To ask Her Majesty’s Government what is their assessment of the condition of private sector pension funds.
My Lords, I apologise for my sore throat, which I assure your Lordships will improve with the lubrication of my speech. I declare a historical interest in the subject as the chairman for 20 years—it seemed to go in a flash and has just concluded—of the UK pension fund of a company called Thales, a very large, state-owned French defence and electronics group that is very active in this country.
I am very grateful to my noble friend Lady Stedman-Scott for stepping in at the last minute for my noble friend Lady Buscombe, who is unavoidably detained. I pay tribute to the contributions of my noble friend Lady Buscombe, particularly over this past year, which been very busy for her. I hope she will be back at work very quickly. I also thank those noble Lords who are taking the trouble to listen to and participate in this debate, particularly my noble friend Lady Altmann, who probably knows more about pension funds than all of us put together. I understand from her that she intends not only to speak but to maintain her very impressive contribution to your Lordships’ Chamber in the future.
The timing of this debate is fortunate because the Third Reading of the Financial Guidance and Claims Bill—its final stage—is planned for consideration in the Commons on 12 March. This debate is very relevant, perhaps not only to informing what will happen in the other place but, in particular, because it has prompted a number of noble Lords to consider the issue.
My starting point is the Green Paper of February 2017, Security and Sustainability in Defined Benefit Pension Schemes. It seems like yesterday that it was published but it is getting on for just over a year. That has triggered a much wider debate on the whole pensions industry, which has been largely well informed and very timely. About £1.5 trillion is held in defined benefit schemes and the average pension provided is £7,000 per annum. There are about 6,000 defined benefit schemes, with, I estimate, well over 11 million members. As a result of very low interest rates for a great number of years, the liabilities of these schemes have been driven up because of the low rate of return on investments. Inevitably, for defined benefit schemes, the obligations increase automatically. Therefore, there have to be substantial deficit contributions. In January 2017, the aggregate deficit of DB schemes was, I believe, of the order of £200 billion—a staggering sum.
The Pension Protection Fund is there as a modest backstop for default but, as noble Lords can see, it has a very daunting task in protecting those schemes. PricewaterhouseCoopers—I declare an interest as a former partner— have warned recently that the deficit could rise significantly. I understand that the government White Paper is due shortly—this year—to give the Pensions Regulator more power to take over DB schemes at risk. This is a most urgent matter. We await the White Paper and hope that it will steady matters. We hope that the Government can give us, in due course, a better indication of timing, if that is possible and appropriate. We await the White Paper.
I turn to defined contribution schemes—that is, where the pension depends on what is invested by the company sponsors and, of course, the enrolled employees. Royal Mail closed its defined benefits scheme to new members in 2008. Apparently, the Communication Workers Union saw that the old scheme was unsustainable. I understand that Royal Mail awaits secondary legislation to introduce a collective defined contribution scheme where independent trustees decide investment policy. I look forward to a White Paper examining such a proposal, the exact role of the Pensions Regulator and the nature of the closure of future accruals.
Turning to other issues briefly—I do not expect an answer on these from the Minister today—the use of the consumer price index, rather than the retail price index, has been discussed in the industry for better protection for pensioners and pensions. That debate continues, and I hope there will be some conclusions on it. Secondly, I turn to cold calling, which came out of pension freedoms—people’s freedom to release their pension pots. The trustees should shoulder more responsibility in dealing with this. It is one thing to provide the freedom; it is another for sensible decisions to be taken.
Automatic enrolment is excellent. It began in 2012 at 2%—shared equally between the employer and the employee—for defined benefit pension schemes and for employees earning more than £10,000 a year. By 2019, I understand that this will have gone up to 8%: 4% each for the employer and the employee. I welcome this very much.
Another issue is the possible merger of the regulators. The Department for Work and Pensions sponsors the Pensions Regulator, and the Financial Conduct Authority, under the Treasury, controls financial advisers. I wonder whether it would be sensible at some stage—it is not urgent—for those two organisations to be merged together.
Finally, still more regulation is to be enacted. The Financial Guidance and Claims Bill, as your Lordships will know, is in the Commons. I believe that Report and Third Reading will be on 12 March, in just a few days’ time. That will create the pensions financial guidance and advisory body, which combines—as your Lordships will know—the Money Advice Service and the Pensions Advisory Service. I hope it will be open for business soon—certainly this year. If possible, some indication of timing in the Minister’s response would be extremely helpful.
Finally, my future wishes—I think I am allowed those in the remaining minute—include a pensions dashboard so that people can look online at an individual’s pension position and an effective ban on cold calling. I mean effective; I know some members of my own constituency have suffered from cold calling, so I have first-hand experience, although I no longer represent that constituency. Finally, I wish for extra powers for the Pensions Regulator. I look forward very much to my fellow Peers participating in the debate and to the Minister winding up.
My Lords, I congratulate my noble friend Lord Freeman on securing this debate on an issue that noble Lords probably know I am rather passionate about. I also welcome my noble friend Lady Stedman-Scott—it is a pleasure to see her here—and I send my best wishes to my noble friend Lady Buscombe, who is equally doing an excellent job for us.
Pensions in the UK have a specific characteristic. Our system has always been structured as one that offers an exceptionally low state pension. The recent OECD figures showed that the UK state pension, even with the new state pension, was the lowest for average earners in a developed world, with a replacement rate of just 29%. Within our country the system has relied on private pensions to top up what is a rather low state pension. In the EU, by contract, most countries have a much more generous state pension and have relied less on private pensions. So private pensions are crucial to the financial well-being of the UK population in retirement. Indeed, we have had a very successful defined benefits system and we now have the success of auto-enrolment.
Today, I will spend a few minutes, given that it is International Women’s Day, talking about pensions for women. Women have been—and in many ways still are—second-class citizens. There have been a number of studies and there are a number of ways one can express the disadvantages that women face in pensions. For example, Zurich Insurance looked at four years, from 2013 to 2016, and found that men were estimated to receive an annual average pension contribution from their employer of some £3,500 a year, compared with £2,500 a year for women. That suggested that women, on average over their lifetime, would have £47,000 less in employer contributions than an equivalent male. Prudential has published figures that show that, on average, 21% of women are saving nothing for their retirement, compared with just 9% of men. The Centre for Policy Studies looked at women aged 60 to 65, whose pension pots were less than half those of men. So there clearly is an issue.
Women are losing out for many reasons. Obviously there is the gender pay gap. We have made significant progress but typically women earn less than men. They also tend to work in industries with lower employer contributions than men’s, such as the health sector, social work and education, compared with more men in financial services, for example. This is also compounded by career breaks. So women have a triple whammy: smaller salaries, lower contributions and fewer years of working.
The Government are embarking on auto-enrolment to try to ensure that pension coverage is spread much more widely, and this has so far been a tremendous success. However, there are issues that still affect women. Auto-enrolment does not cover the lowest earners, who tend to be women. Even low-earners who are covered unfortunately are losing out in an issue that I feel needs far more attention across the country.
I hope that your Lordships might join us in highlighting this issue and that my noble friend the Minister might look into it on behalf of so many women—and indeed men—who currently earn less than £11,500 and are entitled to basic rate tax relief on their pension contributions of the equivalent to the 25% government bonus, but are being denied it without their knowledge, often because their employer has chosen a scheme that even the employer does not realise has this impact on them. If their pension operates what is called the relief at source administration system, these workers will get the 25% to which they are entitled, but if the pension provider chosen by their employer is administered under a net pay system, they cannot get that money. They have to pay their own pension tax relief. The taxpayer does not pay it, so they are forced to pay 25% more for their pension than they should.
This scandal has been going on for a long time and sadly the Government have failed to address it. I have tabled numerous Written Parliamentary Questions asking what the Government plan to do about it, but I have received no answer. I have asked who would be responsible for the losses that these women are facing, but I have received no answer. It seems that they are falling through the cracks.
At the moment, the answer that I typically receive is that it is not a lot of money, but we are about to quadruple contributions under auto-enrolment by next March, and the amount of money that these women, and low earners in general, are losing will keep rising as the number of people potentially affected keeps rising. The failure to take this issue seriously means an ongoing risk of undermining the success of auto-enrolment if there is a scandal about these people being denied the money and there being nobody to take responsibility for it. I urge the Minister at least to speak to the Treasury and ask whether a system could be put in place whereby at least the scheme could claim the tax relief on behalf of these people. It knows who they are because it knows their earnings.
Having said that, if we can sort out the problems, we want to focus on making auto-enrolment an even greater success than it currently is. I congratulate the Government on the pension freedoms that have been introduced and the new arrangements for pensions that have the potential to make the system even better than it currently is. I urge my noble friend to ensure that we get default guidance embedded in the system so that the Financial Guidance and Claims Bill will automatically direct people to get the free guidance guarantee which the Government rightly have set up specifically for them. I hope that we will get proper measures that will effectively, as my noble friend Lord Freeman said, ban cold-calling and the use of leads obtained from cold-calling. That is critical so that the companies that might try to use those leads face the risk of being put out of business.
Then, of course, I eagerly await, as, no doubt, do all of us in the Room, the White Paper that we are expecting by the summer, I believe—perhaps my noble friend could update us on progress—on the sustainability of defined benefit pension schemes. I hope that we will look seriously at increasing the regulator’s powers, consolidating pension schemes and merging them so that we can cut costs, and perhaps giving trustees more responsibility for assessing the strength of their employer covenant in a professional manner, perhaps bringing in outside expertise to assess the company. Such outside expertise could have warned trustees and the regulator about the problems looming at Carillion. A number of hedge fund analysts spotted them just by looking at the report and accounts, but they were not apparently something of which the trustees were aware.
My wish for the future is that we help the pensions industry live up to its responsibility to promote pensions and to explain to the public why pensions are so brilliant. It is free money. We want the pensions industry to stop continually calling for the Government to bring it more customers and for the Government to make those customers pay it more money. The pensions industry is getting enormous amounts of taxpayers’ money from the tax relief. It needs to start serving its customers, making the product attractive, explaining why somebody wants to buy a pension and making them more user-friendly by getting rid of the jargon. One of my pet hates is the jargon that says that every pension scheme must have something that people who do not want to choose their investments should use. What do they call that? A default fund. What is the last thing that most people would want to do with their money—default. Yet that is what everybody is supposed to have. Why not call it “experts’ choice”, or “specially designed for you”? Get people engaged with pensions: have apps; gamification; and user-friendly and popular investment options that are environmentally and socially responsible. Those are all opportunities that we can take.
I congratulate my noble friend on the debate. I look forward to listening to the other noble Lords who will be speaking and to my noble friend’s response.
My Lords, with the leave of the Committee I will speak in the gap about two specific issues related to private sector pensions, both of which are fairly current and have raised their heads in the last few days. The first relates of course to the GKN/Melrose acquisition battle. I call it a battle because it looks, sounds and feels like one. The issue of those who work for, or have retired from, GKN is a live one. Just two days ago the chair of the Business, Energy and Industrial Strategy Committee in the other place wrote to the chief executive at Melrose Industries following the committee’s meeting with them, in which she set out a requirement to inform the committee of Melrose’s plans for applying for clearance from the regulator prior to acquiring the company. That was a result of the company itself having come under scrutiny from the Pensions Regulator, which asked whether it would apply for the voluntary clearance that is all that happens under the current powers of the regulator. The question that arises—given that this is about a principle, not just that specific matter—is, when will the Government be bringing forward the promises they made in their manifesto? To quote the Financial Times, the,
“party pledged to boost the Pension Regulator’s powers so it could veto deals which could harm pension scheme members”.
That is the question that arises in principle about mergers and acquisitions for the future.
The second point is very much about mergers and acquisitions in the Brexit context. Your Lordships may know that the European Union Committee produced a report last month, Brexit: Competition and State Aid. I am a member of the internal market sub-committee. In evidence we heard about the importance of European Commission Regulation 1/2003—that means that it was the first regulation undertaken in 2003—in which the UK is able to co-operate with competition authorities, other member states and the Commission when mergers and acquisitions are being contemplated. The regulation allows co-operation on detecting anti-competitive conduct; sharing confidential information; facilitating cross-border access to evidence; avoiding dual notification of mergers; alignment of national leniency programmes; and mutual recognition of enforcement remedies and court rulings. The committee was further told in evidence that,
“without these information flows, ‘the quality of UK enforcement would very likely deteriorate’, and that information-gathering and monitoring activities would place a significant additional burden on … sector regulators”.
As we know, many acquisitions and mergers do not wholly relate just to companies inside the UK, but also within the European Union. The issue is whether the Government are minded—and how they are minded—to put the free flow of information for regulators very much on the agenda in the negotiations that are taking place, so that whenever there is a potential threat to pension scheme members there is protection and information available in the way that it is now.
My Lords, I start by thanking the noble Lord, Lord Freeman, for facilitating this debate about the condition of private sector pension funds. It is good to see the noble Baroness, Lady Stedman-Scott, in her place; I detect that she is getting some enthusiasm for this role. It is surprising that this important and topical issue has not attracted more engagement; perhaps these are early signs of fatigue induced by Brexit.
In preparing for this debate, it has been assumed that the focus would be largely on the health of DB schemes, notwithstanding that the world of pensions is moving inexorably from DB to DC. Indeed, in evidence to a recent Work and Pensions Select Committee, one of the witnesses, a pensions lawyer, bemoaned the fact that young people coming through her business are likely to be experts in advising when a scheme is to be wound up, closed down or closed to future accrual, but claimed that no one of her generation knows how to set one up. That is possibly an exaggeration but it is perhaps a sign of the times. However, we should not write such schemes off, and I shall come to that in a moment. Before I do, I shall just range over the broader pensions canvas to illustrate its complexity and what is changing beneath our feet; the noble Baroness, Lady Altmann, has been involved in much of this.
Many recent pension policy changes, for both state and private pensions, have their origins in the recommendations of the Pensions Commission. These include: increasing the state pension age; simplification and restriction of pensions tax and tax relief; the new state pension; and, of course, auto-enrolment, the latter coming with mandatory employer and employee contributions; and the basic state pension coming with the triple lock. Along the way are further reforms to public sector pensions.
More recently, we have seen the demise of the default retirement age; abolition of the obligation to annuitise; the introduction of so-called pensions freedoms; and, notwithstanding the launch of Pension Wise, the rise in pension scams—but, thankfully, not a secondary annuity market, or not yet. We are on the cusp of a further exercise to embed the recommendations of the 2017 auto-enrolment review as we enter the era of increased employer and employee contributions and, along the way, the pensions dashboard. I very much join and have common cause with the noble Baroness, Lady Altmann, on the tax issues that she raises. It has been an anomaly outstanding for far too long and should be fixed.
Many of these changes have fuelled the rise of DC schemes. So, among all these changes, how have private sector DB schemes fared, and what is their future? We have the benefit of the recent Green Paper, referred to by several noble Lords, and insights into the Government’s thinking. There are around 11 million members of DB schemes, more than 50% down on the position 10 years ago. Most schemes are only small; only 4% have more than 10,000 members and these hold over 60% of the assets and around 70% of the members. Around £1.5 trillion is held under management.
From the 2017 Purple Book we learn that the proportion of schemes open to new members has fallen slightly in 2017 to 12%, although the decline since 2012 is slowing. The proportion of schemes closed to both new members and future accrual rose by some 4% in the period to 35%, while 21% of members were in open schemes and 55% in schemes that are closed to new members but open to new accrual. The number of active members has been declining over the past decade, and the total membership comprises 47% who are deferred, 40% who are pensioners and 12% who are active. Although continuing to be volatile on a full buyout basis, the aggregate deficit of such schemes fell to £736 billion and funding levels improved to 68%. However, as the noble Lord, Lord Freeman, mentioned, PWC Skyval, which sounds a bit like a Bond movie—I guess I must also declare an interest as a former partner of what was then just PW—points out the limitations of using the buyout basis for much, and prefers a gilts-plus method, which it says is widely used by actuaries. On this basis, it says that aggregate deficits rose by £40 billion to £450 billion at the end of November.
So although there is a clear direction of travel, the sector continues to provide secure retirement income to millions of people. We suggest that this is not the time to write off private sector DB schemes, notwithstanding that, as the Purple Book records, many members of DB schemes are choosing to transfer out for a variety of reasons, including a hitherto buoyant stock market. We should recognise that the switch to DC schemes is likely to accelerate under the 2015 pension freedoms and as schemes continue to de-risk, not only by closing to new accrual but by diversifying investments—moving away from equities towards bonds.
The Green Paper asserts that DWP modelling considers that scheme deficits are likely to shrink for the majority of schemes if promised levels of employer contribution are sustained. Smaller deficits have led to shortened recovery periods; the mean recovery period length is seven and a half years, although the spread is from 12.5 years to those schemes in surplus. We should not overlook that some 1,000 schemes are in surplus.
Some have suggested, particularly given the antics we have seem from some high-profile individuals and their corporate manoeuvring—the noble Lord, Lord German, touched on this—that there is a fundamental problem with the regulatory and legislative framework for DB schemes. The Green Paper concludes that, while not optimal, there are no major structural problems with the framework. It asserts that available evidence does not appear to support the view that DB schemes are generally unaffordable for employers. In this regard, we note the manifesto commitment of the Conservative Party to introduce punitive fines alongside a TPR contribution notice, and to make certain corporate transactions subject to mandatory clearance. That would help the noble Lord, Lord German. I am not sure whether that should be done by the regulator. We would support this approach, but perhaps the Minister will confirm that this is still the Government’s position. Could she put some flesh on the bones of the type of transactions the Government have in mind? Indeed, when will we see the White Paper that will spell this out? I think we were promised it in the spring, although I think spring has sprung.
My noble friend Lady Drake, when giving evidence to a recent Work and Pensions Select Committee, suggested improvements to the regime that included strengthening the duty and requirements on the sponsoring employer to consult and inform trustees, which is important where there is a sponsoring employer who does not want to engage. She further suggested a tougher regime on recovery plans, as well as the need for the regulator to be more proactive and focused on the use of information, albeit recognising that this has resource implications. How do the Government respond to these suggestions and are they satisfied with the level of resources available to the regulator?
The issue of corporate dividends has of course featured in recent cases and the potential conflicts between properly funding the pension scheme and supporting the share price of an enterprise on which executive bonuses may well be based. How do the Government consider the regime can be improved to prevent the deliberate enrichment of shareholders at the expense of the pension scheme? We were told recently by the Minister’s colleague that the regulator does not have the power to stop businesses paying bonuses to executives or dividends to shareholders. Could the Minister say what the alternative mechanisms are that can be used to substitute for the lack of such powers?
We should acknowledge the important role of the Pension Protection Fund in helping to sustain confidence in DB schemes. Given that its payments are met from levies on other DB schemes, it is doubly important that others are not allowed to escape their obligations by dumping schemes into the PPF. This is notwithstanding that the PPF has developed a robust business model that has enabled it to take on major schemes as well as a stream of smaller ones. We are told that 43 schemes entered PPF assessment last year—a declining number—with 130,000 members in receipt of compensation. This has been a major success and important in helping to sustain the DB sector.
In considering whether the existing regulatory arrangement is appropriate, it should be borne in mind that it is a scheme-by-scheme approach and its effectiveness depends on the strength of the employer covenant in each case. As has been said, there are a number of large schemes but also many smaller schemes, often covering older, industrialised, sometimes family-owned, businesses. Smaller schemes may struggle to obtain benefits of scale for their investment strategy and, in terms of governance, to readily attract independent and member-nominated trustees. The possibility of consolidating smaller schemes has been raised, although one can see that this would bring considerable challenges. How might this be helped?
Private DB schemes continue to make a significant contribution to the UK savings market and to help alleviate poverty in retirement. But there is a growing move away from them towards DC arrangements, particularly from the success of auto-enrolment. This changing environment requires alternative approaches to regulation but does not negate the need to strengthen the DB regime. We look forward to the White Paper and follow-up legislation in due course. As others have noted, the Financial Guidance and Claims Bill now wending its way through the Commons should provide some key and necessary safeguards to help members of DC schemes, or of DB schemes switching to the DC market, build better protections. It is right that we proceed on both fronts.
My Lords, I thank my noble friend Lord Freeman for tabling this Question for Short Debate on the assessment of the condition of private sector pension funds. I also thank the noble Lord, Lord McKenzie, for his comment about my enthusiasm for this subject. I got enthusiastic when I started to take interest in my own pension scheme, so I must declare an interest in that I have a pension. I will also give your Lordships’ best wishes to my noble friend Lady Buscombe.
The nature of retirement has changed dramatically over the past decade. People are living longer and working more flexibly. It is important that government encourages and supports people to save for their retirement, to provide security later in life. As a result of recent reforms, millions of people look forward to a more secure retirement. We are continuing to improve the pension foundation for all pensioners, through a fair and sustainable state pension system. To achieve greater security, choice and dignity, we have introduced the new state pension. We continue to provide benefits such as winter fuel payments and have given those not eligible for the new state pension the opportunity to increase their state pension through a top-up.
We have already taken a number of important steps to strengthen the private pensions landscape: more than 9 million people are now automatically enrolled into an occupational pension scheme, and we have given people aged over 55 greater choice in how to access their private pension pots, which noble Lords have referred to. The new single financial guidance body will provide savers with more information and guidance on their retirement options.
We all know what a great success automatic enrolment has been in reversing the long-term decline in pension saving, and 2018 is a particularly important year, with the beginning of work to take forward and build support for the proposals we set out in our review of automatic enrolment, Maintaining the Momentum, published in December last year. This work highlighted some remarkable progress since 2012 in workplace pensions coverage. The workplace pension participation rate for women is now equal to that of men among eligible employees in the private sector, with around three-quarters of men and women participating in workplace pensions. Total annual contributions into workplace pensions were at a 10-year high of £87 billion in 2016. Automatic enrolment is normalising pension saving.
We will keep this movement going with two planned increases in contribution levels for automatic enrolment, in April this year and April 2019, at which point people who have been automatically enrolled will be saving 8% of their qualifying earnings. As a result, by 2019-20 we expect that an additional £20 billion will go into workplace pensions annually.
The increased number of people saving through automatic enrolment has led to a considerable expansion in the master trust market, from around 200,000 in 2010 to around 9.2 million by January 2018, with the majority of employers choosing to use a master trust pension scheme rather than setting up their own pension scheme. We will ensure that members of master trust schemes are provided with similar protections for their savings to members of other pension schemes through the authorisation and supervision regime set out in the Pension Schemes Act 2017.
Defined benefit pension schemes provide an important source of income in the retirement plans of millions of people. In the private sector alone, nearly 10.5 million members rely on such schemes with around £1.5 trillion of assets under management. They help to fuel the UK economy through investment in UK government bonds, corporate bonds and equities. News of increased deficits combined with a number of recent high-profile cases have led some commentators to declare that there is a fundamental problem with the funding and regulation of these schemes. While it is true that the defined benefit pensions landscape is evolving, as these schemes continue to close and be replaced by other forms of provision, it is not the case that fundamental change to the underlying legislation and regulation is needed. There are indeed new challenges for trustees and employers, but the Government are committed to improving the powers of the Pensions Regulator so that the defined benefit system continues to work in the best interests of those involved; that is, for members and pensioners, for today’s workforce, and for employers.
The noble Lord, Lord McKenzie, asked about the private sector defined benefit scheme and its future. The Government’s position on defined benefit pensions is clear: where employers can, they must continue to meet their responsibilities. The noble Lord, Lord German, asked whether the Government would meet their commitment to boost the Pensions Regulator’s powers. The Government’s manifesto further signalled our commitment to protect private pensions and indicated a number of areas in which they will bring forward, or will consider bringing forward new powers for the Pensions Regulator. In our upcoming defined benefit pension schemes White Paper, to be delivered in the spring—I know that the noble Lord, Lord McKenzie, said that spring has sprung; I am a little behind him on that, but we live in hope—we will explore the Government’s manifesto commitment to take action to prevent and punish those whose deliberate actions put pension schemes at risk. The White Paper will also set out the steps being taken to deliver new measures and build on existing measures to strengthen the regulator’s anti-avoidance framework and information-gathering powers.
There is a well-established legislative framework that provides protection for members. The Pension Protection Fund was set up by the Government to pay compensation to members of defined benefit schemes where the sponsoring employer is insolvent and the scheme’s funding level is not sufficient to secure pensions at least equal to the level of compensation that the Pension Protection Fund would pay. It is also important to note that the Government are acting in a joined-up way to ensure that all parts of the business, legal and governance framework are considered.
I shall now answer some of the questions that noble Lords have raised, and within the timeframe I have, I shall do my best to go through them. The noble Lord, Lord Freeman, talked about the Green Paper. I should say that the Green Paper has considered the powers of the Pensions Regulator and has encouraged a debate on striking the right balance between the needs and aspirations of sponsoring employers and members. As I have said, the Pension Protection Fund operates in the wider economy to ensure that no one in any group is unfairly disadvantaged. I think I have covered the publication of the White Paper. However, I have to say that the pensions dashboard mentioned by the noble Lord, Lord Freeman, sounds like a good idea. I should be most grateful if the noble Lord could write to help me understand it.
My noble friends Lady Altmann and Lord Freeman both talked about a cold call ban. We are committed to introducing a pensions cold calling ban as swiftly as possible. We tabled an amendment to the Financial Guidance and Claims Bill to enable us to make regulations to implement the ban. If we have not made these regulations by June, we will publish a statement explaining why and outline a timetable for delivering it.
My noble friend Lord Freeman mentioned CPI and RPI. In the Green Paper we discuss schemes that still use RPI and will set out our position in the White Paper.
My noble friend asked about Royal Mail and the CDC scheme. Royal Mail will close its defined benefit pension scheme and open a defined contribution scheme from 1 April this year. It is working hard with the Communication Workers Union to develop a collective defined contribution scheme, which both parties believe will better meet their needs. This is expected to replace the defined contribution scheme when and if the Government make the necessary changes to the legislation. We expect details of Royal Mail’s proposals imminently. Ahead of that, it is too early to say exactly how the Government will respond. It is also not possible to be more specific about the timetable.
My noble friend also asked about the timing for the introduction of the single financial guidance body. After Royal Assent, we will need time to get the body up to speed, so it will not be before the autumn of this year.
I thank my noble friend Lady Altmann for her contribution to this debate. In the Chamber the other day I mentioned that around the House there are giants on certain subjects. That met with an interesting response but I consider her a giant in the pensions field. I am pleased to have her here today and I hope to learn much from her. I shall be very happy to meet her along with officials, who I am sure will set up that meeting.
On the issue relating to women that my noble friend raised, automatic enrolment was designed specifically to help groups who historically have been less likely to save, such as women and low earners. The workplace pension participation rate of women is now equal to that of men among eligible employees, with, as I said, 73% of women now participating. In the words of, I think, the good man General William Booth, “That and better will do”.
My noble friend Lady Altmann asked what independent trustees can bring to the role. A professional independent trustee can help to ensure that the scheme is run professionally and avoids some of the governance and financial risks inherent in a less experienced and less professional approach. My noble friend spoke about the promotion of pensions and “free money”, which we do not hear about too often. The Government agree that pensions are a fantastic product, which is why noble Lords will have seen posters and TV commercials promoting automatic enrolment.
My noble friend also asked what the Government are doing about default guidance. The Government tabled further amendments on this on Monday. These will be debated in the Commons next Monday, when the Financial Guidance and Claims Bill reaches its Report stage.
The final point that I will make in the time allowed is about GKN and Melrose, raised by the noble Lord, Lord German. It would not be appropriate for Ministers to comment on individual cases. They are a matter for the independent regulator, and therefore we cannot discuss the specifics of this case. The regulator operates a statutory clearance procedure to provide greater certainty for those who are considering transactions involving companies with defined benefit schemes. If clearance is not applied for and granted, the regulator may exercise its powers up to six years after a transaction has taken place if it considers that the transaction was aimed at avoiding a debt for the pension scheme.
I have tried to answer as many of your Lordships’ questions as possible. If, on reading Hansard and talking to the officials, I find that I have missed any, I will ensure that all noble Lords are written to. I end by thanking everybody for their preparation for and contributions to this debate on a most important subject.
To ask Her Majesty’s Government what is their assessment of the future of United Kingdom inland waterways.
My Lords, I start by thanking all noble Lords who have joined us today for this debate. I declare my interests as a member of the Inland Waterways Association and honorary president of the Monmouth, Breconshire and Abergavenny Canals Trust.
There are currently 4,700 miles of navigable waterways across England, Scotland and Wales—plus, of course, the waterways in Northern Ireland—and a further 1,800 miles of unusable waterways, 700 miles of which are proposed for restoration. The ownership and control of these thousands of miles of waterways rests with more than 100 navigation authorities. The largest manager is the Canal and River Trust, which looks after 2,000 miles, followed by the Environment Agency, which manages 650 miles.
Our inland waterway network is a unique and precious national asset, which has the potential to transform places, enrich lives, improve mental and physical health, support communities and promote economic development. More than half of the population live within 10 minutes of a waterway. Because of their historical role as the motorways of the past, waterways pass through not only wondrous countryside but also the heart of our conurbations. Take a few steps from Paddington station or the Birmingham International Convention Centre and you are immediately on the canal and towpaths of a country-wide waterway network. Unlike the grand places that are among the primary assets of the National Trust, which are often tucked away in some glorious piece of countryside, our waterways pass through some of the most deprived communities in our land. My purpose in this short debate is to shine a light on the value of our waterways, to examine the economic potential that they can unlock and to put to the Government a range of issues where government action can make a difference to realising the waterways’ full potential.
I start by concentrating on the economic potential that waterways provide. Analysis and research of this impact are somewhat sketchy, but they suggest that the value of land and property alongside a navigable canal is some 10% greater than comparable land alongside a disused canal; so values rise where working waterways exist. This rise in value is a vital tool for local authorities up and down the country where there are disused canals. The potential for planning gain should be of great interest to local authorities seeking to promote economic development. Planners have long used development potential to fund public goods such as roads, schools and other forms of community infrastructure, so applying some of this development gain to the restoration of the canal would be a wholly appropriate use for the public good.
The question I pose to the Government is: where is the economic planning policy that would drive this enhancement to our communities, and what steps are the Government taking to encourage local authorities to think carefully about the link between economic development and canal restoration? Another consequence of restoring canals is increased tourism spend. I know that my noble friend Lord Lee will expand on this later. My challenge here is to ask the Government what they are doing to encourage this economic potential.
Like other noble Lords, I should like to have a better understanding of the recent decision by Ministers to put on ice the transfer of the Environment Agency’s navigable waterways to the Canal and River Trust. Perhaps the Minister can tell us where these discussions are at the moment. Has the Minister met with the CRT to explore its offer to take over the operation of these waterways? Can the Minister tell us whether the department is looking for an improved offer from the CRT? If that is the case, can the Minister tell us what more the CRT can do to improve the merits of its offer?
There is some speculation that this is related to the large structures on the waterways that are controlled by the Environment Agency. Of course structures of that size also bear a risk of failure or decay. The Government presently stand behind the Environment Agency as the guarantor for dealing with any damage or consequence of an event to those assets. If an asset of that sort were to be passed to the CRT, there would obviously be a need to either crystallise the risk into a form of payment or to back it with some form of guarantee. Can the Minister let us know whether this issue is one that needs to be resolved and, if so, what is the timescale?
The Canal and River Trust can leverage funding in a way that the Environment Agency cannot. As Environment Agency budgets are squeezed, so its ability to maintain structures and the assets that it manages for government becomes equally restricted. Its ability to restore and repair is reduced. These were precisely the reasons why the CRT was established, and why there was always an expectation that the Environment Agency waterways would eventually be included in the transfer to the Canal and River Trust. The CRT has guaranteed government funds through to 2027, which enables it to borrow and lever additional funds and invest in the longer-term future of our waterways. It produces a return which far exceeds that which the old British Waterways could provide. The sad state of canal closures in Scotland demonstrates the value of the trust structure that we now have in England and Wales.
If our waterways are to maximise their full potential, the Government must engage and appreciate their worth. There is some feeling—I have experienced it—that the Government, having passed on much of the work to the Canal and River Trust, have stood back from promoting the worth of our waterways which, after all, is not necessarily an economic issue for government but it is something that government can promote. It would be reassuring if the Minster could tell us the number of visits that he and other Ministers have made in their official capacities to see our waterways in action. It is not just Defra Ministers who need to engage. Waterways provide access to millions of people; they touch many of our most deprived communities; they can address health inequalities; and they reduce physical inactivity, obesity, diabetes and poor mental health. Through adoption by local people, they can help to build strong, resilient communities—more than 200 community groups have now adopted a stretch of waterway and that number is rising by 20% each year. Beyond that, waterways support learning and skills, covering such diverse areas as natural science, engineering, heritage, arts, technology and mathematics. They help to restore natural habitats and protect endangered wildlife species—and so the list goes on.
Waterways play a role that spans so much of the life of our country, be it in education, health, leisure, sport, local government, tourism or the environment. In reality, this spans many government portfolios. What role is the Minister’s department playing in co-ordinating the government overview of the impact of our waterways on life in our country? It is so important for joined-up action in the promotion of the role that waterways can play. Our waterways are our asset on the doorstep. They need to be nurtured, treasured and—most importantly—used to the full, and the Government have a major role to play in providing that support.
My Lords, I congratulate the noble Lord, Lord German, on having obtained the debate. I make it clear at the outset that I agree with almost every word that he said, which is a novel experience for me. I also declare an interest: I have been interested in waterways—in fact, I have been on them, mainly in the English Midlands—for the last 20 years. I am on my second narrowboat; as you buy them they get more and more expensive, so I do not think I will go further than that. Like the noble Lord, I congratulate the Canal and River Trust on its successes. I know that there were worries when it was formed as to whether it would be successful, but it has been very successful. Like him, I am disappointed that we have had the hiccup with regard to the Environment Agency’s waterways coming into the CRT, but in the long run that must happen; if it does not, the problems will increase.
The noble Lord also mentioned the way in which the CRT can continue to help with the restoration and recovery of canals, and I want to highlight a couple of important measures on that point. One would of course be to put in place the link that has been talked of for some time between Milton Keynes and Bedford, which would make access to the Environment Agency’s waterways in the east much easier and would considerably extend the opportunity for leisure use there. I give a more immediate welcome to what is proposed with regard to Daventry. The noble Lord mentioned that it is open to local authorities to use the planning system to generate the money that will create a canal. In Daventry we are talking about only something like a mile and a quarter, but it would enable people who currently go past Daventry on the Grand Union to go in and take advantage of the town itself. That is one of the great advantages that we see from the waterways.
We are dealing with waterways in the United Kingdom, which enables me to bring in those in Northern Ireland. The problem is that there are not that many of them, unfortunately. There were a number of canals but none is active at the moment. The railways in Ireland never made any money, nor did the canals; it has to do with the way in which the population is distributed and the absence of large industrial sites outside the Greater Belfast area. We have a problem there. We have the Fermanagh lakes, the Lower Bann and its great lake, which is problematic in some ways. However, I draw attention to two potential developments in Northern Ireland. The first is the Lagan Navigation, which is this year starting a process of restoration to one of its locks. In fact, it is the first lock that you encounter in Belfast, because the Lagan Navigation goes from Belfast to Lough Neagh. We are starting with what will be the most expensive lock to restore, which is a good first step forward. In that connection, I have to mention that my wife is the deputy chairman of the Lagan Navigation Trust, so I am slightly prejudiced.
I also mention the Ulster Canal, which starts and ends in Northern Ireland but, in between, it meanders through large parts of the Republic of Ireland. That enabled us to choose that to develop as a cross-border co-operation project. I was well aware of the extent to which the Government of southern Ireland had taken a strong lead in the restoration of canals, and have succeeded in putting in place the two major canals that go from Dublin to the Shannon, thus extending greatly the area that can be cruised. I knew that officials in Belfast did not have the same enthusiasm and it seemed to me that, if we put together a cross-border body and exposed them to the broader horizon that their southern counterparts had, that might have a positive result.
I do not know whether what I am going to say is absolutely true, because I am dealing with what other people have said to me, but they have told me that there is an annual meeting under the aegis of Waterway Irelands between the people representing north and south. In the course of this annual meeting, the folk from Dublin said, “Here’s our money for beginning the restoration of the Ulster canal”, and the Northern Ireland representatives hummed and hawed and got uncomfortable as they had not got anywhere. They had not got past the idea that was prevalent nearly 40 years ago that there was no significant market for leisure activities based on canals and had not realised that huge leisure opportunities are developing on canals. From the point of view of Northern Ireland tourism, this adds another niche. Tourism in Northern Ireland is always going to be a matter of niche markets, because we do not have sun and the temperatures that people get in the Mediterranean and elsewhere, but this is an important niche to add. I hope that sooner or later the penny will drop and we will some steps being taken on the Ulster Canal. As it links Lough Neagh with Lough Erne, that would give an integrated waterways network in Northern Ireland, which would generate more leisure activities.
My Lords, I congratulate my noble friend on securing this debate. In my short contribution today, I want to focus primarily on the tourism aspects of our inland waterways. I declare an interest as chairman of ALVA—the Association of Leading Visitor Attractions. It has 70 members, all of which receive more than 1 million visitors a year, and a very important member is the Canal and River Trust. It manages 2,000 miles of historic navigable waterways, which is 70% of our national network. When I was Tourism Minister in the later 1980s, inland waterways were regarded very much as a lost tourism opportunity. Many waterways were overgrown, full of debris and unnavigable. The Thames was then regarded as a hugely underdeveloped tourism and national asset. However, even then improvements were starting. In my Pendle constituency, significant work was done in cleaning and upgrading the Leeds and Liverpool Canal.
In recent years, mainly thanks to the work of the Canal and River Trust, formerly British Waterways, huge strides have been made. Many waterway networks within and around our older industrial towns, such as Birmingham and Manchester, have been transformed and restored. The Canal and River Trust licenses and supports 33,000 boats on our waterways, and in a typical two-week period the waterways welcome 2 million walkers and 180,000 fishing visits and facilitate 600,000 joggers, 700,000 cyclists and 150,000 canoeists, rowers and paddle boaters. The trust’s waterways are home to 63 SSSIs and the third-largest collection of listed buildings in the country, including significant individual attractions such as the Anderton boat lift. It is estimated that 2,500 jobs are sustained by inland marinas and boat hire.
Turning from the macro, a couple of years ago we had the privilege to move from south of Manchester to Richmond, Surrey and now live 200 yards from the Thames. This section of the Thames is a major tourism and sporting draw. On the river there are moored boats, canoeing and rowing—it is marvellous to see youngsters participating—as well as small boat building and repair operations, fishing, the very occasional brave swimmer. There are paddle steamers and larger boats taking passengers through the Teddington lock to Kingston and Hampton Court and in some cases to Westminster. There is wonderful birdlife, with a wide variety of ducks, gulls, herons and cormorants. Given the number of herons and cormorants, it is quite clear that the Thames is host to a very substantial fishing stock. I judge that there is a much greater fishing opportunity than people realise.
I fished the Thames locally on three occasions with Warwick Salzer, a Thames fishing guide, in his converted landing craft and caught a number of nine-pound and 10-pound pike. A couple of weeks ago, I had the opportunity of seeing a seal in action, taking a fish for itself just off the towpath. All this activity brings substantial tourism footfall and spend to Richmond, obviously benefiting the wider economy—cafés, pubs and restaurants. Most tourists walk the riverbank. I describe this as “towpath tourism”, for jogging, walking and cycling, but I have to say that it is not ideal, in many respects, to see walkers and fast cyclists so intertwined—though fortunately, I have seen no serious accidents yet. Of course, Richmond is somewhat special, given its history, with the Turner view, the park, Kew Gardens, Twickenham Stadium; but the river is the number one draw for most visitors. Many other communities up and down the country benefit from tourists and visitors engaging in water pursuits or just walking the towpaths.
I want to ask the Minister about pollution and prosecutions. In a Written Answer to Question 515 on 21 June last year in the other place, the Minister— Dr Thérèse Coffey—gave details of successful prosecutions in England, with Wales having been devolved over the past 10 years. In each year, between 2007 and 2010, there were over 100 successful pollution prosecutions. However, since 2011, that number has fallen steadily. In 2015, there were only 22, and last year, only 14 in the first half of the year. Of course, since 2011, enforcement undertaking offers have been available, which are legally binding voluntary agreements containing proposals for the restoration of any environmental harm. They have been available as an alternative to formal prosecution. Does the Minister think that the fall in prosecutions is perhaps because of the aforementioned alternative? Does he have any numbers on agreed enforcement undertakings? My concern is that, perhaps because of manpower reductions or cost-cutting, the Environment Agency is not able to police our rivers and inland waterways and investigate reports of pollution incidents as speedily and thoroughly as would be ideal. Obviously, I totally understand if the Minister would prefer to write to me on that specific point.
In conclusion, I hope and expect that our inland waterways will be steadily improved and expanded further in future for the benefit of residents, communities, tourists and—of course—future generations.
My Lords, I welcome the debate of the noble Lord, Lord German, UK inland waterways and the opportunity to take part. I have nothing to declare: I am not an associate and I do not own a longboat, unlike my noble friend, but I enjoy walking along our many waterways with my two friends, Daisy and Ted, who are my dogs. I enjoy them and they enjoy it, too.
Bringing our waterways into the big society puts decision-making into the hands of the thousands of people who love the waterways—like me—and have the pleasure of living near them. Therefore I welcome the Government’s commitment to invest and support local communities and volunteers helping to shape the future of our much-loved waterways.
Importantly, the main and overriding issue is that of safeguarding the safety and structural integrity of water infrastructure and the safety of users and neighbours. One of the main issues must be improving water quality and managing flood risks, as well as enhancing and supporting our heritage while respecting the character of our landscape, creating ample space to develop leisure and commercial activities—as previous speakers have alluded to. Of course, there are many challenges but I always think that challenges bring new ideas.
Waterways are our history; demonstrating their individuality and uniqueness is important. We may not be Holland, with many miles of waterways, but our network of 200 year-old canals and rivers is valued and therefore must be preserved. Our landscape, too, is very precious, so both have to be supported for long-term sustainability, highlighting the opportunity to welcome our visitor economy.
An important issue to raise today is our waterways’ connection to our health and wellbeing. They are integral in encouraging and supporting physical and healthy outdoor activity. They are an opportunity for someone who may feel isolated and lonely; they can be a lever to begin volunteering, resulting in creating long and lasting friendships, particularly as we are all living longer and healthier lives.
It is also the time to value the environment. Almost 50% of the population live within five miles of a waterway and nearly 1 million people live within a 100-metre catchment. Attention must be drawn to improving physical access to canals and to introducing creative signage, with up-to-date public information to keep awareness and interest for people. As I have stressed, securing the long-term future of our managed waterways is a given, as well as resolving the best outcome for the public purse. Lots of work is also needed to rid our canals of the scourge of the many types of microplastics entering the environment via sewage and sewage sludge.
From soft landscape to commercial opportunities, there are huge opportunities for businesses and small and medium-sized enterprises which want to relocate and stimulate a community, bringing work and jobs. It is particularly important to our rural areas which are situated in an idyllic setting.
Finally, it is important just to be able to enjoy the ambience as well as valuing our natural environment; to discover the pleasure of just being there beside our canals, for everyone who wishes to preserve our heritage. They, too, want to make a better place for our future generations.
Once again I thank the noble Lord for tabling this debate and look forward to the Minister’s response in encouraging the improvement of our canals and waterways. I hope there is support, so that canals and waterways will have a future.
I thank the noble Lord, Lord German, for bringing us here today. I would say to the noble Lord, Lord Trimble, that one of the best scenes I have seen in my life was on the shore of the lake by Enniskillen, where the hotel is. When we opened the curtains in the morning and looked down to the water, at the cattle with their feet in the water, it was absolutely magnificent. If those sorts of things are not exploited, somebody needs to do something about it, because they are eminently saleable.
My history goes back a long way, I am afraid. I was present at Reading Town Hall at the initial meeting of those who were determined to stop the Government abandoning the Kennet and Avon Canal, and at the start of the restoration of that canal, alongside which I lived for a long time, at Bradford on Avon. My history is on the railways. I want to bring to the Minister’s attention the huge input that is now achieved on the railways from the community rail partnerships, of which there are a very large number. Those people do a variety of things in terms of looking after buildings, gardens and making sure the station is pleasant. Much of that encouragement has come from the train operating companies and Network Rail putting seedcorn down to encourage people, giving them training where necessary, and tools and accommodation that they can use. Thousands of people are fascinated by railways; I think they are even more fascinated by canals.
What I really want to draw attention to is the fact that, although there are a lot of willing, and increasingly skilled, volunteers—I believe that a lock at Stroud in Gloucestershire has been restored almost entirely with volunteer labour—that must never be seen as a means of government washing its hands. If volunteers ever got the idea that the efforts they put in meant that the Government would withdraw their support, that would be almost pernicious. Whatever problems there might be with funding—and there will always be such problems—supporting those volunteers is vital to the Canal and River Trust and to the railways. Volunteering and the allegiance that people feel to their railway lines and canals is a strange thing. It is not something that I think motorways suffer from at all—people want to get away from those.
I wanted to speak in this debate to say to the Minister, “Look at what the community rail partnerships are achieving and make sure you give at least equivalent support to the volunteers”. There are many ways that can be done—through training and dealing with buildings and gardens, and even just picking up rubbish, which is very important in many of these places. I shall be very interested to hear what the Minister has to say when he replies.
My Lords, I am very grateful to the noble Lord, Lord German, for tabling this debate and to all noble Lords for reminding us of the joys of participating in the nearly 5,000 navigable miles of inland waterways. We in the UK are very privileged to have access to such an abundant network of canals, rivers and lakes, with all the opportunities they bring for leisure and work. As noble Lords have said, they provide enormous opportunities for recreation, whether fishing, cycling, walking or simply messing around in boats. They also continue to provide inexpensive and environmentally beneficial opportunities for moving freight around the country—something I am sure we could exploit more than we do at the moment. They even provide affordable alternative living space. At least one of my noble colleagues resides on his canal boat in London when the House is sitting—even during the bad weather, he told me, although he also told me that the increased mooring charge is finally pricing even him out of that lifestyle.
Boat ownership is now more prevalent than it was at the height of the Industrial Revolution, and we have heard a little about the joys that it brings. Canals also provide significant wider environmental benefits. There are benefits to wildlife from restored waterways, including improved biodiversity in flora, fauna and habitat, and they play their part in reducing CO2 emissions and improving drainage and flood alleviation. As a number of noble Lords have said, the restoration projects that have taken place have provided enormous community benefits and opportunities for volunteering, as well as improved health and well-being, which goes along with that.
Therefore, it is important that we do everything we can to maintain the quality of the water and the surrounding pathways to ensure that the highest environmental standards are maintained. I pay tribute to the work of the Canal and River Trust and the Environment Agency for their hard work in protecting these valuable natural assets. However, clearly more needs to be done, as we have heard today.
We still face huge challenges from water pollution—a matter raised by the noble Lord, Lord Lee. The Environment Agency recently said that England’s water companies are still responsible for an alarming number of pollution incidents each year—at least one a week. As its chair, Emma Howard Boyd, pointed out:
“This pollution can lead to the death of wildlife, major environmental damage and, in the worst cases, puts the public at risk”.
Last year, Thames Water received a record £20.3 million fine after it admitted dumping 1.4 billion litres of raw sewage into the Thames between 2012 and 2014, leaving people and animals ill and killing thousands of fish. Although the fine was the biggest in the Environment Agency’s history, it represented just 10 days’ operating profits for the company. Therefore, we need to ensure in the future that fines are proportionate and that they truly act as a deterrent. So I ask the Minister: what further action is proposed to ensure that water companies take their environmental responsibilities seriously? Meanwhile, I was pleased to read that Michael Gove has also laid into the water companies and has threatened to give Ofwat greater control over what he described as their “opaque” finances. I also have to say that I visited the Thames tideway super-sewer project a few months ago and was pleased to see that the company was finally taking positive action to clean up the Thames.
Although we think of canal boats as being environmentally friendly, we cannot avoid the fact that they contribute to the air pollution caused by nitrogen oxides. Particularly in residential areas, they are responsible for the pollution caused by wood-burning and solid wood stoves, and boat engines used for propulsion and electrical generation. Of course, canal boats typically have diesel engines. So there is a need to accelerate the search for alternative fuels and energy storage, including the wider use of solar panels and hydrogen- and battery-powered engines.
Farmers owning adjoining farmland also need to play their part in cutting back on river and canal pollution. Although there is much greater awareness and education of landowners these days, more than half of our rivers have been found to have unacceptable levels of phosphorus caused by sewage effluent and contaminated run-off from farmland. Can the Minister update us on the steps being taken to ensure that farmers are compliant with environmental standards? How many prosecutions have there been of farmers who wilfully ignore their responsibilities?
Canals and rivers also play their part in harbouring non-native invasive plants and animals. We know, for example, of the destructive impact of non-native crayfish, but people are also guilty of disposing of plants intended for garden ponds and aquariums in our rivers and waterways without realising the harm they can cause. Can the Minister remind us what steps are being taken to educate the public about the threat these pose, and also to educate volunteers, who do so much to clean up our waterways, about what they should look out for in terms of non-native invasive plants and animals, and what action they should be taking?
We have debated the negative impact of plastic on our rivers and waterways several times recently. All too often single-use plastics are dumped or washed into rivers and flow out to sea, creating huge marine pollution as well as unsightly shorelines and beaches. As we know, nearly half of all single-use plastic bottles are currently not recycled. Instead, they are discarded or put into regular bins, and end up in landfill. Once there, as we all now know, they take hundreds of years to break down. We urgently need to cut back on their use by implementing a bottle-deposit scheme, as well as improving recycling rates. Perhaps the Minister could remind us of the outcome of the recent consultation on this issue and tell us what action the Government now propose to take on single-use plastics.
Finally, I am aware that many of these issues are addressed in the 25-year environment plan. When the plan was published, we expressed concern at the lack of urgency and the need for more measurable targets. There was intended to be follow-up on this issue. Can the Minister update us on the progress of that action?
I am conscious that my contribution has focused on some of the challenges facing our waterways, rather than celebrating them. They are a much-loved part of British life and my concern is only that that should continue to be the case.
My Lords, I too congratulate the noble Lord, Lord German, on securing this debate, particularly given his contribution as president of the Monmouthshire, Brecon and Abergavenny Canals Trust. Protecting those very important canals is a great achievement. I have listened with great interest to noble Lords, given their considerable interest in and experience and knowledge of our inland navigation system.
As your Lordships will know, the first canal system dates from Roman Britain and was used largely for irrigation or to link our rivers. Many of our canals were built at the height of the Industrial Revolution, which demanded an economic and reliable way to transport goods and commodities in large quantities. I am always struck when one travels up the M1 that one can see the motorway, the railway and the canal and note how beautiful the canal is. However, I had better not go down that line too much.
That highlights how our canals and rivers have played a significant part in our country. Of course we treasure the tangible connections with the past, and probably even more equally, if that is possible, we realise the benefits of the waterways not only for today but for the future. They encapsulate a history of growth and then decline, and from the 1970s onwards a story of regeneration and increasing commercial and recreational use. I am thinking of some of our urban centres. My wife is a sculptor and the foundry she uses is in Limehouse. If one visits Limehouse today, or indeed Birmingham and Leeds, we can see that in many of the towns and cities that were the hub of the Industrial Revolution, the canals and rivers are the open door because of their development potential, as the noble Lord, Lord German, highlighted. Moreover, when we think of heritage it is obvious to move on to tourism, as the noble Lord, Lord Lee of Trafford, emphasised in his remarks.
A great many listed buildings line our canals and rivers: scheduled ancient monuments, heritage structures ranging from small iconic milestones as well as working structures such as lock gates and swing bridges. We can marvel at the Caledonian Canal cutting through the Great Glen or the 29-lock Caen Hill flight on the Kennet and Avon Canal. I recall in a previous life the valiant work of the late Admiral Sir William O’Brien with the Kennet and Avon Canal Trust. We also have the architectural splendour of the grade 1 listed Pontcysyllte Aqueduct carrying the Llangollen Canal over the River Dee. That structure alone is a UNESCO world heritage site which attracts 300,000 visitors a year.
Apart from their traditional role as a system of travel and transport, our inland waterways serve the many purposes to which noble Lords have referred. The noble Lord, Lord German, talked about regeneration and growth, as well as the contribution they make to water supply and transfer, drainage and flood management, and as a means of commercial transport, a point highlighted by the noble Baroness, Lady Jones of Whitchurch. From the fishing point of view, the noble Lord, Lord Lee of Trafford, raised the importance of angling and how the angler often is the person to notice when there is pollution in the water and thus is part of the early warning system.
We said in our manifesto and in our 25-year environment plan that we want to be the first generation to leave the environment in a better state than the one we inherited. We want everyone to be able to enjoy ready access to our blue spaces—that is, the towpaths of our canals and our riversides which provide great benefit. I was struck by the words of my noble friend Lady Redfern when she spoke of the sheer pleasure derived by the large number of people who live close to our waterways. We could describe that as the green and blue prescriptions that the waterways provide.
The significance of the formation of the Canal and River Trust is that it was the first major transfer of a public body into the charitable sector and it has acted as a flagship. As has been said, the trust has ownership of more than 2,000 miles of waterway. I hope that the noble Lord, Lord Bradshaw, will not mind me emphasising this, but providing the trust with £800 million under a legally binding 15-year grant agreement in what I would call stretched times is an indication of the appreciation of what the trust is doing now and can do in the future, which is a very strong endorsement. The funding has given the trust financial certainty so that it can plan for the long term as well as achieve value for money and attract funding from other investment and commercial income such as boat licensing—I heard what the noble Baroness said about that—and donations.
I will highlight the words of my noble friend Lady Redfern and the noble Lord, Lord Bradshaw. One key objective in creating the trust was to increase the involvement of local people in the waterways. I would recommend to noble Lords the Library pack, which set out the annual report of the trust. I was impressed that, in 2016-17, the trust harnessed 540,000 volunteer hours. I so agree with what the noble Baroness, Lady Jones of Whitchurch, said about invasives—I spent a really enjoyable day pulling Himalayan balsam with volunteers in the river catchments of the New Forest National Park. Not only are the volunteers doing great environmental work but, when I said, “Thank you very much”, they said, “Don’t you realise how much pleasure we derive from doing this work?” It is bearing fruit, because there is less Himalayan balsam in these upper reaches causing damage.
The noble Baroness also mentioned raising awareness, which is why our Check, Clean, Dry campaign is so important, with its message not to bring back anything with your sponge bag. I will be having a meeting on floating pennywort, which is also causing great problems to watercourses because, at some point, a member of the public took it from their pond and put it in the watercourse. We need to raise awareness of that. The trust has also increased community involvement—which was also raised by noble Lords—including in arts and education projects. Last year, 43,586 children took part in its waterways education programme.
The Environment Agency is the second-largest navigation authority in the country, with the majority of the length of its waterways accounted for in the Fens and Anglian waterways, the River Thames and the River Wye. The agency manages more than 3,000 assets for the benefit of more than 26,000 boat users and the wider public. These waterways also provide a significant contribution to the UK economy and are an intrinsic part of the urban and rural landscapes through which they pass. The Government are providing funding of £13 million to the Environment Agency to support the maintenance of its navigation assets from 2016-17 to 2019-20. Additional income is raised from boat licensing charges and commercial income.
I turn to the Broads Authority, because I have responsibility for national parks and the Broads Authority is in that family. They are wonderful waterways; I spent a wonderful day on them in my ministerial capacity and a number of other days in other capacities. The authority undertakes a vital role in looking after the 120 miles of navigable waterways in Norfolk and Suffolk. This beautiful waterscape alone attracts 8 million people a year, bringing in around £550 million to the UK tourism economy. I raise that, because I think it is a small example of what the waterways bring in terms of tourism, and indeed what tourism brings to our national economy and to our reputation.
All of the many other navigation authorities take very seriously their stewardship role. Both Natural Resources Wales and the trust are responsible for a number of the waterways in Wales. Scotland and Northern Ireland manage their respective inland waterways. I was particularly interested in what my noble friend Lord Trimble said about Waterways Ireland, which is one of the six north-south implementation bodies established under the British-Irish agreement in 1999. The funding currently reflects the current distribution of waterways in each jurisdiction—the Northern Ireland Assembly accounts for 15% and the Irish Parliament for 85%—but capital development programmes are funded separately by the jurisdiction where the works are carried out. My noble friend highlighted the collaboration and co-operation in the restoration of the waterways that serve both parts of that island, which is a key example of a force for good.
I pay tribute to the Inland Waterways Association, its 16,000 members and the many volunteers who—as I have said—work tirelessly in helping to safeguard and enhance our waterways. It is a very strong partnership.
The noble Lord, Lord German, and my noble friend Lord Trimble raised the issue of the transfer of Environment Agency navigations to the trust. The Inland Waterways Association and many in the boating community have welcomed this, and we are working on it. My honourable friend Thérèse Coffey has met the trust, and they are working on this; she has instructed officials in Defra and the Environment Agency to work with the trust on a revised proposal which fully accounts for which assets could be transferred and the timings for that. If I have any further details, given the hour and time, I shall write to the noble Lord.
I shall also have to write to the noble Baroness about some of the examples of pollution. I have a lot more to say on pollution, which is a scourge. It is something that we need to deal with, whether it emanates from farming or boats—wherever it emanates from—because we need to bring down pollution rates and improve water quality. That is a key part of the 25-year environment plan.
I am sorry, but I have been at the equine forum this morning, so I shall say that this has been a very brisk gallop through a very important subject. I conclude by saying that my honourable friend spent a very interesting visit to the Birmingham canals, and I have over my time visited many canals. The trusts are right to celebrate this year the 50th anniversary of the Transport Act 1968. I wish them, and all those who have the responsibility for navigation and inland waterways, all success, because the future is very much one where, whether it is an enhancement of quality of our green or our blue environment, the waterways have a key role to play in the fulfilment of a better life for the people of this nation. So I am most grateful to the noble Lord for this opportunity.
To ask Her Majesty’s Government what steps they propose to take to reverse the decline in the use of buses in England outside London.
My Lords, I think this is the third debate in Grand Committee about bus services. One was tabled by the right reverend Prelate the Bishop of St Albans and one by my noble friend Lady Randerson. Having read the debates, I thought that the conclusions really meant almost nothing at all; the words went into the air but the actions did not follow.
Much time is spent by politicians discussing the bus industry. Unfortunately, most of them talk about ownership. This has little to do with the major issue that confronts the bus operators: congestion. The use of buses in England outside London has been on a downward trend for about nine or 10 years. Congestion affects private and public sector operators regardless of ownership. I often travel on buses in Reading, which are run by a municipal company, and in Oxford, where the companies are privately owned. In both cities there are fairly effective partnership arrangements, modern vehicles and enterprising ticketing systems, which are improving. Nevertheless, they are suffering declining levels of patronage caused by congestion, which is felt throughout Great Britain. This subject will form the core of my remarks. I hope that the Minister, in her reply, can give some positive answers.
First, I draw attention to the fact that the bus industry has suffered a significant decline in financial support relative to the car. Fuel duty for road transport has been frozen since 2011. The bus service operator’s grant, which the bus industry has traditionally enjoyed, has been reduced by about 20%; that means that, relative to the car, its costs associated with fuel have increased. Wages in the bus industry have to be competitive to attract and keep drivers, because bus driving is not a very nice job, and have risen well in advance of general wage levels, particularly in the cities.
Another fiscal measure that needs close examining is the availability of concessionary travel to young people. These people have a high propensity to travel and will make more and more journeys if they can afford it. Making young persons’ railcards available on trams and buses—as well as trains—would stimulate travel, and serious consideration should be given to this measure. It might not be very expensive because of the high propensity to travel. It would also be a disincentive to car ownership. It really is time we stopped talking about this and moved on to some action.
However, bus operators must shoulder high fixed costs. They have to provide vehicles of higher and higher standards because the engines’ emissions have to keep improving; they pay wages that rise faster than average; and they must operate to high standards of reliability and punctuality to retain or increase market share—and indeed to continue to enjoy the privilege of a licence to operate.
The efforts of operators to maintain standards of punctuality are frustrated by increasing traffic congestion. It has been shown that efforts by the bus industry to maintain punctuality by increasing the number of buses operating on a route increases operators’ costs by an average of some 8%. However, it provides no additional revenue, and if costs are passed on through higher fares, passenger numbers decline further and we are in a vicious circle. One is forced into a situation where government, either nationally or locally, must take action if effective remedies are to be found for the problems of bus punctuality. Almost any initiative the companies can make without tackling the problems associated with congestion is likely to fail.
That brings us to the fundamental question of why so much is done in cities to encourage car use and so little to facilitate bus operation. Is it because of the intense pressure from the motoring lobby or the cowardice of politicians nationally or locally—local authorities vie with each another to attract cars to their shops with offers of highly subsidised parking, often ignoring the land values attaching to city-centre car parks—or is it because of an unwillingness to get tough with obstructive parking? When all these advantages are weighed in any objective assessment, what advantage does the bus have and who speaks for the bus user? In this situation, should not government, local or national, try to redress the balance effectively?
What ambitions are available apart from effective road markings and effective enforcement? Obviously, the simplest is the introduction of road user pricing. This can be made fiscally neutral by adjustments to vehicle excise duty but it would mean that those who chose to drive on the busiest roads at the busiest times would pay more and those in the country would pay less or, more likely, nothing at all. This use of the pricing mechanism is the way that markets work in almost every other field, and I believe it is the policy of the Government. Pricing would be time-related so that small charges would be made between the peaks and none at all at night. The whole process could be conducted automatically, so there would be no need for vehicles to stop. The technology is essentially the same for policing low-emission areas and can be expected to operate reliably.
The Traffic Management Act 2004, brought into force by the then Labour Government, provided for some measures to deal with congestion, including decriminalisation of certain offences such as abuse of parking regulations. These may be enforced by local authorities, which are enabled to retain the proceeds from penalty notices to defray the costs of enforcement. Most local authorities elected to apply to take up these powers, although some still have not. In fact, the area in which I live in South Oxfordshire has not done so and has tried to rely on police enforcement, which does not exist. The police have far greater priorities—we have only to look at what has gone on in Salisbury.
The result is that dangerous and illegal parking is rife in the area, which has undesirable consequences in terms of congestion. It also brings the law into disrepute. Because people see offences routinely not being prosecuted, they push further and further and ignore other regulations. However, local authorities which have adopted these decriminalised powers wish to go further to eliminate some other offences which aggravate congestion, such as illegal right turns and the abuse of yellow box junctions. Powers for Her Majesty’s Government exist within Schedule 6 to the Act but have not been brought into effect outside London, despite huge pressure from the Local Government Association. I urge the Minister to agree to do this right away and to impress on those local authorities that have not adopted the decriminalised powers to do so quickly.
Access to the highway for roadworks, mostly by the utilities, causes delay. Under the same Act, we were supposed to see “highway management”, which would see some control exercised over the utilities by the introduction of things such as lane rental. What has become of this, and why does the Minister think that the co-ordination of roadworks, which was promised at the time, does not work? Highway maintenance causes delays for which the supposed remedy of lane rental has not been an effective response, while the unresolved problem of potholes goes from bad to worse. It is no good berating the bus companies about punctuality, as Transport Focus does, unless the root causes are tackled by the Government. Buses, unlike the railways, have no control over the highways on which they operate. That control belongs to government, both local and national, as does the enforcement of their operation.
Partnerships work well in some areas such as Brighton, but even there some 13 buses have been added since 2012 to the fleet of 200—
I am sorry, but the noble Lord’s time to speak is up.
I am sorry, but I have almost finished. Those buses have been added because of the effects of congestion. In Oxford, in 1996 the journey from Abingdon to the city centre took 70 minutes but now takes 96. Within the city, a trip to Kidlington which in 1986 took 60 minutes now takes 80. I have many other examples from elsewhere around the country. The single issue I want to hear more about from the Minister is what the Government propose to do about congestion.
My Lords, some of your Lordships will remember the cuts made in the 1960s to train services following recommendations made in the Beeching report. The effects of that still haunt many rural areas, particularly in the south-west peninsula and in my own county of Devon. Regrettably, there is evidence that we are suffering a similar decline in our rural bus services. This has accelerated rapidly since the Cameron Government slashed grants to operators and funding for councils. The situation we face is that UK bus coverage has now hit a 28-year low, down to levels of service last seen in the 1980s. In the past 10 years alone, we have seen the loss of 134 million miles of coverage. Further evidence of the speed of decline is stark. In 2016, some 248 services in England were reduced or altered, with 124 being withdrawn. The worst affected that year was my county of Devon, where 58 services were affected.
In 2017, cuts to local authority funding support for the south-west were 10%. In that year, for example, Dorset County Council slashed £1.85 million from its subsidy scheme, cutting the number of bus services it assisted from 35 to a mere seven. In 2018, the decline looks likely to continue. We have just heard that Northamptonshire County Council has voted to remove its entire bus subsidy. Local authorities have historically been at the forefront of subsidising unprofitable routes, but this proud and worthy record now seems destined to quietly slip away. It will leave gaps in whole swathes of our rural areas covered either by commercial operators, which are becoming more risk-averse and therefore investing only in profitable routes, or by community and charitable groups.
The only area where services have increased is London, which now accounts for 25% of all the bus miles travelled in England, and where you can see bus after bus with scarcely anyone in them. It would be easy to blame this situation on a lack of demand and an increasing rise in car use. In Devon, the third biggest county in England, with a population of around 750,000, around 150,000 people—19% of the county’s population—are without the use of a private vehicle. Also, many of those with cars are struggling because of the lack of service facilities outside urban centres. The decline in rural garages has been dramatic. Since 2000, some 4,000 out of a total of 7,000 independent operators have closed down.
The further isolation of our rural communities is something that this Committee should deplore, but why? In addition to social mobility, many people are now struggling to reach the basic services most of us take for granted, including shops, education and health. It is estimated that 400,000 people are in work or in a better job because of the availability of a bus service. Fifty per cent of students are frequent bus users for access to education and training. Our economists calculate that bus commuters generate £64 billion of economic benefit per year, with bus users making shopping and leisure trips worth £27.2 billion per year.
So how are the Government going to address these issues? Although the Bus Services Act 2017 was designed to get local authorities and bus companies working in partnership to improve services, clearly it did not take into account continuing cuts to local authority budgets. The Transport Secretary has suggested a change to demand-led services, Uber style. I remind him of the enormous value of our community and charitable organisations. In Devon, for example, rural community transport charities provide a ring-and-ride service on a wheelchair-enabled minibus for shopping, a volunteer car service for people requiring transport to important appointments at hospital and so on, and a community minibus hire service. Similar services are being provided in other cut-off communities in Wales and north-west England.
What can be done? I shall make a few suggestions. First, more noise is needed to prevent a Beeching-style repeat. Secondly, assuming that local authority budgets will be slashed further, local authority budgets should be ring-fenced or top-sliced for the continued provision of rural services. Thirdly, there should be a review of the method of funding, revenue support being more helpful than capital. Fourthly, there should be an urgent review of the effects on rural bus services of the English national concessionary scheme, which provides free travel for those aged over 65. Fifthly, we should consider making rural bus services a statutory provision, as with education and health, rather than optional. Sixthly, we should establish a national connectivity fund. Seventhly and finally, we need a total transport scheme which can use the power of the digital world to provide integrated networks.
The Transport Secretary needs to get to grips with this as there is much anxiety and aggravation out there. Mr Reg Varney from the TV series “On the Buses” will surely be after the Transport Secretary unless something happens.
I thank my noble friend Lord Bradshaw for tabling today’s debate and for being so effective in keeping the woes of the bus industry on the agenda because buses tend to get overtaken by railways.
Like the noble Earl, I shall use my time to speak about rural bus services in England, where there is a particularly intractable set of problems. Last year, when the Bus Services Bill was going through this House, rural issues were raised quite a number of times. The Minister, to his credit, was forced to admit that not enough attention had been paid to the potential benefits that could come from the Bus Services Act if it was implemented in the right way. I know we are not so far on, but it would be very interesting to hear from the Minister what work is going on in the department to make sure that rural areas are not forgotten. During the passage of the Bill, we talked about the way in which the commissioning process could use the Public Services (Social Value) Act criteria to level the playing field with social and community providers of transport. That was something the Minister was quite responsive to, so I would like to hear a little more about that.
I shall make two points which at one level are rather obvious, but which are not always well understood. First, there are different sorts of rural areas. The village I live in in Suffolk is tiny. There are about 200 people in the parish, and it has never had a regular bus service. People stay there only if they have access to a car, and community transport plays an important part for a very small number of people with particular needs. A mile away is a village 10 times the size, which is a completely different kettle of fish. It has always had a very good bus service. People moved there knowing that they had access to the nearby market town and then onwards to Ipswich and Bury St Edmunds. The service has undergone successive contractions and it is now getting harder and harder for people to use the bus to get into work, or to hospitals and other places. These are both rural communities but they have very different expectations and needs.
The second point is that it is convenient to think about rural and urban areas separately, but of course they are inextricably linked. The overall health of the bus industry, as we heard from my noble friend Lord Bradshaw, is very bad, and if it is bad overall, it is dire in rural areas. We have to understand that they are linked. Also, there is the congestion problem: given that most rural journeys might originate in a rural area but are going to an urban area, they are also impacted.
The CPRE has recorded that supported mileage by local authorities has fallen by 24%. It is using the term, “the Beeching of the buses”. Many of them are in rural areas. It is quite illuminating that the Campaign for Better Transport worked out that the total of those lost grants is £225 million in England. That is a lot of money for local authorities, but in government terms, it is the cost of a single bypass. It represents 17% of bus journeys but the ones that are the most socially necessary for some groups.
In 2016, this House published a report on the way in which the Equality Act is being delivered. There was a particular strand of evidence from users about the way in which local authorities fail to do proper impact assessments when they are making decisions about bus provision. As a consequence, a number of groups now face very real problems, which are bad enough if you are in an urban area—in a rural area, it is hopeless. Many older people are unable to drive and depend on public transport. Reimbursement of the bus pass is not keeping up with the costs and, in any case, in many places there are no services on which to use a concessionary pass. In some areas, including my own, a switch to community transport schemes is all very well, but the local authority has used the licensing regime of the buses used to deny passengers the use of their concessionary fares pass.
We know that younger people are taking fewer journeys. In an urban area, that is probably quite a good thing, but in rural areas the only practical way for younger people to look for work or attend higher education—or even have some sort of social life—is running a car. I was talking to providers running the Government’s flagship National Citizen Service; they told me that rural transport is a real barrier to participation for many young people and—because the NCS is provided on a county basis—there was a ridiculous situation where students on the Cambridgeshire border were expected to get to Ipswich, which was just impossible by public transport, but could not go to Cambridge, where there is a bus. The delivery of some of these other services really needs looking at.
For jobseekers without access to a car, just getting to job centres is a real problem. There is the iniquity of people being sanctioned when the system lets them down. Then, of course, there are people on low incomes, who are very dependent on buses. In rural areas, because there are no buses, it is more likely that people who really cannot afford to do so are having to run one or even two cars just to get to work and so on. The irony of all this is that collectively we are actually spending quite a lot of money on buses. Between the bus operators grant, concessionary fares, home-to- school transport, the voluntary sector and health and social providers, there is a lot—but it has never been joined up.
I know that the Government have created some pilots under the Total Transport scheme, covering 37 local authority areas. It would be really useful to know a bit about the outcome of the pilots and what lessons were learned. On a linked point, the Campaign for Better Transport and the Passenger Transport Group are keen to see a connectivity fund, which would bring together this expenditure. I look forward to the Minister’s answer and I hope that she understands the very real concerns that are being expressed today about the overall state of the bus industry, particularly in rural areas.
I, too, thank the noble Lord, Lord Bradshaw, for bringing this important question before us today. The topic is close to my heart: I have spent much of my life and ministry working in rural areas. I declare an interest as a vice-president of the Local Government Association. Given that I, too, am going to talk about particular challenges to do with rural bus services, which the noble Earl, Lord Arran, and the noble Baroness, Lady Scott of Needham Market, have spoken about, I also declare my interest as president of the Rural Coalition.
As a former Bishop of Shrewsbury and the current Bishop of St Albans, when I was looking at the statistics I was deeply alarmed to discover that Bedfordshire, in my diocese, and Shropshire, in my previous patch, have seen the second and third-greatest reductions in bus services in terms of miles lost in the country in the past four years, beaten only by Bracknell Forest. Even worse is the decrease in the quantity of subsidised bus miles in those two areas, which has decreased by 77% and 81% respectively. This has a huge impact on a whole variety of groups, particularly vulnerable people in our rural areas. I hope that Her Majesty’s Government will not ignore it. Indeed, as we are wanting, longing, hoping and working for a flourishing, thriving rural community and countryside, this is a really vital aspect.
Age UK’s 2010 Loneliness and Isolation Evidence Review found strong evidence that physical isolation is still the single factor most closely associated with feelings of loneliness. Lack of a good rural bus service has an impact on a large number of groups: those who are too elderly or too young to drive, who cannot drive due to a disability or who simply cannot afford to drive at all. In those cases rural transport, particularly buses, is a vital lifeline, as well as providing important social interaction. A lack of transport is a barrier to community and to flourishing in the countryside.
As more and more services become available online and local services close or amalgamate, those without good internet connectivity or digital skills must travel even further to get the help they need. That is one of the reasons why I have been particularly passionate in talking and working with the whole issue of rural connectivity: it is fundamental if we are going to see our rural areas continue to thrive. Not everyone can use online banking. A trip to the hospital for a regular appointment can be a huge endeavour if you live in a rural area—less than one-fifth of those in rural areas have access to a hospital within a reasonable time by public transport or walking. That is not to mention the problems people can have enrolling for universal credit when they do not have a computer at home and the nearest job centre is miles away, as we have already heard, or the challenge of looking for work when people cannot drive to interviews or have young children at home to look after.
I am sure it will not surprise noble Lords that surveys show that people in rural areas express significant levels of dissatisfaction when it comes to issues of public transport. According to an analysis produced by the Department for Transport this year, more than 70% of people living in London are satisfied with their bus service compared to only 24% of those in the most rural areas.
The 2012 decision to cut the bus service operators grant, which central government gives to local authorities to subsidise socially necessary bus services, continues to bite, and has bitten especially hard in more rural parts of my diocese. Community groups, charities and church groups do extraordinary work to serve their communities by providing transport. Last week I was visiting a parish where all sorts of people use cars and minibuses to collect a whole lot of young people together for a youth group. A few weeks ago I was at a church where people were describing their weekly lunch for the elderly; they manage to ensure that everybody gets their lift in. This is, of course, informal and voluntary; it is not the same as a consistent bus service so people are able to get to places when they need to. In 2014, the Transport Select Committee of the other place concluded that:
“Central Government and local authorities are being unrealistic if they expect voluntary community transport projects to compensate for decreased bus services. Although community transport has an important role to play, in practice it does not serve all sections of the community and therefore cannot substitute for bus services”.
Young people in rural areas in particular suffer when they do not have access to consistent, timely, affordable bus services. I would therefore like to know from the Minister what Her Majesty’s Government are doing to make rural bus services a priority. What assessment have they made of the appropriateness of current access to services, and what analysis has been made of the impact of cuts, both centrally and to local government funding, on service provision? What are the Government doing to ensure that the worst off, particularly the young, have reasonable access to bus services? Will the cross-governmental strategy on loneliness be doing any work on rural transport?
As I travel around, I hear this issue raised time and again and I cannot overstate its importance. Bus services are a lifeline for rural communities and are becoming increasingly important in a digital age. I hope that today’s debate will spur Her Majesty’s Government, and indeed all of us, on in this important area.
My Lords, 5% of all journeys are made by bus and buses are the most popular form of public transport. It is interesting that you do not meet many bus enthusiasts; you meet lots of train enthusiasts, but trains are in fact far less important to the day-to-day life of our nation. Some 4.5 billion journeys a year are made by bus but, as the noble Earl, Lord Arran, stated, the bus network is now back at 1980s levels and has shrunk by 8% in the past decade—or by 134 million miles—with 2,000 services affected. North-west England and Wales have been hardest hit, with a 40% reduction in rural areas in the past decade. Yet, ironically, in England at least, the number of passengers has increased slightly. It is just that there is no bus for them go on and nowhere for them to go. The demand is clearly there. The analogy with the Beeching era and the cuts to trains in the 1960s is a very good one.
The cause of all this needs to be examined. The key issue is certainly local government finance. Local authorities face financial constraints and they have cut discretionary subsidised bus services. Councils have a statutory duty to fund concessionary travel by pensioners and disabled people. This is very popular with the public, but councils estimate that there is a shortfall of at least £200 million for the funding of concessionary fares. This has meant that they have diverted money to make up this shortfall, taking it from previously subsidised routes, concessionary fare schemes—which, in many cases, they had set up themselves, very often for young people—and community transport.
Although I am hopeful that the Bus Services Act will encourage better working between operators and councils, I believe that the Act missed opportunities. There were things that could have been done that were not done. For example, it could have been made easier for councils without elected mayors to establish franchising and there could have been stronger incentives or requirements for environmental improvements. I am very pleased that the Government are giving nearly £40 million to retrofit buses, which is going to 20 local authorities as part of the clean bus technology fund. That is great, but in some areas there are no buses to retrofit, and £40 million is certainly not going to solve the emissions problem. The Government could have created the bus passengers of tomorrow with mandatory concessionary fare schemes for young people, who need buses to get to jobs and education and for their social lives.
The Minister has heard time and again this afternoon concern for rural areas. I am aware that there was a phone-in programme recently where a man from Devon rang to say that in his village there were only three buses a week. He explained that if he wanted to go to the doctor, which was in the nearest town, he had to stay overnight because by the time he had had his appointment, the bus had returned home for the day. That is really dysfunctional and it makes it almost impossible to live in some rural areas without a car. A colleague of mine in the Welsh Assembly talked about seeing hitch-hiking pensioners in her rural constituency. I am worried enough about the concept of hitch-hiking pensioners; the idea that teenagers might be tempted to hitch-hike worries me even more.
The irony of all this is that one of the reasons why buses are struggling in urban areas is increasing traffic congestion, which leads to unpredictable journey times, and yet congestion is one of the main reasons why we need more buses to encourage people out of their cars on to more environmentally friendly forms of transport. A further irony is that another threat to our bus services is the fact that some councils, in attempting to set up ultra-low emission zones, are targeting buses—diesel buses—first. That is totally topsy-turvy. I realise that a diesel bus is polluting but you can get dozens of car owners on a diesel bus and save dozens of car journeys and therefore prevent those emissions. The establishment of ultra-low emission zones must be done in a balanced and sensible manner.
I end by asking the Minister: can she assure us that the Government will put more resources into supporting low and zero-emission initiatives for buses? Will the Government work with local authorities to ensure that buses are not primary targets in the establishment of ultra-low emission zones? Can she give us even a glimmer of hope that the Government are prepared to evaluate the potential benefits of youth concessionary fares? I emphasise that this is an issue of intergenerational justice. Older people such as me can have a bus pass but in many areas young people are not able to get that bus pass for themselves. Finally, will the Government review the grants to local authorities and the refunds for concessionary fares with a view to reforming them to create a better and fairer system for local authorities’ financial support for bus services?
My Lords, I join other noble Lords in thanking the noble Lord, Lord Bradshaw, for tabling this Question for Short Debate. It is very good to be able to discuss this important issue. I also draw the attention of the Grand Committee to my interest as a vice-president of the Local Government Association. As we have heard, buses are an important lifeline for people, and the decline in bus use outside London is a serious problem that is affecting the viability of communities, particularly rural communities and those areas in our towns and cities less well served by other modes of transport, as they strive to be sustainable.
The noble Earl, Lord Arran, referred to the cuts in funding to bus schemes by local authorities and the effect that this has had on rural communities. I agree with him. I also agree with his comments about the need for effective bus services to enable people to get to work. Rural areas will suffer further decline if working people cannot live there and get to work—a point made by the right reverend Prelate the Bishop of St Albans.
The noble Baroness, Lady Scott of Needham Market, also spoke about rural areas and the dire problems experienced there with the decline in bus services. The risk of course is that they become places where people in cities have second or weekend homes, and that further exacerbates the problem until an area becomes unsustainable and dies. The right reverend Prelates spoke about the need for thriving communities, and I agreed with his comments about loneliness. Bus use and the provision of bus services have to be part of integrated services to make communities viable. Their decline is doing huge damage. The noble Lord, Lord Bradshaw, spoke about car use and car parking. Work is going on to deter this but, as he said, it is not matched by a good bus service being in place to encourage people to get out of their cars and on to buses.
As we have heard, about half the bus journeys in England are made outside London, and, since bus deregulation in 1986, these are largely delivered by private operators. The Bus Services Bill was passed into law in 2017 and generally it is a good piece of legislation. It certainly seeks to help reduce the decline in bus use outside London. It has been on the statute book for only a year, which is probably too short a period to see whether it is having the desired effect.
However, generally there has been a downward trend in bus use over a number of years in both metropolitan and non-metropolitan areas. Bus deregulation may have played a part in that, as operators have sought to work on the more profitable routes without the constraint of the routes, timetables and fares being set for them, as has been the case in London for many years. I agreed with the point that the noble Lord, Lord Bradshaw, made about congestion. That has been a real issue affecting bus use in recent years.
Of course, the decline in bus use could be attributed to other forms of public transport coming on stream in addition to the railways. I have certainly noticed light rail and modern tram services in some of our major conurbations, such as Greater Manchester, the West Midlands and Nottingham. There may also be other issues affecting bus use. We have heard about the reductions in spending as local authorities have had to take account of their resources, and that has had a knock-on effect on the money spent on buses.
Car use is still high in rural areas and, as services have declined, the reliance on car journeys has increased even more. One bus in and one bus out a day from a town to nearby villages five days a week does not deliver the required level of service. You then get a self-fulfilling prophecy of decline, which has a huge impact on communities.
There are also issues with bus fares, operator revenues and government grant schemes, which, again, have had an effect on bus numbers and need to be taken account of. The noble Lord, Lord Bradshaw, made a point about the effect of bus punctuality. We in London are very lucky with the number of buses that we have but in fact London has the worst punctuality rate in the whole of England. There is always another bus coming along, so no one knows whether it is late or not.
Earlier, I mentioned the Bus Services Act 2017. As I said, this was an attempt if not to increase bus use then certainly to halt its decline, and I wish that legislation every success. Work being done to make buses more user-friendly is to be welcomed. I was particularly pleased to hear that audio-visual services on buses outside London are to be improved. That should help to make disabled people more confident about getting on buses. Perhaps the noble Baroness, Lady Sugg, can update us on that when she responds to the debate.
We have had various partnership schemes between bus operators and local authorities for many years. These have not stopped the decline in bus use but they may have slowed it. The enhanced partnership schemes introduced by the Bus Services Act are a further extension of that. If the noble Baroness can say what has happened since the Act was brought forward, that would be helpful, although I appreciate that it has been in force for only a year. I am aware that there is a procedure to go through, including consultation and the issuing of notices, but anything that she can say will be helpful and I look forward to hearing from her.
One thing introduced in the Act, of course, was bus franchising, which was very welcome. But one thing that I was unhappy about was the obsession of the Government with metro mayors. You got these powers by default rather than having to apply to the Secretary of State only if you had a metro mayor. That is a regrettable decision and not very localist. I am aware that Andy Burnham in Greater Manchester, Steve Rotheram in Liverpool and Tim Bowles in the West of England have all pledged to use the powers. I am not sure how far they have got yet in establishing a scheme, but I was surprised that Andy Street, the Conservative metro mayor for the West Midlands, had not made any pledges at all. I actually know the West Midlands really well. I lived there for many years, and that certainly is one area that could do with a system where a bus franchise could have its timetable, fares and routes regulated much more by the metro mayor. I hope that he changes his mind. If the Minister has any more information, I would be pleased to hear it.
We have heard about open days, which would be useful to make things more helpful for bus users. I was particularly interested to read the briefing from Age UK about the problems older people have in terms of getting to, for example, hospital appointments. As I said, having one bus in and one bus out a day really is not helpful to get you to hospital appointments. The quality of the buses, uncomfortable journeys and inconvenient times are all issues. Of course, what happens then is that people either have to have very difficult journeys or they revert to cars or taxis, which cost more money. I think that is a shame. Perhaps the Minister could say something about what we can do to ensure that there is better non-emergency transport for patients, either through better bus services or through other schemes. That, again, is one of the regrets we had in the Bus Services Act. I won an amendment here to delete that ridiculous clause about no more municipal bus companies, but then it was reversed. We never intended to have a stampede of bus companies, but it was a shame that councils could not now do something in little local areas to deal with the problems there.
I think my time is up, so I will cut my remarks there. I look forward to the Minister’s response.
My Lords, I thank all noble Lords for their contributions today. I thank in particular the noble Lord, Lord Bradshaw, for securing this debate and allowing us to talk about buses and the hugely important role that they play in our transport system.
Buses connect our communities to the workplace and to vital public services such as healthcare and education. For many, particularly those in rural areas—which I think all noble Lords spoke about today—the bus is an absolute lifeline, as over half of those who rely on buses outside London do not have access to a car. They play a vital role in our economy, with some 4.5 billion journeys a year, and remain the most popular form of public transport, as the noble Baroness, Lady Randerson, highlighted.
Under-21s make up a third of bus passengers, and the use of buses by older people is increasing as a result of the national concessionary pass. As all noble Lords have highlighted today, the picture of bus usage across the country is mixed. While bus patronage has increased in some areas, other areas have seen a significant decline in passenger numbers.
The benefits of a reliable and innovative bus service are clear: greater productivity, and communities that are connected rather than apart. I agree with the noble Lord, Lord Bradshaw, and the noble Baroness, Lady Randerson, that heavy traffic makes buses less reliable, less prompt, more costly to run and more polluting—and obviously less attractive to use because of that. They operate along fixed routes and cannot use any alternatives. It is not really a good advertisement to use buses when you see one stuck in traffic.
What is the answer? The best answer is encouraging more people to use buses. It is still the best form of regular high-capacity transport that we have. Unlike rail, a bus can go virtually anywhere, and a bus service can be set up very quickly and at a fraction of the cost of rail. But buses need help to achieve this. One solution is to improve traffic in the key corridors used by buses, and one of the most effective ways is to give them priority over traffic. The sight of a bus cruising past lines of stationary cars or getting ahead of the queue at a junction is a much better advertisement and certainly sends a clear message to motorists. Priority measures offer good value for money, and we are funding many bus projects up and down the country through the Local Growth Fund. There are rapid transit schemes in Slough, Reading and Swindon and bus priority corridors in Manchester and Birmingham, which are genuinely innovative projects that are making a big difference in some of our busiest towns and cities. Busways, which provide dedicated corridors only to buses, such as in Cambridge and Luton, are also extremely effective and have the ridership to prove it.
The Government introduced the Bus Services Act 2017 to help local authorities and bus companies work together to make bus travel more attractive. Together they can identify congestion hotspots that disrupt bus journeys and, through partnership commitments, do something about them. Bus operators have to up their game by making using the bus an easier option. We discussed the secondary legislation relating to the Bus Services Act 2017 earlier this week. The Act contains a range of options to improve local bus services in England. In addition to franchising, there are new and improved options to allow local transport authorities to enter into partnership with their local bus operators to improve services for passengers.
Local authorities can provide bus priority measures or do other things to make buses more attractive. As the noble Lord, Lord Bradshaw, touched on, this can include reducing car-parking provision, increasing its cost or better enforcing existing parking restrictions, introducing park-and-ride schemes, altering traffic light phasing and establishing bus lanes. There are lots of tools. The Act also allows local bus operators to improve their services by introducing multi-operator smart ticketing, using more environmentally friendly vehicles and providing comprehensive timetable and fares information. The partnership can also co-ordinate bus timetables and ticketing with other modes, such as rail services, to provide a seamless journey.
The noble Lord, Lord Kennedy, mentioned the bus open data powers in the Act, which will go further than the partnership provisions to require all bus operators in England to open up real-time route, timetable, fare and ticket information to passengers by 2020. Since the Bus Services Act came into force last year, around 30 local authorities up and down the country have expressed an interest and we are working with them to roll out the scheme.
On the bus services operators grant—BSOG—which many noble Lords mentioned, commercial bus operators receive 43% of their income from the public purse. Each year the department provides £250 million in direct revenue support for bus services in England via the BSOG. Of that, more than £40 million is paid directly to councils outside London to support buses that are not commercially viable but which they consider socially necessary. The rest goes to commercial bus operators. Without this support, fares would increase and marginal services would disappear. The BSOG is currently paid on the basis of fuel used, but we are looking at ways of reforming it to make it even more effective in supporting bus services.
On local authority funding, I fully appreciate that local authorities are making very difficult choices as a result of ongoing financial pressures. The right reverend Prelate and others were correct to point out that BSOG funding was reduced in the 2010 spending review. A decision was made to reduce it by 20% to reflect the economic climate of the time. Since 2012 the Government have continued to maintain the BSOG at current levels and we are very aware of the importance of bus services to local communities. In recognition of this, we were able to protect BSOG funding as part of the 2015 spending review. We are looking at reforming the way the BSOG is paid to make it more effective in supporting bus services.
Noble Lords mentioned the advantages of more young people using buses, and I entirely agree. The level of fares is a complex area. There is no statutory obligation to provide discounted travel to young people, and I am afraid there are no plans to introduce it. Many commercial and publicly funded reductions are available. We are working to deliver significantly discounted bus travel for apprentices to ensure that no young person is deterred from taking up an apprenticeship by travel costs. I listened with interest to the point made by the noble Baroness, Lady Scott, about the National Citizen Service, which is an excellent programme. I will take that away and have a look at it.
The noble Lord, Lord Bradshaw, spoke about road user-charging for vehicles as a solution to congestion. While I listened with interest, there are technical costs and privacy challenges and, not least, the importance of public acceptance of it, so I am afraid the Government have no plans to introduce such a road-pricing scheme. I am afraid there is more disappointment for the noble Lord, Lord Bradshaw, as the majority of English local authorities have taken on civil parking enforcement powers, but obviously not in the area in which the noble Lord lives. We think that CPE represents the most effective way for local authorities to manage and enforce parking. While we continue to support the rollout of CPE, we think it is up to each local authority to consider the financial and operational implications of taking on parking enforcement duties. For that reason, we let local authorities freely choose whether to apply for these powers, and have no plans to force the remaining non-CPE authorities to adopt them. But as I said, if they wish to do so, we will work with them. I am afraid I must also disappoint the noble Lord, Lord Bradshaw, on the extension of civil enforcement powers to moving traffic offences, such as the yellow box. We have no plans to extend them. It is important to recognise that congestion has a wide range of causes. Obviously, there is that enforcement in London and Wales. Although we still have congestion here, we think there are better ways to address it and we are working on those.
The noble Baroness, Lady Scott, the noble Earl, Lord Arran, and the right reverend Prelate the Bishop of St Albans all raised the important issue of rural areas. The noble Baroness is quite correct that different areas have very different needs and expectations. Of course, extra pressures are placed on local authorities to provide services in more isolated areas. The Minister for Local Government is intending to increase support for the most sparsely populated rural areas by more than quadrupling the rural services delivery grant from £15.5 million to £65 million by 2019-20.
The right reverend Prelate also made the important point that bus services are relied on by many different groups in rural areas. It is important that the lack of provision does not further exacerbate any issues of loneliness. I will certainly go and see whether we can address the issue of transport.
Since this is International Women’s Day, we ought to note in this debate that bus passengers are much more likely to be women than men. There is an issue here not just of intergenerational fairness but of gender equality.
I thank the noble Baroness for her intervention. I was thinking about whether I could say something about women, given that it is International Women’s Day. I was not aware of that fact, so I thank her.
Providing transport solutions across wider geographical areas requires the effective use of all available options, whether it be traditional fixed-route bus services, community buses, dial-a-ride—as the noble Earl mentioned—or other services, such as social care or non-emergency patient transport. At present, the Government provide over £2 billion each year in funding for those services. That is spent by different bodies which are often providing transport for the same people at different times; for example, someone using non-emergency patient transport to get to a routine hospital appointment one day can be using a local dial-a-ride service to go shopping or visit friends the next day.
The funds do need to be spent in a more joined-up way. The noble Earl raised the issue of Total Transport. Two years ago, we launched our Total Transport pilot schemes across England to explore how councils, the NHS and other agencies can work together. The results of those pilot projects are still being analysed, but it is already clear that there is considerable further scope for public sector-funded transport to work together, whether it is provided by local authorities, community groups or the NHS. We will be publishing those results shortly.
The noble Lord, Lord Bradshaw, asked about lane-rental schemes. The Government have trialled lane-rental schemes, encouraging utilities to work together at weekends and in the evenings. There is good news: that has proved successful. We are now encouraging local authorities to set up schemes in other areas across England. We laid a statutory instrument last week with guidance for local authorities and I look forward to the impact that may have on congestion.
The noble Baroness, Lady Randerson, asked about the environment. She is quite right that buses emit fewer air pollutants than the equivalent number of car journeys taken by road, but on urban routes, where the majority of buses operate, with the stop-start conditions, the slower speeds and the traffic, as we have discussed, there are obviously issues. That is why we are trying to clean up the bus fleet. As the noble Baroness recognised, we invest in green buses. There is more that we can do: we will shortly be publishing our strategy towards zero-emission vehicles. Emissions have not yet been calculated on a per-head basis, partly because that would impact on decisions on bus purchasing, and we want to encourage the purchase of clean buses. But we are looking at further developing our transport energy model, possibly including emissions per head.
There is no single solution that will work everywhere, but the Government have a commitment to local transport, and the powers in the Bus Services Act will help reverse the decline in bus use and drive up patronage. However, central government can go only so far to encourage bus use. Buses are not provided by the state: outside London, some 80% are provided by commercial bus operators. Most of the roads that buses use are the responsibility of local authorities. Much is in the hands of local politicians, local authorities and the bus operators themselves. We all need to work together to make sure that buses can provide an effective way of tackling congestion.
Again, I thank all noble Lords for their contributions today and the noble Lord, Lord Bradshaw, for introducing this debate. Buses are a key part of our transport system and perhaps we do not discuss them enough in your Lordships’ House. As the noble Baroness, Lady Scott, said, often our emphasis is on rail. However, with the SI this week, the debate today and the Question on rural buses from the noble Baroness, Lady Randerson, I am pleased that we have been given the opportunity to do so. Very appropriately, after waiting so long for a debate on buses, we have now had three come along at once. I hope that I have been able to demonstrate that the Government are committed to maintaining and improving local and public transport in all areas, whether in the largest cities or the most rural villages.
To ask Her Majesty’s Government what steps they are taking to address health issues in the Gypsy, Traveller and Roma communities.
My Lords, I first want to give Her Majesty’s Government credit for commissioning the Traveller Movement to produce the report, Impact of Insecure Accommodation and the Living Environment on Gypsies’ and Travellers’ Health by Professor Margaret Greenfields and Mr Matthew Brindley. On International Women’s Day, it would be right to say that the report makes clear that it is the women who are most likely to report poor health, including mental health. My questions for the Minister are, now that it has been published for more than a year, what has been done to implement the recommendations, and how is progress being monitored?
The main findings were that the physical conditions of their environment were a key element of social determinants of health and thus had a measurable effect on the physical and mental health outcomes for Gypsies and Travellers. Sixty-six per cent of the sample reported bad, very bad or poor health, mental as well as physical, with those with the worst self-reported health living on unauthorised roadside sites, followed by those living on poor quality local authority sites. Thirty-nine per cent of the sample reported anxiety or depression, and the majority of those lived in conditions where they felt insecure because of planning status, threat of eviction or poor site conditions or had reluctantly accepted to live in bricks and mortar because there was no pitch available on a Traveller site. It is also notable that the majority of respondents rated their health as bad or very bad by their mid to late 30s and by their 40s a steep decline had begun.
Asthma and repeated chest infections, particularly among children, were noted in about half the interviews, but it was difficult for many at insecure sites to be registered with a GP. Chronic conditions, such as diabetes or kidney problems, were therefore inadequately treated and exacerbated. This was in contrast to those on secure sites, who were all able to access a local GP. Gypsies and Travellers who lived on private sites with planning permission felt that they had the best health. The experiences of racial harassment recounted to the interviewer are particularly heart-breaking, especially when the Gypsies and Travellers concerned had deep-rooted family connections to the area and had lived there for many generations.
The more secure a site, the fewer incidents there have been. It is not as if many Gypsies and Travellers did not engage in their local neighbourhoods when they did have stability through schools, councils and service providers. Respondents at two-thirds of the sites gave chapter and verse about this. Since they did much more caring for immediate household members or the wider family than the general population do, I think they did indeed have something valuable to contribute.
It is pretty well evidenced that improving the environmental health factors of existing sites and providing stability of tenure would improve health outcomes considerably. This would, of course, be cost effective in terms of reduced spend on ill-health and disability, as well as having a positive effect on children’s education, and it would deliver a measure of justice to those so heavily and unfairly penalised by the shortage of authorised sites.
Under the Health and Social Care Act 2012, commissioners of healthcare services have a duty to reduce health inequalities in access to services and outcomes. This, combined with the equality duty under the Equality Act 2010, should oblige local authorities responsible for accommodation to work with healthcare commissioners and health and well-being boards to sort out a fairer deal for Gypsies and Travellers. Will the Minister tell the committee how many local authorities have taken this role on board?
As local authorities have in the past been so slow to assume their responsibility for fair standards for their Gypsy and Traveller citizens, the report says, the duty once placed on local authorities to provide sites where a need has been identified should be reinstated. If the Welsh Government can do it—with a consequent drop in expensive disruption and protests—why cannot we?
At the very least, more robust data should be gathered by the MHCLG on the provision of new pitches on Gypsy and Traveller sites explicitly linked to health outcomes for people on insecure sites, monitored under Health and Social Care Act 2012 duties. Such monitoring should include the impact of the August 2015 Planning Policy for Traveller Sites’ change of definition, which can so damage the capacity of Gypsies and Travellers to obtain reasonable planning permission.
Non-governmental organisations, such as Friends, Families and Travellers, of which I have the honour to be president, also ask for the data to be disaggregated for Gypsies, Roma and Travellers. The amalgamation of data has skewed statistics for the different communities, who have different characteristics. There is no systematic monitoring because they are not yet included in the NHS data dictionary, so how can health outcomes be understood and resources properly targeted? Friends, Families and Travellers has asked Jeremy Hunt to include accommodation status in NHS data collection, so as to present a clearer picture of how homelessness impacts on health. Will the Minister tell me what is happening about this?
Time prevents me listing all the sensible recommendations of this report, but your Lordships’ Committee and the Gypsy and Traveller communities themselves are owed a progress report by the Government on what they are doing about them. I remind your Lordships that the inequalities of health among Gypsies and Travellers result in significantly decreased life expectancy—up to 12 years less for women and 10 years less for men—a miscarriage rate of 29% as opposed to 16% for the mainstream population, the highest maternal mortality rate of any single group and 17.6% of them having experienced the death of a child as opposed to 0.9% of their low-income peers, quite apart from increased chronic illness, a marked increase in incidence of mental ill-health and a lack of support in bereavement and suicide.
These are dark days for our cherished diversity. Gypsies and Travellers have never shared much in our much-vaunted tolerance, but now that the alarming increase in the racial harassment they experience is so clearly documented, what are Her Majesty’s Government doing to show that all our citizens are of equal worth?
My Lords, I thank the noble Baroness, Lady Whitaker, for securing the debate and for her passion and leadership on this very important issue. I will make a contribution about Roma people, of whom there is a significant community in the city of Derby, where I am privileged to serve. I chair the Multi-Faith Centre, which brings together different faiths and cultures, and we have a particular project working with Roma people in the city. I will draw on that experience to highlight this element of the Question and to point to some things that we might want to consider more deeply.
My colleague the most reverend Primate the Archbishop of Canterbury has published a book, Reimagining Britain. One of the tables in it shows that Roma people and other groups are a barometer of many of our problems as a civilised society. That is what I want to explore. Your Lordships will know that Roma people are a migrant, unsettled people. They are reputed to have come from northern India more than 1,000 years ago and migrated into the Balkans and parts of Europe. What has been highlighted in our experience of trying to work creatively with Roma people in Derby is that while we have developed a way of handling society and health issues through what I would call settled systems, and it is difficult for people who do not have a settled lifestyle to fit into such systems. Rather than thinking that they are old-fashioned people who need to settle down and fit into our settled systems, I think that they bring with them an important challenge that the Minister might like to comment on. My wife lives with me on the edge of Derby and works in London; she is a mobile, modern person. It is very difficult for her to make an appointment with the doctor, for instance, because the system is settled but she has a flexible lifestyle. Many of the Roma people are testing our systems, so we need to be creative. We need to be pushed towards greater flexibility in dealing with these people, not simply making them conform to things that might be too tight for them.
In my experience and that of my colleagues, the scale of deprivation among Roma people is enormously high. Literacy rates are low. There is a history of discrimination, so there is a mentality of not being confident about fitting in. There are high levels of unemployment and smoking. There are low rates of child immunisation and high infant mortality. In 2014 the European Commission said that poor health among Roma people is closely linked to social, economic and environmental factors. People such as the Roma are a barometer of the health of our society, and that is why it is worth taking them seriously and learning from them.
They come with difficult cultural norms. As a long-oppressed people with no real sense of home, there is fatalism and a tendency to live in the moment. We run a youth club for young people because they tend to congregate in open spaces, which is their lifestyle, and it is sometimes difficult to hire somewhere for those young people to meet. There is such an explosion of energy and engagement in the moment and we have somehow to see how that can be a part of our civilisation, something that can be seen to be creative rather than anti-social and not fitting in with our norms.
At our multi-faith centre we run the Roma Community Care project in partnership with Derby City Council. The Minister might like to reflect on how we can encourage local authorities to partner with voluntary energy to reach out and be alongside people to help with integration and to offer health services. We try to use Roma people. We train them within the project and try to develop self-help and development skills. Some things need to be done to put some flesh on engaging creatively with people who bring unsettlement into our settled system. First, as I have said, we need voluntary energy and local authority funding to bring schemes together. Secondly, we need mediators and champions, people who will engage with these communities and raise up people who can come back and engage with us. We need to make home visits, not just to meet people in our territories—our surgeries, our hospitals and in A&E departments—because in Roma culture, people will talk about their health only within the privacy of their own home. They are nervous about talking in what they think of as a more public place. We need to train and equip people from the Roma community as workers and volunteers, and we need outreach programmes.
One of the most interesting things we have learned is that in a culture with low rates of literacy, it is no good producing leaflets to help people access healthcare. Roma people communicate through conversation. Quite honestly, in a civilised society, is it not better to communicate through talking rather than by leaflet? That is why we need advocates—people to make the connection. There is an interesting challenge. Do our systems have enough space for conversation? You have to fill in a form online or ring up to make an impersonal appointment with some sort of machine. Roma people present a challenge that is not just a problem to be overcome but is to make us think about our systems slightly more creatively. We have to encourage our professional services to engage with people such as the Roma more on their own terms, with proper cultural awareness.
Finally, the Roma are a very vulnerable people and we have high levels of trafficking in our city of Derby. We have had cases of child trafficking, sexual exploitation and forced labour where there have been prosecutions and Roma people are victims, because they are so vulnerable.
I hope we can look at our systems of housing and health—of connecting with these communities—to see how we can reach out to meet them. We should not just expect them to conform, but should look for a cultural engagement where we give a bit to bring people in and reach out, and they have to learn to give a bit to participate in what we are offering for a healthy society with healthy Roma people within it.
My Lords, I very much thank my noble friend Lady Whitaker for giving us the opportunity of this debate. I have to mention this: I always enjoy listening to the right reverend Prelate because he always speaks with the authority of engagement. He is not just telling people what they should do or theorising about it; he is actually involved in doing it, which is very challenging.
I put the record that I deeply appreciate the information I received from the Traveller Movement, which produced a very helpful briefing for the debate. I should also like to put on the record my appreciation of our Library. I always like it there. It does first-class work in making available helpful information on the issues before us. I just wish that more of us in the House would look at what it produces and value it, because it is of a very high standard.
It is a difficult time for a whole host of reasons. The shortage of money and the reduction of money for local authorities, when they are on the front line, is a real worry—yet another. My time in the Council of Europe—just short of 10 years, which I enjoyed tremendously—offered another illustration, on the issue of Gypsies and Roma, of how, to work satisfactorily, we had to look at it strategically as well. Therefore, there is a great need to work closely with our friends in Europe. Whatever happens as a result of all our late nights here on the legislation to prepare for leaving Europe, we will need to go on working closely with our friends and colleagues in Europe. We need to understand each other; of course, in some countries in Europe there are still situations that lead to more Roma and Gypsies coming to our country. In a way, that is a credit to this country.
My other point is that I am sure that we have—the right reverend Prelate already talked about this—an immense amount of work to do with our community in terms of understanding. Some schools are doing very imaginative work, but much more needs to be done. It should not just depend on an inspired teacher who happens to be interested in the subject and is therefore doing something about it. It should be integrated because this is part of our community; it should understand what being part of that community is. I never hesitate to make what could be said to be a rather idealistic point; I am glad it is said to be so. One of the things we must get right in British society is learning to celebrate and enjoy diversity. There are always situations and pressures from the unfamiliar by which people can feel threatened, but that is essentially because people are not well informed. Therefore, there is a terrific job to be done.
As the right reverend Prelate said so wisely, we need—he said “champions”; I would say emissaries—people who go out and help the Roma and Gypsies. The challenges for the Gypsy community are huge, but the challenges for the Roma are terrific. We must help them to better understand the society they are living in and to find their way about in it. We must help them to integrate, to the extent that they are in dialogue with the society of which they are a part, and help that society to understand. I would be lying in this Committee if I did not say that I sometimes feel quite distressed when I am going through a beautiful part of the country, or a very attractive country town, and suddenly see a mess. It is not nice and people can react in a host of ways. I do not believe that if we really had the right kind of communication we could not tackle that issue together with the Roma and Gypsies: we would help them to understand how other people see their lifestyle and what it is doing to them.
This debate is supposed to concentrate on health, and health issues are huge. Life expectancy is 10% below that of the general population; that is, 10 to 12 years less than the general population. Infant mortality is still deeply worrying, as is the high maternal mortality rate. There is low child immunisation. There are issues around levels of mental health problems, substance misuse and diabetes. There are very disturbing statistics on all these conditions on which we need to concentrate. If we are talking about what can be done and what the Government should be doing, my noble friend has asked very specific questions and I support her in saying that I hope we get specific answers to those questions. Information sharing is tremendously important, not just between the long-established settled community and Gypsies and so on, but between different parts of the settled community, which often react in isolation from each other. There needs to be much more integration.
We also need community engagement and to find ways to make mainstream services relevant and accessible. I liked what the right reverend Prelate said about his wife. Most of us have the same kind of experience with our GP at home, wherever we live, and our lifestyle here. Poor living conditions need to be addressed. I am very glad that my noble friend has given us the opportunity to concentrate on this issue for a few minutes, but we are good at talking about the issue; it is when things are actually happening that we should worry. At the moment, if viewed as history, or looked at from another planet, we do not have a very good story to tell about these underprivileged people and the kind of challenges they are enduring. We need to wake up and do something about it.
My Lords, I thank the noble Baroness for securing this important debate and setting out the issues so clearly. We all take healthcare for ourselves, our families and children extremely seriously and want it to be available when we need it. This right has to be extended to the Gypsy, Roma and Traveller communities.
When elected to Somerset County Council, I was persuaded in 1995 by a colleague to chair a small working group looking into the needs of Gypsies, Roma and Travellers in the county. There was widespread support for the deliberations of this working group, including from the Traveller Education Service, social services and the various district and parish councils. We talked to many Gypsies and Travellers and found that it was all but impossible for them to access healthcare, due mainly to the need for a permanent address in order to register with a GP, as the noble Baroness said. There was also some suspiciousness on their part about having contact with officialdom and filling in forms. The county council at that time had a strong Gypsy and Traveller department, which looked after the six sites for Gypsies in the county’s ownership. Gypsies and Travellers arriving in the county from outside and camping in unregulated sites were provided with water bowsers and visited to ensure that their needs were met, especially if there were children present. We take the provision of water as a given, but many have recently realised just how difficult it is to live if their water supply is cut off.
Although the report of the working group was welcomed by some, this was not the case for everyone. I had the extremely unpleasant experience of attending a public meeting in part of the county where one vociferous gentleman stood up and said that the only thing to do with Gypsies was to stand them up against a wall and shoot them. Mercifully, his extreme and irrational hatred was not replicated by others in the room.
I wind the clock forward 13 years to 2008-09 when, as a member of the local district council, I took part in a piece of work run by the Centre for Public Scrutiny. A group of councils looked at health services available to communities on the margins. Two councils, of which mine was one, looked at the provision for Gypsies and Travellers, while two others looked at provision for sex workers and two others looked at provision for ethnic communities.
During our work in south Somerset, we visited two gypsy sites. We talked to the teenagers, young women and mothers on the site. We found they had good access to maternity services, and midwives visited the site to do antenatal checks. They were all pleased with the level of support they got. As they lived on a permanent site, the young mothers and more mature women were registered with local GP practices and got good support, not only for themselves but for their children, although this did not seem to extend to dental care.
There was, however, little health support for Travellers, who were often camping in woodland sites and on the corner of farmland, usually with the support of the local landowner or farmer. These were not permanent arrangements and, therefore, access to health care was very limited. Their children were unlikely to receive the usual inoculations that we take for granted for our children. Although Gypsies and Travellers need to access healthcare, they rarely, if ever, wish to access social services. It is part of their culture that they look after their own elderly relatives, while we in the settled community tend to call up services to help us with our infirm and elderly relatives.
The Equality and Human Rights Commission, in its report in March 2016, found that Gypsies and Travellers, compared with the general population, were more likely to suffer bad health, as has already been referred to. This includes lower life expectancy, high infant and maternal mortality rates, low child immunisation levels, chronic cough or bronchitis—even after smoking is taken into account—asthma, chest pains and diabetes. They also have higher rates of smoking. This is exacerbated by the fact that many Gypsies and Travellers remain, as I have indicated, unregistered with GPs.
Although variability in general health among different ethnic groups can sometimes be explained by an older age profile, this is not the case for Gypsies and Irish Travellers, of whom only 6% were aged 65 or above in 2011, and who had a low median age of 26. Improved life expectancy for Gypsy and Traveller communities appears to be associated with the availability of established site provision and access to medical care. Having a pitch on a permanent site is vital to accessing healthcare, to which every speaker has referred.
A recent report from the Department of Health noted that accommodation insecurity, the conditions of Gypsies’ and Travellers’ living environment, low community participation and discrimination all play key roles in exacerbating these poor health outcomes. It is suggested that these factors also hold the key to effectively addressing and improving health and well-being. The report calls for long-term, joined-up working at both local and national levels to address the wider social issues of Gypsies’ and Travellers’ ill health. Similarly, emerging evidence shows that the health inequalities of Roma people are close to those among Gypsies and Travellers. These include a high prevalence of diabetes, cardiovascular disease, premature heart attacks, obesity, asthma and mental health issues.
Poor familiarity with healthcare provisions and language barriers may make it difficult for this group of marginalised people to access services. Their culture may prevent some Roma people using support services for mental health issues, sexual health and drug and alcohol misuse. However, it is known that Gypsies and Irish Travellers have low rates of GP registration. While somewhat out of date, in 2004 16% were not registered, compared with 1% of comparators.
I have been looking at and involved in this subject for more than 20 years. We do not as a society appear to have moved forward in ensuring that this marginalised part of our nation has equal access to health care. What will the Minister do to allow these people to have access to the healthcare services the rest of us take for granted?
My Lords, I, too, congratulate my noble friend on securing this important debate. I pay tribute to her strong advocacy and campaigning work with the Gypsy, Traveller and Roma communities over the years, most recently as the president of the Friends, Families and Travellers organisation, which plays such a key role in the network of community organisations fighting hard against injustice, discrimination and poor health outcomes suffered by Gypsy and Traveller communities across the UK.
It is timely, one year on from its publication, to seek a clear and unequivocal response from the Government to the key recommendations and call for urgent long-term and joined-up working contained in the excellent work undertaken by Professor Greenfields and Matthew Brindley on the health impact of insecure accommodation and poor environmental conditions, so ably summarised by noble friend in her speech. As the foreword to that document states:
“This report makes it clear that the conditions in which members of this group are born, grow, live, work and age contribute significantly to their poor physical and mental health outcomes…Tackling these wider determinants is crucial to breaking this cycle of deprivation and health inequalities”.
Noble Lords have today painted a bleak picture of this cycle of deprivation and poor health. Gypsies and Travellers have poor access to healthcare generally, with difficulty in registering with GPs and poor access to services as a result, including health screening, home visits, dental services and access to secondary health care. We have heard about the life expectancy of over 10% less than the general population, with other health issues such as high infant mortality rates, high maternal mortality rates, low child immunisation take-up, mental health issues, substance misuse and diabetes, which are all prevalent in the Gypsy and Traveller communities.
The Care Quality Commission report in 2016 on end of life care came to the stark conclusion that, overall, health commissioners and services in most areas have done little to reach out to the Gypsy and Traveller community. Can the Minister tell the Committee what the Government are doing to address this? Should not each clinical commissioning group have a lead or champion, as we have heard, for all the four groups vulnerable to poor health that were identified by the National Inclusion Health Board, which includes this key group we are discussing today?
As the debate has clearly demonstrated, there is much for all of us to learn and understand about the history, values, traditions, culture and vibrancy of the Gypsy and Traveller community—for example, its strong family networks and relationships and their carer responsibilities and commitments. The Greenfields study showed that 42% of respondents were carers involved in helping to care for immediate household members or wider family onsite or in the immediate vicinity. That is significantly above the rate found in mainstream populations and, as the study underlines,
“reflects cultural values common to Gypsies and Travellers and significant cost-savings to local authority and health services who would otherwise need to engage with delivering care to vulnerable individuals”.
Like the wider communities, many of the adults and disabled being cared for within Gypsy communities will have comorbidities, particularly relating to high levels of respiratory disease and diabetes, as we have heard, resulting from poor care and accommodation, all of which make life more challenging and difficult for the carer and the cared-for. On International Women’s Day, as has been said, it is right that we underline the key role of carers, the majority of whom are women, as well as the importance of the role that women play in the communities that we are talking about.
Like other noble Lords, I am very grateful for the expert and comprehensive briefings that we have received from the Traveller movement and the FFT and for the thorough House of Lords Library research brief. They not only set out the problems and the challenges that individuals and communities face but address the myths and assumptions that lead to the health inequalities and widespread discrimination that we are discussing today. Most prominent among such misunderstandings is Gypsies’ and Travellers’ long-established roots in their local communities—yet they are so often wrongly labelled by the local community as newcomers.
I look forward to the Minister’s response on the issue of local authorities’ duty of care to Traveller communities and the Greenfields report’s call for the reinstatement of their responsibilities to provide Traveller sites where a need has been identified, an issue raised by my noble friend Lady Whitaker. Does the Minister agree that that would address one of the root causes of unauthorised sites and encampments, which will not only have an adverse and negative impact on the health and well-being of Traveller communities but stoke up local community resentment and misunderstanding and deepen community risks? The Government are not usually very fond of giving praise to the Welsh Government on health and related issues, but the application of such a duty in Wales has had very positive effects, as speakers in the debate have pointed out. Indeed, the Welsh Government’s updated 2016 delivery plan for the Gypsy and Roma community, Travelling to a Better Future, is an excellent strategic and cross-service approach to raising awareness and providing the joined-up services across health and social care and accommodation that are being called for today.
I referred earlier to the CQC report on end-of-life care support, A Different Ending. I am currently undertaking a fellowship with the Industry and Parliament Trust on the hospice and end-of-life care movement, so I was particularly concerned at the CQC findings on the huge barriers to good end-of-life care faced by Gypsy and Traveller communities. The cultural misunderstandings that we have heard about throughout this debate are often at the heart of the poor care that they experience, such as the failure by hospital services and staff to recognise the importance of extended family being able to visit a dying person while they are still alive, and as a family or a group in large numbers, not just filing in one at a time in accordance with hospital single-visitor rules. There are also negative experiences around parking caravans in hospital car parks while visiting for long periods, often met with aggression and threats to call the police, and the failure to recognise the need for the quick release and burial of the body in Traveller culture.
Case studies under Professor Greenfields’ research work on the bereavement experience of the Gypsy and Traveller communities highlight the appalling lack of appropriate psychological follow-up care provided to families, particularly in relation to post-natal bereavement or stillbirth or following on from the suicides of close relatives. By contrast, good end-of-life care experiences cited by the CQC included both hospital and hospice support for the person being able to die at home in their trailer and the welcoming of the whole family into one room on hospital or hospice facility sites. The CQC cites a project in Suffolk where hospices and Gypsy and Traveller communities work together to raise awareness of Gypsy and Traveller culture. There is much to learn here. What plans do the Government have to help to raise awareness among health and community services of the end-of-life care needs of Gypsy and Traveller communities?
No debate on the health and well-being of the Gypsy, Roma and Traveller communities can pass without reference to Rodney Bickerstaffe, the former UNISON general secretary who sadly died last year. He was president of the Labour campaign for Travellers’ rights in the 1980s and 1990s, spearheading the adoption of some key policy initiatives that were subsequently taken forward by the Labour Government in office. The most important of these was supporting the drive for more Travellers’ sites through the inclusion of Gypsy and Traveller accommodation assessment needs in regional spatial strategies, sadly later abandoned by the coalition Government. As a former employee of UNISON, I can testify to Rodney’s heartfelt and indefatigable campaigning and commitment to working to improve the lives and health of the Gypsy, Traveller and Roma communities, which he carried on through into his presidency of the National Pensioners Convention after his retirement from UNISON.
This has been an excellent debate on a crucial issue that needs urgent attention, and I look forward to the Minister’s response.
My Lords, this has been a fascinating debate, and I thank the noble Baroness, Lady Whitaker, for initiating it. It is exactly the sort of debate that we should have in this House, and I have certainly learned a lot along the journey of my briefings.
As the noble Baroness, Lady Whitaker, mentioned, Gypsy, Roma and Traveller communities are among the most disadvantaged in British society. They experience some of the poorest health in the UK, with life expectancy up to 10 to 12 years less than the general population. Some 39% of Gypsies and Travellers have long-term illnesses, compared with 29% in a comparison group. At the same time, as the noble Baroness, Lady Bakewell of Hardington Mandeville, said, they tend to be younger than the average population.
The situation is exacerbated by so many Gypsies, Roma and Travellers not being registered with GPs, as the right reverend Prelate the Bishop of Derby and other noble Lords mentioned. Poor familiarity with healthcare provisions and often language barriers may make it difficult for people to access health services. Other factors that have an influence are accommodation insecurity, the living environment, low community participation and discrimination.
So what have the Government done about it? All noble Lords talked about healthcare, and the poor health outcomes faced by Gypsies, Roma and Travellers are in many ways entrenched and difficult to resolve, but the Government have supported a number of focused developments to improve the system. The Inclusion Health programme published a number of resources from 2013 to 2016 on key issues affecting this group of people. These included guidance for services on planning and commissioning inclusive services and a report on the impact of insecure accommodation and the living environment on Gypsies’ and Travellers’ health. This was published in January 2016 and made a series of recommendations to government.
While there is still much to do, good progress has been made in the last two years in meeting some of these recommendations—for example, improved joined-up working between central government departments and between local authorities, police forces and Police and Crime Commissioners. Among other points, the National Inclusion Health Board emphasised the importance of identifying the health needs of these vulnerable communities, particularly through local joint strategic needs assessments, which could be met by the local authorities or by clinical commissioning groups; providing leadership at local level, including through joining up health and local authority interests, where public health has a pivotal role; and commissioning for inclusion, including by strengthening local arrangements and protocols to ensure services are accessible and welcoming.
Many noble Lords have mentioned good practices in that area. The noble Baroness, Lady Bakewell, mentioned a particularly interesting project going on in Suffolk and the right reverend Prelate mentioned what was going on in his area as well. There is another very good area practice taking place at the moment, in the Market Harborough medical practice in Leicestershire. Through local NHS funding arrangements and GP contract levers, it has delivered an enhanced care model for Gypsy/Traveller communities. This met the needs of people on two large Traveller sites close to the A6 motorway. The focal point, after registration of patients, was a nurse-led minor illness clinic. The medical centre takes a more relaxed position on appointments with Travellers; if they turn up without an appointment, rather than forcing them to make an appointment, staff will see them at the end of the clinic—an arrangement that works well and suits both parties, according to staff. Gypsy/Traveller engagement was costed into the design and delivery of services at this practice, which in turn built confidence with the GRT community through a named trusted professional. As the right reverend Prelate said, that is so important. They felt safe talking to a particular person, and, equally, that person was able to visit them in their communities.
The National Inclusion Health Board has produced practical advice for the professionals responsible for service design and provision. This is to support efforts to facilitate the social inclusion of these groups, notably around the lack of data, and to support local health staff to take account of the often complex needs of vulnerable groups when they are commissioning services.
The noble Baroness, Lady Whitaker, talked about registration difficulties experienced by Travellers. An Inclusion Health training guide was published in 2016. In November 2015, NHS England produced guidance for general practices to clarify the rights of patients and the responsibilities of providers in registering with a GP practice, and to facilitate better understanding about the process of registering with a GP. This guidance has now been complemented by the publication of a leaflet for members of the Gypsy, Roma and Traveller communities on how to register with a GP. I know that the right reverend Prelate the Bishop of Derby said that it was not always the answer to hand out leaflets but in this case the leaflet was co-produced in March 2017 by the Gypsy, Roma and Traveller communities for them to hand out within their own communities.
On accommodation and planning, the noble Baroness, Lady Whitaker, talked about the problems with roadside sites, as did the noble Baronesses, Lady Wheeler and Lady Bakewell of Hardington Mandeville, and the noble Lord, Lord Judd. The Government are committed to reducing the number of unauthorised sites by ensuring that local planning authorities plan and make provision for affordable, good-quality accommodation for Travellers, while recognising their distinct cultural lifestyle. Local authorities are best placed to make decisions about the number and location of such sites locally, having had due regard to national policy and local circumstances. However, a proposal has been made to implement more widely the negotiated stopping policy which is currently operational in Leeds and seems to be working very well. This allows unauthorised encampments that do not cause trouble to stay for a fixed period of time. The authority works with the unauthorised encampments and the local settled community to set out ground rules on noise, fly-tipping or on issues that some people in rural communities have experienced with unsettled communities such as problems with their dogs. The encampment is tolerated for a short period of time. This policy has also been found to increase community cohesion. Leeds has estimated that it has saved it £240,000 a year.
We expect that local authorities should identify a five-year—ideally a 15-year—supply of deliverable and developable sites for Travellers against locally set targets. This should be annually updated. As my right honourable friend the Secretary of State for Housing, Communities and Local Government said in a speech earlier this week, for the first time all local authorities will be expected to assess housing need using the same methodology, which will be a big improvement on the current situation.
Many noble Lords talked about educational problems. We have invested £137 million in the Education Endowment Foundation to identify what works to raise disadvantaged pupils’ attainment and to communicate this to schools. Between 2012 and 2014 the Department for Education funded two local authorities to trial a virtual head teacher for Gypsy, Roma and Traveller pupils, with responsibility for supporting schools to promote better pupil outcomes. The effective practice identified was disseminated to every local authority in 2017. In 2017, the Department for Education held a conference for local authority Gypsy, Roma and Traveller leads to identify and disseminate best practice in this area. The Department for Education has produced good practice case studies for schools working with Gypsy, Roma and Traveller pupils, and Ofsted has released a report specifically on the education of Roma pupils, which has recommendations for schools and local authorities.
What are the Government doing now? The noble Baronesses, Lady Wheeler and Lady Bakewell of Hardington Mandeville, and other noble Lords mentioned joined-up thinking. The Ministry for Housing, Communities and Local Government maintains close contact with Gypsy, Roma and Traveller stakeholder groups, while the Department for Education has established a Gypsy, Roma, Traveller stakeholder group. The DHSC, the Department for Education and the MHCLG—I hate acronyms—held a trilateral ministerial meeting to discuss Gypsy, Roma and Traveller issues in November 2017, and we plan to continue holding regular cross-government meetings.
The noble Baroness, Lady Whitaker, asked about the NHS data dictionary and how we will cope with it. We are scoping out with NHS England and NHS Digital the development of a unified information standard. This would mean that, if were possible for the NHS data dictionary to identify Gypsy, Roma and Traveller communities as separate groups for the first time, the dictionary would set out standards for data collection in the NHS. If that standard was implemented, we would fully understand the extent of the inequalities experienced by Gypsy, Roma and Traveller communities by making it easier to determine their health outcomes and uptake of health services. It is in the scoping process; until that is done, it has not been decided how we will view the housing status of this group. We also have the added possibility of taking it from the 2011 census, which we obviously have at the moment, or waiting for the 2021 census to get a proper update of what is going on.
The Ministry of Housing, Communities and Local Government, working with the Department of Health and Social Care and the Department for Education, is funding up to six community-led pilot groups. These projects will improve educational attainment, health, and social integration for Gypsy, Roma and Traveller communities and will be delivered in 2018-19. These projects will be reported quarterly and there will be a full report at the end of the year. The Department of Health and Social Care has commissioned research to investigate which approaches to community engagement are most likely to be effective at enhancing trust between Gypsy/Travellers and mainstream health services. This project is due to report back in 2018.
I again thank the noble Baroness, Lady Whitaker, for bringing forward the debate and all noble Lords for taking part. We all need to work with this community to enable it to have good healthcare, good education—particularly as far as girls and women are concerned—and the availability to keep their culture, which they should be able to celebrate and which has been honed over several centuries. As always, I will write to any noble Lords whose questions I have failed to answer and, as always, I seem to have run out of time. I thank noble Lords again for having taken part.
To ask Her Majesty’s Government what assessment they have made of the risks of antimicrobial resistance.
My Lords, I declare an interest as the CEO of the International Longevity Centre-UK, which has done quite a lot of work on the issues that we are discussing. Antimicrobial resistance poses an unprecedented threat to human health. As bacteria become resistant to antibiotics, even minor infections have the potential to become serious and indeed fatal. The rise of drug-resistant infections is estimated to account for around 700,000 deaths per year worldwide, with 50,000 of those deaths occurring within Europe and the United States.
I am sure that noble Lords will be familiar with the review of the noble Lord, Lord O’Neill, on antimicrobial resistance, published in 2016, which projected that by 2050 global mortalities due to this could reach 10 million a year and cost the global economy £66 trillion in lost productivity. The Chief Medical Officer, Dame Sally Davies, has also shared her concerns that the recent era of material mortality improvement will give way to many years of material mortality worsening if drug-resistant infections continue to develop at current rates. Willis Towers Watson’s head of mortality and longevity has calculated that a “plausible” worst-case scenario for the development of antimicrobial resistance will,
“largely zeroise or even negate”,
the longevity improvements made since the mid-20th century.
Fortunately, there have been some developments in the global effort to reduce the spread of AMR. The Access to Medicine Foundation’s 2018 Antimicrobial Resistance Benchmark report found that nine life sciences companies are active in antimicrobial resistance surveillance programmes covering 147 countries between them. There are also currently 28 antibiotics for high-priority pathogens in late-stage development. However, in other areas there is cause for concern as progress seems to have stalled.
A freedom of information request issued to Public Health England in 2017 found that prescriptions of colistin, the last line of defence in antibiotic treatment, rose by 40% between 2014 and 2015, from 346,000 doses to 485,000. Antimicrobial resistance was common in the more than 1 million urinary tract infections caused by bacteria identified in NHS laboratories in 2016. Some progress was observed in reducing rates of prescribing in secondary care in 2015, but there has not been a sustained reduction in total antibiotic prescribing in this care setting. While antibiotic prescribing reduced by 5% overall between 2012 and 2016, when measured as defined daily doses per 1,000 inhabitants per day, significant regional variation in antibiotic use continues to occur.
Unfortunately, there is also significant regional variation in the uptake of a crucial means of preventing the spread of antimicrobial resistance—I am talking about vaccination. The review by the noble Lord, Lord O’Neill, noted that vaccine programmes can reduce antibiotic consumption by preventing secondary infections and that, in addition, they often save society more than 10 times their original cost by protecting against vaccine-preventable diseases.
A study conducted jointly by the Department of Health and Social Care, the Norwegian Institute of Public Health and the South African directorate of health estimated that universal coverage with pneumococcal conjugate vaccine could avert up to 11.4 million days of antibiotic therapy annually worldwide in children younger than five years of age. A separate study published in the Journal of Clinical Infectious Diseases and Practice found that the introduction of a universal influenza immunisation programme for everyone aged six months and over in Ontario in the year 2000 resulted in a 64% decrease in influenza-associated respiratory disease antibiotic prescriptions relative to other regions.
However, despite the demonstrable impact of vaccination on antibiotic prescription, there is significant regional variation in immunisation uptake rates. Uptake targets set by the Department of Health and Social Care are sadly being missed. Between September and December 2017 flu vaccine uptake among GP patients aged 65 and over varied from a high of 74% in Greater Manchester to only 64.9% in London. Between September 2016 and August 2017 shingles vaccine coverage in the routine cohort—those aged 70—declined 13.5% since the start of the programme to 48.3%. I can speak personally about that vaccine. With shingles about to descend into my eye, it was so quick in getting rid of it. It was extraordinary and I am very wedded to this.
The coverage rate for the infant pneumococcal vaccination programme is now sadly below the 95% national target adopted by the Department of Health and Social Care. Given that the coverage level in the UK is already falling, it is worrying that the Government might deprioritise pneumococcal immunisation following a recent proposal to remove a dose of the vaccine from the infant pneumococcal immunisation programme. This advice has recently been consulted on, so it is to be hoped that in the interests of public health, the Government will consider the views of stakeholders closely, including the potential impact of a reduced schedule on antimicrobial resistance before making any policy decisions. The Government could also consider how they can ensure that the NHS benefits from future vaccines targeted at preventing hospital-acquired infections such as MRSA and C. difficile, which are of particular relevance to AMR. The Government should consider how tackling AMR can be incorporated into decision-making processes about the introduction of vaccination programmes.
Finally, given that the Civil Contingencies Secretariat 2017 national risk register categorises antimicrobial resistance and climate change as long-term trends that pose severe risks to the UK, I would urge that each of us should approach the problem of antimicrobial resistance with the same urgency and vigour as the threat posed by climate change.
My Lords, I congratulate the noble Baroness on securing this debate on the risks of antimicrobial resistance, or AMR. Although it is last on the list of the short debates this afternoon, this debate follows quite nicely on from the debate we had on 22 November last year when we discussed the same sort of problems. The standard of wound care was the main subject then.
The global threat of AMR, in both human and economic cost, has been well documented. I will not repeat the statistics of the grave consequences that are predicted if we do not act. I shall have to read what the noble Baroness said. It sounded terribly complex, but I will catch up with it tomorrow.
As noble Lords will know from past debates, I have been a champion of research and development to create new treatments so that we can get ahead of the superbugs. I have been greatly impressed by the work of Matoke Holdings. This small British biotech firm has pioneered reactive oxygen technology, a novel antimicrobial, initially as a treatment for serious infected wounds. This could be ground-breaking in tackling antimicrobial resistance. I do not have any financial interest to declare, but I have an interest in that my younger brother recently lost a leg from MRSA and the remaining leg was successfully treated with reactive oxygen technology. Professor Davies has warned in the past of apocalyptic consequences if antibiotics stop working. Overuse of antibiotics is speeding up the rate at which bacteria evolve, making common infections much more difficult to treat. With a lack of significant investment in antimicrobial R&D from big pharma companies, it falls to small and medium-sized enterprises, such as Matoke, to put in the leg work to develop new products to meet the global AMR challenge. However, for SMEs in particular, the cost and timescale of the R&D process is a significant challenge.
I was pleased to see in the Government’s response to the Accelerated Access Review at the end of last year the announcement of a new accelerated access pathway to support R&D for the most innovative products. The pathway will designate around five breakthrough products a year, which will receive bespoke support from government to take new innovations from lab bench to bedside. Given that there have been no new antibiotics in the past 30 years, the pathway is an excellent opportunity to speed up the development of new antimicrobials and to get ahead of the AMR threat. Will the Minister confirm whether the pathway will prioritise novel antimicrobials when allocating breakthrough product status? Will the Minister join me in meeting Matoke to get a first-hand account of the challenges faced by SMEs on the front line of the struggle against AMR?
My Lords, I, too, thank the noble Baroness, Lady Greengross, for securing this extremely important and timely debate. I begin by declaring an interest as vice-chair of the APPG on Global Tuberculosis, and I refer noble Lords to my interests as set out in the register and my work with the Global TB Caucus. I will, perhaps not surprisingly, concentrate my remarks this afternoon on tuberculosis and multidrug-resistant TB.
The review on AMR by the noble Lord, Lord O’Neill, estimated that one-third of all AMR-associated deaths are currently caused by drug-resistant TB. In 2016, an estimated 600,000 people developed drug-resistant TB. While rates are going down gradually, drug-resistant TB rates continue to rise in some parts of the world. This situation is particularly true in Europe, which has seen the fastest growing rates of multidrug-resistant TB of any world region. Although it has the lowest TB incidence, it has the highest rates of MDR TB. Of the almost 300,000 cases of TB in Europe last year, more than 120,000 were drug-resistant. I should say at this point that this is the European region as defined by the World Health Organization, which includes the central Asian countries of the former Soviet Union. In other words, well over one-third of all TB cases in Europe last year were drug-resistant.
Of the 30 countries identified as having the highest rates of drug-resistant TB, nine are in the European region and the countries of the former Soviet Union. The reasons for the particularly high levels of TB and MDR TB in the countries of the former Soviet Union are complex: steep economic decline and the sharp rise in poverty in the 1990s, when the Soviet Union collapsed; the disintegration of the Soviet healthcare system; an HIV epidemic; very high prison populations and dilapidated prison facilities; and the excessive hospitalisation of patients who are no longer infectious as they have been taking their medication. In addition, since independence, many of these countries have seen significant deregulation of pharmaceutical provision and the ready availability of antibiotics to buy in privatised kiosks, often without a doctor’s prescription, throughout the cities of the former Soviet Union. In some countries, there are also difficulties in securing newer drugs available to treat MDR TB, from which patients could greatly benefit.
With the Global TB Caucus I have been visiting many of these countries over the past 18 months to try to raise awareness of multidrug-resistant TB and its causes among parliamentarians in the countries of the former Soviet Union, to encourage them to set up parliamentary groups like APPGs in their own Parliaments and to work with civil society organisations and their health ministries to take action against drug-resistant forms of TB. Clearly, the APPG in this department has very similar aims.
The noble Lord, Lord O’Neill, in his review of AMR, recommended as a first intervention that there should be a global public awareness campaign. Will the Minister say how successful he thinks this public awareness campaign has been up until now, and what further measures the Government intend to take to achieve this goal? Drug-resistant strains of TB are more expensive to treat because of the cost of medicines, the length of treatment and the amount of additional support required by each patient to manage side effects. I have spoken to many patients with drug-resistant TB in Ukraine and central Asian countries, as well as here in the UK, and they have told me of the difficulties of swallowing up to 20 pills a day, along with painful injections and the side effects to their mental and physical health of having to cope with such a harsh regimen, often for a period of 18 months or more. Considerable support networks are required to ensure that patients continue with their treatment and, clearly, not continuing with the treatment adds to the risk of developing a form of TB which is even more drug-resistant.
There have been relatively few advances in finding new treatments which work more effectively and more quickly against drug-resistant TB, which leads me to my second question to the Minister. What measures do the Government intend to take to incentivise the production of new and more effective antibiotics for TB, and multidrug-resistant TB in particular? The Global TB Caucus estimates that $1 trillion will be lost to the global economy between 2015 and 2030 if no major steps are taken. Increases in rates of MDR TB can put a massive strain on healthcare systems and national economies. KPMG predicts that Europe could be due to lose nearly 0.02% of its economy between 2015 and 2050 due to MDR TB alone should urgent action not be taken.
In autumn this year the United Nations will hold a high-level meeting on TB. This represents a significant opportunity to adopt a concerted international effort to tackle multidrug-resistant TB. Will the Minister say what preparations the Government are currently making to prepare for this high-level meeting?
I will end with a quote from the review by the noble Lord, Lord O’Neill:
“The burden of TB is too great, and the need for new treatments too urgent, for it not to be a central consideration in the role and objectives of a global intervention to support antibiotic development”.
My Lords, I thank my noble friend Lady Greengross for securing this short debate. It may be short but it is of tremendous importance globally. AMR is widely recognised as the biggest threat we face.
Many years ago I was the first person in your Lordships’ House to have a debate on MRSA, after the late Lord Gerry Fitt’s wife died from MRSA in the Chelsea and Westminster Hospital. After that, along with a group from the Science and Technology Select Committee, I went to America to look at the problems around antimicrobials and infection. One of our recommendations was that there should be quick tests for infections so that the correct antibiotic can be prescribed. This is now happening in some places, and that is good news.
The famous physician, Sir William Osler, who is sometimes described as the father of modern medicine, said in 1892 that there are three phases to treatment: diagnosis, diagnosis and diagnosis. In modern times, diagnostics are vital to guiding clinical decision-making, determining whether a patient should be treated with antibiotics, and if so, which ones will be effective.
Sepsis is a bigger killer in the UK than bowel, breast and prostate cancer combined. With the increasing challenges of antimicrobial resistance, it is more important than ever for hospitals to diagnose accurately and rapidly so that patients with sepsis can be treated. The lack of consistency across UK hospitals in their diagnosis of sepsis has been highlighted. Research has found that 56% of hospitals are using only one set of blood cultures where sepsis is suspected rather than the recommended two sets. This leads to much less chance of the successful identification of the bacterium involved.
World Tuberculosis Day is approaching, so I thought it appropriate to remind your Lordships that TB remains the world’s deadliest infectious disease, with 10.4 million people infected and 1.7 million dying from the disease in 2016. In his review on AMR, the noble Lord, Lord O’Neill, estimated that around a third of all AMR-associated deaths are caused by drug-resistant TB. The UK itself struggles with TB and has been known as the drug-resistant capital of northern Europe. I join with the noble Baroness, Lady Suttie, in her remarks on this very important subject.
Until recently, doctors relied on the microscope to identify TB and it took months of growing cultures in laboratories to determine if the strain of TB was drug resistant. However, things have changed for the better with the production of the GeneXpert TB testing machine, which can analysis DNA. The test can identify whether someone has TB and can detect whether there is resistance to one of the main TB drugs, rifampicin. The UK Government have been central to advancing this technology by making a significant investment in it through the Ross Fund. Scientists and policymakers are working to improve this diagnostic tool and ensure that it is used as widely as possible.
The availability of a rapid diagnostic test is vital to fighting AMR and will ensure that those who need antibiotic treatment urgently receive it. It will also ensure that antibiotic drugs are not misused or prescribed inappropriately, thus driving further drug resistance. This is also important to animal health and farming. Exciting research in this field is going on around the world and certain new technologies are now able to determine antimicrobial resistance in as little as 30 minutes. We must invest to drive forward the research and development that will protect patients and the public.
Concern has been expressed about outbreaks of multiresistant hospital bacteria among newborns in hospitals, including in neonatal intensive care and special care baby units. Controlling MRSA has been improved due to hard work, but in high dependency care units where patients are more vulnerable to drug-resistant infections, the risks are great. Is anything being done to systematically collect the data, identify improvements that can be made and fund the emerging diagnostic and monitoring technologies that enable a rapid infection control response?
Another problem that needs addressing is the epidemic of Clostridium difficile-associated diarrhoea in hospital patients, largely attributable to antibiotic overuse. Good work is being done, but it is translation into practice that seems all too slow.
Finally, does the Minister agree that the European Vaccine Action Plan is of great importance? With more and more infections becoming immune to antibiotics, it is vital to prevent conditions such as gonorrhoea, which is resistant to antibiotics and needs a vaccine, as do norovirus, Clostridium difficile, HIV and many others, and a better vaccine is needed for TB. That would make the world a safer place for everyone.
My Lords, I add my thanks to the noble Baroness, Lady Greengross, for introducing this debate on such an important matter.
The seriousness of this issue was stated starkly by the Chief Medical Officer, Professor Dame Sally Davies, who said that if we do not act, it is possible that we will return to 40% of the population dying prematurely from infections that we cannot treat. The sad fact is that overuse and misuse of antibiotics and other antimicrobials in humans, animals, including farmed fish, and crops have been major contributors to an acceleration in the emergence of drug-resistant strains of bacteria, viruses, parasites and fungi. The noble Baroness, Lady Masham, referred very powerfully to the role that better diagnostics can play in enabling us to use antimicrobials with circumspection. I concur with her completely.
When the review on AMR, led by the noble Lord, Lord O’Neill, was published in May 2016, it generated a much-needed urgent focus on the issue, leading to a commitment to act by world leaders at the high-level meeting of the UN General Assembly on AMR in September 2016. Countries reaffirmed their commitment to develop national action plans on AMR, building on the blueprint developed in 2015 by the World Health Organization, the FAO and the World Organisation for Animal Health.
The fact is that common and life-threatening infections such as pneumonia and gonorrhoea, and post-operative infections, as well as HIV, TB and malaria, are increasingly becoming untreatable. Very worrying is the fact that cases of completely untreatable gonorrhoea have been recorded in the last year in developed countries.
I shall concentrate the rest of my remarks on international development, which is the brief on which I speak for my party, the Liberal Democrats. TB is a disease that kills 1.8 million people a year. My noble friend Lady Suttie has already spoken passionately about the rise of multidrug-resistant TB globally. Last August I was in Liberia and, courtesy of RESULTS UK, I visited a clinic where patients with multidrug-resistant TB were being treated. As my noble friend Lady Suttie said, the treatment is complex, very costly and toxic. It can last from six to 30 months and can consist of more than 14,000 pills and daily injections for six months. What was clear to me was that the patients I met were the lucky ones and that many more in the community potentially carried MDR-TB because the resources to carry out comprehensive tracing were just not there.
What is urgently needed is a vaccine for TB. Prevention would obviate the need for treatment with antibiotics and give us a chance to eradicate the disease. However, the development of vaccines is a lengthy process, so recent progress is at risk unless vital investment is provided with a long-term commitment to give developers—in particular, product development partnerships—the confidence to plan for the future with certainty. I fully echo the words of the noble Lord, Lord Colwyn, on that. The UN high-level meeting on TB this September offers a rare chance to turn the tide against TB and I hope the Government will take the opportunity to drive the vaccine agenda forward.
Malaria is another long-time scourge of the developing world and now the problem is compounded by the discovery of drug-resistant mosquitoes in Myanmar, Thailand, Lao PDR, Vietnam and Cambodia. I draw the Minister’s attention to the extremely dangerous situation that exists in the Rohingya camps in Bangladesh, as identified by the Malaria Consortium—I declare that I am a trustee of that organisation. The monsoon rains are due next month and these, coupled with the combination of poor sanitation and emergency, substandard housing, will provide perfect breeding conditions for malaria-transmitting mosquitoes. The danger to the refugees is obvious, but what also needs to be considered in the mix is that the refugees have come from Myanmar, where malaria resistant to artemisinin-based antimalarials has been detected, including in the nearby Sagaing region. The native population of Cox’s Bazar in Bangladesh is highly vulnerable to malaria because the people have not been exposed to the disease recently. We can see the dangers inherent in that situation. We cannot risk the further spread of drug-resistant malaria and I ask the Minister to relay these concerns as a matter of urgency to the appropriate personnel. DfID is well placed to take action as a world leader in the fight against malaria and is already in place, combating diphtheria and cholera in the camps.
Prevention is always better and cheaper than cure. In its March 2016 report on limiting the spread of drug resistance, the AMR Review Board estimated that improved water and sanitation in middle-income countries could reduce the volume of antibiotics used to treat diarrhoea by at least 60%. We need to apply common sense and ensure that good housekeeping takes precedence over popping a pill. The availability of antimicrobials is shifting action away from prevention and the good practice of investing in basic sanitation infrastructure.
Previous speakers have spoken about market failures. We see that investment in developing new antibiotics has gone into reverse. We need new ways of stimulating innovation and to do that we must find a way to delink the cost of research and development from the price and volume of sales. How will the Government ensure that new antibiotics and other innovations are affordable to the NHS and health systems around the world? In the same vein, will the Minister comment on the progress of the UK and China Global AMR Research Innovation Fund?
To conclude, considering that we are in a global space where it is easy to spread AMR infections through trade and travel, and that resistance has been observed in terrestrial and aquatic environments, where wind and currents take them out of our control, we begin to see the scale of the problem we face. The fact is that we know what we have to do. Political will and leadership is what is needed now.
My Lords, it is a great pleasure to wind up for the Opposition and thank the noble Baroness, Lady Greengross, for an excellent contribution, which other noble Lords added to. I want to raise two issues. One is about the use of antibiotics in animals and the other is about incentives for developing new drugs and vaccines. First, I refer to the wide-ranging speech of the noble Baroness, Lady Greengross, in which she referred to immunisation uptake, which is a very worrying issue for health in this country, let alone in other countries. I have seen various reports that there is ever more misinformation out there undermining people’s confidence in vaccines. We saw with the MMR issue the problems arising when this gains ground. Is the Department of Health and Social Care exercised about this and is it developing a strategy?
On the use of antibiotics in animals, I know that the Government made a progress report in 2016, commented on this and particularly referred to compliance with Red Tractor assurance scheme standards and to the work of the task force Responsible Use of Medicines in Agriculture Alliance. My noble friend Lord Grantchester, to whom I have referred on this, has made the point to me that, alongside this and influenced by various suppliers, farm assurance schemes are having a positive impact in reducing the use of antibiotics in animals. Will the Minister comment on this and give a progress report in that area?
On how better incentives can be used to promote investment in new drugs and vaccines, the report by the noble Lord, Lord O’Neill, was very clear that the current pipeline of new antibiotics shows that there is a mismatch between the drugs that the world needs and the number and quality of new antibiotics that are being researched. He recommended,
“a global system of market entry rewards for antibiotics and alternative therapies”.
He suggested that the challenge really is,
“to ‘de-link’ the profitability of an antibiotic from volumes sold, reducing uncertainty and enabling reward without encouraging poor stewardship”.
This arises from the fact that it is very difficult in the current model for the industry to see how it can get any return on the development of new antibiotics, and because of that, we have this very big problem.
I know that the Government have acknowledged the principle of de-linking, particularly in their endorsement of the 26th UN declaration on AMR but, just to reflect on the problem, STOPAIDS, which is a UK network of agencies which have developed a global response to HIV and AIDS, set out the de-linking issue, stating that the incentive to innovate is still tied to the price that pharma companies can charge for the products they create and therefore there is still a risk of continuing this problem of high price. The ABPI, the trade association for the pharma industry, is continuing to work with the noble Lord’s department on this to explore reimbursement and evaluation models, which could perhaps be piloted in the UK, but I wonder whether the noble Minister can say a little bit more about whether progress is being made.
I refer noble Lords to a recent—2018—report by the Access to Medicine Foundation, which is an international NGO based in the Netherlands. Very recently it produced an anti-microbial resistance benchmark. The report states that despite some progress being made by some companies, there are still too few in the pipeline and we need to strengthen that pipeline. I wonder whether there are other actions that now need to be taken to provide the right incentives.
My Lords, I first thank the noble Baroness, Lady Greengross, and congratulate her on securing this debate on an incredibly important topic, which definitely performs above the graveyard slot it has been given on a Thursday afternoon. It has been a very useful and informative debate, and a good opportunity for us all to reflect on an important—indeed, vital—area of medicine and health, not least because it highlights the potential risks we face as humankind in dealing with this issue, but also to set out some of the things that are being done to deal with it. It is also worth our taking the opportunity to thank my noble friend Lord O’Neill, who is not here. In so many ways, the work that he has done has set the tone for the work that we are all doing together now. I will not rehearse the risks that have been set out very clearly by others, but I think a word the noble Baroness, Lady Greengross, used was “unprecedented”, which is the scale of what we face if we do not get this right.
I thought it would be useful to rehearse a little of the action that the Government have been taking over the last few years—if nothing else, to emphasise the seriousness with which we take the issue. Noble Lords will know that the Chief Medical Officer used her annual report in 2013 to highlight the risk of antimicrobial resistance. Later that year, a five-year antimicrobial resistance strategy across human and animal health was published. Following that, my noble friend Lord O’Neill was asked to forward a globally facing independent review, which was published in 2016. That report produced the truly alarming figure we have heard of 10 million extra deaths a year, with a potential economic impact of $100 trillion. A very powerful point was made by the noble Baroness, Lady Suttie, namely that up to one-third of those statistics is driven by drug-resistant TB. I did not realise that until she said so. It is truly alarming, hence the focus on TB in this debate. AMR was also added to the national security risk assessment in 2015 as a tier 1 risk for our country: that is how important it is.
As for what the UK’s strategy includes, we have an acronym of the three Ps: prevent infection occurring in the first place; protect the antibiotics we have through good antimicrobial stewardship; and promote the development of new drugs, which, as noble Lords have said, is incredibly important.
On prevention, the noble Baroness, Lady Greengross, mentioned urinary tract infections. They are a huge driver of both the use of antibiotics and the development of antimicrobial resistance. There are very interesting, and very simple, things going on such as the good use of catheters, which can have a profound effect both on infection occurring in the first place and the knock-on impact on the benefit of the antibiotics that we still have now. All this work is underpinned by our world-leading R&D base in this country.
The Government’s response to the review by the noble Lord, Lord O’Neill, set out new ambitions, including halving healthcare-associated gram-negative bloodstream infections and inappropriate antibiotic prescribing by 2021. We welcomed the emphasis in the review on the use of diagnostic tests, which was brought to the fore by the noble Baroness, Lady Masham, in her speech.
I do not know whether noble Lords had a chance to see it, but only last week Public Health England published details of the modelling work it has done to look at inappropriate prescribing. The work found that, using a conservative approach, around 20% of current antibiotic prescribing is inappropriate, and therefore the ambition should be to reduce that by 10% from a 2016 baseline. Between 2012 and 2016, we had already reduced our use of antibiotics by 5%. Clearly, though, to some extent that was the low-hanging fruit, and now we need to take on the more difficult areas. In doing so—I think back to debates we have had about wound care and sepsis—we must never forget that these drugs are vital. Although we want to reduce inappropriate prescriptions, we also have to make sure that people who need them are not being restricted access to them. It is not just about gram-negative bloodstream infections but other health-acquired infections. I was sorry to hear the story of my noble friend Lord Colwyn’s brother. That shows the horrible impact that can happen.
I have talked mainly about humans but, as other noble Lords have pointed out, we also need to set an ambition to reduce antibiotic use in livestock and fish farmed for food. The good news is that we have met our ambition two years early: sales of antibiotics for use in food-producing animals dropped by 27%. In answer to the noble Lord, Lord Hunt, that is good progress. Perhaps it is an answer to the noble Baroness, Lady Suttie, about whether awareness campaigns work: it is evidence that they do. New sector-specific targets were published in October 2017 and we will be reporting against them in the months to come.
As all noble Lords pointed out, AMR is ultimately a global issue. This Government helped to secure the UN declaration on AMR in September 2016. We are committed to working not just with the global health community but with the finance community to create a system that rewards companies that develop new, successful antibiotics and, critically, make them available to all who need them.
Noble Lords will, I hope, know that the UK has been a leading advocate at the G20 for the piloting and rollout of global solutions that incentivise new antibiotic development. We continue to promote the need for global action. Noble Lords will also be aware that our Chief Medical Officer is a driving force in these efforts; she really is a wonderful and zealous advocate of this agenda. They will also know that she is totally unbending in her desire to keep this at the top of the global agenda.
AMR is embedded in all relevant strategies, particularly the sustainable development goals agenda. I also want to point out that the UK has helped to create the Fleming Fund, which is a £265 million commitment over five years, as a development project dedicated to AMR globally. It focuses on increasing capacity and capability for diagnosis and surveillance of AMR in low and middle-income countries. The noble Baroness, Lady Sheehan, made a very important point that the people who are most likely to suffer from the consequences of AMR, although spread across the world, are focused on those communities that are likely to be the poorest.
Noble Lords have asked about that incentivisation and pulling through the new drugs. There is the £50 million Global AMR Innovation Fund, which looks to develop neglected areas. The noble Baroness, Lady Sheehan, asked about China; a new partnership is soon to be launched on that although I do not have details now. When I do, I will certainly write to her. In the UK, we are channelling investment through the National Institute for Health Research, Research Councils, Innovate UK and so on to attract high-quality research proposals. As the noble Baroness, Lady Greengross, said, there is some cause for cautious optimism on drug development in this area. Not only do we need to get the drugs developed but we need to find ways to pull them through. My noble friend Lord Colwyn talked about the accelerated access pathway; that could be one route by which these drugs come through.
I want to spend a little time talking about vaccination, because it has been mentioned by all noble Lords. I absolutely agree that it is an important part of reducing the need for antimicrobials and a key weapon in slowing down antimicrobial resistance. We have a world-class vaccination service that reduces the overall burden of disease in this country. Uptake is among the best in the world: about 90% of the population get childhood vaccines, for example. However, it is fair to say that we need to do better, not only in making sure—in this era of fake news—that rumours and false information about the dangers from vaccines are firmly rebutted, but in using every opportunity and channel we have to promote the uptake of vaccines in families and other groups. That is something that the health family, as we sometimes describe it, is working on, to better understand local variation; there is huge variation from area to area, as pointed out by the noble Baroness, Lady Greengross.
It is worth saying that, from an R&D perspective, we have a great strength in this country in the development of vaccines. It was a major focus of the life sciences industrial strategy. Research Councils have just invested just over £9 million in five new vaccine networks, and the Government have invested £100 million in focusing on vaccines of epidemic potential. A lot is being done but, as noble Lords have pointed out, the task is growing because antimicrobial resistance is growing.
Specifically on pneumococcal immunisation, our expert group—the Joint Committee on Immunisation and Vaccination, as noble Lords will know—has been consulting on its advice on the number of doses. It would not be appropriate for me to pre-empt that decision at this stage. My honourable friend in the other place, the Minister for Public Health and Primary Care, will, of course, give its advice due consideration, but I will pass on the concerns that have been expressed in this debate about that, so that they understand—as we do—that there is deep concern about any dilution of our vaccination programme.
I want to quickly deal with the issues I have not dealt with. My noble friend Lord Colwyn asked whether the AAP will focus on antimicrobials. It will suggest a new suite of products in April. I have tried to leave the expert group to it; it will come to us, but that is certainly a route forward, and I would be happy to meet with the company that he mentioned to talk about its work.
The noble Baroness, Lady Suttie, asked about the UN high-level meeting, which marks an important moment to secure a political commitment to TB control. She will be pleased to know that the Government are engaging closely with the WHO and taking a lead on that. There is some benefit coming from raising awareness, but clearly there is more to do to ensure that the UK is fully engaged. On the development of new anti-TB drugs, DfID is contributing to the Global Alliance for TB Drug Development, which I hope is to some extent a reassurance that we are playing our part.
I should congratulate the noble Baroness, Lady Masham, who is a woman of many firsts. She led the first debate on the issue of MRSA in the House. We have made some really good progress on controlling MRSA and C.diff in hospitals but, of course, that is the only part of controlling infection. We are making some progress and better diagnostic techniques now exist. She also asked about the diagnosis of TB. I made a fascinating visit to a Find & Treat service in Camden which was doing on-street work. Unfortunately, it is one of only a few services of this kind, and we certainly need to do more of that sort of work.
Finally, the noble Baroness, Lady Sheehan, asked about the Rohingya community. I am not familiar with those issues, but I shall certainly take her concerns to DfID and I understand the seriousness of them.
The final and very major point to make is to ask how we break the link between price and the cost of drug development, which was raised by the noble Lord, Lord Hunt, and the noble Baroness, Lady Sheehan. The truth is that this is not an issue that faces drug development in this area alone; it concerns drug development in every area, as drugs and medicine become more stratified. The answer lies in partnership but, to be honest, we do not yet have the model for doing that. However, we are developing it, and we have a good relationship with industry to help us to do that.
In conclusion, once again I thank the noble Baroness for initiating this fantastic debate and all noble Lords for their contributions. I think that we are making good progress, but there is a long way to go. The lodestar here is Sweden, which has succeeded in reducing antibiotic use by 40%, although it has taken the country 20 years to do that. We are a few years down the track in the process, and I hope that we can learn from Sweden and others to accelerate our progress. I finish by wishing to make sure that noble Lords understand that keeping antibiotics working lies at the heart of the Government’s strategy, and our job is to keep the issue at the forefront of everyone’s mind.
Thursday 8 March 2018
Private Sector Pension Funds
Question for Short Debate
Question for Short Debate
Question for Short Debate
Gypsy, Traveller and Roma Communities
Question for Short Debate
Question for Short Debate
Committee adjourned at 5.52 pm.