We store cookies on your device to make sure we give you the best experience on this website. I'm fine with this - Turn cookies off
Switch to an accessible version of this website which is easier to read. (requires cookies)
  • May 12, 2021:
    • Queen's Speech - Debate (2nd Day) | Lords debates

      My Lords, the gracious Speech made a very brief mention of the Government's intentions on health and care, but the recent White Paper was a little more helpful. Today I ask: why this and why now? There are three key reasons why I would rather have seen a draft Bill for consultation than the immediate introduction of the forthcoming health and care Bill.

      First, to integrate health and care, desirable although that is, without previously carrying out the long-awaited reform of social care is partial and unwise. It is like refurbishing one wheel of a bicycle while the other wheel is bent and rusty. For years, we have had a social care crisis. Provision is fragmented between public, private and third-sector providers, which makes consistency of standards and access to information difficult. It has been chronically underfunded for years, which makes for a lack of confidence on the part of both those who invest in it and those who need its services. Meanwhile, self-funders overpay to cover the shortfall in fees from cash-strapped local councils. This is unfair.

      Worst of all, because many settings have closed, there are fewer services available for those who need them. Those who may need services in future fear, as the noble Lord, Lord Rooker, put it-yes, really fear-what might happen to them, especially if they get dementia. About a million older or disabled people are already unable to get all the support they need. There have been many opportunities to work cross-party to correct this, sort out the funding and give a decent living wage to those who work in social care, but successive Governments have failed to grasp that nettle. In the gracious Speech, we were given nothing more than another promise to deliver what the Prime Minister told us two years ago was a ready plan.

      Secondly, a Bill that plans to reform a health and care system that is struggling to recover from a pandemic, without considering what state it is in and what lessons can be learned, is precipitate. One of the biggest issues, as I see it, is the staff. They are stressed and exhausted, yet they face an uphill struggle to deal with the backlog of treatment needs. The number of people now waiting more than a year for treatment has risen from 1,600 before the pandemic to almost 390,000. I welcome the recent NHS announcement of upfront money for a few integrated care services that present a cogent plan to increase their elective treatments to 120% of pre-Covid levels. This will help a few ICSs, but it is not universal.

      We started this pandemic with too few beds, too few doctors and too few nurses, and no more than a five-year staffing plan for the NHS. No wonder the staff struggled. Today, on International Nurses Day, I welcome the record number of students joining the nursing profession and those returning, but we now need an independent 10-year staffing plan for NHS and social care. Will the Minister please consider the necessity for that?

      Thirdly, we have a crisis in mental health. Demand was not being met before the pandemic; there were long waiting lists, especially for young people. Because of the pandemic, the situation is now much worse. I hope that, when deciding on the policy to reform and fairly fund social care, the Government will consult the sector, users and across parties.

      Implementation is another challenge, but here I think we have a good example. People have rightly praised the vaccine rollout. The Vaccine Taskforce and the thousands of NHS workers and volunteers who have delivered the vaccines so brilliantly invented by Oxford University and other scientists have done a wonderful job. I believe the vaccine rollout has been a success because of two things from which we can learn: mission focus and a "whatever it takes and whatever it costs" attitude from government. That focus and that investment are needed to sort out the three crises of social care, mental health and the waiting lists. It will be cost-effective in the end, because it will reduce the pressure on acute hospitals. We need this before we try to implement the reforms in the Bill, many of which I would probably happily support at the right time. I ask the Minister whether the Government will withdraw the Bill for consultation and bring it back when they have sorted out the crises in social care, mental health and NHS and social care staffing.

  • Apr 21, 2021:
    • Covid-19: Obesity - Question | Lords debates

      My Lords, can the Minister assure me that the Government will not renege on their promise to ban the advertising of high-fat, high-sugar and high-salt foods online? Will he ignore the objections of junk food producers and advertisers, and remind them of the similar ban on Transport for London when the amount of advertising actually went up? Reformulated and low-calorie options generate revenue too.

  • Apr 16, 2021:
    • Botulinum Toxin and Cosmetic Fillers (Children) Bill - Second Reading | Lords debates

      My Lords, I thank the noble Baroness, Lady Wyld, for bringing us the Bill, and I support it as far as it goes. However, I would like assurances that, using the powers to make regulations in Clause 5, the Government will ensure that, for the most part, botulinum toxin procedures on under-18s do not take place at all, even by a clinician.

      We live in a world where young people, particularly girls, are under great peer pressure about their appearance and their weight. Undertaking a dangerous procedure such as this is not necessarily the answer. If the matter affects the mental health of the young person, it should be treated as a mental health issue, not with Botox.

      The charity Changing Faces has provided us with the voices of young girls affected by "visible difference". One said, "Everywhere I looked, clear-skinned models told me the same thing. I never saw a public figure that looked like me and I felt totally alone. I spent hours researching various scar removal surgeries and extreme treatments and started saving for them." These young people require support, information, the attention of professionals and the protection of the law.

      When the Bill was debated in another place, amendments were tabled to ensure that medical practitioners could provide non-surgical cosmetic procedures to a person under 18 only if it was medically necessary. I agree with this. There may be situations where facial disfigurement from whatever cause is causing physical or mental distress to the patient and for which botulinum toxin is considered by a doctor to be the appropriate treatment, rather than more intrusive cosmetic surgery. In such cases, regulations could be used to lay down those matters which should be considered before a clinical decision is reached.

      Laura Trott MP, the sponsor of the Bill, argued that it already had safeguards to ensure that under-18s would receive these procedures only where medically necessary. The Minister, Nadine Dorries, agreed that there would be a review of the regulations to assess any unintended consequences. I would like an assurance that this review will consider regulations to restrict the use of this procedure except in certain clearly defined conditions of medical need.

      I am aware that GMC guidance says that doctors performing cosmetic interventions can provide treatment to children only when it is deemed to be medically in the best interests of the patient. However, I would like to see the Government making their intentions clear in regulations that under-18s should not receive this treatment except where strictly medically necessary. I would also like the Minister's assurance that mental health support will be provided to patients in this situation where appropriate.

  • Mar 25, 2021:
    • Covid-19: One Year Report - Motion to Take Note | Lords debates

      My Lords, I support the regret Motion from my noble friend Lady Brinton and echo the thanks that she gave. She highlighted how the Government have failed, which is why we should not trust them by giving them a blank cheque on our civil liberties. I also agree with points made in the Motion of the noble Baroness, Lady Thornton.

      The issue underlying both regret Motions is the incompetence of this Government in their handling of the pandemic. That is why it is the Government themselves who should be amending this Act, since we are unable to do so. There has been a failure to plan and prepare, decisions have been taken at the wrong level, there has been an overreliance on private sector providers at enormous cost and there have been failures of transparency and providing for democratic scrutiny.

      It is incompetent for Governments not to plan properly. This involves horizon scanning and putting measures in place to adequately respond to identified risks. The horizon scanning by the national security risk assessment happened and still does, but a recent study by the Centre for the Study of Existential Risk made several criticisms and recommendations. One criticism was that there is no process, body of expertise or oversight mechanism in place to ensure that departments' risk plans are adequate. That had fatal results in the case of this pandemic.

      The study also concluded that the UK's pandemic influenza strategy, which was fairly detailed, did not make any plans for a lockdown, despite this being one of the dominant response strategies for Covid-19. Can the Minister give the Government's response to this serious analysis and say how they plan to learn lessons about planning our risk identification and response in future? Simple mistakes were made, such as failing to ensure that stocks of PPE were in date and fit for purpose.

      It is incompetent not to provide adequate basic resources for worst-case scenarios. We started this pandemic with 11,000 too few hospital beds, 5,000 too few doctors and 40,000 too few nurses. We had a fraction of the number of ICU beds and ventilators of other European countries, which is probably why our death rate is one of the highest in the world. Do the Government plan to provide the resources to correct this?

      It is incompetent not to care for the most vulnerable in society, for whom the consequences are most serious. For example, it is extraordinary that the DHSC did not realise that sending older people back to care homes to clear hospital beds without first testing them for the virus was catastrophically dangerous. Many deaths occurred in the closed environments of care homes at the beginning of the pandemic that have never even been recorded as Covid deaths-people did not have a test, even when they fell ill. The death rate in care homes was double the rate in the wider community. It was incompetent not to provide care homes with PPE at the start and it was not true to say that care homes were safe-they were not.

      The so-called NHS app was incompetent from start to finish. The first system did not work and was replaced. The second system did not pass on information about Covid hotspots to the authorities. People were advised by the app to isolate because of contact with a positive case, but they were not entitled to the £500 support at first, unless they also had a call from another authority -people did not know that because of incompetent communication.

      Then there is test and trace-an exemplar of the biggest incompetence of all, which is making decisions at the wrong level. The Government relied on central decision-making and provision, aided by expensive management consultants and private companies, instead of devolving responsibility and decision authority to local government, where the skills and experience could do the job better. Indeed, in the end, when they started to get the necessary information, resources and authority, local authorities proved this very decisively. As the noble Baroness, Lady Bennett of Manor Castle, mentioned, management consultants have been marking their own homework and are being paid to do tasks that should be undertaken by civil servants as part of their job. We need answers about this. It was incompetent to delay taking action when advised to do so by scientific advisers. That was probably the most fatal incompetence of all.

      Finally, it is incompetent not to understand your own Act of Parliament. It is not true that failure to renew this Act would remove good things such as the furlough scheme and measures to keep us safe, as some government spokesmen have suggested. That is not what this is about. It is about a blank cheque to control our civil liberties and reduce democratic scrutiny. We will not give that to anyone, especially not this incompetent Government.

  • Mar 22, 2021:
    • Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021 - Motion to Regret | Lords debates

      My Lords, the noble Baroness, Lady Thornton, raises several serious issues. She is right to criticise the delay in acting following scientific advice. Sadly, slowness to react has been a feature of this Government's handling of the pandemic and has probably contributed to the fact that we have almost the highest death rate of any country in the world. The fact that the regulations failed to prevent the Brazilian variant coming in indicates that they are ineffective, unmonitored and not supported.

      It is illogical to force travellers coming directly from red-list countries to isolate in a hotel while allowing those from the same countries, via a short stop in a third country, to isolate at home. I have to accept that the only way to ensure that people do isolate is to ensure that they go into suitable accommodation, with proper support. Since the Government have not provided that, the very least that they should be doing is monitoring that those who are supposed to isolate at home are doing so-but microscopically little of that has been done. Why?

      There is also the issue of support. No amount of pre-travel testing will get over the fact that many travellers, like others who are asked to self-isolate for other reasons, are not able to do so. The reasons are usually financial but may be caring responsibilities. These Benches have been calling for many months for paying people their wages to enable them to isolate, but our appeals have fallen on deaf ears. To get the benefit of the NHS vaccination programme, we must do more to prevent variants coming in. Will the Government now look carefully at the evidence from other countries that have put all travellers from abroad into isolation accommodation? It worked at the beginning of the pandemic, when passengers from a cruise ship with an outbreak were isolated in vacant nurses' accommodation on the Wirral. It could work now.

  • Mar 15, 2021:
    • Amendment 82 | Domestic Abuse Bill - Report (3rd Day) (Continued) | Lords debates

      My Lords, I am sorry; I had not realised I had been called and did not hear the Deputy Speaker.

      I am most grateful to the noble Baroness, Lady Bennett, for seeing the opportunity to bring this really important issue before your Lordships again. As she said, now is a very good time to return to a subject I first raised in your Lordships' House 20 years ago, soon after I was introduced as a Peer. The time was right then, and it was also right when a group of us tried unsuccessfully to completely remove the reasonable punishment defence during the passage of the Children Act 2004. It is even more right now, as violence against children has increased during the Covid-19 pandemic. Any time is a good time to stop violence against children.

      The fact is that if this country cannot give its children equal protection under the laws of assault, such as their parents enjoy, it cannot say that it values its children and protects their rights. The committee on the UN Convention on the Rights of the Child agrees and has been very critical of the UK. Public opinion also agrees: 20 years ago, 80% of the public thought it should be illegal for anyone to hit a child. Indeed, many thought it already was. I suspect it is even higher now. Most people think violence against a child is a particularly egregious act, especially when it happens in a child's own home, from which she cannot escape, and is done by someone she should be able to trust to protect her.

      Of course parents have a right to bring up their children to behave well, but there are many more effective ways of demonstrating right and wrong. In the 58 countries where the law bans parental violence against children, parents have been helped to learn better ways of carrying out their duty to discipline their child. It is often called "positive parenting". Violence against a child is definitely negative parenting, and most young parents today agree and would not dream of hitting their child.

      As the noble Baroness, Lady Bennett, has said, children learn by example. Parents who beat their child cannot be surprised if the child copies that behaviour and hits other children in the playground and, because violence begets violence, they may also grow up to beat their own children. Violence is also detrimental to the development of the child and should be regarded as an adverse childhood event-an ACE-deserving of intervention.

      Recent research supports a ban on hitting children. A large long-term longitudinal study by Ma, Lee and Grogan-Kaylor, published in the Journal of Pediatrics in February, of a range of adverse child experiences with particular focus on violence against children, reached the following conclusion:

      "ACEs and spanking have similar associations in predicting child externalizing behavior. Results support calls to consider physical punishment as a form of ACE. Our findings also underscore the importance of assessing exposure to ACEs and physical punishment among young children and providing appropriate intervention to children at risk."

      In other words, they found that hitting children does not stop them misbehaving; indeed it can make it worse and has an adverse effect on their development, so services with a duty to protect the child should intervene to stop it. That starts with the law of the land. In the UK, we have already acknowledged that a child who watches violence against its mother in the home is at risk of mental and emotional trauma. How much more trauma will a child suffer who is treated to the same violence himself or herself?

      We all want to help parents with the hardest of tasks-bringing up a child healthy and happy-but the current law does not do that. It is discriminatory to children and unhelpful to parents. Hitting a child hard enough to cause a bruise is illegal, but some children do not bruise easily, so could be hit harder without the parents breaking the law. How does a parent know how hard they can hit a child before overstepping that limit? Of course, the answer is not to do it at all and find a better way that does not damage the child you love. The law is nonsense and must be changed.

      People have realised this in other countries, including the other three in our own union. Scotland has banned and Wales is about to ban violence against children, and Northern Ireland is looking at it. It is instructive to look at how other countries did it; there is a common approach. When I was in New Zealand, I heard directly from the Minister there about how a lot of help was put in place for parents to learn better ways of disciplining children before removing the very damaging option that we are discussing today. Help with positive parenting and someone to turn to for advice-we need to do that too. It is not that difficult or expensive, but the benefits are enormous for families.

      I have a final point. Sweden was the first country to ban parents from hitting children, over 40 years ago, yet Swedish prisons are not and were not full of caring parents who occasionally lost their temper and gave their child a trivial smack. By the way, most parents who do that regret it very much afterwards. Those who fear criminalising otherwise caring parents should remember that the CPS will charge someone with a criminal offence only if the situation meets two tests: first, there is a good chance of obtaining a conviction and, secondly, it is in the public interest. The situation I have just described would not fulfil those tests. However, the law on assault should be clear, helpful to parents and fair to children.

      The Government need to show leadership here. When Sweden banned hitting children in 1979, there was not a majority of public opinion in favour of the change, as there is here, but its Government went ahead and did the right thing anyway. Now, Sweden could not get away with legalising hitting children as, I am pleased to say, strong public opinion would prevent such a move. I beg the Government to show similar leadership and accept this amendment, or do I have to spend another 20 years campaigning for it?

  • Mar 11, 2021:
    • Offshore Gas Rigs - Question | Lords debates

      My Lords, I declare that a family member works in the oil and gas industry. The Oil and Gas Authority's policy on flaring is to ensure that the flare and vent volume requested for permission is at a level where it is "technically and economically justified". Why is the word "environment" not included in this policy?

  • Mar 8, 2021:
    • Covid-19: Care System - Question | Lords debates

      My Lords, teenagers with learning disabilities in residential care homes have not had as much focus as older people. It was months before these homes received enough PPE, and testing was very slow. There was no comprehensive programme for their care and education. What measures are now in place to ensure equality of care and resources between younger people and older people in care homes?

  • Mar 4, 2021:
    • COVID-19 Vaccine Certification - Question | Lords debates

      My Lords, in considering whether to introduce vaccine certification, will the Government consult organisations representing patients who have been advised by their clinician that it would not be in their interest to take the vaccine? How would such patients be able to navigate a world in which vaccine certification was widely used?

  • Feb 24, 2021:
    • Covid-19: Vaccination Programme - Question | Lords debates

      My Lords, the vaccine programme certainly is going well, but there is evidence that some groups are being left behind. One such group is housebound people. Although they cannot leave their homes, carers and family come in, which opens them up to infection. Why does NHS England not record the number of housebound patients who have received the vaccination? What is being done to speed up their vaccination? The other group is people in poor areas and demographics. What is being done to correct this?

    • Covid-19: Vaccination Programme - Question | Lords debates

      To ask Her Majesty's Government what assessment they have made of the progress of the COVID-19 vaccination programme towards meeting its (1) delivery targets, and (2) objectives.

  • Feb 16, 2021:
  • Feb 11, 2021:
    • Dentists: Covid-19 - Question | Lords debates

      My Lords, do the Government plan to continue to enforce activity targets in the next financial year? The new contract is only seven weeks away, and those in the profession has heard nothing about the basis on which they will be paid next year. When do the Government plan, at last, to deliver wider NHS dental contract reform, which they committed to in 2010? The issue keeps being kicked into the long grass.

  • Feb 10, 2021:
    • Covid-19: Self-Isolation - Question | Lords debates

      Does the noble Lord the Minister dispute the figure quoted by my noble friend Lord Scriven about the number cutting short their isolation, or is he just planning to ignore it? Does he accept the figure from local authorities that two-thirds of applicants for the £500 do not receive it? Does he therefore agree with me that most of those who apply for it actually need it to help them do the right thing?

  • Feb 3, 2021:
    • National Risk Register - Question | Lords debates

      My Lords, Professor Dame Sally Davies, the UK envoy on anti-microbial resistance, is calling on academics, Governments and not-for-profit organisations to work together to tackle this global health risk, which is a threat to both lives and economies. What action have the Government taken and what are their plans, following the recent update of the noble Lord, Lord O'Neill, on his 2016 review on this issue?

  • Jan 27, 2021:
    • No-fault Evictions - Question | Lords debates

      My Lords, campaigners have asked for a coronavirus home retention scheme of £750 million in support to be made available to help renters in arrears, recover loss of income and avoid rent debt. Have the Government conducted a cost-benefit analysis comparing such a fund with the potential cost of making many families homeless because of rent arrears?

  • Jan 25, 2021:
    • Trees - Question | Lords debates

      My Lords, the Corporation of London has warned against focusing just on increasing numbers of trees and thereby ignoring the role of wood pasture and slow-growing, long-lived landscape trees, which sequester more carbon than equivalent areas of woods plus pasture. Is this fact being taken into account as well as the amenity value of such areas?

  • Jan 20, 2021:
    • Covid-19: Early Years Sector - Question | Lords debates

      My Lords, even before the pandemic, 65% of children in some areas were not receiving the mandated two-and-a-half-year health visitor check because of cuts to the workforce. Will there be any additional resources for the health visitor workforce to help them to catch up with missed visits to vulnerable young families during the pandemic?

  • Jan 19, 2021:
    • Health: Eating Disorders - Question | Lords debates

      My Lords, the eating disorder faculty at the Royal College of Psychiatrists has recently reported that eating disorder teams are being asked to ignore the NICE guidelines for treatment as being unrealistic and too expensive. Will the Minister either justify this or condemn it?