Covid-19 (Public Services Committee Report)

Baroness Pitkeathley Excerpts

Thursday 22nd July 2021 Lords Chamber

[Baroness Pitkeathley (Lab)]

My Lords, I was delighted to be appointed to the new Committee on Public Services. I knew that under the chairmanship of my noble friend Lady Armstrong it would be a lively experience, and I join others in paying tribute to her and the clerks who supported us so well.

Of course, when we began, we had no idea that we should be producing our first report during a pandemic, nor that that report would focus on how those public services we were investigating would react to that pandemic. I must record what a privilege it was to work with a group of such experienced, wise and committed Members, and to reach a degree of consensus which was, and is, part of the pleasure of our work together.

A Critical Juncture is the title we chose for our report, which we are debating today, recognising that Covid represented an unprecedented challenge to our public services to which they responded with innovation and commitment. The outcomes are critical in terms of lessons learned, what can be retained from such excellent outcomes, and how resilience against any further challenges can be built up.

We have had some wonderful and heart-warming examples of how services responded to the pandemic: huge upscaling of provision, rapid decision-making and the breaking down of long-standing barriers by the urgent needs of the moment, but of course the virus further disadvantaged those already left behind. Black and minority-ethnic groups and those on the margins suffered disproportionately, and the years of underfunding of preventative and early intervention services came home to roost. Poor children’s education attainment got worse and the ability of local services to understand the needs of their communities was sometimes ignored in favour of some overcentralised and needlessly bureaucratic national service provision.

Lessons must be learned if we are to reap the benefits we have gained and not slip back to old ways as soon as the pandemic is over. Nowhere is this more important than in the issue of co-production, already mentioned by the noble Lord, Lord Bichard, and the noble Baroness, Lady Pinnock, where the users of services are involved in their design and planning and treated as equal partners. Our witnesses emphasised that this approach could have helped to predict and short-circuit some of the problems that came up. On the rough sleepers initiative, already mentioned by some of my colleagues, that separate sleeping accommodation was required by male and female rough sleepers would not have been a sudden surprise to providers if they had talked to rough sleepers before they set up a service which did not provide it, wasting time, money and good will. We must remember that most users when consulted—and I mean really consulted, not presented with a plan once it has been agreed—do not ask for the moon, as many providers think they do; on the contrary, their asks will usually be modest and far less than expected. If more services adopted this approach, it would be possible to maintain some if not all the innovation we saw over Covid. We must never undervalue the lived experience of users and customers—that is a very important lesson.

This lesson must be learned by public services, and they must similarly hear that the way really to engage with their consumers is most likely to be not through statutory service providers but through the voluntary and community sector. If you are single mother with addiction problems, you do not want to talk to your social worker for fear that you will lose your children, but through a local support group where you meet other mums in the same situation, share your fears and get advice and, above all, support; you will learn to deal with your difficulties, gain in confidence and become a reliable mother to your children. Time and again, we had examples of these experiences, but time and again too, we heard charities and community groups say that were treated like poor relations, did not have a seat at the table and were patronised and talked down to. Many of those barriers were broken down due to the simple urgency of the situation. The speed of acting may be much easier for a charity or community group, and many were able to mobilise services quickly without going through the various procedures and permissions which are inevitable in the statutory sector. We must commend the courage and willingness to take risks which was shown not only by staff and volunteers in charities but by their trustee boards. Often thought to be resistant to risk taking, they stepped up magnificently to support innovation and speed of delivery. The better relationships and increased respect which were gained in the pandemic must not be allowed to slip away. Not only will it provide more satisfactory services, meeting the needs of users rather than the notions of providers, but it will often save money too.

I hope the Minister will be able to confirm the value the Government place on the voluntary sector and their willingness to support it, not only in terms of funding but in ensuring that both the sector and the users on whose behalf it advocates are treated as equal partners in the provision of services, and in ensuring that the voice of users is strong and influential whenever public services are planned.

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

The noble Lord, Lord Dubs, has withdrawn, so I call the noble Lord, Lord Bourne of Aberystwyth.

[Lord Bourne of Aberystwyth (Con) [V]]

My Lords, it is a great pleasure to follow the noble Lord, Lord Bilimoria, who spoke compellingly about collaboration. It has been a pleasure and an honour to be a member of the Public Services Committee, which has behaved throughout in a collegiate and constructive way, and I thank my committee colleagues. Like others, I would like to thank our excellent chair, the noble Baroness, Lady Armstrong of Hilltop, who has demonstrated throughout hard work, dedication and great good humour. Thanks also go to our secretariat—the team of Tristan Stubbs, Claire Coast-Smith and Mark Hudson —for their utter professionalism.

Our first report, as has been stated, commenced physically in February last year, before the first lockdown, but we quickly moved to working virtually. Work was carried out remarkably smoothly on our report A Critical Juncture for Public Services: Lessons from COVID-19, which was published in November last year. I thank officials, broadcasters and all who made this possible. I will focus on three areas in particular, although, as has been demonstrated by those serving on the committee, our report was wide-ranging. I would like to look at prevention and early intervention, then at local delivery, and then at the importance of voluntary organisations.

On prevention and early intervention, a key area, the evidence that we saw was clear. People who are obese, who smoke, who are diabetic and who live in unhealthy social, economic and physical environments are at a far higher risk of dying from Covid-19. That seems now almost beyond challenge. The Prime Minister himself nailed the danger of obesity when he spoke of Covid-19. Yet the Government in their response to the report did not recognise these factors explicitly, rather surprisingly, saying that further analysis of the evidence will inform our learning. I hope that the Government accept the very clear evidence, and it will be good to hear from the Minister on this.

Our inquiry heard from Sir Michael Marmot about the underfunding of prevention services, and we heard that obesity rates were highest in deprived areas. It is laudable that the Conservative manifesto of 2019 commits to extension of healthy life expectancy by five years by 2035. A litmus test of the Government’s approach will be the attitude to the recently published national food strategy, the Dimbleby report, the last part of which was published last week. That report is clear on action at producer level to reduce salt and sugar in foods, just as we have done successfully under a Conservative Government for soft drinks. That action would produce results. I hope that the murmurings of some on the libertarian extremes, who suggest that exhortation is sufficient, are ignored, given that they are the voices of a few people who have not been following the evidence of the pandemic, and who are committed to an imagined libertarian Valhalla. Not only will positive action help hundreds of thousands, if not millions, of our fellow country men and women, it will also of course ease pressures on the NHS and, indeed, on the economy from the impact of ill health. The details of how the Government are to carry out future arrangements are awaited with interest.

The importance of preventive services in the Ministry of Justice and the Home Office is also highlighted in our report. The Government’s response does not pick up on how there will be investment here in preventive services for those who have been impacted by addiction, homelessness and poor mental health—evidence that we received on this from Revolving Doors. By the same token, early intervention on education, particularly as disadvantaged children have fallen further behind, is crucial. Beyond the existing pupil premium, we need to pick up the proposals on catch-up that Sir Kevan Collins put forward.

On localisation, in the memorable phrase spoken earlier by the noble Lord, Lord Shipley, running England out of London is not on. I agree with that, as does the report. Local provision, whether through the public sector or voluntary organisations, is vital; it is familial, trusted, responsive and fleet-footed, and it is more likely to be flexible. We need to recognise that through public health teams and more local funding, not just because of a democratic deficit but because of lack of local provision, certainly contributing to the disease and to death. I welcome the progress that has been made on metro mayors, and I anticipate more—but much more than that is needed for the localisation that is necessary.

The third area of our report that I wanted to cover related to the importance of voluntary organisations. As I have indicated, they are trusted and familial. Their reach is extraordinary, as I found during our inquiry. For example, Ian Jones, the chief executive of Volunteer Cornwall, told us of 4,500 Cornish charities. Many local councils pick up and work with the voluntary sector. Camden Council, for example, relies on Hampstead Volunteer Corps to help with food distribution, and we welcome the development of the new outsourcing playbook by the Cabinet Office. It is welcome, but we need to see it being followed by ensuring that public service commissioners prioritise social value when contracting services. We look forward to that.

In short, there is a lot to do, and I look forward to hearing from the Minister on taking things forward—in all our interests, but particularly in the interests of those most disadvantaged, which, as we have heard, includes the BAME community, as well as the Gypsy, Roma and Traveller communities. Generally, those at the bottom of the pile have been hardest hit, and the Government must do more to help them.

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

The noble Lord, Lord Desai, has withdrawn, so I call the noble Lord, Lord Sikka.