I am not sure that I agree with the noble Lord but, looking forward, we are clear that younger apprenticeships matter a lot. That is why the system tries to encourage them. We also want to give the younger people the jobs, without stopping older employees being able to apply for apprenticeships as well, but I agree that the cliff edge between the younger apprenticeships and the older apprentice is an important issue.

It is partly a question of resource, although I point out to the noble Lord that the country that spends the most money on healthcare and has the worst results is America. It is not just a question of resource. It is how we spend it as well as the amount of money.

The noble Lord, Lord Harrison, is quite right about the dynamism of this industry. He also mentioned the VisitEngland programme, which tries to ensure that more people come to visit the United Kingdom and that once they come to the United Kingdom, particularly to the capital, London, they venture outside London to visit attractions all over the United Kingdom.

My Lords, productivity growth represents a serious challenge for all advanced economies, and the UK is no exception. The Government last year published our productivity plan, Fixing the Foundations. In last month’s Budget, we went further—for example, announcing additional reductions in corporation tax to incentivise investment, and giving the green light to infrastructure projects such as Crossrail 2 and High Speed 3.

My Lords, I am bursting with enthusiasm and full of energy to get things done. I cannot claim that this Government will not encounter some of the problems that previous Governments down the ages have encountered when implementing their plans, but I refer the noble Lord to chart 2.B in the National Infrastructure Delivery Plan, published a fortnight ago, which shows that, of the 602 projects that the plan sets out and are in the pipeline, 61% are in construction, 50% will have been completed by 2020-21 and a further 49% will by that point be either under construction or part of an active programme. So we are full of enthusiasm, full of energy and we are getting going.

The Ministry of Defence (MOD) recognises the valuable skill sets of our reservists, all of whom have full access to the MOD's language schemes. We work to ensure that those reservists who already have a second language are able to use and develop that language. Any reservists employed in roles with direct requirements for language capability receive the same training as regular personnel.

The MOD maintains a pool of linguists through the Education and Training Services (Reserves), which provides additional language capability to exercises, operations and Defence Engagement tasks. A new training programme, which makes use of courses and bespoke training provided by the Defence Centre for Languages and Culture, has recently been introduced to develop the skills of linguists in the reserves.

Officials from HM Revenue and Customs have already met representative bodies of employee ownership schemes. HMRC will be working with those groups to develop further public guidance and discuss any other proposals their members might raise.

The Ministry of Defence (MOD) regularly reviews its requirements for linguists to ensure that all operational demands for linguists are met in full, and trains its personnel accordingly. For languages with little or no immediate operational requirement, the MOD ensures that there is a baseline of linguists that can be called on for contingency tasks and Defence Engagement.

Long and short-term language priorities are agreed at a strategic level and provide the basis for the statement of training requirement against which defence language training is delivered.

The Armed Services recognise 48 languages for which they declare a capability. The Joint Arms Control Implementation Group is the only unit which employs personnel in the direct role of interpreter. Across the Armed Services a total of 697 personnel are recorded as holding a level of language qualification and currency that is functional or above. These are broken down as follows:

The number of languages that Ministry of Defence (MOD) employees could conceivably need to converse in is extremely broad. The MOD employs professional interpreters for more niche languages and has robust strategies in place to ensure the quality of contractors’ interpretation skills.

The Defence Centre for Language and Culture (DCLC) has an extremely agile training delivery model, comprising a core of military and specialist civilian lecturers supported by a commercial training contract supplying contracted tutors. The DCLC covers a number of languages. This enables the Ministry of Defence to respond rapidly to new requirements, at scale, and at short notice. A dedicated Contingency Wing has been established specifically to respond to and manage this type of short notice demand, particularly in operationally focused languages. Plans are regularly reviewed to ensure that we have already considered broad options for the delivery of new requirements.

HM Revenue and Customs (HMRC) has been consulting representative bodies through the Valuation Fiscal Forum over the last 18 months.

HMRC has not withdrawn valuation services that are most relevant to employee share ownership schemes.

These include:

• Enterprise Management Incentives (EMI),

• Company Share Option Plans (CSOP),

• Save As You Earn share option schemes (SAYE),

• Share Incentive Plans (SIP) and

• Employee Shareholder Status (ESS).

  HMRC has, however, announced a review of the valuation services for those schemes and is consulting interested parties.

  HMRC has withdrawn valuation checks for income tax and PAYE that are not part of these recognised employee ownership schemes. Most people submitted acceptable valuations and therefore the valuation service offered was not seen as needed.

No impact on UK productivity is anticipated. HMRC has not withdrawn the valuation service for those share schemes most relevant to small and medium sized enterprises.

These include:

• Enterprise Management Incentives (EMI),

• Company Share Option Plans (CSOP),

• Save As You Earn share option schemes (SAYE),

• Share Incentive Plans (SIP) and

• Employee Shareholder Status (ESS).

  HMRC has however announced a review of the valuation services for those schemes and is consulting interested parties.

  HMRC has withdrawn valuation checks for income tax and PAYE that are not part of these recognised employee ownership schemes. Most people submitted acceptable valuations and therefore the valuation service offered was not seen as needed.

The report “Tax-advantaged employee share schemes: analysis of productivity effects” was prepared for HM Revenue and Customs by Oxera and published in August 2007.

The research represents a valuable addition to the evidence base on employee share schemes, but there are important limitations to its scope. While the research uses real measures of company productivity, it does not take into account potential complementary effects or assess the effects of share schemes on other performance measures, such as staff turnover, or in achieving wider objectives such as promoting share ownership.

No impact on the productivity of small and medium-sized enterprises is anticipated. HMRC has not withdrawn the valuation service for those share schemes most relevant to these enterprises.

These include:

• Enterprise Management Incentives (EMI),

• Company Share Option Plans (CSOP),

• Save As You Earn share option schemes (SAYE),

• Share Incentive Plans (SIP) and

• Employee Shareholder Status (ESS).

  HMRC has however announced a review of the valuation services for those schemes and is consulting interested parties.

  HMRC has withdrawn valuation checks for income tax and PAYE that are not part of these recognised employee ownership schemes. Most people submitted acceptable valuations and therefore the valuation service offered was not seen as needed.

My Lords, UK productivity levels hover around the middle of the park in relation to the G20 and the EU28. We face a significant, ongoing and long-standing productivity gap with the most productive nations of the world, such as the United States. The Government have of course recognised that and, within the overall fiscal framework, are working to remedy the problems and fulfil the challenge they set themselves in last summer’s productivity plan, Fixing the Foundations.

My Lords, the noble Lord asked a number of questions and I shall plump for the middle one. I assume that many Members of the House have not had a chance to digest the details of today’s Budget, but I am very pleased to say that we are accelerating our infrastructure plans, on which there is already quite impressive independent evidence. I could highlight a number of things that have been announced today. One that is very dear to my heart is that we are accelerating—compared with before, and taking on board the full recommendations of the independent National Infrastructure Commission—so-called HS3. In particular, the target is for the train journey time from Leeds to Manchester to drop to 30 minutes.

The UK’s flexible and effective restructuring and insolvency regime is very much in keeping with the general themes of the EU Recommendation. Following the European Commission’s 2014 Recommendation, the Government conducted a call for evidence seeking the views of stakeholders and submitted a response to the Commission’s survey on how Member States comply with the Recommendation. The Government published the UK’s response in August 2015. This can be accessed here: https://www.gov.uk/government/consultations/european-commission-recommendation-on-business-failure-and-insolvency-call-for-evidence

The Health and Social Care Information Centre provides information on the number of nursing, midwifery and health visiting staff employed in the National Health Service in England but it does not separately identify diabetes specialist nurses.

It is for local NHS organisations with their knowledge of the healthcare needs of their local population to invest in training for specialist skills and to deploy specialist nurses.

NHS England and Monitor are working closely together to ensure that the payment system supports service developments in the vanguard sites (including those where integrated diabetes care is a focus) as well as monitoring local innovative approaches to supporting integrated care taken by some clinical commissioning groups (CCGs). This is to ensure that the payment system keeps abreast with the development of future service models and is not a barrier to the development of new models of care.

During 2016/17, NHS England will look at the current incentives and funding arrangements for diabetes to see how greater alignment could be achieved between the financial incentives for primary and secondary care.

Information on how much money the National Health Service invested in structured education for diabetes patients is not collected centrally.

Under the Health and Social Care Act (2012), NHS England has a statutory duty to conduct an annual assessment of every CCG. Since April 2013, CCGs have been assessed twice, for the period 2013/14 and for 2014/15.

For 2016/17, NHS England will introduce a new CCG Improvement and Assessment Framework (CCG IAF). This new framework will align with NHS England’s mandate and planning process, with the aim of driving improvements in a number of key areas including the management and care of people with diabetes.

NHS England has been working with Diabetes UK on including diabetes indicators in the CCG IAF. The proposed diabetes indicators are:

- the percentage of diabetes patients that have achieved all three of the National Institute for Heath and Care Excellence recommended treatment targets; and

- newly diagnosed diabetes patients referred to, or attending, a structured education course.

Under the proposals, diabetes will also be one of the six clinical priority areas in the CCG IAF that will be overseen by an independent group.

The CCG IAF proposals are subject to the outcome of an engagement process which closed for comments on February 26 2016. More information can be found at:

https://www.england.nhs.uk/commissioning/ccg-improvmnt/

NHS England and Monitor are working closely together to ensure that the payment system supports service developments in the vanguard sites (including those where integrated diabetes care is a focus) as well as monitoring local innovative approaches to supporting integrated care taken by some clinical commissioning groups (CCGs). This is to ensure that the payment system keeps abreast with the development of future service models and is not a barrier to the development of new models of care.

During 2016/17, NHS England will look at the current incentives and funding arrangements for diabetes to see how greater alignment could be achieved between the financial incentives for primary and secondary care.

Information on how much money the National Health Service invested in structured education for diabetes patients is not collected centrally.

Under the Health and Social Care Act (2012), NHS England has a statutory duty to conduct an annual assessment of every CCG. Since April 2013, CCGs have been assessed twice, for the period 2013/14 and for 2014/15.

For 2016/17, NHS England will introduce a new CCG Improvement and Assessment Framework (CCG IAF). This new framework will align with NHS England’s mandate and planning process, with the aim of driving improvements in a number of key areas including the management and care of people with diabetes.

NHS England has been working with Diabetes UK on including diabetes indicators in the CCG IAF. The proposed diabetes indicators are:

- the percentage of diabetes patients that have achieved all three of the National Institute for Heath and Care Excellence recommended treatment targets; and

- newly diagnosed diabetes patients referred to, or attending, a structured education course.

Under the proposals, diabetes will also be one of the six clinical priority areas in the CCG IAF that will be overseen by an independent group.

The CCG IAF proposals are subject to the outcome of an engagement process which closed for comments on February 26 2016. More information can be found at:

https://www.england.nhs.uk/commissioning/ccg-improvmnt/