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  • Nov 16, 2017:
    • Young Women: Self-Harm - Question | Lords debates

      My Lords, I thank the Minister for acknowledging the shocking 68% increase in the number of young girls being admitted to hospital for self-harm over the last decade. Does he agree that school counsellors can be a very valuable resource in helping to tackle this terrible epidemic of emotional distress among young people, because they are non-stigmatising and easily accessible? However, I visited an area yesterday where I was told that all the school counsellors have had to be sacked because the schools cannot afford to pay them. Will the Minister work with the Department for Education to ensure that by the end of this Parliament every secondary state school in this country has a school counsellor, so that we can tackle the welfare requirements of young people as well as their academic requirements?

    • Young Women: Self-Harm - Question | Lords debates

      My Lords, on behalf of my noble friend Lord Storey, and at his request, I beg leave to ask the Question standing in his name on the Order Paper.

  • Nov 2, 2017:
    • A Manifesto to Strengthen Families - Motion to Take Note | Lords debates

      My Lords, I start by welcoming the Minister to the House of Lords and congratulate him on his meteoric rise to the Government Front Bench. I also thank the noble Lord, Lord Farmer, for a very interesting debate and extremely important manifesto. There are so many policy areas that could be improved in order to redress the magnitude of family breakdown in this country that it is hard to know where to start. However, I plan to mention adoptive families, the benefits of family hubs, what can be done to keep offenders in touch with their families to reduce reoffending and the importance of teaching children about relationships in school.

      I start with adoptive families-not mentioned by anybody except the right reverend Prelate the Bishop of Oxford-since I have a particular interest in them. I was recently contacted by a couple who are both psychologists and are adoptive parents. I took very seriously the points they were making, which were about burnout of adoptive parents and the lack of support for them. They reminded me that adoptive parents take on some of the most needy and challenging children in our society-traumatised children whose mental and physical health has been damaged by their life experiences. The people who take on these children are heroes and their attempts to give them a stable and loving family in which to recover from their previous trauma should be applauded and supported. However, these adoptive parents often have to deal with violence directed at them or other siblings, self-harm, incontinence, inappropriate or dangerous sexual behaviour, anger, school refusal and many sorts of mental health problems. Adoptive parents cannot take sick leave, resign or ask for a transfer to another department. Unlike foster parents, they do not get much help. Indeed, if they adopt after fostering, whatever help they had before often just stops.

      Adoption UK thinks that as many as a quarter of all adoptive parents are in crisis and in need of professional help to keep the family together. But local authority post-adoption services vary tremendously; despite the fact that adopters save local authorities a massive amount of money, some are less than helpful when asked for help. Can the Minister say what is being done to ensure that an appropriate level of support for adoptive families is offered everywhere? If we do not do this, the NHS will be saddled with the cost of the mental health issues of the parents as well as their children.

      Mental health has been mentioned by several noble Lords-the noble Lords, Lord Farmer, Lord Shinkwin and Lord Alton, among others. This brings me to the subject of teaching relationship and sex education in schools and the ability of schools to identify and signpost mental health problems. The best way to deal with mental health is of course to prevent the problems arising in the first place-the noble Lord, Lord Bird, mentioned prevention. Many of the issues that children face arise from family break-up or from violence or poor relationships in the family. Many children do not have a good model of healthy and respectful relationships at home. It is therefore often the job of the school to pick up the pieces and help build up children's resilience. There is a major role for relationship and sex education in this, so I welcomed the Children and Social Work Act earlier this year, which should ensure that all children get it in an age-appropriate manner as part of their PSHE curriculum.

      I have become aware, however, that the regulations to mandate schools to prepare and publish their RSE policy have not yet been made. Can the Minister say why this is and when it will be done? I welcomed the Prime Minister's initiative on mental health first aid training in schools and wonder if the Minister can update us on how that is progressing. Such work can help children to ride out the worst effects of family unhappiness or even breakdown.

      We live in a very unequal country, and an interesting statistic in the briefings we have received caught my eye. It showed that poor families break up more frequently than more affluent ones. As the noble Lord, Lord Parekh, said, almost half of five year-olds in poorer families are in broken families, compared with 16% in wealthier ones. This did not surprise me. It is widely known that a high percentage of parents are worried about money, and that money is frequently the cause of family arguments, so what is being done to improve the finances of families with children? I am afraid that the marriage tax allowance, which the noble Lord, Lord Morrow, mentioned, brings in less than £5 a week, even if the family applies for it, so that is not going to make much difference. By the way, I am not suggesting that it be improved, as I do not approve of it in the first place. I do not think it is the role of the state to support particular kinds of families.

      Benefit cuts and the six-week wait for universal credit have sent far too many families into debt, and to food banks. If the Government are really concerned to keep families together, which, of course, is a laudable aim, they need to do everything possible to ensure that parents can feed their children and pay the bills. We hear about the record number of people in work, but the fact is that many jobs are very low paid and a high percentage of poor people are in work and eligible for benefits, which makes a nonsense of the Government's constant claim that the best way out of poverty is through work. I would say it depends what sort of work, and how well it is paid. Can the Minister say what plans the Government have to make what they choose to call the living wage into something people can actually live on?

      Many families need a range of services to help them survive, stay together and bring up their children successfully, and it is desirable that these services be easily accessible and linked together. That is why I, like the noble Lord, Lord Farmer, and others, support the idea of family hubs, which can be based on children's centres or Sure Start centres. I hope they will not become what the noble Lord, Lord Mawson, called the shiny new thing that disappears before long, as they would offer a wide range of services for parents as well as children. This is not a new idea. Several years ago, I visited the Coram Centre, where all kinds of services such as debt advice, immigration advice, English lessons and help to find a job and a home were offered to the parents of children in the nursery. It was a great example of what can be done in response to the particular needs of the families in the locality. Therefore, can the Minister say whether the Government support family hubs and whether extra funding will be made available, given the savings to many other services that they could provide in the future?

      I will say a few words about prisoners and their families. There is an important role for families to keep in touch with offenders while they are in prison in the interests of their relationships with their spouses and children, and of reducing reoffending. However, in many cases, the prison system does not make it easy for families to visit. There is some very good practice, such as Skype conversations, but in some cases it is hard to see the logic of where offenders are placed. For example, there is a large, brand new prison in Wrexham, near where I live in north Wales. I recently learned that only 10% of the inmates come from Wales and that many come from a very long way away in England. In addition, the prison is located on an industrial estate miles from the nearest railway station. It cannot be easy for families without their own car to visit in those circumstances, so what is being done to ensure that families who want to keep up their relationship with the offender are helped to do so?

      Finally, from experience, I issue a warning about impact assessments. During the coalition Government, my then honourable friend Sarah Teather said that policies would have a child rights impact assessment. I am not aware that that is being done. Therefore, if we are to have a family impact assessment, I hope that it really happens.

  • Oct 30, 2017:
    • Child and Adolescent Mental Health Services - Question | Lords debates

      My Lords, does the Minister agree that early intervention is essential to prevent escalation into crisis and lifelong problems? Is he aware that the number of CAMHS psychiatrists fell by 6.6% between 2013 and this year, while demand for their services rose? The number of qualified doctors who go into psychiatry is 2.6%, the lowest of any specialism, and some universities do not send any. Will he consult Health Education England to find out what it is doing about this, because the pipeline is drying up?

    • Child and Adolescent Mental Health Services - Question | Lords debates

      To ask Her Majesty's Government what action they are taking to ensure that children and young people can obtain timely access to Child and Adolescent Mental Health Services.

  • Oct 26, 2017:
    • Air and Water Pollution: Impact - Motion to Take Note | Lords debates

      My Lords, I thank my noble friend Lady Miller for her inspiring introductory speech. As an asthmatic person who has to come to London every week from the beautiful clean air of my home village in North Wales, I have a personal interest in this topic. As I stand by the roadside outside this building, I can smell the pollution, and it certainly affects my breathing. Unfortunately, I know that this is not a short-term effect, because the Royal College of Physicians tells us that the effects are lifelong and can make us more susceptible to infections and cancer. Indeed, I have noticed that too.

      However, I am an adult, and developed as a child in an environment with much cleaner air. On the other hand, the children of today, especially those who live and go to school in deprived urban areas, are growing up and developing in air that is toxic. One in five of London's primary and secondary schools is in an area of high air pollution, and 85% of those are in areas of greater than average deprivation. There are 950 schools and 1,000 nurseries across Britain close to an illegally polluted road.

      However, we should not be concerned just about areas of high pollution. A recent study in the Harvard New England Journal of Medicine concluded that there is no safe level of air pollution and that disadvantaged people have the greatest adverse health effects, so, for reasons of health quality, we need to tackle it urgently.

      The lungs are obviously the most susceptible organ. A study in southern California showed a clear link between the risk of developing early school-age asthma and air pollution associated with traffic. Apart from the obvious lung impairment and consequent increased stress on the heart, it is not widely known that air pollution, particularly the microparticulates in diesel fumes, can cross the placental barrier and affect the developing organs, including the foetal brain. This can have a very serious effect on all aspects of brain development, including cognition, and can also affect older people. We are reducing babies' life chances before they are even born.

      Infants are also particularly susceptible because they have a higher metabolic rate than adults and breathe a greater volume of air compared to their size. It is a double whammy: they breathe in more air and are more susceptible to its harmful effects. On top of that, they are often pushed around in buggies which put them exactly at the level of car exhausts. That is why it is particularly important for us to monitor the level of pollution around schools and nurseries and reduce it where necessary. We need to know what the problem is before we can address it.

      Schools are usually on main roads, often at intersections, where pollution is greatest because vehicles have to stop and idle. Of course, many parents drive their children to school, although a recent report on air pollution and London schools suggested that this is not a major contributor to air pollution. The same report emphasised the importance to children's health of physical activity and recommended active ways of getting to school, such as walking or cycling. It calculated that the benefits of the activity outweighed the risk of doing it in polluted air. However, it would obviously be better if the air was clean. I know a doctor who has carefully planned his children's walking route to school along those lines, making sure that they walk along the less traffic-ridden roads and experience cleaner air.

      I am sure that several speakers will recommend ways of reducing pollution in the first place, such as phasing out coal-fired power stations, supporting renewable energy sources, charging drivers of polluting vehicles for entering clean air zones, mandating reduced emissions standards for private cars, removing the dirtiest vehicles from the roads, encouraging electric cars and the charging infrastructure for them and, of course, improving access to public transport. I agree that those prevention measures are really important but, while we are waiting for all these measures to improve the air we breathe, we need to think about mitigation measures.

      Our greatest allies in that fight are trees and other green plants. London is one of the greenest major cities in the western world, with many large and wonderful parks and gardens and thousands of street trees. Not for nothing are our public parks called the lungs of London, and the same applies in other British cities. Private gardens play a very big role, too. A consequence of that is the proliferation of beekeepers in London, since the number and variety of forage plants is so great. It is probably this fact that prevents us having even dirtier air in London since, not only do trees absorb carbon dioxide from the air and give out oxygen, helping to mitigate global warming, but many of them are also very good at removing pollutants from the air before transpiring it out again.

      I am pleased to say that many big developers are quite aware of the benefits of trees and other greenery around their buildings and infrastructure, and build landscaping and planting into the plans from the start. A good example of that is the new American Embassy in Nine Elms Lane just opposite where I live. They are planting many mature trees, hedges and ornamental grasses around the new building, which will buffer the noise and pollution from the traffic and contribute to the well-being of users of the building and local residents. We need local authority planners to insist that all developers do this, and to plan sufficiently far in advance to allow British growers the time to grow the stock they need in the interests of British biosecurity. All noble Lords will have heard about the many plant diseases that we inadvertently import, so I am sure we would all want to support our own home-grown British industry. Do the Government intend to include the planting of trees and green areas in their plans to meet the legal limits for air pollution? I know there is a plan to plant 1 million trees, but many of them will be in rural areas, which have clean air anyway. They should be in urban areas.

      Of course, there are those who believe that our limits are too high anyway, so I urge the Government to keep going, even when current legal limits have been achieved. As members of the European Union, we have signed up to those legal limits, which we have still not achieved everywhere. I disagree with the noble Earl, Lord Caithness: it is not the standards that are wrong, it is the people who try to avoid them, such as VW. So, Brexit or no Brexit, will the Government introduce a new Clean Air Act so that we have new systems in place to achieve the standards to which we have signed up?

  • Oct 16, 2017:
  • Oct 12, 2017:
  • Oct 10, 2017:
    • Adult Social Care in England - Private Notice Question | Lords debates

      My Lords, the CQC report emphasised the need to co-ordinate care by stating that in future it will report not only on the quality of care in individual providers but on the quality of co-ordination between services. It quotes examples of services working together using technology and innovation to share data and improve care. How do the Government plan to encourage this approach? Will they look at funding models to make sure that they encourage co-ordination rather than deter people from co-ordinating?

    • National Health Service - Question | Lords debates

      I thank the Minister for his reply. Does he also agree with Professor Ted Baker's statement:

      "The model of care we have got is still the model we had in the 1960s",

      and that this "needs to change"? Can the Minister say how many of the new models of care are up and running and how many of the sustainability and transformation plans are in special measures? On World Mental Health Day, will he look into how many clinical commissioning groups are failing to commission good and timely mental health care, especially for young people?

    • National Health Service - Question | Lords debates

      To ask Her Majesty's Government what assessment they have made of remarks by the Chief Inspector of Hospitals that the NHS is not fit for the 21st century.

  • Sep 18, 2017:
  • Sep 12, 2017:
    • Gaming Machines - Question | Lords debates

      My Lords, younger gamblers, aged 18 to 24, have a greater propensity to develop problem gambling and mental health issues. They do it mostly online, which is very quick and easy. What will the Government do to reduce the volume of gambling advertising, particularly at sporting events? In many cases, the tone of this advertising is very clearly aimed at young people.

  • Sep 6, 2017:
    • National Health Service (Mandate Requirements) Regulations 2017 - Motion to Regret | Lords debates

      My Lords, we on these Benches support this Motion.

      This debate shines a spotlight on the existential quandary facing CCGs and NHS Providers. I am sure that at the end of the debate the Minister, in his usual courteous and thorough way will, as he always does, give us lots of figures about how much more the Government are spending every year and how many more treatments are being delivered and how well the STPs are doing. With demand rising, naturally the raw numbers are higher, but the Government have chosen an RTT target in percentage terms and they must live with that decision and fund the consequences. Over recent years, the increase in funding for the NHS has not kept up with rising demand. This year we have a lower increase than before, and so now is crunch time. As the noble Lord, Lord Hunt, said, nobody is even pretending that providers will be able to deliver the targets while remaining within their budgets. So there is no point in the Government watering down the targets and pretending that no one will notice. The noble Lord, Lord Hunt, and many others have noticed, and I am grateful to him for giving us the chance to have an honest and open discussion about this.

      NHS staff work hard and do their best to meet the targets under difficult circumstances. It is not their fault that the RTT targets have not been met for 16 months. But changing the targets is a political decision, whether it is being done openly or not, and that is only right. It should certainly not be left to local decision-makers, in a postcode lottery, to quietly ignore them or try and fail to live up to them and then take the flack when people criticise. If the Government choose to change the target, they should take the responsibility for the consequences. But the trouble is that patients will live with the consequences, living longer with debilitating and painful conditions. Having those conditions worsen and requiring more complex and expensive treatment, they may even become untreatable, and their quality of life and perhaps their mental health will deteriorate. So although the 2012 Act was intended to pass the blame on to anyone but the Government when things go wrong, everybody knows that the Government's NHS mandate is the Government's NHS mandate and nobody else's. The NHS can spend the money only once, and the Government should not be expecting two treatments for the price of one. The bald facts are that, this year, demand was expected to rise by 5.2% while the funding is only going to rise by 1.3%, which is 2.3% less than last year-which was too little anyway. So this is a deliberate choice on the part of the Government.

      Waiting lists are projected to rise to almost 5 million by 2020, and clearing this backlog will require not only funding but appropriately trained staff. With staff who are EU citizens leaving in droves because of Brexit uncertainty, and UK staff leaving because of overwork and stress, NHS Providers is finding it impossible to deliver waiting time targets. At the same time there is spare capacity in the private sector but it charges more than the NHS, so that is a hard choice for managers to make. I therefore ask the Minister a simple question: what assessment did the Government make of the potential impact on patients and waiting lists of deprioritising elective care and taking the decision to relax the 18-week target?

      The RTT is not the only target the Government have changed, as the noble Lord, Lord Hunt, mentioned, and this is looking rather like a habit. For example, NHS England and NHS Improvement are reportedly setting new targets for CCGs and providers for bed occupancy levels, to keep them below 92%. This is significantly higher than the recommended safe limit of 85%. The Royal College of Surgeons has warned:

      "Anything over this level is regarded as riskier for patients as this leads to bed shortages, periodic bed crises, and a rise in healthcare-acquired infections such as MRSA".

      This is another target that was routinely missed last winter, and the latest figures show that the overnight occupancy rate for general and acute beds hit a record high in the fourth quarter of 2016-17, averaging 91.4%. If the Royal College of Surgeons is right, this high level of bed occupancy is not a measure of efficiency but could lead to greater costs and crises, which put patients in danger.

      Is it not time for the Government to stop pretending that all is well and that they have all the right answers, and set up a cross-party commission on the funding of health and social care, as recommended by my right honourable friend Norman Lamb MP? We on these Benches would be enthusiastic about taking part in such discussions. I think that the public are very fed up with health and care being a political football and would like to see us working constructively together. They want some honesty and realism. Of course we do not want to go back to the 1950s: I was waiting for a tonsillectomy and after two or three years, when my mother was fed up of waiting, she discovered that I had been taken off the list on the assumption that I had grown out of it. Actually, I had, but we need to be a great deal more ambitious for the NHS than that.

      I know that the Minister makes the best of his brief but I would like to think that he will go back to his department and use his considerable powers of persuasion to stop the Secretary of State from burying his head in the sand.

  • Sep 5, 2017:
    • End of Life Care - Question | Lords debates

      I thank the Minister for his reply. The resource impact tool published with this guidance shows that by investing £12.7 million in implementing the guidance, savings of £34.7 million could be made by the NHS in England. What plans do the Government have to emphasise to local commissioners the cost effectiveness of implementing the guidance? Secondly, does the Minister think it is right that adult hospices in England receive 33% of their funding from statutory sources while children's hospices receive only 22%?

    • End of Life Care - Question | Lords debates

      To ask Her Majesty's Government how they intend to implement the NICE guideline End of life care for infants, children and young people with life-limiting conditions: planning and management.

  • Jul 20, 2017:
    • *No heading* | Department of Health | Written Answers

      Her Majesty's Government when the next meeting of the Crisis Care Concordat Steering Group will take place.

    • Health: Congenital Heart Disease - Question for Short Debate | Lords debates

      My Lords, I congratulate the noble Baroness, Lady Boothroyd, on her tour de force and many other noble Lords on their very authoritative speeches. I feel a bit sorry for the Minister, who might be feeling a bit lonely.

      In decisions such as the closure of a highly successful and reputable unit such as the CHD unit at the Royal Brompton, the key driver must be to maintain and improve the quality of patient care. Any merger or closure decision must be made on the clinical evidence and not on cost saving, although, in this case, the costs of the change could well be greater than the existing provision.

      The Brompton is a highly experienced unit, as the noble Baroness, Lady Finlay, told us. It performed 512 congenital heart disease operations and 554 catheter procedures on children and adults in 2014-15, more than any of the 12 other NHS trusts performing such work. As the noble Lord, Lord Patel, mentioned, its adult CHD research team is responsible for publishing more cited research papers than any other CHD centre in the world. It is at the cutting edge of innovation. Despite the severity of the health problems experienced by its patients, as we have heard, survival rates and the quality of care are very high.

      However, NHS England's concerns about the Brompton focus on two issues. First, Standard B10 requires there to be four CHD surgeons, each of whom has presided over at least 125 operations per year. At the Brompton, I am told, three out of the five surgeons fall short of 125 cases-an arbitrary figure, according to the noble Lord, Lord Darzi. I listened to him very carefully.

      Secondly, NHS England is concerned that a number of linked paediatric services are not collocated in the same hospital but are provided by the Chelsea and Westminster and St Mary's hospitals, both easily within 30 minutes of a child's bedside. It is worth nothing that 30 minutes is the time limit proposed by the standards even when the services are collocated. This partnership is very close, with joint rotas, ward rounds and meetings and shared IT systems. This high level of communication is essential to the working of such a partnership.

      To comply with the rapid availability of paediatric cardiology, ICU, anaesthesia, gastroenterology and other services, the Brompton has formed joint teams with the Chelsea and Westminster, which is five to 15 minutes' walk away, depending on how fast you walk. You can be more than 10 minutes' walk away from another department in the same hospital on a large site such as my own local hospital-I have done such a walk many times. The main thing is that you can get there in time. The Brompton has proved that it can do this by its claim that, for the 1% of paediatric CHD patients who have needed these services, it has a 100% record of providing them in time, in an emergency, day or night.

      Given that there are many downsides to closing the unit, NHS England should apply the standards a little more flexibly when it comes to how they are complied with, as long as the standard of patient care is not compromised. The issue of collocation seems to have been appropriately dealt with by the partnership arrangements. The issue of the number of cases presided over by each surgeon could surely be addressed in the interest of saving the large amount of money that would need to be spent on closing the unit. I understand that the cost of redundancy payments alone amounts to £13.5 million, let alone the cost of increasing the number of beds elsewhere. Last December, my noble friend Lord Sharkey told the House that closure of the unit would remove a quarter of paediatric CHD beds in London. Can the Minister say what the plans are and what the cost would be of recreating beds for these 12,000 patients elsewhere? Where is the cost-benefit analysis? At a time when the NHS is struggling so hard financially, it seems highly risky to take the proposed line.

      There are other, considerable risks to closing the unit. Take staffing: how do we know that existing staff are prepared to relocate? Experienced UK staff and those coming from abroad are attracted by the Royal Brompton's reputation and, especially in the uncertain climate of Brexit, we cannot be certain that they will still come. Already, almost 90% of children's units express concerns over how they will cope with staff shortages over the coming months. Already, one in five vacancies for junior children's doctors is unfilled, on a rising trend. Now is not the time to upset an already wobbly apple cart.

      As we have heard from the noble Baroness, Lady Morgan, then there is the effect on other departments that would be threatened with closure because of volume reductions. The hospital claims that, without child CHD services, its children's intensive care unit would become unsustainable because of the reduction in volume. Consequently, its paediatric respiratory unit and paediatric cystic fibrosis and asthma services would also have to close, and other services would be under threat. NHS England admits that it has not done a detailed assessment of the knock-on impact of closing CHD surgery on other departments at the Royal Brompton. Can the Minister say when this will be done?

      Talking of unintended consequences, will the Minister look carefully at the funding models for surgery to ensure that there is no barrier to the hospital taking a holistic approach to the patient's disease? For example, I understand that the range of a consultant heart surgeon's practice has been limited by the funding model, since, although heart patients may well also have other diseases, the heart consultant will never deal with them, yet it is all part of the same syndrome.

      As the noble Lord, Lord Darzi, mentioned, there are examples of where centralisation of services can improve patient outcomes, which is what we all want, and I congratulate and support them. High among those is stroke and trauma services in London. However, we must not assume that one size fits all. It really depends on where you are starting from and in the case of the Brompton we are starting from a very high base. We have to look at the scope for doing even better and consider all the options for improvement. While this debate has been very supportive of the Royal Brompton, it also raises challenges for the trust, and I am sure it will rise to them. Surely there is a way of addressing some of the issues that NHS England has mentioned without closing the unit, with all the attendant downsides.

      I agree with the noble Baroness, Lady Masham, that "if it ain't broke, don't fix it" is a very good motto. In reflecting that this debate has had contributions from nine women and five men, I wish all hard-working noble Lords a very happy summer holiday.

    • NHS: Contaminated Blood - Statement | Lords debates

      My Lords, I welcome the fact that we are to have a proper inquiry at last and that it will be fully independent. I also welcome that the secretariat to the inquiry will be someone who has never worked at the Department of Health. However, the remit of these inquiries always has an enormous effect on the deliberations and the outcomes. Victims are concerned that the Department of Health could sign off the remit. To be seen to be completely independent, will the Minister consider which department would be more appropriate than her own for signing off the remit? Perhaps it could be the Cabinet Office.

      The inquiry must have statutory powers not just to summon witnesses but to compel them to appear and to receive documents. In the debate in another place last week the Minister seemed to see two alternatives: either giving the inquiry these important statutory powers or providing a,

      "Hillsborough-style panel-which would allow for a sensitive investigation of the issues, allowing those affected and their families close personal engagement".-[Official Report, Commons, 11/7/17; col. 187.]

      I do not see these as two alternatives. If the inquiry is properly constituted and the remit laid down by an independent body with the approval of the victims, it could command their trust and close personal engagement could then be achieved. However, these inquiries usually take a long time, and the victims of this scandal need help now. How will the Minister ensure that victims have access to the compensation they deserve in the short term? Will she reverse the decision made in April not to increase the compensation payments in line with inflation? Will the Minister set a date for responding to the consultation on the support scheme, which closed in April?