House of Lords
Tuesday 28 November 2017
Prayers—read by the Lord Bishop of Worcester.
Teacher Education: Arts, Crafts and Design
My Lords, at their most recent Ofsted inspection, 100% of initial teacher training providers were judged to be either good or outstanding. We have worked with a sector-led group chaired by Stephen Munday to develop a new framework of core initial teacher training content which was published last year. It is enabling providers as well as trainees to have a better understanding of the essential elements of good ITT content, including in the arts.
My Lords, does the Minister agree that high-quality teaching of art and design subjects in schools is essential, not least for driving future innovation, an ambition of the industrial strategy? Has he looked at the recent Oxford Brookes University research, which bears out the increasing concern that for these subjects the PGCE route, which is contracting, is significantly preferable to School Direct, not just because of the subject-specific training but for the wider context of networking and access to community-based practice? Will the Government address these concerns?
My Lords, I agree with the noble Earl that a broad and balanced curriculum is an essential part of a child’s education. I am afraid that I have not seen the Oxford Brookes report but I reassure him that many schools buy-in the PGCE qualification to run alongside their own School Direct programme to enable students to benefit from this in addition to the practical emphasis of the school-based approach.
My Lords, the Government have missed their own target for the last five years on teacher recruitment and retention. Does the Minister think that lifting the public sector pay cap, tackling rising workloads and allowing teachers more say in the curriculum might alleviate the serious position in which the Government have put us?
My Lords, we have 15,000 additional teachers in the system today compared with 2010, and an increasing number of teachers are returning to the profession. Last year, we had increasing numbers recruited in maths, all the sciences, modern foreign languages, geography and art. I acknowledge that there are one or two shortages but I do not feel that we have in any way a teaching recruitment crisis.
My Lords, will my noble friend be kind enough to tell me what the precise arrangements are between his department and BEIS in order that his department should play its part in the work that has to be done if the industrial strategy is to include this important area, which was announced as a central theme yesterday when the industrial strategy was implemented?
My Lords, in 2014 we asked Sir Andrew Carter to chair an independent review of the quality of ITT courses. Following on from that we have issued three reports in our efforts to improve the framework. We have the framework on the core content of ITT, new behaviour management content and national standards for school-based ITT mentors.
My Lords, I thank my noble friend for that reply, and I wonder if I can push him a little bit further. I think the whole House would agree that provision of the arts for school-age children is vital if we are to maintain our position as one of the world-leading nations in contributing to the arts globally. Can we get any comfort from the Minister on the provision of, and the Government’s promise to provide, arts in the classroom for our children growing up?
My Lords, as I said a moment ago, the Government strongly support a broad and balanced curriculum. We recently announced £400 million of funding between 2016 and 2020 for a diverse portfolio of arts and music education programmes. This includes £300 million for music education hubs and £58 million in 2016-18 for music and dance schemes. We have music education hubs supporting over 14,000 ensembles and choirs, nearly 8,000 of which are based in schools. Over 340,000 children participate in these. We also have Progress 8, which, as I am sure noble Lords will be aware, encourages a broad and balanced curriculum. Of the eight subjects that are measured, three are open subjects, which include arts.
I paraphrase, of course. Design and technology is one of the subjects that many teachers are now unable to offer because of the Government’s failure to adequately fund schools. A Labour Government will provide an arts pupil premium to allow every primary school child—
I can understand the nervous laughter in various corners of the House. It will allow every primary school child in England to learn a musical instrument, to experience dance and drama and to regularly visit theatres, museums and art galleries. Our aim is for arts facilities in state schools to match as near as possible those in many private schools. Can the Minister tell me why his Government do not match that ambition?
My Lords, I suspect that we have a slightly different emphasis on education and its priorities. However, I assure the noble Lord that the number of art and design teacher trainees has risen nearly every year for the last five years. Indeed, in 2016-17 we had the most we have had in five years.
My Lords, does my noble friend agree that it is absolutely crucial, particularly after 2019, that both our teachers and our young people are kept alive to the glories of European civilisation in all its manifestations, and to the particular contribution that this country has made to them?
My Lords, I strongly support my noble friend’s statement. The EBacc has brought important subjects such as history back into the curriculum. We have seen an increase in the number of pupils studying history, which did not happen under the previous Government.
Mental Health Care: Vulnerable Children
To ask Her Majesty’s Government what actions they are taking to address the concerns raised by the Care Quality Commission in its review published in October about the particular difficulties faced by children and young people in vulnerable circumstances, such as looked-after children and those with learning disabilities, in accessing mental health care.
My Lords, improving children’s and young people’s mental health is a priority for the Government, especially for the most vulnerable. The Government welcome the CQC’s recent report in this area, which was commissioned by the Prime Minister in January. Government initiatives to improve the mental health of vulnerable children include piloting new approaches to the mental health assessments that looked-after children receive as part of their initial health assessment, and testing models for personal budget use for looked after children.
My Lords, I thank the Minister for his response. With the Green Paper promised before Christmas, I hope we will not have to wait until the next CQC review for the urgent action that is needed, given the scale of unmet need for mental health care among vulnerable children. Barnardo’s recent survey showed that one in four looked-after children faced a mental health crisis on leaving care, and yet nearly 65% of them did not receive any statutory support; and whilst in care, local factors such as a lack of permanent or settled placement can lead to support action being denied. On children with learning difficulties, in all my research for this Question I was truly alarmed at the lack of information that is available on the scale and problems of this vulnerable group of children. What action is the Minister taking to ensure that the CQC, Ofsted and, sadly, the police and probation inspectors combine their efforts to investigate this issue as closely as it deserves?
The noble Baroness is right to highlight these disturbing facts about the mental health of looked-after children. Nearly 50% of looked-after children have a diagnosed mental health disorder, so that is what we are up against. In terms of how we are dealing with it, the increases in funding to raise the number of treatments that are taking place by 70,000 will obviously help vulnerable children, and there is the additional assessment that I have talked about. She asked particularly about children with learning difficulties. I am sure that she is aware of it, but I would point her and other noble Lords to the Lenehan review, which set out several recommendations, all of which the Government have adopted. One of the actions that stems from that includes new guidance from the Local Government Association and NHS England on commissioning mental health services for children with learning difficulties.
Does my noble friend the Minister agree that we can take some comfort from, particularly, chapter 4 of the first phase of the CQC report, which was commissioned by the Prime Minister only in January this year? With 80% of specialist mental health care for children and young people being rated as good or outstanding, there is much, to quote the report,
“we should celebrate and learn from”
My noble friend is right to highlight that overall the provision is good. There is still work to do, particularly in specialist community mental health services. Part of the strategy we are undertaking is to make sure that those services have the staff they need. There will be 21,000 more posts in mental health services to ensure that the average rating improves over time.
Does the Minister agree that there remains, despite lots of good work, a terrible stigma attached to mental health problems? Will he assure us that the Government are committed to tackling it, as we seek to do in the Church, while also improving provision for identification and treatment?
The right reverend Prelate is quite right: there is stigma attached. There have been a number of important initiatives, not least from His Royal Highness Prince Harry—who I am sure we all want to congratulate on his recent engagement—to reduce stigma and to demonstrate that mental health problems can, unfortunately, strike anyone of any positional station in society at any time in their life. Making that admission is the first step to seeking help.
My Lords, what are the Government doing to make sure that health trusts spend the resources available on this area of work? The facilities that these children are being seen in is appalling in some cases. What are the Government going to do about both of those issues?
I can reassure the noble Lord that spending on children and young people’s mental health by CCGs, which are responsible for commissioning those services, increased by 20% between 2014-15 and 2015-16, so spending is increasing. Clearly, one of the areas in which that money is being spent is on better facilities. One of the additional changes is that about 150 new beds will be commissioned in underserved areas so that we can reduce the number of out-of-area placements, which can be quite disturbing for some of the children and young people who have to use them.
My Lords, in England there are around 60,000 looked-after children, and there is evidence that some health providers are denying treatment to looked-after children if they have not yet established a permanent living situation. This is completely unacceptable. What action are the Government taking to ensure that all children’s care is addressed? Will the Minister confirm that the long-awaited Green Paper will be published this year?
I ask the noble Baroness to write to me on that specific case. Of course, health services should never be withheld on such a basis; they should be provided on the basis of need, as we all know. I can confirm that the Green Paper will be published before the end of the year.
My Lords, can the Minister explain why some looked-after children who have been on waiting lists for mental health care and are then transferred out of the area for foster care have to start their wait for access to mental health services again, if we have a National Health Service?
I think this picture of a fragmented service is one that the CQC report highlights. One of the ways in which the Government are trying to address that is through incentive payments in the tariff system to make sure that trusts are incentivised to join up care, particularly when children are moving from place to place.
The Minister mentioned concerns about mental health, but crisis teams are reported not to be available in all parts of the country for under-18s, who are very vulnerable. Will the Minister look into crisis teams not being available for under-18s in many parts of the country?
The noble Lord is highlighting that there is a good deal of variation, which is again highlighted in the CQC review. I think that is what he is describing in terms of crisis teams. I will certainly look into that and write to him with more details.
My Lords, we have committed £3.5 billion for air quality and cleaner transport. We are helping local authorities to tackle pollution hotspots and have allocated £255 million to accelerate local action to meet concentration limits. Ninety-two per cent of monitored roads will meet limits next year. We are investing in vehicle retrofitting, ultra-low emission vehicles, cycling and walking, and implementing tougher real driving emissions tests. Next year, our clean air strategy will outline how we will tackle air pollution more widely.
My Lords, I am grateful to the Minister. However, will he confirm that, according to the United Nations, air quality in 44 of our towns and cities is such that it is too dangerous to breathe? According to the Royal College of Physicians, last year, the health impact of poor air quality was £20 billion. It is estimated that 50,000 people die each year from poor air quality, of whom 9,000 are in London. Surely we have to do more than the Minister has said the Government will do?
My Lords, the Government take this seriously because we are well aware of the health issues. This issue affects many countries; as the noble Lord will know, 17 other EU member states have the same problem with nitrogen dioxide. We are working very closely with local authorities, particularly those in which we need to make more rapid progress, to escalate the issue, because we are well aware of the health consequences. It is a very serious issue.
My Lords, will the Minister explain to the House whether there are ongoing discussions with motor manufacturers in the United Kingdom, particularly those—there are some—that offer only vehicles with diesel engines while exporting to other parts of the world with petrol engines in exactly the same vehicles? Is it not clear, particularly after what my noble friend Lord Dubs said, that oxides of nitrogen and other particulate matter from diesel engines are the biggest single threat to health in this country, particularly among children, who go to and from school and play and shop at street level, therefore risking damage to their health?
My Lords, I entirely agree with a lot of what the noble Lord said. That is precisely why this country intends to act and why we have invested in the ultra-low emissions vehicle regime. Importantly, we are in discussions with motor manufacturers because one of the problems we have had with nitrogen dioxide is that the driving emissions tests have been on a laboratory, not a real driving, basis. From September this year, all new cars will have to meet emissions limits in real driving conditions.
My Lords, does my noble friend agree that diesel cars—I must confess that I drive one—are extremely important in rural areas and for people who drive long distances? Will he ensure that any future false reporting by manufacturers will be penalised, so that the vehicle driver is not left to pick up the pieces? Surely this is an area in which he can work very closely with BEIS.
My Lords, my noble friend makes a very strong point. Manufacturers undoubtedly have a responsibility. What happened with Volkswagen was a disgrace. Clearly, we do not seek to punish those drivers who in good faith went for diesel, but there was a dash for diesel, which we all now very much regret.
My Lords, the Minister referred to the Government’s sum of £255 million to improve air quality. Is he aware that Transport for London has a budget of £875 million to improve air quality in London alone? Does he therefore accept that £255 million is a woefully inadequate sum if local authorities are to be enabled to improve air quality and the Government are truly to improve air quality across the whole country?
My Lords, I think I should repeat the first line of my reply: we have committed £3.5 billion for air quality and cleaner transport. We are helping 28 local authorities that need to accelerate their plans so that we can specifically tackle those hotspots. I reassure the noble Baroness that we are very much concentrating on this matter.
My Lords, since 2014 there have been 27 air pollution episodes. That does not sound particularly bad until you realise that one episode lasted 10 days, 300 people died and 1,600 people were admitted to hospital. There is currently no action plan in place for Public Health England. Will the Minister ask it to put one in place, as it does for hot and cold weather?
My Lords, obviously this is a matter on which we have to collaborate and we are, with both the Department of Health and the Department for Transport. Another issue for collaboration is that there are times when half the air pollution in this country comes from abroad. I suspect we send some to them. This is why international collaboration is also very important.
My Lords, the Minister spoke about working with local authorities. Will he be a little more specific about what the Government may outline for local authorities that have schools in very high traffic pollution areas, some of them with playing fields underneath motorway flyover areas?
My Lords, this is very important. The City of Westminster, for example, is concentrating on stopping idling engines outside schools. This is also an area where, under the Environment Act 1995, local authorities have duties to review and assess local air quality. There are provisions around schools, so this should and can be addressed.
My Lords, does the Minister accept Defra’s own modelling, which shows that the most effective measure to reach compliance with the law in the shortest possible time is to introduce charges for polluting cars entering designated clean air zones? Why do the Government not act on their own best advice and expect all polluting local authorities to act on it?
My Lords, under our arrangements in the air quality plan to do with nitrogen dioxide in particular, there are all sorts of ways local authorities can take action, and they have ability to create clean air zones. That is on the statute book and is something we are working on with local authorities. Clearly there will be highly localised solutions to some of these problems with nitrogen dioxide.
My Lords, we now have to deal with a very serious issue. We are not compliant only on nitrogen dioxide; we are compliant in all other areas of air quality. This is one that we need to address. My noble friend is absolutely right that this problem has come about because we dashed for diesel. It is diesel vehicles that have caused the problems with nitrogen dioxide that we are now addressing.
Budget: Reduction of Waste
My Lords, the Government’s call for evidence to explore whether the tax system or charges could help reduce single-use plastic waste will be launched early in the new year. The implementation of policy thereafter will depend on the outcome of this call for evidence.
I thank the Minister for his Answer. While I welcome all plans for reducing the amount of waste that is being created, will the Minister also commit to implementing the strategy announced in April by the last Government, which promised a world-class anti-littering campaign and a litter innovation fund?
We launched the litter strategy for England earlier in the year. That has an ambition to ensure consistency in anti-littering across government, tough enforcement on those responsible for littering and an ambitious clean-up of our streets, highways and byways. The litter innovation fund was launched in August and it will be open to people to come forward with innovative ideas as to how we can implement that strategy. I think we are in a strong place as regards that.
My Lords, in the Budget report there is reference to £30 million being allocated to the Environment Agency to deal with illegal waste management arrangements. Why is that money being allocated only to the Environment Agency and not to local authorities, when they are dealing with a huge problem nationally of illegal tipping, which is stripping out from local authorities funds that are preciously needed in other areas of environmental health?
The noble Lord is absolutely right in saying that the Environment Agency takes the lead on that. The £30 million was committed to it and in 2015 we announced another £20 million to tackle waste crime, which costs local authorities, the taxpayer and business around £605 million a year. It is a very important part of this, the Environment Agency in England takes the lead on it and it is right that it should have the resources to tackle waste crime.
These are great and innovative ideas and things that ought to be looked at. We have some very strict targets for increasing the recycling of paper products and we are on our way to meeting them by 2020. It means that everyone has to play their part, including the House magazine.
My Lords, has the Minister had a chance to study reports from the Institute of Engineering and the London School of Hygiene and Tropical Medicine which state that between 6% and 10% of greenhouse gases are produced by food waste, that around 100 million tonnes of food was dumped in Europe in the course of the last year alone and that, worldwide, if the food that is being wasted were available to eat, it would feed 1 billion people who are estimated to be without food or hungry today?
The noble Lord is absolutely right. Of course, as part of our clean growth strategy, we have an ambition to reduce the level of food waste by half by 2030. The Courtauld initiative is also aiming to reduce food waste between 2015 and 2025. It is also part of the ambition of sustainable development goal 12. So all the strategy, all the rules and all the ambition are there—we just need to see the action.
My Lords, given the nearly 40% cut in local authority funding this year, can the Minister say what incentives he intends to implement to encourage householders to increase recycling to assist councils to meet their recycling targets and reduce expensive landfill and fly-tipping?
In terms of landfill, of course it was the landfill tax introduced by the Conservative Government in 1996 that has reduced the amount going into landfill by some 70%. On local authorities, it is not just about money; it is actually about ambition and determination. We have neighbouring local authorities with varying recycling rates. Lewisham has a recycling rate of 18% but Southwark has a recycling rate of 35%, while Trafford has a recycling rate of 60%. We think that it is not just about money; it is about learning and the political leadership that will ensure that we deliver this.
My Lords, does the Minister accept that normally this House would take some encouragement from the fact that the Treasury is taking the lead on an environmental issue? But what is it proposing to do? It is proposing to carry out an inquiry into how taxation impacts on plastics. Surely it can be a bit more proactive than that.
One of the most recent ideas we had on that was about plastic carrier bags; we put 5p on them two years ago. As a result, we have seen usage reduce by 83% in two years, saving 9 billion plastic bags and leading to a 40% reduction in the number of plastic bags washed up on British beaches. That is exactly the type of innovative initiative that the Treasury should be working on, in partnership with other government departments.
My Lords, following on from that comment, does my noble friend recognise that in fact large numbers of people in this country would welcome a complete ban on plastic bags throughout England? There is also a general sense that there is excess packaging on fruit and vegetables. Just as my noble friend suggested that we could start at home, large amounts of fruit and veg that are delivered to this House go from grower to wholesaler, are wrapped in plastic and then delivered for immediate consumption in the restaurants in this building. It is unnecessary.
My noble friend is absolutely right. This matter is urgent because if you put one plastic bottle in the ground today in a landfill site, it will not be fully degraded until 2457. The legacy we are leaving to our children is extraordinary. That is part of the reason we are taking the tough action that we are—not just for this generation and this time but for future generations.
Brexit: Release of Impact Assessments
My Lords, I shall now repeat in the form of a Statement the Answer given to an Urgent Question in another place. The Statement is as follows:
“On 1 November the House passed a Motion asking that impact assessments arising from sectoral analyses be provided to the Committee on Exiting the European Union. Mr Speaker, this Government take very seriously their parliamentary responsibilities and have been clear that they would be providing information to the committee. In the past three weeks, departments have worked to collate and bring forward this information in a way that is accessible and informative.
I am glad to be able to confirm this information has been provided, not only to the Committee for Exiting the European Union but to the House of Lords EU Committee and, indeed, the devolved Administrations. I can also, with Mr Speaker’s permission, inform the House that we have initiated discussions with the parliamentary authorities to make this information available to all colleagues through a reading room.
We were clear that we would respond to the Motion but also that the documents did not exist in the form requested. Indeed, I made it clear to the House during the debate that day that,
“there has been some misunderstanding about what this sectoral analysis actually is. It is not a series of 58 economic impact assessments”.—[Official Report, Commons, 1/11/17; col. 887.]
The sectoral analysis is a wide mix of qualitative and quantitative analysis, contained in a range of documents developed at different times since the referendum.
The House of Commons has itself recognised that while Ministers should be as open as possible with Parliament, the Government also have an obligation to consider where it would not be in the public interest for material to be published. Furthermore, it is important to recognise that in some cases there may be confidential or commercially sensitive information in this analysis, and that in many cases it has been developed to underpin advice to Ministers of the negotiation options in various scenarios. It is well understood, as was the case under successive Administrations, that such advice to Ministers must remain private. We have also explained that we have a clear obligation not to disclose information when doing so would not be in the public interest.
In light of all that, my right honourable friend the Secretary of State made a Statement on 7 November, in which he explained that, given that the documents did not exist in the form requested, it would take some time,
“to collate and bring together this information in a way that is accessible and informative for the Committee”.—[Official Report, Commons, 7/11/17; col. 231WS.]
He committed that those reports would be provided within three weeks. In providing that information to the committee yesterday, we have met that commitment.
Ministers also have a specific responsibility, which Parliament has endorsed, not to release information that would undermine our negotiating position. Contrary to what has been asserted in some places, the committee did not give any assurances that what was passed to it would not subsequently be published in full. Where there are precedents for Government passing information to Select Committees in confidence, these will be on the basis of assurances received before the material is shared, or a clear set of rules such as those governing intelligence material.
When he met the Secretary of State, the chairman of the committee said that he was willing to enter into a dialogue after the committee had received documents from the Government. This is not the same as an assurance that, if we had provided confidential or sensitive material, it would not be published, and it is not in keeping with the usual practice of committees on these sensitive issues. As such, the sectoral reports do not contain material which would undermine the UK’s hand in the negotiations, or material that is commercially or market sensitive.
Mr Speaker, this debate really seems to be about the “release” of the reports. As you pointed out succinctly yesterday,
‘publication is to the Committee and the matter is in the hands of the Committee’.—[Official Report, Commons, 27/11/17; col. 50.]
Therefore, I suspect many of the questions I receive today should be directed to the chair of the committee and his fellow members. The House should be in no doubt—this has been a very substantial undertaking. We have been as open as possible, subject to the overwhelming national interests of preserving our negotiating position. We have collated over 800 pages of analysis for the committees less than a month from the Motion being passed. This covers all of the 58 sectors.
We now consider the Motion of 1 November 2017 to have been satisfied”.
I have not read all the reports, although I have read very many of them. These documents are constantly being updated and collated. New information is coming to light and new facts are emerging, all of which inform our negotiating position. The Government have been very clear that we are leaving the customs union and the single market. I believe that this will be firmly in the country’s best interests.
My Lords, are this Government not a serial offender when it comes to the arrogance of their executive power? The Brexit pledges were all about taking back control and Westminster sovereignty, but Parliament has been refused a decision on Article 50. There has been an attempted power grab in the withdrawal Bill and now there is this.
In her speech to the Conservative Party conference in October last year, the Prime Minister gave many pledges about change, transparency and honesty and how she had heard the call of millions of people. Is it not time to stop hiding from the British people and to stop keeping them in the dark about the Government’s extreme Brexit plans? Should these reports not be published in full, rather than going through a Whitehall whitewash? Why are the Government trying to spare their own blushes and hide from the people the disaster that Brexit will mean for their jobs, their rights and the environment?
We are not hiding behind any documents. We have provided an unprecedented level of information to the committee. We have been as open and transparent as possible, subject only to preserving our negotiating position. With the permission of the House, I should like to answer a question which I was not asked, but which I expected to be asked by the noble Baronesses—will the House have access to this material? The answer is yes.
My Lords, I can confirm that, as acting chairman of your Lordships’ European Union Committee, I have received these documents. I have not read them all, but I had a chance to look at some of them last night. The committee will have a chance to discuss a way forward at its meeting tomorrow afternoon. It will want to take account of the views expressed in this House this afternoon before it comes to any conclusion.
Meanwhile, will the Minister expand a little on the reference in the covering letter from David Davis to Hilary Benn and to me to,
“aspects of the analyses which may still be sensitive to the negotiations, especially in the context of this particular point in time”.
When will this particular point in time have passed, at which point the sensitivity about releasing the information will presumably also have passed?
My Lords, as the House will be aware from media reports, this is a very fast-moving and dynamic negotiation environment. Some people might observe that the negotiations are sometimes not moving as fast as we might like. Nevertheless, things are changing all the time. New information is coming to light; papers are shared and discussions take place with our European partners. It is a complex and varied negotiation and we will be as open and transparent as possible. We will share all the information we possibly can, subject only to preserving our negotiating position. I cannot believe that most Members of the House would think anything else wise to do.
My Lords, does the Minister accept that in the normal course of events, notwithstanding his replies to date, when legislation is published in Parliament there is an impact assessment released for the benefit of parliamentarians? Will he confirm that when, for example, the agriculture and environment Bills come before this place it is the Government’s intention to publish the usual impact assessments at that time?
My Lords, I might be repeating myself but this is a series of sectoral analyses, analysing individual sectors of the economy in great detail. They show what things are going on in their sectors, what stakeholders have said to us and other key factors facing us. As I have said, it is the policy of the Government that we will leave the single market and the customs union, because that is in the best interests of satisfying the result of the referendum.
My Lords, the implication of what my noble friend has said is that the Government announced immediately that we would withdraw from the single market and the customs union before they had all the information, which has now become available. Should they not reassess the position?
My Lords, will the Minister confirm what I think I understood from his answer to one question, which is that the 850 pages form a completely different document to that which the Government put together on the basis of 58 sectoral analyses? If he does confirm that, can he explain why it was that in the debate in the other place on revealing the 58 studies, nobody from the government side explained that they were being asked, as he said, for something that did not exist?
No, they are not completely different documents. Much of the material is the same as it was in the original documents. Some of them were drawn up two years ago and some more recently. We thought that they should be updated and the information in them is often more current. There is more information in them than in some of the original documents. We think it is in a more accessible and open format.
My Lords, the Government state that this is unprecedented. I declare an interest: I was involved in an earlier exercise which the Conservatives in 2010 demanded, under the coalition agreement, that the Liberal Democrats should have access to. We had 32 detailed reports on the balance of competences between the United Kingdom and the European Union, which I negotiated as a Minister with David Lidington and Greg Clark. When they came out, Number 10 was very unhappy that almost all of them said that the single market was clearly in Britain’s interest and that the balance of regulations suited industry and other stakeholders. It did its best to suppress them; they were usually published as we broke up for the summer or for Christmas. Unfortunately, in the run-up to the referendum not only the leave campaign but the Conservatives in the remain campaign ignored that evidence base. Can we be sure that this time the Government will not ignore evidence as they continue these negotiations?
My Lords, of course we will not ignore evidence, but the Liberal Democrats seem to want to ignore the result of the referendum. The referendum result was clear and the Article 50 Bill was passed in both Houses. We are leaving the European Union, and of course we will use all available information to inform our negotiating position. This is the most important negotiation that any Government have carried out for many years. We are determined to get it right, and we are determined to get a good deal for the United Kingdom.
The noble Lord has told us that we are ignoring the result of the referendum. Nobody is arguing about the result of the referendum. However he did say in response to my noble friend Lady Hayter’s question that he had read “some” of these sectoral analyses, but he did not answer her question about what those sectoral analyses told him. He simply asserted that it is in the long-term interest of the United Kingdom to leave the European Union. What did the sectoral analyses that he has read say about whether it is good or bad for those sectors in terms of leaving the EU?
My Lords, in relation to a matter of this importance and the release of information, is it really right that the Government should be judge in their own court? Would the Government be prepared to let independent people, perhaps a group of privy counsellors, look at the information that has not been revealed and decide whether more of it should be revealed to the House of Commons and to this House?
Maternal Safety Strategy
My Lords, with the permission of the House, I shall repeat a Statement made by my right honourable friend the Secretary of State for Health in the other place on the maternity strategy. The Statement is as follows:
“Giving birth in England is the most common reason for admission to hospital. Thanks to the dedication and skill of NHS maternity teams, the vast majority of the roughly 700,000 babies born each year are delivered safely with high levels of satisfaction by parents. However, there is still too much avoidable harm and death. Every child lost is a heart-rending tragedy for families that will stay with them for the rest of their lives. It is also deeply traumatic for NHS staff involved. Stillbirth rates are falling, but still lag behind many developed countries in Europe, and when it comes to injury, brain damage sustained at birth can often last a lifetime, with about two multi-million pound claims settled against the NHS every single week.
The Royal College of Obstetricians and Gynaecologists said this year that 76% of the 1,000 cases of birth-related deaths or severe brain injuries that occurred in 2015 might have had a different outcome with different care. So in 2015 I announced a plan to halve the rate of maternal deaths, neonatal deaths, brain injuries and stillbirths. Last October, I set out a detailed strategy to support this ambition. Since then local maternity systems have formed across England to work with users of NHS services to make maternity services safer and more personal. More than 80% of trusts now have a named board-level maternity champion, and 136 NHS trusts have now received a share of an £8.1 million training fund. We are six months into a year-long training programme and, as of June, more than 12,000 additional staff have been trained. The maternal and neonatal health safety collaborative was launched on 28 February; 44 wave 1 trusts have attended intensive training on quality improvement science and are working on implementing local quality improvement projects with regular visits from a dedicated quality improvement manager; and 25 trusts were successful with their bids for a share of the £250,000 maternity safety innovation fund and have been progressing with their projects to drive improvements in safety.
However, the Government’s ambition is for the health service to be the safest, highest-quality care available anywhere in the world, so there is much more work that needs to be done. Today I am therefore announcing a series of additional measures. First, we are still not good enough at sharing best practice. When you fly to New York, your friends do not tell you to make sure you get a good pilot. But if you get cancer, that is exactly what they ask about your doctor. We need to standardise best practice so that every NHS patient can be confident they are getting the highest standards of care. So when it comes to maternity safety, we are going to try a completely different approach.
From next year, every case of a stillbirth, neonatal death, suspected brain injury or maternal death that is notified to the Royal College of Obstetricians and Gynaecologists Each Baby Counts programme—about 1,000 incidents annually—will be investigated not by the trust at which the incident happened, but independently, with a thorough, learning-focused investigation conducted by the Healthcare Safety Investigation Branch, or HSIB. The new body started this year, drawing on the approach to investigations in the airline industry, and has successfully reduced fatalities with thorough, independent investigations whose lessons are rapidly disseminated around the whole system. The new independent maternity safety investigations will involve families from the outset, and will have an explicit remit not just to get to the bottom of what happened in an individual instance but to spread knowledge around the system so that mistakes are not repeated. The first investigations will happen in April next year, and will be rolled out nationally throughout the year, meaning we will have complied with recommendation 23 of the Kirkup report into Morecambe Bay.
Secondly, following concerns that some neonatal deaths are being wrongly classified as stillbirths, which means a coroner’s inquest cannot take place, I will be working with the Ministry of Justice to look closely into enabling, for the first time, full-term stillbirths to be covered by coronial law, giving due consideration to the impact on the devolved Administration in Wales. I would like to thank the honourable Member for East Worthing and Shoreham for his campaigning on this issue.
Next, we will do more to improve the training of maternity staff in best practice. Today we are launching the Atain e-learning programme for healthcare professionals involved in the care of newborns to improve care for babies, mothers and families. The Atain programme works to reduce avoidable causes of harm that can lead to infants born at term being admitted to a neonatal unit. We will also increase training for consultants on the care of pregnant women with significant health conditions such as cardiovascular disease.
We also know that smoking during pregnancy is closely correlated with neonatal harm. Our tobacco control plan commits the Government to reduce the prevalence of smoking in pregnancy from 10.7% to 6% or less by 2022, so today we will provide new funding to train health practitioners, such as maternity support workers, to deliver evidence-based smoking cessation according to appropriate national standards.
The 1,000 new investigations into Each Baby Counts cases will help us transform what can be a blame culture into what needs to be a learning culture. But one of the current barriers to learning is litigation. So earlier this year I consulted on the rapid resolution and redress scheme, which would offer families with brain-damaged children better access to support and compensation as an alternative to the court system. My intention is that in incidents of possibly avoidable serious brain injury at birth, successfully establishing the new independent HSIB investigations will be an important step on the road to introducing a full rapid resolution and redress scheme in order to reduce delays in delivering support and compensation for families. Today, I am publishing a summary of responses to our consultation, which reflect strong support for the key aims of the scheme: to improve safety, patient experience and cost effectiveness. Going forward, I will look to launch the scheme, ideally from 2019.
Finally, a word about the costs involved. NHS Resolution spent almost £500 million settling obstetric claims in 2016-17. For every pound the NHS spends on delivering a baby, another 60p is spent by another part of the NHS on settling claims related to previous births. Trusts that improve their maternity safety are also saving the NHS money, allowing more funding to be made available for front-line care. In order to create a strong financial incentive to improve maternity safety, we will increase by 10% the CNST maternity premium paid by every trust, but refund that increase, possibly with an even greater discount, if they can demonstrate compliance with 10 criteria identified as best practice on maternity safety.
Taken together, these measures give me confidence that we can bring forward the date by which we achieve a halving of neonatal deaths, maternal deaths, injuries and stillbirths from 2030 to 2025, which I am today setting as the new target date for our ‘halve-it’ ambition. Our commitment to reduce the rate by 20% by 2020 remains and, following powerful representations made by voluntary sector organisations, I will also include a reduction in the national rate of preterm births from 8% to 6% within this ambition. In particular, we need to build on the good evidence that women who have continuity of carer throughout their pregnancy are less likely to experience a preterm delivery, with safer outcomes for themselves and their babies.
Mr Speaker, I would not be standing here today making this Statement were it not for the campaigning of numerous parents who have been through the agony of losing a treasured child. Instead of moving on and trying to draw a line under their tragedy, they have chosen to relive it over and over again. I have often mentioned members of the public such as James Titcombe and Carl Hendrickson, to whom again I pay tribute. I also want to mention Members of this House who have bravely spoken out about their own experiences, including the honourable Members for Colchester, for Eddisbury, for Lewisham, Deptford, for Washington and Sunderland West, for Banbury and for North Ayrshire and Arran. The passionate hope of bereaved families outside this House as they stand shoulder to shoulder with those Members inside this House is that by drawing attention to what may have gone wrong in their own case, mistakes are not repeated and others are spared the terrible heartache that they and their families endured. We owe it to each and every one of them to make this new strategy work, and I commend this Statement to the House”.
My Lords, I thank the Minister for repeating this important and very serious Statement today. To lose a baby is a heartbreaking matter for parents and families, and something from which sometimes they never recover. Clearly, it should not be so hard for parents to find out what may have gone wrong and why they do not have the healthy baby that they were so eagerly anticipating. So it is quite right to have a much simpler and more transparent process to find out whether anything went wrong, what it was and whether it might have been avoided, and to apologise in a timely fashion if things went wrong.
I welcome the announcement that all notifiable cases of stillbirth and neonatal death in England will now receive an independent investigation by the Healthcare Safety Investigation Branch. The HSIB is a new organisation; are we going to see primary legislation in this Session establishing it? This development is definitely an important step that could bring certainty and closure to hundreds of families every year. We on these Benches also welcome the moves by the Secretary of State to allow coroners to investigate stillbirths. There is much else to welcome in this, including the tobacco control plan, which is a passion of my own.
Our National Health Service offers some of the best neonatal care in the world, and the progress set out today is a tribute to the extraordinary work of midwives and maternity staff across the country. However, it is shocking and heartbreaking that in nearly 80% of the cases referred to by the Minister, improvements in care might have made a difference to the outcome for the baby when things have gone wrong. There is no doubt that staffing shortages mean that midwives are under enormous pressure, which can lead to situations that have a devastating impact on families. While of course we welcome the Secretary of State’s ambition to bring forward to 2025 the target date for halving the rate of stillbirths, neonatal deaths, maternal deaths and brain injuries that occur during or soon after birth, that can be delivered only if the NHS units providing those services are properly resourced and properly staffed.
I looked in vain for something in the Statement to tackle the low levels of maternity staff, an issue that is clearly linked to safety. Noble Lords will know that the heavy workload in maternity units was among the main issues identified by today’s report, with service capacity in maternity units affecting over one-fifth of the deaths reviewed. Earlier this year, research revealed that half of maternity units had closed their doors to mothers at some point in 2016, with staffing and capacity issues the most common reasons. The Royal College of Midwives tells us that we are around 3,500 midwives short of the number needed, and this summer, for the first time, there were more nurses and midwives leaving the register than joining it. This issue will be exacerbated by the fall-off of new recruits from Europe post Brexit.
A survey published by the National Childbirth Trust this year showed that 50% of women having babies experienced what NICE describes as a red-flag event. These are indicators of dangerously low staffing levels, such as a woman not receiving one-to-one care during established labour. What action will the Government take alongside some of these excellent proposals properly to address the staffing shortages as part of the strategy to improve safety? I hope that the Minister can reassure us today that the Government will provide the resources that NHS midwives and their colleagues need to deliver on these ambitions.
Finally, if and when parents resort to legal remedies, as they sometimes feel they have no choice but to do, do the Government intend to deal with the performance of the NHS Litigation Authority in terms of both timeliness—acknowledging fault in a timely manner—and learning lessons which are properly disseminated? As the Minister quite rightly said, we must have a learning culture, but one area which fails is the conduct of the NHS Litigation Authority.
I thank the Minister for the Statement, and we would be very interested in working with him to put legislation on the book that makes these proposals happen.
My Lords, I pay credit to our midwives, who do a wonderful job all across the country, and to those who campaigned to get the report and have spoken about it—I woke up this morning to a very moving Radio 4 piece on the “Today” programme.
I also welcome the Statement from the Secretary of State. Bereaved parents certainly want an answer, and this is an ideal way of helping them to reach some sort of closure. One of the critical points that the Each Baby Counts report makes about maternity care is the importance of continuity of care both for the expectant mother and for the team in the delivery suite. Staffing is an issue, with the workforce being short by 3,500 and a third of our midwives approaching retirement. Some midwives are adopting different patterns of work or choosing to leave the profession, but temporary midwives, be they bank or agency, are not the solution. They undermine the continuity that is so critical. A perfect storm is approaching about recruitment and retention.
Will the Government reconsider some form of financial support for midwives in training? Are any other incentives being considered? Will they guarantee an NHS midwife who is an EU national a job should we leave the EU? What measures are being considered to bolster the morale of NHS midwives, because at the moment, it is really quite low?
My Lords, I thank both noble Baronesses for their overall support for the important announcements made today, and join them in paying tribute to both the staff, who provide amazing care every day, which of course is the norm for most parents, and those campaigners who have campaigned so bravely to raise the profile of these issues with great success.
I shall deal with the issues raised in order. First, on legislation, it is important to point out that the Healthcare Safety Investigation Branch is up and running. Obviously, the intention is that the Bill will put it on a statutory basis, which will give it a degree of security and continuity. Draft legislation will be considered by a committee before turning it into a fully fledged Bill. Although I am not entirely sure of the timetable, I reassure the noble Baroness that we intend to have proper primary legislation following consideration of the draft Bill.
It is important to recognise that the number of staff has increased in the past few years, whether maternity nurses working in maternity services and neonatal nursing, midwives or doctors working in obstetrics and gynaecology. It is also important to recognise, first, that the number of births has risen, so there is a greater workload; and secondly, that on average births are becoming more complicated, as mothers become older, on average, and have more concomitant health problems—smoking and obesity are two of the greatest. I recognise the challenge.
I should point out that more than 6,800 midwives are in training, so there is an intention to continue growing the workforce. However, I recognise that more needs to be done to support them so that they can deliver the care. That is why the training packages announced today are so important.
In terms of learning lessons, the whole point of the rapid-resolution redress process by involving the HSIB is to provide resolution to parents so that they are satisfied while avoiding the sometimes adversarial situation that can emerge, when all that happens is that the problem is delayed for 10 years and creates great heartache for the families involved. We are trying to come up with a process that deals with it more quickly, without disadvantaging the families concerned, and means that it is easier to spread the lessons. That is why the independent HSIB investigations are so important.
Finally, I emphasise the point about the importance of continuity of care, which is referred to on page 16 of the maternity strategy. Here is a stark fact: women who receive continuity of midwife-led care are 16% less likely to lose their babies. That is about one in six, an extraordinary statistic. I understand that it does not necessarily require more staff to deliver that but it does require staff to be organised differently. That is one of the challenges that we have ahead.
My Lords, credit where credit is due: I commend the Government for this initiative. It was first suggested some years ago but that does not matter; it is here now. My question relates to the root cause analysis, which is rightly the way to analyse stillbirths that occur. It should take account of all the circumstances, including staffing levels, as mentioned. It is not just about the care itself. Can the Minister clarify how the system of doing root cause analysis of every stillbirth will work if, at the same time, a coroner is doing an investigation?
I thank the noble Lord for his support for today’s announcements. Obviously, independent investigations are just that. They will be operated by HSIB, which will be able to delve into the causes of the tragedy, however it might have happened, and provide an opinion on that. On the interaction with the coroner’s report, obviously we have focused mainly today on these new independent investigations and we are looking at extending coronial law to take in stillbirths that were previously not included. That is one of the issues that needs to be worked out in the coming months through interaction with the Ministry of Justice.
My Lords, I start by declaring my interests. I am a fellow of the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the Royal College of Nursing, and president of the National Childbirth Trust. Those positions are unremunerated but I am remunerated by NHS England for implementing the report of the review of maternity services.
There is absolutely no doubt that the Secretary of State has concentrated the minds of all of those working in and for the NHS on safety. It is the golden thread that has run throughout his time in office, especially now when he is concentrating on maternity services. We have never seen safer services, but we are being urged to go further with some new initiatives that have been declared today.
I welcome the Statement, particularly the part on investigations. Those of us tasked with implementing the report Better Births—the review of maternity services for England—have been concerned by the way many investigations have been conducted, causing further misery and trauma to the families concerned. We have full confidence that the Healthcare Safety Investigation Branch will ensure independence, and above all, will involve the families. After all, the families were there; they knew what took place. They have a legitimate role in investigations, but often their views and experiences are ignored. Even worse, the learning that has been gathered has not been passed down to the teams within the trust, nor indeed has it spread to other organisations in the wider world. It is absolutely essential that that happens so that we see fewer stillbirths, early neonatal deaths and brain-injured children.
It was those anxieties that made us in the maternity review consider a new scheme, for which we coined the title “rapid resolution and redress”. I pay tribute to Professor Sir Cyril Chantler, who was my vice-chairman. He has worked tirelessly with colleagues across the world and in this country to frame the scheme, so we are delighted that Ministers see the merit of this proposal. However, I should like to question my noble friend about the timing. I understand that more policy work is to be done, but is it possible to bring forward the second part of the implementation of rapid resolution and redress so that the families in question do not have to wait until 2019?
I am interested in the coroner’s investigations. I understand the desire to ensure that no stone is left unturned, but I want to express my concerns at this moment because it is another inquisitorial initiative, when RRR is designed to avoid using the courts in order to spare parents from trials and tribulations. Therefore, I ask my noble friend to consider whether there could be a pause so as to wait for the evaluation of RRR; otherwise, we will have a range of initiatives which not only might cause confusion but will be in conflict with one another. I thank my noble friends for introducing continuity of care—something that is very close to my heart.
I am delighted to be able to respond to my noble friend, who, probably more than anyone else, has really led the charge in this area. I pay tribute to her for her work on better births, as I do to Sir Cyril Chantler, her deputy. She is right that patient safety is the golden thread that runs through all the work that the Secretary of State has led, and she is right to highlight that we have safer services. The changes that we are making, together with bringing forward the “halve it” ambition, will save 4,000 babies’ lives, which is a great prize.
With regard to my noble friend’s questions, the endorsement of the HSIB is very welcome. Some months ago I organised a briefing for noble Lords with Keith Conradi, who runs it, and I shall be very happy to organise another one. It is a very interesting organisation with an interesting methodology that has proved incredibly effective in the airline industry, where Mr Conradi comes from.
On RRR, I appreciate my noble friend’s concerns about the timing and I will certainly look into whether it is possible to bring forward its implementation. As she knows, there are some issues around governance and how it will operate that mean that we need to tread carefully, but I shall certainly take that into consideration because we want to get the scheme up and running as soon as possible.
My Lords, I too declare an interest. Like the noble Baroness opposite, I am an honorary fellow of the Royal College of Obstetricians and Gynaecologists. Of course I welcome this investigation that the Government have announced, but I am a little worried that at the end of the investigation we shall hear the usual phrase “lessons will be learned”. From past experience, lessons are never learned, especially in the health service, because the main cause of the difficulty and of these babies dying is a shortage of midwives and a lack of staff. When will the Government seriously address funding in all sectors of the health service but, on this occasion, especially midwifery?
The whole point of these reforms is that lessons should be learned, and they can be. The Francis inquiry, and other investigations that have taken place into poor practice, have led to dramatic improvements. The fact that there are over 10,000 more nurses on wards was a direct response to the Mid Staffordshire crisis and the finding that there were not enough staff on wards to look after patients and make sure that they were not vulnerable. It is possible to be optimistic about this. We are already seeing improvements through the learning from deaths programme and from the reduction in the number of stillbirths. The noble Baroness is shaking her head but that is rather a gloomy view, which does not reflect the support for these proposals in this House.
In answer to the point about staffing, there are more midwives in the service and more coming through training. We need to make sure that that continues so that the level of support that is needed is there.
My Lords, like others, I welcome the Statement and the determination to deal with this issue. The Minister will recall that a few weeks ago I asked him about coroners’ inquests on stillbirths and I will address myself to that. Does he agree that, for many parents, the depth of their bereavement at a stillbirth means that they feel the weight and authority of a coronial investigation is absolutely warranted? I therefore welcome the discussions that are to take place. Can the Minister tell me a little about the timing of that and about the legislative vehicle? I understand that primary legislation will be necessary and a Private Member’s Bill that refers to this is currently in the Commons.
I am glad to be able to return to the topic, which the noble Baroness has raised before. There was a powerful story on “Today” this morning, about parents who wanted precisely that for the level of authority it would bring. The hospital was not necessarily treating them as well as it could. These independent investigations will provide a degree of authority and independence that is perhaps sometimes lacking. We want to see how this pans out, but the Secretary of State is committed to looking at coroners investigating stillbirths. This is obviously a complex issue, so I hope the noble Baroness will forgive me if I am not in a position to provide more detail at this point. However, there is a desire and willingness to look into this in the months ahead. When we have some more details, I will certainly write to her.
Space Industry Bill [HL]
Clause 67, page 43, line 13, leave out from “make” to end of line 14, and insert “further provision for the regulation of spaceflight activities and sub-orbital activities, and the activities associated with them.”
My Lords, this amendment is the result of unfinished business at the end of Report. Basically, there has been an argument throughout this Bill, and there will be in other Bills that come before us, about the worrying nature of the use of secondary legislation that is vaguely promised and vaguely described in primary legislation. In this respect, Clause 67(1), which is vaguely written, refers back to Clause 1(1) which again makes vague commitments. The amendment merely suggests that there should be crisper and more tightly drawn references which avoid blank cheques and abuse of secondary legislation.
I do not intend to press this to a vote this afternoon, but to leave it as a bit of business still to be considered. The other place will need to look at it, because it should be as worrying to them as it is to this House.
I put on record my appreciation for the removal from the Bill of the Henry VIII clause, and I hope that will be a guide for other Bills that are coming before us. I am very grateful to the noble and learned Lord, Lord Judge, who is not in his place, who has made it quite clear that Henry VIII clauses were to be avoided, and that this example of putting in Henry VIII clauses and vague “blank cheque” secondary legislation was a problem that needed to be addressed. That is not to deny the fact that we also need to be able to future-proof Bills as best we can, particularly a Bill such as this. It is a matter of getting the balance right between future-proofing and ring-fencing them in terms of the powers that we write in.
As the noble and learned Lord, Lord Judge, emphasised in his lecture at King’s College in 2016:
“This is not an attack on delegated legislation”.
However, in that lecture he quoted one of his distinguished predecessors as Lord Chief Justice—Lord Hewart—who, in 1929, warned against,
“the increase of bureaucratic, departmental authority over the citizen”.
The moving of power from Parliament to the Executive is one of the ironies of the Brexit process.
We believe that if we do not heed the warnings of the noble and learned Lord, Lord Judge, and others, we face a constitutional car crash. At the very least, future-proofing should be tightly drawn. The super-affirmative process should be used where necessary, as should sunset clauses. I believe that we need to look at the case for making certain types of secondary legislation amendable by both Houses. That is the thinking behind this amendment—a billet-doux to send down the Corridor to the other place. I beg to move.
I assume that when she comes to respond the Minister will talk about the wording of the amendment and, if she is not going to accept it on behalf of the Government, will indicate why it is not acceptable. Therefore, my brief comments and questions are based on the assumption that she will talk about the wording of the amendment and what it would mean if it were included in the Bill, because obviously I share the concerns that have been expressed. I hope that if the Minister is not prepared to accept the amendment on behalf of the Government, she will at least indicate a willingness to reflect further on this matter prior to its being considered in the House of Commons.
In her response, perhaps the Minister could say what the Government envisage they might want to do through regulations under Clause 67(1) as it stands that they consider they would not be able to do through regulations under Clause 67(1) if it were amended in line with this amendment. Or, to put it the other way round, what do the Government consider they would not be able to do that they might want to do through regulations under Clause 67(1) amended in line with this amendment that they would be able to do through regulations under Clause 67(1) as it stands?
My Lords, we debated this issue extensively in Committee and on Report, and I regret that I have been unable to convince noble Lords of the necessity of this provision as drafted.
The wording of the clause—which is why we are keen to include it rather than the amendment put forward by the noble Lord, Lord McNally—is consistent with that contained in Section 60(2) of the Civil Aviation Act 1982, the latter being a power to do anything,
“generally for regulating air navigation”.
A similar power arises under Section 11(1) of the Outer Space Act 1986 to enable the making of regulations generally for carrying that Act into effect. That is why we put forward the wording that we did in the Bill.
As noble Lords are well aware, there are a number of other regulation-making powers in the Bill, notably around security and safety. However, we need to ensure that we can regulate those wider matters relating to spaceflight and associated activities carried out in the UK that are not covered by the other powers. For example, this may include implementation of our international obligations relating to spaceflight arising from bilateral or multilateral treaties. We know from our experience in other sectors, such as aviation, that despite our best efforts there needs to be the flexibility to deal with any unexpected circumstances. The Government therefore remain convinced that this provision, as currently drafted, is needed to ensure that all aspects of the Bill can be fully implemented effectively.
I ask your Lordships please not to mistake this for simple intransigence. Throughout the Bill, the Government have listened and acted, and we have worked hard to balance the need for flexibility against noble Lords’ concerns on the scope of the Bill. As the noble Lord, Lord McNally, recognised, we removed the Henry VIII power and placed a requirement to consult on affirmative regulations in the Bill. We comprehensively reviewed the land powers, strengthened the position on space debris, noise and emissions, and accepted the amendment on gross negligence. However, to unduly limit the scope of this power would mean that we would need to use primary legislation to make provision in response to developments in technology, which could hold up the timetable for enabling safe launch from the UK.
As I have mentioned previously, it is not as if this power is unlimited; regulations can be made to carry the Act into effect or to facilitate regulation of spaceflight activities and associated activities only as set out in Clause 1(1). I therefore hope that noble Lords will take some reassurance from this explanation, and I ask the noble Lord to withdraw the amendment.
My Lords, as I indicated, what we said, the probing of the noble Lord, Lord Rosser, and the Minister’s reply are in Hansard and will be of use in the other place when they make their judgment about whether the Bill is drafted tightly enough in these matters. With that, I beg leave to withdraw the amendment.
A privilege amendment was made.
My Lords, I thank all those involved for their interest in, engagement with and scrutiny of the Bill over the past few months. The UK space industry is a British success story—a story of invention, innovation and global ambition. The Bill will take us further, enabling new satellite launch services and low-gravity spaceflight from UK spaceports, and supporting our industrial strategy to deliver a stronger economy that works for everyone.
I thank my predecessor, my noble friend Lord Callanan, who took the Bill through its early stages, and I thank the noble Lords, Lord Rosser, Lord Tunnicliffe, Lord McNally, and Lord Fox, and the noble Baroness, Lady Randerson, who provided rigorous scrutiny throughout this process. I am grateful for the contributions of my noble friend Lord Moynihan; I, for one, will miss the strong advocacy for a certain location in Scotland. Finally, I thank policy officials and lawyers from the UK Space Agency, the Department for Transport and the Department for Business, Energy and Industrial Strategy for their work on the Bill.
It has been a privilege to debate the Bill with noble Lords, whose knowledge and expertise I have found incredibly helpful. We have taken on many of the recommendations of the DPRRC and the Constitution Committee, and I thank them for their work. The constructive engagement, conversations and debates we have had together have led to significant improvements to the Bill. This is an example of this House at its best, where proper scrutiny and challenge can—put simply—lead to a better Bill. Today, therefore, we stand one step closer to a new commercial space age, and I beg to move.
My Lords, I take this opportunity to thank the noble Lord, Lord Callanan, the Minister and the Bill team for their willingness to consider the points we have raised about the Bill during its passage through this House. A number of meetings have been held, which we appreciated, and we welcome the changes the Government have been prepared to see made to the Bill as a result.
I also thank my noble friend Lord Tunnicliffe for—I was going to say “his advice and support” but the reality is that it has been infinitely more than that. I also thank Grace Wright in our office for all the hard and vitally important work that she has done for us on the Bill.
My Lords, I join the noble Lord, Lord Rosser, in thanking both the noble Baroness, Lady Sugg, and the noble Lord, Lord Callanan. Although I teased him at the time that he was not missed, it is clear that there was a smooth and orderly passing of the ball to the noble Baroness, Lady Sugg, who has carried out her role with great skill and charm and has made herself and officials available, for which we are grateful. Our Bill team consisted of Sarah Pughe, who has been a great help to me, and my noble friends Lady Randerson and Lord Fox. I have enjoyed working with the noble Lord, Lord Rosser, who brings his eye for detail to these matters, and with the noble Lord, Lord Tunnicliffe, who brought his experiences as an ex-pilot. I will remember two contributions by the noble Lord, Lord Tunnicliffe. He reminded us that a rocket is a controlled explosion, which puts some of the health and safety aspects into perspective. He also said that the first civil aviation Act in 1920 completely underestimated the explosion of air travel that was about to come. Therefore, those who write off this Bill as a bit of futurology may be surprised at how soon some of this comes to pass.
I take pride that the problem of space rubbish has been put firmly in the Bill. It is now part of the Liberal Democrat lexicon, along with clean pavements and other matters. It was a delight to have contributions from the noble Lord, Lord Willetts, who, as a Minister, made such a contribution to giving the space industry of which we are so proud its impetus. We all look forward to the opening of the Moynihan International Spaceport in Scotland, which I am sure will be a festive occasion.
One has to say and lead the worry that Brexit casts a long shadow over this industry. It is important that, if Brexit were to go ahead, the industry be well protected to make progress.
Again I thank the Minister and her team for making this Bill a good example of the House of Lords at work.
My Lords, I add my gratitude and appreciation to the ministerial team, both present and past, who have worked so diligently on this Bill. It was very helpful that the Bill was published in an early form for consultation in both Houses, which has led to a series of improvements. My noble friend the Minister has listened carefully, particularly on the question of secondary legislation, to ensure that as much of that as possible was addressed during the passage of the Bill. Indeed, it will continue to be so in another place.
This is an important Bill which provides the regulatory and legal framework now which will take the industry forward. However, none of us should be under any illusion—while we can provide the regulatory and legal framework—that we do not need to work closely with the private sector to make sure that this is a commercial success. Ultimately, these spaceports will require close co-operation between government and the private sector.
My noble friend has mentioned that I have been an advocate in part for a certain location in Scotland, which I think was her phrase. The House should be under no illusion whatever that that location is Prestwick Airport. It is head and shoulders the best airport to be licensed for spacecraft activities at the earliest possible stage in this country. This has been self-evident throughout our deliberations. All noble Lords will, of course, be welcome to the opening of Prestwick when it is finally licensed as the first spaceport in the United Kingdom.
My Lords, I wonder whether I might be permitted a brief intervention. I do so with some diffidence and an apology to your Lordships for not being present on Second Reading, for diary reasons, although I have sat in on some of the subsequent parts of the Bill.
I too have an interest to declare. Like my noble friend Lord Moynihan, I live quite close to Prestwick Airport—almost as close as he does, but on the other side of the runway. However, I am glad to say that I am on the same side of the argument as him. I strongly endorse all that he said with such clarity, efficiency and thoroughness throughout all the stages of the Bill. Regarding the suitability of Prestwick Airport—I know that we are talking about the Bill, not just Prestwick Airport; I had better say first that it was a good Bill and is now a better Bill as a result of the consideration it has had—I cannot help but support its case. It is a fine, well-established airport of long standing. It was a base for the stratocruisers that left London, on their way to New York; they stopped there to refuel, both outwards and inwards. From there, it moved on to another fine record, with the location of Scottish Aviation. It now has 2,300 aerospace jobs nearby. It is close to the sea and open at all hours. Really, it is underused, but it has a basic infrastructure that could receive all the elaborate infrastructure needed for a space base.
There is a slightly broader point that is briefly worth making. The fact remains that the Scottish economy is trailing that of the rest of the United Kingdom, for reasons that I will not indulge in, for political reasons. In Scotland, the Ayrshire economy is also suffering to a considerable degree. It is one of the most socially deprived areas in Scotland, with one in five people living in a deprived area—rather more than in the rest of Scotland. Unemployment is at nearly 8% in Ayrshire, compared to 5% in the rest of Scotland. There is a strong case for the triggering of a huge potential economic payback from the circumstances in which the spaceport would be located.
The Government made a commitment in their manifesto at the last election to invest in Scotland. This is an opportunity to do so.
Bill passed and sent to the Commons.
Telecommunications Infrastructure (Relief from Non-Domestic Rates) Bill
1: Clause 1, page 2, line 36, at end insert —
“(c) require that a certain proportion of the relief granted to providers under this Act must apply to hereditaments in deprived or isolated areas of England and Wales.”
My Lords, I now bring us from space back down to earth with the telecoms Bill. I draw the House’s attention to my interest as a councillor in Kirklees and as a vice-president of the Local Government Association.
As I said at earlier stages of the Bill, this is a constructive way of providing an incentive to IT providers to lay more fibre, with the intention of enabling more properties—both households and businesses—to access superfast broadband. My concern throughout the passage of the Bill has been that a scarce resource—public money—is being used indiscriminately. Any company that lays fibre, be it a billion-pound company or a smaller provider, can benefit. Any fibre that is laid will qualify, regardless of the wider public interest.
The benefit of fibre to the cabinet in the street is dependent on the distance from that cabinet to the property. At 300 metres away, the benefit will be negligible—although the Government’s current, but unjustifiable, measure is 1 kilometre. Broadband speeds are also dependent on the connectivity from the cabinet to the property; a copper connection further degenerates the broadband speed available. By the way, I am pleased to see that action is being taken elsewhere to ensure that adverts for broadband speeds will show realistic speeds attainable in properties, particularly households.
The concerns I just described are the reasons for the amendment. Its purpose is to make sure that the Government make the most effective possible use of scarce public resources. I listened most carefully to the Minister’s response in Committee to the practical difficulties in my amendment. It would now add this to the list of potential regulations under proposed new subsection (10) of Section 44 of the Local Government Finance Act 1988. It would require that at least some part of the resources is allocated to improve connectivity in areas of deprivation and isolation. I beg to move.
My Lords, the noble Baroness, Lady Pinnock, raised connectivity in remote areas. I thank her for her remarks. It is an issue that we explored at Second Reading and in Grand Committee, and one that I absolutely agreed is of utmost importance, as I do now.
The amendment seeks to ensure that deprived or isolated areas receive “a certain proportion” of the relief. However, it is not clear what exactly that would entail as the term “a certain proportion” is not defined. By its very nature, all areas would get “a certain proportion” of the relief depending on how much and where fibre is deployed and lit from 1 April 2017. If the noble Baroness intends for “deprived or isolated areas”—again, those are not defined—to receive a higher proportion of the relief than others, the amendment would not have that effect.
The Government cannot therefore agree to the amendment as it is technically deficient and does not fully engage with how the telecoms networks are deployed and the approach taken to upgrade our networks with more fibre. I do not want to dwell on the technical deficiencies because even if they were resolved the amendment would still not be in keeping with the Bill’s very simple aim—to promote fibre connectivity wherever it takes place.
As my right honourable friend the Minister for Digital said in the other place, we need to think of the fibre network like a growing tree—he is a romantic soul. We already have a strong trunk, which links our great cities and connects Britain to the world, but we must now grow the boughs and branches. We must grow out this fibre not just in the trunk or the boughs, but in a multitude of branches that serve people’s houses, businesses, and all the public services of the land. The point is, we need to support fibre everywhere and if the relief is not available to support the growth of those branches then they may not grow at all, such is the difficult balance of the business case for more fibre. Therefore, if we seek to ensure that particular areas benefit more than others it is possible we will undermine that business case and deprived or isolated areas may not benefit at all. I do not believe this was the noble Baroness’s intention.
We do agree that it is vital to see improved connectivity in remote and indeed rural areas. People need at least acceptable broadband at home and at work; it is essential for modern life. That is why the Government have consulted on the design of a broadband universal service obligation, which would provide a digital safety net by giving everyone, no matter where they live, the legal right to request a connection to broadband speeds of at least 10 megabits per second. But we are not satisfied with just acceptable levels of access: we want to ensure that businesses and households throughout the country have access to faster broadband—superfast and better. By the end of this year, 19 out of 20 premises will have access to superfast broadband. We are taking steps to ensure that the figure rises even further in the next two years so that 97% of households and businesses have superfast access.
Some £30 million of the £200 million funding under the England Rural Development Programme has been made available through Defra. This is targeted at supporting rural businesses and growth, for broadband services in these areas at speeds of 30 megabits per second or faster where this is not currently available or planned, and to ensure that all areas can and do have the broadband speeds they will need for the future.
The Government are delivering a series of measures to support the rollout of fibre broadband in addition to the measure we are debating today. We launched the £190 million challenge fund as part of the Autumn Budget for local bodies to bid into as part of the local full fibre networks programme. As it was being developed during this year, we received a great deal of interest in that programme from local bodies in all parts of the UK, not least in rural and remote areas. The projects delivered under this programme will, we expect, encourage further commercial development of future-proofed fibre networks right across the country. This follows our announcement last year of more than £1 billion to support digital infrastructure.
Also part of that substantial sum is the digital infrastructure investment fund. That involves £400 million of government financing now being administered by fund managers and will attract significant private investment which will be available for alternative providers to use for fibre networks. This work will have impacts right across the country and enable operators to make the commercial case for wider deployment. In summary, therefore, the Government acknowledge that all areas of the country need decent broadband. That includes urban and rural areas which do not have it. I have outlined the measures the Government are taking to achieve this, but the Bill has one simple aim: to incentivise new fibre optic cable wherever it is laid, because we need it everywhere. I therefore hope that the noble Baroness will feel able to withdraw her amendment.
My Lords, I notice that the Minister, in his detailed response, made the assertion that we would have what he described as “decent broadband” throughout the country. I have to say that I query the definition of “decent broadband” that is provided by the Government. A speed of 10 megabits per second is not really acceptable in the current way that business and households operate. The Government’s measure of “decent broadband” being within one kilometre of where the fibre is laid to the street cabinet certainly does not provide broadband speeds at the property, given that 300 metres away it has degenerated to such an extent that the improvement is negligible.
What concerns me, and I have pressed it throughout the passage of the Bill, is that all public bodies—understandably, and supported by me—are moving to digital by design. For instance, if you are unemployed and in receipt of employment and support allowance you are required to make job applications online. If you are not in a facility with good broadband speeds, that is really difficult.
Let me make one thing clear: the universal service obligation, which we have said will come in 2020, will be at 10 megabits per second which although I know is not acceptable to a lot of people, will allow things such as job applications to be done: you can even download and watch a film at 10 megabits per second. The universal service obligation, which is a safety net, will be available to everyone.
I thank the Minister for his intervention but if he has ever tried to watch a film at 10 megabits per second he will discover that you get gaps while you are watching it because the download speed is variable.
I am concerned about people who live in isolated areas and those in more deprived communities who will not be able to afford full fibre to their household and the consequent monthly payments. I have been making this case throughout the passage of the Bill, because we need to consider broadband access as an essential utility and at the moment I do not think that the Government are seeing it in that light. Nevertheless, I understand the technical arguments that have been made and I accept the Minister’s statement that the Government appreciate the importance of all households having access to broadband Therefore, I beg leave to withdraw the amendment.
Amendment 1 withdrawn.
Clause 2: Relief from local non-domestic rates: unoccupied hereditaments
Amendment 2 not moved.
Clause 3: Relief from central non-domestic rates
Amendment 3 not moved.
4: After Clause 3, insert the following new Clause—
“Time period for the availability of the relief under this Act
(1) Subject to the provisions under section 6(2), the amendments made by this Act will have effect for the period of five financial years after 1 April 2017.(2) The appropriate national authority may by regulations made by statutory instrument extend the time period for which the relief is to be made available.(3) A statutory instrument containing regulations made by the Secretary of State under subsection (2) may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.(4) A statutory instrument containing regulations made by the Welsh Ministers under subsection (2) may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, the National Assembly for Wales.(5) For the purposes of this section, “appropriate national authority” is(a) in relation to England, the Secretary of State;(b) in relation to Wales, the Welsh Ministers.”
My Lords, first, I draw the attention of the House to my registered interests: namely, as a councillor in the London Borough of Lewisham and a vice-president of the Local Government Association.
As we have heard, the Bill is not controversial. It seeks to help with the boosting of the switchover to fibre from our old copper broadband network. This is important as we need to increase the take-up of fibre at a faster pace, and it is recognised that an exemption from business rates could prove an incentive to speed up the process and get more of our outdated network on to a fibre network in a shorter period of time.
Amendment 4 in my name adds a new clause which puts into the Bill the time from which the relief from business rates will operate; namely, five years from 1 April 2017. I considered the issues at Second Reading and in Committee and my amendment seeks to give an additional power to the Secretary of State in England and to Welsh Ministers in Wales: that is, the ability to seek approval to extend the period for which the business rate relief is available to those companies that are installing new fibre beyond the initial period of five years.
The extension would have to be approved by both Houses of Parliament using the affirmative procedure. There will be parliamentary oversight of the process as it enables the Government to have the power to extend the scheme without the need for primary legislation. I think it is proportionate in the circumstances. It is a simple measure and will be an effective way of continuing the scheme if it has been deemed successful in helping roll out the network faster. Of course, if it has not been successful, the scheme will be ended and the option will not be taken up. I beg to move.
My Lords, I am grateful to the noble Lord, Lord Kennedy, for moving this amendment. As noble Lords will know, the matter of whether the five years of the rate relief scheme should appear in the Bill was also raised by the Delegated Powers and Regulatory Reform Committee.
As currently drafted, the Bill would allow the relief to apply indefinitely. The draft regulations that we published for consultation would provide that the relief is limited to five years from 1 April 2017—so the five-year period of the scheme appears in secondary legislation rather than in the Bill. We have taken this approach to retain the ability to repeat the scheme for later years without the need to return for more primary legislation. This will allow us to consider the success of the scheme in a timely manner as 2022 approaches.
Nevertheless, the noble Lord, Lord Kennedy, has made a very strong argument for why the five years should appear in the Bill. We have been clear that the purpose of the Bill is to implement the Chancellor’s commitment to offer five years of relief, and we now accept that such a fundamental aspect of the policy should appear in the Bill. But I am grateful that the noble Lord also recognises the value of retaining the ability to extend or repeat the relief scheme without another Bill. Therefore, we also agree that we should take a power to change the period of the relief and that this power should be subject to the affirmative resolution procedure, as the noble Lord set out.
As I have discussed with the noble Lord—and I appreciate the opportunity to do so—we intend to move our own amendment at Third Reading, achieving the noble Lord’s aim but ironing out one or two drafting defects just to ensure that we can make these changes. We will table the amendment tomorrow. Once more I thank the noble Lord for his constructive and helpful approach. I hope that, with these assurances, he will feel able to withdraw the amendment.
I thank the noble Lord, Lord Bourne, very much. As he said, we had a very useful meeting a few days ago. I am very pleased that the Government have accepted the main thrust of what I am suggesting to the House. I am happy to withdraw the amendment at this stage and look forward to seeing the Minister’s amendment when he tables it tomorrow.
Amendment 4 withdrawn.
Mental Health Services: Black and Minority Ethnic Communities
Question for Short Debate
My Lords, in moving the Motion in my name on the Order Paper, I pay tribute at the outset to the very many black and minority ethnic patients who have suffered from what the Prime Minister rightly described as “a long-standing injustice” —discrimination in the mental health service of our NHS. I want also to pay tribute to their carers, their families and the clinicians who have stood behind and alongside them in what has often been a difficult and challenging fight to have recognised the injustice to which they have been subjected.
This injustice is rooted in the issue of race. There is no escape from that reality, however uncomfortable it may be. All the evidence—from the Mental Health Foundation and the Prime Minister’s own excellent race disparity audit—shows that, if you are from a black or minority ethnic community, you are more likely to be hospitalised, to be in receipt of pharmaceutical rather than talking therapeutic interventions, to be detained or to have less good outcomes than your white counterparts. You are also more likely to feel alienated and ill served by the mental health service. This is the sad reality of the conditions that black and minority ethnic patients face in the mental health system.
In earlier debates in this House, we have heard that it is the Secretary of State’s wish that safety should run like a golden thread through the NHS. This is a commendable wish but, sadly, for black and minority ethnic people NHS mental health services are not a safe place. Too many have died or been the subject of abuse for us to be able to say this with any degree of certainty.
In his ground-breaking report on the tragic circumstances surrounding the death in secure hospital accommodation of Rocky Bennett, Mr Justice Blofeld referred to institutional racism in NHS mental health services. He referred to the services received by black and minority ethnic communities as “a festering abscess” on the NHS. I fear that many people who have experienced what the black and minority ethnic communities go through in the NHS will concur with that verdict.
The Prime Minister has done the nation a great service by highlighting the injustices in the treatment of black and minority ethnic people within the NHS and by initiating an independent review of the Mental Health Act. I commend and welcome that, but it is important to remember that it is only one part of the picture. The wider picture is the context in which the Act is administered. So we look forward to the outcome of the independent review. We hope that the Government will legislate urgently on it and that it will have rights-based conclusions. These will enable patients to access services that are underwritten by capacity within the health service so that we can meet the norms that we look to achieve. We hope for all those things.
In the meantime, it is vital that we address the issue of patient care now. I hope that in the course of this short debate we will be able to come up with some practical recommendations and proposals in that regard which can be implemented—and implemented as a matter of urgency. Over the years, there have been many inquiries and studies in this area. They were initiated by successive Governments with good intentions but the reality is that, in the main, they have been only partially implemented and when they have, I fear that they were underresourced. I urge the Minister, as she takes forward the Prime Minister’s initiative on mental health, to ensure that along with the recommendations come resources, a timescale for those recommendations to be implemented and, importantly, a gathering of the data to enable us to judge the outcomes. Without the data, we will not be able to make the judgments or have the insights necessary to establish whether patients are getting the care that they need.
It is also important that we spread good practice. I have been a very junior Health Minister and I know that the holy grail in the NHS is to spread good practice. There is some great stuff going on out there, even in the field of BAME mental health, but there is also some terrible stuff. The challenge for Ministers, service providers and commissioners is in how we spread the good practice and ensure that inevitable pressures on budgets do not lead to neglect of this area because it is simply all too difficult. It is difficult and complex; we are dealing with not just an illness but racism and the encompassing social disadvantage and exclusion. No one pretends it is easy but we have to address it, and in ways that make a practical difference on the ground to hard-pressed clinicians, to hard-pressed community workers and, above all, to the patients and their carers.
I shall make a number of brief points on some positive ways forward. First, it is important to recognise the interface between local authorities, health authorities, hospitals and providers in this area. I believe—I championed this as Chief Secretary to the Treasury and I go on doing so—in having pooled budgets wherever you possibly can. I am also driven to the conclusion that although the Treasury does not like hypothecation or ring-fences, there is no alternative when it comes to mental health. If we do not ring-fence then I am afraid, for reasons that many Peers in this Room who have day-to-day experience of it will know, it simply will not happen. I urge the Minister, as she takes forward these proposals with her colleagues, to look at pooled budgets and ring-fencing.
Secondly, it is important that we find ways of ensuring that patients themselves have a voice and that patient advocacy is taken seriously. My early experience as a young community lawyer in this area showed that patients need advocates. They may need community advocates and sometimes they need professional advocates. We have to look at how they access help in that regard.
My third point is on early intervention. I fear that, when we look at what the evidence shows in relation to black and minority ethnic communities, all too often it is the police and the prison officers who have to deal with this issue, because there has been no earlier accessing of services. I have been Police Minister and Prisons Minister. I know just how hard it is for those professionals, without adequate training or support from the surrounding services, to deal with mental health patients in custodial settings and in circumstances in which the police are called to the scene on the streets or in private premises. We have to look at ways, whether community street triage or whatever, of ensuring that the police and prison services get the professional support, and the funding underpinning that, to enable them to respond and, even more importantly, that these communities have a sense that they can access services before they reach that acute and desperate level; that is, early intervention.
Finally, progress and best practice in this area have tended to come when the community and the voluntary sector in the community have been involved. There are some excellent examples in Brent, Lambeth, Birmingham and elsewhere of black and minority ethnic community-led voluntary organisations working with GPs and hospitals to deliver services. Very often, these organisations are the first to get cut at a time of pressure on local authority and health budgets. They are, in fact, the last organisations we should be cutting out of the picture, because they are a depository of good practice and understanding and a gateway into the service for the community.
I end on that, save to say: we know what needs to be done. I sense that across the Chamber, in both Houses and in the wider community there is a desire and a will that it should be done, so let us adopt what I learned in South Africa as a particular approach when there is a will and when there is an outcome. It is encapsulated in this one word “Vukuzenzele”, which simply means, “Let’s get on with it. Let’s do it”.
My Lords, I thank the noble Lord, Lord Boateng, for securing such an important and timely debate on an issue of real interest to many people and communities across the country. Good mental health is essential for a healthy society, and it is positive that recently there has been a greater emphasis on mental health and calls for it to be afforded parity with physical health. I have worked with people with mental health difficulties. I worked in Tottenham in mental health services, I was a councillor in Hackney and in Islington, and I sat on one of the first mental health and social care trusts, the Camden and Islington trust, which was established about 15 years ago to bring mental health and social care together—so we have come a long way. However, the figures show that black and minority ethnic communities are still not getting access, quality services and, as the noble Lord, Lord Boateng, said, early intervention at the appropriate time.
Yesterday, while preparing for this debate, I read that there are now 5,000 fewer mental health nurses than there were in 2010. Will the Minister say whether that is the case—and, if it is, what is being done to recruit more mental health nurses?
Figures show that in recent years people from the black community have had the highest rate of detention in hospitals under the Mental Health Act—56.9 per 100 people—and people from Asian groups have had the second-highest rate. These are shocking and very stark figures. We know that socio-economic factors contribute to these findings. We know that coming from a poorer background, living in an inner city and encountering poverty and discrimination contribute to poor mental health. Stigma is attached, and there is a lack of willingness to seek help when necessary because families and individuals worry that they may be stigmatised within their own community.
For a long time there has been a lot of research—it is not new research; it has been going on for many years—and many findings about the challenges facing BME communities. However, so far there has not been significant change to improve the outcomes and satisfaction consistently—this is the important point—across the country. There are pockets of excellence, and some very good services, but they are not always accessible to people across the country. Health services and local councils, as I have said in my previous roles, have a range of statutory duties and functions related to mental health and supporting mental health well-being. From housing to public health, social care and leisure services, councils lead local services that help prevent mental ill-health and which support early intervention and provide ongoing support.
The evidence, some of which was referred to by the noble Lord, is overwhelming. It always shocks me—it did when I first read it 15 years ago, and it still shocks me now—that people from black and minority ethnic groups living in the UK are more likely to be diagnosed with mental health problems, more likely to be diagnosed and admitted to hospital, more likely to experience a poor outcome from their treatments, and less likely to have talking and other therapies.
It is particularly shocking that African-Caribbean people are still more likely to enter mental health services via the courts or the police than from primary care, which is the gatekeeper for treatment for most people. They are more likely to be treated under the Mental Health Act and more likely to receive medication, and are often overrepresented in high and medium secure units and prisons. This was the finding of a report by the Mental Health Foundation in 2014. I would be very surprised if those figures have changed dramatically in the intervening years. It is very disappointing.
I will turn briefly to youth justice. The Taylor review in 2016 indicated that many children and young people who offend have mental health, behavioural or learning difficulties, and often these conditions have gone undiagnosed. These problems can often be the root cause of a child’s offending, and frequently are a barrier to progress in education and proper engagement at school. This is particularly concerning because as many as 60% to 70% of children and adolescents who experience mental health difficulties have not had appropriate interventions at an early age. Can the Minister say what is being done to address this appalling statistic?
In a recent review of child and adolescent mental health services by the CQC, waiting times were highlighted as a big concern. Young people themselves, when they were interviewed for the report, said that they felt that the waiting lists were the big problem and that when they reached crisis point they ended up in A&E. Staff in A&E are already at breaking point and are not trained sufficiently to deal with this. This is a real problem and creates a revolving door for many young people.
At school, mental health support is not always there. As we have already heard, early intervention support is not always available, so young people and children in schools who need it are often quickly labelled as “naughty”, “a troublemaker” or “difficult”, and find themselves excluded or facing time out of school, when in fact what they and their family need is proper support in dealing with these early signs. There is a great disparity in the way BME communities, children and young people are treated. There is a plethora of research and information which highlights this. We do not need to prove it; we know it exists. What we are doing is highlighting what we can do about it.
The commission called for a patients and carers race equality standard to be piloted in mental health, to ensure that there is no discrimination against particular groups of patients, alongside other efforts to improve the experience of care for people from BME communities, including staff training. Will the review of the Mental Health Act consider how we can prevent more people from BAME communities reaching mental health crisis in the first place?
What steps will the review of the Mental Health Act take to ensure that the views of a cross-section of society are being represented? It is really important that views are heard. If we want to reduce the inequalities in mental health for BAME communities, we need to make health services work for them. That means listening, particularly to those who are already in the system, their families and their carers, who are constantly trying to get the best services for family members. It also means supporting the voluntary and community organisations that are working to meet the needs of communities. Without this, it would be impossible for BAME people to have confidence in mental health care services.
My Lords, I thank the noble Lord, Lord Boateng, for securing this debate and for his eloquent introduction to it. No one is better equipped to articulate this issue than the noble Lord, with his experience not only on the streets across London and other parts of the country but in occupying high office.
My own experience with mental health services goes back some four or five decades, running local authority adult care services at a time when mental health services were almost invisible. Predominantly white mental health patients were hidden away, left in corners or locked away. Very rarely were any specialised services prioritised for people with mental health conditions. That is the memory that I still hold of seeing how mentally ill people were treated. Thankfully, we have moved on and that era is now over. We are better aware of the needs of people with mental health disorders.
As the noble Lord, Lord Boateng, pointed out, what was important during that period was community-based responses to the needs of people within those communities who were being deprived of the right diagnosis and the right care. The extent and complexity of mental health issues require careful consideration to determine the appropriateness and adequacy of provision to meet the different and varied needs of patients and sufferers, as well as providing support for their dependants and carers. That was the situation then and it remains so now.
Another complexity within this debate is how we respond to an increasingly diverse population, with a wide range of ethnic minority groups experiencing some degree of adverse mental health conditions. Given language and cultural differences and the way that people interact with standardised perceptions of monocultural responses, there are likely to be wrong diagnoses and inappropriate prescriptions. That has been the case in responding to the mental health needs of black and minority ethnic sufferers over the years.
Incremental improvements in service provision have been driven by representations and campaigning by voluntary community groups. That has been backed up by community representation and research studies showing ethnic disproportionality and race disparities, with the evidence of discriminatory treatment. Data from surveys and studies consistently confirms variations in the prevalence of disorders affecting different ethnic groups and requiring appropriate responses to meet their particular needs.
Arguing about the particular and different needs of ethnic minorities is often seen as pleading for special treatment. However, we should understand that, by responding to the different needs of BAME patients and sufferers, the NHS is able to enhance its responses to all sufferers and patients by recognising the importance of dealing with each individual in an evidence-based and appropriate manner. It is the way in which we are able to deal with one particular problem that exposes the weaknesses of not treating people as individuals and diagnosing their needs in a proper and appropriate way. The ultimate benefit of ending discrimination and disproportionality in mental health services as they impact on black and minority ethnic communities will be the essential knock-on effect of making mental health services provision more appropriate for meeting the individual needs of every mental health patient and sufferer in the country.
Race and ethnic disproportionality is a fact, as the noble Lord, Lord Boateng, pointed out. It is a reality. With one in six adults in the UK and one in 10 children experiencing some form of mental health condition, the NHS is under pressure to respond with adequate resources—one issue already picked up—expert practitioners, clinicians, carers and the provision of advice and support to meet the medical and care needs of patients and sufferers and, to stress once again, their families and those who are supporting them.
The Government’s recent Race Disparity Audit reveals that, in the general adult population, black women were recently assessed as more likely to have experiences of common mental disorders such as anxiety and/or depression and black men were the most likely to have experienced psychotic disorders. There is nothing new in that. Most significant, and well known for years among the black and minority ethnic communities, is the fact that black adults were more likely than adults in any other ethnic minority group to have been sectioned under the Mental Health Act.
Assumptions made by some police officers when attending reported incidents, particularly involving black and ethnic minority men, often result in them being detained in police cells rather than receiving appropriate treatment for their mental health disorders. Many of the deaths in custody, which have indeed disproportionately involved black and minority ethnic men, appear avoidable in retrospect. Some have even received inquest verdicts of unlawful killing without any consequential prosecutions or justice for the families of the deceased. The use of unreasonable force in such scenarios has been highlighted by campaigning organisations, and the recently reported use of Tasers by police entering mental hospitals when called on is another issue that must be addressed, because it is of concern to the community.
With regard to the progress being made to improve mental health services for black and minority ethnic communities, it is important to get some response from the Minister about the guidance alluded to by the noble Lord, Lord Boateng, on good practice: how it is being disseminated and implemented, the action that should flow and who is involved in assessing the effectiveness of the implementation and the process. Are community organisations, families and, indeed, patients part of that process? There is also concern about the involvement of community groups in helping to reduce barriers and improve the uptake of and access to psychological therapies to all sections of the community.
In conclusion, my final point is one which probably deserves a lot more time. It is the increasing number of children and young people who are affected by mental health conditions. It would be useful if the Minister could tell us what systems are in place for the rapid and early identification of children in need of specialised services and for them to be referred to the Improving Access to Psychological Therapies programme, with access to evidence-based and appropriate interventions.
My Lords, I, too, am very grateful to the noble Lord, Lord Boateng, for securing this debate and, like the noble Lord, Lord Ouseley, pay tribute not only to his eloquent introduction but to all he has done in this area. We owe him a great debt of gratitude.
Some of the evidence which has already been cited—there is lots more— concerning black and minority-ethnic individuals and mental health is a dreadful indictment of our society. One of the most shocking statistics to me is that UK minority-ethnic individuals are 40% more likely than white Britons to come into contact with mental health services through the criminal justice system rather than through referral from GPs or talking therapies. There have been a number of explanations for these differences, including limited awareness of or reluctance to engage with statutory services at an early stage of illness, possibly due to previous poor experiences, the belief that services are not culturally appropriate, or the stigma around mental health in some communities. Cultural differences in how mental health is perceived may also decrease the likelihood of individuals seeking care before reaching crisis point.
However, it has been recognised that differences in treatment for individuals experiencing mental health issues also arise from what is politely described as cultural differences on the part of the onlooker—in particular in relation to a number of high-profile cases involving Afro-Caribbean men, to which the noble Lord, Lord Boateng, has already referred. The problem arises from racialised views of a black man being more aggressive or out of control. Such views are racist and a terrible indictment on our society.
It is good that organisations working with black and minority-ethnic communities around mental health have recognised and responded to many of these issues. Understanding them and highlighting best practice, as has been indicated, is crucial to tackling poor mental health outcomes in black and minority-ethnic communities. I fear that the Church’s record has not always been good in its attitude to mental health or indeed, in its attitude to black and minority-ethnic people. We are now working very hard on both, and I hope that we have something positive to offer.
Medical Ethics: A Christian Perspective, published by the Mission and Public Affairs Council as a position paper, articulates salient theological themes informing Christian approaches to healthcare in general and adumbrates four guiding ethical principles arising from them: affirming life; caring for the vulnerable; building community; and respecting the individual. I make reference here only to the imperative to affirm life. That is to say that every individual life has purpose, value and meaning, even if some individuals may doubt that for themselves. It also means that we wish to see everyone attain the highest quality of life possible in whatever circumstances they find themselves. A civilised society is one that fundamentally affirms life and ensures that this and other benefits and protection are fairly experienced by all its members.
In practice, of course, this means giving particular attention to vulnerable individuals and groups. History indicates that the powerful will often neglect or abuse the vulnerable unless strong and specific action is taken to protect them. Caring for the vulnerable, however, goes beyond issues of protection. It includes ensuring that vulnerable people are supported, cared for and enabled to live fulfilled lives, and being afforded the same respect as other members of society. That is what is at stake here. You do not have to be a Christian to sign up for all that.
As the noble Lord, Lord Boateng, suggested, most people agree on what needs to be done—on both sides of this House, in the other place, and in wider society. If we are to be a truly civilised society, we need to put resources into ensuring that these problems are properly addressed. The noble Lord, Lord Boateng, has suggested some sensible, practical ways forward while we await the outcome of the welcome inquiry into mental health legislation which the Prime Minister has announced.
What can the Church do? We have been looking at this as part of a black and minority-ethnic concerns mental health project. In Breaking the Circles of Fear, the Church of England Mission and Public Affairs Council published a report in which we make it clear that in addition to church leaders, church workers and chaplains becoming more fully aware of mental health issues among black and minority-ethnic individuals, we want to ensure that cultural competence is displayed by all those ministering to individuals with poor mental health.
That could have a large effect on wider society. The Church has a ready-made network of communities, buildings and pastoral contacts that we want to utilise in helping to design and deliver culturally appropriate and accessible services in collaboration with local communities. Being embedded in communities, the Church can play a leading role in helping to educate both communities and health professionals with regard to health issues. At all levels the Church can be a voice for the voiceless, helping to reduce the stigma often associated with early mental illness, and thereby helping to address the problem of the lack of early intervention among black and minority-ethnic individuals.
I stand with the noble Lord, Lord Boateng, in commending the Prime Minister’s initiative on mental health and in pressing for the question of patient care to be addressed in the meantime, before the independent inquiry reports. I hope that the Minister will be able to give assurances on this.
My Lords, I too thank my noble friend Lord Boateng for promoting this important debate and for the very masterly way in which he introduced it. I also welcome the return of the noble Baroness the Minister. I normally speak on alcohol and drugs issues but there is a very strong overlap here with mental health, and I hope to speak on mental health more in the future than I have in the past—particularly on this area, where I have some experience.
As we are aware, the Government’s recently published race audit highlighted differences in the rates of mental illness among different ethnic groups. For example, it is estimated that in the past year psychotic disorders were more than 10 times as prevalent among black men as among white men. With regard to access to treatment, the audit highlighted that white British adults were more likely to receive treatment for a mental or emotional problem compared with other ethnic groups.
The acute care commission report, led by the noble Lord, Lord Crisp, who is here today, helpfully summarised some of the evidence around access to general mental health services. For example, Indian, Bangladeshi and Chinese people had consistently low referral rates to crisis teams, but BME groups, particularly black Caribbean patients, were generally more likely to be admitted to hospital once they had been seen by a crisis team. There is also evidence that some BME groups have more complex pathways into care than white patients, with more involvement by the police and the criminal justice system, as my noble friend Lord Boateng and others have mentioned.
We also know that, compared to white patients, black patients are 53.8% more likely and Asian patients 42.4% more likely to be detained under the Mental Health Act. I therefore welcome the independent review into the Mental Health Act being led by Professor Sir Simon Wessely. I hope that it will provide an in-depth analysis of why this is happening. I hope that the review will also consider how we can prevent people reaching a crisis in the first place and how we can improve crisis services for those who need them most. Therefore, I would be grateful if the noble Baroness could say just what research will be coming out in this exercise and how we are going to establish the main causes behind these problems.
Moving back to services, we know that the literature suggests that there are multiple complex reasons for these differences between ethnic groups. BME groups have higher rates of mental illness, and there are also some psychosocial factors to take into consideration. For example, there is evidence that some BME groups are less likely to view themselves as having a mental illness. In some communities, there is still a large amount of stigma surrounding mental illness and there can also be a mistrust of the services on offer. These factors may lead to patients not seeking help early and thus presenting in crisis.
So why is this still happening? We have known about inequalities in our mental health care system for many years and a number of policies have tried to tackle these issues—for example, there was the Delivering Race Equality in Mental Health Care report as long ago as 2005. These policies have helped to raise awareness of the issues, but the inequalities still remain. What is the Minister’s analysis of why these policies have not had the desired effect and how can we implement policy which starts to improve the current situation?
Next, I would like to focus on the recommendation from the acute care commission, led by the noble Lord, Lord Crisp, which asked for a patients’ and carers’ race equality standard to be piloted to try to improve the experience of care for people from BME communities. What progress has been made on the report’s recommendation that it should:
“Identify a clear and measurable set of Race Equality Standards for acute mental health services by October 2016 and pilot them in a selection of Trusts from April 2017”?
We need to raise awareness of mental ill health and availability of services among BME groups. We need to ensure that there are strategies in place to reduce the stigma of mental illness and to ensure that services are more culturally aware. One recommendation from the guide published by the joint commissioning panel for mental health is that we need,
“targeted investment in public mental health interventions for BME communities”.
What it is being done to ensure that commissioners across the country are starting to take this recommendation on board and act on it?
How can the Government bring together different groups, such as healthcare services, social services, police, community groups, commissioners and, of course, drug and alcohol treatment services, so that patients and carers work together on this topic to develop culturally appropriate interventions and to make real improvements? One problem that I often see is that if someone has a drink and drug problem as well as a mental health one, no attention is paid to the latter. Vice versa, if someone goes into hospital with mental health as well as drink and drug problems, no help is offered to them. They fall between the two and we need to look for ways to bring the services together and avoid a repetition of the problems.
In summary, inequalities in mental health have, as we all know, persisted for many years. Past attempts have not had the impact we would like to see in improving the situation. We need to be united in our campaign efforts to ensure that people from BME groups get the access to mental health services they need. We need to improve public mental health and focus more on prevention than we have in the past. The Five Year Forward View for Mental Health says:
“People with mental health problems, regardless of their age, ethnicity, or any other characteristic will have swift access to holistic, integrated and evidence-based care for the biological, psychological and social issues related to their needs, in the least restrictive setting and as close to home as possible”.
How can we make this a reality now?
My Lords, I thank the noble Lord, Lord Boateng, for bringing this crucial debate to this House and for exploring many of the key issues so eloquently. I declare my interest as a qualified mental health nurse of some 39 years’ standing, who has worked in south London and in rural communities. I am particularly pleased to welcome the return of the noble Baroness. She qualified as a nurse at about the same time as me. I also thank Kathleen McCurdy, a psychiatrist from Oxleas NHS Foundation Trust, who is working with me at the moment and who has helped me with this speech.
Other noble Lords have already highlighted the huge disadvantage faced by black and minority ethnic people in the area of mental health. They suffer higher incidences of mental illness, higher rates of admission, threefold excess of compulsory detention under the Mental Health Act, longer periods of hospitalisation, negative experiences of services and poorer overall outcomes than the majority of the population.
As the recent race disparity audit highlights, it is impossible to generalise about BME people and health in the UK. Given the multicultural nature of our country, the term encompasses any number of different societies and cultures, each with a heterogeneous population. We have to remember that each patient is a person with their own unique needs within this wider cultural context and with a right to equal and uncoerced treatment for their mental health problems. Co-design between patients, their significant others and health professionals is essential good practice.
As a signatory to the UN Convention on the Rights of Persons with Disabilities, the UK was scrutinised last year by a committee, which was highly critical of our treatment of people with a range of disabilities. Its subsequent report expressed significant concern about the use of physical and chemical restraint in healthcare settings on people with disabilities and expressly noted that this disproportionately affected persons belonging to ethnic minority communities. The committee criticised what it referred to as the,
“absence of a unified State party strategy to review these practices”.
I am optimistic that the current review of the Mental Health Act will offer recommendations on that, but that will of course take time. Indeed, there is plentiful evidence to suggest higher rates of coercive practices when it comes to the groups we are talking about. Not only are the rates of compulsory detention under the Mental Health Act significantly higher for ethnic minorities, in particular Afro-Caribbean men, but research by McKenzie and Bhui suggests that people of BME backgrounds are more likely to be placed in seclusion during their admission and much less likely to be offered psychotherapy or other talking therapies. Even following release from hospital, the use of restrictive practices persists for some ethnic groups. Black men are five times more likely to be placed on a community treatment order than their white counterparts, meaning that they may be recalled to hospital if they do not comply with a set of conditions.
Another aspect I wish to highlight is the interface with the criminal justice system, as many BME patients come into contact with mental health systems not via GPs but via the police, the courts or in prison. Black people are 50% more likely to be referred to the mental health system by the police. Additionally, black people disproportionately make up 25% of prisoners and some 40% of young offenders. Other groups are also over- represented in prison populations, particularly Traveller communities, but none is as highly represented as the BME group.
The Angiolini report, published in January this year, acknowledges the disproportionate number of BME people who die after the use of force in custody. We know from a report by the Equality and Human Rights Commission that 50% of people who die in custody have mental health problems and 20% are black, which is hugely in excess of the 3% black people in the population as a whole. This is perhaps an unsurprising statistic given the number of high-profile cases of deaths in psychiatric hospitals and police custody secondary to restraint, including Seni Lewis, who was only 22 when he died while being restrained by police on a psychiatric ward. He is one of 46 mental health patients who died following restraint between 2000 and 2014. I am optimistic that the Mental Health Units (Use of Force) Bill making its way through the Houses of Parliament will begin to improve the situation by standardising and allowing scrutiny of practice, but it will be a drop in the ocean compared with the cultural and systemic changes required to improve this complex issue.
However, it is important to acknowledge the positive steps being taken and improvements in good practice that already exist—for example, the street triage schemes, in which a mental health professional, usually a psychiatric nurse, accompanies police to incidents where a subject may need mental health support. Initiated in 2013, these schemes have been effective at reducing Section 136 emergency admissions to hospital and may benefit ethnic minority patients who may otherwise be detained unnecessarily in a police cell or at a place of safety.
I was impressed to hear about the Black Thrive scheme, an initiative led by the Afro-Caribbean community in Lambeth to create a positive dialogue around mental health. It is linked to Healthwatch and the local health and well-being board, and aims to help in prevention, access to support and experience.
On workforce and staffing, it is vital to have a workforce that reflects the diversity of the community it serves. The NHS is the largest employer of BME people in the UK, and since its formation has prided itself on employing BME staff from both the UK and around the world. In 2008, 25% of successful applicants to nursing courses identified as BAME, and this number increased to 30% in mental health nursing. Since the scrapping of bursaries for student nurses, the number of applicants to nursing has fallen. Work needs to be done to make nursing an attractive option to minority ethnic students from the UK, particularly in the context of the drop in overseas nurses coming to work here. I have talked before about the importance of continued professional development, and a key part of this is cultural competence. The European Psychiatric Association recommends mandatory training on cultural competence and sensitivity in areas where it is needed.
There is a well-established link between staff satisfaction and subsequent patient experience—when people understand each other. However, BME staff consistently report higher levels of discrimination and bullying in the workplace and are afforded less opportunity to advance their careers. For example, over two-fifths of London’s population and its NHS staff are from BME backgrounds, but only 8% of trust boards and 12% of senior management are from the same background. Will the Minister give due consideration to investing in a diverse and culturally competent NHS workforce that, at all levels of seniority, reflects the multicultural society in which we live and is trained to be culturally sensitive and able to empower patients?
My Lords, it is a pleasure to follow my noble friend Lady Watkins of Tavistock, who is a mental health nurse—an extraordinarily important profession in the whole world of mental health. I also congratulate the noble Lord on raising this important debate. As he said, there has been some improvement but there is much further to go, and it needs to be used and tackled systematically and practically. I note that this is not a simple issue, bringing together as it does issues of race, culture, societal attitudes and epidemiology. However, there should no longer be any excuses for the slow progress that is being made. It has been discussed and thought about for years, and expert guidance is now available from the Joint Commissioning Panel for Mental Health, set up by the Royal College. I declare an interest as an honorary fellow of the Royal College of Psychiatrists.
First, can the Minister say how effectively this guidance on commissioning is being applied, and with what impact? As other noble Lords have said, it is also good to see that the review of mental health has been asked by the Prime Minister to look particularly at the disproportionate numbers of people from black and minority ethnic groups who have been detained under the Act. I ask the question that other noble Lords have asked as well: will this review consider what can be done to prevent people from black and minority ethnic communities reaching mental health crisis point in the first place? We need to stop the flow into the system, not just treat people better when they are in the system.
On my own recent experience and observation, as the noble Lord, Lord Brooke of Alverthorpe, already mentioned, I had the honour to chair on behalf of the Royal College an independent commission on adult acute in-patient psychiatric care, which was made up of a whole group of patients, carers and many people from black and minority ethnic communities. We published a report in February last year—almost two years ago— and as the Minister knows, we are still waiting for the Government’s response. I thank her colleague, the noble Lord, Lord O’Shaughnessy, for his recent reply to my Written Question, which assured me that the response will be published soon—indeed, I think he said “shortly”.
We made headline recommendations about treating mental and physical health with parity of esteem. The two big issues were: why do we not have a four-hour standard for mental health as we do for physical health; and why are so many people still being admitted for general psychiatric issues out of their own area, sometimes over long distances?
Those were the headline issues, but we also addressed issues relating to people from black and minority ethnic communities. We found clear evidence of the problems that people have talked about here. We saw and heard from people about their experiences. We also saw and heard about good experiences and good practice—both exist within the health service, as the noble Lord, Lord Boateng, said.
We made two specifically relevant recommendations. The first one was about carers. We found that all too often carers were excluded from the initial assessment of patients when they were brought into the service—sometimes with good cause, of course, but in general not; in general it was a routine exclusion of carers. This is related to the points made by the noble Lords, Lord Boateng and Lord Ouseley, about the importance of community-led engagement and voluntary organisations. Carers are a vital source. They provide continuity of experience and advocacy and some level of stability. Their exclusion is probably particularly damaging in cases of people from black and minority ethnic communities who may be feeling disadvantaged within that environment in the first place. We recommended that patients and carers are enabled to play an even greater role in their own care, as well as in service design, provision, monitoring and governance.
I am delighted to say that the noble Lord, Lord Brooke of Alverthorpe, has already mentioned the second recommendation—it is always good when one’s own recommendations are recommended by someone else—but let me spell it out a little more. I suspect people know that in the NHS there is a workforce race equality standard. This is a standard introduced by Yvonne Coghill and colleagues from NHS England which looks at the way in which the workforce within the NHS is treated with regard to a few key indicators about how people from black and minority ethnic communities may be treated differently from others. That was published earlier this year and is starting to have an impact and effect because trusts are able to see the actual experience of their staff. We said as part of our review, “Why is there not a patient and carers race equality standard? Why is there not a standard that looks at the experience of patients and carers?” This could potentially have the same impact of drawing to the attention of trust management and trust boards—who sometimes do not know about these things because they are not close enough to the ground—the experience of their patients and carers. It is interesting that one was introduced in the NHS for staff before one for patients and carers, but I will not go down that route. We recommended that a patient and carers race equality standard should be introduced and piloted in mental health because it was evident that there was a problem in that area.
I conclude—satisfactorily within my time, I hope—by asking a final question: when will we receive our response; and, when the Government respond, will they accept these two recommendations on carers and, importantly, on the patients and carers race equality standard?
My Lords, I, too, congratulate the noble Lord, Lord Boateng, on the incredibly powerful and vivid way in which he introduced this debate. I will remember for a long time the words about this being a festering abscess.
The fact that we are having this debate shows not only how complex and critical the subject is but, frankly, how little progress has been made in improving mental health services for people from the BAME communities, despite repeated reports over the years highlighting the issues, debates in this Chamber and elsewhere. We pride ourselves on being a nation of diversity and equality, and yet the Government’s recently published Race Disparity Audit demonstrates that this is an issue in which we have patently not managed to provide anything like an adequate solution. Indeed, the NHS adult psychiatric survey published only last year showed that black adults were the least likely to receive treatment for mental illness.
The NHS’s The Five Year Forward View for Mental Health states:
“There has been a transformation in mental health over the last 50 years”,
due to “advances in care” and,
“the growth of community based mental health services”.
Obviously, such advances are welcome. However, research over that time period has shown repeatedly that people from BME communities have more adverse experiences and negative outcomes from mental health care, in terms of access to care and experience and type of care—things we have already heard about today.
Despite earlier targeted programmes, such as the Department of Health’s Delivering Race Equality programme—back in 2005, for those with a long memory —these inequalities have not improved. There are still significant ethnic disparities in rates of admission to hospital, detention under the Mental Health Act and practices such as the use of seclusion, as we heard from the noble Baroness, Lady Watkins. Indeed, one of the main concerns driving the independent review of the Mental Health Act is the disproportionate number of people from black and ethnic minorities detained under the Act. Like other noble Lords, I welcome the review and the sharp focus that the Prime Minister has placed on mental health as part of a wider social justice agenda.
I want to say at this point—I think it has come across strongly this evening—that it is so important that the review does not look purely at the point at which someone is being detained, but considers how we can prevent people from reaching a crisis in the first place and what we can do to improve crisis services for people who need emergency help. That has been one of the key points in the debate.
It is a statement of the obvious, but still worth saying, that focusing primarily on mental ill-health, rather than on how we can keep our communities healthy in the first place, is like trying to fix a leak by putting a bucket under the hole. Preventing mental health issues from arising, and intervening early if problems surface, can happen at a local level. Local government has a vital role to play. Clearly, local authorities need adequate funding to commission personalised services and to promote good mental health and well-being in their communities. I know from LGA figures how the core money that local authorities receive from central government has been going down year on year, which makes it difficult for them to fulfil their public health duties. Against this backdrop, can the Minister say what plans the Government have to encourage local commissioners to implement the Joint Commissioning Panel for Mental Health guidance on services for black and minority ethnic patients, specifically to identify and implement concrete measures to reduce the inequalities we have heard about?
As other noble Lords have highlighted in the debate, it is also important to acknowledge the socioeconomic factors that play a large part in psychiatric illness, with people from poorer backgrounds, people living in deprived communities and people encountering adversity and, yes, discrimination being particularly at risk. There are other critical issues: repeated studies have shown that cultural understanding is key to providing an effective mental health service that works for everyone. Other noble Lords have talked about that; I do not want to repeat what they have said.
It is a matter of real concern that there has been no real specific, targeted and strong national framework for improving mental health care for black and ethnic minority communities since 2010. Campaigning groups have expressed concern that mental health services lack a sense of strategic direction for reducing the inequalities in black and ethnic minority mental health that we have heard about.
However, there is positive news to report. There is good practice on the ground. Previous reports have highlighted many suggestions for solutions, and I have heard heartwarming stories from different local communities about the projects that have been set up to tackle the issue. Like the noble Baroness, Lady Watkins, I was encouraged to hear about the Black Thrive project in Lambeth, particularly the way in which it encouraged local people to understand their mental health needs and what services are available, and supported them to use their voices to shape and influence the commissioning of local services.
I applaud the new Synergi Collaborative Centre that has just been launched. This five-year collaboration between Queen Mary University of London, the University of Manchester and Words of Colour Productions is concerned with addressing the links between ethnic inequalities, multiple disadvantage and severe mental illness, with funding from the Lankelly Chase Foundation. This begs the question: what are the Government going to do to support and encourage excellent initiatives such as these? To be truly effective we need a clear national framework championed by government to improve mental health services for people from black and minority ethnic communities, with clear lines of accountability. It cannot all be left to the voluntary sector and local responses, however praiseworthy they may be.
Last year, the Government committed to invest an additional £1 billion in front-line mental health services by 2021 to deliver the five-year forward view for mental health—a welcome road map for reform of mental health services. I noticed that there was no mention of this in the Budget; indeed, there was no mention of mental health at all. I conclude by asking the Minister what proportion of money announced for the NHS in last week’s Budget will be earmarked for mental health care, whether it will be ring-fenced and whether specific money will be earmarked for tackling the quite shocking inequalities in access and outcomes for black and minority ethnic communities that we have been talking about.
My Lords, this has been a very moving and powerful debate. I pay tribute to my noble friend Lord Boateng for leading it. I well remember when, as a Health Minister, I met him at the Home Office to discuss health in prisons. I learned then very clearly his passion and determination. I am glad he has brought that to our discussions tonight. He talked about the issue being injustice rooted in race. I do not think we can describe the problem more explicitly.
We have had an amazing amount of briefing from many organisations, and I thank them. I am certainly not going to repeat them; the case is absolutely made and convincing. However, I looked at the briefing from the University of Essex’s Institute for Economic and Social Research, which showed the clear link between racial and ethnic harassment and mental health. Around one in 10 people from an ethnic minority background living in England has experienced some form of racial harassment in the past year and the briefing showed the connection between that harassment and stress, anxiety, depression and poor mental health. This is a fundamental issue that we have to tackle in society and in the National Health Service, because there are real issues about the way people from black and minority ethnic communities are treated by our National Health Service.
We know that there is forthcoming mental health legislation and we have the Prime Minister’s promise of action, which are both welcome, but the overwhelming message to the Minister is that we cannot wait for this before some determined action needs to take place. I was struck, as my noble friend Lord Boateng said, that we have had so many reports. We know what to do. The report from the noble Lord, Lord Crisp, waited two years for a response from the Government. We have the Five Year Forward View for Mental Health, published in February 2016, with 57 recommendations. I put it to the noble Baroness that we constantly hear from Ministers that this is a priority, but we do not see any real hard-edged action to put these recommendations into practice.
I want to revisit some of the points raised by my noble friend. He set out some issues to be tackled, such as the need for hard recommendations, with timescales for implementation and resources. I agree with him about hypothecation. I know that we are beginning to see extra spending on mental health, but how long has it taken the NHS to do this? I am afraid I do not believe the NHS, left to itself, will ever prioritise funding for mental health services. That is why I firmly believe there will have to be a hypothecated budget.
I also think we have to look at the way in which financial incentives are put in place in the health service, because the Five Year Forward View for Mental Health fundamentally attacked the present funding system. The use of block contracts is rewarding low-cost interventions, regardless of outcomes, and penalising those that increase access or deliver more costly interventions, even though they may improve outcomes. We cannot go on like this. Why do we still have block contracts in mental health? It is because it is regarded as less important within the Government and the Department of Health. We have different, more sophisticated systems for other parts of the health services; why is mental health being left till last? It has produced a horrendous situation where we disincentivise the most effective outcomes.
My noble friend talked about data outcomes. We have to have reliable data so that we can judge outcomes. Spreading good practice, local authority/NHS collaboration, pooled budgets: none of this is rocket science. We know that it can be done—the question is whether there is a will to do it. On the Patient Voice and using community action groups and the voluntary sector, the health service seems to have done its best to cut out many of these groups because of its funding decisions in the last few years. That is a very great pity.
The noble Lord, Lord Ouseley, talked about discrimination and the right reverend Prelate the Bishop of Worcester talked about cultural competence. I fear that the NHS has a long way to go before we can say that it has really tackled those issues. We are focusing on mental health services but I hope that Ministers will reflect on a more general cultural problem within the NHS, which is as much about the workforce, as the noble Baroness, Lady Watkins, said, as it is about service provision. My noble friend Lord Brooke anticipated the report of the noble Lord, Lord Crisp. I totally agree with him about carers being excluded from initial assessment. It is difficult to fathom how that can be justified as a general principle. What he had to say about the workforce race equality standard and patient and carers’ equality standards was very profound and would be very helpful to the boards of organisations, which are probably not aware of some of these issues at the moment.
My noble friend ended by asking how we are going to make it happen. He said, “Let us get on with it”. I agree with him, but my final point for the Minister is this: if the Government stick to the mantra that this can be left to clinical commissioning groups, albeit with some national commissioning advice, we might as well give up and go home now. It simply is not going to happen. CCGs do not have the capacity or the will to do it. At the end of the day, Ministers have to take responsibility; they have to take a grip and there has to be national direction and national hypothecation. We know what needs to be done but at the moment I simply do not see the tools at central government level to enable it to happen. I hope that the noble Baroness will correct me if I am wrong.
My Lords, I thank the noble Lord, Lord Boateng, for securing this short debate and other noble Lords for their contributions on this important issue, which is close to my heart as well. I will try to address as many points as possible after my opening remarks. I apologise if I speak rather fast, but I always seem to be beaten by the clock when there is so much that I want to say. As the noble Baronesses, Lady Hussein-Ece and Lady Watkins, and the noble Lord, Lord Brooke, all mentioned, we know that people from black and minority-ethnic backgrounds experience significant inequalities in access to, and experience of, mental health care, with particular overrepresentation in acute and secure mental health services.
In the past, as noble Lords have mentioned, matters have gone terribly, tragically wrong, so in July 2016, as the noble Lord, Lord Boateng, mentioned, the Prime Minister launched the race disparity audit, an audit of public services to help end the burning injustices that many people from ethnic minorities experience. Last month, the Cabinet Office published the audit, which showed a complex picture. In some measures it reported significant disparities between and within ethnic groups, and in others it showed that there had been a narrowing of the gaps between ethnicities.
As the noble Lords, Lord Brooke and Lord Ouseley, mentioned, we know that black women are more likely than any other ethnic gender group to experience a common mental health disorder such as anxiety or depression. Similarly, black men are the most likely to have experienced a psychotic disorder in the past year. However, as the noble Lord, Lord Brooke, mentioned, white British adults are more likely to be receiving treatment for a mental or emotional problem than other ethnicities.
As the noble Baroness, Lady Watkins, mentioned, we also know that a disproportionate number of people from black and minority ethnicities are detained under the Mental Health Act. As the noble Baronesses, Lady Hussein-Ece and Lady Watkins, the noble Lords, Lord Ouseley and Lord Brooke, and the right reverend Prelate all mentioned, the Mental Health Foundation reported that Afro-Caribbean men were more likely to enter mental health services via the criminal justice system. The report also suggested, as did the noble Lord, Lord Ouseley, that there was a potential for mental illness to be overdiagnosed in people whose first language was not English. As the noble Lord, Lord Brooke, mentioned, we also know that the stigma of mental illness prevents many people from a variety of cultural backgrounds seeking early help.
The current situation is clearly unacceptable. Therefore, what are we doing? As the noble Lords, Lord Boateng and Lord Ouseley, mentioned, we are reforming mental health legislation. We have commissioned an independent review of the Mental Health Act, which will report next year, aiming to improve the lives of tens of thousands of people detained under the Act each year. Professor Sir Simon Wessely will chair the review and work is under way with stakeholders to identify priorities, as the noble Lord, Lord Brooke, mentioned, with an interim report expected in early 2018. The noble Lord, Lord Boateng, will recall from his time in government the previous revision of the Mental Health Act, which he commenced in the late 1990s. Earlier this year, the Government accepted the recommendations of the independent Mental Health Taskforce report, the Five Year Forward View for Mental Health, which made it clear that inequalities must be tackled at local and national level.
However, this is not just about reports. As the noble Lords, Lord Boateng, Lord Ouseley and Lord Hunt, mentioned, it is about what is happening now. We are committed to real service improvement. NHS England set an expectation for local services to improve representation and recovery rates for black and minority-ethnic groups in improving access to psychological therapies services, leading to consistent improvement over the past five months. These therapies, as the noble Lord, Lord Boateng, and the noble Baroness, Lady Watkins, mentioned, are vital.
In secure care, NHS England’s project to address the overrepresentation of black individuals in mental health secure settings has resulted in a new mental health community forensic model to be piloted from next year. A “black voices” network has also been established to encourage co-produced approaches to wider initiatives.
NHS England has also commissioned the National Collaborating Centre for Mental Health to develop guidance to support commissioners and providers in addressing health inequalities. In due course NHS England will publish new pathways for crisis and acute care, building on input from experts-by-experience from ethnic-minority backgrounds. As the noble Lord, Lord Boateng, said, patients who have a voice need to be part of the solution. This will be followed by a community mental health pathway in 2018-19 and a patient and carers race equality standard.
However, we know that successfully improving mental health care for black and minority-ethnic groups needs specific local community as well as national action. The noble Baroness, Lady Tyler, and the noble Lord, Lord Brooke, talked about a joined-up approach. That is why initiatives such as Birmingham’s 300 Voices project, led by the government-funded Time to Change campaign, are essential. Young African and Caribbean men, health professionals, the police and community representatives shared their experience of mental health support, including issues of stigma and discrimination, and produced a practical toolkit which can be rolled out to communities across the country.
The Care Quality Commission is developing a publication to highlight providers’ good practice in reducing the need for restrictive interventions. This will be published by December 2018. We know that restrictive physical interventions are risky for all individuals involved and have a negative impact on patients’ dignity and trust in services. The CQC also has an important role in improving equality as part of the mental health trust inspections. As the noble Lord, Lord Boateng, mentioned, good practice is vital. The CQC recognises the good practice of those providing services with a focus on improving black and minority-ethnic mental health.
The noble Baroness, Lady Hussein-Ece, talked about recognising that mentally ill people need access to dedicated care at all times of the day. That is why, in January 2016, we announced that crisis resolution and home treatment teams would receive £400 million in additional funding by 2021 and that we would invest £247 million to 2021 in hospital emergency departments to support people with immediate mental health needs. Just last month, we launched a new £15 million scheme—Beyond Places of Safety. This will provide capital grants to help develop and enhance facilities for urgent and emergency mental healthcare in 2018-20, including places of calm—crisis cafés that offer support to people who are at risk of mental health crisis.
The noble Lord, Lord Ouseley, and the noble Baroness, Lady Hussein-Ece, talked about children and mental health. The soon-to-be-published joint education and health committees’ Children and Young People’s Mental Health Green Paper will set out improvements for the mental health of children. To further help equip our children and young people with the life skills they need, we have committed to providing mental health first aid training to a teacher in every secondary school by 2019, and to reach 1,000 schools by the end of the year. In their manifesto, the Government expanded this commitment to every primary school, and we are exploring options to deliver this.
During a debate yesterday on education and skills, there was an interesting comment about pharmacies as a tool for gathering information on people who are prescribed anti-depressants. This could give a local view of problems in an area and enable people to move in to help.
The noble Lord, Lord Boateng, and the noble Baroness, Lady Hussein-Ece, talked about recruitment and training. The Mental Health Workforce Plan, published in July, underpins the start of one of the biggest expansions of mental health services in Europe, creating 21,000 new posts by 2021. The recommendations of the independent review of the Mental Health Act, alongside ongoing work in response to the Five Year Forward View for Mental Health, will be instrumental in addressing the perennial injustice of racial disparities on display within mental health services. We will sustain efforts at national and local level to do so.
Many noble Lords mentioned the importance of data. NHS England is requesting from NHS Digital and other partners that all relevant data reports are broken down by protected characteristics. Breakdowns of access and outcomes across ethnic groups are now available within the mental health services dataset. This will allow the systematic identification of areas for improvement and monitoring of progress.
The noble Baroness, Lady Hussein-Ece, mentioned the workforce, as did the noble Baroness, Lady Watkins. I mentioned the extra 21,000 but it is interesting that in looking at the present workforce, there were 15,512 community psychiatric nurses in May 2010 and in July 2017 there were 16,583. The figure has gone up but obviously not by enough and we need to really concentrate on that.
The noble Baroness, Lady Watkins, talked about overseas staff and staff speaking the necessary languages. We have to concentrate more on making sure that we try to bring people into mental health nursing and the other professions who speak a range of languages. But as far as Brexit is concerned, it is important that these staff are not unnecessarily concerned about their future. The Prime Minister has been clear that she wants to protect the status of EU nationals living here.
I am looking at the time but I want to answer the point made by the noble Lord, Lord Crisp. He mentioned carers being excluded from an initial assessment. This seems absolutely extraordinary and I am going to take it back to the department. It seems to me completely obvious that they should be included in first-time assessments and, if it is not happening, I shall certainly find out why. As to when the response is coming out, I say soon.
The noble Lord, Lord Boateng, mentioned ring-fencing and I say quickly that it is for local areas to decide where to invest, based on local needs, in line with national priorities set out by the Government and NHS England.
As always, if there are points that I have not covered, which I am sure is true, I will make sure that we write to noble Lords. We must all work together to make sure that the vulnerable, their families and carers can feel confident that they are getting the right treatment in the right place and at the right time. As the noble Baroness, Lady Watkins, said, the treatment must also be equal for all. I thank noble Lords for all their contributions.
Question for Short Debate
My Lords, I draw noble Lords’ attention to my entries in the Members’ register of interests. I am delighted that a number of noble Lords have put their names down to speak this evening and I shall try not to be too long-winded so as to give plenty of time to others.
This debate comes closely behind a debate in the other place on the UK’s amphibious capability, which took place on 21 November, and the debate on UK defences in this House on 23 November. They were both excellent debates and ably moved, first, by the Member for Stoke-on-Trent North and, secondly, by the noble Lord, Lord Soley. Many Peers and Members of the other place rightly described the increasing threats not only to our security but to that of our allies and the overseas territories for which we are responsible. Many drew attention to the importance to us, as a maritime nation that relies so heavily on trade moving by sea, of having an effective Royal Navy and Royal Marines. Furthermore, the financial predicament of the Ministry of Defence was described in detail in both debates.
The common thread continually made by Peers and Members of the other place was the necessity for this country, if it wishes to retain any credibility in defence and to comply with its treaty obligations, to fund defence to meet the threats and our nation’s needs—and to retain our amphibious capability. There was overwhelming support and gratitude expressed during the debates in both Houses to the Royal Marines.
Amphibious warfare is not an occupation for amateurs. It requires deep knowledge, great experience, expertise and skill. I remind Members of the House that we possess those skills in the naval service and have refined them over decades. The business of getting troops from ship to shore with supplies, ammunition and resupplies—including heavy and armoured vehicles, artillery, engineers and their equipment, medical facilities, water and so forth—is extremely complex. The logistics, timing and flexibility required dictate that you need a knowledgeable and experienced team, whatever operations are being conducted. From all-out combat to humanitarian operations, teamwork and experience are essential.
Only HMS “Bulwark” and HMS “Albion” have the necessary command and control capabilities, and only these ships have the necessary landing craft to deal with heavy loads. The landing craft and the skills of their Royal Marine coxswains and crews are an essential arm in any amphibious operation. These skills in amphibious operations are not a relic of the past. In the past 15 years, we have used our amphibious capabilities in all-out combat in Iraq, peacekeeping in Sierra Leone and, this year, in the Caribbean on humanitarian relief operations, where 40 Commando Royal Marines were deployed in the shortest time and distinguished themselves in that operation. It is a skill that, if lost, would be extremely difficult to recover.
We in the naval service have this experience, knowledge and flexibility. Of our allies, only the United States has this amphibious capability—albeit that it is far greater. The House has been told at least once that Lieutenant-General Ben Hodges of the United States army gave his views in robust terms as to the advisability of us retaining our amphibious contribution to the allied effort. The ability of a UK Government to operate effectively on their own territory from the sea gives the maximum political choice to any Prime Minister.
I could embellish the point, but I want to lead on to remind the House of some of the main operational capabilities that the Royal Marines, which are only 4.5% of Britain’s defence forces, bring to this country’s joint defence effort. The Royal Marines comprise three commando units. They are all part of 3 Commando Brigade. One commando unit is always lead commando group and is vital for joint theatre entry. The lead commando group offers the political choice to which I have referred and has 28 days’ self-contained supply when deployed on land. The Royal Marines and 3 Commando Brigade sit at the core of European amphibious initiatives. We have unique, long-lasting relations and friendships, particularly with the United States Marine Corps, with which in recent decades we have served on numerous operations. We have very close relations with the Royal Netherlands Marine Corps and the French marines. We are an essential partner in the United States Marine Corps/NATO amphibious force initiative.
In addition, some of the additional and essential capabilities the corps provides include the provision of what I have in the past described as the uniquely high proportion of the UK’s badged regular Special Forces operators. I have said in the past that if you shrink the pool of talent, you necessarily shrink the number of Special Forces operators. The noble Viscount, Lord Slim, who I am delighted to say will be speaking this evening, has unrivalled knowledge and expertise on this matter, and he has made the point time and time again. Our Special Forces have the highest reputation. Their tasking is growing continually. They are an increasingly vital and crucial part of this country’s defence effort.
Uniquely to Britain, the Royal Marines provide expertise in mountain and Arctic warfare. This is especially relevant at present given the growing threat from Russia to our northern flank. Our allies, particularly the Norwegians and other Scandinavian countries, put great value on this. We provide courses open to other members of Britain’s Armed Forces and allies. One such course, the mountain and Arctic warfare course, is extremely rigorous and demanding and provides a vital core of expertise and capability. We provide most of the ships’ force protection teams and security for the nuclear deterrent. The Minister will be well aware of the foregoing and will also be aware of how fortunate we in the Royal Marines are in our ability to recruit and retain officers and enlisted men of the highest calibre.
As a measure of that quality, approximately 17% of enlisted men passed for training have degrees, and 40% are educationally qualified to be officers. Those are fantastic statistics. The Royal Marines’ selection and training ensure that we have troops not only with stamina, strength, fortitude and courage, but also with high intelligence, flexibility and the ability to improvise. Officers, non-commissioned officers and marines have initiative and the highest standards. This is one of the reasons why we provide such a high proportion of the United Kingdom’s badged, regular Special Forces. Our Royal Marines can think for themselves and have a strong team spirit, comradeship, self-discipline and their own unique sense of humour.
At this point, I must pay tribute to the commanding officer and staff of the Commando Training Centre Royal Marines at Lympstone. They manage not only officers’ and recruits’ training but also the training of many of the specialist qualification courses conducted by the Royal Marines. These cover not only mountain and Arctic warfare, to which I have referred, but heavy weapons, platoon weapons, snipers, assault engineers, physical training and other specialisations essential to ensure that a Royal Marine who manages to be selected for training, which is an achievement in itself, and who passes the arduous nine-month course is properly equipped immediately for deployment in a commando unit. If a marine is recommended for promotion to corporal, he must be selected and pass the junior command course, which lasts some months and is rigorous and demanding. The same process occurs again if a corporal is recommended for promotion to sergeant and selected for the senior command course.
A quick résumé of last year’s activity of 3 Commando Brigade illustrates the importance of a brigade that is consistently 50% to 70% deployed at less than five days’ notice to move. Recently, the lead commando group and attached ranks were deployed at very short notice on Operation Ruman for disaster and humanitarian operations in the Caribbean. Immediately 40 Commando were deployed, 45 Commando were brought into readiness and have taken on that commando’s role. Royal Marine units were activated in response to various UK terrorist threats and operations. Members of the 3 Commando Brigade Royal Marines have operated in 35 countries this year.
Routinely, we have three boarding teams and up to four maritime sniper pairs embarked in Royal Naval ships. We have multiple ships force protection teams and two United Kingdom Border Force protection teams deployed around the world. We have conducted 20 training team tasks so far this year and deployed in places such as Ukraine, Kenya, Somaliland, Morocco, Tunisia, Cameroon, Saudi Arabia, Oman, India, Indonesia, Lebanon and Senegal. We have, in addition, contributed to the migrant task force in the Mediterranean. We have expertise in jungle and desert warfare, as well as warfare in other climates and terrains. In addition, 43 Commando is tasked to protect the strategic deterrent every day, and that unit remains the defence lead practitioners, outside the UK Special Forces, in close-quarter battle in the land environment.
There would be plenty more to say if I had the time. The point is that as a country we are incredibly fortunate to have, in the Royal Marines, a small force of just under 7,000 men—as I have said, 4.5% of Britain’s Armed Forces—that does so much at the sharp end. We are an integral part of the naval service, and unique in defence in that our officers and enlisted men, and all our commando courses, train at the same place—the Commando Training Centre Royal Marines at Lympstone. This provides a life-changing bond and shared ethos. During the training process, which is long and arduous, you will see the gradual erosion of selfishness and the growth of teamwork and self-discipline. We are an egalitarian force that is motivated by the highest standards. We are commandos within the naval service: we are not a small army in the Navy but a fully integrated part of the naval service. The qualities of Royal Marines—intelligence, strength, stamina, courage, independence and adaptability—make us ideal to lead defence in the new way of warfare. We continue to welcome and master new technologies and changes.
As with personnel of other branches of our Armed Forces, we have recently, and over the centuries, lost many brave men in operations, and many others are having to cope with life-changing injuries. I believe the Secretary of State and the Minister recognise the crucial importance to British defence of the Royal Marines and the importance to the UK of our amphibious capability. I very much look forward to hearing the Minister’s response.
Reports of possible cuts and uncertainty are damaging. The Royal Marines—as I said, 4.5% of our Armed Forces—were awarded over 30% of the gallantry awards in Afghanistan. These outstanding men, to whom we owe so much, have the support and admiration of this House, the other place and the entire country. They are often called on to put their lives in mortal danger on our behalf. They give their wholehearted loyalties to this country, and it is time that this was reciprocated.
My Lords, I start by declaring an interest—or, some may think, a dark secret—in that I spent three years in the Royal Marines as a university cadet. I left, or resigned, as I came down from university. I subsequently joined the Army but I retain a great respect for the Royal Marines, about whom we have heard a great deal from the local Lord, Lord Burnett. It may be of interest to the House to know that I left the Royal Marines quite a long time after the noble Lord, Lord Ashdown—at least, I think it is of interest.
I congratulate the noble Lord, Lord Burnett, on calling the debate and on expounding the position of the maritime forces, specifically the Royal Marines. Perforce I will not take up too much of the House’s time, but I ask these questions of the House and indeed the Government: what are our ambitions in defence? Do we wish to be able to defend our trading interests? Do we wish to be able to defend our overseas territories or indeed to help them in humanitarian operations, as we have just heard, or do we want to retreat behind the Channel? Do we wish to remain a permanent member of the United Nations Security Council? Do we wish to be regarded as a serious player in NATO? Do we wish to punch above our weight? This is the nation of Drake, Raleigh, Nelson, Jellicoe and Fisher. Do we want to be a serious player in maritime and world affairs?
If, as is rumoured, we were to scrap our maritime landing capability, what signal would that send to an expansionist and aggressive Russia, which daily is testing our maritime defences with submarines? I was listening this morning, as were one or two other Members of the House, to Rear Admiral Bob Tarrant, who stood down last month as Chief of Naval Operations. He expanded on the increase in the bellicosity of Russia and explained that the number of incidents involving Russian submarines has shot up.
What signal would such a move send to Iran, which can currently dominate the Straits of Hormuz coming out of the Persian Gulf and is supporting the Houthi rebels in Yemen, probably for the reason that it wishes to dominate the sea passages into the Red Sea and up to Suez? What signal would it send to our allies, our friends in NATO and especially to the USA? What sort of nation do we want to be?
The last Secretary of State designated this the Year of the Navy but we read that the national security capability review is likely to cut the Navy, particularly maritime landing craft, yet further. It is not just the naval service, the Royal Navy and the Royal Marines, but defence and the Armed Forces as a whole. We have to spend more or abandon our ambitions—it is quite straightforward.
I know Mark Sedwill, the National Security Adviser. Noble Lords may not know that, like me, he was a Royal Marine, also, I think, as a university cadet, and then he went on to—dare I say “better” things?—certainly greater things at the Foreign Office. He has been traduced by the press because he is concentrating on cybersecurity. Cybersecurity is hugely important, and I suggest that he is not to blame for having to make this a priority.
My point is that well-equipped people will always remain crucial in terms of defence; they are the big stick that we need to carry.
We must increase our defence spending. Enough, if I may say so, of this trotted out comment of 2% of GDP. Two per cent of GDP would not have included the deterrent cost until six years ago. Two per cent of GDP spent on defence includes my pension but, fit, able and aggressive as I may be, I think it unlikely that I shall be called back to the colours.
We need to spend up to our ambitions, and to a Conservative Government who I support, I say that we need to get our spending priorities right, or retreat as a nation into mediocrity in world affairs. The nation will rightly hold us culpable if we fail to defend it. I have often parroted and now hear Ministers parrot the old adage that the first duty of government is the defence of the realm. I say to my Government: please live up to that pious ambition, aspiration and adage; let us all see it.
My Lords, I congratulate the noble Lord, Lord Burnett, on securing this timely debate. Rumours abound about possible cuts to the Armed Forces. We were told this autumn that there needed to be minor adjustments to the defence programme, but it is clear that defence is in such a mess that, far from minor adjustments, the Government are considering significant cuts. We are witnessing a defence review by stealth. The impact on service morale is huge. Those of us who know the services talk to people who know that to be true, yet we have been told again and again that, far from being in difficulty, the defence budget is growing and all in the garden is rosy. Clearly, it is not.
Why should this be? Despite claims by their detractors, the new carriers are certainly not to blame for the problems in defence funding. First, the spend of 2% of GDP on defence has been achieved by smoke and mirrors. Secondly, the funding of the future equipment programme depends on the services finding substantial efficiencies, which are becoming increasingly unfeasible. Lastly, the falling value of the pound against the dollar presents a new slew of difficulties with many US equipment buys in the pipeline. In short, there is a growing black hole in the MoD budget.
Particularly under fire, it seems from the rumours, is our invaluable amphibious capability. Others will talk in detail about the Royal Marines—indeed, we have heard already what amazing fighting men they are and how important they are for the Special Forces—but I will focus on amphibious shipping and why that impacts on Royal Marine numbers.
Britain’s security and prosperity require unimpeded maritime access and transit. As an island nation, the country needs a broadly maritime strategy: one that has sea control at its core but which enables power and influence to be projected inland. Indeed, being an island—although, amazingly, the national security strategy failed to mention the fact—all operations beyond our shores are expeditionary and demand theatre entry. Strike carriers and amphibious forces are the enablers of this theatre-entry capability. The true fighting power of a navy is its ability to ensure entry around the world using carrier air and amphibious forces and to cause sea denial using carrier air and nuclear submarines.
Since 1945, this entry capability has been used more than 10 times but, despite its significance, there was pressure to remove our amphibious capability after our withdrawal from east of Suez in the 1970s. It was retained primarily for the important reason that Soviet Union war plans included the invasion of north Norway, and it was vital to show our capability of defending that region. With the resurgent Russia, that is still important today.
In 1981, the removal of our amphibious capability was mooted again. At the last moment, an element of it was reprieved and, by very good fortune, nothing had been removed before the Argentinian invasion of the Falklands. Every scrap of amphibious shipping and the Royal Marine Commando Brigade in its entirety were crucial to recapturing the islands, as were 76 British manned merchant ships. Post the Falklands conflict, it was decided that the UK needed to maintain amphibious capability of a full commando brigade, two helicopter landing ships capable of ensuring a simultaneous two-company lift—a lesson from the Falklands, although only one, HMS “Ocean”, was built—two landing ship docks capable of complex communications and command and control, very heavy lift and carrying large landing craft, four logistic landing ships, or the equivalent, a number of smaller landing craft and the ability to take up merchant ships from trade. However, it has been nibbled away at. Post SDSR 2010, the decision was made to reduce the commando brigade to a commando group. Of the four new landing ship dock auxiliaries to replace the landing ship logistics, one was sold to Australia for a knockdown price, after we had paid full price in this country.
In addition, one of the landing ship docks was put into reserve status—only one would actually run. More recently, the Royal Marines have lost another 400 men and the newly refitted HMS “Ocean” , having just had a £57 million refit, is up for sale—an almost incomprehensible decision in strategic capability terms. The latest rumours talk of cutting the marines by a further 1,000 and selling the two LPDs. This would effectively mean the end of the UK amphibious capability and with it, the end of the Royal Marines. Without large amphibious shipping—we are already eating into it—the demand for sea soldiers would switch and drop down below the level of one commando: one battalion in other words. The decision to get rid of the shipping would effectively get rid of the Royal Marines in the form that they are at the moment as a key part of the naval service and as sea soldiers.
Has there been any change to the strategic environment that has provoked this decision? Of course not. This is nothing more than a possible savings measure. We urgently need more spending on defence. The Government should be as robust about this as they are about foreign aid, which now equals 38% of the defence budget. The decline in capability is a choice and not one which our nation should make in today’s chaotic, unpredictable and dangerous world. Our nation would live to regret the loss of our hard-won amphibious capability and the Royal Marines that go with it. Once gone, it will be extremely hard to recover.
My Lords, it is a great pleasure to come into the debate so thoroughly and ably introduced by my friend and former noble friend on the Liberal Democrat Benches.
It might be timely to repeat, if I may, the remarks of the Admiral of the Fleet, Lord St Vincent, when the Royal Marines were formed. He said:
“I never knew an appeal made to them for honour, courage or loyalty that they did not more than realise my highest expectations. If ever the hour of real danger should come to England, they will be found the Country’s sheet anchor”.
Those words summed up that period. He was of course a great supporter of Lord Nelson’s tactical skills, and supported him throughout his career.
Now we have the problem, of which the noble Lord, Lord Robathan, has given some indication, of how these decisions come about. I shudder when I hear the word “cyber”, as indeed I shudder when I hear about driverless cars. I do not think we should overrate those aspects of our modern life. What matters, as Lord St Vincent said, is that the rigorous training and enormous character of a body such as the Royal Marines is not just part of our defence mechanisms but an inspiration to all.
I am rather disappointed that the kinds of values, development and loyalties of the Royal Marines are not more used in schools. It seems that the ethos in schools nowadays is to provide cannon fodder for industrial development and the growth of our GDP—all very important, but the kinds of words used by Lord St Vincent will probably be of great use to those at school of a young age. I do not think schoolchildren should now be tested at a young age or be asked to pass exams; I think they should learn what it is to live a life of honour, bravery and all the things that have been mentioned. That is lacking. Those who advise government have not actually said that the Royal Marines are superfluous but they downgrade their importance for the future.
I am sure we all agree that we are very fortunate to have the noble Lord, Lord West, here, because he has explained so well the ongoing usefulness of the amphibious duties of the attached naval forces, which include, principally, the Royal Marines. Even in the 18th century—I happen to have an ancestor who was involved in an amphibious raid during the American War of Independence—they were considered the world’s leaders in amphibious landings. I think they still are, and that need will be enduring.
I will not go on. I spent too much time quoting Lord St Vincent and I do not want to get a ticket in my pocket or whatever. I just end by saying that it has been a great pleasure to speak in this debate and to have been able to voice an opinion about the value of training, hard work, a team spirit and all the things alluded to by the noble Lord, Lord Burnett. I hear that the reduction in the number of bands will not now happen. Apart from the band of the Scots Guards, in which my son served, certainly the greatest band that I have ever heard—I heard it beating retreat at Greenwich one year—is the band of the Royal Marines. It is probably one of the greatest orchestral experiences that one could have.
My Lords, I very much support what the noble Lord, Lord Burnett, said. As a young army officer many years ago, I served alongside the Royal Marines in Hong Kong and Northern Ireland, and ever since I have had the greatest respect for them and their ethos.
I believe that a serious cut to the Royal Marines would put our international credibility at risk. The noble Lord mentioned General Ben Hodges. I hope that the Government will take on board what he said: that some of the best officers whom he has served with have been Royal Marines, and that he would hate to see the institution that produces men like them degraded. He went on to say that, if Britain cannot maintain its amphibious capability commitments, it risks,
“going into a different sort of category”,
of ally, which would,
“make the job simpler for a potential adversary”.
The noble Lord, Lord Burnett, drew attention to the importance to the United Kingdom, as a maritime nation relying so heavily on trade moving by sea, of a strong Navy and a strong Royal Marines. Without maritime expeditionary strike options, there is a reliance on access to friendly ports or airports, and historical evidence indicates that such access can often be denied or be conditional or unsuitable. A lack of access will narrow options, increase operational risk and potentially make current crisis response plans unviable. Global reach and flexibility are inherent characteristics of a full spectrum Royal Navy able to protect the nation’s vital interests. The ability to act across a spectrum, from disaster relief to expeditionary strike, preserves political choice.
The United Kingdom’s comparative advantage in maritime theatre entry—something that few can emulate—is of critical importance to our key partners. The Royal Marines have a leading allied capability, interwoven with NATO and European initiatives, and are the United States’ partner of choice in the littoral and the Arctic. Their cold-weather-capable commando force is hugely appreciated in north Norway.
Chaos is a dominating feature of our world today. Islamic fundamentalism is a threat that grows more vigorous and malign by the day and it has reached our own shores. Russia mobilises in all dimensions to press her advantages from the Balkans to the Baltic and from Libya to Damascus, to erode the West’s sphere of influence, both conventionally and in the hearts and minds of many of its citizens. The United Kingdom remains a key player in global politics, but it competes in a world where many regional powers, nation states, criminals and extremists are expanding their influence. If we want to have an effect where the vast majority of the world’s population lives, the ability to operate between the sea and the land is vital. Battles may be won at sea, but wars are won on land, among the people. Despite the huge technological leaps that have characterised the last century, this remains true; to have a decisive effect on an opponent, you must at some point land and close with him.
The US recognises the importance of an expeditionary strike capability. With the recently approved littoral operations in a contested environment concept, it seeks to better integrate existing naval and Marine Corps capabilities to overcome the emerging threats within littoral areas, which it sees as rapidly expanding in operational depth, complexity and lethality. This concept will provide the United States with an enhanced geographic flexibility and a range of options with which to respond to the threats within the littoral. To give some indication of the scale of US investment in this concept, it relies on the delivery of a multi-purpose, 38-unit, amphibious fleet. I very much hope that we do not become a “different sort of category” of ally.
My Lords, I, too, am grateful to the noble Lord, Lord Burnett, for asking his Question for Short Debate. In 2010, the Conservative-led Government made a decision to retain the carrier programme. To be fair, I could easily argue that decision both ways. However, there is no doubt that the carriers will, in due course, give us a fabulous strategic capability. Even the US has only 11 full-size aircraft carriers in service. We should be able to deploy a UK carrier battle group matched with an amphibious task group. Contrary to what some newspapers seem to think, we have not been able to launch an opposed beach landing for a very long time. However, what we should be able to do is deploy 3 Commando Brigade almost anywhere we would want to in the littoral world, given only a suitable beach—and we can do this with full and effective air cover from the carrier. Furthermore, we could do it with a limited call on US assets in theatre. In other words, we can look after ourselves, which is extremely important to the Americans. As I understand it, the only other European ally which could possibly do this is France—but I do not know to what extent.
This capability is of strategic importance to our relationship with the United States and its President. Of course we co-operate very closely in the submarine world, but that is covert; no one sees it or even detects it. Sometimes it might be desirable for a carrier amphibious group not to be detected, but at other times a show of force may be all that is necessary to avoid or deter open conflict. What on earth is the point of having a carrier battle group capability if we do not have a fully bombed-up 3 Commando Brigade and the amphibious task group to go with it?
I understand that 42 Commando Royal Marines has already been, or will be, made non-deployable as a formed unit. This generates considerable savings as there is no need to train as a formed unit to achieve the required collective performance level and other specialist training is not required—so this increases the Royal Marines’ capacity for other desirable tasks, of which there are many. The unacceptable downside is that it reduces the ability of 3 Commando Brigade to be deployed with two match-fit commandos at any time, because if the choice is only between 40 and 45, one of them might easily be recovering from a battle group level operation or deployment.
The noble Lord, Lord Burnett, and others referred to our two landing platform docks, HMS “Albion” and HMS “Bulwark”—and the noble Lord, Lord West, gave us some detail. SDSR 15 determined that both were essential. If not, they would have been taken out of service at that point, so they must have been essential. My noble friend the Minister will tell us that no decision has been made and that everything is speculation. It seems to me that the only solution we have is to allocate some of the international aid budget—something that I would have opposed even six months ago.
Nevertheless, I have to say that I am extremely depressed about our current defence position. In my opinion we are heading towards having our posterior kicked hard at some point, and we will deserve it. Just because we are doing much more than our larger European partners—with the exception of the French—that does not mean that we are doing enough. Our Armed Forces may be engaged in numerous small but commendable military operations, but that does not equip us to deal with an existential or strategic threat. I believe that Ministers at the highest levels of government are living in a fool’s paradise so far as military capacity is concerned. As far as I am concerned, my noble friend the Minister and his colleagues are on their own and I cannot support this direction of travel.
Like others, I thank the noble Lord, Lord Burnett, for so powerfully introducing this debate. He is a long-standing champion of the Royal Marines.
It is a very long time ago, but back in 1974 I was a naval Minister. As such, I chaired the Admiralty Board and we found ourselves in the midst of a very challenging situation because there was a defence review. In the midst of that challenge we decided to say that the one thing we wanted to concentrate on was having a Navy which met the challenges of post-imperial Britain in the kind of world in which we were living, that faced up to the nature of likely future threats and that was designed to meet them. I very quickly came to the conclusion that the Royal Marines were absolutely indispensable in that context. I have never met before or since a body of people with more esprit de corps and personal motivation. I have never met a Royal Marine who was not full of personal motivation. Whatever they did, they did with professional skill of the highest standing on the basis of the most exacting training—and always with a cheerful disposition, it seemed to me. There was a lot of humour in the Royal Marines. They liked twisting the tail of the Minister and challenging him to unarmed combat.
They operated in so many different places and always adapted very quickly. One of my proudest moments was when I was up in the Arctic Circle in Norway on an exercise. The Commandant-General of the Royal Marines, General Gourlay, who became a great personal friend, took me into the sergeants’ mess and told them that I had been working very hard to secure the future of the Royal Marines and that as a token of this he wanted to present me with a Royal Marines tie—and do I treasure that Royal Marine tie.
He was followed by Peter Whiteley, who also became a friend. He was a general of great distinction who was also a distinguished musician. I thought that was appropriate, because one of the unsung heroic stories of the Royal Marines is how they take youngsters from quite modest backgrounds in relatively deprived parts of Britain and turn them into first-class musicians. However, they are not only first-class musicians but first-class soldiers as well. They combine the two, which is something very special.
When I look at the future, I cannot conceive that it will not require flexibility, the ability to move fast, to deploy wherever it is needed and, preferably, to contain situations before they get out of control. When we have a motivated, distinguished, effective organisation such as the Royal Marines, can one think of anything more central to that kind of operation? I have an unrivalled regard for the Army and for much of what we demand of it these days. But it is a fact—I put it this way—that the Royal Marines can move, be there and be doing it while the Army, with its more cumbersome bureaucracy and considerations, is still working out exactly how it should be done.
It would be wanton irresponsibility in any way whatever to reduce the capability of the Royal Marines. On this I very much agree with the noble Lord, Lord Astor. The challenge is to build up the capability of the Royal Marines, not to undermine it. From that standpoint, I am glad that we are having this debate today and I hope it strengthens our Minister in what I am sure is his own personal involvement in this matter—I would be shocked if it was not. I hope that he will go away from this debate feeling that he has a strong body of support across the Floor in this House to say, “Don’t cut the Royal Marines!”.
My Lords, it gives me the greatest pleasure to follow the noble Lord, Lord Judd, who gives so much to your Lordships’ House and always speaks so well.
It is always a pleasure for me to talk about the Royal Marines. My parent regiment is the Argyll and Sutherland Highlanders, and after World War II we came even closer together. During that gloomy moment, when “Prince of Wales” and “Repulse” were sunk, those Royal Marines that got ashore, escaped and were saved were sent as reinforcements to my battalion, which was fighting on the Malayan Peninsula. The liaison and friendship has lasted. We swap an officer between us every year and we get on rather well
I make no bones about it: I hold the British politician responsible for allowing this continuing dismantling of the armed services, and one day I may hold them culpable. We are not prepared, we are not in the best of shape, and we have, I am sad to say, a Government who are always tinkering downwards. They talk about what will arrive, but even the keels of the ships are not down, certainly the submarines are not being made at the moment, and there is a lot more—armoured vehicles and goodness knows what.
I am worried about a reinforcing calamity. If we get medium to large casualties we will have a big problem reinforcing units. Let me give an example of what used to happen. In an hour-and-a-half in Korea, my regiment lost about 30 killed and 70 wounded. The system was geared at that time to get battle-trained reinforcements to units as quickly as possible. In 36 hours we were reinforced by six officers and 100 battle-trained men and once more we became a battalion worth watching. Today if you were to take 200, 300, 500 or 1,000 men from the Royal Marines, if they took heavy or medium casualties there would be no chance of reinforcements.
You do not build a Royal Marine or a soldier overnight, or in a week, or in a month. He is almost built at one year and might be really useful in 18 months. It is no good saying we will find some soldiers or marines to reinforce. It would be bad news if the marines had to take medium or heavy casualties.
The noble Lord, Lord Burnett, has already mentioned that the military relies on the Royal Marines to perform well with the Special Boat Service. The difficulty is that if you start cutting you dilute the product. The lake of selection becomes a rather muddy pond. If anything goes wrong or there is any diminution of the Royal Marines, I see great trouble in keeping up the strength of the SBS, which is a component and a large chunk of the special forces of our country. There is great danger.
I am not having a go at the Minister. The noble Earl is regarded as something rather special in your Lordships’ House. We like him and have affection for him. Perhaps I may explain it in an old soldier’s way: I would happily share a slit trench with him. He may never have been in one before and may never have had his hair parted by a bullet, but I know that he would fight like a good officer and be a marvellous companion. However, I blame his Government at the moment. The noble Earl, Lord Attlee, and the noble Lord, Lord Robathan, are quite right: we have thrown British taxpayers’ money like confetti to various Governments and it is time we looked after ourselves first.
My Lords, it is wonderful for me to be the only girl so far to say something which, I hope, will make a contribution to the debate. There is another girl on the other side of the House who will be closing for the Liberal Democrats and I have no doubt that she will contribute too.
I thank the noble Lord, Lord Burnett. I have read his CV: it is quite extraordinary. He seems to have been fighting for most of his life. We are very honoured to have him here and hear what he said, and I am honoured to follow the noble Viscount, Lord Slim. I have heard him speak many times before; he is always passionate and always moves me.
I declare my interest and the reason why I am standing. I was born and bred in Plymouth. Before I say anything else, I hope that that Doorkeeper will smile at me, because he has been moaning at me all week to make sure I stood up. Where is he? There he is. We have a Marine here with us today.
I grew up in a family that either fished or fought. Indeed, fishing and fighting were wonderful things to do. I remember my grandmother’s parlour as a very peculiar place where the curtains were always drawn. I only went in there in strange times, usually when one of her men had died. In her parlour, she only had photos of people who had died in action on the walls. If you did not die in action, my grandmother never put you in that room. Poor Uncle Ernest came back with all sorts of dreadful things having happened to him during the war, but he never got his photograph in there because he did not die in action. Those are the sort of families that grow up in Plymouth. Those are the sort of families that gave me my confidence; they taught me how to cheer when the “sea soldiers” came along and marched in and marched out, when we went to see the ships come back and see whether any of our men did not make it. Therefore, if I may, I want to speak for my town and for the people whom we lost during that time.
There are rumours that reductions in the Royal Navy’s amphibious fleet are being considered under the cross-government review of national security responsibilities, as part of the continued implementation of the 2015 strategic defence and security review. That includes the potential to downgrade the UK’s amphibious capability, with plans to decommission HMS “Albion” and HMS “Bulwark”, and possible subsequent reductions in the Royal Marines garrison in Plymouth. HMS “Albion” and HMS “Bulwark” are central to the UK’s overall amphibious capability; many of the 350 personnel assigned to each of these Devonport-based ships, and their families, live in Plymouth. Maintenance and refit programmes for these vessels also contribute significantly to the city’s economy, directly supporting high-quality jobs at Devonport dockyard and across the wider supply chain.
While I agree that there is a need to ensure that the United Kingdom has the right capabilities to deliver on the SDSR’s objectives, we should want to reiterate the serious security and economic impact of the decision to significantly downgrade our amphibious capability. We have heard that said many times this evening. To maintain UK defence forces at a sufficient level to contribute to global peace, stability and security, I believe that the ability to deploy amphibious craft for both military and humanitarian exercises is a vital factor. The loss of HMS “Bulwark” and HMS “Albion” at Devonport would put that capability at serious risk. Furthermore, Plymouth is currently home to over 700 Royal Marines; speculation over reduction in their numbers at their base location would be felt acutely in the city—the city that bore me.
I urge the Minister to encourage his colleagues in No. 10 to tread carefully as we sail away from the European Union to fresh waters. I am vice-president of the Girl Guides. We are always committing our girls to be prepared. Tonight, I seriously urge that motto on our Government.
My Lords, I add my thanks to the noble Lord, Lord Burnett, for securing this timely debate on this critical Question. I declare my honorary captaincy in the Royal Naval Reserve and my membership of the Chief of the Defence Staff’s strategic advisory panel, though I speak as an individual this evening. I also declare a long-standing respect and affection for the Royal Marines since accompanying them to the Norwegian Arctic in January 1978 as a young journalist on the Times to report on their annual reinforcement exercise to protect NATO’s northern flank during the Cold War. A man learns something about himself if he spends a night in a snow hole up a mountain somewhere north of Narvik that is full of Royal Marines. I shall not elaborate.
Speaking at the Royal United Services Institute on 22 November, General David Petraeus declared that,
“strategic effect comes from capabilities that are truly employable and really matter”.
It is my contention that our country’s amphibious capability, to which the Royal Marines and the sustenance of HMS “Bulwark” and HMS “Albion” are crucial, passes the Petraeus test. Given our deep maritime past, many of us in the UK think amphibiously quite naturally, but in continuing to do so and reacting to the scattering of newspaper reports about the possible decommissioning of “Bulwark” and “Albion” and cuts to the Royal Marines, I do not think we are succumbing to an emotional spasm or nostalgia or an impulse for our country to retain what Stryker McGuire, Newsweek’s man in London for many years, used to call our appetite for being “a pocket superpower”, by which he meant possessing a wide spectrum of top-of-the-range military capabilities in too small quantities.
In terms of the Petraeus test, what does our current amphibious strength bring us and our allies in a perilous and, some would say, darkening world? Greater authorities than I will ever be have already outlined how they see this. I agree with every word they said. Above all, it gives us an ability to react rapidly, flexibly and with agility in a crisis, and a high degree of what a naval friend of mine calls “poise”—the capacity to maintain a position either on the flank of a crisis for deterrence purposes or to apply close-in coercive power in critical places if deterrence fails.
The quality of amphibiosity that the Royal Navy and Royal Marines currently provide is potentially a great disrupter of an adversary’s calculations because it offers the kind of intense hard power that no alternative does, however ingenious—if “Albion” and “Bulwark” go—the alternative of placing marines and helicopters on an adapted Royal Fleet Auxiliary or on carriers way out might be. This UK capacity is highly valued, as many noble Lords have said already, by our allies in the United States and Europe. Indeed, it is the best of its kind among the European powers. To shed it would be noticed and treated as a talisman of decline, a shrivelling of nerve and a shrinking of aspiration—a self-inflicted loss of highly skilled people and specialist equipment that almost certainly could not be made good if the international climate worsened.
I have concentrated on the hard power aspects of amphibiosity, but as we all know and appreciate, and as other noble Lords have highlighted, capacity for humanitarian rescue and protection is needed by a country that not just thinks globally, but has its people living and working in myriad locations in a world 90% of whose population live within a few hundred miles’ reach of the sea. So-called littoral power is a perpetual factor in any serious security calculation.
Possible cuts in Royal Marines manpower reflect the still-wider danger lurking within those early drafts of the 13th defence review since the Second World War, which the Cabinet Office is co-ordinating as we debate this week, with a view to completing I think early in the new year. For example, is it the right moment to cut a corps that provides, as other noble Lords have emphasised, more than 40% of the country’s Special Forces? This is another possibility that our allies are contemplating with real anxiety.
I accept that the country’s economic outlook is far from buoyant and spattered with anxiety-inducing uncertainty, but through all of it we must remain a hard-nosed, hard-power people whose calculations are grounded in the world as it is rather than the world as we might wish it to be. With all its sapping, Brexit-related preoccupations I profoundly hope the Government will not deprive us of our very special bespoke amphibious capability, almost in a fit of absence of mind, despite all the talk about being a more globally minded country post Brexit. If they do, this will be the decision above all others for which the 2017-18 defence review will be remembered. One day, I fear, it will be deeply, deeply regretted.
My Lords, I am grateful for the opportunity to speak in the gap. It is a privilege to follow the noble Lord, Lord Burnett, and so many others who have served. I am president of the Council of Reserve Forces’ and Cadets’ Associations and so want to focus on the Royal Marines Reserve.
Members of the RMR complete the commando course, earn the green beret and serve on front-line amphibious operations worldwide alongside their regular counterparts. They embody all the qualities the noble Lord, Lord Burnett, spoke of and provide an essential link to our civilian population. The RMR is a compact organisation, recruiting from four main unit locations in Bristol, London, Merseyside and Scotland, each of which has four or five detachments around the country designed to give them a good geographic coverage. The RMR punched above its weight in operations in Iraq and Afghanistan in the first decade of the new millennium, when integration into the Regular Forces at the junior level was seamless and the professionalism and ability of the reserves was clearly recognised. As an example of this, in 2008 RMR Lance Corporal Matthew Croucher received the George Cross for his actions while deployed with 40 Commando in Afghanistan.
The RMR currently has men deployed on global counterterrorism and counterpiracy, maritime security operations and defence engagement. I understand that the RMR is on course to achieving its target manning level for 2020—the Minister might care to indicate the figures. There are, however, a number of issues affecting it and an important one is the slow responsiveness of the contracted service medical process. Candidates are frequently initially identified as potentially medically unfit and by the time they are reviewed and found to be fit, recruit training has started and the next chance to join is 12 months later. This is a recurring problem across the reserves and I urge my noble friend to address it.
The RMR routinely contributes to 3 Commando Brigade, the Lead Commando Group, 1 Assault Group RM and elsewhere; for example, through ship force protection teams. It provides an important contribution to British defence from a small establishment and at a small cost. It is a real blow that all overseas training in the current year has now been cancelled to help make the savings required, with likely effects on recruiting and retention. I am concerned that, perhaps because of its small size, the RMR’s contribution needs to be better recognised.
My Lords, like all noble Lords who have spoken this evening I thank my noble friend Lord Burnett for securing this incredibly important debate. Unlike other noble Lords who have spoken, I will also apologise to him for passing a note from the Whips saying, “Time’s up”. If my noble friend had sat on the Back Benches and hidden away, he might have avoided the Whips’ note. I have never been asked to be a Whip and I believe that is because my party has understood that my timekeeping is always a bit off, so I was a little embarrassed to be the person passing the note. I also note that the Whips have come in force to make sure that I do not do more than my five minutes.
The Royal Marine Commando mindset is: be the first to understand, the first to adapt and respond and the first to overcome. These are all incredibly important, but the Royal Marines can do those things only if there are Royal Marines in sufficient numbers. It is absolutely clear that across your Lordships’ House and in the other place there is considerable concern about the rumours of further cuts to the Royal Marines. Back in April, the First Sea Lord suggested that the Royal Marines had decided to restructure to better balance skills across the force. Can the Minister tell us whether the Royal Marines indeed decided to restructure, or were they forced to restructure because of financial matters? Are the Royal Marines being adequately resourced? Does the MoD view the Royal Marines as the jewel in the crown of our Armed Forces?
Many Members have mentioned extreme weather training and going to the high north. I had the opportunity to go to northern Norway in February to visit the Royal Marines doing their training. It was illuminating to discover just how important the Royal Marines’ training is, not just for our forces but to our Norwegian and American allies. The idea that training is being reduced is a considerable worry. If we are not able to provide the training that we have been doing, what are the Royal Marines going to provide instead? It is particularly concerning to hear that the Royal Marines Reserve is no longer going to be allowed to go overseas to train. Can the Minister tell us precisely what the Government are expecting to do with the Royal Marines? Can he reassure us that there will not be cuts either to numbers or to the training, which is so important? The Arctic, jungle and desert training are all vital. We have troops who are second to none but every cut weakens our reputation.
As so many Members have said, this is a time of considerable threats. If we take away the training in northern Norway, what message does that send to our NATO allies and to Russia? Presumably not the message Her Majesty’s Government intend to send. The security threats that we face in 2017 are not reducing; if anything, they are getting greater. Leaving the European Union will not reduce any threats. If anything, the need to co-operate with our NATO allies will make it even more important that we work closely together. Our second-to-none Royal Marines should be a fundamental part of that.
On almost everything, these Benches can agree with the mood of the Chamber. But there is one area where it is important to suggest that the Liberal Democrats cannot quite agree with every view. We are committed to defence and we would like to hear that Her Majesty’s Government remain committed to defence expenditure, but we are also committed to international development. Development and defence go together, as we saw recently in the way that we reacted to the hurricanes. Does the Minister agree, and will he reassure the House that aid and defence will go together and that there will be no cuts to the Royal Marines?
My Lords, I, too, thank the noble Lord, Lord Burnett, for introducing the debate. The essential question seems to be: what is the future of the Royal Marines? I believe that with this Government the future is very uncertain—and the reason is the 2015 SDSR.
Defence is in a mess. The gap between the SDSR promise and the money required seems to be, by consensus, some £2 billion per annum. Hence the Royal Marines are under threat, together with HMS “Albion” and HMS “Bulwark”. Labour believes that our amphibious capability is hugely important to the UK’s humanitarian work around the world, as demonstrated recently in Operation Ruman. Cutting this would signal that we are stepping back from our global responsibilities.
The effect of the 2015 SDSR is already showing in the morale of the Royal Marines. I quote from the UK Regular Armed Forces Continuous Attitude Survey 2017, which states:
“In 2017 the Royal Marines have seen large decreases in morale and satisfaction with Service life in general … The proportion of Royal Marine Officers who rate Service morale as high has decreased 20 percentage points from 2016 to 41%. The proportion of Royal Marine Other Ranks who rate Service morale as high decreased 13 percentage points from 2016 to 16% … Self morale and Unit morale have also fallen for this Service compared to last year. Around a third (32%) of Royal Marine Other Ranks rate self morale as low (up from 24%) and almost half (47%) rate Unit morale as low (up from 32%) … Royal Marine Other Ranks have decreased satisfaction with many aspects of work compared to 2016 whilst other Services remain unchanged”.
“Satisfaction with my job in general” has fallen seven percentage points. “Sense of achievement” has fallen by five percentage points. “Challenge in my job” has fallen by three percentage points, while “the amount and variety of work” has fallen by five percentage points. What is the cause of this collapse in the morale of our elite force? It is not about their immediate superiors. The same review showed three-quarters of all personnel saying that their immediate superiors supported them in their job. More than two-thirds said that their immediate superiors set a positive example. Most organisations would give their right arm for results like that.
So perhaps it is the cuts in training or in overseas deployment that we see in press reports. Can the Minister assure the House that the level of training of the Royal Marines is sufficient to achieve the standards we expect of this elite force? Have there been cuts in equipment? Rumours about “Albion” and “Bulwark” must leave uncertainty in the minds of Royal Marines. Is uncertainty the essence of this collapse in morale? Defence is in a mess. When are this Government going to sort it out?
Finally, I have no doubt that, in his response, the Minister will want to refer to the strategic defence and security review implementation. Last week he said that this was a cross-government review and that Ministers expected to consider its outcome towards the end of the year. I remind the Minister that the end of this year is less than five weeks away. I hope that he will achieve his aspiration. When will we in this House see the review and hear of the cuts to our Armed Forces that we all so fear?
My Lords, I congratulate the noble Lord, Lord Burnett, on securing this debate on a subject that I know is of great importance to him. I pay tribute to him for his staunch support for the Armed Forces, including in his role as president of the Tavistock branch of the Royal Marines Association. I welcome the opportunity to discuss this extremely important subject.
It is widely recognised that the Royal Marines have a proud and rich history. They were formed in the reign of King Charles II on 28 October 1664, as the Duke of York and Albany’s Maritime Regiment of Foot, or Admiral’s Regiment. The name “Marines” first appeared in the records in 1672 and, in 1802, they were titled the Royal Marines by King George III. On 28 October this year, the Royal Marines celebrated their 353rd birthday. They were present at Lord Nelson’s victory over the combined fleets at Trafalgar—one of the most decisive naval battles in British history. They were involved in the raid on Zeebrugge on 23 April 1918, where two Royal Marines earned the Victoria Cross for their bravery and conduct during the operation. During World War II, at the landings in Normandy on 6 June 1944, 17,500 Royal Marines took part in the largest amphibious operation in history. In 1982, the Royal Marines were essential to the recapture of the Falkland Islands.
I would like to pay tribute to the contribution that the Royal Marines have made to the defence of this country and, indeed, to the defence of others. Today, the Royal Marines are the United Kingdom’s commando force and the Royal Navy’s amphibious troops. An elite force held at very high readiness, they are trained for worldwide rapid response and to be able to deal with a wide spectrum of threats and security challenges, operating in often dangerous and extremely difficult circumstances.
The main deployable force is 3 Commando Brigade, with a Lead Commando Group held at high readiness to deploy globally in support of the UK’s national interests. I say to my noble friend Lord Attlee that 42 Commando has transformed into a dedicated maritime operations commando unit, to work alongside our sailors in a variety of roles, deployed on naval warships and on auxiliary shipping overseas in highly specialised boarding and counterpiracy teams.
Looking back through 2017, the Royal Marines’ activity has been significant, having deployed to more than 30 countries around the world. The tempo was particularly high recently, as has been mentioned, when the lead commando group was deployed at very short notice on Operation Ruman to provide essential and very swift disaster relief in the Caribbean. As a measure of their quality and as the noble Lord, Lord Burnett, emphasised, approximately 17% of Marines have degrees and 40% are educationally qualified to be officers. Royal Marine units in the United Kingdom were also activated for tasking on Operation Temperer, in response to the failed bombing on the London underground. In addition, Royal Marines have contributed to the EU’s naval operation to disrupt the business model of human smugglers and traffickers in the Mediterranean, where many thousands of migrants have been rescued. That illustrates the point made by the noble Lord, Lord Judd: the Royal Marines are very versatile.
Looking to the future, over the next two years we will see women joining the Royal Marines in the ground close combat role. This is an exciting opportunity and the naval service is already managing expressions of interest from young women who are keen to rise to the challenge.
Being a Royal Marine is about maintaining the standards of the most feared and most respected fighting force in the world. One of the key requirements that is drilled into recruits during the gruelling commando course which all potential Marines must pass is self-reliance in any environment, whether in the middle of the desert or the heart of a tropical jungle. The Marines’ ability to deploy at short notice by air, sea or land means that they comprise a vital component in the Armed Forces’ rapid reaction force, including Special Forces. They deploy around the world in support of UK operations ranging across international engagement, maritime security and warfighting.
Global reach and flexibility are the inherent characteristics of a full spectrum Royal Navy, able to protect the nation’s vital interests and support the Government’s priorities of security, influence and prosperity. In an unstable and uncertain world, there remains a premium on versatility and agile crisis response, which maritime manoeuvres and assured access uniquely provide. Capital ships with a combination of aviation facilities, command and control and surface offload capabilities, along with an embarked Royal Marines commando force, represent a vital component of the nation’s power projection capabilities, which will be enhanced by carrier strike. Furthermore, the Queen Elizabeth class aircraft carriers will be utilised by all three services of the UK Armed Forces. The strategic defence and security review of 2015 made provision to augment the Queen Elizabeth class aircraft carriers and maximise their ability to support expeditionary strike operations. I agree with my noble friend Lord Astor, who said that the ability to act across that spectrum preserves political choice.
Having made that point, perhaps I might address a couple of issues raised by the noble Baroness, Lady Smith of Newnham. She asked about the Royal Marine rebalancing. The changes planned to the size and structure of the Royal Marines, which we have already announced, will allow approximately 200 positions to be reallocated within the naval service. These changes are expected to be broadly cost-neutral within the overall headcount of the naval services. She and the noble Lord, Lord Tunnicliffe, also asked about cold-weather training. I can confirm that, as a short-term measure, a number of collective training exercises will not take place this financial year—I emphasise the phrase “short-term measure”. It is anticipated that specialist Royal Marine collective training overseas will resume in the next financial year.
However, I endorse the point made by the noble Baroness about the international aid budget. The UK plays a vital role in helping the world’s poorest and most vulnerable through our aid budget. That is not only our moral duty but in our enlightened self-interest: our humanitarian efforts pay a security dividend and, as we have heard, the Royal Marines can play a part in that.
In recent weeks there has been significant media speculation on possible cuts to our amphibious capabilities and to Her Majesty’s ships “Albion” and “Bulwark” and of a manpower reduction of 1,000 Royal Marines. I have to repeat to the House that these reports are pure and simple speculation and, as I said last week, extremely unhelpful at a time when the Ministry of Defence is contributing to a cross-government review of national security capabilities. This review is being conducted to ensure that the United Kingdom’s investment in capabilities is as joined-up, effective and efficient as possible. Defence aims to use the national security capability review to understand how to spend our growing budget in a more intelligent way, further modernising our Armed Forces against the harder threats across the spectrum of potential conflicts now and into the future. Absolutely no decisions have been taken, and therefore any discussion of specific platforms or capabilities is pure speculation. In answer to the noble Lord, Lord Tunnicliffe, Ministers will consider the conclusions of the national security capability review in due course. My right honourable friend the Secretary of State is taking the opportunity to look at all the work that has been done, study the evidence and reach conclusions in a considered way.
What I can say now—I address this particularly to my noble friend Lord Robathan—is that we have every intention as a country of remaining a leading global power in matters of defence and security, as long we have been. The ability of defence to move troops from ship to shore is an important capability that is expected to endure into the future, the nature and continued delivery of which must be developed in line with current and predicted threats. Similarly, the requirement for defence to possess the ability to operate in the high north remains an important skillset. The Royal Marines are the UK’s specialist Arctic warfare force, as was identified in SDSR 15, and are rightly recognised among our close allies, as noble Lords have mentioned.
I end by reassuring my noble friend Lady Wilcox that the south-west, Plymouth and Devonport in particular, is set to remain as the centre of the Royal Marines. The Royal Marines are an integral part of the Royal Navy and of the United Kingdom’s defence. Their distinction combines excellence, versatility and unique amphibious skills. They have provided 353 years’ unbroken service, protecting the nation’s security with timeless distinction. Through dedication, impressive training and incredible resilience, they have played a crucial role in keeping our country safe, and they will continue to do so.
House adjourned at 7.22 pm.