My Lords, I want to touch on the health service staff and on universal credit. I am very grateful to the noble Baroness, Lady Finlay of Llandaff, for raising the issue of hospital doctors on the third day of debate on the gracious Speech. She warned that more legislation would not lead to better care. There might well be some improvements for the health service in the long-term plan, but it does not take away the responsibility of the Government for their top-down reorganisation, their failure to fund the service adequately and their past treatment of staff.
In 2016 there was another important event—the referendum was not the only one. It was the hospital doctors’ dispute. The Government’s treatment of the hospital doctors was shameful. They were called greedy, while what they wanted was to be able to get home occasionally and spend more time with their families. Family breakdown and suicide rates are shockingly high among doctors, and professional support is patchy at best. Staff shortages through illness and failure to recruit put extra strain on all involved. Should we really be treated by doctors who are beyond exhaustion? The failure by the Government to deal with these issues will affect our health and that of the vulnerable in the future.
Let us not forget that the shortage of GPs was exacerbated by the Government’s action on their pensions. It became fashionable to attack public service pensions, and the outcome was that GPs decided to go in their thousands. Professor Ted Baker, the CQC’s Chief Inspector of Hospitals, has linked the issue of poor community care with the 50% of A&E departments that are failing. Patients are increasingly frustrated at not being able to have an appointment, and this will eventually be reflected in people’s attitudes to GPs and the health service. The Government use the right words, but their actions need to speak louder.
I turn now to universal credit. The Prime Minister has indicated his support for the continued rollout of universal credit. This is worrying in the light of so many structural problems. The DWP has hired 1,000 extra staff to develop a specialist intelligent automation garage. A unit based in Newcastle and Manchester is developing machine learning to check claims for fraud through 100 welfare robots. The details are secret, as the DWP has refused freedom of information requests to explain how it gathers data on citizens.
There are clearly huge benefits to be claimed from automated intelligence-gathering, but if the human element of the welfare state is being diluted, and the
vulnerable end up in what has been described as a “digital poorhouse”, what are the human rights implications? As Ed Pilkington said in his excellent article:
“What happens if you are one of the five million adults in the UK without regular access to the internet and with little or no computer literacy? What if the algorithm merely bakes in existing distortions of race and class?”
There is evidence of a rising error rate. Some 5,700 people a month are affected by claims of incorrect data sharing between HMRC and the DWP. I ask the noble Baroness for assurances—if not tonight then after the debate—on human rights, transparency, the objectivity of algorithms being used and on how vulnerable claimants will get to speak to a human being.
Turning to the “controversial Managed Migration pilot”—not my words but those of the Secondary Legislation Scrutiny Committee in its seven-page commentary on 5 September—there has been strong criticism of laying the replacement regulations,
“on the cusp of the summer recess”,
and three months after the High Court judgment, using the negative procedure when it was clearly a matter for the affirmative procedure. Members of the House described it as “disrespectful to Parliament”. The Secondary Legislation Scrutiny Committee described it as a “tactical ploy”. I describe it as sharp practice. It has been stated that the DWP will publish an “evaluation strategy” by the end of 2019 and publish the evaluation of the pilot before returning to Parliament with further legislation to continue migration activity. Can the Minister say when the evaluation will be available to Parliament and when there will be a debate in this House on the managed migration pilot?
Finally, I will say a brief work on universal credit and the self-employed. I have said many times that UC is not fit for purpose for the self-employed because of its clunky methodology known as the “minimum income threshold”. It is estimated that about 700,000 families with at least one self-employed earner will claim support from universal credit. A study by Policy in Practice has revealed that this figure is likely to be a significant underestimate, which makes it all the more important for the Government to look at it again, and in particular at the vulnerable self-employed. If nothing is done, they too will end up in the digital poorhouse.
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