The noble Lord, Lord Cope, talked about UKTI’s shift in focus towards SMEs. This is very welcome and is having a real impact. The other specific initiative taken by the UKTI—one of the most cost-effective initiatives that the Government have undertaken—is its appointment of trade ambassadors from across your Lordships’ House. These are having a material impact on developing trade links with some of the countries that we have traditionally ignored; my noble friend Lord Sharman in Morocco and my noble friend Lord Risby in Algeria, for example. We are finding that there is considerable scope for enhanced UK trade with parts of the world that we have tended to ignore.

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The noble Lord, Lord Cope, talked about the challenges of the PAYE system. I agree with him. He may be right in saying that companies will find it simpler in the long run to adopt the latest technology. With regard to national insurance, we have introduced a £2,000 per year allowance for businesses. That will be particularly beneficial for SMEs. That is not a mechanical point but it is a hard cash point.

The noble Baroness, Lady Kramer, talked about funding, particularly the challenges in getting new forms of funding into SMEs. I very much agree with her. One of the leitmotifs of this debate has been people drawing on experience from elsewhere in Europe and North America. We can learn from these countries but it is quite difficult, as the noble Lord, Lord Sainsbury, says in his book, to replicate exactly their institutions. The American community development and investment funds work very well in the States, but it is not easy simply to transpose them here. On the question of new sources of funding for SMEs, one of the key things to have happened is that the PRA has in effect torn up the old methodology of the FSA in terms of getting new banks going. It was virtually impossible to start a new bank in the UK and we clearly need a raft of new banks, not least business banks. I believe that the PRA’s approach to this will prove to be extremely beneficial. In the mean time, the Government have introduced the Funding for Lending scheme, which should help small business funding and is in the process of establishing a business bank.

The noble Lord, Lord Giddens, thinks that we should be academic-led in the way that we look at these issues—I suppose that, as an academic, he would. I hope that we do not need to wait to have a raft of academic literature in front of us before we can start doing a lot of the things that he would like us to do. He talked, for example, of shale gas and whether we could take that opportunity quickly enough. As he will know, when the spending review was announced, we announced that we were taking a series of steps in the very near term to move forward on the development of shale gas here. These include developing technical planning guidance for shale gas exploration and looking at how we can put in place a generous community benefits scheme so that those communities that will be affected will be fairly recompensed. We are also consulting on tax incentives to encourage exploration. Hopefully, we are making a lot of quick progress in an important area that is bound to be controversial.

The noble Lord, Lord Monks, used a phrase that I have not heard for a considerable time, “the commanding heights”. It used to be extremely prevalent in political discussion. One of his main concerns was that too many UK companies have been bought by foreign companies and that foreign owners have different priorities from domestic ones. That is right, sometimes. However, we must have a more nuanced view. One of the most impressive success stories in British industry in recent years is that of Jaguar Land Rover. Does anyone think that there was a company in Britain that could have taken over Jaguar Land Rover and made the success off it that Tata did? I do not. It has been a phenomenal success. The Kay review, looking at short-termism and long-termism, will play a part in trying to redress the

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balance here, but I do not think that a great constraint on foreign ownership of British companies is a good idea.

The noble Lord spoke of the problem of top salaries and growing income inequality. That has been a very significant development in recent years, driven largely, but not exclusively, by the financial services sector. When I served on the top pay board, we looked at methods of beginning to redress this, not least by shareholder activism, and the Government are implementing a large proportion of those measures. Bank bonuses, without a bank bonus tax, have fallen very significantly—they are down 70% in the case of RBS and 40% in the case of Barclays.

The noble Baroness, Lady Valentine, raised a number of issues. I cannot deal with all of them. On airports, all I will say is that the Government taking quick, decisive action would be extremely easy if there were no such thing as public opinion. In this case, any Government would, quite rightly, take public opinion into account, as well as the narrower, though crucial, economic analysis that would underpin any decision.

The noble Baroness made a point about immigration and visas. As she knows, we are looking at methods of improving the situation in respect of visas, not least for China. We have introduced a VIP visa service for visitors from China. I could not claim that we have this right. It would be easier, in a narrow respect, if we were members of the Schengen agreement, but she knows as well as I do that that simply will not happen. We are looking at other ways of redressing the problem.

She pointed out that London is a centre for businesses that want to trade in Europe and that we need to engage in the EU as an equal partner. I agree with everything that she said on that subject. I also agree with the noble Baroness, Lady Donaghy, who pointed out the costs of adopting a Norwegian posture. To me, that is simply a risible option.

I thank the noble Lord, Lord Bates, for his speech, not least because he has saved me from saying a great deal of what I would otherwise have said about what has been happening.

The noble Lord, Lord Bhattacharyya, referred to protecting the science budget. The Government have done that. Any debate about science, particularly this one, should recognise the seminal role that the noble Lord, Lord Sainsbury, played as the first politician for a very long time to take science seriously. Without his persistence, we would not have had the expenditure on science in the previous Government that this Government have been able to build upon.

I share the support of the noble Lord, Lord Bhattacharyya, for HS2. While I agree with the noble Lord, Lord Mitchell, that the way we do business is changing, I have spent a great deal of time travelling to Birmingham over the past 20 years—once to do with developing Brindleyplace, as it now is, in its early stages and, secondly, working for a charity—and in both cases there is no way I could have done that without being there and engaging people face to face. While I am sure that a hologram of myself in front of Birmingham City Council or a head teacher would have been mightily impressive, I simply do not believe that at any point in the foreseeable future we will be able to do without transport.

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We will need more of it. One of the things that has not been mentioned is that the population of the UK is set to increase significantly over the coming decades, which means that all forms of transport will need to be enhanced. That is why the Government have put so much effort into looking for longer-term infrastructure proposals, and why those proposals are included in, and form the basis of, the spending review last week.

I liked the point of the noble Lord, Lord Bhattacharyya, about evaluating the way in which we do things. I shall certainly raise that issue with my colleagues in BIS.

The noble Lord, Lord Bradshaw, referred to the value of engineers and said that there were too many apprentices who were not engineers. What we have got to do is to increase the number of engineering apprentices and not reduce the number of apprentices in a range of other industries. An apprentice in the catering industry is as important to me as an engineering apprentice. There are good examples of leading companies in the UK who have terrific records on apprentices—BAE and Rolls-Royce, for example. The university technology colleges will help to change, to a certain extent, the bias against a vocational approach to careers and I hope that they succeed.

I have referred to the points made by the noble Baroness, Lady Donaghy, but I would like to comment again on the shortfall in engineering graduates. One of the matters that the noble Lord, Lord Sainsbury, mentions—and with which I strongly agree although it is controversial—is that we need to better align the courses that we provide in further and higher education with labour market needs. This is a major challenge, not least because many young people are working very hard to obtain degrees in subjects that they think are quasi-vocational, such as law, and then find that the careers that they had envisaged for themselves simply are not available because of the excessive competition. I agree with the noble Baroness that tourism is a hugely important sector that is sadly overlooked.

The noble Lord, Lord Skidelsky, raised a raft of macroeconomic conjectures. The only part of Keynes that I would like to quote back to him is the importance of animal spirits. It seems to me that animal spirits are now operating in a different direction than they were a year ago. That is one of the key reasons why we are seeing growth, and will see faster growth in the future.

I agree with him completely about looking at the unemployed as a resource. However, I think his analysis is flawed because when you look at the level of unemployment in London—8.6%—who can say that there are not jobs in London for every Londoner who wants one? London has hundreds of thousands, if not millions, of people who come from the rest of the world to take up jobs that could be done by Londoners if they were properly trained. This is not a macroeconomic failure. There is a huge supply-side failure that we have completely failed to grapple with over the years, and we need to do better.

The noble Lord, Lord Hunt of Chesterton, referred to the Damascene conversion of Mr Willetts and asked me to comment on it. I am afraid that I cannot see within the mind even of my own colleagues, far less

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those of my coalition partners. I am sorry that he did not mention the fact that the Government have confirmed that they are investing in the new high-performance computer for the Met Office, which I am sure he will welcome.

The noble Lord, Lord Kirkwood, talked about long-term unemployment, which is a huge problem. The Work Programme is designed to address that. Although it is doing better it needs to be more flexible, and I hope that it will be.

The noble Baroness, Lady Turner, referred to investment being the key. Indeed it is. The Green Investment Bank has £3 billion of government funding, and so far, of the £633 million it has committed, for every government pound committed private investment has brought in three.

The noble Lord, Lord Stone, raised the question of self-awareness. I hope that he will start with Members of your Lordships’ House.

The noble Lord, Lord Shipley, raised a number of key points, some of which I have dealt with. On public procurement policy, the problem that he raised, which was new to me, seems to be a very real one. I shall take it up with my colleagues and write to him.

The noble Lord, Lord Davies, basically suggested that things were extraordinarily gloomy. The only thing I would say to him is that there was a 1.4% growth in real household disposable income last year; over 1.3 million more people are now working in the private sector; last year employment grew faster than in any G7 country; and the number of women employed is the highest it has ever been.

This has been a fascinating debate. We have discussed fundamental issues relating to the economy and society and I am extremely grateful to the noble Lord, Lord Haskel, for initiating it.

2.17 pm

Lord Haskel: My Lords, unfortunately our time is up and I cannot respond to each individual speech. I hope that the Minister on the Woolsack will give me a moment to say that this has been an informed, interesting and lively debate. I thank the Front Benches for their responses, which have been most fulsome. I hope that the rest of the Government are listening with an open mind because an awful lot has been said today that is based on knowledge, experience and an enormous amount of good will, which we can all value.

Motion agreed.

Civil Society

Motion to Take Note

2.18 pm

Moved by Baroness Prosser

To move that this House takes note of the future of civil society.

Baroness Prosser: My Lords, I am pleased to have been given the opportunity to lead this debate today on the future of civil society.

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The impact of organisations that we collectively describe as civil society has for many years been recognised across many walks of life as of importance and value. There is, however, sometimes confusion about the term. That is not surprising, because civil society is made up of many and various people and organisations. We have the truly voluntary, such as the Scouts and the Guides, amateur boxing clubs and golf clubs, the National Federation of Women’s Institutes, church groups and play groups. Then we have umbrella groups such as Community Service Volunteers and the National Council for Voluntary Organisations, which among other activities provide networks of support and advice. In the past, CSV has provided educational training on citizenship as part of the school curriculum.

The third wing, known generally as the voluntary sector or the third sector, provides professional help often including advice and representation. This group includes law centres, CABs and advice centres of many kinds, dealing with issues of race or gender, or helping those who have been trafficked or abused or those without housing. Some services are very specific, for example for children and young people, the elderly or drug addicts.

Where does the government initiative on the big society fit in here? The Conservative Party website states:

“The Big Society is about putting more power in people’s hands—a massive transfer of power from Whitehall to local communities. We want to see people encouraged and enabled to play a more active role in society”.

No one, I am sure, would disagree with the second sentence, but a transfer of power from the state to local communities should be considered more warily.

The TUC’s 2011 report, Civil Society and Public Services, contends that the overall concept of the big society is the outsourcing of public services to providers from civil society and to social enterprises. It says that it must be seen in the context of huge cuts to public spending.

The report quotes from another report, Cutting It: The Big Society’ and the New Austerity, produced by the New Economics Foundation. It argues that there might be merit in the theory of empowering communities, opening up public services and promoting social action, but that these aims cannot at this time be separated from the Government’s programme of deep and rapid spending cuts. As the foundation puts it:

“Unpaid labour and the charitable and voluntary sectors are due to fill the gaps left by public services, providing support to increasing numbers of poor, jobless, insecure and unsupported individuals and families”.

Was it a little harsh? Was it jumping the gun in 2011 when the big society had hardly started? We shall see.

Let us look at where we are now. The Charity Finance Group’s March 2013 report, Managing the New Normal—Adapting to Uncertainty, found that 93% of the charities that it surveyed said that they were experiencing a squeeze on fundraising, while two-thirds said that demand for their services had increased.

CSV declares that individual citizens in small community groups cannot tackle widespread complex and costly social, health and social care problems alone,

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and that a well resourced independent and responsive sector is needed to get the best fit and to find and support the vulnerable and needy. It also says that voluntary sector organisations that involve volunteers need to be properly resourced in order to effectively and efficiently recruit, support and retain volunteers, and that this is particularly important when volunteers are engaging with vulnerable families and individuals as well as people in difficult circumstances.

While the aim of the big society might be laudable, the funding of small, often isolated groups of individuals cannot and will not make up for the gaps that are being left by the cuts to local authority budgets and the subsequent reduction or loss of vital professional services. According to the NCVO, reporting this year on the June spending review, the further reduction in funding from local authorities, together with the negative impact of many welfare changes, will mean the likelihood of more and more people seeking support while the charities that are geared up to providing that support become more and more financially precarious.

The NCVO goes on to say:

“Given that charities play a major role in preventing social problems and therefore reducing costs, councils looking to balance their budgets will need to have meaningful discussions with the voluntary sector about how they can support their communities”.

I hope that when the Minister replies he does not tell us that these decisions are local and local authorities are free to choose their own priorities. While that might be factually correct, the size of the financial pot that largely determines these priorities is very much a national decision.

I turn now to some brief specifics, such as areas of service and/or need that have been hit particularly hard by the current austerity measures. The availability or lack of civil legal aid was discussed at length in this Chamber during the passage of the recent legislation and in a debate last week, so I will not labour the point. Suffice it to say that problems addressed early on do not often develop into major crises. The Law Society is quoted as believing that one in three law centres will be forced to close because of its reliance on legal aid funding. Most of these centres are in areas of deprivation and most need. With nowhere to go for help, many problems are certain to turn into crises.

The 2012 report, Perfect Storms, by Children England, which is the membership organisation for the children, young people and families voluntary sector, cites an example of a national charity providing advocacy, legal representation and information and advice to vulnerable young people and adults that uses both paid staff and volunteers. Despite the local authority duty to provide such a service, the charity has seen the allocation of core funding reduced on all its contracts, which has meant the loss of 15, or 10%, of paid staff, and 19, or 5%, of volunteers.

According to a survey by the National Children’s Bureau, more than 65% of children and young people’s charities responding said that they are reducing both the level and range of services they deliver due to public spending cuts. The TUC has reported that more than 30% of funding to sexual violence and sexual abuse services for women has been cut. Women’s Aid says that it has been turning away 260 women

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per day because of its cuts. Yet the Government’s announcement only this month of a £4.3 million boost to big society funds to put communities in control cites among other areas of priority: troubled families, improving maintenance arrangements for children of separated families, and improving social mobility. This is virtually the same client group as those currently losing funding. It seems very strange that we are starving well established and experienced organisations of the funds they need to deliver the services in which they are the experts and then providing more funding to set up something unprofessional and new.

The only conclusion I can reach is to go back to the Conservative Party website, which I remind the House talks about:

“a massive transfer of power from Whitehall to local communities”—

in other words, services on the cheap provided by local people with little or no experience to some of our most vulnerable and needy citizens. It will end in tears and somebody in the future will have to pick up the pieces of a very short-sighted and poor policy.

Finally, lest anyone thinks that I am more in favour of bureaucracy than the development of communities, I can tell the House that this is not the case. I spent many happy years in the 1970s and 1980s working in community development and a community law centre, and I absolutely believe that many communities have hidden strengths and that many people very much enjoy participating in local activities, helping those more in need than themselves. However, those people who are in need of help deserve to know that the assistance given to them comes from professional and experienced advisers. The volunteers working in local centres or agencies also deserve the support of those with professional know-how. I look forward to listening to the contributions of noble Lords.

2.30 pm

Lord Hodgson of Astley Abbotts: My Lords, I begin by congratulating the noble Baroness on giving us the chance to discuss this important matter and, indeed, on drawing the attention of the House to the multifaceted nature of civil society.

Before I go into my remarks, I have what the police would call “form” on this matter and need to declare some interests. I chaired a task force for the Government that produced a report, Unshackling Good Neighbours, which sought to look at what stopped people volunteering and giving money and what stopped smaller charity and voluntary groups growing. My reward for that was to be appointed the official reviewer of the Charities Act. I produced a report a year ago and here I have to chide my noble friend on the Front Bench somewhat. The report, which contained 100 recommendations, was deregulatory and generally welcomed by the sector but has yet to receive an official response from the Government. It is 12 months now and I have to say to my noble friend that I do not think that that is quite good enough. The sector is anxious to hear whether any of the ideas which I proposed, after consultation, are going to be proceeded with, and the Government need to hurry up. In producing those two reports, I visited many parts of the country and saw at first hand

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what wonderful work was being done by men and women, often in small groups and with very limited resources, tackling some of the most deep-seated and intractable problems of our society. They deserve our support and encouragement.

I said that I wanted to congratulate the noble Baroness, Lady Prosser, on introducing this debate. I do so, but she will not be surprised to learn that I do not really agree with her analysis of the situation. I will not go through a point-by-point rebuttal but I will say that she completely failed to mention the appalling economic situation that this Government inherited from the previous Administration. There is no way that the charity and voluntary sector can be insulated from that. Indeed, the Government are to be congratulated in many ways on what they have managed to achieve.

I draw the House’s attention to three important aspects of government policy. The first is the coming into force in January of this year of the Public Services (Social Value) Act, which for the first time imposes a duty on commissioners to consider the social, economic and environmental benefits before commissioning a contract. That is a really important way of getting local input and commitment to projects. The second aspect is the changes in gift aid, which have simplified the whole process considerably through the Small Charitable Donations Act. The fact that no donor declarations are needed for smaller amounts of gift aid is really important and helpful to small charities in boosting their ability to raise money and cutting down the amount of paperwork they have to undertake. Last, and most important, is the development of the social investment market, which recent reports suggest grew by 25% last year. This is a win-win situation: more funding for the voluntary sector and the emergence of the UK as a world leader in this whole area of social investment and in the way in which we can carry it out. Those three aspects are extraordinarily important and the Government are to be congratulated on having pioneered them.

My noble friend would not expect me not to have a shopping list of things that the Government should be going on to execute over the remainder of this Parliament. I offer him two or three that he should get his officials to look at with expedition. The first is the rather technical issue of trustee duties. Our trustee law currently makes no distinction between trustees of an ordinary trust and those of a charitable trust. Preservation of capital is exceptionally important in an ordinary trust—you need the capital preserved in your pension fund in order to pay the pension. However, it is perfectly possible for trustees of a charity to spend some capital in pursuance of their charitable objectives. That is an important difference and I hope that the Government will persuade the Law Commission, which is beginning its review of charity law, to begin to undertake a really serious look at this in order to draw a distinction in law between these two types of trust in the future. It would have substantial practical implications and benefits for charities.

The second issue is volunteer and trustee liability. I discovered that there is a perception of risk out there. It is true that some of it is based on myths and some of it is based on completely counterintuitive outcomes to

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legal cases, which have been well publicised. However, we live in a litigious age and we need to offer our volunteers, trustees and workers in charities and the civil society sector protection and the understanding that the law is on their side when they are acting sensibly. I hope that the Government will continue to look for ways to provide that reassurance. I am sure it will have a great benefit in terms of the readiness of people to volunteer.

The third issue is commissioning. Commissioners tend to be risk-averse. If we are going to find a way to encourage the voluntary sector, we are going to have to provide commissioners with some air cover so that they are prepared to chance their arm, so to speak. We could establish yardsticks that the Government would help promulgate as best practice. The Government would not have to enforce them, but they could be there as a yardstick. These could relate to, for example, the number of tenders that you call for in relation to the size of the contract. You can have only one winner. If you have six or seven tenders, you have to have five or six losers, and all the work and cost that has gone into preparing those tenders is wasted. You could also have yardsticks about the cost of preparing a tender and the cost of monitoring in relation to the size of the contract. All these things would help the charitable and voluntary sector compete more effectively, as it would not be put under undue or unfair competitive pressure.

The last issue is that we are clearly going to see voluntary groups and charities begin to have to form syndicates. They are going to share services with other charities that are providing different expertise to that syndicate, which, of course, brings in the issue of VAT on shared services. Value added tax regulations are a bourn from which no traveller returns and are exceptionally complicated. The Government could do a great deal to help the development of syndicates and to help consortia of smaller groups compete in the brave new world if the VAT situation could be addressed.

Finally, I should like to address the question of failure. We should be prepared to expect and accept that some charities and voluntary groups will fail. The voluntary sector is tackling some of the most difficult and hardest-to-reach areas of our society and not all plans are going to succeed. My noble friend Lord Cope referred to the high failure rate of commercial enterprises and the charitable and voluntary sector is not exempt from similar ratios. Failure is not the same as fraud, but sometimes in the voluntary sector the two are confused. I hope the House will agree that this is not a matter to be defensive about. Indeed, some might argue that if there were not failures that would show that the sector had lost some of its dynamism and its entrepreneurial instincts.

2.38 pm

Lord Rooker: My Lords, I congratulate my noble friend Lady Prosser on introducing the debate and welcome the opportunity to say a few words. Before I set out an example of civil society, I want to do a tiny bit of scene-setting. As we saw this week, the UK is home to three times as many banker millionaires as the whole of the EU put together. The RSPCA has

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raised the pay for top executives into the £150,000 a year range, despite falling donations, and, in my view, is wasting money on prolific private prosecutions. Under the austerity regime that we are experiencing at the moment, when civil servants have been on an effective pay cut due to the pay freeze and pension cuts, the very top Civil Service levels have continued to receive eye-watering five-figure bonuses. I am as annoyed as Eric Pickles is at CLG at the failure to tackle the runaway local authority chief executive salary trough and the perks that are added to it. The Charity Commission, as it appears from the recent BBC “File on Four” programme, is busy certifying non-charities as charities. Seven out of 10 commissioners on the board are new and only one of them has any significant experience in the sector at all.

That is a bit of scene-setting for talking about civil society. Then I read Peter Oborne’s column in the Telegraph today. He says that the coalition has been brave and ambitious in challenging the official culture,

“dominated by the assumption that controlled, state-directed action held the key to national happiness”.

I have never agreed with that and I do not think that my noble friend has, from what she said earlier on anyway. Peter Oborne goes on to say that the programme of social change and economic reform,

“in its scope and audacity has no precedence in the post-war period, including the Thatcher years”.

The undertone of what is happening is extremely dangerous. I do not disagree entirely with everything that he says, but he then fails to ask who picks up the pieces as the state withdraws. That is the key question. If the policy is to have a shrunken state, which it clearly is—it has nothing to do with austerity in many ways—who picks up the pieces?

The effect of local authority funding being decimated is having a real negative effect on some of the frontline civil society organisations. On the one hand, local authorities are retreating from work by raising the bar of intervention—say in social services—and on the other cutting support to the private and third-sector operators in those areas. A young woman I met recently in one of our large northern cities works for an organisation that helps young people who are either homeless or in danger of becoming homeless. Her case workload left me staggered. It did not compare with what I had experienced during my 27 years in the Commons when qualified social workers carried out the work that she described. Social services have not even contracted out the work. They have simply raised the bar, saying that they do not do this any more, and their intervention comes only at the crisis level and then after lots of chasing up. This young woman had recently taken on supporting a very vulnerable female teenager who had run away from home several times and no one knew where she had gone. She had a drug history and was associating with much older men. For the princely sum of a pay rate that was a few pence above the minimum wage, this young woman worked over and above the call of duty in hours, support and liaison, and at levels which I know from experience qualified social workers did in the past.

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This cannot be the way to pick up the pieces. As my noble friend said, it will end in tears. I fully appreciate that agencies at the centre and locally are having to make savings. I do not complain about that. I fully understand it and do not wish to be involved in a party-political dialogue about who is to blame. The fact is that that is the reality. It is obvious that the desire to replace services and shrink the state, which is certainly a central policy, is leaving gaps in areas that are difficult at the best of times. These areas were difficult when there was plenty of money. That is the point. By definition they are labour-intensive—very labour-intensive if one gets into the support of families. They are very challenging and often very sensitive. In short, they are the stuff that makes big headlines and calls for public inquiries when something goes tragically wrong in a specific case. That is the reality that we will be called to account for.

Slow growth and austerity are here for a while. I accept that. It would be ridiculous to work on any other basis. The population is ageing. More families are moving away or being moved away from social networks. These types of case will multiply. We need somehow to find a way properly to support the voluntary organisations. They are the bedrock and I am in favour of their not having as much red tape as local government. We need to do this not only with grants—finance is one area—but also with better routes into and support by the existing, remaining public services that can no longer fill their traditional roles. We have to accept that traditional roles are not being fulfilled by the statutory services, but they remain there with expertise infrastructure. We must find a way of enabling the voluntary sector, which is providing these services, to link in. We do not have that at present. It will end in tears if things simply carry on as they are at the moment. This is not all a call for more money. There has to be a better way of operating in the civil society.

2.44 pm

Baroness Barker: I thank the noble Baroness, Lady Prosser, for introducing this debate and I declare an interest. I have a small consultancy that works with charities.

I am not a big fan of the phrase “civil society”. Every time that I come across it, I think that it does a disservice to what it is trying to describe, but I cannot think of anything better. I am not always entirely sure what it is. I listened to the noble Baroness, Lady Prosser, giving her explanation at the beginning. For me, civil society means the point at which the statutory, voluntary and private sectors come together to make a difference to the common good and the lives of citizens.

If we had had this debate about 10 or 15 years ago, I do not think that we would have talked very much, if at all, about the role of the private sector in all of this, but we do now. It is the part of civil society about which we know least. There is a new report by Dr Catherine Walker, published by Directory of Social Change, which looks at corporate giving. There is some very interesting information in it that noble Lords will probably not have heard before.

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The report is an analysis of the giving of the top 550 corporate givers. It uncovers that companies play an important part in political and social development, but there is little evidence about what they do. They give approximately £700 million to £800 million, though it is a bit difficult to tell, because some multinational companies do not declare. That represents 2% of all charitable income, and 20% of companies give 90% of the cash that is given to charities. Cash donations to charities make up about 77% of the donations and the balance is gifts in kind. The average donation by a company is about £1.1 million. There are 73 companies that give more than £1 million. As far as we can work out, the total contribution as a proportion of pre-tax profits is 0.3%. Does that not say something?

In England, the biggest beneficiaries of charitable corporate donations are in Greater London, which gets about 33%. The West Midlands gets 1%. As far as we can tell—where it is possible to tell—the giving is totally unrelated to need. Corporations give where their offices are. They give primarily to community and social welfare charities, to education and to children’s charities; more than 50% of all giving goes to them. Causes such as human rights and women’s issues are far less popular. They get less than 10%. Arts and culture are traditionally seen as the domain of corporate givers rather than of individuals.

Despite everything that has happened since 2008, the financial sector is still the top sector for charitable giving. It gives about £245 million in cash. The least charitable sector, with an average spend of just about £300,000, is technology. I am glad that the noble Baroness, Lady Lane-Fox, is now in her place. There are also corporate trusts, and they provide about half a billion pounds in grants, 50% of which goes to three causes: education, community and social welfare, and children. This is the first report of its kind and it has set a benchmark in reporting. I hope that it will be possible to repeat the exercise and grow the statistical basis. We know that we need more transparency in reporting. There are also some limitations. We know practically nothing about the corporate giving of small and medium-sized enterprises.

The report is an important piece of work. Why is it important? It shows that giving varies dramatically across the country and that there is a key role for government in making up the deficits geographically and in terms of sectors, because of the disproportionate benefit to different localities.

I hope the Minister saw the Institute for Government’s report Making Public Service Markets Work because the private sector increasingly plays a huge role in and benefits enormously from the delivery of public services. We know that the big four—G4S, Capita, Serco and Laing—get by far the majority of the billions of pounds of public service expenditure. We also know from last year’s NCVO and CAF survey that local charities are beginning to lose out because of the way in which commissioning and, in particular, procurement is being done. The noble Lord, Lord Hodgson of Astley Abbotts, was absolutely right.

In its submissions to government on government procurement, NCVO said that social value ought to be both the strategy objective and at the forefront

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of the Government’s policies on procurement and commissioning. The Social Value Act is incredibly important as public services will remain large and significant employers in different localities, particularly in hard-hit areas outside London. It is therefore important that we take all this information into account and that the Government rethink the part they have to play in relation to the private sector’s role in civil society and in enabling all citizens in all parts of the country to get the best from it.

2.51 pm

Lord Hastings of Scarisbrick: My Lords, I, too, am grateful to the noble Baroness, Lady Prosser, for initiating this debate. I am also very grateful to the noble Baroness, Lady Barker, for her comments about the private sector. I declare an interest as the vice-chairman of the Global Agenda Council on the Future of Civil Society at the World Economic Forum. I draw to the House’s attention the report published at the World Economic Forum in Davos this January. I retain that position for a further two years. The essence of the report, which contains 80 expert interviews and insights from 200 analysts, including those from the charity, not-for-profit, business and government sectors, is that there is a new and very different paradigm for civil society going forward. It is far too easy to think of civil society as the domain of NGOs, charities and foundations and to miss the point—I am not suggesting that the noble Baroness, Lady Barker, did—that there is a lot beyond corporate giving that the private sector actively, persistently and continuously does. We need to see civil society not in purely cash terms but also in engagement terms.

I will give one or two examples and then try to draw a point. I was pleased to have a short conversation in the Bishops Bar with the noble Lord, Lord Livingston, who was introduced into the House this week. He will be the Government’s trade envoy, although he retains his position of chief executive of BT. For the past nine years, I have sat as a non-executive member of the BT responsible business board. The noble Lord and I spoke about BT’s Net Good ambition, which the noble Lord announced the day before the Prime Minister announced his responsibilities in this House and as trade envoy.

BT’s Net Good commitment is that for every tonne of carbon it consumes as a result of its activities, it will replace that effectively. Instead of putting carbon in the atmosphere, it will remove 3 tonnes from the atmosphere—a 1:3 ratio—by working alongside its stakeholders, suppliers and customers to help them learn about not just energy efficiency but different lifestyle approaches. This is not something BT needs to do. As one of the largest consumers of energy in the country, from a profit base it need only pay its bills, but the opportunity to engage the public in a responsible civil society approach to environmental responsibility goes way beyond merely the corporate saving of carbon or the massive contribution of BT to multitudes of charities and voluntary organisations around the country. That is part of the business/civil society engagement.

Another example is another organisation to which I am connected, as a trustee: the Vodafone Foundation.

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At a board meeting last Friday, we agreed to continue the active support that Vodafone is giving to the establishment of communication hubs in emergency centres around the world. The latest is being established in Goma in the Congo this very week. It will allow refugees to communicate closely with their families and in doing so not only retain those communications but benefit from the opportunity of a life beyond disaster. Again, this is not something that a mobile phone provider needs to do, nor is it CSR. It is the active collaboration of three sectors: the humanitarian relief sector, which would traditionally be seen as civil society; the responsibility of government; and the opportunity of the private sector.

Let us get a little more grainy. Just over a week and a half ago, I visited Wormwood Scrubs as a trustee of the Vodafone Foundation and in connection with the charity Only Connect. Only Connect was established by the great man Danny Kruger, who has written many speeches for David Cameron. It is a great charity that we all respect. It helps offenders and ex-offenders learn how to bring their lives into coherence by using the arts and by connecting to one another in prison to enable them to work together outside prison. During a meeting with the governor, we heard that one of his express desires was to help prisoners begin to build their own groupings of communication connectivity so that they can establish family networks and not be isolated individuals who return to repeat crime. We approved a grant on Friday to enable Only Connect to create its own LinkedIn-sourced connecting system for prisoners within the British system. That is not something that a mobile phone provider needs to do. It is not in the P&L and it is not CSR. It is the combination of all the factors that civil society now represents: the responsibility of government, the opportunity of the charitable sector and the privilege of profit to serve the interests of the public.

In just a few moments, I shall meet the Prime Minister’s special envoy for development in Afghanistan. He is coming to this House, having served in that role in Iraq and having previously been chief executive of KPMG International. Why would he take on that role? It was because, as Gordon Brown and David Cameron acknowledged, you need that kind of private sector expertise to deliver public goods in an efficient, effective and consummate way.

What is the future for civil society? In the judgment of this report—KPMG authored this report with the World Economic Forum, and I am directly responsible for its content—I firmly believe that the new civil society that we all need to welcome is where we allow the three sectors to stand as equal legs of the same stool and find solutions that are not based just on seeking cash from the private sector. I share some of the deep concerns about public sector cash restraints, but the reality of our new world is that we need to bring the three sectors into common understanding to find solutions that are not based just on more money.

I was proud to serve for 21 years as a trustee of Crime Concern and for 15 years as its chairman. One of the most important things it did before it merged with the Rainer Foundation and created Catch22 was to create in 1989 not just the backbone of Victim

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Support but the basis of Neighbourhood Watch. We all recognise the power of those realities as civil society truths through which we enjoy our safety and community to this very day. Unless we are prepared to take an open stance to involving the private sector, government, NGOs and common institutions in finding solutions, we will have three sectors fighting one another. There is no need for that in the future, and I hope that our speeches and the Government’s response will acknowledge this new opportunity and embrace it.

2.58 pm

The Lord Bishop of Derby: My Lords, I, too, thank the noble Baroness for securing this debate. I shall pursue the definition that the noble Lord, Lord Hastings, began to open up in his speech with the notion of the three legs of the stool and what civil society means. I start from the presupposition that we live in an age of liberalism in the technical sense; that is, we are very concerned for the individual to be free, and to be liberal about all those freedoms. Those freedoms are very good things, but any good often creates a problem.

I want to preface what I am saying with some words from TS Eliot. He said that the danger in liberalism is that it releases energy rather than accumulates it. It releases energy and then it is difficult to gather it together, because everybody is free, to make the building blocks of a civil society. He said that it relaxes rather than fortifies. The more we create rights, the bigger the problem with what we call cohesion. The more we are concerned about individual good, the bigger the problem with the common good. The more people have individual freedom, the more chance there is of becoming isolated, lonely and marginalised. It is very important to debate the civil society at this time when we desperately need energy to be accumulated around people for their well-being and flourishing and not dissipated into people being atomised on their own. The Government want to work with civil society—for the state to co-operate in accumulating energy for good things to happen. The National Council for Voluntary Organisations defines civil society as when,

“people come together to make a positive difference to their lives, and the lives of others”—

accumulating energy, making a positive difference to their lives and the lives of others.

I think, however, that we have to remember the historical context in which we seek to reaccumulate energy for human flourishing and public well-being, and I suggest that there are a couple of layers of civil society. The historic one is the institutions that existed between the individual and the state: the family, where there was a negotiation around gender and generation; the nation, which was a mix of kinship groups and regions; and the church, a spiritual hinterland that people explored and shared. Those three sites of civil society—the family, the nation and the church as a symbol of a spiritual hinterland—were not something that anybody chose; you were just born into them and negotiated your way within those frameworks. You started off with an accumulation of energy, in Eliot’s

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terms, through the family, through kinship groups and regions, through a spiritual hinterland.

Today, energy has been so liberated that civil society is now an elective exercise: people have to be persuaded to join together to create the energy and the momentum for human flourishing. The traditional bits of civil society—the family, the nation and the church, which gave a big framework—have got very weak. The Government desire a big framework for us to operate in so we are scrabbling about to bind people together for a common energy in something about which it is very difficult to persuade people, certainly beyond the local.

In my own experience in Derby and Derbyshire, where I work, the Government are inviting elective groups in civil society to co-operate with, as we have heard, the provision of services and well-being in the community. National charities are coming into our local area to bid for contracts and do the dealing—because they are organised, like the private sector, in a large way—and local charities are suffering, withdrawing and retracting, and the energy is dissipating. On the private model you need big-scale operations and the large charities are coming in to take the ground. That is very dangerous. The local is where you are in touch with people enough to understand what is going on in their lives, to listen to the stories of the homeless or whoever, and to focus the accumulation of energy appropriately to help people flourish and have the care and support they need.

There is a real danger that in trying to reduce big government we may be setting up big civil society. Civil society needs to be quite local and small-scale in many ways. If we set up a big civil society of big successful groups which can bid and deliver contracts all the local voluntary energy and connection is going to be marginalised and disappear. That would be catastrophic in many local communities. We need to encourage local civil society—small-scale civil society that people can elect to join. We need to remember that that kind of activity is committed to human flourishing, not to the delivery of services. It is a big framework, like the one that the family, the nation and the church stood for. People who get drawn in to civil society through their own choice want to share their values with others. They want to improve life on a big scale; they do not just want to deliver services and get a good return so that they can keep doing it. The Government somehow have to create an atmosphere of encouraging aspiration and idealism as well as instrumentalism in the design and delivery of services.

I want to raise three issues for the Minister to comment on. First, how will the Government endeavour to fortify the foundations of civil society—the traditional ones of the family, a sense of a nation and a sense of a spiritual hinterland? That is a big aspiration that excites people. They want human flourishing for themselves and for others and not just a narrow service delivery. Secondly, how will the Government help to encourage the smaller, more local agents of civil society and not dissolve big government into big civil society? Thirdly, how will the Government help civil society to be about human flourishing—the accumulation of goodness, in Eliot’s terms—and not about a more

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pragmatic, problem-solving exercise in trying to pick up the problems in society, rather than about raising human spirits in the way that civil society has always done and needs to do if it is to be a proper part of the three-legged stool that we have just heard about?

3.06 pm

Baroness Gould of Potternewton: My Lords, I, too, thank my noble friend Lady Prosser for initiating this debate on civil society, for it gives me the opportunity to discuss the important contribution made by the women’s voluntary and community services as part of civil society. That is not only my view; it is a view supported by Theresa May MP. When she was Minister for Women and Equalities she said:

“the women’s sector is a model of the Big Society we wish to build. That is a society in which we all work together to address problems, conscious that government has a role to play but that it does not have all the answers, and recognising the role played by charities, voluntary groups and others”.

Irrespective of women’s organisations seemingly being a perfect example of the big society, within a year of the Minister’s comments the voluntary and community sector faced, and still faces, unprecedented uncertainty.

In concentrating my remarks on the women’s sector, I thank the Women’s Resource Centre, the Fawcett Society and other organisations for sending me information based on their own experience and research. Nearly 1,300 women’s voluntary and community organisations have been established since the early 1970s with the aim of challenging inequality and empowering women to overcome discrimination, building on the many initiatives of the then Labour Government. While the organisations vary in size and income, collectively they are a family of volunteers, providing holistic and integrated services, with a mission to ensure that women and children improve their life chances and lead independent lives. These services meet the needs of a diversity of women, young and old, some with multiple and complex needs, some who have experienced domestic and sexual violence, alcohol or drug misuse, or have mental or physical difficulties. These timely interventions improve mental health and well-being, improve financial inclusion, reduce reoffending, improve independence and social and communication skills and provide a pathway to educational and vocational development. For BME women they reduce social exclusion and introduce community cohesion.

In 2010-11 Brighton Women’s Centre, of which I am patron, provided open access and out-of-hours drop-in services for nearly 12,000 women who needed mental health and emotional support. Some 250 women attended counselling services, a 40% increase on the previous year, and 533 women offenders and women at risk of offending accessed Inspire counselling, which was able to demonstrate to them that support, not crime, could provide lasting solutions to their problems. A social-return-on-investment study of Inspire showed that for every £1 invested, £3.57 is generated in social value for women, children and society. An Inspire client said:

“I had to fall to the bottom, to be forced to stop and take a look at the problems I was hiding from. Thank you so much for helping me not only change but save my life”.

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Women’s organisations have, however, traditionally found it challenging to find sustainable long-term funding. That might due to a misconception that equality has somehow arrived and they are not needed any more. Maybe donors are a little bit more sentimental about where they give their money. I have nothing against donkeys, but the Donkey Sanctuary receives more donations than the combined incomes of the largest violence against women and girls organisations in the UK.

For these organisations, the income stream has come from a combination of public donations from charitable trusts and grants by local authorities and health bodies. However, financial restraints to all these bodies have spiralled down to reducing support for the women’s voluntary organisations. Research by the North East Women’s Sector Network showed that half of the women’s organisations have lost funding, with those working on violence against women and girls facing cuts of over 40%—this is replicated across the country—while 70% of them are using or planning to use their reserves, leaving no buffer for the future, which could lead to ultimate closure. All the research shows that this is a reality. I was distressed to hear this week that the Government, in giving evidence to CEDAW, said that there is no evidence that women’s services are being affected by austerity. Perhaps the Minister can tell the House the basis on which such a statement was made.

The limited number of available income sources has severely affected organisations, meaning that more and more of them are chasing the same pots of money. There are also unintended consequences by changes to needs-led grants, by commissioning, by the new structure of health services and by payment by results. As the noble Baroness, Lady Prosser, and the right reverend Prelate said, many of the women’s voluntary organisations are too small. They rely solely on volunteers and cannot compete with larger organisations that can dedicate time and resources to compiling complicated bids in order to raise funding.

Coupled with those changes are the levels of cuts to legal aid and welfare reform. Of women suffering domestic abuse, 54.4% do not now qualify for legal aid under the new eligibility criteria. Their only recourse is to go to the voluntary sector for help, 94% of which has seen an increase in demand, with 77% of referrals coming from statutory bodies. The question is where those women will go. Where are they going to get the help and support they need? In an economic culture of budget deficit reduction, cost-effective services that produce positive outcomes are more essential than ever. There is no question that a small investment can produce an increased value to society, financially and practically.

What is the answer? How are the Government and local authorities going to understand that a little resource could have an enormous benefit? We need to think, perhaps, about how positively we can help and what action is required from both the Government and local authorities, which should give due regard to the crucial role played by voluntary women’s organisations, building an equalities framework into the commissioning process, thereby ensuring that the needs of specific

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communities can be met. The gender equality duty should be used to monitor the impact of policy and funding decisions—if it still exists after the review. If not, a key requirement to end discrimination will be scrapped, with dire consequences.

Commissioners are now commissioning more generic services, which further exacerbates the problem. Political agendas such as the Troubled Families programme do not include an understanding of the need for women-specific services, as they take a whole-family approach when, historically, the women’s sector has recognised that if we are to support our families and communities, we must start supporting women as the primary care-giver. Equally, it is important that women’s voluntary organisations are recognised as partners in meeting local needs, be it the police and crime commissioner, the clinical commissioning groups or the local authority. None of that can be achieved unless there is a mechanism to hear the voices and views of the women concerned. That, unfortunately, is not happening at present. Further, women must be represented on all key decision-making bodies, nationally as well as locally. Their value will then be understood as a crucial part of civil society.

3.15 pm

Baroness Tyler of Enfield: My Lords, I, too, congratulate the noble Baroness, Lady Prosser, on securing this timely debate when the combination of public spending cuts, decreasing charitable donations from the public, and sharply falling trends in corporate giving have pushed the sector into a fragile financial state. I declare an interest as president of the National Children’s Bureau, vice-president of the charity Relate and co-chair of the parliamentary inquiry Growing Giving.

As other noble Lords have already said, civil society does not limit itself to the voluntary and charitable sectors but runs across all aspects of public life. However, it differs in one key respect from other sectors, in that it has a mission statement that is focused on the benefit of society and the collective good. Today I will be focusing my remarks on charities and the voluntary sector, concentrating particularly on three issues: the overall funding situation, the reduction in individual donations and improving the impact that the corporate sector can have.

On funding, a recent Charities Aid Foundation report on UK giving found that there had been a 20% fall in individual public giving, leaving charities £1.7 billion worse off. According to NCVO, 43% of charities’ funding is provided by individual donations—the sole largest contributor—and this has left many charities struggling to find other sources of funding. Indeed, one in six charities said recently that it is likely that their charity may have to close in the next 12 months. Other charities, as we have already heard, are having to make heavy cuts to frontline services at precisely the time when the need for the crucial services they provide is going up, particularly for the most vulnerable. The second biggest funding contributor is the state, providing 37% of charities’ income. This is a dangerous balance at a time when, as we all know, public funding is in short supply and

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approximately 50% of local authorities are cutting charitable grants disproportionately to the rest of their public services.

So the problem is very clear, but what are the solutions? Many charities are adapting to a new climate, and I know from my own experience that many have been doing this through mergers and collaborations, developing new business models such as social enterprises, and seeking new sources of finance, including the newly emerging social investment market. It is also important to remember that the vast majority of charities—the figure is thought to be 75%—do not receive funding from statutory sources and so look to the general public for money. However, there is a clear need for the Government to assist charities in this major change, and I look forward to hearing from the Minister what the Government are doing and what more they plan to do in this respect.

I turn to individual giving. The cross-party parliamentary inquiry, Growing Giving, chaired so ably by the right honourable David Blunkett and of which I am a co-chair, has highlighted a reliance from charities on support from older people and is looking into new innovative ways of getting younger people involved and excited about giving their time and money to charity, with a particular focus on the importance of charities providing volunteering opportunities and helping young people to get involved as youth ambassadors, young trustees and so on. The inquiry has highlighted the need for charities to be more involved in the current citizenship curriculum in secondary schools in order to highlight the issues that they tackle and to give students as much information as possible.

A key point is finding organisations that young people feel passionately about, but also trying to match that with charities that are in greatest need of support. Perhaps it is unsurprising that charities that affect children in particular were found to be the most popular among children, with some 35% of 9 to 11 year-olds selecting those as the type of charity they would most like to support. It is vital that charities can clearly demonstrate the impact of their work to children and the wider public, and I think that this is easier when their involvement is local. What are the Government doing to encourage schools to develop partnerships with local charities, to enhance not only the immediate prospects of those charities but also the long-term benefit of educating children from a young age about the impact that their money and time can make—something that can then take root and translate into more sustained giving in later life?

What is the role of the corporate sector? A recent report by the Directory of Social Change, referred to by my noble friend Lady Barker, found that companies are keen to encourage giving in the workplace by their employees, including by providing volunteering opportunities through company foundations and associations with charities, as other noble Lords have said. Simple initiatives such as Movember—the competitive growing of moustaches for donations to testicular cancer in November—have proved very popular with employees who enjoy showcasing their charitable efforts. The introduction of payroll giving, which takes place in a relatively small number of companies, has

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certainly helped in the giving of money to charity by providing an easy way for employees to give money every pay day. It has proved a popular scheme. However, it would seem many companies are missing a trick. A recent Charities Aid Foundation report found that one in three employees would be likely to give through payroll giving if they had a chance. That same report, however, showed that only one in 34 employees in Britain gives regularly through the payroll giving scheme, showing the huge margins by which this scheme could be expanded.

Like my noble friend Lady Barker, I was fascinated by the recent report showing the new data on corporate giving, particularly the fact that big private companies, in terms of reinvesting pre-tax profits, are nowhere near the 1% benchmark set, and that the top 420 companies are giving somewhere in the region of 0.3% in terms of cash, making up some 2% of charities’ income.

So what do I think the solution is? I think one solution would be to encourage companies to match the charitable giving of their employees. This has been suggested as one way of increasing the amount donated by companies. Matching schemes, while having the positive effect of the overall company giving, could also galvanise the workforce, giving employees the feeling that they have more power to make a difference if what they donate will be doubled. Perhaps the Government could look at ways of incentivising corporate giving, perhaps through the tax system.

It is important that we do not forget the roles of smaller businesses in the UK, which are also vital players in civil society, often at a more grass-roots level. The sponsoring of sports teams, giving to local charities and paying greater attention to the environment are all aspects that small businesses have worked on, and due to their greater geographic spread they have managed a much wider reach than some of the big corporations that are largely London-based. I conclude by also quoting from the World Economic Forum, which stated:

“Civil society should be the glue that binds public and private activity together in such a way as to strengthen the common good … based on the core values of trust, service and the collective good”.

3.23 pm

Baroness Gibson of Market Rasen: My Lords, I, too, wish to thank my noble friend for instigating this debate. Today I want to concentrate most of my speech on voluntary organisations so it follows on quite well from the speech of the noble Baroness, Lady Tyler. Like my noble friend Lady Prosser, before I came into your Lordships’ House, I was a national official of a trade union. In my case it was the Manufacturing, Science and Finance Union, one of the forerunners of Unite. Like my noble friend Lady Prosser also, at one time I had responsibility for our members who worked in the voluntary sector, both full and part-time, in organisations and charities such as the NSPCC, the RSPCA and the National Children’s Bureau. I stress that these were and are workers, not volunteers, whose pay, pensions and working conditions are paramount to them. I always marvelled at our members’ dedication and commitment to those with

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and for whom they worked. These were and still are people on whom society relies every day to care for those least able to help themselves, such as children and adults, and especially the elderly and those with disabilities, or to take care of animals others no longer wanted or wanted to care for.

Workers in voluntary organisations often carry out the jobs that others do not want to do. I worked as a national union official in the 1980s and 1990s. Over the years views about the role of voluntary organisations have changed quite significantly, and Governments’ attitudes towards them are certainly very different today. Successive Governments have veered towards the voluntary sector and have wanted to work with it in developing political agendas—for example, in the health service, the education system and even in the criminal justice system.

More involvement with government and business has inevitably meant that the voluntary sector role has expanded and developed. In principle, for Government, business and the voluntary sector to work together sounds fine. As the NCVO has said:

“The voluntary and community sector … is a vital and vibrant part of civil society”.

As the right reverend Prelate the Bishop of Derby said earlier, civil society is where people come together to make a positive difference to their lives and the lives of others for mutual support, to pursue shared interests, to further a cause they care about, or simply for fun and friendship. It is where “me” becomes “we”.

This is both encouraging and to be encouraged. However, it must be remembered that if the new formations in society are to work, voluntary organisations must be funded well enough for them to operate properly, to respond to the new challenges facing them and to ensure that their independence is not compromised. Unfortunately, in many cases this is not happening. Stephen Bubb, of the Association of Chief Executives of Voluntary Organisations, recently expressed his worries about the possible impact of public spending cuts on this sector.

There are reasons for concern. I was recently contacted, as I am sure other noble Lords were, by the Charities Aid Foundation, a charity that works to improve the charitable giving environment to ensure that donations are used as efficiently as possible. Over the past year it has investigated the charitable sector and found some interesting but daunting facts. Donations to charities fell by 20% in real terms in 2011-12, the public having given £1.7 billion less than in the previous year. As the noble Baroness, Lady Tyler, said, 17% of charities believe that they may face closure in the next 12 months, 26% of charities have already cut frontline services and 25% said that they had already made staff cuts. These are just a few of those findings. The effect on the viability of the organisations concerned is obvious.

Of course, these were national statistics, but the effects of cuts on local people and services are also important and are vital to civic society. The best way of finding out about these is to read local papers. I have recently seen two good examples. In my own area, Essex County Council is closing a centre in a little town near Colchester because it wants to sell the property. It has given a month’s notice to the organisations

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that use the centre, which include a local school of dancing and a youth centre. Needless to say, the local people affected are very worried. In Lincolnshire, where I was born and brought up, the county council wants to cut staffed libraries from 40 to 15, and to cut their opening hours. The small market towns and the villages surrounding them will suffer most if this happens.

In the Charities Aid Foundation paper there are some proposals for government and employers to consider to encourage charitable giving which have proved successful. These include reminding people that money can be left to charity in wills and encouraging employees to give to charity by including in a company appeal a photograph of an employee who already gives to charity. It also suggests encouraging effective ways of giving such as payroll giving, as mentioned by the noble Baroness, Lady Tyler, encouraging businesses to maintain or increase their support for charities and getting the Government to work with charities to modernise and improve fundraising. Do the Government have any plans to encourage employers to guide their employees towards charitable donations and will the Government be taking positive steps to assist charities, such as modernising and promoting payroll giving?

Finally, I turn to another phenomenon brought about by the economic circumstances in which we find ourselves. Last week somebody asked me about food banks and I explained that when those of us who can afford to give to food banks do our weekly shopping, we buy an extra item to place in the food bank boxes, which can now be found in many supermarkets and local shops. That item could be a tin of soup, a packet of biscuits or a box of breakfast cereal—anything that would be useful to a family struggling with its finances. A local food bank then collects the boxes from the shops and families go to the food bank as and when they need to. The food banks are usually established in premises that are convenient to local people, such as a shop that might have closed down on the high street. The person to whom I gave that explanation thought it was an excellent idea as, of course, it appears to be. However, it is a sign of how times have changed and how we as a society assist those who would once have probably been helped by charitable organisations or by the Government. I wonder what the Minister feels about food banks and what they signify for the civil society in which we live.

3.31 pm

Lord Janvrin: My Lords, I, too, thank the noble Baroness, Lady Prosser, for introducing this timely debate. I declare my interests as recorded in the register and, in particular, that I chair two charities and am on the boards of three others, including one called Philanthropy Impact, which aims to promote and inspire philanthropy.

I welcome this debate for the obvious reasons that many others have already mentioned. Times are difficult for a great many individuals and families and, at such a time, a strong, active, innovative civil society has a vital role to play in addressing social and economic needs. I agree with those who have said that such a civil society has a real role to play at any time and I

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associate myself with the remark of the noble Lord, Lord Hastings, that this is a partnership between government, business and civil society. In a world where Governments cannot do everything, charities, social enterprises and NGOs can take risks, innovate and go to places at the cutting edge, where publicly funded bodies may not go. If times are hard for individuals, as others have pointed out, times are also very hard for civil society. Charities and voluntary-sector organisations are struggling to make ends meet and several others have already drawn attention to the remarkable figure that funding for charities fell by 20% in 2011-12. We need to recognise that this is a sector under severe pressure.

Against that background, I will focus on one aspect of encouraging philanthropy in support of civil society—as one report had it, encouraging more people to give and people to give more. When it comes to giving, it is not all doom and gloom. As many commentators have often observed, the British people are extremely charitable and, to quote the Charities Aid Foundation, research suggests that when times are difficult, donations to charity are often less likely to be cut back than other forms of spending. There are, as others have mentioned, signs that young people are very positive about giving time and money, and I associate myself with the remarks of the noble Baroness, Lady Tyler, about how important it is to encourage this.

For many, giving is becoming easier, through social media or online giving sites; as in so many other ways, technology is transforming the ways in which we do things. But my point in speaking today is not only to draw attention to the importance of philanthropy and to give credit to those many people who give generously to all sorts of causes, but to urge that we continue to look for ways in which to encourage more giving at every level, many of them mentioned already, including individual, corporate and governmental.

At the individual level, among other things, we need to support those campaigns that encourage people to give in different ways. I draw attention to the Give More campaign, which encourages people to give a little more this year if they can, and a little more than they did last year—a simple idea and a good campaign. I also suggest that we need to sort out how better to recognise generosity. Some donors do not want it, but others shun it because they fear unwelcome consequences. That is a pity. The honours system is better focused on giving recognition to philanthropy, but I hope that more can be done to recognise those who are generous, particularly in the media and at local level.

Many noble Lords have mentioned issues at corporate level. I particularly endorse the remarks about looking for ways to introduce more matched funding schemes, and I was very interested in the reference from the noble Baroness, Lady Barker, to the report about the level of corporate giving. I certainly agree with those who say that more could be done to encourage payroll giving. Many organisations have effective schemes, but many more could do so. Like much of the business of encouraging more philanthropy, it is a question of making it easier to give; payroll giving undoubtedly does this.

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Mention has also been made of corporate social responsibility and community investment programmes undertaken by many enterprises. It is easy to dismiss some of these programmes as just a form of marketing but, having been involved in some of them, I think that this is probably too cynical a view. I believe that many young people are introduced to volunteering and engagement with civil society in this way. It needs to be further encouraged, and I welcome the fact that the Government have recently announced consultation to see how CSR could be made more effective.

I pay tribute to what the Government have done in difficult circumstances for philanthropy. Leaving aside perhaps the 2012 Budget, there has been progress with, for example, Legacy 10, encouraging people to leave more to charity in their wills, and a willingness to look at ways of streamlining Gift Aid. There is also the stated aim to look at tax incentives to encourage social investment, which is undoubtedly an exciting and important area where the UK is a world leader, as others have said.

There is more that the Government can look at. I, too, have a shopping list. I hope that they will continue to consider, when the time is right, further fiscal measures to encourage giving, including the merits of lifetime legacies or charity remainder trusts. I hope that they will encourage payroll giving, as I have said, particularly within the Civil Service. I hope that they will keep under review the level of funding of the Charity Commission, because it is in all our interests to have an effective regulator for the charity sector. Above all, I hope that they will continue to support and encourage more philanthropy and giving at every level, and encourage those who seek to make it more effective. This will have a direct benefit on the health and strength of our civil society, which is in all our interests.

3.39 pm

Baroness Smith of Basildon: My Lords, I congratulate my noble friend Lady Prosser on securing today’s debate, which is not just enjoyable and interesting but also important. It is important that we recognise and address the challenges facing civil society. I have three points to make.

The first is about the value of civil society. That is not a term invented by any Government; it has been around for a long time. We all think that we understand it, but we all interpret it differently. A key part of civil society is the voluntary and community sector, but I think it is a much broader, a much wider and a much more inclusive concept. When the current Government replaced the Office of the Third Sector with the Office of Civil Society, they relied on the more traditional definition of being synonymous with the voluntary and community sector. They announced that government policy would concentrate on three issues, all related to the voluntary and community sector. The noble Lord, Lord Taylor of Holbeach, in a parliamentary Answer, stated that the Office for Civil Society,

“will support charities, social enterprises and voluntary organisations … encouraging a big society and addressing disadvantage by making it easier to set up and run such organisations … the office will co-ordinate work across government to implement the big

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society and establish a number of flagship big society projects”.—[

Official Report

, 21/7/2010; col. 969.]

We now rarely hear about the big society, but my point is that those government definitions miss the point. It is not about structures. As important as the voluntary and community sector is, I will offer a different definition. Civil society is the glue that unites and connects society: the notion that we are not just individuals, but that by coming together and working together we can improve the lives of others, improve our own lives, improve society and contribute to our communities, however local or global those communities may be. It is not part of state institutions.

My second point concerns the role of civil society. I am coming to regret that the role is too often seen as just third-sector delivery of services. I am certainly not against contracts or third-sector commissioning. I declare an interest since I chair the board of trustees of a not-for-profit organisation, Resolving Chaos, and am involved with a number of charities and voluntary organisations that provide services. Some are commissioned, some funded and some are provided voluntarily. I am slightly disconcerted by the Government’s publication yesterday of the lobbying Bill, which, taken alongside comments made before the last election, could fetter and curtail the activities of such organisations in a way that could work against the benefits that civil society brings.

In the previous Government, I was the Cabinet Office Minister with responsibility for the charitable and third sectors. I made it clear that the Labour Government would continue to be a strong advocate for the campaigning role of civil society organisations. The role of voluntary and community sector campaigners provides a voice for some of the most disenfranchised, disengaged and vulnerable in our communities.

To assert, as Oliver Letwin did in a speech to the NCVO Conference in February 2010, that what he treasured about the sector was not its campaigning role but its “special contribution” to do something to “change things” and solve problems is to misunderstand fundamentally the inextricable link between the two. Those that complain that,

“so much … effort in some parts of the voluntary sector is devoted to campaigning”,

should recognise that such campaigning is an intrinsic part of civil society and wider democratic engagement in the system.

I will go further. I will give a hypothetical example of a charity that supports homeless people. It may have some contracts; it may have some funded services. It will raise funds and have supportive donors. If there is an area of council or government policy that in its professional opinion, at the sharp end of service delivery and support, is exacerbating the problem, surely it has a duty to its supporters, to its donors and to civil society to campaign to try to address that issue. It cannot turn away from its campaigning role and its responsibilities in that regard. It has an obligation to the homeless whom it is seeking to help.

It was Dom Helder Camara, a Brazilian Archbishop, who said:

“When I give food to the poor, they call me a saint. When I ask why the poor have no food, they call me a communist”.

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We need to take care that we do not slide into the position that we accept civil society as long as it knows its place, which is to provide direct help and support, but not to tackle or help tackle the causes of the problems and to campaign to address the causes of those problems. That would be plain wrong.

The lobbying Bill refers specifically to third-party organisations’ campaigns at election time. It does not specify which election, so I assume that it refers to all elections. There are issues to be discussed, but we need to ensure that we do not curtail legitimate campaigning activity or provide an opportunity for government or local authorities to issue bad news and unpopular policies just before elections, thus preventing third-party organisations campaigning against those policies.

My third and final point concerns financial issues. We have heard a considerable amount about the impact that cuts are having on organisations that support the community. I have genuine concerns that the future of civil society is being undermined by funding problems. The previous Labour Government had a number of programmes, including one I particularly liked—the Grassroots Grants programme—that directly supported more than 130,000 local groups to make a real difference in the heart of communities.

A report from the NCVO and research by Compact Voice show that the voluntary sector at the heart of civil society is facing an unprecedented level of cuts and further threats to income. Funding is not the only way of supporting civil society, but we need to take care that funding, whether through contracts, subsidies or grants, provides value for money in both financial and social terms, and the impact on civil society must be taken into account. My community is in Essex—as is that of my noble friend Lady Gibson. When Basildon borough council announced a cut in the subsidy to local community centres for pensioners’ hot meals, local residents were shocked and appalled. They understand the social benefit to civil society of the centres. Perhaps what made that cut particularly shocking was the fact that the responsible council cabinet member declared that the meals were not good value for money while her cabinet colleague defended spending £150,000 on consultants to measure grass—that is bizarre but it is true—as being good value for money, so measuring grass was more important than providing hot meals. I am convinced that the public see that as nonsense and understand that value for money is not just a purely economic judgment. They make those same judgments in their own personal spending. They understand value judgments, not just economics. It is about common sense, communities and the value that institutions of government at whatever level place on society.

Too often, it seems that local authorities find it easiest to impose cuts on the voluntary sector. I strongly believe in the power of volunteering for the volunteer and those being supported. As we heard from my noble friend Lady Prosser, some volunteering grows organically but needs structure and support to obtain the best value from it. Like many others, my local volunteer centre in Basildon has now closed. Due to funding cuts, it could no longer sustain its work. I have sincere worries about the impact that will have on civil society.

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In conclusion, engagement in civil society adds value and improves quality of life. It is not something we can just pay lip service to here today and say how wonderful it is, then go away and do nothing. It is intrinsic and essential and it needs and deserves our support.

3.48 pm

Baroness Uddin: My Lords, I thank my noble friend Lady Prosser for giving us the opportunity to take part in this important discussion. Civil action in civil society has defined a generation of activism and activists who have changed communities and our country and have given us a more equitable society—we stand on the shoulders of giants.

I want to make a few points about a particular aspect of civil society—Muslim organisations. As a Muslim I think that this is the right moment to discuss civil society; it is the ninth day of the fasting month of Ramadan, which focuses on the Islamic understanding of community, civic duties and equity. During this month Muslims are encouraged to fast from dawn to dusk—an 18-hour stint at present—and share, forgive and show solidarity with those less fortunate than themselves. They are also encouraged to give alms—zakat—and to be aware of the needs and rights of those around them regardless of their ethnicity, culture and religion.

Ramadan is the ultimate month to reinvigorate and renew the recommended spirits of good, responsible and proactive citizenship. Muhammad, the Prophet of Islam, upon whom be peace and blessings, said:

“The best amongst you is the one who is the most beneficial to others”.

At its core, Islam is about enjoining good and forbidding evil, to encourage and facilitate virtuous, practical deeds. This month, British Muslims dedicate their energy and money to benefit their communities. A civil society is the backbone of Muslim communities and is the glue that bonds British Muslims’ lives together. It ranges from street-level self-help groups to the delivery of services. It is as diverse as drug rehabilitation programmes, fatherhood circles, supporting families, women fleeing violence, arts projects, sports clubs, community centres, mosques—masjids—Sunday schools and study circles. However, it is an ad hoc development that has taken place in the face of racism and Islamophobia and in spite of weaknesses in strategic planning and a serious shortage of formal financial support.

As a result, the Muslim leaders who are actively heading these organisations within the civil society sector are struggling and under severe strain. The Muslim-led third sector is unable to consolidate, risks being reactionary in nature and continues to work in silos. Sadly, it is not in a strong position to implement and share some of the core teaching of our faith, which is pertinent and much needed in dealing with some of the social ills facing our society and the vulnerable communities of today. We need to learn more about those who are working in organisations within this sector, have a vision to encourage them and courage to invest in their development.

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The aim is to build relevant, sustainable social, cultural and economic institutions; to even more closely monitor the huge amount of zakat, or religious duties, and sadaqah, or charity; and to encourage debate and discussion in the way funds are raised in the UK. They should not be used only to support those who are in need abroad but also to strengthen some of the civic organisations within the UK. The long-term benefit of investment and attention from our institutions would and could be a counter to the imbalance in the attention constantly being paid to the so-called Prevent agenda.

It is estimated that nearly £200 million will be collected this Ramadan alone. The potential here is incredible but it is unregulated or, at least, not part of civil society discussions. Muslims in Britain, more than anywhere else, have a unique opportunity to rediscover and share their unparalleled historical precedent in creating civil society institutions. The pragmatism, wisdom and vision that created the Islamic ideal community in Medina during the life of our noble Prophet have many lessons for us all. The community brought together the generous and the persecuted, men and women, nobility and slave, people of faith and those with no faith. All British Muslims within the UK aspire to the ideals of such harmonious communities, especially during Ramadan, and this is a difficult ambition. Perhaps the most important challenge facing Muslims today is how to recreate this civic society after more than two centuries of colonialism, bad governance and social systems, not to mention migration. Civic society is in absolute tatters, shredded by the “me and me” culture—which has been mentioned before—and by greed and despair.

Not much work is being done with these organisations to consolidate their work or give them recognition and bring them into the fold. This is why I am proud to be part of a project called Faith, Khidmah and Citizenship: Connecting Spirituality and Social Action to Build Civil Society, which is bringing in all the organisations that are working in separate silos. It is a joint effort by an organisation called An-Nisa Society and the Radical Middle Way. Both these organisations have previously worked with the Home Office and other areas of government. The analysis of their report has produced an insight into how these long-standing reputable organisations have evolved and how they can contribute to strengthen communities in difficult times. The report also looks at organisations, how they function and contribute to the overall debate on civic society and civic actions, post-9/11 and 7/7. The report also proposes solutions for a durable and effective civil society to emerge in our country.

It has been interesting to hear the debate and what some have said about corporate social responsibility. Much of this corporate social responsibility has created an elite set of leaders of civil society that excludes many aspects of different communities, women being only one of them. Even when women are discussed, there are divisions over their status—who is included and who is not.

On our doorstep in east London are companies that are worth billions, many of which are owned by outside investors. Yet the connection on their doorstep

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whereby civil society can be empowered has been ignored—at the peril of the well-being of our common good.

3.56 pm

Baroness Pitkeathley: My Lords, we are indeed all grateful to my noble friend for giving us the opportunity to have this far-ranging debate on civil society. However, I must say that at this stage of a debate, I feel a bit like the bishop who, when asked to make a speech about sin, stood up, said that he was against it and sat down again. If I am asked about civil society I can say, just as simply, “I am for it”. Similarly, when asked about the future of civil society, I can say, “There is one”. However, we are concerned to examine the current situation, the potential difficulties and the role that we expect civil society to play, although there are many different interpretations of what constitutes civil society, and we have heard them today. The single common factor that we should remember is that it is about participation in decisions about services in your community, in how services in your community are shaped, in delivering those services and, particularly, in decision-making.

We should be clear from this debate that, despite rashly delivered statements about a broken society, civil society is not in decline. Indeed, to the contrary, although membership of political parties, churches and traditional women’s groups may be in decline, membership of new social movements, non-governmental organisations and pressure groups is flourishing. I want to focus on some of the matters that have been reported to me, and I should declare my interest as patron and president of various charities and as chair of the All-Party Parliamentary Group for Civil Society and Volunteering.

The first thing that I want to mention is, inevitably, funding. I keep hearing Ministers say to the voluntary and community sector, “You must do more with less. Don’t expect government at local or national level to support you financially”. Okay, charities understand that; but let us not forget that, as we have heard, a quarter of civil society organisations rely on government for most of their funding, and that it is a drastic change to go from encouraging voluntary organisations to become service deliverers—encouragement which has been given by successive Governments—to finding that the funding is no longer there. As we have heard today, who is it who suffers when that funding is no longer there? It is, of course, the most vulnerable in our society.

Nor should we be tempted into thinking that more government necessarily means less civil society and that less government means more civil society, as the noble Lord, Lord Rooker, reminded us. It has been shown in inner cities in Russia and the United States that when the state retreats, the vacuum may be filled by crime and gangs, as well as by civil society organisations. Many of the nations with the most active civil societies still have very active and involved governments. We must be wary, too—with the greatest respect to the noble Lord, Lord Janvrin—of thinking that philanthropy will ride to the rescue. It is by no means certain that our society is yet at a stage where philanthropy can fill

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the gaps, as seems to be expected by some in government. Even the best community organisers and the most enterprising social entrepreneurs need support.

The Government seem to have a suspicion of the infrastructure that exists to support the charitable sector, and they are right to point out that that infrastructure may need reform and rationalisation—far be it from me to argue that we should not expect existing mechanisms to change and develop. As a veteran of two mergers I am an active advocate of mergers and collaborative working—and we have seen some very effective ones, such as the recent one between the NCVO and Volunteering England. However, we must not throw babies out with bathwater. Many of these infrastructure bodies are delivering through their local organisations exactly the kind of innovations—such as time banks, community pledge banks, social enterprises and civil action—that the Government and society need. Let us not forget that.

I turn to social investment. I was a member of the original Commission on Unclaimed Assets, which released the money in unclaimed bank accounts into the social investment sector, and am now a trustee of the Big Society Trust, which oversees Big Society Capital. There is no doubt that this field is developing. Social impact bonds are increasingly popular. They are designed to transfer the risk of social programmes from the public sector to the private sector. An interesting one was launched just yesterday. Developed by the Consortium of Voluntary Adoption Agencies and Baker Tilly, this social investment bond has raised £2 million from Bridges Ventures and Big Society Capital. The money is going into a fund called It’s All About Me, which is designed to invert the market so that a child seeks out adoptive parents, not the other way round. It is a very innovative and interesting approach. I recently saw another such social investment project in south Wales. It helps children who are normally very disruptive in class not to be excluded through intensive intervention. These are excellent initiatives and very welcome developments.

However, we must sound a note of caution. There is a long way to go before the concept is proved. Many would-be investors are having trouble finding investment-ready projects. I do not think that these can ever entirely replace the funding lost, about which we have heard so much today, although they certainly can be part of the funding mix. I would be glad to have the Minister’s view of what proportion of voluntary sector funding social investment will eventually provide.

I will say a final word about volunteering. The statistics about volunteering are always absolutely stunning. The proportion of people volunteering at least once a year has increased from 65% of the population a couple of years ago to 71% recently. The Olympic and Paralympic Games, as we know, inspired volunteering on an unprecedented scale—as is always quoted. However, we must remember that that particular type of volunteering was a pretty easy gig. It was fun, you got to see events, there was a nice uniform, a link with people who were volunteering alongside you and so on. However, it bore little relation to the kind of volunteering that goes on throughout civil society: bringing people back

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from suicidal intentions, driving people to hospital who are pretty difficult and often not grateful, sitting with people with dementia who are doubly incontinent so that their carers can have a break. I am sceptical about what the Olympics can teach us about volunteering, except for the fact that a lot of trouble was taken with recruitment and selection and fitting people into the right slots. There was a lot of emphasis on supporting those volunteers—investment was made in them. I hope that the Minister will reiterate that the Government continue to see that volunteering needs investment. Volunteering is very good value, but it is not cost-free. I think that that is also a pretty good description of civil society.

4.03 pm

Baroness Hayter of Kentish Town: My Lords, we are all grateful to my noble friend Lady Prosser for securing this important debate, because civil society matters, in communities, nationally and here in your Lordships’ House, where so many Members draw on their experiences in a range of non-governmental groupings. Such activity, whether in a tenants’ group, trade union, advice bureau, book club, ramblers’ association, parents’ council or faith community, provides the vitality of civil society.

As we heard, my noble friends Lady Gibson and Lady Prosser first earned their spurs by representing fellow workers, while other speakers helped carers, women, consumers, the old, animal lovers, children or families, far away from any governmental structures.

A healthy civil society produces a community that fosters empathy, trust and respect—the most important feature of a good society, according to a survey commissioned by the Webb Memorial Trust, of which I am vice-chair. Civil society is also about citizens having their own space to develop, free from interference by the state and often outside their work environment. It is a good in itself: it should not be part of—in the words of the noble Lord, Lord Rooker—the shrinking of the state. While it can deliver state-funded services, that should be because the Government recognise the importance of community-driven provision, not because they seek to parcel off parts of our National Health Service to the lowest bidder.

As my noble friend Lady Prosser reminds us, the Government have indeed used the words “the big society”, but it is damaging the voluntary, flexible and innovative sector that gives voice to the voiceless and empowers those who are often only at the receiving end of decisions. Governments can support voluntary organisations but they should not see their value simply as an agent for service delivery, particularly as an agent on the cheap.

The cuts in public services and the economic situation are increasing demands on the voluntary organisations, as we have heard, just when their income is falling through a 20% drop in individual donations and half of local authorities disproportionately cutting their voluntary sector funding, despite three-quarters of voters disapproving of such cuts.

The Minister, the noble Lord, Lord Freud, who is not in his place, may believe that people go to food banks only because they are there but, as the right reverend Prelate the Bishop of Truro corrected him a

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day later, people are driven to go. They do not choose to go—they have to go. He described food banks in the 21st century as a complete scandal.

We also face a problem with they way in which services are commissioned. It might suit government but not the voluntary sector, particularly the small charities that comprise 97% of the sector. They have had nothing but a negative experience of the commissioning process. Indeed, only one-quarter of small charities surveyed by the FSI feel that they can carry on bidding for local authority contracts. The issues have been well described today by the noble Lord, Lord Hodgson of Astley Abbotts. If the commissioners fail to respond to what he says, small charities will be excluded from service delivery.

It is not only small charities that the process fails. I am a patron of the Blenheim Trust, which works with alcohol and drug misusers, and I am now going to report its views on the procurement, tendering and commissioning process. As has already been mentioned, the cost for the bidders and commissioners is estimated at £300,000 per tender. That is money that is not going to beneficiaries. Contracts are often one-sided, allowing cancellation with three or six months’ notice. There are often minimum turnover requirements of £5 million or £10 million. These preclude small and medium charities or force them into not necessarily advisable mergers. Providers are forced to compete on price rather than on quality, with no reference to the skills of advisers.

This impacts detrimentally on services and undermines the morale among committed, experienced staff and volunteers. Significantly, we are seeing the demise of local third sector organisations that are attuned to their communities as they are replaced by either profit-driven or growth-driven organisations, as has been described by the right reverend Prelate the Bishop of Derby.

I rise to the right reverend Prelate’s defence because the noble Lord, Lord Hastings, referred to conversations in the Bishops’ Bar. I make clear to anyone listening that not only have I never seen a Bishop there but that it is a tea room rather than a bar.

The worry about smaller organisations goes beyond this House. Chris White, the Conservative MP, has criticised his own Government for locking out charities and social enterprises from winning government contracts due to the large size of those contracts.

While under any qualified provider voluntary organisers can bid for NHS contracts, private health companies have won nearly half the bids. As today’s report from the IFG, mentioned by the noble Baroness, Lady Barker, shows, private firms are gaming £100 billion of government services for their shareholders at the expense of the taxpayer. The IFG analysis of outsourcing programmes, such as those to help the unemployed back into work, found private firms creaming off easy cases where they could make profits while parking problematic ones. Furthermore, big outsourcing companies are monopolising services, making it harder for smaller companies or charities to compete. The report says:

“a number of large providers now deliver a wide range of services (commissioned by separate departments) in particular areas of the country. This allows these providers … to undercut competitors, making their services attractive to commissioners”.

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The Cabinet Office response was that the Government were encouraging the voluntary sector to get involved in delivering services but, it seems to me, with little understanding that smaller, locally-based organizations are even less able to compete against these giants.

Charity leaders are frustrated and demoralized by being sidelined in the provision of services and are watching aghast as the Cabinet Office’s annual funds for the third sector are being cut by 75% since the Labour Government’s last year in office. The leaders know that their energy is going to be devoted to fundraising rather than responding to their users’ growing needs. If charities cannot deliver services, beneficiaries suffer. Sadly, there is a paradox that civil society flourishes best where it is least needed, and is weakest in areas where there are highest rates of poverty, as the noble Baroness, Lady Barker, described. In the north-east, six out of 10 charities have lost funding.

As the voluntary sector increasingly has to deliver public services, its role in the public eye changes. If it is seen as an arm of the state, civil society risks losing its independence and uniqueness; its ability to enrich lives through connections with others; the informal education of citizenship; the encouragement of plurality and diversity; pioneering ways of doing things; representing users of public services; and holding authorities to account. We must not risk losing these roles.

More than 100 years ago, Beatrice and Sidney Webb set out their belief that the state and civil society should play different but complementary roles. According to them, the proper role for government is to take care of basic needs, guarantee rights and security, ensure a minimum standard of life and provide education and preparation for work. The role of civil society is to operate above this basic minimum and to ensure that citizens participate as full members of society. I could not put it better. Civil society contributes to a healthy, vibrant democracy that neither stagnates nor grows arrogant. We need it and we need the Government to foster, not hamper, its future.

4.13 pm

Lord Wallace of Saltaire: My Lords, it is a particular pleasure to answer this debate on the future of civil society because with my FCO hat on I spend some time reading telegrams about attacks on civil society in other parts of the world—the tremendous pressure under which all autonomous institutions in Russia are now operating; the problems in Egypt; tremendous problems in Pakistan; resistance to the growth of autonomous bodies in Saudi Arabia and so on.

So we can at least start by welcoming the fact that we have in this country a thriving civil society alongside the state, but not too dependent on the state. It seems that we are moving towards a consensus in the United Kingdom that the state cannot provide everything that we are going to need in the next 10 to 20 to 30 years. We therefore need a strong and diverse of network of civil society institutions alongside the formal institutions of state and government at local and national levels.

When I was active politically in Manchester 30 years ago, and a parliamentary candidate for an inner city seat, I was appalled by the extent to which the local

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council and its officers treated the inhabitants of the largest single council estate in Manchester as people who had things done to them. The councillors and the council officials knew what was best for them, they would tell me, and were not going to change their minds—even though the large number of people I met and canvassed suggested that they were not happy with what they were doing—because, in the long run, it was best for them.

As we all know, that left a lot of alienated people in our cities, who are still there. As I visit the big council estates in Bradford and Leeds, I find just how many alienated people there are, embittered by the fact that the state does not seem to do enough for them. However, they do not know what to do for themselves yet, which is part of the problem that we face.

On the other hand, as the noble Lord, Lord Rooker, warned us, some free-market radicals believe that there is no such thing as society, that we do not really need local government, that the only individual motivation we are talking about is economic and that the search for profit and financial gain is what drives everyone. I would say to him that it is not the aim of this coalition Government to radically shrink the state. There are some free-market radicals around who would love to do so, in the Institute of Economic Affairs and elsewhere, but we all recognise that we cannot shrink the state very far, given the enormous demands that we all face. I think that we all share, across the parties, a basic emerging realisation that, first, the state cannot provide all that our society will need in the coming years, particularly as the number of people over 70 continues to grow, and as the demands on the National Health Service, on social services and on other services will continue to grow exponentially. I remember an article by Polly Toynbee in the Guardian a few years ago, in which she said that the NHS budget would have to rise at a compound 2% above the rise in GNP, otherwise it would fail. That is part of the problem that we are now up against in the NHS and elsewhere.

Secondly, we are discovering that the public will not pay for the state to provide everything that we want. That, again, is a problem which all political parties now have to recognise. We have to persuade the public that these things are worth paying for. I am afraid to say that almost all of us find on the doorstep that the Daily Mail tells people every day that the state should cut taxes and raise benefits, but that is not possible. I think we also agree that financial gain and individual profit is not what drives everyone, and that altruism and community spirit also motivates citizens and provides, as has already been said, the essential glue that holds our society together. We have to find a way of building the strong local institutions—they have to be local institutions as far as possible—alongside the state, which will help provide the services that the state itself cannot entirely provide.

That raises all sorts of questions about regulation, how far organisations should be financially dependent on the state and how far the state should encourage, as a number of noble Lords have said, giving through one means or another, such as tax advantages. There are other forms of support as well, such as the nudge unit suggestion that one puts in the corner of various

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government things, saying that you should leave money in your will to various charities, which will increase the amount of giving that takes place.

I recognise the tension that has been spelled out in a number of speeches between national voluntary organisations and local civil society organisations. My experience in Yorkshire is certainly that some of the best voluntary organisations are those that are rooted in their communities, but they are very often too small to attract the attention of national commissioning authorities. The Cabinet Office and other sections of government are struggling with the issue of how you get down to discover which are the really useful local bodies.

Of course, part of that has to be that we devolve more decisions and eventually more authority to local government. The City Deals will help us in that respect, as will double devolution, which we have much talked about but not sufficiently carried through, to re-empower local communities. We also recognise that the character of the sector is in some ways difficult to pin down. Many of the most impressive voluntary organisations that I have met exist as they are because they have a small number of charismatic people driving them along. They can be impossible. Indeed, they succeed partly because they are impossible. That is part of what keeps voluntary organisations going and it is difficult to put that into a major institutional framework.

Much of this has to take place at the local level. I am conscious that the loss or the weakness of the church networks, and particularly the nonconformist ones that did so much, is part of what has gone wrong in many of these areas. I am conscious of this in particular because I live in a village, Saltaire, that has a historical society, a festival committee, an arts trail, a Friends of Roberts Park society and two allotment societies, and frankly does not need anything more by way of local civil society. Three or four miles away from us, in Bradford, there are a number of areas that have very little going on and in which the community organisers, who are part of the Government’s big society initiative, are doing their best to teach people how to get together and do things themselves, rather than sitting around being deeply bitter that someone else is not doing something for them.

I am a strong believer in the big society and there are a number of initiatives that are also pushing us in that direction. National Citizen Service is going into its third summer this year. I was entirely converted last summer by taking part in one or two National Citizen Service schemes in Bradford. We helped show teenagers what they could do for themselves and what they could do together for others, thus teaching them the principle of community service, including how to organise things together, raise money and work together. It is a similar case in local schools around the country. Primary schools and others are learning about how you work and help people in the community. This is all extremely desirable.

I am also a great fan of community foundations as a means of diversifying sources of funding for local activity. I would like to see the Community Foundation Network given a great deal more support. I say to the noble Lord, Lord Hastings, that part of the problem with community foundations and other local activity

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is that it was the local entrepreneurs and companies that provided local charity. As we have moved towards multinational companies, how you get them to think not only about London but about what happens in York, Bradford and Leeds, all of which have lost so much of their local corporate leadership, is a problem with which we all have to struggle. We are doing our best to learn from the process that is going on. I say to my noble friend Lady Barker that this morning I printed out the Institute for Government report on making public service markets work and it is one of the things that I intend to read at the weekend if my wife allows me not to pick all of the soft fruit on the allotment. I am a member of the Saltaire Canalside Allotment Society.

A number of other major points were raised in the debate. The noble Lord, Lord Hodgson, expressed his regret that the Government have not yet published their response to his extremely useful report last year. The Government thought that it might be preferable to wait for the report of the Public Administration Select Committee that came out on 6 June and was in many ways not just a post-legislative scrutiny of the Charities Act but a commentary on Lord Hodgson’s report. I assure him that the full response to both of these will come out shortly.

A number of noble Lords talked about the problems of a large drop in charitable giving. I am told there are different assessments of how severe that drop has been. Different surveys provide different answers, but in a number of ways, including by encouraging payroll giving and encouraging companies, we are doing our best to encourage more people to contribute.

Perhaps I should say at this point that part of what we all have to do in this country is to change the moral atmosphere from that which was around, in a way, in 2010—the corporate pursuit of individual gain and the City culture as such—and to remind everyone, including my neighbours in London who earn so much more than I do, that they are living in a society to which they should pay not only their taxes but their other dues. As we are all part of a national society and, within that, of various local societies, part of our responsibility is to contribute in all sorts of different ways in time and in money to the society around us.

I welcome those who mentioned the utility of the Social Value Act. We very much hope that that will help in shifting the way in which commissioning takes place. I welcome the fact that the Crown Representative for the voluntary community sector is now beginning to look at social enterprises. In my experience of visiting charities and voluntary sector organisations, I have on occasion been horrified to discover large charities that are entirely dependent on state contracting. That is not healthy for the third sector. I like those that do their best to make sure that they earn some of their income from what they do. That is a definition of a social enterprise that is also a voluntary organisation.

The Government have been making a number of efforts—payroll giving, Big Society Capital, the Innovation in Giving Fund, the Social Action Fund—to ease the transition and to encourage more people to bring in money to this very important sector. For example, the Communities First campaign is a £80 million government-funded programme that helps communities

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come together through different community groups. I am sure that noble Lords will be familiar with community challenge, the community right to buy and various other schemes that the Government are developing.

In answer to other points, we need to consider corporate giving further. I suspect that we will, in time—whether this Government will be able to do it or whether it will have to be post-2015, I do not know—have to consider a change in company law to make sure that a company’s duty is to all stakeholders, not just its shareholders, if we are to create a sea change in the approach to corporate giving.

The noble Baroness, Lady Gould, spoke about the role of women and the extent to which voluntary organisations support them. This is one of the most fascinatingly difficult areas in the evolution of civil society. My mother was a stalwart of civil society, among other reasons because when she married, she had to give up her job and her career. From then on, she poured her enormous energy not entirely into her children—thank goodness—but also into doing good works wherever she was living. We all know now that the transformation of the role of women means that that dimension of civil society has half disappeared as young women attempt to combine careers, children and family. In their place, the fit retired of both sexes have come to be part of what holds our civil society together.

The right reverend Prelate the Bishop of Derby asked how we maintain or revive the traditional pillars of civil society. I am not sure that that is entirely the role of the state. The state can do some of that, but it is certainly something that the churches themselves should be playing a very large part in and reminding us of. I am happy that the most reverend Primate the Archbishop of Canterbury talks about the church providing real moral leadership to the nation.

The noble Baroness, Lady Gould, mentioned confidence-building for vulnerable women. There is a wonderful charity in Yorkshire called Together Women which picks women up as they come out of prison and does its best to give them a sense that they really can do things again. This is an extremely important part of the work that needs to be done. I entirely share her view that it is a tragedy that we still have a society in which dedication to the welfare of animals is very often stronger, both in financial and commitment terms, than dedication to the welfare of human beings of both sexes and all ages.

The noble Baroness, Lady Gibson of Market Rasen, talked about the current challenges to the sector and asked about the Government’s plans to guide companies to encourage payroll giving. We are providing as many incentives as we can to encourage companies to expand payroll giving. Again, that is not merely a matter for the Government. Companies, the CBI and others should also be encouraging it. It is part of our shared corporate responsibility. None of these things is for the state alone. We can provide leadership but the rest of society has to provide it as well.

The noble Baroness, Lady Smith of Basildon, said a number of things about the Lobbying Bill, as published yesterday, which I did not entirely recognise. We are having an all-Peers meeting on this in Committee Room 3 at 4 pm on Monday and I very much hope that she will come along—

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Baroness Smith of Basildon: If it helps the noble Lord, I will explain the point I was making. The Lobbying Bill suggests that third-party organisations would not be allowed to be involved in campaigning during a general election. I wanted to ensure there would not be the unintended consequence of stopping them campaigning at all during elections when there might be legitimate reasons for them to do so.

Lord Wallace of Saltaire: I can allay her concerns on this. I was very struck when I was briefed this morning on this by the sheer scale of the funds some organisations have used and targeted. It is that sort of development we are thinking about. I hope I have covered most, if not all, of the points made in the debate.

Baroness Pitkeathley: Can the Minister answer my specific question about social investment and the Government’s view on what proportion of social investment will eventually find its way into the sector?

Lord Wallace of Saltaire: I would prefer to write to the noble Baroness rather than give her a half-informed answer now, if she will permit me. There are a number of social investment schemes under way but I do not have them entirely in order in my head at the moment.

We all share a commitment to a stronger civil society. I hope we all share a commitment to a stronger local civil society. I am very struck by the problems of large communities in some of our cities who feel themselves powerless but do not know what to do about it. As I said to the noble Baroness, Lady Prosser, that is part of what the big society initiative is really concerned with. It will take a long time. For example, in Harehills and Gipton in Leeds the local Methodist, Catholic and Anglican churches used to do an awful lot but almost no one goes to church any longer. Creating alternative social networks and a sense of local empowerment and local confidence is a huge challenge for all of us and the state, society and others have to work together on it.

I hope we are all committed to this. I thank all noble Lords who have taken part in this debate and I recognise that this is a challenge that will face every Government in Britain for the next 20 years and more.

Baroness Hayter of Kentish Town: There were some more questions about the commissioning of services. It would be really useful if the Minister would undertake to ask other departments, beyond the Cabinet Office, to look at the commissioning process to see whether it can be made better. I do not know what his dialogue with the other departments is but it would be really useful if he was able to play a co-ordinating role.

Lord Wallace of Saltaire: There is now a commissioning academy. We are working with other departments. We are learning from experience how to work more effectively with local organisations where we can. The social value Act also helps us in that regard. I must not overrun my time; I give way to the noble Baroness, Lady Prosser.

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4.35 pm

Baroness Prosser: My Lords, I thank all noble Lords who have participated in this afternoon’s debate, particularly the Minister for his opening comments, which reminded us that our discussion has been focused around the United Kingdom and civil society. His initial comments, however, brought to our attention the breadth, depth and history of civil society across the world. We ought not to forget that when we consider the importance of all of these matters.

I can safely say that the nature of the debate has demonstrated the huge variety of subject matter that comes under the heading of civil society and the huge variety of provision we have seen. Some parts of it we have had for many years; some have been developed more recently; some may be suffering slightly and in need of some assistance; and others that are developing with great speed—demonstrating the changed nature of the society in which we live—and we must face. Those are all big questions that we will all be chewing over for a considerable time to come.

Something that has struck me about this debate is that there is a great need to be clear when talking about civil society and the nature of the solutions that we might wish to propose. There are many different pieces to this jigsaw but in the discussion about solutions I have detected a blurring between solutions which are suitable for service provision and those which are suitable for what I would call community development. The Minister gave as one such example the people on a housing estate in the north, and that was my experience as well when working in community development in the London Borough of Southwark, where precisely the same issues and difficulties arose. In that project our role was to enable the local people to find their voices and to speak up. The Likes of Us, by Michael Collins, is an excellent book based around some housing estates in Southwark which records how the people there had said that they had been done to, but never given the opportunity to put their own point of view. It is an important point to make. The right reverend Prelate described it as “human flourishing”. I would put human flourishing under the community development umbrella.

Before concluding, I say to the noble Lord, Lord Hodgson of Astley Abbotts, that I was rather pleased that he disagreed with me—I would be asking myself questions about my analysis of these issues if he had said that he felt I was right. I am not upset by that—as I say, I am rather chuffed.

Motion agreed.

People with Learning Disabilities: Health Inequalities

Question for Short Debate

4.38 pm

Asked by Baroness Hollins

To ask Her Majesty’s Government what steps they are taking to address the health inequalities highlighted by the Confidential Inquiry into Premature Deaths of People with Learning Disabilities.

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Baroness Hollins: My Lords, this is such a timely and important debate, coming the same week as the Keogh mortality review, the Neuberger report and the latest report from the Health Service Ombudsman. Our focus tonight is on health inequalities for a group that comprises some 3% of the population. Our focus is on the remit and findings of the Confidential Inquiry into Premature Deaths of People with a Learning Disability. The inquiry’s report was published in March and the Government’s response was released last Friday. The House will wish to be reminded that I have worked as a psychiatrist with people with learning disabilities for over 30 years and that my adult son has a learning disability.

The institutional discrimination and health inequalities suffered by people with learning disabilities come as little surprise to many of us. For me it is a throwback to some of my own research from over 20 years ago when I reviewed the age and causes of death of people with learning disabilities in three London boroughs over a 10-year period. I found that adults with a learning disability were 58 times more likely to die before the age of 50 than the general population. Over half died of respiratory disease—which I presumed to be a final common pathway—compared with only 15% of the general population. The problem was that I could not get the results published. The BMJ and other medical journals said that it was not of wide enough interest. It was eventually published in a specialist disability journal. Government began to show leadership, however, with the White Paper, Valuing People,and Chapter 6, which addressed healthcare, accepted my suggestion that a confidential inquiry should be included as a recommendation.

In 2006 a formal investigation was conducted by the Disability Rights Commission and in 2007 Mencap published Death by Indifference. By this stage, although Valuing People had recommended a confidential inquiry, it had still not been set up. Death by Indifference was a landmark report and it told the stories of six people with a learning disability who had died in NHS care. It triggered an independent inquiry which was led by Sir Jonathan Michael—I should mention that I was a member of the inquiry team—and the Parliamentary and Health Service Ombudsman conducted an investigation into the six deaths. The Michael report, Healthcare for All, made a firm recommendation to set up a confidential inquiry and the Government at last agreed.

What is a confidential inquiry? It aims to identify common causes of deaths and to make recommendations to improve clinical practice. There are many in existence, some going back more than 50 years, with varying degrees of effectiveness. They involve the systematic review of cases with the identity of patients and clinicians remaining confidential and only aggregated findings being made public. Several of these inquiries have resulted in long-term monitoring and regular reports and one of these is NCEPOD, the National Confidential Enquiry into Patient Outcome and Death. It started with a pilot study of mortality related to anaesthesia but steadily expanded into a wider inquiry to cover all hospital specialties, now including near misses as well as deaths. NCEPOD distributes reports on very specific mortality concerns and if it feels that

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important recommendations are not being met, it lobbies at both local and national levels. It is this ongoing monitoring and national oversight of the uptake of recommendations combined with the fact that it has been in existence for decades which makes this inquiry effective.

In the confidential inquiry that we debate today Dr Pauline Heslop and her team have recommended the establishment of a national mortality review—basically a beefed-up confidential inquiry. This would guide detailed local reviews but also include a national overview panel. Its wider remit and role would provide an oversight of core data relating to all deaths of people with a learning disability. It could monitor and direct where more detailed reviews need to take place and, vitally, it would make recommendations for changes in practice. A longer-term commitment to this vulnerable patient group is needed for a real impact to be seen. The United States started similar mortality reviews and over the past 10 years it has seen an increase in life expectancy among people with a learning disability. The confidential inquiry we are discussing today was only established for three years—effectively as a pilot. It looked at the deaths of 233 adults and 14 children across five PCT areas in the south-west. Its focus was to determine whether the deaths of people with learning disabilities were premature. The principal aims were to detect factors which contributed to death as well as gaps in health and care services.

The results expose the gulf that still exists between the care received by people with a learning disability and that received by the rest of the population. It found that 37% of deaths would have been potentially avoidable if good quality healthcare had been provided. It found that on average, men with a learning disability died 13 years earlier and women 20 years earlier than the general population. Mencap says that this means that over 1,200 deaths each year across England could have been avoided with good-quality non-discriminatory healthcare—almost 25 children and adults per week. That is a shocking figure, which equates to the number of people thought to have died needlessly over a four-year period at the Mid Staffordshire hospital.

I am sure that other noble Lords will address some of the findings in more detail, but I will focus on the wider picture for a little longer. While Mid Staffs rightly hit the headlines, as did Sir Bruce Keogh’s report earlier this week, the avoidable deaths of people with a learning disability, some of the most vulnerable people in our society, go largely underreported and consistently fail to feature prominently on the parliamentary agenda.

What are the Government doing about premature mortality? On 5 March 2013, Jeremy Hunt said in the other place:

“Today, I am publishing ‘Living Well for Longer: A call to action to reduce avoidable premature mortality’”.—[Official Report, Commons, 5/3/13; col. 60WS.]

Sadly but perhaps predictably, the document did not even mention people with learning disabilities. That is despite the fact that in the 2011-12 NHS outcomes framework, the Department of Health added a placeholder indicator for measuring premature mortality in people with learning disabilities. This was further specified as the,

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“Excess under 60 mortality rate in adults with learning disabilities”—

“under 60” because that reflects the current average age of death for people with learning disabilities. Unfortunately in the latest NOF—national outcomes framework—for 2013-14, this indicator is still in the inactive “development” stage. Will the Minister advise when the Government will give it live status and assure the House that the threshold will be reviewed year on year to bring it closer to the threshold of age 75, as in the general population? That would ensure the collection and publication of some vital data.

However, one of the problems is the difficulty that we still have in the identification of people with learning disabilities in health and care records. This was one of the recommendations of the Michael inquiry and, again, the confidential inquiry notes it as being of critical importance. Dr Heslop explains that concerns would never have been raised about many cases reviewed by the confidential inquiry had their care not been scrutinised. I agree with her that professionals learn more and change their practice more by being reflective and reviewing cases using a root-cause analysis approach. Merely telling a professional to do something rarely works, as is evidenced by the lack of adherence to the Mental Capacity Act and the Equality Act.

This inquiry provides a firm foundation of knowledge upon which the Government could take real and purposeful action—urgent action—to address these startling and persistent inequalities. However, this is not borne out in the Government’s unambitious response which acknowledges the findings that health inequalities exist but contains no set goals or timescales and no ways of measuring improvements. They could instead have followed the structured style of response they made to the Winterbourne View hospital scandal by working with stakeholders, including families and carers—many of whom are listening to the debate today, and whose presence I welcome. Will the Government consider a concordat to take forward the confidential inquiry recommendations and the construction of a clear, timetabled action plan?

The lack of commitment to the inquiry’s central recommendation about a mortality review body is disappointing. Despite the overwhelming evidence that this is the right thing to do, a decision will not be made until March 2014, by which time another 1,000 children and adults will have died prematurely. I urge the Government to bring this to the top of the agenda, not to push it down the priority list yet again.

As for the Francis inquiry, we say yes; but what about the enormity of the challenge that the Government face in achieving equality in access to healthcare and in health outcomes for this group? I ask the Minister to persuade the Secretary of State to include in the remit of all future health reports and inquiries, and in the work of the new Chief Inspector of Hospitals, the question, “Did people with learning disabilities fare better or worse?”. At the moment the answer is probably “worse” in all aspects of healthcare. I know that noble Lords will pick up many of the specific issues that I have not touched on, and I thank them for their support and passion for this debate. I also look forward

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to the Minister’s response and hope that he will be able to reassure this House that the Government are not indifferent and will act much more persuasively in future.

4.50 pm

Baroness Browning: My Lords, I refer the House to my registered interests regarding disability and health and I congratulate the noble Baroness, Lady Hollins, for bringing this very important debate to the Floor of the House.

I begin with the part of the report that deals with annual health checks. Such checks for people with learning disabilities are an excellent way for doctors to pick up early even more serious problems than the patients themselves realise they have or are able to articulate. In some cases, if a person is not medicated, it could be the only time in a year when a GP sits face to face with them.

Linking the health check with health action plans is extremely important. The regular screenings that the rest of the population almost take for granted—because we are reminded that we are due a certain screening and we welcome this preventive and early opportunity to check whether there is a problem—is something that people with learning disabilities may lose out on because, when a letter arrives telling them it is time to phone for an appointment for a particular screening, they may simply throw away the letter and never have the screening. The annual health check therefore provides that opportunity.

The confidential inquiry found that the weakest link in the chain of the care pathway for people with learning disabilities was problems with diagnosis. It is very easy to misinterpret or ignore something from someone who is unable to articulate their symptoms or pain. I believe that it is key that the annual health check is expanded beyond its current very useful functions to ensure that it is used to provide a much more comprehensive look at, and a holistic approach to, that person’s health. The Government have accepted that there is inequality in healthcare investigations. They have detailed how NHS England will address this through working with clinical commissioning groups, and I understand that they will set out the details later in the year. That will be a crucial piece of work, which I hope will include tangible and measurable objectives on improving investigations that lead to diagnosis.

For people with learning disabilities in particular, and—the House will not be surprised to hear me say—for those on the autistic spectrum, many of whom also have learning disabilities, communication is a major issue. It is important for primary care services to understand the patient; if that person needs to attend a GP or nurse appointment accompanied by someone who can interpret their mood, behaviour and articulation, the primary care services must take into account that this can be quite painstaking and time-consuming. If people with a learning disability are to be treated equally, it is very important that the primary care service, and the services in hospitals when investigations often take place, allow for the fact that there may need to be a person in support who will help the clinicians to interpret how the other person is feeling.

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I turn now to the part of the report that deals with the Mental Capacity Act. A number of reports, including the Confidential Inquiry into Premature Deaths of People with Learning Disabilities and the Francis report, have identified problems with how the Mental Capacity Act is understood and applied. They identified the lack of compliant practice with the Act as a barrier to effective NHS care. The inquiry found evidence of disagreement about what professionals understood by “serious medical treatment” and thus a lack of consistency about appointing independent mental capacity advocates to support those without family members to represent their views. There has also been evidence of unlawful NHS practice.

Declaring an interest as a mother, I add at this point that it is not just people without relatives to speak up for them who are not always listened to. In that shocking report from Mencap, Death by Indifference, which the noble Baroness mentioned, and reports that have followed on from the original report, we have seen the deaths of young people whose mothers have stood by their bedside and tried to explain the symptoms of their adult children to clinical staff, only to be told, “He’s over 18 and he hasn’t expressed his wishes in that way”. There is no other word for it but wicked.

So what are the Government pledging to do? The Department of Health has apparently agreed that mental capacity advice should be available 24 hours a day. It said:

“There should be staff trained in the MCA available 24 hours a day, and there should be specialist advice available in all care settings”.

It also says:

“Service providers have the primary responsibility for ensuring existing staff have the required knowledge and awareness of the MCA … The responsibility for the content of education and training curricula … lies with”,

Health Education England and,

“the professional regulators and the appropriate Royal Colleges”.

As a member of the Select Committee in this House that is currently looking at the post-legislative scrutiny on the Mental Capacity Act, I was somewhat concerned, when we took evidence at our first session on 18 June, that we were told by Department of Health officials when asked about the ability to assess for mental capacity,

“the assessment revealed an inconsistency in assessing capacity in some trusts to ensure that the Act was fully embedded”.

Claire Crawley, who spoke on behalf of the Department of Health, said:

“In terms of hard evidence, could I sit here and say, ‘I absolutely know that every local authority has appropriate plans and training processes in place’? I could not say that because I have no way of getting that evidence. The regulator of the industry, as it were, the Care Quality Commission, does not monitor local authorities or inspect them any more, so I would not know”.

Very often the local authority appoints the person who has the day-to-day care for the patient, so local authorities are as much involved in this as the NHS. When pressed by the noble Baroness, Lady Andrews, about the position of NHS trusts with regard to assessment of capacity was concerned, Claire Crawley told us:

“That would probably have been the CQC’s process … rather than the department’s process”.

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I say to my noble friend that when a department, particularly the Department of Health, puts a piece of legislation such as the Mental Capacity Act on the statute book, it has a duty and responsibility to ensure that it is complied with, particularly for this vulnerable group of people. It is simply not good enough to say, “Not me, guv, it’s somebody else’s responsibility”.

4.58 pm

Lord Touhig: My Lords, I refer the House to my interests as a vice-president of the National Autistic Society. I congratulate the noble Baroness, Lady Hollins, on securing this timely debate, coming, as she said, so soon after the publication of the Government’s response to the Confidential Inquiry into Premature Deaths of People with Learning Disabilities and just two days after the publication of this report from the Health Service Ombudsman, which I want to speak about.

I welcome this debate because it affords us the opportunity to debate the wider subject of health inequalities affecting people with a learning disability. The confidential inquiry is a crucial piece of work and shows that 37% of deaths could potentially have been avoided if good-quality healthcare had been provided. It is a terrible indictment of our care support system for the most vulnerable group of our fellow citizens, who are being let down. They and their carers often find it hard to express themselves in a way that might help prevent the tragic happenings that the inquiry has revealed. Like many noble Lords, I am aware that the support groups and those who work with people with learning disabilities have significant concerns about the Government’s response to the inquiry, a point well made by the noble Baroness, Lady Hollins. They feel that it is simply not strong and purposeful enough to really drive the change that we all wish to see.

On a wider point, a report from the Health Service Ombudsman, laid before Parliament on Tuesday this week following an investigation into a complaint against a GP practice, makes some pretty awful reading and should act as a wake-up call. It reveals how a GP service let down a young man with severe learning disabilities and it starkly draws into focus the attitudes that pervade in the system.

The young man is just 23. He has severe learning disabilities and behavioural problems, and he has epilepsy. He has historically been prescribed a series of medicines in liquid or dissolvable form because he becomes very distressed if he has to take tablets. One of the medicines was midazolam, used in emergencies if his epileptic seizures lasted beyond three minutes. In April 2011 his mother asked their GP for a repeat prescription in liquid form to help her son’s epilepsy. The GP refused her request because it was too expensive. He would only prescribe her son suppositories or tablets in future.

The mother advised the GP that her son had been prescribed only liquid medicine from a very young age, as his learning disabilities caused him to become very distressed if he had to swallow tablets. Despite this, the GP said he would no longer prescribe any of the young man's medicines in liquid form for cost reasons and would prescribe only tablets in future. The doctor told the mother to find a GP,

“‘who has bigger budgets’ and who would ‘be happy to prescribe the medications’”.

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The mother was clear that the decision not to prescribe her son suitable medication put him at risk, including of death. However, when she subsequently complained to the GP practice about the doctor's decision, the response was far from understanding and helpful. She got a letter informing her that there had been a “total breakdown” in the doctor-patient relationship and advising her to find a new GP within 21 days as she and her son were to be removed from the practice’s list.

I can only ask noble Lords to imagine the significant distress that followed. The General Medical Council guidance is clear: doctors must ensure that prescribing of medicine is appropriate and responsible and in the patient’s best interests. The guidance also states that doctors should, when appropriate,

“establish the patient's priorities, preferences and concerns”,


“discuss other treatment options with the patient”.

After investigating the case, the ombudsman found that the GP had not given the young man the medication he needed on the grounds of cost, and had ignored disability discrimination law in the process. The ombudsman was clear in the report that the doctor,

“did not act in line with the Mental Capacity Act, GMC guidance and established good practice.”

The report found that the doctor,

“did not consider his responsibilities under the Mental Capacity Act in reaching his decision”,

about the young man's medication. He did not assess the young man’s,

“capacity to make a decision about his own treatments or medications. Nor did he take any of the required actions that could have led him to reach a ‘best interests’ decision”,

on the young man's medication.

The case shows a lack of understanding of reasonable adjustments and disability rights. Public bodies are required to comply with the Equality Act 2010, which includes the duty to make reasonable adjustments. They should also have regard to the various statutory codes of practice that have been published to assist in the interpretation of the legislation. The ombudsman’s report brings into sharp focus a specific case and uncovers the treatment that people with a learning disability and their families can face within the health service. The ombudsman, Julie Mellor, said:

“This is yet another case where someone with learning disabilities has been failed. When there are failures in the care and treatment of people with learning disabilities, there are consequences in terms of their health and in too many cases, their life expectancy.”

Unless the Government take strong action in this area, cases such as these will continue to occur. That is why I strongly support establishing a national mortality review body, which would allow for the collection of mortality data and, importantly, for investigations of specific cases, a point made by the noble Baroness, Lady Hollins. Critically, it would provide the opportunity to improve the understanding of the causes of premature deaths and enable the National Health Service to improve care for people with a learning disability.

The ombudsman’s report highlights a terrible wrong committed against a vulnerable young person. I hope

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that this Parliament and this Government will act to stop these awful and discriminatory cases occurring in future.

5.05 pm

Baroness Jolly: My Lords, I, too, thank the noble Baroness, Lady Hollins, for bringing to the attention of the House the report that gives us the opportunity to discuss this issue. The report makes for sobering reading. Many noble Lords speaking in this debate have far more expertise in these matters than I have—in fact, looking around the Benches, I think that they all have—but the first NHS trust board that I sat on more than 15 years ago was a community trust with learning disability, mental health and community health responsibility for all of Cornwall, so I come at this with at least some understanding. I commend the work in this area by both the noble Baroness who, during her tenure as president of the BMA, sought to raise the profile of learning disability, and the noble Lord, Lord Rix, a long-time advocate of those with learning disability, and president of Mencap, which I thank for producing an excellent briefing.

In the past, there have been plenty of situations and reports, and we have heard about some of them today, that should have given successive Governments a wake-up call regarding poor provision for people with a learning disability—Budock Hospital and Winterbourne View, to name two, both of which point to the inevitable health inequalities. For many years now we have known that the health commissioning of learning disability services has been poor. Many PCTs wrote a cheque to providers and effectively asked them to get on with it. Indeed, there is a historic similarity with mental health service commissioning. Mental health now has parity of esteem status with physical health, but it does not feel as if the same can be said for learning disabled people.

The history of a lack of communication between health and social care in this area is well known, too. It was as if, after the move to take people out of large establishments and put them into domestic settings, commissioners and providers decided that the job was done, the spotlight went off, attention moved elsewhere and quality was forgotten. I must acknowledge that there are some splendid services, but that standard is not yet universal.

So what are good services? Here I have to thank Professor Jim Mansell of the University of Kent for the list from his 2010 report, Raising Our Sights. Good services should be individualised and person-centred, treat the family and carers as expert, focus on staff relations with the individual, sustain the package of care and be cost-effective. In addition, they should be supportive, use appropriate advocacy and be predictive and well implemented. I do not wish to belittle the work of the professor but none of this list should come as a surprise to the House. The surprise and shame is that this list is not part of universal practice.

That brings us to the Confidential Inquiry into PrematureDeaths of People with Learning Disabilities. The report was commissioned by my right honourable friend Paul Burstow following the events at Winterbourne View. It is thorough and contains a detailed and

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practical set of recommendations. In the time that we have, I am unable to cover all aspects of the report so shall focus on information, staffing and the Mental Capacity Act. The report puts the spotlight back on mortality. As we have already heard, it is particularly appropriate that we are discussing the mortality of people with a learning disability in the week when the Keogh report did just that for the total population served by 14 hospitals. Sir Bruce was able to do that because he had the data. This report is based on a dataset that is not normally collected for people with a learning disability.