Debate on the Address

My Lords, we have certainly had a very wide-ranging and first-class debate covering six Bills and three government departments. It will be difficult for me to do justice to every contributor but I want to congratulate our six maiden speakers on their excellent contributions. The noble Baroness, Lady Butler-Sloss, commented on the inconsistency of the colour of our carpets. I do not know whether she has yet encountered the Pugin Room, which will confuse her as it is red. It belongs to the House of Lords, yet we cannot use it. If she can find a way through that, we shall all be very grateful. The noble Baroness, Lady Meacher, comes very well qualified to talk to us on mental health issues. She has a long record in this area and is also the current chair of a mental health trust. My noble friend Lord Bradley, who has perhaps returned to Manchester, promoted the city with great skill. As a Birmingham resident, I was rather squalling when he seemed to try to track yet more government money towards Manchester, but certainly all of us who went to that city in the autumn acknowledge the tremendous developments that have taken place there. The noble Lord, Lord Low of Dalston, brings considerable experience and expertise to your Lordships’ House. He made the point very strongly that it is wonderful to see the achievements of many blind people. But, as he suggested, we also have to reflect that many blind people suffer deprivation and social exclusion. Whatever system of social or benefit support, we have to ensure the continuum of care and support that is needed. I look forward to debating the Welfare Reform Bill with the noble Lord when it arrives in your Lordships’ House. I noted with interest the analysis of the noble Lord, Lord Morrow, of the current situation in Northern Ireland, and particularly his acknowledgement of the successes of the education system. He rightly pointed out the problem of low achievers and referred to the potential of schools and teachers and particularly the FE sector. I very much agreed with his comments on the role of employers in the skills agenda. That is of course a matter for my department, and it is a vital consideration in achieving the objective of an 80 per cent working-age population over the years. The noble Lord, Lord James of Blackheath, in his non-controversial way, started off on the issue of Lords reform. He said that if something is not broke, we should not fix it. I think that many noble Lords would agree with that, although sadly, I suspect, not his own Front Bench—or, at least, not his own leader. None the less, the one thing that I can guarantee is that he will have many opportunities to talk about Lords reform in the months and years ahead. We look forward to all our maiden speakers making further contributions. They have shown tonight that they have very much to offer your Lordships’ House. The noble Lord, Lord Kirkwood, said that government is hard. It is. But it is better than opposition, even in winding up our debate tonight. Has a theme come through what we have heard? I think so. The over-riding theme that I commend to your Lordships, because I believe that it goes to the heart of what this Government stand for, is: to seek social justice and fairness for all as the essential basis for helping people to fulfil their own potential, where economic efficiency and social justice are not opposites but partners, where aspirations and compassion are reconciled, and where excellent public services are delivered. I believe that we covered all those aspects. Nowhere is social justice and fairness more important than in pensions policy. I shall respond first to the noble Lord, Lord Fowler, and my noble friends Lady Turner and Lady Hollis. The first aim of the Government on pension policy was to alleviate the inheritance of pensioner poverty. That is the importance of the introduction of pension credit, winter fuel payments and other measures, and the essential foundation on which we wish to build a long-term pensions settlement. It is why we have the desire to uprate basic state pension in line with earnings; to reduce the number of national insurance qualifying years, so that many more people will benefit from full basic state pension; to encourage people to enrol in personal accounts and so secure a better pension for themselves; and to meet the tremendous pension challenge over the next 40 or50 years. My noble friend Lady Turner referred to the financial assistance scheme. I have written to her with details of the extension of that scheme, and obviously we hope that more payments will be made in the future. If the noble Lord, Lord Oakeshott, were here, he would ask me how many payments would be made. The current number is 508 with a total of 1.8 million. The noble Lord, Lord Fowler, mentioned in passing the ombudsman’s report. Our decision was a reluctant one, but we believe that the information was not inaccurate or incomplete, and that no causal link between the information provided by the Government and scheme member losses has been demonstrated. My noble friend Lady Turner asked me why it has taken so long to restore the earnings link. It would be preferable if we could restore that as soon as possible. But, as I said earlier, the Government’s aim was to tackle the immediate issue of pensioner poverty, which is what we have done through the introduction of pension credit. Our aim is to restore the earnings link, and the decision will be taken in the first year of the next new Parliament. Clearly, in terms of building a settlement for pensioners in the future, this will be a very important measure. But in the interim period, there is a serious affordability issue. I know that the uptake of pension credit causes concern. My noble friend Lady Turner and the noble Lord, Lord Skelmersdale, referred to that. The current figures that I have suggest that 61 to 69 per cent of eligible pensioners take up pension credit, but that 70 to 80 per cent of those eligible for the guarantee credit, which is available only to the poorest pensioners, do not claim it. We have run big campaigns and many visits have been made to help pensioners make those claims. It is clearly more challenging to reach those entitled to either smaller amounts or to just the savings credit, but we will continue to do everything that we can to achieve a bigger uptake. My noble friend Lady Turner thought that the intention to raise the retirement age could be unfair to lower socio-economic groups and perhaps some other employment groups. I understand the issues she raises. It is difficult to set a state pension age for which you can take account of the causes of health inequalities. The Turner commission looked at this issue and suggested different S2P and basic state pension retirement ages, but that would be complex. It is worth saying that if current differentials remain the same, men in the lower socio-economic group would not experience any reduction in length of life after the state pension age was raised to 68. My noble friend Lady Hollis was even more eloquent than usual in talking about national insurance issues and the impact on women. She is, of course, right that society has moved on since Beveridge, and analysed the role of national insurance in society and conditions for payment, suggesting that it is an institutionally gendered fabrication. I hear what she says, but national insurance is in the psyche of the nation. My noble friend says that it is in the psyche of men rather than women, but we believe none the less that the contributory principle is important now and will remain so. By our proposals to reform the contributory system, we are making it work better for women: first by reducing the number of years of contribution required to 30, then by giving greater recognition to the role of women as carers. My noble friend is of course right that women’s lives are messier. It is hard for them to tick the boxes, but the measures we have taken will make it possible for many more women to receive full basic state pension. The corollary is that were one to take a different route from the citizen’s pension, there would be issues of immediate cost, as well as some practical issues because of how long it would take to base it on residency. I know that my noble friend will always have an answer to that, and I suspect that we will have many interesting debates during the passage of the Pensions Bill. The noble Lord, Lord Skelmersdale, and my noble friend Lady Turner referred to the second part of pension reform. If I can put it this way, it has been trailed in the Queen’s Speech that we will bring forward proposals for the personal accounts delivery authority in the first Pensions Bill. A number of issues that arose tonight will be best addressed when we publish a White Paper, which I hope will be done shortly. There are clearly some interesting issues. On levelling down, I say to my noble friend Lady Turner that we have done some research and analysis of the views of 2,500 employers whose costs would increase. Only just over 1 per cent of those who are now contributing 3 per cent or more say that they would level down. Only 2 per cent report that they might close their scheme. The evidence shows that the critical importance of employers making that contribution is that it is a clear incentive to employees to take part in the scheme. There is a Bill in another place on welfare reform, and I hope that it will not be too long before it is received in your Lordships’ House. The debate has mostly concerned the impact of people with mental health issues, and that is absolutely right. The noble Baronesses, Lady Meacher and Lady Barker, made some telling points. The employment rate for disabled people as a whole is about 47 per cent, which is an increase of about 8 per cent since 1997, but for people with depression it is 23.7 per cent and for people with serious mental illnesses it is 11 per cent. Therefore, everything we do to reform incapacity benefit must be focused on the experience of people with mental illness, or we will not increase that employment rate or be able to get 1 million people off incapacity benefit. It is essential that we ensure that the approach is sensitive to the needs of people with mental health illnesses. I recognise the contribution that cognitive behavioural therapies can make and I accept that the National Health Service has an important role to play. Fluctuating conditions are a fact of life, and the system will have to respond to that. In relation to the linking rules, the aim is to provide safeguards, but if the noble Baroness, Lady Meacher, cares to let me have details of specific matters that she has encountered in east London, I will be very happy to look at them. The noble Lord, Lord Skelmersdale, briefly mentioned benefits simplification. We will debate those matters, and we are committed to simplification. The welfare reform proposals will lead to simplification, but there is always a trade-off between simplification and sensitivity. I hope that when we come to consider the numerous amendments that will be made when the Welfare Reform Bill is before your Lordships’ House, we will remember that Parliament has a key role to play in ensuring that there is a simplified system. The noble Baroness, Lady Butler-Sloss, made some important points about the life outcomes of looked-after children. We know that they are very poor: poor educational attainments, poor work records and poor life outcomes in general. I accept her view that part of the foundation of doing something about that is to improve the capacity and confidence of people working in social services. I agree that we need to do more to improve the image and self-esteem of social workers and to encourage people into the profession. I know that the Department of Health is very exercised about this matter and that the Minister is concerned to do what he can to raise the image of social workers. I accept the more general point made by the noble Baroness, Lady Greengross, about demographics and the need to ensure that social care is in a good position to deal with those enormous challenges. My noble friend Lady Massey and the noble Lord, Lord Northbourne, emphasised two things about looked-after children: first, that there needs to be cross-government action; and, secondly, that we need to do what we can to encourage local authorities to improve their performance. There is cross-cutting working together, and I assure noble Lords that our wider programme to tackle poor outcomes and social exclusion will mean that the position of looked-after children must be given every consideration. That must include the issue of local authority performance. I very much take the noble Lord’s point about fostered children and the continuity of employment for those employed in children’s homes. The noble Lord, Lord Northbourne, made some very supportive remarks about the new adoption legislation. He said we had made progress but that clearly there were challenges ahead. I very much agree. In the same vein the noble Earl, Lord Listowel, talked about the need for more investment in social care workers. He will know that resources for social work have increased over the last few years. He raised the cost issue of newly qualified social workers. I do not have that information to hand but I will ensure that he is written to. That conveniently leads me on to the Child Support Agency. What can one say about it? We are making progress. The CSA under its new chief executive is implementing an operational improvement plan. We are beginning to see some progress. I say to the noble Lord, Lord Skelmersdale, that the contracting out of the collection of debt began in August this year. By the end of October the agency had transferred over 7,000 cases and over £180,000 has already been collected. Perhaps even more encouraging is that before a case is given over to the private company, a warning letter is sent by the agency to inform clients that this is about to happen. This resulted in a quarter of a million pounds being collected before going out to the agency. We are beginning to turn the culture of enforcement around, building on the tremendous work of my noble friend Lady Hollis. It is early days to say how successful this will be, but the signs are encouraging. My noble friend raised the point about the contribution that a reformed and redesigned child support system can make to deliver more children out of child poverty. Basically and bluntly, that depends on the size of the disregard. We have committed ourselves to a higher disregard. I am not in a position to disclose that today but, as she will know, we are always engaged in constructive discussions with our friends in the Treasury. Let me turn to education. My noble friend Lady Warwick is right about the skills agenda. On the challenges of a global economy, as she described it, the skills requirement of employers is increasing all the time. We have 75 per cent of the working-age population in work. We aspire to get that up to 80 per cent. We need that to meet the demographic challenge and to respond to the global economic challenge; but that means that we must equip our people with higher skills. I am very hopeful that the Bill that will come before your Lordships is one way to deal with that. I say to the right reverend Prelate that I am advised that there can be consultation through a wide range of bodies that may well include faith groups, local authority schools and community groups. On the ability of colleges to award degrees, of course close collaboration will continue between universities and colleges. The requirements for gaining degree-awarding powers from the Privy Council will remain stringent. The new powers will in any case have an impact only on a small number of large colleges which will be able to respond. All foundation degrees are based on modular principles. The role of the QAA will be as for other degrees. The Secretary of State will set the criteria that institutes will have to meet to award a foundation degree. The Government will consult on the criteria. The QAA will continue in its role of advising the Privy Council on the application of those criteria robustly and fairly, and its role will be as robust and fair on foundation degrees as it is for any other degrees. I turn to the Mental Health Bill. The noble Earl, Lord Howe, expressed some disappointment at its shape. The noble Baronesses, Lady Finlay and Lady Barker, and my noble friend Lord Morris of Manchester all commented on its importance. I certainly recognise that it has had a long gestation. There is no question but that it has been a very difficult process. We are seeking to find a way through some very difficult and controversial areas. The noble Baroness, Lady Barker, asked about our engagement with stakeholders. The very fact that the Bill to be brought before Parliament is different from the original proposals shows the impact of our engagement with stakeholders. An adapted supervised treatment order is being introduced. We decided against a separate condition for patients at substantial risk of causing harm to another person and against the policy that anyone should have the statutory right to request an examination by the relevant authorities against the first four criteria—and so on and so forth. The Government have talked and listened to stakeholders. We will continue to do so. I know that my noble friend Lord Warner is eager and anxious to talk to noble Lords about any issues or concerns that they have. Surely it must be recognised that the status quo is not an option. Surely we are aware of the detrimental revolving-door cycle of discharge, relapses, readmissions, and the misery that that causes people whose mental health lacks stability. Surely we should recognise that supervised community treatment addresses that cycle by providing a framework for community living with powers to tackle problems before the crisis occurs. I hope that when the Bill comes before your Lordships' House, instead of there being a knee-jerk reaction of opposition, the matter will be given genuine and fair consideration. Of course I accept the comments made by the noble Baronesses, Lady Finlay, Lady Barker and Lady Meacher, about the state of mental health services and the need to develop them, but since we came into power, the Government have done a tremendous amount to make mental health a priority. I refer noble Lords to a comment made by Matt Muijen, a former director of the Sainsbury Centre for Mental Health, who is enormously admired by many people in the field of mental health and who now works for the World Health Organisation. In an article, he explained that mental health services in Britain are better funded, better structured and better supported than anywhere else in Europe. We cannot be complacent; there is much that we have to do; but the Bill soon to come before your Lordships' House is one of the foundations on which we will take the matter forward. I pay tribute to the noble Lord, Lord Harries, for his work with the HFEA and for the work that he did chairing the Select Committee following the great debate that we had about the order concerning embryonic stem cell research. He was very persuasive in arguing that the legislation should be reviewed. He gave some examples where greater clarity is required. I know that some noble Lords expressed concern about the decision to create a merged authority. That will be subject to pre-legislative scrutiny and the Government will be very interested to hear the comments of noble Lords. We believe that that will produce a more co-ordinated system of regulation, building on the tremendous work of the HFEA and of the Human Tissue Authority, which has more recently come into being. I conclude by talking about health issues. There have been many comments and questions about the National Health Service. I did not recognise the pessimism that seemed to emanate from some noble Lords about the condition of the National Health Service. I ask noble Lords to consider the past nine years and the amount of resources that have gone into the health service, the waiting times that have been slashed, and the extra number of doctors and nurses. Of course the health service faces challenges at the moment, and of course there are reconfiguration issues. Those issues should have been tackled many years ago, but it is this Government who have had the courage to get to grips with these critical strategic and structural problems. The overall condition of the NHS, however, is very much to the good. The response from members of the public who use the NHS shows that time and time again. On dentistry, the noble Lord, Lord Colwyn, is no longer drilling and filling, but he is sedating, although not, I suspect, on a treadmill. As he knows, I was responsible for the first discussions with the BDA some time ago on developing the new contract. What has been produced follows the nature of those discussions, which were about getting dentists off the treadmill. The great majority of dentists, representing about 96 per cent of NHS services, signed new contracts in April 2006, and PCTs are commissioning more activity in NHS dentistry than was delivered last year. We do, of course, need to keep these matters under review. We want to keep dentists with us. We also want members of the public who want NHS dentistry services to have access to them. There are positive signs. The noble Lord, Lord Fowler, and the noble Baroness, Lady Gould, referred to sexual health issues. I pay tribute to both of them for their tremendous record in this area. There is no room for complacency, although fortunately we have a relatively low prevalence of HIV. There has been a large drop in the number of people diagnosed with AIDS, and a 70 per cent drop in the number of AIDS-related deaths following the successful uptake of highly active anti-retroviral therapy since the late 1990s. But sexual health remains very much a priority. As my noble friend Lord Warner said earlier this afternoon, we have made it clear to the NHS that it is one of its six priorities. I understand the concerns about funding and why my noble friend Lady Gould would prefer there to be ring-fencing, but we think that the NHS must be free to take its own local spending decisions. We do not believe that ring-fencing is the right approach, but, by making this a key target, we demand that PCTs show what they are doing to improve waiting times and to reduce infections. We are introducing a national support team for sexual health that will intensively support the 10 to 20 per cent of areas that are finding it the most challenging to meet their targets. There is no complacency here. This matter will be kept under close review. The noble Baronesses, Lady Greengross and Lady Finlay, made very important points about the end-of-life experience which I shall draw to the attention of Health Ministers. I have noted the very interesting exposition by the noble Lord, Lord Cameron, of rural access and funding. We do believe the formula to be the best approach. It is a very serious approach, and an advisory committee, made up of managers, academics and GPs, continually oversees the formula, but I will draw the noble Lord’s remarks to the attention of the Department of Health. I certainly understand the importance of rural-proofing NHS services. Indeed, the Department of Health has funded a rural-proofing toolkit, which was developed by the Institute of Rural Health. I do not, I fear, have time to refer to patient forums and local involvement networks, although we intend to seek an early legislative opportunity. This is the same answer that I would give to the noble Earl, Lord Howe, on the regulatory system and the merger of the regulatory bodies. Overall, this has been a splendid debate. It has been a privilege to answer or attempt to answer so many important points raised by noble Lords. I very much look forward, as do my noble friends on the Front Bench, to debating these important issues in the months ahead. In so doing, I thank very much all noble Lords who have contributed. On behalf of my noble and learned friend Lord Falconer of Thoroton, I beg to move that the debate be adjourned until Thursday next. Moved accordingly, and, on Question, Motion agreed to, and debate adjourned accordingly until Thursday next.