with the noble Earl, but I also emphasise that the Government are concerned about the fact that women still earn less pay than men for comparable roles in our society. We need strategies to tackle that.

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