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Health and Social Care Bill

The noble Baroness is right: this has been a very good debate. Part 4 introduces the health in pregnancy grant, which will provide additional financial support to expectant mothers during the important last weeks of pregnancy. I welcome the opportunity to set out this policy in more detail and hope that I shall be able to address some of the specific questions raised by noble Lords about the grant. We believe that for many women, particularly those less well-off, the grant will provide a welcome addition to their income at what is often a very difficult and stressful time. We know that life chances are impacted upon before birth and that the support provided to the expectant mother during pregnancy has an impact on those chances. We also know that maternal health and well-being are affected by a wide range of factors, from the behaviour of the expectant mother to her financial circumstances and the support she receives from professionals and her family and friends. The Government’s wider strategy of providing support for women during pregnancy and the early years of their child’s life has seen statutory maternity pay increase from 26 to 39 weeks, the creation of a new right for fathers of up to 26 weeks’ additional paternity leave and pay and the extension of the right to request flexible working to carers of children under the age of six. The health in pregnancy grant fits into this wider strategy by providing additional financial support for women during pregnancy. Linking the grant to the advice available from health professionals during pregnancy will help all pregnant women to access adequate support, thereby helping to alleviate some of the strain that competing financial pressures can cause in the run-up to birth. Since the Bill was introduced, the Government have been clear that the health in pregnancy grant is intended to support a woman’s general health and well-being in the later stages of her pregnancy so, linked to the advice from a health professional, the grant will provide flexible additional financial support, enabling pregnant women to identify for themselves the best way in which to spend the money. On the point addressed by the noble Baroness, Lady Cumberlege, about Australia, the Australian baby bonus is very different from the health in pregnancy grant and is more similar to our existing system of child benefits, so making a comparison with the new grant may not be very useful. The Australian baby bonus is worth the equivalent of approximately £1,900—in other words, 10 times the amount of the health in pregnancy grant. It supports women with the cost of bringing up a child, like the UK system of child benefit, and is not payable until after birth. It aims to reverse the decline in the fertility rate and to encourage Australians to have larger families. Now, there’s a thought! It is payable when someone has a child and is not linked to any other conditions of entitlement. Paid maternity leave in Australia is not compulsory, so it would assist women going back to work. The grant was criticised at Second Reading and in the other place for being paid too late in pregnancy to have any beneficial effect on a woman’s nutritional needs during the early stages of her pregnancy and for not recognising that women expecting twins or multiple births have additional nutritional requirements. However, there is already support for nutrition from early in pregnancy through the Healthy Start voucher scheme. The health in pregnancy grant is not designed to duplicate Healthy Start; if the grant was just about nutrition, it would have been very differently designed in order to meet that express purpose. Because the health in pregnancy grant is intended to have a much wider purpose, the conditions of entitlement and the timing of the payment have been designed to help pregnant women with the costs of their individual needs for a healthier lifestyle and with the wider costs in the weeks leading up to the baby’s birth. The noble Baronesses, Lady Cumberlege and Lady Murphy, raised the issue of the different amounts that may be prescribed in the Bill. The flexibility to vary the grant is for the future; it allows us to change the grant from £190, which we currently intend, if necessary. The total cost of the grant is £145 million per year. At the beginning of his remarks, the noble Earl raised the issue of what my right honourable friend the Prime Minister said in his PBR 2006 speech. He said that the extra costs borne by parents should be recognised in the last months of pregnancy and that nutrition is important throughout pregnancy. I do not think that anybody would disagree with those words. The noble Baronesses, Lady Howarth and Lady Cumberlege, raised the issue of the type of advice that might be given. It is health advice, not necessarily nutritional advice, although that would be contained within it. It would include lifestyle issues, such as smoking, weight, diet and so on. The grant may well encourage women who have not yet presented for support and antenatal care during their pregnancy to come forward into the system, which suggests that it is a very good idea. As has already been mentioned, research by the baby charity, Tommy’s, has shown that the stress that pregnant women face as the result of financial worries has an adverse impact on pregnancy and birth, and getting £190 at the 25th week may help with that. Several noble Lords, including the noble Earl, raised the issue of why the grant is paid to everyone and what the evidence base for that was. I remind noble Lords that when child benefit was introduced it was not means-tested and was made a universal grant, which has been praised as important. The introduction of that grant was not based on evidence at all; there was no evidence base when child benefit was introduced. It was thought that it would be a good idea of benefit to women and their children. We think that this benefit will have a beneficial effect on women and their children. The fact that there is no evidence base at the moment that says that it will have an impact—that it will do one, two, three, four—is not a reason for not introducing this grant. The effect it has is surely the important matter. The noble Baroness, Lady Howarth, asked about the quality of the guidance and the support that might be given. In my previous speech, I said that there is an advice booklet for health professionals, Routine antenatal care for the healthy pregnant woman, which sets out the kind of issues that health professionals should cover in their advice to expectant mothers. Clause 126 provides the Commissioners for Her Majesty’s Revenue and Customs with regulation-making powers to enable officials to administer the new health in pregnancy grant. I hope the Committee will have noted that Clause 126 does not create any new powers but extends existing regulation-making powers under the Social Security Contributions and Benefits Act 1992, the Social Security Administration Act 1992 and the Social Security Act 1998, which provide for the administration of social security benefits. Clause 127 introduces a civil penalty that may be imposed on any person who fraudulently or negligently provides false or incorrect information in relation to the health in pregnancy grant claim. There will always be a very small number of people who set out deliberately to deceive. This system of penalties is a deterrent and is in line with the other provisions administered by HM Revenue and Customs. I hope the Committee will see clearly that this provision is not about penalising those claimants who do their best to claim in the correct manner, nor is it designed to deter pregnant women claiming money to which they are entitled. The clause seeks to provide a deterrent for the small minority who will try to cheat the system.