House of Lords
Thursday 17 November 2022
Prayers—read by the Lord Bishop of St Albans.
Introduction: Lord Leong
Sonny Leong, CBE, having been created Baron Leong, of Chilton in the County of Oxfordshire and of Camden Town in the London Borough of Camden, was introduced and took the oath, supported by Lord Kennedy of Southwark and Baroness Smith of Basildon, and signed an undertaking to abide by the Code of Conduct.
Introduction: Baroness O’Neill of Bexley
Teresa Ann Jude O’Neill, OBE, having been created Baroness O’Neill of Bexley, of Crook Log in the London Borough of Bexley, was introduced and took the oath, supported by Baroness Eaton and Lord Porter of Spalding, and signed an undertaking to abide by the Code of Conduct.
Oaths and Affirmations
Lord Hoyle and Lord Bamford took the oath.
To ask His Majesty’s Government what assessment they have made of the report by Carers UK Heading for Crisis, published on 18 October, which showed that 40 per cent of carers receiving Carers Allowance are in debt and unable to make ends meet; and what steps they intend to take in response.
The Minister for Disabled People, Health and Work is looking forward to an early meeting with Carers UK to discuss this and its recent report. Our main conclusion from that helpful report is that carers in financial need may wish to check whether they have applied for all the benefits that they are entitled to, including means-tested benefits. That can provide them with an extra weekly income and additional help with the cost of living. For example, carers can get up to £2,000 on the carer’s element of universal credit.
I thank the Minister for her Answer and for her personal commitment to this issue. I know she understands the economic case for supporting carers because they save the nation nearly £200 billion every year, but I wonder if the Government also understand that there is a strong political case here too. Some 84% of the general public think the Government should supply more support for carers, while only yesterday the Association of Directors of Adult Social Services said that 97% of directors thought the Government should provide more financial and practical support for carers. A top-up payment to get them through the winter and a relaxation of the earnings rule, so that they could keep more money if they managed to get a job, are modest enough demands but they would make a huge difference to carers, to health and to social care, and perhaps even give a much-needed boost to the Government’s reputation.
I accept that the requests in the paper are modest—I really do. I must pay tribute to the work that carers do; it is much valued and respected. With regard to a top-up or an extra payment, unpaid carers can already get a top-up through means-tested benefits. I re-emphasise that we must make sure that they claim everything they should. The earnings limit for those in receipt of carer’s allowance who are able to maintain some contact with the employment market is currently £132 a week. I have no information that tells me that that is going to be changed.
My Lords, given that many people in ordinary households are very worried about their fuel bills this coming winter, it seems highly likely that carers, often with very delicate people to support, will be even more worried. Can my noble friend offer them any crumb of comfort?
There are two things. We understand the pressures on carers facing the cost of living crisis, especially around energy costs. They will get support through the energy price guarantee, which is supporting millions of households with rising energy costs. I am just waiting for someone to ask me about uprating. We have nine minutes to go until the Chancellor’s Statement, and I stand here in hope.
My Lords, carers who care for longer are more likely to be struggling to meet the cost of living crisis at the moment and are more likely to be falling into debt. The Carers UK report shows that that is particularly the case for those who have cared for over five years. What plans do the Government have to set up some sort of independent inquiry looking into the relationship between carers and poverty and to try to come up with some solutions for bringing unpaid carers out of poverty?
My very straightforward answer is that there are no plans for a review or working group on this. Knowing how vociferous the noble Baroness is about things that matter to her, I would have thought that a letter to the Secretary of State would not be a bad thing.
My Lords, this Minister and other Ministers constantly tell us that carers are well valued, yet the carer’s allowance continues to be paid at a lower rate than equivalent benefits, despite the growing evidence of the serious hardships experienced by carers. How can this state of affairs be justified? Asking carers to claim means-tested benefits is not the answer.
We should wait and see what the Chancellor says, and I am hopeful about that. I re-emphasise that means-tested benefits can increase payments to carers quite significantly. I am sure that, when Carers UK meet the Minister for Disabled People and talk about the report, they will discuss in detail some plan to raise awareness of those benefits.
My Lords, in response to the Question from the noble Baroness, Lady Pitkeathley, my noble friend the Minister replied that carers are not always aware of all the benefits they are entitled to. Could my noble friend enlighten the House on what steps the Government are taking to make sure that more carers are aware of the benefits available to them?
I go back to my previous answer. We have done it for pension credit, and we have had quite some impact there. I cannot commit to doing the same for carer’s allowance, but I am sure that, when Carers UK meet the Minister for Disabled People, that should be if not number one then number two on the agenda. There are other ways people can know about those means-tested benefits, including GOV.UK and through citizens advice bureaux and other organisations such as Carers UK.
My Lords, is the Minister prepared to talk to the Department of Health and Social Care to see whether there could be an additional allowance to carers immediately on a relative being discharged from hospital to try to reduce delayed transfers of care?
My Lords, the Minister is rightly encouraging people to claim the benefits to which they are entitled, but can I take her back to the question asked by her noble friend Lady Fookes? Even people on benefits may be struggling at this point. The report showed that those who are caring have extra costs which others do not. The report was incredibly moving. One person said:
“My son is incontinent … if we don’t wash him in warm water several times a day this will cause him to physically decline. So how do we pay for the gas to heat the water if we are currently at max budget?”
“my husband has terminal brain cancer, I am worried about how I will cope over the winter months as I can’t allow him to be cold—I need him to be as comfortable as possible in his final months at home”.
Those who are on just carer’s allowance do not get any extra help with fuel. What are the Government going to do to see whether the money given to those who are caring is enough to meet the costs they encounter?
Those who are on carer’s allowance receive the £400. Those who are on carer’s allowance but who are entitled to the carer’s element of UC, where they are not required to look for work, can get another £2,000. The Government are helping, and we are four minutes away from finding out what more they might do around energy costs. The stories and case studies that the noble Baroness read out are harrowing, but the Government are doing everything they can, within the limits of their financial position.
My Lords, have the Government given any thought to those people on carer’s allowance getting automatic increases rather than having to means test? We already know that means testing makes it more difficult for claimants to receive the money they need.
I think the noble Lord is asking me whether people on carer’s allowance will automatically get means-tested benefits. There are other benefits which are means tested and cannot automatically be applied. I have no information that those rules are to change. I agree that the noble Lord is justified in his question.
My Lords, does my noble friend not think that it is high time we had a review of the whole basis of social care? I do not know what the Chancellor is going to announce, but did we not take a wrong turn when we placed the emphasis on people not having to sell their family homes, rather than on getting the resources needed to support professional carers, as well as carers at home, and on reinforcing support where families take on that responsibility but are covered by additional help? It really is urgent, and it is one of the reasons we see ambulances parked outside hospitals and hospital beds being blocked.
I completely agree with my noble friend that the situation is urgent. We have launched the People at the Heart of Care White Paper, which set out a 10-year vision for reforming adult social care. I do not make light of the facts; we are all aware of the extraordinary position the NHS is in with the backlogs. I am sure that my noble friend Lord Markham—I am not passing the buck—has got this under control and will be prepared to share that with noble Lords.
Addressing childhood obesity remains a priority for the Government and we remain committed to achieving our ambition to halve childhood obesity by 2030. We are delivering an ambitious programme of work to create a healthier environment to help people achieve and maintain a healthy weight. We recognise that there is more that we need to do, and we will continue to work with the food industry to make it easier for people to make healthier choices.
My Lords, first, could the Minister clarify whether the previous Administration’s policy, either to weaken or to repeal much of the 2020 obesity strategy, still stands or whether the Government will do better than that? Secondly, does he agree that health visitors play an important part in educating and informing families and parents so that, when children are young, they are brought up in an environment where they are encouraged to have a diet that tackles obesity?
I agree that health visitors play a vital role. We all know that a good start to life with healthy eating is a good foundation for the rest of your life. We also know that a lot of the problems around adult obesity obviously start in children under the age of five. I completely agree on continuing to strive to do better in government. I will answer some more questions on the actions we are taking, from which the noble Lord will see that we are very active.
My Lords, does the Minister agree that, as 40 million people are obese in this country, marching inevitably to a premature death from a variety of very unpleasant diseases, it would be a good idea to encourage them to have one less meal a day? This might encourage children to follow suit and put fewer calories into their mouths, which would help prevent them developing type 2 diabetes before they are 10.
My Lords, I agree that we—both as the Government and in general—need to be clear about what our recommended calorific intake is each day. Whether you choose to change that by eating one less meal, or however else you distribute your eating across the day, it is our role to help educate people on healthy eating. I agree that it is an issue and a big cost to both the health service and the economy. Our latest estimates are that it could cost the economy as much as £58 billion a year, so it is a critical message to get across.
My Lords, would the Minister enlighten us on the position of the BOGOF—buy one, get one free—deals? Are we going to remove the disincentive to people buying extra calories in the form of an extra portion? Or will the Government encourage people not to buy the first portion?
As I think the noble Lord is aware, the position on BOGOF, so to speak, is that we have delayed those restrictions for a year. We have taken significant action in this space, most critically in supermarkets, by moving the promoted items away from tills and prominent aisle endings to remove this so-called pester power. We will very much keep this under review; when we see the impact, particularly of moving those items, we can look again at whether we will introduce more BOGOF restrictions.
My Lords, the Minister has mentioned that what children eat is very important, but is the amount of proper and physical exercise young children get not just as important? Is he concerned, as I am, that primary schools, more and more, do not have officially registered physical education teachers, resulting in children getting very little properly organised exercise? Does he think that this is important, as far as obesity in children is concerned?
I agree with the noble Baroness, particularly given her previous position, that sport and physical activity are vital. As I am sure she is aware, we have a 60-minute target for children and £320 million of PE funding to back that up—but active lifestyles and sport are critical to that.
At this moment, as both an Englishman and a Welshman, I take the opportunity to wish both teams all the best in the World Cup.
My Lords, is it not a factor that exercise, no matter how much you do, will reduce only 20% of your overweight? Some 80% is from food and drink. Will the Government spend more time looking at fat and sugar? Why will they not promote research into alternatives to sugar, notably stevia? Instead, they leave it to the private sector and the manufacturers to do the work, and they are doing no work whatever on it. In those circumstances, will the Government take action themselves?
I agree with the noble Lord that a healthy lifestyle in terms of exercise gets only you so far and that the amount we eat is critical to that. We have played a very active role on sugar reduction—of course, I say this in the context of this being Sugar Awareness Week. Obviously, the sugary drinks levy has reduced sugar in soft drinks by 44% by using artificial sweeteners, so this is something we will look to continue to research and to add to, if the evidence backs it up.
My Lords, I draw attention to my registered relationship with ukactive. I ask my noble friend whether he would agree that there is, on this occasion, as the noble Lord, Lord Stevens of Birmingham, said once, a silver bullet: it is called physical activity. This is in line with the question from the noble Baroness, Lady Hoey. In supporting physical activity, my experience was that the Department of Health needed to work with DCMS and the Department for Education to promote school sport partnerships. In my former constituency, 51 primary schools benefit from the school sport partnerships. It is a really important priority that every youngster, not just those who are really good at sport, gets the chance for that physical activity.
I thank my noble friend and totally agree with him. As we have all mentioned, physical activities are a key part of a healthy lifestyle, regarding not just obesity and healthy eating but mental health. There is a lot of evidence to show that sport and a healthy lifestyle are good for everyone. We are working with the DfE and DCMS on this, but I agree that it we will need to keep it central to our agenda.
My Lords, obviously the situation in the UK is extremely concerning, but we should consider what is going on elsewhere in the OECD: some countries have a better record than us, and others have brought in extremely innovative initiatives. What can we learn from other countries?
I thank my noble friend for his question. Absolutely, we always need to ensure that we are trying to learn from best examples, either in this country or from around the world. The OECD talks about four major strands: information and education; increasing healthy choices; modifying costs, such as a sugar tax; and restrictions on the placement of food and promotions. Noble Lords can see that we are taking much action in all those areas. Most of all, I am pleased to see that, influenced by a trailblazing initiative started in Amsterdam, we are now funding five local authorities to follow that across Birmingham, Bradford, Nottingham and Lewisham to see what we can learn from those initiatives.
My Lords, what parents, health professionals, educators and retailers want is some consistency and clarity from the Government. Can the Minister confirm whether the Government intend to maintain the previous Prime Minister’s plans to ditch the vast majority of their 2020 obesity strategy, against the advice of the current Chancellor, who just two months ago signed a letter from former Health Ministers on the need for an anti-obesity strategy? We need to know where we are.
My Lords, is it not the case that we have had strategy after strategy, all well intentioned—we all agree on what we want to do—but it is not working? The Government pussyfoot around this. As my noble friend Lord McColl said, we need to tell people that it is not acceptable to be obese. If you are obese, guess what, your children think that it is acceptable to be obese. Might not we have a bit more of a robust strategy on this?
I like to think that we have an active strategy in this space. Personally, I prefer carrot to stick in this area. However, as I answered in the previous question, I am prepared to learn from anything that has worked in this country or abroad. If there is evidence of where the stick works better than the carrot, I would be willing to look at that and see whether we should be copying some of it.
Peerages: Letters Patent
The Government are aware that there is some precedent for individuals deferring taking up their seats in the House of Lords—for example, by agreeing a delay in the issue of Letters Patent. However, that is limited and largely reflective of personal circumstances. As the noble Lord will know, advice between the Prime Minister and the sovereign is confidential.
My Lords, perversely, the topical Question granted for yesterday helps us to clarify the Government’s position, not least on the difference between an MSP and a Member of the House of Commons, and the constitutional position and implications, not least for the monarch. Let me ask a very simple question: will the Government support tomorrow the Private Member’s Bill, which will be proposed by the noble Lord, Lord Norton of Louth, to strengthen the House of Lords Appointments Commission?
I very much sympathise with the noble Lord, in that his Question is being answered today rather than yesterday, and I very much look forward to participating in the debate tomorrow on the Private Member’s Bill proposed by the noble Lord, Lord Norton. The Government have no plans to change the status of the House of Lords Appointments Commission. It is an independent non-departmental public body, as noble Lords will know, and the Prime Minister is democratically accountable. As I said yesterday, we do not believe that appointments should be determined by an unelected body—but, of course, we will be listening and participating in the debate secured by the noble Lord, Lord Norton.
My Lords, the Minister yesterday asserted the principle that the Government are entitled to have a similar majority in the Lords to the Commons, but that is not a principle that was understood in the last partial reform of the Lords in 1999. Indeed, the then Labour Government survived with fewer Peers in the Lords than the Conservatives for many years afterwards, and the noble Lord, Lord Strathclyde, as Leader of the Conservative Opposition, carried a great many votes against the then Government.
Could the Minister take us a little further on that principle? Does she assume that, in the event of a change of Government, it would be appropriate for the Conservatives to retire enough Peers to enable the new Government to gain an alternative majority, or does she think that the House will then have to go towards 1,000 Peers?
As I said yesterday, I am not willing to speculate on what might or might not happen after a future general election. However, I repeat that the Conservative Party, despite winning a succession of elections, has still only 34% of the seats in the House of Lords. It is interesting that 408 Members were appointed over the 13 years from 2010, and 404 Members have been appointed over the 12 years between 2011 and 2022.
My Lords, the late noble and learned Lord Mayhew and I, as ex-Attorney-Generals, gave evidence to this House’s Constitution Committee that the Government could not rely on the royal prerogative to go to war as it was outdated, and the committee agreed. The committee chaired by the noble Lord, Lord Burns, did not make any suggestions on how to stop a Prime Minister proposing increases in membership of this House. Will the Government consider referring to the Constitution Committee the use of the royal prerogative to recommend peerages, as its unlimited use is similarly outdated?
I do not see it quite that way. We have retirements and departures, and we support the continuation of encouraging more retirements. I think that the Liberal Democrats in particular have not as many retirements as some other parties. As we have said, we look more broadly at the role of the Lords, but it is an important point that significant measures—which I think could stem from the noble and learned Lord’s question—on the size and composition of the House of Lords are a matter for the democratically elected Government. Of course, the House and committees have a role in offering advice, but significant changes have to be for the Government of the day.
If the Minister is unable to answer this question, could she at least reflect on it? Should a peerage be allocated to somebody who is a sitting MP and they subsequently blot their copybook, will the Government rescind their peerage, or ask the monarch to do so? Have we also completely now abandoned the process of two out, one in?
I would like the Minister to remind me when it was that Prime Minister Boris Johnson resigned. When was it? Then, we know that the speculation that has been talked about is about a resignation list, not an honours list and not nominations—we had nominations recently. That is the speculation. She keeps saying that the Prime Minister takes responsibility. Will Prime Minister Sunak admit responsibility for this list, and will he stop and make sure that he does not put His Majesty in this invidious position, because it will bring disgrace on the Government and disgrace on His Majesty?
It is a convention that has been observed by successive Governments that a resignation honours list can be put forward by a departing Prime Minister. It can take a bit of time: I think that Theresa May and John Major took a few months to put their resignation lists together. They are then forwarded to the Prime Minister of the day. The practice now is that the House of Lords Appointments Commission looks at proposals and makes recommendations, which are taken into account by the Prime Minister in the confidential advice that he offers the sovereign.
My Lords, I am sure that before tomorrow’s debate the Minister will study the Bill proposed by the noble Lord, Lord Norton, and I think she will see that it does not propose that the Appointments Commission should determine membership of this House but that that responsibility should remain with the Prime Minister.
May I suggest that the Minister visit the Members’ Cloakroom downstairs, where she will see eight red boxes containing seals that have not been collected by a number of Peers, including the noble Lord, Lord Lebedev? Would one way of achieving the excellent proposal from the noble Lord, Lord Burns, for reducing the size of this House be to find a way to get rid of the Peers who fail to turn up regularly without reasonable excuse?
I cannot agree with that. Like others, the noble Lord, Lord Lebedev, was nominated on his contributions to society and that included his understanding, obviously, of Russia; but also, he has been extremely critical of the murderous Putin regime. He—
Let me finish. He, like other Members who turn up less than the rest of us, brings a difference perspective. I was present for his maiden speech. The point about the House of Lords is that it is a part-time House and some people bring other aspects and contributions which are not on the Floor of the House.
In answering the Question yesterday and today, the Minister mentioned that when, in the past, Members of the House of Commons have been nominated for a peerage, it has in a very few cases been postponed “for particular reasons”, I think her phrase was. Who determines the particular reasons? Would it be a Minister of the Crown, in which case it would be subject to judicial review, would it not?
I think I was trying to make the point that it is down to the particular circumstances of the individual. In the cases in question—I think there were three or four, and I will not go into them—the particular circumstances and needs of those involved, for example, being a Member of the Scottish Parliament, meant that a deferment was possible and appropriate.
My Lords, according to the Global Financial Centres Index, London is the second highest-ranked financial centre in the world after New York, while Paris is 10th. The UK continues to be the pre-eminent financial centre for derivatives and foreign exchange trading. In all equities instruments, the UK almost doubles France’s total market capitalisation at $6.2 trillion. To support the UK’s competitiveness, the Government are undertaking ambitious reforms to keep pace with innovation.
My Lords, I totally accept that there are various people trying to analyse the levels of trading—although it was a wake-up call last year when on some grounds Amsterdam was seen to overtake London as the premier financial trading centre, and last week some of those organisations claimed that Paris had overtaken London as the premier stock exchange. In the light of us trying to build an economy which properly rewards our workers and protects our environment, what are His Majesty’s Government doing to increase confidence in London’s reputation in financial trading and as the premier stock market?
I am so glad that the right reverend Prelate has given me a chance to set out what the Government are doing. The Financial Services and Markets Bill has just completed its work in Commons Committee, setting forward a whole range of reforms to inherited EU law to make us more competitive. He also mentioned the environment. The Government’s ambition is to make London the premier place for green finance, to ensure that our financial markets take into account the challenge of climate change, so that we then can ensure that we are pursuing green growth across the whole of our economy.
My Lords, having lived and worshipped for nearly 40 years in the diocese of the right reverend Prelate the Bishop of St Albans, I have benefited greatly over the years from the spiritual advice that I have received from his predecessors and my local clergy. But is my noble friend aware that this is the first time I have ever heard a bishop of the Church of England complain that the stock market is not high enough? Is that because the bishops have ceased to worry about spreading Christianity and now propose the worship of Mammon, or is it simply a delayed anti-Brexit point, which is not the role of the bishops?
I cannot speak for the right reverend Prelate but he mentioned two things. One was ensuring green growth, which I have addressed, and the other was workers and jobs. Maybe he knows that there are 2.3 million jobs supported by the financial services sector, with two-thirds of these outside London in finance hubs including Birmingham.
My Lords, I do not accept the premise of the noble Lord’s question, which he may be unsurprised to hear. In fact, in 2021, over 120 companies chose to list in London, the highest number since 2014 and ahead of its European competitors. These listings raised a total of £17 billion, the most raised in 15 years.
My Lords, I am sure that the noble Baroness must accept that in 2015 the value of the London Stock Exchange was twice that of the French stock exchange, and today it is lower. Will she also accept that there could be a number of reasons for this? First, it could be, as the Governor of the Bank of England said this week, that the markets have lost confidence across the board in the UK economy. Secondly, could it be because of the damage to the economy that the previous Prime Minister did in her 44 days? Thirdly, could this be—whatever the noble Lord, Lord Lilley, might think—a result of Brexit, as the Times said today? Or does she agree that it is all three?
I think the noble Lord forgot to mention a global pandemic and Putin’s war in Ukraine. He also forgot to acknowledge the point that I have made throughout this Question that London continues to be either the highest or second highest-ranking financial centre in the world.
My Lords, obviously we cannot be complacent, but can the Minister remind the House that Paris has 795 listed companies on its exchange, whereas London has 2,484 companies. We should look not just at the most valuable companies, such as LVMH, which is quoted in Paris and has a market capital of over €300 billion, but at all those small companies that are raising capital on the London market.
I think my noble friend has reminded the House on my behalf of those figures. I take the opportunity to say that we are not complacent about London’s position, and we are doing a lot of work beyond the Financial Services and Markets Bill to ensure that it remains competitive—the listings review from the noble Lord, Lord Hill, the second capital raising review and the wholesale markets review, among other pieces of work. The FCA has already delivered a number of rule changes based on the listings review to ensure that we remain competitive.
The noble Lord will know that risks come alongside being a premier financial centre. The important thing is that we take action to address those risks. That is what the Government have been doing and will continue to do. We had part one of the economic crime Bill in the previous Session and part two will be forthcoming.
The noble Lord is right in one respect: both the rest of Europe and the UK face heightened energy prices as a result of the war in Ukraine, and jurisdictions such as the US do not face equal pressures. But the UK also faces a tightness in its labour market that we see in the US, for example, that is not seen in other European countries. Factors have come together to make things harder for the UK in the current circumstances.
Is it possible to produce a definitive ranking order of the causes of our economic woes, specifying war in Ukraine, Brexit, Covid and a defined period of government mismanagement? It seems to me that everybody hides behind a mix of them. Is it possible to have an independent and defined ranking order of them to cut away some of the dispute?
Our biggest economic challenge right now is the high levels of inflation that we are facing as a country, and the biggest driver of that inflation is heightened energy prices caused by the war in Ukraine. Yes, there are other factors at play, but I think those two things are undisputed.
The fact of the matter is that the Government have weakened the City by their policies towards the single market and Europe. I wonder what the Government are doing about the fact that people who work in the City selling financial services—I declare my interest, as a member of my family works in the City—cannot sell or are restricted in selling in Europe unless they are accompanied by somebody from the country in Europe where they are trying to sell, because of the deal we have with Europe. This is weakening the City.
I disagree with the noble Lord. I think that our leaving the EU presents opportunities for the City, which is exactly what the Government plan to capitalise on through the Financial Services and Markets Bill and other things that I have already mentioned. We do not just trade with Europe, and we continue to be one of the pre-eminent global financial centres in the world.
My Lords, my noble friend is absolutely right to say that there are a number of ways of measuring the rankings of different financial centres. In the ranking to which the Question refers, one reason why Paris has overtaken London is because of the value of LVMH—one company, which has doubled its share price. It shows the challenge of making sure that we are attracting growth companies. What are the City and Government doing to make sure that we continue to attract growth companies to list in London?
My noble friend is absolutely right that one factor in play here is that different sectors are represented more strongly in the different stock markets, which have been affected differently by the global uncertainty and inflationary pressures that we have faced. On his point about what we are doing to attract investment into the UK, I say that two elements of the growth plan that were retained were around the annual investment and small enterprise investment—I will get the acronym wrong, but I refer to the other investment allowances. We consider that to be incredibly important. I have mentioned before a number of the changes to listing rules including, for example, dual class share structures, which have been taken forward by the FCA.
Business of the House
Motion on Standing Orders
That Standing Order 44 (No two stages of a Bill to be taken on one day) be dispensed with on Wednesday 23 November to enable the Counsellors of State Bill [HL] to be taken through its remaining stages that day, and that, in accordance with Standing Order 47 (Amendments on Third Reading), amendments shall not be moved on Third Reading.
Missile Incident in Poland
The following Statement was made in the House of Commons on Wednesday 16 November.
“With your permission, Madam Deputy Speaker, I will make a Statement about the missile strike in Poland overnight.
At approximately 7 pm local time last night, there were missile explosions in a village in eastern Poland, approximately four miles from the border with Ukraine, killing two civilians and wounding four, during an extended Russian bombardment of Ukrainian territory.
As soon as I received the report, I contacted my Polish counterpart to express the sympathy and solidarity of the United Kingdom—I am sure the whole House will share that sentiment—and to offer our practical support. I then spoke to my right honourable friend the Prime Minister in a trilateral call with my right honourable friend the Defence Secretary, while the Prime Minister was attending the G20 summit in Indonesia.
The Prime Minister immediately called President Duda of Poland to convey the UK’s condolences for the tragic loss of civilian life and to assure him of our unwavering support to a steadfast NATO ally. My right honourable friend then spoke to President Zelensky about the latest situation and also attended an ad hoc meeting of G7 leaders called by President Biden to discuss the evolving situation.
This morning, I spoke to the Polish Foreign Minister and I commended Poland’s decisive, determined but calm and professional response to the situation. It is wise to advise the House that, at this point, the full details of the incident are not complete, but, earlier today, Jens Stoltenberg, the NATO Secretary-General, said there was
‘no indication that this was the result of a deliberate attack’.
He added that the incident was
‘likely caused by a Ukrainian air defence missile fired to defend Ukrainian territory against Russian cruise missile attacks.’
Poland will lead the investigation to establish exactly what happened, and the UK stands ready to provide any practical or technical assistance. In the meantime, we will not rush to judgment; our response will always be led by the facts.
The House should be in no doubt that the only reason why missiles are flying through European skies and exploding in European villages is Russia’s barbaric invasion of Ukraine. Secretary-General Stoltenberg was absolutely right when he said today that what occurred in Poland is ‘not Ukraine’s fault’ and that ‘Russia bears ultimate responsibility’.
Yesterday, Putin launched one of the heaviest attacks since the war began, firing wave upon wave of more than 80 missiles at Ukrainian cities, obliterating the homes of ordinary families, destroying critical national infrastructure and depriving millions of Ukrainians of power and heat just as the winter sets in. This brutal air campaign is Putin’s revenge for Ukraine’s successes on the battlefield, where Russian forces have been expelled from thousands of square miles of territory. Now he is trying to terrorise the people of Ukraine and break their will by leaving them shivering in cold and darkness. I have no doubt that he will be unsuccessful in that endeavour, but this is why Britain is helping Ukraine to strengthen its air defences, and we have provided more than 1,000 surface-to-air missiles thus far. I know that the House will be united in our support for Ukraine’s right to defend her territory and her people.
On Monday, I signed a memorandum of understanding as part of our £10 million commitment to help Ukraine rebuild its critical energy infrastructure. The tragic incident in Poland last night is ultimately the result of Russia’s aggression against Ukraine. That is the only reason why it has happened, and it would not have happened otherwise. That is why the UK and our allies stand in solidarity with Poland, and that is why we are determined to support the people of Ukraine until they prevail and their country is once again free. Madam Deputy Speaker, I commend this Statement to the House.”
My Lords, the loss of life in Poland is a brutal reminder of the tragic consequences that Putin’s illegal invasion of Ukraine is having. I am sure the whole House will wish to express condolences to the families of those killed. As NATO’s Secretary-General said yesterday, and as the Statement reflected:
“Russia bears the ultimate responsibility as it continues its illegal war against Ukraine.”
The Government of Poland, along with NATO, should be praised for their level-headed response. We should also recognise the risk of miscalculation that results from this war. Is the Minister able to give a further update on the NATO meeting yesterday to discuss its reaction to the incident? Can he also confirm that we are, either directly or through NATO, giving maximum support to the investigation to establish the full facts?
This week has seen the largest barrage of missiles against Ukraine since the war began, with a completely unjustified focus on civilian infrastructure, which we all know will have consequences for innocent people, families and children as the winter approaches. We must continue to offer our full solidarity with the people of Ukraine, and of course the Opposition are absolutely at one with the Government in our support for Ukraine. I hope, however, that the Minister can tell us that, in expressing our solidarity, we are also exploring new ways of bolstering Ukraine’s defences. In particular, can he tell us what further steps we are now taking to strengthen its air defence capacity?
In terms of maintaining global unity in support of Ukraine, I assume that the Prime Minister’s Statement on the G20 will cover a major part of this, but can the Minister tell us more specifically what we have been doing with the EU to ensure that we maintain absolute unity in the fight against Putin’s illegal war?
My Lords, I also associate these Benches with the condolences offered by the noble Lord, Lord Collins, to those affected by this. We agree with the NATO Secretary-General when he said that
“this is not Ukraine’s fault”
because the cause is Russia, which “bears the ultimate responsibility”. Putin will of course seek division, and therefore it is important that the UK and our allies are together with President Zelensky in supporting the Polish Government and investigating the direct cause of this.
It is to be welcomed that the UK and our allies at the G20 conference reacted in a sensible and cautious way. I support the work of the Government on this. The Foreign Secretary said in the Statement that
“the UK stands ready to provide any practical or technical assistance”
to the Polish Government. Can the Minister say whether the Polish Government has asked for that from the UK and whether that is to be provided? We offer great resources when it comes to investigative capacity, and our intelligence networks are of course second to none. I hope that they are fully open to the Polish authorities.
The Government have said that the UK has provided
“more than 1,000 surface-to-air missiles thus far”
to Ukraine. We have supported the deployment of UK assets provided to Ukraine. Can the Minister give an estimate of how many of those have so far been used and whether UK support with regard to missile capability needs to be replenished? The Minister knows well enough from questions in previous debates that we have sought clarity as to UK stocks of supplies, not only for supporting Ukraine but for our own defensive capabilities. It would be helpful to know what level of resources that we have made available has been used.
Can the UK now work with our allies to move into a new phase of tackling what could well be apparent impunity? The random bombardment of cities with missiles from the Putin regime is fully grotesque. There is no question in my mind that this is now absolutely a clear crime of aggression, in addition to the crimes against humanity that we have already discussed. Can the Minister update the House with regard to the UK policy on the crime of aggression? The UK has not ratified the amendments to the Rome Statute made in Kampala in 2010. We have not been as clear as I believe we should be in support of those who have called for a hybrid chamber on the crime of aggression of the UN and Ukraine, so that we can see movement on reducing the prospect of impunity for the Putin regime. Is this not now the appropriate time to review the UK’s position on the failure to ratify the amendments to the Rome Statute on the crime of aggression? The UK should be seen as a facilitator in moving to establish a chamber where we can see some of the crimes that have so clearly committed by the Putin regime put to the judicial process, so that there can be punishments for the crimes that are so obviously taking place.
My Lords, I first thank the noble Lords, Lord Collins and Lord Purvis, for their strong support of the Government’s position. I align myself totally with the condolences extended to those impacted by the tragic deaths in Poland, which I am sure reflect the view of the whole House. Let us not forgot that this is a direct action caused by Mr Putin. There were 80-plus missile attacks across Ukraine in a blanket manner. We are of course working with the Ukrainian Government, and again I am thankful to both the Front Benches and their respective parties across both Houses for their strong support for the position that the Government have taken in support of Ukraine, and indeed in our strong alliances with our key partners through NATO, the European Union and with other countries as well.
The noble Lord, Lord Collins, raised the importance of co-ordination with NATO. As he may be aware, my right honourable friend the Prime Minister conducted, first and foremost, a direct call with the Polish President, showing absolute solidarity with President Duda. My right honourable friend the Foreign Secretary spoke to the Foreign Minister of Poland and the Prime Minister also spoke immediately to President Zelensky. Indeed, we co-ordinated some of these calls at the G20 with other key allies. As for the response, there was co-ordination with the EU through various partnerships, including the convening of a meeting of the G7 by President Biden, which the Prime Minister and the President of the European Commission attended. This underlines the strong unity of purpose and action across the piece among all allies in support of Ukraine, and of course standing in solidarity with a fellow NATO member, Poland.
The noble Lord, Lord Collins, asked about our co-ordination and support of air defences. As the noble Lord, Lord Purvis, said, we have provided support, and I assure both noble Lords that we work in a co-ordinated fashion with our NATO partners to ensure that the munitions and equipment required by Ukraine and other NATO allies are kept constantly under review in the current crisis. There was an emergency meeting of NATO ambassadors that the United Kingdom Permanent Representative to NATO also attended, which covered many of these issues around exact requirements and the response from Poland, but also, importantly, how we as the NATO alliance should react to the situation that arose.
It was quite notable—as I am sure all noble Lords would acknowledge—the restraint that was shown, including in public statements. I remember sitting in your Lordships’ House as this issue unravelled and, as I left, I sought an immediate update. With the continuing war and Russia’s indiscriminate bombing in Ukraine, it was, frankly, deeply concerning to see that this situation had crossed the border. I have been to the border and seen some of the air defences of the Polish Government. Again, I reassure both noble Lords that we are fully aligned and co-ordinate through NATO on the level of support required, not just the direct support that we are providing to the Ukrainian authorities, which we have listed many times, but how we can co-ordinate our best response as the NATO alliance.
On technical support to Poland, I assure the noble Lord, Lord Purvis, that those conversations have happened; he can take it as read that we are offering whatever support Poland needs. Poland has played a phenomenal role in the situation in Ukraine, as I and other noble Lords who have visited the region have witnessed, through the support it has provided for those fleeing the conflict in Ukraine, including support within Poland. We talked the other day about victims of sexual violence in conflict, and there are victims of sexual violence in this conflict. Again, we are working very closely with the Polish authorities to ensure that the correct information is provided to those seeking action on such crimes.
The noble Lord, Lord Purvis, talked about atrocity crimes and co-ordinating our response. I assure him that we have had detailed discussions, including with the ICC prosecutor. As he will be aware, we have set up a specific group with our key partners to look at atrocities on the ground in Ukraine. He asked about co-ordination with the EU. That group works specifically with the EU and the United States, and we will continue to work in a co-ordinated fashion to ensure that the perpetrators of crimes in Ukraine are brought to justice quickly. We need to learn from conflicts past. The mechanics, the structures and the systems being set up in Ukraine will allow prosecutions to take place effectively and in an expeditious manner. It is particularly important that we ensure that testimonies are collated. We are working on that front specifically, and I will welcome all noble Lords attending the conference at the end of the month, where we can have a specific focus on how we can further strengthen our response through testimonies, particularly those from survivors of sexual violence, to ensure that crimes inflicted can be documented appropriately. We are working with key groups such as Nadia’s Initiative to ensure that survivors are at the forefront of our mind.
I thank both noble Lords for their support. I assure them that we are co-ordinating with our G7 partners. It was interesting that this took place during the G20; it perhaps allowed other countries within the G20 who have not been as focused and strong in their support for Ukraine to reflect very carefully on what this conflict means, for not just Ukraine or Europe but the world as a whole.
My Lords, the war has now been raging in Ukraine for several months, and the danger of armed conflict is that you can get unplanned escalation. There have been a number of incidents that could have led to such unplanned escalation, including the one in Poland that we are discussing. That would lead to world war. We are having to replenish our own stocks and we are providing stuff to Ukraine. Does the Minister agree that it seems extraordinary that, in this many months, we have not actually increased our defence spending? As I say, this could easily tip over into world war. There are real pressures and we have real problems within the defence forces, and we really need to do something. Not only have we not done anything so far but it sounds as though we are about to cut defence spending, which is extraordinary in the world we are in.
My Lords, I note what the noble Lord says. In the context of Ukraine, we have already committed to the funding we gave previously to Ukraine for military support. That £2.3 billion of military support will continue for next year as well; that is a standing commitment. The noble Lord talked about the importance of replenishing stocks. I assure him that, as we continue to support the requirements of countries such as Ukraine, and indeed our commitments through NATO, we keep a very close watch on our own assets and replenishing stocks for our own defences as well.
The noble Lord raises two very important points about the continued commitment from the Government to military and defence spending during the current crisis we face. As I speak, a Statement is being made in the other place by my right honourable friend the Chancellor. Equally, we have made commitments internationally, through our spending on NATO. I suggest that our commitment to NATO spending, particularly at this time, is an important call to the other countries of NATO to ensure that they are also spending the required 2% of GDP on their contributions to NATO defences.
My Lords, I shall continue on this theme, strongly supporting the noble Lord, Lord West, in what he said. Is my noble friend absolutely confident that, if this conflict escalates, as well it might, this country is not only able to continue supplying Ukraine but has sufficient munitions itself to tide us through a decent period of time? That is vital. Can my noble friend give the House that assurance?
My Lords, we work very closely with our colleagues in the Ministry of Defence. As I have said numerous times, the first duty of any Government is the security and defence of their own country and people. I am sure all noble Lords will agree that we have among the best—arguably the best—Armed Forces, with their experience, insights and the professionalism that they bring to the world scene. That is reflected in our contributions to NATO, which remain very strong. I agree with my noble friend that as we look to support Ukraine, it is important, as the noble Lord, Lord West, reminded us, that we stay equally strong in our defences and defence spending at home.
My Lords, one of the most remarkable features of the conflict in Ukraine since February has been the consistency and quality of the leadership of President Zelensky, but in his statement since the strike on Poland he seems not to be as co-ordinated with NATO. Indeed, he seems to be trying to drag NATO into more direct involvement in the conflict. Can the Minister assure your Lordship’s House that His Majesty’s Government are making it clear to President Zelensky that expanding the conflict is in nobody’s interest?
My Lords, the noble Lord will know from his own insights, experiences and dealings with Ukraine the importance of ensuring that we stand firm and solid with our friends and partners in supporting it. What President Zelensky’s country is going through is unimaginable. Let us not forget that, as I said, at the time of this incident in Poland missiles were flying in abundance over every city in Ukraine—every key city was under attack in a blanket, indiscriminate missile attack. What we saw in response from President Zelensky, whom we all agree has played an amazing role, was a strong defence of the territorial sovereignty and integrity of Ukraine.
I know the noble Lord is fully aligned with that objective, but I give him that reassurance. That is why, as I said, my right honourable friend the Prime Minister, along with other key G20, G7 and NATO leaders, talked directly from the G20 to the President of Poland and, importantly, President Zelensky about the importance of co-ordination. As Ukraine is confronting a time of war, it is important that calm heads prevail.
My Lords, the risk of miscalculation in war is very great. The Statement we are discussing is somewhat outdated and has been overtaken by events, which have shown that cool and calm analysis is necessary in what would otherwise be a dangerous situation. The noble Lord referred to the moment when he first heard the news; when I first heard it, like many others, I feared the worst. Fortunately, we now know what happened.
It was a coincidence that the G20 leaders were meeting in Indonesia. It is not for nothing that the photograph of people clustered around the President of the United States and the British Prime Minister has been published all over the world, but they just happened to be there together. Can the noble Lord assure the House that the experience of this incident will be used to make sure that the mechanisms for conferring within NATO and, in light of the previous comments, with the President of Ukraine—whose views slightly diverged from what has otherwise been a fairly common front—are absolutely in order? God forbid that this should ever happen again, but if it did, we would need an effective and quick mechanism to avoid the risk of any terrible miscalculation.
I agree with the noble Viscount. I assure him that, even within our internal systems, the importance of how information is cascaded, decisions are taken and people are informed is part and parcel of learning from any type of incident such as this. That needs to be reflected in the systems within the FCDO and the MoD and across government. I talked to officials yesterday about this very point. As he said, the G20 was together and President Biden immediately convened a meeting of the G7. That is why NATO matters. Different steps were taken in different places at the same time, which reflected the planning that has gone into ensuring co-ordination at a time of war. As I have said time and again, and I know noble Lords agree, this is not about one country being at war with another or a war on one continent—an escalation of this crisis would have global implications and consequences.
While it was perhaps coincidental, I suggest that there was also a degree of divine intervention at work to ensure that those leaders who have perhaps not been as strong in recognising the impact of this war, not just in terms of food or energy security but its degree of escalation, had that reality brought home. I assure the noble Viscount that the systems and structures are in place. I hope he also recognises that in some of the calls my right honourable friend the Prime Minister made; one of the trilateral calls he immediately made was with my right honourable friends the Foreign Secretary and the Defence Secretary, to ensure that our response as His Majesty’s Government was fully aligned.
My Lords, the missile strike on Przewodów was a tragedy. Even if it was not deliberate, it was in the context of a brutal Russian bombardment on many cities and civilian targets in Ukraine, so only one country can be responsible for it. The Minister said something about air defences. Supplying hardware is one thing but can he say something about the training we are giving to Ukrainian military personnel to man these systems?
My Lords, we are fully engaged in training personnel; from the annexation of Crimea, we have been working strongly with the Ukrainian authorities and have specific programmes for it. There is currently a live programme training 10,000 personnel and a raft of other programmes and initiatives that we are running directly with the Ukrainian authorities to ensure that they do not just have the best equipment, which we are providing, but are well trained in using it.
The Minister and my noble friend were right to praise the restraint of the Polish Government—incidentally, they have also responded magnificently to the refugee crisis—but does this incident not reveal vulnerabilities? Poland held back and refused to invoke Article 5 of NATO, yet Russia is waging cyberwarfare at the moment on a number of NATO countries. Is it the Government’s view that cyberwarfare is capable of leading to an invocation of Article 5?
My Lords, I will not speculate on the triggers of Article 5. The Polish Government followed the protocols very specifically; they reflected on the Article 4 elements of ensuring that consultation took place immediately with NATO members, which was the right approach as facts were being established. The noble Lord rightly raises the threat and challenge posed by cyberwarfare. I do not recall if he was in the House yesterday when we discussed the situation in Georgia—the continued occupation of the breakaway republics and the Russian influence in Abkhazia and South Ossetia—but one of the areas of support we are providing to the Georgian authorities is in exactly that space. The United Kingdom is among the leaders on cyber, in both dealing with cyber threat and cyber defences. I assure him that we are focused on all these fronts in our response to, and support of, not just Ukraine but other countries directly impacted by Russian aggression.
My Lords, the Minister did not reply to my question about the failure of the UK to ratify the Kampala amendments to the Rome statute on the crime of aggression, which means that we are unable to promote the UN General Assembly and Ukraine in setting up a hybrid chamber to prosecute Putin for the crime of aggression. Can he respond to that?
My Lords, I am aware of Ukraine’s request on this. It has approached us directly but we have reservations, not least about how the structures would work. I answered the question at least partially in saying that we have dealt with these issues directly with the International Criminal Court, which is working on the ground. We want accountability and justice for the perpetrators of crimes and are looking to work through the practical solutions that can best bring that about as quickly as possible.
My Lords, as I said, we are working through NATO to identify exactly what the requirements are for Poland. It is a member of NATO, and the NATO protocols are very clear. We are working very closely with our NATO allies and the Secretary-General to ensure that Poland’s requirements are met by the alliance as a whole, of which the UK is a part.
My Lords, if the House will allow me to return to my previous question, we have been teetering on the brink of a possible world war. No one wants that to happen, but mistakes, errors and miscalculations occur. Does the Minister agree that, on that basis, bearing in mind that this has been happening for several months, our Armed Forces should be able to move seamlessly into an alliance that is in a position to fight that world war? Does he believe that the investment we have put into defence in the last few months has put us in that position?
My Lords, we have made major investments. Without going into the territory of the Ministry of Defence, the Government have been strong in our commitment to our defences and our support for our NATO partners. Equally importantly, we have stood up for and strongly supported Ukraine. We have been among the leaders in military, humanitarian and economic support for Ukraine, which reflects the planning that has gone on.
However, I am sure I speak for every single noble Lord in recognising that we do not want to venture into an escalation. We have seen the dangers of that, and I fully concur with most noble Lords that a war such as the one on Ukraine can escalate very quickly, even through a missile which may have had other intentions. That could happen, or deliberate actions could happen. It is very clear that Mr Putin continues to wage this war on a sovereign nation. There is an easy fix to de-escalate: stop the war now.
As I said earlier, I am not going to indulge in speculation. Every Government speak for their own citizens and my job is to speak for the United Kingdom Government. The primary responsibility of any Government, of any political colour, has to be, and should remain so, the security of its own citizens, first and foremost. I assure you His Majesty’s Government take that very seriously.
Motion to Take Note
My Lords, I think the first thing I need to say is that Covid is not over. People are still catching Covid; some are still being very ill; some end up with long Covid. Our NHS is still battling with Covid itself and the terrible effect it has had on the whole of the NHS’s ability to do its job and catch up with the backlog which Covid produced, on top of the waiting lists which already existed and were growing in 2019 before the pandemic. This is the background of our discussion today
Given the number of speakers across the House for this debate, I am very pleased that so many agree it is about time we reflected on the emerging short and long-term challenges of long Covid. I thank the Library, the British Medical Association, Nuffield Health and many others who provided us with such large quantities of briefing.
I thank all the speakers who will follow me, and I anticipate a well-informed debate which will no doubt be challenging for the Minister, not least because, although this is designated a health debate, I think if 2.1 million—and I have seen lower and higher figures—of our fellow citizens are reporting experiences of some or many of the range of symptoms of long Covid, then this has wider societal implications. It affects the workplace, incomes, families and our mental health and social care services. It raises questions about defining a disabling condition, which will affect treatment, support, insurance, pensions, income support, careers, jobs and the reasonable adjustments which need to be made, and how we will support children who may get long Covid.
Part of the challenge is that it seems there is yet no internationally agreed clinical definition of long Covid, and the evidence base on what constitutes long Covid, in terms of range and length of symptoms, is still emerging. In October 2021, the World Health Organization defined “post-Covid-19 condition” as occurring
“in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis.”
More recently, the NICE guidance on managing the long-term effects of Covid-19 covers care for
“people who have signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than four weeks and are not explained by an alternative diagnosis.”
As noble Lords will be aware, common symptoms include fatigue, shortness of breath, chest pain, problems with memory, heart palpitations, dizziness, joint pain and many others.
To advance our understanding of long Covid, it is crucial that prevalence data is collected, and this is my first substantive point for the Minister. Government commitments have been made; for example, in June 2021, NHS England committed to setting up a long Covid registry to collect long Covid activity data. However, to date, data is not collected accurately and consistently across the UK, meaning the UK Government are still relying on ONS self-reported data. When will this important data collection happen in a consistent fashion?
There are currently a lot of unknowns when it comes to treating long Covid. Despite recent investment, more research is needed to increase the understanding of the condition, including psychological aspects, and to develop more effective treatments. In October 2020, NHS England and NHS Improvement set out a five-point plan for long Covid support, which included a commitment of £50 million to fund research. The Government said that £20 million of the £50 million previously committed to research would go into 15 UK-based research studies, through the NIHR, the National Institute for Health Research, to better understand the condition, improve diagnosis and find new treatments. As part of this investment, various studies are investigating whether there might be potential pharmaceutical treatments that would be effective in treating long Covid.
Long Covid is a focus for researchers globally, with the European Commission announcing it would accelerate its research into long Covid and develop treatments, while the United States is also running clinical trials. I would like to ask the Minister whether we are participating in these research programmes, and, if so, what are the outcomes?
Similarly, major pharmaceutical companies have demonstrated an interest in developing targeted new treatments or repurposing existing ones. Although researchers have been surveying the broad spectrum of symptoms associated with long Covid, it has to be said they have not found one biological explanation. It is likely there are various mechanisms involved. Similarities between long Covid and other post-infection syndromes need to be considered, and I am confident this will be raised during the debate today.
Despite the investment into research for treatments for long Covid, much of the research is in its early stages, resulting in a lack of evidence on effective treatments. In terms of resources, of the million or more who are reporting with long Covid, only 60,000 patients can access treatment. This means that hundreds of thousands of people with long Covid are feeling isolated and frustrated in their search for treatment, and as a result sometimes live in poverty and despair. I would like to commend the patient groups that have been doing a great job in mutual support and campaigning.
Let us look at the research, of which there must be much more. It is true the Government agreed to invest £50 million in research, although I think there are some blockages, which I would like to raise with the Minister, such as approvals to facilitate research pathways, and through developing pathways support more rapid implementation of promising findings in relation to the diagnosis, assessment, and treatment of long Covid. It would seem, despite the increased funding in research, the UK Government need to increase the infrastructure to meet the scale of the problem. While the MHRA, through the Innovative Licensing and Access Pathway, aims to accelerate the time it takes to get treatments to market, there may need to be some changes to clinical trials research legislation to enable this to be carried out. Is that the case, and are the Government considering it, and what should happen next, because it is vital that if the research is there and the pharmaceutical industry wants to bring forward treatments, we should make sure the pathway is completely clear of any obstacles.
There are huge challenges concerning work and long Covid. The first is the need to support the post-pandemic return to work, which we have discussed before in this House. Since the pandemic, there has been a marked increase in the number of workers aged 50 to 64 who have left employment. Recent labour market statistics from the ONS found that the number of people in this age group classified as “economically inactive” stood at 374,000-plus from June to August this year, compared with 37,000 in the first three months of 2020, as Covid-19 took hold. A recent analysis by the ONS found that 51% of people in this age category who had left work since the pandemic and had not gone back had reported a physical or mental health condition or illness, including long Covid. Apart from anything else, this points to the fact that people need extra support from employers to prevent them being squeezed out of the workplace. It seems to me that guidelines for employers are required—are they available? Are they being planned?
There are health and social care workers who have been particularly exposed during the pandemic. Of course, long Covid makes it even more difficult for the NHS to function as it should, to say nothing of the lives being wrecked and the families suffering terribly. The Industrial Injuries Advisory Council has made its recommendations to the Secretary of State regarding the circumstances in which long Covid should be prescribed as an occupational disease. Why have the Government not acted on this? Covid special leave provisions ended across the UK by 1 September 2022. The British Medical Association has repeatedly called for enhanced Covid-19 sickness pay provisions to continue until a long-term strategy for dealing with Covid-19 is in place. I need to know why the Government have not put a sufficient compensation scheme in place for healthcare workers who are developing long Covid.
Further to this, the Secretary of State for Work and Pensions published the Industrial Injuries Advisory Council report on Covid-19 and its occupational impacts. This report was provided to the Secretary of State and was laid before Parliament yesterday; I thank the Minister for making it available to this House. The council argues that there is sufficient evidence to recommend prescription for health and social care workers whose work brings them into frequent proximity to patients and clients where there is a significantly increased risk of infection, subsequent illness and death. Now that the Government have that report, and it has been made public, will they act upon it?
We need to address the issue of preventing long Covid in children. Will the Government develop a campaign with more consistent messaging about long Covid and clear information and guidance for parents regarding the benefits of vaccination for children and how it can protect children from long Covid?
Clearly, there needs to be more support for health professionals to identify and treat long Covid. All health professionals should be supported and equipped with up-to-date information to ensure that they understand the variable symptoms of long Covid and are aware of the available support and how to refer people to it. In terms of the funding and resources to establish multidisciplinary services, pathways for long Covid should focus on addressing patients’ multisystem symptoms and rehabilitation needs and provide individualised care plans accordingly. There also needs to be a more consistent provision of long Covid clinics, including for children, so that there is less variation in waiting times for treatment. Increased funding and independent workforce planning are key to the success of these services. How many more multidisciplinary centres are planned, and by when?
Turning to improved financial and wider support for people unable to work due to long Covid, the Government need urgently to provide employers with better guidance on how to support employees with long Covid. Perhaps the Government should set up a task force to review the UK’s statutory sick pay allowance system and whether it should be increased so that it is in line with other OECD countries. Does the Minister accept that the decision to end special Covid leave for NHS staff has put patients and healthcare workers at risk? Why do the Government not reinstate this scheme until a longer-term compensation scheme to support staff is in place?
At the end of this debate, I would welcome an acknowledgement by the Minister that the Government recognise that long Covid is having a major impact on productivity, employment and wider society, as well as our health services. I would like the Minister to tell me that they have a plan for this to be tackled in a comprehensive fashion across government. I beg to move.
My Lords, I start by thanking the noble Baroness, Lady Thornton, for bringing about this important debate. She has held the Government’s feet to the fire—in fact, she held my feet to the fire—on this issue, and I absolutely commend her persistence.
Rehabilitation in general and post-viral syndromes in particular have a long history of being horribly overlooked in this country. I am afraid that this regrettable neglect has contributed darkly to the long-term poor health of many in this nation. However, before I speak about the consequences of this on long Covid, I will take a moment to recognise that Britain has done more than almost any other country to address long Covid. Professor Chris Whitty and the CMO’s office prioritised NIHR research, with £50 million going into 19 projects, giving a clear signal for other research. The NHS, and in particular the noble Lord, Lord Stevens of Birmingham, launched a welcome five-point plan, as the noble Baroness mentioned, and Amanda Pritchard has rolled out excellent long-term long Covid clinics. Treatments such as monoclonal antibodies and pulmonary rehabilitation are emerging as a result. I pay tribute to Dr Harry Brünjes, who pioneered the Breathe programme at the English National Opera, which is a fantastic example of social prescribing that has produced some very promising clinical trial results. I thank the noble Lord, Lord Darzi, who kicked off the important REACT programme at Imperial College which has generated hefty longitudinal population studies. Lastly, I pay tribute to the patient groups, who are both vocal and thoughtful in their responses, for their testimony.
Despite these considerable collective efforts, I am sad to say that the long Covid story has become a parable for how the UK health system fails to protect people’s freedom from disease and illness. It fails to properly rehabilitate our sick, and we are paying a horrible economic price as a result. The scale of long Covid is enormous, as the noble Baroness rightly pointed out, but the clinical response I referred to is sadly inadequate. The ONS says that there are 1.5 million sufferers, yet the long Covid clinics can see only 60,000 patients per year. Patient groups are frustrated that, when they do get seen, clinicians do not have the latest pathways that might lead to positive outcomes. The NIHR agrees with patients that there are a lot of unanswered questions.
We are familiar in this country with the rationing of scarce health resources and the uneven distribution of the latest research—uncomfortable though that is—but I will focus a few words on the profound economic effects of this troubling British healthcare strategy. ONS data reports that 500,000 people have left the workforce over the last 18 months, and 75,000 of those are economically inactive due to long Covid. The Institute for Fiscal Studies has a slightly different figure of 110,000, and it says that the cost is almost £1.5 billion in lost earnings a year. Another IFS study suggests that there is an average of 2.5 hours of sick leave per worker being taken due to those who have long Covid. Either way, the OBR has recognised that Covid in the round could cost around £2.7 billion in welfare benefits such as incapacity and housing. That is an absolutely staggering sum.
My point is that we cannot shrug our shoulders about the impact of conditions like long Covid on the economy. We have to take on the challenge of making this country healthier and pivot towards prevention. Andrew Haldane, chief executive of the Royal Society of Arts, put it well in his recent speech:
“We’re in a situation for the first time, probably since the Industrial Revolution, where health and wellbeing are in retreat … Having been an accelerator of wellbeing for the last 200 years, health is now serving as a brake in the rise of growth and wellbeing of our citizens.”
Yesterday, Andrew Bailey, the Governor of the Bank of England, told the House of Commons Treasury Committee that part of the reason the country was being held back was the sharp decline in the size of the workforce since Covid.
Despite this, the Treasury plan for living with Covid makes no mention of investment in rehabilitation or major initiatives for getting the workforce back to work. Finances in the UK Health Security Agency and the Office for Health Improvement and Disparities, the main legacy public health organisations—
My Lords, the vaccine programme has been an astonishing success, and the uptake of those vaccines has shown the enormous public confidence in them. I will speak on another date about the profound impact this has had on the health of the nation.
My point here is that, at this moment when we are feeling the effects of Covid heavily on our workforce and economy, the finances at the UKHSA and OHID are under huge pressure. The public health infrastructure built over the pandemic has largely been dismantled. At the same time, we have an NHS straining to look after the sick and a workforce many of whom are too sick to work.
It is time that we work towards a new political settlement that prioritises the health of the nation and not just the treatment of the sick; and that we make the operational decision in health and care to move towards prevention.
My Lords, I thank the noble Baroness, Lady Thornton, for bringing this important subject to the House. I have a very close relative who has had ME for a number of years, and I have seen at first hand how debilitating and life changing it can be. I have become the vice-chair of the APPG for ME and I have talked to hundreds of ME patients who have had their condition ignored or ridiculed. They have been subject to inappropriate and sometimes dangerous medical intervention, and they are struggling with an employment and benefits system that simply does not acknowledge the realities of their condition. Those 250,000 ME patients are now, in effect, being joined by over 2 million long Covid sufferers.
It is worth starting by pointing out that debilitating post-infection syndromes such as long Covid are not new clinical entities. In American medical literature, ME-like symptoms are described as far back as 1934. When ME was first noticed in this country it was described as “yuppie flu”, but in fact these syndromes affect millions of people suffering from a range of viruses, including those living in poor, third-world countries.
The Institute for Fiscal Studies estimates that one in 10 people with long Covid have given up work, with “persistent labour market effects”. This month’s Lancet said that
“post-acute infection syndromes could pose a substantial public health burden in the near future if appropriate measures are not … taken”.
Despite the huge economic cost they inflict, as the noble Lord, Lord Bethell, said, post-viral illnesses have been neglected, dismissed and under-researched for far too long. We still have no diagnostic blood tests for either long Covid or ME.
As well as the breathlessness, chest pains and loss of taste or smell which characterise long Covid, patients exhibit a cluster of symptoms such as the debilitating fatigue, post-exertional malaise, cognitive dysfunction, PoTS and sleep disturbances that are also diagnostic of ME and other post-infection syndromes. While all the funding for research into long Covid must be welcomed, it is disappointing that some researchers are still ignoring or are not aware of what has already been learned about what may be causing ME and how this could help us to understand the causes of long Covid.
Almost 40 clinical trials into possible treatments for long Covid have been registered, some involving interventions that have already been assessed in ME. Some of these treatment trials have small sample sizes or no control groups. The lessons do not appear to have been learned from the use of poor-quality methodology in many clinical trials involving ME. Some health professionals who are managing people with long Covid are unaware of or ignoring what we have learned about the management of ME and other post-infection syndromes, on activity and energy management particularly. The ME charity sector produces excellent information on symptom and energy management, as does the new NICE guideline, but people with long Covid are often simply unaware of this information, as are many health workers.
Another important lesson that needs to be learned from ME is that misdiagnosis can occur when people with chronic fatigue are not properly assessed and are labelled as having a post-viral syndrome. There are some very disturbing cases being reported of people having long Covid when, in fact, they have another medical condition. A Suffolk councillor recently featured in the news when, it turned out, her long-standing diagnosis of long Covid actually proved to be lung cancer.
Research into the cause and diagnosis of, and effective treatments for, long Covid could help those with ME. The ME Association has requested that clinical trials for long Covid treatments include a group with ME. What has been learned about the management of ME can help many people with long Covid.
Harlan Krumholz, a cardiologist at Yale, said:
“No one wanted the pandemic, but sometimes a jolt to the system can create innovation in ways that wouldn’t have occurred otherwise”.
That should be our guiding principle.
My Lords, I thank my noble friend Lady Thornton for initiating this debate. I am concerned about the low level of awareness of something that affects up to 2 million people. One person said to me on Monday, “Does that mean they’re still contagious?” I am also concerned about the economic implications, particularly for the health service, whose staff were on the front line throughout the worst period. My third concern, which my noble friend Lady Thornton already raised, is about continuing government funding for research into long Covid.
On public awareness, are the Government satisfied that they are doing enough to raise the profile of the devastating effect of long Covid? Now that the newspapers and media appear to have moved on from covering Covid, the sufferers must feel like the disappeared.
I chair the mesothelioma oversight committee, which ensures that payments are made speedily and efficiently to some of the 3,000 people a year who are dying from mesothelioma. It has a low profile, but at least those diagnosed have the satisfaction of knowing that they and their families will have financial support—thanks to the noble Lord, Lord Freud, when he was the Minister.
Of course, I do not claim that long Covid is a terminal illness for most sufferers. I am grateful to and thank the noble Baroness, Lady Scott of Needham Market, for using the parallel cases of ME sufferers. Awareness, financial support and funded research are vital in all these health areas. What plans do the Government have to raise awareness and enable families to feel supported?
Secondly, on the economic and employment implications, I am aware that the National Institute for Health and Care Research is doing some research into economic evaluation, but does the noble Lord have more information about the impact on health workers? How many are affected, and in what areas? Given the number of vacancies in the health service, surely a focus on the recovery of these workers as speedily as possible would pay dividends.
The BMA said that doctors who had contracted long Covid had been let down by the Government’s failure to provide adequate support, with staff faced with a premature return to work—assuming they are physically able to—or with being unable to pay their mortgages. We know that 2,100 health and care workers lost their lives due to Covid-19, and at least 199,000 NHS workers are living with long Covid. They are seven times more likely to have had severe Covid than other workers, and much of this took place with no or inadequate PPE.
Temporary staff or locums have already lost their jobs because they did not have job security. Does the Minister know how many formal absence procedures have been initiated in the health service, and how many people have been dismissed due to long Covid? We still do not appear to know the extent of the loss to the labour market. The noble Lord, Lord Bethell, also broached this. The Resolution Foundation stated that it could be 600,000. The Institute for Fiscal Studies estimated that it was one in 10. It is clear that the majority are not getting enough help. NHS England data suggested that, up to August 2022, only 60,000 people suffering from long Covid had been assessed by an NHS specialist. If the 600,000 figure is correct, the gap is concerning.
This brings us back to the questions of awareness and profile. The patient does not know that they can get help, and the GP does not recognise the symptoms. Either way, there is a huge job to do. What role do the Government have in improving the position?
The Chief Executive of NHS England, Amanda Pritchard, said recently:
“The NHS faces the toughest winter of my career and potentially the toughest winter in its history.”
This does not sound like someone expecting adequate support from the Government.
In the paper, Our Plan for Patients, published by the DHSC in September, the then Secretary of State, Thérèse Coffey, said that
“this Government will be on your side when you need care the most.”
This sounds fine, but there is no reference to long Covid in that paper.
Finally, what assurances can the Minister give about the Government’s continuing funding for research? I am aware that the NIHR is conducting 19 studies. Ten years ago, I was an independent member of one of its sub-committees, but I no longer have that link. Many of these pieces of research are still in progress, but some themes are emerging. Mesothelioma was underresearched for decades. Will the Minister guarantee that this will not happen with long Covid?
My Lords, I join other noble Lords in thanking the noble Baroness, Lady Thornton, for having secured this important debate and for the very thoughtful way in which she introduced it. I declare my own interests as chair of King’s Health Partners, chairman of UK Biobank and an active researcher in the field of thrombosis, a particular pathophysiology that has both impacted acutely on Covid and may have some role in long Covid symptoms.
We have heard that some 2.1 million people—some 3.3% of our population—have self-reported, as part of the ONS data collection programme, symptoms attributable to long Covid. It is striking that some 500,000 of those individuals reported having had Covid some two years previously. This represents a substantial, ongoing, chronic burden of disease. We should all be conscious of its potential impact on the way in which we are able to deliver healthcare through the National Health Service.
As we have heard, little is known about the etiology of long Covid. There is a suggestion that part of it may be attributable in some individuals to a failure to properly clear the virus from their bodies. It is also possible that there are genetic determinants that drive individual immune response and that this dysfunction is part of the explanation for long Covid symptoms. There is a now well-established phenomenon of dysfunction in the microvascular and endothelial cells that line blood vessels, which may be responsible for some of the long Covid symptoms. Indeed, a profound hypercoagulable state—a tendency to a risk of thrombosis and blood clots—manifests itself in an important number of long Covid patients.
We have heard of the importance of research in trying to understand more about the etiology of long Covid and to better understand its history. This is critically important if we are to be able not only to research and develop new therapies but to address the question of long Covid through the mechanisms underlying its development and sustained impact. This research is also critically important in understanding how we should properly develop services to manage patients. At the moment, His Majesty’s Government have committed some £194 million to the provision of clinics and services to manage Covid patients—some £90 million of which is to be spent in the financial year 2022-23. However, when one looks at the burden, this resource is only able to provide services for some 5,000 patients a month. The substantial demographic of long Covid is running into many hundreds of thousands, if not millions, of people. We clearly need to understand from prospective research not only what volume of services is needed but how those services should be constructed, based on our knowledge of the natural history of the disease, in order to adequately and properly manage the requirements of those patients beyond symptom control.
Is the Minister content that the approach to research is sufficient? As we have heard, some £50 million has been committed by the Chief Medical Officer to a variety of research programmes. Is he able to address the question, raised by the noble Baroness, Lady Thornton, of why a national cohort has not been established to allow us to marshal the current clinical burden of long Covid in our country and then to apply an appropriate methodology and protocols to the evaluation of these individuals? Research undertaken in this systematic fashion is not only highly efficient but provides the best opportunity for us rapidly to understand and start addressing the questions that need to be addressed if we are to be able to develop these new therapies and organise and deliver services in the most appropriate way for these patients.
Beyond the financial commitment to the development of a long Covid research cohort, there is also the need to ensure that the data collected through routine exposure of these patients to NHS services can be marshalled to inform the research effort. Those data should be able to link with other datasets whose huge value in addressing acute Covid and in the post-infection period has been established. I reiterate my interest as chairman of UK Biobank, which has been used in this regard. It is a unique resource, available to the country, where half a million of our fellow citizens have provided their biological material. The genome in those individuals has now been mapped and the opportunity exists to interrogate the dataset, using that biological material, to assess novel biomarkers and the prevalence of disease. The deep phenotyping and repeat imaging give the capacity to understand structural end organ dysfunction in Covid. All this requires an approach from His Majesty’s Government with regard to data sharing, within and across datasets, between researchers in different institutions and, as we have heard, with those outside the public sector wishing to support this research. Is the Minister able to provide some reassurance on this?
My Lords, I too thank the noble Baroness, Lady Thornton, for securing this important and timely debate.
I will focus my remarks on the rural dimension of long Covid, which is having an impact on many people in Devon where I am privileged to serve. I am concerned about rural sustainability and the need to ensure that the Government’s levelling-up agenda is not focused exclusively on urban deprivation. Rural poverty may not show up on government statistics because it is dispersed in pockets, but it is just as real. Research suggests that structural inequalities, including poverty, are important in the development and course of Covid-19 and may form an important context for long Covid.
As far as Devon is concerned, the picture postcard view of my county beloved by holidaymakers is only half the story. The best information we have is that there are currently around 16,000 people living with long Covid in Devon and, as I am sure the noble Baroness, Lady Watkins of Tavistock, will corroborate, it is impacting on the economic life of our county.
As in other parts of the United Kingdom, we know that the groups most likely to be affected by long Covid are people between the ages of 35 and 69; women; people living in more deprived areas; those in care; those with a high body mass index; those working in close-contact professions; and those living with long-term health conditions. Of the 16,000 people in Devon living with long Covid, only around 70% have been referred to long Covid treatment services. Research has revealed that children, older people, men and those living in deprived areas are less likely to seek help and be referred.
The pandemic has impacted people’s health and self-confidence, well-being and the demand for services. It has had an adverse effect on mental health, with higher levels of mental health anxiety and loneliness. For those suffering from long Covid, unsurprisingly, research has revealed that they have lower levels of life satisfaction and happiness, and some have lost hope of change or improvement. Overall, the pandemic has had a greater impact on those groups already suffering from greater disadvantage and higher health inequities than average across the county. In Devon, service providers have reported increased demand for mental health, domestic violence, and drug and alcohol support services. There have also been increased concerns over the safety of children, young people, and vulnerable adults.
Sadly, young people in Devon reflect the national picture, with a significant rise in child obesity during or after the lockdowns, especially among boys and those living in the most deprived communities. The noble Lord, Lord Dubs, highlighted that in his Question this morning.
The picture is not all negative. I am immensely proud of my county and the resilience of many rural communities, much of it, I am proud to say, fostered and supported by local churches.
However, one particular concern in Devon is the impact of long Covid on the workforce. National research shows that before contracting Covid-19 and then developing long Covid, two-thirds of respondents had been working in front-line jobs such as hospitality, schools, care homes, childcare, emergency services, retail, transport and delivery. Most respondents believed that they had almost certainly, 41%, or very likely, 18%, caught Covid-19 at work, pointing to the lack of PPE and the direct contact with Covid-positive patients. As one researcher commented:
“Key Workers are overwhelmingly paying the price of workplace Covid-19 exposure with loss of health, loss of employment and loss of income.”
As we move into winter, this is really serious.
This national picture is exacerbated in rural counties such as Devon. One of the problems facing the countryside post Brexit has been the shortage of workers, both in the care sector and agriculture. Not only is there a smaller population in rural areas from which workers are drawn but, on average, they have to spend more time travelling to and from their jobs or, in some cases, between jobs. Because long Covid disproportionately impacts lower-paid women in front-line roles, this has made it more difficult to recruit suitable staff in the countryside. This shortage is now being seen in many rural businesses in Devon, especially in the hospitality sector, which are closing for the winter period due to lack of staff and higher energy bills.
In conclusion, therefore, I ask the Minister: what research is being undertaken to assist the medium and long-term effects of long Covid, specifically in rural communities?
It is a pleasure to follow the right reverend Prelate the Bishop of Exeter, whom I know well and whose speech I completely concur with. Happily, mine does not completely reflect it. I also acknowledge the work of the noble Baroness, Lady Thornton, in getting this debate for us to consider today.
I will particularly highlight the challenges of long Covid on mental health services, healthcare staff and children’s education and health, and therefore need to declare my interests as a registered nurse and president of the Florence Nightingale Foundation.
I note that the lack of consistency on the definition of long Covid makes it difficult to measure and analyse the emerging evidence. Despite this, the NIHR estimates that 1.8 million people in the UK—as others have said, 3% of the population—are experiencing symptoms of long Covid. Its studies published in 2021 showed that up to one in three people who have had Covid-19 report long Covid symptoms, and up to one in seven children. The scale of chronic ill health and disability after Covid-19 has been described as the next big global health challenge. I am not sure that it is the next big one; I think it is the immediate one.
According to the NIHR’s survey of 3,286 people with long Covid, 71% said it was affecting family life and 80% reported that it affected their ability to work. The Ulster University survey of 3,499 healthcare staff demonstrated that 49.3% felt overwhelmed by pressures of the pandemic, with social work and nursing the most impacted.
NHS Check, a study by King’s College London—where I must declare I have a visiting chair—looked at 18 partner NHS trusts and found high levels of distress and symptoms of anxiety in staff working in healthcare. A concerning finding was that there was a high prevalence of PTSD symptoms and self-harm. This has caused long-term absence of staff due to Covid-related sickness, resulting in people at work carrying out jobs out of their skill set and/or being overworked. It is reported that these issues have directly impacted the quality of care and waiting times and, in extreme situations, have led to unsafe practices. Dissatisfied patients have resulted in increased abuse towards healthcare workers, exacerbating their exhaustion and anxiety levels. Those on long-term sick-leave have suffered isolation and financial difficulties, intensified by the recent soaring cost of living, leading to further distress and longer absences from work, and some healthcare workers have lost their jobs due to long Covid.
The impact of staff shortages from long Covid has also led to a breach in some patients’ human rights: namely, the illegal detention of patients. Last week, the Independent reported that mental health patients were being held “unlawfully” in A&Es due to shortage of staff to undertake timely mental health assessments. I must stress that I believe that that has been to protect their safety, but none the less it is a severe problem.
The effects on our children are highlighted in Ofsted’s second report on the impact of the pandemic and school closures. It demonstrates that children have regressed in basic skills, physical fitness and learning, particularly those whose parents were unable to work flexibly—including, of course, health workers. Children were found to show increased signs of mental distress, including a rise in eating disorders and self-harm.
Social isolation and greater exposure to family conflicts have added to children’s mental ill health, leading to an increase in the number of referrals to CAMHS, which has not been matched by an increase in investment in children’s services. A large study by the NHS in 2020 found that mental health conditions among children had risen by 50% compared to three years earlier. I think that will be even higher in the next piece of work on that issue. It is sad that Baroness Sally Greengross is not here to argue for intergenerational fairness on this issue.
These academic studies have shown major organisational changes across the NHS, with substantial physical and mental health challenges for NHS staff and other care workers during the pandemic. Results also indicate the importance to support staff so that they can contribute to service recovery. Therefore, can the Minister explain the Government’s position regarding the implementation of the proposed 10-year mental health and well-being plan for NHS staff and, in particular, the investment to support staff with long Covid?
Will the Government make further contributions to NIHR for global collaborative research to increase our understanding of long Covid and its impact and, in particular, to generate evidence-based interventions that may enable the health recovery and mental resilience of staff impacted by long Covid and support them to return to work, thus ensuring their retention in healthcare practice?
My Lords, I thank my noble friend Lady Thornton for having secured the debate, to which I am very pleased to make a short contribution. There will be many tens, if not hundreds, of thousands of people and their families up and down the country who will be grateful to her for having given them the opportunity to have their experiences of what we call long Covid both explored and legitimised. Many interesting points have been made in the debate. I was struck by the reference of the noble Lord, Lord Bethell, to the economic impact, which is staggering and a point to which I will return. The House may know that there was a debate in the other place about long Covid six months ago, so it is high time that we had our own debate here today.
My first main point is that the outcome of the debate will be, I hope, that we agree on the need: for more research into all aspects of Covid, including long Covid; and to explore the link that may exist between long Covid and the recent exit from the UK workforce of so many people. I remind the House that it was the brilliance of scientific research, including research conducted in this country, that enabled the vaccines to be developed from which we have all benefited. Now we have the challenge of long Covid. One way of thinking about it is to say that it is the persistence of symptoms in those who have had, and thought that they had recovered from, Covid. It is interesting that the majority of people with long Covid are PCR-negative, which indicates microbiological recovery, although the chronic symptoms extend beyond 12 weeks. In other words, long Covid is the time lag between the microbiological recovery and the clinical recovery.
By May or June last year, some of the most commonly reported symptoms included the following: fatigue, cough, chest tightness, breathlessness, palpitations, myalgia, and a difficulty to focus. I will illustrate that with some direct evidence that I have received from long Covid sufferers. A person who fell ill with Covid in the first wave in 2020 wrote:
“I was knocked sideways by it. I have never been so ill.”
“bed-bound for 2 weeks, coughing badly for 2-3 months thereafter. Feeling weak and frail.”
Now I want to introduce your Lordships to the concept of brain fog. Let me again use the words of another sufferer:
“Brain fog came on insidiously after an initial period of recovery. Unaware of it at first, but slowly it engulfed me.”
“had no name for what was happening … for a long time”,
and it was a
“relief when others started naming it and talking about it”.
This is where today’s debate comes in. It will be very helpful for people to know that their symptoms are being recognised. I have received a long list of some of the symptoms, which I am sure that many of your Lordships will recognise: the inability to write or concentrate; a short attention span, forgetfulness, memory loss, word lapses, sleep problems, eye problems, balance problems; a terrible sense of brain congestion, of which one person wrote that it felt
“sometimes as if my head would split”;
exhaustion, weariness, and others. Someone said:
“My vocation is gone and I am unable to write. As though a door has shut in my brain and I cannot work.”
“A desire to flee from company and crowds. I now avoid outings where possible. I am de-coupling from life.”
It is worth noting that many of those who suffered from long Covid did have vaccinations and boosters.
I understand that some people have taken private action to secure the drug ivermectin and that it had a beneficial effect in some cases, albeit for a short time. I mention that because I tabled Questions to the Minister’s department earlier this year about that drug, and I would be grateful to know what the department and Minister’s current views are about it.
This is not the debate in which to refer to the cuts in public expenditure announced by the Chancellor in another place while we have been sitting here, but of course cutting back on science research would fatally undermine research efforts. I hope that the Minister will be able to reassure the House today that the Government will protect the £50 million that is being invested in long Covid, as set out by the National Institute for Health and Care Research. As I understand it—I am grateful to the Library for this information—the NIHR has published its latest themed review, entitled Researching Long Covid: Addressing a New Global Health Challenge, in which it refers to: three studies considering who gets it and why; two studies looking at the biological causes; three studies looking at the diagnosis; four studies evaluating treatments; three studies considering recovery and rehabilitation; one study looking at the impact of vaccination; and two studies looking at how health services can treat the condition and the health and economic costs of the disease.
That brings me to my second major point, which I will have to truncate. What is the link between long Covid and the people who have left the workforce? As has been referred to, the Office for National Statistics has published several articles. Time does not permit me to give all the details, but it is clear that a huge proportion of those in the age bracket of 60 to 65 are unlikely to return to work, and the pandemic has affected decisions to leave the labour market. The report published in July 2021 by the ONS listed some of the major reasons that workers cited for not returning. Research by the Health Foundation indicates that economic inactivity in the UK has increased by about 700,000 people since before the pandemic. That is an absolutely enormous number, and the cost to the UK will be very great. It seems as though we are living through a pandemic of inactivity, as it were. The Health Foundation report concludes that
“these contributing factors are exacerbating a pre-pandemic trend of the increasing prevalence of poor health as a reason for inactivity”.
I will end there. We certainly need more research, and I hope that this debate might have what I might call a catalytic effect both on the discussion of long Covid and on the reply from the Minister.
My Lords, I am glad that the noble Baroness, Lady Thornton, asked for this debate, and I applaud her comprehensive introduction. When I asked an Oral Question on this topic on 23 May, I cited a figure of
“1.1 million sufferers of long Covid in the UK … unable properly to undertake day-to-day activities as a result of their condition.”—[Official Report, 23/5/22; col. 656.]
That ONS figure now stands at 1.6 million—the figure is in the excellent Library briefing—and a total of over 1.1 million have been suffering for more than a year, so this is a growing problem. Even though we may be over the worst of Covid as a life-threatening disease, at least for now, a significant minority of those who contract Covid continue to develop long Covid. It is a debilitating illness for the individuals concerned, and its extent represents a wider social problem that the Government need to take seriously.
Many of us know people suffering from this condition, professionally or as friends or relatives. My concern in this debate is what can be done better for those who are suffering, from their own point of view. I thank those with long Covid to whom I have talked about their situation. One friend—under 60 with no discernible underlying conditions, and living in rural Hampshire—contracted Covid in September last year. As symptoms persisted, the GP said that she would be referred to a long Covid clinic in two to three weeks, but that happened only 10 months later, with nothing happening in between. Hers is by no means an isolated case. As the Minister will appreciate, this is not just about the waiting time to get to a clinic, crucial though that is; it is also about what happens up to that point. So I ask him: what is being done to help upskill all GPs, and what can be done as soon as a patient contacts a surgery? What can be done to better signpost the support that a patient requires at an early stage? Indeed, what can be done to ensure that those who have long Covid or suspected long Covid contact a GP in the first place?
My friend tells me that, ideally, the GP should have said, “Stop work completely. I’ll fill in a sick note. Come back in four weeks and we’ll keep an eye on you”. This is with hindsight, of course. She believes that, if she had been set on the right road and been monitored from the off, she would be much further down the road to recovery. She would also have missed much less work. As it is, over a year later, she can still do at most only two days of work a week.
Her main symptom is fatigue, in line with 70% of the 1.6 million that I have cited. This is not just about not being able to climb a hill; it is about not having any energy to do anything for a period of time. Of course, many people’s stock reaction to this, sufferers and non-sufferers alike, is “Carry on regardless, try to take more exercise”—one very good reason why long Covid should be treated professionally as quickly as possible.
Additionally, addressing these concerns will avoid in toto a significant loss to the economy, as others have pointed out. The Government need to take a significant note of that. There must be faster access to long Covid clinics, as the noble Baroness, Lady Thornton, said. Clearly there is still a postcode lottery about referral. Many more clinics need to be put in place across the whole of the UK, to decrease waiting times and to ensure that everyone has the same level of access, which continues to vary hugely across the country.
Fortunately, my friend now has a case manager, a qualified physiotherapist who can refer her to different services according to the symptoms displayed. We know that a multitude of symptoms are exhibited by sufferers, so there is the respiratory team, the occupational therapy team and so on. The problems do not stop there, though, in terms of delivery, because there are also difficulties in accessing those services, as has been pointed out. Can that be looked at, as well as the priorities over access and the funding involved for long Covid patients? One good thing in my friend’s case is that meetings with her case manager are through Zoom. Travelling is very difficult for long Covid patients.
Such is the demand for treatment and the slowness of NHS provision that there are now heavily subscribed private online programmes of treatment. People are desperate but there is a question over whether these services are a substitute for those services referred through the NHS as part of what, ideally, should be a complete and integrated programme of recovery. I say this as an open question.
In an informative video on YouTube, one sufferer, Gez Medinger, sums up what many sufferers experience when he says, “It takes every aspect of your life and pretty much crushes it”. The Government need to do as much as possible to support those with long Covid, as well as putting money into research to beat this condition.
My Lords, I am grateful to my noble friend Lady Thornton for a masterly introduction to this debate. I speak with a little trepidation because I am no authority in this area, but I recognised very quickly what the noble Lord, Lord Kakkar, had to say. His request to the Government about the need for a national cohort is very important indeed, and if the Government do nothing more today, I hope they will at least respond to that.
I approach this from an unusual angle. When Covid started, noble Lords may recall that every day, on the BBC, we saw photographs of the people who were dying. They were mainly old. There was a preponderance of men rather than women. A disproportionately high number came from the UK’s BAME population and 50% of those dying were overweight. My noble friend Lady Thornton knows that I have laboured on this subject for a long time. I and others noticed this. The research findings then bore out that there was a categorisation in this form—the research backed it up. The Government then decided that they had to do something about obesity and very quickly produced their 2021 strategy, as these underlying causes were substantial contributory factors.
We had higher death rates in the UK than the rest of Europe. Our numbers led the field for a period. Put me right if I am wrong, but I think we have performed particularly poorly. We did extraordinarily well with the vaccines, but the death rate was very high indeed. We are generally seen as one of the unhealthiest nations in Europe, part of which goes back to obesity, again linked with Covid. I have not read Covid-19 and Occupational Impacts, only glanced at it, but some important information there relates to the BAME community and sheds light on the problem there. However, I cannot find out whether there are any common factors on a substantial scale that can be identified within people with long Covid.
For example, I know people who have got long Covid who are overweight. They were overweight before, so they had an underlying cause and they were at risk. They continue with long Covid, yet they have a continuing problem with their weight. This is a difficult subject but we must address it honestly and straightforwardly. If there are continuing underlying factors not dissimilar from the problem in the first instance, we must acknowledge them, look at them, give support and assistance in those areas, and not run away from some of the difficulties that may be around. In this country these days, we run away so much from some of our underlying problems. It is too difficult politically and too sensitive to address them on head-on.
I am speaking marginally out of tone with the rest of the debate. I have just as much compassion, but it is important to have a frank and honest debate on this topic. I express my gratitude again to my noble friend for the opportunity to speak up and fully debate the topic before us. It is a very big one, which may be repeated elsewhere with other issues that come along later. I would be grateful if the Minister could tell us whether we are performing badly compared with the rest of Europe—whether we are getting more cases of long Covid than elsewhere. Are we doing better or less research than elsewhere in Europe? I pick up from the noble Lord, Lord Bethell, that the evidence indicates that we are leading the field in the research, which is good.
Fundamentally, we must keep coming back to prevention in the first instance. Until we make our country healthier, we will not be in a position to meet all the problems that will come with climate change, new diseases and unforeseen issues. If we are healthier in the ill to come, as we face it, we stand a much better chance of doing better next time round, with fewer people left with a continuing illness than we have at the moment.
My Lords, I apologise for having to be virtual this week. I thank the noble Baroness, Lady Thornton, for this debate, with a very special “thank you”.
I am a member of the All-Party Group on Coronavirus. On several occasions we have taken evidence on long Covid. On the last occasion, three ladies gave us evidence—a doctor, a teacher, and a train driver. All would like to be working, but it was impossible. Long Covid had struck them so badly that they were unable to leave their houses and fatigue and brain fog had taken over their lives. One of the ladies said, “We are the forgotten”. I said, “No, you are not forgotten”. That is why my “thank you” to the noble Baroness, Lady Thornton, for having this debate, is so special.
Recently, I met a doctor at a BMA dinner who is doing research on long Covid in Birmingham. I asked him how he found long Covid, and he wrote to me, stating:
“I have been reflecting on the challenges I am facing in both my roles as a clinician and researcher in long Covid. One of the biggest issues for me personally is the definition of long Covid. It is necessarily broad, given that we do not fully understand it, but it includes such a heterogenous group of patients that the diagnosis has limited use for patients. As a result, it is also very difficult to design studies to understand it better. Funding for specific research to address this would benefit the community greatly.
Pragmatically, my experience of the long Covid services has been good, though I should emphasise I only have experience with one centre, and I am fully aware that across the country services are patchy. We have been fortunate locally to have rehabilitation experts who have joined the team and made a positive contribution”.
Services are patchy across the country in respect of so many health issues. People living in rural areas should not be forgotten, as the right reverend Prelate the Bishop of Exeter said. The key messages from the APPG on coronavirus are that long Covid is having and will continue to have a significant impact on both the UK’s health and economy, that Covid-19 must be recognised as an occupational disease, that a compensation scheme must be put in place for key workers living with long Covid, and that a comprehensive long Covid care system must be established to tackle the significant burden that it will continue to place on the NHS.
Long Covid impacts significantly on the UK population and will continue to do so, including on the UK workforce in both public and private sectors. Many of those living with the acute health challenges presented by long Covid were initially infected as a result of work they did during the pandemic on the front line—caring for patients, educating children and continuing to provide vital transport services—yet support from employers and indeed the state is hugely variable.
The APPG has heard of long Covid’s devastating impact on children. Long Covid can have a significant impact on children’s education as a result of lost learning, and the level of support offered by schools to pupils and to parents of pupils living with long Covid is extremely variable. The APPG has heard that
“children experience a wide range of Long Covid symptoms, and that these symptoms can differ from those displayed in adults”,
yet there remains little research into treatment or specific care pathways for children. Without such research, long Covid will continue to impact the health and education of those children living with it.
There should be government guidance on long Covid across the country for GPs, employers, private and public services and the public at large. Some GP surgeries do not want to be involved, but patients only want to know where to go for help.
I am just about to finish. They need directions—not to feel forgotten and not worth advising. Does the Minister agree?
We need compassion at this difficult time across the country. We need to solve the mystery of why some people develop long Covid and others recover without complications, and to take any similarities into consideration.
My Lords, I thank my noble friend Lady Thornton not just for making this debate available to us but for her having demonstrated stamina beyond the normal in the way that she has fronted for this side of the House—indeed, I think she has spoken for Members across the House—during the entire troubles that we have been through with Covid. Covid may have a long form, but those who speak about it and remind us of its importance can also have a long form, and I thank her for that. I also pay tribute to our friends in the Library for their briefing note, which is truly extraordinary and has been mined by many of us in the speeches that have been made.
The noble Baroness, Lady Scott of Needham Market, has drawn attention to the way that ME played out through chapters of misapprehension and wicked neglect through its course, until we got on to more certain ground. I might add dyslexia as another condition that suffered from not having adequate analysis or forensic understanding, which led to its own misapprehensions.
All that leads me to focus my intervention on the first of my noble friend Lady Thornton’s points: the need for data—the need for an adequate basis from which to draw empirical and helpful conclusions. In pressing the Government, and my noble friend is certainly not the only one who has done this, we must almost insist, if that is within the bounds of the conventions of this House, that the Government really give us an answer on that one: how do we get the evidential basis upon which we can draw reasonable conclusions? I heard from the noble Lord, Lord Kakkar, who is not in his place at the moment, a suggestion that concrete ways of responding were available, although they might need to be enriched and all the rest of it. It is urgent that we have that evidential base, for this is something that we must know more about scientifically.
I have a son who went down with all the symptoms that my noble friend Lord Stansgate mentioned, and was laid flat out for months. He has made a good recovery so that is a possibility, but I have to say that his family live with the possibility that it may recur. Again, that emphasises the need to understand this disease better than we do currently. I have to say—and a father would only want to do this—that in my son’s recovery he played a key role in the way that the funeral of the late Queen played out. He works for Westminster City Council, responsible for their street management. He resourced the queues and cleaned the streets once the horses had left their hallmark, and did all the things that were unseen.
However, I have another son who has not had Covid but Covid has had him. He has a small business that collapsed the day that lockdown started, and he is reinventing himself all the time. Long Covid, in an economic and personal way, is not related to the disease in the bloodstream or whatever it is but is playing itself out in as insidious a way, and the economic outcomes have to be borne in mind. Meanwhile the marriage of my daughter—who lives in France—did not manage to survive lockdown. Once again, those things happened as a result of Covid, and there is an ongoing realisation that we have to cope and deal with it as best we can. Long Covid in its clinical phase of operation and understanding, together with its outcomes in personal and economic life, all need to be held together.
One thing is certain in my mind as I draw my remarks to a close. The noble Baroness began by saying that Covid is still with us, and the worry is that it might recur when we thought we had cracked it. On a lighter note, I have to say that I went down with it once. The symptoms were mild but it was on my significant birthday when I could not finish my salmon steak or my glass of wine. So I have a real grudge against Covid, and I hope that will be taken into consideration.
My Lords, I applaud the noble Baroness, Lady Thornton, for bringing forward this incredibly important debate and for her outstanding introduction to it.
Long Covid is undoubtedly a serious challenge for the NHS and, as the noble Lord, Lord Bethell, said, for the economy, and a devastation for about 1.5 million people across the country. My principal reason for speaking in this debate is a concern that, for reasons that I simply do not understand, the chronic fatigue syndrome that too often results from the Covid virus is not linked in doctors’ minds, or indeed in many other minds, to the chronic fatigue syndrome that can be triggered by other viruses, and from which more than 1.5 million people suffer and have suffered for many years.
The principal symptom of chronic fatigue syndrome, as we know, whether it is triggered by Covid or by some of the virus, is extreme physical and mental tiredness that does not go away with rest or sleep. Sufferers find it difficult to carry out everyday tasks and activities and, as others have mentioned, too often they cannot work. This applies to the 1.5 million or more people with chronic fatigue who have had it for however long—for years, in many cases—and to those with chronic fatigue from Covid. They are exactly the same.
Other symptoms, as other noble Lords have mentioned, may or may not include muscle and joint pain, headaches, flu-like symptoms or feeling dizzy or sick. Covid-triggered chronic fatigue may also include a loss of taste and smell, and that is a slightly misleading piece of the jigsaw. In the main, chronic fatigue triggered by Covid and chronic fatigue triggered by another virus are indistinguishable other than by this rather weird issue of the loss of taste and smell. Does the Minister have any evidence to suggest that these two chronic fatigues that I have mentioned are in any way distinct, other than in this little piece, which I think is just a separate element of the consequences of Covid?
As someone who will have asthma for the rest of my life as a result of Covid, I also experienced a complete loss of taste and smell for several months after Covid. I am not just being self-indulgent; there is a point to bringing this in. It seems clear that the loss of taste and smell following Covid should be regarded as separate from chronic fatigue and separate from asthma or any other post-Covid illness. The fact that post-Covid chronic fatigue sufferers may lose their taste and smell should not suggest that it is in any way different from other post-viral chronic fatigue syndromes. They are surely identical, and medical treatment and research should focus on all types of chronic fatigue syndrome, including Covid related CFS. We know there has been a lot of money devoted to research because of long Covid; it is crazy for that money and research not to include other causes of chronic fatigue. It just cannot be right.
I very strongly welcome the focus of the noble Lord, Lord Bethell, on the alarming economic consequences of long Covid. Again, the economic consequences of chronic fatigue, whether triggered by Covid or any other virus, are eye-wateringly large. Urgent attention, both medical and in research, should be given to the prevention and treatment of chronic fatigue, however it is triggered.
I raise this issue in part because in the past chronic fatigue sufferers have experienced the most unpleasant stigma from doctors and others who tended to take the view that chronic fatigue was in no sense a physical illness, just something in the mind. Clearly, post-Covid chronic fatigue syndrome is acknowledged to be a physical response to Covid with a deeply unpleasant set of symptoms. It would be very helpful if the same understanding were applied to CFS triggered by other viruses or events. I will be grateful if the Minister can respond to this point, and to the important economic concern raised by the noble Lord, Lord Bethell, in his summing up.
My Lords, I join those who have congratulated my noble friend on, and thanked her for, introducing this debate. I am sure that she is very pleased with the expertise we have had in the House today, which shows the kinds of contributions we can make to furthering issues of this kind. I am not an expert on health matters in any way, but it has been striking how significant the big picture of the problems facing everyone is, and we should all be aware of the difficulties that are being created.
The estimates we have heard about are of 2 million cases or more, because it is self-reporting. It means that this is a very significant problem both for individuals who are affected but also for society and, as the noble Lord, Lord Bethell, was saying, for the economy as a whole. Long Covid affects the individual, but it also affects their family, friends, employment, society as a whole and the economy, as we have heard. The cases we have heard about show the extent and range of problems that are involved. I was struck by the BBC today talking about a young girl in the north-east who had missed virtually two years of education because of long Covid, which obviously affected the whole of her family.
We have heard today about key workers in particular who have had their lives turned upside down. It has been difficult for them as individuals and for their families, but it is also a great loss for all of us if they are not in the National Health Service participating as key workers. The fact that many are not able to return to work is a very significant problem for us all. I listened to what was said about medical research. I think we were all very struck by what the noble Lord, Lord Kakkar, said, and I hope the Minster can accept that that is a particular way forward.
Regarding the impact on the economy and society, I want to pick up what my noble friend Lady Thornton said about the need for employers to have better guidance on how they should react. I would like to know more about what is happening here, because we are suffering very significant skills shortages in many areas, which is holding back our economic progress. The fact that individuals vary in how they are affected by long Covid needs to be more widely understood. Somebody may be okay one day but not the next, which is not easy for employers to deal with. The need for greater flexibility on employment is important, but we also need co-ordination across government.
Turning to the impact on individuals, the situation seems to be extremely varied. Early on, there was probably a lack of understanding by medics and others, but many people who suffer from long Covid, as was being said on other illnesses, find that doctors and medics generally vary in their understanding. Some people feel that it is very difficult to be taken seriously for problems of this kind. The idea of a post-Covid assessment service is clearly very welcome, but it is concerning to hear that over a third of the people who need that service must wait for several months—and that is not months since they first got Covid but months since they first realised that there was a longer-term problem. So we need to get a grip on that difficulty.
The right reverend Prelate referred to issues in his area, where only 17% of people were getting access. The issue of a postcode lottery in any area of health is a problem—and it certainly is here—as is the difficulty that sometimes arises with statutory sick pay. Not all people are entitled to it, and people tend to go back to work because they have no option and need the money, which can lead to longer-term problems in the end. So we need some better co-ordination on the part of government to ensure that everybody is covered.
I will raise two particular points with the Minister. The first is the fact that Covid is not over, and I worry about complacency settling in on this issue. Mention was made that, in the early days, it was in the media all the time, but now it is hardly ever mentioned. People are not coming forward for vaccinations as much as they should. We do not know what the next variant will be or when it will hit us, and the Government must be prepared to step up their game to make sure that we do not become too complacent.
Secondly, the current Chancellor of the Exchequer was chair of the Health Select Committee and, if the Minister looks up the tweets and statements made by Jeremy Hunt when he had that role, he will find many quotes that the department can use to get leverage for extra funding in this area. So I recommend that he does his homework on the present Chancellor of the Exchequer; his department might find that very useful.
My Lords, I declare my interests as chair of University College London Hospitals NHS Foundation Trust, chair of Whittington Health NHS Trust and a member of the North Central London Integrated Care Board, as well as other interests stated on the register. I am most grateful to the noble Baroness, Lady Thornton, a wonderful fellow non-executive director at Whittington Health, for securing this debate. I too am very grateful to the Library, which has been hugely helpful, and I am enormously grateful to all other speakers, because most have said most of what I was going to say.
I have a very specific point. At UCLH, we a run a well-known and much-admired long Covid service, which is led by the remarkable Melissa Heightman, who is also a national specialty adviser for NHS England and the co-chief investigator for the STIMULATE-ICP study, the largest long Covid trial to date. We know that the service is desperately needed; we have heard that all around the House. Those who run this particular service are working night and day; it does not have the resources to do what is needed, to the extent that those who run it are begging for bits of resource from elsewhere, mostly for people. So short is the service of staff that they recently asked UCLH Charity to fund an extra consultant for two years, which it has agreed to. I am well aware, as we all are, that today is the day of the Autumn Statement and that times are tough, but it is really serious when an NHS trust with a £1 billion turnover has to ask its charity to support an on-the-ground service led by the national lead, even for a limited period of time—particularly for a service designed to help other NHS staff across London.
Worse still, as other noble Lords have said, some 10% to 14% of reported cases are NHS staff. Although we all know that, it is not generally known among the population—but it is not really surprising, given the higher exposure to the virus that they all had. What a difference getting them well and back to work would make to the cash-strapped NHS and to the challenge over staff numbers. We have real trouble in recruiting and, as others have said, we have people leaving the service.
Can I personally endorse what the noble Baroness just said, in particular her testimony on Melissa Heightman and the team at UCLH? I had extensive dealings with them as a Minister, and their work is absolutely first class. I am heartbroken to hear that they are having to reach to charity for financial support.
I am extremely grateful to the noble Lord, and I shall make sure that Melissa knows about that.
Meanwhile, we have all the figures that everybody has cited, and the ONS has reported that long Covid has adversely affected the day-to-day activities of 1.6 million people—that is absolutely huge, and other noble Lords have mentioned that fact. The NHS has tried to help with that ongoing issue but, unfortunately, not enough. I want to go through that, because I think that it is relevant.
In October 2020, NHS England announced a five-point plan to support long Covid patients; it commissioned NICE to develop new guidance and established designated long Covid clinics to provide
“joined up care for physical and mental health”.
It also created the NHS long Covid task force to guide the NHS’s national approach on long Covid, and it funded NIHR research on long Covid better to understand the condition. In July 2021, NHS England published its long Covid plan for 2021-22, which included investing £70 million to expand long Covid services and £30 million in the rollout of an enhanced service for general practice, to support patients in primary care. But when NHS England published its updated plan in July this year, the previously enhanced service funding was not continued, so primary care no longer receives any ring-fenced funding for this condition—yet, as we know, it affects nearly 2 million people.
The problem is both insufficient resources to do all the work that is needed and insufficient forward planning to enable those services that do exist to build up capacity, engage in research, recruit, train, educate, and care for patients, including, importantly, the large number of NHS staff who appear to have been affected. We have a major health problem here that is likely to run for many years. Treatment is uneven across the country and research, which will need a lot of funding, is in its early days. This is an additional burden on an already very stretched NHS, both with patients with long Covid and with the large numbers of staff who have it.
What we really need is a properly NHSE-commissioned service to be put in place now, with secure funding for the next several years, even in these cash-strapped times. It feels like a hand-to-mouth, temporarily funded arrangement, so it is really hard to build a resilient service for the longer term. Can the Minister assure this House that such long-term commissioning will now be put in place, given the recent evidence of the numbers of people away from work with long Covid, the huge proportion of NHS staff affected, making other NHS backlog issues worse, the general impact on the UK economy, which others have mentioned, and of course the sheer suffering that long Covid is causing?
I offer warm congratulations to my noble friend on securing this debate and on the way in which she introduced it. She and other noble Lords will know that, by the time you get to this stage of a debate, there is not much new to say. However, I have been listening very carefully, and there is no doubt that there is a great deal of agreement about the fact that long Covid provides a new challenge for an already much-challenged health sector. In listening to the excellent speeches that have been made, I see three main problems about long Covid. There is the issue of recognition and awareness, the issue of treatment, and the issue of its impact.
The first problem seems to be knowing whether you have long Covid or not. The same could be said of Covid itself. When I tested positive for Covid last year, no one was more surprised than I; I thought I had a little head cold, and was astonished to find when I was tested here at your Lordships’ House that I was positive. I know many people have had the same experience. This very uncertainty of knowing whether you have long Covid adds to the anxiety of sufferers. Just this morning, I was speaking to a young man in his 30s who had such awful brain fog, as he called it, after getting long Covid, that he thought that he had senile dementia coming on. I am glad to say that he is now recovering.
This also applies to treatment. There seems to be no agreed accepted programme of treatment for long Covid sufferers and availability of treatment is patchy in the extreme. In many areas, it seems to depend on the chance of finding a sympathetic doctor or nurse. If you have had symptoms for more than four weeks that is supposed to be an indicator, but it is not always accepted that these are the same symptoms and that they are always present, as we have heard many noble Lords mention. There does not seem to be any agreement about that and we are all reminded of the experience of those with ME, which noble Baronesses have brought to our attention. Many people suffered for many years with what was called “yuppie flu”, and it was seen as the last resort of malingers, causing much distress to sufferers.
That brings me to the impact of long Covid. Much has been said about its effect on the labour and employment market. The Institute for Fiscal Studies has been mentioned by many. It said that
“long COVID shows some persistent labour market effects, with impacts being felt at least three months after infection”—
I emphasise “at least”. I remind your Lordships that we must consider these possible effects on the ability to work in the light of the terrible workforce problems that many noble Lords have mentioned, particularly in the health and social care sector. There are nearly 170,000 vacancies in social care alone already, and so many people are burned out and leaving the workforce. If long Covid further affects these shortages, as seems likely, we must be fearful of the ability of the NHS and social care to provide even the minimum care which citizens have a right to expect. As others have said, the need for further research and for action as a result of research already commissioned is urgent.
I must draw noble Lords’ attention to the particular problems faced by unpaid carers in this regard. We all know that many carers have been extremely careful with the possibility of catching Covid and have been shielding for much longer than the general population so that they do not pass it on to the person they care for. From a benefits perspective, people with a new illness, such as long Covid, who are of state pension age, must have evidenced health needs for six months before they can even claim attendance allowance. The cost of being impaired by long Covid will not be offset for this group or for their carer. As one carer said: “My husband may not be able to return to work due to long Covid, so the loss of half the monthly income, coupled with the rise of everything from fuel to heating costs and a new baby, will be devastating for us as a household”. One carer who themselves had long Covid said: “I am a carer who has long Covid and I am on a long waiting list to get help. I have been told that I will most likely have to wait for nine or 10 months before my initial appointment. I asked for my situation as a carer to be taken into consideration but I was told this was not considered as a circumstance that would merit any special consideration.” This is not acceptable.
There is no doubt that long Covid is having a negative impact on our nation, especially on the most vulnerable. We must take it seriously. We must give support in the benefits system, in practical support and in long-term policy around how this is going to affect us in the future. I hope the Minister will be able to confirm that the Government are committed to many of the things that have been called for today—better diagnosis, better collection of data, more consistent messaging and, above all, an understanding of the wide-ranging impact of long Covid on the health, both physical and mental, of our whole nation.
My Lords, I declare my interest as a vice-chair of the All-Party Parliamentary Group on Coronavirus. I add my congratulations to the noble Baroness, Lady Thornton, on securing this important debate. She and I have spent most of the last 30 months in the parliamentary trenches of emergency Covid legislation, Statements and Questions, along with the noble Lord, Lord Bethell, and, more recently, the noble Lord, Lord Kamall. The noble Lord, Lord Markham, does not know how lucky he is to have missed those times.
The speech by the noble Baroness, Lady Thornton, eloquently set out the issues. I thank the organisations, including the Library, that have sent briefings. I also thank everyone who has spoken so far in the debate; there have been many powerful contributions from all around the House. Despite the worry of the noble Baroness, Lady Pitkeathley, that there was nothing left to say, she certainly said many things, including different things, and it is a pleasure to follow her.
I start by taking us back 100 years. The excellent book Pale Rider by Laura Spinney—which both the noble Baroness, Lady Thornton, and the noble Lord, Lord Bethell, have heard me quote repeatedly—shows evidence of excess deaths throughout the late-1920s and 1930s, after everyone thought the Spanish flu epidemic was over. But no one made the connection; all they knew was that there was excess death from cardiac and respiratory disease over a decade. Now, we understand more, of course. I have a key question for the Minister. It is already evident to me that parts of the NHS and many parts of government want to put Covid behind them. Will he undertake to make sure that we do not repeat history and stop learning from Covid, because it is not yet over, as others have said?
The authoritative and expert contribution of the noble Lord, Lord Kakkar, was really helpful. The scientific world is now publishing papers that show the consequences of Covid after that initial infection period. One in 22 will have a major cardiac event within 12 months of having caught Covid and one in five will get long Covid—as we have heard, that is over 2 million people to date. Covid damages the brain. A friend of mine in his 70s and his wife thought that he had very bad rapid onset dementia; last week, he discovered after an MRI scan that it was not dementia at all, but many micro clots in his brain, which were definitely affecting his capacity to think, speak and do physical things. That will be with him now for the rest of his life. Covid also damages the vascular system and the immune system. Variants mean that herd immunity and even one course of vaccines are no long-term solution.
Among the studies published recently is one from Washington University in St Louis. One American commentator, a scientist, says:
“We don’t know everything about long COVID yet, but what we do know is downright terrifying. But you’d never know it if you don’t seek out that information yourself … This pandemic is a mass killing AND a mass disabling event. Long COVID is going to be a defining issue of our times.”
The Americans have a reference system. The US veterans’ association provides a longitudinal study for Covid, and an article in Nature, published in May, showed that, after breakthrough SARS-Covid infection, there is considerable evidence of further and long-term problems. And the more you get Covid, the more likely you are to get long Covid or other serious consequences.
The right reverend Prelate referred to health inequalities in rural areas, and the noble Lord, Lord Brooke, referred to health inequalities for people catching Covid. Interestingly, this was also a major problem in the Spanish flu pandemic 100 years ago. We have that long tail—100 years—but have learned nothing.
My noble friend Lady Scott of Needham Market made a strong and impassioned argument for not falling into the trap of assuming that long Covid is about weakness or psychology. There are still no blood tests to identify long Covid or ME. She and the noble Baroness, Lady Meacher, made the vital connection with other post-viral conditions. Researchers this week are seeking volunteers with long Covid to take part in a study that looks at psychological factors, full stop. After all the evidence that we have heard this morning, that is breathtaking.
If noble Lords have not seen it already, Rowland Manthorpe, the excellent technology correspondent of Sky News, has a long article on the Sky website about his two-year journey with long Covid. It is very moving, including people saying that he just needed to start doing things gently and build up—not the answer. The noble Earl, Lord Clancarty, spoke of the difficulties in accessing appropriate support with GPs. At this point, the questions others have asked about definitive research become really important, but it is not just research; it is ensuring that the training for all our front-line healthcare and clinical staff understands that and they do not stick by the old thoughts.
The noble Lord, Lord Brooke of Alverthorpe, spoke about the high number of deaths in the UK. This was thought to be principally due to late lockdown in the first big wave, if we look at excess deaths, and comorbidities were key. It was not just about obesity, but obesity was among them. Significantly, people with high blood pressure, a history of heart problems or asthma also faced high death rates.
Long Covid definitely affects children too. My noble friend Lady Harris of Richmond, who cannot be in her place today, has spoken often in your Lordships House about the devastating effect that long Covid can have on children, from familial experience. The noble Baroness, Lady Taylor, referred to a young girl from the north-east and her two-year experience of long Covid. Yesterday, Hayden from Elvington in Kent, a previously fit and healthy 15 year-old, told the BBC how his life completely changed after he caught Covid in December 2020. He used to swim and play judo, but now has to use a wheelchair and is largely bed-ridden with, among other things, extreme and severe fatigue.
The noble Viscount, Lord Stansgate, referred to ivermectin. That is a longer debate for another day, but I strongly recommend he reads the one-pager that he can find online where a scientist explains why it should not be used in humans at all—in vitro, possibly; possibly even in cows; but not in humans.
The employment issues are vital. The right reverend Prelate referred to employment stats in Devon and the All-Party Group on Coronavirus also found statistics. The big issues that seemed to affect employees were that Covid-19 was often first contracted in the workplace, especially, as we heard, in professions deemed key and essential workers. As the noble Baroness, Lady Neuberger, said, 10% of those are in healthcare, so it is really shocking that the NHS is now sacking staff with long Covid and when those staff say, “But I caught it at work”, the NHS says, “You cannot prove it, end of case”. That happened to a friend of mine who was a senior midwife and it is appalling that she is now lost to the profession.
The all-party group has received many examples of healthcare professionals who were forced to work with Covid-19-positive patients with inadequate PPE. We have also heard of employers forcing them to work in unsafe conditions and offering no support for return to work, and a growing trend that those with long Covid feel physically and mentally unable to challenge dismissals or wrong PIP allocations. That is a real problem, because it means they are not getting benefits to which they are entitled.
The noble Baroness, Lady Thornton, set out the medical problems. I want to raise another issue. A number of Education Secretaries over the last 30 months have continued not to take account of Covid and long Covid in schools. That is why we have so many children with long Covid, so why are we not following the example of America, where all children are eligible for the vaccine? A colleague of mine, Councillor Oliver Patrick in Somerset, has devised a very cheap ventilator for children’s classrooms. You need only one and it costs about £100 to create, but schools are not getting support to do that and the word is certainly not getting around. So, when we have the next wave, expected in January and February, schools will once again act as a vector for Covid, and arising out of that will be long Covid.
I finish by asking the Minister some questions, some of which have already been asked. We need guidelines for employers, in both the private and public sectors, about how to manage employees who have had Covid. Will the Government undertake a compensation scheme, available to all front-line key workers who have Covid? Will the Minister look at the care system, as the noble Baroness, Lady Pitkeathley, outlined? Will the Government look at measuring, reporting and monitoring the number of people, including children, with long Covid in the UK? Finally, as the noble Baronesses, Lady Watkins and Lady Taylor, said, long Covid is a key part of Covid. Until the long Covid tail is over, Covid is not over. Will the Minister undertake to make sure that the Government act by that?
My Lords, I refer to my entry in the register of interests. I thank the noble Baroness, Lady Thornton, for securing this important debate and all noble Lords across the Chamber for their thoughtful and considered contributions. I will try to do their points justice in my response; where I do not, I promise to follow up in writing.
The pandemic has tested us all in many ways, as I am sure noble Lords agree. Governments and healthcare systems around the world are all facing the same set of challenges in tackling long Covid. Although I am to some extent still “the new guy”, I am under no illusions about how these add to the existing challenges facing the NHS, some of which have already been debated in the Chamber. We have done much already, but I shall not pretend that we have got it all right. We must do more, as was well put by my former colleague, my noble friend Lord Bethell, and many others.
Today’s debate has been wide-ranging, and I will do my best to respond to the issues raised. I will set out what the Government are doing on the serious challenges of long Covid, such as NHS healthcare, research, employment and social support. However, with the presence in this House of so many of the key players in the fight against Covid—my noble friend Lord Bethell and the noble Lords, Lord Darzi and Lord Stevens—it is only right that we first recognise the critical role they all played and the support they gave in the unprecedented global challenge we faced. The country acted decisively and, I think we broadly agree, got the big calls right. We were the first country to administer an approved vaccine and the first to administer a bivalent vaccine for the original strain and omicron, and we had the fastest booster programme across Europe. I pay tribute to my predecessor and all other colleagues for the tireless work they did in that area.
As mentioned by many noble Lords, including my noble friend Lord Bethell, we all agree that prevention is better than cure. It is the best defence. Not only have vaccines been proven to stop serious illness, but—I accept, more anecdotally—they are thought to reduce the risk of long Covid. As we all know, we have administered 139 million vaccine doses, 40 million boosters and a world-class programme. On the point made by the noble Lord, Lord Brooke, rather than being one of the worst in Europe, in terms of excess deaths, which is the internationally recognised definition, we are one of the best. However, I agree with my noble friend Lord Bethell that we need to bring what we have done on Covid prevention into our research on long Covid prevention.
The point was very well made by many noble Lords that it is not just about research into Covid but, as the noble Baronesses, Lady Scott and Lady Meacher, said, linking how long Covid might connect with ME, chronic fatigue syndrome and other similar areas. As we know, it is a complex area. Various speakers, including the noble Baroness, Lady Masham, and the noble Viscount, Lord Stansgate, mentioned how complex this is. We need to make sure that our research digs into all these areas. Some 220 different symptoms are included, I believe. The research we have done, such as the REACT study from Imperial, in which the noble Lord, Lord Darzi, has been so involved, and the UCL research on brain fog, mentioned by the noble Viscount, Lord Stansgate, and to which I am sure the noble Baroness, Lady Neuberger, is connected through her UCH connections, is vital. There are honest debates around this; there is also research into weight management and its impact on long Covid, as brought up by the noble Lord, Lord Brooke. We all agree that there must be an honest debate to really understand the drivers behind it. We need to be clear about that.
I can commit that the £50 million for research is protected. As the noble Baroness, Lady Brinton, said during her excellent history lesson—I will look up Pale Rider—there are many lessons to learn from Spanish flu. I agree that Covid is not over, unfortunately, so she has from me a commitment to that research.
In answer to the point made by the noble Lord, Lord Brooke, about the levels of investment, the £50 million we are investing in research is, I believe, second only to the USA, so we are very much among the leaders. This is in addition to the £108 million spent on Covid research to date. To answer the point made by the noble Baroness, Lady Thornton, we are fully committed to international research, and making sure it is a two-way process in which we share our findings and commit our data.
Regarding data, some excellent points were made by the noble Baroness, Lady Thornton, and the noble Lords, Lord Kakkar and Lord Griffiths. Noble Lords have heard me say before that I am a bit of a data anorak, so I totally understand its value in this space. I will make sure that noble Lords have a detailed answer on this, but it is something I very much support and believe we need to be doing.
I say in response to the noble Baronesses, Lady Scott and Lady Meacher, who spoke about trying to understand how long Covid might interact with, or have similarities to, ME and chronic fatigue, that funding is still available. The right reverend Prelate the Bishop of Exeter spoke about the rural impact, and I would say there is scope there. The noble Lord, Lord Kakkar, asked if we need to do more. Funds are still available within that £50 million, but it is something we believe in, and as we know from short Covid—if that is the right term for it—our research was vital and we remain committed to playing a leading role on the world stage.
We all know that research is only of any use or has any point if it actually creates treatments we can use within the NHS. As many speakers have said, only if these are substituted into services will they really help. The UK was one of the first countries to recognise and respond to long Covid, and we set up the national long covid commission guidance with new care pathways. As part of that, as mentioned by many speakers, including the noble Earl, Lord Clancarty, access to information and education for doctors is key. The Royal College of GPs and the HEE have put out information, but to judge from some of the examples given today, it has clearly not been disseminated widely enough.
I appreciate the tips from the noble Baroness, Lady Taylor, about getting extra funding from the Chancellor. As many of us might have seen, extra funding was announced in the other House earlier, but I appreciate the tips and, believe me, I will be using them. I assure the noble Baroness, Lady Neuberger, that the £224 million we have already invested is a commitment, and it has helped set to up 100 specialist treatment centres, many in rural areas. I had a chance to look up the figures, and I think I counted seven in Devon, but I will confirm that, because it is not just an inner-city issue but a whole-country issue. There is also the question of the impact on young people and children, a point made by the noble Baronesses, Lady Watkins and Lady Masham. Fourteen of those 100 centres specialise in treating children and are therefore helping to deal with this issue.
The point that these measures are only any good if we are making people aware of them all was very well made by the noble Baronesses, Lady Donaghy and Lady Pitkeathley, and the noble Earl, Lord Clancarty. I am proud of what we have managed to achieve on the Your COVID Recovery web app: we have had 12 million visits from people looking at advice on how they can recover. However, I am by no means complacent about the need to make sure that there is advice everywhere.
I will get back to the noble Viscount, Lord Stansgate, on ivermectin, as I need to get some detailed advice on that. However, as the noble Earl, Lord Clancarty, talked about people feeling the need to go to private centres and often try unproven medicines, generally I would caution against that, as I am sure many of us would. While this is a complex area and we are still learning about it, I advise people to stick to the proven methods we are trying to adopt through our own NICE guidelines and our own centres. That is what we are trying to do right now through the NHS, but as the noble Baroness, Lady Brinton, and others mentioned, this is not a one-and-done matter. This is a long-run thing, so these services will need to evolve over time, and we will need to keep up.
As we all know, looking at what we are doing health-wise is only part of the picture. The noble Lord, Lord Bethell, started the discussion on this point very well, and a number of noble Lords contributed to it, speaking about the whole impact on employment, work and schools, and—as was well said by the noble Lord, Lord Griffiths—on a personal basis. The impact of long Covid is much wider than just on health, and I very much recognise its impact on employment and work. As many noble Lords will know, I was the lead NED of the Department for Work and Pensions before I came into this role, so I am very aware of the 2.5 million people out of work due to long-term sickness, towards which we now know that long Covid is contributing. Action in this area to help those people is vital not only to their health but to the health of the economy. I know that this is a priority of colleagues at the DWP, and it is part of the £1.3 billion investment to support the long-term sick into work.
I totally accept the point made by a number of noble Lords, including the noble Baronesses, Lady Donaghy, Lady Watkins, Lady Masham, Lady Neuberger and Lady Brinton, about the impact of long Covid on our own NHS staff. We need to make sure that we are supporting them through this. I have done a bit of research on whether long Covid can be defined as an occupational disease, as was mentioned. This is a complex area, because, as we mentioned before, there are 220 different symptoms connected with it. However, the DWP is being advised by the independent Industrial Injuries Advisory Council on this. It has recently published a paper prescribing five complications following Covid which should be considered in awarding personal independence payments. I am sure this will be an evolving picture, but my DWP colleagues are looking at it.
Of course, this issue is much wider than the NHS; it should be embraced by all employers. I am very pleased that I have an opportunity to speak at the CBI conference shortly about health in the workplace. This is something that I plan to bring up then, because it is important that all our employers recognise that health is everyone’s business, as was said in a consultation document that recently went out, to which we will respond shortly. Clearly, the role of employers is key to all that.
Personally, I would like to see the sort of approach taken in Japan, in which employers take on a big role in the health of their workforce and very much look at prevention. As my noble friend Lord Bethell said, it should not just be our health service looking at prevention methods; we need to be giving people over 50 health MoTs, and looking at cardiovascular impacts as well as how employers can help in that space.
I hope I have answered many of the points raised today. I commit to cover any I have missed in a detailed response. I finish by again thanking the noble Baroness, Lady Thornton, and all the speakers. I found this a very informative debate. We can all say that we have much more to learn about long Covid and that we continue to be guided by the science. But the virus has definitely not gone away and, unfortunately, as many noble Lords mentioned, we will have to live with Covid and long Covid for a long time to come. We must continue to be proactive to prevent through our vaccine programmes, to treat through NHS services, to research to continually improve understanding, and to support people to get back into work. I thank noble Lords.
My Lords, I thank the Minister for that reply and the noble Baroness, Lady Neuberger, for outing me, because I did not declare my interest as a non-executive director of the Whittington; she is my boss there. I will just use these last few minutes to say that this was an excellent debate and I hope it has the kind of impact that most speakers said they would like. I will just mention a few of them.
I thank the noble Lord, Lord Bethell, for a wonderful contribution. There was a time when he and I felt that we saw more of each other than we did of our partners. I should include the noble Baroness, Lady Brinton, in that comment.
The noble Baronesses, Lady Scott and Lady Meacher, were correct to make the links they did and to raise issues such as there being no diagnostic blood tests for ME and CFS, even now. My noble friend Lady Donaghy was also completely right about the need to raise awareness.
The noble Lord, Lord Kakkar, is always concise and I am always grateful for the medical exposition he gives, which I would never dare attempt. I was hoping he would do so and indeed he did. I wish I had thought of the words “national protocol”, and I hope the Minister takes the opportunity to look at what he said about how data could be used. I do not wish to bring the two together, because I am sure they know each other, but I thought that his offer was very pertinent.
The right reverend Prelate the Bishop of Exeter and the noble Baroness, Lady Watkins, brought to our attention the problems in rural areas and with mental health. I am very grateful to my noble friend Lord Stansgate because he and other noble Lords, such as the noble Earl, Lord Clancarty, and the noble Baroness, Lady Masham, talked about the personal experiences of long Covid of people they had spoken to. It is very important that we give voice to those experiences in this Chamber. Many noble Lords did that and I had hoped they would, because I knew I would not be able to in my opening remarks.
I am very grateful to my noble friend Lord Griffiths for his extremely kind words and for reminding us, as he often does, about the human costs of the pandemic—not just the medical costs. My noble friend Lady Taylor talked about the significance of long Covid for society, and I was very struck by the noble Baroness, Lady Brinton, who again reminded me of a book that I still have to read. I promise her that I will now read it because, as she says, history has things to teach us and we need to hear those words—and the Minister does too.
My noble friend Lady Pitkeathley quite rightly talked about carers and unpaid carers. I thank her too for her expert round-up.
I thought that the Minister did the best he could—I have been in his place; there are so many experts in this House, and as a Minister you can only do your best with them—but I think the noble Lord needs to go through this debate. I asked about eight or nine specific questions, some of which he answered and some of which he did not. For example, he did not address the question of the Industrial Injuries Advisory Council. It is very important for our NHS staff to know the answer. I should be grateful if the Minister and his officials could go through this debate, pick out those questions and write to everybody who took part in this debate, putting the answers in the Library, so that we can see and take this forward as we know we will need to do.
National Security Bill
The Bill was brought from the Commons, read a first time and ordered to be printed.
National Women’s Sports
Question for Short Debate
My Lords, it is no secret as to why I have brought this issue forward. We have had a long run of great sporting success. For someone who would sooner cheer for Scotland, unfortunately this has been mainly by English teams. We have all seen our national women’s sides enjoying a tremendous run of success in team games that were originally thought to be male dominated.
The Euros were an odd one—for me, a hardened rugby union player, football suddenly became enjoyable to watch. This was not only because there was a successful team to relate to, but also for the sheer joy the players seemed to have in competing and in that success. Who would have thought that a song, brought out in 1969 by Neil Diamond, would be belted out with such great gusto and with which everybody would join in? “Sweet Caroline” has become an anthem for British sport. It happened because a group of female players enjoyed and enlivened their success. It engaged the vast majority of us in a way we did not expect.
This success has been backed up—though this is a little bitter-sweet—by the England rugby union team, which had 30 consecutive victories at international level. I do not know how many records that broke, but it was magnificent. If we cannot celebrate this degree of success with better grace and embrace it a little more than we have done so far, we are going to be in trouble.
The whole structure of sport encourages people to take part and enjoy it. I am asking the Government what we are doing to get the best social, health and emotional health benefits from it. How are we going to do this?
What did we do to allow that success to be seen? First, we made sure that it was all on free-to-air television. If either of those tournaments had been tucked away in even the most brightly lit corner of a streaming service, the vast majority of the population would not have seen them. This had to be something that the BBC and ITV particularly took on and said, “Here it is.”
It is also about the warm-up to it, not just the events. Women’s football has been available for a long time, mainly on the BBC—we have seen it. If you did not see it, it does not really matter, and that applies to any form of public entertainment or engagement that goes on. For the first time, rugby union having the women’s competition in stand-alone tournaments when you can watch it has been massively beneficial to getting people engaged in it.
Why does this matter? If you are getting the women and girls to think that sporting activity is normal, you can encourage more of them to take part in it. It is not a totally closed book because they are out there now, but most of the clichés and stereotypes which have stood against female participation are thus addressed. You are going through and making sure that people can get out and get involved. How do you access this and encourage people to do it? You start at school, I hope by having a smorgasbord of opportunities to try. You encourage children to get out there and enjoy the sports that are going on. However, the thing about school is that you leave it. Generally speaking, people drop out of sport post 16, 18 or 21, when they leave this controlled environment where to an extent it is made easier for you or you are encouraged—indeed, forced—to take part in sport.
What do we do to break that down? You encourage children to try sports, hopefully ones that are culturally available to them. For instance, if you are talking about codes of rugby, I suggest that St Helens rugby league might be your first port of call—this might be the first opportunity to celebrate that other bunch of Lionesses who got into the semi-final of that particular tournament. You have to make sure that it is culturally available for your background and the groups that you are going out to, and then you must encourage people to go from the club at the school to the small amateur clubs—the big, professional, international, shiny stuff does not really matter that much as regards the benefit to society if you do not get people taking part in these games on a voluntary amateur basis.
In this country, government is very lucky that we have a tradition of sports clubs which founded themselves, fund themselves and look after themselves. Sport does a lot. Government helps but primarily, sport helps itself. That is why they are there and why, for instance, local government finds itself assisting football clubs with their grounds, not providing all of them as they do in most of Europe. The Government should be encouraging that. One of the easy ways of doing this is to make sure that there is an effective link between school and club activity. You get better coaching and the idea that you can carry on afterwards. I hope that this will be encouraged.
For women and girls, this might mean expanding the traditional bill of fare. We have just spoken about two sports which are not encapsulated in the traditional diet of netball and hockey, although they should both be represented. Indeed, both those sports have had their degree of success but possibly, if we televise them more we might do them a bit of a favour. However, maybe that is taking the debate a bit too far down one avenue.
How are we going to encourage this, making sure that that offer to take on these things in later life is done? We have to do more on that. School sport partnerships took a step in that direction—I do not know whether they were all-encompassing and fully working that through, because in most cases they got stopped when they had only just started to get going. Can the Minister give us an idea of what they are going to do?
I return to one of the things which government should probably do more of, which is to celebrate better team sports generally. We are in an odd position here, in that we have handed out honours and awards like toffees for people who have had modest successes. It was great back in those heady days when England won the Ashes for the first time, but they should have beaten Australia before that. Everybody got a gong—or whatever the correct term is in cricket; others will correct me later—at the end of it, even if they sat on the bench. Then England win the Rugby World Cup. Great: everybody gets a gong. The England women’s team were amateurs in 2014. The definition of amateurs is that you pay to play, you are not paid; you give up time and effort and you put money in. When they won the World Cup—and they are much more consistent about getting to finals, and so on, than the men—two of them got medals. Has the person who devised that for a team game never actually watched a team game, let alone participated in one? Do not goalkeepers and defenders count in football, or the people who do the hard work to win the ball in rugby, or is it only the glamour boys? I speak as someone who was definitely in the grunt brigade.
This is what the Government could easily do. If it upsets some weird table of achievement or the giving out of awards, give one medal to the entire team and give people a copy of it. That is a way out. The example I give of where that has been done is the equestrian teams for eventing. There used to be one medal; now they give them each one, but it still counts as one medal. That is something that the Government could do easily.
I know the Government had a lot on their plate this summer, but they did not have an official reception for the Lionesses: come on. There was enough of the Government left to celebrate that better. Why did that not happen? You could probably do it now and nobody would lose any Brownie points for having a party late, as opposed to not having it.
As the clock beats me, I thank everybody for taking part and hope that the Government will be able to answer my questions and the other thoughtful ones that I know are coming.
My Lords, I congratulate the noble Lord, Lord Addington, both on obtaining the debate and on his erudite and detailed analysis of the circumstances of women’s team sports over recent years. I intend, as is natural for me—as with the noble Lord—to concentrate on rugby union and leave football to the noble Baroness, Lady Taylor, and others.
I start with the observation that, tomorrow evening, my rugby club, the Kings Cross Steelers, will be celebrating on the Terrace their victory in the worldwide gay tournament, the Bingham Cup. In itself, that victory is not relevant; what is relevant is that we will have three members of the England women’s rugby team present: Shaunagh Brown, Ellie Kildunne and Sadia Kebaya. We are honoured, because their success in recent weeks has caught the attention of the nation. I say to Sarah Hunter, our captain, on behalf of the whole team, not only have you caught our attention but you have gained our respect. We all know how difficult it is to accept defeat—and such a close defeat, at that—but you have gained our complete respect.
Why? When I told my members that we were going to have three members of the England women’s team present, the reaction was a communal, “Wow, that’s great!”. For the first time ever, because of television coverage and the like, the rugby union team has attracted our attention in the same way that the football team has done. Why has it attracted our attention? Let us be honest, with the level of professionalism that we now have—which is rising and can go on rising—the skill levels in team sports have risen. Therefore, nobody dismisses them now and says that it does not matter, or that they are just out there playing rugby union, football, cricket, rugby league or whatever; there is a skill level now available which everybody can and should appreciate.
Along with a number of other Members of both this House and the other place, I had the pleasure of pressing the Government for funding for the women’s Rugby World Cup in 2025. I was pleased that the Government granted that assistance. In Auckland, a week ago, the stadium was full to 40,000—its maximum capacity. The RFU has set a target of filling Twickenham, with a capacity of well over 80,000, for the final in 2025. It is a great target and it should be achieved. It reflects the growing interest in women’s sport that is being displayed across the nations.
As the noble Lord, Lord Addington, said, although we can admire the achievement and the increased professionalisation and skills, we must recognise that it is not a total success story. I served on a committee with the noble Lord, Lord Addington, and the noble Baroness, Lady Grey-Thompson, and others. We looked at the statistics in relation to activity levels. Among women, those levels are on average 10% below male activity levels, and markedly lower among certain socioeconomic groups and ethnic communities. Those are the people who need to be attracted by the performance of women in team sports to generate an interest on a day-to-day basis at a lower level in sport generally, because role models are not the only solution to achieving participation.
My Lords, I too congratulate the noble Lord, Lord Addington, on securing this debate, and share his pleasure in the recent successes. But I want to emphasise that we should always bear in mind that national success of this kind is built on the grass-roots activities that underpin them and which are so important and so common throughout the country every weekend. That is very important.
As the noble Lord, Lord Hayward, said, my particular interest is in football. I make no apologies for that, though as a good northerner, I should say that women in rugby league, while not in this Saturday’s final, deserve some credit for giving that game a much higher profile. They need recognition for what they have achieved over the last few weeks, especially given that they are not even fully professional.
Football has seen remarkable changes recently in the public perception of the women’s game. It is remarkable that attendances at women’s football matches have gone through the roof—over 50,000 on some occasions. The noble Lord, Lord Addington, is right that free-to-view television has been an important factor. However, this weekend, a large number of people will pay to watch women’s football on television. That is partly because there is no FA Premier League, but nevertheless it is a significant breakthrough. Another breakthrough is the number of women commentators, not just on women’s football but on all football. We have made some successes there.
As I said, it is the grass roots that have built up to this success. I must mention AFC Bolton Ladies, who are self-funding but have had real difficulties post Covid. The Government must consider these small clubs in the light of what has been happening there. I make special mention of a group of women football players, the pioneering Manchester Corinthians, of Fog Lane Park, not least because they were founded by a scout from Bolton Wanderers in 1949. They made breakthroughs, and were the first women’s team to represent England at an international level and beat the Germans—just to mention that. The team even played in front of 50,000 people in Benfica—and this was when women’s football was banned. It is incredible that it was not until 1971 that women’s football was recognised as even existing. It has been an uphill struggle, and a lot of that struggle was conducted at that very low level. I hope that Manchester Corinthians get the recognition that they want for their history.
But all is not well and easy. A report by sports scientists out just yesterday highlights the lack of football kit actually designed for women, and how women therefore have more injuries of certain kinds, because there has not been that recognition. While we are celebrating success, I will celebrate in particular the success of the Lionesses: undefeated in 26 games, winning the European Championship and providing that role model. I agree with the noble Lord, Lord Addington, that a reception would be very nice, but I think the Lionesses would rather have the legacy of the Government making sure that football is available for every girl and woman to play, with the kind of support necessary to make that success continue into the future.
My Lords, I congratulate my noble friend Lord Addington on obtaining this debate and opening it in such a thoughtful and constructive manner. In the short time allocated, I will concentrate my remarks on one specific area: the benefits of involving women in custody and those on the cusp of the criminal justice system in sport.
When I became Minister of State for Justice in the coalition Government in 2010, and later chair of the Youth Justice Board for England and Wales between 2014 and 2017, I instinctively assumed, from my own experience, that sport would play an important part in diverting young people from the criminal justice system or helping in rehabilitation once they were within it. The advice I was initially given was that there was no evidence that participation in sport could play such a constructive role. I spent my seven years at the MoJ actively searching for such proof.
Fortunately, over those years, individuals and organisations helped change attitudes to the importance of sport in our criminal justice system, not just for boys but for girls and women too. There was the ground-breaking research by Professor Rosie Meek, of Royal Holloway, University of London, in her 2018 report for the Ministry of Justice, which reviewed sport in youth and adult prisons. In her foreword to that report, Professor Meek said:
“Evidence confirms that sport can play a huge role within our Criminal Justice System. As well as being a way to bring together disparate groups, develop communication skills and learn life lessons, it also has the advantage of being something many people are passionate about.”
I was also encouraged by James Mapstone, co-founder and chief executive of the Alliance of Sport in Criminal Justice, and was given great encouragement by a member of my Youth Justice Board, now the noble Baroness, Lady Sater. I look forward to her remarks later in this debate. Protocol prevents me referring to her as my noble friend, but perhaps I may refer to her as my partner in crime. She is now a co-chair of the All-Party Parliamentary Group on Sport and Physical Activity in the Criminal Justice System, along with Clive Efford MP, with James Mapstone providing the secretariat and Rosie Meek as an adviser. I am confident that we can keep up the pressure for greater recognition of sport within the CJS.
Beyond the need for change in the criminal justice system, it is also clear that much still needs to be done to provide access to facilities and the right equipment, and in the recruitment of coaches. I was interested in the point that the noble Baroness, Lady Taylor, just made about equipment. Forty years ago, as an MP, I remember being approached by a young female constituent who told me that access to sports bras was a deterrent to girls playing sport. As the noble Baroness, Lady Taylor, said, a report earlier this week called for more comfortable and practical sports bras, shorts and hijabs, as well as boots and other equipment specifically designed for the needs of women and girls and their bodies. As she said, there is still work to be done at that level.
Although time has prevented me paying full tribute to the way that the skills of, and opportunities for, women in sport have exploded into the public consciousness, I do so now and hope that we will enjoy success in more sports and at all levels in the years ahead; that we will celebrate, as the Motion asks us, the success of our women’s team; and that we will put forward practical measures to underpin that success in future.
My Lords, like every other noble Lord, I express my pride in both the Lionesses and England’s women, who put in such a gutsy performance in the world championship, losing by such a small margin against New Zealand.
As the noble Lord, Lord Addington, said in his excellent opening remarks, during their teenage years girls drop out of sport at three times the rate of boys, yet girls need load-bearing exercise even more than boys during those years. It is the best time to build bone density, helping to protect us from osteoporosis later in life. The push from our sports councils to get more females into exercising and keep us there is not just a social move towards some sort of sporting equality. It is important for our health and well-being, including the impact on the NHS budget.
Football is the most popular team sport in the UK, with millions of people playing regularly. It is a “gender-affected activity”, in the words of the Equality Act, meaning that mixed-sex play would not be fair for females because males are stronger and faster, even when they are the same size. From the age of 12, boys and girls play separately to give females fair and safe play. Even in primary schools, it is common to have girls’ teams and boys’ teams. A 10 year-old girl will tell you that boys will not pass to girls and that she prefers playing with other girls because boys are too rough. The effects of male puberty are clear: more muscle, bigger heart and lung capacity, denser bones, stiffer tendons and the rest.
In the school playground or in the park, you will see boys, not girls, having an impromptu football game. The result is that for every female playing football in the UK, there are nine males. That is almost a whole team. If football is to become a girls’ game too, it is obvious that girls and young women need their own teams. They also need role models. After the success of the England women, girls can see they can be female and sporty, and that can be life-changing.
Here is the problem. Since 2015 the Football Association has had a policy that males may play in women’s teams if they lower their testosterone or, in some cases, even if they do not. Lowering testosterone will slow them down a little but does not reverse male puberty and it certainly does not remove male performance advantage in sport. An average male runs 10% faster than an average female. In a dash to the ball, he needs to be only half a metre in front every time and she will never get a touch. Up to the age of 18, even that requirement is absent. The FA’s current policy says that under-18s may play in the team of “their reassigned/ affirmed gender”, so although talented girls can be forced to drop out of boys’ teams after the age of 11, boys who say they are “girls inside” get to join a girls’ team.
This year the England Universities women’s football squad has a trans-identifying male player, a 30-something six-foot-tall post-pubertal male who now identifies as a woman, in goal, where size advantage really counts. If you had to play them, would you not want a trans-identifying male player in your women’s team too, in order to level the playing field a little?
Last autumn the UK’s Sports Council Equality Group published new guidance on transgender inclusion in sport. It said that the inclusion of trans-identifying males in female sport could not be balanced with fairness, and in many cases safety, for females. This summer English and Welsh rugby reinstated female-only teams, though Scottish Rugby has yet to follow, but football is not there yet.
Women’s football was huge in the early 20th century but was outlawed by the FA in 1921 and remained so for 50 years. Now, once again, women’s football has a chance. Let us hope the FA will not hand it to the boys this time.
My Lords, I thank the noble Lord, Lord Addington, and also the noble Lord, Lord Harlech, for today’s debate. I would like to draw noble Lords’ attention to my entry in the register of interests; I have many connections in sport.
There is indeed a lot to celebrate. Ten years ago, the London Olympics and Paralympics became known as the “women’s games” because of the success of British athletes. This summer I have loved the Euros, the rugby union and rugby league; it has been incredible. Women’s sport is on the rise, but we are not there yet. It still feels like we are at the beginning of a journey. We have to be careful about the next steps we take and what we might consider giving away, and we must not be complacent about the future.
The organisation Women in Sport has said that the successes are built on shaky foundations, with “stubborn inequalities”, stereotypes and practical barriers, which may be different at each stage of life, disrupting many women’s and girls’ experiences of sport. Over the years many misogynistic men have told me that women do not play sport because apparently, “they” do not like it. Turning it around, “they” are hopefully starting to realise that we do like playing sport and we are good at it, but there is still so much more we have to do.
I was part of a conversation recently in which someone tried to tell me that you know women’s sport has made it when top coaches—they meant men—decide they want to coach women. Let me be clear that I am not against men coaching women; three out of four of my coaches were men. I know incredible men in sport. But the inference that we are only good at sport when men decide we are, is just a little bit irritating. There is not enough time to go into that particular debate.
We have to keep looking and checking. Where are the women coaches, administrators and volunteers, and what opportunities are we going give women athletes? What platform do we give them? Sport matters and women must be part of the discussion about the future. In the US, Title IX prohibits sex-based discrimination. I have long believed that we need that in the UK, perhaps now more than ever, in order not just to keep investing in success but to make sure that we have the right opportunities.
Also in the US, the NCAA rules have recently changed, benefiting some women, who have been able to sell their name, image and likeness for great financial reward. It is probably seen at the moment as a non-traditional form of endorsement. It does give some power to women, but not all women can do this or want to.
Women are catching up in sport. Women have been allowed to compete in the Olympic marathon only since 1984, and in the pole vault, since 2000. There are plenty more other sports I could mention. We have an opportunity now not just to celebrate success but to turn the tide of inactivity. So, what do we need to do? We have to stop sexualising the uniforms women are required to wear, or at least give them a choice. We need to listen to what women want in sport and to tackle the inequalities in sponsorship and media coverage, and at the grassroots.
Women in Sport says that
“4 in 10 girls feel women’s sport is still viewed as of lower value than men’s sport and that girls are not expected to be good at sport”.
More than one-third of parents of girls, 37%, think that girls are not encouraged to do sport and physical activity as much as boys are. You have to see it to believe it, and this summer we have seen the success of women’s sport in spades. It has been incredible, and there is a lot to celebrate. Now, we have to do more to widen the opportunities and ensure we have future success.
My Lords, I congratulate the noble Lord, Lord Addington, on securing this short debate and on his excellent speech. Many national women’s teams in the United Kingdom have cause to celebrate a fine year. To name a few, gold medals have been won at the Commonwealth Games by the England women’s hockey team and by the GB women’s rowing crews at the European championships. In rugby union, the Red Roses were unlucky to lose narrowly against the All Blacks. English women were also runners-up in the cricket world cup. Above all, of course, we celebrate the magnificent victory of the Lionesses. That was great for women’s sport. It brought in a large audience, has raised the sport’s profile and has attracted many new players.
It is important that we celebrate, and that government now build on the enthusiasm generated to promote support for girls and women equally with boys and men. Champions attract newcomers. From the mass of young participants come future champions. With them, we will have future successes. It must and can be a virtuous circle. Government must nurture young sportswomen.
It is good for society if we all exercise and participate, with greater or less success, in sports. Teams are valuable for the less-gifted participants. Many children love sport, if encouraged and given the chance. Many just want to be in a team, even the third or fourth team—and that applies, as I know, to boys and girls alike. Team sports promote loyalty and friendship; to be a “team player” is a compliment we give people in life. Society wins from more involvement in sport.
However, too many girls do not play sport in their teenage years. The reasons are complex, but puberty and changing body shapes cause difficulties. There is embarrassment in changing rooms, so, wherever possible, there must single-sex changing facilities. They should not have to share facilities with boys or, later, with men. Nor should they be deterred by faster and stronger trans women in direct competition. It is simply not fair for a taller, well-built natal male with artificially lowered testosterone levels to play contact sports with girls or women. It is not just unfair; it carries increased risk of serious injury. It is not a level playing field. Inclusivity must not mean being unfair to females, who, after all, are half our population. Being kind to trans women does not justify invading the dignity of the female sex or putting them at a physical disadvantage; sensitivity to female needs and fairness to females must come first.
Sport for women should result in happy and confident persons. If we drive proper sport for females forward, we shall have more champions to cheer. So let us celebrate, build on the success we have had and drive women’s team sports to still greater heights. Let the Government now show that they believe that women and girls are the equal of men.
I too congratulate my friend the noble Lord, Lord Addington, on securing this excellent debate and thank him for highlighting and celebrating women’s team sports. I also thank the noble Lord, Lord McNally, for his kind words, for raising a very important issue, for all the work he has done in promoting sport and physical activity at the YJB and for his continued support with the APPG.
As others have mentioned, there has been huge progress in the last few years in bringing women’s sport to national attention, most notably through the fantastic achievement of the Lionesses in winning the Euros earlier this year. We have also seen, in recent days and weeks, the GB tennis team make the semi-final of the Billie Jean King Cup for the first time in 41 years, and the England women’s team make it all the way to the final of the Rugby World Cup. A wide variety of women’s team sports are clearly on the rise and getting more exposure in the media—and what fantastic role models they are.
We must maintain this focus on women’s sport and build upon the progress and success we have seen. It is vital that we continue to strive for greater equality and opportunity in sport. We have an amazing opportunity to help inspire the next generation of sportswomen by teaching girls in schools the right skills and strategies from an early age. We know that more work remains to be done on this agenda as, according to a Women in Sport report published earlier this year, girls are not only “less physically active generally” than boys but are
“also far less likely to take part in team sports”.
While 55% of girls play team sports, the figure is 71% for boys. Schools have an important role to play along the journey in achieving national successes. We know that many schools are delivering excellent sporting facilities, but I am afraid that this is not true of all schools, be it down to a lack of workforce, facilities or equipment.
We all know the knock-on effects of what better physical health can have on mental health and helping our children with their learning in school. The Association of Physical Education states:
“The difference that high quality Physical Education, School Sport & Physical Activity make to the lives of young people is quite remarkable.”
That includes improved behaviour and attitudes and building confidence, social skills, personal development and much more.
With all the successes of national women’s sports and the increased demand in recent years, perhaps we should consider modifying and adapting the curriculum so that we can build on the success. We must always listen to the voices of girls; they are not a homogenous group—they have different attitudes towards sports, and we must recognise this to help inspire more girls to get active. It should, of course, not come at the expense of individual sports and other activities, which is why we need to provide a broad and balanced offer.
Sport and physical activity should be a must-have, not a nice-to-have. One way to embed more focus on sport and physical activity, including encouraging more girls to play sport and giving them more opportunity to play team sports, would be to classify PE as a core subject. Does my noble friend the Minister agree that this would give PE a higher priority and focus in schools?
I agree with the noble Lord, Lord Addington, in his comments about clubs, and the pathway between schools and clubs. Sport does not stop at the school gate. We must ensure that we support and strengthen the relationship between schools and local clubs so that we can help more girls on their journey to becoming elite sportswomen. I have no doubt that on the back of the successes that we have seen across a wide variety of women’s sports on the national stage in recent years, there will be an increased demand from more girls to play more sports in schools. We have an opportunity here to unleash the full potential of women in sport in this country, and we must seize it.
First, of course, I congratulate my noble friend Lord Addington on securing this important debate.
I would like to tell noble Lords a story about my first serious engagement with women in sport. As the newly elected MP for Solihull, I was invited to see a women’s rugby match at a local constituency club called Camp Hill. Warmly wrapped up, I stood on the try line nearest the bar, ready to cheer the Camp Hill Chargers on, not really expecting to find women’s rugby a very serious endeavour. How wrong I was. I can tell noble Lords that it was not handbags. Indeed, to prevent a try being scored, a Charger threw herself on top of the ball so no opposition player could get to it, winded herself, took off her scrum cap, had a little sick, put the cap back on and ran back on to the pitch. I began to appreciate that women’s sport is, to women, an incredibly serious matter.
That game was in 2005, a time when women’s sport was grossly undervalued, both in the attention it received in the media and the financial support that it was given. But these days, the popularity of women’s sport is huge, and is growing at different rates right across the board. Only days ago, the Red Roses reached the final of the Rugby World Cup in New Zealand—who, as we know, won, playing on home turf. Britain’s Rugby Union chief executive, Bill Sweeney, agreed that the nail-biting finish
“was probably more entertaining than the men’s game”.
But success attracts investment, and this rugby final attracted the largest crowds ever for the women’s game.
Is the real win the benefits it brings to those who take part? Many minority groups have been mentioned by noble Lords this afternoon for inclusion. My noble friend Lord McNally mentioned sports participation and the criminal justice Bill. It is about inclusion of all kinds. Several noble Lords have also taken the opportunity to raise the trans issue, an important issue on which we should perhaps have a further debate on another day.
My noble friend Lord Addington queried the value of what the Government are doing to celebrate the success of these fantastic teams. Why did the Lionesses not get invited to a formal reception at No. 10? While I appreciate that there have been one or two other small things on the Government’s plate of late, it is a simple thing to recognise our women’s success. It does not cost a lot. It creates good publicity. It improves public morale, which we could certainly do with at the moment, and shows that, even though we can mess up the economy in six days, we are good at something. That should be recognised and celebrated.
My Lords, I too congratulate the noble Lord, Lord Addington, on bringing this debate to us today. He has a habit of enriching the Chamber with his knowledge of sport, particularly rugby, and I congratulate him on all that he does to promote that.
It is right that we celebrate the achievements of our national women’s sporting legends, but we need to do much more than that—we should celebrate those who have led the way in opening up sport generally so that women, so long excluded, can feel welcome and able to play competitive sports on equal terms with their male counterparts. We have, as all speakers acknowledge, much to celebrate and even more to look forward to, but it is worth just reminding ourselves of the journey women in sport have been on. I will tell a story which, I hope, illustrates the point.
In 2000, when I was a Minister in the Home Office, I was travelling home late in a ministerial car and had a new and rather sparky temporary driver. As you do, we fell into a conversation about football, and within a few minutes my driver explained that she played for one of the top women’s clubs and had played for Doncaster Belles, Arsenal Ladies and Croydon Women in recent seasons. She also told me she was England’s centre forward. I remarked, “There’s clearly something wrong here, I should be driving you”. Imagine the noble Lord, Lord Parkinson, being driven home by Harry Kane—well, that is how it felt.
We then embarked on a conversation in which it was explained to me just how hard it was for women footballers to perform at the highest level. To train and get time off for games they had to plead with their employers, who were often wholly unsympathetic and opposed to helping the women’s game. Senior women footballers of that era were truly pioneers to whom the current generation of England and Women’s Super League players are grateful. Many were just paid “boot money”.
Much has changed in the world of football for the better for women players, but there remains much more to do in the marketing of the game, clubs giving greater exposure to the women’s game in their stadia, pay levels in the professional leagues, the transfer market and the treatment of the game in the media, in particular. Schools football, its governance and the encouragement of the grass roots, as the noble Baroness, Lady Taylor, explained to us, all need work before we can get anywhere near parity with the men’s game. I remind noble Lords today that the highest transfer fee for a woman footballer is £350,000, paid back in September this year. Women, despite their incredible drawing power, as illustrated by the Euros, are still undervalued.
Women are powering ahead as winners in UK sport in football, cricket, rugby, rugby league, athletics, tennis, gymnastics, cycling, curling, rowing and a whole range of Olympic and Paralympic sports and much more. Our sports bodies and organisations are doing much good work in opening up opportunities and making sport more inclusive. For the long term, we need to do more to ensure we protect our sporting heritage with secured funding and investment in school facilities, playing fields and open spaces—much missed in the last few years. We need to challenge unconscious bias and ensure that the culture surrounding women in sport is right and appropriate by ensuring that we raise standards in the world of sports administration.
There is much to celebrate but, as the noble Baroness, Lady Grey-Thompson, said, much more to do. Let us learn from our wins—and our defeats—celebrate today our women’s achievements and ensure that future generations build on that legacy.
My Lords, like other noble Lords, I thank the noble Lord, Lord Addington, for securing this important debate on the success of women’s sport. The timing is, as noble Lords noted, particularly apt with so much success occurring across women’s sport, not least the success of England’s Red Roses reaching the final at the women’s Rugby World Cup last weekend—and coming so tantalisingly close to winning the tournament—and the Lionesses at this summer’s Euros. I am very happy to be responding to this Question for Short Debate at such an exciting time, and I assure noble Lords that His Majesty’s Government are keen to build on this success and momentum to create a lasting legacy for women’s sport.
The Government are fully committed to supporting women’s sport at every opportunity, pushing for greater participation, employment, commercial opportunities, visibility—a point that the noble Lord, Lord Addington accentuated—and opportunities at school. It is important that we take the time to recognise and celebrate success, which is why today’s debate is so important as well as so timely.
This summer we witnessed a major success in women’s sport the Lionesses beat the German team at Wembley to lift the UEFA European championship trophy. This inspirational tournament was staged in July across England, from Rotherham and Wigan to Southampton and Brighton. As noble Lords have noted, the final at Wembley was attended by a record crowd of over 87,000 people. That was not only a new record for a women’s international game in Europe but broke new ground for a women’s or men’s Euros final tournament game. The tournament also became the most watched women’s Euros ever, with a global cumulative live viewership of 365 million people across television, out-of-home viewing and streaming. This massive figure is more than double the number that watched the last UEFA European Women’s Championship in the Netherlands in 2017.
The tournament was truly a ground-breaking moment for the sport and has dramatically boosted interest in the women’s game, bringing it to the forefront of people’s minds. The event held for the Lionesses in Trafalgar Square the day after the final was a momentous occasion and saw 7,000 fans celebrate with their heroes. My right honourable friend the Secretary of State and the former Prime Minister Liz Truss met the Lionesses at their training ground to congratulate them and were very proud to support the event in Trafalgar Square. However, as the noble Baroness, Lady Taylor of Bolton, said, it is also important that we focus on the long-term legacy by way of celebration. To commemorate their already incredible achievement, we are working with the Football Foundation and the FA to name sites after the players in towns and cities that shaped their careers. We hope that that will inspire many generations of more players.
We will also continue to invest in grass-roots sport to bring on the next generation of Lionesses. We know how valuable physical education at school is: it gives pupils an opportunity to excel, to be active and to lead healthy lives. My noble friend Lady Jenkin of Kennington talked about the importance for bone density and preventing diseases such as osteoporosis. That is why we are actively working with the Department for Education to understand the barriers that prevent the ambition of two hours of PE a week being achieved. We will also continue to work with the Department for Education to ensure that girls have equal access to sports.
There is more work for us to do to identify and address the different barriers to participation that exist for young people; we have heard about some of those again today. We will continue to adopt a more targeted approach as part of our new sport strategy. Alongside this, the Department for Education is working on updating the School Sport and Activity Action Plan, which will set out steps to improve PE teaching in primary schools and to help schools make better use of their sport facilities.
On facilities, my noble friend Lord Sandhurst spoke about the importance of single-sex changing facilities. The Government are committed to maintaining the safeguards that allow organisations to provide single-sex services and we do not plan to announce any changes to the law.
Aside from the Women’s Euros, there are a number of other recent examples of success in women’s sport. Over the last week, we have seen the England Red Roses reach the final of this year’s women’s Rugby World Cup, as well as the other Lionesses—as the noble Lord, Lord Addington, put it—reach the semi-final of the Rugby League World Cup. The Great Britain team reached the semi-finals of the Billie Jean King Cup for the first time—as my noble friend Lady Sater said—in 41 years. Great Britain’s women also won three medals at the recent Gymnastics World Championships in Liverpool. Jessica Gadirova claimed an historic floor gold medal for Great Britain on the final day and sealed Great Britain’s first ever women’s all-round World Gymnastics Championship medal with bronze in Liverpool. This year’s Commonwealth Games also highlighted the success of women’s sport with Eilish McColgan’s outstanding performance in the 10,000 metres, to give just one example. Some 173,000 spectators attended the T20 women’s cricket at Edgbaston, a record for women’s cricket.
It goes without saying that Emma Radacanu’s win at the US Open in 2021 truly inspired the nation as well. A peak audience of 9.2 million tuned into the match on Channel 4, including 48% of 16 to 34 year-olds. The UK’s honours system can provide a way of recognising stellar sporting achievement and moments of national celebration. Examples of this include the MBEs awarded to the GB women’s hockey team who won gold at the Rio Olympic Games in 2016 and the damehood awarded to Dame Laura Kenny as a result of her becoming the most successful female cyclist in Olympic history following her performance at the Tokyo Games in 2020.
I take the point the noble Lord raises. Of course, the honours system is independent of government, but his point will be well heard and, I am sure, fed back to those who sit on the independent committees.
All those sportswomen, whether honoured yet or not, are inspiring the next generation to follow their dreams. We are looking forward to this momentum being maintained and built on with the rugby league World Cup final this weekend, the ICC women’s T20 World Cup in South Africa, the FIFA women’s World Cup in Australia and New Zealand, the netball World Cup in South Africa and the Solheim Cup in Spain. I am sure all noble Lords will want to send our best wishes to the mixed England team who are in the finals of the wheelchair rugby league World Cup tomorrow.
As noble Lords can see, there is much to celebrate in women’s sport, but it is not enough that we celebrate these successes; we must continue our hard work in ensuring that they continue for decades to come. We are doing this by investing £230 million between 2021 and 2025 to improve grass-roots facilities across the UK. In addition, after Emma Radacanu’s spectacular win, we put just under £22 million into tennis court facilities. We will also look to continue our world-leading reputation for hosting major and mega sporting events and bringing all those special moments, like the Lionesses’ victory, to the United Kingdom. Major events make people feel good in a way unlike others and it is right that we should all have the opportunity to witness at first hand the successes of our brilliant athletes, men and women.
With this in mind, we must continue to build our pipeline of sporting events so that we can inspire more people across the country to watch, participate in or volunteer in sport, putting emphasis on the need for events to consider their social impact and legacy at the early bidding stage, to maximise the benefits after conclusion. It is worth highlighting in that regard that we successfully won the bid to host the women’s Rugby World Cup in 2025 in May this year, and I pay tribute to my noble friend Lord Hayward for securing the financial commitment from the Government for that and pass on, via him, my congratulations to the Kings Cross Steelers for their victory in the Bingham Cup. Hosting the women’s Rugby World Cup in 2025 and delivering the legacy programme will generate transformational social impacts across rugby fans and more widely, including in the towns and cities which play host, and the legacy programme will look to focus on access to rugby for women and girls across the country. The 2026 ICC women’s T20 World Cup was announced as being awarded to England and Wales in July this year, another important opportunity that will further boost the ECB’s strategy to make cricket a gender-balanced sport.
The UK has also won the bid to host the International Working Group on Women and Sport from this year until 2026, another great opportunity not only to share the fantastic work we are doing but to learn from other countries. There is no doubt that the visibility of women’s sport is continuing to grow, and this was boosted earlier this year when we added the FIFA women’s World Cup and the UEFA Women’s European Championships to the listed events regime, meaning both tournaments will remain available for free-to-air television broadcasters and to the biggest audiences.
We want to continue to build on recent successes, such as the Women’s Euros and the good work already being done to encourage more women and girls to participate in sport and physical activity. We need to look ahead and be prepared to take advantage of opportunities and find ways to overcome challenges, such as have been outlined in today’s debate. We need to keep talking about issues relating to women in sport, asking questions and pushing ourselves to do more, so that women can continue to be in the driving seat of our national sporting success and not just of the Government Car Service. I am very grateful to the noble Lord, Lord Addington, for today’s debate and to all noble Lords who participated in it.
Motion to Take Note
My Lords, there has been no shortage of reports on housing of all tenures over the past 10 years. There is a general consensus that our housing market is not fit for purpose. We are not building enough new homes; most houses that are built are unaffordable except to those on above average earnings; young people find it impossible to get on to the housing ladder; we have a growing elderly population in homes not adapted to suit their needs; and more and more people are being forced into the private rented sector.
The House of Lords Built Environment Committee addressed many of these problems in its 2021 report and stressed the need to improve housing supply, saying
“too many people are living in expensive, unsuitable, poor quality homes.”
I am sure that all these issues and more will be raised in this debate. I will focus most of my contribution on social and supported homes, but I start with some very basic facts.
Looking at affordability, the latest ONS figures show that the average UK house price was £296,000 in August 2022, up 14.3% over the previous year in England. Prices in England have gone up by 76% since 2012. Despite regional differences, all areas have experienced increased prices. Average house prices in London, despite it having the lowest annual house price growth rate, remain the most expensive of any region in the UK. The ONS also estimates that full-time employees can typically expect to spend around 9.1 times their workplace-based annual earnings on purchasing a home in England, compared to 3.5 times in 1997. The number of new social rented homes has fallen by over 80% since 2010. The Government committed in their 2019 manifesto to build 300,000 new homes annually by the mid-2020s. I hope the Minister will tell the House what plans are in place to deliver on those numbers, given the stark facts I have listed.
The Grenfell Tower tragedy of June 2017, in which 72 people lost their lives in a high-rise fire in west London, focused political attention on social housing and the relationship between tenants and landlords. The Government’s response has been painfully slow. Although they have begun to make changes, as the right reverend Prelate the Bishop of Chelmsford said in a recent debate, there is a need for significant investment in new social housing and a comprehensive housing strategy.
We currently face a grave affordable housing crisis which continues to worsen, with 4.2 million people currently in need of social housing in England. Understanding the scale and types of housing need across the country is essential for planning effective policy responses and informing the debate around the need for new homes. People in Housing Need, a report published by the National Housing Federation last December, found that half a million more families are in need of social housing than are recorded on official housing waiting lists. Two million children in England—one in every five—are living in overcrowded, unaffordable or unsuitable homes. Some 1.3 million of these children are in need of social housing, as this is the only suitable and affordable type of home for their families.
Need for social housing has risen in all parts of the country, yet the supply of social rented housing has fallen, as I have said, by 85% since 2010-11, with the number of social rent homes available for letting each year also falling since 2014-15. We are living through a severe crisis of housing supply and affordability, which is increasing housing vulnerability. Long-term investment in social housing would provide people with suitable homes that they can afford and support the Government’s commitment to level up disadvantaged communities across the country. Social housing brings down the housing benefit bill, supports better health and well-being outcomes and reduces reliance on temporary accommodation.
Last year, housing associations built more than 38,000 new homes. Building these homes directly added £2.1 billion to the national economy, supporting more than 36,000 jobs. Housing associations in England currently provide 2.8 million homes for 6 million people, housing 11% of the population. The lower rents they charge save tenants £9 billion annually, making significant savings for the Treasury by bringing down the housing benefit bill. However, current inflationary pressures are having a significant impact on housing associations’ ability to deliver new developments. According to data commissioned from the Centre for Economics and Business Research, material costs for repairs and maintenance have increased by 14% and it is 12.3% more expensive to build new homes than it was last year.
Planning reforms included in the Levelling-Up and Regeneration Bill would replace the Section 106 agreements with a new infrastructure levy. This would have significant implications for the delivery of new affordable housing. Although Section 106 is not perfect, it delivers significant numbers of affordable homes; currently around 50% of all new affordable housing is delivered in this way. As it stands in the Bill, the infrastructure levy would enable local authorities to divert developer contributions away from affordable housing and towards other unspecified forms of infrastructure. Around two-thirds of Section 106 proceeds currently go towards affordable housing, so this would represent a dramatic tilt away from affordable housing delivery when demand for it is increasing all over the country. Will the Minister tell us what steps the Government are taking to ensure that their new infrastructure levy does not result in a net loss of affordable and social housing delivered via the planning system?
The current energy and cost of living crisis urgently solidifies the importance of energy-efficient homes for the future. England’s homes produce more carbon emissions every year than are produced by all the country’s cars. Much of the country is living in draughty homes that are not fit for purpose, which not only has an impact on the environment and the future climate but leaves many unable to afford to heat their homes. It is imperative that we decarbonise all homes in England, to reach the national net-zero targets by 2050. The social housing sector is the best place for the Government to start. The quantity and variety of homes within the sector mean that there will be more opportunities to deliver change at scale and provide the market mechanisms required to build up supply chains.
It is vital that the energy efficiencies of homes are greatly improved. Over 60% of social homes are certified EPC C or above, but other tenures average just under 40%. An immediate commitment to long-term retrofit funding will do wonders to move people away from gas and prevent residents moving into fuel poverty. Will the Minister protect the existing social housing decarbonisation fund? Can she tell the House when the Government will release the remainder of the £3.8 billion investment up to 2030?
The horrific tragedy at Grenfell Tower has shown that more needs to be done to ensure that tenants are listened to by their landlords when they talk about issues related to quality and safety. Currently, 23% of privately rented homes are non-decent, rising to 29% of homes privately rented by people receiving housing support. Some 16% of owner-occupied homes and 12% of social housing homes are currently non-decent. The recent appalling case in Lancashire reinforces this point.
Social housing landlords have been working to encourage a culture of transparency. Some 207 housing associations have signed up to the Together with Tenants charter, which has developed relationships of mutual trust and respect in over 2 million homes. The Social Housing (Regulation) Bill is a welcome step to empowering residents through stronger consumer regulations. Does the Minister agree that any measures brought forward must be meaningful to residents but also proportional to the capacity and resources available for housing providers of all sizes?
I now move on to supported housing. Good-quality supported housing transforms lives. It gives people choice and provides tailored, person-centred support that is vital to their resilience, health and well-being. Residents with physical and mental health needs benefit from specialist homes and services, and live independent, healthy lives. Supported housing can be a lifeline for older people and those with long-term care and support needs, including learning disabilities, autism and mental health conditions. This vital housing resource is facing a number of acute funding pressures which represent a serious threat to its long-term future. Against a backdrop of reduction in commissioning, the current inflationary pressures are crippling supported housing services, with increases in energy costs, costs of repairs, maintenance, building safety upgrades, legal and insurance costs and the costs of cleaning materials. The sector is also experiencing significant issues with recruitment and retention of staff, largely due to the low levels of pay providers are currently able to offer.
The cost of providing supported housing schemes is much higher than in other tenures. Operating margins for supported and sheltered housing schemes are tight and are on average 8% lower than social housing lettings overall. These margins have become only tighter as costs have risen across the sector. For example, one small supported housing provider I know of is currently operating on a very thin margin of 0.9%. One medium-sized provider recently saw bills for its gas and electricity increase by 100% from last year to this year, from £1 million to £2 million, adding that if it had to go out to tender at this point, the bill would come to £5 million. Some housing associations are considering pulling out of supported housing provision altogether. Given the unique funding pressures facing this vital part of the sector, can the Minister tell us what the Government are doing to improve funding certainty for supported housing providers?
The Government have produced a number of policies to address some of the issues I have outlined, but they have made little or no progress on the underpinning problem: we are not building enough homes, and we are not remediating enough of the existing homes which form the vast bulk of the housing market.
In conclusion, it is clear that we need a joined-up, long-term, outcomes-based strategy for housing people on lower incomes. Reform in the sector is often piecemeal and disjointed, as illustrated by the fact that we have had five different Housing Ministers in the past year and 14 different Ministers since 2010. Affordable housing is a key driver of economic growth. Managing and maintaining housing associations’ existing homes directly adds £11 billion to the national economy annually. Housing associations are an essential part of the housing market. I hope that the Minister will agree that it is vital that they are able to continue this contribution and deliver much more.
My Lords, I congratulate the noble Baroness, Lady Warwick, on securing this debate and on her introduction to it. It is strange how rarely we discuss the housing crisis in this country, since I believe it is the root of most of our social problems and many of our economic ones. I have tried to raise it from time to time and have found that there has been a tendency to ignore the issue.
I once made a speech in the House of Commons which was reported in the local newspaper with the headline, “MP says cure for housing crisis is to build more houses”. I have often complained about the inaccuracy of headlines relating to speeches I have given, but I have to say that this was spot on. That was exactly what I said, and what I want to say today: the cure to the housing crisis is building more homes. I thought this was uncontentious, but the headline sparked controversy in the columns of the St Albans Observer, with people writing in to say, “How can our MP say anything so stupid as to argue that the cure to the housing crisis is building more houses? Everybody knows that it is about simply keeping house prices down, because they are artificially high”—no, they are high because there are not enough houses. It is not that the shortage is caused by the houses being expensive.
Others said that the cause of the problem was mortgage interest rates or deposits. No—however much we fiddle around and subsidise or regulate mortgage interest rates or deposits, that does not create a single extra home for anyone. We cannot by changing the price of a bottle get a quart into a pint pot. We have to build more homes.
Others said that there are plenty of affordable homes in the north of England, the regions or the nations of the United Kingdom. Even if that is true, in most of our regions the price of houses relative to incomes in those areas is still exceptionally high compared to what it was historically. Even if they had a point, who is going to force people to move to the north, Northern Ireland, Scotland or Wales? When I gently suggested to people in my old constituency that perhaps they were volunteering to move themselves, they were shocked. That was another vote lost.
We have to face these arguments and ask ourselves why we have such high house prices in this country and at this time, especially given that the rate of births is below the rate of deaths. We are not creating more households domestically to create this demand for housing. Until recently, the main driver of demand for housing was that households were becoming smaller. As people left home earlier or lived longer after their children had left home, so that there were only two instead of four in the household, or after their partner had died, so that there was only one instead of two, average household size was coming down. This was also aggravated by the sad break-up of families through divorce or separation. That used to mean we had to add 0.5% to the housing stock every year to cope with smaller households.
That has come to an end. Young people are now unable to leave home and are leaving later. In 1999, 2.4 million adults aged between 20 and 34 lived at home with their parents. By 2019, 3.5 million people in that age group lived at home with their parents. So what is the reason?
The main reason, which I suspect no one else in this debate will mention, is not migration into the south of England or London from the rest of the United Kingdom. That is often the reason given, but in the last two or three decades there has been a net outflow from London and south-east England to the rest of the UK. The inflow is from abroad. We have seen mass immigration into this country on a scale never before seen in our history. We know that the official figures from the last decade understate the numbers coming here. We found, when we asked European residents to register, that there were 2 million more of them than we knew about. Over the last decade, the official figures show a net increase to our population of 2 million from those coming to settle here from abroad.
That is equivalent to our having to build cities the size of Nottingham, Derby, Leicester, Middlesbrough, Carlisle, Oxford, Exeter, Portsmouth and Southampton, every decade, just to keep up with the net inflow from abroad. They are predominantly young people of childbearing age, so they soon have families. That is a great joy for them, but it means that the demand for housing increases. I am talking about legal migration into this country, not the boat people, whose numbers are very small compared to the scale of legal migration into this country.
We have to be honest about this and recognise that we have a simple choice. Either we continue treating this country as if it was like Canada, Australia or America, with large open spaces to populate, or, if we allow a continued net inflow of 200,000 or 300,000 into this country, we have to build extra houses on top of the demand of the domestic population that is already here. We can strive to reduce the inflow, but we will still have to build a lot of houses and there will still be a lot of objections to that housebuilding. I do not mind which side of the debate people take, as long as they are honest about it. If they say, “We want to see mass immigration into this country and we are prepared to build all those extra properties every year—the equivalent of all those cities every decade”, that is fair enough, but they may oppose that.
In my constituency, I invariably found that the Lib Dems both criticised me when I raised the issue of immigration and opposed every building project in the constituency. Before the last election in which I stood, the great and good 1,000 people who belonged to the civic society in my constituency threatened to run a candidate against me, specifically on the issue of housing, if I did not agree to oppose all new housebuilding in the constituency.
This is the sort of pressure which Members of Parliament face. I stood up to it. They eventually backed down on the condition that I held a big public meeting during the campaign, at which they would organise opposition to housebuilding in the area and expose me as someone who would not oppose it. I was with the other candidates, and I opened by saying that this was a moral issue. Did we want homes for our children somewhere near to where we live, or not? Did we think the next generation had to live at home until it was probably too late for them to form a family, or not? We have to accept the building of houses and find the least bad places in which to build them. We must not put our heads in the sand and pretend that they are not necessary. Because I took a moral position, the rest of the candidates were forced to follow suit. By the end of the evening, 400 people who had arrived at that hall, screaming that we should not have any more housebuilding, had largely accepted that we should.
We have to face up to this opposition to housebuilding, and we have to be honest about it. I believe too that we need to reduce the net inflow from abroad if we are to make the problem manageable. We cannot do what too many people try to do, pretending we can have massive immigration into this country and not build the extra homes this will require.
My Lords, I welcome the noble Baroness, Lady Taylor of Stevenage, to this House. I look forward to what will no doubt be a thoughtful, considered and pertinent contribution to this debate. We worked constructively alongside each other in Hertfordshire for many years. I hope to do so again in your Lordships’ House.
I will make a quick aside to the noble Lord, Lord Lilley. I was dubbed “the pro-development mayor” by my political opponents, so nimbyism is not confined to one party.
I thank the noble Baroness, Lady Warwick of Undercliffe, for bringing forward this important debate. Quite rightly, we seem to be talking a lot about housing in both Chambers at the moment. As the noble Baroness cogently argued, we need a cross-sector housing strategy—one that spans 10, 15 or even 20 years. To succeed, I believe that it must have some degree of cross-party consensus. We on these Benches welcome this debate and the fact that the Labour Party, in common with us, is clearly putting housing front and centre of its political thinking. We too have just finished updating our housing policies, and it is not surprising that there appears to be much agreement, as there needs to be.
Across the many pressure groups, professional institutions, think tanks and government departments that provide us with many excellent briefings and statistics, there are clearly many areas of broad consensus, but none more so than the private rented sector, on which I will centre my remarks.
Change is so slow in coming. It is now more than three years since the then Prime Minister, Theresa May, declared with a fanfare of trumpets and a roll of drums that the Government would abolish no-fault evictions. In the words of the off-chanted song, why are we waiting? In that time, not only have hundreds of thousands of tenants been evicted through Section 21 notices, but more than 45,000 households have been threatened with homelessness as a result of being served such a notice. When will the renters reform Bill, based on the recent A fairer private rented sector White Paper, come to Parliament? Where is the timetable? We were promised that it would be enacted during the 2022-23 Session. According to an Answer given recently in the other place, this has now slipped to “at some point during this Parliament”. Will it abolish Section 21 evictions, or has there been some pushback from landlords?
Noble Lords may sense my frustration. The sector has always been characterised by insecure tenancies and high rents, and often poor conditions. In England, there are more than four million privately rented homes, housing more than 11 million people. There will always be a need for a decent, well-regulated private rented sector, but we do not have this now. House prices are getting beyond most low-waged and many median-waged workers, who cannot save enough to get a deposit together, given the significant rise in house prices and what they pay in rent. They can often be paying more in rent than a mortgage costs, but without the bank of mum and dad or an inheritance to provide the deposit, they are going to be renters for most of their lives.
This situation has become more acute in recent months, with letting agency statistics showing far fewer properties available to rent. Rightmove’s latest data shows that in the third quarter of this year, tenant demand for properties increased by 20% compared with the same quarter last year, and the number of properties available to rent was down by 9%—a loss of some properties, undoubtedly, to the more lucrative short-term lets market. Even the Royal Institution of Chartered Surveyors has warned of rents increasing as a result of the rise in tenant demand; at the same time, the number of new landlord instructions is falling.
I have been shocked by local anecdotal accounts of the fierce competition for properties and the lengths desperate renters are going to in order to secure a property. There is evidence from letting agents of a beauty parade of renters who are competing for properties, resorting even to sending in CVs of their well-behaved children and photos of their equally well-behaved dogs, alongside the more obvious deals of offering more months’ rent up front, agreeing to do some repairs and decorating—in short, anything to get into a property. In this climate, there are no prizes for guessing who does not get the house. The like of this has not been seen before, as the country faces a financial crisis—we are now officially in recession—and a winter of much discontent. Thus the need for urgent action, and hence the frustration.
If fast-tracked through the system, the rental reform White Paper, with its 12 excellent proposals—again, broadly agreed on—could have eased the situation for many as the winter crisis looms. In the meantime, will the Government consider a two-year rent freeze while the current economic pressures are expected to reach their peak?
The Government have decided once again to freeze local housing allowance, which will push millions of hard-pressed tenants to breaking point. Will they reconsider this, if only as a temporary measure? Does the Minister agree that there is an imperative to prevent evictions as winter approaches?
Latest government figures show homelessness in England rising by 11% in three months. Also according to the Government’s own figures, eviction from private tenancies is the second leading cause of homelessness. What worries me most about these recent statistics is that, despite being in full-time work, 10,500 households were found to be homeless or threatened with homelessness. This is the highest number of people in full-time work recorded as homeless since the Government started collecting this data. There are massive implications and messages in that one statistic.
Let us not forget that those statistics are people: families, all wanting the same as we do. Eventually they tip up to their local council offices, which are cash-strapped because we have had year upon year of cuts. They are met by fewer council officers—because of the cuts—who have had years of rationing a scarce resource: namely, social housing. Given the increasing number of families and individuals in dire circumstances, that is a really tough job. In effect, they are having to play God, trying as fairly as possible to allocate a decreasing number of homes to a greater number of people. I am certain that others will elaborate on this sector.
My one plea to the Minister is: will the Government finally agree to allow councils to keep 100% of right-to-buy receipts with no strings attached, other than to build replacements? I look forward to the answers to the questions asked by the noble Baroness, Lady Warwick, on social housing. There will always be a need for a social rented sector, and recent legislation to improve it cannot become effective quickly enough, as the recent death of young Awaab Ishak, who was living in social housing, proves.
Some 21% of homes in the private rented sector are non-decent, according to the most recent English Housing Survey. Making all homes decent is surely a laudable, ambitious aim for any Government, doing the right thing by people as well as creating jobs and saving money for the NHS. A recent Building Research Establishment report found that poor housing costs the NHS £1.4 billion a year, and society as a whole £18.5 billion. I say to the Chancellor that these are potentially significant long-term savings, and just think of the considerable long-lasting good.
Is there the political will to do this? It is clear that we are going to be more heavily reliant on the private rented sector than ever before, and it is in need of urgent reform now, not to be pushed back. Does the Minister have a reason for the delay, other than another new Prime Minister and yet another Housing Minister? In view of the worsening economic situation, will the Government consider pulling together all the “could do” solutions that have broad consensus and fast-tracking them to help ease the crisis that will inevitably worsen over the winter and the next two years?
Finally, how will local authorities be given the support to help those increasing numbers who will inevitably end up at their doors or on their streets?
My Lords, it is a pleasure to follow the noble Baroness, Lady Thornhill, and I thank her very much for her kind comments.
It was with the greatest humility, gratitude and anticipation that I received the news that I was to be nominated by Sir Keir Starmer to join this House—something that would never have come into my wildest dreams, for reasons your Lordships will learn of when I introduce myself. I start by thanking Keir for my nomination, and my two great friends and supporters who got me through the unique experience of being introduced to this House, my noble friends Lord Kennedy of Southwark and Lady Wilcox of Newport. I thank sincerely my noble friend Lady Smith of Basildon, our Leader in this House, who has shown me the greatest kindness and encouragement, and noble friends on these Benches who have given me such a warm welcome, as have noble Lords from across the House.
The noble Lord, Lord Soames, and I were introduced to this House on the same day, and indeed had our appointment with Black Rod together. It struck me then how extraordinary it is that he and I, coming from almost polar opposite ends of British society, could be entering your Lordships’ House together—such is the strength of our country and our Parliament. I thank the noble Lord, Lord Soames, for his courtesy and kindness.
On my second day here, I approached the Peers’ Entrance with some trepidation, impostor syndrome on full throttle. The day before, at my introduction, I had been accompanied by my family, friends and supporters, but this felt very different. I did not need to worry. As I showed my pass, the doorkeeper greeted me with the kind words, “Do come in, my Lady, and welcome back home.” That, I have come to learn, is the culture and warmth of this place. From my very first appointments with Garter, Black Rod and the Clerk of the Parliaments to my day-to-day interactions with the doorkeepers, staff and catering teams, everyone has been welcoming, helpful, knowledgeable and highly professional. Thank you so much to all of you; it is a truly exceptional team.
I thank my noble friend Lady Warwick of Undercliffe for securing this important debate today and introducing it. It gives me the opportunity to make my first speech in this House on a topic so close to my heart and so interwoven into my life and career that it has literally shaped who I am and what I have done. That is because my hometown, the place where I was born, brought up and still live, is Stevenage, Britain’s first post-war new town; a town that was built to house people, to provide the homes for heroes that had sadly not been delivered after the First World War, and to keep that promise after the ravages that London and other major cities had suffered during the Second World War. Our new towns were born from the inspirational vision of the same post-war Labour Government that created our NHS and the welfare state, including the National Assistance Act 1946 and the Transport Act 1947. Stevenage was designated to be the first of this new generation of new towns, almost exactly 76 years ago, on 11 November 1946.
My parents, both Londoners, married in 1954. They had searched endlessly for a home in London that they could afford, but with mum a trainee pharmacist and dad recently demobbed from national service in the Royal Air Force and embarking on his engineering career, there was little that they could afford. Then dad was offered a job with English Electric, soon to relocate to Stevenage, and they were offered a three-bedroom house along with the job. My parents, like so many others, became new town pioneers. This has given me the extraordinary privilege of growing up not only in my hometown but with my hometown, which is just 10 years older than I am.
The vision for new towns was set out in the New Towns Act 1946 and championed by one of our local heroes, a late Member of this House, Lord Lewis Silkin. He did not always have an easy ride during the passage of the Bill. It seems that planning was just as controversial in 1946 as it is now. When he arrived in old Stevenage for a public meeting relating to the new town, the railway station sign had been removed and replaced by angry residents with one saying “Silkingrad”. Lord Silkin held his nerve. His vision was to enact the Abercrombie plan for a town that was planned thoroughly in advance of being built, with segregated residential, commercial and industrial areas, and good connectivity by road and rail; a town planned to have connected but self-contained communities, each with their own health, education, leisure and shopping facilities, and with plentiful green spaces and access for all to parks and countryside. Importantly for today’s debate, it was to be a town with a variety of housing to meet the needs of working families of all income levels.
No one, especially me, will pretend that our new towns developed without their own challenges and issues. But my pioneering parents gave me and my sisters the opportunity to grow up in a strong, cohesive community. That is why, following a career where I worked in the defence industry, for John Lewis Partnership and, latterly, spent the most incredible 13 years as staff officer to the chief constable of Hertfordshire, my lifelong support for the Labour Party drew me to stand as a Stevenage councillor, to give something back to the town and community that I love.
My first election was on 1 May 1997, a date emblazoned on the memories of most of us on this side of the House. I have been a councillor since then; I have led my council since 2006, and have been fortunate to contribute to the leadership of local government nationally through the Local Government Association since 2009. My specialism has been the labyrinthine world of local government finance, which is partly the key to unlocking the housing challenge that we face. That is why I want to focus on social housing today.
Between 1945 and 1980, local authorities and housing associations built 4.4 million social homes—more than 126,000 a year—but by 1983, that supply had halved to just over 44,000 a year. This followed a major shift in social housing policy, particularly, but not exclusively, the right-to-buy scheme of Margaret Thatcher’s Government. Failure to replace the stock bought under right to buy means that, in Stevenage, our stock has fallen from 32,000 to less than 8,000 homes. The promise to our pioneers that their children, grandchildren and parents would be housed has been broken.
The retained right-to-buy funding regime permits only 40% of the cost of constructing a replacement dwelling to come from right-to-buy receipts. Failing to take account of rising property, land and commodity prices in the construction industry, the shortfall on a new-build property in my area is currently £186,000, forcing us to use additional borrowing, with a trade-off between repairs and management of existing stock or building private homes for sale simply to fund any replacement homes at all.
Over 2 million sales of social homes have taken place, but research shows that over 40% of these are now rented privately. Affordable social housing turned into unaffordable private rented housing, with a consequent catastrophic effect on family budgets. It is also economically illiterate, as housing benefit spending has risen by 50%, peaking at £24.3 billion in the last year of recorded statistics. The average monthly rent for a two-bedroom privately rented property in my town is now £312 a week, against the local housing allowance of £195. No wonder there is a cost of living crisis.
Against a target of 300,000 homes a year, we are currently building a little over 100,000. This problem will not get better unless we turbo-charge the number of homes of all tenures, particularly social housing, that we build in this country. Let us get back to those first principles of our new towns—of building communities and homes, not just places and houses. Let us take the design and detail of our development seriously and, to meet the challenge we have that Lord Silkin did not, let us build sustainably, so that we do not exacerbate the backlog of £204 million that I will need to decarbonise 8,000 social homes in Stevenage.
We all know that a safe, warm, secure home is the foundation stone for every individual, family and community. My passion for housing is undimmed, as is my pride in Stevenage, the town I grew up with. I finish by quoting Lord Silkin:
“The new towns can be experiments in design as well as in living … This combination of town and country is vital … I believe that if all these conditions are satisfied, we may well produce in the new towns a new type of citizen, a healthy, self-respecting, dignified person with a sense of beauty, culture and civic pride. Cicero said: ‘A man’s dignity is enhanced by the home he lives in’.”—[Official Report, Commons, 8/5/1946; col. 1091.]
Let us renew our vision, our focus and our inspiration so that everyone in our country, and indeed future generations, will have the opportunity of a home that enhances their dignity. Thank you.
My Lords, I am delighted to follow the noble Baroness, Lady Taylor of Stevenage, the “of Stevenage” being particularly significant. I congratulate her on a splendid maiden speech. No-one could bring a more relevant lifetime of experience and understanding of housing issues, for which we are deeply grateful. I know she brings considerable experience as a county councillor for Hertfordshire and as leader of Stevenage Borough Council. I must declare my own interest, in passing, as a past president and now a vice-president of the Local Government Association. She was deputy chair of the LGA from 2008 right through to 2017 and I know she was a huge success in that role.
Stevenage’s motto is “The heart of a town lies in its people” and I think the heart of the noble Baroness, Lady Taylor, lies in the town she has served continuously for over 25 years. Times may be tough for local government, but I am certain that the noble Baroness will ensure that its voice is heard loud and clear in this Chamber.
I thank the noble Baroness, Lady Warwick of Undercliffe, for leading this most timely debate and I echo her view that the nation’s housing is in a critical state. But the acute shortage of the homes we need has accumulated over decades: for over 30 years, the number of extra homes built each year has been less than the number of new households that have formed. These years of undersupply are finally catching up with us.
Dramatically fewer people have been able to get on the housing ladder, with owner-occupation for those aged under 30 falling from 47% 20 years ago to under 25% today. Now those wanting to buy face even greater problems, made worse by the hike in interest rates following the fateful mini-Budget. Over 1.5 million households are queuing for social housing from councils or housing associations, but that sector has halved in size, from one-third of the nation’s homes to just 17%, while social landlords face a mountain of extra building and borrowing costs that will hold back their new-build affordable housing programme.
For more and more people, the only option is the private rented sector, which has doubled in size during the first two decades of this century. However, here we are seeing falling numbers of available lettings because landlords, deterred by higher interest rates on top of other disincentives, are exiting the market or, in some areas, switching to Airbnb and very short-term lettings.
Demand is up by 20% while supply is down 9%, as noted by the noble Baroness, Lady Thornhill. With consequent fierce competition for privately rented properties, young people are spending half their income on securing a rented, not always decent, flat. More couples must postpone having children indefinitely. Down the income scale, overcrowding and slum conditions exacerbate health inequalities and put further strains on the NHS. Rent increases, coupled with frozen levels of housing allowances, push more households below the poverty line. Councils spend over £1 billion a year on temporary accommodation. Street homelessness has risen again and, of course, there is simply nowhere for refugees and asylum seekers to be housed.
There are a dozen urgent measures that could and should provide temporary relief, but we also need to address the underlying cause of this national failure. What would make the biggest difference to getting more homes built—as the noble Lord, Lord Lilley, suggests we need to do—and galvanising the process of reducing the disastrous housing shortages?
Top of my wish list for fundamental change is the adoption of the mechanisms for land value capture advocated by Sir Oliver Letwin in his 2018 review. Sir Oliver got to the heart of why we have been failing, year after year, to build what we need. Yes, we should resource our local planning departments to speed up the planning process, but that is not why we get such a slow build-out of new developments and build so few new homes affordable to the half of the population on average incomes or less, or why we have developments that continuously fail us on so many counts. We also see SME builders being excluded, despite those firms often being more in tune with local needs, the local vernacular and the local labour market.
Leaving to one side the handful of excellent new developments by enlightened landowners and non-profit developers, the UK is simply not getting the quantity or quality of homes we need. The reason, says the Letwin review, is that we have handed over the decision-making process for all major housing developments to the oligopoly of volume housebuilders. These companies initiate each new scheme: they secure the land, they produce their plans and they build their development, in their own time and at a speed that suits them. The role of the local planning authority is confined to raising objections and fighting back, without the staff or the budget to insist on an alternative development that would genuinely meet the requirements of the locality.
The housebuilders’ business model requires them to fight, with their lawyers and consultants, for the minimum number of affordable homes—the maximum number of properties they can squeeze on to a site, with the least green infrastructure and the fewest amenities, and to build at a speed that ensures the continuing scarcity that drives up prices. Our system rewards the very actions by housebuilders most at odds with the public interest.
Instead, the Letwin review tells us we should take back control. Letwin puts the scale at 1,500 homes but his formula is just as applicable for 150: for every major development, land should be acquired at a price that relates to its current use—for example, for agricultural land, Letwin suggests paying no more than 10 times the agricultural value—with a master plan that determines what is built and parcels out sites to different builders and providers, for a range of uses and tenures. Having bought the land at a reasonable price, using compulsory purchase powers if necessary, a development becomes viable that actually and promptly delivers the social benefits missing today.
To achieve this upending of the current, highly unsatisfactory process, Letwin proposes local authorities establish arm’s-length development corporations, as is quite possible under existing law. These would borrow the finance to buy the site and capture the land value uplift. The development corporation’s master plan can then incorporate all the features of healthy place-making.
This approach follows the pattern of the garden cities and the new towns in a scaled-down version—the noble Baroness, Lady Taylor of Stevenage, pertinently referred to the technique of the new towns. The cost to the Exchequer is less for a much higher-quality outcome. This process accelerates delivery, removing the friction and delay from the housebuilders and the planners waging war, often for years.
I commend these Letwin recommendations and would greatly welcome the comments of the Minister. Let us address the root causes of our housing ills; let us take back control and start building what society wants and desperately needs.
My Lords, it has been a relatively short debate so far, but it has been a privilege to be here and listen to contributions and, inevitably, to the magnificent introductory speech of my noble friend Lady Taylor. I think it has set a difficult standard that not all of us reach.
We have a very broad subject before us. I am going to focus on the private rental market in London. It is arguable that, because of the nature of London, the private rental market is particularly important because of the people who come to London, how long they stay here and the sort of people they are. The problem is that the private rental market in London is failing.
First, I will say a word about London. It is, of course, the greatest city where all human life can be found. To pick up a point from the noble Lord, Lord Lilley, we welcome people to London from all over the world. They are welcome and we regard them as being a net benefit to our life—even taking account of the decent housing with which they must be provided. The important point is that the success of London is not counterposed to the success of the rest of the country. I would argue, though it is not always a popular argument, that the success of the rest of the country depends on a successful London. To a significant extent, because of the particular and distinct importance of the private rental market in London, the success of the country depends on a functioning private rental market in London. This echoes the point made by the noble Lord, Lord Lilley, that it is an economic issue; decent housing is not just about accommodation but about the whole economy and its success.
The 2021 census estimated that London’s population stood at 8.8 million. It is forecast to grow, heading towards 10 million on some estimates. Of course, that is a churning population: people come, and people leave. I find it difficult to understand why they leave—I have stayed. The private rental housing market in London does not serve the purposes of this rotating population. This is in the context of our worsening cost of living crisis; the fiscal Statement earlier today forecast that things are going to get worse over the next few years.
Already, more and more Londoners, particularly those in private rental accommodation, are finding it such a struggle to make ends meet and to afford their basic needs. They are faced with a situation where, as the GLA reported this year, in
“March 2022, the median rent for a privately rented home in London was £1,450 per … month, … twice as high as the median in England as a whole … London’s rents are so much higher than those of other regions that the median monthly rent for a one-bedroom home in the capital (£1,225) is higher than the median rent for a home with four or more bedrooms across all of the North and Midlands.”
Following the success at moving away from Covid—I am not suggesting that we have solved the problem, but we are in a favourable trend—rents are now increasing faster than the temporary respite they had during the Covid pandemic. Zoopla reports that average rents in London were 17.8% higher this July than they were in the year before.
As I have explained, London’s economic success depends on a successful privately rented housing sector, alongside an important role for social housing. I gave a speech on social housing in this Chamber last week on the Motion tabled by the noble Lord, Lord Moylan, in which I emphasised the importance of council housing. I will not repeat that, although it is worth repeating it again. I discussed Harold Macmillan’s success, when he was Housing Minister, of achieving the then Conservative Government’s target of 350,000 new houses a year, many of which, I assume, were in Stevenage—so it can be done. However, I will not address that on this occasion; noble Lords can read my detailed contribution in Hansard.
Instead, I will continue to focus on private rental housing. I do not go along with the idea of demonising private landlords. I do not assume that they set out to provide poorly maintained stock at excessive costs, but clearly there are problems. The GLA, which I will cite again, has undertaken a survey of private tenants, finding that
“55% of private renting households in London”—
“said they were satisfied with … their accommodation”.
In other words, 45% were dissatisfied—representing an increase from 33% two years previously. The underlying problem we must confront is the inevitable tension that arises between, on the one hand, the provision of a human service—in this case, housing, which should be a social right that is available, of a good standard and affordable—and, on the other, a service that is being provided commercially. As we operate it at the moment, it is to the detriment of the people who are in the private rental sector.
I am glad that the issue of Airbnb was mentioned, because that is creating particular tension in some areas of London. However, I am not talking about Airbnb or the high-value rentals available to those on high incomes; I am talking about the lower-cost housing for people on incomes that are lower than average and who cannot afford to buy, but who need or want to work in London for employment, family or other reasons.
There is the oddity and counterintuitive fact that it is often more expensive to rent than it is to buy the house, provided that you have some capital in the first place. People are in the fix that they cannot afford to save to buy a house, because they are paying too much in rent. It is in that light that, again, these GLA figures tell us that 40% of London’s private renters are likely to struggle to make their rent payments in the next six months—so we have an immediate crisis.
The mayor, Sadiq Khan, held a housing crisis meeting earlier this week with representatives of the housing sector, and they are calling for greater security and safety for London’s private renters. I support the mayor’s call on the Government to introduce a two-year rent freeze, analogous to holding down the cost of energy, to address the soaring costs of living in London. Such a freeze has been introduced in Scotland. The Government should represent the democratic mandate that the mayor achieved; he fought on the basis of achieving this rental freeze, and we should look to the Government to support him in achieving this policy.
My Lords, I particularly welcome the noble Baroness, Lady Taylor of Stevenage, to her place. I am aware of the substantial work that she did on regional development banking, which has been of particular interest to me since the 1970s, when I wrote a paper. I also liked her reference to Lewis Silkin, who in 1960 I met in Milan in Italy when I was a 17 year-old boy, and who advised me to join the Labour Party, having had a political discussion with me.
I want to concentrate my remarks on a controversial report on Exempt Accommodation from the Levelling Up, Housing and Communities Committee. At its heart is a disturbing commentary on the appalling conditions in which people in exempt accommodation are having to live. I need to quote directly from the report, because there is a desperate need for all of us fully to understand what is happening. The devastating attack on housing provision for the poor should be considered in the context of the report’s opening comments:
“it was surprising to have undertaken a piece of work that has shocked and alarmed us as much as this inquiry has … the system involves the exploitation of vulnerable people who should be receiving support, while unscrupulous providers make excessive profits by capitalising on loopholes. This gold-rush is all paid for by taxpayers through housing benefit.”
What an indictment that is of government housing policy. The report goes on to challenge “the quality of provision” and
“its … significant growth in some areas … and the exploitation of the system by people seeking to make profit from it”.
The report cites the impact on people, stating that:
“It is clear from our inquiry that some residents’ experiences of exempt accommodation are beyond disgraceful, and that some people’s situations actually deteriorate as a result of the shocking conditions in which they live. Where the very worst experiences are occurring, this points to a complete breakdown of the system … Areas with high concentrations of exempt accommodation can also attract anti-social behaviour, crime—including the involvement of organised criminal gangs—rubbish, and vermin”.
The report calls for a system of national standards for referral of those people in desperate need and proposes that local authorities take on that role. It calls on the Government to publish national standards, with powers for local authorities to enforce those standards which would include a referral process that works, proper care support and supervision, standards of housing quality and, most importantly, information that a provider would be required to give to the resident as to their rights. The committee regarded the whole problem as so acute that it warranted special additional funding.
In a series of dramatic statements on domestic abuse, the report flagged up its finding that
“organisations with no expertise are able to target survivors of domestic abuse and their children and provide neither specialist support nor an appropriate or safe environment”.
This is Dickensian stuff. The report seeks to ameliorate the position of those suffering domestic abuse, and proposed that
“where a prospective resident of exempt accommodation is a survivor of domestic abuse, there must be a requirement that housing benefit is only paid to providers that have recognised expertise and meet the standards”
of care in the Domestic Abuse Act.
The report revealed that, while extraordinarily some providers do not fall under the remit of any regulator, the patchwork of existing regulation was full of holes. It reports on an acute absence of data on exempt accommodation—which I found quite incredible—and then reveals that there is an absence of data and statistics rendering the committee’s inquiry
“unable to establish how widespread the very worst experiences are”,
“how many exempt accommodation claimants and providers there are.”
It is a devastating report, perhaps one of the worst I have read during my many decades in Parliament. I say to colleagues: please read it. The report goes on with a call to the Government to urgently conduct a review of exempt housing benefit claims to determine how much is being spent. The committee felt that
“the current system offers a licence to print money to those who wish to exploit the system.”
The truth is that we are being taken for fools by those who are prepared to play fast and loose with our laws and ignore human rights.
There is one final recommendation in the report on the wider issue of authorisation. The suggestion is that the Government “end the existing exemptions” that registered providers enjoy from HMO licensing arrangements, and
“that the loophole relating to non-registered providers with properties containing six or fewer residents also be addressed so that they are brought within the”
whole exempt accommodation regime within the law.
This whole debate about exempt accommodation, which I knew very little about before reading this report, and I suspect that many Members of the House have little knowledge about, raises real questions about priorities in life and our treatment of those who have little and so often live in real poverty.
My Lords, it is a great pleasure to take part in this important and timely debate and I congratulate the noble Baroness, Lady Warwick, on leading it. I also greatly congratulate the noble Baroness, Lady Taylor of Stevenage, on her maiden speech, which showed us what we need and what we are missing. I liked a lot of what she had to say about the fact that it is communities and not just buildings we are talking about here. I must say that I had not heard Lord Silkin’s inspiring words before she said them at the end of her speech.
I am coming at this from the perspective of quality rather than numbers—quality and health. I suspect that I am probably the least knowledgeable person about housing in this debate. I have come to it rather late, after realising something I should have realised long ago about the extraordinary interconnections between health and housing and how absolutely fundamental they are. A number of noble Lords, including the noble Lord, Lord Lilley, have made the point that housing is a foundation for people’s lives. I think he said something about how many of our social and economic problems stem from poor housing within our society. I absolutely agree with that.
I have been gradually learning about housing and have been astonished to understand what major problems there are right across the entire system, from the inability to build the numbers that we say we are going to build, to questions of quality of construction and repairs and questions of planning. Within all that, there are some obvious health issues. I refer briefly to the tragic story of the young child in Rochdale who died very recently from mould in completely inadequate housing. I refer also to how, during Covid, we know that things such as lack of ventilation and overcrowding affected the lives of many, sometimes with fatal consequences. There are something like 2 million older households living in poor housing. As has already been said by the noble Baroness, Lady Thornhill, the NHS faces massive costs because of poor housing: one estimate is at least £1.4 billion annually. Of that, 60% was due to cold and around 30% to falls—two things that are preventable, but neither of which it looks as if in the near future we will see much improvement in. Of course, there are other issues here about independent living.
There are extraordinary interconnections between poor housing—which is what we are talking about—and health, and it is vital to get both right. This has a long history; indeed, the first Minister of Health was also a Minister of Housing. I am not going to suggest to the current Secretary of State that he may wish to add that to his other duties at the moment but, somewhere, the close connection between housing and health has got lost. This is a very clear example of why we need the sort of strategy that the noble Baroness, Lady Warwick, is proposing, which looks at it in the context of wider social, economic and environmental issues. I have been talking about health, but somebody else in this debate could equally stand up and talk about the environmental impact of poor housing and the fact that so much carbon is used, not just in the construction but on a continuing basis. I think it was the noble Baroness, Lady Taylor of Stevenage, who commented on how much finance would be needed in Stevenage to bring houses up to the required standard.
So there is a clear need for a new strategy that takes a really comprehensive view. As part of that, we obviously need to get regulation right. I am in fact not a great fan of regulation, having run teaching hospitals in Oxford and been very aware that ill-thought-through regulation can be extraordinarily damaging. But there is a need for less—in some ways—but smarter regulation here. I have heard plenty of examples—and we have just heard them again from the noble Lord, Lord Campbell-Savours—of where regulation does not cover the entire field, where there is conflict between different sets of regulations, or where there are policy conflicts. I am aware myself of policy conflicts where it is very difficult to get through planning some of the obvious things that are needed to improve environmental issues. There is a whole range of conflicts here.
However, I was surprised to discover, when I talked to the chief executive of one of the major housing developers, which produces very high-quality houses, about regulation—which obviously he did not particularly want—the point he made was that there is nobody who checks up on the regulation. This, I guess, must be known well to other people in the Chamber, but the surprising point that he was making is that there is a lot of regulation but not very much in the way of inspection. Local authorities and others have lost a lot of the staff who would otherwise be making sure that regulation was properly applied. The implication he left me with was that good developers of course pay attention to the regulations, but many others do not.
So there seem to be some major problems in the way regulation is handled at the moment. What are the levers that this Government are going to use, perhaps including regulation but maybe including codes of good practice or incentives? How will they ensure that in future we will not see more poor-quality homes being built? Because we are seeing poor-quality homes being built, partly through permitted development rights but also through other routes. How can the Government ensure that we stop the problem getting worse, let alone move forward to improve things?
We need a comprehensive strategy that covers social, economic and environmental aspects. There is plenty of expertise around. There are plenty of reports. My noble friend Lord Best spelled out the importance of Sir Oliver Letwin’s report of some years ago now and how it pointed to an essential problem underlying all of this. So, there is an enormous amount of expertise and we also need a clear vision of what this or any future Government seek to do with their housing strategy. While I and others have been talking about all the negative impacts of poor housing and poor maintenance and the impact they have on people, there is also a positive aspect here. It takes us back, of course, to the new towns and garden cities, to Port Sunlight and other aspects of past developments when people saw and understood that housing as part of the development of cities and towns is about enhancing life, about the ability to provide a foundation for people’s lives so they can thrive, and about their health and well-being, as well as everything else.
I will end on two final points. One is that we need to start to think about this in positive terms, addressing the problems but actually setting out a strategy that builds something that is positive for the future and sees this as the foundation of people’s lives and their ability to thrive, as well as being essential for their health and well-being. We cannot expect the nation to prosper successfully if we treat people’s homes in the way we are doing at the moment. I return to my final question. How will this Government ensure that there are no more poor-quality homes being built?