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The Sale of Student Loans Bill is being introduced by the Department for Innovation, Universities and Skills. The student loans book is an asset of £18 billion, which will grow significantly over the next decade. The Government’s established policy is not to retain assets unless to do so fulfils a public policy purpose. We believe that in principle the private sector is able to manage the risks associated with this loan book and has an appetite to do so. However, in response to the points made by the noble Lord, Lord Higgins, and my noble friend Lady Warwick on behalf of the universities, let me stress that this is an enabling Bill. The timing of any sales will be at the discretion of the Government and we would obviously carry through such sales only when we believe that they will be advantageous to the taxpayer. I should reiterate that the Government are not altering in any way their policy on student support. Student loans will not become commercial loans. Borrowers with student loans will experience no difference whether their loans are sold or retained in the public sector. The experience of the students will not change at all as a result of these reforms.

The Health and Social Care Bill was set out more fully by my noble friend Lord Darzi in his opening remarks. By bringing together the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission into one body, we will create a more efficient, integrated regulator, much like the merger of children’s services inspectors with Ofsted two years ago. I am glad that this move has been broadly welcomed by the noble Earl, Lord Howe. I agree with him and others speaking in the debate that the culture of an institution is vital to its success and is much more important than the precise legislative provisions we make. I also want to reassure my noble friend Lady Pitkeathley that it is important to retain the expertise of all three predecessor bodies, not least the Commission for Social Care Inspection, in the new organisation. It is central to our policy that that should be the case.

The noble Earl, Lord Howe, asked where the duties of the Care Quality Commission will extend to PCTs. I can tell him that the commission will publish independent comparative information, including an assessment of the performance of commissioners for both health and adult social care—which means both PCTs and local authorities. We see that as important to maintaining public confidence in the transparency and accountability of commissioners and in how effectively they use public money. However, it is important that the new commission should not duplicate or overlap with the role of strategic health authorities and, as with the current regulators, the Care Quality Commission will not have powers to intervene with PCTs as commissioners. Intervention, including action to develop PCT capability where necessary, will be part of the performance management role of strategic health authorities.

The noble Earl also asked whether the Care Quality Commission would handle complaints. We have decided that it would not be appropriate for the new regulator to have a role in processing individual health or social care complaints, but rather that it

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should have a role in looking at the outcomes from complaints and focusing on the standard of complaint handling. However, the detailed requirements of regulation by the Care Quality Commission are likely to require all providers of NHS and adult social care services to have appropriate complaints processes in place, and the boards and senior managers of provider and commissioning organisations will be responsible for ensuring that local complaints arrangements are robust and able to deliver a full and accurate response to anyone making a complaint. I am informed that the responses to the Making Experiences Count consultation, which ran from June to October of this year, indicated overall support from respondents to this approach.

The Bill will also deliver on the Government’s commitment to improve clinical governance in response to Dame Janet Smith’s recommendations following the Shipman inquiry, and it will update existing legislation to enhance professional regulation as set out in the recent White Paper, Trust, Assurance and Safety. The noble Baroness, Lady Barker, my noble friend Lord Warner and others raised the issue of the standard of proof in professional regulation, which is a matter that will have to be considered in detail as the legislation goes through. As noble Lords said, the Bill will require all health and social care regulatory bodies to adopt the civil standard of proof during fitness to practise procedures. It will require each regulator to include this requirement in their fitness-to-practise procedure rules, and it will also apply to the new independent adjudicator. I know that concerns have been raised about this, but we believe that the proposal is appropriate and that it is right to proceed in this way because of concern that the use of the criminal standard protects the interests of the professionals regulated by the General Medical Council, the General Optical Council and the Nursing and Midwifery Council at the expense of the patients they are there to serve.

I also note that 10 of the 13 regulatory bodies covering the regulation of health and social care across the United Kingdom already use the civil standard of proof. Further, it applies in other areas where professionals can potentially lose their livelihood. For example, since 1999 the Independent Police Complaints Commission has employed the civil standard in misconduct proceedings. We believe that this reform is well founded and serves the wider public interest in the delivery of health services.

As noted by my noble friend Lord Darzi in his opening remarks, the Government are also introducing through this Bill new benefits for expectant mothers which we believe will further improve support for children, particularly those coming from poorer and more vulnerable families. The health and pregnancy grant will be a one-off payment made to all expectant mothers in the final stages of their pregnancy who are ordinarily resident in the United Kingdom. This, like so many of our other reforms as set out in the gracious Speech, builds on 10 years of systematic improvements in the quality of provision available to individuals through our public services. In the specific case of the health and pregnancy grant, it builds on an increase in statutory maternity pay from 26 to 39 weeks, on the

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creation of a new right for fathers of up to 26 weeks’ additional paternity leave and pay, and on the extension of the right to request flexible working to carers of adults.

A host of other points were raised and I will run through a few briefly before I conclude. The terrible situation in child trafficking, which was raised by the noble Lord, Lord McColl, and the noble Baroness, Lady Morris, is one to which we have been giving a great deal of attention and action. The United Kingdom Government signed the Council of Europe Convention on Action against Trafficking in Human Beings this March. On 3 October last year, the UK Human Trafficking Centre was set up. It plays a key role in co-ordinating work across stakeholders and with its partners delivers a diverse set of programmes, including targeted campaigns, to prevent and reduce the trafficking of human beings.

The noble Lord, Lord Colwyn, raised the issue of NHS dentists. I promised the noble Lord that my noble friend Lord Darzi would reply to him. When I mentioned this to my noble friend he said that he replies almost weekly to the noble Lord on issues relating to NHS dentistry. But I promise the noble Lord that a still larger torrent of letters will be coming in his direction to deal with the issues that he raised.

Let me set the wider context. There has been very significant increased investment in NHS dentistry. In this financial year, NHS spending on dentistry is over £407 million more than it was in 2003-04. This has, for example, enabled a 25 per cent increase in undergraduate training places. I could say a great deal more but that is a good news story to tell while recognising that there are still issues, including some of those which the noble Lord raised.

The noble Lord, Lord Fowler, raised the issue of public health budgets and the attention paid to public health among the many other priorities in the NHS. Ultimately, funding arrangements are a matter for the NHS and primary care trusts. We believe in devolution and the making of decisions, where possible, at the local level. We think it is right that they should be free to prioritise their local funding according to local needs. However, there are key targets for sexual health—an important area mentioned by the noble Lord and in which he has done great work over the years—which must be included in all local PCT delivery plans and we are working on major improvements to the way in which data are collected to improve performance management in this area. PCTs must be able to show what they are doing to improve waiting times, to reduce infections and to deal with these other public priorities.

Sexual health was one of the six top priorities for the NHS in the past year, as outlined in the NHS planning and priority framework, and the 2007-08 NHS operating framework confirms that sexual health and access to genito-urinary medicine services will continue to be a priority for the NHS in the year ahead.

In conclusion, let me latch on to the remark of my noble friend Lord Warner, who said that the gracious Speech was a good blend of the visionary and the

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practical. It also needs to be seen in the context of very significant increases in public investment in all of the key areas of public services over the past 10 years. One can have the greatest visions possible in the world but when it comes to delivery of improved education and improved health, without resources very little will be achieved. While I do not in any way question the commitment of noble Lords opposite to quality public services—I pay tribute to those who have been Ministers in the past and have carried through significant improvements in some areas—if we take health specifically, the fact that in 1997 public investment was £35 billion and today it is £90 billion, rising to £110 billion by 2010-11, is the single strongest testament to the commitment which we on this side of the House have to seeing that quality public services are not simply an aspiration but become a reality for the overwhelming majority of people in our country.

We recognise that there is still more to do. We are not in any way complacent but this gracious Speech builds on 10 years of sustained investment and reform; it builds on significant improvements in quality; and it is a testament to our commitment to building a more open and more equal society. I commend it to the House.

Baroness Crawley: My Lords, on behalf of my noble friend Lord West of Spithead, I beg to move that the debate be adjourned until Monday, 12 November.

Moved accordingly, and, on Question, Motion agreed to, and debate adjourned accordingly until Monday next.

Bournemouth Borough Council Bill [HL]

The Chairman of Committees informed the House that, in accordance with Private Business Standing

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Order 150A (Suspension of Bills), the Bill had been deposited in the Office of the Clerk of the Parliaments together with the declaration of the agent. The Bill was presented and read a first time. It was then deemed to have been read a second time and reported from the Select Committee.

Manchester City Council Bill [HL]

The Chairman of Committees informed the House that, in accordance with Private Business Standing Order 150A (Suspension of Bills), the Bill had been deposited in the Office of the Clerk of the Parliaments together with the declaration of the agent. The Bill was presented and read a first time. It was then deemed to have been read a second time and reported from the Select Committee.

Transport for London (Supplemental Toll Provisions) Bill [HL]

The Chairman of Committees informed the House that, in accordance with Private Business Standing Order 150A (Suspension of Bills), the Bill had been deposited in the Office of the Clerk of the Parliaments together with the declaration of the agent. The Bill was presented and read a first time. It was then deemed to have been read a second time and committed to an Unopposed Bill Committee.

Transport for London Bill [HL]

The Chairman of Committees informed the House that, in accordance with Private Business Standing Order 150A (Suspension of Bills), the Bill had been deposited in the Office of the Clerk of the Parliaments together with the declaration of the agent. The Bill was presented, read a first time, passed though all its remaining stages pro forma and sent to the Commons.


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