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To slow the pace of reform now, to hint at any return to command and control, would put this at risk. I am told, and the noble Lord, Lord Darzi, has repeated it, that there is no intention to reverse the process of reform. But I hear different mood music, a subtle silence that will not do. The word “choice” has disappeared from documents. Competition from the independent sector is no longer talked about. Yet unless there is overt, visible drive, the reforms will stop. The great NHS machine will see to that. Rather than slowing down, the Government need to step up the pace of reform, to build up the capacity of commissioners and to improve the range and quality of information on clinical outcomes that are available to patients and the public, both to inform choice and to stimulate clinicians to improve their own results. We have the mortality data, which is a start. We need far greater outcomes data. We must support boards, senior managers and clinicians in developing the capabilities that they have to empower front-line staff and lead high-performing organisations.

In Monitor we have tried to do a number of things. I have mentioned service line reporting. We have introduced with the Cass Business School at City University a tailored training programme for finance directors to help them to make best use of the freedoms offered to foundation trusts. We are developing a training programme for non-executive directors to help them to challenge their executive directors more effectively and to help to drive performance.

The review that the noble Lord, Lord Darzi, is undertaking provides an excellent opportunity for the Government to cement their commitment to reform. If the reforms are combined with effective regulation, which I hope we will see from the forthcoming Bill, we will have a chance of sustainable improvements in our health and social care services.

2.10 pm

Baroness Morgan of Huyton: My Lords, in speaking about the education section of the gracious Speech, I particularly welcome the emphasis that it placed on giving all a chance to fulfil their potential. In this context, I believe that raising the school leaving age is a symbol, offering to all that which is currently available to some. I am pleased, however, that this will be a phased-in measure, not taking full effect until 2015, as rushing quickly would be a mistake. After all, this will work only if the levels of overall literacy and numeracy from the early years through primary and secondary schools are raised for those currently underachieving. Alongside it, we need a renewed emphasis on the curriculum available for 14 to 19 year-olds and the rolling out of the much needed expansion of apprenticeships. I recall talking last year with a group of British Aerospace apprentices in Preston, who spoke enthusiastically of their renewed interest in learning. Finally they could see the point, as it was in the context of their new and exciting jobs. There is much to be said for learning from existing apprenticeship schemes.

The comments of the Secretary of State for Children, Schools and Families about the obligation

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of the Government to offer a range of choices and a strong curriculum are very positive. If the raising of the school leaving age is seen predominantly as punitive rather than as an extension of opportunity, we are in danger of antagonising the very pupils whom we are seeking to reach, and I welcome the overall approach in this area. It is of course right, however, that schools, the Government, parents and pupils all have shared responsibilities. Our hope must be that legislation by 2015 becomes almost irrelevant because we will have reached almost full participation by that date. However, the promise of the legislation will, I believe, act as a bit of a kick to the system.

That kick is still necessary. I am currently chairing a charity, Future Leaders, which trains potential head teachers for the most challenging urban secondary schools. It is focused and strongly mission-led, making it absolutely clear that excuses for failure are unacceptable. The lead tutor is a great former head teacher, Sir Iain Hall, who used to teach in the north-west. Every Friday he writes an uplifting missive to the participants. This week’s communication was particularly pertinent. He writes:

On the whole, they are not there through their own actions, but through a range of other influences.

Sir Iain goes on to ask us to imagine the consequences of the slot machine. With the first pull of the lever, he states:

today it could be a girl as well.

With another pull of the lever, the machine spins again:

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Let us try again:

The machine is set for one last spin:

They have plenty of company, but not much likelihood of success.

Sir Iain then urges the participants, these future head teachers—whether they had a lucky start in life or managed themselves to break through the barriers, perhaps because they had the opportunity of attending a great school—to help those in the coming generations to break through these barriers, too, and to help pupils to raise their sights by delivering to them the education that they clearly deserve. That almost missionary zeal to raise the life chances of disadvantaged children through education is one that I believe we all can and should support. It is no longer acceptable, thank goodness, to be fatalistic and explain failure in detail. Our responsibility is to deal with failure and underachievement.

There is another group of children not picked up in those Rowntree Trust figures: children in care. The low achievement of these children is well documented and I am delighted that the Children and Young Persons Bill will offer protection for older children and minimise school movements, both very worthwhile measures. I know that we will spend a good deal of time debating those issues in this House.

It is vital that, in addition to the new Bills announced in the gracious Speech, there is continued effort on the basics, the building blocks of achievement. So there can be no let-up in the concentration on literacy and numeracy skills; without them, a wide-ranging and fulfilling later education is impossible. I would urge further consideration of, as Jim Rose advocated, the use of synthetic phonics in our schools. I confess personally that, if a school is not achieving high literacy rates and is not choosing phonics, I would want to know why. In this area, as in so many others, intervention is both justified and necessary.

The Prime Minister’s recent speech on education emphasised that the Government will close failing schools quickly. That has to be right. We cannot stand by and let a generation of young people fail in case the school gradually improves a bit. The extension of city academies in this context, particularly sharing the expertise of leading independent schools and universities, is very welcome.

The recipe for great schools does not change; for me, it is a concentration on teaching and learning, a

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focus on literacy and numeracy until students reach an adequate level using whatever extra help it takes at whatever level of schooling, a strong school ethos with clear codes of behaviour understood and operated by the whole school community, the expectation and celebration of success and, crucially, a great head teacher leading a committed team.

Recently I visited a school in Liverpool, the North Liverpool Academy, formed by the amalgamation of two poor comprehensive schools. It is in one of the most deprived wards in the UK, where the head and her teaching staff are totally focused on transforming the opportunities for the pupils by concentrating on each student, one by one, and stretching them to go as far as they possibly can achieve. That focus and commitment was humbling and the response of the pupils remarkable. Yesterday I spoke to the head teacher, Kay Askew, to ask her permission to mention the school to noble Lords today. Her response was, “Yes, please, but you must tell them this”. I promised that I would, and she went on to say that,

Kay Askew is right to be proud, as she clearly is. It is in schools such as this that we can really deliver the opportunity for all, for which we strive. I look forward to our debates around this subject in the coming year.

2.20 pm

Baroness Howarth of Breckland: My Lords, the gracious Speech outlined by the noble Lord, Lord Darzi, certainly has vision, as the noble Lord, Lord Warner, said in his inimitable way, but vision has value only where it has application, and the government programme will succeed or fail on its implementation and outcomes. Remember: aspiration is not achievement. As deputy chair of CAFCASS, I know that only too well, having moved into an organisation whose conceptual framework was excellent but whose application and implementation were chaos. Fortunately, with a strong board and a superb chief executive, we now have an organisation serving more children than any other social work department, and serving them well. But it shows that you have to have a clear plan of implementation whatever the concept of the vision.

The Government tell us, for example, that they want the best for children and young people, especially children in care. I know that that is a continuation of the Every Child Matters agenda, on which I congratulate the Government, but there remains much to be done. I continue to watch with

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care and interest—I will no doubt come back to the Minister on this at some point—the way in which Ofsted inspects some social care services.

We know that children want to be heard, to be emotionally understood and to have continuity in their care, but that can be achieved only if we have the right professionals in place. In his discussions the Children’s Rights Director, Roger Morgan, was told of the importance of social workers in the lives of children and young people in care—indeed, one in three of the children and young people in his survey saw them as among the most helpful and important people—and yet we still fail to value them. Consequently, there is a high turnover in many areas and it is extremely difficult to recruit, particularly in London.

Surely the children’s voices should be heard here. So perhaps I may quote one young person who, looking back on their time in care, said:

Contrast that with the experience of a man called Michael, who came into care at birth. His childcare officer saw him through placement breakdown and approved schools into a secure foster home and through the formation of his own secure family—50 years of contact. He credited much of his emotional security to her and his foster families’ consistent emotional connection to him. Of course there were care plans, but he received what another child described as wanting from their ideal social worker:

I do not expect that every child will have a care worker such as the one I have described, but does the Minister think that we will come anywhere near this in the new Bill while we continue to undervalue and underpay the social work profession? Will he not commit himself again to improving conditions so that children have people with the right skills and attitudes to meet their needs? It is that and not more structural change that will achieve what I know the Government and the Minister seek.

As I am speaking of children in care, perhaps I may raise an issue that came to mind during the debate. If we are trying to keep children in placements consistently, what will the Government do about school exclusions? Many children with difficult backgrounds are difficult in class and in some schools there is great encouragement to exclude them because of the difficulties they cause for others. There is a real conflict of interests here and I should be interested to know how the Government intend to tackle the issue.

The question of value arises also in other fields. For example, does the Minister consider it appropriate that support workers for young adults with challenging behaviour that stems from learning difficulties—whose tasks require skill, a capacity for careful risk assessment, and the charge of these young people on behalf of their parents—should be paid barely above the minimum wage? I recently heard that

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a cleaner at Heathrow could earn almost as much as a support worker working with people with learning disabilities.

One example after another—it is only shortage of time that prevents me giving further illustration—seems to demonstrate that personal care has become the poor relation in health, education and the social care spectrum. That was stated far more eloquently than I can by the noble Earl, Lord Howe. I would like the Minister to reassure me that when the legislation is introduced to create what is described as a strong health and social care regulator, social care will have as central a position as health.

Social care increasingly affects more people than health, yet we spend huge sums on acute services to save people with brain injuries or premature babies, only to tip them out into an inadequate postcode lottery of community support services. If you bust your head in a car accident and survive, most likely with serious personality changes and physical disability, you may be lucky enough to be in the catchment area of a brain injury support unit such as the Grooms-Shaftesbury in Suffolk; but you are much more likely to have very little indeed apart from your frantic family, and we know that many of these families break down. We need a regulator who, apart from monitoring existing services, is able to say something about this; a regulator who has the same commitment to users as the Commission for Social Care Inspection has demonstrated under the leadership of Dame Denise Platt. Progress since the commission’s inception has been strong, with an increase in 2005-06—for the fourth consecutive year—in the average percentage of minimum standards met in the services inspected by the commission.

The commission also drew attention to the matter raised by the noble Baroness, Lady Barker, which I also emphasise: the gap in the legislation protecting the human rights of elderly people in private homes. I hope that we can fill that gap during this Session.

As the Healthcare Commission merges into the new super-regulator, the Care Quality Commission, I ask the House to ensure that, in its consideration of the Bill at all stages, the voice of social care is strongly maintained and carried forward. It would be wrong not to note that there are serious concerns in the social care and voluntary sectors about the proposed merger. Too many people are closely affected by these services. Any of us sitting in this Chamber, our friends and our families might need to use those services.

The commission has led much of the debate on improvement. It has championed individual budgets and direct payments, examined the workings of the market for care and carried out a range of well-regarded and important studies. I therefore ask the Minister whether it is true that, as the legislation is currently drafted, the new commission will be precluded from producing reports or studies until 2010, and then only after an annual discussion with the Secretary of State. I thought that the new Government were to be more open and transparent. If the position I described is true, it smacks of extraordinary control over the facts being collated by the new commission in its wider role.

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Whether it be for vulnerable children, people with a variety of disabilities or the steadily increasing numbers of frail elderly people in need of support, social care is vital to our civilised society. To meet this need it must not be lost in other services but be a true and equal partner with health and education, meeting the aspirations of our people to enjoy a full life and to experience emotional—as well as good physical—health and well-being.

2.29 pm

Lord Soley: My Lords, I welcome the emphasis in the Queen’s Speech on children and education. The Government’s emphasis on those areas over the past 10 years will make it hard for future Governments of any complexion to reverse the progress that has been made.

I want to touch on the issue of parenting, one of those issues that are profoundly difficult for politicians and Governments to talk about and yet intensely important to the quality of an individual’s life and the society we live in. Recently I have seen headlines, not just from the Leader of the Opposition but across the board, about how we live in a “broken society”. We really do not, and the evidence for that is very strong. I understand how, if you read the newspapers every day, particularly about what young people are doing, or indeed watch too many episodes of “EastEnders”, you might come to the conclusion that the British public generally, not just young people, could be put into two boxes: one marked “Psychopathic killers” and the other “Depressive and addictive personalities”. Actually, society is much better than that. The polling that was reported on the BBC recently, showing that about 70 per cent of people regard their family life as being high quality, is much closer to the truth. It is time that we started paying attention to the successes in this area.

As I say, talking about parenting is always difficult for politicians and Governments, but it runs through much of what they are trying to achieve. It interests me that the teenage years—which are a nightmare for teenagers and parents alike, incidentally—are the ones that we find most difficult to deal with. Schemes such as Sure Start, of which I am a great supporter, and the child trust fund are profoundly good at the early years stage, and we are getting much better at helping parents and families to deal more effectively with the early stages of life. When it comes to the teenage years, we all seem to back off a bit because it is so difficult.

It does us no harm if, whether as parents or as people who do not have children, we sit down quietly in a corner somewhere and remind ourselves what it was we did as a teenager—not all the good times we had, but the things we did that were both bad and deeply embarrassing. When I have done this exercise, it has often taken me so long that I have had to come back to it at a later stage and say, “I have a lot more work to do on that”. I suppose I should not go too far down this road because the Bishops might say, “Yes, we agree with you”, and I will end up doing “Thought for the Day” on Radio 4. What is important is not just that the exercise is good for your soul, but that it puts

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you in touch with your feelings as a teenager and therefore with some of the problems teenagers face today, which are not essentially different from what they used to be. There are some differences—the availability of drugs, and things of that nature—but by and large teenagers’ problems are not that dissimilar. It is important to try to understand that.

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