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Speaking as the son of someone who spent his life in the colonial service—indeed, my mother was in the colonial nursing service—I believe that Britain’s fourth contribution was imperial. We should not, at the Olympic Games or on other occasions, feel ashamed of our sovereign achievement in constructing the Empire. I have made a note of the number of ex-imperial countries that will be present at the Olympic Games: 53, at least. That is a substantial percentage of the 200 that will be there. The British imperial contribution was not simply a matter of presiding over the slave trade, as some of our critics believe. On the contrary, the British achievement was associated intimately with the abolition of the slave trade, as Nelson Mandela had the sense of historical accuracy to point out in his magnificent speech a few years ago in Westminster Hall.

These things, and others, should be emphasised in our contribution to the Olympics. The Olympic flame that we shall see in London should be encouraged to burn in their honour.

2.29 pm

Baroness Bonham-Carter of Yarnbury: My Lords, I start by welcoming the fact that culture has finally been allowed into what the noble Lord, Lord Baker, referred to as the mingle-mangle of this debate. Despite the greatness of this country’s cultural heritage—to which the noble Lord, Lord Thomas, referred—and the rich variety of its ongoing creative endeavour, the subject is too often treated as a poor relation in the arena of political debate. Culture is not a sideshow and the creative industries that it fosters are not trivial just because a lot of them have to do with entertainment. In fact, they are a key economic driver, the fastest growing sector of the economy today, notwithstanding the credit crunch.

Two years ago, leading organisations from across the cultural sector published a manifesto, Values and Visions. This pointed out that in the future,

“Britain’s economic prosperity ... will not depend on industrial prowess, natural resources or cheap labour but on developing, attracting, retaining and mobilising creativity. In this 21st century, goods, services and industries driven by knowledge and creativity will define Britain’s competitive edge”.

Those words sound even wiser today and we ignore them at our peril.

The UK has the third largest computer and video games market in the world and is the third largest market for music sales. The economic benefits of the visual arts sector are estimated to be in the region of £1.5 billion per annum. So it is to be welcomed that we now have a Minister for Communications, Technology and Broadcasting, with the added bonus that he sits in this House—I refer to the noble Lord, Lord Carter—and that he is undertaking a timely review into how to secure the UK’s place at the forefront of innovation, investment and quality in the digital and communications industries. It appears that the Government have finally grasped how important the creative industries are to the nation’s well-being.

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The importance of culture is not simply about generating income and employment. It is, to use those often repeated words of John F Kennedy,

In the UK, culture is part of the smallest government department, but it reaches into almost all other departments, certainly into all the areas that we are debating today. As regards education, creativity needs to be nurtured from the beginning. Yet it seems to me that creative skills are stifled by a school system that is dominated by exams and league tables. Priority is given to what is measurable, not to open-ended exploration.

Many noble Lords have mentioned the children, skills and learning Bill. One of its aims is to equip people with the skills that they need to realise their full potential. It is vital that creativity is central to this. Will the Minister ensure that culture is at the heart of the Bill from the start and not, as has happened in the past, belatedly tagged on or, worse, overlooked?

The Government’s Creative Partnerships scheme, which I have often mentioned, sends artists into schools to work with teachers and pupils. It helps teachers to teach more imaginatively, crucially across the whole curriculum, and to focus on developing creative skills that are fundamental to success in the 21st century. It has been hugely successful. Ofcom has given it glowing reports and 90 per cent of the teachers involved find that it improves their ability to help young people to reach their full potential, one of the Bill’s stated aims. I cannot think of a greater endorsement than that of young people reaching their full potential.

The Government are to be congratulated on initiating the scheme and on having guaranteed funding until 2011. But why is it that, despite the fact that a report by the House of Commons Education and Skills Committee into Creative Partnerships identified the scheme as “core education”, not a penny comes from the DCSF? The DCMS shoulders full financial responsibility. The annual budget of the DCMS is 4 per cent of that of the DCSF, £2 billion versus £50.4 billion. Can the Minister explain this unjust allocation of resources?

Another area in which the DCMS has been expected to shoulder a disproportionate financial burden is the Olympics. One of the reasons why London won the 2012 Olympic Games was the promise of a cultural olympiad of events to be held across the country from 2008 to 2012. However, when it became clear that the financing of the 2012 Olympics was running into difficulty, which led to the arts and heritage sector being targeted through raids on the lottery that ate into its funding, the then Secretary of State argued that the arts should contribute to the Olympics bill because the promise of a cultural olympiad would leave a lasting cultural legacy. However, as Nicholas Hytner, the director of the Royal National Theatre, pointed out at the time, the money raided from the lottery largely affects small, innovative, experimental organisations and individuals, the very organisations that are expected to be the backbone of this UK-wide cultural festival, for which, by the way, the Olympics organisers have admitted that they are providing very little funding.

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A recent survey by Arts Quarter, Impacts of the 2012 Olympics on theUK Cultural Sector, makes for sobering reading. Only a fifth of respondents see a positive legacy for the arts as a result of 2012. A substantial majority think that they will lose out as a direct consequence of the Olympics. The vision, as outlined on the London 2012 website, of a festival celebrating the diversity and richness of culture in London and the UK looks to me as if it is in peril.

We on these Benches, along with Camelot, the National Lottery operators, proposed changing the taxation regime for the National Lottery to a gross profits tax. If that had been introduced this year, it would have put £270 million back into the lottery good causes and raised an extra £120 million for the Exchequer between 2009 and 2019. It is a simple way of replacing money taken from the cultural sector to deliver the hardware of the Olympics and of ameliorating the fall-off in other sources of investment due to the credit crunch. It is very disappointing that the Government have chosen not to do this.

I cannot take part in a debate about culture without mentioning television and here I declare an interest as the associate of an independent production company. The inspired creation of the BBC, leading to ITV and then Channel 4, has played a crucial role in sustaining and fuelling British creativity. As well as nurturing the cultural sector, these radio and television channels have provided virtually free access for all across the creative spectrum. Yet one of the most pressing problems that we are facing in the cultural arena is that of ensuring the future of public service broadcasting. I believe that the digital review of the noble Lord, Lord Carter, will address that. Some argue that he should abolish the licence fee. We on these Benches disagree and so, according to recent Ofcom research, do the large majority of licence fee payers. I am a member of the Communications Committee. On a trip to America we were told by many across the broadcasting, newspaper and political spectrums how lucky we were to have the BBC as a cornerstone of public service commitment.

Today, we have many channels, some dedicated to the arts. This has its benefits but also its risks in that it potentially ghettoises such types of television. In the present economic climate, the fact that they are relatively unprofitable means that they get smaller budgets and broadcast slots outside prime time on the terrestrial channels and increasingly outside terrestrial channels altogether. This means smaller audiences with a more focused interest and the erosion of that great PSB tradition of inheritance, whereby the “EastEnders” fan or news junkie is drawn into a programme about the Emperor Hadrian, or vice versa, because that is what is showing next on the TV channel that they are watching. In the multichannel landscape of the digital future, universality of public service broadcasting must be maintained and so must plurality. There, the future poses particular funding challenges to the commercial public service broadcasters.

We on these Benches do not believe in top-slicing the licence fee. This would undermine the ability of the corporation to do what it does best and, if Channel 4 were to take public money, its unique independence would be undermined. However, we agree with Ofcom’s

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suggestion of BBC help through “practical partnerships”. Today’s response from the BBC, in the document Public Service Partnerships: Helping Sustain UK PSB, has many things that we welcome, among them that the BBC share infrastructure with ITV to offset the cost of regional news, that it share new technology, such as the iPlayer, and that it open up BBC Worldwide so that it can be used by all PSBs to exploit their content.

Finally, I share the sentiment expressed by the noble Lord, Lord Brooke, that it is extremely disappointing that the heritage protection Bill has not been included in the Queen’s Speech and that there will now be no primary legislation implemented to make the very necessary changes to the system of how we safeguard and preserve our cultural legacy. In these turbulent times, the cultural sector can provide great social, personal and economic benefits. I trust that the Chancellor will not turn to the already underfunded DCMS when looking for targets for efficiency savings.

Soon after becoming Prime Minister, Gordon Brown made a speech in which he said:

“The legacy of any Government has got to be to take culture seriously, as it is at the heart of everything that being British is about ... We have an enormous amount of creative work that makes us the great creative centre in the world and we have got to back that”.

Will the Minister assure the House that the Government intend to act on these sentiments?

I cannot make a speech on culture without demonstrating just how cultured I am, so here is a bit of Matthew Arnold. He said that culture is,

Surely that is the entitlement of every British citizen.

2.42 pm

Lord Brooke of Alverthorpe: My Lords, I welcome much of what is in the Queen’s Speech and I will be supporting it. I want to take us in a rather different direction from the two or three previous speakers and say something about drugs and alcohol public health policy. I shall be speaking as a trustee of the charity Action on Addiction. It is a relatively new charity, formed in April 2007 by the merger of three well established addiction charities: Clouds, the Chemical Dependency Centre and Action on Addiction, from which the new charity has taken its name.

Addiction is one of the biggest preventable killers in the UK. It breaks up families, it damages communities and it destroys lives. In some way, it touches all of us. Action on Addiction takes action to try to disarm addiction. It does so through a uniquely comprehensive approach that encompasses a range of responses from prevention through to recovery. We cover research, treatment and rehabilitation. We also increasingly provide support for families and children, workforce development and education and campaigns against addiction. Like many others, we have been closely involved with the Government’s first drugs strategy, which came to an end last March. While we might argue about its merits and effectiveness, we finally have an alcohol harm reduction strategy. Had I had the opportunity to

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speak on Tuesday in the home affairs debate, I would have congratulated the Government on some of the steps that they announced then, which they hope will reduce the level of crime, particularly arising from alcohol misuse.

A significant amount of money has been invested over the past 10 years in drug treatment; I believe that it is moving to close on £1 billion. As a result, more people have had access to some form of treatment and, if somewhat late in the day, we are seeing a growing recognition of the need to provide proper support to families and carers, including children. The current strategy brings the needs of families to the fore. I am not sure that the culture of the commissioning and treatment system is yet ready to respond appropriately. In some areas, there have been clear improvements in commissioning and service provision. In respect of the latter, I acknowledge the contribution of the European Association for the Treatment of Addiction in introducing an internationally recognised accreditation scheme. We now need to learn the lessons of the past 10 years and act accordingly. Therefore, I shall focus on the four areas that we believe are key to an effective second stage of the strategy: treatment, research, family support and workforce development.

The predominant mode of treatment for heroin users remains a methadone prescription. There is no argument about the fact that methadone maintenance is a legitimate, evidence-based and necessary intervention if we want to help to stabilise chaotic drug users’ lives and reduce crime. However, we must wise up to the fact that this predominantly pharmacological approach has all too often been deployed as a response to the demand to achieve targets of numbers of people in treatment rather than to secure sustainable long-term benefits and to be the platform from which individuals can make progress to a life free of drug dependence.

Maintenance works when it is provided as part of a meaningful package of support, but I am disheartened to learn that it is common for people on methadone to be seen for as little as one and a half hours a month and to receive evidence-based psychological interventions for less than four hours a year. There appear to be no reductions in alcohol or crack use, and problem drinking is said to exist in 40 per cent of methadone clients.

It appears that to all intents and purposes the goal of a drug-free existence—not for its own sake but because it is something that is known to bring a wide range of benefits to the individual, his/her family and society—has fallen off the radar. This makes little sense when we consider that major outcome studies, including the UK’s own national treatment outcome research study, which was the very thing that gave rise to a treatment strategy, indicate that abstinence is a viable treatment goal achievable by large numbers. It also fails to take into account the fact that, according to one leading researcher, most clients would prefer not to have methadone, and certainly not for life.

The neglect of the abstinence option has resulted in significant damage to the sector providing services working to that model. Action on Addiction is in that field. These are primarily voluntary sector-based organisations and many are residential units. Yet the NTORS stated clearly enough:

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“The clients in the residential programmes presented with some of the most severe problems and complex needs and these clients made some of the greatest treatment gains”.

While full cost recovery is seldom an issue for prescribing services, it most certainly is a problem for those providing abstinence-based programmes. Should it really be easier to stay on drugs than to get off them, as presently seems to be the case? Why is it perceived in many quarters that abstinence-based programmes have not been given the same support as chemically delivered programmes have? Maybe that is a misunderstanding—if it is, I will be pleased to hear that from the Government—but there is a general perception that little sympathy has been given in recent years in this direction. I do not want to exacerbate the divide that has grown up between different treatment modalities—quite the contrary. I want a treatment system that encourages and facilitates people to move out of their drug-dependent lifestyle, to experience maximum well-being and to fulfil their potential at the earliest opportunity.

We need intensive and extensive treatment and rehabilitation and in that regard I draw your Lordships’ attention to Action on Addiction’s Working Recovery project in Boscombe, Bournemouth, which operates under the compelling slogan:

“A working recovery is a recovery working”.

That pioneering project helps to build on the gains made in treatment, supporting people to develop life skills and to enter employment and training. Working Recovery, which has depended almost entirely on charitable grants, is celebrating its 10th anniversary. The pride that participants feel when they come off benefits as well as drugs is indeed a moving sight to behold.

People can, I believe, achieve much more than we are inclined to think. We should incentivise progress to the exit from dependence, rather than continue with policies and practices that encourage inertia. Treatment is not only important to one generation. Well over a million children are growing up in households where parental alcohol and drug problems dominate their family life. Seeing that parents have the best chance of recovery is an investment in their children’s lives, too.

On research, if we are to improve our treatment system to achieve the goals to which I have alluded, we need to learn more about what helps people to progress. Momentum is, happily, growing within what has become known as the recovery movement. There are large numbers of people in drug-free recovery across this country. We need to understand the factors that helped them to initiate and sustain recovery, then ensure that our treatment system takes full account of what we learn to make it possible for more to have that experience. That is one direction that research should take. One aspect of the recovery movement that I applaud is the drive to establish local recovering communities, which have the potential to effect a significant cultural and social change on communities blighted by drug misuse. The more we can increase our understanding of how that can be made to work, so much the better for the whole of the country.

On families and children, there are literally millions more people personally affected by someone else’s substance misuse than there are actual substance misusers.

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The wide and varied range of symptoms relating to the psychological and physical distress that they suffer—anxiety, depression, aches and pains, disturbances—is multiplied by the number of people suffering from them and the treatment received. We should recognise and address that as a major public health issue. Any other condition placing that level of demand on our health service would certainly be viewed in that light.

Action on Addiction’s Families Plus—also celebrating its 10th anniversary—has shown that, with the right kind of economic support, these symptoms can be dramatically improved. If such interventions were widely available, significant savings would be made to the health and social costs associated with the distress caused. Furthermore, Families Plus argues that supporting family members and families in their own right, rather than simply in relation to the treatment of the substance misuse, could well have a significant beneficial impact both on the family members and on the misuser. That is another area that we need to investigate much more thoroughly than we have done so far.

The Moving Parents and Children Together programme, devised by Families Plus, is timely indeed. With alcohol and drug misuse becoming ever more socially entrenched, we are beginning to see several generations afflicted with this problem. The children who grow up in these families are isolated, vulnerable and disadvantaged. They often do not have a voice. Many end up effectively taking care of their parents, losing their childhood in the process. They are at significant risk of developing a host of problems. M-PACT offers these children and their families an opportunity to make collective change, with the help and support of other families in similar situations.

Action on Addiction aims for this programme to become available across the country, so that fewer children go to bed at night feeling that drugs or alcohol are more important to their parents than they are. I hope that, while my noble friend the Minister may not be able to respond on this point, in the context of some of the problems that we currently see in dealing with children he will ensure that the department reviews this again, to see whether we can start to see more work done around the programme that I have been describing.

Finally, as I am running out of time, I will mention workforce development. As so many other contributors have said, particularly when speaking on the health service, it is vital to have people in the field who are not just keen to be there but want to make change. They should be handed all possible support and training, to ensure that their work produces the result that we need. Again, I believe that Action on Addiction has contributed significantly here, by establishing a Centre for Addiction Treatment Studies, where students are trained to degree level on courses that equip them to become addictions counsellors and to work in a variety of settings and modes. The centre has formed a productive partnership with the University of Bath, which awards the foundation and honours degrees. The aim of the centre is to raise professional standards across the UK. I would like to see workforce development promoted

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much higher up the agenda in the drugs and alcohol field. How else are we to see that the significant sums of taxpayers’ money mentioned as being committed to treatment are being well spent?

2.56 pm

Lord Colwyn: My Lords, the gracious Speech announced a new health Bill and made further commitments to providing a healthcare system organised around the needs of the patient. The Minister has explained that the Bill looks to build on his report, to improve the quality of NHS care and services and to improve public health by creating an NHS constitution.

This debate enables me to bring to noble Lords’ attention the state of NHS dental services in the UK, with the progress that has been achieved throughout 2008, and to suggest what needs to be done in the coming year to provide the dental service that the Government clearly realise is needed. Providing quality care and services is something that dentists pride themselves on. I must declare an interest in that I am on the dental register and, although I am not practising, from time to time I offer noble Lords advice on their teeth.

The April 2006 dental services contract had the stated aims of improving access, getting dentists off the treadmill and enabling a more preventive approach to care. Sadly, the combination of a target-driven, treatment-focused contract, with poor commissioning by primary care trusts and a lack of prioritisation by strategic health authorities has made it increasingly difficult for dentists to provide the high quality and personal service for which they have been trained. I look forward to hearing from the Minister how the health Bill will impact on dentistry.

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