I am keen on two other things. One of my predecessors as Transport Minister was the great Fred Mulley. Denis Healey once said he thought that Fred was the most underrated Minister in Whitehall. He may well have been because he was a delightful fellow. Later, after I left transport, I served under him at defence. He loved roundabouts. I hate roundabouts. They are the biggest damned-fool contribution to road congestion in this country. If I had my way, we would replace every God-damn roundabout in sight with grade separation. It would cost a lot of money but this fellow, the Transport Minister, has lots of money for capital improvements. It would speed up the traffic, reduce pollution and add to road safety in this country.

There is one other thing that I did not get around to doing in the 15 months that I was at transport. We should have at least one overhead gantry sign before every turnoff on every motorway. If you do not have them and there is a line of lorries on the inside lane, you do not even see that your exit is coming and you can miss it very easily. There are lots of ways in which sensible money can be spent on the transport infrastructure of this country without wasting it on mad ideas such as airports in the middle of the North Sea or high speed rail and trains that we do not need. I am grateful to noble Lords.

8.42 pm

Baroness Walmsley: My Lords, I like roundabouts. They often have flowers on them and are very good reservoirs for wildlife. I shall focus my remarks on the Children and Families Bill that is currently going through another place. I am pleased to say that there are several things to welcome; for example, the improvements in the independence of the Office of the Children’s Commissioner. Like Oliver Twist, I always want more, so I will be hoping for a few further improvements. However, generally, the Bill provides a great step forward and one that will allow the Office of the Children’s Commissioner to take its place at last around the table of international children’s ombudspersons.

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I also welcome the changes to the arrangements for children with special educational needs, for which we have to thank my honourable friend Sarah Teather, the former Minister of State for Children and Families. Thanks to her, at last we will have a holistic approach to the needs of these children. I know that there are concerns about this and how it will work but I am sure we can sort that out when the Bill comes to your Lordships’ House.

I welcome the parental leave measures and I welcome with caution the changes on the arrangements for adoption but it is a pity that the Government did not take the advice of the Select Committee on Adoption Legislation in relation to racial matching and how soon fostering for adoption can be considered. Those matters will be debated in more detail on Thursday afternoon, so I will keep my powder dry until then.

The main issue on which I shall concentrate is the proposal to change the ratios of adults to children in early-years settings. I think that that is a daft idea. I am a great believer in evidence-based policy and in consultation. I am afraid that there is no evidence that these proposals would result in either an improvement in the welfare of children or in the affordability of childcare. When 95% of the professionals responding to a consultation tell you that you have got it wrong, the Government must pause for thought. Fortunately, my own party leader, the right honourable Nick Clegg, read the consultation responses and took notice. I was delighted with his statement that he is not convinced these proposals should go ahead. I agree and hope that he will stand firm.

The Government report, More great childcare, proposed changing adult to child ratios for babies under two years from one to three to one to four, and for children aged two to three years from one to four to one to six. Of course, some might say, “I had four children and I managed”. Yes, but they were not all under two at the same time. We need to remember that, however well qualified and committed, a child carer has only one pair of eyes and one pair of hands. So to be asked to look after too many children could actually put children in real danger as well as impeding their development.

These changes are counter to research evidence on quality and ratios. The current ratios are not there by accident but for a very good reason. Research for the Department of Education by Munton, Barclay, Ballardo and Barreau in 2002 and research from New Zealand in 2011 indicates the safe and effective ratios and I do not believe that they should be changed. It has been said that Sweden, whose childcare we all admire, has no national ratios. However, it has ratios but these are established locally.

Changing the ratios so that young babies vie with three others for their needs to be met by one practitioner will inevitably mean that many of their attempts at communication through eye contact, babbling and pointing will be missed. Yet evidence tells us that it is the responsiveness of the carer, noticing and responding to these small signs of communication and mirroring the child’s facial expressions, which supports language development.

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As we all know, language development is one of the most important factors which must precede learning to read. A confident speaker with a wide vocabulary will become a confident and happy reader, and that will have an enormous impact on his future academic achievement. Research by Wells and Nicholls, Language and Learning: an Interactional Prospective, and significant articles from The Journal of Child Psychology and Psychiatry provide the proof of the importance of interaction with adults in language development. This would be impeded if the ratios were increased. The changes are also counter to evidence and recommendations in the government-commissioned Nutbrown review of 2011. I believe that Professor Nutbrown, among many other professionals, has expressed her concern about the Government’s proposals.

If ratios are revised upwards, babies will find their care needs to be less well met, leaving less time for peaceful cuddles during feeding or for patient coaxing during weaning. Responding quickly to need plays a large part in supporting babies’ development of empathy and self-control. A recent book by Paul Tough, How Children Succeed, brings together evidence from numerous research projects in the United States, one of which shows how important is the touching and cuddling of the baby to brain and social development. This helps the child to develop resilience and the ability to concentrate and persist in a task, all essential for future success. Much of this is, of course, provided by the parents, but when a child is being cared for by somebody else it is very important that this interaction is carried on.

The main reason given for the idea of changing the ratios is to make childcare more affordable for parents. However, we are told that settings will be able to raise the ratios only if they have highly-qualified staff. While I strongly support the aim of increasing the qualifications of staff working in the early years, I cannot see how this would bring the costs down. More highly-qualified staff will want to be more highly paid, thus cancelling out any savings that might have been made by the nursery by taking on more children per adult. It is only right that staff who work to get higher qualifications should expect to be paid more. Otherwise, why would they bother? The sector is not highly paid, so there must be some incentives to train.

Andreas Schleicher of the OECD has been quoted in support of the changes, but what he actually said was that, while staff qualifications are more important than ratios, the research relates to “formal schooling—primary, lower secondary and upper secondary”. But here we are talking about the youngest children who have very different needs. Sir Michael Wilshaw, the head of Ofsted, has also been quoted in support of the Government’s proposed changes, but Ofsted has taken no public position on the matter. Sir Michael rightly supports improvements to staff qualifications, but he accepts that the arguments for the youngest children are different.

I know that these changes would be voluntary, but it is clear from the consultation that most parents do not want them either, and I think they will look very carefully at ratios when choosing care for their children. There are other ways of making childcare more affordable while protecting quality and the Government have

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made a great start with recent announcements about tax relief. The noble Lord, Lord Griffiths of Burry Port, who is not in his place, said that education is a good investment. I agree with him; indeed, I usually do, and today is no exception. But good quality early years education is a particularly good investment, beneficial to the individual and to the economy, and the Government should embrace it. The evidence for this is “sky high”, to quote a Scottish Minister when proposing more Scottish Government investment in the field. Will my noble friend the Minister look kindly on the evidence when the Children and Families Bill comes to your Lordships’ House?

8.51 pm

Lord Turnberg: My Lords, the Care Bill represents an important recognition by Government of the need to tackle one of the major problems facing society: how we cope with the growing number of elderly dependent people. The fact is that we are all living longer, and although we are also remaining healthy and active for longer—here I must disagree slightly with my noble friend Lady Hollis; we are extending healthy life for longer, at least for women—we are leaving behind a long tail of unfortunate elderly people who are increasingly disabled with multiple chronic illnesses, many living in poverty, lonely and neglected. It is this growing group that is too frequently admitted to hospital as an emergency when they are tipped over by an acute exacerbation. They stay in hospital for far too long when they would be much safer and certainly better off at home. This is the picture that is painted so clearly in a recent Age Concern publication.

The Bill goes some way to providing help for pensioners themselves in the cap it will put on how much they have to pay for their long-term care. We can argue about how high or low the cap should be, but it is important to recognise that an extra financial burden will be placed on local authorities. Once an individual’s cap is reached it will be up to the local authority to pick up the bill for their care. Yet the local authorities are already under severe constraints and are complaining bitterly about being unable to fund even basic levels of care. The projected shortfalls in the face of increasing demand over the next few years are positively frightening, and I shall return to funding issues in a moment.

The Bill also takes up the challenge of the Francis report and proposes a number of measures to try to reduce the scandal of abuse and neglect. However, in focusing on systems for the detection of bad practice and more punishment of those who offend, the Bill seems to be missing the need to prevent bad practice in the first place. I believe that it would be much more effective in preventing bad behaviour to have someone on the ground at ward level who has responsibility and sufficient clout to ensure that high standards of care are maintained. As I have said in previous debates, that person has to be the sister or charge nurse in charge—really in charge—in a career grade post, not rushing off up the nursing career ladder in a year or so. Here I would echo very much what the noble Lord, Lord MacKenzie of Culkein, said. She or he should be rewarded and given a salary similar to that of a consultant, in recognition of the level of responsibility

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that she or he carries. These preventive measures are likely to be more effective than simply looking for abuse once it has happened.

One really big problem is how to prevent elderly patients being admitted in the first place, where we have been failing miserably. The Bill talks of the responsibility of local authorities to promote well-being and to prevent the need for care and support but it cannot say how they might do this or where they might find the money. There are many constructive things we could do now, without waiting for government action. It is worth examining what makes so many patients end up in accident and emergency departments. Many turn up with “dizzy do’s” and falls, and yet we could prevent most of those. Poor lighting at home and the absence of handrails or chair-lifts could all be discovered by regular home visits and corrected in a timely way, which may prevent many a fall. We can reduce the incidence of fractures, particularly hip fractures, which have such a big impact on the need for admission, by reducing the prevalence of osteoporosis through screening for it, treatment with calcium and vitamin D, and regular exercise, all at trivial cost compared with hospital admission. Then there are the “blackouts” that are so common. Screening the vulnerable elderly for predisposing causes—cardiac rhythm disorders such as atrial fibrillation, transient ischaemic attacks, epilepsy—and checking for hypertension and diabetes could prevent even more admissions. Far too often, it seems that patients with a diagnosis of dementia turn up in casualty. It is surprising but true that this may be the first time that a diagnosis of dementia is made, despite it being hardly likely that their dementia has suddenly appeared overnight.

All these rather obvious, and you might think straightforward, measures should be taken in primary care with the help of social services. Unfortunately, the regular screening of the vulnerable members of a practice is far from routine. I hope that the noble Earl, who is not here at the moment, will say in summing up whether it is possible to press those in primary care to include such screening. Focusing social and mental health services around GPs will bear dividends, but we need to take more action at that level than we have managed so far. It is particularly needed in poor inner cities, where it is least likely to be available. I was, incidentally, encouraged to hear that the Secretary of State was asking for ideas along those lines. There they are.

That still leaves us with what to do about patients lingering too long in hospital when they should be at home. Here again we have lots of ideas about what to do but seem quite unable to put them into practice in more than a few places, patchily, around the country. Why do all hospitals not appoint an officer whose sole responsibility is to plan for a patient’s discharge from the moment they enter the hospital? Better co-ordination between hospital and social services now occurs in a number of well rehearsed places but we have failed in trying to scale this up. The idea of pooled budgets between the NHS and local authorities is a good one, since it promotes better integration of functions, even though pooling two rather inadequate sources of funds will not provide much of the extra money that is needed.

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All these measures can help, but the overriding problem will remain one of trying to provide more care in the community with too little money. Some believe that we should close NHS hospitals and beds to provide the money. Although there may be good service and quality reasons to focus expertise in fewer places—I am all in favour of that—it is a vain and somewhat naive hope that simply closing beds will save much money. To be clear, I am talking here of the 30% of beds occupied by elderly patients who should be at home. Close those, and Bob’s your uncle. However, hospital costs are not simply dependent on bed numbers. They lie much more in the high level of acute care, which is so labour-intensive. It is the high-cost medical and nursing care that severely ill patients need for their investigation and treatment that consumes so much resource. Those services are now so stretched but are hardly used at all for long-stay patients sitting in beds waiting to go home. Closing those beds will save very little, since the hospitals will still be stretched by their acute, high-intensity work. Certainly, discharging patients home quickly is a worthwhile endeavour for the patients but I do not believe that we should be looking for much in the way of savings there.

So where is the money to come from? In his excellent report, the noble Lord, Lord Filkin, pointed quite rightly to the need for the whole Government to respond. We need a combined effort across the whole of government, including housing, transport and work and pensions, and the Treasury and the Cabinet need to consider their overall priorities. Ultimately it is the priority that government as a whole gives to care of the elderly compared with the many other pressures it is under that will count.

9 pm

Viscount Bridgeman: My Lords, in the short time available to me, I propose to speak about the role of general practitioners, who are regarded widely as the jewel in the crown of the National Health Service.

Your Lordships will be aware that throughout 2012 there were tortuous negotiations with the Department of Health about the GP contract. Agreement was reached at the start of 2013. I intend to touch on one aspect of this agreement today: doctors’ out-of-hours service. Of course, there is no question of GPs going back to the situation before 2003, when doctors in general practice were effectively on call on a 24/7 basis. Since then, a number of arrangements have evolved for dealing with out-of-hours work; some are run by the former primary care trusts, some by co-operatives of GPs and some by independent contractors. With any of these structures there must inevitably be a degree of patient dissatisfaction—perhaps I should say unease—since the patient will not be seen by a member of a GP practice familiar to him or her. This must be accepted and the challenge is to make these out-of-hours services as efficient and patient-friendly as possible.

I am advised that some of the doctors engaged in out-of-hours work will have had no experience of the particular skills it demands during the 10 years that the current out-of-hours regime has been in place. While out-of-hours doctors have to have the minimum

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qualifications to be a GP, and it is not a speciality as generally understood, nevertheless particular skills are required in assessing acutely unwell people; by the very nature of this work, there will be limited or no documentary back-up. Undoubtedly there are many able practitioners engaged in this work, where they may find the flexibility of out-of-hours work attractive and they may not want the responsibilities of a GP partnership—or indeed simply for the extra money. Nevertheless, it is a widely held view in the profession that there are many doctors in out-of-hours work who would have difficulty getting mainstream GP jobs.

Added to this is the media interest in this subject, including a particularly critical article in the Daily Mail yesterday, which that newspaper has followed up today. Now that responsibility for out-of-hours work has been passed back to GPs, does the Minister envisage an expansion in terms of numbers in the out-of-hours work service? Is he able to confirm that provision has been made for the costs of training? Fundamentally, what degree of monitoring does he envisage for the contractors and the qualifications of their personnel, bearing in mind media reports that cite instances of specialised nurses taking the place of doctors due to shortages of the latter?

I have the privilege of speaking after the noble Lord, Lord MacKenzie of Culkein, who has unrivalled knowledge of the nursing profession. I will address one particular aspect that affects nurses. Attention has been drawn previously in your Lordships’ House to the matter of language testing of nurses from the EU who have the right under the freedom of movement directive to practise in the UK. Significantly, there are different procedures for doctors and nurses. The GMC may register doctors from the EU. It can assure itself inter alia of the candidate’s English skills and only then issue a fitness to practise certificate; in other words, it is a perfectly workable and effective arrangement.

The nurses’ regulating body, the Nursing and Midwifery Council, is constituted under different legislation from the GMC and, crucially, does not at present have the freedom to monitor the competence in English of EU nurses before releasing them into nursing in Great Britain. I know from previous dialogues with the Minister that his department is aware of and sympathetic to concerns about the problem and so, in its more measured pace, is the Commission. However, the latest proposal for discussion coming out of Brussels seems to suggest that registration and fitness to practise should continue to come simultaneously. The effect of this is fundamental. It means that, once an EU nurse is registered, the Nursing and Midwifery Council still has no control over that nurse’s fitness to practise. The Government’s position on testing for English language competency appears to be set out in a Commons Written Answer of 25 October 2010 in which my honourable friend Anne Milton states:

“Post registration it is for employers and contracting bodies to ensure that any nurses or midwives they employ or contract with have the necessary skills and competencies (including language competence) for the job”.—[Official Report, Commons, 25/10/10; col. 126W.]

I appreciate that, as the directive now stands, that is the only course open to the Government, but I strongly

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suggest to your Lordships that it is not satisfactory and detracts from the authority of the NMC, the regulatory body.

The current proposal from the commission does nothing to alter the position and it is certainly of concern to the NMC. I would welcome an assurance from the Minister that his department will continue to press Brussels for an English language proficiency regime for nurses from the EU to be effectively the same as for doctors, so that there is a period during which the NMC can assess the English language skills of a registered nurse from the EU before issuing the appropriate authorisation to practise.

In March 2012, the Law Commission launched a consultation on the regulation of healthcare professionals in the United Kingdom, and it is due to present its final report and draft Bill in early 2014. I understand that this is likely to recommend the streamlining of fitness-to-practise legislation regarding health professionals across the UK. If this assists in resolving the problems of regulation and fitness to practise for nurses posed by the freedom of movement directive to which I have referred, it will be very welcome, as indeed will any reassurance that the Minister is able to give the House today.

9.07 pm

Lord Morris of Handsworth: My Lords, I, too, pay tribute to the gracious Speech and to the three excellent maiden speeches that we have heard today. I want to say a few words about the invisible generation, usually labelled as “the elderly”, and like many Members of your Lordships’ House, I have to declare an interest.

As the elderly, we are constantly reminded that we carry a high maintenance cost in respect of health, pensions and of course welfare support. We struggle with our technology and are sometimes described as non-productive consumers. Mostly ignored are the positive contributions made to society by the elderly. They are carers of a husband or wife, and sometimes of grandchildren and other relatives and friends; they are the providers of support for neighbours less able than themselves; they are minders of children whose parents are being told that they must go out to work. Very many give financial support to children and grandchildren who could not otherwise stay on at school, go to university, buy a house or pay a deposit on a rented property. They are the silent army, making up an estimated 30% of all volunteers for a wide range of organisations and often filling in the gaps in care homes, hospitals, hospices, schools and more.

Yet increasingly they are denigrated by politicians and the news media. The retirement pension to which they have contributed during their working life is now a benefit, which many politicians would like to see means-tested. The elderly are criticised for taking a free prescription and bus pass, a free television licence at aged 75 and the winter fuel payment that many of us in any case hand over to charity. For many, the loss of the travel pass would mean isolation. They would be unable to visit families and friends, get to the shops or the post office, or travel to their voluntary activities, particularly in rural areas. Bus routes would be closed.

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Those who could afford to use a car would be castigated for not being environmentally friendly.

Nearly every debate on issues affecting the elderly starts with the precursor “the problem is”. What a difference it would make to start such a debate by merely saying “the issues are”. The fact is that Britain is woefully underprepared for the rising numbers of elderly people. We are told on the one hand to welcome the fact that we are all living longer while on the other hand that it is not affordable. For those with retirement in sight, there is mass confusion. We have had the Turner and Dilnot reports, and the report of the Select Committee on Public Service and Demographic Change. Is it any wonder that fear and insecurity is the approach of many for their retirement plans?

At what age will they be able to retire? Who knows? We saw a change flagged up in the gracious Speech, which prompted calls for another increase because in today’s world the elderly are healthier and so able to work longer. Quite suddenly, the elderly are among the shirkers with the curtains drawn who do not look for work. If they do, they become the enemies of the young, who fear that the jobs of tomorrow are being taken by the old of today. What of pensions? It is not unreasonable that many pensioners are wary of the provisions of private pensions having lost so much in past debacles, yet we are now treated as though we are responsible for the pension crisis.

One provision about which we are clear within the gracious Speech is that of the single-tier state pension, but can we please have a guarantee that recipients will not be told that this is a benefit for which they should be grateful rather than a pension for which they have paid? In March we heard from the Chancellor that the Government will introduce in 2016 a modified version of the proposals in the Dilnot review. Given the continual change in the retirement age and the state pension arrangements, early and clear decisions would be welcomed by those contemplating retirement.

The gracious Speech sadly missed the opportunity to confirm the welcome statement from the Chancellor that funding reforms for long-term care for the elderly will be introduced and that the maximum anyone will pay is £72,000. I am not clear what will happen to those who do not have £72,000. I am guessing that, as Dilnot proposed, they will be expected to sell part of the equity of their homes to pay for their needs—assuming they have homes. Currently, there are many cases of elderly people attempting to do that and risking large sums of money as a result. I fear that many will do so in future.

Many of those issues have been rehearsed in this House and in another place. I return to my original point. Old age is seen as a problem, and elderly people are seen as a liability. Those negative portrayals must change, not only for the elderly but for other groups labelled and taunted. There was a time when the target was immigrants and the unemployed. Then it was the turn of single parents and those on benefits. Over recent years, people with disabilities have been in the firing line. Now it is the turn of the elderly.

The denigration of groups and communities in our society must end soon. I very much regret that the gracious Speech made no reference to the Select Committee

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report,

Ready for Ageing

?

, which could be our compass for future travel into retirement. I, for one, hope that the Government will set out their analysis of the issues and challenges and their vision for public service in an ageing society, and that a White Paper is published well before the next general election.

9.16 pm

Lord Kirkwood of Kirkhope: My Lords, it is a real pleasure to follow the noble Lord, Lord Morris of Handsworth. I share his analysis in his powerful speech. I certainly subscribe to his view that we have yet to bottom out the full extent of the necessary changes to public policy to deal with the significant impact of longevity, not just in the areas to which he alluded in his excellent speech but more widely across government. In my brief remarks this evening, I also follow him on the need to look after low-income households, whether they are elderly or of working age.

I have enjoyed this debate. I have listened with care. I was interested in the remarks of the noble Baroness, Lady Armstrong of Hill Top, with which I largely agreed. The noble Baronesses, Lady Drake and Lady Hollis, both made powerful speeches about the legislation in the Queen’s Speech with which I will be most directly involved relating to pensions and carer issues.

The context of this Queen’s Speech, the political atmosphere in which we are considering these measures, is different from anything that I have seen in my political experience, and I have been around for a long while—I am not as young as I look, but that is not to mention how I feel. There is a lack of understanding of the pressures that the bottom 15% of households in our income distribution are feeling. They are severely distressed in a way that is likely to be with us for some time: longer than many of us would wish. We need to do something about that. I was recently reading some figures that demonstrated that graphically. Comparing household income internationally, the ONS discovered that the UK has dropped from fifth place in 2005 to 12th place in 2011, so it is under stress in a way that will affect all dimensions of public policy, in the Queen’s Speech and elsewhere. Welfare reform was addressed in the Welfare Reform Act 2012, but it will still cast its shadow over the coming year and beyond.

The noble Baroness, Lady Armstrong, made a point with which I particularly agreed. There is a different tone in the public mood about social protection. I have never experienced it to be quite so negative and we cannot ignore it. Again, I was looking at some figures on this, which show that 20 years ago 15% of the public thought that people lived in need because of laziness or lack of willpower; now, it is 23%. We have to be aware of that. Now, it is difficult to pass legislation to deal with such things, but it would be quite wrong not to take care to appreciate that the circumstances in which we are introducing this legislation are substantially different.

I want to say a word about housing, particularly new low-income housing. I know there are other colleagues in here who have much better experience of housing associations and I am looking forward to hearing what the noble Lord, Lord Best, says. However, I have come to the conclusion that the most important thing

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in the welfare domain is trying to deal long-term with housing benefit. Reflecting on and reading some of the background, I have also concluded that the only way sensibly to do that in the long term is to develop housing policy, particularly the construction of new low-income housing. We need to encourage the Government to adopt a cross-departmental strategy to deal with this. It should also be cross-country because we need to be conscious of the fact that other constituent nations of the United Kingdom are dealing with these issues—and in some cases dealing with them quite differently. We need to make sure that co-ordination is maintained.

We also need to do that with a much closer association and a more trusting relationship with local authorities because they can, and must, play a more constructive role in trying to address some of the problems. We are simply not building enough new affordable housing. I think that the National Housing Federation and others have identified the gap as being something in the region of 240,000 units each year, so the conflict between the demand and the supply is really quite substantial.

I am not saying that the Government are not taking steps, because I know that they are. Indeed, the noble Lord, Lord Best, with help from some of his friends, managed to get the noble Lord, Lord Freud, to undertake a review of some consequences of the Welfare Reform Bill that related to housing benefit changes and the like. We might get access to some of these details and statistics in the not-too-distant future, and I look forward to looking at them carefully and discussing them. This is perhaps more a matter for the comprehensive spending review which we will see in July because then we will see the spending profile that the Government have in mind, although that might take us only into the first year of the new Parliament. My real concern is that if we leave the adoption of a more coherent, cross-departmental framework in this very important area, it will be 2016 before we get started. That will be unforgivable and we will be wasting a lot of time that we do not have.

There are some obvious benefits in adopting a comprehensive new strategy for new build for low-cost housing. There is an economic case and an employment mobility case. It increases disposable income for low-income families if they have lower rent costs. More than anything else, it has a political dimension as well because ever lengthening waiting lists for housing are a major cause of concern. It is one of the reasons why the electorate is in such an unhappy situation, to put it at its mildest. If we could demonstrate some progress in reducing waiting lists, even though it cannot be done immediately, that would be beneficial.

There are lots of things that we really need to do. They need to be done in a joined-up way and to embrace future levels of capital investment and rent levels as well as housing benefit costs, but we have to do this in a way that looks as if we are addressing the problem seriously. The evidence is that we are not doing that.

I shall end with the surprising statement that I came across the other day which demonstrates that currently for every pound the Government spend on housing, 95p goes on housing benefit and 5p goes on new build.

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That is completely the wrong way round, and we have to use the next year to do as much as we can to redress that balance and make that change a positive reality in the not-too-distant future.

9.25 pm

Lord Noon: My Lords, I am grateful to be speaking as part of the debate on the gracious Speech. In the time available, I shall comment on the education proposals that were mentioned, but first I must declare an interest as chancellor of the University of East London. I was very fortunate to take up this position in January this year, and I am very proud to be associated with such a diverse university in the heart of East London. In fact, it is one of the most diverse universities in the country with over 28,000 students from more than 120 countries world wide, so I am particularly interested in the likely impact of new measures in the Government’s planned legislation affecting education.

I agree with the Government that we need to see more young people having access to quality higher education programmes, but at the same time we should be doing more to encourage students from overseas to take up places here in the UK. It is good for them, and it is good for us. It enables us to build stronger bridges with different countries and spread understanding about the opportunities and strengths of the UK economy. As our economy continues to struggle, this could not be more important.

Earlier this year, my noble friends Lord Patel of Bradford and Lord Parekh and I were asked to be part of the business delegation that accompanied the Prime Minister to India. It was the largest trade delegation ever to accompany a Prime Minister on an overseas visit. The visit clearly demonstrated the importance of India to the future prosperity of the UK. Despite us being the only three delegates from the Opposition, all the Ministers and officials treated us with the utmost courtesy and respect and our views were sought out and listened to.

One of the issues I raised while I was in India was the importance of enabling more Indian students to come to study in the UK. That is something we should welcome, and it is especially important for a university such as the University of East London. We can learn a great deal from the rich diversity in our universities, especially in the business world.

This is an area that I am passionate about, and I know that there are many challenges that students face to succeed in this area, especially those from ethnic minority backgrounds. Therefore, when I was given an opportunity last year to help establish a centre at the University of East London to provide opportunities and support for students from various ethnic backgrounds to enter into and sustain careers in the business sector, I relished the opportunity. A grant was made available by the Noon Foundation that has enabled the establishment of the Noon Centre for Equality and Diversity in Business within the Royal Docks Business School, and I am pleased to say that last week I had the pleasure of spending a whole day meeting and speaking to some of the brightest and most committed business students I have ever met who have benefitted from the work of the centre.

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Although these students are doing well with the support provided, the challenges are immense and include access to higher education and high-quality courses that ensure future employment. I welcome the Government’s commitment to increasing access to a good university education. I also hope that we will see more practical measures to ensure greater diversity among those students who gain a good degree. As a businessman, I welcome the emphasis on skills and on access to training and apprenticeships. My company, Noon Products, employs more than 2,000 members of staff at my manufacturing plant in west London, where our national dish, chicken tikka masala, is produced in the thousands every day. I know at first hand how important it is to have young people starting work for the first time who are skilled and have the right aptitude for work.

One of the ways in which we can support this is by encouraging effective apprenticeships, but the challenge to achieve this is great. Last year nearly 750,000 19 to 24 year-olds were not in education, employment or training. The so-called NEETs are the young people we need to target. The numbers missing out on education and opportunities are far too high. If I have understood correctly, the apprenticeship provisions in the deregulation Bill are intended to address this. We are told that there will be greater flexibility in delivery and increasing employer involvement in the design and assessment of apprenticeships. This is to be welcomed, and as an employer I would very much like to be part of this.

The Government are currently consulting on apprenticeships. The review report is entitled, The Future of Apprenticeships in England: Next Steps from the Richard Review. As I understand it, the stated intention of the review is to ensure apprenticeships are rigorous, responsive and able to meet the changing needs of our economy. I very much hope that the review will help us to achieve this and I look forward to reading the final results when it is published in the autumn.

However, employers are employing people now, and all those young people in need of opportunities do not have time to wait. We need to do significantly better to promote and improve their life chances through apprenticeships and access to higher education. This is key to securing a lasting and robust economic recovery, and we need to act now. Our future lies with the young. Our future prosperity must be firmly rooted in theirs, so I very much hope that we will see practical and effective measures in the Bill that can be taken now. I shall watch with great interest.

9.32 pm

Lord Best: My Lords, my contribution to this debate considers the issue of housing in the context of health, welfare and several other aspects of the gracious Speech. My theme, to quote a Canadian saying, is that housing is the home of all issues. I declare my interest as president of the Local Government Association, chair of the Hanover Housing Association, chair of the council of the Property Ombudsman and, since I will touch on related matters in the context of the forthcoming Care Bill, a member of the advisory board of the Equity Release Council.

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The fundamental housing requirement, which is of equal concern to all the main political parties, is to secure the building of far more homes to reduce the acute housing shortages that are the underlying cause of homelessness, overcrowding, high rents and low standards of accommodation. However, the benefits of a boost to housebuilding go much wider. It is the construction industry that can act as the engine of growth, as it always has done in previous recessions. Within that industry it is housebuilding that delivers the biggest bang in terms of jobs, not least in maintaining, modernising and upgrading the energy efficiency of existing homes. I hope that the Government can strengthen the connection between youth unemployment, now at 20% and carrying the terrible danger of a lifetime of worthlessness if skills are not acquired, and the opportunities for training and jobs presented by investment in new homes.

We have all admired the contribution of migrant building workers, particularly from Poland, but there is much to be said for investment in apprenticeships and training in the building industry for our own young people. To capitalise on this chance of tackling two huge social issues simultaneously, youth unemployment and acute housing shortages, the Chartered Institute of Building and the Construction Industry Training Board, with the Youth Build Trust, have asked Nick Raynsford MP in the other place and me jointly to chair an inquiry by parliamentarians on this theme. I feel sure that the Government will want to support this initiative.

On other occasions I have commended the determination of the Minister for Planning to overcome barriers to much-needed housebuilding, including the obstacle of the seemingly universal local opposition to virtually any development. Recently, the Government have come forward with bold plans for help-to-buy mortgage guarantees and equity loans. There is always the danger that stimulating demand, rather than directly boosting supply, will simply push up prices. But as part of the mix, these financial measures could give the housebuilders confidence to get more homes built and on to the market. However, the private sector housebuilders will construct only around half the number of new homes needed to match the number of new households formed each year. We also need subsidised housing for those who cannot afford to purchase or to pay full market rents. Housing associations could double their output with the requisite funding through the Homes and Communities Agency and the Greater London Authority. This investment really should be a high priority for the Government’s forthcoming spending review. Now is the time to harness the lending capacity of councils, which used to match the output of the private sector and build half the country’s new housing, by removing the unnecessary cap on their prudential borrowing for housing purposes, as the LGA is advocating. This would enable local authorities to finance the building of some 60,000 extra homes, mostly on land that they already own, without the need for subsidy.

Some will argue that one area of housing on which there should have been an announcement in the Queen’s Speech is the regulation of the private rented sector. However, I was delighted that the efforts of your Lordships in support of the noble Baroness, Lady

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Hayter, led the Government to bring forward an amendment to the Enterprise and Regulatory Reform Bill that will give the consumer greater protection by requiring all lettings and managing agents, who look after about 60% of the private rented sector, to be part of an independent ombudsman dispute resolution scheme.

Sadly, the Government did not listen to your Lordships on another housing issue on which they suffered successive defeats in this House—the issue of welfare reform, which has targeted support with housing costs for those on the lowest incomes. The caps, ceilings and limits on housing benefit and local housing allowances, which are more likely to deter private landlords from letting to poor people than to persuade landlords to reduce rents to help them, have been accompanied by the levy on housing association and council tenants deemed to have a spare room. I have been much criticised for naming this the bedroom tax, but I suspect that Ministers now regret introducing this controversial measure. This levy penalises those in work as well as those who must find the money from their other benefits by cutting back on basic essentials. It is not too late for the Government to moderate its impact through a major increase in the totally inadequate level of discretionary housing payments, which local authorities need to deploy in the many cases of hardship, and where tenants cannot be offered a suitable smaller property.

It should be noted that the housing associations whose tenants are hit by the welfare reform cuts are anticipating major problems of rent arrears. This not only means they must cut back on spending on new housing investment just when the Government need them to do more, but they will be less able to undertake the brilliant community work that so many of them have been doing to provide for those with special needs, to tackle anti-social behaviour—again, something that the gracious Speech makes clear is a government priority—or to support young people into training and jobs.

Finally, I want to note the immensely important link between housing and the Government’s plans for funding social care, which we will be debating when the Care Bill reaches us. The Government’s proposals, in seeking to assist those who encounter high social care costs, are welcome, but the help provided for those in residential care may not go as far as many have hoped. A large proportion of the fees will be excluded because they cover the board and lodging or hotel costs, while the care costs will be met only at low levels, probably well below the average in each area. By my calculations, in a typical case the individual would probably not be assisted until they had spent some £144,000. If their fees reached £300,000, they could expect only some £50,000 in support.

This is where housing issues come in. If an older person’s own home is manageable, warm, accessible, affordable and safe and secure, independent living can remain a sensible option for their lifetime, with care delivered to the home when needed. They can return home from hospital, perhaps after a short stay in a residential setting, and the emotional traumas and heavy cost of moving permanently into institutional

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care can be avoided. If their housing is right, the Dilnot inquiry’s key recommendation for limiting care costs can work well and vital savings can be made to the NHS and social care budgets. This argues for priority within the hoped for boost to housebuilding to go to developing really high-quality older people’s housing. This has the enormous added benefit of freeing up for the next generation some of the 4.2 million houses occupied by pensioners that have more than two spare bedrooms.

The interrelationship between housing and care also argues for more and better opportunities for safe and sensible equity release schemes. These can enable home owners to recycle some of the wealth tied up in their home to do the improvements that will cut their fuel bills, make the adaptations such as replacing a bath with a walk-in shower, and generally ensure that it is not their home that forces them into residential care. Giving priority to the nation’s housing can not only change the lives of young and old but can support the Government’s wider ambitions for reviving the economy, tackling youth unemployment, reducing social care and health costs and so much more. I hope that the Government are listening.

9.41 pm

Baroness Pitkeathley: My Lords, as the Care Bill announced in the gracious Speech will have its Second Reading next week, like some others I have decided to keep my powder dry today and focus only on why the Bill is needed, not on its content.

Your Lordships will know that there is nearly universal agreement that the social care system is not fit for purpose. It was set up originally for a country where men died shortly after they retired at the age of 65 and women died before they were 70. The new statistics showing that, for example, 11 million people who are alive today will live to be 100 are cause for celebration, as is the fact that people are living not only longer but with greater degrees of disability. However, this also means that we are spending inadequate amounts on care and support, both publicly and privately. Social care funding has totally failed to keep pace with demographic change. Since 2004, spending on the NHS rose by £25 billion, but spending on social care rose by just £43 million—or 0.1% in real terms.

We all know what local authorities have done to cope with rising demand and static resources—they have increased charges for social care and rapidly raised the eligibility criteria. The percentage of councils providing support to those with moderate needs decreased from 50% in 2005 to 18% in 2011 as the eligibility criteria have been raised to cover only those with substantial or critical needs. This has been compounded by local authority spending reductions, with social services directors reporting £1 billion-worth of cuts to services in 2011-12 and warning of even greater cuts to come.

Public provision in this area is largely seen as providing poor services for poor people, and the media all too often give us distressing examples of that. However, anyone who works in this field must also acknowledge that good care is provided to individuals within the

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system because of the dedication and skill of thousands of workers. There are pockets of great service to be admired and we should always remember that. In general, however, the system is perceived to be starved of cash; failing to meet the volume of need; and unfair—a lottery, especially for people with middle incomes—for the simple reason that if you die neatly without needing to use care services you pay nothing while if you happen to have an illness or condition such as Alzheimer’s, you may need expensive services for many years, costing thousands, perhaps hundreds of thousands, of pounds. The system is also regarded as extremely confusing and difficult to find your way around.

These problems will only get worse if nothing is done. Within 20 years, the number of over-85s will double and the number of people living with lifetime disabilities will grow too. Relatively fewer people will be working and paying taxes to help pay for support. However, apart from the practicalities of money and how it is to be paid for, there are other changes in society that affect what we can expect from social care. People want greater choice and control than is offered by our current system and expectations about the standards of care are rising. It still comes as a shock to the average user of care that there is so little integration and such poor communication across health and social care systems—still less, as we have heard today, across housing and transport—regardless of the fact that people’s care needs do not come in discrete packages but are stretched across the whole of an elderly person’s life including their housing, their families and their income.

What happens when people’s needs for social care are not met? We all know what happens—they turn to the NHS. This results in increased demand for unplanned and emergency services and delays in hospital discharge. Your Lordships will have seen and heard all the publicity about pressure on A&E services recently and the conflicting views about both the cause and what should be done about it. These extra pressures of course come at a time when the NHS is already under severe financial pressure.

It is easy to be extremely gloomy about the problems in social care. However, we may have some opportunities now, principally in the Bill in the Queen’s Speech, to deal with some of them. The Government are to be praised for bringing forward a Bill which is intended to address some of the problems that I have set out by looking at the Dilnot commission and the Law Commission’s proposals and, perhaps very importantly, by defining the purpose of social care and how it is delivered.

The enactment of the care and support Bill will not just consolidate and streamline into a single statute 60 years of piecemeal law-making; it will place on a statutory footing for the first time both the principle and the practice of self-directed personal care based on individual assessment. Particularly pleasing to me is that the well-being principle is also to be applied to the individual’s carers. However, it cannot be denied that, taken together with the introduction of a capped system of funding and a national eligibility threshold, the Bill represents a significant implementation challenge for everyone with a stake in the care and support system.

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Like other Members of your Lordships’ House I had the privilege of serving on the Joint Committee which gave pre-legislative scrutiny to the care Bill. We called many witnesses and received huge amounts of written evidence. Two themes were paramount. The first was the need for more integration, and the announcements today about integration between health and social care are very welcome indeed. The second was the need for more resources. Everybody was concerned about the inadequacy of the resources. I am sure that we will spend many happy hours debating that as the care Bill proceeds.

I hope that in the course of our discussions we will be able to give attention to some of the ideas that were set out in the report Ready for Ageing?, which has already been mentioned and was produced by the committee led by my noble friend Lord Filkin. It states very plainly that the welfare state was predicated on full employment and a brief period of retirement. Now, however, centenarians are common and a third of life may be spent in retirement, and yet pensions and social care continue to be organised on 1950s models. The report calls for, and states that there is a desperate need for, a national strategy that includes a radical reconfiguration of health and social care. The budgetary split between them is no longer sustainable. They must be commissioned and funded jointly so that resources can be better used.

All of this is a terrific challenge. However, it may also be the clearest call that we have ever had for a new vision for social care—indeed, for a different settlement for the older people whom we will all become. We certainly need a different vision and, by the way, more recognition of the contribution made by older people themselves. Let us not forget that 60% of childcare is provided by grandparents. Let us think also of the huge numbers of older volunteers. These are important political issues that we are actually going to have to address.

The Bill that we will consider gives us an opportunity to put a welcome focus on social care—always, thus far, the poor sister of the NHS. It will also give us the opportunity, if not to implement this new vision, then at least to consider and discuss it.

9.50 pm

Lord Black of Brentwood: My Lords, I want to address an issue that affects millions of families in this country. It is a subject that cuts right across many of the areas that we have been discussing today, including health, welfare and education. It has a breadth and width throughout society that is in many ways far greater than the important measures outlined in the gracious Speech, yet it rarely gets a look-in when it comes to legislation and regulation. That issue is animal welfare.

We are a nation of animal lovers; 48% of UK households, some 13 million of us, own between them 22 million pets. I am proud to declare an interest as an owner of one of them, a venerable Russian Blue. At the moment, however, we are experiencing what the RSPCA has described as,

“a growing animal cruelty crisis”.

Last year, there was a 15% increase in the number of people being taken to court for the neglect of and

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cruelty to animals in England and Wales, and an increase of a third in the number of convictions. As a result of every conviction, more animals are taken in by animal welfare charities for care and rehoming.

I heard at first hand, on a visit last year to the wonderful National Cat Centre in Sussex, which is run by Cats Protection, that there is an unprecedented demand for its services in taking in stray and abandoned cats. However, at the same time, requests to adopt a cat have dropped to a third of what they were at the start of 2010. That is the perfect storm of increasing need and declining resource.

Many of these problems are of course part and parcel of the economic hardship that we have been experiencing, which my noble friend Lord Kirkwood of Kirkhope mentioned. Pressure on family incomes of the sort that he described often means that people have to give up their pets when they cannot afford to feed them or pay for veterinary care. We have a duty to do something about this growing crisis. The treatment of animals is a barometer for the health of our society, and if we want to live in a decent and tolerant society we should be doing all that we can to promote and enhance the welfare of all animals, particularly domestic pets who give so unconditionally of their love to many of society’s most vulnerable members, including the sick, the elderly and the lonely. It is a love that we should return.

There is much that government can do to help without placing a strain on overstretched public finances, and a number of measures outlined in the gracious Speech are of particular importance in this respect. The Care Bill represents an excellent new approach to looking at well-being and personal care, centred as it is on,

“domestic, family and personal relationships”,

of which domestic pets are of course a key part. Owning a cat or dog is an incredibly close, personal relationship. Cats Protection submitted powerful evidence to the scrutiny committee looking at the draft Bill—I hope the noble Baroness, Lady Pitkeathley, remembers seeing it—about the health benefits that companion animals such as cats or dogs can offer in preventing or delaying the onset of health problems and promoting general well-being, not least in alleviating depression and loneliness and lowering stress, with the benefits that that brings to cardiac health. I therefore hope that the Bill will encourage the use of care budgets for companion animal support programmes and recognise the important role that pets play in personal well-being.

The measures in the Anti-Social Behaviour, Crime and Policing Bill to deal with dangerous dogs are welcome, too. However, it is vital that the Bill cracks down on attacks by dogs on all “protected animals”, as defined by the Animal Welfare Act 2006, and not just on attacks on people and assistance dogs. In most weeks, there is a report in the press of at least one fatal attack on a cat by a dangerous dog, and that should not be tolerated. This Bill should be extended to allow us the chance to deal with this dreadful problem. In addition, we should use it as an opportunity to review the penalties for cruelty to animals under the Animal Welfare Act 2006. Those who harm animals—for instance,

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in the cases of those who have attacked and injured cats by poisoning them with anti-freeze—should face significant custodial sentences.

If owners of dangerous dogs that attack people in public face two years in prison, why should not those who harm their pets? I heard just this morning a most awful story from my vet of how he had taken in a puppy that had been rescued by the Dogs Trust. This puppy had been wrapped up, placed in a bin liner and kicked down nine flights of stairs in a tower block. At just three months of age, it came in with 40 broken bones in its body and a lump on its head that was bigger than its head. Those who do those sorts of things should feel the full force of the law.

Welcome though these various measures are, a lot more needs doing, not least in the updating of legislation on animal welfare, which is becoming obsolescent. I wish that the gracious Speech had contained measures, for instance, to repeal and replace the Pet Animals Act 1951, which covers the breeding and sale of pets. It stems from a time when people bought pets from the window of a pet shop, but today pets are bought online. This outdated legislation does not deal with the abuse of animals that comes from the repeat breeding of pets for sale on the internet. Similarly, the Animal Boarding Establishments Act 1963 badly needs updating and simplifying to provide a modern and effective licensing regime for boarding establishments such as kennels and catteries.

Even in the absence of new laws or the repeal of old ones, we can do a lot within the framework of existing legislation to deal with the animal welfare crisis that we are facing. We have the Animal Welfare Act 2006, which sets out a framework for the care of animals, including establishing their five basic needs. Yet that Act has not fulfilled its ambitions because regulations under Section 13 to repeal outdated legislation have not yet materialised. I hope that my noble friend will ask his colleagues at Defra to look into this. Indeed, Ministers should look afresh at the whole structure of animal welfare legislation, dealing with commitments that have not yet been delivered and looking to deal with the out of date laws that I mentioned earlier.

I hope I will not sound like a cracked record if I return to an issue that I raised in a debate on the national curriculum in the Moses Room earlier this year. The key to effective long-term care for animals lies in education. It is essential that children in primary schools are taught about the five basic needs of animals and about the responsibility that comes with owning a pet. My noble friend Lord Nash has said that he will look into this area, and I hope that the Government will listen carefully to the concerns of Cats Protection and other animal charities.

Finally, I must tell your Lordships that since I have been studying these issues in recent months—they have been a welcome break from the rigours of the Leveson inquiry—it has struck me that the care of our animals, which is crucial, as I said at the outset, to the development of a civilised, liberal and caring society, encompasses a huge number of issues and hence a number of government departments. Some lie with Defra, where my noble friend Lord De Mauley is a

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tower of strength, but the Home Office has important responsibilities too. There are also issues relating to care that fall under the Department of Health, and of course there is education, which lies with the Department for Education. There are also spending issues; after all, the issue of irresponsible dog ownership alone costs the taxpayer nearly £80 million per year. If ever there was a case for joined-up government, it is this, so would it not be a good idea to establish a post for an animal welfare champion to draw all these threads together, championing the cause of vulnerable animals, saving the taxpayer money, ensuring that our children are educated in the care of pets in a way that would be of real benefit to their all-round education, and at the same time helping the elderly and the lonely? That would be a win-win for our society.

The Prime Minister rightly declared that this is a gracious Speech for ordinary hard-working families, and so it is. Let us just ensure that we include our pets, such a special part of so many families, in that noble ambition too.

9.58 pm

Lord Sawyer: My Lords, when my noble friend Lord MacKenzie rose to speak, he said that he had had to tear up his original speech because of the speeches made by my noble friend Lady Wheeler and others, and I feel the same about mine. My noble friend made an excellent speech on the health service and on nursing in particular, and I should like to be fully and completely identified with what he said. However, there are a couple of things regarding this issue that I do not think were dealt with in that speech or in others, and I should like briefly to say something about them.

The first concerns nursing and nurses spending more time with patients and more time on the ward. My noble friend Lord MacKenzie implied that it was time to get nurses back to basics. It is part of the current ethos about the problem in the National Health Service that nurses are not spending enough time on the wards. Certainly, given the Francis report and other things, I can understand why that might be thought to be the case. At the same time, in my experience, it is crucial that we do not overlook the importance of high-quality nurse managers. Matrons and charge nurses are managers as well as nurses. Their clinical qualifications and expertise as clinicians are not always matched by their qualifications and expertise as managers and leaders.

Basically, hospitals work in teams. It is only teams that deliver. Anyone who has been a patient or worked in a hospital will understand that nurses do not work in isolation; they work in teams. Skills are needed to build and develop a team, to take it forward, to fill a gap, to look after an absence, and to deal with a crisis. All those important skills have to be learnt and developed by nurse managers. It is important that that is said.

In the past 10 years, developments have taken place in the commercial sector and some parts of the charity sector, and investment has been made in helping people to become high-quality managers and leaders. I am not sure that that same development has taken place in the National Health Service. We need to address that. I do not know whether the Minister would be

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kind enough to write to me about the ambitions in this respect. I do not expect chapter and verse, but I should like to know the direction of travel in making sure that we have world-class leadership among our nursing staff. It is worth using that word because in order to deal with the problems that we have seen in the Francis report we need that kind of ambition.

Secondly, on what I would call an holistic approach to patient care, again, the drum-beats at the moment are about patients left on trolleys and nurses not caring properly. However, the patient experience is about a lot more than a nurse and a doctor. It is about something much more fundamental and basic. If the first call to a general practitioner’s surgery is badly answered by an inattentive receptionist, it is the first step towards a bad patient experience. In the National Health Service, it is possible to have several bad patient experiences before you ever meet a clinician. It is very important that people who work in all professions—nursing, non-nursing and supporting professions—understand that the patient experience begins with them.

Everyone has responsibility for giving good patient care, including the GP who does not have time to listen properly to a patient, and the consultant who is too busy to explain exactly what the issues are and what might be done to help a patient’s situation. These skills are not taught in medical school or nursing school. I ask: are they taught or are they picked up? It is expected that these skills will be picked up and learnt on the journey from being a clinical practitioner to a manager and a leader. My opinion is that often those skills are not learnt and that they are badly lacking in a lot of health service experiences. We need to do something about that.

The skills required are those of listening, empathy and understanding. Sometimes they would be called soft skills, but they are crucial in the health service. Patients feel vulnerable, worried and anxious about what will happen to them, so it is very important that everyone who works in the health service understands that the patient experience begins with them and that they are responsible in just the same way as doctors and nurses. If it not too much trouble, I would not mind a note from the Minister about how that wider holistic approach to patient care, not just by clinical practitioners, doctors and nurses, is seen. I ask everyone in the health service to be aware of the importance of the patient experience.

10.04 pm

Baroness Benjamin: My Lords, I was delighted that the gracious Speech contained several mentions of the intention to focus on the well-being and education of children and young people by putting measures in place to bridge the social mobility gap. I congratulate the coalition Government on their continuing efforts to address this issue. In my speech, I would like to concentrate on how even more can be achieved through cultural education within the curriculum.

Exposure to art and cultural experiences is the perfect way to build confidence, satisfy our well-being and stimulate the imagination, and the earlier children are provided with this type of stimulus the better.

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However, recently I chaired a Westminster Education Forum conference at which several educationalists expressed a desire for a clear direction, a national plan, as suggested in the Henry review, on how to deliver cultural education in the classroom as many did not feel confident about what was expected from them and how best to deliver cultural provision to the children.

I believe that one effective way to do so is through the discovery of Shakespeare. The many beneficial attributes this has are not all obvious for, as well as words and language, connections with music, drama and art can also be gained from studying Shakespeare. It can be used to help children develop a critical eye, teach them simple philosophy, build their natural curiosity and help them to learn to analyse information in a fun and exciting way.

Shakespeare is loved across the world. He is the most performed playwright internationally. Half of the world’s schoolchildren study Shakespeare. In surveys, Shakespeare is cited as one of the reasons many people feel proud to be British, and yet here in the UK so many children leave school with minimal exposure to this icon who is part of their cultural heritage. Whole generations encounter Shakespeare only as a topic for examination and therefore believe that Shakespeare is not for them or is too difficult.

Well, a change is a coming. I heard it for myself. Yes, the Shakespeare Birthplace Trust has plans for young children to be exposed to Shakespeare. It has started a campaign focusing on children aged nine to 11 in primary schools to discover Shakespeare. Too difficult? Too prescriptive? Too elitist? No, no, no. To be or not to be, that is the question. Well it will be, because in March 2014 Shakespeare Week will be launched as a major new national schools and cultural campaign to open up Shakespeare’s legacy to every child in Britain, uniting our numerous cultural venues and our versatile artistic practitioners in a nationwide celebration of Shakespeare’s creative influence. It will be a bold and original approach to learning.

Modern learning tools will be used to engage the children as several free online resources will bring the Bard to life for every subject in the curriculum. For geography, Shakespeare’s characters will be used to spark off children’s imaginations on the subject—for example, matching characters to countries. There will be resources demonstrating how pulleys helped fairies fly over the Elizabethan stage as an introduction to engineering. There will also be resources used to spark off children’s interest in writing and literature and lead them to discover other writers, historical and contemporary. As well, it will help them form a love for art and design because their young minds will not be influenced by negative assumptions. It will inspire them to have aspirations in whatever they choose to become and assist them to achieve their goals.

Most importantly, it will give them the opportunity to have fun with Shakespeare at an age when magic can still happen and before someone tells them, “It is too difficult for you, so do not bother”. Furthermore, it will provide teachers with a free, flexible resource to draw on, as much or as little as they like, in any subject they choose.

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The pupil premium is encouraging schools to seek imaginative ways to broaden their outlook in provision for children. In just three weeks since the launch of Shakespeare Week, many have embraced this opportunity. Five hundred schools have already registered to take part in Shakespeare Week and the figure is rising, which is simply wonderful. I have seen at first hand how joyfully and enthusiastically young people react when they are exposed to Shakespeare. They identify with the characters who are so cleverly written as they reflect contemporary society and deal with all the emotions and feelings that young children are likely to grow up to experience: jealousy, anger, humour, revenge, guilt, fear, love and passion, emotions which are felt across all cultures.

The lyrical rhythm of the language is great for those with autism, dyslexia and learning difficulties. Many people from challenging backgrounds who are rarely exposed to the theatre are often transformed by discovering Shakespeare. The Shakespeare Birthplace Trust has been charged with promoting the enjoyment and understanding of Shakespeare’s works, life and times. The trust has been awarded Arts Council funding to support Shakespeare Week for just two years, 2014 and 2015. I truly believe that this initiative should go beyond that time. It will ignite young children’s appetite for art and culture and develop confidence which will indirectly have an effect on their ability to learn across the curriculum in the classroom and beyond, giving them a lasting legacy. So I ask my noble friend whether the Government will consider making Shakespeare Week an annual event in the primary school calendar for the sake of our children’s holistic well-being, especially those from disadvantaged backgrounds.

The first book I chose as my school speech day prize back in 1961 at the age of 12 was the Complete Works of William Shakespeare. Little did I know that the content would be a revelation to me and serve me well in my career. The works of Shakespeare were written for all people and were not meant to be exclusive, but inclusive. It is worth noting that at the television BAFTAs last Sunday two awards were given to Shakespeare productions. Yes, the Bard is still thrilling audiences 400 years on.

Shakespeare Week is an important initiative for future generations, so let us make it a permanent resource and give all our young children the opportunity to feel that they are part of something great. Who knows, one of them could even become the Shakespeare of the future. With that, I say:

“Good night, good night! Parting is such sweet sorrow, That I shall say good night till it be morrow”.


10.17 pm

Lord Patel of Bradford: My Lords, how does one follow such a passionate, energetic and fabulous speech at this late hour? I am afraid that mine is going to sound a bit like “Macbeth”, but I am pleased to have the opportunity to raise a somewhat neglected issue in the Queen’s Speech. I am talking about mental health, which does not feature prominently in the Government’s planned legislation and on which there are some critical issues that I want to raise.

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The noble Earl will be pleased to hear that I shall start off on a positive note. I have to say that the coalition Government, when they first came to power, actually made a good start in trying to address inequalities in the area of mental health. In particular, the Government should be commended on their mental health strategy, No Health Without Mental Health, and the ambition it represented to see mental health provision achieve “parity of esteem” with physical health. I was also very pleased when on 28 February this year, the Mental Health (Discrimination) Bill became law. This Act removed the last significant forms of discrimination in law and was a big step towards breaking down the prejudice and stigma surrounding people with mental health problems.

However, in spite of these positive developments, the problems are not getting any better. My noble friend Lord Layard, in his report last year with the London School of Economics, set out some of the starkest evidence I have seen that the problems are actually getting worse. For example, those with severe mental illness are more likely to be the victims of violent crime, have poor physical health, and a life expectancy up to 25 years shorter than that of the general population; in fact, mental illness now accounts for nearly half of all ill health suffered by people under the age of 65, and it is more disabling than most chronic physical disease. Yet only a quarter of those involved are in any form of treatment. The hidden costs of this to the economy in terms of lost employment and productivity are immense, at an estimated £105 billion, which is more than the entire NHS budget.

Despite this, only 13% of NHS funds are devoted to the treatment of mental health issues—and I have to question the efficacy and the appropriateness of some of the ways in which that money is being spent. For example, we know from the Health and Social Care Information Centre that prescriptions for anti-depressants are rising. In fact, the NHS in England spent more than £270 million on anti-depressants in 2011—a massive 23% increase on 2010. The NHS spent almost £1 million a week more on these drugs than the year before, resulting in a startling 46.7 million prescriptions a year. Can the Minister explain how this is happening against a background of a national programme to increase access to psychological therapies, which the evidence supports as being far more effective? While we are on the subject, how is increasing access to psychological therapies making a difference for people from black and minority ethnic backgrounds? I fear that even after decades of lobbying Governments of all persuasions to address the disproportionately poor outcomes of people from black and minority ethnic communities in mental health services in Britain, there continues to be little progress with adults and young people. There are some notable successes, such as Open Mind in Leicester, but on the whole the situation is extremely poor.

We know from the Count Me In census, which for the first time collected statistics on ethnic minorities in mental health services, that there are stark differences in access, experience and outcomes for minority ethnic groups in terms of mental health. In fact, some groups of young black men are up to 18 times more likely to be admitted to a mental health ward than their white

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counterparts. There are also significantly disproportionate numbers for black and minority ethnic women.

These are extremely worrying figures but they are not the only ones. The coalition Government’s own No Health Without Mental Health strategy shows that 20% of children and young people are believed to have a mental health problem. That is a fifth of all children, but we do not know how many of those young people are from a black and minority ethnic background. Given what we know about the breakdown of disorders for black and minority ethnic adults, surely it is unacceptable that these data are not available for minority ethnic children and young people. Can the Minister urgently look into this area and rectify what is obviously a glaring omission? In fact, I would welcome a commitment to gathering these data so that we can get a full picture and be better equipped to start doing something about these gross inequalities. This is vital because I fear that, without proper attention to these issues, the services for black and minority ethnic adults and young people will only get worse, especially against the background of the current upheaval caused by the NHS reforms.

The impact of this disruption within the NHS can also be seen by the fact that Section 117 services, which are for the most vulnerable mental health service users, are under threat again in the Care Bill. I was very dismayed to see that the Government have chosen to return to this issue, given that we have already dealt with it under the Health and Social Care Act. As noble Lords will recall from previous debates, Section 117 of the Mental Health Act concerns the provision of aftercare services for people leaving treatment after a period of detention in hospital. The Government finally accepted our amendments to the Health and Social Care Bill that these vital services should be preserved, and yet here we are again facing significant changes to the definition of aftercare that will in effect remove these services from many people. Clause 68(5) of the Care Bill introduces for the first time a statutory definition of “after-care services”, which I and others believe is too restrictive and could generate complex legal disputes over whether a service should be provided under Section 117. I fail to see the Government’s rationale for this and will be seeking answers from the Minister about the impact of these changes during the passage of the Bill.

Care of the vulnerable should surely be at the forefront of our efforts. I would have thought that after everything that happened at Winterbourne View we should be much more focused on preventing harms. What have we done since the scandal of Winterbourne View? For example, at the time, the case refocused the spotlight on the appropriateness of restraint and physical intervention as an approach to managing challenging behaviour. The review into the failings recommended that the Government should consider banning the use of certain forms of restraint on patients with learning disabilities. Can the Minister update us on the Government’s progress in meeting this recommendation?

However, this issue does not concern only those with learning disabilities. It would be fair to say that the approach to restraint has been confusing and shambolic within the mental health sector as a whole. Many providers do not carry out risk assessment of

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techniques. If we are to develop appropriate regulations and consistent training for staff, work urgently needs to be done, by appropriate medical experts, on the likelihood and probability of physical and psychological harm with regard to each restraint technique in each position. Restraint is a physical intervention and should be seen as such; therefore, like all other physical interventions, it should be based on evidence of efficacy, safety and acceptability. Is it not time that this issue is reviewed by NICE and clear recommendations made, based on evidence? Finally, the Care Quality Commission should review its actions and ensure that a robust inspection process is in place that covers not only the process of restraint in care homes but the training that staff receive.

In conclusion, I am calling on the Government to take this opportunity to do more to address the inequalities in mental health for black and minority ethnic communities, adults and young people alike; to hold to their commitment to protect aftercare services, as defined by Section 117 of the Mental Health Act; and to bring forward actions to ensure appropriate use of restraint and physical intervention across mental health and learning disability services. I would like to see a clear commitment by the Government to take action within this parliamentary Session to tackle these issues. Without such action, we could be heading towards a crisis point and once again placing some of the most vulnerable people in our communities at real risk.

10.21 pm

Baroness Jones of Whitchurch: My Lords, first, I pay tribute to the impressive number of speakers in today’s debate, and the quality and range of the topics covered. I, too, congratulate the noble Lord, Lord Berkeley of Knighton, the noble Viscount, Lord Ridley, and the right reverend Prelate the Bishop of Winchester on their wise and inspirational maiden speeches. I know that we all look forward to their future contributions with considerable interest.

There is a new enthusiasm in social media for the concept of crowdsourcing. We could do worse than apply this principle to the contributions today, because if we amalgamated all the proposals made by your Lordships we would have a much more substantial Queen’s Speech than the rather timid mouse of a legislative programme that we have been debating today. It seems that the Government cannot raise much enthusiasm for their own programme. We have already heard that the coalition is split on the legislation to increase staff/child ratios in nurseries, and now the Prime Minister himself is saying that he is relaxed about Back-Benchers amending his own legislative programme. What kind of leadership is this for the country at this time?

The country is crying out for leadership and action to tackle the 1 million young people out of work, the fall in family living standards, the lowest number of new home completions since the 1920s, inflated energy bills while energy companies’ profits rise, and the health service creaking at the seams. A Government on top of their game would be laying substantial proposals in front of us to tackle these issues head on.

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What conclusions can we draw about the rather insubstantial policy offerings that we are debating here today? First, a number of the proposals make extra demands on local services that are not matched by additional local support. Local government is already struggling with a 33% cut in central government funding, and the projections are worse. For example, my noble friends Lord Hunt and Lady Wheeler, and others, have made challenging analyses of the Care Bill and raised some vital questions. Underpinning these issues, the Local Government Association estimates that there has already been a cut of £1.89 billion in social care funding, and more cuts in services are planned. It is a cruel deceit to suggest that social care provision can be modernised and integrated when the funding is not in place to make this a reality.

We support the principle set out in the Bill of capping care costs and giving family carers more support, although we share Andrew Dilnot’s concern that the cap is being set too high. There is concern that the Bill does not address the daily struggle of those seeking support right now. What reassurance can the Minister give to those people about the current and future funding necessary to deliver a modern, integrated care system?

On the issue of public health, rightly raised by a number of noble Lords today, I hope the Minister can reassure us that measures on plain tobacco packaging and minimum alcohol pricing will form part of the “other measures” to be laid before us in due course.

Secondly, on welfare reform, the Government appear determined to push on with the scapegoating of vulnerable people, including the disabled and unemployed, as well as of low-paid working families who are seeing their incomes cut. We have heard today how this is distorting public attitudes towards these groups. Meanwhile, the Government are doing nothing to raise families out of poverty. The Work Programme is failing to get the long-term unemployed into work, and the implementation of the universal credit system is beset by delays and problems.

We believe that, as a start, every young person who is out of work for more than a year should be offered a job guarantee to avoid a deskilled and demotivated generation losing faith in the prospects of fulfilling work. We would also introduce a compulsory paid job, linked to benefit entitlement, for every adult who was out of work for more than two years. Can the Minister explain what new proposals the Government have for creating meaningful work opportunities for young people and the long-term unemployed that might match this policy?

The one area of welfare reform that gives us some optimism is the Pensions Bill. I would be interested to know whether the Minister shares the views expressed in the insightful contributions of my noble friends Lady Hollis and Lady Drake in this regard, and whether he accepts their concerns about its potential implementation.

Thirdly, the Government are neglecting the country’s children by failing to invest in their economic, social and physical well-being. The recent report of the Institute for Fiscal Studies has concluded that, by

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2015, the number of children living in absolute poverty will rise by 900,000 to 3 million and that, by the end of the decade, 3.4 million children—about one in four—will find themselves in relative poverty. This reverses all the progress made by the previous Government in tackling child poverty and is a real indictment of the callousness of this Government. Instead of reaching the target for rates of child poverty that are no higher than 5%, they will oversee an increase to levels of 27%. Is tackling child poverty still a priority for this Government and do they still intend to take the original targets seriously?

A further example of the Government’s disregard for the welfare of young children is the ill conceived plan to increase child/staff ratios for nurseries, an issue that has been raised by several noble Lords. We said at the outset that such an increase would threaten the quality of childcare while being unlikely to reduce childcare costs, and this view is now echoed among professionals in the sector.

We are grateful that, rather belatedly, the Deputy Prime Minister is beginning to raise the same concerns. What is the status of this flagship policy now? Are the Government going to press ahead despite the overwhelming concerns expressed? When are we likely to see the carry-over Children and Families Bill in this House? I am sure that a large number of my colleagues would like to contribute to that debate. Perhaps the Minister can enlighten us as to the proposed timetable.

The Government’s disregard for the physical health and well-being of children is all too well illustrated by their policy on school sports. Under the previous Government’s school sport partnerships, the proportion of children taking part in weekly sport increased from one in four to more than 90%. As we have heard today from my noble friend Lady Billingham, the Government’s decision to unravel this provision, followed by a partial U-turn, has left a fragmented and underfunded service with no funding guarantees. That this should happen in the aftermath of our stunning Olympic success is a real tragedy. School and community sport need long-term funding commitments and an integrated programme if we are ever to repeat our global sporting success. Perhaps the Minister could enlighten us as to what plans the Government now have for how that might be achieved.

Another way in which Michael Gove has let down this country’s young people is his failure to grasp the importance of the arts and creativity in education. His tenure has been marked by grand announcements and policy shifts followed by rethinks and retreat. Not surprisingly, as described by my noble friend Lord Puttnam, Mr Gove has had a demoralising effect on the whole teaching profession. The example of the proposed EBacc was a case in point, with no status given to art, music and drama in the original proposals. The new curriculum proposals represent only a partial reprieve and the whole redesign of the curriculum has been marked by secrecy and intrigue when it should have been an open and transparent national debate about appropriate learning for the next generation of young people. Incidentally, confidence in the Government’s proposals is not helped by Michael Gove’s admission that research he recently quoted about children’s knowledge came from Premier Inn and UKTV Gold

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studies. Could the Minister explain how the new curriculum proposals will be debated in this House and what opportunity will exist for a real input into the final design?

The cultural legacy of the next generation is being squandered in so many ways, not just through the failings of education. The Secretary of State at DCMS has belatedly and ineffectively caught up with the economic contribution of the arts but fails to address the wider contribution, which is about our identity, ability to express ourselves, and health and well-being as a nation. This point was eloquently made by a number of noble Lords, including the noble Lord, Lord Berkeley, whose impressive maiden speech we have all applauded and whose godfather’s centenary I celebrated only last week. The Arts Council has been struggling with the burden of 30% cuts, with more to come, and local authority arts funding is being cut, sometimes to the bone. Nothing in the Queen’s Speech gives any comfort or optimism to those who see the potential of a strong local, regional and national arts presence in the UK.

A number of noble Lords raised concerns about the delay in implementing Leveson and the process of resolving the two competing royal charters. I share these concerns. Similarly, there has been a gaping silence where the communications Bill might be. We have been promised and promised again a White or Green Paper, but deadlines come and go and nothing has materialised. We need urgent action to protect children and tackle the highly concentrated and monopolistic nature of the industry. Can the Minister tell us when the communications Bill might be expected?

Finally, what kind of legacy do the Government offer young people on the environment? Whatever happened to the heady days of claiming to be the “greenest Government ever”? Who can remember the last time the Prime Minister even mentioned the green agenda positively? Not surprisingly, the Government’s proposals hold out little hope for those of us who care about these issues. Meanwhile, as CO2 emissions reach record levels, Tory MEPs have just sabotaged attempts to reform the EU Emissions Trading Scheme and the Chancellor is continuing to veto the introduction of a decarbonisation target in the Energy Bill. Can the Minister explain why, against this backdrop, consumers are faced with soaring energy bills while the profits of the energy companies continue to rise? How will the Government address the powerful critiques from several noble Lords of their failure to implement effective market reform in this area?

In conclusion, there have been many more thoughtful contributions today and I am sorry that I have not been able to reference them all. I am sure that the Minister will prove more skilled than I am at that. As I said at the outset, we have the makings in this debate of an alternative Queen’s Speech that could prove to be radical and exciting. I have certainly learnt a great deal and taken copious notes. I hope that, in the aftermath of the next election, we on this side of the House will be able to produce a Queen’s Speech that rather more successfully addresses the challenges of the nation that we have debated today.

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10.34 pm

The Parliamentary Under-Secretary of State, Department of Health (Earl Howe): My Lords, it is one of the glories of the debate on the gracious Speech that it engenders a wealth of varied and expert contributions from all quarters of the House. Correspondingly, it falls to the lot of the responding Minister to try to do justice to those contributions. Because of the large number of speakers today and the limited time available to me, I hope that noble Lords will understand if the justice that I do is of a rather rougher nature than I would ideally like, but I undertake to respond in writing to those noble Lords whose questions I have been unable to cover.

I cannot, however, omit to compliment our three maiden speakers on their contributions, which so lit up this debate—the noble Lord, Lord Berkeley of Knighton, on the economic and wider societal benefits of music and the arts; my noble friend Lord Ridley on the importance of affordable energy to economic growth; and the right reverend Prelate the Bishop of Winchester on religious education and social well-being. The right reverend Prelate has asked me to say that he has been called back to his diocese on a very urgent matter. The House listened with admiration to all three, and we look forward to their participation in our proceedings in future.

It is perhaps natural for me to begin with the Care Bill. I was grateful for the welcome accorded to the Bill by a number of speakers. As those noble Lords have highlighted, the Care Bill is essential to achieve a modern, clear and fair legal framework for care and support. There are issues which we shall doubtless debate in Committee. The noble Lord, Lord Hunt, questioned why the cap on care costs in the Bill was set at £72,000. Of course, that is the equivalent of £60,000 in 2010-11 prices, when the Dilnot commission reported. Simply, the cap is set at that level to strike a balance between protecting social care users and public affordability. The same principle will apply to national minimum eligibility criteria, which were raised by several noble Lords, including the noble Lord, Lord Northbourne, and the noble Baroness, Lady Greengross, and which will be published in draft following the announcement of the spending review settlement on 26 June.

The noble Baroness, Lady Wheeler, raise the issue of overall funding of social care. I would like to believe that she does not begrudge what we have done. We have sought to prioritise adult care and support. This year, the NHS is transferring funds of £859 million to support adult social care services, which also have a health benefit. Alongside that, we have seen examples of local authorities redesigning services to find more efficient ways of using scarce resources.

A number of noble Lords, including my noble friend Lady Jolly and the noble Lord, Lord Hunt, raised the issue of young carers. Both departments—of health and for education—are working closely with carer organisations and young carers themselves to consider how they can best be supported through legislation and other means. We do not, however, believe that the adult statute is the right place to make provision for children. The boundary between legislation

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for children and for adults ensures an appropriate distinction between what is expected of adults and of children.

The noble Lord, Lord Patel, raised the issue of free social care at the end of life. I hope that he will understand if I say simply at this juncture that I note that that idea has merit, as the Joint Committee on pre-legislative scrutiny concluded. The noble Lord, Lord Morris of Handsworth, and the noble Baroness, Lady Pitkeathley, both raised the Ready for Ageing? report by the Select Committee on Public Service and Demographic Change. I thank the Select Committee for its thorough report, and the Government will respond in due course.

The Care Bill also sets out critical elements of the Government’s response to the findings of Robert Francis QC, which are vital to delivering our commitment to ensuring that patients are,

“the first and foremost consideration of the system and everyone who works in it”.

In that context, the noble Lord, Lord Hunt, questioned why we are not merging Monitor and the Care Quality Commission. The answer is that those bodies have different functions. The Care Quality Commission’s need to address quality and highlight features of care should not be conflated with Monitor’s responsibility to oversee the turnaround of failing NHS providers.

The criminal offence of providing false and misleading information was also raised. Perhaps I need to make clear that it applies to all care providers. However, as the Francis report identified that distortions to mortality rates are most significant, we plan to limit the application of the offence through regulations to provision of this kind of information.

On the issue of criminal sanctions for individuals, there are already existing routes for prosecution through the Health and Safety Executive, the corporate manslaughter Act and the laws of negligence. In future, when the new Chief Inspector of Hospitals identifies criminally negligent practice, they will refer the matter to the Health and Safety Executive to consider whether prosecution is necessary.

The lack of reference to minimum alcohol pricing and standardised tobacco packaging in the Care Bill has been mentioned by a number of noble Lords, including the noble Baronesses, Lady Jones of Whitchurch and Lady Morgan of Drefelin, and the noble Lords, Lord MacKenzie of Culkein and Lord Patel. Introducing either of these measures would be very significant. We are actively looking at them both but we are determined to take the time to consider all the available evidence, rather than rushing to legislate. I look forward to further debates on the issues covered by the Care Bill with the many noble Lords who are expert in these areas.

On other health issues, my noble friend Lord Colwyn raised dental foundation training. My figures are that in this year’s recruitment, only 33 out of 1,000 applicants failed to secure dental foundation training places. We are committed to improving the process but this is a competitive process open to others including, noticeably, EU graduates. The noble Lord, Lord Turnberg, raised the issue of early identification of dementia. The

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Government are introducing a new enhanced service as part of the GP contract for 2013-14, rewarding practices for early identification of dementia. My noble friend Lady Barker asked about social enterprises. The Department of Health’s Social Enterprise Investment Fund has invested almost £110 million in 650 organisations, while over 10% of community health services are now provided by social enterprises through the “right to provide” programme.

The noble Lord, Lord Patel of Bradford, spoke powerfully about mental health. We are investing over £400 million to give thousands of people, in all areas of the country, access to NICE-approved psychological therapies. The mandate to NHS England makes clear that “everyone who needs it” should have,

“timely access to evidence-based services. This will involve extending and ensuring more open access to the Improving Access to Psychological Therapies … programme, in particular for children and young people, and for those out of work”.

Finally on health, the issue of charges for migrants was raised by a number of noble Lords, including the noble Lord, Lord Hunt. Such charging was actually welcomed by the shadow Secretary of State for Health in yesterday’s debate in the other place. Our approach is simply to ensure that everyone who uses NHS services contributes. We are seeking to do that in a way that will be simple for services to be provided and will be consulting on the details in the summer.

Just as care and support needs reforming, so fundamental reform to state pensions is vital in order to have a system fit to meet future challenges. This is taken forward by the Pensions Bill. The single-tier pension will deliver simplicity, introducing a flat-rate state pension for future pensioners that is set above the basic means test to provide a clear foundation for retirement. I thank the noble Baronesses, Lady Hollis and Lady Drake, and my noble friend Lord Stoneham for their words of support for these crucial reforms. The noble Baroness, Lady Hollis, stressed the need to consider healthy life expectancy when looking at state pension age. The Pensions Bill introduces a regular review of the state pension age. The guiding principle of that review will be that individuals should spend a given proportion of their lives drawing a state pension but other factors are important. An independently-led body will consider and report on other relevant factors, which could include variations in healthy life expectancy and regional variations in life expectancy.

My noble friend Lord Stoneham remarked on the difficulty of the ending of contracting-out for defined benefit schemes as a consequence of these reforms. The Government recognise that this is the case; that is why the Pensions Bill contains a statutory override to help employers make any necessary changes. The noble Baroness, Lady Drake, spoke of the importance of the single-tier pension in a world where employees will be automatically enrolled into workplace pension schemes. She mentioned the importance of the single-tier pension retaining its value relative to earnings. The Pensions Bill includes provisions which mean that the single-tier pension will be annually uprated by at least earnings.

I shall turn briefly to the water Bill. The water industry has come a long way since privatisation, using private sector investment to deliver major improvements in infrastructure and the environment,

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but we are now facing unprecedented pressures on our water resources as a result of growing population and changing weather patterns. Doing nothing is not an option. The noble Lord, Lord Hunt, suggested that the water Bill fails to deal with public affordability. However, the Bill will increase resilience, efficiency and innovation in the water sector, which will keep customer bills affordable. My noble friend Lord Redesdale raised sustainability. Ofwat has had a statutory duty to contribute to the achievement of sustainable development since 2003. We are supplementing this by introducing a new primary duty to secure the long-term resilience of our water services.

On issues around culture and media, I agree with my noble friend Lord Clement-Jones regarding the importance of creative industries and the contribution of arts and culture to our society. The noble Lord, Lord Berkeley of Knighton, talked of the excellent returns of investment in the arts. The Government are committed to the creative industries as a vital part of our strategy for growth.

I shall conclude with remarks on two Bills carried over from the previous Session. The Children and Families Bill will transform the system for children and young people with special educational needs, reduce delay in the adoption system and reform childcare to ensure the system focuses on providing safe, high-quality care and early education for children. A number of noble Lords, including my noble friends Lady Barker, Lady Jolly and Lord McCall and the noble Baroness, Lady Massey, raised issues which demonstrate their real expertise in this area. The noble Earl, Lord Listowel, my noble friends Lord Storey and Lady Walmsley and other noble Lords raised the important issue of childcare. We strongly agree that we need to do more to encourage high-quality, better paid professionals in the sector. Our proposals will help to attract more talented people into the profession by making it easier for providers to pay better wages. I hope I can offer some reassurance. The Government’s proposed new ratios bring us into line with practice in countries such as France and the Netherlands, both of which operate with less restrictive ratios combined with better qualified and better paid professionals. We want to give providers in this country these same freedoms to improve the quality of staff. The new ratios will be available only to those providers who employ highly qualified staff. We have consulted on the qualification thresholds and are considering the responses. We will be publishing the response soon.

As the noble Lord, Lord Puttnam, so rightly said, nothing has more impact on children’s achievement than the quality of teaching they receive. My right honourable friend the Secretary of State for Education is raising the bar for new teachers, supporting existing teachers to improve and creating teaching schools which model and share outstanding practice. In response to the noble Lord, Lord Griffiths, I must stress that our ambitions and these critical improvements are for all children and all schools. The steady stream of applications to set up new free schools demonstrates the continuing demand from parents for a greater choice of schools within their communities. The success of the academies programme is something for which the Government do not apologise. We make no apology for our investment in a programme which is proven to

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drive up standards and make long-term school improvements. We want as many as possible to take advantage of the significant benefits that academy status brings.

The noble Baroness, Lady Billingham, and the noble Lord, Lord Hunt, spoke of the importance of the Olympic legacy in schools. We entirely agree that we must harness the sporting spirit of 2012 for all our young people. That is why the Department for Education is providing £150 million per year and reintroducing competitive sport into the heart of the curriculum. By doing that, we can achieve an Olympic legacy in our schools of which we can be proud.

A number of noble Lords spoke about the review of the national curriculum. The noble Lord, Lord Northbourne, and the noble Baroness, Lady Massey, are concerned that the breadth of education is important. The right reverend Prelate the Bishop of Winchester raised the importance of religious education in schools, my noble friend Lady Miller asked about the teaching of nutrition and my noble friend Lady Benjamin highlighted the importance of Shakespeare. The aim of the curriculum review is to enable a focus on the essential subject knowledge that all young people should acquire to be educated citizens while freeing up teachers to use their professional judgment about what to teach beyond that core and how to teach in a way that will inspire and challenge their pupils.

Finally, the Energy Bill seeks to reform the electricity market by ensuring security of supply, reducing our emissions by transition to low-carbon generation and doing all of this at the lowest cost to the consumer. I am grateful for the contributions of many noble Lords more expert than I in this area, including my noble friend Lord Jenkin of Roding. The noble Lord, Lord Oxburgh, and my noble friend Lord Crickhowell raised the slow progress of energy reforms. These reforms are complex and it takes time to work through them with stakeholders. Therefore I hope that the Energy Bill will progress quickly through your Lordships’ House.

The issue of shale gas was raised by a number of noble Lords, including my noble friend Lord Ridley. The Government have set up the Office for Unconventional Gas and Oil. In the Budget, the Chancellor announced plans to incentivise shale gas development in the UK.

The noble Lord, Lord Donoughue, questioned the scientific orthodoxy on climate change. The Government are committed to implementing the Climate Change Act 2008. This commits us to reducing greenhouse gas emissions by 80% by 2050. It also sets the long-term framework for planning about which my noble friend Lord Redesdale is rightly concerned.

It is a pity that I do not have time to respond to many of today’s excellent contributions, including those of my noble friend Lord Bridgeman, the noble Lord, Lord MacKenzie, on nursing, the noble Lord, Lord Touhig, on autism, the noble Lord, Lord Noon, on higher education, and the noble Lord, Lord Best, and my noble friend Lord Kirkwood on housing. I could name many more. However, in such a relatively short speech, it is challenging to do justice to a debate of this diversity and length. As I mentioned, where possible I will write in response to other questions that were

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put today. I look forward to future debates on all the measures announced in the gracious Speech and I commend the programme to the House.

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The debate adjourned until Wednesday 15 May.

House adjourned at 10.52 pm.