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Health and Social Care Bill

The noble Baroness, Lady Howarth, has three or four groups of amendments during which she can see whether she can remember her point. I shall be happy to answer it if I can. We come to the health in pregnancy grant. The Bill allows the Government to set out in regulations when the grant should be paid. We have published draft regulations to help the Committee in its deliberations, which set out that the grant will be paid from the 25th week of pregnancy. I have placed copies of the draft regulations in the House Library. I know that concerns have been expressed about the timing of the payment, as this amendment demonstrates. However, there are good reasons for the Government’s choice of 25 weeks and I thank the noble Earl for giving me the opportunity to explain them. First, although we know that maternal health is important at all stages of pregnancy, if the grant is paid at this time not only will it supplement expenditure on all aspects of health and well-being but it will come at a time sufficiently into the pregnancy when it can help to alleviate some of the stress and anxiety that competing financial pressures can cause when women will be thinking about giving up work and possibly buying larger items. Similar payments are made in the later stages of pregnancy in other European countries, including France, Finland and Belgium. Secondly, linking in with existing antenatal care at the 25th and 28th weeks will also keep the burden on health professionals and pregnant women to a minimum. Finally, the Government already have a targeted, voucher-based scheme explicitly aimed at improving diet during pregnancy for women on lower incomes. The health in pregnancy grant complements the targeted support already provided by the Healthy Start scheme. Amendment No. 203A would require that the advice given by health professionals to all expectant mothers must, as a minimum, include advice on a number of specific issues, such as nutrition. I agree wholeheartedly with the principle that all pregnant women should receive the advice that they need to have a healthy pregnancy and delivery. However, I hope that I am able to persuade the noble Earl that we should not seek to specify in the Bill what advice a health professional should provide and when he or she should provide it. The noble Baroness, Lady Howarth, was completely correct in anticipating that that would be my point. The noble Baroness, Lady Finlay, made the good point that the advice should be tailored. The pregnant woman must have the advice before she can get the grant and that advice must be given by a health professional. We have said in draft regulations that the health professional should be a doctor, nurse or midwife. We are lucky in this country to have highly trained and highly skilled health professionals. It is their role, rather than that of the Government, to decide what kind of advice meets each individual woman’s needs. That advice should be based on the professional’s clinical expertise and the circumstances of the woman concerned. There is already guidance available for health professionals. The National Institute for Health and Clinical Excellence has produced an advice booklet for health professionals called Routine Antenatal Care for Healthy Pregnant Women, which sets out recommendations on the issues that health professionals should cover in their advice to expectant mothers. On Amendment No. 204, in common with child benefit and tax credits, Clause 125(3)(b) requires a woman to be in Great Britain when she makes a claim to the health in pregnancy grant. As with child benefit and tax credits, the Government intend to prescribe in regulations the circumstances where a woman is or is not to be regarded as being in Great Britain. We have published draft regulations to show how this provision will be used; as I have said, copies are available. These regulations will require a woman to be ordinarily resident in Great Britain and will provide for any circumstances where a woman’s temporary absences may be disregarded. Removing this power would remove entitlement to the health in pregnancy grant from members of the Armed Forces and their partners who are serving abroad, for example. The amendment would also entirely remove the means of providing for a woman to be ordinarily resident in the UK in order to be entitled to the health in pregnancy grant. Without this requirement, any woman who satisfied the other conditions of entitlement but was not ordinarily resident in the UK could successfully claim, provided that she was in Great Britain when she made her claim. That is clearly not a sustainable policy. I hope that in the light of these arguments the noble Earl will feel able to withdraw his amendment.