Levelling-up and Regeneration Bill

Baroness Pitkeathley Excerpts

Consideration of Commons amendments
Monday 23rd October 2023 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

I thank those who supported the original amendment at earlier stages. I thank the Minister for the certain assurances that he has made this evening, on which I will press him further, but I will not move the amendment.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

Motion P1 has been moved as an amendment to Motion P.

[Noble Lords]

Not moved!

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

I am so sorry; I did not hear the noble Baroness.

Motion P agreed.

--- Later in debate ---

[Baroness Pinnock (LD)]

I beg to move.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

I want to be sure that I have heard it right. Is the noble Baroness moving this one?

[Baroness Pinnock (LD)]

Yes, I wish to test the opinion of the House.

Health and Care Bill

Baroness Pitkeathley Excerpts

Lords Hansard - Part 2 & Report stage
Monday 7th March 2022 Lords Chamber

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

My Lords, the noble Lord, Lord Howarth, is taking part remotely. I invite him to speak.

[Lord Howarth of Newport (Lab) [V]]

My Lords, I congratulate the noble Baroness, Lady Bennett of Manor Castle, on bringing back this issue on Report; I was sorry not to be able to speak in Committee. We must also be grateful to the academics at the University of Surrey who followed the money and, a year ago, published their exposé, Careless Finance.

The noble quartet of the noble Baronesses, Lady Bennett, Lady Brinton, Lady Tyler and Lady Altmann, has previously provided the House with an excellent analysis of predatory financial manipulation of the social care sector by hedge funds and offshore entities. I just want briefly to underline certain points.

What we have been seeing is legalised theft. Financial operators are leeching, for their own profit and benefit, substantial proportions—16% to 20%—of the funds provided for social care by both the public purse and self-funding individuals; “grey gold”, the profits thus extracted are sometimes called. This racket, unacceptable at any time, has been perpetrated during a period when the Government have chosen to underfund social care lamentably. Because sufficient budgets are not available to local authorities, many people who should be eligible for social care are not receiving it and many who are in social care are experiencing threadbare services. The workforce is depleted and miserably paid.

It is in the context of this crisis that unscrupulous operators have been ripping off a broken system. In their greed they are putting the business survival of providers at risk. As Christine Corlet Walker, Angela Druckman and Tim Jackson of the University of Surrey have reported, we have been seeing a large-scale transfer of money from the poorest to the richest. As they say,

“the ongoing cost is the silent tragedy of the most vulnerable in society.”

Meanwhile, the Government have made little or no effort to address the problem, which indeed they do not appear to acknowledge exists. The noble Earl, Lord Howe—for whom personally I have great regard—in his response on behalf of the Government in Committee, said that the noble Baroness’s amendment to improve transparency was not proportionate or necessary. He suggested that the Care Act 2014 and the CQC’s market oversight scheme should take care of any problems. However, since the abuses continue, it is obvious that these policies have been ineffectual with regard to them.

The noble Earl also said that it was for local authorities to shape, oversee and manage the market, but only the Government can act to close opportunities for rogue investors to carry out these abuses. He suggested that BEIS was on the case, but BEIS has been inexcusably dilatory.

The Government claim to be fixing social care, but all they are doing is providing a meagre and delayed increase in funding for social care by dint of imposing extra tax on the poor. The only reform they are truly interested in is to relieve the affluent of the need to sell their homes to pay for care.

Even the Government are now exercised about the abuses by Russian kleptocrats. So too they should be very seriously exercised by the abuses of the social care system by unscrupulous investors. Can they not see the evils that have flowed from marketising the social care sector? As the noble Baroness has just said, on Wednesday, the House will debate the Economic Crime (Transparency and Enforcement) Bill. We should also be debating an overdue “social care financial abuse (transparency and enforcement) Bill”, brought forward by the Government.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is also taking part remotely. I invite her to speak next.

[Baroness Brinton (LD) [V]]

I thank the noble Baroness, Lady Bennett, for tabling these amendments, slightly amended from Committee, and in particular for responding to the Minister’s concerns that the first amendment had perhaps been too broad and would catch the day-to-day business of companies. That cannot be said about Amendment 145.

I also want to pick up a point that the noble Earl made in Committee. He said:

“A company’s working capital, by its nature, is money that is used to fund day-to-day operations in general, and one cannot associate a particular pound with a particular business activity.”—[Official Report, 4/2/22; col. 1161.]


Yet the Charity Commission does have the ability to intervene in the event that a charity, or series of charities stretches—shall we say?—those rules. Its Internal Financial Controls for Charities, CC8, provides very specific guidance. Indeed, in recent years, one charity, the Plymouth Brethren Christian Church, was investigated for a circular set of donations. Each donation to each different body was paid tax relief out of the public purse, coming back to serve the schools that the adults at the community church sent their children to. The way that was structured was similar to a financial instrument employed by the few companies that abused the funding they received from the public purse for social care.

The noble Earl also referred to the Treasury guidance Managing Public Money and Accounting Officer Assessments. I have been through that, too. It is very interesting and clear. Under the heading

“expenditure which may rely on a Supply and Appropriation Act”,

Managing Public Money lists

“routine administration costs: employment costs, rent, cleaning etc … lease agreements, eg for photocopiers, lifts”.

It does not say: “Re-charging sister/parent/daughter companies for large amounts of borrowing and the interest thereto”, which is what has been happening.

It is important that we start to debate how public funding is spent by these companies, particularly those overseas, when we cannot see how that money is spent. I also support the other amendments in the group, which ask for a review of financial regulation. It is interesting that the Treasury guidance refers constantly to the Nolan principles, which are absolutely vital in talking about transparency and responsibility when spending public money. These amendments might not be quite right to deliver that, but it would be good if there were a review under way.

The other thing we must have when these companies spend large amounts of public money is publication of their full accounts. They should not be able to hide behind very short, superficial accounts from overseas.

Health and Care Bill

Baroness Pitkeathley Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, Clause 142 seeks to amend Section 50 of the Health Act 1999 in relation to making changes to the professional regulatory landscape through secondary legislation. It will simultaneously widen the scope of Section 60 and extend the Secretary of State’s powers. At the moment the Government have powers to bring new professions into regulation or make modifications through secondary legislation but can remove a profession from regulation only through primary legislation. The clause enables the removal of a profession through secondary legislation and makes it clear that a profession would be removed from regulation only when it was no longer required for the purpose of protecting the public.

I went and had a little look at the record. I am sorry the noble Earl is no longer here today, because in 2009 I was in Grand Committee, as the then Health Minister, and we were discussing the regulation of psychologists. I have to tell the Committee that that was not an uncontroversial matter. We had gone through whole series of regulatory reforms that year, as noble Lords who have been following these matters will be aware. I said at the time that

“the reforms set out in this draft order aim to enhance public confidence in the ability of the healthcare regulatory bodies to protect the public and deal with poor professional standards.”—[Official Report, 5/5/09; col. 510.]

The debate we had that day included the noble Earl, Lord Howe, who, at the time, was in my position now, as it were. He also welcomed the fact that the regulatory regime was in existence and, although he rightly had questions about the regulation of psychologists, which was indeed a controversial matter at the time, he did not question the need for public scrutiny of professional regulation.

That is why I have tabled the Motion that clause 142 not stand part. I am left wondering what exactly the yardstick will be, what criteria will be used to determine when there is no longer a need to protect the public and who will decide those criteria. Does professional regulation not also help to facilitate consistent common standards? What is lacking at the moment is any sense of the principles that will be allowed to inform decisions to bring professions into regulation or remove them. Will patients’ organisations, representative bodies or regulators be consulted on any new criteria applied? I can tell the Minister that in 2009 we went through weeks and weeks of discussion and consultation about every single independent regulatory body that this House helped to establish.

I suggest that the system works and there is absolutely no need to change it, though perhaps the Minister can tell me why there is such a need. Moving the power to abolish professions to secondary legislation is not putting scrutiny and transparency at the forefront. I have to say that doing so without putting any indication on the record of which professions are being considered does not instil confidence that this power grab has been considered properly or is in fact needed at all. The implications for the devolved nations, particularly Scotland, are also important but it was clear from discussions in another place that they had not been addressed. Perhaps they have by now, and the Minister would like to tell us what the outcome of that consultation is.

At the risk of repetition, there is a consistent theme in the Bill of seeking greater powers for the Secretary of State without parliamentary oversight, for reasons that are quite unclear. I beg to move.

[Baroness Pitkeathley (Lab)]

My Lords, I declare an interest as a former chair of the Professional Standards Authority. I was happy to go down memory lane with my noble friend on the Front Bench.

When thinking about professional regulation, we always have to bear in mind—I hope the Minister will be able to convince the House that this is what the Government bear in mind—the protection of the public. It is never about the glorification or protection of a profession; it is always about the protection of patients and the public.

The Professional Standards Authority developed the concept of right-touch regulation, whereby you identify the problem before the solution, quantify and qualify the risks, get as close to the problem as possible, focus on the outcome and use regulation only where necessary. I draw the House’s attention to the very successful project of accredited registers, which the Professional Standards Authority has developed in order to have, as it were, regulation at a lesser level than the very tight regulation that is necessary for some professions. You should keep it simple; the system is far too complex at present. You should check—as we always must with legislation, but it seems to me that we do it far too seldom—for unintended consequences. You should also review and respond to change, and the Government are doing just that with the proposals.

However, I must echo the caution of my noble friend on the Front Bench regarding the new powers for the Secretary of State to deregulate as well as regulate professions. We know that the risk profile for different occupations changes over time and a more agile method of responding is sometimes necessary. I hope that is what the Government have in mind. However, I emphasise, and I hope the Minister will reassure me on this, that a commitment to keeping patients safe must guide any decisions made to deregulate professions. There must be a robust and independent process to ensure that decisions are made after a clear assessment of risk—and I emphasise “independent”.

If the Secretary of State has the power to abolish regulators by secondary legislation, will there not be a threat to the independence of the regulators? If they know that the Secretary of State can abolish them at a stroke, as it were, might they become too focused on pleasing—or, rather, on not antagonising— whichever Government are in power, instead of, as I have stressed, working always and solely in the public interest? I hope the Minister will assure the House that that is the Government’s intention.

[Lord Young of Cookham (Con)]

My Lords, Clause 142, which comes under the heading “Professional regulation”, deals with the regulation of healthcare and associated professions. One of the objectives of the Bill is to integrate health and social care, and I very much hope that under the heading “associated professions” it will be possible to look at the registration and regulation of social care as well as those who work for healthcare.

Noble Lords may remember a brief exchange three weeks ago at Question Time when I asked the Government what plans they had to regulate and register social care. I was grateful for the reply, which outlined the welcome support being extended to the social care workforce. It also mentioned a skills passport, but the Minister was silent on the issue of a register.

I pressed the Minister and pointed out that Scotland, Wales and Northern Ireland already have a registration scheme for their social care workforce, and that if we are truly to integrate health and social care, as the Bill seeks to do, we need to have parity of esteem between health staff and social healthcare staff with improved pay, working conditions and career opportunities—much of which was mentioned in the debate we have just had. A registration scheme could facilitate the professionalisation of the social care workforce.

We then had an interesting exchange, in which the Minister mentioned a voluntary register and the need to assess the skills of the existing workforce, 56% of which has no qualifications. He said that he was consulting on whether registration should be mandatory and was concerned that mandatory registration might cause people to leave the sector. However, I do not believe that that has been the experience in other parts of the UK.

Health and Care Bill

Baroness Pitkeathley Excerpts

Lords Hansard - Part 2 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Baroness Meyer (Con)]

My Lords, in speaking to Amendment 266, I shall not speak for long because everything has been said. The noble Baroness, Lady Finlay of Llandaff, explained the problem very clearly as did other speakers.

The only reason I want to speak is that in April last year I spoke in favour of the Private Member’s Bill introduced to this House by my noble friend Lady Wyld which sought to prevent cosmetic procedures being performed in England on people aged under 18 unless under the direction of a medical practitioner. The Bill was passed with cross-party and government support. As a result, children are now better protected. It is high time that we protected the population at large. When one hears of all the side-effects and that people can buy a product online and inject it into themselves or somebody else, it feels like the wild west, and the consequences can be quite dramatic, as we have heard. I very much hope that the Government will be able to support this amendment. This is not complicated and needs to be done quickly.

[Baroness Pitkeathley (Lab)]

I want to follow the noble Lord, Lord Sharkey, because I am former chair of the Specialised Healthcare Alliance. I shall speak very briefly in support of Amendments 164 and 178 in his name and that of my noble friend Lady Wheeler.

Every reorganisation of the NHS leaves patients who have a rare or less common condition anxious about how their particular needs will be assessed, how they will be met and even how they will be noted. It is sadly true that the rarer or more specialised a condition, the more it comes down to a postcode lottery whether the patient will be able to access care in spite of established national standards. Not only is it harder to access care, it is also harder for these patients to access the support groups or information networks which are vital when finding out the sometimes rare information about these conditions. The suggestion in Amendment 164 that the CQC assess the provision by ICBs of care for those with rare or less common conditions would provide the assurance that is so badly need.

[Baroness Bennett of Manor Castle (GP)]

My Lords, in part because I listened to the lecture with which we started this session but more because it is an old anecdote, I shall forbear from telling my hospital food horror story. However, I will pick up on the points made by the noble Lord, Lord Hunt, and the noble Baroness, Lady Barker, about hospital food and how hard people are trying to improve the situation. This relates to the answer the Minister gave me on Monday in Oral Questions. Of course, it is dependent on the budget that caterers have and the quality of the food that is available to them. I was pleased that the Minister then said that the Government are looking to tackle government procurement to improve the quality of vegetables and fruit. In terms of joining up the dots, that is a useful point to make.

On Amendment 243, I offer the Green group’s support and note that, having been in your Lordships’ House for only a little more than two years, I have debated a very similar amendment at least once before—I think it must have been on the Medicines and Medical Devices Bill. We have all seen briefings that are very much a cry from the heart from the nursing profession for this to happen. Surely we can get this into this Bill.

Covid-19

Baroness Pitkeathley Excerpts

Thursday 6th January 2022 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

I thank the noble Lord and the noble Baroness for their comments. First, touching on the questions of the noble Baroness, Lady Smith, about our international efforts, she may well be aware that last week, we pledged a further £105 million of UK emergency aid to help vulnerable countries tackle the omicron variant by scaling up testing capacity, improving access to oxygen supplies and providing communities with hygiene advice and products. That builds on the £1.3 billion of UK aid already committed to the international health response, supporting vaccines, health systems and economic recovery in developing countries. I am delighted to say that we met our 2020-21 target of delivering more than 30 million vaccines to more than 30 countries as part of our pledge to donate 100 million doses to the world. This year, we will be donating millions more vaccines, including 20 million AstraZeneca doses and 20 million Janssen doses.

The noble Lord and noble Baroness both rightly asked about education, and of course there will be more detail in the further Statement later today, but we have delivered almost 3 million doses to children aged between 12 and 17 in England. We continue to work on increasing uptake, including through repeat offers, ensuring parental consent forms are translated into appropriate languages and collaborating with leading social media platforms to direct people to trusted sources of information. Obviously, we must make sure that where people can get vaccinated is clearly evidenced, and we are working with the education sector on that.

In relation to catch-up, the noble Lord is absolutely right. It is a priority, and always has been, to try to keep schools open, which is why we have been putting so much effort into that, and we are incredibly grateful to all the teachers and other staff in schools who have been helping to make that happen. We already announced £5 billion for education recovery, including £1.5 billion for tutoring, to provide up to 100 million tutoring hours for five to 19 year-olds by 2024, more than £800 million to fund 40 additional hours per student in 16 to 19 education and more than £950 million in flexible funding for schools to use how they see best. We are very cognisant of the need to ensure that young people do not suffer yet more during the pandemic, and we have a lot of work in place to do that.

The noble Baroness asked about antivirals, and I am pleased to say that we are leading in the number of antivirals bought per head of population in Europe. We are currently rolling out neutralising monoclonal antibodies and antiviral treatments for patients at highest risk of severe disease and hospitalisation, and up to 1.3 million patients could benefit if they are clinically eligible. We have a plan to personally communicate with those patients and make sure that they receive prioritised PCR test kits to ensure early access to treatment if they become ill. Antivirals are and will be playing an increasing role for us in coming to live with this virus, so I can certainly assure the noble Baroness that we are in the forefront of making sure we have access to the drugs, which are developing constantly, to help tackle Covid.

The noble Baroness asked about lateral flow tests for the 100,000 critical care workers. These kits will be sent directly to organisations, including those who work in critical national infrastructure, national security, transport and food distribution and processing. These are separate and in addition to the tests already allocated to our public services, and we will be working with those sectors on distribution; but, as I said, tests will be sent directly to those sectors.

Both the noble Lord and the noble Baroness asked about testing capacity. We are now delivering record numbers of lateral flow tests to pharmacies across England, with almost 8 million tests being made available this week alone. I can reassure the noble Lord and noble Baroness that we are tripling our supply of lateral flow tests in January and February from our pre-omicron plan of 100 million to 300 million a month. Of course, we will continue to review and work with the sector on where we can source tests to ensure we can meet the demand, which they rightly say is unprecedented. But this shows how conscientious the public are being in protecting themselves and their loved ones by testing regularly, and we are very grateful to everyone for everything they are doing to keep each other safe.

The noble Baroness asked about statutory sick pay. We have extended it to those who are self-isolating and made Covid-related SSP payable from day one, meaning that it could be up to 75% more generous for full-time employees who need to self-isolate. Statutory sick pay is £96.35 a week, and that remains the statutory minimum, but more than half of employees receive contractual sick pay from their employer. It should not be looked at in isolation. We have taken other measures through universal credit and employment support allowance, so we have been focused on and cognisant of the need to provide support for people. We have also provided the £500 test and trace support payment, which we have extended until the end of March. We have already committed more than £340 million to ensure that there are no financial barriers for those isolating in England, and we have made nearly 400,000 of those payments.

On the NHS’s preparedness, the noble Lord and noble Baroness will be well aware that we have provided record investment to tackle the backlog, with £2 billion this year and £8 billion over the next three years to deliver an extra 9 million checks, scans and operations. We have provided an extra £5.4 billion for the NHS to respond to Covid up to April, including £2.8 billion for costs including infection control measures, £600 million for day-to-day costs, £478 million for enhanced hospital discharge and £1.5 billion for elective recovery, together with capital funding. I hope that they will agree that we are supporting our NHS with further investment to help it get through this incredibly difficult time.

Both the noble Lord and the noble Baroness asked about critical incidents, which, as they will know, are determined and activated locally. Of course it is serious when that happens, but noble Lords will be aware that the NHS also takes this approach during non-Covid winters, because it is a way of ensuring that the local NHS can continue to best serve patients and protect staff, as it is an operational escalation mechanism. Ministers are working very closely with NHS England to get the assurance that proper support is being delivered.

The noble Baroness rightly asked about mental health. Noble Lords will know that at the heart of the NHS long-term plan is an expansion of mental health services. Mental health will receive at least a further £2.3 billion a year of extra investment to support 380,000 more adults and 345,000 more children.

I was grateful to hear the noble Lord mention the changes to the travel rules. The one thing I would say is that there have been no changes for unvaccinated adults: the changes that have been made are for those who have been vaccinated, and we are keeping the definition of fully vaccinated under review. If it changes to include boosters, plenty of time and notice will of course be given to make sure that people understand and are aware of that.

The noble Lord asked about reducing isolation times. Our current assessment is that shortening the period would be counterproductive. In some settings, such as hospitals, it could actually worsen staff shortages if it led to more people being infected.

In relation to your Lordships’ House, as the noble Lord said, legislating, of which I believe voting is a key part, is the central element of what we do. I disagree with him: I believe it should be done in person. We are working to make sure that it is as safe for everyone as possible. I am afraid that I disagree with him on that point.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

The noble Baroness, Lady Harris, is contributing virtually, so I call her as the first Back-Bench speaker.

--- Later in debate ---

[Baroness Donaghy (Lab)]

My Lords, I am appalled by the level of complacency about the availability of lateral flow tests—

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

My Lords, the time allowed has elapsed. Before I call the next debate, I draw your Lordships’ attention to a change in the running order of speakers. The noble Baroness, Lady Smith of Newnham, will open for the Lib Dem Benches and the noble Lord, Lord Purvis of Tweed, will wind up at the end of the debate.

House of Lords: Governance

Baroness Pitkeathley Excerpts

Wednesday 8th December 2021 Grand Committee

[Lord Desai (Non-Afl)]

My Lords, it has been a long day in this debate. I put my name down—

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

My Lords, there is a Division in the House. The Committee will adjourn for 10 minutes.

Business of the House

Baroness Pitkeathley Excerpts

Thursday 4th April 2019 Lords Chamber

[Lord Warner]

That the Question be now put.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

My Lords, I am instructed by order of the House to say that the Motion “That the Question be now put” is considered a most exceptional procedure, and the House should not accept it save in circumstances where it is felt to be the only means of ensuring the proper conduct of business in the House. Further, if the Member who seeks to move it persists in his intention, the practice of the House is that the Question on the Motion is put without debate. Does the noble Lord still wish to move the closure?

[Lord Warner]

I do.

Women: Representation

Baroness Pitkeathley Excerpts

Tuesday 8th March 2016 Lords Chamber

[Baroness Hussein-Ece (LD)]

My Lords—

[Baroness Pitkeathley (Lab)]

My Lords—

[Lord Morgan (Lab)]

My Lords—

Care: Costs Cap

Baroness Pitkeathley Excerpts

Monday 14th September 2015 Lords Chamber

[Baroness Chisholm of Owlpen]

This is a very important group at a most vulnerable time in their lives. The Government remain fully committed to introducing the cap on social care costs and helping people to cope with the potentially high costs of social care. It is not cancelled and will be brought in by 2020, but until then means-tested financial support remains available to those who cannot afford to pay for care to meet their eligible needs. Where a person can afford to pay for their care, we are clear they should not be forced to sell their home during their lifetime to do so. Since April this year, deferred payments have been available across England for people with less than £23,250 in liquid assets who might otherwise face that risk. By entering into a deferred payment agreement, a person can defer or delay paying the costs of their care and support until later, including out of their estate if they choose.

[Baroness Pitkeathley (Lab)]

My Lords, is the Minister aware that for many families, the postponement of the cap on care costs is seen as a betrayal that is adding to their disillusionment about the persistent underfunding of social care? Surely the Government must understand that families who look after people—for example, someone with Alzheimer’s—cannot go on taking these responsibilities if promises are broken and if the support they need is either non-existent or too expensive. Will this problem not exacerbate the Government’s existing problem with delayed discharges if families are in future less willing to take on caring, and is the Minister concerned about the delayed discharges issue?

[Baroness Chisholm of Owlpen]

This is indeed a concern, but I must emphasise that this delay is not a decision that has been taken lightly. A letter from the Local Government Association dated 1 July was clear that we need to think carefully about all the options, including postponing new initiatives. Therefore, we will make further announcements and they will follow in due course. Furthermore, we will continue with other efforts to support social care, in particular through the better care fund, which will drive the integration of social care and the NHS.

Care Sector: Apprenticeships

Baroness Pitkeathley Excerpts

Monday 6th July 2015 Lords Chamber

[The Earl of Courtown]

The noble Baroness is quite right about people leaving these courses after they have been accepted on them. Ministers in various departments are discussing this issue.

[Baroness Pitkeathley (Lab)]

My noble friend’s question refers to the care sector. Does the noble Earl agree that the care sector must extend to domiciliary care—care given in people’s own home—where job satisfaction is even lower, what with 15-minute visits and so on? Improving the quality of that care is essential. Does he agree that these apprenticeships should also take domiciliary care workers into account?

[The Earl of Courtown]

The noble Baroness is quite right. Domiciliary care for people in their own home is so important. At the same time, the standard of care also has to increase.