House of Lords
Thursday 22 July 2021
The House met in a hybrid proceeding.
Prayers—read by the Lord Bishop of Lincoln.
Oaths and Affirmations
Lord Harlech took the oath, following the by-election under Standing Order 9, and signed an undertaking to abide by the Code of Conduct.
Arrangement of Business
My Lords, the Hybrid Sitting of the House will now begin. Some Members are here in the Chamber, while others are participating remotely, but all Members will be treated equally. The social distancing requirements in the Chamber have been removed, but I strongly encourage Members to continue to wear face coverings while in the Chamber, except when speaking, and to respect social distancing in relation to staff in the Chamber.
Oral Questions will now commence. I ask those asking supplementary questions to keep them no longer than 30 seconds and confined to two points. I ask that Ministers’ answers are also brief.
National Insurance Numbers: Electoral Register
My Lords, Cabinet Office officials have continued to work with colleagues in HMRC on the inclusion of additional information on registering to vote in letters issuing national insurance numbers. I am assured that this change will be implemented by HMRC shortly—at the very latest, in October.
My Lords, I am delighted if progress is being made, but I remind the Minister that, on 8 October last year, the House voted overwhelmingly for the Government to consider further action to get more young people registered to vote. On 26 November last year, he said that this was happening, but it has taken eight months since then. Why has it taken so long for the Government to consider adding perhaps a dozen words to a form in order to encourage more young people to register to vote?
My Lords, the Government are committed to making registration as easy as possible, and we encourage everyone eligible to register to do so. I stand by those earlier statements. Due to internal processes, there have been delays in implementing the changes to the letter. There are HMRC processes in place to implement change that involve HMRC’s IT partners, but I repeat that HMRC has assured us that this matter will be implemented by October.
We read that the Government are so keen to encourage young adults to vaccinate that we are all to be threatened with domestic Covid ID. Can the Minister confirm that they are just as keen to encourage young people to vote? If that is the case, will the Government explore automatically registering them for the electoral register at the moment when an NI number is issued?
My Lords, the Government do not support automatic registration, but we certainly wish to see everyone register and exercise the right to vote, for which so many people have made sacrifices for so long. Our Register to Vote website is used by many young people, with almost 10.8 million online applications having been submitted by 16 to 24 year-olds since the service was introduced. I remind noble Lords that the number of people who have voted in recent elections has continued to grow, and that is hugely welcome.
My Lords, the Select Committee on the Electoral Registration and Administration Act 2013, which was excellently chaired by my noble friend and much missed colleague, the late Lord Shutt of Greetland, called for the piloting of automatic registration for attainers. Further to his previous answer, would the Minister consider having such a pilot? Does he further acknowledge that removing barriers to registration would be a positive step forward in encouraging more young people to vote?
My Lords, we have spoken often about the great service of the late Lord Shutt. We are determined to see people exercise their right to vote, but there are numerous important practical reasons to oppose automatic registration, and that is the position of the Government. Automatic registration would likely require a single national electoral register and/or a centralised database, and the Government have no plans to move in that direction.
My Lords, I welcome the comments made by the Minister a few moments ago. I regard this as a substantial step forward in encouraging participation by attainers in elections, and it should be greeted as such. Progress can be made in encouraging people to vote and to register, and, like him, I do not believe in forced registration.
I thank my noble friend for his remarks. Each step is important. I acknowledge that this has taken time; HMRC has competing priorities—noble Lords will understand the situation that we have been living through—but we have been assured that this will happen by October. As my noble friend says, this is one small step, but we should all engage in the battle to get more and more people exercising the right to vote.
My Lords, can I pick up the noble Lord on the last point he made? It has long been conventional wisdom among politicians that we want to see an increase in those registering and, indeed, an increase in those participating in elections. Yet the Minister has set his face against automatic registration, when we also have coming before us at some point, when we return from the recess, the election integrity Bill, which some of us think of as the voter suppression Bill. Will the noble Lord rethink on both these issues—on that Bill, which will make it harder for people to vote, and on this issue of automatic registration?
My Lords, we will have many hours to discuss these matters on the Elections Bill. Time is short now, but I reject the view that that Bill is anything to do with voter suppression. I think the Labour Party has adopted a position on that which is contrary to the overwhelming view of the public that voter ID is sensible. So far as automatic registration is concerned, I can only repeat that the Government have no plans to introduce it.
My Lords, one person’s forced registration may be another person’s citizens’ rights. When I was the Lords’ Minister in the Cabinet Office, some years ago now, government digital experts were discussing the greater integration of local and central public data and the idea that digitisation might well extend to the electoral register. Is that still on the cards? Is this something that we may expect to be covered, either positively or negatively, in the Government’s digital strategy paper, when next it appears?
My Lords, I have indicated that the Government do not see attractions in producing a single national electoral register or centralised database. It is one of the aspects of our position that we should not move forward to automatic registration, and there are others. I have to disappoint the noble Lord on that score.
My Lords, I too welcome the news that my noble friend has given us. Would it not help to reverse the rather worrying trend in recent years that has seen the number of 16 and 17 year-olds on the registers, in readiness to vote at 18, fall by some 20%? Has any recent assessment been made of the effectiveness of the work done by electoral registration officers in schools, where Northern Ireland has had particularly marked success?
My Lords, my noble friend raises an important point and we will certainly look at the Northern Ireland example. As he and the House may know, we have been working to try to encourage enrolment through the universities, and an evaluation will be published today of Cabinet Office work looking at the effectiveness of the student electoral registration condition. These are all important areas where we need to continue to work.
My Lords, does the Minister accept that there is a fundamental difference between forced registration and increasing participation by young people in the democratic process? In the light of the comments from my noble friend Lady Chakrabarti, does he accept that increasing young people’s involvement with citizens’ rights and democratic processes is as good as mandating the vaccine for all care staff? I think that mandating young people to vote in the democratic process would be a really good thing.
My Lords, the Government do not support compulsory voting, and, in fact, it has very limited public support, but I agree with the need to encourage participation. We have the parliamentarian youth engagement toolkit, as well as the secondary schools’ resource, introduced in 2018. I hope that, following remarks from my noble friend Lord Lexden, these will be increasingly used.
My Lords, I welcome the proposal to remind young people to vote, but for those who somehow do not get an automatic national insurance number, Covid-19 restrictions have made it almost impossible to get one. Those waiting in the growing backlog, through no fault of their own, should not be further disadvantaged from registering to vote. I know that, at the moment, you cannot register online without a national insurance number. Has the Minister made an assessment of how many people have been affected in this way? What steps does he have to address this?
Net Zero Test
My Lords, over the last three decades the UK has achieved record clean growth. Between 1990 and 2019, our economy has grown by 78%, while our emissions have reduced by 44%—the fastest reduction in the G7. The Government recently set out the UK’s sixth carbon budget, which would reduce 2035 emissions by 78% compared to 1990. We have strong governance around net zero; this includes two Cabinet Committees, one of which, the Climate Action Strategy Committee, is chaired by the Prime Minister. We will respond officially to the CCC report in due course.
My Lords, I am grateful to the Minister for that response and I declare my interests as set out in the register. I was privileged to be present to hear the speech of Special Presidential Envoy John Kerry, in London this week. He spoke passionately of the scale of the challenges the world faces and the urgency and breadth of the action needed to avert catastrophic climate change. Do the Government accept the need highlighted in the recent report of the Climate Change Committee to put a climate lens on all government legislation and all policy choices? Will they show global leadership on this issue, in the run-up to COP 26 in Glasgow, by committing to a net zero test in their imminent, I hope, net zero strategy?
Well, as I told the noble Baroness in my Answer, we have really strong governance around climate change. There are two Cabinet committees, one established and chaired by the Prime Minister and the second chaired by the COP 26 president designate. Of course, we look at all policies and their impact on climate change.
Can the Minister confirm that, as stated in their response to the Climate Change Committee recommendations, government policy that flows from the Agriculture Act and the Environment Bill that impacts on agriculture will take a holistic approach and take into account the significant benefits that agriculture does and will deliver, such as carbon sequestration in soils, crops and plants?
I agree with the noble Lord on the important contribution that agriculture makes and will need to make in the fight against climate change. Defra is looking at ways to reduce agricultural emissions and is progressing its environmental and land management schemes. It is also looking at other options to reduce agricultural emissions, including some very innovative solutions on the use of, for instance, methane-inhibiting food additives.
In Monday’s debate on transport decarbonisation the Minister said:
“The more we can set out … what our expectations are, the more we expect that development to increase.”—[Official Report, 19/7/21; col. 26.]
The Government’s wish list is unsupported by effective plans for action. A yet to be published report of the Science and Technology Committee that deals with the means of transport decarbonisation has stated that the Government’s actions do not align with their ambitions to achieve net-zero emissions. What is required is an independent office for climate responsibility, which can assess the extent to which the Government’s actions correspond with their stated objectives. Do the Government recognise this need?
I understand the point the noble Lord is making, but I would refer him to the independent Committee on Climate Change, which does many of the things he is suggesting. It was established by the Climate Change Act 2008 and provides expert advice to the Government on climate change mitigation and adaptation. As he will have seen in its written reports, it is not afraid to point out what it sees as any deficiencies.
This is the decisive decade for action and achievements, yet behind the Government’s scatter-gun rhetoric there is only dither and delay to key strategic coherency: the net-zero strategy, the hydrogen strategy, the Treasury’s finance road map, and others. Can the Minister confirm reports that another key strategy document, the heat and buildings strategy, is further delayed? According to Sky,
“Whitehall negotiations are stuck over how best to incentivise the public to change to low-carbon alternatives”.
How will the different strategies combine to support the UK’s climate change goals on both net zero and adaptation, along with wider environment-related goals?
The heat and buildings strategy will be published in due course. I do not agree with the noble Lord that we are not doing anything. I refer him to action we have taken recently: the energy White Paper, the revised emissions trading system, all of the announcements and investment to do with offshore wind, the pledge to phase out new petrol and diesel vehicles, the transport decarbonisation plan, and so on. Of course, there is always more to do, but I do not accept the noble Lord’s premise.
My Lords, I would like to congratulate the Government on their achievements so far, with the fastest reduction in the G7. We have two Ministers—one in the Lords and one in the Commons, my noble and honourable friends—who are determined to help reduce our emissions and achieve success for the environment. I agree with the noble Viscount, Lord Hanworth, that an independent assessment of the net-zero impact of policy is important and I commend the work of the Climate Change Committee. However, I hope the Government will continue to focus, for example, on direct action, by encouraging institutional and pension fund investors to invest in climate change mitigation, and promoting a net-zero approach to investment portfolios rather than asking officials to continue with a net-zero test in a way that the family test has been more of a tick-box exercise.
I thank my noble friend for her comments and certainly agree with her. As she is well aware, the trustees of occupational pension schemes are independent of government; they are not bound by the commitments we have signed up to. However, given the significance of the financial risks posed by climate change, we expect all investment decisions made by pension scheme trustees to take climate change into account. As of 2019, trustees of pension schemes with 100 or more members have been required to set out in their statement of investment principles policies on stewardship on an ESG, including climate change.
My Lords, if this test was brought in, would it not help government departments by giving them a very clear direction of travel? It would cover the sorts of decisions we are still wrestling with—Cambo in the North Sea and the Cumbrian mine—which have somehow slipped through despite government ambitions to reach carbon neutrality. This test could save future Ministers’ blushes. Can the Minister say what discussions have been had about this proposal and whether he will advocate it to his ministerial colleagues?
We have not had any discussions about implementing this proposal yet. We will respond to the Climate Change Committee’s recommendations in due course. But we are looking at the impact of climate change across all our policies. As I said, we have a couple of senior Cabinet-level committees, one chaired by the Prime Minister, which take all of these things into account.
My Lords, the Climate Change Committee sees local authorities as having a critical part to play in achieving net zero. On 16 July, the NAO revealed
“serious weaknesses in central government’s approach to working with local authorities on decarbonisation, stemming from a lack of clarity over local authorities’ overall roles, piecemeal funding, and diffuse accountabilities”.
Does the Minister agree with its assessment that there is
“great urgency to the development of a more coherent approach”
and can he explain how the MHCLG, BEIS and other departments are responding to this challenge?
I do not agree with the noble Lord. Of course, local authorities are critical in terms of delivering this agenda and I have many meetings with them to discuss a number of the grand schemes for which I am responsible. We have spent something like £1.2 billion in dedicated funds given to local authorities through the local authority delivery scheme and the public sector decarbonisation scheme to help them in this job.
My Lords, the Government’s remit to the Oil and Gas Authority is MER, maximising economic recovery—also known as “drill every last drop”. The Government’s continued support for this policy leaves them open to applications such as the Cambo oilfield, which one trusts they will turn down. May I ask the Minister how the MER policy is compatible with our net-zero targets, given that existing oilfields already in production will take us over our agreed NDC?
The independent Committee on Climate Change recognises that there is an ongoing role for oil and gas, and we are working hard to drive down demand and emissions. The updated Oil and Gas Authority strategy includes a requirement for industry to “take appropriate steps” to support the delivery of the net-zero target—and, of course, we have put forward the ambitious decarbonisation plan for the North Sea. With regard to the Cambo field, Shell and Siccar Point have put forward a development proposal seeking consent, with an intention to commence production in 2025. This is not a new project; it was licensed in 2001 and 2004 and is going through the normal regulatory approval process.
I recognise my noble friend’s interest in this issue, but the Government do not have any plans to introduce higher bands for council tax. Many people living in high-value properties are on low incomes and may have lived in their homes for a long time. Higher bands risk penalising such people, including pensioners, who have seen their homes increase in value. They could face a substantial tax rise without having the income to pay the higher bill.
Does my noble friend agree that it would be odd to calculate today’s income tax on what people earned 30 years ago, but this is the basis on which we fund local government? The council tax is out of date, arbitrary and regressive. While the right policy would be revaluation, ducked for too long by successive Governments, would it not be right in the meantime to take the higher band and, without breaking any manifesto commitments, introduce two extra bands to bring in extra revenue from those with more valuable assets?
My noble friend’s suggestion has some merit. Even a limited revaluation would be costly and would yield significant extra revenue only in those parts of the country where house prices are the highest, given that council tax income is not redistributed. It would also leave council tax payers in a rather odd, and arguably less fair, situation where some were paying their tax based on 1991 values while others were doing so based on prices in the present day.
According to the citizens advice bureau, council tax is the most common debt problem faced by families in Britain, with 86,000 people in England struggling to keep up with payments. The current system heavily favours the south-east and disproportionately disadvantages the poor. As part of the levelling up agenda, what consideration have Her Majesty’s Government given to a land value tax to address these inequalities?
My Lords, the Government do not have any plans to introduce such a land value tax, but they are committed to supporting those on low incomes, including by increasing the living wage and by spending £111 billion on welfare support for people of working age in 2020-21.
My Lords, the council tax was introduced as a result of the abolition of the community charge, which was introduced as a result of the discredited rates system. One reason why the rates system became so discredited was that there was no revaluation. There has been no revaluation of council tax for 30 years. Are we going to find ourselves in the same position in another five years if we do not act soon?
I note my noble friend’s call for a council tax revaluation. As I said in my previous answer, a full revaluation would be costly. The council tax bands are well understood by residents and provide a stable income for councils, so at this stage we have no plans for a full revaluation.
My Lords, how is it possible for a £54 million luxury house in London’s Mayfair to have a lower council tax than a former council house on Windebrowe Avenue in Keswick in Cumbria and almost the same council tax as an £80,000 house on Moorclose Road in Workington, both in my former constituency? Is it not the simple truth that the whole council tax system is now discredited? It is unfair, it penalises much of the north, it favours London and much of the south, and it is now in urgent need of reform.
My Lords, I am interested to hear the specific examples given, but we must recognise that, for local authority funding, council tax represents only a proportion of the income received. That is why we try to equalise through measures such as the grant system, which recognises the index of multiple deprivation as one of the reasons in how you provide grant—
Yes, it does. On that basis, grant enables areas with lower council tax bases to receive 16% more in core spending power.
I recognise the point made by the noble Lord about the disparity in valuations between the north and the south, but it is a system that works well to develop the funding that councils need at the moment.
My Lords, I refer the House to my registered interests. What consideration will the Government give to the potential benefit of a proportional property tax, as recommended by the Housing, Communities and Local Government Committee to replace council tax and business rates in its report published earlier this week?
My Lords, we have looked at putting on hold the reform of the local government finance system because of the pandemic, and further reforms will be potentially be brought forward as a result of the spending review. I note the idea that the noble Lord raises.
My Lords, I yield to no one in my passionate belief that the state should tax the citizens less, but domestic real estate is by international standards undertaxed. It would not be that expensive to restrict a revaluation to council tax band H properties —perhaps those over a certain current market value. We should then look at empty properties. There are currently 30,000 empty properties in London alone, with a value of £15 billion. They should attract a surtax, along with overseas-owned properties.
My Lords, I note that my noble friend again calls for a new, higher band of property. If that higher band were based on 1991 values, the Valuation Office Agency would need to revalue all properties in the current top band. That would certainly be cheaper than a full revaluation.
I refer noble Lords to my registered interests. The impact of the pandemic has led to the worst recession of any major economy. With the virus still not under control, local councillors will again be forced to raise council tax this year to protect vital local services, just when many families are struggling to make ends meet. Will the Government remove the necessity for planned council tax rises by giving councils the resources they need and stand by their pledge, so far not honoured, to do whatever is necessary to support councils?
My Lords, I do not recognise the picture that the noble Baroness paints. Throughout the pandemic, we have provided considerable additional funding for local authorities. Local authorities received £3.8 billion in social care grant funding through the social care grant and the improved better care fund. We continue to support councils throughout this very difficult period.
Hardly a week goes by without a news story about someone’s new basement causing problems to their neighbours. Should there not be an automatic revaluation when such improvements are carried out and higher bands introduced to cope with massively inflated property values, or do we need a new system altogether, related to the ability to pay?
My Lords, I am delighted that all these ideas are being floated on how we should support and organise the funding of local government. As I said, the Government have put that on hold, and we are looking at bringing forward measures as part of the spending review.
My Lords, there is a clear rationale for introducing higher-rate council tax bands. The gap between the top and bottom bands is ludicrously small compared with the value of the premises. I ask the Government to consider reviewing the whole territory of property taxation and introducing a new, fairer tax covering property—commercial and residential.
I thank my noble friend. He joins the chorus of people calling for new bands and a reform of the council tax system, but, as I have said, we do not intend to bring in new bands. Plans around local government finance reform have been put on hold and will be carried forward as part of the spending review.
My Lords, does the Minister not realise that the disparities in council tax create a lot of the poverty that he referred to in his earlier statement? Is he aware that the maximum level in Westminster is £1,655? In every district in Cumbria, the average is in excess of £4,000. How can that be fair?
My Lords, I point out that Westminster has a low-tax policy and sets probably the lowest council tax in the country, and it should be commended for being a low-tax authority. Certain authorities know how to squeeze every penny in every pound, and I commend Westminster on being able to do that.
Zimbabwe: Human Rights
To ask Her Majesty’s Government whether they conducted an assessment of the political and human rights situation in Zimbabwe prior to the decision to deport Zimbabwean nationals to that country on 21 July; and if so, from whom they sought evidence when making that assessment.
My Lords, assessment is made against the latest country of origin information and relevant case law. This is based on evidence from reliable sources; reputable media outlets; local, national and international organisations; human rights organisations; and Foreign, Commonwealth and Development Office information. Sources are included in the footnotes of the country policy and information notes published on GOV.UK.
My Lords, in a response from the Minister for Immigration Compliance to a letter from over 75 Peers and MPs, the Government sought to distract attention from the human rights situation in Zimbabwe by focusing on foreign national offenders. However, as the minutes of the meeting between the British Embassy in Harare and the Zimbabwean Government dated 30 June make clear, this is a PR tactic, and it was agreed at that meeting that Zimbabwean nationals who were not foreign national offenders could also be included on the 21 July flight.
Can the Minister clarify to the House whether it is the Home Office’s policy to deport only foreign national offenders to Zimbabwe, or does it intend that future flights will include those who are not FNOs? Can the Minister also tell the House how many deportation orders were originally issued for the removal of Zimbabwean nationals on 21 July and how many were subsequently found to be unlawful or were otherwise stayed by the courts?
I can confirm to the noble Lord that it is government policy to deport foreign national offenders who have received a custodial sentence of 12 months or more. We are not trying to distract from human rights issues. Regarding the flight that departed last night, 50 were due to be on it; 14 were returned and 44 submitted last-minute claims.
The Home Office has a poor record in relation to Covid-19 safety, having already been warned by the High Court about its approach to the asylum system in this regard. Following what happened at Napier barracks, what is the position at the Brook House immigration removal centre? Is it that there has been at least one confirmed positive Covid-19 case? Were any of those on the scheduled deportation flight to Zimbabwe, whom the Government said were all foreign national offenders, people who were awaiting a Covid-19 test result; had tested positive themselves; or should have been, or were, self-isolating for 10 days because they had come into contact with somebody with Covid-19?
My Lords, I can confirm to the noble Lord that public health guidance is adhered to on all removal flights. I will have to get further information on how many were from Brook House. The welfare of those detained in our care is of the utmost importance. We are working closely with our providers and PHE to stop the spread of the virus. That absolutely includes immigration removal centres.
My Lords, to come back to the assessment of the situation and consultation before decision to deport, in April, the US State Secretary, Antony J Blinken, assessed Zimbabwe as one of the worst countries abusing citizens’ rights, with state-sanctioned violence continuing a culture of impunity. Zimbabwe’s security forces acted with tacit support for President Emmerson Mnangagwa’s Government, torturing human rights groups by brutal sexual assault and beating with clubs, cables, gun butts and heavy whips. Victims were forced to eat human excrement and drink poisonous chemicals, among other tortures. Victims included MDC Alliance members, Joana Mamombe, Netsai Marova and Cecilia Chimbiri, who suffered 36 hours of sexual abuse and physical torture. Can the Minister confirm whether the US report was included in the Government’s human rights assessment? If not, why not? And what were the conclusions of the assessment?
What I can say to the noble Lord is that, back in 2018, the Government, with officials from the embassy in Zimbabwe, agreed to redocument Zimbabwean nationals without a right to remain in the UK, including foreign national offenders. Since we commenced that redocumentation in 2018, we have returned 50 people to Zimbabwe. While it is an FCDO priority country for human rights—the noble Lord is right—we have received no reports of human rights violations against those returned since the 2018 agreement.
My Lords, while I fully understand the rationale behind deporting serious foreign national offenders, what is the level of the seriousness of the crime? At a time when Zimbabwe is in the grips of a major Covid outbreak with very little spare capacity, what assessment was made of the timing of this deportation, and what assessment has been made of the planned patriot Bill, which will make it illegal for members of the Opposition to criticise the Government?
Well, the types of FNOs are those who received a custodial sentence of 12 months or more, subject to limited exceptions. The types of criminals on the flight yesterday included murderers, rapists, sexual offenders against children and drug suppliers. In terms of Covid, they receive PPE and other support when they return. I cannot remember the last point the noble Lord raised, but that is two of the three questions answered.
My Lords, last night, a High Court judge accepted that anyone on the deportation flight given face-to-face interviews with Zimbabwean officials before being granted an emergency travel document required to enter Zimbabwe could be at risk on return. The judge directed that the individual who brought the case be saved from boarding the flight, but by the time the news of that order was made public, others who may have been able to benefit from it had had their phones confiscated. Should the Government have put anyone on the flight who had been in such an interview, given the judge’s ruling? Does this not defy the international principle that non-refoulement? Can the Minister tell me, now or by letter, how many of the 14 individuals on the flight this applied to?
As the noble Baroness will not be surprised to know, I will not discuss individual cases. What I will say is that on that flight were murderers, rapists, people who had sexually offended against children and suppliers of drugs. To go back to the question from the noble Lord, Lord Chidgey, in terms of the frequency of reviewing concerns about human rights: FCDO regularly and consistently raises any concerns and would do so if there was any evidence of violations against those returned.
My Lords, the note of 30 June that my noble friend Lord Oates referred to is the framework agreement with the Government regarding these flights, which the British Embassy indicated
“would start with around 100 possible persons … We agreed the flight would focus on Foreign National Offenders (FNOs) and (if capacity allowed) some immigration offenders.”
On the media points, it stated that in proactive and reactive communications that the returnees on the flight would have criminal records and, therefore, had to return to their country of origin. But that will not necessarily be the case in future if it includes those who have administrative removal for immigration purposes. Will the Minister please investigate this and reassure the House that, if this is a framework for flights going forward, all those on return flights who do not necessarily have criminal records will not all be badged as FNOs and therefore be highly vulnerable to abuse in the country of return?
My Lords, can the Minister tell us how often Home Office officials meet the Zimbabwean diaspora here, in London in particular, who are well aware of the difference between a genuine asylum seeker and someone who has been deported for very heinous crimes? How many times have Zimbabwean officials from this embassy been involved in meetings with Home Office officials and the person who is about to be deported? Very often, that brings back to them what will happen to them when they go back to Zimbabwe, and the Home Office should not be doing this without a Home Office official there, taking notes.
I shall say to the noble Baroness what I said to the noble Lord, Lord Chidgey: the FCDO regularly and consistently raises any human rights concerns with the Government of Zimbabwe, and we would do if we had any evidence of violations against those returns.
Arrangement of Business
My Lords, before we start the main business of the day, I rise to say a few words with the agreement of my noble friend the Leader of the House, the usual channels and the Convenor of the Cross-Bench Peers. Since 21 April 2020, the House has sat virtually or in hybrid fashion. Following the decisions taken by the House last week, from September we will to all intents and purposes return to our normal physical ways of working. This means that today is likely to be the last day of hybrid proceedings.
As noble Lords acknowledged in our debate in May, creating and maintaining the hybrid House was the work of many. While the hybrid House has had its frustrations and flaws for all of us, it is right to pay tribute to the staff of the House who have worked, seen and unseen, to ensure that the House continued to function for so many months. Today, at the end of the hybrid House, I thank some of the staff who have worked to maintain the hybrid proceedings. This includes those who managed the daily invitations to Members to participate; those who assisted Members with technical difficulties; and those who worked in the hub, to link the broadcasters to the Chamber. They include Eleanor Clements, who ably led the behind-the-scenes co-ordination and administration of the virtual proceedings, as well as her colleagues Maggie Barnes, Alex Brocklehurst, Simon Nicholls and Seonaid Still. I also thank Sally Freestone, David Loader and their colleagues in the Parliamentary Broadcasting Unit, and our contractors, NEP Bow Tie. I also thank all those in the Virtual Participation Administration Team and the Hub Clerk Team, which were created at the start of the pandemic to enable Members to participate virtually in the Chamber and Grand Committee. The staff on these teams volunteered to take on this work in addition to busy day jobs to keep the House running.
I am sure I speak for the whole House when I pay tribute to their unstinting professionalism, hard work and dedication—and, not least, their patience. We are very grateful, and we thank them all.
My Lords, I thank the Chief Whip for those remarks and echo his thanks to the staff of the House, the Digital Service, the Parliamentary Broadcasting Unit, the Virtual Participation Administration Team and the Hub Clerk Team. I also thank the Members of the House. This has not been an easy 18 months but technologically we have achieved much more than we ever thought possible. Our virtual and hybrid House arrangements were world leading and, importantly, we have continued to carry out our constitutional duty.
Chief Whips are not accustomed to being thanked in the Chamber, but today I do just that. The Chief Whip, together with the Leader of the House and all members of the usual channels and the Convenor, deserve our thanks. The work they do to build consensus, often in very difficult circumstances, is a great service to the House. During this period, they have worked tirelessly. Ahead of the rise of the House today, I wish all noble Lords and staff a very restful and enjoyable Summer Recess. It has never been more well deserved.
Special Public Bill Committee (Charities Bill)
That, as proposed by the Committee of Selection, the following Lords be appointed to the Special Public Bill Committee on the Charities Bill [HL]:
Etherton, L (Chair), Barker, B, Barran, B, Bellingham, L, Cruddas, L, Fullbrook, B, Goudie, B, Parkinson of Whitley Bay, L, Ponsonby of Shulbrede, L.
That the Committee have power to send for persons, papers and records;
That the evidence taken by the Committee be published, if the Committee so wishes.
Draft Online Safety Bill Committee
That the Commons message of 21 July be considered and that a Committee of six Lords be appointed to join with the Committee appointed by the Commons to consider and report on the draft Online Safety Bill presented to both Houses on 12 May (CP405) and that the Committee should report on the draft Bill by 10 December;
That, as proposed by the Committee of Selection, the following members be appointed to the Committee:
Black of Brentwood, L, Clement-Jones, L, Gilbert of Panteg, L, Kidron, B, Knight of Weymouth, L, Stevenson of Balmacara, L.
That the Committee have power to agree with the Committee appointed by the Commons in the appointment of a Chairman;
That the Committee have power to send for persons, papers and records;
That the Committee have power to appoint specialist advisers;
That the Committee have leave to report from time to time;
That the Committee have power to adjourn from place to place within the United Kingdom;
That the reports of the Committee from time to time shall be printed, regardless of any adjournment of the House;
That the evidence taken by the Committee shall, if the Committee so wishes, be published.
Common Frameworks Scrutiny Committee
Communications and Digital Committee
Secondary Legislation Scrutiny Committee
Youth Unemployment Committee
Common Frameworks Scrutiny Committee
That Lord Keen of Elie be appointed a member of the Committee, in place of Lord McInnes of Kilwinning.
Communications and Digital Committee
That Baroness Stowell of Beeston be appointed a member of the Committee, in place of Lord McInnes of Kilwinning.
Secondary Legislation Scrutiny Committee
That Lord Hutton of Furness be appointed a member of the Committee.
Youth Unemployment Committee
That Baroness Blower be appointed a member of the Committee, in place of Baroness Clark of Kilwinning.
European Union (Future Relationship) Act 2020 (References to the Trade and Cooperation Agreement) Regulations 2021
Motion to Approve
Electricity Capacity (Amendment) Regulations 2021
Motion to Approve
Environmental Authorisations (Scotland) Regulations 2018 (Consequential Modifications) Order 2021
Motion to Approve
Fisheries Act 2020 (Scheme for Financial Assistance) (England) Regulations 2021
Motion to Approve
International Travel Rules
Commons Urgent Question
The following Answer to an Urgent Question was given in the House of Commons on Monday 19 July.
“After a hugely challenging 16 months for the aviation industry, I am delighted that new rules allowing fully vaccinated people to travel to nearly all amber list countries, without isolating upon return, came into effect this morning, although people will still need to comply with necessary testing requirements. This coincides with a change in our advice, meaning that the do-not-travel rules for amber countries have now been relaxed, which will be a huge boost to our aviation and travel sectors ahead of the vital summer season.
Also from today, children under the age of 18 will not have to self-isolate when returning to England, making family reunions and holidays far more accessible. Children aged four and under will continue to be exempt from any travel testing, while children aged five to 10 will only need to do a day two PCR. Eleven to 18 year-olds will need to take both a pre-departure test and a day two PCR, as is the case for arrivals from green list countries.
I must reiterate that public health remains our priority, and with our measures on international travel we are safeguarding the gains made by our successful domestic vaccine programme. That is why, on Friday, the Government took the decision to exempt France from the new arrangements for fully vaccinated people returning to England. This decision was taken after concerns were raised by the Joint Biosecurity Centre over the persistent presence of cases in France of the beta variant, which was first identified in South Africa. I understand that the Minister for Covid Vaccine Deployment, my honourable friend the Member for Stratford-on-Avon (Nadhim Zahawi), will be able to answer questions on the data and the concerns raised by the JBC in a Statement shortly.
I can also confirm to the House that, since 4 am this morning, there have been changes to the countries in the traffic-light system. Bulgaria, Croatia, Hong Kong and Taiwan have been added to the Government’s green list; Croatia and Taiwan have also been added to the green watchlist, signalling to passengers that these countries are potentially at risk of moving from green to amber at short notice should swift action be required to protect public health in England.
The Balearic islands and the British Virgin Islands have been added to the amber list and, unfortunately, Cuba, Indonesia, Myanmar and Sierra Leone have been added to the red list.
We keep all these measures under constant review to ensure that they remain necessary and proportionate. The system we have designed is adaptable to the evolving epidemiological picture, and the UK Government are prepared to take action at any time to protect public health.”
My Lords, it is not possible to travel to France without the need for quarantine and all the costs and upheaval that involves, as France, following a sudden decision, is now in a separate subcategory of amber-list countries. As one Conservative MP put it when this UQ was discussed in the Commons,
“public confidence in going abroad is now in a ditch”.—[Official Report, Commons, 19/7/21; col. 679.]
Another Conservative MP said,
“the further restrictions for France stretch both the credibility of the system and the patience of the travel industry. The whole industry … continues to watch as its reserves are dried up”.—[Official Report, Commons, 19/7/21; col. 685.]
The travel industry was promised a rescue deal, which has never materialised. When do the Government intend to give this important industry the support that it needs, as we have called for, and as the shadow Secretary of State demanded again in the Commons on Monday, to which there was no response from the Minister?
My Lords, the noble Lord, Lord Rosser, talks about the decision that we had to make on France, which of course was not made lightly. We have in place a good traffic-light system which enables us to categorise countries according to risk and, therefore, travel can happen accordingly. However, we have also reduced requirements for people who have had double vaccinations in order to travel to amber countries. That is of great benefit to the travel companies and I am sure that they will take advantage of that opportunity.
Can the Minister explain why the Government, with a fanfare of publicity, moved France on to the amber list while at the same time issuing instructions that from Monday, Border Force officers no longer have to verify that new arrivals from green-list and amber-list countries have negative Covid tests or other legally required paperwork? Can the Minister explain why the decision to remove these checks was made? Was it due to a lack of staff and, if so, why have the Government not provided enough Border Force staff to perform checks at a predictably busy time of year?
My Lords, all the decisions that this Government make are on the basis of risk—risk to the country as a whole from a public health perspective and risks to travellers who choose to go abroad where they are able to. It is not the case that checks were dropped because of reduction in demand. However, we need to keep the travelling public as risk-free as possible. That is a great benefit to citizens, but also to the travel industry.
My Lords, what are the prospects and timing of agreeing a deal with the United States that would allow quarantine to cease for vaccinated individuals from both countries? This is our largest market, with a high rate of vaccination, so “risk”, in the words of my noble friend, is low. And what is the answer for Japan? I should declare an interest, as I need to travel there as chair of Crown Agents.
Japan will be taken under consideration as we review the traffic lights system going forward. Transatlantic travel is hugely important for both the US and the UK, and as announced by the Secretary of State for Transport on 8 July, we are confident that vaccines will play an important role in normalising travel, when it is appropriate. There is a UK-US expert working group specifically driving this work forward.
My Lords, the queues at arrivals at our airports are now completely unacceptable. They are two hours or more, as I have experienced recently. Why do the Government not do two things? First, they could get airlines to check documentation before passengers board planes to the UK. Secondly, with universities having closed, they could employ university students, or recent graduates, train them up in a day or two and get them to check Covid documents at arrivals at the airports, with one or two Border Force agents supporting and supervising them, and then let the passengers through to the e-gates and to the immigration officers to do the passport checks. These two moves would remove the congestion and queues in one swoop.
I thank the noble Lord for his suggestions, and I will ensure that my colleagues at the Home Office listen to them as well. We have always been very clear that wait times at the border may be extended due to biosecurity checks being carried out. These are essential to protect the public and the success of our vaccination programme. Passengers have a key role to play in this, as to a certain extent do airlines, because they do some checking before passengers board aircraft. The noble Lord mentioned e-gates. Automation is also really important. We have been able to upgrade the e-gates to speed passengers through the airport.
I draw your Lordships’ attention to my entry in the register of interests. The travel industry is at present on its knees. Regular changes in government policy, as well as changes in the government policy on the admittance of British businesspeople and holidaymakers from other countries, are making the situation considerably worse. Could the Minister tell us what consultations, if any, have been held with the Treasury about some sector-specific assistance to this vital industry?
My Lords, we believe that by the end of September 2021 the air transport sector, for example, will have benefited from around £7 billion worth of government support since the start of the pandemic. Decisions around the sector support will of course ultimately be a matter for the Chancellor based on the evidence that we have been able to provide. Of course, we have regular conversations with our colleagues at the Treasury, but also with industry. We are listening very carefully to the sector.
My Lords, perhaps one of the more confusing issues surrounding the traffic lights system is not knowing on what basis the grading is made. Chile, for example, has falling infection rates and is at least on a par with our high vaccination rates here, yet it remains red. Could my noble friend give us some idea as to how exactly these grades are calculated and whether she is aware of any red countries likely to move to amber in the foreseeable future?
I am unable to provide any insight to my noble friend as to what might happen in the future in terms of countries moving from one group to the next, but we look at a range of factors when making these decisions. Of course, we are reliant on the joint biosecurity centre for producing a risk assessment of the countries and territories. The factors that the JBC risk assessment considers are very varied. They include the genomic surveillance capability within the nation, the Covid-19 transmission risk and the transmission risk of variants of concern. A range of measures is incorporated into reaching these decisions.
My Lords, I would like to pick up on the point on France raised by my noble friend Lord Rosser. The Government’s decision on Friday to change quarantine rules on return from France has bewildered and angered not just the travel industry but the hundreds of thousands of UK citizens gong to France on holiday or for work. Can the Minister tell the House when this decision will be reviewed—and hopefully reversed—given the small number of beta variant cases in mainland France, as opposed to La Réunion, so that people can get on with their jobs when they return without self-isolating first.
I am happy to provide some more information to the noble Baroness. GISAID data suggests that the beta variant accounts for around 5% of cases in France, with data earlier in the month suggesting it could be as high as 9%. This data does not include La Réunion. It includes Corsica, which is included in the quarantine policy, and Monaco. This data for the beta variant compares to similar data from Spain and Greece of less than 1%, so that it why we are concerned about France. It has nothing to do with La Réunion. That is why we took that decision. I cannot say at this time when that process will come under review. Of course, we would love to have people travelling to France again, but it was the right decision taken on the information available.
My Lords, many people travelling from Belfast to international destinations will initially fly to London or Manchester before continuing their journey on to their final destination. Given that the decisions made by the United Kingdom Government for travellers in England will therefore also apply to large numbers of travellers from Northern Ireland, what discussions is the Minister, or her officials, having with her counterparts in Belfast to ensure that changes to international travel rules agreed in London are properly conveyed to holidaymakers departing from Northern Ireland?
We have ongoing conversations with all the devolved Administrations, because this is so important. I recognise the noble Lord’s point: if you are travelling to Northern Ireland, chances are you may be coming through one of the large airports in England. It is very important, but we must recognise that health policy is devolved. However, we have every intention of working as closely as possible with the devolved nations and ensuring that our interventions are as aligned as possible.
The time allowed for this Question has now elapsed. I apologise to the noble Baronesses who could not be called.
Commons Urgent Question
The following Answer to an Urgent Question was given in the House of Commons on Tuesday 20 July.
“I thank my right honourable friend for asking this important and timely question. Yesterday, on 19 July, the UK Government joined like-minded partners to confirm that Chinese state-backed actors were responsible for gaining access to computer networks around the world via Microsoft exchange servers. As the Foreign Secretary made clear in a Statement yesterday, this cyberattack by Chinese state-backed groups was reckless, but sadly a familiar pattern of behaviour. The Chinese Government must end this systematic cybersabotage and can expect to be held to account if they do not.
The attack was highly likely intended to enable large-scale espionage, including acquiring personally identifiable information and intellectual property. At the time of the attack, the UK quickly provided advice and recommended actions to those affected. Microsoft has reported that, at the end of March, 92% of customers had installed the updates that protected against the vulnerability.
As part of that announcement, the UK also attributed the Chinese Ministry of State Security as being behind activity known by cybersecurity experts as APT40 and APT31. Widespread, credible evidence demonstrates that sustained irresponsible cyberactivity emanating from China continues. The Chinese Government have ignored repeated calls to end their reckless campaign, instead allowing their state-backed actors to increase the scale of their attacks and act recklessly when caught.
Statements formally attributing Chinese responsibility for the Microsoft exchange attack and actions of APT40 and APT31 were issued by the EU, NATO, the UK, Canada, the US, Australia, New Zealand, Norway and Japan. That co-ordinated action by 39 countries sees the international community once again calling on the Chinese Government to take responsibility for their actions and respect the democratic institutions and personal commercial interests of those they seek to partner with. The UK is calling on China to reaffirm the commitment made to the UK in 2015 as part of the G20 not to conduct or support cyber-enabled theft of intellectual property or trade secrets.”
My Lords, I must admit that I share the view of Iain Duncan Smith about the seriousness of this matter and why there was not a Statement from the Government at the time. In the Commons, the Minister estimated that approximately 3,000 UK-based organisations may have been vulnerable to this attack, but there was no confirmation on whether any public bodies are included in this figure. Can the noble Lord, Lord Ahmad of Wimbledon, state whether any public bodies were compromised and what urgent steps are being taken to secure public bodies from future attacks? Also, when the Government acted with targeted sanctions against individuals involved in the Russian state-backed cyberattack on the German Parliament, why were there no sanctions in response to Chinese state-backed cyberattacks, on—among others—the Finnish Parliament?
My Lords, I agree that we need to ensure protection for all organisations. The noble Lord is correct in saying that 3,000 organisations were impacted. Obviously, we made a full evaluation when we were informed of these attacks to ensure that all the information was readily available. He asked specifically about government organisations. We do not believe that government organisations were victims. Because this was an untargeted action, it is not possible to give a credible assessment of the overall economic damage. He asked about further mitigation. As he knows, the National Cyber Security Centre is very much world beating and, together with Microsoft, we have worked to give specific and timely advice. By the end of March, 92% of all those organisations impacted had taken appropriate mitigations.
My Lords, the Answer in the House of Commons suggested that there had been a response in the form of a statement by 39 countries. That is welcome, but what action are the Government taking, beyond making statements, to ensure that the United Kingdom and her allies are no longer vulnerable to China? Statements are one thing; sanctions or other actions would surely be far more effective.
My Lords, I am sure that the noble Baroness will acknowledge that when we call out such action, as we have on this occasion, that is done in co-ordination with our key partners. The fact that 39 countries, including those of the European Union and NATO, including Norway, as well as Japan, are among those demonstrates the strong condemnation of these actions. Alongside international partners, we continue not just to call this out but to ensure that we are vigilant to these threats, wherever they come from, and ready to defend against them. As for specific sanctions, the noble Lord, Lord Collins, pointed to Russia, and the noble Baroness will be aware that we have an autonomous sanctions regime and, where necessary, we have acted in the past, although I cannot speculate on any future action that we may take in this respect.
My Lords, last year Twitter suspended more than 32,000 accounts linked to Chinese, Russian and Turkish propaganda operations and more than 170,000 state-linked bot accounts tied to China. Analysis by the Australian Strategic Policy Institute found that China’s influence operation targeted users outside the mainland, where Twitter and Facebook are blocked, aiming to manipulate opinion on issues including the Hong Kong protests, coronavirus and Taiwan. What assessment has the Government made of such state-linked propaganda campaigns targeting UK citizens and the attempts to destabilise British society?
My Lords, my noble friend makes an important point and I assure her and your Lordships’ House that we work in co-ordination with international partners, as well as through the National Cyber Security Centre, to ensure that those who may be targeted and, indeed, those who have been targeted are properly supported. Equally, we share information which allows further mitigation of risk. We must close down this space. Cyberspace is a force for good for many, in the opportunities that it offers, but any use of cyber must be legal, responsible and proportionate. The actions taken on this occasion, supported by the Chinese state, fall foul of that. It is right that we work with international partners in condemning such action.
My Lords, do the Government systematically seek to identify all businesses and individuals who may have been targets for cyberattacks, whether from China or elsewhere? If so, do the Government, as a matter of policy, advise all such businesses and individuals of their potential vulnerability? Do they offer help in how to avoid or minimise the deleterious consequences of such exposure?
My Lords, the noble Lord makes an important point and I shall answer it on two bases. We have worked consistently with other countries, particularly those that do not have the technical capacity to take appropriate mitigation against cyberattacks. We have invested a great deal, including through the Commonwealth, on issues of cybersecurity. Working through the NCSC, we also recommend that, where possible, organisations update to the latest version of software and patch frequently to protect against cyberthreats. On this occasion, both the NCSC and Microsoft have published actionable advice for network defenders. As we improve our capacity to defend, we continue to work with key partners to further mitigate risks to any individual or organisation within the UK.
My Lords, the widespread nature of this attack shows that cybersecurity is a global issue which needs global co-operation. What steps are the Government taking to play a greater role in the United Nations innovation agencies to help to make future technologies more cyberspace-secure?
My Lords, the noble Baroness points to multilateral action. Cybersecurity and cyber more generally remain a point of discussion within the context of the United Nations, as well as other multilateral organisations. It is worth reflecting that, when I mentioned 39 countries earlier, that demonstrates that this is an international challenge that, as the noble Baroness rightly recognises, requires international action, as on this occasion. Working with international partners and organisations, we have illustrated the need for uniform action and calling out those who seek to use cyberspace to attack other countries, organisations or individuals.
My Lords, cyberattacks are part of the low-intensity warfare being waged by President Xi with the aim of securing global domination. Other weapons are terror in Xinjiang, Tibet and Hong Kong and the illegal occupation of neighbouring countries’ territories. Is it not now the time for the Government to impose trade sanctions and a ban on Chinese products and investment?
My Lords, the Government have been at the forefront in the broader challenges. Indeed, as the UK Human Rights Minister, I am at the forefront of the work that we have done at the Human Rights Council, for example, in calling out the systematic detention and abuse of the Uighur community in particular. Most recently, we backed the Canadian statement and worked with our Canadian partners to ensure that more than 40 members at the Human Rights Council called out the situation of the Uighurs and to ensure the access of the human rights commissioner to Xinjiang. We have taken action. The noble Lord talks about sanctions, and the noble Lord, Lord Collins, mentioned them too. Back in 2018, the UK, along with 14 partners, called out, on the basis of APT 10, the action that China had taken. We work systematically and will continue to focus our activities on calling out human rights abuses wherever they occur.
My Lords, notwithstanding the focus on any Chinese or Russian interference in our security and civil liberties, in light of the Guardian investigation and reports, and given the Statement made to this House by the Minister, the noble Lord, Lord True, that our Government are fully aware and made representations about potentially illegal surveillance of British citizens and institutions, will the noble Lord say if he is aware to whom representations have been made? What assurance can he provide that such security breaches have been stopped as a result of our Government’s work and that the Government are not failing to protect our citizens and institutions against any further attacks from seemingly friendly countries and partners?
My Lords, I assure the noble Baroness, that it is essential—I say this very clearly—that all cyber actors use their capabilities, as I said earlier, in a legal, proportionate and responsible way. On the issue that she highlighted, which has been the cause of media reporting, I assure her that we make representations to all appropriate Governments. We work closely with our allies on this important issue and, ultimately, to tackle cyberthreats and improve resilience. That is what we have done in the case of China. We will continue to act responsibly to ensure that citizens and organisations in the UK and, indeed, across the world are protected in the best way possible. We will continue to work to mitigate such actions.
My Lords, the time allowed for this Question has elapsed and I apologise to the noble Lord, Lord Foulkes of Cumnock, who was not able to ask his question.
The following Statement was made in the House of Commons on Wednesday 21 July.
“Before I start my remarks, I would like to take the opportunity to pay tribute to the noble Lord Stevens, who will shortly be standing down as chief executive of the NHS. I thank him for his dedicated service over the past seven years, especially his stewardship during our battle against this virus and his huge contribution to this nation’s vaccination programme. I am sure that the whole House will join me in thanking him and giving him our best wishes for the future.
With permission, Madam Deputy Speaker, I would like to make a Statement on our support for the NHS. In the NHS’s proud 73-year history, no year has been as tough as the last. Everyone working across the NHS has achieved incredible things in the face of great difficulty—from building the Nightingale hospitals in just a matter of days to rolling out our life-saving vaccination programme. They have been there for us at the best of times and at the worst of times. As a Government, we have sought to give them what they need at every stage of the pandemic.
Today, I would like to set out for the House some of the support we have been giving. Throughout the pandemic, we have worked to deliver manifesto commitments—50,000 nurses, 40 new hospitals and 50 million more GP appointments—and we are taking every opportunity to invest in our NHS to make sure that patients feel the benefits of the latest treatments and technologies.
Only this week, we announced a new innovative medicines fund to fast-track promising new drugs. This builds on the amazing work of the cancer drugs fund, which has already helped tens of thousands of patients access promising cancer treatments, while we use the data to make sure that they represent good value for the wider NHS. It is estimated that one in 17 people will be affected by a rare disease in their lifetime, and this fund will support the NHS to fast-track access to treatments that could have clinical promise. This new £340 million initiative takes our dedicated funding for fast-tracking promising drugs to £680 million, showing that we will do everything in our power to give patients access to the most cutting-edge therapies.
Doing right by the NHS means making sure that colleagues have the right team around them. This was true when we made our manifesto commitment for 50,000 more nurses by March 2024, and it remains especially true in the face of the challenges brought by the pandemic. I am pleased to report that we have almost 1.2 million staff working in NHS trusts, an increase of over 45,300 compared with a year ago. This includes over 4,000 more doctors and almost 9,000 more nurses, taking us to over 303,000 nurses in total, and we are on track to deliver on our 2024 commitment.
We recognise that, with so much being asked of our NHS staff, many will not yet be feeling the difference of these extra colleagues on the front line, but I can assure those hardworking nurses that you will feel it soon. Yesterday, I heard from NHS Employers that, for the first time, Hull University Teaching Hospitals NHS Trust will have a full complement of nursing staff when the intake of new nursing graduates begins work in September. I know that we all look forward to hearing that kind of news from more and more places across the country.
Finally, I want to update the House on our autism strategy. Our NHS long-term plan set out our commitment to improving the lives of autistic people. Today, we have launched our new autism strategy, which sets out how we will tackle the inequalities and barriers faced by autistic people so that they can live independent and fulfilling lives. I am truly grateful to everyone who has contributed to shaping this strategy, including autistic people and their families, and the All-Party Parliamentary Group on Autism in particular. I would like to take a moment to recognise the contribution of Dame Cheryl Gillan, the former Member for Chesham and Amersham, for her incredible advocacy of autistic people, including the inquiries she led in 2017 and 2019. She left an incredible legacy, and we are all so grateful to her for her work.
Today’s strategy builds on our previous strategy, “Think Autism”, and we have made so much progress since then. We now have diagnostic services in every area of the country and a much better understanding and awareness of autism, but there is much more to do. The life expectancy gap for autistic people is still about 16 years on average compared with the general population, and almost 80% of autistic adults experience mental health problems during their lifetime. The coronavirus pandemic has been tough for many autistic people. Far too many autistic people face unacceptable barriers in every aspect of their lives—in health, employment and also education—so we have worked together with colleagues in the Department for Education to extend the strategy to children and young people as well as adults, reflecting the importance of supporting people all through their lives, from the early years of childhood and through adulthood.
The strategy is fully funded for the first year, and it contains a series of big commitments, including getting down the Covid backlog; investing in reducing diagnosis waiting times for children and young people; preventing autistic people from avoidably ending up in in-patient mental health services; improving the quality of in-patient care for autistic people when they are receiving it; funding the development of an autism public understanding initiative so that autistic people can be part of communities without fear or judgment; funding to train education staff so that children and young people can reach their potential; and many more commitments. This landmark strategy will help to give autistic people equal opportunities to flourish in their communities, as well as better access to the support that they need throughout their lives, so that all autistic people have the opportunity to lead fuller and happier lives, as they deserve.
We owe so much to our NHS and the incredible people who work there. They have done so much to support us at this time of national need. As a Government, we will give them what they need, not just through this pandemic but to face the challenges that lie ahead. I commend the Statement to the House.”
My Lords, I first record from these Benches our thanks for the hard work of the noble Baroness, Lady Penn, who has gone on maternity leave. We wish her and her baby all the very best for the future. Also, adding to the words of the Government Chief Whip, I thank the clerks, the virtual technicians, the managers and all our staff, for keeping the show on the road and for keeping us safe throughout this year. I particularly echo his words about their patience with us. We have continued to do our job and could only have done so with the support of these dedicated teams. I also thank the Lord Speaker, his predecessor, and Members of all those Committees that have been in almost permanent session this year, for guiding us through.
This is the last repeat Statement before the summer—I think this may be number 50; the Minister will know. We have three matters to deal with today: the somewhat puzzling Statement made in the Commons yesterday afternoon, the Written Statement from the Secretary of State which announced the results of the NHS pay review and—I have given the Minister notice—I will also address some of the issues raised in the Covid update given in the Commons this morning.
The Statement made by Helen Whately yesterday was an odd moment. We of course join her and the Minister in thanking Sir Simon Stevens for all his work in the NHS—he has also taken up his place in your Lordships’ House. We also join others in welcoming progress on the autism strategy, which the honourable lady talked about in her speech; although, in due course I will seek the views of the organisations who are experts in this area. However, the honourable lady gave what can only be described as a parliamentary doorstep clap for the NHS and its staff. Welcome though that might be, it does not pay the bills or provide the respect that this Government owe to our NHS staff.
The Statement was followed within hours by a Written Ministerial Statement outlining the NHS pay award. This is not a respectful way to treat Parliament or our NHS staff. As my honourable friend Dr Rosena Allin-Khan said yesterday, once again the Government have had to roll back on a shoddy, ill-thought-through position, with their 1% pay rise—a real-terms pay cut —rejected by the independent pay body. Less than an hour before, there were competing briefings on what the deal was to be and, at that moment, it turned out to be nothing. Our NHS staff deserve better than this. My honourable friend invited the Minister in the other place to shadow her in the A&E department where she has worked shifts throughout the pandemic. I suggest that she takes her up on that offer, and that the Minister here might do the same.
My right honourable friend John Ashworth has said:
“Ministers were dragged kicking & screaming to 3% for NHS staff. But after years of cuts & rising pressures, NHS staff will feel let down & disappointed especially after today’s chaos. And where is the pay rise for junior docs? Where is a fair pay rise for care workers?”
It really was not worthy of a Government. We had chaos and confusion, with the Government once again rowing back on their position. Does the Minister agree that the pay review body has done what Ministers could not and would not do in recognising that our NHS staff absolutely could not be given a pay cut? Does he accept that, after last year, this is not enough?
Does he accept that this is not an NHS-wide pay settlement? It does not cover all the health and care workforce, who do not fall under this pay review body, and it does not cover junior doctors—I declare an interest, as two are nephews of mine, both of whom were redeployed during the pandemic. We know that our junior doctors have been put on the front line, caring for sick patients, and redeployed across an understaffed, pressured NHS, and that their training has been disrupted. Will the junior doctors get a pay rise? Will all health staff employed in public health receive the settlement? Again, when we know absolutely the value of care workers, why do the Government not guarantee a real living wage for those working in social care?
How will this pay settlement be funded? NHS trusts do not even know what their budget is beyond September, and NHS employers pointed out that this settlement will cost the best part of £2 billion, so where is that coming from? Is the Minister expecting trusts to find it from their existing budgets? These Benches keep repeating this question: the Government seem not to appreciate how central this is to stopping the spread of the virus, so when will they address support for low-paid workers who have to self-isolate?
I posed many of the immediate questions yesterday to the Minister. Sometimes I felt enlightened by his answers and sometimes I did not, but the one I wish to go back to concerns the Government’s plans for September. Are they ready to reimpose safeguards? Will our schools get filtration units over the summer so that we can feel that our children will be safer? Will our teenagers be vaccinated so that, next year, this cohort can do a full year of learning without being sent home in their millions?
My Lords, I echo the thanks to all the staff who have made a hybrid Parliament work over the last year especially, from these Benches, to the health team, because of the high workload of health and Covid business. I also repeat the good wishes to the noble Baroness, Lady Penn, as she starts her maternity leave.
Along with colleagues in the Commons, I am unconvinced that the first half of this Statement was planned to be delivered by the Minister yesterday. In the bizarre events of this week, of Covid restrictions being lifted, a rush of announcements—Monday’s, and today’s on vaccine passports—U-turns, and No. 10 contradicting Ministers, this Statement is definitely filed under “Y” for “You couldn’t make it up”.
Yesterday morning, the press were briefed and opposition politicians heard on the parliamentary grapevine that the NHS staff pay rise would be announced in the Statement. Even Sky News and the BBC news channel were saying that there would be an announcement on NHS pay in the Commons yesterday afternoon. Yet, when the Minister stood up, there was not one word about the pay award, just an end-of-term report and a much-deserved paeon of praise about how wonderful our NHS staff are—they are, and they deserve that praise. However, an extraordinary line in the Statement says:
“But I can assure those hardworking nurses: you should feel it soon”.
Well, they did. Four hours after that Statement, a Written Ministerial Statement and a press release were slipped out, bypassing parliamentary scrutiny, presumably in the hope that it would not be spotted. NHS staff, especially junior doctors and nurses, are appalled. I am not sure this is what the Minister meant by
“you should feel it soon”.
However, it gets worse. This morning’s Times says that the 3% NHS staff pay rise will be funded by robbing the expected increase in national insurance contributions reserved for the social care proposals leaked earlier this week by the Government. That is an absolute disgrace, especially given the appalling way that No. 10 has handled the social care reform proposals. After the Queen’s Speech, Ministers told us that it would be this autumn. Last week, they suddenly said that there would be an announcement this week but, this week, they have thrown the proposals back into the long grass, with a promise—again—of later this autumn, two years after the PM promised us, on the steps on No. 10, that this was his absolute priority. His actions are showing otherwise.
I know that the Minister understands that social care needs urgent reform and that it has borne the brunt of the first year of the pandemic. Can he confirm the Times story about the funding of the NHS pay rise and whether this decision was made by the Secretary of State for Health and Social Care or by the Chancellor of the Exchequer? Can he also say when the full proposals for social care will now be published, including the funding arrangements?
Moving to the only substance of this Statement, the autism strategy, we on these Benches also pay our respects to the late Dame Cheryl Gillan MP, who was such an advocate for those with autism. Peter Wharmby, the autistic writer, speaker and tutor, says that the autism strategy sets its targets very low in saying:
“Moreover, we have been able to transform society’s awareness of autism, as … 99.5% of the public have heard of autism … which is so important in autistic people being able to feel included as part of their community.”
Peter Wharmby is right. Much of the strategy talks about continuing as usual, but if you talk to autistic people or parents of autistic children, they all say that much needs to be done in supporting those with autism, especially in education and at work. Knowing that autism exists is not the same as providing the best environment for those with autism to overcome the barriers they face in society and giving them the support that they need to succeed. The Disabled Children’s Partnership points out that the pandemic has exacerbated existing problems around support for those with autism, creating further social isolation and poor health outcomes. It is depressing that the autism strategy is so unambitious.
One particular problem that parents face when trying to get support for their autistic children is an automatic assumption that parent carers are treated as a resource—worse, their parenting capacity is often questioned. There is no mention here of support for their needs. As John Bangs, a special needs expert, points out, this deliberately ignores carers’ legal rights. It is noticeable that this autism strategy makes no real reference to ensuring that parental and familial carers are supported. When will these wider issues relating to positive support for those with autism and their familial carers be addressed?
Finally, briefly on the Covid Statement in the Commons today, page 4 says that
“two doses of a covid vaccine offers protection of around 96% against hospitalisation.”
But the key bit of information we need in the “pingdemic” at the moment is the rate of double-jabbers getting Covid. I understand that it is part of the same study that is quoted, but what is the answer and where can we find it? If the pingdemic is due to the virus spreading —we hear of police and control rooms unable to operate and empty shelves at supermarkets—perhaps it is time we actually understood how many double-jabbers are getting Covid and having to go into self-isolation, and thereby creating a problem. The Minister needs to consider whether lifting all restrictions on Monday was the right thing to do.
My Lords, I join the noble Baronesses, Lady Thornton and Lady Brinton, in thanking my noble friend Lady Penn for her hard work over the last 18 months and wishing her well in her pregnancy. She looked absolutely fantastic as she left, and our hopes and good wishes are with her.
I also thank the usual channels, the House of Lords staff and the Speaker’s office for all their contributions to the virtual House and for keeping the business of the House going during this awful pandemic. There has been an enormous amount of traffic from the Department of Health—more than 50 Statements, 2 Acts and hundreds of regulations. I thank all noble Lords for their challenge, their scrutiny and their patience during this difficult time.
The pay review body has given us its recommendations, and we have accepted them. I thank it for its work and insight. I reassure the noble Baroness, Lady Thornton, that the Office of Manpower Economics will publish its analysis online shortly. We are extremely pleased that we can follow the guidance of the pay review body. Junior doctors have their own separate framework, worth 8.2% over four years. They are working from that framework today.
On the funding of the pay review, as noble Lords know, we gave the NHS a historic £33.9 billion settlement in 2018 and have provided £92 billion to support front-line health services throughout the pandemic. The pay uplift will be funded from within that budget, but we are very clear that this will not impact funding already earmarked for the NHS front line. We will continue to make sure that the NHS has everything it needs to continue to support its staff and provide excellent care, throughout the pandemic and beyond. That is why we accepted the PRB’s recommendations in full and provided NHS workers in scope with the pay rise.
On the question from the noble Baroness, Lady Brinton, on safeguards in September, I cannot make any guarantees but I definitely hope not. We very much hope that we are in the final stages of this pandemic, as the impact of the vaccine is being felt, bringing down the R number and saving those who are infected from hospitalisation, severe disease and worse.
The noble Baroness, Lady Thornton, talked about filtration for schools, and I noted her question on this yesterday. I said that we had been looking at it. I am not aware that the results of that analysis have come through yet. To be honest, I am wary of investing too much in unproven technologies. The two things that have been proven to work are isolation and vaccination; we are backing those two measures most of all. However, I accept her point about the importance of ventilation and will continue to look at it.
Likewise, the JCVI is looking very carefully at vaccination for children. We are working with international partners to get to the bottom of it. At the moment, we have a clear read-out—we will move—but our priority is providing either third shots or variant booster shots in the autumn to the most vulnerable. That is where our priorities are at the moment.
The noble Baroness, Lady Brinton, asked about social care. I note the Government’s statement on that; we will bring reform recommendations in the autumn. On her point about the autism strategy, I also pay tribute to the contribution of Cheryl Gillan, who worked so hard in this area and whose impact is still being felt.
I think the noble Baroness, Lady Brinton, overlooks some of the really good work in this strategy. There is £74 million of funding for a number of high-priority projects, which have been designed in collaboration with stakeholders from the community. I guide her to the implementation plan that accompanies the strategy, which has detailed recommendations on a six-point implementation matrix that has grit and traction. I would be very grateful for her feedback on that.
I pay tribute to parent supporters; the noble Baroness, Lady Brinton, is entirely right that they often bear the brunt of care and are often best placed to care for and support those with autism. I remind her that we have provided £31 million through the mental health and well-being recovery action plan specifically for the parents of those with autism, recognising how the pandemic was hitting that group in particular.
My Lords, we now come to the 20 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers.
My Lords, following our debates on the Medicines and Medical Devices Act earlier this year on an innovative medicines fund, the announcement in this Statement of a ring-fenced £340 million budget for innovative medicines is very welcome. When will those become available, so that clinicians and patients can access this funding? Given that it now takes us beyond cancer drugs and innovations, will there be a focus on those diseases for which there has been no effective treatment?
My Lords, I am grateful to my noble friend for highlighting this important development. The cancer drugs fund was a great success, and we are building on it with a substantial investment. The new fund will support patients with any conditions, including those with rare and genetic diseases. Dementia is one area where we are extremely interested in looking at investing further, and I hope that this would be captured, but we are waiting for recommendations from NICE and the data that it will provide before we set the right prioritisations. In terms of the date, I do not have that at my fingertips, but I would be glad to write to my noble friend with the details.
My Lords, the strategy promises millions to prevent mental health crises for autistic people and to help people detained in hospital back into the community. The Written Ministerial Statement responding to my 2020 independent report about people with learning disabilities and autistic people detained in long-term segregation was laid in the other place after the Minister’s Statement had finished. My report emphasised the urgency of these strategy promises. Will the noble Lord commit to meeting me, with the Secretary of State, to discuss the full implementation of my recommendations?
My Lords, I am enormously grateful to the noble Baroness for her hard work in this area. We are taking a range of actions to drive further, faster progress on reducing the number of autistic people and those with learning disabilities in in-patient mental health settings, including robust action by the CQC, work on our new cross-government “building the right support” delivery board, and reform of the Mental Health Act. I would be very glad to meet the noble Baroness and her colleagues to discuss these and other measures in more detail.
I declare my interests as set out in the register. My Lords, Ministers rightly come to these Chambers and praise NHS staff for all they have done throughout the pandemic, yet a third of NHS staff are considering leaving their job. Vacancies are endemic and, to top that, we have a looming summer crisis. For an average nurse, 3% is equivalent to £15.40 a week. Inflation removes £11.58 of that; so, for all the Minister’s kind words, in real terms that is a pay rise of £3.82 a week, or 55p a day, and less than half of that for a newly qualified nurse. Does the Minister think this is fair, and what does he think the nurses should do with their 55p a day?
My Lords, I am also enormously grateful for the contribution of NHS staff at all levels and from all parts of the United Kingdom. This pay settlement is based on the recommendations of the pay review body. We said that that was the mechanism we would follow, and we are following it; in that respect, we are doing what we said we would. I reassure the House that recruitment to the NHS is extremely strong. We are hitting our targets on the recruitment of 50,000 nurses and our targets for GP trainees and in other parts of the NHS.
My Lords, I welcome the Minister’s offer to meet the noble Baroness, Lady Hollins, to discuss her devastating report. We should be ashamed to see the way some of our people with learning disabilities and our autistic young people have been treated. I would like to know whether the Government’s action plan can give some realistic dates on when there is likely to be proper service and support given within local communities and within homes that should be created for them.
Secondly, on Covid generally, I have been double-jabbed with Pfizer, so it is unlikely that I will go into hospital, but I have Covid. I would like to pick up on the question from the noble Baroness, Lady Brinton—what are the figures for the number of people who have had their vaccinations but are now starting to suffer from Covid? This is not flu; it is quite different from flu. You get the jab for the flu and you stay clear of it. With this, you get the jabs but you can get it just the same—and I have been suffering. Why are the Government giving mixed messages that people are now going back to normal? This is just not the case. We are sending out mixed messages and giving the impression that we have this “freedom day”. Yes, there will be freedom, but there will be freedom to spread on a scale that we have not experienced latterly. So I hope the Government will be cautious with the mixed messages they have been issuing and they will underline that having the double jab does not necessarily mean that people are clear of catching the disease.
The noble Lord has my profound commiserations. It is an extremely tough and nasty disease, as he rightly points out. Even for those who have had two jabs, if they get the disease it can still be a really horrible experience, which he has at this moment.
He is not quite right, though, on the mixed messages. We have been crystal clear from the very beginning, even before the first vaccine arrived, that the vaccination was not going to be a panacea in itself. It will not prevent all people from getting all Covid diseases for all time, immediately. These things are incremental. The societal impact of the vaccine is to drive down the infection rate to the point that R is below one; that is the objective. But, in the meantime, those who have had the vaccine not only remain infectious but can be heavily symptomatic, and I am very sorry for the position he is in. Incidentally, that is also true of the flu vaccine; it is not a 100% vaccine, but it does an enormous amount to break the chain of transmission and to reduce the spread of flu on exactly the same basis.
My Lords, if more people anxious to show their support for our magnificent NHS staff would see being vaccinated and wearing masks in crowded places as a smart move on their own part, would they not also see it, crucially, as sending a signal of support to all those in the NHS?
My Lords, my noble friend hits the nail on the head. Not only is getting vaccinated and wearing a mask in the right settings a sign of support for NHS staff, it is a sign of support for the whole of society. We depend on each other during this pandemic. When someone catches the disease asymptomatically and spreads it to someone else, they hurt all of us. We all have to be careful to take our tests when we are going into a position of risk, to wear our masks when we are close together and, of course, now that the vaccine is available to all over 18 year-olds, to ensure that all the people we can persuade have taken two jabs.
My Lords, the Minister has on more than one occasion in the last few minutes been asked about the position of care workers. They have been totally left out of the pay settlement. They are working on extremely low wages. Does the Minister not agree that something must be done to help care workers, whether in domiciliary care or in care homes, to have a decent wage and not be treated as the country cousins in this whole thing?
The noble Lord is right: we are concerned about the pay, conditions, career prospects and retention of care workers. I have spoken about this in detail in debates on social care, and I share the sentiments of the noble Lord. When we come to social care reform, the correct provisions for social care workers will form an intrinsic part of those reforms. I do not wish to be obtuse, but this is about the NHS. The NHS is a direct employment body, whereas social care has a different employment system and is therefore not covered by this particular settlement.
My Lords, while I am sure that we appreciate the work done by NHS staff, I remind noble Lords that it was NHS staff in the Radcliffe Infirmary in Oxford who put a “Do not resuscitate” notice on my good friend Caroline Jackson’s bed without her knowledge—she found out about it only much later. I have asked the Minister about this. The last Written Answer I got said that a report would be produced “in due course”. Can the Minister ensure that these notices are rigorously reviewed before they are put on people’s beds and certainly not, as in the case of Mrs Jackson, put on the bed without her or her husband or anyone close to her knowing that it had been put there? Not all NHS staff are perfect.
As my noble friend will know, I know Dr Jackson extremely well from the old days and heard her story with great regret. I took the story back to the department and played it into the system, as I told him I would do. A report is being drafted and I can reassure my noble friend that it is being taken seriously. The clarification of guidelines has been sent to all wards and there has been additional training for staff put in the position of needing to consider and engage with loved ones on this issue. However, may I push back against my noble friend? It is not right to try to generalise about staff on this point. I have the highest regard for NHS staff. In the very large majority of cases, they have worked extremely well in difficult circumstances in these situations and they are owed our respect for that.
My Lords, the Minister made that point very well. I declare an interest as a member of the board of the GMC because I want to ask him about workforce strategy. Clause 33 of the Health and Care Bill sets out a duty on the Secretary of State to publish
“at least once every five years … a report describing the system in place for assessing and meeting the workforce needs of the health service”.
The Minister will be aware that a number of NHS organisations say that this is not going far enough and that what is needed is the development of regular, public, annually updated long-term workforce projections so that the health service can meet the undoubted challenges that lie ahead. Is the Minister prepared to consider this?
My Lords, I have heard the noble Lord on this point two or three times and he makes the argument extremely well and persuasively. As he knows, a huge budget of the NHS goes on the workforce; essentially, the NHS is a mobilised healthcare workforce. It is intrinsic to the success of the NHS that we manage our workforce correctly. There are substantial workforce transformation programmes in place at the moment, including the People Plan, and a huge recruitment drive is going on, including the creation of a much clearer employer brand, which has landed very well among the workforce generally. However, I take the noble Lord’s point. I am not the workforce Minister but I will take it back to my colleague Helen Whateley in the department and ask her for her consideration.
My Lords, I hope that my noble friend, who deserves a real holiday, will accept that it would have been far better and more honest had the pay award been made in an Oral rather than a Written Statement. We all send our warm wishes to the noble Lord, Lord Brooke of Alverthorpe, for a speedy recovery. However, does not his story underline the need for clarity in Oral Statements? I put to my noble friend last week the idea of statements in all the newspapers which would be clear, cohesive and coherent. Is that idea still being followed up, as he promised it would be?
My Lords, I have followed it up. We have invested a huge amount in our statements. This takes up a large bandwidth for our broadcasters and of the advertising budget of the Cabinet Office and the department—we could not have spent any more money on advertising than we have done to try to get our messages across. However, some of these messages are difficult to understand and sometimes difficult to accept. We all wish that the vaccine was as clear-cut and emphatic as are the vaccines for polio or the other blockbuster vaccines. However, as the noble Lord, Lord Brooke, just described, and as poor old Sajid Javid is currently feeling, two jabs do not guarantee that you will not be infected and infectious. However, neither of them is in hospital and neither of them is suffering from severe disease. The message is nuanced: the vaccines work, will reduce transmission and will help us to get this country out of the disease, but people will still have to proceed with caution, isolate when they are in contact with those with the disease and protect themselves from transmission with masks and social distancing.
My Lords, I express my gratitude to each and every one in the House for their care and attention these past difficult months. To echo the noble Lord, Lord Balfe, I, too, have been messaged on hundreds of occasions over the last few months on the issue of DNR, on which I will ask a question. In the light of the reports of 39,000 deaths in care homes and the fact that 59% of all those who perished had a disability or autism, when will the Government commence the national inquiry so that those who lost their loved ones can be reassured that no deaths occurred unnecessarily due to government policy decisions and lack of proper and adequate safeguards for all residents in care homes and their well-being and that DNR was not applied disproportionately to people with disability and autism without sufficient oversight, given the incredible pressures on the NHS during these months?
My Lords, we will be accountable for the use of DNR and it is right that the noble Baroness’s specific question should be asked: were any groups disproportionately at the wrong end of this? She is right to ask the question. I cannot give her a precise date for the inquiry, but I have given absolutely cast-iron reassurances that it will happen. I am very tired, as is everyone else, and the thought of starting an inquiry today while preparing for the winter is not one that will help our productivity or help to save lives in the difficult time that we have ahead. The right time for the inquiry is probably when the pandemic is truly behind us.
My Lords, the NHS is highly regarded by most people because it is available to all for free. But, as the Statement rightly recognises, despite record investment, it faces major challenges. In particular, survival rates for many cancers trail those in comparable countries. How do we secure the necessary improvements in the NHS, especially at a time when it faces record waiting times?
My noble friend gives me an opportunity to raise one of my main ambitions for the health service, which is clearly outlined in the life sciences vision. She is right: we catch too much cancer at stage 3 or 4, when there is sometimes not much that we can do, and anything that we do will be very expensive and make only marginal differences. That is not the same in all countries and it is not good enough in this country. That is why we need to invest in diagnostics and preventive medicine. We need to reweight our health system away from clinical interventions on lumps and bumps at a very late stage. We need to interact with patients at a much earlier stage of their disease. Only in that way will we be able to afford the healthcare system that this country deserves and to give people longer, better lives.
My Lords, as we have reached 2 pm there is no need to adjourn the House, but I will arrange a short pause to allow the relevant people to be in their places for the next item.
Arrangement of Business
Covid-19 (Public Services Committee Report)
Motion to Take Note
My Lords, the report is the Public Services Committee’s first. The committee was established in February 2020 and is the first in this House to hold the Government to account on a range of issues that cut across public services and on policy areas that are the responsibility of multiple departments and so, too often, are the priority of none. It is a Standing Committee, so will continue to work for many years, I hope. I have the enormous privilege of being the first chair and am working with an outstanding group of Members from across the House, who have all worked with energy, commitment and challenge throughout. We have also been served by similarly outstanding officials, and I want to say thank you to all involved.
The establishment of the committee coincided with Covid-19 and it soon became clear that the pandemic was the most testing experience that our public service model had faced for several generations. It would reveal its strengths and weaknesses, and would be an opportunity, some might say a critical juncture, for reform. This became the focus of our first report.
We heard from 165 organisations and individuals, and I am enormously grateful to them. Unfortunately, no government Minister found it appropriate to come and talk to the committee. However, much of what we heard has informed our follow-up work on commissioning and data sharing, as well as our current inquiry on child vulnerability. How public services are organised, how they are funded and how effectively that funding is spent, how different services work together and, most importantly, how services are experienced by the people and communities that use and need them are the priorities for the committee.
Covid-19 has been a national tragedy for the United Kingdom. We have lost more than 130,000 people to the virus and Covid-related pressures have pushed many families to crisis point. After 18 months of tireless service, our front-line workers are exhausted and their well-being is at an all-time low.
However, the inquiry also gave us cause for hope. Amid all this despair were incredible innovation and civic action, often at local level, to support communities to stay resilient under unprecedented pressure. Decisions that before the pandemic took months or even years were made in minutes. National government worked with councils to accommodate 15,000 rough sleepers. Many of those had access to addiction and mental health services for the first time.
We were inspired by the surge in voluntary action: there are now more than 4,000 mutual aid groups across the UK. Innovative local authorities played a key role in co-ordinating volunteers to support hard-to-reach groups. For example, Agatha Anywio, 76 years old from London, relied on her local Age UK group to support her during the first lockdown. A few weeks ago the committee heard from her again. She told us that she was still getting support from the local voluntary sector to connect her to her local community. Age UK even organises two virtual exercise classes a week, which she participates in and loves.
We also saw how digital technology was used more widely and more successfully than ever before. Changing Lives, a charity working with vulnerable adults, moved many of its addiction recovery services online during the pandemic. This gave service users greater flexibility and responsibility. They were not given daily scripts by the NHS, but weekly ones instead. This meant that they were more empowered. It was risky, but, actually, it resulted in increased engagement with services, a reduction in the relapse rate and, ultimately, fewer drug- related deaths.
However, while these innovations are impressive, unless government acts urgently to lock in such changes, this good work will be lost, and we heard evidence that this is already happening. Shay Flaherty is recovering from addiction and now volunteers in Birmingham with the charity Revolving Doors. At a follow-up evidence session last month, he warned us that much of the good work with rough sleepers during the early stages of the pandemic had already been undermined. He said that, once people had been moved out of temporary accommodation, their point of contact with mental health and addiction workers was often lost. Many have relapsed and returned to the streets.
Moreover, Covid-19 revealed how innovation and community resilience are too often undermined by fundamental weaknesses in the way we deliver public services in this country. Going into the crisis, the national Government too often did not take local expertise seriously. This played out with disastrous consequences. Jessica Studdert, who is the deputy chief executive of the New Local Government Network, told us that, during Covid’s early stages, too many local authorities did not get the information that they needed from the NHS about shielded groups, even though it was the local authorities’ responsibility to deliver food and essential supplies.
We found that our poorest communities went into the pandemic with incredibly low levels of resilience. Witnesses told us that the funding of preventive and early intervention services had not been a priority in the years preceding Covid-19. This had placed greater pressures on the NHS and increased costs to the state through poorer education, employment and justice outcomes for the most vulnerable.
Sir Michael Marmot reported to the committee that cuts to local authorities’ public health grants had fallen disproportionately on the most deprived areas. Since 2014, England as a whole has seen a cut in public health budgets of £13.20 per person: in the Midlands, it was £16.70 per person; in the north, it was £15.20; and the north-east has been worst affected, with cuts of £23.24 per person in the public health budget. Witnesses told us that the upshot of those cuts was that obesity and associated diseases such as diabetes were concentrated in our very poorest communities and among our most marginalised groups. That made them extra vulnerable.
Covid-19 mortality rates in the most deprived areas were almost twice as high as those in the least deprived. Diabetes was mentioned on 21% of death certificates where Covid was also mentioned. The proportion was 43% among Asian people and 45% among black people. It was higher in all BAME groups than in the white British population.
Pre-existing inequalities have only deepened during the last 18 months. Sir Kevan Collins, who resigned as a government adviser over school catch-up funding, recently told the committee that disadvantaged children had fallen even further behind their better-off peers as a result of lost school time. His resignation should be a wake-up call to the Government that such disparities cannot be left unaddressed.
The pandemic influenced innovative local areas to break down long-standing barriers between the NHS, local authorities and other services, but in much of the country we found that collaboration between agencies was wanting. Many did not share crucial data on people’s needs. During the crisis, the lack of integration and parity of esteem between health and care saw patients discharged from hospitals into care settings without testing, resulting—we believe—in thousands of unnecessary deaths. The proposals in the Future of Health and Care White Paper and the subsequent legislation to strengthen co-ordination between the two services are welcome and necessary. True integration will depend on delivering real parity of esteem between the NHS and social care. It is deeply disappointing that the legislation to put adult social care on a secure financial footing has been delayed yet again—until, we are now told, later this year. Can the Government confirm whether the forthcoming legislation will include proposals for the reform and integration of social care, alongside any new funding settlement, to increase the resilience of the sector?
To address fundamental weaknesses in public services, strengthen the resilience of our communities to future crises and ensure that the innovations from the pandemic are not lost, the committee called for a national programme of reform. In carrying out this essential task, we asked that the Government should be guided by eight key principles. These included the Government and public service providers recognising the vital role of preventive services and early intervention.
In its response to the report, the Government said that they were committed to levelling up life expectancy. They have not yet set out how they will invest in preventive services in order to meet their 2019 general election manifesto commitment to extend healthy life expectancy by 2035, and to narrow the gap between the richest and the poorest. Health prevention and early intervention in education were not a focus of the March 2021 Budget. To date, levelling-up announcements have largely focused on physical infrastructure and skills. How will the Government address this in the forthcoming spending review? The role of charities, community groups, volunteers and the private sector as key public service providers must also be recognised. They must be given appropriate support and encouragement.
Witnesses told us that the procurement guidance, introduced by the Cabinet Office in response to the pandemic, granted local public service commissioners greater flexibility to award long-term funding and contracts based on social value, rather than just the lowest cost. We were disappointed that the Transforming Public Procurement Green Paper failed to embed those flexibilities. It did not differentiate between the commercial purchasing of goods from the private sector and the commissioning of services for people, whether delivered by the voluntary sector or by other organisations to meet the needs of the local community. In recent letters to the Government, we have urged them to work with the voluntary sector and with commissioning experts to ensure that the procurement Bill promotes social value and delivers long-term funding agreements for charities delivering services. Can the Minister update us on progress in engaging the voluntary sector on this issue?
Another principle is that public services require a fundamentally different, vastly more flexible approach to data sharing. The Information Commissioner wrote to us as part of our current inquiry on children’s vulnerability. In her letter, she acknowledged that the current threshold for sharing data on children was too high and that her office would be working with the Department for Education to update its data-sharing guidance. Can the Minister tell us how this important work is progressing?
We argue that integrating services to meet the diverse needs of individuals and communities is best achieved by public service providers working together at local level. This should be supported by joined-up working across government departments at national level. I welcome the establishment of a Cabinet committee. Will the Minister set out how this committee will co-ordinate government activity to improve data sharing and integration? Local services and front-line workers must be given the resources and autonomy to improve, and innovate in, the delivery of services. How will the Government use the forthcoming levelling-up and devolution White Papers to achieve this?
People themselves are best placed to understand how services should meet their needs, strengthen their resilience and support them to thrive. I am running out of time, so I cannot go into this in detail. It is critical that the government strategy for public service reform takes this as its core in the months and years ahead. If people and places are to be resilient in the face of future crises, services must have political and financial support, as well as autonomy, to be truly preventive and integrated around the needs of their local area and people. They must have the places and the people they serve at their heart. I beg to move.
My Lords, I remind the House that I am a vice-president of the Local Government Association. First, I congratulate the committee on its report and thank the noble Baroness, Lady Armstrong, for her introduction. She is absolutely right in calling for us to learn the lessons of how public services have been delivered—or, indeed, not delivered—during the pandemic. She also talked about the importance of resilience and of engagement with people and communities. I subscribe to everything that she said.
As the title of the report says, this is a critical juncture for public services. The committee was right to use those words. It is urgent that we learn the lessons of the Covid pandemic. It brings into stark relief the delay in this report reaching the Floor of the House for debate. It was published in November 2020. The Government replied three months later, but it has taken a further five months for this House to hold a debate. Can the Minister explain why there has been such a delay?
I want to make one crucial point this afternoon, and it is this: you cannot run England out of London. The Government’s replies to paragraphs 117, 139, 140 and 141 of the report, on the need for decentralisation and local integration of services, are, frankly, inadequate. I submit that it is not enough to promise a White Paper “in due course” based on directly elected combined authority mayors and regional partnerships such as the Midlands Engine and the Northern Powerhouse. This leaves out counties, public health structures and local government generally. It does not address the need for a single, unified health and social care service and for greater investment in prevention, which could in turn save public money, as the report makes clear.
Crucially, and as the report also makes clear, we cannot continue with a system of overcentralised delivery of public services, poor communication from the centre and a tendency for service providers to work in silos. This, my Lords, is a hub and spoke model, so beloved of bureaucracies, which promotes silo working rather than service integration. As the committee has pointed out, local authorities often receive divergent messages from different government departments. As worrying was the need for local areas to interpret public announcements by the Government without prior consultation.
I said earlier that you cannot run England out of London. We do not try to run Scotland like that, nor Wales, nor Northern Ireland, so why, for example, do we run Yorkshire like that? The argument the Government have used has been that decisions have had to be made quickly. Of course they have, but that is no excuse for national attempts at recruiting volunteers not being aligned with locally co-ordinated responses, nor for national public health executive agencies not using local public health resources effectively, nor for the expertise of local authority contact-tracing teams being unused in the design of test and trace. These are fundamental matters. It is vital that local areas are seen as partners with far greater decision-making powers.
Very wisely, the committee, on page 14, described the German public health system, which has local and regional governance structures with 375 local health offices empowered to make decisions. We could learn much from them, and I hope we will.
I want to raise a final issue, which relates to schools and which the noble Baroness, Lady Armstrong, mentioned. The Prime Minister appointed an adviser, Sir Kevan Collins, as education recovery commissioner. He produced a report, supported, it seems, by the Prime Minister, calling for substantial funding over three years to assist pupils who had lost school time, but the Treasury refused to fund it. Just £1.4 billion was allocated for one year—about a 10th of the money asked for, albeit over three years. The commissioner resigned. This is not joined-up government.
Covid has exposed serious flaws in our systems of government. I hope this is understood by the Minister and his colleagues, because they have the power to drive the change we need.
My Lords, I begin with a tribute to the noble Baroness, Lady Armstrong, who chaired our committee with tact and skill. Her professional background in social work has been a real advantage, not just in putting witnesses at ease but in managing any neuroses from committee members. We were well-served by our clerk, Tristan Stubbs, our policy analyst, Mark Hudson, and our operations officer, Claire Coast-Smith, who navigated the virtual network between us and our witnesses.
We are a collegiate committee with a broad range of relevant expertise, and our discussions have been non-partisan and good humoured. Thanks to Zoom, I am now familiar with my colleagues’ tastes in literature, paintings, casual dress and light refreshment. In our report, we mentioned what went well during the pandemic—often overlooked by the commentariat: the success of DWP in coping with a huge number of claimants for universal credit, and introducing the £20 supplement; the Treasury’s furlough scheme and wider support for business; and, of course, the stunning success of vaccine procurement and distribution. But we also identified a number of structural problems, some touched on by the noble Lord, Lord Shipley: over-centralisation, departmental silos, underinvestment in preventive measures and ill-preparedness for emergencies, themes that are recurring in our current inquiries.
I want to focus on the lessons to be learned from the three countries from which we took evidence: New Zealand, Taiwan and Germany. They are all different, but they are grappling with identical viruses with the same range of policy options and the same information about the disease.
I have three points to make about New Zealand. First, like Great Britain, it is an island—or, rather, two islands—but unlike us it challenged the early WHO advice that border restrictions were unnecessary, and in retrospect it was absolutely right.
Secondly, to deal with departmental silos, it has just set up interdepartmental boards, which they call joint ventures. We were told that
“all the interesting and difficult public policy issues are on the interface”,
by which was meant that they cross departmental boundaries. Here, NHS Health and local authority social care spring to mind. The joint ventures bid direct to the treasury for funds and a cabinet Minister is in charge, but instead of a permanent secretary, a board of the relevant permanent secretaries delivers the policy. My noble friend might like to ask the Cabinet Office to keep in touch with New Zealand on this, as it is often ahead of the game in the development of public policy
Thirdly, public confidence in the Government rose as the pandemic progressed, whereas the opposite has happened here. We did not press too hard for the reasons—again, the Government might want to pursue that further—but it was ascribed to firm leadership, a strong culture of co-operation and robust dealing with fake news.
Taiwan’s approach avoided lockdown entirely and last year it recorded record GDP growth, but its experience may not be entirely representative as it had the background of coping with SARS and a tradition of wearing masks, which was described to us as the equivalent of a vaccine.
Its equivalent of Eat Out to Help Out was more broadly based, focused on retail spending rather than just spending in restaurants, and those on low incomes were included, receiving vouchers worth about £80, whereas our scheme was much narrower and arguably regressive. Ninety-eight per cent of the population in Taiwan participated, and you got a bonus if the money was spent out of doors.
I turn finally to Germany, with its federal structure, where health and education is devolved to the Länder, which managed most of the Covid response. Perhaps the most remarkable contrast was on health spending, where there are no government-imposed cash limits, as insurance picks up the tab. I quote verbatim what we were told:
“There is no room for refusing somebody an operation that he needs or a pharmaceutical drug that she needs for financial reasons … There is no place in the German health system for refusing money because somebody is 90 years old and has a life expectancy of only seven more years. In that case … if it does not medically kill them and they can stand the operation—then go for it and the finance system has to follow that.”
That, of course, has wide ramifications for how we fund the NHS, but against the current background, I thought it worth mentioning.
I make one final point on Germany. The local authorities there all have equal powers. Our witness, John Kampfner, told us:
“It is one thing to advocate the devolution of powers within England to local authorities; it is quite another to be able to deliver that within the patchwork quilt of local government that we have at the moment, which in my view is really not fit for purpose to deal with a crisis like this, as distinct from what exists in Germany.”
Clearly, it is easier to manage devolution if the bodies you are devolving to have equal powers. At the end of the session on Germany, we asked for a key message. “Plan for the future and build in some slack”, was the reply.
I hope the Minister in response to our debate will recognise that the present system of running the country is capable of improvement—without wholly adopting the Cummings agenda of hard rain—and can tell us that the Government have an open mind on some of the radical implications of our report.
My Lords, as a member of the committee I welcome this debate, partly because it gives me an opportunity to warmly thank both the noble Baroness for the way in which she has chaired the committee and the staff for the quite exceptional way in which they have supported us.
Some of us have spent many happy hours down the years talking to empty rooms about the need to reform government, not because we long for some bureaucratic nirvana but because we were convinced that without reform some of the most disadvantaged people in our society would continue to experience poor, difficult-to-access services, and we as a nation would continue to waste scarce public money. So I was pleased that for its first report the committee chose to look at what the pandemic could teach us about our public services, and I was not surprised that it concluded that there was now an overwhelming case for reform, notwithstanding the outstanding commitment of so many of our public servants. That view seems now to be shared by the Government themselves because in their own Declaration on Government Reform, published just a few weeks ago, they accepted that the pandemic
“has … exposed shortcomings in how government works.”
I hope the Government will now revisit the committee’s recommendations, particularly the eight principles of reform that the chair referred to earlier.
For today, I shall focus on four of those principles which, surprisingly, the declaration of reform barely mentions. The first, as has been said, is the need to prioritise prevention and early intervention. Our system of government is designed to respond to problems rather than prevent them, and the pandemic has demonstrated how short-sighted that can be. Covid hit hardest those with preventable disease, such as obesity and type 2 diabetes, living in poorer communities. It is not just in the field of health that we need to prioritise prevention. Our prisons are full of people who have been failed by the education system, whose mental health problems have never been addressed and whose addictions have been left untreated. We are now seeing the cost of responding too slowly to the impact of climate change, measured in terms of the human misery caused by flooding and pollution. Any credible vision for the future and the reform of government has to prioritise a shift from response to prevention.
It also needs to tackle the issue of sharing data. The declaration of reform mentions data only as a way of enhancing the accountability of services. While that is important, the committee found countless—and I mean countless—examples of how the failure to share data between services has stood in the way of improving those services and providing essential services. We were told that schools are often not aware that a pupil is receiving support from social services, GPs are not told that a family is involved in a child protection process and criminal gangs are able to exploit teenagers in county lines because of the failure to share information between the police, children’s social care and health. We found some excellent examples of how, during the pandemic, services had found new ways of sharing data—usually at the local level—to benefit clients, but in a governance system that is now so fragmented we have to find better permanent ways to share information across bureaucratic boundaries if we are ever to reform government.
As the chair has said, the committee also saw many great examples of how charities, community groups, volunteers and the private sector had delivered essential services, often supported by their local councils. These non-statutory services, not for the first time, showed how they could respond quickly, how they could innovate and make services more accessible and how they were more trusted than traditional providers. To be fair, we saw many examples of how statutory services had helped them by introducing new flexibilities, not least in the way in which services were commissioned. Again, though, our concern was that these changes would not survive the return to normality. We felt strongly that the new normal should be about services for public good being provided by a coalition of providers, some statutory, some voluntary, with those in the voluntary sector being given real parity of esteem as professionals in their own right.
Lastly, the committee became persuaded that, in future, public services should be designed and delivered with a great deal more user involvement. We heard how the failure to do that in the past had resulted in services being provided in the wrong place, at the wrong time and in the wrong way. Civil servants and local officials need to find new ways to involve citizens and users, children included, not via ever more sophisticated consultations but by way of genuine co-design and co-production. That is especially important if the inequality of access experienced by minority groups is to be tackled.
The pandemic exposed serious flaws—we need to be honest about that—but the innovative response from so many points us to how we should change by creating a system where public services are more devolved, co-designed with users, focused on prevention, delivered through diverse providers and better at working in partnership and sharing data. That should be our future.
I declare my interest as a Cumbria county councillor.
This report from our Public Services Committee, chaired by my noble friend Lady Armstrong, is one of the best things that I have ever read on the reform of public services. It sets out an ambitious agenda, drawing on the lessons of the Covid crisis and international experience. It shows what a cross-party consideration of these issues can achieve and how a remarkable degree of consensus on principles for reform can be established.
However, I am afraid my question is whether our politics is up to the challenge. We saw a very weak response from the Government to this report, both in their refusal to engage in the work of the committee and in their very weak response. The response popularised by the Government is the so-called levelling-up agenda, but we saw in the recent Prime Minister’s speech how empty that is. When you come out with a proposal for a £10 million plan for dealing with chewing gum on the streets, that shows that you do not really have sensible principles for reform in your head. It seems to be a splash of central government paint to cover up fundamental cracks in our society.
I agree with the noble Lord, Lord Shipley, in his condemnation of overcentralisation. Not only is that a very inefficient way of trying to tackle deprivation and complex problems of poverty at local level but it is, frankly, quasi-corrupt; it is getting near to pork-barrel politics, and that is not where we should be going.
We need fundamental reform in governance and funding. At present, the Government are levelling down, not levelling up: the proposal to withdraw the universal credit supplement will plunge many poor families further into poverty; the rejection of Sir Kevan Collins’s plan for educational catch-up was a very bad sign; and, despite all the talk, there is still no long-term funding solution for the NHS and social care.
Yet the present moment is an ideal time for a Government to make difficult tax and spending choices. Everyone is aware of the cracks exposed in public services, but at the moment we are seeing the Government allowing a manifesto commitment that they made on taxes to trump the lessons of Covid—and of course that commitment came well before the Covid crisis. The point about manifesto commitments applies equally to my own party: some in my party want to elevate the 2019 manifesto to semi-sacred status, but really we should be looking at the lessons of the Covid crisis and developing policies for public services along the lines of the committee’s report.
It is not enough to simply say, “Let’s spend more money”; we also have to have a credible agenda for reform. On reform of the NHS, we have to recognise that, despite its achievements, the NHS has failed so far to provide an equal opportunity for people to live a healthy and full life, and the emphasis has got to shift to prevention. In education, we have got to recognise that there are many problems of deprivation leading to poor educational opportunities and schools where standards need to be raised.
We know that people in public services work very hard, but they often work in silos. We have to be prepared to use the charity and the voluntary sectors and even, at times, the private sector, which we must see not as an enemy but as a potential partner. We have got to avoid hidebound, bureaucratic approaches that lead to inadequate data sharing, as we have heard.
We need an ambitious agenda of public service reform. I hope that a Labour Government would be prepared to follow the principles of this committee report, which are so sensible and so wise. I thoroughly commend the committee on its work.
My Lords, I draw the attention of the House to my relevant interests recorded in the register as a member of Kirklees council and as a vice-president of the Local Government Association. As a member of the Select Committee, I too wish to praise the leadership of the committee by the noble Baroness, Lady Armstrong.
My abiding memory from the witnesses who gave oral evidence to the committee was of the dedication of all those involved in providing public services. Service providers rose to the multiple challenges posed by the pandemic and overwhelmingly put first the needs of the people they served. As we know, some of them literally gave their all. I pay tribute to all those in public service for their heroic actions during this continuing pandemic.
As we have already heard, this is a wide-ranging report and I wish to focus my comments on the response of services provided by local government. What struck me most in listening to the witnesses was that staff were energised by the challenge of continuing to provide services in a different way. They were almost always motivated to continue providing the best services they could and determined to find ways round the barriers rather than be intimidated by them. The result, we heard, was that innovative practices were introduced. Some were the result of government initiatives and funding. As we have already heard from the noble Baroness, Lady Armstrong, 15,000 rough sleepers were rehoused in hotel accommodation very quickly thanks to a government grant and local government action. This was a significant success and one that had other benefits for homeless people.
Innovations were also sparked by practitioners from different services and organisations, such as NHS community services and local government social care working more closely together and with local and national charities and voluntary groups. They described how they felt empowered by the challenges of the pandemic to pay less heed to existing service guidance and just find a better way of doing their job.
One of the examples in the report is of social care and the NHS in the Leicestershire area establishing what they call their “care home cell” to ensure co-ordination. That is an example of dependence on already very good working relationships across the organisations. The importance of effective personal relationships was repeated by other witnesses.
It was also vital in another strong theme that emerged: the importance of local, place-based services. Time and again we heard evidence about topdown control being less effective than local solutions. For instance, as someone in the Local Government Association described it:
“Guidance came out in dribs and drabs. One of my [local authority] colleagues said it was like trying to construct a piece of Ikea furniture with a piece missing and the instructions being posted daily in bits and pieces.”
Another example of topdown instruction not being as effective came from my own local authority. Early in the pandemic there was a significant outbreak in a meat processing factory in Kirklees. The central data provided was so poor that the council’s public health director asked the council’s digital service to provide the data in a more meaningful and accurate way. This was successfully achieved.
However, it was clear from the witnesses that local services of all kinds were in a fragile state following years of austerity. Age UK wrote that the pandemic had revealed the
“true extent of the impact that underfunding, structural issues and market instability have had on the system’s ability to respond”.
Local government was described as much less resilient as a result of very significant funding cuts.
One of the lessons was best described by users. They said that where providers have listened to them and then changed their practice as result, their needs were much more effectively met and there was a reduction in duplication. This co-production—codesign— was much the best way forward for users who gave evidence.
This is a valuable report; I have touched on just a small part of its deliberations and conclusions but to me the lessons are clear. First, we should reduce central control and have much more local, place-based definition of service provision. Secondly, we should enable coproductions to flourish. Thirdly, we should recognise the enormous contribution of people and personal relationships in innovating and overcoming adversity, and value those people. Finally, underfunding services on which our society relies cannot continue if care for the more vulnerable among us is important to society as a whole. The challenge for the Government is how these vital lessons are to be at the forefront of their thinking and funding decisions. I hope the Minister will explain how the Government intend to respond to these very significant challenges.
It is a real pleasure to follow the noble Baroness, Lady Pinnock and to speak this afternoon as a member of the Public Services Committee on the first report of the committee. This was a very revealing inquiry prompted by the unfortunate and unexpected arrival of the Covid-19 pandemic.
I pay tribute to the chair, the noble Baroness, Lady Armstrong, and the committee staff who worked under extreme pressure, frequently producing documents and suchlike at very short notice. I also pay tribute to my fellow committee members whose depth of knowledge and diversity of life experience made this inquiry so interesting and worth while. This was the first inquiry that I had been party to since joining your Lordships’ House, and I found it quite thought-provoking.
I say that it was a revealing inquiry because it highlighted areas of government that hitherto had been accepted as perhaps good working practice or, at the very least, accepted as the norm, with no real incentive for change. The Covid pandemic certainly put many of these previously accepted practices to the test, and they were found wanting when the chips were down. The report identifies many of these, a recurring theme being that of data sharing and, as it says clearly and is very well evidenced, Covid-19 has highlighted the inadequate data sharing between national agencies and local services.
As can be seen, we identified a number of conclusions and recommendations. If I were to choose an area from the inquiry that really caught my attention, it would undoubtedly be the overcentralised delivery of public services. We heard compelling evidence from a large number of witnesses identifying a clear lack of involvement at local level. In many cases they had been left in the dark as to the support that they were entitled to but denied due to confusion and a deficiency of clarity caused by a very centralised approach.
This was made abundantly clear by a number of witnesses. I too want to mention Agatha Anywio from Wandsworth, who told us of her experience in the early days of lockdown. She said that
“I had a letter from the Government telling me that I should officially shield, but nothing happened … It was about four weeks into lockdown before I was actually recognised, only because I persisted … If I had kept quiet and done nothing about it, I have a feeling that I might have been completely forgotten.”
Debra Baxter from Wigan, who is 55 years old and has cerebral palsy, told the committee that she was now a full-time wheelchair user. She said:
“My personal experience was that if it was not for the support of my daughter, who is here beside me, during lockdown I would not have been able to cope … I also felt that this pandemic, shall we say, took us all by surprise, and there were no actual structures with the social care setting to deal with emergencies like this. If it were not for my daughter and the friendly neighbours who live around me, I would struggle a great deal during lockdown.”
The impression left by front-line public service providers who gave evidence was that there was no co-ordinated communication strategy across government departments. Dr Jeanelle de Gruchy, president of the Association of Directors of Public Health, told us that her colleagues from central government
“often failed to draw on local resources because they were unaware of the role played by local authority public health teams”.
“There was a really poor understanding and recognition of the role of the director of public health, the local public health system and indeed local government as a key partner in managing this pandemic”.
The Government’s response has been to recognise the importance of public services working together, saying:
“We are evaluating how Government can be more joined up for local government. The recent Spending Review outlines Government’s ‘Focus on Outcomes’ … and as part of this HM Treasury has been driving a X-Whitehall approach on outcomes, and evidencing impact and public value.”
It cannot come soon enough.
In contrast, there was a very constructive aspect of the response of government to the pandemic. I refer to the way in which the homeless were taken off the streets and found accommodation.
“The Government’s March 2020 ‘Everyone in’ initiative requested that all local authorities provide accommodation for rough sleepers in their area, often in hotels or hostels … by May 2020 a total of 14,610 people in England who were sleeping rough, or who were at risk of sleeping rough, had found emergency accommodation.”
I am bound to say that that was quite some achievement.
We heard from Revolving Doors, a truly remarkable organisation which aims to help people with substance misuse, mental health problems, domestic or sexual violence, homelessness or who have had frequent contact with police and the criminal justice system. Shay Flaherty, who I have already mentioned, a volunteer with Revolving Doors who gave evidence to the committee, is nine years into recovery from alcohol addiction and helps support homeless people in Birmingham. He was keen to tell the committee that the help the homeless were getting
“in the premises they happen to be in, whether hotels or hostels, has given them a start in life and a chance to get access to addiction services and support workers.”
“I have been amazed at how the Government and councils have managed to get the entrenched homeless off the streets … This might be the first step to getting a roof over their heads permanently.”
The important point here is that, when push comes to shove, government can be innovative. As we point out in the report,
“the Government and public services must now act to ensure that the progress made is not lost.”
Shay Flaherty told us that some innovations were being abandoned:
“Slowly but surely, the guys are coming back out on to the streets … because the accommodation is being withdrawn.”
That is disappointing, to say the least. There is no doubt that the Government’s approach to rough sleeping during the pandemic has proved what can be done by working with local authorities.
I ask—I hope—that this report will galvanise the efforts of government departments to learn from the experience of Covid-19 and acknowledge the deficiencies of a centralised government approach, in order that those less fortunate members of society may benefit. This report is worthy of recognition and of being acted upon at all levels of government. I am delighted to have been involved in the inquiry.
My Lords, I declare my non-executive membership of the Cabinet Office. It is a pleasure to follow the noble Lord, Lord Davies of Gower, a colleague in the police service, the House of Lords and this Select Committee.
I add my own thanks to the noble Baroness, Lady Armstrong, for this debate and her determined and human leadership throughout the Select Committee—no easy task, given that the committee was new, the membership had not worked together and it had to be arranged virtually. I would also like to thank the clerks of the committee, who were flexible and very hard-working, for keeping the committee and the witnesses well briefed and cared for: a great achievement.
I fully endorse this report and our recommendations but wish to talk about only two issues, which were themes running through the evidence. The first is whether prevention is truly prioritised by the Government. The second is the ability of our public services to share data for the benefit of our citizens. Covid and the consequent lockdowns have brought both into sharp relief.
Nearly every public service claims that prevention of harm is its principal objective. This must be true logically; it is better that someone does not contract a disease or become a victim of crime if it can possibly be avoided. They will not suffer harm and the public service can either be allocated fewer resources in the future or—more likely—use the resources for other priorities. However, Covid showed that we did not prevent the spread of the disease and that we did not have a clear plan for how to prevent the spread of the disease.
It is also true that each public service struggles to articulate a detailed plan for how they will implement a preventive strategy. To take policing, all chief constables say they have a clear preventive strategy, but, when you ask for details of how they will do it, there is no detail. They cannot clearly indicate in their budget the resources allocated for this purpose. Yet we know that the design of products, for example cars, and places really helps reduce crime. People could not steal cars until recently because they were designed not to be stolen. Reasonable alcohol-control strategies, not allowing drug markets to get out of control, special measures to help and protect young people, and giving information to potential victims about how to avoid becoming a victim, will all have an impact. Health has a similar list.
The pandemic showed that we do not have clear and measurable preventive strategies and 10 to 20-year plans for either of these particular challenges. The UK was particularly affected by this pandemic because of obesity and diabetes making people more vulnerable to serious and sometimes fatal side-effects; both obesity and diabetes being preventable problems to some extent. So I urge the Government to take prevention seriously. It is not, as it is often portrayed, a soft, woolly subject; it is as hard-nosed a discipline as engineering, and susceptible to hard-nosed, effective measurement.
In terms of data sharing, we heard some excellent examples during the pandemic that local public service partners had found imaginative, effective and radical ways to overcome hurdles to sharing data. This was excellent news, but the question must be asked: why did they need to be so creative? Why did it take a world- wide pandemic to create the perfect circumstances for such a leap forward? The various regulators cannot understand why the public services say they cannot share data. Well, I am afraid, “They would, wouldn’t they?”
The reality is that legislation is designed generally to prevent the sharing of data: we have privacy legislation to protect our confidentiality and data protection legislation to stop the inappropriate sharing of private data held digitally. This is, of course, commendable. However, I do not think Parliament, when seeking to prevent the inappropriate sharing of private data, also intended to inhibit public services from sharing personal and mass data for the purpose of giving benefits to citizens in terms of health and security—as just two example. But this seems to have been the outcome.
At the very least, public service practitioners and leaders believe there is a problem, and there is clear evidence that poor data sharing is leading to poorer outcomes. The regulators say they will produce yet more guidance to reassure the practitioner. I believe that it is time consider legislative change to change the landscape. I propose that a statutory defence should be created for public services that share data. It is a simple “reasonableness” defence. If they share data believing it is to carry out their duties and help a citizen, they should have a full defence in law to any breach of privacy or data sharing breaches.
The pandemic has allowed public servants to take risks on our behalf in the sharing of data. However, they should not have to take those risks and, by providing a clear defence in law, the Government will reassure our public services and improve their efficiency for the collective good.
My Lords, I was delighted to be appointed to the new Committee on Public Services. I knew that under the chairmanship of my noble friend Lady Armstrong it would be a lively experience, and I join others in paying tribute to her and the clerks who supported us so well.
Of course, when we began, we had no idea that we should be producing our first report during a pandemic, nor that that report would focus on how those public services we were investigating would react to that pandemic. I must record what a privilege it was to work with a group of such experienced, wise and committed Members, and to reach a degree of consensus which was, and is, part of the pleasure of our work together.
A Critical Juncture is the title we chose for our report, which we are debating today, recognising that Covid represented an unprecedented challenge to our public services to which they responded with innovation and commitment. The outcomes are critical in terms of lessons learned, what can be retained from such excellent outcomes, and how resilience against any further challenges can be built up.
We have had some wonderful and heart-warming examples of how services responded to the pandemic: huge upscaling of provision, rapid decision-making and the breaking down of long-standing barriers by the urgent needs of the moment, but of course the virus further disadvantaged those already left behind. Black and minority-ethnic groups and those on the margins suffered disproportionately, and the years of underfunding of preventative and early intervention services came home to roost. Poor children’s education attainment got worse and the ability of local services to understand the needs of their communities was sometimes ignored in favour of some overcentralised and needlessly bureaucratic national service provision.
Lessons must be learned if we are to reap the benefits we have gained and not slip back to old ways as soon as the pandemic is over. Nowhere is this more important than in the issue of co-production, already mentioned by the noble Lord, Lord Bichard, and the noble Baroness, Lady Pinnock, where the users of services are involved in their design and planning and treated as equal partners. Our witnesses emphasised that this approach could have helped to predict and short-circuit some of the problems that came up. On the rough sleepers initiative, already mentioned by some of my colleagues, that separate sleeping accommodation was required by male and female rough sleepers would not have been a sudden surprise to providers if they had talked to rough sleepers before they set up a service which did not provide it, wasting time, money and good will. We must remember that most users when consulted—and I mean really consulted, not presented with a plan once it has been agreed—do not ask for the moon, as many providers think they do; on the contrary, their asks will usually be modest and far less than expected. If more services adopted this approach, it would be possible to maintain some if not all the innovation we saw over Covid. We must never undervalue the lived experience of users and customers—that is a very important lesson.
This lesson must be learned by public services, and they must similarly hear that the way really to engage with their consumers is most likely to be not through statutory service providers but through the voluntary and community sector. If you are single mother with addiction problems, you do not want to talk to your social worker for fear that you will lose your children, but through a local support group where you meet other mums in the same situation, share your fears and get advice and, above all, support; you will learn to deal with your difficulties, gain in confidence and become a reliable mother to your children. Time and again, we had examples of these experiences, but time and again too, we heard charities and community groups say that were treated like poor relations, did not have a seat at the table and were patronised and talked down to. Many of those barriers were broken down due to the simple urgency of the situation. The speed of acting may be much easier for a charity or community group, and many were able to mobilise services quickly without going through the various procedures and permissions which are inevitable in the statutory sector. We must commend the courage and willingness to take risks which was shown not only by staff and volunteers in charities but by their trustee boards. Often thought to be resistant to risk taking, they stepped up magnificently to support innovation and speed of delivery. The better relationships and increased respect which were gained in the pandemic must not be allowed to slip away. Not only will it provide more satisfactory services, meeting the needs of users rather than the notions of providers, but it will often save money too.
I hope the Minister will be able to confirm the value the Government place on the voluntary sector and their willingness to support it, not only in terms of funding but in ensuring that both the sector and the users on whose behalf it advocates are treated as equal partners in the provision of services, and in ensuring that the voice of users is strong and influential whenever public services are planned.
My Lords, it has been a pleasure and a privilege to serve on the Public Services Committee under the exemplary leadership of the noble Baroness, Lady Armstrong. I too thank our excellent committee staff.
Our first inquiry offered a unique opportunity to examine the state of public services in response to the pandemic, to acknowledge the positives, the amazing innovations to meet the Covid challenges and the incredible dedication of front-line workers, and to identify what needs to change as part of a major programme of public service transformation.
As we have already heard, the committee identified a number of fundamental weaknesses which must be addressed to make services resilient enough to withstand future crises. These included insufficient support for prevention and early intervention, overcentralised delivery of public services, poor communication from the centre, a tendency for service providers to work in silos and a lack of integration, especially in services working with vulnerable children and between health and social care. None of this is new—indeed, it will be depressingly familiar to many in your Lordships’ House—so why has it proved so difficult to move the dial: inertia, lack of political will or not?
As we have heard, the committee identified a number of key principles for public service reform which will require a fundamentally different mindset. I highlight just three: first, the vital role of preventive services in reducing the deep inequalities that have been exacerbated by Covid; secondly, central government and national service providers radically improving how they communicate and co-operate with local-level service providers; and, thirdly, the much-needed integration of services—the joining up of the silos—which is best achieved by public service providers working together, certainly at the local level but, critically, supported by joined-up working across government departments at the national level.
Other noble Lords have already highlighted the importance of preventive action. One of the report’s key recommendations was that an approach to public health that focused on preventing health inequalities would pay real dividends by increasing the resilience of communities and reducing the pressure on the NHS when a crisis occurred. The committee heard that many deaths from Covid could have been avoided if preventive public health services had been better funded. Therefore, I am disappointed that the Government have not committed to publishing a public health strategy to reduce health inequalities to fulfil their 2019 general election manifesto commitment to
“extend healthy life expectancy by five years by 2035”.
I join other noble Lords in asking the Minister when the Government intend to set out their plans for doing this. What assurances can he give that the Health and Care Bill will place clear duties on integrated care boards to reduce health inequalities, with sharp lines of accountability?
On the lack of integration between health and social care, our conclusions were stark. They were that
“the Government’s own pandemic planning … identified that social care would need significant support during the outbreak of a disease like COVID-19, yet social care was the poor relation to the NHS when it came to funding”
and allocation of PPE during the first lockdown. Discharging people from hospitals into care settings without testing and with inadequate PPE led to the tragic loss of the lives of thousands of older and disabled people. Our evidence suggested that the failures in adult care resulted from insufficient planning coupled with years of underfunding. The Nuffield Trust told us that although the Government’s 2016 pandemic planning exercise, Exercise Cygnus, had shown that care homes and domiciliary care
“would be in need of significant support in a pandemic”,
no advance arrangements were put in place to meet those needs. It concluded that integration between health and social care hinged on reform in three key areas: first, parity of resources; secondly, equal visibility and priority in policy-making, and, thirdly, commitment to better data collection and sharing. These things lie at the very heart of the report’s findings.
A further key issue revealed in our excellent international evidence, already referred to by the noble Lord, Lord Young, was on health system resilience—specifically, the need to build in spare capacity rather than have the NHS run continually at red-hot levels of bed occupancy. It was salutary to learn that the UK has 2.7 hospital beds per 1,000 of the population, compared to an EU average of 5.2—far lower than Germany with 8.2 and France with 6.2.
The committee produced 41 recommendations for government, including recognising the vital role of preventative services and early intervention and committing to interim funding to ensure that adult social care gets sufficient support to protect older and disabled people in any further waves of coronavirus and future pandemics. In short, it came up with a comprehensive agenda for change to address the systematic weaknesses revealed by the pandemic to deliver lasting and transformative reform.
Being charitable, as I like to be, I can only describe the Government’s response as lacklustre. While they largely agree with the committee’s main conclusions—it would be hard not to—their response contains very little detail on how or whether they plan to address its recommendations. It is, to say the least, disappointing that after tantalising rumours in the press that the PM is finally going to bring forward his proposals to reform adult social care before the Summer Recess, they appear to have been relegated to the long grass again.
Covid has been a serious wake-up call for this country and particularly for the way we plan and fund our public services. There really is a chance to build back better if the Government are prepared to do things differently and invest in the areas highlighted in this report.
My Lords, the House of Lords Public Services Committee was established to consider the operation and future of public services, including health and education. It started work in February 2020, and the committee recognised very quickly, following the outbreak of Covid-19, that
“the pandemic would have an enormous impact on the delivery of public services in the years to come.”
Therefore, it set up an inquiry to examine what the experience of the coronavirus outbreak can tell us about the future role, priorities and shape of public services. The committee found five key weaknesses in public service provision, which it argued made the response to the pandemic more challenging. One of them was
“insufficient support for prevention and early intervention services,”
which I will come to.
The committee made various recommendations, and one of those that I want to focus on was:
“Recognising and supporting charities, community groups, volunteers, and the private sector as key public service providers.”
If one word stands out throughout the pandemic, it is “collaboration.” Last year, at the beginning of the pandemic, I was privileged to be appointed a trustee of the National Bereavement Partnership right from its outset. It has carried out inspirational work throughout the pandemic under the leadership of our inspirational CEO Michaela Willis. The National Bereavement Partnership has made a difference to the emotional well-being of callers. These are people who call in with very sad and tragic situations. The National Bereavement Partnership provides emotional support and therapeutic intervention and is a conduit between other services, enabling long-term well-being. It adds value to NHS services; it saves the Government money; and it keeps people out of the mental health system. So here we are where the public sector and charities work hand in hand to the benefit of each other.
When it comes to prevention and early intervention, the committee cited evidence highlighting the disproportionate impact of Covid-19 on BAME communities, including:
“almost a third of all patients critically ill with COVID-19 in hospitals were from BAME backgrounds—despite making up just 13 per cent of the UK population—
that is, almost double the proportion of the population being critically ill—
“and … people of Bangladeshi background in England were twice as likely as white British people to die if they contracted COVID-19.”
The committee recommended that the Government take an approach to public health that focused on preventing health inequalities over the longer term.
The pandemic has highlighted the potential of the NHS to drive forward large-scale change and new approaches in a short period of time. There are so many examples of this. The vaccines are a great example; we have a world-leading vaccine programme with Kate Bingham, a private sector individual, appointed by the Government in May last year. On 8 December, we had the first vaccination. We had six vaccines on order and 400 million doses for a population of 67 million. Today, almost 90% of the adult population have had their first dose and almost 70% have been double-jabbed.
Again, this could not have happened with the public sector on its own; it is due to the public sector working with the private sector, with Oxford University, with the university sector, and with the Serum Institute of India in Pune, the largest vaccine manufacturer in the world, which now has a 1 billion-dose contract with the Oxford AstraZeneca vaccine. Of course, it is international collaboration: AstraZeneca is a Swedish-British company headquartered in Cambridge.
The way we worked with the ventilator challenge was amazing. We got 20 years’ worth of essential ventilators in 12 weeks. So was the way we created the Nightingale hospitals, such as the 4,000-bed centre at the ExCeL centre—the first where you had the private sector, the Armed Forces, universities and the NHS all working together.
All this underlines the importance of the health and life sciences sector. As president of the CBI, we have launched our economic strategy for the next decade, called Seize the Moment. Within that, one of the pillars is:
“A healthier nation, with health the foundation of wellbeing and economic growth”,
which is absolutely crucial.
“COVID-19 has put the health of the nation under the spotlight. Firms have stepped up, with a significantly increased emphasis on the health and wellbeing of their employees. And, for us as a country, the crisis has been a wake-up call, bringing the pervasive impacts of health inequalities into stark focus, underlining the importance of health to people’s personal and professional success, and reinforcing just how vital our life sciences capability is to the UK’s progress now and in the future.”
Poor health is expensive: 63% of years lost to poor health are in the working-age population. This costs the UK £300 billion in lost economic output annually, excluding health costs. So, life sciences and health can be a major driver of economic success for the UK, with the global market in pharmaceuticals and medtech worth £1.2 trillion in 2020; and it is expected to see a strong growth of around 5% a year through to 2030. The secret, again, is collaboration between the public sector, charities and the private sector.
People talk about building back better. Well, I chaired a CBI event with the mayor of Athens, and he said, “We do not talk about building back better; we talk about building forward better.” So, let us build forward better.
My Lords, it is a great pleasure to follow the noble Lord, Lord Bilimoria, who spoke compellingly about collaboration. It has been a pleasure and an honour to be a member of the Public Services Committee, which has behaved throughout in a collegiate and constructive way, and I thank my committee colleagues. Like others, I would like to thank our excellent chair, the noble Baroness, Lady Armstrong of Hilltop, who has demonstrated throughout hard work, dedication and great good humour. Thanks also go to our secretariat—the team of Tristan Stubbs, Claire Coast-Smith and Mark Hudson —for their utter professionalism.
Our first report, as has been stated, commenced physically in February last year, before the first lockdown, but we quickly moved to working virtually. Work was carried out remarkably smoothly on our report A Critical Juncture for Public Services: Lessons from COVID-19, which was published in November last year. I thank officials, broadcasters and all who made this possible. I will focus on three areas in particular, although, as has been demonstrated by those serving on the committee, our report was wide-ranging. I would like to look at prevention and early intervention, then at local delivery, and then at the importance of voluntary organisations.
On prevention and early intervention, a key area, the evidence that we saw was clear. People who are obese, who smoke, who are diabetic and who live in unhealthy social, economic and physical environments are at a far higher risk of dying from Covid-19. That seems now almost beyond challenge. The Prime Minister himself nailed the danger of obesity when he spoke of Covid-19. Yet the Government in their response to the report did not recognise these factors explicitly, rather surprisingly, saying that further analysis of the evidence will inform our learning. I hope that the Government accept the very clear evidence, and it will be good to hear from the Minister on this.
Our inquiry heard from Sir Michael Marmot about the underfunding of prevention services, and we heard that obesity rates were highest in deprived areas. It is laudable that the Conservative manifesto of 2019 commits to extension of healthy life expectancy by five years by 2035. A litmus test of the Government’s approach will be the attitude to the recently published national food strategy, the Dimbleby report, the last part of which was published last week. That report is clear on action at producer level to reduce salt and sugar in foods, just as we have done successfully under a Conservative Government for soft drinks. That action would produce results. I hope that the murmurings of some on the libertarian extremes, who suggest that exhortation is sufficient, are ignored, given that they are the voices of a few people who have not been following the evidence of the pandemic, and who are committed to an imagined libertarian Valhalla. Not only will positive action help hundreds of thousands, if not millions, of our fellow country men and women, it will also of course ease pressures on the NHS and, indeed, on the economy from the impact of ill health. The details of how the Government are to carry out future arrangements are awaited with interest.
The importance of preventive services in the Ministry of Justice and the Home Office is also highlighted in our report. The Government’s response does not pick up on how there will be investment here in preventive services for those who have been impacted by addiction, homelessness and poor mental health—evidence that we received on this from Revolving Doors. By the same token, early intervention on education, particularly as disadvantaged children have fallen further behind, is crucial. Beyond the existing pupil premium, we need to pick up the proposals on catch-up that Sir Kevan Collins put forward.
On localisation, in the memorable phrase spoken earlier by the noble Lord, Lord Shipley, running England out of London is not on. I agree with that, as does the report. Local provision, whether through the public sector or voluntary organisations, is vital; it is familial, trusted, responsive and fleet-footed, and it is more likely to be flexible. We need to recognise that through public health teams and more local funding, not just because of a democratic deficit but because of lack of local provision, certainly contributing to the disease and to death. I welcome the progress that has been made on metro mayors, and I anticipate more—but much more than that is needed for the localisation that is necessary.
The third area of our report that I wanted to cover related to the importance of voluntary organisations. As I have indicated, they are trusted and familial. Their reach is extraordinary, as I found during our inquiry. For example, Ian Jones, the chief executive of Volunteer Cornwall, told us of 4,500 Cornish charities. Many local councils pick up and work with the voluntary sector. Camden Council, for example, relies on Hampstead Volunteer Corps to help with food distribution, and we welcome the development of the new outsourcing playbook by the Cabinet Office. It is welcome, but we need to see it being followed by ensuring that public service commissioners prioritise social value when contracting services. We look forward to that.
In short, there is a lot to do, and I look forward to hearing from the Minister on taking things forward—in all our interests, but particularly in the interests of those most disadvantaged, which, as we have heard, includes the BAME community, as well as the Gypsy, Roma and Traveller communities. Generally, those at the bottom of the pile have been hardest hit, and the Government must do more to help them.
My Lords, I thank the noble Baroness, Lady Armstrong of Hill Top, for this debate and the Public Services Committee for its immensely insightful report. Future generations will wonder how their Government permitted nearly twice the number of their citizens to die during the Covid pandemic than all the civilians who died during the Second World War. Yes, we need to transform public services, but that cannot be done without transforming politics, and economic and social policies. We need a visible politics of care and compassion. The fact that the Prime Minister was comfortable with 83,000 Covid fatalities in the age group 18 or over is really a sad low point in British values. Front-line workers, including hospital staff, care home workers, transport staff and retirees feature disproportionately on the Covid death list.
As Sir Michael Marmot’s recent report demonstrates, the main reason is that, due to low incomes, people have poor access to good food, housing, healthcare and personal space. The pandemic has shown us that poverty and inequalities cause death, but the Government have done little to check that; indeed, they continue with their wage freezes, without any impact assessment on the lives of people or the capacity of the country to manage pandemics. In 1976, the workers’ share of the gross domestic product was 65.1%, and just before the pandemic it dropped to 49.4%—a decline unmatched in any other industrialised country. The average wage was stagnant in the decade preceding the pandemic. This economic legacy has weakened the people’s resilience to pandemics. Many people tested positive for Covid but could not find a safe place to isolate, as they lived in cramped accommodation, all because they are poor.
To manage pandemics, countries need institutional memories and capacities; we lack both. The NHS lacked investment before the pandemic. To manage the crisis, the Government hired expensive and often ineffective private sector consultants for their test and trace programme, which has not augmented the long-term capacity of the NHS. Consultants quickly enter and exit an organisation and leave little trace of their activities. This makes it harder to build a pool of experience and draw lessons.
The Government need to look at their own obsession with privatisation, a key factor in the deaths in care homes. Since 2010, central government grants to local authorities have been cut by 38% in real terms; this accelerated the privatisation of social care. In care homes owned by private equity, nearly 11% of revenues vanish in servicing contrived debt. Private equity also expects a return of 12% to 14% on its investment, which meant that 20% to 25% of the revenues of private equity disappeared in returns, leaving very little for care home residents. Care home workers and residents suffered. Of the 1.49 million workers in care homes, only 50% are full time—nearly 24% are on zero-hour contracts. Almost 42% of the domiciliary care workforce is on zero-hour contracts, and staff turnover is nearly 30%.
In March 2020, the real-term median hourly pay of staff was just £8.50 an hour. In these circumstances, it is difficult, if not impossible, for carers to get to know patients and provide personalised care. Low-paid staff cannot afford to isolate or take time off to recover. It is hard to recall any government concerns about the negative outcomes from privatisation of social care. We cannot build capacity to tackle future pandemics by just creating poverty.
The Government’s economic policies are also creating new dangers and diseases—just look at the water industry, where almost every water company has been fined for anti-social practices. Southern Water is the latest example. The company illegally dumped tonnes of raw sewage into rivers and seas, increasing the likelihood of diseases. Its directors calculated that it was better to pay fines than to treat the sewage, so they dumped it. The puny £90 million fine is no deterrent: Southern’s chief executive has just received a bonus of £551,000 for boosting profits. I cannot recall seeing any health impact that accompanied the Government’s two-thirds cut in the Environment Agency’s budget or deregulation, which expects water companies to self-report their illegal practices.
I hope the Government will reflect on how their political, economic and social policies have inflicted death on thousands and sadness upon millions of innocent people, but I am not too optimistic.
My Lords, I declare my interest as a vice-president of the Local Government Association and I congratulate the noble Baroness, Lady Armstrong of Hill Top, and all the members of the Select Committee. Although I put my name down for this debate, I seem to be one of the few people speaking today who did not sit on that committee. When I put my name down, I did not think the report would be this good—I had not read it—so I would like to say that it is an absolutely amazing report and I thank the committee for achieving it. It is wonderful to see such excellent cross-party working, which is often true of Select Committees.
It is good that the noble Lords, Lord Young of Cookham and Lord Davies of Gower, mentioned the positives about the Government because, quite honestly, looking through this it is hard to pick out the positives. The way that homelessness was dealt with was one of them, but unfortunately homeless people are now being thrown out and are back living on the streets—I see evidence of that every day. I hesitate, being one of the few speakers today who was not on the Select Committee, to comment on every issue, but there are three areas I want to speak to, because they seem so important.
The deep, ongoing inequalities in our society are well documented and clearly had an impact on our ability to deal with the disease, for individuals and for organisations. From a green point of view, we always argue for less inequality, because if people cannot feed their children, clothe themselves, pay their bills and their rent, it is very hard for them to care about other issues, such as the climate emergency. We are better as a nation if we are more equal. That has always been true, and it is something the Government have not grasped and acted upon. The report says:
“People … who live in unhealthy social, economic and physical environments are at higher risk of dying from COVID-19.”
The greater the inequality, the more people will die from a disease such as Covid-19. The Government have to be aware of that and change their actions on this issue. Their job, as a Government, is to care for us all, to reduce inequality, to lift people out of poverty and to prevent worse poverty in the future. What part of government is actually working on a plan to reduce inequality, now and for the future? Of course, many children are likely to be disadvantaged in the long-term by the first lockdown, possibly—probably—leading to much worse life outcomes for them. As a nation, we lose their potential, their skills. So, what do the Government plan to do to make sure that those children catch up as quickly as possible?
I do not get the feeling that the Government understand just how important the National Health Service is and how they need to resource it better. Better resourcing does not mean selling bits of it off. I do not know whether this is still true, but earlier I read that there was going to be a 3% pay rise for NHS staff, and it was going to come out of national insurance. Obviously, that was a few hours ago and the government policy could have changed in that short time, as it sometimes does; however, I want to know why that 3% rise might come out of national insurance when it should come out of tax, so that everybody who is on a higher income would pay more and people on a lower income would pay less. That seems much fairer to me than what the Government are planning to do.
It is a common view that the Government completely messed up on the pandemic. We have heard about a few areas where they did not, but they were incredibly lucky that the NHS did the heavy lifting, made them look better and saved many lives. Of course, the NHS is still saving lives. There are still people with Covid-19, the numbers are rising once again, and the Government have instituted a “Freedom Day”, which is essentially the freedom to get a nasty disease and possibly die.
The third area is why the Government did not send anybody to the Select Committee to give oral evidence. That seems to me to be a derogation of duty and it shows a lack of respect for the House of Lords, which clearly does immensely good work, time and again. It also fits with the Government’s refusal to launch an inquiry. They keep saying, “Now is not the time, because it would distract people”, but of course it will not be the same people dealing with the pandemic at the moment who would be looking into what actually happened. The committee has said that it is not trying to look at all the failings but to set out a road map for the future, which is fair enough. As people dealing with the inquiry would be different from those coping with the pandemic, why are the Government still resisting? Are they hoping people’s memories will have faded? Why cannot an inquiry start immediately? Why not tomorrow?
We cannot afford to deny that this has been a disaster. This report is an excellent way forward. I think the Government should learn from it and accept that the road map being offered is an excellent one. I urge the Government to follow it.
My Lords, as the noble Lord, Lord Shipley, pointed out, your Lordships’ committee wrote this paper some nine months ago—sufficient time for events to prove the committee right or wrong. Events have proved it overwhelmingly right and the Government’s response totally inadequate.
For example, the paper speaks of overcentralised delivery of public services. Thanks to a report earlier this week by the National Audit Office, we are able to compare the centralised procurement in England, using companies without experience of PPE—but, incidentally, with connections to the Conservative Party—and companies new to test and trace, with the Welsh procurement, where local authorities carrying out this work used trusted and experienced suppliers. Not surprisingly, the result was that the cost per head of the test and trace and PPE in Wales was half the cost in England, with no decline in quality and service. As a result, Welsh businesses were supported more generously. In Wales there were winners all round. Surely one of the first lessons learned must be the need for careful analysis of whether services are best delivered from the centre or locally.
The committee calls for a more flexible approach to sharing data. Surely, there is no better example of this than the speed at which an effective vaccine was produced and distributed. Years of research, financed and carried out in the public sector, produced the revolutionary RNA system of vaccines, which enabled the private sector to produce and distribute a Covid vaccine within months, instead of the years previously needed. It was this that enabled the Government quickly to vaccinate a large part of the population. Surely, the lesson learned here is to encourage this co-operation as a matter of course, not as an exception when there is a crisis.
The report also calls for radical improvement in the way government communicates and co-operates with local service providers. This means that the Government must provide clarity to local authorities and businesses. We are currently suffering exactly from this, because the 10-day stay-at-home alerts are advisory rather than legal obligations. Also, there is now inconsistency over wearing masks and social distancing, caused by abrogating responsibility to local authorities, businesses and each one of us individually. Only yesterday, the British Chambers of Commerce said that companies were struggling to make sense of which staff were defined as critical workers and so were eligible to continue working when pinged by the NHS app or by test and trace.
By asking us to make sensible decisions without clear guidance and without providing the tools to make these decisions, the Government are guilty not only of creating uncertainty by mixed messaging but of further endangering public health. Indeed, this lack of clarity has become a defining feature of this Government. The Joint Committee on Statutory Instruments, of which I am a member, almost weekly takes the Government to task over lack of clarity in one or more of their instruments. These examples show that the committee is absolutely right to call on the Government to make public services more resilient and more able to withstand any future crises. As my noble friend Baroness Armstrong explained in her excellent opening speech, this lack of resilience has taken a huge toll on human life and caused enormous physical and psychological damage—as well as damage to the economy. The committee is right: we must learn the lessons, so that we are better prepared if it happens again.
I thank my noble friend Baroness Armstrong and her colleagues for this excellent report. It is a true road map for the Government to follow, coming out of Covid and taking us forward—not building back but building forward. We must look forward and ensure that we go forward and put the correct finance behind this.
I was very disturbed on reading the two pieces in the report about education and inequality. We know that for a child, from the time it is born, equality, food and care are important, as is education. We have seen throughout this pandemic that money for young children and mothers has been cut. There have been no Sure Start start-ups, and no real efforts to provide free nursery education. There is the whole question of food banks and benefits for food. We know that children cannot concentrate without food, and their lungs and the rest of their body are affected too. We are talking about the future generations of this country. Promises have been made but not kept by the Education Minister, and it is a disgrace. We were so lucky that teachers stayed and continued to try to work.
I must ask this Government to think seriously about education. It is not an issue I am known to speak about often, but I find it impossible not to address the way the Government have dealt with it. This report really makes the case, and the road map is here. We must look not only at education from the point at which a child is born, but at the way mothers are treated in hospital and the care they need. We have seen, through this report, how vulnerable mothers from certain sectors are. They need more care, and their babies need care. We also know that a child’s brain, if it is not helped, is not going to grow well; and again, I mention the lungs.
I ask the Minister to undertake that she will ask the Government and the Department for Education to look yet again at children’s education from the very start. We need to have Sure Starts. We cannot rely, as we do, on the voluntary organisations and others that help to make this happen. Sure Starts in all primary schools also have to be brought back. They help not only the children but mothers who are working from home; they need this social contact with each other. Further, we have to give a better undertaking in respect of food banks and how the associated cards operate—when you pay for food, the money is not on them. Why are we using agencies and consultants that cannot deliver? As many noble Lords have said, we pay lots of money to consultants, but nothing is given back. Also, we must look again at the benefits system as we come through Covid. If people cannot look for work, they need benefits to keep themselves and their families going. That is absolutely vital; otherwise, this is going to cost the health service much more, as the report says.
I support all my colleagues in what they have said today. I look forward to hearing what the Minister has to say.
My Lords, since coming here 10 months ago, I have read a lot of legislation and reports and to be honest, it has all been a bit of a chore. However, this report sparkled. I know it has had lots of plaudits, but I commend the noble Baroness, Lady Armstrong of Hill Top, and all the members of the Public Services Committee for an accessible, informative and thought-provoking document. There is lots in it I disagree with, but it was just so useful—and unusual for these toxic times, in that it was free from rancour and “gotchas”. As it says itself, it is not about apportioning blame for past failures, but making constructive suggestions for future reforms—a great relief.
One caveat: in general, I am wary of any sphere allowing the normal of the pandemic to automatically become a new normal by default. The call in the report is to lock in innovations, but that makes me nervous. Yes, it is very useful to kickstart debate, but not to institutionalise as a rigid fait accompli. For example, we all know that digital technology may have facilitated everything from working from home to digital health consultations. But as the report itself points out, Zoom teams and the like could never, and should never, replace face-to-face services. I note with concern that too many GPs and, for example, university lecturers and senior managers, seem reluctant to resume real-life interaction, at the expense of service users.
One striking feature of the report that I would like to make explicit is the cost of treating the NHS as almost a sacred cow public service. It is understandable to celebrate and almost sacralise the health service in a health pandemic, but this can be at the expense of other services. Testimony in the report noted that support for the NHS, especially during the initial part of the pandemic, might have been necessary but should not have come at the expense of preventive and public health services. I agree.
The Nuffield Trust is quoted as noting how the Covid crisis highlights the startling inequality between health and social care services. Many of us felt uncomfortable that that initial “clap for the NHS” neglected care workers. Even today, all the focus is on the pay rise for the heroic NHS staff, whereas social care is plagued with poor wages and awful employment conditions; and now we have even singled out social care workers as the only workforce facing mandated vaccines or the sack.
So, it is important that the report highlights that, long before Covid, successive Governments prioritised funding the NHS—especially acute services—and neglected funding social care. The Nuffield Trust notes that the NHS received generous emergency funding from the Treasury in the early stages of the pandemic, which then enabled a dramatic expansion of capacity. Care providers, in contrast, said that extra funding did not reach them. Also, and related, the deputy director of the New Local Government Network contrasted the experience of local government with the NHS. The NHS had its costs met in full and deficits written off unquestioningly, but that was a privilege not afforded to councils or other public services. I do wonder about this hierarchy of priorities.
The consequences go beyond material funding. As ADASS points out, the historical tendency to prioritise the NHS has influenced policy decisions, sometimes with tragic consequences. In the name of saving the NHS, rather than the NHS saving lives or the public, we now face the collateral damage of non-Covid deaths from cancer and heart disease and huge waiting lists for many in dire need of medical interventions, with the terrible news of an increase of 50% of under-20s hospitalised with eating disorders. In a different debate earlier today, we also heard about the use of “do not resuscitate” in hospitals. We cannot ignore these things.
But perhaps the greatest horror associated with the focus on the mantra of protecting the NHS was the scandal of patients being discharged from hospital into care homes without testing—what the Nuffield Trust called, as quoted in the report, a
“rapid clearing of hospital beds in the early stages”,
regardless of the
“lack of preparedness of the care settings”.
The most vulnerable died as a consequence and, at the very least, it is important that we be able to query NHS policies without being shut down as somehow disloyal to NHS staff who, I agree, have been and are heroic and hard workers—but so are other workers. I do not think that you should be called a traitor to the institution if you query it.
Another striking aspect I read from the report is the wasted potential of civil society in helping deal with the pandemic. On a positive note, of course, the report gives lots of examples of innovation happening because bureaucracy was swept away. In fact, sometimes to tear up the red tape is caricatured as a laissez-faire, careless approach, but the removal of overly bureaucratic hurdles allowed public services to work alongside charities and community groups and volunteers, and the private sector stepped up. Altogether, this played a huge role in delivering services.
The surge of civic action, such as the 4,000 Covid-19 mutual aid groups and the local WhatsApp and Facebook groups I am sure we were all in as volunteers, showed a real appetite for providing practical solidarity in the emergency from so many people. We saw the generosity of 750,000 people signing up in four days when NHS England’s Royal Voluntary Service was launched in April 2020, but sadly that was wasted. The Institute for Volunteering’s research rightly notes in the report that overcentralised co-ordination was not aligned to locally organised activities, significant time was taken to respond, enthusiasm dwindled and people became demoralised. I think it was just so sad when volunteers could have helped, for example, relieve the pressure on social care workers, or indeed NHS workers.
In general, the official approach to Covid was to demobilise the public—to squash initiative and volunteerism. The report notes how the German public health service, in contrast, mobilised and seconded public servants from across departments: forestry, museums—