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Lords Chamber

Volume 715: debated on Thursday 26 November 2009

House of Lords

Thursday, 26 November 2009.

Prayers—read by the Lord Bishop of Ripon and Leeds.

Armed Forces: Compensation Scheme

Question

Asked By

To ask Her Majesty’s Government what progress has been made in the current internal review by the Ministry of Defence of the Armed and Reserve Forces Compensation Scheme 2005; and when they expect it to report.

My Lords, the review of the Armed Forces compensation scheme currently being chaired by the noble and gallant Lord, Lord Boyce, continues. The latest phase of the review ended on 19 November and sought views from members of the public and the Armed Forces. Responses are currently being analysed and it is expected that the final report will be presented as planned in a few months.

My Lords, I am grateful as ever to my noble friend. Will the review’s findings be published before the Ministry of Defence makes any decisions and can he say by when he expects this House to be able to debate them? The closing date for written submissions having passed, will oral evidence be taken from war-afflicted veterans and bereaved families still wishing to have their voices heard? Finally, does my noble friend accept that the compelling justification for all possible help for our Armed Forces from this review is that they, alone in this country, contract with the state not only to risk but to lay down their lives in its service, as they have been doing so bravely day by day for months now in Afghanistan?

My Lords, I am sure that the whole House will join me in paying tribute to the noble Lord’s contribution over many years to the welfare of former members of the Armed Forces. The review will report to the Defence Secretary and will be published by him with an indication of the steps that he intends to take as a result. It will of course be for the usual channels to determine whether and how this should be debated in your Lordships’ House. The review’s public engagement phase was widely publicised, with many and varied responses solicited and received, including through a number of focus groups held with Armed Forces personnel and their families. That phase ended on 19 November. On the noble Lord’s third point, in last year’s service personnel Command Paper, the Government clearly articulated their recognition of the unique nature and demands of military service and how this sets our Armed Forces apart from others who serve and protect society.

My Lords, is it not the case that Her Majesty’s Government have already had to increase or even double inadequate levels of compensation, have had to go to the Appeal Court to resolve the meaning of poorly drafted secondary legislation and have been virtually panicked by public pressure to bring forward the review from next year? Is it not also the case that experts maintain that the scheme is based on the wrong principles and cannot, for example, take full account of the continuing effects of disablement? Does the Minister not agree that the present scheme is unfit for purpose and must be replaced after a thorough, independent inquiry to restore public confidence?

My Lords, I think that there were some six questions there, but I shall do my best. We were always committed to review this scheme after five years. Incidentally, I have studied it a number of times and I do not accept that it is not fit for purpose. We have brought the review forward by a year because of interest in the scheme. The process is to look at the whole scheme, to make sure that the principles on which it was based with regard to fairness, feasibility and sustainability are working and to make recommendations for change. The court case was brought about to ensure that the scheme was properly understood. The decision of the MoD to proceed with the appeal has been vindicated by the Appeal Court judgment by Lord Justice Carnwath, who said that,

“the Secretary of State was in my view entirely justified in bringing the appeal … It seeks to clarify some important and difficult issues relating to the construction of the scheme”.

It is entirely proper that we considered the scheme, that we introduced some improvements and that we continue to consider it. However, we must strike a balance between being fair to our Armed Forces, which is paramount, and representing the proper interests of the taxpayer.

My Lords, in supporting the call of the noble Lord, Lord Morris, for the report to be properly debated in this House, may I ask the Minister whether he knows how many submissions have been received, particularly from serving members of the Armed Forces?

My Lords, I am afraid that I do not have that information at hand. However, there was an open invitation for contributions. An important contribution was the decision by the review and its independent chair to use a focus group technique to better understand in depth the concerns of those currently serving in the Armed Forces and those who had left the Armed Forces. It is important that the review is bringing new issues into consideration—for instance, the burden of proof and mental illness—and a new depth to yet further improve the scheme.

Can the noble Lord confirm that plans to compensate victims of terrorism overseas were dropped from the gracious Speech because Ministers could not agree how they might relate to compensation paid to wounded service personnel, given that such payouts backdate only to 2005?

My Lords, I hate to reveal the extent to which I was not consulted in the drafting of the gracious Speech. Proposals in relation to victims of overseas terrorism are being actively considered and consulted on across government. I am not going to apologise for the fact that the Government are participating in joined-up government.

My Lords, the public image tends to be of injuries to people who have suffered mutilation and loss of limbs, but people also suffer from the long-term residual effects of combat, such as combat stress, which appear years after the combat is over. Are their interests also being considered by the inquiry?

Essentially, yes, my Lords. The present scheme has a five-year time limit for applications. However, that time limit will be considered by the review, particularly in relation to late-developing conditions and mental health.

My Lords, ought not this matter be debated in your Lordships’ House, where we have the advantage of noble and gallant Lords, before the next review?

My Lords, I am always enthusiastic to have these issues debated in this House, if only for the number of noble and gallant Lords who contribute. However, I repeat that it is a matter for the usual channels to determine whether a debate should take place.

Game Licences: Scotland

Question

Asked By

To ask Her Majesty’s Government, further to the Written Answer by Lord Rooker on 13 June 2007 (WA 259) and the answer on 21 February 2008 (HL Deb, cols 270–72) regarding the abolition of game licences in England, what discussions they have had with the Scottish Executive about abolishing game licences for shooters in Scotland.

My Lords, this is a devolved matter. Game licences were abolished in England and Wales in 2007. They are still required in Scotland but it is for the Scottish Executive to decide whether or not to abolish them. We have had no discussions with the Scottish Executive on this issue.

I thank the Minister for that rather appalling reply. Does he not agree with his noble friend Lord Rooker, whom I am delighted to see in his place, who advised on 3 July 2007 at col. GC 97 that game licences are—or, in the case of England and Wales, were—counterproductive in revenue terms? Would he further agree with his noble friend that,

“we do not want any cross-border issues like this”?—[Official Report, 3/7/07; col. GC 99.]

Could I urge the Minister to do all that he can to persuade his opposite numbers in Edinburgh that this is a complete nonsense?

My Lords, the noble Lord can be appalled by the Answer only if he is opposed to the devolution settlement. This is a matter for Scotland. Of course I always agree with my noble friend Lord Rooker, particularly in his view on the licence, which I recall him on that occasion saying was introduced to ensure that working people could not shoot because of the cost involved. The cost involved at that time was £6—in present day values, it would be £1,500—and the cost now is still £6. The Scottish Executive are consulting on a draft wildlife Bill and intend to include in it the provisions that we have already enacted in England and Wales.

My Lords, is this not a farcical situation? A friend of mine went to renew his game licence last year and found that his number was the consecutive one to that on the licence that he had applied for the previous year.

My Lords, one is always sorry about mishaps. As far as England and Wales are concerned, the Government took steps in 2007 to abolish the licence. Obviously, a great deal of shooting goes on in Scotland and licences are still required at the moment, but I have indicated that the Scottish Executive are fully seized of this matter and are consulting on legislation. The legislation would take a year to enact, but it appears that it could easily be only a year or so before there is no requirement for the licence in Scotland.

My Lords, would it not be perfectly reasonable, and no breach of comity between the devolved Parliament and our own, to indicate that a certain number of tourists from this House rather enjoy shooting in Scotland? They are very welcome there but they find it rather irritating that the present law exists. It would be particularly timely to give that indication in view of the impending legislation.

My Lords, game shooting brings some £1.6 billion to the UK economy, but I doubt that that is attributable solely to Members of this House, although their interest is acknowledged. The Scottish Government are all too well aware of the significance of shooting to their economy.

My Lords, I declare an interest as someone who owns game-shooting land in Scotland. Given that the noble Lord, Lord Rooker, said in reply to my noble friend in February 2008 that it was up to the Scottish Executive what they do and how they decide to spend the money, can the Minister tell us how many other functions of the Post Office generate money for the Scottish Executive or Scottish local authorities and whether the costs are charged to them?

My Lords, I have not been briefed on the finances of the Post Office except to reassure the House that these licences were issued only at main post offices. In fact, there is an arrangement for the licences in Scotland to be issued only at one post office in order to smooth the administration. If the noble Duke is indicating that such smoothness sometimes eludes the issuing of licences, let me say that all the indications from the consultation are that there will not be an obligation on the Post Office in Scotland or anywhere else to issue the licences.

My Lords, while we are considering game licences, would it not also be sensible to reduce some of the overprescriptive legislation on firearms, which takes up so much police time? For example, should a silencer, which is after all not much more than a tin can, count as a weapon on a firearms certificate and require a visit from a policeman to inspect it? Could not the same common sense be applied also to firearms legislation in England?

The noble Lord, uncharacteristically, is guilty of straying a little from the main Question. He is asking me about the law on firearms, an issue that concerns the Home Office, when we are talking about one particular pursuit, which is the use of firearms in an entirely peaceable and legal way—namely, shooting—in Scotland and, I might add, Northern Ireland and the issuing of licences for it. If the noble Lord wants to pursue the issue that he is concerned about, he should address himself to the Home Office.

My Lords, where is the single post office at which one can get a shooting licence in Scotland and how far is it from the furthest shooter?

My Lords, I think that the post office is in Dunkeld. It is not meant to be distant from the operations, but shooting in Scotland covers a very wide terrain. The concept is to smooth the administration as far as possible to ease what is an exercise in technicality. No one thinks that the licence provides any useful purpose whatever, as my noble friend Lord Rooker graphically expressed several years ago. That is why in England and Wales we have already abolished it and, as I have indicated, progress is to be made elsewhere.

Roads: Markings and Signs

Question

Asked By

To ask Her Majesty’s Government whether they will use their powers to ensure that road markings and signs are compliant with regulations, particularly where markings or signs create dangers for road users.

My Lords, the Government would consider using their powers to direct local authorities to remove traffic signs where there was sufficient justification.

My Lords, I am delighted by that Answer. I think it would be the first time in 18 years that the Government had done this. When we set out the relevant legislation and the secondary legislation that goes with it, we were careful to specify exactly what signs and lines should be used, both on the grounds of safety and to ensure that people understood, wherever they came from and wherever they found themselves, what those signs and lines meant. Is the Minister aware of the extent to which these rules are disregarded, and that if he walks out of this palace he will find examples of flagrant disregard within 100 yards or so? Is he also aware that disregard of the regulations in places like Sunderland has gone as far as creating real dangers to pedestrians and other users of the road? Does he not think that it is time the Government used the powers that they have been given to keep councils in line?

My Lords, I am sure that the whole House admires the noble Lord for the zeal of his campaigning on this and other issues; he asked a number of questions along these lines before. By virtue of Section 64 of the Road Traffic Regulation Act 1984, the majority of traffic signs in Great Britain are prescribed by the Traffic Signs Regulations and General Directions. As I said in my Answer, the Act gives the Secretary of State power to direct a highway authority to remove traffic signs, and, where an authority fails to do so, to carry out the work himself and recover the cost from the authority. As the noble Lord says, however, these reserve powers have never been used because we take the view that it is far more appropriate for local and highway authorities to take the responsibility for this; it is impossible for the Department for Transport to police road signs over the whole country. It would be in only the most exceptional circumstances that the Secretary of State would consider using these powers.

In the case of Sunderland there is a legal issue under way, but the Government Office of the North East has advised Sunderland council that restrictions imposed by zigzag markings apply to lay-bys as well as the main carriageway, which I believe is at the heart of the issue in Sunderland to which the noble Lord refers.

My Lords, does the Minister agree that it is particularly unhelpful when signs on the roads themselves wear out and are not renewed quickly enough? Will he encourage prosecuting authorities to bear in mind that any prosecutions in those circumstances would probably fail and indeed are probably illegal?

The noble Lord makes a very good point. The responsibility for ensuring that signs remain visible and in use is that of the highways authorities, and I shall draw his remarks to the attention of the department.

My Lords, does not the existence of large numbers of road signs on roadways, particularly at junctions, serve only to confuse the motorist, who can absorb only so much information? Should not many of those signs be removed? Perhaps we need a little regulation here.

A national traffic signs review is under way, which was launched in September 2008. It involves all of the interested parties such as the county surveyors, Transport for London, the Highways Agency and the enforcement agencies. Its purpose is to consider how the traffic regulations are provided, and it will seek to simplify the regime. I hope very much that when that report is implemented, some time next year, it will meet the point that my noble friend makes.

We on these Benches believe that the maintenance of road signs is a matter for local authorities, and we would not seek central direction to apply to it. However, the local authorities are very short of money. Can the Minister tell me how many local authorities have taken advantage of the opportunities which exist to impose special parking area restrictions and to decriminalise a lot of acts, so that they get the money and then have it to spend on the road signs?

I very much welcome the noble Lord’s support for the Government’s approach; this is a matter for local authorities and highways authorities. I am able to answer his question; so far, out of a total of 327 local authorities, 265 English local authorities have civil parking enforcement powers.

My Lords, is the consultation to which the Minister has just referred broad enough to consider left-hand filters at traffic lights? Those would ease the flow of traffic considerably

My Lords, it is my understanding that everything concerned with traffic signs is on the agenda for the review, and I am sure that the point which the noble Lord makes will be taken into account.

My Lords, given the potential danger to vulnerable pedestrians posed by shared space schemes, will the Minister commit to checking such schemes as they are proposed to ensure that they comply with regulations?

My Lords, we are aware of the concerns that blind and partially sighted people have about shared space. We are investigating those concerns and producing advice to local authorities on how to overcome them. Comprehensive research is at present being conducted into the matter; if I may, I shall send the noble Lord the appraisal report that has just been published. I should be grateful for his views on that as well.

My Lords, following on from my noble friend’s question, will the Department for Transport be supporting the mayor’s initiative on a pilot to see whether cyclists can turn left on a red light?

That matter has still to be resolved, and I am afraid that I do not have an answer that I can give to the noble Baroness now. If I may, I shall write to her with a comprehensive reply.

Terrorism: Northern Ireland

Question

Asked By

To ask Her Majesty’s Government what is their assessment of the threat presented by dissident terrorists in Northern Ireland.

My Lords, the threat posed by dissident republicans remains severe. The most recent report from the Independent Monitoring Commission confirms that the level of activity by dissident republicans is more serious than at any time since it started to report in April 2004. Dissident loyalist activity is largely criminal and sectarian in nature.

My Lords, I thank the noble Baroness the Leader of the House for that Answer. Can we expect continued intelligence and information to come from the Republic of Ireland?

Yes, my Lords, there was a fine example of co-operation in what happened very recently. Indeed, I am sure that the House would join me in commending both the PSNI and An Garda Siochana for their professionalism, courage and bravery in thwarting the terrorist attack at Garrison, County Fermanagh last weekend. The investigation is continuing and two men have already been charged in connection with that attack.

My Lords, would the Minister agree that intelligence gathering and surveillance of terrorists has been greatly reduced, caused by the reduction in numbers of Special Branch officers in Northern Ireland?

My Lords, it would not be entirely appropriate for me to comment on all issues in respect of that question. I merely say that it is an operational issue and therefore for the chief constable of Northern Ireland to determine. I do not agree with the ethos behind the noble Lord’s question.

Would my noble friend agree that, while the threat is of course serious, it should not be used as a reason for delaying the devolution of policing and criminal justice powers to Stormont, but rather as a reason for expediting that process?

I entirely agree with my noble friend. The only way forward is indeed to devolve policing and justice. While that has not been devolved, there is a vacuum. Where there is a vacuum there tend to be more dissident operations.

My Lords, would the noble Baroness accept that there is certainly a recognition that this is a serious situation? With the current level of unemployment rising in Northern Ireland, there are rather more idle hands around, which might give added resources to those wishing to cause trouble. Will she confirm that the strongest efforts are being made, as in the past, to ensure that there is no outside source of munitions or equipment? Problems in Northern Ireland have in the past been bedevilled by overseas supplies being made available to terrorists. Will the Minister also confirm the vital importance of the Republic making its fullest contribution, as appears to be the case at the moment? This is an attack not only on Northern Ireland but on the prosperity of the whole island of Ireland.

My Lords, I can certainly confirm that the strongest efforts are being made to ensure that weapons do not come from third-party countries. Employment is of course a devolved issue but I am delighted that Declan Kelly has recently been appointed by the US Government as an economic envoy to Northern Ireland. That should improve the investment opportunities in Northern Ireland. Yes, the relationship with the Republic is very strong, as it is between the two police forces. It is important that we move forward together.

Would the noble Baroness agree that it is important to get dissident republican activity into perspective, and that the overwhelming majority of Roman Catholics and Protestants totally condemn dissident republican activity? Would she also agree that in Northern Ireland we are now enjoying one of the lowest levels of unemployment for 40 years; continuing inward investment; a growing population which is now over 1.7 million; and that the dissident republicans must not be allowed to damage this progress in Northern Ireland?

My Lords, the noble Lord is entirely right in everything that he says. It is absolutely clear that the vast majority of both communities in Northern Ireland have entirely rejected this sort of criminal activity. They are thriving and they want their country to thrive, as it must and should do.

My Lords, I was glad that the noble Baroness the Leader of the House agreed with the noble Lord, Lord Dubs, that transferring justice and police powers to Northern Ireland is the best way to produce a mature democracy, which we all want and which would deal with the dissidents most effectively. What efforts are being made by the Secretary of State to get the First Minister and the Deputy First Minister to do their business, deal with any disputes that they have on this matter, and then devolve policing and justice to Northern Ireland as quickly as possible?

My Lords, not only the Secretary of State but the Prime Minister, personally, has been very engaged in this whole issue. They work regularly with the First Minister and the Deputy First Minister to ensure that the very small number of issues that are still outstanding and which prevent the devolution of policing and justice can be addressed, so that we see speedy devolution of policing and justice.

Is the noble Baroness confident that there is no danger at the margin that any members of Ulster unionist groups will use these incidents as reasons to weaken or undermine the power-sharing deal?

My Lords, it is clear that people from both communities on both sides of the political divide want to move forward. They are both being very constructive in wishing to move forward.

My Lords, while joining in the admiration for the co-operation in the case of the Fermanagh incident to which the Leader of the House referred, does she wish to comment on the fact that other events have occurred without the security forces having any early warning that they might occur?

My Lords, it is not appropriate for me to comment. It is good when good co-operation exists. Co-operation is increasing and we can expect that in future more and more operations such as the one at Garrison will be thwarted.

Will the noble Baroness reassure the House that the chief constable, who is responsible for all operations within the Province, has adequate resources, and explain what is available to him?

My Lords, we should all congratulate the chief constable, Matt Baggott, on what he is doing. He is an excellent new chief constable appointed at a very difficult time. He has adequate police resources. Indeed, with the devolution of policing and justice, the adequacy of the resources will continue.

Senior Salaries Review Body

Announcement

My Lords, with the leave of the House, I will make a short statement on behalf of the House Committee. As I know the whole House will be aware, in June this year the Senior Salaries Review Body was commissioned to conduct a review of the financial support available to Members. On behalf of the House Committee, I confirm that the report has just been published and that copies are now available in the Printed Paper Office. I understand that the usual channels will seek to make time available for the House to debate the report before we rise for Christmas.

Business of the House

Motion on Standing Orders

Moved By

That Standing Order 41 (Arrangement of the Order Paper) be dispensed with on Tuesday 1 December to allow the motion in the name of Baroness Thomas of Winchester to be taken before the Second Reading of the Northern Ireland Assembly Members Bill [HL].

My Lords, in moving this Motion, in the interests of transparency I shall say a few words so that the House is fully aware why I am proposing it. The Motion would set aside Standing Order 41, which gives proceedings on Public Bills precedence over Motions on negative instruments. This would allow the Motion of the noble Baroness, Lady Thomas of Winchester, to be taken before the Second Reading of the Northern Ireland Assembly Members Bill next Tuesday 1 December. This order of business is being proposed following discussions through the usual channels which concluded that in this case the proposed order of business might be for the general convenience of the House. I understand that the noble Baroness, Lady Thomas of Winchester, is content with the proposal, subject to the agreement of the House. I am grateful to her for her understanding.

Motion agreed.

Queen’s Speech

Debate (6th Day)

Moved on Wednesday 18 November by

That an humble Address be presented to Her Majesty as follows:

“Most Gracious Sovereign—We, Your Majesty’s most dutiful and loyal subjects, the Lords Spiritual and Temporal in Parliament assembled, beg leave to thank Your Majesty for the most gracious Speech which Your Majesty has addressed to both Houses of Parliament”.

My Lords, we are here today to debate the education, health and equality Bills announced in the gracious Speech. I hope to inform that discussion by outlining the key proposals in those Bills. Before I do so, perhaps I may say how much I am looking forward to hearing contributions from the noble Lords, Lord Aberdare and Lord Sacks, who will be making their maiden speeches during today’s debate.

Very strong themes run through the Bills in this year’s gracious Speech. They should be familiar themes because they have run through much of the legislation introduced by this Government. Those themes are a commitment to equality, a determination to extend opportunity and a desire for every member of our society to have the opportunities to do the best for themselves and their communities.

Over the past 12, years our policies have led to many proud achievements, among which are the introduction of the national minimum wage, record numbers of students in higher education, a National Health Service with shorter waiting times and thousands more nurses and doctors, and a million pensioners lifted out of poverty. The four Bills that form the subject of today’s debate continue that work for the benefit of all the people in this country. The Bills are the Personal Care at Home Bill, the Equality Bill, the Child Poverty Bill and the Children, Schools and Families Bill. This Government have made investment in the NHS, and in healthcare generally, a priority. Since 1998, we have seen an unprecedented expansion of the NHS workforce, with over 26 per cent more nurses, 12 per cent more midwives and 59 per cent more doctors in training. The average waiting time for hospital treatment is now just under eight weeks. The publication of the NHS Constitution earlier this year was a historic moment and has safeguarded the NHS for generations to come.

The aim of the Personal Care at Home Bill is to enable more people to avoid or delay entering residential care by supporting them at home. We know that many people nearing the end of their lives or suffering from severe and chronic health conditions wish to remain in their homes. We want to transform the adult social care system, and this Bill will act as a bridge to the national care service outlined in the Green Paper published in July. The Bill strengthens current legislation, widening its scope to include many older people and working-age adults with disabilities who have until now funded all their own care. The Bill guarantees free personal care for around 280,000 people suffering from conditions such as serious dementia and Parkinson’s disease. It will protect the savings of around 166,000 people who currently receive all of their care at home free; and will relieve the financial burden on a further 111,000 people who currently pay for part or all of their personal care at home. A further 130,000 people will benefit from “re-enablement”, a process of intensive support that will help them regain and strengthen their independence. The Personal Care at Home Bill will allow more adults of all ages with the highest care needs to continue living in the place where they feel most at ease.

The cost of the free personal care will be £335 million in the first half-year: £210 million from Department of Health budgets and £125 million from local government efficiencies. That will equate to £670 million in the first full year. For the record, coverage in yesterday’s Times was quite wrong. The Government’s commitment to the funding of research into cancer and dementia will be unaffected by proposals in the Bill. All the necessary savings and priorities are outside the ring-fenced NHS research and development budget, and will not affect front-line research projects.

I turn to the Equality Bill. The Government have a proud history of equalities legislation. Since 1997, we have introduced the national minimum wage; brought in paternity leave; improved maternity pay; introduced new rights for disabled, lesbian, gay, bisexual and transgender people; and moved to tackle institutional racism. In October 2007, we set up the Government Equalities Office, with responsibility for the Government’s overall strategy and priorities on equality issues. However, we can and should go further. The Equality Bill will deliver much-needed simplification and harmonisation of discrimination law by combining nine pieces of discrimination legislation in one Act. Surely this will be welcomed by many.

The Bill will narrow the gap between rich and poor by imposing a new socio-economic duty on key bodies. With around £220 billion spent last year by the public sector on goods and services, the Bill will make it clear that public spending can be used to drive equality outcomes, and provides a power to ensure that public bodies look at how this can be done. The Bill also creates a power that would require private and voluntary sector employers with 250 or more employees to publish information about their gender pay gap after 2013 if they fail to do so voluntarily. This will be welcomed by all those concerned about the pay gap. For the first time, it will create a ban on age discrimination not just at work but also when providing goods or services like healthcare.

To encourage a more diverse workforce, the Bill extends the scope for employers to use voluntary positive action when choosing between two candidates who are equally suitable. I take as an example an issue that has been of concern in this House on occasion. If a primary school wants to increase its proportion of male teachers where they are under-represented, the Bill will help it to do so.

Several changes have been made to the Equality Bill since it was first introduced. The principal one is the insertion of a new clause prohibiting combined discrimination, where a person is discriminated against because of a combination of two protected characteristics, such as race and sex. Measures to strengthen and advance equality benefit individuals, as well as society and the economy. In difficult economic times, they are more important than ever.

In 1999, the Prime Minister committed the Government to the historic goal of eradicating child poverty within a generation. Since 1997, we have lifted half a million children out of poverty, and the Child Poverty Bill pledges to end child poverty by 2020. It makes the eradication of child poverty a priority for every future Government and a shared mission for our society. The Bill sets out four income targets against which we will measure our progress and establishes an accountability framework making central and local government, and our delivery partners, accountable for the success of their strategies to end child poverty.

Under the legislation, the Secretary of State is required to publish a UK child poverty strategy, which must be revised every three years, and publish annual progress reports. The Bill similarly requires Scottish and Northern Irish Ministers to publish child poverty strategies and annual progress reports. Importantly, a child poverty commission will be established under the legislation to provide advice on the development of the child poverty strategies. As well as the obvious benefits to the individual children and families concerned, the eradication of child poverty would be a significant step towards the creation of a fairer, more equitable society and, of course, a more prosperous one.

I come now to the Children, Schools and Families Bill. We are very proud of our achievements for children and young people over recent years. Our ambitious Children’s Plan is delivering change for children and their families in every part of the country. Sure Start children’s centres are an established part of every local neighbourhood, providing the services that parents need.

The school estate, both primary and secondary, is being refreshed and rebuilt following the biggest injection of capital investment for a generation. Ofsted tells us that our teachers are the best ever, and the academic achievement of our pupils goes from strength to strength.

The Children, Schools and Families Bill continues our commitment to provide children with the best start in life, parents with help to juggle their working and family lives, and the economy with an appropriately skilled and qualified workforce for the future. The Bill would give pupils and their parents a clear idea of what they can, and should, expect from a 21st-century schools system.

To ensure that all children receive the education and support that they are entitled to, in a safe environment, the Bill will introduce a new system of registration and monitoring of elective home education arrangements. There will be a compulsory registration and monitoring system for home-educated children in England, allowing local authorities to carry out visits at least annually to ensure that children are receiving a suitable education.

I stress that the Government are committed to home education as a viable choice for parents. In implementing the Badman review, we are committed to helping parents to improve the educational outcomes of their home-educated children. The Bill will also reduce the risk, in a very small minority of cases, of home education being used to conceal child neglect or abuse.

The Bill will also contain provisions to make personal, social, health and economic education statutory in the national curriculum. The Government believe that it is important for children to be supported in their emotional and social development. Although schools have always been encouraged to provide a programme of PSHE education, it is not currently a statutory subject, although obviously to date some elements of it have been. This legislation will add PSHE education to the national curriculum and change the parental right to withdraw children from the sex and relationship education elements of the subject, permitting withdrawal only up to the age of 15.

The Bill contains provisions for changes in the primary curriculum as well. Following widespread consultation, and after reviewing much international evidence, we are making the changes that teachers have asked for. But let me be clear, we are not abolishing subjects. The new law will organise the primary curriculum into six broad areas of learning that will give schools the flexibility to provide more coherent and more integrated learning experiences, tailoring teaching to meet the needs of all their pupils.

The primary curriculum has not been updated for nine years. The Bill follows Sir Jim Rose’s recommendations that schools should have greater flexibility to tailor teaching to the needs and interests of their children, while also focusing on the basics of literacy, numeracy and ICT. Organising the future curriculum into six broad areas of learning will allow greater focus on literacy and numeracy skills, and more time to study essential knowledge and skills in depth. However, contrary to some reports, British history will still be taught, and very young children will be taught only the elements of the sex and relationships curriculum that are age-appropriate. We have published the proposed areas of learning and would urge noble Lords, as ever, to take a look at them on our DCSF website.

The most significant measure in the Children, Schools and Families Bill is the provision of guarantees for parents and pupils, setting out what they can expect from a 21st century schools system. For the first time, the Government are setting out a series of specific entitlements for all children and their families and providing a means of redress if schools fail to meet those expectations. The guarantees express our key priorities for pupils and parents within the context of a complaints system already introduced by the Apprenticeships, Skills, Children and Learning Act 2009. Building on more than a decade of improving school standards, the Bill will help to create a modern schooling system that meets the needs of every pupil, allowing each one to achieve his or her full potential and to contribute to this country’s future success.

The Equality Bill, the Children, Schools and Families Bill, the Child Poverty Bill and the Personal Care at Home Bill form important elements in the continuing progressive agenda of this Government. These measures express our determination to create a fairer society; one which protects its most vulnerable citizens, young and old; and prepares all people for the challenges of the future. I commend these Bills and the gracious Speech to the House.

My Lords, it is a great privilege to reply to the Motion on the humble Address. I look forward also to the maiden speeches of the noble Lords, Lord Sacks and Lord Aberdare. Before I move on to my remarks, I should point out that my noble friend Lady Verma will cover education and equality. Accordingly, I will concentrate most specifically on health and social affairs. However, I shall begin by making some general remarks about all four areas in Her Majesty’s gracious Speech.

These are areas where time and again we see consensus. We all want to improve healthcare; we all want to give more help to struggling pupils at school; we all want to end child poverty; and we all want to ensure that British people do not have to face discrimination because of race, gender, religion, age, sexual orientation, or background. What a pity, then, that this Queen’s Speech seemed so political in its vain attempt to find dividing lines between the Government and Her Majesty’s Official Opposition.

How wrongheaded is that approach? The main concern on these Benches is that the Government are promising only the minimum that people should expect. Too often in the Queen’s Speech we see targets without real reform and objectives without substantive change to back them up.

I turn now to health issues in more detail. In Her Majesty's gracious Speech, we were told that the Government would ensure that individual entitlements guaranteed good services and would work to build trust in democratic institutions. We were also informed that the Government would,

“introduce a Bill to enable the wider provision of free personal care to those in highest care need”.

We have called for an NHS constitution and would indeed expect it to contain rights for patients to have access to the treatment that they need when they need it and the chance to exercise choice about its provision. The Government may bring forward within those provisions a right to access treatment within maximum waiting times. We would support that policy.

However, we do not think that it goes far enough. The Government propose a maximum of 18 weeks’ waiting time. We on these Benches argue that, as a blanket target, that simply does not do the job. Surely it is obvious that the target must relate to the particular needs of a specific case. After all, for some people, 18 weeks would be far too long—perhaps disastrously too long. Furthermore, that is very far from representing the radical reform suggested. Ninety-five per cent of patients are already treated within the proposed 18-week window. That is all to the good. It must be noted, however, that the new reforms will make very little difference to most people's experience.

We must aim higher, and so give people choice and diversity of NHS providers. As the party of the NHS, this would be our ultimate concern and at the heart of our proposals for reform. We must go further than two narrow process changes and instead ensure that changes are brought forward that will deliver the best health outcomes possible.

With that in mind, I turn to the Government’s proposals for their Bill on personal care at home. The Green Paper, Shaping the Future of Care Together, discussed how care for the elderly might be structured. It looked at five funding options, ruling out two categorically. In particular, it ruled out the option of funding any new system through tax. It stated:

“This is ruled out because it places a heavy burden on people of working age”.

That Green Paper was out to consultation until 13 November, so I must commend the Government on the speed and efficiency of their response—in no more than two working days. Speed is the only commendation. In content, it is perverse to incorporate in the Bill an approach based on exactly one of the options ruled out—that of paying for a care system out of general taxation. Yet that is exactly what the Bill will do. It will, apparently, fund the entire home care requirements of 280,000 people with the highest needs and offer assistance for a further 130,000. It will not, of course, be paid in part, as the Minister claimed, by efficiency savings but, in the end, by taxation. “Efficiency savings” seems to be a synonym for taxation. Just because the Government raise money and waste it for a period does not mean that it is any the less taxation when it is spent more sensibly, or at least more identifiably.

What on earth is going on? I think I can hazard a guess. This is another forlorn attempt to offer a gift to the electorate of their own money. Of course, the Government do not have that money now; they are currently indulging in a borrowing binge of heroic proportions. The money will be paid by our children, and probably by our grandchildren. It is a gift from our children, which the Government have so thoughtfully arranged for us as we age. Rather than a coherent strategy of old age care based on partnership, optional insurance or comprehensive insurance, as laid out in the Green Paper, we have a Bill that ignores the desperate funding position into which the government finances have plunged. I note that the noble Lord, Lord Lipsey, a distinguished former member of the Royal Commission on Long Term Care for the Elderly, has branded the move a gimmick, and he is right. This decision means that we will not have a proper strategy to debate, but a piecemeal, one-off measure that takes us, according to the Green Paper, in entirely the wrong direction. Where in all of this are proposals that would provide real help to all who need it, not just to those who have the greatest needs, but to all who require care? We on these Benches would advocate a system that instead looked at alternative options for social care, would create a better balance between the state and the individual and would also be financially stable in the long term.

Our concern is that the proposed Bill, with its state-funded approach, may represent not an anomaly but a new direction of travel. If it is a precursor to the introduction of a national care service, promised in the new year, the financial implications are little less than horrific. According to the Department of Health,

“a National Care Service could cost the State between £18.2 billion and £20.7 billion in 2014, depending on the funding model chosen”.—[Official Report, Commons, 12/10/09; col. 758W.]

That will be a matter for our great-grandchildren, even if disability benefits for the over-65s, such as disability living allowance and attendance allowance, are sacrificed to part-fund this cost, as the Government seem to be suggesting. Throwing these two benefits into the government spending pot would raise less than half the amount required. The sums involved are eye-watering, and demographic trends will make them worse still. A Government who have seen fit to do nothing to solve these problems for 12 years now seem only to have political point-scoring on their mind, rather than working for cross-party consensus to address this serious challenge in a serious way. I am not surprised that noble Lords on the government Benches are in despair. I can only counsel them to be patient.

I will now turn to social affairs. Here the Government are progressing their Child Poverty Bill. Let me make it absolutely explicit that we on these Benches abhor child poverty and are determined to reduce it substantially. I will not use the term eradicate, as the Minister did, since that word seems to have become a matter of technocratic definition and now means, I understand, to “reduce to less than 10 per cent”. The Child Poverty Bill is a long way from establishing effective ways of achieving the goal implied in its title. Let me remind noble Lords of the pledge that Tony Blair made in 1999 to halve child poverty by 2010-11 and end it by 2020. The Government missed their 2005 target and seem set to miss their 2010 target by a substantial margin, quite probably by more than half a million children. Shockingly, we see that since 2004 the number of children living in poverty, far from declining to meet the target, has actually increased. The Government should perhaps have taken to heart the lesson handed down to us by our under-appreciated and only Danish king, Knut, that there are some forces that even the most powerful temporal authority cannot control by dint of command.

Instead of carefully devised, long-term strategies to tackle this problem, we have a statutory target. What are statutory targets? They represent a clear-cut constitutional innovation by this Government, but one of dubious value. What happens if they are missed? Nothing, it seems. When missed targets have been tested in court, such as the fuel poverty target set in the Warm Homes and Energy Conservation Act 2000, little, if anything, has emerged. In that case, the Government were able to plead, successfully, that resources were not available, so statutory targets do not seem to wield teeth.

What happens when the targets in this Bill conflict with the requirement in the fiscal responsibility Bill, which the Government are introducing, to reduce the budget deficit? Which target takes precedence? What protocol should we have to decide such a question? Considerations such as these lead one to conclude that these targets are in effect worthless. They are commands to stop the waves. At least King Knut knew he was making a demonstration. But these targets are worse then worthless. To the extent that they are acted on, they could actually encourage us to concentrate resources on the wrong things. What we have here is not a child poverty target but an income inequality target. As Neil O’Brien, the director of Policy Exchange, warned the Public Bill Committee in another place last month, that will drive government,

“relentlessly towards downstream intervention to give people income, rather than upstream intervention to tackle the causes”.—[Official Report, Commons, Child Poverty Bill Committee, 22/10/09; col. 101.]

We should concentrate our efforts on the complex underlying causes of child poverty, not on tipping families’ incomes over some arbitrary relative-income mark. That is much harder to achieve, as this Government have demonstrated in their 12 years in power.

To conclude, I am afraid that we are disappointed by the changes proposed in Her Majesty’s gracious Speech. We see targets, pledges and promises, some with worthy roots. Unfortunately, however, the Government cannot just legislate policy outcomes into being; they need real backing and substance. The overwhelming impression left by the Queen’s Speech is that this Government have run out of ideas, out of drive and out of coherent strategy. We are reaching the end of this Parliament with a Government who have let the reform of the NHS grind to a halt; a Government with an education system from which a quarter of a million pupils left primary school this year unable to read, write or add up properly; a Government who have failed to reach more than half their equality targets; and a Government who look set to fail monumentally to achieve their next year’s child poverty target. One message emerges loud and clear from the Queen’s Speech; it is time for a change.

My Lords, it is a pleasure to open the contributions from these Benches to the debate on the humble Address today, which covers such important matters as equality, social affairs, health and education. I will concentrate my remarks on education and children, this being my portfolio, and leave the other matters to the galaxy of talent arrayed beside and behind me. I, too, look forward to the two maiden speeches.

At this stage in any Parliament, it is tempting in a debate such as this to review the Government’s record and this afternoon I have no intention of resisting that temptation. I am afraid that I have rather a lot of negative things to say but, before I do so, I will pay a few compliments. It is true that this Government have tried to do more for children than any other recent Government. The results of their efforts may be limited, but I for one have never denied their good intentions and I do not do so now. I may differ from them in the way in which I would achieve the much needed improvements in the lives of British children, but I share the Government’s intentions on the whole. Their greatest success has been in the sphere of early years, where the Sure Start children’s centres, based as they are on multidisciplinary working, enable problems to be identified early and help to be given.

Before I turn my attention to the legislation that we are promised and that is within my portfolio, I will review where we have got to in the past 12 years. The Government have been far from inactive. Since 1997, the variously named education departments have produced 11 Green Papers, nine White Papers, 11 education Bills, 500 press releases and 1,800 statutory instruments. Each year, the amount of guidance sent out by the Department for Children, Schools and Families amounts to 4,000 pages of documentation, which is more than the King James Bible. The Bills relating to children brought forward by the Home Office and the Ministry of Justice are too numerous to mention. We have had a £500 million literacy strategy, a numeracy strategy and the Every Child a Talker strategy, which I welcome.

There is no doubt that more money has been spent on education and on the fabric of school buildings. We have had money and legislation by the bucket load, but have we had progress? Perhaps we should compare a few statistics. In 1997, after 18 years of a Conservative Government, more than half—54 per cent—of 15 year-olds failed to achieve five good grades at GCSE. In 2008, according to the DCSF’s figures, more than half of 16 year-olds failed to achieve five good GCSEs including English and maths. In 1997, only 63 per cent of 11 year-olds reached level 4 in English. In 2009, we still had one-fifth of children leaving primary school without being able to read and write properly.

In 2008, the equivalent of 2 million more school days were lost than in 1997 as a result of truancy. In 1996, according to a survey by the Association of County Councils and the Association of Metropolitan Authorities, 600 schools still had outside toilets and there was a £32.2 billion backlog on school building repairs. That situation has much improved. There are no outside toilets. The Government must be flushed with success. But the Building Schools for the Future programme is two years behind schedule and still if you want a new school it usually has to be an academy, whether you like it or not. Since 1997, the number of young people not in education, employment or training has gone up despite the Government’s best efforts. Despite the target of reducing NEETs to 8 per cent by 2010, nearly 12 per cent of 16 to 18 year-olds are currently in this category.

Even more worrying statistics relate to the discrepancy between the life chances of children in different demographic groups, a matter that I would have thought would be a top priority for a Labour Government and certainly would be for a Liberal Democrat one. Fewer than one in four children entitled to free school meals achieve five good grades in GCSE including English and maths. Only 7 per cent of children in care achieve those grades in all subjects, compared to 62 per cent of all children, despite the Government’s target of 15 per cent for this category of children. This Government have been ambitious and very keen on setting targets for themselves, but last December the DCSF admitted that it had failed to achieve half of them.

Research has shown that many more schools in poorer areas than those in richer areas fail to meet the Government’s target of 30 per cent of children achieving five good passes in GCSE including English and maths. It seems that, while the gap between rich and poor has widened under this Government in economic terms, so has the gap in educational terms. There is a strong correlation between socio-economic background and educational achievement, with its consequent negative effect on social mobility, and that is after 12 years of a Labour Government. As regards children’s rights, the rights that a child can expect to be honoured are determined by the setting in which he finds himself, but we will debate that in more detail, I hope, during Second Reading of my Private Member’s Bill on children’s rights.

This Government seem to believe that if you legislate it happens, but it does not. It is just like a child writing out his Christmas list for Santa, pushing it up the chimney and then waiting confidently to see lots of interesting lumps and bumps in his stocking on Christmas morning. But it is not like that in the real world. In the real world, Santa’s little elves have to do a lot of very hard work to make the toys. Here, I am drawing a parallel with teachers.

Most people in education know that driving up standards, the stated objective of this Government, is best done by taking note of good research and by investing in high-quality teachers and school leaders and then giving them the training, support and freedoms that they need to do the job, rather than by constantly imposing new bureaucratic burdens. Even before legislating, the Government have failed to take account of evidence in setting their priorities, a good example being the profligate way in which they threw away years of detailed research when they arbitrarily dismissed the findings of the Cambridge Primary Review.

Take class sizes. Official statistics in May this year showed that 10,000 five to seven year-olds were in unlawfully large class sizes—that is, over 30. England’s primary school classes are among the largest in the developed world, the average being 26. Among the OECD countries, only Japan, Korea and Turkey have larger ones. This is despite clear evidence that class size matters a lot at this age and despite the Prime Minister’s declared aim of reducing class sizes to those that exist in private schools. Indeed, I do not think it a coincidence that, while this situation exists, the UK has plummeted down the international league tables of reading and maths standards. Unless the child gets a good start at school, it is very difficult for even the best teachers to correct the situation. The Liberal Democrats are committed to a costed policy of reducing infant class sizes to 15 so that the teacher has enough time with each child, a policy that neither of the other parties will fund.

After 12 years of Labour government, we still live in a country where performance at school is determined by how rich your parents are and where you grew up. The poorest children currently fall behind before they even start school and often fail to catch up. We on these Benches want to break the link between social background and academic performance so that all our children can fulfil their potential. That is why we have devised a pupil premium, increasing the funding for the poorest children to private-school levels—and, unlike the Conservatives, we have said how we would fund it.

Apart from driving up standards, this Government have made a great thing about parental choice. I have no problem with that as long as it is real choice. However, in January 2009, one in six parents did not get their first choice of secondary school for their child and over 20,000 parents did not get their child into one of their top three. Children themselves are not getting a true choice of curriculum in school. Many schools no longer offer a GCSE course in a modern language. There is much evidence that schools are choosing exam courses with the infamous league tables in mind rather than offering what is best for the children. Courses with four GCSE equivalents are offered to boost the school’s position in the league tables instead of others that are perceived to be more difficult. These league tables have skewed our education system and stifled choice to a horrifying extent and it is high time that they were abolished.

Let me now turn to what is on offer in this short parliamentary Session, the swansong of this dying Government. We are offered a pick-and-mix schools Bill that is worthy of the late, lamented Woolworths. The Children, Schools and Families Bill, which is to start its progress in another place, contains one or two desirable things, such as the mandatory PSHE, which the Minister mentioned and for which I have long campaigned. In parenthesis, I assume that the courses will contain the material about the unacceptability of domestic violence, on which I congratulate the Government.

However, much of the rest of this Bill is premature, unpiloted and no more than aspirational. Indeed, it even amends measures in the apprenticeships Act on which the ink is hardly dry since we passed it through this House no more than a month ago. Little did I know when I expressed concerns and reservations about the new schools complaints system a few weeks ago that the Government were already planning to open the floodgates with a whole lot more meaningless opportunities for parents to complain. I was staggered when I read the first clause of this Bill, about pupil and parent guarantees, to find that it contains a set of “ambitions” for pupils and “ambitions” for parents. I have never come across this expression in a piece of legislation coming before this House in the 10 years that I have been here. I can only surmise that this Bill is no more than a lot of ambition with no prospect whatever of becoming law or providing anything real to the children of this country. I looked in a little more detail and consulted my Oxford English Dictionary, where I read that the word “ambition” means,

“a strong desire to do or achieve something”.

The root of the word, I discovered, comes from the Latin “ambire”, meaning,

“to go around (canvassing for votes)”.

I leave your Lordships to draw their own conclusions about the real purpose of this piece of legislation.

But what are these ambitions? Does the list contain the ambition for every child to fulfil his true potential, as suggested by the Minister? No, it does not. Schools can carry on concentrating on the C/D borderline at GCSE in order to protect their position in the league tables instead of helping the potential grade F pupil to reach grade E or the B-grade student to raise his sights to an A. But no, the first ambition is for all pupils to go to,

“a school where there is good behaviour, strong discipline, order and safety”,

motherhood and apple pie for lunch every day. I jest about the last two, but this ambition raises a serious point about the safeguarding of children in schools.

I have seen research where members of school staff have been convicted of child abuse offences against pupils, some of the gravest severity, and yet a subsequent Ofsted inspection bears no reference to the failures that might have contributed to the abuse. Neither have the failures to safeguard been inspected again to ensure that no such thing ever happens again. It is the duty of parents to hold schools to account for the safeguarding of their children, but parents look to Ofsted for evidence of this and Ofsted is failing in its duty to parents. What is more, the DCSF is not holding Ofsted to account for this failure. Unless that changes, the Government’s ambition of a safe school for every child will not be achieved. Will the noble Baroness, Lady Morgan, agree to meet me to discuss these very serious problems to which solutions have already been found in other common law countries?

I will mention only one other item in the Bill, which is the proposed introduction of a new licence to practise for teachers. I believe that that is premature. It is essential that the Government should carry through their welcome commitment to introduce an entitlement to continuing professional development for teachers before introducing a licence to practise or it will be meaningless and people will get around it. That entitlement needs to be real and comprehensive so that all teachers have a fair and equitable chance to meet the requirements of the new licence—and, of course, the quality of the CPD experience is crucial. If we simply add the licence to practise as another layer of accountability on to teachers and schools, the message that they will take from the initiative will be not that they are trusted, but rather the opposite, which would be a disaster.

I look forward to debating all these issues in greater detail at the Second Reading of the Bill. I also welcome the Child Poverty Bill, in which I will take part. First, however, I look forward to the Minister’s response to the debate.

My Lords, I want to make particular reference to two linked elements in the gracious Speech, referring to child poverty and the Equality Bill, leaving matters of health and education to our own galaxy of talent on this Bench. I welcome the Child Poverty Bill and I hope that we will pass it into law as soon as possible. The commitment expressed here to deal with this most pervasive of social injustices has been a welcome part of this Government’s policy. I have three particular comments to make.

First, we are becoming more aware of the need for a minimum income standard for individuals and families. I hope that the Government will commit themselves to having regard to independent research on minimum incomes in this legislation so that we have some independent knowledge of the minimum income necessary to live a fulfilled and effective life. Secondly, we need to watch the prevalence of poverty not simply in the child population as a whole, but in particular groups. For example, the recent report from Save the Children and the Family Fund reveals that 27 per cent of disabled children live in poverty. That continues to be a terrible indictment upon our society. I hope that the Child Poverty Commission, which I welcome, will look carefully at the needs of particular groups in society as it develops its work.

Thirdly, the danger of legislation such as this is that it can make it appear that poverty issues are only for government. Legislation will not work unless others, too, respond to the challenge, including schools, churches and church-based charities. In that connection I salute the work of Church Action on Poverty and Christians Against Poverty in responding to real need. I went to a meeting a few days ago in Leeds of Christian groups which respond to poverty issues. They presented the work that they do to help the homeless, asylum seekers and those who at a very young age move into prostitution. These are all examples of poverty, including child poverty, which Christian groups and many other groups seek to tackle at local levels. We need to continually stress and welcome the role of the voluntary sector in dealing with child poverty.

My response to the Equality Bill is mixed. I welcome the bringing together of disparate strands of equality legislation and I am particularly grateful for the legislation on disability and the way in which it is brought together in the Bill. I had the privilege last night of taking part, with the noble Baroness, Lady D’Souza, in a memorial event for the late Baroness Chapman of Leeds. It was a wonderful occasion, bringing together at Elland Road her passionate advocacy of the rights of the disabled to equal treatment and her equally passionate support of Leeds United. I am delighted that the Equality Bill responds to and develops the former of those passions, and I hope Ministers have noticed the rise in the fortunes of her and our football club.

However, at the heart of the equality legislation there is a fundamental dilemma. The Nobel Prize-winning economist Amartya Sen commented:

“Everyone is in favour of equality: they just cannot agree about equality of what”.

We see this played out time and again in debates about education—equality of opportunity, of provision, of freedom to choose, of outcome. There are times when they are incompatible and choices need to be made. In the Bill there is a dilemma between freedom for individuals to shape their own lives and freedom for groups and communities to define the nature of their common bond. In a pluralistic society, there must be freedom for communities with particular identities to flourish. The Bill is grounded in a view of society as a collection of individuals with rights but fails to take account of the needs of communities to flourish. That can quickly lead to an authoritarian imposition of an individualistic understanding of difference rather than a celebration of plurality within our society.

The Bill, absolutely rightly, defends people from oppression and discrimination, which is why the clauses dealing with disability are particularly welcome. It fails, however, to reflect the way in which faith groups, including churches, must operate in a plural society. For example, the definition of employment for the purposes of an organised religion defines that employment as,

“leading or assisting in the observation of liturgical or ritualistic practices of the religion”,

or,

“promoting or explaining the doctrines of the religion”.

I cannot imagine that any Christian would recognise their faith in those descriptions, and I do not believe that it would be true of those of other religions either. Christian belief and the doctrines of religion are promoted through the whole life of the believer. Faith is not an add-on, but integral to the whole of life and behaviour. In practice, especially in smaller churches or faith groups, many employees play a multi-tasked role which could fall foul of the requirement that their employment wholly or mainly involves leading worship.

There remains an inadequate social analysis underpinning the Bill. It fails to take seriously the right of communities in a plural society to order their own life, yet our society is dependent for its common good on the flourishing of such communities. The Bill allows exemptions to religious groups only on grounds which fail to understand the nature of religion itself, and so it fails to provide an equal freedom to practise a religion according to the beliefs, practices and ethics intrinsic to that faith.

That is damaging both to individuals and their practice of faith, and to the contribution which religious groups seek to provide to our plural society, not least in the eradication of child poverty, as in the examples which I have used, which is so rightly dear to the heart of this Government.

My Lords, when I entered this Chamber for the first time, I did so from the Moses Room. I thank noble Lords for the extraordinary lengths to which they went to make a rabbi feel at home. Today, I feel the other side of that occasion, for it was Moses at the burning bush who felt so overwhelmed by emotion that he told God that he could not speak; he was,

“not a man of words”.

Mind you, that did not stop him speaking a great deal thereafter. In fact, on one occasion, when pleading with God to forgive the people for making the golden calf, he spoke for 40 days and 40 nights. However, on another occasion, when asking God to heal his sister, Miriam, he limited himself to a mere five words. I am told by your Lordships that, when making a maiden speech, it is better to err on the side of the latter than the former; and that I will try to do.

The powerful emotion that I feel today is simply explained. My late father came here as a child fleeing persecution in Poland. My mother’s family had arrived here somewhat earlier. And the love they felt for Britain was intense. It took me a while to understand it, but eventually I came to realise what so many Jews in Britain know in their hearts and their very bones: that had it not been for this country, their parents or grandparents would not have lived and they would not have been born.

That visceral sense of indebtedness to this country is what made Jews want to give back, to contribute to society as a whole, which they did with all their heart. They contributed to its arts and sciences, its law and medicine, its business and finance, its Armed Forces and its public life, its charities and its voluntary associations. And they wanted us to do the same, to be proud of being British and be proud of being Jewish, seeing no contradiction between the two but, on the contrary, a mutual reinforcement. I believe that the same is true for other minority groups in this country.

My late father had to leave school at the age of 14 to help support the family, and he wanted us, his four sons, to have the education that he lacked. For that, too, I am deeply grateful. We were able, all four of us, to go to university, the same university that educated a Foreign Secretary of Israel, Abba Eban, who began his speech, when he returned there many years later to receive an award, with the words:

“It was here that I learned the honesty, integrity and love of truth that have been such a disadvantage to me in my political career”.

I, too, learnt lessons there that I will never forget. I was religious; my doctoral supervisor, the late Sir Bernard Williams, was Britain’s most intellectually gifted atheist. Yet never once did he deprecate or even challenge my religious faith. For we were both equal participants in that collaborative pursuit of truth that Judaism’s sages, long ago, called,

“argument for the sake of heaven”.

It is this that I have rediscovered in your Lordships’ House. What extraordinary things happen here. When somebody speaks, other people listen. When people disagree, by and large they do so politely. What special gifts these are in this age of clashing soundbites, diminishing attention spans, angry voices and gladiatorial politics. I hope that, whatever constitutional changes are in store for this House, those things will always be preserved. For what I have found in your Lordships’ House, and what I learnt at university, are the foundations of the virtues that made Britain the country my parents loved: its tolerance, its decency, its undemonstrative but indomitable sense of fairness and justice.

With this, I come to my point. Democratic freedom is not just a matter of political arrangements, of constitutions and laws, elections and majorities. It depends, too, on what Alexis de Tocqueville called “habits of the heart”: civility, the willingness to hear the other side, respect for those with whom you disagree, and friendships that transcend the boundaries between different parties and different faiths. And those things must be taught again and again in every generation.

If there is one insight above all others to be gained from Jewish history it is that freedom depends on education. To defend a country, you need an army, but to defend a civilization, you need schools. Abraham was chosen, says the Bible, so that he would teach his children to practise righteousness and justice. Moses commanded, in what has become the most famous of our prayers:

“You shall teach these things diligently to your children”.

In ancient times, the Egyptians built pyramids, the Greeks built temples, the Romans built amphitheatres, but Jews built schools. And because of that, alone among ancient civilizations, Judaism survived.

I wonder whether, even now, we value teachers sufficiently highly, for they are the guardians of our liberty. Schools teach us theories and facts. They help us answer the question, what do I know? Schools teach us skills. They help us answer the question, what can I do? But they also teach us the story of our nation, what freedom is and how it was fought for, and what battles those who came before us had to fight. They help us to answer the questions: who am I, of what story or stories I am a part, and, how then shall I live? They teach us about keeping faith with the past while honouring our obligations to the future. At best, they teach us collective responsibility for the common good.

Sadly today, schools have to fight against a culture that sometimes overvalues material success. Some years ago I visited a school whose children came from affluent backgrounds. They told me that the previous week an inspector had visited the school and tested the children—they were seven or eight years old—on their vocabulary. He asked the class, “Who can tell me the meaning of the word ‘economy’?”. One of the children put up his hand and said, “Please sir, that’s where the other people sit on a plane”. True story.

Thankfully, such things are rare. Therefore, with your Lordships’ permission, I simply wish to say: let us value our teachers, celebrate our schools, keep education at the top of our priorities, and we will raise a generation of British children who will make us proud.

My Lords, I feel sure that noble Lords from all sides of the House will agree with me that the maiden speech just delivered by the noble Lord, Lord Sacks, was deeply moving, filled with wise and cogent comment and tinged with quiet but perceptive humour. This is not really surprising, given the brilliance of his academic career both religious and secular and his willingness to enter into meaningful dialogue with people of all faiths and none, together with his clearly demonstrated belief in the value of education. It is through education that people can celebrate their diversity of culture of background as well as gaining a deeper understanding of each other. That, more than anything else, could probably lead us to a more peaceful and just world—which, I hope the noble Lord, the Chief Rabbi, will allow me to say, heaven alone knows we need. He is a great ambassador not just for the Jewish community but for our wider society and the values that we all hold so dear, as his many broadcasts and articles regularly demonstrate. I look forward, as I am sure we all do, to his participation in the business of this House with much pleasure and anticipation.

I turn to today’s debate on the humble Address. I declare an interest as a commissioner on the Equality and Human Rights Commission. I will confine my remarks to those relating to the Equality Bill, health and care.

Equality in this sense is not about sameness but about the ability of everyone to achieve their potential and to flourish. To that extent, the Bill is well framed and proportionate. It will help to unblock some of the systemic problems that may get in the way of equal opportunities for everyone in Britain. It should improve public service delivery and business performance; we can ill afford to underutilise or neglect the skills and talents of all our people. It extends protection to the wide range of groups that unfortunately still face discrimination today.

The unfairest inequality, perhaps, that any of us may face is that of access to healthcare. Unfortunately, in 2009 health inequality remains a major problem facing us in the United Kingdom. The Health Select Committee in another place conducted its own inquiry into this issue, and in March this year published its third report into health inequalities. It found that the health of people in England has improved markedly over the past 150 years, as we know, but, despite these huge improvements, there are marked differences in the health of different groups.

Perhaps the most dramatic difference is what amounts to a death sentence: if you live in the better parts of west London, you will have 10 years or more longer to live than if you happen to be born in the poorer districts of Glasgow. This is actually grotesque, and we cannot continue to tolerate it. The difference in life expectancy is between 87.8 years and 77.1 years, and that cannot continue.

Health inequalities are apparent not only between people of different socio-economic groups but between men and women, between different ethnic groups and particularly among older people with mental health problems or with learning disabilities. This is not surprising in the case of older people, given the discrimination that they still often face. Drug trials, for example, are often carried out on younger people and the drugs are then prescribed to older people without full knowledge of the difference in how they will affect them. Treatment is still often denied to older people. People with dementia are often not diagnosed.

In June this year Professor Sir Michael Marmot published an interim review of health inequalities in the United Kingdom. The review will contribute to the development of a cross-government national health inequalities strategy, which is desperately needed. A key issue, though, is who will pay for this and who will provide it. Methods of both accessing care and providing it are changing, as are consumer attitudes, expectations and demands. I hope that the Minister can give us an assurance that these problems will be addressed quickly.

One area where there are particular issues of inequality and discrimination is in dementia, in terms of access, diagnosis, treatment and care. We know now that one in three people reaching the age of 65 will die with dementia, and numbers are rising all the time. In response, in February this year the Government published the National Dementia Strategy in England, which was a welcome sign of hope, setting out a road map for improvements in dementia services. It is essential that the strategy is translated into practice as a matter of urgency, and I hope that we can be reassured on this point.

The numbers here are significant. In February 2007 the Alzheimer’s Society, in conjunction with King’s College London and the London School of Economics, published a major study on the social and economic impact of dementia in the United Kingdom. The report showed that as the UK’s population ages, the number of people with dementia will grow substantially. It also showed that there will be more than 1 million people with dementia by 2025, and the financial cost of this disease to the UK is more than £17 billion a year.

We must urgently develop safe and effective treatments for people with dementia. Unless researchers develop new treatments, within a generation 1.4 million people will live with dementia in the UK alone. The summit recently convened by the Government and the Medical Research Council, which I was privileged to chair, pointed to the urgency of putting in place a co-ordinated research strategy that needs to be implemented immediately, and which will ensure that nationally and internationally co-ordinated registers are kept.

The expenditure on dementia is £11 per person, while on cancer it is now £300 per person in this country. Cancer research altogether accounts for £248.5 million—for dementia, the figure is £32.4 million. The difference is extraordinary when you consider that more people suffer from dementia than from cancer. Research into dementia must be greatly increased, with appropriate funding commensurate with the huge numbers of people who experience some form of this disease, and it must be introduced rapidly.

Professor Martin Prince at the Institute of Psychiatry at King’s College said last September that by next year there will be 35 million people globally with dementia. By 2030 that figure will double to 65.7 million, and will be more than 115 million by 2050.

In April of last year, the All-Party Group on Dementia published a report, Always a Last Resort, which revealed that up to 105,000 people with dementia are given antipsychotic drugs inappropriately. Thankfully, a tough new action plan to tackle the overprescribing of antipsychotic drugs was announced on 12 November by the Care Services Minister. Phil Hope. The action plan responds to an independent review by Professor Banerjee, commissioned by the Department of Health, and calls for the introduction of protocols for the prescribing, monitoring and reviewing of antipsychotic medication for people with dementia. That must be implemented immediately, and I hope that the Minister will be able to assure me on that point.

More recently, on 17 November, the Alzheimer’s Society report Counting the Cost: Caring for People with Dementia on Hospital Wards, which was based on a survey of 2,427 people with dementia and their carers, nursing staff and nurse managers, found that 47 per cent of carers said that being in hospital had a significant negative effect on the health of the person with dementia. Meanwhile, 89 per cent of nurses said that people with dementia were treated with dignity and respect, but 36 per cent of carers said that they were not. We know that more than half of the people who have dementia and go into hospital with a broken or fractured hip stay for two weeks or more, and that people who do not have dementia come out in far less time. That has a huge cost to the nation, and if it was replicated across the whole country the costs would be extraordinary.

In June this year, I chaired a dementia round table here in the Lords which revealed that while much of the basic work has been done, none of the existing strategies or recommendations was dementia-specific or covered the broad range of care, cure, cause and prevention—specifically, in looking at research. The overuse of antipsychotic drugs is a particularly insidious form of inequality and an infringement of human rights. Then in October, the Nuffield Council on Bioethics published a report on the ethical issues around dementia. It felt that the concept of “supportive care” is particularly helpful in dementia, by emphasising the need to support both the person with dementia and their family from the moment of diagnosis onwards. That would have a hugely beneficial effect, and I hope again that it will be introduced speedily.

Lastly, on care, people with dementia are deemed to be in need of social care when they are in fact suffering from a terminal illness. This form of discrimination differentiates them from most other very sick people, who can benefit from NHS care that is free at the point of delivery. It leads to the current complex and incomprehensible system which people have to navigate, and through which they often pay out huge sums of money at a crisis point in their lives when they are at their most vulnerable.

I look forward to the forthcoming Green Paper; that must lead quickly to a White Paper and legislation representing political consensus on a long-term agreed policy, which will be fair to dementia sufferers, to their carers and to future generations as a cornerstone of sound equality policy. That is something we could all support with enthusiasm and immense relief.

My Lords, I, too, offer my congratulations to the noble Lord, Lord Sacks. I should like to crave his indulgence in the future should I attend any of the classes that he proposes.

As someone who has had decades of experience in promoting race equality, I have a special interest in the Equality Bill and its provisions. However, today I will concentrate on a provision that is much needed in that Bill but has been left out. My suspicion is that there is little or no concern in the Bill for tackling the institutional racism that is still inherent in British society, as evidenced so vividly by the resurgence of support that the BNP has received in this country and in Europe. While I accept that the BNP’s status will always remain as a minority party, my concern is that the Aryan myth of white superiority that underpins it is alive and well among many more than those who vote for that party. These myths and beliefs translate into action in competitive situations with a crucial impact on the life chances of black people. They do so now but, unlike in the past, there are more subtle and insidious ways in which they rear their ugly head.

Discrimination is now buried in phrases like, “Employers want to hire the best person for the job”. No one, black or white, would disagree. However, the invariable outcome would lead to the illogical conclusion that no black person could ever succeed in any labour market when the competition is with a white person, especially for management posts. Does the Bill before us equip us to engage practically, positively and decisively with such an environment? I think not. The Bill uses the term “as qualified”; the guidance notes use “equally qualified”. I am ashamed to say that I heard one of my honourable colleagues speak of “equally acceptable” as a criterion when seeking to establish the principles of equality.

When a black person is “equally acceptable”, what does that mean—and in what way, in the context of the Aryan myth? Above all, will the Bill prove more effective than the Race Relations Act in allowing black people to prove that they were discriminated against? Will it also allow them to access the professional legal resources necessary to obtain justice through the judicial system? I suspect not. I find the Bill not fit for purpose in this area; I think that the words would be “a paper tiger”. The belief that the tribunal system is a quick and easy solution for redress for a person who feels that they have been discriminated against is false and erroneous.

Companies involved in such litigation have access to skilled professional practitioners experienced in the use of procedure, artful in interrogative techniques and sophisticated in adversarial encounters. Unleashed, they would terrify all but a minuscule number of confident and equally sophisticated complainants. Most black people would have to fend for themselves alone and unaided. Experience at a tribunal can therefore often achieve the reverse of its intention, by further aggravating the distress suffered and leaving the individual doubting the authenticity of the discrimination that they suffered. I have seen that happen time and time again.

I suggest that the Equality Bill needs to be reconsidered and to have installed within it representative actions in all such cases of racial discrimination. This approach is not novel to government. It would put a brake on the number of cases and reduce the professional costs of bringing actions and the time and cost of the tribunal system. Only then will I feel that the ambitions enshrined in the Bill might in any way be met.

My Lords, I add my congratulations and, indeed, thanks to the noble Lord, Lord Sacks, on his moving and brilliant speech, which, above all, reminded us of why we love our country. In light of the long list of speakers today, I shall concentrate my comments only on the education proposals in the gracious Speech, although with some self-denial in not responding to the points made by the noble Baroness about dementia.

It was with some sinking of the heart, I confess, that I heard that we were going to plunge into late-night sittings on a Bill which, as far as one can see, offers too many empty promises, encourages hopes with no practical proposals as to how they could be fulfilled, and invites litigation from parents with no prospect of meaningful redress. It stuffs yet more social issues into an already crowded curriculum, adding personal, social health and economic education and, as we were told yesterday, education about domestic violence, to the mandatory subjects. However laudable these subjects are, one wonders how many schools have the capacity to deliver this. I know that this is a worry shared by the head teachers’ associations.

Perhaps a better strategy to meet the country’s urgent need for science and engineering specialists would have been to guarantee, for example, an entitlement to all who wish and are qualified to do so to follow the triple-science GCSE, which has been shown to increase both interest and performance in A-level sciences. Instead, it seems we are to have a Bill which guarantees every child the right to a good education. This comes from a Government who, despite their good intentions—which I do not doubt—have just been told by Ofsted that one-third of schools are failing to offer a good education to their pupils; and a Government who have presided over a regime under fire from senior managers in schools, leading teacher unions and respected academics. I will not repeat the many statistics of the noble Baroness, Lady Walmsley, but there is a clear demonstration that many things have not been successful in the education world and the education policies of the current Government.

The criticism, however, from both practitioners and academics, backed by meticulous observation and research from the Cambridge Primary Review, as well as parental experience, is directed at the oppressive target-setting, inspection, testing and examinations regime, which has so sadly restricted the creativity of teachers and, in so doing, has threatened the creativity of their pupils. Teachers’ unions have no expectation that the proposed report card will alter this regime. More seriously, the research from Cambridge and elsewhere has demonstrated that this targeted test-results regime has failed both the least able and the most able of this generation of young people.

Why is this so? It is because the test results now carry a huge weight of implications for the funding of the school and the salaries of the teachers. Understandably, therefore, the teachers spend time working to maximise the number of pupils reaching the modest C grade on which their success is calculated. They simply cannot afford the time to help those struggling too far below that level, or to stretch and inspire those who are far above it. The pressure that this system induces is not confined to teachers and head teachers. It is, so parents report, passed on to pupils, who feel that they are now responsible for their teachers’ welfare, as well as for the standing and prosperity of their school. Parents tell us that even young children in primary schools, which love their teachers and want to help them, suffer disturbed sleep patterns and increased anxiety when testing time is coming.

Legislative guarantees cannot guarantee a good education for every child. The Education Act 1944 laid down an entitlement for every child to an education suited to their age, ability and aptitude. It was a noble ambition and has guided much education legislation in the 60-plus years since it was passed. Sadly, we know all too well that many children never receive such an education. Now Ofsted’s stark report tells us that we are failing perhaps one in three of our young people, and we know that over half of 16 year-olds fail to reach the minimum standard of five good GCSE grades, including English and maths.

I find it dispiriting in the extreme that the Government’s response to the barrage of evidence that they are on the wrong track with the current regime is to turn to more legislation, as if an Act of Parliament could magically ensure that every school becomes a good school; that generations of social and educational deprivation can be swept away because Whitehall has so decreed; and that parents whose child is failing in school can turn to the courts to wave a wand and turn their children’s school into a high-achieving success. What kind of thinking has convinced the Department for Children, Schools and Families that legislation is the key to raising standards for every child in every school?

I am deeply sad. So much additional money has been poured into education by the Government that a real opportunity to make a difference could have been seized. Of course, some good things have been achieved, but we have had ever-tightening control from Whitehall, endless legislation from the DCSF—I think we are now into the 11th Bill in 12 years—and more and more restrictions on the freedom of teachers and schools. Much of the extra money has come in packages to implement ministerial priorities, not to help with the priorities which teachers and heads know are right for their school.

There is only one guarantee of quality in education, and it is the quality of teaching. When the classroom door is closed, it is the interaction between teacher and pupil which determines the learning experience. The support which is needed is to restore the morale, creativity and professionalism of teachers. We have a superb teaching force—among the best in the world—yet it has been restricted and controlled in the past decade as if teachers were low-grade, semi-skilled workers, incapable of operating a curriculum and methodology appropriate to their pupils and their needs.

A word of caution must also go to the laudable effort to guarantee remedial help for children falling behind by offering them individual tuition. As Sir Jim Rose’s study pointed out, one-to-one teaching for these children helps them to succeed. That is hardly surprising. Of course, individual tuition works, but for many schools in the most deprived areas the offer of such provision is simply unrealistic, since it is not an occasional child who needs extra help, but the majority. There are schools where the majority have English as a very poor second language, or lack parental support, and who bring with them into school the deprivation and despair of their family and community. What school can offer several hundred children the one-to-one tuition that we all agree would help?

Finally, the proposals for a licence to practise could be helpful if the licence were really used to raise the professional status of teaching, and if resources were found to provide the promised entitlement to further professional development. As the National Union of Teachers points out, continuing professional development is very patchy, and many schools are unable to meet the wishes and needs of teachers for further training. It is highly unlikely, in the present financial climate, that such resources will be found. The best way to raise the status of teachers, which is a key ingredient in the success of countries which top the international league table and the best guarantee of raised standards, is to take away the dead hand of central control—of Whitehall coming between teacher and pupil—and allow teachers to put into practice the extensive and expensive years of training that they have undergone before entering the profession. In short, if we care about excellence in education, we must learn, as our Scandinavian friends teach us, to trust our teachers.

My Lords, it is part of the custom of the very agreeable fellowship that is our House to praise maiden speakers, but the speech that we heard from the noble Lord, Lord Sacks, is in a class of its own. I cannot remember listening to a maiden speech that was as moving, witty, shrewd and wise as his. As a secular Jew who shares the noble Lord’s ethnicity but not his faith, it is a particular joy for me that he is in the House to add to our wisdom. I shall say a little more about religion later.

At long last the Equality Bill is about to reach the House. What is the role of legislation? Law is not a panacea in promoting equality of opportunity and combating unjustifiable discrimination and it cannot by itself change hearts and minds, but it serves important purposes in tackling complex social problems. It gives support to those who do not wish to discriminate but feel compelled to do so by social pressure. It gives protection and redress to everyone, including members of minority groups, and it provides for the peaceful and orderly adjustment of grievances and the release of tensions. Law reduces prejudice by discouraging the behaviour in which prejudice finds expression. It is based on our common humanity as individual human beings rather than as separate communities.

Unjustifiable discrimination involves not only direct discrimination, the less favourable treatment of individuals on forbidden grounds, but indirect discrimination—practices and procedures operated by employers and service providers which apply equally to everyone in a formal sense but which hit disproportionately at particular groups and have no objective justification. Individual litigation by alleged victims is not always the best way to eliminate discrimination, and positive duties on public authorities and large private bodies to promote equality and eliminate discriminatory practices are essential. There needs to be professionally conducted and effective monitoring without creating paper mountains or unnecessary bureaucracy. Government need to set a good example, and the values underpinning the law need to be translated into voluntary action.

The Equality Bill seeks to harmonise discrimination law and to strengthen the law to support progress on equality. Those aims will surely be welcomed across the House. In its 1997 election manifesto, new Labour pledged itself to tackle unjustified discrimination wherever it exists. The Government can be given credit for an impressive list of achievements in that direction, all of which have had consistent support from Liberal Democrats. The Minister has referred only to some of them. The Human Rights Act has enabled claims to be brought in our courts of unjustifiable discrimination in breach of the convention rights, such as the right to education or to property. The anti-gay Clause 28 has been abolished. The Race Relations Act has been strengthened by placing public authorities under a general duty to eliminate unlawful discrimination and promote equal opportunity and good relations between people of different racial groups. The Civil Partnership Act gave legal protection to gay and lesbian couples. The Gender Recognition Act gave rights to transgender people. The Disability Discrimination Act 2005 enhanced the earlier one. The Government have supported EU initiatives that resulted in new equality directives and sets of implementing regulations. The Equality Act 2006 created a single Equality and Human Rights Commission, extended the public sector duty to gender, and made provisions to make religious and sexual orientation discrimination unlawful.

It is an impressive list, but the accumulation of so many piecemeal measures and inconsistencies of legal definition, as well as the absence of a coherent set of governing principles, has created a great barrier reef of different statutes, regulations, procedures and codes of practice, as well as of European legislation and case law.

It is more than eight years since I drew attention to the pressing need for a single Equality Act after four years of trying to persuade Ministers of the need for reform. In her reply to the debate, the noble Baroness, Lady Blackstone, recognised that I had, in her words,

“made a powerful case for grasping the opportunity for comprehensive reform”.—[Official Report, 25/4/01; col. 312.]

Unfortunately, the Government failed to do so. Instead of carrying out comprehensive reform of the mess of current legislation, the Government set up the Equality and Human Rights Commission, putting the cart before the horse. The Ministry of Justice refused to take any responsibility for the commission, and major errors were made, undermining confidence in that much needed body. The work on law reform was deeply flawed and botched during the first attempt under different ministerial leadership from the present leaders.

But the Bill before us deserves our support. I look forward to the speech of the noble Baroness, Lady Verma, for the Official Opposition at the end of the debate because I hope and believe that there should be wide support for this measure. I do not at all share the viewpoint of the right reverend Prelate the Bishop of Ripon and Leeds on the dilemma that he put forward. If his view on community rights were accepted, it would not be compatible with EU law or European Convention law, both of which are based on the rights of individuals, not of groups. It is dangerous to postulate the idea of groups of people with rights opposed to those of other groups of people, such as Christians against homosexuals. That is not the basis on which human rights law and equality law operate. We are not concerned with group rights in that sense.

On these Benches, we will seek to ensure that the Bill is passed. Most of the Bill is well designed, but we shall seek some significant improvements. The Bill is much needed. In the main, it should not be politically contentious since all three parties surely accept the importance of having equality legislation that works in practice. One sensitive and controversial issue concerns the importance to be given to religion in equality law in our secular society. One person's religious belief may be blasphemy for someone of another faith, and claims of equal treatment for those of different faiths or of no faith may be divisive and implicate freedom of speech as well as freedom of religion and belief. That is one of the reasons why I have profound reservations about what the right reverend Prelate said. Where sexuality is concerned, one person's religious morality can offend the very essence of another person’s being. I hope that religious issues will not dominate our debates because that is not appropriate, in my view, for the Bill as designed.

Labour's 2001 manifesto stated:

“Women still suffer an 18 per cent pay gap compared to men. We are committed to tackling the causes of this inequality”.

But almost 40 years after the enactment of the Equal Pay Act 1970, women now earn, on average, 22.6 per cent less than men. A recent study showed that male doctors in the NHS earn on average over £15,000 a year more than their female counterparts. It will be important to consider whether the Bill's current provisions are likely to narrow the pay gap where it is caused by direct or indirect discrimination against women rather than other factors, or whether, as I believe, that part of the Bill will need to be strengthened.

To give other examples, there is still direct discrimination on racial grounds. A recent DWP study showed that having an ethnic sounding name significantly reduced a person's chances of being selected for a job interview. There are worrying indications of racial bias in policing, and in the prosecution, conviction, and sentencing of members of ethnic minorities. However, I do not agree with the criticism of the noble Baroness, Lady Howells of St Davids, of the Bill. Her complaints are about access to justice and enforcement by the Equality and Human Rights Commission. I fully agree with her about representative actions, which go wider than simply race discrimination, but I do not think it is right to say that the Bill is weak in tackling race discrimination—an issue with which I have been involved for several decades, as has the noble Baroness.

Disabled people are still twice as likely to be out of work as those who are not disabled. Disability comes in many shapes and sizes, and is not always physical. That needs to be considered.

The default retirement age of 65 is discriminatory. We hope that will be abolished during what remains of the lifetime of this Parliament.

The use of the law to promote equality and combat unjustifiable discrimination is an issue on which there should be cross-party agreement, as I have said. It was a Conservative Government under the noble Baroness, Lady Thatcher, who in 1989 introduced major discrimination law reform to strengthen the fair employment legislation in Northern Ireland. She herself made her maiden speech supporting equal pay for women. Surely all of us will agree that the law is unsatisfactory and in need of comprehensive and coherent reform; that everyone should be treated on merit; and that practices and procedures that are barriers to equality of opportunity and treatment should be removed unless they are justified. We hope that all parties will come together to enable the Bill to become law.

I look forward very much to the maiden speech that we are about to hear from the noble Lord, Lord Aberdare. Finally, I will pick up on the reference of the noble Lord, Lord Sacks, to the Moses Room. He may remember The Jew, a poem by Isaac Rosenberg, in which the Mosaic code is described as,

“… a moon

For mutable lampless men”.

I regard the Equality Bill as a moon for lampless, mutable human beings.

My Lords, some years ago I helped to organise an event in the Cholmondeley Room, in the course of which I had the opportunity to make a short speech of thanks. I said then that it would probably be the only speech that I would ever make in this House. As I make my maiden speech today, I hope that noble Lords will not feel too much regret that my powers of foresight proved so poor.

My arrival here would have been even more daunting were it not for the generous welcome I have received from your Lordships and the helpfulness of the staff of the House, who have shown great patience in putting me back on the right path when I have frequently strayed from it. In addition, I am fortified by the advantage of having two outstanding examples to follow in my efforts to contribute to this House. The first is that of Lord Bledisloe, in whose place I was elected. It is clear from what I have heard and read about him that I have substantial shoes to fill. The other is that of my father, Morys Aberdare, who was a member of this House for nearly 50 years, 16 of them as Chairman of Committees. They have set a high standard for me to try to live up to—as did the noble Lord, Lord Sacks, in his splendid maiden speech, which it is a great, if daunting, privilege to follow.

I am delighted to have the opportunity to speak in this debate on the Queen’s Speech and to offer some thoughts on education, particularly the transition from education to employment. I declare my interest as a director of two small social enterprises, WALTZ Programmes Ltd and The Twist Partnership Ltd. Both work to help people in London—mostly young and in disadvantaged or difficult circumstances, and many from ethnic minorities—to acquire the skills that they need to find and keep jobs.

Your Lordships will be aware that many young people are currently finding it extremely hard to get jobs, with the resultant danger that some may fall into a culture of worklessness and disillusion, if not despair. I welcome the range of efforts being made to tackle this issue and to help as many young people as possible to take the essential first step on to the employment ladder. Many of the young people we work with are disadvantaged not so much by their lack of knowledge and skills but by a lack of aspiration and of self-belief. Surely a “joined-up” education system should address these needs as well. I am sometimes shocked that young people may come from families with not a single member in employment and may emerge from their education with little idea about work and jobs: what opportunities exist, what sort of work might suit them and what it actually involves—from basic things like punctuality and appearance to key skills such as communications and teamwork.

Part of the role of an education system should be to address issues like these that make it easier for young people to cross the bridge from education to employment, even if that has to be done through activities outside, or supplementary to, the mainline curriculum. These may include mentoring—even at an early age, in primary schools—after-school clubs, community engagement projects and especially activities involving local employers, such as talks, visits or work “taster” sessions, all of which are too often seen as marginal. A number of young people for whom we have arranged such activities, who had had no thought of going on to further or higher education after leaving school, changed their minds after discovering an area of employment that attracted them—for example, in travel and tourism—and realising that they needed higher-level qualifications to build a career in that area.

Group activities such as singing in a choir can also help to build key skills and attitudes. Some noble Lords may have seen the television series “The Choir”, in which a young choral conductor, Gareth Malone, created successful choirs in seemingly unpromising communities, including a mixed secondary school in Middlesex that had never had a choir and a boys’ comprehensive in Leicester specialising in sport, where singing was initially viewed—by staff as well as pupils—as distinctly un-cool. A striking feature of these programmes was the way that choir members gained in confidence, energy and a sense of achievement as the programme progressed—which can only serve them well in their careers.

Sport can fulfil a similar educational purpose: it, too, can generate enthusiasm, motivation and a sense of achievement. Recently I was taken on a coach tour of some of the Olympics 2012 sites in east London, which reinforced my belief in the opportunity presented by the Games. I hope that the Olympics will succeed in conveying a spirit of hope and enthusiasm to young people, as well as involving them directly—whether as spectators, competitors, staff or volunteers—in ways that will reinforce their motivation and employability.

I hope, too, that these opportunities will extend beyond the London area to all parts of the United Kingdom, not least to the land of my own fathers, Wales. I do not mean just by holding some events locally—for example, football in the Wales Millennium Stadium. I am thinking more of the sort of nationwide impact made by the Great Exhibition of 1851, which attracted more than 6 million paying visitors from all over the country in the six months that it was open and significantly changed attitudes to industry and commerce. It even made a large profit, but that might be hoping for too much. By engaging young people appropriately, the 2012 Olympics could leave an educational legacy comparable in value to their legacy of physical regeneration.

I will end with two brief summary points relating to the Children, Schools and Families Bill, which offers,

“guarantees for parents and pupils, setting out what they can expect from a 21st century schools system”.

First, what matters most is not what is guaranteed but what is delivered. Secondly, delivery must cover all the skills, attitudes and expectations needed by our young people to make a successful transition into employment and worthwhile careers, to the benefit of our nation.

My Lords, it is a pleasure and an honour to follow the fine maiden speech of the noble Lord, Lord Aberdare, who joined your Lordships’ House in a Cross-Bench by-election this summer. He gave us a thoughtful speech focusing on education and employment, and his experience and abilities will no doubt enable him to contribute to debates in the House on a wide range of topics, including the arts, culture and heritage, music—I understand that he is something of an authority on Berlioz—education and skills, especially training for work and apprenticeships. His interest in the corporate sector includes small businesses and entrepreneurships, and he has particular experience in matters of corporate reputation—an important topic at present for many organisations. Most important will be his interest in—and, as shown by his speech today, passion for—social enterprise. I know from my work as chair of the advisory body for the Office of the Third Sector how important social enterprises are proving to be, especially in disadvantaged communities.

Your Lordships’ House does not lack Members with an interest in Wales—I mean the country, not the mammal—but I know that we shall welcome another, especially one who is a trustee of the National Botanic Garden of Wales and an honorary fellow of Cardiff University. From my neighbouring county of Herefordshire, I welcome him too both there and in your Lordships’ House, and I look forward to hearing many more contributions from him as accomplished as the one he has given us today.

I shall confine my remarks to two Bills and, within those, to their effect on families who care. The Personal Care at Home Bill, which was published yesterday, will introduce free personal care for the 280,000 people with the most critical care needs, providing help with basic tasks such as getting out of bed, washing and dressing. This is the first time that people who have savings or assets such as a house will be entitled to free care from the state. As we have heard, there will also be support for about 130,000 people who need support after a spell in hospital, helping them to regain their independence through the installation of specialist equipment or other services.

On my first reading of the Bill, it seems that the immediate effects on families will be as follows. The stress on people who care for someone with a severe condition such as dementia or Parkinson’s will be reduced. Currently, many families worry about how to make ends meet and pay for care, which increases the risk to their own health. At present, families may choose not to use care services because of the cost, putting additional pressure on the carer. This may make the difference between a carer having to give up work or not, which is crucial. I believe that it will mean an end to means-testing for those with the most critical needs, which will be very popular and simple for people to understand. People with these sorts of conditions are often at the sharp end of means-testing and are forced to spend down their assets. In particular, the funding to help people to return home after a spell in hospital could be crucial in changing the way that hospitals, intermediate teams and social care teams work.

Reasserting people’s independence in the home is very important, and it is what families want. It is very important that we see this Bill as a first step towards a reformed social care system. It does not fix the entire problem but it will help to meet some of the most urgent need. As we know, the Green Paper consultation has now closed. It was the biggest consultation ever, as we heard in this House on Tuesday in answer to a Question that I tabled. There is great interest in this agenda and cross-party consensus that something must be done. We must continue to work towards the longer-term vision while implementing this measure.

I know that some of my noble friends and others oppose the Bill. However, I believe that as politicians we need to be careful about rejecting policies which we do not think are perfect but which will in fact have a meaningful impact on people’s lives. It may take several years to legislate for a national care service, however well intentioned we are about bringing that in. In the mean time, this Bill will help thousands of families to meet the costs of care, and I do not think that we should seek to obstruct that. I shall be supporting the Bill wholeheartedly.

There will be challenges involved in implementing the Bill, and the Fair Access to Care Services guidance will need to be rewritten. Local authorities may be incentivised to assess everyone as “critical” if that leads to central government funding, when in fact in recent years the opposite trend has been observed. Therefore, we will have to be very careful about how we monitor what local authorities are doing, and I hope that the Minister will be able to assure me that close monitoring will take place. We need to ensure that the aims of this Bill are achieved.

As we all know, we have a general election coming up, and this may interrupt progress towards legislating for a national care service. The Bill is about a concrete change, to be implemented in less than a year’s time, which will help many of the families in our society who need it most. I support it wholeheartedly.

I turn now to the Equality Bill. This Bill has been carried over from the previous Session and will introduce new rights for carers, protecting them in the workplace and in the provision of goods and services from being discriminated against because of their caring role. Carers UK has welcomed the Bill. We believe that it will provide ground-breaking new rights for carers and should help many carers to combine caring with paid work—something that is, I repeat, extremely important.

There has been much progress for carers in recent years. The three pieces of legislation already on the statute book have all been part of the process of recognising that carers have distinct rights and making it clear that both disabled people and carers should have the right to assessment and support. The Human Rights Act is also relevant here. The title of the Carers (Equal Opportunities) Act 2004 was critical in putting carers in the context of equal opportunities. The wording is significant, and those working in the carers’ field see the Equality Bill as the next step on this journey.

It is vital that the Government do as much awareness-raising as possible. Carers have had the right to request flexible working for nearly three years, yet research this summer showed that the majority of adults—82 per cent—were not aware that carers were legally entitled to ask their employer for flexible working arrangements. More than a third of people surveyed had caring responsibilities which would make them eligible to ask. There was some coverage of this in the media but nothing like enough. This is particularly important as, from a reading of the legislation, it would certainly not be obvious at first to a carer that there was anything that applied to them.

When the Bill passed through the other place, there was some debate about whether caring should be a strand on its own, as opposed to protection being offered as a result of association with a person with disabilities. In that debate, the Solicitor-General said that,

“the starting point when looking at what constitutes a protected characteristic for the purposes of the Bill is to consider who a person is rather than what they do”.—[Official Report, Commons, Equality Bill Committee, 11/6/09; col. 187.]

That satisfied the Bill committee, but I am not sure that the entire carers’ movement is convinced by this argument. The reality is that carers are discriminated against because of their status as carers and often because of a perception of what they do. I look forward to more discussions on this topic as the Bill proceeds.

My Lords, before I begin my contribution on the gracious Speech, I should like to take this opportunity to comment briefly on the significant progress that has been made over the past 10 years or so in promoting the human rights of people with a learning disability and improving their quality of life. Listening to the two noble Lords who have just made their excellent maiden speeches, I am sure that they, too, will be forceful advocates in furthering this promotion.

As your Lordships will be aware, through my current role as president of Mencap, and my involvement prior to that appointment, I have often spoken about the importance of promoting choice and respect for people with a learning disability in a way that many of us simply take for granted. Indeed, I should like to put on record my appreciation of the Government’s progress in this regard and their recognition of the value of people with a learning disability and the contribution that they can make to society.

The Government’s commitment to the learning disability agenda was made clear in 2001 with the publication of Valuing People and this year with the launch of Valuing People Now and Valuing Employment Now, which sets out the Government’s strategy for delivering on their praiseworthy intentions. As I said at the time and have said since, I welcome these documents and the impact that they have started to make in empowering people with a learning disability. Combined with the launch of publications such as Aiming High for Disabled Children, Improving the Life Chances of Disabled People and Putting People First, I believe there is plenty that we can justifiably be optimistic about.

However, as noble Lords will appreciate, real change on the ground in improving the life chances of people with a learning disability requires more than an Act of Parliament or a well meaning strategy document.

One need only look at the six heartbreaking cases highlighted in the Mencap’s Death by Indifference campaign, which emphasised the fact that people with a learning disability receive a poorer quality of healthcare and as a result are 58 times more likely to die before the age of 50 than the general population. If we are to change this and the provision and delivery of local services for people with learning disabilities, as well as change the prejudices of those members of the public who hold them, much more needs to be done. I hope, for example, that the return of both the Equality Bill and the Child Poverty Bill will provide opportunities to promote the specific interests of people with a learning disability. Furthermore, I also welcome the Children, Schools and Families Bill and the valuable opportunities it may also provide.

However, the essence of my contribution to today’s debate concerns the Government’s intentions in the Personal Care at Home Bill. This year, in response to the Government’s Green Paper, Shaping the Future of Care Together, Mencap launched a consultation to ensure that many people within the learning disability community were given the opportunity to contribute to the social care debate. I am pleased to say that whether they were people with a learning disability, or their families, friends or carers, 1,200 responded to the consultation and expressed how improvements in social care have a vital role to play in determining the quality of their daily lives.

Choice is essential. Having the freedom to make choices is crucial, particularly in areas such as financial management, opportunities for employment and access to decent housing, which helps to support independent living. But although many people in Mencap’s consultation enthusiastically support the opportunities offered by the personalisation agenda, we must also ensure that appropriate safeguards are put in place to protect people with a learning disability from financial manipulation and make absolutely certain that the provision of local services is not cut along the way.

Coupled with this, the current social care system is under significant financial pressure. Nearly all respondents highlighted the need for more funding, or raised issues which are a direct result of an underfunded social care system, which in many respects is no longer fit for purpose, and will certainly not be so in 20 years. For this reason, in common with many others, I remain concerned that the Government’s Green Paper on social care did not sufficiently address the current, or indeed the future funding crisis of care services for people with all disabilities, in particular those with a learning disability. That is also not addressed in the Personal Care at Home Bill. However, I fear, as do many others, that the possibility of merging some disability-related allowances into general social care funding is not the way to meet this gap and could potentially undermine the Government’s intentions in terms of the whole personalisation agenda.

Currently some 2,870,000 disabled and older people who receive disability living allowance or attendance allowance are not eligible for other forms of social care support. I suspect that the abolition of these benefits would result in many more disabled people being forced to live in poverty which, in turn, could adversely affect their families and communities, bringing misery and deprivation in its wake.

Issues regarding employment must also be properly addressed which, in terms of preventive measures, are closely interconnected with social care, as the Government have previously acknowledged. Some 800,000 people of working age with a learning disability in the United Kingdom remain the disabled group most excluded from the workforce, with less than 10 per cent known to services in some form of employment, compared to 49 per cent of all disabled people. Again, I acknowledge that the Government have taken some important steps in this regard, but there is still a drastic need for more action, more quickly and more often. All too frequently, still too many of our fellow countrymen and women are left behind as a direct result of the prejudice and discrimination that they face because of their disabilities, meaning that they are denied the opportunities and the rights to which they are entitled and the freedom to live their lives on the basis of dignity, respect and independence. As long as these injustices remain, I shall continue to speak out on behalf of people with a learning disability even though today, thank goodness, many can speak out for themselves.

To conclude, we are all too aware that an election is but six months away, and no doubt many of those who take the party Whip—especially in another place—will be inundated with proposals to put in their respective party manifestos. I hope that I have outlined some of the wishes—nay, rightful demands—in relation to healthcare, local service provision, funding of social care and employment which people with a learning disability trust that they will see in all the manifestos. Here are a few more suggestions: housing and independent living with the right support, the elimination of bullying, inclusive education, further education and training, the safe use of public transport, and preventing tragic cases of hate crime as we saw in the Pilkington case.

I wanted to list some basic wishes so that they can be reported fully in Hansard and, I hope, read by those who are already preparing promises that they fully intend to keep, even though they may have their fingers firmly crossed behind their backs at the same time. Unhappily, Jonathan Swift’s quotation:

“Promises and pie-crusts are made to be broken”,

applies all too often to Governments when they come to power. I remind them, quoting Robert Service this time, that for all disabled people—whatever their disability—and, indeed for the entire electorate:

“A promise made is a debt unpaid”.

My Lords, I, too, pay tribute to the gracious Speech, which highlights the Government’s commitments to promote equality, to narrow the gap between rich and poor and to tackle discrimination. As we await the arrival of the Equality Bill and the Child Poverty Bill from another place, I do not wish to pre-empt those debates, and I will reserve my specific comments on both. However, I want to emphasise the devastating results of inequality in our society.

Inequality is one of the greatest challenges of this generation, caused largely by poverty and fuelled by discrimination, which are two social evils that are inextricably linked. Those who suffer inequality are all around us—the young, the old, the sick and those with disabilities. They are the newcomers to our society and those who are different because of their gender, sexual orientation, nationality or culture. The consequences of inequality are manifestly clear. Examples are all around us, such as unequal pay, housing, health, education and poverty. Inequality in any of these compounds the other.

As my friend the noble Lord, Lord Lester of Herne Hill, reminded us, the gap in respect of pay between men and women has become a problem in the workplace and in society that needs urgent attention. The Equality and Human Rights Commission this month highlighted a 16.4 per cent gap between men and women’s pay, partly because many women work part time and in temporary employment—often the only jobs available to them, particularly for those with caring responsibilities. We also know that when women are doing identical jobs in identical circumstances to men, women on average earn some 13 per cent less than their male counterparts. Despite legislation, a substantial number of UK workers earn less than the minimum wage. I welcome the Government’s commitment to address the exploitation of agency workers.

The consequences of inequality of incomes impact on every aspect of our lives. For instance, inequality will usually determine where we live and the quality of local services, including health, education and transport. It is an indictment of our society that essential workers such as hospital and emergency staff, bus workers, teachers and many others cannot afford to live in the communities that they serve and, increasingly, cannot afford to travel to areas of work, all of which contributes to the problem of improving our local services and infrastructure. Despite the current economic difficulties, I trust that the Government will maintain their commitment to expanding the provision of the social housing sector. Here, I declare an interest as chair of Midland Heart Housing Association.

Let me say a few words about health, because poor health is likely to result in poor housing, and vice versa. We are all aware of the postcode lottery, which is often experienced in the quality of healthcare provided. Where you live can determine the availability of some much-needed drugs and the acute level of services that you receive from your general practitioner or primary care trust. Equity of health care should be a universal right wherever you are living, not a postcode lottery.

While the economy will dominate political debate in the immediate future, it is the quality and content of education that will provide our children with the opportunities to influence this nation's future. Although there has undoubtedly been improvement, some of our inner-city areas are having real difficulty in recruiting quality staff. A disproportionate number of their pupils suffer the effects of poverty, and they probably have to support a high number of children for whom English is a second language.

So far, I have referred to inequality as it affects those who live in urban Britain. Lest we forget, many of our citizens in rural communities suffer inequalities or, as I understand it, rural poverty. In many rural areas, schools, shops, the post office and the local pub are now monuments of history through closures. That is inequality, and it is also rural poverty. Employment is diminishing and public transport services are, at best, minimal, and often non-existent. For those who rely on a car, the cost is higher because the travel distance is much greater—all limiting access to jobs, healthcare and other essential services.

The inequality that I have been describing brings economic and social exclusion. It also brings poverty. Poverty affects all ages, but the worst impact as a legacy is on our children. While figures on child poverty vary, the figures from the Department for Children, Schools and Families state that in 1998-99, 3.4 million children were living in poverty. That is 26 per cent of our children. By 2006-07, the figure had improved, falling to 2.9 million children in poverty. Of course, the current economic climate, with its high rate of unemployment, will have again raised the figure.

Whether or not there has been a slight improvement, the figures are alarming, and the reality of those figures is the blighted lives of our children. In 1999, the Government announced their intention to eradicate child poverty by 2020. It was said that it should be abolished in a generation. We know that a new pledge is to be made. I, for one, welcome the intent to enshrine that pledge in legislation. I look forward to the Child Poverty Bill arriving in your Lordships' House.

I have spoken about the spiral of poverty and the spiral of inequality. That spiral must be broken. It starts with one of the intractable evils: unemployment, which affects where you live, which in turn affects your health and educational chances, which leads to poverty and, in turn, denies the opportunity of gainful and satisfying employment. It affects your health. It affects your education. So the spiral continues—never upwards, always downwards. Not only does inequality affect the family now, it affects the future of every member of that family and, perhaps, for generations yet unborn.

Occasionally, we hear of an individual who has broken away from that spiral, but the fact that we headline such achievements demonstrates how rare that really is. In summary, inequality equals social and economic exclusion, and I hope that the Bills currently in another place—the Equality Bill and the Child Poverty Bill—will at least contribute towards reducing, if not ending, the level of poverty in an unequal society. Our children expect nothing less and, for the next generation and the generation to come, we can deliver nothing less.

My Lords, to return to health, there are many aspects that I wish to discuss: statutory regulation for herbalists and acupuncturists, the current campaign against homeopathy and concern over the Commission’s involvement with the food supplements directive. However, time is limited and, almost by tradition now, this debate on the gracious Speech gives me the opportunity to update the House on the current situation in the general dental service. I declare my interest as a retired general practitioner.

We are entering an important time for dentistry in England. The much reviewed and criticised general dental services contract introduced in 2006 has been confronted with its failures by an independent report for the Department of Health researched and written by the Newcastle dental school dean, Professor Jimmy Steele. Its publication at the end of June offers a new vision of how dental care should be delivered and was notable for the positive reception that it received from the dental profession, dental groups and parties across the political spectrum alike. The report stresses the value of a continuing care relationship between patients and their dentists. It calls for an alignment of the contract to ensure that it promotes quality outcomes as well as improving access and it calls for changes that promote preventive care.

Those recommendations address concerns that are all too familiar to those who have watched the failure of the contract introduced in 2006 as it has unfolded. They echo the concerns highlighted by the 2008 Commons Health Select Committee report on dental services, the review that is acknowledged as triggering the commissioning of Professor Steele’s report. The British Dental Association has welcomed the report. John Milne, chair of the BDA’s general practice committee, praised the report, particularly for a new approach to dental care that dentists hope will mean a move away from the target-driven arrangements currently in place.

The key to taking this opportunity is meaningful piloting of the proposed changes. The failure to pilot key elements of the 2006 reforms, including the patient charge system and the use of units of dental activity to measure dentists’ clinical work, has been well documented. The Health Committee thought it extraordinary that the department did not pilot or test the new payment system before it was introduced in 2006. For the sake of dentists and patients, the same mistake must not be made again. My party has stressed its commitment to the proper piloting of change to develop Professor Steele’s proposals.

In contrast to the welcome given to the Steele report, this year has seen criticism from the profession of the draft dental access contract, emerging from work led by Dr Mike Warburton for the Department of Health and intended for use in 150 to 200 dental practices. In September, the BDA felt it necessary to advise members not to sign such a draft contract if asked to do so by their primary care trust, citing significant concerns about the draft access contract’s content, branding it unsuitable for dentistry and calling for far-reaching amendments. The BDA has continued to engage constructively with the Department of Health to refine the contract in an attempt to make it a more suitable model for the delivery of dentistry. The final version was published on 16 November. Although the BDA will not be advising members against signing it, the contract is still more complex than necessary. It has been introduced without trialling and includes elements of the Steele review that should have been piloted. It is unlikely to represent value for money; the employment of additional staff may be required to manage the contract and a new, untried payment system.

The profession has also had recommendations for improved commissioning by primary care trusts. As an officer of the All-Party Parliamentary Group for Dentistry, I was interested to hear a PCT dental commissioner speak at one of the all-party events in October. Research published by the BDA this year reminded us of the significant challenges that PCTs face. Sixty per cent of those surveyed said that their ability to commission care to meet local needs was constrained by the national contract, 27 per cent said that they did not have the resources to develop variations to the contract and 29 per cent said that they did not receive contracting advice or support from their strategic health authority. However, the survey also reassuringly revealed that dentists and their PCTs generally thought that they had constructive working relationships and saw similar priorities for oral healthcare in their areas. The message is clear: all concerned want local commissioning to work. The relationships are in place. New tools, developed by Professor Chris Drinkwater, are now available to PCTs as a resource that can be downloaded and these should be a real help.

The noble Lord, Lord Morris, spoke about inequalities. This year has also underlined the desperate need to address the persistent oral health inequalities that we see in the UK. Research published in October by the NHS dental epidemiology programme for England highlighted the problem. There are inequalities in prison populations, among older patients, particularly those domiciled in residential care homes, and among patients with disabilities. Access is a complex issue. It is not just about numbers, but about greater priority for particular patient groups and more joined-up approaches to health that include dentistry.

This month is mouth cancer action month. There has been a 41 per cent rise in the number of cases of mouth cancer in the past decade and, in the last year for which figures are available, 1,851 people died as a result of the disease. Statistics from the British Dental Health Foundation show that early detection of mouth cancer improves the chances of a patient surviving by 90 per cent. A regular dental examination is very important.

My party has been clear in its commitment to adopting a more preventive approach to care. We are proposing to invigorate dental programmes in schools to make sure that children are accessing dental care. We are also committed to reintroducing the all-important continuing care relationship between patients and their dentists, something that was diminished by the sweeping away of formal patient registration when the current contract was introduced.

We also have plans to address the problem of many patients still being unable to access NHS dental care. In the past two years, about 3 million people have been unable to make an appointment with an NHS dentist. Which? magazine claims that 4.5 million people have given up trying. Although recent months have seen a sustained improvement in the numbers of people able to access NHS dental care, the latest figures from the NHS Information Centre, which were released this morning, still show that fewer patients have been able to access care in the past 24 months than in the period before the contract was introduced—54.2 per cent against 55.8 per cent. The figures are improving, but they are not good enough. The Conservatives have promised to address the access problem and have pledged to increase access for an additional 1 million patients. We will ensure that newly qualified dentists work in the NHS and will look at making increased use of the wider dental team to deliver care to patients.

The way forward for dentistry is clear. We must pursue the real improvements promised by Professor Steele’s report by meaningful piloting, help PCTs to commission more effectively and place prevention at the heart of the dental care that we provide.

My Lords, in this wide-ranging debate, I shall focus on the Children, Schools and Families Bill, which proposes to,

“introduce guarantees for pupils and parents to raise educational standards”,

linked to,

“ensuring everyone has a fair chance in life”.

That surely applies as much to education as to anything else. How much we applaud the words of the noble Lord, Lord Sacks, who said that to defend a civilisation you need schools and referred to teachers as guardians of our liberty. We have common cause with the noble Lord, Lord Aberdare, who referred to poverty of aspiration and the way in which skills for work may help to address that.

The Government have initiated 12 education Bills in 12 years, creating a barrage of legislation for schools and colleges, and apparently have far more enthusiasm for initiatives than for evaluation. Each change, whether in safeguarding, qualifications, curriculum, funding or other ways, has an impact on schools and pupils as resources are diverted away from front-line services towards work on implementing the changes. Governments who listened to the voice of practitioners would find that they hope that Governments would be discriminating and sparing in making top-down changes in education; they believe that Governments should aim to do so only where there is a very real case that the longer-term improvements will far outweigh the shorter-term disruptions.

After many hours, days and weeks of deliberations on the Apprenticeships, Skills, Children and Learning Bill, which received Royal Assent two weeks ago, it was something of a surprise to discover, as my noble friend Lady Walmsley indicated, that it has already proved deficient and will be amended as early as by Clause 3 in the Children, Schools and Families Bill before us. Within this latest Bill, there is much that we would contend with. Is it necessary, desirable or even realistic? We certainly welcome the introduction of PSHE in the school curriculum, which we have been advocating for some time. Recent news headlines have highlighted the strategy to bring an end to violence against women and girls. Building positive relationships is one aspect of PSHE. It is a step in the right direction that may also contribute to the requirement for schools to ensure good behaviour.

In a powerful piece in today’s Times, Camila Batmanghelidjh, the founder of Kids Company, contends:

“The children who have been profoundly devastated by relentless exposure to violence do not need a PHSE … lesson to know that violence is bad. What they do need is a robust child protection system that has the resources to save them ... Cultural permission for violence towards girls needs to be perceived as completely unacceptable, but let us not forget the boys”.

Schools certainly have a part to play in educating young people with skills for work and skills for life, and in the personal relationships that are so important in both those areas. However, the proposed pupil and parent guarantees raise concerns. The intentions are doubtless positive, but without funding and space in the curriculum it is difficult to see how they can all be fulfilled. If there are unreasonable expectations, what assurances can the Government give that there will not be unreasonable complaints from parents or pupils?

I talked to the head and the staff at a school prize-giving last week. It is always heartening to go to these celebrations of achievement and realise just how much our young people are doing in so many spheres of life in the school context. The staff and the head left me in no doubt that parents already know how to complain if they feel they have cause, but that complaints can usually be resolved speedily. The Bill opens the way for a small number of dissatisfied parents to cause disproportionate upheaval. Surely we all share the aim that every school should be a good school in which pupils have access to the widest range of learning opportunities and make the best of those opportunities. Broadening the curriculum to include practical as well as academic routes should enable more pupils to experience success during their period of compulsory education. We welcome the backing for the apprenticeship route, as established in the previous Bill and discussed in previous debates in this House.

It is not quite so clear where the next Bill will add value. We have heard about recording the performance of schools; this is constantly debated. There is a disturbing emphasis on academic performance and examination results—on outcomes that have a numeric assessment and can be neatly tabulated statistically—but this does not reflect the development of the whole child. Schools with a large number of children from disadvantaged areas may contribute most to their pupils’ development and perform a valuable service to society and individuals, but they may register low marks in the assessments that make up national league tables.

I entirely concur with my noble friend Lady Walmsley that league tables have much to answer for. Instead of reflecting school performance, they drive provision towards what can be assessed and measured. There is increasing evidence of pressure on schools to steer pupils towards qualifications that will be of advantage to the tables, particularly, as the noble Baroness, Lady Perry, said, where funding is part of that drive. Those qualifications may not be the most appropriate ones to their skills and interests.

How will the school report card be an improvement? Will it take variations in schools into account, or will it be another burden for schools to complete and be used as a stick with which to beat them if they do not come up to scratch? The danger is that it will reduce schools’ work to a checklist of indicators and discourage teachers who work creatively and innovatively to improve the life chances of their pupils. Teachers deserve better provision of continuing professional development. It should be available more evenly and to more teachers.

The introduction of a licence to practise needs further consideration. It will not serve a useful purpose if it means that the General Teaching Council has to divert time and funding towards the licensing activity. Will it be an additional administrative burden on teachers and schools if they have to put aside time specifically to compile evidence of teaching ability? It is questionable whether this will raise the standards of teaching or guarantee better teachers. I hope that we will look at this in considerably more detail as the Bill progresses through the House to see whether there are merits in going down that route.

As the Children’s Society has set out, we have no clear definition of the responsibilities of parents. Children will have the best chance to flourish at schools in which there is a partnership between school and home—with pupils, teachers and parents each aware of their responsibilities and duties, as well as their rights, in that relationship. The detail of this is best agreed locally. The Bill’s proposals sound very heavy-handed.

In all our deliberations, we should be mindful of the rights and freedoms under the United Nations Convention on the Rights of the Child and I hope that every consideration will be given to the Bill put forward by my noble friend Lady Walmsley. We shall seek reassurances that the well-being of children is at the centre of proposals and that it is appreciated that the well-being of adults, including parents and teachers, is a key factor if children are to flourish. There is much in these Bills to debate in the short time available and we look forward to their consideration.

My Lords, with only a few months until a general election, I want to encourage the Government, in all their Bills and in other activities planned in the gracious Speech, to give far greater priority, and above all sufficient resources, to the prevention of crime.

It is 35 years since Sir Keith Joseph gave his famous cycle of deprivation speech, and sadly no Government since have put the obvious lessons fully into effect. Penal attitudes have created many more career criminals than would have existed had prevention and social rehabilitation policies been predominant. As a result, we have a prison population that has grown by two-thirds in England and Wales since 1995 and that is larger than that of any other western European country: this despite the fact that the rate of recorded offences has fallen. A quarter of prisoners share cells that are designed for one inmate, which seriously impedes the potential of mental health and rehabilitation programmes. Given that 70 per cent of the prison population have two or more diagnosable mental disorders, it is clear how poor our strategy on rehabilitation is.

The present Government, by virtue of their Sure Start initiatives, greater provision of pre-schooling and other specialist help, as well as the rollout of children’s centres, have certainly made some progress, but far more positive preventive planning by government, local authorities and communities generally is desperately needed. The focus should be on early support for problem families and should certainly involve the invaluable input of third-sector organisations such as Home Start UK. Of course really violent offenders must be imprisoned, but rafts of statistical evidence show that this is not the correct response for most offenders and make quite clear the abject failure of short-term sentences.

Seventy-four per cent of those released from prison sentences reoffend within two years compared with around 40 per cent for those on community sentences. The cost of a year in prison is greater than a year’s tuition at Eton. Indeed, the Prison Reform Trust puts the cost to the taxpayer of a lifetime of crime at £1.5 million per criminal. These figures illustrate graphically just how misplaced our priorities are. However, recent research and a gradually changing mood among policymakers have given me reason to hope. The Scottish Government’s recent attempt to remove counterproductive prison sentences of less than six months was certainly commendable.

The charity Transition to Adulthood—T2A for short—recently polled 151 MPs and found, unbelievably perhaps, that no less than 62 per cent were in favour of abolishing six-month sentences for young adults, so I begin to have hope. The intensive alternative to custody scheme, which is currently being tested in Derbyshire, is an excellent example of productive community and restorative-based alternatives to prisons. They are certainly no soft touch, and they reduce reoffending. Restorative justice in Northern Ireland where young criminals meet their victims has also shown heartening results, with reoffending rates in 2006 only half that of those who were given a custodial sentence.

Most criminals we speak of exhibit signs of future criminality as children. It is with that in mind that I am again heartened by the Prime Minister’s promise of a national framework of family intervention projects. In Dundee, these projects have seen families with chaotic lives helped by experts on an individualised basis with drink and drug problems, mental disorders and learning difficulties. Research done on six family intervention projects shows that complaints against families fell by 82 per cent and school attendance rose by 84 per cent, with a projected lifetime saving to the taxpayer of more than £200,000 per family. Supporting families to support their children works in tackling criminality among the young and is financially advantageous. There are so many things on which we should and can spend money advantageously.

Much crime is clearly related to the criminal's family history. A staggering 63 per cent of boys with a parent who has a conviction go on to offend. The children of prisoners are three times more likely to show delinquent behaviour. Indeed, T2A says that 18 to 24 year-olds make up one-third of all those in British jails, one-third of those committing all crime and one-third of those on probation. With more and more figures like that emerging, it would certainly be helpful to commission research showing for just how many generations delinquency has continued unchecked. That is the “cycle of deprivation”. We must ensure that the needs of this generation are addressed at the earliest possible stage and that courts take fully into account the impact of a defendant's sentence on their children.

In future plans, as the Corston report has made clear, how women offenders are treated is central if, as the Ministry of Justice recently outlined in its report on preventing reoffending, the family is to be at the centre of the entire offender management process. Half Britain's 4,500 women prisoners have children under the age of 16 and one-third has children under the age of five. These women have multiple problems and, even though 38 per cent are given sentences of three months or less, the family usually breaks up and the children go into care. When one sees that women make up just 5 per cent of the total prison population, yet account for 50 per cent of all self-harm incidents, and that one-third have been sexually abused and one-fifth have spent time in care, it is clear that the sentence for most women should be community-based, thus allowing the family to stay together and adequate support to be provided for their problems.

We also need to research what is happening in other countries to see whether those ideas might be relevant here. Our social services should look to the likes of Germany, which has a flexible care system with well trained, graduate carers who are allowed, and have time, to think about the children in their care. The monitoring of social services as well as schools by Ofsted, which has had a bit of criticism recently, should increasingly concentrate on reducing unnecessary bureaucracy due to haphazardly created targets.

In the United States, 40 states have successful day centre schemes for non-violent offenders, which apparently saves the American taxpayer one-third of a billion dollars a year and has cut the demand for prison cells by 7 million nights a year. These centres, which ironically originated in Britain but were dismissed by successive Governments who were keen to look tough on crime, are far from a soft option. Attendance is compulsory. Mornings are spent on education, job-related training and individual counselling, and afternoons are spent on community reparation projects for which local people have voted and which they supervise.

In closing, I again express my hope that we are at last as a country realising that we need to put far greater emphasis on prevention and non-custodial punishments in order to reduce crime. I am encouraged by the Government's recent moves, particularly the more family-centred approach that they have outlined, and I hope that they will show political courage and vision to make good their proposals. If the next Government are Conservative, perhaps I may remind them that their very own Sir Keith Joseph spoke of the “cycle of deprivation” 35 years ago. I remain convinced, whichever party wins the next election, that we can, with the right approach, at last begin to break the cycle of deprivation if we put prevention firmly before prison.

My Lords, I shall speak about the Personal Care at Home Bill, the intention of which I warmly welcome. Its intention is to assure funding for those in greatest need when and where they need it; to give them peace of mind, especially in old age or chronic illness; and to enable them to receive care in their own homes, as very many people—perhaps most—seem to want for as long as possible.

The dignity of the person should be the primary concern of all legislation and is the only basis of the legitimacy and authority of the state. The person, the family, the home and the ability for care to be provided in that environment undoubtedly form part of the context in which for many people that dignity can be affirmed and sustained. However, I should perhaps add that in Her Majesty’s gracious Speech the reference was to,

“the wider provision of free personal care to those in highest care need”.

Therefore, the overall vision and intention is rather wider than simply personal care at home. What matters, of course, is the most appropriate care for all, which clearly will not be at home for everyone, especially those who live in isolation or are deprived of social contact and stimulus.

Nevertheless, with that proviso I hope that all Members of your Lordships' House will endorse the aims of this Bill without qualification. I also hope that an equal or perhaps even more enthusiastic endorsement will be given to the bigger picture of which this Bill is supposed to be a part. In relation to this bigger picture, the Government observed in their Green Paper, Shaping the Future of Care Together, published on 14 July:

“Our existing social care system is a legacy, not of a single bold reform like the creation of the NHS, but of a series of more limited and incremental steps”.

We might have thought that the recently concluded Big Care Debate was designed to remedy that deficiency and would lead to a similarly bold reform in the establishment of a national care service. There can be no doubt but that this is a very worthwhile reform and we should be grateful for anything that contributes to it. However, I have a nagging worry that coming so soon after the end of the consultation process on the debate, the presentation of this Bill, especially if we think also of the independent living Bill presented this week, might represent a continuation of precisely those “limited and incremental steps” that have led to the present untidy situation. The good can sometimes be the enemy of the best and I would hate to feel that piecemeal measures might militate against the more comprehensive reform that is needed.

In the present financial climate there must be questions about the realism of the costings and funding proposals, which will be a challenge to whatever party finds itself in power after the forthcoming general election. Along with the general and genuine welcome that I and many of my colleagues give to this aspect of the gracious Speech, I want to ask how it fits into the bigger picture and also to seek some assurances that these promises are not warm words but can actually be delivered. What could be worse than saying that we will remove anxiety from the most needy without the ability or the will to do so?

My Lords, I welcome the opportunity to participate in what is proving to be a very wide-ranging debate, with, of course, two really quite remarkable maiden speeches.

I am glad that the Equality Bill heads the agenda. I was, for a number of years, a member of the EOC—the Equal Opportunities Commission—at a time when the noble Baroness, Lady Platt, was chair of the commission. A campaign which was introduced at that time, and which I still think was important, was the WISE campaign—Women into Science and Engineering. When I was young, I and the women of my generation left our schools and colleges steered in the direction of the sort of jobs thought suitable for women—mainly in offices, or perhaps teaching or nursing—but we left education with very little knowledge of how things actually work. Happily, things have changed; I believe that the EOC’s campaign headed by the noble Baroness, Lady Platt, who had herself been a professional engineer, has played a substantial role in that, and I still think it is very important.

The Equality Bill, which we will no doubt have the opportunity to discuss in detail when it is before the House, is designed to bring together the various legislative provisions across the whole spectrum of discrimination. I recall that when the notion emerged of the various commissions being made into one, I had my doubts as to whether a new body covering the whole spectrum would be successful. I am still not entirely sure, but I can understand why the Government should have decided to proceed as they have with an Equality Bill designed to ensure that all our citizens should have the right to a free and equal life, and for that they are to be commended.

As far as gender equality is concerned, some problems still remain, and this the Government have identified. There is still a substantial disparity between male and female earnings. It is understood that this may take some time to deal with, but at least it has been recognised. We now have a legal framework providing rights for women, but we should not forget that this has taken many years to establish and previous generations of women have fought very hard indeed to attain what many now take for granted.

But that is the law—culture is often very different. We are rightly proud that we are a very diverse culture; but while other cultures and religions are entitled to respect, our laws must take absolute precedence. Some cultures rely on interpretations of their religion to impose unequal status amounting to repression of women. Attempts are made to deny the right to work, to education, to form relationships, to dress as women wish, to play a part in public life; but women have rights that cannot be denied to them for family or religious reasons. Many women caught up in this so-called culture want to escape from it even though they may be threatened with violence. We must do whatever we can to help them, appreciating how very difficult it must be for them if they face repression within the family.

Another area where substantial progress has been made during the period of the present Government is in relation to discrimination on grounds of sexual orientation. There has also been a very long campaign to secure protection against discrimination for gay and lesbian people—but it is now unlawful to discriminate on those grounds. Again, there is a cultural problem. Again, those who would like to discriminate often do so by citing a religious reason for so doing. Of course there is a right to criticise, if people want to do so, but all too often the right to criticise can escalate into incitement to violence. Homophobic violence is, sadly, on the increase, some of it horrific. We have good, humane laws. We must ensure that these are applied and that those who seek to harass and threaten are speedily dealt with. The Bill does seek to deal with harassment. The right to free speech should not serve as a reason to indulge in threatening behaviour against those whose orientation may displease certain individuals who claim that it affronts their religious views.

As far as religion is concerned, I note that attempts are being made in the Bill to ensure that the management of faith schools, or indeed other religious employers, may not insist that all their employees must be adherents of the particular religion involved. There are, however, to be some exceptions. I hope there will be an opportunity to examine this further when the Bill is finally before us. I can think of no circumstances where any employer would be entitled to make a ruling in regard to the religion or sexual orientation of any individual employee.

Finally, I would like to take this opportunity of congratulating the Government on seeking to deal with the problem of social care of the elderly. Again, we shall no doubt have the opportunity to debate this in more detail when the legislation is before this House. Nowadays, many elderly and infirm people live alone; social changes have been responsible for this. Most would prefer to remain living at home. Care homes are often a last resort. Not only are they often very expensive, recent research indicates that they are often not well run and elderly people suffer in them. There was a case reported even last week of an elderly man who had been allowed to die of neglect in a care home.

I understand from the press that several of my noble friends have been critical of what the Government are proposing. I think that those who hold that sort of view can have had little experience of looking after older people. I have had a great deal of experience, in my own family and also with friends. My own mother, when she was ill, begged me not to put her in a home. She wanted to stay in her own home, and I had to promise that that would be her situation, and she was never sent into a care home. I have had other elderly relatives who felt exactly the same as she did. I was my late husband's carer. In the last few years of his life, he was on dialysis. He certainly did not want to go into a home, and he did not.

I do not know why my noble friends feel as they do. I hope it is not a matter of cost. We must not plead cost as the reason for not looking after elderly people in a humane and sensitive way. We also need to ensure that local authorities are provided with the resources to keep records of the elderly and infirm people in their locality and can provide assistance when this is necessary. There must be an obligation—a responsibility—for this service to be provided. We shall no doubt return to this when the Bill is before us, but, in the mean time, I fully support what the Government are doing.

My Lords, in the many years that I have been a Member of this House, this is the first time that I have made a contribution in the debate on the gracious Speech. However, as I felt that I had something I wanted to bring out without delay, I decided to put my name down. I have been fascinated to hear from the other speakers today.

I am pleased to follow my dental colleague, my noble friend Lord Colwyn. I am also delighted to hear that members of the profession have welcomed the Steele report, because successive Governments have over the years proceeded with dental ideas that were completely opposed by the profession—which makes it unsurprising that none of them has worked very well. My noble friend also mentioned oral cancer screening, a subject very close to my heart. It is very important that it should be introduced as a general theme, and it does not necessarily have to be performed by dentists. As we discussed in a recent debate, the law would apparently allow people who are not registered dentists, but who are simply trained to check mouths, to refer individuals to specialists who could deal with any problems. It is so important that we should do this. My noble friend mentioned the very large increase in the number of deaths from mouth cancer this year, to 1,851. I am therefore delighted to hear about this welcome development.

I also feel obliged to say something in this debate because this was the shortest gracious Speech ever. I have been involved in the health service for many years. I was a dentist in National Health Service practice for 35 years, and I have also been involved with the health service at all other levels, from area health authorities to hospital boards, the Standing Dental Advisory Committee for England and Wales and as an elected member of the General Dental Council. I have had a lot to do with health. It is rather appropriate that I am speaking after the noble Baroness, Lady Turner, because while I was chair of the Royal Free Hospital, she came in every day to see that her husband got his meal, and that is amazingly important.

We have all heard the stories about hospital food, but in many cases patients suffer from malnutrition after they have been in hospital for a long period. Someone—now it is usually just the people who do the catering—brings in the tray and pops it down where the patient cannot reach it or is not well enough to feed themselves even if they could. An hour later the person comes back and says, “Oh, you didn’t like your lunch”, and off goes the tray. The patient has had nothing to eat. We rely on devoted people such as the noble Baroness, Lady Turner, who care, but it should not be like that. The people looking after you in hospital should care about you and be ready to help.

The core of my speech is that I am very concerned about the proposal that from 2013, all nurses will have to be qualified to degree level. I have met many attractive, interested and keen young women who cannot get enough A-levels to qualify for the diploma course, so they have no hope in the world of getting on to a degree course. The other problem is the huge drop-out rate among those studying the degree course. The Nursing Standard magazine reported that 78 per cent of students on a children’s nursing degree course dropped out, while more than 54 per cent on a mental health nursing course failed to graduate. In one university in the north-west, 51 per cent of students did not complete the course, while in the south-west, the West Midlands, Yorkshire and Humber, a third of these students are dropping out. That is not good enough.

I am very much in favour of nurses achieving whatever high level of success they can. If they are brilliant enough to become nurse practitioners or specialist nurses, they are a wonderful resource in the National Health Service and very valuable to patients with complicated diseases, as well as to doctors in that they can take a large workload from them. Indeed, many patients find that their specialist nurse is much more valuable to them than their doctor because they are more available. So I am all for nurses reaching the heights, but I am desperately concerned that a degree is going to be mandatory so that no one can become a nurse unless they can get a university degree. We are going too far in the professions.

In my day in dentistry, if the nurse did not turn up—it happened pretty often because our nurses always came through the jobcentre in Hackney; they did not much like the job, but they would take it and not last long—you would take whoever you could find to fill in as another human being in the surgery. Today, unless that other human being is qualified or in the process of achieving a qualification, they cannot come and help the dentist. If the person who has the qualifications needs to go to the loo, the receptionist is not allowed to stand in for even five minutes to help; everything has to stop. This is taking regulation to a crazy level. It has been said that the new nurse graduates could be “too posh to wash” or “too clever to care”, and the answer from the department is that it “hopes not”. We want more than hope, we want someone to make a realistic assessment of what is going to happen.

Let us have brilliant nurse practitioners at the top working towards whatever they can achieve, but let us also be sure that we have ordinary people doing the other work. In opening the debate, the Minister said that we have 26 per cent more nurses. That is fine, but we will not have anything like that percentage in the future. If only people with degrees can be nurses, there will be a decline. The Minister said that she wants to safeguard the National Health Service, so she had better look into this pretty carefully. If we are to have only nurses trained to degree level, there will be a gradual phasing out of all those who now practise as nurses. Some of the best nurses I have ever known could never have qualified even for a diploma, much less a degree, but they are the most caring, thoughtful and considerate people that anyone could hope to meet.

That is really the point. If we have degree-educated people at the top doing all the clever things, we are going to need another layer of people who care for patients in the health service, in the care homes we have just mentioned, or going into other people’s homes. There will not be enough people with these top qualifications to cope with the needs of the public and the National Health Service. It is important that the Government should examine this carefully and in good time so that we can find out, for example, whether all those people who are dropping out of nursing degree courses are doing so because they cannot cope with the academic side. However, they might still be eminently suitable for working in hospitals. A new structure must be formed to replace the nurses we are going to lose. That is very important. We need to look at the health service in practical terms in order to be sure that patients are safeguarded, as the Minister said in her opening remarks.

My Lords, I welcome the chance to speak today on health, and in particular the mental welfare of our ex-Navy, Army and Air Force service personnel. I have chosen today and not the defence day to speak because I wish to address the issue of personnel who leave the services without any documented physical or mental health problems. They return to the civilian world where they become the responsibility of the NHS. I am disappointed that there was not more in the gracious Speech about this subject.

I want to talk about post-traumatic stress disorder in the ex-service community. Our experience in Northern Ireland shows that the families of these men and women are also worthy of serious consideration in this respect. I am aware of the liberal use of the term PTSD, and not everyone diagnosed has the full-blown disorder, but many exhibit several of the accepted symptoms which are no less damaging. There is no dispute that this is an ever-increasing problem. The Government, the NHS, Combat Stress and other interested parties all accept that. An indication of the increasing size of this problem as the years pass was given several years ago in a review of combat stress by the Health and Social Care Advisory Service. The figures came from a study done by King’s College London, led by Professor Wesley. Further research sponsored by the Government has just been produced and was given its first airing two days ago at the Combat Stress conference in Manchester.

For the first Gulf War in 1991, 1 to 3 per cent of service people were said to have succumbed to some form of PTSD. Going further back to the Falklands war, the figure is 8 per cent, and it is even higher for Northern Ireland tours. It is accepted that PTSD can first affect people immediately after the event, but may not have an effect for up to 15 years, hence the trend of increasing numbers suffering from it. Noble Lords will be aware of the PTSD emanating from the recent operations in Iraq and Afghanistan. I do not want to go into the detail, but I should like to point out some of the precipitating factors that contribute to this form of PTSD being different from that encountered in civilian life. First, there is the high level of long-term occupational stress, such as chronic fatigue, sleep deprivation and hyper-vigilance. Secondly, there is the non-combatant form of traumatic stress from activities such as the recovery and collection of body parts. Incidentally, members of the Territorial Army often man the helicopters employed in that pretty gruesome task. Thirdly, there is combatant stress resulting from being under fire for long periods of time and seeing friends killed and injured. There can be little in the way of immediate stress management, as indeed there cannot be in the circumstances of forward operating bases. Lastly, there is the self-denial of stress by people who are in the services.

When this form of PTSD is compared with that found in the civilian world, normally comprised of individual and time-limited experiences such as car crashes, air crashes, football match disasters and so on, it is clear that it is an entirely different thing. It is therefore true that veterans do not conform to the civilian pattern and that treatment in the NHS is not always as appropriate as it might be. This is a fact rather than a criticism. However, the military covenant is between all departments of government, including health and defence, and the service men and women. This covenant is to look after our service people from recruitment, through service and into retirement.

I am not medically qualified but I declare an interest in that I am a member of the board of the Ulster Defence Regiment and Royal Irish (HS) Aftercare Service in Northern Ireland. I and my family—every single one of whom has been in the forces except for one—my sisters and brothers have been involved for a long time and we have seen this kind of stress affecting people. However, I wish to consider the practical side of the availability of treatment and the access to it by those who develop post-traumatic stress disorder after they leave the services. If access is too difficult, the quality of care is of little importance.

Rather than being theoretical, I shall take the case of a soldier who leaves the Army as an example. On demob, this man has a clean medical history and is offered a summary of his medical forms. He can ask for the full record but it is unlikely that he does so because he is in such a rush to get out. Why do we wait for the soldier to be proactive in obtaining his full record? We should give it to him; we should direct where it goes. The full record does not go to his new GP; it goes to Glasgow, where, to all intents and purposes, it is inaccessible. This record would show his moves to different theatres, immunisations and, if you like, a potted history.

Even if this person gives the summary to the GP, it is not a medical document and record as such and may not be entered on the NHS computer record; it may not be referred to or, indeed, found again. In this case, should there be a problem in the future and the veteran does not admit his service, which is the norm among the younger and more numerous veterans, there is no link through the most obvious and vital channel—medical records. This lack of continuity or joined-up government between defence, civilian life and health is almost unbelievable in the modern world. Why is health in the MoD in a separate world from civilian health? The regulations and standards of care are common throughout, and many NHS personnel serve in our forces from time to time.

Where are the IT links? Why do they not exist? Perhaps the noble Baroness can explain this: how is it that I can own a farm animal—for instance, a bull—which could have changed hands 10 times throughout Europe in several different countries, but every move and change of status of the animal is on an EU database accessible at every local agricultural office in Europe? The lack of such a recording system in monitoring the health of veterans is verging on negligent. It is not a matter of difficulty or that it cannot be done; it is a mentality of refusal to do it. It is the single most effective way of monitoring the health of our veterans. Can the Minister explain why we have more efficient means of monitoring farm animals than we do of helping our ex-service community? What is the military covenant meant to be? Are we keeping it?

I turn now to the issue of access to care. First, it is a fact that the majority of veterans with symptoms of post-traumatic stress disorder do not readily admit it, go for help or seek treatment. Ultimately, all too often this leads to family break-up, homelessness and crime, and the cost to the nation that is associated with it. The reasons for not presenting themselves may be many but one of them is a lack of trust in the treatment and confidentiality of the NHS. I am well aware of the pilot schemes—the NHS veterans’ mental health units—and I ask the Minister to update us on the success or otherwise of these units. It is my understanding that the uptake, which relies on veterans presenting themselves, is much lower than expected.

All the agencies in Great Britain, whether NHS or voluntary, are places where the potential client has to walk in. This is the barrier. In Northern Ireland we have the aftercare service, which is outreach in nature. Trained health visitors find and visit veterans and their families in their homes. I spoke about this service in your Lordships’ House on 7 November 2007 at col. 122 of Hansard. You may read it if you wish; there is no time now. Subsequent to his visit to the service on 21 April 2008, the then Chief of the General Staff wrote:

“Furthermore, the Service could act as a benchmark for the way in which we provide for our veterans on the mainland. I have, therefore, asked DCDS (Pers) to invite the Director of the Aftercare Facility to update the Welfare Conference (8 Jul 08)”.

That was turned down by higher authority. I cannot believe that people were not even interested in it.

The Deputy Chief of the Defence Staff (Personnel), to whom it was sent, wrote back and said:

“I do not consider, however, that we are yet in a position to take decisions on its extension … we are committed to a Review later this year”.

It is now later next year and I would like to know what happened to the review.

Recently, the Minister for Veterans, Kevan Jones, on a second visit to the service, passed a comment to the director to the effect of, “This is what I am trying to organise in the rest of the UK. When we have this as a model, why are we trying to reinvent the wheel?”

The Government are sending the wrong messages to our soldiers, their families and the nation. Another simple example of lack of support and “can do” mentality came on the TV news the other day. The US is producing short-term positive results from showing veterans video war games and footage of incidents in Afghanistan. Reading University is also doing research into this. The news reported that, when asked about it, the MoD reply was words to the effect of, “We are not interested. We are not following suit”. Might it not have been more positive at least to say, “We will watch”?

When he was Secretary of State for Defence, Des Browne gave me 45 minutes of his valuable time in his office and justified rejecting the aftercare model by saying that it was basically a reward and a peace dividend for the UDR and Royal Irish in Northern Ireland—a kind of signing-off military covenant. It is good; it is brilliant; it is the Rolls-Royce model.

Noble Lords should see it this way: our courageous service men and women are fighting abroad, in far-away lands, for peace in the United Kingdom. This is no different to what was happening in Northern Ireland. I ask the Government to give them their peace dividend by enabling them to return home and then, when they finish their service, giving them the follow-up care, treatment and monitoring that they deserve—the military covenant.

My Lords, positioned as I am approximately half-way through the list of speakers for today, perhaps it provides an opportunity for me to summarise some of the themes that have emerged. I do so principally in relation to education and that part of the gracious Speech relating to yet another proposed education Bill. I shall draw on many of the insights that have already been shared with the House by the noble Baronesses, Lady Walmsley and Lady Perry, and by the very distinguished maiden speeches that we have heard today. Among the themes that seem to be running not only through the education part of the debate but also through the social affairs, equality and health elements is that when it comes to building the road to hell the Good Intentions Paving Company still seems to have a monopoly.

The proposed Children, Schools and Families Bill is undoubtedly well-intentioned. It builds on a great deal of progress made across many aspects of the education sector in recent years, to which the Minister referred in opening the debate. The Church of England Board of Education, which I chair, has been pleased to be in partnership with government in delivering improvements in the infrastructure of our schools provision and in driving up standards where room for improvement was clearly identified. But just when we think that these good intentions may be paving the way to something better for our schools and those who lead, learn and teach in them, we suddenly discover that the road is leading to somewhere far more disturbing and disconcerting.

So it is with the advent of the Bill. Pupil and parent guarantees; effective sharing of information about schools’ performance and achievements; curriculum reforms which prepare pupils for a positive life in the community; enhanced status for teachers; safeguarding the vulnerable and increasing confidence in family courts—all these are good and honourable intentions. So why will they not deliver what is desired?

First of all, we are once again in the realm of regulation as the remedy for all ills. The noble Baroness, Lady Walmsley, drew our attention to that poor, sad soul who calculated that education regulations issued since 1997 run to over 1,200 items, adding up in words to more than the combined works of Shakespeare. Some of those have been necessary; most have not. I am afraid that too many new regulations proposed in the Bill fall into the “not needed” category. For example, the proposed report cards will itemise those characteristics of a school which can be measured, counted or valued at a price. However, as the noble Lord, Lord Sacks, reminded us, not everything that matters can be measured; not everything that counts can be counted; not everything that is valuable can be valued at a price. You cannot measure the atmosphere in a school, or count its capacity to care, or put a price on its ethos. These things resist the trivialising tendencies of simplistic statistical reporting, yet they are probably more important when it comes to delivering a great education than anything that can be recorded on a report card.

Then there is the proposed licence to practise as a teacher. We already have Ofsted, competency and capability procedures, and the General Teaching Council’s code of practice. Why is more regulation necessary? The Government’s own commentary on this part of the Bill suggests that this provision will,

“professionalise the workforce and provide teachers with the status they deserve”.

But let us hold on a minute. More teachers than ever are graduates and hold postgraduate teaching qualifications. We have already heard reference made to continuing professional development and the need for more of it, but more teachers are engaging with it than ever before. Is that not sufficient for them to qualify as professional? As for enhancing their status, well, that brings me to my second reason why this well intentioned Bill will not deliver what is desired.

The Minister of State for Children, Schools and Families, in his foreword to Your child, your schools, our future, wrote this:

“A well led, highly skilled workforce is the key to all our plans”.

Surely a crucial qualifier is missing here, for it is not enough for a workforce to be well led and highly skilled if it is not well motivated. This rash of guarantees, licences to practise, surveys and report cards—all well intentioned—will simply contrive further to erode morale, trust and confidence among teachers, many of whom already feel overburdened by bureaucracy and undervalued as professionals equipped to do the job. Yet they still need, apparently, to be regularly relicensed before they can be officially accorded professional status.

Proposed reforms to the primary curriculum following the Rose review have much to commend them, but whether it is the Rose curriculum which is implemented, or something different as proposed by the Opposition, little will be gained by way of added value if teachers finally lose patience with political rhetoric which seems to be increasingly remote from reality.

There is a real risk that expectations will be raised which simply cannot be realised unless far greater resources are made available than current Treasury forecasts are likely to accommodate. Another theme of today’s debate so far is that guarantees which cannot be met are worse than no guarantees at all. PSHE and RE programmes which are under-resourced could well do more harm than good.

Let us be very clear that we in the Church of England Board of Education sign up without hesitation to the Minister of State’s ambitions when it comes to every child realising their potential in a great school where every child really does matter. But under-resourced ambitions can only deliver frustrated outcomes when more is promised than can possibly be delivered. As the noble Lord, Lord Rix, put it, a promise made is a debt unpaid.

There are other elements in this Bill which must await detailed scrutiny before it would be fair to pass further comment. Will increased publication of information relating to family court proceedings result in the interests of the child being given priority and mediation services being used more widely? We must wait and see. Will strengthening the powers of local authorities and others with regard to registration, inspection and intervention result in more effective systems being in place to safeguard the most vulnerable in our society? We must wait and see. Will local surveys prove to be so vague and open-ended that they run the risk of being recruited to serve agendas unrelated to educational excellence? We must wait and see.

Meanwhile, let us be clear that our hopes for this Bill and any which may succeed it are that it and they will result in: first, sustained high levels of morale and motivation in the teaching profession; secondly, well resourced curriculum development and programmes for delivery; thirdly, standards increasing at a sustainable level; and, fourthly, a school experience focused on nurturing the whole person physically, socially, intellectually, morally and spiritually rather than simply fostering a functional approach to education characterised by tick-boxes, targets, report cards and ever more regulatory controls.

I am confident that whenever this Bill finds its way to the Floor of this House, your Lordships will be ready to join me in ensuring that its undoubted good intentions help pave a way to something far better for our children and their teachers than is currently in prospect.

My Lords, we are in the final day of the debate on the gracious Speech. Indeed, we are slightly later in that day than your Lordships might have imagined, as you will have quickly worked out from the list of speakers that I am unexpectedly speaking immediately after the right reverend Prelate.

We are covering a wide range of government commitments to bring forward legislation that bears on education, health and social well-being, and all in a very short Session. We are to consider Bills to enable the wider provision of free personal care to those in highest care need; to introduce guarantees for pupils and parents to raise educational standards; and to protect communities by ensuring that parents take responsibility for their children’s anti-social behaviour and by tackling youth gang crime—not to mention the Equality Bill.

I do not apologise for coming back to a theme that has already been raised by a number of noble Lords: these are admirable aims—nobody could disagree with them. But are the Government sure that these admirable aims will be best approached by adding to the mountain of legislation and regulation? Are they sure that the legislation to be introduced will actually contribute to these aims? Are they sure that it will do so without imposing disproportionate demands on those who have to deliver the service, and disproportionate costs on others?

We all know that we have recently enacted far too much legislation. I am saved from detailing that by the fact that earlier the noble Baroness, Lady Walmsley, gave us a good run-down of the measures of excess, not success, in this matter. It often remains wholly unclear whether the legislation enacted has had its intended effects, whether it has produced unintended—indeed, all too often, harmful—consequences, and whether any of the intended effects that have been achieved have been at disproportionate cost. I believe that there is dissatisfaction on all sides of the House, and in the country at large, about the torrent of legislation that we are inflicting on the institutions and, above all, on fellow citizens—and I agree with the right reverend Prelate about the professionals. We are aware of a lack of systematic, as opposed to selective, and indeed very highly selected, evidence that the intended effects are being achieved. We are aware of very little systematic, as opposed to selective, indeed selected, evidence, that there have not been unintended consequences.

I shall look at one example. We are to see a Bill that aims to introduce guarantees for pupils and parents and to raise educational standards. We all agree that that sounds admirable, but, looked at in the wider context, we all know that there is a raging debate about standards and it needs addressing. As the right reverend Prelate the Bishop of Lincoln has reminded us, you cannot short-circuit these matters. The Government point constantly to the numbers of exams passed, particularly at grades A to C at GCSE. Yet Sir Terry Leahy, the chief executive of Tesco, warned us last week that,

“standards are still woefully low in too many schools”,

and complained that employers have to pick up the pieces. Other business leaders have concurred, all within the past week. He was talking about basic numeracy and literacy among school leavers of 16.

The problem, however, is not just one of basic standards; it is also one of standards at age 18. Like employers, universities often find that these are lower than is needed to begin the intended course and, in particular, that many intelligent candidates have—oh, telling phrase—“given up maths at 16 and languages at 14”, leaving them unprepared not only for degrees in maths and languages but for a very wide range of degrees and an even wider range of careers to which they might otherwise have aspired, particularly careers in business.

Alistair Cox, who is the chief executive of Hayes, the recruitment consultants, has a wide overview of the standards actually achieved by those entering the labour market at 18 plus, often with a degree, and he is right when he comments that a focus on meeting targets has come at the expense of quality—particularly, I would add, at the expense of skills, especially mathematical and linguistic. A Bill to introduce guarantees for pupils and parents and raise educational standards will itself have to meet very high standards if it is to inspire the slightest confidence.

There is a good deal of disagreement about how things might be improved. There is discussion of ways in which we might improve parliamentary process. Not only is there the broad theme of constitutional renewal but the Select Committee on Reform of the House of Commons, chaired by Dr Tony Wright MP, has just reported under the nice title, Rebuilding the House, with numerous proposals for better organisational Commons business. It was published yesterday and is available in the Printed Paper Office.

The Select Committee drew on comparative evidence of approaches in other legislatures that have worked. One can read a good deal of the evidence in the excellent report called The House Rules? International lessons for enhancing the autonomy of the House of Commons. That report was published in October by a team led by Dr Meg Russell, who was also the principal specialist adviser of the Commons Select Committee on Reform of the House of Commons, working in her academic capacity and based in the Constitution Unit of University College London.

I am all for improving the legislative process, but we cannot do so effectively unless we are rather clearer about what would constitute better—indeed, good—legislation. Legislation is, after all, what parliaments produce, and for Parliament, as for others, process is good only if it supports better outcomes. I fear that we are too often unclear about what would count as better outcomes, and what they would be like. We are not self-critical when we end up with unwieldy legislation that establishes hyper-complex institutional structures, with bizarre conflicts of duty that are likely to be dysfunctional and certain to demotivate professionals.

I believe that despite the size and detail of so much recent legislation—and the sometimes useful Explanatory Notes—and despite copious debate and amendment, we are much less clear than we need to be about whether what we produce is good legislation. I hope that the Minister might tell the House what measures the departments working on draft Bills are taking to ensure that the Bills now being prepared, and which will be or have been tabled, are actually needed, that their aims could not be achieved by other methods, that they are likely to achieve their aims if enacted, and that they will not have adverse unintended consequences. I hope very much that she will not answer that consultation with so-called stakeholders has been copious. Consultation, too, is only a process and no prophylactic against poor legislation.

There are those in this House who think that this will be a short Session, because the Bills brought forward are in any case doomed, and that all that will go on is displaced electoral activity. In my view, that would be a waste of parliamentary time and, indeed, an abuse of parliamentary process. I hope that all the forthcoming Bills will be judged as prospective legislation by appropriate and realistic standards.

My Lords, 10 years ago, almost to the very day, I had the honour of making my maiden speech in your Lordships’ House. I spoke then on children’s health and well-being. Ten years later, I am about to do the same thing. I should declare an interest as chair of the All-Party Group on Children, whose members work tirelessly in all sorts of ways for children’s interests, as do the numerous voluntary sector organisations with which I have the pleasure of collaborating.

All Bills, whatever their title, should in my view be examined for their ultimate impact on children. Bills on transport, on climate change, on finance and so on will all relate to children and young people in some way. Today, of course, all the topics give me scope to touch on various aspects of child well-being, so I shall have to be highly selective and will focus mainly on the implications of child poverty.

In the past 10 years, this Government have done well by children and young people, and by families. I make no excuse for repeating that over and over again. There have been many financial benefits for families; Sure Start has expanded, and there have been improvements and expansion in education. In schools that I visit, I do not recognise the glum picture painted by some of the media, although I have reservations about some school inspections. While I shall raise a few concerns today, I am full of admiration for the courage that the Government have shown in placing child well-being so prominently in their agenda—not just intentions but real, solid delivery and outcomes.

On the Child Poverty Bill, at least, there is cross-party agreement on the need to tackle child poverty. The Campaign to End Child Poverty has worked long and hard to hold politicians to account on this, and pointed out the need for the Government to consider the recommendations of the UN Convention on the Rights of the Child. Those are: to provide disaggregated budgetary analysis to identify the amount of expenditure allocated to children, and to consider whether that allocation serves to implement policies and legislation affecting them. There is also concern, which I share, about the definition of the age of a child. It is under 18 in the United Nations convention, but the Bill places it as under 16. On the UNCRC, I am delighted that the noble Baroness, Lady Walmsley, has introduced a Private Member’s Bill. It is certainly time that we discussed this thoroughly.

There is a need for consolidated action, which is why I welcome the Child Poverty Bill. The UK has a high rate of child poverty, which is unequal between regions and even between cities. The life expectancy of a child born in Glasgow is 28 years less than that of a child born a few miles away. The 2007 UNICEF report—I declare an interest as a trustee of UNICEF—placed the UK bottom out of 21 OECD countries on child well-being. Therefore, the Government's commitment to halving child poverty by 2010 and eradicating it by 2020 has to have forceful strategies in place, and there are strategies. Targets have been mentioned several times today already; they can be difficult things, but at least they concentrate the mind and efforts on setting up an awareness of accountability. I have seen that work positively. I am pleased to see that the Child Poverty Bill recommends a child poverty commission. That should maintain the impetus for action on child poverty and ensure that those with responsibilities in this area are engaged.

Supporting the vulnerable is, of course, a key role for local government. Councils, as the LGA points out, have a responsibility to create a better life for communities. Public and third-sector bodies and employers need to work together. It is encouraging that many local area agreements have a target of reducing child poverty and improving the well-being of children and families. We should be aiming, as UNICEF states, to define the successful eradication of child poverty as being no more than 5 per cent of children living in relative low-income poverty. This will require intense effort at all levels of society.

Removing children from poverty means usually addressing family financial and economic status. Poverty goes hand in hand very often, but not necessarily, with poor health, low educational achievement and access to rights and overall development. We also need, therefore, to enhance opportunities for children to have good health, good education and good social circumstances. The Children, Schools and Families Bill aims to enhance those opportunities. Like others, I am delighted that, at last, PSHE is to be statutory in the curriculum; I hope teacher training accompanies it.

The statistics related to crime and anti-social behaviour in young people who have suffered neglect, abuse or have not accessed education are simply unacceptable. Early intervention is key. Involving and supporting parents early is vital, as discussed in the Crime and Security Bill. The real key, of course, is very early intervention, such as when the child is young or when a family is experiencing distress. Family intervention projects now operate in about one-third of local authorities. They support families at risk by assigning an individual key worker to develop a family support plan and help with budgets, diet, health and education. They set out changes expected from family members and point out the consequences of not making changes. They are working well. I hope such programmes will help children avoid involvement with the criminal justice system and maximise opportunities, thus positively affecting cycles of poverty.

Children’s services are under severe stress. Inspections of them are being criticised; front-line social workers are under impossible pressure. Initiatives to remove the need for child protection and enhance child welfare are to be welcomed. I chaired a conference the other week to launch local protocols between drug and alcohol treatment services and local safeguarding and family services. This was jointly organised by the Department of Health, the DCSF and the National Treatment Agency, the special health authority of which I am the chair. I mention this because there are some families who need specific, targeted and very special interventions if the children in them are not to end up in severe difficulty.

Sixty thousand children have a parent in prison; 120,000 children have parents who misuse drugs, excluding alcohol. One in three adults in treatment for substance misuse has parental responsibility. Many grandparents who have the sole care of children because their son or daughter is dead, in prison or incapable due to substance misuse are living in poverty. The charity Grandparents Plus recently launched a report pointing out that 200,000 grandparents have full-time care of their grandchildren. There are even more other kinship carers, four out of five of whom gave up full-time work when they became carers. Two-thirds have an income of less than £15,000 a year; many have much less. They receive little emotional or immediate financial support for taking on children. Every local authority needs to recognise the needs of kinship carers and have, as some local authorities already do, a specialist person to help them with benefit claims and access to other support, such as respite. Such carers save the NHS and local authorities about £750 million a year.

Much has been done to improve the numbers in drug treatment, reduce waiting times and improve services, but in the case of children more interconnectedness between services is needed. Adult and family workers and all those concerned with child well-being need to work together to ensure that lack of engagement with problems in a family—such as drug or alcohol misuse, or prison—does not impoverish the child financially and in other ways. Many factors impinge on child poverty and our structures must examine them all. It is not just the responsibility of government. Whatever the results of elections next year, I hope that a future Government—and Governments for all time—will put a strong focus on the well-being of children across all legislation. We have some way to go, despite huge improvements. Yes, it takes money; yes, it takes energy and commitment. But for the sake of all our futures, it is into children that money, energy and commitment must go.

My Lords, many of us feel that this year’s Queen’s Speech is something of an academic exercise, perhaps on the lines of an A-level sociology question: “The Government are soon to die; how can we introduce measures to fool everyone into the hope of unexpected survival? Discuss”, which we are certainly doing at length this afternoon. The promised action to address care for the elderly is clearly one such measure, as is the education Bill. Both are very welcome, but I wonder whether they will get anywhere.

However, I want to address something completely different, as noble Lords would expect. Before I do so, perhaps I may say what a privilege it was to be in the House today to hear the maiden speech of the noble Lord, Lord Sacks. It was a truly moving and great occasion. I apologise for missing the maiden speech of the noble Lord, Lord Aberdare.

For many years now the NHS has depended on nurses and doctors coming from overseas, often from developing countries which could ill afford to lose them. We have been told on many occasions that they are not employed directly by the NHS but only by agencies, but we all know the extent to which agency nurses and doctors have been used.

It is also argued that if we have vacancies in the NHS, professionals from developing countries should be welcomed, not only in our interest but in the interest of developing their personal professional development and training, which they could not obtain at home. Six years ago I was in Malawi at the height of the AIDS epidemic there, when the hospitals were absolutely packed with dying patients. The doctors and nurses were acting more or less like mortuary attendants. Malawi had a 40 per cent vacancy rate for doctors and nurses at that time. It was easy to see why as there was no professional development, very low pay, and, as I say, doctors and nurses were just receiving dying patients and seeing that they were dispatched to the mortuary after death. I am glad to say that situation has been improved tremendously by DfID, through the Malawi worker support scheme. It has improved the situation in Malawi, although I suspect that it has not improved professional support and training over there as much as we would like. The NHS should do something to repay our debt of gratitude to these people and their Governments.

I was contacted some months ago by a young trauma surgeon, Sohail Khan, from the north of England who, having got a team together, was planning to go out to Gaza just after the offensive there to help with trauma surgery. The problem was, of course, that the members of the team were going in their vacation and needed help from our Foreign Office to ensure that they did not spend the whole of their holiday waiting to be let through crossings. Humanitarian concerns in Gaza were not very high on the list of priorities of the Israeli Government at that time. Mr Khan and his team are part of Mobile International Surgical Teams, MiST, which was formed in 2005. I am honoured to be its patron. Its members will go to any part of the world following war or natural disasters, or simply when called upon to give training to other surgeons in countries less developed than our own. MiST currently has training projects in the Nasser Hospital in southern Gaza, where trauma surgery is desperately needed. It also plans to help other surgeons in Kurdistan, Sudan, Bangladesh and northern India and is setting up schemes with the health services there. Some of the MiST teams helped after the earthquake disaster in south-east Asia in 2005. There are other such teams in the UK in some of our great medical centres—Pima is one, based in Nottingham. I am sure that I will be hearing from all the teams in the next few weeks.

The first problem for the teams is to get visas to go to disaster or war-torn areas. I commend the efforts of the Foreign Office, which works tirelessly to help them. The other problem is that to go on these missions they have either to give up all family holidays or take unpaid leave, which is often very difficult to obtain. At least unpaid leave means that the trusts have the money to pay locums; but surely we can do better than this in the NHS. We owe developing countries a huge debt of gratitude for allowing their medical professionals to come here and shore up the NHS when we needed them. The lack of a health infrastructure and training in developing countries has been addressed by the noble Lord, Lord Crisp, in his report Global Health Partnerships, published in 2007; but we have not yet seen much action.

Many health professionals would do this work abroad; but with only six weeks holiday a year, a lot of them feel that their families must come first. A scheme to release these people could be run locally by consultants to avoid the political involvement of managers. Local negotiating committees could be used for that purpose. Trusts could be reimbursed for the cost of locums by the Department for International Development. Instead of wasting money on aid that might not be well used, it could directly export the expertise of the NHS to help other countries set up infrastructure and train their professionals. A sub-committee of the Royal College of Surgeons is looking at the issue, because doctors and nurses have been the first to recognise the part played by professionals from developing countries in keeping our health services going.

This suggestion was first brought to my attention as a result of the terrible offensive on Gaza last winter. Noble Lords will know that Palestine is of great concern to me. However, I have recently been to Ethiopia, where the Fistula hospital in Addis Ababa, founded by two Australian gynaecologists two or three decades ago, has done amazing work for so long. It has been training people to do surgery on badly damaged women, transforming the lives of those who have suffered dreadfully as a result of the lack of obstetric care in Ethiopia. There are now similar centres in other parts of Africa.

Women in developing countries suffer agonies. Half a million die every year and probably 1 million more are rendered sick or disabled for the rest of their lives, and abandoned by their families, as a result of unattended childbirth. It led me to remark on one occasion that they might be better off dead. This became the title of a report that I have just chaired and will now plug, by the All-Party Group on Population, Development and Reproductive Health. Training birth attendants in simple procedures and the use of inexpensive drugs could transform the lives of women in developing countries, and our midwives could be helping to do this. After all, how many noble Baronesses in this House have African or Afro-Caribbean midwives to thank for the safe delivery of their children? I for one give thanks to those women and I suggest that it is payback time. The NHS needs to repay its debts to the third world and I hope that the Minister will tell us that this will happen.

My Lords, my contribution to this debate relates to the Personal Care at Home Bill. I will endeavour not to repeat or pre-empt comments from other noble Lords, although I agree with many of the sentiments that have been expressed and, as president of the Local Government Association, I hope to contribute to the detailed debate. I will cover two aspects of the debate on provision of care for older people.

I declare my interests as chairman of the All-Party Group on Housing and Care for Older People, chairman of the Hanover Housing Association, which is the country’s largest provider of extra care housing, and chairman of a panel established by the Homes and Communities Agency on innovation in housing for an ageing population, which will release what I hope to be a fascinating report on 3 December. With these housing interests, your Lordships will not be surprised that the first point that I must make is that housing is the all-important third dimension in the care debate, alongside health and personal social care. Without this third leg to the stool, the other two will not stand up.

Appropriate, accessible and well designed housing can both delay and prevent the need for long-term care and entry to a residential care home. As the Government’s excellent policy paper Lifetime Homes, Lifetime Neighbourhoods states, 51 per cent of people in care homes have moved there after hospitalisation because a return to their home has not been practical. Serious housing problems and a physically unsuitable home are cited as key causes of admission to care homes.

In part, these factors highlight the value of home adaptations—downstairs bathrooms, handrails, the removal of perilous steps and so on—and the good work of Care and Repair home improvement agencies should flourish. Sometimes, the best option for the older person will be a move to a new home designed specifically for the older occupier: manageable, accessible, with lower fuel bills and maintenance costs, and perhaps with companionship in place of isolation and loneliness. If light, bright, spacious and new easy-to-manage apartments for older people are built for sale and rent, more of us will be tempted to move from our underoccupied, three or four-bedroomed houses, mostly in the suburbs, which are badly needed by the next generation of families with children. Therefore, when considering priorities for public funding, let us remember the trade-offs between investment in housing for older people and the resulting savings for health and personal care budgets.

My second point prompted by the introduction in the Queen’s Speech of the Personal Care at Home Bill relates to the crucial question of paying for all long-term care, not just for the 20 per cent or so of those with the highest care needs and not just for care delivered to the home. How are we to afford the escalating costs of care as we live longer and so many more of us have care needs, not least as a result of Alzheimer’s and other forms of dementia?

I commend the work in this field of the Joseph Rowntree Foundation, which this month launched five new reports, available on its website, that look at a fairer system and draw on international comparisons, particularly from Germany and Japan. Back in 1996, the foundation published a seminal report from its inquiry into paying for personal care. The hour may now have come for the recommendations from this inquiry. It concluded that a national care insurance scheme could finance a universal national care service of the kind envisaged by the Government’s Green Paper on the future of care. A compulsory addition to national health insurance contributions of about 1.5 per cent was assessed by the Government Actuary’s Department as sufficient to pay the premium, on retirement, for insurance to cover all potential personal care costs. A home equity release scheme would also allow a similar sum to be drawn from any owner-occupier’s property. Such arrangements would make possible non-means-tested provision, with no artificial boundaries between health and social care, and would remove the hazards of potentially ruinous care bills for ourselves or our families, which cause such fear and worry.

A compulsory insurance scheme can be accused of simply being a new tax—albeit a hypothetical and ring-fenced one—but I fear that a voluntary scheme will fall far short of the massive task ahead of raising the money that the nation needs to cover care costs in an ageing society. A voluntary scheme loses all the economies of scale and brings costs of administration and marketing, problems of moral hazard and cherry picking by insurance companies. It will not be taken up by those who are too young to worry about their future care needs or by those who want to spend their money now and throw themselves on the mercy of the state if they need care later.

It is good news that the gracious Speech highlights the issue of personal care at home and I trust that the debate on the Bill will open the door to a real explanation of fundamental reform to the current unfair and unpopular arrangements for care provision. I hope, too, that that key ingredient of housing for older people will take a central place in the debate that follows.

My Lords, it is a great pleasure to follow the noble Lord, Lord Best, in this debate, particularly given his huge expertise in housing and supported housing. I shall concentrate my remarks on adult social care and the Personal Care at Home Bill, which was published yesterday. Some of what I say will be an attempt to respond to the encouragement of the noble Baroness, Lady O’Neill, to concentrate our efforts on producing good and effective legislation. I fear that the Bill falls a little short in that regard.

The Government’s Green Paper, Shaping the Future of Care Together, published in July, followed a six-month engagement process in 2008 with the public, service users, staff and other stakeholders. It set out a clear analysis of the shortcomings of the existing social care system as we live longer and have more care needs and as the working population shrinks proportionately to the non-working population. The costs of social care are rising and will continue to rise, probably faster than inflation, and the cost of home care is rising faster than that of residential care.

Tackling these issues represents a major political challenge for whoever is in government. Yet the Green Paper presented some balanced and measured possibilities for moving towards a comprehensive set of reforms. These would try to integrate the disparate state services and benefits; provide a common set of service eligibility criteria in place of the current postcode lottery; produce a portable assessment of individual needs, which I think is very important; be clearer about what the state would pay for and what was down to the individual or family; and start a process for securing state or private insurance to help people to meet the costs of care in old age. That is a thoroughly good road map for the kind of issues with which we need to grapple.

These ideas were put out for consultation, which ended only on 13 November. The Green Paper was signed by the Prime Minister and seven Cabinet Ministers. The next bit of the choreography was to be a White Paper in early 2010. I am sure that it seemed a good idea to engage the Prime Minister in the change process. Unfortunately, if I may use a “Strictly Come Dancing” analogy, his performance seems to have been modelled more on John Sergeant than on Fred Astaire. He committed himself to premature action on a national care service at the Labour Party conference. Now the Department of Health has been diverted to producing a Personal Care at Home Bill in advance of any White Paper setting out comprehensive reform. Can the Leader of the House say when we are likely to see the Green Paper?

I have more questions, so the Leader of the House may need to take note of all of them.

There are many unanswered questions on the policy consequences of the Bill published yesterday, particularly its compatibility with a more comprehensive scheme of reform. I do not have time to go into all of these today, but I will at Second Reading. However, it is clear from the published Bill that it does not itself make any guarantees; as was made clear in yesterday’s longer consultation paper, much will be left to secondary legislation and guidance. There is still much uncertainty as to the circumstances covered and whether entitlement and payment rates will be decided locally or centrally. This makes it difficult to rely on the Government’s cost estimates in the impact statement, which I wish to probe further. I find it strange that, on the day a Bill is published, the Government should start a consultation on what should be in the substantive part of the legislation, in secondary legislation and in guidance.

My understanding from the Personal Social Services Research Unit at the LSE is that, by 2010, 933,000 elderly people are likely to be in the highest critical needs category for social care. I should very much like to know what proportion of that estimate are now likely to be given free social home care under the Bill who are not receiving some form of care now. What do the Government estimate will be the average annual cost for those people receiving new forms of care? In essence, I would like to be a lot more convinced than I am about the Government’s estimate of £670 million for the Bill’s cost in a full year. More information is needed in that area.

A key issue in this area of social care is how rapidly costs will rise each year. Happily for us, Scotland has just published figures on how the cost of personal home care rises when you make it free. It almost doubled in Scotland in four years, from £129 million in 2003-04 to £257 million in 2007-08. The number of people claiming once it was free rose in the same period from about 33,000 people to nearly 45,000 people—a 36 per cent increase in four years. In the last year for which figures were published in Scotland, the cost increase was 15 per cent in one year. Can my noble friend tell us whether the Government have taken account of Scotland’s experience in this area? When I looked at the impact statement published yesterday, their assumption seemed to be extremely low by a factor of six to seven compared with the Scottish experience.

My final point on cost is that we need more information on where the money is coming from to pay for the Bill. My understanding is that local government will have to find £250 million in a full year. Will local authorities be able to use their current powers to change their service eligibility criteria or charging policies to meet the Bill’s costs? If so, that could effectively mean that another group of service users will be paying for the Prime Minister’s largesse.

The rest of the money for the Bill seems to be coming from the Department of Health budget, but I am a bit unsure about where it will be coming from within that budget. Certainly, the research and development budget seems to have been fingered and is said to be going to fund a significant part of the programme. I would very much like to know how much will be cut from the R&D programme, for how long and which R&D projects will fall by the wayside. I ask that as a member of the House of Lords Select Committee on Science and Technology, which is currently, ironically enough, undertaking a study on departmental R&D budgets—and the Department of Health has just given oral evidence to us. I do not think that the department mentioned this in its oral evidence.

It is now clear that I am not a fan of the Bill. I do not see it as likely to be a particularly useful stepping stone to the wider reforms that the Government were wisely and, I would say, courageously engaged on. It is not thought through and, to many people, it looks like a political gimmick. It could well incentivise people to stay in their homes longer than may be safe.

I do not detect a rapturous reception for the Bill outside this House. Until the Bill appeared, the work done suggested that Labour had given much more careful thought to the important and complex issue of reforming adult social care than the other main parties. Certainly the Conservative proposal for an £8,000 private insurance policy to help to pay for long-term care looks decidedly thin and unconvincing, although I acknowledge that some form of insurance scheme will almost certainly be needed as part of a longer-term solution. I listened carefully to the noble Lord, Lord Freud, but he did not convince me that the Conservatives have a cunning plan in this area.

However, I do not expect the Government to retreat on this and I am resigning myself to the fact that many of us will have to try to make the Bill more sensible and realistic about costs and funding arrangements. Good places to start would be some national rules on service eligibility criteria to avoid a postcode lottery and making local assessments of individuals portable to other areas. There is also a strong case for using the money that can be obtained to improve specific services that straddle the health and social care boundary. The noble Baroness, Lady Greengross, mentioned dementia, which is a case where urgent attention is particularly needed.

I will also want to press the Government to rethink how they want to pay for any changes. My view is that they should be looking at ring-fencing some of the money, perhaps as much as £1 billion or so, from the £15 billion to £20 billion that the NHS chief executive David Nicholson announced in his 2008-09 report that the NHS should be saving by efficiency gains between 20011 and 2014. Has this approach been considered or will it be considered?

I have tried to be constructive as well as critical in my remarks. I hope that others across the House and the various interests outside who have been engaged with the Green Paper work will join together to help to improve this Bill if the Government wish to proceed with it. That would be in the interests of service users. I make it clear that I am a supporter of better arrangements for home care and improved consistency of social care services and support across the country, but the job has to be done properly, with full regard to the public finances and the likely position of our children’s generation as funders. We need a more bipartisan and coherent approach than is provided for in this Bill.

My Lords, it is a great pleasure to follow the noble Lord, Lord Warner. I am very grateful to him for the report Choosing with Care, which he chaired in the mid-1990s. It was influential in improving the quality of staff in children’s homes. I am concerned about what he and the noble Lord, Lord Freud, said about the considerably increased costs that the Personal Care at Home Bill will introduce. I welcome the significant investment the Government have made in children’s services over the past 10 years. Perhaps it has not always been as focused as it might have been, and I regret there is huge further investment to be made if our children are to be better protected in future. I am concerned that huge investment in another direction at this time might not be helpful to that.

In the interests of keeping to time, I hope I may be forgiven for reading from a script on this occasion. However, I shall first say how much I welcomed the maiden speech of my noble friend Lord Aberdare. He has experience in helping young people into employment. At this critical time, with the under-25s being particularly affected by the recession, I welcome his expertise in this House.

I welcome the many important new measures in the Queen’s Speech, particularly the new statutory duty on schools in the Children, Schools and Families Bill to provide personal, social and health education. It is vital if we are significantly to reduce the level of teenage pregnancies and the terrible dependency on the state that they too often give rise to. There are various concerns, but today I shall concentrate on one matter. However, this is the first opportunity to tell the Minister how grateful I was for the ministerial stocktake into Care Matters, the policy for looked-after children, that she laid last Friday. It was deeply gratifying to see local authorities so well represented there. One could see policy and legislation being given the follow-up that they needed for successful implementation. I applaud the Minister and hope that this may be the first of many such stocktakes. I also welcome what the Minister recently said in the Chamber about the value of voluntary adoption agencies, and declare my interest as a trustee of TACT, which is one such organisation.

Today, I will speak about just one matter, which is absent from the Address. Will the Minister assure me that she is giving priority to raising the status of child and family social workers? What, to the best of her knowledge, is their state of morale since the death of Baby Peter? Only if we have a strong and confident social work profession will we see the tide turn for our most vulnerable children and families. When will the Social Work Task Force report? We expected to hear from it in September. Why the delay, and when can we expect publication?

This is a very difficult time for such a report. There is political and economic uncertainty. Past experience is unhappy. The welcome social care White Paper Options for Excellence appeared to sink almost without trace a few years ago. There appeared to be no appetite for investment in the whole system that would have made the White Paper’s vision a reality. I welcome the implementation of newly qualified social worker status, but the whole system needs to be overhauled if improvements are to be sustained. A piecemeal approach simply will not work. Unhappy experiences teach us how easily good intentions are forgotten.

I recently visited health visitors in a borough with high levels of deprivation. Your Lordships may recall that in 1998 Her Majesty’s Government hailed health visitors as the champions and leaders of their plans to reach out to excluded families. Some time between then and now, health visiting has been lost, and today, in London at least, they feel themselves to be in crisis. I was told in a recent meeting that 25 per cent of health visitors are over the age of retirement, and that 25 per cent will reach retirement age in five years. Recruitment has become increasingly difficult.

On that visit, I was taken to meet a young mother and her seven week-old daughter. They shared their kitchen and bathroom with five other families. The isolated and depressed mother was overheating her room, which was causing her child to dehydrate and to run an increased risk of cot death. They had been disowned by the father and had no contact with the family in the mother’s home country. The only visitors and support that the mother had were from the local church, and there was a serious risk that the mother might fall further into depression. This was described to me as a typical case. Again and again, health visitors could not revisit families in need of their help because of the pressure of their case loads.

Back at the office, I heard from the head of health services for children in the borough. She pointed out that she had to find the money for the children’s centre and the family nurse partnership interventions from the same pot as that for health visiting. The implication is that health visiting has suffered as it has played second fiddle to important and very welcome government initiatives. Surely we should be concerned that social work might also suffer the same fate, and that future Governments may prioritise visible, new and welcome programmes above bread-and-butter investment in the profession.

To conclude, I seek assurance from the Minister that the current priority that is being given to social work will not be lost. Her noble friend Lord Adonis has earned respect for his commitment to visiting schools when he was Education Minister. Equally, Mr Tim Loughton, shadow Minister for Children, has earned respect for the pains that he takes to visit services. Will there ever be a Minister for Social Work who will dedicate much of his time to visiting services; listening to professionals, children and parents; and offering highly visible political engagement with struggling sector needs—an Adonis for social work?

Clement Attlee came from an upper middle-class background. His father was a lawyer. Yet through his years at Toynbee Hall, he recognised the imperative to provide an effective welfare state. If politics is becoming a freestanding profession conducted by the middle classes, does it not become all the more important for politicians to spend a great deal of their time at the front line speaking to health visitors, social workers, youth workers, and children and families at risk of exclusion? I welcomed the Minister’s question to local councillors on Friday at the stocktake. She asked how many times they had visited foster families or children and families in the past year. It made me feel uncomfortable. It was a very good question.

I hope that future Governments will choose to legislate less, and allow their Ministers and parliamentarians to spend more time at the front line learning from and giving moral support to teachers, doctors and early years’ workers. I could not agree more with what my noble friend Lord Sacks said in his brilliant maiden speech. If we wish to have a culture and civilisation that survives, above all we have to invest in teachers. If we want to protect our most vulnerable children, above all we have to invest in social workers. The workforce is not one priority among many, but the most important priority.

In terms of child protection, child and family social workers are the priority. Who is the ministerial champion for child and family social workers? A social services director with great success in recruiting social workers—he reduced vacancy rates from 30 per cent to 3 per cent in three years—told me that every day he asks himself: “What have I done for my social workers today?”. Will the Ministers and her colleagues be as single-minded as him or will social work have the same fate as health visiting? I am one of the Minister’s many fans, so I look forward to her response, in which I am sure there will be comfort.

My Lords, I remind the House that, in 1999, I was a member of the Royal Commission on Long Term Care. With my noble friend Lord Joffe, who unfortunately cannot be in his place today, I signed a minority report opposing a tax-funded policy of free personal care for all. Ever since, it has been hard pounding, but last summer I felt finally that we were getting there. The Government produced an excellent Green Paper, which came out in the summer for consultation. It was particularly excellent given the difficulties of shortage of funds under which the drafters were labouring. Perhaps I may run through one or two of its great merits.

First, for the first time we are to get a national care service, which will bring this whole area together in a more coherent way. Importantly, it will provide a single place where old people in need of care can go for advice and counsel, rather than the multiplicity of points to which they have to go at present. That will be a major plus.

Secondly, it contains a proposal which would mean that never again would any elderly person have to sell their house to fund their care during their lifetime. That will be a major plus.

Thirdly, the Green Paper set out options for ways in which people could insure themselves against the costs of long-term care. It did not resolve all the debates. I heard the excellent contribution made by the noble Lord, Lord Best, but I do not totally agree with him. I agree that a voluntary scheme will not be enough, but I do not agree that we should move to compulsion. There is a middle way, which in the case of pensions we have adopted. Under auto-enrolment, you would be in the scheme unless you opted out. As it happens, because I do not believe that I should leave my children huge sums of money when I die, I shall opt out. But I think that the vast majority of people, in time, will opt in and compulsion can be left for another generation.

Those of us who signed the minority report were most pleased that free personal care for all to be paid out of taxation was firmly by the Government “ruled out”. I will not go over the arguments that persuaded the minority of the royal commission that it should be. I will just say that, in three key regards, those arguments have been enormously strengthened by developments since.

The first such development is that it is perfectly clear that my generation, the generation now entering retirement, is the golden, favoured generation. We have the houses that went up and up and up in price, with all the wealth that that leaves us. We have the pensions. My Economist pension is to mouth-water over, I can tell you; otherwise I might not be able to afford, after the SSRB reports, to be standing here in this House. I did not mean that as a criticism of its excellent report—but we have good pensions which are now being removed from the workforce. So we are the fortunate ones and we can afford to look after ourselves by comparison with today's hard-pressed workforce, heavily taxed, who are struggling to pay their way. To make a further huge transfer of income and wealth from the working population to the retired population would be a huge mistake. That is point one.

Point two: I am afraid that we are facing—and this is, I think, common ground between the parties, though the timing is not—an eye-watering fiscal tightening in this country. The gap between taxes and spending has to be adjusted by something like 10 per cent of public expenditure; taxes have to go up, spending has to go down. Don’t let us argue about which happens because both are going to have to happen—that is a fact. At this stage in our history, to take on an enormous new commitment of public expenditure through a completely new programme would make no sense at all.

The third reason—my noble friend Lord Warner referred to this—is what has happened in Scotland. For once in social policy, we have had a controlled experiment: the Scottish free personal care policy. Actually there is not free personal care in Scotland; there is an allowance to individuals to support their spending on free care. It is a set amount because the Scots thought that, that way, they would keep spending down and it would not go totally out of control. Ho ho. Spending last year exceeded the amount predicted for the year 2020 in the Chisholm report which preceded the policy. The noble Lord, Lord Sutherland, author of the majority report for the royal commission and an esteemed Member of your Lordships' House, found, when he looked into it, that there was a £40 million shortfall in funding, which he said the English should pay up for. Ministers declined to follow his advice.

We saw this week the huge rise concentrated—and this is a very relevant point—on care for people in their own homes. There was this Green Paper process going on, and then came along what somebody somewhere dubbed the Exocet: the Prime Minister's conference speech in which he proposed free personal care for all at home. I am not going to set out in full the arguments against that; they are set out in a memorandum my noble friend Lord Joffe and I have submitted to the consultation. If any noble Lord would like to read them, they can. Indeed, I heard the noble Baroness, Lady Turner, say that she did not know what our arguments were. We distributed them at the party meeting on Wednesday; perhaps she was not able to pick one up.

Leaving aside those arguments—and the arguments are important—I think that the process by which this happened should give your Lordships pause for thought. There was a consultation on the government policy, and then suddenly, at a party political conference, the Prime Minister launched his proposal for free personal care for those with the greatest care needs at home.

I immediately set out to find out what he was on about. It was four days before the Department of Health could produce a single paragraph setting out what the policy was. I rang the Minister's office. The Minister's office suggested that I speak to the special advisers; they asked the special advisers to ring me. I heard nothing. They have apologised for that mistake, and I have accepted it as a mistake, but with a well-prepared piece of government policy that has been thought through, those documents would be available to everyone on the day the policy comes out. The Government’s arguments, which we are now teasing forth, would be available so that people could come to a view. On this occasion, that did not happen. I do not say that it is the case here, but the trouble is that the suspicion is born that it owed less to a careful policy consideration and more to the natural desire of all politicians to have a nice announcement to put in their conference speech. So I started with a predisposition against the policy.

I think it is fair to say that things have improved since then. With the publication of the Bill we have had much improved material from the Government explaining what the policy constitutes and their arguments for it, and an impact assessment of the Bill. I notice that it was made available in the Vote Office in the House of Commons but not in our Printed Paper Office. However, I trawled it back from the internet, and very interesting it is too. The Leader of the House is looking at me quizzically; perhaps it is available in the Printed Paper Office, but I got it off the internet, maybe wanting to show that I can do those things. However, it provides some useful information. I sense—I would not put it any stronger than that—a greater willingness on the part of the Government to consider aspects and the detail of the policy which I hope will evolve both before and after the Bill reaches your Lordships’ House.

I want to close on this note. We are dealing with some of the most vulnerable and not always the best informed people in the whole of British society. I have had correspondence this week from people who are dead scared of what they have read and heard about the Government’s policy. It is very important to them that they know what the situation will be. It is no secret that we are coming up to a general election. Some people think—I could not possibly comment—that there might conceivably be a change of government; naturally I hope that that will not be so. What is terribly important is that we do not launch one policy before a general election only for there to be a yawing around to a completely different policy afterwards. When the Green Paper came out and when the Conservatives brought forward their scheme for insurance, I thought that enough common ground was emerging between the two sides that we could have a bipartisan policy. I hope that any legislation passed by this House will make it clear that it does not take effect until after the general election. Incoming Ministers should be able to discuss the policy put forward by this Government and decide whether it is something they, too, can endorse so that it is bipartisan.

As I say, there are worried old people out there, and they deserve better. For 10 years we have failed to bring forward a policy on this issue. Earlier this year, at last we made progress towards a lasting and excellent policy. We owe it to our old people as a House, as a Parliament, as a Government and as an Opposition, to come forward with a set of proposals that command consensus support and can take us forward into the next century with a viable policy that gives people the help and support they so desperately need.

My Lords, it is a great pleasure to follow that speech, and I think that I agree with every part of it, especially the bit saying that we have the right to spend our own money on ourselves and have fun, so our children had better learn to work for a living. As I get older I agree with that more and more, although I do not think I did 40 years ago.

I am going to devote my speech to the home education part of the education Bill—although I cannot call it that because the word “education” has been expunged from every Bill and from the title of the department. I shall refer to it as the schools Bill. Several clauses are devoted to the regulation of home education; that is, people who educate their children at home. This part of the Bill is ill thought-out and unjustified, and I hope very much that we will delete it. In its current form it is a skeleton exposing home educators and their children to the unknown because so much will depend on how the regulations are written. Nothing in it secures their rights as home educators to look after their children in the way they see best. There is an unfortunate conflation of education and welfare which makes the business of improving or looking after the education of these children much harder.

There is no recognition in the Bill of the curricula and forms of education which are commonly used in home education, particularly in autonomous education. Instead, the impact assessment refers to the exemplar curricula which will be produced by the QCDA. In other words, everyone is to be corralled into state education and not allowed to go their own way. There is no reference to the training of local authority staff, which is recognised to be one of the major deficiencies in the current arrangements. There is no proper arrangement for independent appeal when a local authority decides that a person may not home educate. There is a skeleton in the Bill, but it is a skeleton that could be filled out in almost any way.

In this country, we have long had a duty as parents to educate our children and a right to decide how they should be educated. Many of us choose to entrust the state with their education—but that is us entrusting the state with our duty and us exercising our right to choose. The Bill turns that on his head. The arrangement here is that you cannot home educate unless you get the prior permission of the local authority, which has wide grounds for refusing. It can object in any way to your plans to educate your child. It can object and refuse you permission to home educate if you do not allow someone from the local education authority four hours of unaccompanied access to your child every year. Would we contemplate allowing that for our children under any circumstances? What right have these people to do that to home-educated children when there is no real cause for concern?

We are considering a section of the Bill which will cost £20 million per annum, which is about £1,000 per home-educated child. These children receive no money to help pay the costs of examinations; no money to buy textbooks; no money to buy materials; no money and no tuition to help them over difficulties in education. Now the Government can find £1,000 for each of these children—and will spend it on auditing them. Not one penny will go to help the children; it will all go on auditing them. What have these people done to deserve that?

Four separate communities are bundled together under the title of home education. First, there are those who opt for what might properly be called “elective home education”. They are people who have decided, as a matter of principle, that they will pursue an educational philosophy which is not available from the state. Most of this is autonomous education; most of it is a form of education which does not involve curricula or planning but involves going on a journey with children which results in education. This is, of its nature, foreign to many school-based systems, but it has proved immensely successful.

The second group might be called “the despairing”. These are people whose children have been bullied at school to the point where they will no longer go to school; or those who have children with special educational needs which are not being properly catered for and who have therefore decided to turn their lives upside down and educate their children themselves. These people do society a great deal of good by doing so.

The third group consists of the Travellers, who are bundled in here as home educators, which many of them are. Finally, there is what one might call the “year 11” children—those who have always been trouble; who have always truanted; whose truanting has got worse and worse; whose parents are not in control of them either; and who in the last year or so of school just go home and sit watching television. They are classed as “home education” because it is a convenient way for the local authority to classify them.

We do not have a coherent pattern that can be used to produce a coherent set of statistics. All this has been conflated with a worry—I associate it with the NSPCC; perhaps it comes from elsewhere—that a lot of abuse is somehow going on in the home education community. Page 90 of the impact assessment quotes the NSPCC:

“We are concerned that the child’s safety and welfare should be paramount and that there is nothing in the current guidance or framework that would prevent children from being abused by people who may claim to be home educators”.

That sentence applies equally to all of us who are bringing up children. Local authorities are not conducting any supervision of me as a parent to make sure that I am not abusing my children. “That is a bad thing; something must be done about it”; that is what is being said about home-educating families—on the basis of what?

This is probably the first time that I have paid attention to a Bill’s impact assessment, but it is an immensely useful document. It sets out the rationale of the Bill and the concerns that underlie the Government’s perceived need to introduce this section. It states that local authorities estimate that,

“8% of 'home educated' children are receiving no education at all and 20% are not receiving a suitable education”.

That would be concerning if it were true, but it is not.

To understand what is going wrong here, one needs to understand the process that the Government have gone through, with a rushed assessment of the situation under Graham Badman and three successive rounds of applications to local authorities for data, each of them seemingly compiled by a different team because they are none of them consistent with each other. None of them seems to be compiled by people who have an understanding of home education or of local authority practices. Different local authorities respond to the same questions on different bases, understanding them in different ways, providing different kinds of answers and following different rules. From that, the Government have derived a set of high-level statistics such as the one that I have just quoted.

Before Prorogation, I asked a couple of questions of the Minister on this matter. The department refused to answer, saying that it could not provide me with the underlying data because they were confidential. I shall ask similar questions again now. If I receive that same answer, we shall be off to see the Leader of the House, because I consider it deeply disrespectful of this House. These data are there and are available. The Minister may have a team looking at the data. On the other side are 10,000 intelligent, angry, committed home-educating parents finding out the same information. All the information is in the public domain, but how have the Government got their high-level results from it?

Let us look at the 8 per cent who are receiving no education at all. Local education authorities have a duty to make sure that children are receiving a suitable education. A figure of 8 per cent would mean an astonishing level of dereliction. A huge number of local authorities would be in complete breach of their requirements and not using their well established powers to bring children into education. Of course, that is not the case at all. Part of it appears to be a deliberate misreading of the figures provided by local authorities; part of it is rolling in a chunk of the Traveller population, who are already separately provided for by local authorities which have well understood the requirements of them but have included them in the “receiving no education” category. Part of it is the “year 11” problem, which is local authorities’ own problem resulting from things going on in their own schools. When you get down to the residual question of how many properly home-educated children are not being educated, it is somewhere well under 1 per cent—if indeed one can identify any numbers at all.

It is an astonishing misuse of statistics to have done what the Government have done. I shall be pressing the department extremely hard about how it justifies the figures it has produced. It does not appear to have done any research with local authorities. A lot of these figures are made up from a few local authorities that produce very high figures, but there does not appear to have been any questioning of those authorities about what those figures represent. When you do question them, as I say, you find that there are all sorts of spurious factors in there. The 20 per cent who are not receiving suitable education appear to involve people who are just refusing to provide information or are following courses that the local authority does not approve of; the number of people who have been properly evaluated and are known to be providing unsuitable education appears, again, to be well under 1 per cent. The calculation of 8 per cent receiving nothing and 20 per cent receiving less than they should is the foundation for the whole benefit that is claimed for this section of the Bill, but it is an entirely disreputable and untrue calculation.

Then it is said that home-educated children are four times as likely to be NEET as the general run of children. Again, that is total rubbish; the local authorities have just been bundling into the NEET figure any children for whom they do not have any information. Given the relationship between local authorities and home-educating parents by the time the children get to 16 and the parents no longer have to provide data to the local authorities, many choose not to. Again, the Travellers are in there, as are the “year 11” children.

Most damagingly of all, it has been said in the impact assessment that 0.4 per cent of home-educated children are subject to a child protection plan, compared with only 0.2 per cent of the general population. That is a vicious untruth. Yes, 0.4 per cent of the home-educated children are subject to a child protection plan, but the figures for the general population are 0.26 per cent with a child protection plan and 0.34 per cent who have actually been taken into care. We cannot find a single instance of a home-educated child who has been taken into care.

So, rather than the picture painted by the Government in the impact assessment of home education being a dangerous place, the actual figures, which the Government had and could easily have published, say that home education is a much misunderstood place and that, while local authorities are very cautious of it, when it comes to taking children into care, that appears never to happen—or at least almost never.

There is no evidence that this part of the Bill is needed; in fact, the reverse is very much the truth. We have just had the chief inspector saying that one-third of state schooling is unsatisfactory, while the true figures on home education say that maybe 1 per cent of home education is unsatisfactory. The phrase involving beams, motes and eyes comes to mind.

I hope that when the Bill comes to us, as I suspect it will, close to the general election and finds itself in the wash-up, my noble friends on the Front Bench and the noble Baronesses on the Liberal Front Bench will gather together and decide that this section of the Bill ought to be killed. I shall be seeking their assurances that that will be the case.

The past 12 months have done much to poison the relationship between home educators, local authorities and the state generally. It will be a slow process to rebuild it; it is a community that keeps itself to itself and, by doing so, does the rest of us a fair bit of good. It ought to have our support, not our condemnation.

My Lords, I begin by drawing attention to my interests as set out in the Register. Child poverty remains one of the major concerns of the UK Government. The current Administration have failed to meet their targets, despite child poverty eradication being a key priority. The Child Poverty Bill in the gracious Speech will again attempt to address that issue by imposing a new legal duty on the Government to eradicate child poverty by 2020.

It is estimated that 4 million children, or 30 per cent of all UK children, live in poverty, and that is often associated with child abuse or neglect. Overall, it has recently been estimated that 16 per cent of children are physically abused and that 10 per cent are neglected or sexually or psychologically abused. That is because families with economic problems, such as unemployment, have a 16 times greater chance of abusing their child compared with other families with children aged under five. Furthermore, perpetrators of violence target single mothers and their children, such that there is a 12 times greater chance of a child being maltreated in a single-parent family.

To tackle that problem, we have to look further than ensuring that children from low-income families do not lose out on opportunities at school, or in the local community, because of the cost of school trips, family outings or car-parking charges to visit parks and recreation grounds—not to mention hospitals. There has to be a systemic change in how we support families and children in need, with a much greater emphasis on home visitation programmes in order to identify families in difficulty and to target services at those most in need. The importance of primary healthcare teams in dealing with this issue cannot be underestimated, as parents with mental illness or drug or alcohol addiction are 10 times more likely to maltreat their children.

Children who are in poverty or suffering from neglect or abuse are rarely, if ever, presented to health professionals working in medical centres and clinics. They just do not come. It has long been established and recognised by the World Health Organisation—in, for example, its World report on violence and health of 2002—that home visitation is the most effective way to reach these children and prevent harm and family separation. However, the health-visiting profession has been so drastically affected by recent Department of Health policies that families with newborns are lucky if they receive one visit from a health visitor.

The chances of support in the home environment are, again, a geographical lottery, with those areas with Sure Start programmes having better facilities to support low-income families. Successful Sure Start programmes, such as the Essex home visitation care programme, should be identified and rolled out nationally. The Department of Health urgently needs to audit the number of visits that families with newborns receive under different primary care trusts around the country, as that varies dramatically from zero to 12. This information is currently unknown, according to the Community Practitioners and Health Visitors Association, as Unite the union reported on 16 October. Yet no progress can be made without this information. When are the Government making it available?

I hope that the Child Poverty Bill will go some way to standardising the home visitation services offered to children and their families, such that minimum standards are established and implemented throughout the country. Yet I fear that without considerable changes and additions to the Child Poverty Bill, that will not be the case and vulnerable children will suffer preventable harm. For example, families with newborns must be visited in the family home by a qualified health visitor at least six times in the first two years of the child’s life for needs to be identified and preventive services offered. How will the Government meet that target?

I am aware of the Department of Health’s 10 pilot programmes around the UK—at a cost of £7 million—under the nurse-family partnership scheme, which effectively reduces social exclusion for first-time mothers and promotes maternal and child health through weekly home visitations before and after birth. However, with one nurse per 25 families that scheme is so costly that it could never be rolled out nationally; it could only be applied to a fraction of those first-time mothers in poverty. Even then, by not offering home visitations to second or third-time mothers, the Government will miss 70 per cent of those children who will suffer maltreatment. How do the Government plan to incorporate those children in a new and effective programme?

The National Health Service, as I have demonstrated, is surely significantly lacking in these critically needed preventive healthcare programmes, especially for mothers and vulnerable children at home. Yet there is an important World Health Organisation programme which is already in full and effective implementation in a number of countries outside the EU and which fills the immense gap that I have just identified of home visits by a professionally trained health education expert. I refer to the World Health Organisation’s women health volunteer programme. This may, with advantage, be complemented by health education in schools and the establishment of nurse-led health posts, which are best placed in the outreach of a primary health centre catchment area to support the mother from a geographical position closer to her than the primary healthcare centre to which the health posts belong. Community health education meetings of large groups are the final supplement to this preventive healthcare programme.

I turn to the World Health Organisation’s women health volunteer programme as practised to the fullest extent in a country with which we are all familiar and by an NGO that I chair. The AMAR foundation trains and supports over 1,000 women health volunteers from the most underserved and marginalised communities in Iraq. These professionally trained women visit the homes of vulnerable families in their community. They bring vital professional healthcare advice and information, with formal teaching and informal materials on life-saving preventive health topics, such as malnutrition, vaccination, sanitation, breastfeeding and child nutrition. They refer back pregnant women, postnatal mothers and other members of the family who require health interventions to the primary health centre.

The women health volunteer programme forms an integral part of the primary health centre’s mother-child healthcare work. The women health volunteers are continuously trained and supported and then report back to the primary healthcare managers and health professionals. The reach of such a programme is immense. In Iraq, every single one of the 1,000-plus volunteers is responsible for 50 families in the community. Across Iraq, this whole network of women health volunteers at this moment visits 28,000 families every month, reaching 250,000 vulnerable people, and identifying and supporting preventive and curative health needs. Perhaps even more importantly, the programme empowers the women volunteers themselves, providing them with sustained health education, alleviating the poverty that they too suffer and enabling them to shape the health of their families, their community and the nation.

The results speak for themselves. Simple statistics show the impact of the women health volunteer programme. It is a statistically based programme and the information feeds back into each family file and personal medical record in the primary healthcare centre. That medical record—depersonalised, of course—builds up the health profile of the nation. There has, for example, been a huge upsurge in the immunisation of pregnant women and children through women health volunteer referrals to the primary health centres. There has been a similar upswing in the use of mother-child health units in the primary healthcare centre by mothers, both prenatally and postnatally. There has been a great upsurge in the use of child health services, including medical consultations, due to the referral system that the WHVs employ. The objective is to lift the health of the whole catchment area of the primary health centre. Since women are the primary users of health services, as we know, naturally it has impacted most beneficially on women and children. In this situation, in a rather vulnerable country, it is gladdening to see that there have been no cholera cases in the catchment areas where the women health volunteers are operating.

This programme, when it is combined with the health education programme in schools, whereby 78,000 children in 147 schools in Baghdad are taught preventive healthcare in class twice-weekly, plus the placing of nurse-led health posts within the reach of mothers in the hearts of their communities, has an effect on the health of the whole catchment area that is dramatic, evidence-based and wholly positive. We need this programme here. The women health programme does not only function in Iraq, and the World Health Organisation would like to see it in all countries that have signed the Alma-Ata declaration of 1978. This places public health at the heart of the programme of health for the country in question.

I have other first-hand experience of its success in countries as diverse as Lebanon, other countries in the eastern Mediterranean region of the World Health Organisation and elsewhere. To cut child poverty in a shorter space of time, I urge the Government to consider adopting a real focus on preventive healthcare through the programmes I have described so briefly, which supplement and bridge the gap between the fully professional health visitor programme and mothers outside that programme, who form the bulk of our UK population, whom current government health programmes can never reach. In addition, it is a great supplement to the services provided by the primary healthcare trusts. I stand ready to provide information to the various government departments that deal with these issues affecting children and women, especially the Department of Health.

This Government have had many good ideas and have identified the need to tackle child poverty on many occasions. The gracious Speech has again mentioned our national and natural desire to cut child poverty as fast as possible. I hope very much that this time the Government will succeed. I ask them to think not just of regulation and of legislation but of the simple programmes that I have outlined which I believe could be just as effective here as in several other countries that I have mentioned.

My Lords, I am delighted to participate in this wide-ranging debate. I intend to focus my contribution on the health element of the debate. I declare an interest as chair of an acute trust, Barnet and Chase Farm Hospitals NHS Trust, which delivers healthcare to people across north London.

I do not recognise the health service mentioned by the noble Lord, Lord Freud, in relation to an 18-week target. For weeks my trust has met 18-week targets. We are now setting a 12-week target. That is happening all over the place. The picture that the noble Lord painted is unrecognisable to me as chair of a big trust comprising two district general hospitals. I hope that the noble Lord will take the opportunity to look at what is going on in trusts such as mine.

In healthcare today our nation is facing enormous challenges from access and coverage to quality, safety, costs and value. The obligation of everyone engaged in the delivery of healthcare to protect the safety of their patients has been recognised since the time of Hippocrates. Over the past 50 years medicine has improved to the point where many previously life-threatening conditions can be controlled or even cured. This has brought enormous benefit but has also been associated with complacency concerning the primary responsibility of healthcare professionals to ensure patient safety above all else.

An acute trust such as Barnet and Chase Farm Hospitals is responsible for providing safe, timely and high-quality care to our patients. To support this we have developed our patient experience strategy, which emphasises that we must put our patients at the heart of everything we do. This is the first thing we discuss at every board meeting to ensure that we always know how we are doing and where we need to focus our attention to achieve the quality of care that our patients are entitled to expect.

People’s expectations are changing. They rightly want greater choice and quality and a more personalised service that meets their individual needs. Over the past 12 months, quality of care has been the driving force of change in my organisation. We recognise that patients have a right to the highest quality of care. Quality of care has been a focus for this Government. Initiatives have been launched that focus on the fundamental aspects of care that we know are so important to our patients. For example, we know that our patients prefer to be cared for in single-sex accommodation. To that end, and benefiting from central government funding, we undertook significant building work to transform some of our very outdated facilities to achieve that important element of privacy.

We were delighted when the strategic health authority and the Department of Health came to visit our hospitals. They were very impressed with our effective use of funding. Usually one has a sense of trepidation about these visits, in case things are not exactly as they ought to be. This time, it was absolutely superb. Furthermore, we are working with City University and the Royal Free Hospital on a dignity and care project that focuses on the fundamentals of care and quality. For example, we are auditing the interaction between nurses and patients. This, combined with patients’ feedback, is a huge learning tool for our staff. Patients who were cared for in the pilot wards have fed back positively on the quality of care, and we have lessons to learn.

There is a key role for patients and carers in the quality initiative. The involvement of patients and the use of case histories and personal stories are powerful tools to assist in the learning process at all levels, from the board to the ward to the department. My trust recognises that the feedback from the national patient survey is valuable; but it is annual and must be supplemented by more immediate feedback. To provide that, we have implemented the patient experience tracker. In addition, patients are encouraged to fill in “message to matron” cards, which are available on all wards and are used prolifically by patients. We have also just held our first “meet the matron” event in a local shopping centre, where passers-by were asked to tell us about their experiences as patients or carers. At first, everyone including the matrons was reticent; but throughout the day the feedback—both good and less good—was tremendously helpful. Patients’ experiences were shared with us and will be key areas for us to learn from.

Our Government have rightly set challenging targets to reduce hospital-acquired infections. This approach, in association with unannounced inspection visits, raises and sustains the importance of best infection-control practices that encompass not only clinical practice but also high standards of cleanliness. Unfortunately, my trust was on the receiving end of an improvement notice 18 months ago after just such an inspection; but the difference that it made has been absolutely tremendous. We have seen significant reductions of hospital-acquired infections. Last year we saw a 50 per cent reduction in the number of MRSA infections. This has resulted in safer care for patients. Participating in centrally driven campaigns such as Leading Improvement in Patient Safety allows us to focus on learning from incidents and reducing the risk of them being repeated. It is our goal to develop long-term plans to make sure that first-class services continue to be available and to ensure that they are in the right place at the right time to meet the changing needs and expectations of our patients.

We are also working closely with our primary care colleagues to integrate community and hospital-based care in order to provide better, more personalised services closer to home. That is what people and patients want—we have heard that from several noble Lords today. We are developing models of care that facilitate effective management of patients with long-term conditions—for example, diabetes and chronic obstructive pulmonary disease—to meet the needs of our ageing population. In line with the national End of Life Care Strategy that we have also heard about today, we are developing partnership pathways of care that will give patients better end-of-life care and ultimately a good death in the place where they choose to die.

Overall, the Government’s drive has been to develop high-quality, safer care around patients’ needs. I hope that my examples have demonstrated how this important, quality-driven approach is being translated into reality in acute care. I look forward to contributing to the discussions on health and other aspects as this debate continues. I want to express the reality of life inside hospitals and make that part of our deliberations.

My Lords, I want to focus my remarks on the UK’s progress in becoming world-class in developing skills for employment and on the ways in which the Children, Schools and Families Bill and the Digital Economy Bill will take this forward.

In my view, the Government have made huge strides over the past 12 years. The recent report from the UK Commission for Employment and Skills documents this well, but it also highlights that by international comparisons on skills, we are treading water—other countries are doing as well or even better. In the middle of a recession, we have to learn the lessons of the past. We must not cut our investment in learning and training. I echo Graham Bann of Business in the Community, who said:

“Investing in learning and training now … enables companies, enterprises and organisations to prepare themselves for when the market picks up again”.

In different ways, both the Bills that I mentioned address the Government’s desire to ensure that the education system helps to equip the UK for the future and for the demands of the economy. The Children, Schools and Families Bill, we are told, will,

“introduce reforms to the school curriculum so children and young people are equipped with the knowledge and skills they, and future employers, want and need”.

This will sit alongside a continuing focus on the basics of literacy, numeracy and information and communications technology.

Meanwhile, the Digital Economy Bill takes forward the Digital Britain strategy by strengthening our digital infrastructure, recognising that this is vital for the UK’s success in every other area of productivity and for the UK’s position as one of the world’s leading digital knowledge economies.

Although this Bill does not touch on education directly, elsewhere, including in the New Industry, New Jobs White Paper and the First Secretary’s Statement in this House on 11 November, the Government have recognised the need to ensure that the workforce is equipped to meet the demands of this rapidly growing part of the economy, including by supporting the education which underpins creative technologies. This strategy takes its cue from the influential 2006 report by my noble friend Lord Leitch. My noble friend’s report made a powerful case for the need to address the skills needs of the economy if we are to retain our seat at the table among the big eight economies of the world.

This Government took office with a famous commitment to “education, education, education”, and I think that we should note and applaud the fact that the same commitment is evident in this latest Loyal Address. In the area that I know best—higher education—there can be no doubt that the Government’s investment has produced a terrific success story. However, we should not underestimate how difficult it is to predict the skills needs of tomorrow. In the field of higher education, my experience of working with employers and their representatives has shown me that in most cases what employers want, certainly of higher education, is rarely specific competencies. That has been demonstrated most recently by the CBI in its two publications, Stronger Together and Future Fit, the last of which was produced in conjunction with Universities UK. I do not think that I need any longer declare an interest as I have retired from Universities UK and am now its former chief executive. Asked to define the “employability skills they value”, employers point to generic skills. They include team-working, problem-solving and self-management. These are also the skills that will set an individual up for a lifetime of different jobs and roles. Collectively, they are an important ingredient in creating a flexible, adaptable workforce to staff a dynamic economy.

This has never been more important. Even without the current global financial turbulence, the pace of change in response to global competition over the past decade or so points to the need for adaptable individuals to staff industries that have not yet been born. Indeed, the digital economy and the growing economic importance of the creative industries set an important example. Few people speaking 20 years ago would have predicted either their central importance to our current and future ability to generate wealth or the interdisciplinary nature of the skills which underpin them.

I have one note of caution for the Government in applauding their continued commitment to education and skills. We must not take too narrow an approach to defining economically valuable skills. Breadth is important because it gives us the flexibility to adapt to circumstances we cannot or do not foresee. I am partly moved to raise this point because at the beginning of this month the Government published their blueprint for the future of higher education. Higher ambition made it clear that the Government increasingly intend to focus public expenditure on those subject groups that they believe are most likely to deliver economic benefits, such as science, technology, engineering and maths—the STEM subjects.

There is a good rationale for this. Employers frequently cite these so-called stem skills as being particularly desirable and I commend particularly the joint support provided by the Government and the Wellcome Trust for the science learning centres. I had an opportunity yesterday at its reception to learn more about the excellent progress that its regional centres have made in improving the motivation of young people to do science. The director, Professor John Holman, felt that we are on the edge of a renaissance of people doing physics, but its funding is guaranteed only until 2011. I ask my noble friend to review this to see whether a commitment to extend funding of this vital work can be given, so investing in something that is already successful.

Current strategies are paying off here. This country is now competing well internationally in its proportion of young science graduates. The Government may feel that patterns of study within STEM subjects need to change, which points to the need for a nuanced and evidence-based approach to growing STEM numbers. This broader approach is echoed in the recent CBI report focused on STEM provision, whose recommendations urge that STEM teaching should be better funded; all young people should continue in some form of maths education post-16; and all students with the capacity to take triple science at GCSE should be encouraged to do so.

I also want to reinforce the points made in all our previous skills debates about the vital importance of a vibrant further education sector. It will be the engine enabling economic recovery. Colleges can energise young people with the flexibility of their offering, and focused support and guidance. Colleges can partner schools and academies, work with employers, and join universities and community leaders to raise the aspirations of young people. It is worth recalling that over half of foundation degrees are delivered in colleges. The higher education framework and the skills strategy are both essential to equipping this country to meet the demands of a knowledge economy.

The Government are absolutely right in their unswerving commitment to ensure that the UK education system is world class, and that it equips individuals not only to make the most of their capabilities, but sets them up for satisfying, rewarding careers that contribute to our national strength. But I do not believe that education is simply about equipping individuals for jobs—and I do not think employers believe that either. I look forward to hearing how the Children, Schools and Families Bill will take forward the aspiration to shape the curriculum with the knowledge and skills that future employers need. But I shall look to be reassured that, particularly at primary level, this will not overshadow the more important task of stimulating the capacity and desire to participate in broadly based education.

Lord Quirk: My Lords, the noble Baroness, Lady Morgan of Drefelin, has been listening with exemplary patience and, I am sure, great enjoyment, to the many contributions on education that we have heard today—none more incisive or memorable than that of my noble friend Lord Sacks.

I begin my few remarks by citing what a schoolmaster, John Brinsley, wrote in 1612:

“It much concerneth every parent to see their children to have the best education and instruction”.

Four centuries on, Brinsley’s shade must be fretting about how much it must concern every parent to see the bad press that education has been getting in recent days. A new book by Frank Furedi is subtitled, Why Education Isn’t Educating, and it speaks of wasted opportunities, wasted potential and wasted youth. Yesterday's papers were gasping at Ofsted’s revelation that one in three of our schools is mediocre or worse. And they used to say that Chris Woodhead was fierce.

The Independent has run a story about university students who,

“can’t write, spell, or present an argument”,

and new government statistics about 11 year-olds imply that future university students will be no better. Only 61 per cent of children from poor families attain level 4—defined as being able to “write a proper sentence”—leaving 40 per cent who cannot and who enter secondary education thus fatally handicapped.

To make matters worse, this level of incompetence actually seems to have increased in the past year. So despite the assurance of the noble Lord, Lord Mandelson, in his Statement on skills in this House on 11 November that we are making,

“real progress”—[Official Report, 11/11/09; col. 806.]

in tackling illiteracy, the Government’s own figures, issued a week later, suggest the reverse. It is especially alarming that they show white working-class boys to be at the very bottom of the pile, with more than 52 per cent of them unable to “write a proper sentence”. The heads of Tesco and Marks & Spencer have, sadly, nodded their agreement. By contrast, these same government figures show that the relative stars among the children in poverty are the British Asian and Oriental pupils, for whom English is often a foreign language—a point to which I shall return to address its implications.

Of all the skills to which we aspire, maths and language are the two on which all the others must be built. I shall focus on the latter because of my personal and professional interest. Language, after all, is an obvious basis, being the audible and, in writing, the visible indicator of employability. It is basic, too, in its relation to the very meaning of education—educare, to “lead forth” from the local, private, familiar peer group so as to face the challenges of the wider world.

In this country, we seem to have decided in effect that English is the only language we need consider, thus leaving the rest of the world’s youth with the competitive edge of having at least one other language along with the English which they also assiduously learn.

At any rate, you might argue, this at least makes things rather easy for our school leavers, having to bother only with the language into which they were born. All that they should have to do is modestly expand their competence in English, so as to communicate beyond their local, monosyllabic peer group. All we expect is that they can address in speech and writing a general public in the general public English that is often called standard English. That is the language in which even the Sun newspaper, on a good day, is largely written. If our schools cannot cope with that modest goal, so slight compared with what effort and discipline achieve in the schools of China, Japan and Korea, then we are indeed in deep trouble. A warning comes in a recent study by Dr Bernard Lamb, a senior science don at one of our top universities, Imperial College. He has long deplored the poor English of many British students in his degree classes, their work ruinously marred with egregious grammatical and lexical errors, not to mention careless and illegible writing. Suspecting that their English was worse than that of the numerous students he imports from non-English-speaking countries, Lamb carried out a careful study of strictly comparable degree work by both groups and found that indeed the British students were worse, with three times as many errors as the foreign students. Dr Lamb discussed the issue with both groups and noted that the British students had not been taught to care so much about their English, had been taught it less well and had not had their performance corrected or criticised.

Why do so many students think it is cool to be idle? Why do so many teachers think that treating pupils as pals and peers earns their respect? This concerns education at all levels—primary, secondary and university—and it is not something we can expect teachers alone to put right, nor is it a problem that we can expect legislation to address. This is a cultural problem and demands the attention of us all: teachers, parents, employers, consumers, everyone. How many of us in despair at an inquiry desk, a public utility or a reservation clerk have the nerve to say, “Look, you can understand me. Will you please speak so that I can understand you?”? How many of us praise a help desk for its clarity of diction, for neat handwriting? How many parents praise teachers for their efforts at discipline, their success in cultivating pride in children's efforts? How many remind teachers of their professional role in nurturing and improving practical performance in speech and writing, with a beady eye on employability? Such interventions will not produce miracles, but I am sure that Sir Terence Leahy would agree that every little helps.

My Lords, I, too, am delighted to take part in this important debate. I shall focus on health and social care for the elderly. In speaking on health, I should declare an interest as chair of the co-operation and competition panel of the NHS and of the international operations of McKesson Information Solutions UK Ltd, a worldwide distributor of pharmaceutical products and hospital information systems.

Given the ageing population and, particularly, the prevalence of voting in older age cohorts, it is not surprising that the major political parties are keenly interested in policies for the elderly and, particularly, in effective policies for elderly care. For many years, I worked caring for the elderly and, in my experience, there are three key issues. The first is quality, the second is choice and the third is money. Put simply, quality is not negotiable. In the past 25 years, we have seen a dramatic increase in the quality of the facilities and the interventions available for the elderly. That is not to say that there is no room for improvement, but by founding the CQC and through its intervention in this area, I am confident that quality will continue to be built—

My Lords, I am sorry to interrupt my noble friend, but I feel I owe it to the House to point out to him that several other noble Lords have withdrawn from the debate because they were not here for the opening remarks or will not be here for the closing remarks of the debate. I hope that, by drawing this to his attention, he will take it into account in the length of his remarks and perhaps explain to the House that he will bear this in mind for the future.

Thank you, my Lords. That quite breaks the stride, does it not?

I shall focus on the Government’s proposals for caring for the elderly. I return to issues of quality and of money in particular. The matter that is being discussed has been raised before. The noble Lords, Lord Joffe and Lord Lipsey, in their seminal note of dissent in the report of the Royal Commission on Long Term Care for the Elderly in 1999, identified the key issue as striking a balance between what it is reasonable for the state to provide and what it is reasonable to expect individuals to pay for themselves. The Government have produced an excellent paper, Shaping the Future of Care Together. Like many, I am surprised that they have brought forward legislation on this so soon after the consultation.

Briefly, on the question of money, we in this country spend £21 billion a year on long-term care for the elderly. Of this, £8 billion is paid for by individuals and £13 billion by the state from other places. This will continue to rise, and for people over 85 this will rise to £2.8 billion in about 20 years. Clearly this will consume more and more of the resources. As was said earlier, it is important that the Government get their calculations right when working out what this will cost because, in my experience, a great many more people claim things when they are available from general taxation.

In meeting these projected long-term care costs, if the state were to assume responsibility for the £8 billion, it would simply put 2p on the rate of income tax. If the funding of long-term care continues to grow at the same rate, it is not unlikely that it could consume all of the fourth largest tax—fuel duty—by 2030. We all recognise that the responsibility for financing the cost of care for the elderly must be shared between the state and the individual.

The state could get better at running its own services. It could reform incentives to people to enter and remain in hospital, and by pursuing integrated care pathways it could find a way of getting people into the right place in the care pathway.

My Lords, my noble friend Lady Thornton explained just now that this was a rather difficult situation because other noble Lords who had not been in the Chamber for the beginning of this afternoon’s debate on the gracious Speech had withdrawn their names. She very correctly said that as my noble friend was on his feet he might wish to give a very curtailed speech. As the clock is now on five minutes, it is probably better that he sits down.

My Lords, it is an enormous privilege to sum up on the whole of the gracious Speech from these Benches. I am particularly pleased to do so today when we heard two outstanding and memorable maiden speeches. I congratulate the noble Lord, Lord Aberdare, on reminding us of the power of education to liberate the potential of individuals for the betterment of the whole of society.

The speech made by the noble Lord, Lord Sacks, was thoughtful, witty, incisive and longer than when he is on “Thought for the Day”, and we will remember it. He alluded to the strong tradition within the Jewish faith of education by means of question and argument. It has long been a mystery to me why the whole Jewish community is not therefore Liberal Democrat. After all, Liberal Democrats were once memorably described in the Guardian as people who would go to extraordinary lengths to have a good argument.

When I came to this House 10 years ago, something that was extraordinarily helpful, and very moving, was the way in which people from all parts of the House freely and kindly gave me their experience and wisdom. I will therefore in the same way pass on something to the noble Lord, Lord Sacks. It not just that people in this place listen—how they listen—but that they listen to the proposals that we make on these Benches and then they go away. After a while they announce these as their own proposals or policy. I share that with the noble Lord as something for him to mull over.

The noble Lords join us on an unusual day. Normally we debate questions, but today we are not debating a question but a series of topics. In fact, we have talked about two questions, one overtly and one slightly less overtly. The first is, from our different political standpoints, what we believe to be the key priorities on the major issues of education and health. One need not look any further than the speech of the noble Lord, Lord Freud. The second is what we want the electorate to hear from us for the next six months. Sadly, I cannot go into a number of the interesting topics that were raised. The noble Baroness, Lady Howe of Idlicote, talked about prisoners and the noble Baroness, Lady Nicholson, gave us good news stories from Iraq. There are many topics that I would like to follow up, but I have to remain with two.

On equalities, my noble friend Lord Lester set out well the need for equalities legislation. In response to some of the other speeches, we have spent the past 40 years setting out in legislation why people who are different have the right to be treated as equal citizens. It is now time for our diverse society to have a legal basis for that which is common to us all. It would be not least to the benefit of our country economically if we could make that agreement on what our diverse society should be and what we believe to be fair and equal ways of treating our fellow citizens.

We all know that the general election issue will be the economy. The public are not stupid. They know, as well as any of us, that the recession and the huge levels of public debt mean that inevitably there will be a public spending squeeze from 2011. We have not talked much today about the NHS and its future, but it is reasonable to state that the NHS has had unprecedented levels of funding. This Government have funded the NHS to a level not seen before. But it is reasonable to believe that from 2011 the NHS will at the very least have a budget which stands still. In all likelihood it will have to be cut. Indeed, the NHS chief executive, David Nicholson, for one, has openly stated that the NHS will have to look for efficiency savings of around £15 billion to £20 billion from 2011 to 2014. Therefore the timing could not be worse to embark on radical change in the social care system, a system which we have all known for so long is in urgent need of care.

I shall pick up a little on the Conservatives’ pledges. They have pledged to increase the NHS budget in real terms after 2011, a pledge which, according to the Institute for Fiscal Studies, would mean real reductions in other departments of up to 16 per cent over six years. We will need to consider carefully what our Conservative colleagues say not least about education if they wish to fulfil that pledge on health.

Similarly the Conservatives have returned to a proposal that they first unveiled in 2006: to turn the NHS over to an independent board. They made that announcement in 2006 but have since then been very quite about it. I would simply observe that it is rather strange, at a time when politicians on all sides are promising a bonfire of the quangos, to propose establishing what would be by far the biggest quango of them all and giving it responsibility for a tenth of all government funding.

We on these Benches have, like the noble Lord, Lord Darzi, long realised that the space in which there will come about real transformation, real savings and real efficiencies within the NHS is at local level. That is why we believe that there should be a patient contract that guarantees a minimum level of health care to everybody. Beyond that, we would wish to see devolution of power and decision-making down to local health boards. I should hope to see not just hospitals but also local authorities pursuing that agenda of quality, care and change that the noble Baroness, Lady Wall, spoke of so eloquently.

I want to talk a little about the Green Paper. The noble Baroness, Lady Morgan of Drefelin, described the Personal Care at Home Bill as a bridge to a national care service. It seems a bit more like a coach and horses being driven through the proposals which the Government set out in the summer for a national care service. We should not lose sight of some of the very good things that were in that Green Paper—it contained lots of examples of innovation in personal social services. Unfortunately, however, the only commitment it contained was to a ministerial group that would look at taking those examples forward. I would rather like to see the Government commit to rewarding all health boards and social care boards by giving them incentives to innovate in delivering good care.

There is one other point. The Green Paper also talked about having a social care equivalent of NICE. That is perhaps one of its most important proposals, as social care is always desperately trying to find evidence bases for practice. I hope that that proposal does not go.

One of the unfortunate by-products of the publication of the Personal Care at Home Bill is that the costings—the financial models for the options in the Green Paper—have been delayed. The Minister in another place, Phil Hope, said that they would be published this month, but they have not been. I know that this is not the field of the noble Baroness, Lady Royall, but I hope that someone on the Government Benches will be able to tell us at some point when we will see those models. I should point out for the educationalists present that, at the moment, people seem to be coming up with figures for different options for social care without showing how those figures have been worked out, which is crucial. When a proposal is made to spend a particular sum on an aspect of social care, none of us knows from which other budget that amount will come. From where will the sums necessary to implement the proposals for an insurance-based service come?

On the Personal Care at Home Bill, I want to make only one observation. It is not clear where the money going into that, which will be directed towards those in the most urgent need according to the fair access to care services criteria, will come from. The Government have already said that some of it will come from local government efficiency savings. Under the Gershon principles, which have been in existence for the past four years, local authorities have been meeting their targets in a way that central government have not. They have already saved at least £5 billion, much of which has come from their social care budgets. I want to know exactly what it is that central government believe local authorities have to give. Frankly, much though I might agree with the aims of the Personal Care at Home Bill, if they can be afforded only by taking away wardens or some elements of carers’ respite, I am not sure that I would choose them as a priority. It would not necessarily do the best for older people.

We on these Benches remain convinced that despite all the work that has been done during the time of this Government, and indeed going back to the time of Sir Roy Griffiths and the community care legislation, the most thorough and robust analysis was that conducted by Sir Derek Wanless for the King’s Fund. It is therefore our belief that we should base any future system on a guaranteed entitlement as set out in his report. All older people would know that they had a basic entitlement which they could then top up. It does not matter what system of funding one goes for, whether a private insurance fund or a compulsory element, what matters are the criteria under which it would operate. More than that, consistency of criteria between any state funding and private funding is essential. Put simply, individuals cannot know what their care needs are likely to be, but if they do not know what funding will be available from the state, they have absolutely no hope of being able to make the correct provision. We have already recognised that in pensions and it is now time to do so in social care.

Throughout my years in this House, Members on all sides have sought to answer one question: how do we have a system of social care not just for older people but for all adults who need it that is fair, that supports preventive measures and stops people from developing ever greater needs, that recognises diversity and dignity, and is sustainable? We would not have chosen to embark on such a great task when the economic circumstances are so grim, but I suggest that in the light of a general election, for once we might have a debate on social care that truly does lead to dramatic change. I am sure that your Lordships’ House will help that process along considerably.

My Lords, we have enjoyed a wide-ranging debate with excellent contributions, and I should like to join in congratulating the noble Lords, Lord Sacks and Lord Aberdare, on their exceptional maiden speeches. I am sure that we are all in unison when I say that we will benefit hugely from their knowledge and experience in future debates both in and outside your Lordships’ House.

This debate covers four large departmental areas and it would be impossible to do justice to them all today. In closing for our Benches, I thank my noble friend Lord Freud for covering with his usual charm, ease and expertise the areas of social affairs and health. I will therefore confine my main points to what is set out in the proposed Equality Bill and my own area of responsibility, that of education.

On the Equality Bill, we on these Benches are most concerned by the discrimination which many British people face because of their race, gender, religion, age and background. Action must be taken to bring this to an end and we hope that the Equality Bill, when it finally reaches your Lordships’ House, will be subjected to rigorous scrutiny which will help to ensure that effective measures are put in place to end this appalling feature of our society.

The Labour Party first pledged to introduce a single equality Bill in its 2005 manifesto. Plans were subsequently announced by the Government in 2007, and we have been waiting, amid five re-announcements, for two years now. After 12 long years of government, therefore, we are only just getting to the stage where an equality Bill may be put onto the statute book. Last year, my noble friend Lady Warsi, in her opening response to the Queen’s Speech debate, said that,

“we will be looking carefully at the Bill to ensure that it is an effective and practical piece of legislation”.—[Official Report, 10/12/08; col. 405.]

We are still waiting for the opportunity to put that scrutiny into practice, as the Bill is in the Commons and will not have its Report stage there until 2 December. My noble friend Lady Warsi will address the concerns that we have regarding the Bill in greater depth and detail when it reaches Second Reading in your Lordships’ House.

We welcome the fact that the Bill will consolidate nine pieces of legislation, over 100 regulations and over 2,500 pages of guidance and codes of practice. It is vital that both employers and employees have a full understanding of their rights and obligations. However, it is only right to express the concern that we have that the Bill may represent yet another missed opportunity by the Government.

It is no secret that we fear that the Bill may contain proposals which are too bureaucratic and expensive, while still not addressing the real problems or providing tangible results. We want to make sure that there are serious proposals to reduce inequality instead of just targets, top-down measures, box-ticking and expounding on legal rights. We want root-and-branch reform of the very causes of inequality which, among others, may include family breakdown, poor education and personal debt. The story so far does not tell of success in this area.

The Government have failed to meet almost half of their equality targets, including getting more women to start up businesses. Furthermore, while the pay gap has reduced, it still remains very high. Figures from the Annual Survey of Hours and Earnings, which was published by the Office for National Statistics on 12 November, show that it remains at a height of 16.4 per cent for full-time workers. Do the Government accept that reducing the gender pay gap is not only about legislation but about a change in culture? At the moment, we see many sectoral differences, for example, men are more likely to be managers and senior officials, and a fifth of women in employment do administrative or secretarial work compared with just 4 per cent of men. What further plans are the Government making to address this issue?

On the issue of violence against women, a Conservative Government would introduce a three-year funding cycle for rape crisis centres. Do the Government accept that having annual decisions about funding for these services creates instability both for the centres and for those victims of rape, sexual violence and domestic abuse who desperately need the support that they offer? A three-year funding cycle would be key to ensuring stability for this vital service. What action will be taken to ensure that maximum support is given to this vulnerable group?

On education and the Government’s Children, Schools and Families Bill, we on these Benches of course welcome any drive that ensures the well-being of our children and young people and that they have access to a good-quality education in a safe and secure environment, both in and outside their homes. We will strive, as ever, to ensure that, and we would assist the Government in order to achieve these fundamental routes of opportunity. I am pleased to see that a number of our ideas have been taken on by the Government, such as legally enforceable home-school contracts, which we first suggested in our 2007 Green Paper. It is reassuring to see that the Government have accepted our idea, although it is two years later. Sadly, however, that is where we will part company, because while we are determined to put power and decision-making back into the hands of principals, head teachers and teachers, the Government, probably out of habit, insist on complicating it further with bureaucracy and unworkability.

There are components of the Bill which will work and which we will work with the Government to improve, but our main concern is that it does not come even close to getting to grips with the huge challenge that schools face. Our priorities are to raise pupil attainment, extend parental choice, free teachers from bureaucracy, improve discipline and close the gap between the richest and the poorest through social mobility. Yet the Minister is asked to defend a bunch of meaningless guarantees. If the Government had more faith in their teachers, they would know that schools are already trying to deliver all these guarantees among the diktats, targets and initiatives that have poured down from Whitehall.

How many children will be covered by the “one-to-one tuition” guarantee for every child who is falling behind? Will it cover every child who is below average in a class, or half the children in the country? Furthermore, we see that the supposed “one-to-one” guarantee has now morphed into a “one-to-one and small group tuition” guarantee.

Time and again, what captures quick headlines rarely materialises. In their White Paper, Your child, your schools, our future, the Government proposed a new school report card to provide a rounded assessment of the performance of every school. I wonder how the Government would fare if their own report card system was applied to them. What would we see?

We would see a Government under which the most recent Ofsted annual report shows that 6 per cent of schools are still judged to be inadequate. We would see a Government under which the number of young people not in employment, education or training has risen to 1 million overall, 140,000 of whom are 16 or 17 year-olds. We would see a Government under which almost 100,000 parents every year do not get the school that they want for their child. We would see the gaping divide between rich and poor. Richer parents can simply move area or send their children to private school; poorer parents have no choice. We on these Benches think it imperative that we bridge that gap.

We would see a Government which have had to renege on their September guarantee that every 16 or 17 year-old who wanted it should have a college place or apprenticeship. The Learning and Skills Council informs us that, far from funding a place for every 16 and 17 year-old, there is enough money only to fund 22,000 extra places, despite the number of applicants to schools and colleges reaching 74,000. We have yet to hear where the extra £655 million of additional investment will come from, and we have no guarantee that the funding will extend beyond 2010-11. The September guarantee will be replaced by a January guarantee. It would ensure that every young person not in employment, education or training had a place at a school or college or on a training course. Given that this was the basis of the commitment behind the September guarantee, what reassurance can the Government possibly hope to offer here?

With the Government having come into office with a great fanfare to put education at the heart of their political programme and having spent billions of pounds from the public purse, why are 40 per cent of children still leaving primary school unable to read, write and do maths at even a basic, functional level? Why does the story not improve at secondary level? Why is truancy still rising, given the millions of pounds spent on addressing the problem, and why are we lagging so far behind when measured against other OECD countries? It is only fair to say that if we were to see the Government given a report card, it would be marked with a very large F.

As we near the end of this Parliament, we can only hope that the Government will endeavour to improve, and we will of course offer constructive criticism to help them along. However, it really is time for a change.

We have heard from my noble friend Lord Freud on social affairs, health and other issues. I will not detain the House further on them. Suffice to say that on health the Government are yet again not bringing forward the radical reforms for which we might have hoped. Instead they are concentrating on processes, not outcomes. We are seeing that, despite several targets, child poverty has risen for the past three years, so it looks as though the Government will miss their 2010 target by 600,000 children. That is appalling. My noble friend ably identified the flaws in the Government’s proposals and why, after 12 years in power, so little has been achieved. Are we just to hope that the new target enshrined in the new legislation will counter this terrible trend?

We have had five busy days of debate on the gracious Speech this year. We have heard a great many excellent speeches, and the number of speakers in every debate attests to the enthusiasm for effective scrutiny and the desire to ensure that all legislation brought forward in this Session is, as always, held to the highest standard. Each debate has shown your Lordships’ House at its best. The excellent maiden speeches pay tribute to the expertise and knowledge of this great Chamber as we strive to ensure, as scrutinisers of legislation, that the British people hold faith in our political processes.

I thank especially those of my noble friends who spoke so eloquently today, particularly my noble friend Lady Perry, whose experience in the area of education is incredibly extensive. She has provided the House with many words of wisdom, and has once again highlighted the Government’s obsession with legislating for everything in the belief that this will attain educational success. As my noble friend points out, it does not.

My noble friend Lord Lucas has raised a number of challenging questions for the Minister. Parents and children who opt for home education do so out of choice, and I suggest that stigmatising them is not the right direction for the Government to take.

My noble friend Lord Colwyn, in his assessment of developments in dentistry, is right that we must place prevention at the heart of the services that we provide, while my noble friend Lady Gardner of Parkes raised a particular concern that has been raised in your Lordships’ House time and again: the malnutrition of patients, particularly among the elderly. She also mentioned the drop-out rates of people entering nursing. That wonderful profession needs to be accessible to those wanting to enter service as vocational employment, or to those who have a positive career path in mind. We cannot create barriers for them.

My noble friends Lady Warsi and Lady Morris are sorry that they are not here today. My noble friend Lady Warsi would have liked to have been here to speak particularly on equality, but I am sure that noble Lords will understand that she has been called away to prepare for the festival of Eid tomorrow.

We wholeheartedly support the Motion tabled by the noble Baroness, Lady Symons of Vernham Dean, and seconded by the noble Lord, Lord Patel of Bradford, that an humble Address be presented to Her Majesty the Queen.

My Lords, we come not just to the conclusion of today’s debate on the gracious Speech on equality, social affairs, health and education but to the conclusion of this House’s full five days of consideration of the gracious Speech as a whole. I calculate that some 200 Members of this House have spoken during the course of these days of debate; I have not been able to be in the Chamber for them all but I have read every one, and I conclude, as I predicted in my remarks on the day of the gracious Speech itself last week, that in their quality, breadth, knowledge, wisdom, insight and wit, the debates show this House and its Members at their best. It is interesting that health, education, poverty and equality have featured on most days of the gracious Speech debate—they have been threads running right through it.

We have welcomed many new Members to your Lordships’ House, with maiden speeches from the right reverend Prelate the Bishop of Bristol, the noble Baroness, Lady O’Loan, the right reverend Prelates the Bishops of Lichfield and of Blackburn—so many bishops—the noble Lord, Lord Sugar, and the noble Lord, Lord Martin of Springburn, and today I am delighted to echo Members of this House in welcoming the noble Lord, Lord Aberdare, and the noble Lord, Lord Sacks, the Chief Rabbi. I thank them for all their contributions and look forward to their participation in your Lordships’ House.

I turn to today’s debate. Inevitably, joining together in a single debate such a range of topics as we have considered today is akin to trying to get a gallon into a pint pot, never mind a quart, but I will deal with each subject in turn. First, perhaps I might say to the noble Lord, Lord Freud, that in a parliamentary Session immediately before an election, it is absolutely inevitable that policies become more political. More importantly, the programme set out in the gracious Speech lays a strong foundation for the future. It is certainly not an electoral displacement activity. These are actions that we believe need to be taken for the good of our society. But politics in this House, although deep, does not mean gladiatorial combat. So let us have argument for the sake of heaven.

The noble Baroness, Lady O’Neill, reminded us about the need for good legislation. I entirely agree, and I assure her that more assessments are being done before legislation is proposed. Personally, I think that we should have more pre-legislative scrutiny and that we certainly need to speed up post-legislative scrutiny. The noble Earl, Lord Listowel, referred to the stocktaking of—I apologise, but I cannot read my own writing; I did not learn to write properly. It was the stocktaking of care matters, and clearly that is a good example that we should be emulating.

On equality, we saw today a degree of prefiguring the debates that we are likely to see when the Government’s Equality Bill reaches your Lordships’ House next month. Indeed, we hope to have its Second Reading before the Recess. First, I echo the important point my noble friend made in her opening speech; equality benefits individuals, but also ensures the social and economic well-being of our society. The right reverend Prelate the Bishop of Ripon and Leeds reminded us of the great contribution made by our late colleague, the noble Baroness, Lady Chapman. I think of the transport section of the Equality Bill, especially the chapter dealing with taxis, as the Nicky Chapman memorial clauses. I listened carefully to the concerns expressed about the Equality Bill by my noble friend Lady Howells of St Davids. Much of what she said relates, I believe, to justice and enforcement, and to a change of culture as well as legislation. I look forward to her participation in the debates on the Equality Bill, because we certainly need her great expertise.

The Equality Bill simplifies and strengthens discrimination law, making it easier for people to know their rights and to comply with their responsibilities. It carries forward the comprehensive protection provided by the existing Race Relations Act, including the groundbreaking public sector duty introduced following the Stephen Lawrence inquiry. The positive actions provided in the Bill are simpler and easier to use, and will permit a greater range of action to tackle the discrimination and disadvantage that black people still face in employment and elsewhere—a disadvantage that is shameful in the 21st century.

I am grateful for the strong support expressed by the noble Lord, Lord Lester, and for his clear explanation of why we need this legislation. I also pay tribute to his prescient advice of 10 years ago. I rather like to think of the Equality Bill as a moon for lightless human beings, and look forward to many illuminated debates. I am well aware of the noble Lord’s views on the equal pay issue, which was also mentioned by my noble friend Lord Morris and the noble Baroness, Lady Verma. The Bill’s transparency measures will shine a light on the persistent pay gap between men and women, and encourage action to address it. Women have had a legal right to equal pay for more than 35 years and this Bill will help them to secure that right in practice. The noble Baroness, Lady Verma, is of course right to say that we need a change in culture as well as more legislation.

I am immensely grateful to my noble friend Lady Turner of Camden for reminding us of how far we have come, and I entirely agree that we must focus on getting more women into science and engineering. I am proud that my own daughter is a geophysicist. Like my noble friend Lady Warwick of Undercliffe, I welcome STEM and all the work relating to it. Funding is key, and I will get back to her on that issue. I also strongly support the Big Bang, which acts as a catalyst for primary school children to get more involved in maths and science, inside and outside the classroom.

On domestic violence, I believe that this Government—my Government—have made huge strides, many of them spearheaded by my noble and learned friend the Attorney-General. Tomorrow, I shall be speaking at a conference on domestic violence. I never know what it is called—I think it is IDVA—but it does a fantastic job.

On age discrimination, the Equality Bill will, for the first time, ban unjustified age discrimination in the provision of services and the exercise of public functions. That includes healthcare and social services—many of the issues that we have been addressing today. I am quite amazed that nobody in this Chamber has mentioned age discrimination, but I look forward to debates on those issues.

On social affairs and, in particular, on child poverty, the Child Poverty Bill provides a clear definition of the eradication of child poverty by 2010 and establishes a national and local accountability framework for delivering this goal. Importantly, the legislation will mean that Governments will, for the first time, be held to account under the law on the success of their strategies to end child poverty. I welcome the words of the noble Lord, Lord Freud, when he says that we all want to end child poverty. He is absolutely correct, but it is action now, rather than words, that is crucial.

I also welcome the strong support of the right reverend Prelate the Bishop of Ripon and Leeds, who is right to emphasise the important role of the voluntary sector in working with children and families. Just last week I visited a children’s centre in Lincoln, which was providing truly invaluable support for profoundly disabled children and their carers. The charity was, I think, a Church of England charity. The noble Baroness, Lady Nicholson of Winterbourne, talked about child poverty and how we can learn from home visiting projects abroad. She is right, but I would add that we have many excellent home visiting schemes throughout this country; for example, Home-Start.

On health issues, the next stage of reform—the mission of a fourth-term Labour Government—is a great NHS that is preventive and people-centred, placing quality at the heart of all that it does. Important public funding targets and a maximum wait of 18 weeks from GP referral for elective surgery and two weeks for cancer cases will become rights through the NHS constitution. I say to the noble Lord, Lord Freud, that, precisely as I have said, the 18-week target is for elective surgery. Of course we differentiate between health problems. Cancer is especially important. We now have plans to offer patients access to cancer tests within one week. This speedier access to diagnostic tests, alongside our ongoing work to promote early diagnosis of cancer, will help to save up to 10,000 lives a year. I hope that any future Government will respect those plans, if there were to be a Conservative Government.

The noble Baroness, Lady Tonge, reminded us of the debt that we owe to healthcare workers who have come from developing countries whose needs are great. I welcome her comments. We are working on these issues in Malawi, for example. I will come back to the noble Baroness with further information.

Like my noble friend Lady Wall of New Barnet, I do not recognise the picture of the NHS painted by the noble Lord, Lord Freud. My noble friend is absolutely right about the way in which the next-stage review is being used in and by hospital trusts and PCTs to improve health and meet healthcare needs in an innovative way. As the noble Baroness, Lady Barker, said, at the heart of the Darzi review was devolution of power and resources to the local level. I believe that this is happening.

Neither do I recognise the picture of education as painted by so many noble Lords this afternoon, including the noble Lord, Lord Quirk. We expect so much more of our young people these days. Unskilled jobs are no longer available, so people need more skills and qualifications. That is great. I believe that they are achieving those qualifications. The noble Lord, Lord Quirk, mentioned the need for praise; I entirely concur with that. As a fellow linguist, I also recognise the importance of language. We have put more classroom assistants and administrators into schools precisely to ensure that teachers can focus on the job of teaching, and that is exactly what is happening in schools. If one speaks to teachers up and down the country, I think they are very pleased with the current situation. The same Ofsted report quoted by the noble Baroness, Lady Verma, also judged that 69 per cent of schools are “good” or “outstanding”. That is an increase of 10 per cent since 2005-06 when the cycle started.

The noble Baroness, Lady Greengross, raised many important issues relating to dementia. An action plan is currently being developed and a new national clinical director for dementia will be appointed in January 2010 to take forward recommendations, including those made by Professor Sube Banerjee on the use of anti-psychotic drugs. Both the noble Baroness and my noble friend Lord Morris of Handsworth spoke of the scourge of health inequalities. This has been, and is, a top priority for the Government. Life expectancy has increased in all areas for both men and women, including in the areas with great health deprivation, but there is still a long way to go. The strategic review of health inequalities led by Sir Michael Marmot will enable us to build a new national, cross-government health inequalities strategy. That will ultimately assist us in meeting that inequality scourge.

I am glad that the noble Viscount, Lord Brookeborough, referred to the mental health of service men and women who have left the Armed Forces. Just last week I discussed these issues with a group of wives of soldiers from the Fourth Battalion The Rifles. It is of great concern and is something that we are working across government to try to improve. The Secretary of State today announced six mental health projects for ex-service men and women, and I hope that they will pay dividends. I pay tribute to the excellent aftercare scheme in Northern Ireland, but Northern Ireland is different from the rest of the United Kingdom. It is clear that there should, and must, be better data sharing. I recognise that more joined-up action is necessary when those who have served in the Armed Forces join civvy street, but I believe that we are fulfilling the military covenant, which we respect. I cite, for example, the provision of healthcare in theatre and at Selly Oak, which is second to none.

The noble Lord, Lord Colwyn, naturally focused our attention on dentistry. I note what he said about the Steele report and the Warburton review. I put it on record that access to NHS dentistry is growing. The latest data show that access has grown for the fourth quarter running, with 721,000 more patients accessing NHS services in the 24 months ending June 2009 compared with the 24 months ending June 2008. We welcome Professor Steele’s report. He is right to say that changes to the dental contract will need to be carefully piloted. I am delighted to mark Mouth Cancer Action Month, which is terribly important. This was referred to by both the noble Lord and the noble Baroness, Lady Gardner of Parkes. The national screening committee is conducting a consultation on how current knowledge about the incidence and treatment of oral cancer compares to the committee’s criteria for population screening programmes. The main stakeholder organisations for cancer and dentistry have been informed of the consultation and how the consultation document can be accessed on the NSC’s website.

The noble Baroness, Lady Gardner of Parkes, spoke of her concern about nursing degrees. Raising the minimum level of education programmes to degree level is essential in ensuring that future nursing students are fully prepared to undertake the new roles and responsibilities that will be expected of them by the end of the programme. The different structure of programmes will also ensure that all newly registered nurses are competent in meeting the basic care needs of all people as well as being able to deliver complex care in their chosen field. She is, of course, absolutely right to stress the importance of quality care because that is what all our citizens deserve and expect when they are in hospital.

On personal care at home, I am grateful for the support and the views expressed by many noble Lords, including the right reverend Prelate the Bishop of Chichester. More and more of us are living longer. That means that more of us will need care in our old age. The current care system was designed in the 1940s. We need to develop a system that fits our needs in the 21st century. We need a system that is fairer, simpler and more affordable, which ensures that you get really good care wherever you live and provides whatever you or your family need. The key aim of the Personal Care at Home Bill is to enable, support and encourage more people to avoid, or at least delay, entering residential accommodation. Recent advances in technology mean that it is now possible for people to remain at home safely and for longer, when previously often the only option was to go into residential or nursing home care. Around 400,000 people with the highest care needs will benefit. The new proposals, which will cost £670 million, are the Government’s first step towards setting up a new national care service—a simple, fair and affordable care system for everyone.

The noble Lord, Lord Rix, recognised the progress that had been made for people with learning disabilities, but reminded us of the challenges that remain. I am grateful for his manifesto suggestions. He was right to remind us that change must be accompanied by safeguards and that advocacy and support services are extremely important. He, too, rightly referred to the Personal Care at Home Bill.

There is a lot of misunderstanding in the Chamber about this Bill. It is very important not to conflate funding for a national care service and funding for the Government’s Personal Care at Home Bill. One is about putting more money into the system as soon as possible to help people with the highest needs to live independently at home, as was clearly expressed by my noble friend Lady Pitkeathley. That is what the Personal Care at Home Bill is all about. However, we also need to consider how to develop a sustainable system for the future, which is why we have been consulting on how to build a fair, simple and affordable national care service for all adults.

I say to the noble Lord, Lord Freud, that we have a proper strategy that is set out in the Green Paper, which was mentioned also by the noble Lord, Lord Best. He was right to say that we need a system that provides care and support to all who need it, whether they are at home or in residential care.

My children would agree with my noble friend Lord Lipsey and the noble Lord, Lord Lucas, that we are a golden generation; but we must look to the future.

My noble friend Lord Warner made what was in many ways a Second Reading speech. He asked many pertinent questions and I will write to him on the issues; but such detailed consideration of the Bill is not appropriate this afternoon. My noble friend also suggested that the Bill has few friends outside government. That is not true: I disagree with him fundamentally. I could cite many quotations but will choose just one. Imelda Redmond, chief executive of Carers UK, said:

“Many families face crippling costs to pay for care, and this historic pledge to end the means test for those with the highest need could make a huge difference to their lives”.

Unlike my noble friend Lord Lipsey, I have spoken to many people in the outside world who are not scared but delighted by the Bill.

I turn to education and first echo the wise words of the noble Lord, Lord Sacks, who said that to defend a civilisation we need schools, and that we should celebrate our teachers as guardians of our civilisation and our liberty. I predict that that phrase will be used in many circumstances.

Many of our proposed reforms have been consulted on since the end of last year and are widely recognised as good practice. Now we must make sure that every child, young person and family benefits equally—this is precisely what the legislation will afford. Secondary legislation will be proportionate and subject to consultation and laying before Parliament. We make no apologies for the guarantees, which are the means of ensuring that every child and family across the country that uses schools and services will get the opportunities, support and advice that they deserve.

Much was said about the primary curriculum. It has not been revised for nine years, so it is right and proper that this should be done now. However, it is being revised in consultation with the teachers who will teach the curriculum. It is not being imposed on them: we are working with them to develop a new curriculum.

The noble Baroness, Lady Walmsley, rightly spoke about the link between social background and the economic performance of children. That is one reason that we established Sure Start, which is one of our great strengths. Sure Start and children’s centres are doing an extraordinary job—I am glad to say that there are more than 3,000 of them. I am glad that the Conservatives have changed their policy on Sure Start—I really am glad, because it would be a disaster if Sure Start were ever to end. However, I am deeply concerned that they want to cut resources for Sure Start in order to fund health visitors. I recognise, as the noble Earl said, that we need more health visitors; but I would not wish to see funds for Sure Start or children’s centres cut in order to provide more health visitors.

My noble friend Lady Morgan of Drefelin will be pleased to meet the noble Baroness, Lady Walmsley, and any other noble Lords, to discuss education.

Earlier, I mentioned my admiration for teachers. I agree with the noble Baroness, Lady Perry, that we must enhance the status of teachers and trust them. I believe that we have re-established the status of teachers, although there is much more to be done. We have given them more professional training and development, and I agree that a licence to practise is the next step forward in that process.

My noble friend Lady Massey spoke of the poverty of kinship carers. The Government welcome and praise the work of kinship carers, and that will indeed be a focus of the Child Poverty Bill. The definition of a parent under the Children Act 1989 is anyone with parental responsibility for a child, including step-parents, guardians and those with residence orders.

The noble Lord, Lord Aberdare, with whom I have the honour of serving on the board of the National Botanic Garden of Wales, reminded us that delivery is sometimes even more important than legislation. He is right that the transition from education to employment is a key phase for young people, and we fail them if we do not provide them with the requisite skills for that transition. However, that is precisely what we are and have been doing. We want to ensure that they have the life skills, as well as the qualifications, to make that transition. I am delighted that the noble Lord mentioned the 2012 Olympics. I believe that they will provide a real opportunity for the schoolchildren of this country in terms of education, sport and raising aspirations.

The noble Baroness, Lady Howe of Idlicote, reminded us of the excellent Home Start scheme and family intervention projects. She is correct when she says that the family must be at the centre of our criminal prevention services. That is happening, and I shall gladly provide the noble Baroness with further information.

The noble Baroness, Lady Garden of Frognal, mentioned personal, social and health education, and I am grateful for her support. This Government have always been clear: parents bring up children; government do not. However, schools do have a role in ensuring that children and young people are well prepared for adult life. That is what good PSHE teaching is all about. Children today are growing up in a complex and changing world, and ensuring that they have correct, consistent information rather than playground myth will help to preserve their innocence as well as prepare them for adult life. Of course, PSHE is a key part of the core curriculum, and therefore I assure noble Lords that it will be properly funded.

The right reverend Prelate the Bishop of Lincoln is right to say that not everything can be measured. However, it is right to ask parents and pupils what they think, and that is why the school report card is particularly important. It will provide a clearer, more balanced and comprehensive account of each school’s performance. That will complement Ofsted’s inspection reports, inform parents’ choice of school and improve a school’s accountability to parents. It will also bring together a range of information in one easily accessible place.

Clearly the noble Lord, Lord Lucas, does not like the part of the Bill relating to home education. However, the Government are committed to supporting its continuation as a choice for parents. Registration and monitoring will give local authorities the tools that they need to tackle the small number of cases where the education provided is not good enough. It will also ensure that in future there is a clearer picture on home-educated children. Home-educating families are doing a fine job and are co-operating with reasonable requests from their local authority; they will find little difference in their lives.

Finally, turning to the debates on the gracious Speech as a whole, I think we can say both that we have had a series of excellent debate days and that we have considered fully the issues at the heart of the Government’s programme for this final parliamentary Session before a general election. All sides have put their points of view, just as all sides will do in the Session to come and in the election that follows it. Those different viewpoints will indeed be set out in this legislative programme, in this Session of Parliament and in the coming election, and the choice that will be before the people of this country will be made clear—a choice between the party on these Benches, which will offer the right kind of change for the mainstream of this country, and the choice offered by the party opposite.

In closing today’s debate and the debates on the whole of the gracious Speech, I return to my first remarks as the debates opened. I look forward to the arguments that we will have; I look forward to our debates in this House; and I look forward to the election to come.

Motion agreed nemine dissentiente, and the Lord Chamberlain was ordered to present the Address to Her Majesty.

Leeds City Council Bill

Reading Borough Council Bill

Message from the Commons

A message was brought from the Commons that they have made the following Order to which they desire the concurrence of this House:

That the promoters of the Leeds City Council Bill and Reading Borough Council Bill, which were originally introduced in this House in Session 2007-08 on 22 January 2008, should have leave to proceed with the Bills in the current Session according to the provisions of Standing Order 188B (Revival of Bills).

House adjourned at 6.10 pm.