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  • Jan 15, 2019:
    • Breast Cancer: Women Over 73 - Question | Lords debates

      My Lords, has the department carried out any research-and if not, will it do so-into the number of women, like me, who were diagnosed with breast cancer on the final routine mammogram for which they were called? If the number is substantial, surely that indicates that the age range for the routine screening service should be extended, particularly in the light of the fact that we are all getting older.

  • Jan 9, 2019:
    • Brexit: Withdrawal Agreement and Political Declaration - Motion to Take Note | Lords debates

      I ask the government Whip to bear it in mind that the Government have unnecessarily shortened the speakers' list for tomorrow. If they had not done so, we would have several more minutes.

    • Brexit: Withdrawal Agreement and Political Declaration - Motion to Take Note | Lords debates

      My Lords, I did not speak in the first debate. The speaking time is advisory. A number of noble Lords who took seven minutes before Christmas have taken another seven minutes today. I have not spoken on these issues at all, and after 19 years in this House, I think I have a right to finish my brief remarks.

      Finally, to those who say another referendum would be divisive, I say this: what would be divisive is to allow a minority Government without the consent of the people to take us into a situation that would make us poorer and less influential in the world. That would be unprecedented, undemocratic and a betrayal of future generations and the will of the British people.

    • Brexit: Withdrawal Agreement and Political Declaration - Motion to Take Note | Lords debates

      My Lords, it may creep again. The noble Lord, Lord Hennessy, asked us to be optimistic. I would not be a Liberal Democrat if I were not.

      I have great respect for the House of Commons and am optimistic that next week honourable Members will do the right thing. They will vote against making their constituents poorer, damaging the future of their young people and removing this country's influence in Europe. They will vote against Mrs May's deal and reject the disaster of leaving the EU without a deal. Let us be clear, to use a favourite phrase of which the Prime Minister is so fond, especially when she is about to obfuscate: our economy would suffer both from her deal and no deal.

      Our economy is not just some economist's theory. It provides the means to protect the most vulnerable, the young who need education, the old who need care, the unemployed who need benefits and jobs, the poor who need affordable homes, the workers who need efficient transport to work and decent pay, and all of us who rely on the NHS. All this is threatened by every possible form of Brexit. It has become clear over the past two and a half years, to all who are not too blind to see it, that the deal we have as members, and could keep if we wish, is the best we could get with our biggest trading partner, neighbour and friend. Let us not be lured by the fantasy that we will negotiate beneficial trade deals around the world that would more than make up for loss of trade with the EU. This is a typical unicorn promised to the electorate by a campaign funded by money about which very serious legal questions are being investigated. Through our EU membership, we have trade deals, not just with 27 other countries, but with 88. All those would go if we left the EU without a deal.

      I respect the way in which Mrs May has tried to get a good deal while leaving the EU. But she became the architect of her own failure when she stated her red lines, which made it impossible for her to take us out of the EU without damaging our economy and curtailing opportunities for our young people. She has given two and a half years of respect to the "will of the people" as she puts it, although I find it hard to understand how someone who is so keen on the will of the people is so reluctant to ask them for it.

      Let us look for a moment at the will of the people. In 2016, those who would be most affected by the referendum were not allowed to vote: British citizens who were too young at the time but are now on the electoral register; British expats of more than 15 years, many of whose jobs or pensions will be at risk if we leave; and legal EU residents who could vote in local and European elections but not the referendum. All these people were disfranchised. Of this flawed electorate, just over a third voted to leave-17.4 million people out of a population of 65 million; about one in four of the population. On that basis, Mrs May is making the choice-yes, the choice-to lead us over a cliff edge when, as she knows it will be, her deal is rejected in another place.

      How do the public feel now that they could give informed consent, or not, to what this minority Government plan to do? We need to postpone Article 50 and ask the public by giving them a vote on the matter in a final say. I say a final say, not a "neverendum" as some Brexiters are suggesting, because most people would support the outcome of such an informed choice. The Prime Minister has said she wants to unite the country, a laudable aim. I can suggest to her a way in which she could do that because the deal she is proposing now will not do it. The solution is to put it to the people. We know what our current membership package is but what we might have in the future when she has finished negotiating our future relationship with the EU is vague. It is really a matter of trust, because the withdrawal agreement is only the beginning. After we have left, and are in a weaker position to negotiate, the Government will have to start discussing that future relationship within the laundry list-excuse me, the political declaration. Given the poor negotiating record of this Government, as demonstrated by the mess that is now on the table, do we trust in their ability to come out of the next five to 10 years with a set of good deals? I and most of the public think not.

      What the businesses that create our wealth require is certainty. The only certainty we would have if we left on Mrs May's terms is years of further negotiations following a short transition period during which we would be rule takers rather than rule makers. In other words, no certainty. If we left without a deal, there lies chaos, not certainty. The only way in which business can get certainty is if we do not leave and continue as a member of the EU with a voice, a vote and a veto. We would not have any of those under Mrs May's deal. "Ah", say the Brexiters, "but we would have full control of our borders, our money and our laws". Not true. Our borders would be jammed with trucks and we would lose all co-operation from France in the effort to stop illegal migration across the channel. We would be sending away valued EU citizens, who have been contributing to our economy and public services, in exchange for unknown migrants from elsewhere because we need immigration. As for our money, there would be less of it because our trade in goods would be knocked sideways. As for our laws, we would have no say in the 12% of our laws that originate in the European Union but, if we want to continue to trade with it, we would have to abide by its standards and regulations. To coin a phrase "No, no, no".

      I would prefer a voice, a vote and a veto about how the EU develops over the coming years. Europe wants our influence and we should be there wielding it because we will be affected by it whether we are a member or not. We will be affected by how it deals with mass migration, with crime, how its environmental policy develops, whether it thrives economically, and our security will be affected. We will be affected by the EU's politics, where already we are seeing dangerous right-wing tendencies. We will be affected by its attitude to us-risky, given that we still need to attract the brightest and best, even if we insist that we do not want those valuable people who earn less than £30,000 a year. Why give away a say in all that? It does not make sense, and now there is strong evidence that today's electorate believe that too. We have convincing polling results about what people want now. A YouGov poll of 25,000 people over Christmas showed that a majority want a final say, including 75% of Labour voters. When the choice is staying in the EU versus the Government's proposal, remain wins by 63% to 37%, a margin of approximately two to one. If the choice was remaining on current terms versus no deal, remain wins by 58% to 42%. The will of the people now is clear and must not be ignored. We should reject this deal and vote to remain in the EU.


  • Dec 20, 2018:
    • Brexit: Healthy and Nutritious Food - Question | Lords debates

      My Lords, given that 80% of vets in abattoirs are from the EU and that they are vital for the safety of our meat, will the Government look at the visa system prior to Brexit? I am told by scientists that the current visa system is long-winded, impenetrable and not fit for purpose. If the system cannot be understood by highly intelligent scientists, and if it takes many hours of their valuable time to bring members of their team into this country from abroad for scientific research, there is clearly a need for urgent radical improvement. Will the Minister ensure that that happens?

  • Dec 13, 2018:
    • Childhood Obesity - Question | Lords debates

      My Lords, is the Minister aware that food economists have calculated that, calorie for calorie, fruit, vegetables and high-quality proteins are much more expensive than foods high in carbohydrate and fat? Is it surprising that poor parents find that they have to fill up their children with those foods that eventually often lead to obesity? The structural underpinning of this problem is poverty, which goes much wider than the Minister's department. It should be a whole-government issue. What are the Government doing about that?

  • Dec 12, 2018:
    • Brexit: People's Vote - Question | Lords debates

      My Lords, the Minister said that a majority of the electorate had voted to leave the European Union. If I recall correctly, 37% voted to leave, 33% voted to remain and 30% did not vote at all. Ministers go around saying that 52% of the British people voted to leave the European Union-I heard Jeremy Hunt say that on TV the other day. Last time I looked, the population of the UK was about 65 million, and we keep getting told that 17.4 million people voted to leave the European Union. That is about one in four. Does the Minister not agree that Ministers should be a little more precise in their language?

  • Dec 5, 2018:
  • Nov 28, 2018:
    • Independent Inquiry into Child Sexual Abuse - Question | Lords debates

      My Lords, does the Minister accept that every week the Government delay in taking a grip on this issue means more young people having their lives destroyed? When they are considering their response, will the Government take account of the mounting evidence, added to only this week by evidence about the Catholic Church, that unless people are forced to report child abuse to external agencies, and report only within the agency concerned, very often these organisations will cover it up because they afraid of reputational damage? Will the Government take that into account?

  • Nov 27, 2018:
    • Local Government - Question | Lords debates

      My Lords, an important public service that has been and continues to be cut is public health. Directors of public health tell me that they can spend money extremely cost-effectively. Are the Government doing any research into the public health interventions carried out by local authorities, to let everybody know what works?

  • Nov 22, 2018:
    • Universal Sustainable Developments Goals - Motion to Take Note | Lords debates

      My Lords, I congratulate my noble friend Lady Suttie on the comprehensive and powerful way in which she introduced this debate today.

      I will start by quoting a sentence from a briefing I received this week, prior to this debate:

      "Failure to act on climate change now will significantly increase the difficulty of achieving many other SDGs, and will have serious consequences for the stability of global financial systems".

      This sentence could have come from any briefing from any organisation campaigning on climate or environmental matters, but it did not-it came from the Institute and Faculty of Actuaries. It cheered me a lot, because it indicated to me that climate change has developed from being something that only a few biologists and physicists were worried about to a mainstream issue that rightly concerns people in all walks of life. And of course it should, because it is affecting all of us right now, and will affect our children and grandchildren even more in future. The actuaries are quite right that action on climate change can assist us in achieving many of the other SDGs, from education to poverty, from water and sanitation to equality. They also reinforce my view that we need to bring forward our climate change objectives, from 2050 to 2030. We have not much time, and giving permission for fracking is the last thing we should do.

      The fact is that, even if we achieve the target of no more than a 1.5 degree rise in mean global temperature, given the rise we have already had, we will still have to face major negative climate events, changes in habitats, loss of biodiversity, poverty and mass movements of people. If we exceed that target, we will reach the tipping point beyond which we cannot stop it and, if that happens, I fear for the future of our species, as well as the rest of life on earth. So, even if we take a selfish point of view relating to our own species' survival, it is absolutely vital that we do everything we can to slow down and halt global warming. Every degree of change in global temperature makes it more difficult for the diverse life on this planet to survive. That should matter to all of us.

      The interdependence between human life and that of other species was illustrated very well in an item on Radio 4 yesterday, when they interviewed a researcher who had identified a gene in a species of fish which enables it to repair faults that arise in its own heart. Her work on this may help us understand, and indeed treat, heart disease in human beings. We rely on other species not only for our food, our clothing, our shelter, our arts and culture, cleaning up the air we breathe and reducing CO2 but for our health. The natural environment contributes to our well-being and mental health, as well as our economy. For these and many other reasons, we must halt climate change and not do a Donald Trump and stubbornly deny that it has anything to do with wildfires in Florida or, of course, flooding in Yorkshire. Can we hear about the Government's progress on action against climate change?

      The interrelationship between the various SDGs has been well illustrated to me in visits I have made to other countries. On a visit to India with UNICEF-one of those frontline NGOs referred to by the noble Lord, Lord Judd, and of which I have the honour to be an honorary fellow-I was shown women earning money maintaining the pump on the village well or manufacturing sanitation products. Through this work, they gained dignity and earned money to send their children to school, and the village got clean water and sanitation. When the children went to school, as well as education they got access to clean, safe toilets and clean water, lessons in hygiene and soap to wash their hands before lunch, and a child measurement programme that measured their development and identified malnutrition. In the homes, I saw stoves that used gas produced by biomass from animals and human waste, which prevented the women getting respiratory problems, which they used to get from burning smoky wood to cook indoors.

      In Madagascar, I saw the devastation of vast areas of highly diverse primary forest caused by burning trees to make charcoal for cooking, in a country with more sunshine than you could ever hope for and the highest percentage of unique indigenous species in the world. Species such as lemurs and special kinds of woods on the red endangered list were being illegally exported to China, against the Government's best endeavours. The problem is that you cannot blame the people for using what is there to survive. They are some of the poorest in the world and need to cook, eat, shelter and provide for their families, so they will sell what they can, use whatever is available for cooking and overharvest endangered species for food or medicine, without realising that they are killing the goose that lays the golden egg. It is for developed countries such as ours to use the expertise we have to help them make the most of the riches they have around them, their unique habitats and biodiversity. But here in the UK we face many of the same things. In our case, 15% of our species face extinction, mainly because of habitat loss and climate change. We may not know the value of what we have lost until it is gone.

      Many charities and universities are taking up the challenge. In Madagascar, we saw a project run by Kew Gardens, one of the world's leading botanic gardens working in plant conservation in this country and around the world. It is protecting a valley of primary indigenous forest using local labour, trained by expert botanists from Kew, to protect their environment. They earned some money for this, which alleviated their poverty and allowed them to avoid some of the environmental depredations. Kew needs money to provide the benefit of its experts to developing countries and to our own environment. In that respect, I am concerned that the government grant to Kew has been reduced. I wonder whether the Government can give me any hope that this situation might be reversed in the light of the work Kew does to help with the UK's contribution to SDG 15 on life on land, goal 13 on climate action and goal 11 on sustainable communities.

      I also saw a UNICEF project where children were rescued from the streets, having been left there by parents who could not afford to feed them. UNICEF was educating, feeding and clothing them but also trying to reunite them with their families and help them to get work. Here in the UK, as my noble friend Lady Suttie mentioned, we have thousands of children in food insecurity, whose parents rely on food banks and on breakfast clubs and holiday lunch clubs at schools. Universal school lunches in primary schools has been a great success and contributed not only to children's nutrition and physical health but to their education and mental health. Will the Government expand that programme? Poverty is caused by low wages or employment or benefit uncertainty. The Minister might like to use this opportunity to explain the current status of the review of universal credit.

      These few examples illustrate how interlinked the various sustainable development goals are, both here and abroad. Can the Government say what attention they are paying to the links between action on the goals and the individual goals? Sometimes spending on one can bring dividends in several other areas. After I had written the above, I saw the WWF briefing and its recommendations to the Government for the voluntary national review. I was interested to see recommendation 3:

      "The VNR should look at interlinkages between the goals, identify accelerators and develop plans to take them forward".

      All I can say is that I agree.

      This brings me to where I think the UK has failed most seriously in the way the SDGs have been implemented at home. We are not alone on this earth; we are not the only country and we are not the only species, and although we should help other countries, we need to do it all at home as well. Goal 3 is good health and well-being. Goal 10 is reduced inequalities. In this country, we have a shocking level of poverty, as clearly illustrated recently by the UN's rapporteur on poverty, and a high level of health inequality. We have a poor rate of perinatal mortality and child obesity and, as announced this morning, 10 times as many children suffering from type 2 diabetes than was originally thought. Finally, we now even have falling life expectancy. These two failures are closely linked. They are also linked to goal 1, eliminating poverty; goal 2, zero hunger; goal 4, quality education; goal 7, affordable clean energy; goal 8, decent work and economic growth; goal 11, sustainable communities; and goal 13, climate action.

      I think I have made my point: the health of the nation is a whole-government responsibility. I have long proposed a special high-level Cabinet committee on the health of the nation to which all other departments must report when developing new policies. Do they contribute to the health of the nation, or do they damage it? If they damage it, the department should think again. I still hope that the new Secretary of State for Health, with his understanding that the NHS will not be sustainable unless we focus more on prevention of ill health, will eventually come to the same conclusion. If he is not persuaded by me, perhaps he will be persuaded by this debate, which will show where we are failing and why it would be in the interests of all our people, now and in the future, for us to take a holistic view of health and well-being.

      The evidence shows that poor people do not eat well; they live in areas with higher air pollution, in houses which are often cold, damp and expensive to heat because they are poorly insulated. Because of their disadvantages, they achieve less in education and so are less well equipped with the knowledge of how to promote their own health and to get a good, stable job. Their access to junk food is high and their access to good public services is low. Their local authorities are so pressed for cash that they have had to close sexual health services, weight management services, drug, alcohol and smoking cessation services, swimming pools, sports centres and children's centres. All these impact most on the poor and particularly affect their health-QED.

      Will the Government now act to improve our performance against goals 3 and 10 by addressing goals 1, 2, 4, 7, 8, 11 and 13?

    • Inquiries Act 2005: Child Sexual Abuse - Question | Lords debates

      My Lords, what will the Government do to protect whistleblowers who expose child abuse and abuse in other areas but are subsequently hounded out of their jobs, lose their careers and often go into a lot of legal debt protecting themselves? Does she agree that instead of such treatment, these people deserve a medal for service to their country?

  • Nov 20, 2018:
    • Smart Meters - Question | Lords debates

      My Lords, is the Minister aware that if you have solar panels on your roof, you cannot have a smart meter? I know that because I have tried several times and have been told that I cannot have a smart meter if I have solar panels, which we are all encouraged to have. Does he agree that unless a smart meter is developed that can work with solar panels, we are never going to have smart meters in every household in the country?

  • Nov 19, 2018:
    • Breast Scans - Question | Lords debates

      My Lords, can the Minister encourage the NHS to do some proper research with the women who do not turn up for a mammogram when invited to do so and bear in mind that there is more than one reason why? In my case it is the very sharp edge of the plate that sticks under your armpit. It is really extremely painful. Will he agree that such discomfort should not discourage women from attending mammograms, which are so very important for saving thousands of lives, including my own?

  • Nov 15, 2018:
    • Domestic Abuse: General Practitioner Charges - Question | Lords debates

      My Lords, while supporting the concerns of the noble Lord, Lord Kennedy, perhaps I may point out that next week sees the International Day for the Elimination of Violence against Women. Will the Government celebrate the day and the end of austerity by funding more refuges and services for victims of domestic violence? This is necessary because during the recent years of austerity many refuges, which offered hundreds of safe places for women and their families, have been closed.

  • Nov 6, 2018:
    • Government Vision on Prevention - Statement | Lords debates

      My Lords, at last we have a Secretary of State who has been listening to my speeches over the years, or perhaps, more realistically, he has come to the same conclusion all by himself that the NHS is unsustainable with the changing demographics and higher demand unless we do something to prevent the 40% of illnesses that are preventable. I am therefore delighted to welcome the Secretary of State's new focus on prevention.

      However, he said in his speech yesterday that it is difficult to divert money into prevention unless funding is rising, because otherwise you will be taking money from treatment. Well, funding is rising. The Minister spoke about diverting part of the extra £20 billion for the NHS into prevention, but that is only part of the answer. This a whole-government problem. People do not live in hospitals or GP surgeries. They live in cities with polluted air, often in overcrowded and damp homes, in areas with too many fast-food outlets and too few fruit and vegetable shops where the local sports centre or swimming pool has closed. They are stressed about paying the bills on low wages or benefits.

      Then there are lifestyle decisions. Often when people are in their own homes or the local pub, they smoke or send out for a high-fat and high-salt takeaway or drink too much alcohol. Many do not take enough exercise. They are subjected to large amounts of TV advertising for the wrong kind of food and drink, and far too many ads encourage them to gamble. None of this is good for their physical or mental health.

      My point is that the organisations that can help them with this are often not the NHS or wider national government, although both can do a lot. I am speaking about local authorities, whose overall funding, particularly for public health services, has been cut since July 2015 and is projected to carry on being cut. Does the Minister think that this is in line with the Secretary of State's vision? There is evidence that sexual health services, sports centres and weight management services have closed. Smoking, alcohol and drugs prevention and treatment services have been discontinued. Does the Minister not agree that some of the new funding should be diverted from the NHS into local authorities and ring-fenced to allow them to reinstate and widen these services? Of course, NHS professionals must be involved, but this should come under the public health responsibility of local authorities, where it correctly lies.

      Councils run as many of these good services as they can but they cannot afford as many as are needed to stall the national epidemic of obesity and other preventable health problems. According to a systematic review of the available evidence, published online in the Journal of Epidemiology and Community Health, every £1 spent on public health saves £14 on average, as referred to by the noble Baroness, Lady Thornton. In some cases, significantly more than that is saved. We should listen to such a meaty piece of research. Local directors of public health claim that they can spend money more efficiently than the NHS to prevent ill health. Why not fund them to do so?

      Turning to two other matters, I applaud the Secretary of State's initiatives for people with learning difficulties; I strongly wish them well. However, the Minister will understand from my background in cannabis-based medicines that I am still very concerned about the too-restrictive guidance that has been published on prescribing pharmaceutical-grade cannabis-based medicines. It seems that there is still a bureaucratic nightmare for patients who thought that the Government's recent relaxation of regulations meant that their troubles were over. I fear we do not have time now to go into this in detail, but I welcome the intention expressed in the Statement to get it right. What further reassurance can the Minister give me that clinicians will be given the information from patients and other countries to enable them to make sensible prescribing decisions-not just for Sativex and Epidiolex? Can he assure me that it will not have to be done as a last resort when a lot of licensed drugs with nasty side-effects have already been tried unsuccessfully?

  • Nov 5, 2018:
  • Nov 1, 2018:
    • Cannabis: Medicinal Uses - Question | Lords debates

      My Lords, while it is true that the faculty warns against the use of dried cannabis plant of unknown composition, it accepts that there may be benefits to pain management from pharmaceutical products. Fortunately, that is exactly what patients are demanding and what the Government have just legalised. However, the faculty is also demanding that, while we wait for clinical trials, a database-which is essential to better understand these medicines-should be set up. Will the Minister support the setting up of this database and ensure that it contains the massive amount of lived evidence and experience available from patients?

  • Oct 26, 2018:
    • Health and Social Care (National Data Guardian) Bill - Second Reading | Lords debates

      My Lords, I thank the noble Baroness, Lady Chisholm of Owlpen, for introducing this important little Bill. From these Benches, we support it. Patient data is precious to each and every patient, and it is vital to the success of treatment that it is shared appropriately with those who have care of the patient. As the noble Lord, Lord Patel, said, it is also precious to the NHS as a resource for research into new treatments and for monitoring the effectiveness of existing treatments. As such, it has a value, which raises the ethics of how it is used by the NHS and others. These two aspects of data make it highly desirable that we have a person, backed by an office and adequate resources, who can establish best practice and ensure it happens.

      I agree with the noble Lord, Lord Knight of Weymouth, about the importance of knowing that we have proper and accurate data collection to enable us to exploit the enormous potential of artificial intelligence. When I left university more than 50 years ago, I worked at the Christie Hospital reading cervical smears. My job is now done much faster and probably more accurately by a computer, and there are many other opportunities to speed up diagnosis and make it more accurate. That is one of the many reasons why this Bill is needed.

      The measures that have been taken over the last few years, since the debacle of care.data, to protect patients' data and privacy have been very helpful, and I hope this latest step will go a long way to countering the lack of trust in some quarters which followed the data breaches of the past. Fundamentally, to have confidence in the system, patients should be able to know how data about them is used. That is necessary if the NDG is to be meaningful.

      Currently, many patients who want to see how data about them is used go to theysolditanyway.com. While it has a very negative title, it is not an official NHS site. The launch of the new NHS app would be a great opportunity for the NHS to make full and accurate information available to every patient. Patients understand how important it is that their data should be shared appropriately between health and care workers who are providing services to them. Indeed, it is highly desirable that all who have care of patients have relevant information on which to act. We have all heard of cases where this has not happened. I hope the Minister will be able to assure us that, with the safeguards that will be in place when this Bill becomes an Act, the quality, capacity and interoperability of IT provision in the NHS and care systems will be up to the job.

      However, patients are perhaps less aware of the value of anonymised data to researchers. Without access to it, medical research would be put back a long way. The first figures from the national data opt-out designed by the National Data Guardian are now available. They show that while hundreds of people made a consent choice each month using the online service, thousands of people did it at their GP. The latter option has now been taken away by Department of Health and Social Care. Is this the Government's idea of a successful digital service? Is it not vital to have an effective public information scheme so that patients understand the issues surrounding their consent, what is being done with their data and how to make their choice? The figures suggest that that has not been done so far, but it is early days.

      I hope that when the Bill becomes law the Government will be making an effort to explain to patients how their information is being protected and why they can now have confidence that when they allow their data to be used it will be done in an efficient and ethical manner in the interests of all patients now and in future.

      Turning to specifics, I think it is welcome that the NGD may not only issue statutory guidance but provide help and information to assist health and care organisations not just to comply but to achieve excellence in the way they handle patients' data and any constraints on their use of that data in generating income. Clause 4 provides that the Bill extends to England and Wales only. However, the Bill's Explanatory Notes state that Clause 1, which provides for the NDG to publish guidance and give advice, information and assistance, applies only in relation to the processing of health and adult social care data in England. Given that health is devolved in Wales, can the Minister please explain this for the record as it has been explained to me behind the scenes?

      I turn to the issue of cost. The Explanatory Notes state that the Bill may result in some,

      "implementation costs for the bodies and individuals required to have regard to the Data Guardian's published guidance, in that they will need to review and assess the relevance of the guidance".

      Given that NHS trusts, GPs, local authorities in respect of adult social care and so on are all under financial stress, what is being done to provide for these costs? It is not just a matter of assessing the relevance of the guidance, as the notes say; there may be a need to put in place new systems for ensuring that they are compliant with the guidance, and that also has a cost.

      In Committee in another place, Chris Bryant MP made the point that MPs often have confidential information about constituents' health given to them willingly by the patient when asking for help or making a complaint about their treatment, and that sometimes applies to Peers too. He asked whether the NDG would be able to advise MPs about the handling of this data even though they are not covered by the Bill. The answer from the Minister was not very helpful: she said she hoped health organisations would be open and helpful to their MPs about these issues. That is all very well, but it did not give Mr Bryant the assurance that he was seeking about help and guidance for Members, so can the Minister do so now?

      Having asked these various questions, I assure the Minister that we on these Benches are very supportive of this mainly uncontroversial Bill.

  • Oct 25, 2018:
    • Affordable Housing - Motion to Take Note | Lords debates

      My Lords, I will focus my comments on housing which is not just affordable to buy or rent but to live in. It is very tempting to think only of the capital cost of building new houses without considering the whole life cost of heating and maintaining it. By definition, people who need affordable housing are on low incomes and cannot afford the inevitable rising cost of energy. That is one reason for building and adapting houses that need little or no energy for space and water heating. The other reason is, of course, global warming and the need to hit our 2050 climate target well before 2050. Indeed, we should be aiming for energy positive, not just energy neutral, homes.

      Energy used in homes accounts for about 20% of UK greenhouse gas emissions, and three-quarters of that comes from heating and hot water. Eighty percent of the homes people will inhabit in 2050 have already been built, meaning that it is not possible to rely on new builds alone to meet legal energy-saving targets set in the Climate Change Act 2008.

      The Institution of Engineering and Technology has published a new report that highlights how the UK cannot build its way to a low-carbon future without retrofitting old, cold homes to meet 2050 climate targets. Deep retrofitting is a whole-house approach to upgrading energy efficiency in one step, as opposed to a series of incremental improvements. This includes: adding solar panels and local microgeneration, insulation and ventilation, and sustainable heating systems. It has identified the barriers to the development of a national programme of deep retrofit. They include: lack of customer demand; no effective policy driver for change, high costs per home, as there is not yet a supply chain that can deliver deep retrofits cost effectively, in volume, and at speed; and a lack of initial financing.

      The report calls for both national and local government to take the lead in encouraging and supporting the necessary changes, which include: consistent policy objectives and a national programme for deep retrofit and climate resilience, with an initial focus on social housing; reducing costs and building supply-chain capacity by developing pilot programmes; engaging with home owners to discuss the benefits of deep retrofit; and creating larger projects that are attractive to investors, by aggregating smaller projects into bigger blocks and introducing more flexible ways for local authorities to borrow and invest in such programmes.

      Affordable housing should be regarded as essential infrastructure: good-quality shelter is as important as food, mobility, healthcare and community. We simply cannot compete in a global sense if our housing infrastructure is inadequate and poor quality, but at present we fail on both counts.

      I will finish with three other, often disregarded issues. The first is progressive, integrated design and delivery models. A House of Lords report recently dealt with offsite and modern methods of construction. We have a tremendous opportunity in the UK to embrace a genuine culture shift away from construction as we know it, towards progressive, integrated methods, employing design for manufacture and delivery. This could be a game-changer, and move us from what is now an unattractive, backward-gazing sector, to one which attracts the brightest and the best, and moves forward in an exciting way.

      The second is making the most of the UK's renewable resources, particularly timber. We have untapped potential, with the development of UK-derived innovative timber products, which could safely replace plastics, steel and concrete, which are often imported. Not enough focus is being put into supporting R&D in this area.

      The third issue is the large, interconnected network of low-carbon and circular-economy industries, such as domestic-scale, micro-renewable technologies, which could emerge across urban and rural UK regions. This is particularly relevant to Wales, highland and south-west Scotland, but many other regions could contribute. I would be grateful for the Minister's comments on these three opportunities.