Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham of 14 February (HL5163), whether they will undertake a comparison of the impact of the UK's rebate rates in the voluntary scheme for branded medicines with the more favourable rebates in other European countries, given their declared ambitions for the UK life sciences sector.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

We have no plans to undertake such a comparison. Differences in the structure of medicine pricing policies and systems make direct comparisons of payment percentages or rebates with other countries difficult and potentially misleading.

The Government is open to ideas about how a successor to the voluntary scheme for branded medicines pricing and access should operate from 2024 onwards. We will be considering a range of factors and will work with industry to consider learning from approaches in the United Kingdom and internationally, to agree a mutually beneficial successor that supports better patient outcomes; ensures the sustainability of National Health Service spend on branded medicines; and enables a strong UK life sciences industry.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they will take to measure the effectiveness of (1) NHS England's plan to fund art, music or gardening classes instead of prescribing antidepressants, announced on 2 March, and (2) the National Institute of Health and Care Excellence's draft guidance, issued on 1 March, approving the use of digitally enabled therapies for patients with depression, anxiety, post-traumatic stress disorder and body dysmorphia disorders.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

The Department is committed to the roll out of social prescribing and associated activities, including arts, music and gardening across the National Health Service in England. Social Prescribing Link Workers (SPLWs) work with people to understand ‘what matters to them’ then to connect them to agencies for practical, emotional and social support and to community groups and activities. Where individuals consent, SPLWs capture wellbeing outcomes before and after engagement with the social prescribing service as routine practice, using standardised outcomes measures such as Office for National Statistics Four. There is growing evidence on the role that activities, whether they be creative, activity- or nature-based, improve people’s health and wellbeing. The role of SPLW is also being evaluated by the National Institute for Health and Care Research to determine how access, engagement and outcomes vary by delivery model, geography and population characteristics over time.

The National Institute for Health and Care Excellence (NICE) Guidance has been released for guided Digital Cognitive Behavioural Therapy tools for children and young people with symptoms of low mood and anxiety. The technologies in these categories are being evaluated by NICE as part of their Early Value Assessment, which covers both clinical and cost effectiveness.

For NHS Talking Therapies for anxiety and depression services, a key characteristic is the routing collection of clinical outcome measures and monitoring activity. NHS England’s Digitally Enabled Therapies (DETs) Assessment Criteria enables DETs to be reviewed for suitability for use in NHS Talking Therapies Services.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what plans they have to ensure that staff in the adult social care sector (1) are all paid at above the legal minimum wage, and (2) have their pay brought in line with staff undertaking similar roles in the NHS.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

All businesses irrespective of their size or business sector are responsible for paying the correct National Living Wage and National Minimum Wage to their staff.

If any care worker is concerned that they are being underpaid, we strongly urge them to call the the Advisory, Conciliation and Arbitration Service (Acas) helpline for free, impartial and confidential advice about their rights and entitlements. Acas officers will pass on cases to HM Revenue & Customs for further consideration where appropriate.

The Department has no plans to align the pay progression of adult social care workers to National Health Service pay scales.

Question to the Department of Health and Social Care:

To ask His Majesty's Government whether budgets for adult social care for 2023–23 and 2023–24 were adjusted to take account of (1) increased energy and fuel costs, and (2) the need to make greater use of agency staff due to high vacancy rates.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

Local authorities are responsible for setting budgets for adult social care. They are best placed to assess local resources and need. The funding we have made available gives them the flexibility to do so in their local budgets.

Question to the Department for Education:

To ask His Majesty's Government, further to the Written Answer of Baroness Barran on 9 March (HL5961), what estimates they have made of the number of children not regularly in school; whether there has been an increase in the number of children absent from school since the COVID-19 pandemic; and whether they will fund local education authorities to maintain registers of children not in school until they can legislate to make such registers a statutory requirement.

Answered by Baroness Barran - Shadow Minister (Education)

School attendance has improved since 2010, but COVID-19 and its aftermath significantly damaged attendance levels. COVID-19 caused higher levels of sickness absence, and exacerbated existing problems with persistent absence, with vulnerable children particularly affected. Attendance is now improving, and the government is committed to returning to pre-pandemic levels and better.

In autumn/spring 2018/19 overall attendance was 96.7%. The current academic year to date attendance is 4.3 percentage points lower at 92.4%.

Local authorities have a statutory duty to make arrangements that enable them to establish, the identities of children in their area who are not receiving a suitable education. To assist with fulfilling this duty, the department expects all local authorities in England to maintain some form of register to help identify these children, in line with our guidance to local authorities on elective home education. This function is funded through existing budgets and resources.

When the suitable legislative opportunity arises to take forward the Children Not in School measures, the department will review and undertake a further new burdens assessment to assess the level of funding required to support implementation of the registers, as well as for the proposed local authority duty to support home educating families.

Question to the Department for Education:

To ask His Majesty's Government, further to the written answer by Baroness Barran on 9 March (HL5960), what further checks they have made to the 81 settings that claimed to have changed their operations; what steps they have taken to ensure that the 21 settings that have closed their operations have not reopened in another location; what powers local authorities have to close settings that are not compliant with safeguarding requirements; and whether, in the consultation to be launched later this year, they will seek to define "school" so as to enable Ofsted to close unsatisfactory settings more speedily.

Answered by Baroness Barran - Shadow Minister (Education)

It is a criminal offence under Section 96 of the Education and Skills Act 2008 to conduct an independent school which is not registered with the Department. Her Majesty’s Chief Inspector of Schools (HMCI) may, under Section 97 of that Act, inspect without notice any setting which they have 'reasonable cause to believe' is the site of an unregistered independent school. Settings that have previously been inspected under Section 97 and where the proprietor has been issued with a warning notice are likely to be inspected again under Section 97 to check compliance. This includes settings where the second inspection confirms closure or a change to compliant operation. A setting may not be inspected again under Section 97 where HMCI no longer has reasonable cause to believe that an unregistered school is being conducted. This may occur, for example, if the setting has registered as a school and is then subject to inspection as such. Ofsted considers all intelligence it receives about unregistered independent schools and will undertake a Section 97 inspection where it has reasonable cause to believe that an unregistered independent school is operating. This includes where new intelligence is received about previously closed sites or where proprietors that have received warning notices may be operating on alternative sites.

The department has consulted on expanding the categories of full-time institutions that will be regulated in the same way as independent schools, as well as defining what is ’full-time’ for these purposes. Following this consultation, the government intends to legislate in this area at the next available opportunity.

Local authorities have overarching responsibility for safeguarding children and young people in their area, whether these children attend a school (either registered or unregistered), or an out-of-school setting (a setting not offering full-time education). They have a range of legal powers already in place to support them in this responsibility. The department will continue to work with authorities to ensure they are utilising the existing legal powers available to them. The department will also be reviewing and strengthening our existing guidance for local authorities on unregistered schools and out-of-school settings to support them to do this.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham on 6 February (HL5236), when they will publish their final impact assessment on changes to the Statutory Scheme for Branded Medicines.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

The Government published its final impact assessment of updates to the statutory scheme on 2 March 2023. A copy of the impact assessment is attached.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what assessment they have made of the findings of the report by The Association of the British Pharmaceutical Industry False economy? How NHS medicine procurement threatens the UK’s Life Sciences growth engine, published on 23 February, that the continued current high rebate rates under the voluntary and statutory schemes for branded medicines during the next five years would mean foregoing £50 billion in GDP and £17.9 billion in tax revenues as a result of lost research and development investment; and what are their estimates of the value of the potential lost investment in this sector.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

The Department carefully considers all evidence in the public domain on matters relating to the growth and competitiveness of the United Kingdom’s life science sector, including the recent report by the Association of the British Pharmaceutical Industry. This occurs in combination with broad engagement with individual companies, the National Health Service and with charities and patient representatives and will continue moving forward as part of the delivery of the Government’s Life Science Vision.

Question to the Department of Health and Social Care:

To ask His Majesty's Government, further to the Written Answer by Lord Markham on 7 February (HL5233), what assessment they have made of the reports by the Association of the British Pharmaceutical Industry (1) False economy? How NHS medicine procurement threatens the UK’s Life Sciences growth engine, published on 23 February, and (2) At the crossroads: how a new UK medicines deal can deliver for patients, the NHS and the economy, published on 1 March; and what assessment they have made of the findings of those reports that the present NHS medicine procurement system threatens the growth of the UK Life Sciences sector.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

The Department carefully considers all evidence in the public domain on matters relating to the growth and competitiveness of the United Kingdom’s life science sector, including the recent report by the Association of the British Pharmaceutical Industry. This occurs in combination with broad engagement with individual companies, the National Health Service and with charities and patient representatives and will continue moving forward as part of the delivery of the Government’s Life Science Vision.

Question to the Department of Health and Social Care:

To ask His Majesty's Government what steps they are taking to reduce the number of vacant posts in the adult social care sector from their current high level.

Answered by Lord Markham - Shadow Minister (Science, Innovation and Technology)

We are running a national recruitment campaign until 31 March 2023 to encourage more people to consider a rewarding role in care. In February 2022, we made care workers eligible for the Health and Care Visa and added them to the Shortage Occupation list.

We are making available £15 million in 2023/24 to help local areas establish support arrangements for international recruitment and improve workforce capacity in adult social care. In addition, the £500 million adult social care discharge fund announced last September can be used by local authorities for the recruitment and retention of the social care workforce.

Question to the Department for Education:

To ask His Majesty's Government what progress they have made, if any, in (1) registering, and (2) regulating, the home tuition of children to ensure that they (a) are taught a balanced curriculum, and (b) are able to secure recognised national qualifications.

Answered by Baroness Barran - Shadow Minister (Education)

The department remains committed to introducing statutory local authority registers for children not in school, as well as a duty for local authorities to provide support to home-educating families. The department will legislate for these at the next suitable opportunity, to help local authorities undertake their existing duties to ensure all children receive a suitable education and are safe, regardless of where they are educated. However, local authorities’ existing powers and duties, if used in the way set out in our guidance, are enough for a local authority to determine whether provision is suitable.

Elective home education needs to be suitable, although there is no requirement to follow the national curriculum, nor are parents required to enter children for public examinations. However, if the home education does consist of one or more of these, that would constitute strong evidence that education was ‘suitable’ in terms of section 7 of the Education Act 1996.

Question to the Department for Education:

To ask His Majesty's Government what progress Ofsted has made on the (1) registration, (2) regulation and (3) inspection of religious schools such as (a) madrassas, (b) yeshivas, and (c) Sunday schools where concerns have been raised about the appropriateness of the material being taught to children at such places; and what powers Ofsted has to take action, as necessary.

Answered by Baroness Barran - Shadow Minister (Education)

Out-of-school settings, such as supplementary religious schools, are not regulated under education or childcare law and are therefore not required to register with the department or Ofsted. However, the department remains committed to ensuring that children are safeguarded across all education settings and are working closely with key safeguarding partners, sector representatives, and parent groups to develop proposals for how we might further enhance safeguarding in this sector. The department will look to consult on such proposals later this year. We will be publishing updated safeguarding guidance for providers and parents, as well as a new e-learning package aimed at strengthening providers’ understanding of the arrangements they should have in place to keep children safe.

Any education setting which makes full-time provision to five or more pupils of compulsory school age (or one or more such pupils who is looked after or has an education, health and care plan), is not maintained by a local authority and is not a non-maintained special school is required to register with the department as an independent school. It is a criminal offence to conduct an educational setting which meets the definition of an independent school if this is not registered with my right hon. Friend, the Secretary of State for Education.

The government has been working proactively since 2016 to identify, investigate and, where appropriate, prosecute those operating unregistered independent schools. Between 1 January 2016 and 31 August 2022, Ofsted issued warning notices to 132 settings that may be operating as unregistered schools (this includes all settings including those with a secular or faith ethos). Of those settings, 81 changed their operation to comply with legislation, 21 closed and 16 registered. There have been six successful prosecutions against those operating unregistered schools and there are several ongoing investigations.

If safeguarding concerns are raised about a specific setting, we expect local authorities to intervene, as they are legally responsible for safeguarding and promoting the welfare of children in their areas, regardless of the educational setting they attend.

Question to the Department for Education:

To ask His Majesty's Government what arrangements there are for the registration and regulation of private fostering agencies; whether there is a statutory basis for such registration and regulation; and whether other agencies and local authorities are informed of misconduct by an individual foster carer provided by a private fostering agency.

Answered by Baroness Barran - Shadow Minister (Education)

All independent fostering agencies (IFAs) are registered with Ofsted under the Care Standards Act 2000 and must meet the legal requirements set out in the Fostering Services (England) Regulations 2011. IFAs are inspected by Ofsted under the Social Care Common Inspection Framework (SCCIF) on a three-year inspection cycle.

Under the National Minimum Standards IFAs have a duty to ensure the welfare of the children in care and a duty to work effectively in partnership with other agencies concerned with child protection, such as the responsible authority, schools, hospitals and general practitioners.

Serious incidents must be reported by IFAs to Ofsted, including any serious complaints about an approved foster parent. Local authorities must notify the Child Safeguarding Practice Review panel, and by extension the department and Ofsted, within five working days of becoming aware of a serious incident. These incidents are where abuse or neglect is known or suspected.

If a foster carer’s approval to foster is terminated, a copy of the notice must be sent to the responsible authority for any child placed by another local authority, and to the relevant local authority if the foster carer lives outside the area of the fostering service.

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