King’s Speech

Lord Allan of Hallam Excerpts

Thursday 9th November 2023 Lords Chamber

[Lord Allan of Hallam (LD)]

My Lords, I will largely speak to the health and care aspects of the gracious Speech, while colleagues who are more expert will cover some of the other areas.

I have been very struck that, when talking about the gracious Speech, whatever question the Health Secretary is asked, his answer is the new measures on tobacco control. This was echoed to a certain extent by the Minister today, although he does it far more graciously than his colleague down the way. We have all done media training and know the tactic whereby whatever you are asked you try to talk about the thing you want to talk about. However, in this case it feels entirely inappropriate. It feels as though the Health Secretary is using the fig leaf of the new tobacco control measures to cover up his naked embarrassment at the paucity of serious health and care measures in the gracious Speech.

I am inclined to support the new measures, but they are not a cover for inaction elsewhere and should not be used as such. It does not help the families of people being held in inappropriate mental health facilities, who have been waiting for the legislative reform that they need, to be told that children will no longer be able to buy cigarettes. For someone who cannot get a rapid scan of a potentially cancerous lump because there is a lack of scanners and trained staff to operate them, there may be some comfort in knowing that we will reduce the number of people suffering cancer in future but it does not get them the help they need today, and the longer they wait, the higher the risk is to them and the less likelihood that they will survive. There is small comfort for an older person struggling to find the social care they need, who believed the former Prime Minister when he said that he would fix social care, to know that although their grandchildren may be protected from the temptation of vaping—that is a good thing—it does not get them the social care they need today. These measures all could and should have been in the gracious Speech.

The other focus in the gracious Speech is long-term planning, particularly long-term staffing planning, as the Minister touched on. These Benches called for that long-term plan and have welcomed it, but we must recognise that a long-term plan is necessary but not sufficient. The journey towards a better health and social care system requires three things: a road map to the destination, but also a vehicle fit for the rigours of the journey and a driver with the skills and energies to get us there. The recent performance of this Government hardly inspires confidence.

I recognise that the Covid inquiry still has a long way to go, but the picture so far has us alternating between horror and shame at the way in which our health system has been managed. The image it paints is of a car veering from side to side, with the former Prime Minister behind the wheel while his passengers—Messrs Hancock, Sunak and Cummings, the latter using choice expletives as though he were an extra from “The Thick of It”—shout conflicting directions at him and so he jerks the wheel from one way to another. The car occasionally veers off into the VIP lane when it gets flagged down by its mates, but it can hardly be described as a picture of good management. We should give some leeway to the Government, because there was no road map for the specifics of the Covid pandemic we suffered. However, we must also ask what all that civil contingencies legislation and planning was for, given that it appears to have given us very little benefit when we hit the crisis. The driving of that vehicle seems to have been appalling and that is all on the Government, past and present—the same people are in government today, with a few notable exceptions, as those who were driving at that point.

The bright spot is that the vehicle held up remarkably well. That is all to the credit of the staff of our health and social care systems, who went above and beyond. We gave them credit and thanks for it then and should continue to reiterate that today. We have moved on from that episode but it now feels as though the Government are parked up in a lay-by doing route planning but very little else.

Their record on vehicle maintenance is also not looking good. We have record waiting lists that are still growing in many areas. Access to GPs and dentists—the fundamental building blocks of our system—is a daily source of complaint and frustration for millions of people up and down the country, as recognised by the Government when they issue papers describing NHS dental deserts, which are a real thing in many parts of the country today. We have a hospital building programme that will not meet the promises made at election time and staff who are demoralised by a Government who seem to prefer confrontation to conciliation and threats to settlements—settlements which Governments in the devolved parts of the United Kingdom have been able to reach because they approached them with a very different attitude.

This gracious Speech shows us that this Government have lost interest in making real improvements to health and care. If these were a priority, there would be a mental health Bill and long-term reforms to the provision of social care. The Minister said there will be a mental health Bill when parliamentary time allows. Forgive me, but the time of the gracious Speech is precisely when the parliamentary calendar is empty. If this were a higher priority than pedicabs and self-driving vehicles, there would be parliamentary time. It is a choice that the Government have made. We would also be seeing serious efforts to address and update the primary care contracts so that people can get easier access to GPs and NHS dentists. I hope the Minister in summing up may indicate that there is some action in that area. It is clear that this Government prefer to deal with other legislation, which I presume they think is sexier to the electorate, than with the stuff we need to get our health and social care right.

While the Minister may not want my sympathy, I praise him for his ability to defend this very thin gruel with quite a helpful speech. I believe that he personally is sincere in his interest in improving health and care and that he is making valuable contributions to those road maps, particularly on staffing and the new hospital programme. However, his, our and the country’s problem is with the drivers at the other end of the building. They are not a new Government—however hard they try to push the message otherwise—but a Government who have been in power as a single party for the last eight years. The people in charge now—the drivers at the other end—have been at the heart of that poor Administration and they are now too tired and unfocused to give us the solutions we need.

I hope that, over the coming year, the Government will keep working on these long-term road maps for where health and social care need to go, as these are valuable. Can the Minister in responding say whether that includes looking at GP and dental contracts, which are a priority? I hope they will face up to the maintenance challenge, so that this incredible vehicle that is our NHS is not allowed to deteriorate beyond repair. Will he say how they will deal with the deficits that are publicly building up in NHS trusts across the country? That needs to be dealt with this year—it is not a long-term issue—as they are facing real deficits and cash crises.

I will happily travel down the tobacco control lane with the Government to explore the effectiveness of the measures, but I can close only with a statement with which I know the Minister will have to disagree: the best way now to improve health and care in the United Kingdom is for this Government to hand the keys over to somebody else so that they can drive, as soon as possible.