House of Commons
Prayers
09:34 - The House divided: - Ayes: 0 / Noes: 45 - Question accordingly negatived.
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Jonathan Gullis (Stoke-on-Trent North) (Con)
I beg to move, That the House sit in private.
Question put forthwith (Standing Order No. 163)
Sarah Jones (Croydon Central) (Lab)
On a point of order, Mr Speaker, I want to raise comments made on Monday by the Prime Minister, who I believe inadvertently mislead the House. On Monday 31 January, the Prime Minister said in this place that
“we have been cutting crime by 14%”.—[Official Report, 31 January 2022; Vol. 708, c. 24.]
Again on Monday, he said:
“What we are actually doing is cutting crime by 14%”.—[Official Report, 31 January 2022; Vol. 708, c. 50.]
The Prime Minister was referring to the national crime statistics, which were published on 27 January.
In a letter to the right hon. Member for Orkney and Shetland (Mr Carmichael), the UK Statistics Authority said that
“the Prime Minister referred to a 14% reduction in crime, which is the change between the year ending September 2019 and the year ending September 2021. This figure also excludes fraud and computer misuse, though the Prime Minister did not make that clear. If fraud and computer misuse are counted in total crime as they should be, total crime in fact increased by 14% between the year ending September 2019 and the year ending September 2021.”
The ministerial code states:
“It is of paramount importance that Ministers give accurate and truthful information to Parliament, correcting any inadvertent error at the earliest opportunity.”
It seems clear that the Prime Minister inadvertently mislead the House, and I would be grateful for your advice, Mr Speaker, on how he might at the earliest opportunity correct the record.
Mr Speaker
First, may I say I am grateful to the hon. Lady for giving notice of her point of order? She may be aware that the issue was raised by the hon. Member for North East Fife (Wendy Chamberlain) yesterday. I repeat what was said in response to that point of order. Although the Chair is not responsible for the content of contributions made by Ministers, I am sure that the concern was heard by those on the Treasury Bench. If an error has been made in this instance, I am sure that the Prime Minister will seek to correct it as quickly as possible. She will no doubt also be aware of paragraph 8.15 of the ministerial code, which deals with the use of statistics. I am sure she will find ways of pursuing this issue, should she wish to do so.
Animals (Penalty Notices) Bill
Friday 4th February 2022
(2 years, 9 months ago)
Commons ChamberRead Full debate Animals (Penalty Notices) Act 2022 View all Animals (Penalty Notices) Act 2022 Debates Read Hansard Text Read Debate Ministerial Extracts
Andrew Rosindell (Romford) (Con)
I beg to move, That the Bill be now read the Third time.
I thank you, Mr Speaker, and all Members in the House who have joined me today to help me bring my Bill to its remaining stages on the Floor of the House. I also thank the Public Bill Committee, which considered the Bill in detail on Wednesday 8 December last year. The discussion was insightful, and I appreciate the careful and detailed consideration that has gone into the process so that the Bill can today reach this point.
It is clear that we are truly a nation united by our love of animals, and my Bill has attracted strong support from all parties in this House and, most especially, from animal welfare organisations across the country. I am pleased that it has progressed through the House without a single amendment and that Members on both sides of the Chamber value not only its spirit but its content.
I am delighted by the energy shown by so many in ensuring that we get the Bill absolutely right so that it has the best possible impact on animal welfare across the country. Important conversations have been ongoing throughout its passage involving all parties in the House and key organisations outside. Ultimately, that has allowed the Bill to arrive at this final stage.
As you will know only too well, Mr Speaker, I have, like you, been an advocate for the protection of animals my entire life, and particularly during my 20 years as a Member of Parliament. My own dogs were Staffordshire bull terriers called Spike and Buster and they were the best companions anyone could have wished for. They campaigned for me in every general election, sporting their famous Union Jack waistcoats. I have fond memories of my hon. Friend the Member for Buckingham (Greg Smith) looking after Spike during the 2001 general election, and I am delighted that he is in the Chamber to support my Bill.
As we love our country, we also love our animals. From my experience of speaking to constituents and working closely with animal welfare charities, I know the joy that animals can bring. Protecting animals should unite us all. We have a duty of care to the animals that we are privileged to live alongside—household pets, wild animals, farm animals and all creatures of land, sea and sky.
Greg Smith (Buckingham) (Con)
My hon. Friend mentions farm animals. I do not know of any farmers who deliberately mistreat their animals, but sometimes false accusations are made against them. There is some concern in the farming community about the appeals process if they are given a penalty charge notice. Will he assure the House that there is a robust appeals process in his Bill?
Andrew Rosindell
There absolutely has to be, and my hon. Friend is right to raise that point. The purpose of the Bill is to deal with fairly minor offences and act almost as guidance. It is not there to deal with serious offences, which would still be handled through the usual process. I take on board his point that when false accusations are made there must be a robust appeals process, and I know that the Minister will take that on board in dealing with any secondary legislation. I thank my hon. Friend for his intervention.
Our dearly missed friend and departed colleague, Sir David Amess, shared my view on the Bill. He shared all my views on animal welfare and was the greatest champion of the issue among Members of Parliament. He dedicated his life to that. We think of David today, on the first day of a new Member, my hon. Friend the Member for Southend West (Anna Firth). We wish her all success as David’s successor, but no one could replace David. He was unique, and we think of him all the time. His stance on animal welfare never changed throughout his 38 years in Parliament. In fact, he introduced a private Member’s Bill in 1998 that strengthened protections for horses tethered by the roadside, and through his tireless campaigning inspired so many others to continue the fight for strengthened protection for animals. We remember him as we carry on the fight to defend and protect animals throughout the United Kingdom.
It has been an honour to have the opportunity to introduce a Bill that I believe will make a real difference to the lives of animals and help promote greater understanding of welfare. This Bill will directly benefit the health and welfare of this country’s farmed and kept animals and will increase accountability when our country’s biosecurity is put at risk. The Bill introduces enabling powers so that we can apply penalty notices to the appropriate offences and establishes the framework crucial to introducing these penalties through statutory instrument. Penalty notices will bolster our existing enforcement measures and give enforcement authorities more options to influence positive behaviour when it comes to caring for our farmed and kept animals, including companion animals and zoo animals.
As chair of the zoos and aquariums all-party parliamentary group, I recognise that this is a welcome development for that sector. Having worked very closely for so many years with the excellent British and Irish Association of Zoos and Aquariums, which does so much for zoos and the care of animals in zoos and aquariums across the country, I know that it agrees that penalty notices are the right way forward. The debate in Committee highlighted the wide support for the Bill and what I believe it will achieve. I have held ongoing discussions with various non-governmental organisations, and I am delighted that there is a strong consensus that penalty notices will benefit this country and should be introduced. I share the same enthusiasm and excitement for this legislation, which I truly believe will be a gain for animal welfare across this country.
I am also grateful to the organisations that have already invested their time in engaging with myself and the Department for Environment, Food and Rural Affairs to consider the Bill and how it will work for them in practice, and sharing their views so that we can make the Bill as effective as possible. The support of the Royal Society for the Prevention of Cruelty to Animals, Battersea Dogs and Cats Home, the National Farmers Union, Blue Cross, Cats Protection, the National Sheep Association and the National Pig Association, as well as many other animal welfare groups across the country, has been invaluable.
I once again thank hon. Members here today for supporting this landmark Bill, and for the many contributions made at its previous stages. I hope we can agree that this important Bill should progress today, so that it may continue its journey in the House of Lords under the stewardship of the right hon. Lord Randall of Uxbridge, who has agreed to champion my Bill in the other place. The wellbeing and safety of animals is something that I know matters to us all, so as a nation of animal lovers, let us continue to lead the world in enhancing the cause of animal welfare.
I would like to place on record my sincere thanks to the Minister who is not here today, the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Bury St Edmunds (Jo Churchill). She has done so much to support my Bill, and has been very dedicated in helping to ensure that the Bill has reached this stage. It has been my pleasure to work with her to ensure that this new legislation has arrived in this place today, and I thank the Minister in her place—the Minister for Farming, Fisheries and Food, my hon. Friend the Member for Banbury (Victoria Prentis)—for standing in and leading in today’s debate.
I would also like to thank those organisations and Members who have provided such valuable care to animals for vocalising their support for this Bill and giving me full confidence that penalty notices will be a welcome addition to the enforcement of animal welfare when they become available.
Lia Nici (Great Grimsby) (Con)
I thank my hon. Friend for bringing forward this very important Bill. I think members of the public listening or watching might be surprised that this kind of Bill needs to be brought in. What changes will it make to improve the situation and assist us in making sure that people are not being cruel to animals?
Andrew Rosindell
My hon. Friend makes a really important point, because we need to understand the purpose of this Bill. At present, enforcing breaches of animal welfare laws means having to prosecute, so it takes a long time, and involves going to court and all those processes. However, many offences are very minor—mistakes that individuals may have made inadvertently—so, a bit like a parking ticket, the penalty notices are a way of informing people, when they have not done something very serious, that they need to do things better in future. The Bill will give the enforcement authorities greater powers to deal with minor offences speedily, rather than having to go through long processes. Of course, some of those cases will never be prosecuted, because in effect time runs out; there is not enough time to deal with the issue. This Bill will be really effective as a way of dealing with such cases quickly. That is really the nub of the Bill; it will increase the powers in animal welfare laws and make them a lot more effective. I thank my hon. Friend for her intervention, and hope I have explained the background clearly to her.
This Bill will fundamentally reform how we enforce animal welfare, biosecurity and welfare across farmed and kept animals in England. I hope other parts of the United Kingdom will follow suit when this Bill becomes legislation. I believe it will improve this country’s response to offences and strengthen our position as a world leader in the welfare of animals, with whom we are privileged to share this planet. I sincerely hope that we will see it placed on the statute book in the very near future. This is a good Bill that will improve the lives of animals and guide the people of this nation towards better protection and welfare of the animals we all care so much about, and I commend it to the House.
Stuart Anderson (Wolverhampton South West) (Con)
Thank you, Mr Speaker, for calling me so early in the debate. I think we can all agree that my hon. Friend the Member for Romford (Andrew Rosindell) has brought a hugely important Bill to the House. It shows that cruelty to any animal will face serious consequences, and he should be commended for such a worthwhile Bill. If my hon. Friend will bear with me, he is, if I have got this right, the chairman of the all-party parliamentary group on zoos and aquariums, a former shadow Minister for animal welfare, and a committed advocate for the care and protection of animals. He speaks with great experience and authority, so I will be delighted to support this Bill, which will crack down on animal offenders and establish a more consistent, targeted approach to protecting all animals from harm.
I need to be clear that animal cruelty has no place in our society, and I am so delighted that this Bill will close the gap that is being exploited by cruel animal abusers. The Bill has received significant backing from key stakeholders, as my hon. Friend has said, including the RSPCA, which has said that the measures would help to combat the suffering of farmed animals, horses and animals kept in zoos. I welcome the assurance that the animal cruelty offences will always be prosecuted and that penalties will be used in conjunction with tougher sentences to provide better safeguards for all animals. This Bill will provide a welcome powerful additional enforcement tool, providing authorities with an extra measure that could be used alongside warnings and criminal prosecution. I support this Bill, because it builds on the Government’s decisive actions to improve our already world-leading animal welfare standards, including raising the maximum prison sentence for animal cruelty.
Just months after being elected, I met, as did many other Members, Finn, a former police dog who was attacked while pursuing a suspect. Finn’s story convinced me—not that I needed much convincing—of the need to increase the maximum sentence from six months to a more respectable five years. I met many service animals in my time in the armed forces, and I know that they not only work hard but that their actions have saved many lives. I remember when serving in Northern Ireland in the troubles doing 5 metre and 10 metre checks: when walking along a street, every time we stopped we had to look around to check for improvised explosive devices and command wires. We were always nervous doing that and when we had sniffer dogs with us that could smell any explosives a mile away we felt safer straight away.
In 1999, I deployed to Kosovo for the conflict. We were living in very harsh conditions, working 20 to 22 hours a day on average and living in derelict buildings at the start. We were shattered for much of the time. I remember my patrol coming back in one day and meeting one of the attack dogs—war dogs—in the operation rooms. Most of my blokes were too tired to eat, but as we walked in and came face to face with one of the British Army’s finest attack dogs, who certainly made us aware that we had got too close to him, we were all wide awake straight away.
More seriously, a friend of mine who was serving in the British special forces in Afghanistan was, unfortunately, shot in the neck and killed. As a result, the Special Air Service decided to use dogs as members of their team, so they have become an extra member of their team in operations. From knowing some of the people who have used these dogs on operations I can say that they have saved countless lives. Those are some of my personal experiences, where I have seen the love for animals and where they have saved human lives.
I also support this Bill because it provides an important educational tool that can be used before offences become more severe and can prevent offenders from repeating their mistakes—let us educate people on this issue. As a local MP, I want to do all I can to ensure that Wolverhampton becomes a safer place to live, work and visit for everyone, and that includes all the animals that co-inhabit it.
Matt Vickers (Stockton South) (Con)
I pay tribute to my hon. Friend the Member for Romford (Andrew Rosindell) for doing so much to further the case for animal welfare: as a former shadow Minister for animal welfare and the chair of the all-party group on zoos and aquariums, he is an advocate like no other. They say that dogs are a man’s best friend; it is no stretch to say that my hon. Friend is one of the UK animal population’s best friends.
One of my best friends is a sassy little bitch called Karen, a pomeranian chihuahua, or pomihuaha. She is a very small dog with a very big personality—the ultimate companion who can cheer me up at the end of a long day and bring a smile to my face in the toughest of times. Through my time with Karen I am reminded of the special place our pets and animals have in our homes and hearts, why Britain is a proud nation of animal lovers, and why it is so important that we protect our furry friends.
I am very proud that our Government are striving to ensure our animal welfare standards continue to be world leading. We have had the Animal Welfare (Sentencing) Act 2021, or Loder’s law, which has increased the maximum prison sentence from six months to five years for those who harm animals, and a new offence of pet abduction to tackle the sick and depraved individuals who would steal someone’s cherished pet and deprive them of an often-priceless relationship. We also have the Animal Welfare (Kept Animals) Bill tackling puppy smuggling and the export of live animals for slaughter. My hon. Friend’s Bill will bridge the gap between criminal prosecution and warning letters so that action can be taken and sanctions issued straightaway to protect our animals’ health and wellbeing.
In this country, we have an incredible farming community who go above and beyond to care for their livestock. We also have an amazing network of zoos that delivers incredible educational opportunities for youngsters and protects and cares for exotic and rare species to high standards. In our own homes, we are a nation of animal lovers. People across Britain love, cherish and adore their furry friends and family members, but how do we deal with the small minority who do not provide that level of care?
There is currently a gap in the powers available to deal with those people and in some cases we fail to provide a fair, firm, proportionate and prompt response before reaching the threshold for prosecution. It is devastating that last year the RSPCA received 57,000 complaints of animal cruelty. The Bill will provide the penalties and the means to tackle that behaviour at an earlier stage as well as an educational tool to prevent bad situations from getting worse. Our pets are family members and friends who deserve protection. We should give the authorities all the powers they need to tackle those who would do them harm.
Siobhan Baillie (Stroud) (Con)
I commend my hon. Friend the Member for Romford (Andrew Rosindell). It is quite an achievement to secure a Bill with no amendments and cross-party support, and with everyone smiling here today. He is right that this country is united by a love of animals. I have had that reinforced in particular when campaigning on the pet theft laws that the Government are bringing in. It matters a lot to people in Stroud, where we have an amazing rural crime team. The police in particular have asked for increased protections, and the Bill will help with that among the array of tools that the Government are providing. The Government have an excellent track record in protecting animals and increasing welfare standards, and I look forward to hearing from the hard-working Minister—this is my second debate with her this week, so I know that she is always on her feet.
Stroud has an excellent track record on animal welfare and taking care for animals. We have a range of well-loved organisations set up to care for animals, including: Teckels; Cotswolds Dogs and Cats Home; Wild Hogs Hedgehog Rescue; Help a Hedgehog Hospital; Nailsworth Donkey Sanctuary; and Scrubditch Care Farm, just outside my patch, with which I have worked a lot. They are all fantastic organisations, and there are many more.
Yesterday, I was at SGS Stroud College with the skills Minister—the Under-Secretary of State for Education, my hon. Friend the Member for Brentwood and Ongar (Alex Burghart)—where we met animal welfare students busy bathing guinea pigs, which was a complete novelty for the Minister. When we talked to the students and apprentices, we learned that they want to take these qualifications so that they can go on to university and become vets or perhaps go into rescue centres. They will certainly welcome the early intervention measures offered by the Bill.
I am a cat person—my brother bought me a mad cat lady action figure—but my marriage and this job stop me from having a house full of cats. I love all animals, and I know that if I ever lose this job, I will have a house full of animals—that keeps my husband campaigning to keep me in the job.
It is clear from listening to colleagues that we need the steps that the Bill brings, because relying on prosecutions, the police and the courts will not be enough—we know about the delays and pressures on our courts—and it will also not be a deterrent for people who cause problems for and are cruel to our animals. The Bill will speed up penalties for issues relating to animals and should act as a deterrent. We should all be focused on preventive action and early intervention, so I welcome that. I also note that leading lights and trusted charities such as Battersea Dogs and Cats Home have said that they broadly support the contents of the Bill and that they really welcome using fines for technical and low-level breaches. The Bill is good enough for organisations such as Battersea Dogs and Cats Home, and brilliant for my local amazing charities and organisations in Stroud: it will protect our furry friends; it has cross-party support; and I am incredibly pleased that the Government are supporting it. Well done to my hon. Friend the Member for Romford (Andrew Rosindell).
Mr Gagan Mohindra (South West Hertfordshire) (Con)
I congratulate my hon. Friend the Member for Romford (Andrew Rosindell) and join him in his glowing tribute to David Amess, who I am sure would have been in this place today to witness the Third Reading of the Bill.
My hon. Friend has worked hard to champion animal penalty notices and to bring this debate before the House. The Bill is concerned not just with pets, but with zoo animals and livestock. My beautiful constituency is approximately 65% agriculture and I always enjoy seeing the variety of livestock grazing the fields as I travel through it. I have not had the benefit of having a pet myself, but I am fully aware of the love and care that families have for their pets. Indeed, that is part of the reason why I have not taken on that additional responsibility. They really do become a member of the family.
Pets are sentient beings and we must do all we can to protect animals from cruelty. I am pleased to see Government support doing just that. In June last year, the Animal Welfare (Sentencing) Act 2021 raised the maximum prison sentence for animal cruelty from six months to five years. That is a welcome step towards increasing animal welfare and protection, but going to court is not always the most effective measure against animal cruelty, hence the need for the Bill.
I recently had a discussion with David Bowles, head of public affairs at the RSPCA, about its work to keep animals safe. In 2020, the RSPCA had over 1 million calls to its cruelty line and over 140,000 welfare incidents were dealt with by the inspectorate. This issue affects all our constituencies, including my own where there were 24 investigations in 2021. However, in 2020, only 1,743 people were prosecuted for animal cruelty and only 908 were convicted of animal cruelty offences.
Those statistics demonstrate a gap in the legal system to correctly charge people with animal cruelty offences. In the current system without fixed-penalty notices, people have to be taken to court over animal cruelty offences, putting pressure on the court system and increasing the length of time taken. The Bill creates a system of financial penalties of up to £5,000 for animal health and welfare officers, including on-the-spot fines. Fixed-penalty notices are an out-of-court disposal and they serve as an important education tool to help to prevent animal cruelty.
I will leave it at that and I look forward to the contributions of other right hon. and hon. Members. I congratulate my hon. Friend the Member for Romford on getting the Bill to this stage.
Jerome Mayhew (Broadland) (Con)
I join all other hon. Members in congratulating my hon. Friend the Member for Romford (Andrew Rosindell) on introducing the Bill and getting this far. There is a worrying sense of unanimity in the House, which always gives me cause for concern. I will not breach it, save to highlight one or two slight concerns I have about the drafting of the Bill.
There is much to welcome in the Bill, and chief among them is the immediate impact that the levelling of a fixed-penalty notice has on both the individual who receives it and the wider community. There is a direct relation between cause and effect. We all know that speed in justice is enormously important. One of the great problems we have in society today is the delay that has bound up the criminal justice system, particularly in the Crown court but also in the magistrates court.
I also like the direct link between the severity of the offence and the penalty notice amount, with the factors, aggravating and mitigating, set out in clause 4. I recognise that there is also provision for the Secretary of State to give guidance on how those should be properly applied. That is a very important factor that needs to be taken seriously by the Secretary of State for the Bill to be properly applied.
However, the reasons behind the Bill’s benefit also give me some grounds for caution as we seek to apply fixed-penalty notices as a mechanism for bypassing the normal course of the criminal justice system. One of the reasons my hon. Friend the Member for Romford gave for why it is so important to have fixed-penalty notices was the delay in the magistrates courts. Surely, the best way to deal with delay in criminal justice is not to bypass it with fixed-penalty notices but to adequately fund magistrates courts and the criminal justice system that serves all of our country.
There is a requirement in clause 1(1) for the enforcement authority to be “satisfied beyond reasonable doubt”, but there is no requirement in the Bill for them to obtain or secure sufficient evidence to be satisfied. I query whether there is a risk that a prosecuting authority may see this as a shortcut past obtaining sufficient evidence to create a proper prosecution, and that fixed-penalty notices may be given more readily than a decision to prosecute otherwise would be. If that were the case, it would be a cause for concern for us all.
That leads me to who those enforcement authorities are. We see from clause 1(4) that the Bill does not tell us who they are; we are told that that will be provided by regulation. There is nothing wrong per se in secondary legislation providing further detail, but in this instance I start to get a little concerned. In clause 1(5), we are told who the Secretary of State might consider to be an enforcement authority. It says that that may be the Secretary of State himself or herself—fair enough—a local authority or, in paragraph (c),
“any other person that the Secretary of State considers appropriate.”
It would be impossible to draft that definition more widely. I respectfully highlight that issue to the Minister and invite her at least to consider it in responding to the debate, because this is the very definition of a blank cheque for the Secretary of State.
I wonder whether enforcement authorities might include, for example, private prosecutors such as the RSPCA. If that were the case, it would run counter to the current considerations of the Law Commission, which is interested in considering the future for all kinds of private prosecutors. We have a recent history of significant miscarriages of justice where private prosecutors have acted. I have only to pray in aid the biggest criminal justice scandal in our nation’s history—the Horizon scandal, where the Post Office acted in the role of private prosecutor—to demonstrate why the Law Commission may not be keen to continue to allow private prosecutors right across our criminal justice system.
The reason I know that is that I approached the Law Commission myself in relation to the Care Quality Commission and its powers as a private prosecutor in the health sector because of a scandal at Cawston Park Hospital in my constituency, where three patients with mental ill health and autism, as well as Down syndrome, died over a 27-month period because of neglect and, certainly in one case, physical abuse. I therefore raise a serious concern about whether private prosecutors could amount to enforcement authorities under clause 1(4).
Finally, I turn to clause 5(2). Enforcement authorities can apply a fine of up to £5,000. Most of that money will return to the central funds, but clause 5(2) gives enforcement authorities the ability to deduct their own costs of prosecution from any fines. That is a clear financial incentive to issue fixed-penalty notices, because it pays for their own operations. I hope we will all be naturally concerned to ensure that we do not apply a parking fine company approach to this area of law. That would be wholly not what my hon. Friend the Member for Romford, or any of us, intends. It is important that the Secretary of State, when coming to the secondary legislation and regulation on this matter, thinks hard about that potentially poisonous mix of financial incentive and private prosecution.
In conclusion, I thank my hon. Friend the Member for Romford again for getting behind this legislation and bringing it to the House and, I hope, to a happy conclusion, but I ask the Minister to think carefully about potential unintended consequences. We have heard about Staffordshire bull terriers and about Spike and Buster, but let us not forget that we need to look after John Bull as well, as he is persecuted by the heavy hand of the state. We want to give him protection too, and we must ensure that our legislation is well drafted.
Jonathan Gullis (Stoke-on-Trent North) (Con)
It is a pleasure to speak today and to congratulate my hon. Friend the Member for Romford (Andrew Rosindell) on bringing forward this piece of legislation. He is a Member of this House who has long been a passionate advocate for his love of animals—as well as, I like to think, spotting Conservative talent, because when he saw me before I was elected to this place he thought I had a chance of winning. He may regret that now, having seen what I am like in the Chamber, but I appreciate his kind words. I also appreciate what he is doing for animals across the United Kingdom.
I did not have a Spike or a Buster before I got elected; I now have a Bella and a Bailey. I like the idea of Union flag waistcoats, and I will try to replicate those as I go around Stoke-on-Trent North, Kidsgrove and Talke at the next general election. Perhaps I will get a few nice tweets rather than the ones I have been receiving recently for being overly zealous in the Chamber in my support of the Prime Minister.
Coming back to the Bill, this is exactly the type of legislation that organisations such as Greyhound Gap, which works in the Kidsgrove area, or Baddeley Green Hedgehog Rescue, which also does fantastic work in the constituency, want to see: showing respect for our beloved animals and ensuring that those who seek to persecute, take advantage of or simply be cruel to an animal are held to account. There is no excuse, as a human, to ever be cruel to an animal. Those people who think that that is right or is something they can do should absolutely feel the full force of the law.
I could not agree more with my hon. Friend the Member for Broadland (Jerome Mayhew), who said, accurately, that by introducing fixed penalty notices we will free up court time, speeding up the process of punishing those who have clearly and evidently broken the law and ensuring that they feel the wrath financially—which is often where animals are mostly taken advantage of. I am proud to support this fantastic piece of legislation.
We should not forget that this affects not just our pets, but our zoo animals and livestock. I know my hon. Friend the Member for Buckingham (Greg Smith) will talk passionately, as he has in the past, about those farmers who do a lot of really good work and look after their animals appropriately, and the tiny minority who sometimes bring a slur on the wider profession. It is important that we remember that many of our farmers do the right thing, but those who do not should be held to account, because they are ultimately profiteering from the animals they keep.
The fact that the fixed penalty notice
“may not exceed whichever is the lesser of—
(a) £5,000, and
(b) the maximum fine for which a person convicted of the offence is liable on summary conviction”,
is fantastic. I like to see big, hefty fines for such people. I have introduced my own private Member’s Bill, relating to rogue landowners who destroy history and heritage, and I want to see that fine go from a £1,000 cap to being unlimited, to allow a judge to use their discretion and expertise to determine the seriousness of the damage done. This case is similar, and that hefty fine will be a deterrent to those who seek to break the law.
I am also delighted to see the partisan—[Interruption.] Apologies, I am used to being partisan—the bipartisan way the House is approaching this issue, as has been the case with many animal welfare and animal rights issues, as well as the issue of waste. I note the hon. Member for Newport West (Ruth Jones), the shadow Minister, has talked passionately about north Staffordshire and Walleys Quarry and many other issues. I know she is backing the “Stop the Stink” campaign and I am grateful for her support, as the issue also affects my constituents. It is good to see that we are all working together.
It is a shame that what my hon. Friend the Member for Romford has done over his career has never been rewarded with a ministerial post. Perhaps the rumoured great reset will finally put him on the Treasury Bench, where he belongs. He is a fantastic advocate for animals and for our United Kingdom, and I am proud to support his Bill today. I look forward to hearing the following contributions.
Brendan Clarke-Smith (Bassetlaw) (Con)
I thank my hon. Friend the Member for Romford (Andrew Rosindell) for his excellent Bill and for moving Third Reading today. I have been looking forward to speaking on it, although I must admit that I have very little experience of working with or owning animals. They tell us never to work with animals or children, and I failed miserably on the latter as a secondary school teacher. I suppose that is where the comparison should end, before I get myself into trouble.
Most of my experience with animals is from being out and about delivering leaflets on the campaign trail. I tend to step around driveways like Fred Astaire, trying to avoid various things. This brings back happy memories of the time I lived in Sweden and went on an expedition in the Arctic circle. I was pulled in a sled by dogs, and there were reindeer. My phone suddenly rang with a call from the now Secretary of State for Transport, which I was not expecting. He said, “Brendan, it is very nice to speak to you. Can I ask what you have been doing for the Eastleigh by-election?” There was very little signal and it was quite cold, as Members can imagine, so I said, “I am currently in the Arctic circle being pulled along on a dogsled.” He replied, “Okay, I believe you”—I tried to take a selfie to send to him—“but you could make some phone calls.” That was my job during one of my animal experiences.
Since being elected, I have seen the great success of Westminster dog of the year, about which my hon. Friend the Member for Romford is very passionate. It was a pleasure to see Sir David’s dog there this year. I was lobbied quite heavily, especially by my hon. Friend the Member for Ashfield (Lee Anderson) for his dog Alfie. I am afraid I must confess that I did not support his dog this year, but he is not here today, so I feel safe in relaying that story.
I have a cat, which is a new thing for me. I am very fond of my cat, and pet owners are attached to their animals. It is an experience I would recommend. My first experience of owning an animal was when I had a white rabbit with pink eyes. If the legislation were reversed, the rabbit would have received many on-the-spot fines for attacking me. My second pet was a terrapin called Gary, who had a red band across his head. He was very similar to a ninja turtle.
Finally, I have the cat. We had to decide a name, and my son, who is five years old, decided on Jerry, supposedly after “Tom and Jerry”. I had to explain that Jerry was the mouse, not the cat, but one cannot argue with a five-year-old, so we called the cat Jerry, who is now one of my best friends. We regularly sit together to watch “Match of the Day”. He sits on my lap, and we discuss the issues of the day such as taking the knee or Gary Lineker’s salary. We have not had a single disagreement, which is fantastic.
Of course, the landmark Animal Welfare (Sentencing) Act 2021 has come along and introduced five years’ imprisonment, and it is something of which we can be incredibly proud. I remember the fabulous Finn coming to this very building with Dave Wardell, his handler. It was one of our most popular events, which shows how well it went down with the public and with Members, too. The snaking queue was so long that at one point I thought it was an attempt to recreate the “Labour Isn’t Working” poster. I hope that my friends on the Opposition Benches will forgive me for mentioning that.
I am delighted that the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), has taken such a supportive approach to the Bill, as has the House of Lords. Opposition Members have also made some excellent contributions to the debate. Chris Sherwood, the chief executive of the Royal Society for the Prevention of Cruelty to Animals, has said
“Fixed penalty notices are… useful to…combat suffering of farmed animals, horses and animals kept in zoos.”
The RSPCA, he said, was pleased about the proposals for powers of enforcement and tougher sentences. It supports the Bill wholeheartedly, as do I. I think that the United Kingdom can be world-leading in animal welfare, not just through the Bills that we have already introduced, but through excellent Bills such as this. Once again, I congratulate my hon. Friend the Member for Romford and wish the Bill well.
Ruth Edwards (Rushcliffe) (Con)
I join my hon. Friend the Member for Bassetlaw (Brendan Clarke-Smith) in congratulating our hon. Friend the Member for Romford (Andrew Rosindell) and thanking him for all the work he has done over his career to further the cause of animal welfare. I also echo his remarks about our late colleague Sir David Amess and all the hard work that he did to protect animals during his many years in this place.
I am delighted to welcome the Bill back to the Chamber, because it is an important part of our reforms to strengthen the protection of animal welfare across the full spectrum of offences. At the most serious end, the Animal Welfare (Sentencing) Act 2021 has increased the maximum sentence for animal cruelty from six months to five years. That covers, for instance, dog fighting, illegally cropping a dog’s ears, and gross neglect of animals. This Bill addresses offences at the other end of the spectrum, toughening penalties for less serious offences by creating a system of fining offenders up to £5,000. I welcome that approach: I welcome the toughening of laws at the less serious end of the spectrum, and hope that those tougher laws will serve as both a deterrent and an educational tool for many.
As the common agricultural policy payments wind down and cross-compliance is phased out, we have opportunities to improve and strengthen enforcement mechanisms by introducing a range of proportionate enforcement measures and by providing new, more consistent penalties by extending penalty notices to all kept animals—or, rather, to all those who keep animals. As I mentioned last time the Bill was debated in the House, it does not address the issue of errant animals. On that occasion, I recounted the escapades of our pig Andrew and our donkeys Sergeant Wilson and Godfrey, who staged a break-in at the chicken run. I am sorry to say that, in the month since we last debated the Bill, things have not improved.
Just a few weeks ago, we had another break-out. This time it was the alpacas, Florence, Vera and Wilbur. It was a lovely, peaceful, sunny Saturday morning, we had just enjoyed a nice breakfast and we were sitting down for coffee when my husband looked out of the window, did a double-take and said, “Where are the alpacas?” I said, “I don’t know—perhaps they have gone out of that gap in the hedge that you confidently assured me they would never escape from.”
So into the car we piled, still in our pyjamas, now in our wellies too, and bombed down our drive at about 100 miles an hour in our Land Rover—which is shaking and falling apart—scanning the horizon and the fields for a ginger head, a black head and a white head grazing peacefully, but no, we could not see them anywhere. On to the main road we went; there was no sign of them. In the village we accosted the startled-looking postman, asking, “Have you seen our alpacas?” “No, not since I came to deliver the mail; they were in the paddock then.” “Great! They can’t have gone far.” So back we went. We tried going the other way, and drove around a few more fields. Finally we found them, munching happily away, completely unaware of the drama and excitement they had caused to our Saturday morning. Life would be so dull without them, Madam Deputy Speaker. I am proud to support this excellent Bill, which offers the protections that they deserve.
I know that the Bill is welcomed by the NFU, the RSPCA, Battersea Dogs and Cats Home and Blue Cross. It is fantastic to see that huge spectrum of support. I appreciate that the NFU has raised some questions about the appeal mechanisms, as flagged up by my hon. Friend the Member for Buckingham (Greg Smith). I am interested to hear from the Minister what recourse there is for appeal in the case of genuine misunderstanding or misinterpretation of the facts.
Our country is a world leader on animal welfare. There is no place for those who mistreat animals and I welcome the part this Bill will play when it becomes law.
Jo Gideon (Stoke-on-Trent Central) (Con)
I thank and congratulate my hon. Friend the Member for Romford (Andrew Rosindell) on bringing forward this really important legislation, which fills a gap; a suite of legislation is coming forward to help to safeguard and strengthen our animal welfare.
Animal welfare is close to my heart and it is one of the top issues that my constituents raise with me. That is not surprising given the statistics locally. RSPCA figures reveal that about 3,000 complaints about animal cruelty are made in Stoke-on-Trent and Staffordshire every year. Sadly, the west midlands has been one of the 10 animal cruelty hotspots over the past five years, which is why animal welfare is among my top priorities.
Animal cruelty horrifies our society, and figures tell us that there are suffering animals in Staffordshire that need help every day. It is shocking that people can be capable of such deliberate brutality towards animals. Equally, it drives us on to ensure that appropriate action is taken on animal welfare and related offences. In particular, I am grateful for the work being done locally by RSPCA staff and volunteers, who transform the lives of thousands of animals in Staffordshire every year.
I fully support the aims of the Bill, which will mean that penalty notices can fill the enforcement gap between taking no action and seeking criminal prosecution. I am delighted that today’s debate provides us with the opportunity to discuss how we can go further to improve animal health and welfare in this country.
Several of my constituents selflessly volunteer at Animal Lifeline in Stoke-on-Trent. It is a fantastic charity that has cared for dogs for more than 40 years, with approximately 100 dogs in care at any one time. Each year, the charity rescues and rehomes around 300 dogs and puppies and it has saved more than 11,000 over the years.
A volunteer recently shared with me concerns that have arisen as a result of covid. The pandemic has hit animal charities hard financially due to charity shops having to close and kennels not being able to hold their usual open day fund-raising events. Animal charities across Stoke-on-Trent and the county have had to take in more animals than usual due to owners passing away. Having a reduction in income means that they can no longer afford to keep them. Couples who are separating have not been able to cope during this time. Many people, we know, looked to animals during lockdown. Many people acquired pets and then were not able to look after them That has been compounded by the fact that animal charities have not been able to have visitors to view dogs suitable for adoption and by the inability to complete home checks of people who ring in inquiring about adopting.
I praise local animal charity staff, who have been amazing. Many have taken cuts in wages and found innovative ways to reduce costs. The cost of living challenges are also pushing up the cost of essentials such as dog food, vet bills, utility bills, fuel and wages. With all that in mind, we should all consider the options to provide sufficient support to charities to ensure that they can continue to provide a vital service to our local communities.
I have been involved in the national food strategy. Within that, we look at a range of recommendations for improving animal welfare with regards to food production. The Government are looking at that at this time. Thankfully, the UK already leads the world in animal welfare and livestock husbandry. The same cannot be said of many of the countries that we import from. Allowing cheap imports from such countries not only undermines our own standards, but undercuts our farmers. This is an issue that many people feel strongly about, with 94% of the public wanting existing food standards to be maintained in future trade deals.
The national food strategy argues that, when making new trade deals, the Government should only agree to cut tariffs on products that meet our core standards. As such, I am pleased that the Government recently launched a new Trade and Agriculture Commission, which will inform parliamentarians and the public about how new free trade deals are consistent with UK laws on animal welfare. The Government must go further, however, and draw up a list of core minimum animal welfare standards that they will defend in future trade deals. I am pleased that when they announced the Australian deal, they said that they would include measures to protect our standards. It is reassuring that the deal contains a chapter on animal welfare, and I urge the Government to come forward with more details as soon as possible to allow Parliament to sufficiently scrutinise that part of the deal.
Again, I congratulate my hon. Friend the Member for Romford on bringing forward the Bill, which I am delighted is fully supported by the Government and the Opposition. I look forward to continuing my support for this legislation as it passes through the House, in addition to championing animal welfare causes in years to come, whether by calling for more support for local animal charities or for more animal welfare protection in future trade deals.
Jane Stevenson (Wolverhampton North East) (Con)
I rise to speak briefly in support of the Bill. I pay tribute to my hon. Friend the Member for Romford (Andrew Rosindell), who shares my enthusiasm for animal welfare. His commitment to the cause is valuable and appreciated by many hon. Members on both sides of the House. It has also been a great pleasure to listen to many hon. Members share experiences of their pets of various shapes and sizes.
It is valuable for children and adults to have and care for a pet to learn an appreciation and love of animals. For many hon. Members on both sides of the House, it informs our choices in this place and advances the cause of animal welfare. I should mention my two Cavalier spaniels, Cromwell and Bertie, who appreciate everything I do in this place on animal welfare. I am sure they look forward to seeing me later and congratulating me.
Jerome Mayhew
I rise not to talk about Cavalier King Charles spaniels, but to ask whether my hon. Friend agrees that the direct impact of the fixed penalty notice being applied as soon as the relevant authority considers that there is evidence beyond reasonable doubt adds a powerful deterrent to people causing cruelty or neglect to animals.
Jane Stevenson
I absolutely agree. Education and those low-level interventions will be important. At the moment there is not a good enough safety net on animal welfare, because only the most serious cases are likely to be investigated and only the most serious abusers are ever likely to be fined or prosecuted.
The Bill will do a valuable job of introducing low-grade fines and of providing the opportunity to give advice to pet owners, which is key. Some people are unintentionally not creating the best environment for their pets, but we can have a culture where they might get a warning and advice on animal welfare from an appropriate officer. That is what I most like about the Bill: it is pragmatic, it is not heavy-handed, but it will certainly raise standards broadly in animal welfare across the United Kingdom. I thank my hon. Friend the Member for Romford again for bringing forward such a useful and important Bill as part of the Government’s commitment to improve animal welfare.
Ruth Jones (Newport West) (Lab)
I add my voice to the tributes paid to our friend Jack Dromey earlier this week. I was unable to speak during the tributes, but I want to acknowledge the strength and inspiration of the Mother of the House, my right hon. and learned Friend the Member for Camberwell and Peckham (Ms Harman), and say how much I will miss Jack and all he did and meant to us all.
I will not detain the House any longer than necessary, because the hon. Member for Romford (Andrew Rosindell) has almost got his Bill through the House. At times, I wondered whether the Government were waiting in the wings to pounce, but obviously not. It can only be a matter of time before his hard work, tenacity and diligence is rewarded by ministerial office, so I just ask that he does not forget us on the way up the pole.
The Bill is important. Hon. Members will know that Opposition Members, particularly my hon. Friend the Member for Cambridge (Daniel Zeichner), have sought at all times to be a critical friend and to provide a wise and objective view. The Bill enables the potential use of penalty notices, such as fixed penalty notices, for a wider range of primary and secondary legislation related to animal health welfare offences.
The Bill encompasses two pieces of primary legislation that affect dogs and cats: the Animal Welfare Act 2006 and the Dangerous Dogs Act 1991. It is a cross-party attempt to deliver improved health, safety and welfare conditions for animals. Like the excellent Battersea Dogs and Cats Home, we on these Benches broadly support the Bill, because it will enable statutory enforcers to take early action and provide them with the tools to deal with infringements of a technical nature.
I have been a Member of Parliament for almost three years now, and I have to admit that not all legislation has provided a clear and common focus and target, but this Bill does. I congratulate the hon. Member for Romford and all involved. I would like to acknowledge the hard work and commitment of all those involved in getting the Bill through the House and wish it well as it goes to the other place. I thank the staff of the House, the Clerks, the Committee staff and the parliamentary staff in the offices of all Members involved. I also thank the campaigners, the stakeholders, the animal rights charities and the organisations who are fighting for decency and progress. It is great to see consensual politics in action and actually achieving results.
I acknowledge the hon. Members for Romford, for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), for Newcastle-under-Lyme (Aaron Bell), for Brecon and Radnorshire (Fay Jones), for Wolverhampton North East (Jane Stevenson), for Crawley (Henry Smith), for Gedling (Tom Randall) and for South East Cornwall (Mrs Murray), and my hon. Friends the Members for Rotherham (Sarah Champion), for Denton and Reddish (Andrew Gwynne), for Hammersmith (Andy Slaughter), for Canterbury (Rosie Duffield) and for Bristol East (Kerry McCarthy), who all served on the Bill Committee. That is a broad coalition of the willing from across the country. I gently urge them all to maintain their interest in animal welfare issues and support the Glue Traps (Offences) Bill and the Animal Welfare (Sentience) Bill, which are working their way through the parliamentary process. I know that Labour peers stand ready to act now.
The Minister for Farming, Fisheries and Food (Victoria Prentis)
I wonder whether it might be in order to wish my hon. Friend the Member for Halesowen and Rowley Regis (James Morris) an extremely happy birthday. It is good to see him in his place.
I join everyone in thanking my hon. Friend the Member for Romford (Andrew Rosindell) for his tremendous and attentive work on this excellent Bill, and congratulate him on steering it through the House. As he and other hon. Members have mentioned, this is an occasion when we feel the loss of David Amess very sharply, although of course we also look forward to welcoming the new MP for Southend West following her election last night.
We have heard some excellent speeches this morning. My hon. Friend the Member for Wolverhampton South West (Stuart Anderson) spoke about service animals, including Finn, and his personal experience of serving with animals on the frontline. My hon. Friend the Member for Stockton South (Matt Vickers) mentioned the “sassy little bitch” Karen, and pointed out that the Bill is a way to prevent bad situations from getting worse. That is exactly the purpose of the Bill. My hon. Friend the Member for Stroud (Siobhan Baillie) pointed out that everybody in the Chamber was smiling as we consider the Bill, as was everyone in the photographs I saw of the Minister’s visit to the guinea pigs in her constituency yesterday.
My hon. Friend the Member for South West Hertfordshire (Mr Mohindra) made the point that going to court is not always the most effective way to deal with the problem, and my hon. Friend the Member for Broadland (Jerome Mayhew) made some serious comments about the Bill. I can reassure him that we will go into further detail in secondary legislation and, if necessary, guidance on who will enforce the penalty notices. To give him some idea, we envisage that the Rural Payments Agency, the Animal and Plant Health Agency and local authorities will be the bodies most likely to be charged with doing this. I share his concerns about incentivising the issuing of fixed penalty notices, but I would ask him to look at the Treasury guidelines on that very point. I reassure him that that will always be at the forefront of my mind.
My hon. Friend the Member for Stoke-on-Trent North (Jonathan Gullis) told us about Greyhound Gap and the hedgehog rescue centre, and made an unexpectedly bipartisan speech, which was good to hear. My hon. Friend the Member for Bassetlaw (Brendan Clarke-Smith) meets animals on the campaign trail, but I was also glad to hear about Jerry the cat’s enjoyment of “Match of the Day”. I would not have thought that such activity would be subject to the issuing of a penalty notice. My hon. Friend the Member for Rushcliffe (Ruth Edwards) made an important speech, although she did sadly refer to her extremely badly behaved animals. I was delighted to visit her constituency last Friday and eat some Cropwell Bishop stilton with her for lunch.
My hon. Friend the Member for Stoke-on-Trent Central (Jo Gideon) rightly makes animal welfare a priority of hers, because of the sad record of her constituency in this regard. Recognising that is in many ways the best way of dealing with the problem, and I applaud her for her work in this area. My hon. Friend the Member for Wolverhampton North East (Jane Stevenson) understands the value of pets to us all. We are about to hear a great deal more from her, and I would like to add that I enjoyed meeting Cromwell and Bertie on Zoom—they certainly hold their own in her household.
I associate myself with the comments of the hon. Member for Newport West (Ruth Jones). It was an honour to attend Jack’s funeral earlier this week. Although he was not always bipartisan, he was a model of how cross-party working can take matters forward, so I think he would be pleased with what we are doing today.
This Bill is just one of a series of animal welfare reforms being supported by the Government, building on our action plan for animal welfare. Penalty notices will be an important tool in encouraging animal keepers to follow the rules and to discourage those who break them from committing more serious offences. The Bill was in Committee on 8 December. It introduces a new financial penalty system and gives us tools that we can use against those who commit offences against animals. We will not tolerate threats to the health and welfare of animals, the quality of our animal products or the biosecurity of our nation.
I acknowledge the time and effort given by the animal charities listed earlier by my hon. Friend the Member for Romford. The Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), is avidly looking forward to continuing the engagement she has had with those charities and to working with them constructively as we put the flesh on the bones of the Bill in secondary legislation. That will ensure that penalty notices meet the needs of animals and help those who enforce them to change the behaviour of people who are not quite doing the right thing.
My hon. Friend the Member for Buckingham (Greg Smith) in an intervention and my hon. Friend the Member for Rushcliffe made some serious points about the appeals process. That point has been raised by the NFU, and I know that my officials have been working with it on this issue. It might help Members if I give a bit of an overview as to what will happen in enforcement terms in the farm animals space. The inspector will visit or identify the fault. He will then identify and discuss with the farmer what sort of fault has occurred. It might well be one of record keeping or lateness in organising a TB test, for example. The farmer will then have two weeks to rectify that fault, and only then would a penalty notice be issued. If the farmer disputes that penalty notice, the best thing to do is simply not to pay it and explain why not. If the authorities continue to wish to enforce that penalty notice, the farmer would be able to have his day in court.
Greg Smith
I am delighted that the Government are supporting this Bill and about the commitment my hon. Friend has just made. Can she give me an assurance that within the secondary legislation that the Government intend to bring forward, instead of someone who disputes a penalty charge notice simply not paying it, there will be a channel locked in for them to give the reasons why they are disputing that, so that the inspector can consider those reasons?
Victoria Prentis
I am very happy to continue to work with my hon. Friend and the NFU as we take the secondary legislation forward. I would like to reassure him that this process is intended to have discussion built in at its very core. It is there to guide people towards compliance, not penalise them for non-compliance, so we will be able to achieve the outcome that he wants.
I take this opportunity to extend gratitude once again on behalf of my hon. Friend the Member for Bury St Edmunds to those who so avidly engaged with the passage of the Bill. Their support is really appreciated, and their expertise has been invaluable to the robust consensus we have built. In this country, we pride ourselves on our high standards of animal welfare, and we have powerful laws to maintain them. I reiterate the Government’s unwavering support for this important Bill. I wish it well under the stewardship of Lord Randall in the other place. I add my thanks to all those mentioned by the hon. Member for Newport West (Ruth Jones), and I also add my thanks to Claire Ingham, who has managed this Bill so well to date. I hope we are able to see it on the statute book soon.
Andrew Rosindell
With the leave of the House, I will say a few words of thanks. I particularly thank the Minister for leading on behalf of the Government today and for her support and the reassurances she has given about how the Bill will be implemented. I thank the hon. Member for Newport West (Ruth Jones) for her support and the enthusiasm she showed for the Bill. I echo her words about Jack Dromey, who was a real gentleman. We disagreed politically, but my goodness, he was a very kind and genuine person. We will all miss him, and our sympathies go to the right hon. and learned Member for Camberwell and Peckham (Ms Harman), who has served this place so well for so long.
I thank all Members who have spoken in the debate, including my hon. Friends the Members for Wolverhampton South West (Stuart Anderson), for Wolverhampton North East (Jane Stevenson), for Stroud (Siobhan Baillie), for Stockton South (Matt Vickers), for South West Hertfordshire (Mr Mohindra), for Broadland (Jerome Mayhew)—he made a lot of valid points that I completely take on board—for Stoke-on-Trent North (Jonathan Gullis), for Stoke-on-Trent Central (Jo Gideon), for Bassetlaw (Brendan Clarke-Smith), for Rushcliffe (Ruth Edwards) and for Buckingham (Greg Smith). My hon. Friend the Member for Buckingham made a superb intervention. I thank all Members for their comments.
I also put on the record my thanks to my hon. Friend the Member for Bury St Edmunds (Jo Churchill) for her work helping me to ensure that the Bill reached its final stages in this House. I also thank Lord Goldsmith of Richmond Park. We have enjoyed a strong working relationship over many years, particularly over the issue of protection of animals and conservation. I am honoured to have had the opportunity to work with him on the Bill. Lord Randall of Uxbridge has my deepest gratitude for kindly agreeing to take my Bill forward in the House of Lords. I have no doubt that he will ensure that it passes all the necessary stages before—hopefully—it receives Royal Assent.
I am also eternally grateful to the team at DEFRA for their advice and guidance throughout this process, especially Claire Ingham and Kirsty Groves for their tireless efforts and regular engagement with me.
I thank very much indeed my hon. Friend the Member for Castle Point (Rebecca Harris), who has given me great advice and guidance during the passage of the Bill and is always there when I need her.
Finally, I could not possibly fail to thank the staff in my parliamentary office, who have worked so hard, especially Elliot Keck and Stephen Reed, who unfortunately have both now left. They have been replaced working on the Bill by Scott Sherlock and Daniel Burden. I thank them for their valued and unwavering support and hard work. No Member is successful without the support of their staff, and mine have gone above and beyond the call of duty. A huge thank you must also go to the Clerks of the House of Commons, who have supported me from day one and made sure that I kept things properly on track, to ensure that we get to the successful place I hope we are reaching today.
Madam Deputy Speaker, thank you. In this historic year of the Queen’s jubilee, let this Bill ensure that the animals that inhabit our cherished land and islands will be the winners under this new legislation.
Question put and agreed to.
Bill accordingly read the Third time and passed.
Glue Traps (Offences) Bill
Friday 4th February 2022
(2 years, 9 months ago)
Commons ChamberRead Full debate Glue Traps (Offences) Act 2022 View all Glue Traps (Offences) Act 2022 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Consideration of Bill Amendments as at 4 February 2022 - (4 Feb 2022)
Madam Deputy Speaker (Dame Rosie Winterton)
Before we get on to the proceedings, I want to remind Members of the difference between Report and Third Reading. The scope of the debate on Report is determined by the amendments that Mr Speaker has selected. The scope of the Third Reading debate to follow will be the whole Bill as it stands after Report. Members may wish to consider these points and then decide at which stage they want to try to catch my eye.
Clause 1
Offences relating to glue traps in England
Mark Tami (Alyn and Deeside) (Lab)
I beg to move amendment 1, line 3, after “rodent” insert
“or any other vertebrate animal”.
This amendment, and Amendments 2 and 3, would create an offence of setting of a glue trap capable of catching any vertebrate animal, removing a potential defence of a user claiming that a trap had been set to catch a non-rodent vertebrate.
Madam Deputy Speaker
With this it will be convenient to discuss the following:
Amendment 2, line 6, after “rodent” insert
“or any other vertebrate animal”.
This amendment, and Amendments 1 and 3, would create an offence of setting of a glue trap capable of catching any vertebrate animal, removing a potential defence of a user claiming that a trap had been set to catch a non-rodent vertebrate.
Amendment 3, line 11, after “rodent” insert
“or any other vertebrate animal”.
This amendment, and Amendments 1 and 2, would create an offence of setting of a glue trap capable of catching any vertebrate animal, removing a potential defence of a user claiming that a trap had been set to catch a non-rodent vertebrate.
Amendment 4, in clause 2, page 2, line 24, leave out paragraph (a).
This amendment would require that licences for glue traps be issued at a class or individual level only, in order to minimise their use only to exceptional and specific circumstance.
Amendment 5, page 2, line 25, leave out “all pest controllers”.
See the explanatory statement for Amendment 4.
Amendment 6, page 3, line 29, leave out from “provides a” to end of paragraph (a) and insert “pest control service, or”.
This amendment would clarify that individuals whose businesses may “involve” pest control, but who are not pest controllers by training and trade, cannot be licensed to use glue traps.
Mark Tami
First, I would like to put on record my thanks to the hon. Member for Wolverhampton North East (Jane Stevenson) for bringing in this Bill. Particularly as she is a new Member, I hope she will get the Bill through. That would be more than I have done in 20 years in this House, so she will have done incredibly well.
Following other Members, I feel I must very quickly, before I upset you, Madam Deputy Speaker, mention Muffin, Bobby and Mrs Skittles, who are my cats. I would advise Members to look at the House calendar, because Mrs Skittles features in this month’s photograph. That was organised by the late David Amess, who organised the competition for many years. We certainly miss him in this place.
My amendments cover two key areas. The first area looks at where a trap is laid and an animal other than a rodent is caught. At present, the wording in the Bill is:
“A person who sets a glue trap in England for the purpose of catching a rodent commits an offence.”
I am sure Members of the House are well aware that it is not just rodents that are caught in glue traps—even though that practice, to me, is barbaric in itself. Birds are caught too. They are also probably aware of the tragic situation in which a pet cat was trapped for some time on a glue trap or a number of glue traps and had to be put down. I hope this provision is not a loophole; I am looking at the Minister. I am sure, as we have heard previously, that that is covered in other legislation and that there is not a problem with any loophole in this Bill. Clearly, if people look to get around the legislation by claiming that they are laying traps for a different purpose, that defeats what we are trying to achieve.
The second area looks at dealing with regulation. Pest control is not a very well regulated industry, and the concern I and a number of others have is that we cannot have a situation in which anybody can designate themselves as a pest controller. I would certainly want some assurances that that is not the case, so that a porter in a hotel or a restaurant—or the owner, or anybody else—could not suddenly describe themselves as a pest controller and have access to glue traps. It is important that the industry is regulated, or at the very least that there are some assurances that this is a person’s profession rather than something they have just decided to do for a period of time.
I would like those assurances, and if I receive them I will wish the Bill swift progress and will not push the amendments to a vote.
Jane Stevenson (Wolverhampton North East) (Con)
I want to speak briefly to the amendments, as it gives me a chance to thank the right hon. Member for Alyn and Deeside (Mark Tami) for all his work on glue traps. He has tabled an early-day motion on these barbaric traps and we share the aim of stopping the cruelty and suffering that, sadly, they cause. I want to reassure him: I have also been contacted by animal welfare charities and believe that clause 1(2) closes the loophole:
“A person who sets a glue trap in England in a manner which gives rise to a risk that a rodent will become caught in the glue trap commits an offence.”
I cannot think of a location where a trap could be set even if someone said they were setting it for parrots or for cats; I cannot think of an occasion when another animal could be in a place that could be guaranteed to be free of rodent access. For that reason I did not think that the amendments were necessary, but I appreciate the right hon. Gentleman’s efforts.
The other points the right hon. Gentleman raises in the amendments give me the chance again to plead with the Minister to make the licensing enforcement regime watertight. I share the concern that people given licences should have to prove a very high level of competence in the ability to dispatch quickly and humanely any animal stuck on a glue trap. I thank the right hon. Gentleman again for his contributions.
The Minister for Farming, Fisheries and Food (Victoria Prentis)
I hope I will be able to reassure the right hon. Member for Alyn and Deeside (Mark Tami), and indeed Muffin, Bobby and Mrs Skittles along the way.
I understand the concern expressed through the amendments on glue traps, as we do want to prevent other small vertebrate animals and indeed birds from falling victim to the traps. The Bill already addresses that in its current wording, however, so the amendments are unnecessary.
The Bill refers specifically to rodents as they are the primary target of glue traps, which are marketed with catching rodents in mind; however, it would not be a defence for a user to claim that a trap had been set to catch a vertebrate that was not a rodent. If a trap is set in a manner which gives rise to a risk that a rodent will become caught, that is an offence regardless of the intent. It does not matter what was the target or intended target of the trap; if a trap is set outdoors to catch another vertebrate animal, that in itself is an offence, so other vertebrate animals at risk from a glue trap would still be protected by this Bill. It is also important to note that it is already an offence under the Wildlife and Countryside Act 1981 to set a glue trap in any place where a wild bird could be caught.
Again, I understand the reasoning behind amendments 4 and 5, but the Bill already covers what they seek to address. They might also create difficulties for a future licensing regime. The Bill is drafted to allow a range of licences to be granted in order to ensure that the Secretary of State has the flexibility to grant the most suitable type of licence for the intended use or pest controller. The precise details of the licensing regime will only be worked out following extensive discussions with stakeholders, who will include pest controllers, animal welfare organisations and the licensing body. We do not want to prejudge the outcome of these discussions; however, whatever the form of licence granted, the Bill makes it explicit that licences can only be issued to pest controllers on an exceptional basis.
The Bill sets out clear limits on the Secretary of State’s power to grant licences to ensure that any licence can only be granted once the Secretary of State is satisfied that the licence is necessary to preserve public health or safety and there is no other satisfactory solution available to meet this purpose. It would not be appropriate further to restrict the type of licence that could be granted, as that might need to reflect a number of variables such as their intended use, the pest controller to whom the licence is to be granted, and the measures that can be taken to safeguard the welfare of any rodents or other animals that might be caught in a licensed glue trap.
Finally, I turn to amendment 6. Again, I fully understand what the right hon. Member for Alyn and Deeside is trying to get at in the amendment, but I think it is unnecessary, as it would not change the effect of clause 2 and his concerns will be addressed through the licensing regime. The amendment seeks to ensure that the definition of pest controller is worded to apply to a business that provides a pest control service. The current wording—
“a person…who, in the course of a business, provides a service which consists of, or involves, pest control”—
amounts to the same thing. I know that he is concerned that a restaurant owner could class themselves as a pest controller. However, we cannot see that a court would agree with that interpretation; indeed, no one would like to think of a restaurant business providing its customers with a service that included pest control.
Jane Stevenson
I beg to move, That the Bill be now read the Third time.
I am delighted to present the Bill for its Third Reading. I thank all hon. Members who have supported it to this stage, as well as animal welfare groups and members of the public who have contacted me in support of it. The Bill has broad support. I should also like to take a moment to thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory). Unfortunately, at the time of the Bill’s Second Reading, I was struck down by covid-19 and propped up on a sofa, so my hon. Friend very capably presented the Bill. Sadly, she cannot be here today for me to thank her in person, but it is good to put that on the record.
The Bill would ban the use of glue traps for catching rodents in all but the most exceptional circumstances. The important thing is that members of the public will no longer be able to use these traps. We heard distressing evidence while the Bill was being drawn up from people who had no idea that they would come down after setting a trap the night before to find a screaming, live, distressed rodent attached to a board in their kitchen in a small flat. They had no idea how to dispatch the animal humanely. They had no idea that they would have to deal with such a distressing situation. I received correspondence from people who urged others not even to consider using these traps because of the significant distress it had caused them to feel that they had to dispatch a suffering animal.
Glue traps cause immense suffering. The British Veterinary Association reports that trapped animals can suffer from
“torn skin, broken limbs and hair removal and die a slow and painful death from suffocation, starvation, exhaustion and even self-mutilation.”
Many other animals are caught on the traps, with over 200 incidents reported to the Royal Society for the Prevention of Cruelty to Animals over five years, involving cats, garden birds, hedgehogs, squirrels and even a parrot. The right hon. Member for Alyn and Deeside (Mark Tami) mentioned Miles the cat, who was stuck to four glue traps. He had a large infected wound where he had tried to free himself from the traps, and his back legs had been stuck together. The RSPCA took him to a hospital to try to save him, but sadly his injuries were too severe and he had to be euthanised.
It is therefore not surprising that a 2015 survey found that 68% of the public support banning glue traps. While the Bill applies only to England, I note that since I introduced it in June last year, the Welsh and Scottish Governments have announced their intention to ban glue traps. I send my thanks to Members of the Welsh Assembly and the Scottish Parliament for the work they are doing to move in step with this Bill in the name of animal welfare.
I would like to give some reassurance about the concerns raised on Second Reading by my hon. Friend the Member for Christchurch (Sir Christopher Chope)—he is not in his place today—that this is a rat protection Bill. It is not. There is no evidence to suggest issues in dealing with rodent infestations in Ireland and New Zealand, where such traps have been banned. There are so many other, better methods available. Effective rodent-proofing is the best solution and, when used with live capture and release traps, is the method that I would recommend. I used that method when I had a mouse visitor to my house in the past. There is no distress and no need to deal with a dead animal, which most members of the public do not have the stomach for at the best of times. Break-back traps are also available and, while they seem cruel, they do kill instantly in most cases, so they are much more humane than glue traps.
I have brought the Bill before the House because where we need to prevent rodent infestations, we have a duty kill animals in the most humane way possible, and that is at its core. It is right that glue traps will not be available for use by the general public.
Jane Stevenson
I thank the hon. Member for his contribution, and I hope that we will have that education around their sale. Most hardware shops, where they used to be available, have already stopped selling them, but they are still available online. Hon. Members have asked why the Bill does not propose an outright ban on their sale. With devolved Administrations travelling at different speeds, that was not possible. However, he raises a valuable point. It is crucial to educate members of the public that these traps will no longer be legal, and I would like people who sell them—well, they should not be selling them—to advise that they should be used only by licensed pest controllers with a licence to use them.
I hope we can agree that the Bill will provide significant improvements to animal welfare standards. The Government have made real progress in animal welfare over the years, including on puppy smuggling and live animal exports, and I am proud to join the large number of MPs pushing for better animal welfare. At this point, I want to pay tribute to Sir David Amess. The last time I saw him, we discussed the Bill at an event for the Conservative Animal Welfare Foundation at our party conference where he was promoting Beatrice’s Bill: an end to hen caging. I hope that, at some point, we will fulfil his legacy by passing a Bill to that effect.
It has been a great honour to describe the Bill and I look forward to hearing hon. Members’ contributions. It is crucial that we end the use of these traps as quickly as possible. There will be a two-year period during which a licensing regime will be put in place, and I hope that that will ensure that licences are given only in exceptional circumstances. In New Zealand, fewer than a dozen are granted each year, and I hope that our use of them will reflect that figure.
Craig Williams (Montgomeryshire) (Con)
It is a real pleasure to support my hon. Friend the Member for Wolverhampton North East (Jane Stevenson), who has done a terrific job in moving the Bill forward. I know the unfortunate circumstances around Second Reading, so I am delighted to see her in her place today and to support her.
There are a couple of particular points I would like to make. First and foremost, as a Welsh Member of Parliament, I thank her for paying attention to devolution, and for going further and working with parliamentarians from the other Parliaments to ensure we can move at the same speed. I ask the Minister, in pulling together the next steps, about the possibility of using legislative consent motions and the powers afforded to us by the UK Parliament, to ensure that, in terms of timing, we help the other places to move together, so we can get to the education points. It is worth reflecting, as the right hon. Member for Alyn and Deeside (Mark Tami) said, on the availability of glue traps in some DIY shops and, in particular, online. The BVA gave evidence that they were available for about 99 pence, so they are clearly still both cheap and available. We need to do much more to ensure that my Welsh constituency sees the benefits of the Bill.
I was quite taken by the evidence, mentioned by my hon. Friend the Member for Wolverhampton North East and the right hon. Member for Alyn and Deeside, not just about Miles the cat, but the other 200 pieces of evidence from the RSPCA about hedgehogs, wild birds and the unintended consequences of traps. I am heartened that the Government, in their usual way, are looking at licensing as a way to allow their use where all other options have been exhausted. From the evidence, we can see that the aviation sector has a particular problem. While we remove glue traps from as much of the United Kingdom as possible and as quickly as possible, I very much welcome that there will be a licensing regime for the removal of pests where absolutely necessary.
From the licensing regime and the authorised inspector, I want to draw my remarks to a conclusion by returning to where I started: pulling the measures together at the same pace. On most Bills I speak to, especially when they say, “England only”, I look over my border constituency and think how great and wonderful it is to be supporting my English colleagues in progressing them. However, we must do more as the United Kingdom. I reinforce the point about legislative consent motions in the Welsh and Scottish Parliaments to bring these measures together at pace and at the same time, especially bearing in mind the complete consensus on this issue across the Government and Opposition Benches, and, I should imagine, all Parliaments of the United Kingdom.
I wish my hon. Friend well—I am entirely jealous that she is managing to effect legislation at a far quicker pace than I seem to have to date—and I wish the Minister well in pulling together the devolved Parliaments.
Lia Nici (Great Grimsby) (Con)
I congratulate my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) on bringing forward this important private Member’s Bill.
We often talk about the love we have for our pets and for animals more generally. I found it concerning that somebody had called the Bill a “rats protection Bill”. I grew up at a time when I was told by people who lived in the countryside and in the city, that we are never more than 10 feet away from a rat. That is quite horrifying. However, we must remember that rodents are one of the most successful mammals on the globe because they take advantage of human beings: the way we work and the disgraceful mess we sometimes create.Although there are important issues such as Weil’s disease—a terrible curse to anyone who contracts it—we should remember that as human beings we must respect animals and euthanise them, if need be to protect our own safety, in the quickest and most humane way that we can.
It never ceases to amaze me how barbaric human beings can be, and glue traps, I am afraid, are not selective. Someone may wish to catch a rat or a mouse, but my hon. Friend the Member for Wolverhampton North East eloquently described the distressing situation that follows. Rats and mice are highly intelligent creatures, and it must be the most horrendous death for them. Moreover, the UK, in particular the area around my Great Grimsby constituency, is vital for migrating birds; 90 million birds leave the Arctic every year, and the UK is an important area for them to live in. It would be terrible to think that the ongoing use of glue traps might cause the demise of even more of our important wildlife.
Rats in particular are very dangerous, so I welcome the clauses of the Bill that permit the Secretary of State to award licences for glue traps to those professionals who know what they are doing. There are, as we know, some instances where rats and mice, particularly rats, cause serious health protection problems. Environment officers and agencies are a vital part of our local authorities and local councils and ensure that we are protected.
I wholeheartedly thank my hon. Friend for introducing the Bill; it is an important and balanced Bill that ensures not only that we can protect ourselves and our health, but that we are not causing undue stress to other sentient beings. Anybody who has ever caught a rat or seen a rat when it is alive will know what intelligent animals they are. That is why we must ensure that we are not being unduly cruel.
I also stress to people that the best way to reduce rodent infestations is to ensure things are packed away correctly and foodstuffs are not left out—certainly not to throw their takeaway down the road out of the car, as I have seen on many occasions. Rodents are clever creatures and as soon as that food is out there, they will take advantage. If human beings would take a little more care in how we look after our world, we would not need to introduce Bills in this place to prevent people from doing barbaric things to rodents, even though we do need to control them at times.
Stuart Anderson (Wolverhampton South West) (Con)
I am delighted to support my colleague and constituency neighbour, my hon. Friend the Member for Wolverhampton North East (Jane Stevenson). As her neighbour, I share the same passion, although she is a great champion of animal rights and animal welfare across Wolverhampton and in many areas that she speaks in. In Wolverhampton, we want to see the right thing done for the whole community, so I welcome this Bill and the Government’s support for it.
When people find out I am an MP, family, friends and many constituents will tell me great ideas for Bills that I could introduce. Normally they are very well-meaning; I get everything from jumping on a trampoline to cure covid to other things—
Stuart Anderson
That is a genuine one I have had. However, when I think of it, it is very hard to bring forward something meaningful that will get the support of the House and change legislation. We have seen my hon. Friend the Member for Romford (Andrew Rosindell) and now my hon. Friend the Member for Wolverhampton North East introduce two great Bills.
As we have heard, the point of this Bill is to ban the use of glue traps to catch rodents in all but the most exceptional circumstances. That is a fair and proportionate policy, which is in line with the Government’s own world-leading action plan for animal welfare. The action plan has already introduced a series of reforms providing further protection for the welfare of animals, whether they are on the farm, at home or in the wild. It is also committed to restricting the use of glue traps as a means of pest control; as has already been mentioned today, there are more humane ways of removing rodents from our buildings.
The manifesto on which I was proudly elected states
“High standards of animal welfare are one of the hallmarks of a civilised society. We have a long tradition of protecting animals in this country, often many years before others follow.”
Glue traps are inhumane tools which go against that theme. They cause great suffering and painful deaths to animals. Their use is cruel. Animals can remain alive for 24 hours after capture, and my hon. Friend the Member for Wolverhampton North East gave some examples of the unintended consequences involving pets and wildlife.
I agree with my hon. Friend that we have a responsibility to use the most humane methods in order to prevent unnecessary suffering. Levelling up animal welfare standards ought to be a top priority for all levels of Government, and also—as we heard from one of my Welsh colleagues, my hon. Friend the Member for Montgomeryshire (Craig Williams)—for the devolved Administrations. I hope that news about the great progress that is being achieved through this Bill will travel far and wide, and will feature prominently in Ministers’ conversations with devolved Administrations.
As we know, however, glue traps are not the only things that animals can find themselves caught up in. Since the introduction of the plastic bag charge, the Government have successfully prevented billions of plastic bags from being sold and ending up in oceans and the environment where they have the potential to harm animals. I am a keen advocate for a safer, cleaner Wolverhampton, and, as my hon. Friend will know, I regularly run “Stuart’s street clean”. In the centre of a huge, built-up area is a beautiful place called Smestow Valley. If you walk down there from Cupcake Lane, you could be in any nature reserve in a country area rather than in the middle of a built-up urban area, and you would absolutely love it. I recently went on a litter pick there, and Members will be pleased to hear that the number of plastic bags has been reduced as a result. The wildlife in the valley is amazing, and it is a great pleasure to walk or run along it, perhaps with the family. Many dog walkers enjoy doing that.
Jane Stevenson
I thank my hon. Friend for his regular litter picks, which have become somewhat legendary in my home city. Does he agree that in an urban, industrial centre such as Wolverhampton we need to enjoy what nature we do have? Given that Smestow Valley and the canal network that spreads into my constituency—the canals around Wednesfield—are such a haven for wildlife, should we not do all that we can to protect them?
Stuart Anderson
I do agree with my hon. Friend. It is such a beautiful area, and we must indeed do everything possible to ensure that it is preserved. We have many beautiful parks as well. I know that this is not meant to be a Wolverhamptonfest, but it would be remiss of me not to mention, for instance, West Park and Bantock Park.
As I have said, I was proud to be elected on a manifesto which pledged to raise standards in areas such as animal welfare and the environment, and that is why I am delighted to support my neighbour’s Bill.
Jerome Mayhew (Broadland) (Con)
I believe it was my hon. Friend the Member for Christchurch (Sir Christopher Chope) who, in an earlier debate on the Bill, described it as a rat protection Bill. Were it to be one, I would certainly not be supporting it. I grew up in an old farmhouse; some of my most profound memories of childhood involve rodents, and not in a particularly positive way. I remember lying in bed as a small child in that seemingly interminable period between being put down and actually falling asleep and hearing the scurrying of the mice—I hope they were mice, but we were never sure whether the mice or the rats had the upper hand at any one time. They would go up the wall and I would hear them pitter patter across the ceiling. I was used to it from an early age, so it became rather soothing after a while, which seems odd in retrospect.
We had a mouse in our kitchen for a period that became very bold. They are normally nocturnal, but one lived behind the gap where there should have been a dishwasher. It took to coming out into the kitchen while we were having our breakfast and would wander across the floor. It was rather sweet so we did not take effective action for a week or two, but I am sorry to say that my mother eventually decided that hygiene was the better part of that relationship. I am sure that she did not use a glue trap but an effective means was found to say goodbye.
I mentioned the contest between the ascendancy of the mice and the ascendency of the rats. It may be an urban myth but I have always assumed that there is only ever one kind in the house—mice or rats. I stand to be corrected on that. I remember that, when my brother was on a rat hunt in the larder with a baseball bat, he effected a clean hit on a moving target, which gave him enormous status, certainly in my eyes—I have looked up to him ever since.
Lia Nici
My hon. Friend is telling us a beautiful story of growing up in the countryside, about which I would like to read more in his future memoirs. I may have a sleepless night tonight though because “The Ascendency of the Rats” sounds like a new horror film. I am concerned that perhaps we should look at banning baseball bats with regard to rodents as well.
Jerome Mayhew
I thank, I think, my hon. Friend for her intervention. One thing to be said for baseball bats as a method of controlling rodents is that, although they may not be very effective, and people rarely make contact, when they do, they are decisive.
I reminisce because we need to control rats and rodents, but we share this world. Growing up with the kind of childhood that I had, I instinctively understood how much we share this world with wildlife and I benefited enormously from that. When we need to control animals, therefore, particularly sophisticated animals such as mice and rats, we need to do that quickly and humanely, so I support the Bill almost in its entirety.
I run the risk of sounding a bit like a lawyer this morning, because I made a rather tedious intervention on the previous Bill and I am afraid I will do so again. I made the point on Second Reading, and was punished by being put on the Committee as well, where I took the opportunity to make the same point, for which I received cross-party support and agreement, that there is an issue in clause 1(5) that needs to be addressed.
The Bill has the effect of outlawing the laying of glue traps, but not entirely. It is still perfectly legal for licensed operators to lay glue traps in certain circumstances. Clause 1(4) says:
“A person who knowingly causes or permits an offence to be committed under subsection (1) or (2) commits an offence.”
That has in mind people who perhaps pay someone else to lay a glue trap on their behalf. Clause 1(5) says,
“A person commits an offence if the person—
(a) finds a glue trap in England that has been set in a manner which gives rise to a risk that a rodent will become caught in the glue trap, and
(b) without reasonable excuse, fails to ensure that the glue trap no longer gives rise to such a risk.”
This subsection relates to the passer-by. It is in that context that I have significant concerns about the current drafting, because a bystander will need to know the legal requirements for the setting of a glue trap.
A perfectly innocent bystander or passer-by who sees a glue trap in any situation will have to identify, first, that it is illegal, and then whether it is a licensed glue trap. Either it will put the passer-by at risk of committing an offence or it will be a terrible nuisance to licensed operators who legally lay glue traps for which there is a specific need, as passers-by will throw themselves upon the glue traps to disable them. I am concerned that the drafting still does not take account of this genuine concern.
Jane Stevenson
I thank my hon. Friend for enduring the ordeal of serving on the Public Bill Committee, to which he made a valuable contribution. I understand his concern about these measures, but it is crucial that we close the loopholes. I do not think a member of the public could be expected to know, and it would be a reasonable excuse, because a glue trap is essentially a piece of cardboard that is not recognisable as being very harmful, but a pub landlord might ask a pest controller to put them down, and he would be liable. He could not claim, “It wasn’t me, so I cannot be prosecuted.”
Jerome Mayhew
Actually, my hon. Friend’s example would be caught be clause 1(4).
I am also concerned about clause 1(5)(b), because it has the seeming effect of reversing the burden of proof. The defendant, the innocent passer-by, has to prove that they had a reasonable excuse. I would be grateful if the Minister addressed that point to reassure me and other hon. Members that we will not inadvertently create unintended consequences while continuing to support what is, without doubt, a very useful and much-needed amendment to our legislation.
Matt Vickers (Stockton South) (Con)
I pay tribute to my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) for introducing the Bill. I congratulate her on the constructive and positive discourse and cross-party dialogue she has engaged in and facilitated on this Bill.
As has already been much laboured today, glue traps are a barbaric and gruesome form of pest control that have the potential to cause immense, unnecessary and sustained suffering to the animals they catch.
Mark Eastwood (Dewsbury) (Con)
We are talking about glue traps being a danger to animals. Can my hon. Friend think of circumstances where they could be a danger to babies and small children?
Matt Vickers
I can only imagine. We heard the story of a cat that lost its life to these glue traps, so they are a huge danger and a huge hazard.
This Bill will be a fantastic addition to the Government’s efforts to ensure that we maintain the highest animal welfare standards in the world. Although I am a fan of Roland Rat, Remy and Mickey Mouse, I fully appreciate that rodents are a real and significant health issue for businesses, restaurants and homes across the country. I was stunned to learn how many babies the common brown rat can produce in a year. Without proper action, rodents can and do pose a dangerous threat to humans, damaging property and spreading very serious disease.
Although few would argue with the need for pest control, I am sure that nobody would accept that it should be less humane than necessary. We are all aware that the end result of many traps aimed at dealing with pests will often involve death, but we should strive to ensure that that is as quick and painless as possible. Few people, if any, would accept that a slower and more painful death for whichever animal gets stuck to a trap justifies any sort of cost or convenience benefit.
I draw the House’s attention to a British Veterinary Association report that pointed out that trapped animals can suffer from torn skin and broken limbs and die a brutal, slow and painful death, often from suffocation, starvation, exhaustion and even self-mutilation. I find that barbarity hard to reconcile, and on researching the traps I was disgusted to see their impact on rodents and other unintended victims. Apart from the fact that glue traps cause unnecessary harm to the rodents that we actually want to deal with, as others have said they also represent a real danger to other animals, creatures and birds. The RSPCA has noted that over five years it has had 200 reports of incidents involving cats, birds, hedgehogs and squirrels that have all suffered horrific and unnecessary injuries.
I do not believe that restricting the use of glue traps will harm our ability to deal with rodents, and I note, as others have, that both the Republic of Ireland and New Zealand have restricted the use of the traps with no significant detriment to pest control. I recognise that this is a devolved issue and ask that we continue to liaise with the devolved Administrations in the United Kingdom to try to secure some parity and co-operation in tackling the traps. I congratulate my animal-loving hon. Friend the Member for Wolverhampton North East on the progress of the Bill and look forward to seeing an end to the use of these barbaric devices, which cause so much unnecessary harm and suffering.
Several hon. Members rose—
Madam Deputy Speaker (Dame Rosie Winterton)
Order. May I gently point out that if Members want to catch my eye to speak, it is quite useful to stand and indicate it from the beginning? I recognise that people might be suddenly inspired to speak at the last moment, but even if colleagues have put in to speak it does not mean that they necessarily want to, so it is quite useful if people indicate that wish. I almost went straight to the shadow Minister, so those who have started bobbing now might have been missed out.
Brendan Clarke-Smith (Bassetlaw) (Con)
I was relatively inspired by my hon. Friend the Member for Stockton South (Matt Vickers), Madam Deputy Speaker, and would like to share my brief experience with rats.
As has been mentioned, rodents are not necessarily the most popular thing. There is the worry of disease, and of course in this very House, in many of the corridors leading towards our offices, we see many and various traps lying around. One job I am given where I live is to put various bits of poison down, as we had a little bit of a problem once upon a time. One morning, I opened the front door and we had been left a surprise gift at the front of the house of a particularly large rat. It did not appear to have any life signs and I was subsequently tasked with removing it with a bag and sending it away. My son ran behind me to see what was happening and I had to use my diplomacy skills to say that the mouse, as I called it, was just sleeping, at which he informed me, “No, Daddy, it’s dead.” Thanks to his greater knowledge, I disposed of the rat and of course we used poison.
I must say that I was incredibly ignorant of the concept of glue traps. I had never heard of them before, so my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) introduced me to the concept. When I googled them and clicked on the images, I was genuinely shocked to see these traps that can be purchased for as little as 99p. The images were not of rodents, but of hedgehogs and birds. We saw some quite nasty things.
Although we want to tackle the problem of rodents, there are better ways of doing it. The Bill is a sensible and humane way forward, so I commend it to the House and thank you, Madam Deputy Speaker, for giving me the opportunity to follow the inspiring speech made by my hon. Friend the Member for Stockton South.
Ruth Jones (Newport West) (Lab)
This is another Bill that will make it through the House this morning and on to the other place. It appears that Friday is the new Wednesday in this House when it comes to productivity and excitement.
I am grateful for the opportunity to speak from the Labour Benches in support of this Bill on Third Reading. I should say that it is good to see the Minister in her place. I feel as if I have seen more this week of her, her fellow Minister the hon. Member for Bury St Edmunds (Jo Churchill) and the hon. Member for North Devon (Selaine Saxby) than I have of my husband, my children and my cat. I suspect the same goes for the Minister, too.
I congratulate the hon. Member for Wolverhampton North East (Jane Stevenson) on raising this important issue and on the constructive way in which she has worked with colleagues on the Opposition Benches. I gently say to the hon. Members for Montgomeryshire (Craig Williams), for Wolverhampton South West (Stuart Anderson) and for Stockton South (Matt Vickers) that devolution is alive and well and working throughout the UK. The Senedd and the Scottish Parliament will work to achieve the same aims in their own way in their respective countries. I gently ask them to remember that when they talk about UK-wide legislation.
Craig Williams
I am sure that the hon. Lady will have noted that I talked about legislative consent motions. I not only understand devolution and welcome devolution, but pay due reference and respect to devolution by asking for the Administrations’ consent. I gently push back and say to her that I was being quite pro-devolution.
Ruth Jones
I thank the hon. Member for his intervention. Of course I take it that you were respectfully in support of devolution, which is a lovely thing—thank you very much.
Ruth Jones
Sorry, I thank the hon. Member. I do apologise, Madam Deputy Speaker.
As the Bill now prepares to move to the other place, it is important to note that the banning of glue traps is supported by a range of campaigners, stakeholders and organisations. That support stands today and extends, as it has previous, to those on the Opposition Benches. I feel sure that my friend Baroness Jones of Whitchurch is raring to pick up this Bill and the points around enforcement, scope and language as their lordships consider the Bill. The Opposition did not table any amendments and will not seek to push to a vote, but I do want to acknowledge the comments and campaigning prowess of my fellow countryman, my right hon. Friend the Member for Alyn and Deeside (Mark Tami). He is right to have raised his important points, and I thank him for his care and interest in these issues.
We wish the Bill well as it travels out of this House, and look forward to the devolved Governments working together to deliver real action, not just hot air. As the shadow Minister for air quality, may I say that all measures to tackle hot air are to be welcomed.
I wish to acknowledge all those involved in the Bill and in ensuring its safe passage. I should say to the hon. Member for Wolverhampton North East that this shows what a Member of this House can do with the support of the Leader of the House and the Government. I asked her for tips on success when the Bill Committee was in session. I think the simple answer for those on the Labour Benches is to ensure that a Labour Government is elected, although I do not expect the Minister to welcome that, but we can always live in hope.
I thank the hon. Members for Orpington (Gareth Bacon) and for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), my hon. Friend the Member for Rotherham (Sarah Champion), the hon. Members for Westmorland and Lonsdale (Tim Farron), for Broadland (Jerome Mayhew), for South West Hertfordshire (Mr Mohindra), for Hartlepool (Jill Mortimer), for West Bromwich East (Nicola Richards), for Romford (Andrew Rosindell), Stockton South (Matt Vickers) and for North Devon, my very experienced and knowledgeable hon. Friend the Member for Bristol East (Kerry McCarthy) and my right hon. Friend the Member for Alyn and Deeside. I give a special thanks to all their staff for their assistance, hard work and commitment. The same, of course, applies to the staff of this House, including the Clerks and the Library staff.
The hon. Member for Wolverhampton North East knows that we on the Labour Benches think that she has done many animals a great service by bringing this Bill to the House. Like her, I also acknowledge the hon. Member for Truro and Falmouth (Cherilyn Mackrory), who so ably stepped in previously, and I thank her for doing so.
I look forward to seeing the Bill’s progress in the other place and wish it, on behalf of these Benches, very well indeed.
Madam Deputy Speaker (Dame Rosie Winterton)
Before I call the Minister, may I just mention that the word “you” has been used quite a lot to address Members directly? Let me remind everybody that, when they say “you”, they mean me. Fortunately, this morning, it means that I have had an awful lot of praise—inadvertently. This is just a reminder, because I know that it is sometimes tempting in these Friday sittings to address each other directly, so please beware.
The Minister for Farming, Fisheries and Food (Victoria Prentis)
I am extremely grateful to my hon. Friend the Member for Wolverhampton North East (Jane Stevenson) for her tremendous work in introducing this Bill and for navigating it to this stage. It has been a real pleasure to work with her.
We have heard some excellent speeches this morning. First, my hon. Friend the Member for Montgomeryshire (Craig Williams) made the valid point that there are still some sectors in which it may be necessary to continue to use glue traps. One he suggested is the aviation sector, and if there is an area where a mouse or a rat is causing trouble—particularly in gnawing through wiring, for example—and the layout of the area means it is impossible to get in another type of trap to catch the animal, a glue trap might be appropriate. That is why we have left the licensing provisions in the Bill.
My hon. Friend the Member for Great Grimsby (Lia Nici), who normally talks to me a great deal about fish processing, reminded us—I am not sure that we were grateful—how close we are to a rat, probably at this very moment. She also talked about how intelligent they are.
My hon. Friend the Member for Wolverhampton South West (Stuart Anderson) made valid points about how people are working together in Wolverhampton to make animal welfare better across the sphere. He also made the valid point that litter picking is definitely part of the answer to troublesome rodents.
My hon. Friend the Member for Broadland (Jerome Mayhew), who was soothed to sleep by rodents as a child, discussed the truly horrific event—I am not surprised it is seared on his memory—of his brother killing a rat. However, he also made some serious points, which I will address. The offence in clause 1(5) covers a situation in which a person fails to remove a trap set by somebody else. It is really aimed at people, for example, in house purchasing, such as the new owner of a property. The concept of reasonable excuse, as he knows very well, is widely used in criminal legislation. It does not seek to impose the burden of proof on the defendant. If the defence of reasonable excuse were raised, it would be for the prosecution to prove beyond reasonable doubt that the defendant did not have a reasonable excuse. Reasonable excuses would certainly include trespass and the tort of interfering with somebody’s property. I am sorry, Madam Deputy Speaker, but occasionally I cannot help behaving like a lawyer.
My hon. Friend the Member for Stockton South (Matt Vickers) talked seriously about the effects of slow death on animals. My hon. Friend the Member for Bassetlaw (Brendan Clarke-Smith) was also keen to share his experiences of rats, and he was right to draw attention to the large variety of traps available in this very building.
I agree with the hon. Member for Newport West (Ruth Jones) that I have seen considerably more of her this week than I have of my family. It is, as ever, good to have her support on this Bill.
If I may, I would like to say a little about the rodents for which glue traps are currently marketed. I think it has been accepted across the House that we do need to control rodents, but in our nation of animal lovers, it is important that we do so as humanely as possible. We think the house mouse arrived in Britain in the iron age. Archaeological evidence indicates that they were present in large numbers by Roman times. The Mammal Society suggests that the availability of food and habitat for mice, and in turn their population, will have reduced—and I, for one, think that is good news—since the 1960s owing to changes in housing construction, the way we keep food, such as in sealed containers, and indeed developments in agriculture, including more secure grain storage. It is true to say that mice can breed prodigiously. In man-made environments where there is a good supply of food, litters of between five and eight baby mice can be born at roughly monthly intervals. Although house mice can be found out in the countryside, they are poor competitors with other rodents, particularly wood mice. The house mouse is very happy to live side by side with humans, and its movement patterns and current widespread distribution are really because of its ability to adapt to us.
The brown rat is a very adaptable species. They are mainly nocturnal animals, and being able to climb and swim allows them to exploit a wide range of resources. They prefer habitats with dense cover and, of course, an abundance of food: they will eat just about anything. They are prevalent in rural farm buildings, but also occur in other rural habitats, most notably the river environment as we all know from children’s literature. Densities vary dramatically before and after harvest. Substantial populations, such as the ones we have largely heard about today, also exist in urban areas, where they frequent sewers and other areas where food waste is available. They also live in buildings, and in many coastal habitats, especially salt marshes and grasslands.
It comes as a surprise to many people to learn that brown rats have only been in this country for around 300 years. They seem to have been introduced to the British Isles as a species in around 1720. Their forerunner, the black rat, has a longer history and, rightly or wrongly, is associated with outbreaks of plague. It is not a native mammal to these islands either. The brown rat has subsequently spread throughout the British Isles and indeed much of the world, often carried in ships. Reproduction is observed all year round, females can begin to breed at three to four months old, and they typically have five litters of between six and 11 baby rats a year.
If I may, I will suggest a few alternatives to the use of a baseball bat, which is not recommended by the Government, as a means for trapping house mice and brown rats. They can certainly both be viewed as pests. That has led to humans persecuting rather than conserving them, often through the use of traps. It is likely that people have trapped mice for as long as people have had houses. The word “mousetrap” dates from at least 1475, and reference to “a mousetrap” is made in “Hamlet”. The world’s first produced mousetraps seem to have appeared in the late 19th century. While arguments rage as to who invented it, candidates include a British ironmonger, Mr Atkinson, who in 1897 designed the “little nipper”, which is still the basis of one of the widely used break-back traps today. A wide selection of foodstuffs can be used to catch mice. My husband favours peanut butter, and I am surprised we have not heard more from hon. Members about their preferences for use in break-back traps.
There is a live and wide debate about who was the first to develop the first lethal mousetrap with a spring-loaded cast iron jaw. Various American lay claim to doing so. It is notable that many patents are filed for new mousetraps every year. The Government fully support innovation in this field and the development of more humane means of trapping rodents, which can only be welcomed by us all in this House.
I, too, would like to express my gratitude to animal welfare organisation who have helped with the Bill. Although the scope of the Bill is narrow, it is a vital addition to our animal welfare legislation. We have heard about the suffering the traps can cause and it is therefore right to ban their use in all but the most exceptional circumstances. We look forward to working closely with animal welfare groups and pest control organisations to ensure that the licensing regime is appropriate and effective. I also warmly welcome the positive news that, since the Bill was introduced last year, the Governments in Scotland and Wales have both made announcements of plans to introduce similar legislation. We will wait to see how those develop, but aligning legislation to ensure an effective ban across Britain would seem desirable.
I offer my thanks again to my hon. Friend the Member for Wolverhampton North East for introducing the Bill and to all hon. Members who have contributed today and in previous stages. I am pleased to reiterate the Government’s support for the Bill and wish it well in its progress.
Jane Stevenson
With the leave of the House, I would like to take a few moments to thank everyone for their interesting and sometimes disturbing contributions to today’s debate, including my hon. Friends the Members for Montgomeryshire (Craig Williams), for Bassetlaw (Brendan Clarke-Smith), for Wolverhampton South West (Stuart Anderson), for Great Grimsby (Lia Nici) and for Stockton South (Matt Vickers). I would also like to thank Members who supported the Bill in Committee and its earlier stages.
I could not close without thanking all the animal charities. We had several online roundtables throughout this process. There are too many to mention, but the Humane Society, the RSPCA, the UK Centre for Animal Law, Cats Protection, People for the Ethical Treatment of Animals and the Conservative Animal Welfare Foundation are among them. I again thank the Minister for her reassurance that they will be involved in the licensing regime to make sure that humane options that they have suggested, such as pressure pads or maximum time limits, are looked at.
Lia Nici
We had a discussion about this issue, and it is something I am concerned about with animal welfare. There has been lots of discussion about what happens when a rodent or any animal is caught on a glue trap. Often, that animal will be in distress and probably take at least 24 hours to die. I notice in the Bill that it does not stipulate anywhere for a professional pest control organisation or person to act. Could they just lay a glue trap and it be there for a very long time and we would still be in the same situation with inhumane death, or is there something else that we would expect to see?
Jane Stevenson
I reassure my hon. Friend that very strong representations have been made to the Minister, and I do not think her arm needs twisting too hard on this issue. I would like to see pressure pads used with glue traps, because it will be rare that they are used, and the placement of a pressure pad underneath a glue trap could alert a licensed pest controller almost immediately to an animal. I hope that any licences granted would have a responsibility to attend that animal in a very short timeframe. It is an important point, and I thank my hon. Friend for raising it.
I also thank the team at DEFRA, who have been fantastic in helping to draft the Bill. I thank the people in my office, who are all sitting in Wolverhampton, cheering the Bill on today. I also thank the dynamic duo on the Opposition Benches, the hon. Member for Newport West (Ruth Jones) and the right hon. Member for Alyn and Deeside (Mark Tami). Both are such heroes for animal welfare, and it is a great pleasure to see their commitment to getting animal welfare legislation through and working so co-operatively and sensibly on this Bill.
Finally, I thank the Ministers, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) and my hon. Friend the Member for Banbury (Victoria Prentis), who I thank for her rat reproduction and history lesson today. I had absolutely no idea that the first mousetrap was invented in 1475, which is absolutely fascinating.
Briefly, when I look back into my family history I see that one of the great industries of Wolverhampton in the 18th and 19th century was making animal traps, and that my Mattox ancestors were vermin trap makers in Wednesfield in Wolverhampton, so perhaps my bringing this Bill before the House is a sort of atonement on a descendants’ basis. I had not thought of it until the Minister raised the historical context of our trapping rodents. I am a lifelong animal lover, and I had pet gerbils as a child—we have heard about a lot of pets today—but I was not disturbed by rodents in my bedroom running around and keeping me awake. I greatly enjoyed keeping gerbils, and I have great fondness for rodents, who are very intelligent animals.
With all my thank yous wound up, I thank you, Madam Deputy Speaker, for indulging me in with a few moments at the end of the debate. I look forward to seeing the Bill progress. Another thank you goes to Baroness Foulkes, who will hopefully introduce the Bill in the House of Lords next week.
Question put and agreed to.
Bill accordingly read the Third time and passed.
Down Syndrome Bill
Friday 4th February 2022
(2 years, 9 months ago)
Commons ChamberRead Full debate Down Syndrome Act 2022 View all Down Syndrome Act 2022 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Public Bill Committee Amendments as at 26 January 2022 - (26 Jan 2022)
Dr Liam Fox (North Somerset) (Con)
I beg to move, That the Bill be now read the Third time.
May I begin by thanking Members on both sides of the House for the support that they have given the Bill from the very outset? There are not many things that justify the downsides of being a Member of Parliament, but this is certainly one of the upsides—when we can see what will inevitably be a crisis emerging and do something about it in due time. That is one of the privileges given to us, and I am grateful to Members for their support in taking the Bill forward. They have not only supported it here in the House but advocated for it outside the House, where it has become one of the best-known private Members’ Bills in recent times in terms of public awareness of what is happening. That matters a great deal, because the Bill is not exactly the same as it was when we considered it on Second Reading—a subject that I will come to in a moment.
The most common question that I am asked is, “Why have you been so concerned with this issue?” I explained on Second Reading that when I was growing up, the boy next door to me had Down syndrome. As a GP, I saw a number of those with Down syndrome and their families, and I saw the difficulties that they encountered. We regularly see one of my friends in my constituency, where I live, whose son Freddie has Down syndrome. As Members of Parliament, we have all recognised that having someone in the family with Down syndrome is not just a single problem to be dealt with; it is a conglomeration of problems. Families find themselves fighting on a number of fronts to get the quality of care that, frankly, they already have a right to. For me, that was why we needed a separate Bill.
All Members will have had letters asking why the Bill could not have been wider—why we could not have included more conditions in it. I suppose there are two answers to that. The first is that private Members’ Bills have to be short and concise if we are going to get them through. Let me be very frank: getting a foot on the ladder of legislation in areas such as this is crucial. If we reach for too much in a private Member’s Bill, we can end up with zero. I think we have set the appropriate level of ambition in this Bill.
We also have to recognise the complications that come with an extended Bill when it comes to the view of the Treasury. Many years ago, I was in the place of the Lord Commissioner of Her Majesty’s Treasury, my hon. Friend the Member for Castle Point (Rebecca Harris). It is definitely a case of gamekeeper turned poacher, but you learn a great deal as the gamekeeper for when you have to be the poacher later on when it comes to private Members’ Bills. I put on the record my thanks to her for her help. The role of the Friday Whip is not well understood outside Parliament, but when they are on your side, they can be very powerful allies indeed, and her support is very much appreciated.
We also wanted the Bill to be separate because it is about a definable group in the population. Down syndrome is not something where there is any dubiety about the diagnosis and, as I said, there are complex identifiable needs. For example, we know that those with Down syndrome have a higher level of issues such as congenital heart disease, they have a higher instance of leukaemia, they have myriad ear, nose and throat problems, and the earlier they are dealt with, the better. It is difficult enough for parents to be fighting waiting lists and fighting to be regarded with sufficient urgency; if they are also dealing with the education system and trying to get help for a learning disability, that is an additional problem.
The successes in medical care are the main driver for the Bill. When I was growing up, that boy next door had a life expectancy of 15 years. When I became a doctor in 1983, the life expectancy was about 30. Now, it is about 60. We should all be extremely grateful for that, but, as ever with advances in medical science, it brings its own problems. The problem, if we want to see it as such, is that parents will have this extra worry: “What will happen when I’m not there?” That is why I referred at the very beginning to a perfectly identifiable crisis that is on its way to us. If we actually take measures now, we can prevent individual tragedies. If there is a real justification for Members of Parliament having their own constituencies and dealing with real people, rather than being creatures only of a political party, it is that constituency link, which tells us about problems that need to be addressed and gives us the early warning sign to pass legislation to be able to deal with them. The complexity of the issues is one reason why we need separate legislation and why we had to bring different provisions into the Bill as it comes back for Third Reading from when it left the House after Second Reading.
Ruth Jones (Newport West) (Lab)
The right hon. Member is making such a powerful point. He and many other Members have had numerous letters questioning the narrowness of the Bill. Will he reassure us that this is only the beginning and most definitely not the end of the process?
Dr Fox
Indeed. I would not even say it is the end of the beginning. It is on the way to being the end of the beginning, but this will be a perpetual battle. So long as medical science is able to make advances in genetics and immunology, this process will continue into the future and we will need to look at it. It is worth pointing out, to answer the hon. Lady’s question more directly, that we considered this in Committee. The Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), made it clear that in the guidance that will be issued, which I will come to in a moment, it is entirely possible to deal with the effects of other conditions that may have the same effects as those emanating from Down syndrome. In a way, yes, we are starting the process, and the way in which we change the Bill is absolutely key to that.
On Second Reading, I think it is fair to say, because we can be a little self-critical, that this was a well-meaning Bill that went as far as we could. However, I made it clear that one big issue was missing—the enforcement of rights. It is all very well to make available new provisions and rights in law, but if an individual or parent does not have the ability to enforce those rights, if there are no mechanisms or levels to pull to enable them to get the full benefit of what the legislation supposedly gives them, ultimately we are failing to achieve what we want. We discussed two major issues. I purposely left them out of the Bill on Second Reading because we were not ready. There is nothing worse than poorly-thought-out legislation that we have to come back and amend. It is far better to think the process through, get agreement on both sides of the House and with the Government, and then proceed on the basis of unanimity, as happened in Committee.
The changes were essentially twofold. The first was getting agreement from Ministers that they would issue guidance to local health and education bodies and planning authorities to ensure that healthcare, education and long-term care issues would be properly taken into account. That was a major step forward. Again, it answers the question of how we can broaden the effects of the Bill, even with measures that are not in the Bill. That means looking at other conditions that will face the same problems as created by Down’s syndrome. However, that agreement created its own parliamentary problem for us, because as those who listen to debates in the other place will know, guidance issued by Ministers that is not laid before Parliament creates a potential democratic deficit. That is why I think it was the first major step forward for the Bill in Committee when the Government agreed not simply that the Minister would issue guidance, or that that guidance could apply directly to the various bodies concerned—another important step in itself—but that that guidance would be laid before Parliament.
Up to that point, I had considered whether we needed to put a sunset clause in the Bill, to have it completely reviewed to see whether it worked in practice. The fact that the guidance will be laid before Parliament enables us to look in real time at what is happening, including parliamentary Committees looking at how the guidance actually works. That is a huge step forward. I think it is actually precedent-setting and turns this from a nice Bill into a cutting-edge and meaningful Bill. That is a huge achievement and one thing for which the Bill will be most remembered.
Craig Williams (Montgomeryshire) (Con)
I pay huge tribute to my right hon. Friend for bringing forward the Bill and the manner in which he has done so. On the territorial extent of the guidance, as a Welsh Member of Parliament I pay tribute to him, but he will know far better than I, given his length of service in this place, that the Bill’s territorial extent is England only. The Minister has alluded to working with devolved counterparts, but may I ask him to use his passion and experience to urge the devolved Administrations to follow suit?
Dr Fox
I thank my hon. Friend for that question. It will not surprise him to hear that, as a committed Unionist, I will come back to that. We need to consider the quality of life of all citizens in the United Kingdom, not just those for whom we are directly legislating today.
I turn to the second element of precedent-setting changes that we made to the Bill in Committee. As we move to the new integrated care structure in the health service, we will have a named individual on the integrated care boards responsible for the application of this legislation, should it receive Royal Assent. That really matters, because those who have Down syndrome, their parents, their families and communities will know who in the new structure is responsible for ensuring that the guidance issued by Ministers is given effect on the ground. I think that even the direct application of ministerial guidance—as it would have had—and parliamentary scrutiny would not have been not quite enough to guarantee the effect of the Bill’s provisions where it really matters.
That is precedent-setting. I doubt very much whether this will be the only occasion on which my hon. Friend the Minister has to consider representations for named individuals to take responsibility, but I take great pride in the Bill being the first, because I think it is a major step change from what we have had. It will give the new integrated care plans the idea of responsibility for their application to named individuals, which gives us a point of pressure in the system that did not otherwise exist.
Finally, I turn to the Bill’s application to one part of the United Kingdom. At the beginning of the legislative process, we had a choice. We could have set out a United Kingdom Bill and challenged the Governments in Scotland, Wales and Northern Ireland for legislative consent orders. We could have said, “We dare you not to have the same provisions.” However, that would have become a debate about devolution, not Down syndrome, and I passionately wanted the Bill to focus on the needs of those with the condition and not become an argument about Government process or our constitutional relationships.
Having said that, I completely take the view that a person with Down syndrome should not have fewer rights in one part of this United Kingdom than in any other. The Bill is making speedy progress through the House. I hope that it will make speedy progress through the other place and that, hopefully, it can get to Royal Assent before World Down Syndrome Day on 21 March, at which point we would be the only country to have legislated for it. That is important for our concept of global Britain, which cannot be just about trade, defence or economies; it must also be about our values, and I can think of no clearer signal to send than to legislate on this point.
I say to those in charge of the legislative programmes in Wales, Scotland and Northern Ireland that it is unthinkable that people with Down syndrome living in those parts of the United Kingdom should have fewer rights, or rights applied at a later date, than those in England, for whom we are legislating today. When it comes to health, it is the duty of all those who run those devolved parts of the United Kingdom to ensure that everybody in the UK, irrespective of where they live, gets the same access at the same time to the changes to which we are giving effect today.
This Bill began with great intentions, and ends now as a landmark Bill. It recognises that, in the provision of services, whether in health, education or long-term care in this country, Parliament will give not only rights, but applicability and enforceability of those rights in our systems. That is a change in the whole way in which we think about such legislation in this House.
I am very proud to have been the mover of this Bill; as the mover of the Bill, I am also very moved by the support that has come from every party in the House of Commons and from the Government. I thank all my colleagues and, with your indulgence, Madam Deputy Speaker, I may be able to thank some others who have been instrumental in the progress of the Bill a little later.
Edward Timpson (Eddisbury) (Con)
It is a real pleasure to follow my right hon. Friend the Member for North Somerset (Dr Fox), who, in a more modest way than I normally remember, has established an important part of what has made this Bill possible: his energy, enthusiasm and drive to get it to this stage in this shape and at such speed.
Many of us in this House will have different personal and professional reasons for supporting this Bill. For me, I must go all the way back to the early 1980s: believe it or not, I was alive and about seven or eight years of age. My parents had started fostering a few years before, and ended up doing so for about 30 years. During that period from the early ’80s to the mid-’80s, we as a family looked after Down syndrome babies, who came to live with us for weeks and sometimes months. We also offered respite care once a month for a long weekend for a Down syndrome boy in his early teens, to give his parents a much-needed break from an incessant and stressful time. Despite the love they had for their son, they needed a pressure valve in order to maintain their ability to look after him and keep their energy levels up.
We were as happy as could be to provide that respite care. I recall it vividly, because it captured some of the most enjoyable images of our time in fostering. I recall many occasions with that young teenager, who had a couple of obsessions that infiltrated our household. The first was with the recording artist Shakin’ Stevens, who I am sure is also a favourite of all those present. That young boy was a fanatic follower of Shakin’ Stevens, and whenever he came to join us for a weekend, the first thing he would do was to put on our Shakin’ Stevens tape, and we would all dance together in the kitchen with real abandon. I remember it as an extremely happy time.
That teenager was also fixated on the wrestling on “World of Sport” with Dickie Davies on a Saturday morning. He used to sit very close to the screen, because he did not have great eyesight, but he was transfixed by the bouts that were shown. Often, an hour or so would go by and he would not have moved.
There was one scarier moment when we took him to a local swimming pool, where he was very keen to put on a mask and snorkel, go underwater and have a go at swimming. Unfortunately, it became apparent very quickly that he could not swim, so someone who was on duty had to jump in, fully clothed, and rescue him. However, the fact that he wanted to do those things and that he was given the opportunity was important, because, as my right hon. Friend said, we must ensure that the rights people with Down syndrome have are the same as for everybody else. That includes all those opportunities that we come across in our lives.
That experience has led me to want to speak to the Bill—unfortunately, I was not on the Committee—as I am extremely supportive of what it seeks to achieve. There is clearly a lot of crossover between the reforms to the special educational needs and disabilities system, which I brought forward as children’s Minister, and this private Member’s Bill. As a learning disability, the estimated 47,000 people who have Down syndrome will potentially benefit from that system.
The diagnosis will come extremely early in people’s lives, so there is no reason why an education, health and care plan cannot be put in place as early as possible. A focus on outcomes, whether educational, social or employment-related, can be built into those plans, which can go up to the age of 25. As we know, the life expectancy of those with Down syndrome has increased dramatically from the days when we were looking after Down syndrome children, so there is every reason to ensure that those outcomes are brought to fruition.
In publishing the guidance that the Bill brings in, there is an opportunity to ensure that the reforms to the special educational needs and disabilities system, particularly to the code of practice and the local offer that must be published in every local area to explain the services available for those with special educational needs and how to access them, marry up with what is already out there. That will ensure that there is a clear pathway for parents and carers to know what is available and how they can access it.
The level of support that those with Down syndrome need throughout their lives will vary considerably. It is important to remember that they are people with different individual needs, although there are certain services that they are more likely to need than others, such as speech and language therapy, physiotherapy or optician or hearing specialists. Therefore, the Bill is an opportunity to pull together the different routes to accessing key services.
It is vital, however, that those children, young people and adults with Down syndrome have a sense of agency and that they feel that those things are being done not to them but with them, so that they have a stake in their future. For example, with the increased life expectancy of those with Down syndrome and some outliving their parents, they are having to be cared for by other means. There are recent instances of people ending up in an elderly care setting that is not necessarily as appropriate for them as it could be, which may have stymied the possibility of them reaching out to a more individual lifestyle and having support in the community.
The Bill presents an opportunity to ensure that the guidance reflects the fact that those with Down syndrome need to be very much part of what they need for their future, so that the services that are built around them reflect that and ensure that the outcomes that they know they are capable of are reached. Although we have the Equality Act 2010 and the reasonable adjustments that go with it, they need more focus and definition through this Bill, for all the reasons that the Down’s Syndrome Association has illustrated so well in the case studies that it set out and that show the difference that will make.
I accept the point about other conditions, but doing all that will provide a blueprint for how each individual person, irrespective of their condition, can be provided with guidance, support and wraparound services. We need to use the Bill as a way to demonstrate our commitment not just to those with Down syndrome, but to all those living with a learning disability for whom we know we can do better by bringing together the services that already exist more effectively. With medicine and our understanding of conditions improving, we can ensure that the way that we build services reflects the needs of all those who require them.
I am hugely supportive of this Bill, for the personal and professional reasons I set out, and I very much hope and expect it will make a significant difference to many lives. It truly is the landmark that my right hon. Friend the Member for North Somerset suggests.
Selaine Saxby (North Devon) (Con)
I congratulate my right hon. Friend the Member for North Somerset (Dr Fox) on introducing this Bill.
It is always a pleasure to speak on a Friday, when, the hon. Member for Newport West (Ruth Jones) is right, we have an opportunity to get things done. We come together as one. As her fallen colleague, Jo Cox, said in her maiden speech, we have
“far more in common than that which divides us.”—[Official Report, 3 June 2015; Vol. 596, c. 675.]
Today, many colleagues have referenced our fallen colleague, Sir David Amess, which is so timely the morning after the election of his successor for the city of Southend; we all look forward to welcoming her to the House next week. We hoped it would usher in an era of kinder politics and I just hope that will be mentioned to the people who wrote the emails in my inbox today.
It is a great delight to have the opportunity to hear my right hon. Friend the Member for North Somerset speak with such compassion on such an important issue, and to have the opportunity to speak today. I share a friend with him in Annabel Tall, the mother of George, Freddie and Samuel. Freddie has Down syndrome. I believe Samuel is waving at us from the Public Gallery and is here to see the Bill go through, and I think Annabel is watching on television.
This is a big moment. As my right hon. Friend said,
“this Bill is not about a condition, but about people—people who have a particular condition, their families, and the people who care for them.”––[Official Report, Down Syndrome Public Bill Committee, 26 January 2022; c. 10.]
Annabel wrote to me earlier this week to explain why the Bill is so important to her family. She finds it
“disheartening to see new parents and carers having to fight exactly the same battles we were 20 years ago.”
She describes it as a
“spectrum of different difficulties and abilities with common themes. I have lost count of the number of times I have had to explain Down syndrome to professionals who should know, let alone friends and family who still largely base their Down syndrome stereotype on the last person with Down syndrome they met.”
I was very fortunate as a teenager. Despite not having the same family experiences, I helped at a Down syndrome support group with a large number of Down syndrome infants, from tiny weans and right the way through. They had marvellous day trips. I was not even a woman at the time and, as a young girl, it impressed on my mind how important this is.
I very much hope the Bill is the start of a journey for people with other conditions as we move into the integrated care system, so that we are able to do exactly what my right hon. Friend intends. The Bill aims to improve services and life outcomes for people with Down syndrome, but hopefully we will be able to help and assist people with so many more conditions.
I will keep my remarks brief, as I know many colleagues wish to speak. I thank my right hon. Friend for all his work in this area. It is a privilege to speak today.
Laura Farris (Newbury) (Con)
I begin, as others have, by congratulating my right hon. Friend the Member for North Somerset (Dr Fox) on this truly groundbreaking Bill. I will add a few reflections of my own, the first of which dovetails with his remarks on Second Reading.
Our understanding of and respect for people with Down syndrome and equivalent conditions have evolved so much in my lifetime. Forty years ago, people with Down syndrome or something similar were viewed as problems to be managed, rather than people with potential to be realised. Employment, if it existed at all, was seen as an act of charity, rather than an opportunity for a person to be productive or to be in a role in which they could develop and thrive. The idea of someone with Down syndrome having a personal intimate relationship was taboo. It is amazing to think how far we have come. We have a far greater understanding not only of developmental conditions but of how they can exist on a spectrum. There are far more opportunities for education, employment and training. So many excellent employers in Newbury employ somebody who has a learning disability, but I want to give a particular mention to a young lady with Down syndrome called Karen who is doing a fantastic job and loving life at Nando’s in Newbury. The Bill recognises the specific challenges, particularly with health and care, but squarely places them alongside recognition of the dignity of people with Down syndrome and the idea that their families should not be scrubbing around for care and that that should be dependent on the provision of their local authority.
While I was preparing my speech, I thought about how far we have come in Parliament in what we say about disability. The Disability Discrimination Act 1995 and the Equality Act 2010, particularly the latter, contained important provisions about disability, such as the duty to make reasonable adjustments, which was mentioned by my hon. Friend the Member for Eddisbury (Edward Timpson). It is notable that the focus in the interpretation of both Acts was on physical disability, long-term health conditions such as cancer, or mental conditions such as schizophrenia or depression.
I know that I am right, because I refreshed my memory of the statutory guidance published to go with the Equality Act to see what it said about disability. It is an extensive body of work on just the subject of disability, running to 60 pages and giving example after example of how society should respond, and there is not a single reference to Down syndrome and scant reference to any form of learning disability. I mention that not to minimise the significance or value of the Equality Act, but to point out that we as a society have been reluctant to confer on public authorities, employers or anyone else much in the way of positive duties on learning disabilities. If we are honest with ourselves, we know that we would be nervous to say very much about learning disabilities at all. I applaud my right hon. Friend the Member for North Somerset for taking the bull by the horns and presenting the Bill.
I want to conclude with remarks on two points that have been made by other Members but are important. The Bill will receive Royal Assent, but it is right that we should not ignore all the other people with learning disabilities, particularly when there is an intersection with health concerns and a need for ongoing adult social care. I have a niece who falls into that category, and she was in special needs education throughout her younger years. The majority of her co-pupils had Down syndrome, so it is fair to say that she was considered by the authority to have something similar. She is now a young adult who has had significant challenges with her health and some of her communication abilities, but she has a job and a very busy social life and she is living a really productive life. A lot of the issues the Bill seeks to address apply equally to her and to thousands of others. The difficulty is in the definition, and finding statutory language that would correctly encompass all those conditions is technical and challenging—I do not resile from that. Of course I respect the ambit that my right hon. Friend chose for his Bill, but I must put on record my ambition that it will go wider and that we will see soon progress from the Department.
Ruth Edwards (Rushcliffe) (Con)
I commend my right hon. Friend the Member for North Somerset (Dr Fox) on the Bill and on his long-standing championing of people with Down syndrome. I know it stems from his time as a GP, his personal life and his time in this place.
The Bill is making an important simple but necessary change to improve the lives of people with Down syndrome. The issue matters to many people in Rushcliffe. I have heard from many constituents and organisations such as the National Down Syndrome Policy Group in praise of my right hon. Friend’s action and willing me on to support it. I am proud that the Government are supporting the Bill and to speak on the issue today.
I understand that people living with Down syndrome, their carers and families can find themselves disadvantaged by the inequality of access and the provision of basic services. My hon. Friend the Member for North Devon (Selaine Saxby) has set out some really personal examples of how that is affecting her constituents today.
Starting at a young age, people with Down syndrome face greater challenges in school and in life than their peers. I know that many parents of children with Down syndrome worry about sending them into mainstream education, where support may vary wildly. Other parents are left facing the cost of specialist support where help is not available locally. As a Conservative, I want everyone to have opportunity and choice. For some, specialist education might be the right path; for others it might be support in a mainstream school. The point is that people need to have choice. They need to be able to choose their own destiny and, at the moment, there are too many people with Down syndrome who are not able to do that. I am so pleased that the Bill will start to address that inequality.
Shockingly, although people with Down syndrome are likely to be hospitalised more often and for longer periods of time than people without the condition, there is little guidance for NHS commissioning boards or trusts on how best to care for their specific needs. Adults with Down syndrome are likely to require social care and council support much earlier in life than the national average, yet local authorities do not have a standard playbook or guidance on meeting those needs. Because of that, young adults with Down syndrome often end up living in facilities with people several decades older than they are, with no specialist care available.
Local authorities already have a duty to provide support and carry out assessments of need to help them to meet that obligation, and the Bill will provide much-needed guidance on best practices to local authorities who are delivering healthcare, social care, housing and education-related services, helping them to understand and deliver on their duties. That work will make public amenities more accessible and inclusive for the Down syndrome community, and help them to lead active, healthy and more independent lives. It will also raise awareness among the wider public, giving them insight into the facts of living with Down syndrome.
Multiple organisations have welcomed the steps the Government are taking. The chief executive of disability charity Mencap described this as
“a positive step towards ensuring that the needs of people with Down syndrome are met.”
I know the Government are consulting on how the proposed guidance will look so that we can learn from families, communities and organisations that know best. As my hon. Friend the Member for Eddisbury (Edward Timpson) said, this is something that people need to feel is being done by them, not to them. It is so important that they feel that this is something that they are consulted on and included in, and that is driven by them. I look forward to seeing the outcome of the consultation.
I hope that what we do here in the Bill can serve as a model for future work and discussion on helping those with other neurodevelopmental conditions, making society more accessible and fairer for everyone. I want to reference the comments made by my hon. Friend the Member for Newbury (Laura Farris), who described that very well. I come from the cyber-security sector, where we have lots of people with neurodiverse conditions excelling in jobs. There is no reason why that cannot happen in many more sectors of the economy. I really hope that we can use the Bill as a launchpad for expanding the number of conditions that have guidance that public authorities need to take into account.
People with Down syndrome deserve the same access and choice to education, public institutions and services as anyone else. They deserve the same opportunities to lead a healthy, fulfilled and prosperous life, and I am pleased to support the Bill, which will help to make that possible. I very much hope that we will see it enacted for World Down Syndrome Day on 21 March.
Mr Gagan Mohindra (South West Hertfordshire) (Con)
Like others, I start by congratulating my right hon. Friend the Member for North Somerset (Dr Fox) on his important work in bringing the Bill to the House and on reaching Third Reading. Like my hon. Friends the Members for Eddisbury (Edward Timpson) and for North Devon (Selaine Saxby), we all know individuals with Down syndrome. My experience is similar to that of my hon. Friend the Member for Eddisbury: when I was growing up, living in the house next door was a young lad by the name of Mark, who was the great love of his parents, Tony and Carol. It just so happened that he had this condition, Down syndrome, but that was not a barrier to the fulfilment of his life chances. Unfortunately both Tony and Carol have since passed away, but I am aware that Mark is leading a very full life. He is in work, and I believe he has his own individual accommodation, although he may require support and has a large network around him.
Our role, as legislators, is to ensure that people are able to achieve their full potential, and also to strive to give them the confidence to be ambitious. We who have been brought up in this country are very fortunate, in that the barriers to success are very limited. As a second-generation immigrant, I still pinch myself to make sure that I really am sitting on the green Benches in the House of Commons.
My previous experience as chairman of the board of governors of a further education college, and also as a governor on the board of a school for young people with autism, has shown me directly that when we do things right, we do them really right. That means being able to say to people, whatever their status or condition, “Be good, be great, and be a real world leader.”
Ruth Edwards
My hon. Friend is advancing an excellent argument. Can he outline some of his experience of best practice on the board of governors, and of what works and is successful?
Mr Mohindra
That returns me to my hon. Friend’s own earlier comment. The skills required in certain industries may not necessarily be academic. I suffer from dyslexia and have always regarded that as a superpower, although I am sure that if I had been diagnosed at an earlier age, others might have regarded it as a disability. The ability to think differently, to be a disruptor and to question the status quo, which conditions of this type may typically entail, benefits us as a society, and—here I allude to the previous role of my right hon. Friend the Member for North Somerset in defence—it makes our country even more secure than it might otherwise have been.
My right hon. Friend is an astute and successful legislator, and I am personally reassured that his Bill will have a lasting impact, but as others have said, this is the start of a process and not the end. Today we are focusing on Down syndrome, but I think it would be easy to replicate this model for the purpose of other conditions. I believe that these measures should be adopted as soon as possible, and I look forward to the fulfilment of the ambition of my right hon. Friend to complete the Bill’s passage before World Down Syndrome Day in March. I hope that the Government can provide us with some confidence that that will be the case.
The role of politicians at whatever level, whether in local or in national government, frequently involves signposting. The provision of a named individual in the integrated care system will be a game changer for the families and loved ones who may not understand the bureaucracy of whatever public service they are having to deal with. The ability of a Member of Parliament to direct a constituent to a named individual with an email or other correspondence address can only help the system and make it smoother. Our role as politicians is to reduce the barrier, to make life as easy as possible for our constituents. The Government have a proud history in this regard, given the work we have done to date. We spent £2.6 billion over the 2021 spending review period on new school places for children with special educational needs and disabilities in England, and will more than triple the current capital funding levels to over £900 million by 2024-25.
I was not going to mention this, but I will, because I think it important. I read an article in the media today about a lady called Beth Matthews. She is a young lady of 22 who has achieved in her life: her story is important because she is now a model and she also happens to have Down syndrome. For me, that is an irrelevance, but people feel the need to show her as a leading light. Similarly, there is Tommy Jessop, an actor in “Line of Duty”. It is good that we normalise people with a condition, whether hidden or obvious. I look forward to the day when they are getting named not for their disabilities but for their ability and the fact that they are a master of their art.
Ruth Edwards
Does my hon. Friend agree that it is important to have role models from neurodiverse conditions in all areas of life, and that that will encourage others to believe they can also fulfil their ambitions and dreams?
Mr Mohindra
Absolutely; my hon. Friend is on a roll with her interventions and I look forward to more of them.
When I was growing up—I am sure others will have had a similar experience—I always looked at the TV screen, the media or the newspapers and asked where the people of my ilk had got to and what they had achieved. It can only be a good thing for people to be able to see others who look or sound the same as them being world leaders or industry leaders or social activists—people who change others’ lives.
Locally to me, I want to give a shout out to DS Achieve and its teamwork across Hertfordshire. I did a bit of research—unfortunately for my right hon. Friend the Member for North Somerset I was unable to be involved in previous iterations of this Bill—and reading its website and understanding what it is doing is reassuring: it is about people achieving their potential and not being regarded as just having a disability. There is lots of work going on—my right hon. Friend commented earlier about the expected lifespan now associated with this condition, which is to be applauded—but we need to make sure that we consider not just living but quality of life. This Bill goes hand in glove with that aim, ensuring a safety net of local councils and communities so that additional support is in place if individuals feel they need it. Others have spoken about the fact that people’s needs are different: different individuals will need support at different times in their life, and not all the time, and being able to dip in and out knowing there is a named person they can go to as a one-stop shop for support is a smart idea, so I applaud my right hon. Friend for his foresight.
Edward Timpson
I am enjoying my hon. Friend’s speech and agree with his comments. Does he agree that in the past too often the default position for those with Down syndrome as they grew up was to envelop them in cotton wool and not give them a chance to grow and develop and demonstrate what they are capable of with the right support in place? The societal attitudinal change coupled with this Bill presents an opportunity for them to demonstrate, as we have seen on our TV screens and elsewhere in the media, that they can have a successful career and loving and meaningful relationships as long as we ensure, as we would for anybody else with a condition or difficulties in their lives, that they have the support and networks in place to be able to progress. In the past, those with Down syndrome have potentially been seen as simply to be managed, as my right hon. Friend the Member for North Somerset (Dr Fox) said in his opening speech.
Mr Mohindra
My hon. Friend speaks from a position of significant knowledge and is absolutely right: the culture change both in the community and in the public bodies involved in this sector has moved on in leaps and bounds within the space of a generation, and rightly so. The message now is, “Be great at what you’re doing.” That does not necessarily mean being an excellent employee. It could mean being brilliant in a charity, brilliant at community work, or brilliant in a sport. There are so many different aspects. Success should be what a person thinks it is internally, and not what society thinks.
When I was growing up, I was very much steered towards certain careers. Admittedly, politics was not actually one of them, so in some eyes I may have failed in my life. I assure Members that I really enjoy being in this place; having spoken to colleagues across the House, I know that we all feel truly honoured to be here. I look forward to the day when, whatever disability our colleagues may have, no one bats an eyelid. There is nothing stopping that from happening. I look at some of our colleagues in this place. For example, my right hon. Friend the Member for Harlow (Robert Halfon), who is a very good friend, has not been held back by his disability.
Our role as parliamentarians is to say loudly and clearly that people’s perceived disability is not really a disability. We face so many challenges in life. Hopefully, when statesmen or community leaders say enough times, “Actually, you have very few barriers,” people will begin to believe it. I look forward to providing support in whatever small way I can.
I will wrap up now, because I know others wish to contribute to debate on this Bill. In conclusion, this Bill not only helps people with Down syndrome, but, as my right hon. Friend the Member for North Somerset has already said, sets out a framework for how we can provide services in the future for those with a range of disabilities and special needs. This is the first in what I hope will be a series of legislative measures that we can all get behind.
Siobhan Baillie (Stroud) (Con)
It is a pleasure to speak in this debate. I congratulate my right hon. Friend the Member for North Somerset (Dr Fox) on all of the work that he has done. I see that team Freddie and a number of friends are in the Public Gallery providing their support.
This Bill means a lot to thousands and thousands of campaigners. There are 47,000 people with Down syndrome and their families around the country. I give particular credit to the families from Stroud and Gloucestershire who have reached out to me to express their delight that this Bill has been introduced and also to explain their experiences and why it is so important. This is actually a spectacular use of a private Member’s Bill. I am also thrilled that the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is at the Dispatch Box. We have discussed Down syndrome for many, many years, because we are both blessed with nephews with Down syndrome. Those boys give us great joy, particularly as a distraction from this mad job.
The Bill proposes, for the first time, a duty on the Secretary of State to give guidance on housing, education, youth offending and national health authorities. It also imposes a similar duty on the relevant authorities, which is very important. The guidance will set out the steps required to meet the needs of people with Down syndrome, and I sincerely believe that it will be the start—and it is the start—of many other areas of policy and work to undo some of the problems that people with Down syndrome face in their daily lives.
My nephew, Rhys, is now 19 years old. He is the light of every room he enters. He works for the Thames Valley Cleaning company at the Select Car Leasing Stadium for the Reading Royals. He is right royally unimpressed with me—I am not cool, particularly when I am in a suit on the telly, so I hope he is not watching now. Let me relate part of Rhys’s story—[Interruption.] I am sorry if I get upset. It is not just because I am pregnant; I once tried to talk about Rhys in Camden Council many years ago and cried then as well—
Mr Mohindra
Let me give my colleague a brief respite. I know that she is a massive fan of the Bill of my right hon. Friend the Member for North Somerset (Dr Fox) and I look to hearing further words from her.
Siobhan Baillie
I am blessed by having great colleagues in this Chamber.
Alice fell pregnant aged 15. As she was so young—we had no Down syndrome in our family and there is a common belief that only older, geriatric mothers as they are often referred to in maternity terms have Down syndrome children—Alice was not offered any advice. She did not have any discussions about Down syndrome. She was 15 and scared. Her family was not around her, we did not know about the pregnancy in the early stages, and I doubt that she asked any questions. It was 20 years ago, too, so there were few smartphones and limited ability to google.
When Rhys was born, Alice was immediately in love with her baby son, but a few days later, my nurse mum spotted signs of Down syndrome. Notwithstanding the absolute love that she felt for her child, it is fair to say that my sister was pretty shocked by what was happening. Remembering that she was still a child herself and all the hopes and dreams that go into a pregnancy, I have since spoken to other parents of Down syndrome children and parents of other children with disabilities—
Mr Mohindra
On that point, does my hon. Friend agree that we need a real focus not just on the person with Down syndrome but on the bubble around them—carers, friends and family—because they are involved in the potential ups and downs of the journey as much as the person with Down syndrome themselves?
Siobhan Baillie
I completely agree. I have spoken to other parents who have discovered upon their child’s birth that they have a child with a disability about their fear, and about the loss of their hopes and dreams; their belief that they would take the child to university, or to get married, is dashed. With Down syndrome in particular, people believed that the child would die aged about 30. There is such a lack of education. That was particularly the case when Rhys was born, but I think it is still true now. Thinking about the bubble—the whole family—is incredibly important, and that is hopefully what the Bill will do. So much of what we think we know when it comes to disabilities is often not true.
Ruth Edwards
My hon. Friend is giving an incredibly powerful account of her personal experience. I know that she works with many parents and people with Down syndrome. Does she think that support for new parents to come to terms with and understand the condition of their child has improved at all since her sister gave birth, or does she believe that we are still quite far off the mark?
Siobhan Baillie
That is a really important question. I think there have been improvements—my right hon. Friend the Member for North Somerset will attest to that—but there is still a lack of understanding and education. We have a real issue with people feeling that they need to have a termination when they are told about Down syndrome. There is a big campaign on not screening out children with Down syndrome, because they live very fulfilled lives and bring great joy to so many people. Education for all is really important.
Jonathan Gullis (Stoke-on-Trent North) (Con)
Let me quickly add my support for the Bill introduced by my right hon. Friend the Member for North Somerset (Dr Fox). On the point that my hon. Friend the Member for Stroud (Siobhan Baillie) made about education, we need education not just for expectant parents or young people but for employers too. One of the things that shocks me most is that there are plenty of people who have Down syndrome who could, if they wanted, be in our workforce playing a fulfilling role. We know that the benefits of work include increased life expectancy, as well as better physical and mental health. Warwickshire County Council had a great scheme supporting employers to understand how to support not just people with Down syndrome but those with other learning disabilities, and how to make them an important part of their workforce. That encouraged a lot more people to enter the world of work. Does my hon. Friend agree that those are the sorts of things that we need to see happening, so that employers understand the full potential of everyone across our United Kingdom?
Siobhan Baillie
I completely agree. Rhys earns £9 an hour—he is far richer than me, because he has no outgoings—but he enjoys his job and he feels fulfilled by it. Schools such as The Shrubberies in my patch do an awful lot of work to make sure that people go on to be work-ready, as do our colleges, such as SGS Stroud. Again, that is why the focus that the Bill will bring for the Government, local authorities, schools—everybody—is so important. We are thinking slightly differently, and I really welcome that.
I should be honest and say that I did not handle my sister’s being pregnant very well. I was still a teenager myself. I genuinely thought that, as a teenage mum, her life was completely over and she would not get to enjoy a lot of the things that I had enjoyed, but I could not have been more wrong. She definitely had a very different life from me in many respects, but I deeply regret my lack of understanding and some of the anger I felt on her behalf. It was unjustified and it was wrong, because Rhys was the best thing that happened to all of us in our family for so many reasons. But, boy, our learning curve has been so steep. I have seen my little sister battle for the understanding of people with Down syndrome.
Mr Mohindra
One thing I wanted to mention was to ensure that we realise that this affected all communities up and down the country. It is not specific to a particular geographical area or heritage. Does my hon. Friend agree that the Bill will be beneficial to all communities?
Siobhan Baillie
Absolutely. That is so important. When I reel off this list, if I can get through it, Members will understand why it is so important.
I have seen my little sister battle for understanding about Down syndrome. I have seen her battle for the right to medical care for operations in a timely fashion. She has battled for education. She has battled for housing. She has battled to get landlords to take people with benefits. She has battled during the transition from Rhys being a child to an adult, and she is still doing that. She has battled to get the council to complete the required assessment. She has battled with the welfare system and disability living allowance appeals. She has battled with endless application forms and then had to re-do them because they have been lost by various authorities and had to start all over again. She has battled during covid. I know that a lot of families battled really fearing for their loved ones with Down syndrome, who are vulnerable, often with respiratory issues. Covid was thrown at all of us, but we found that parents were being ignored, or certainly felt they were being ignored, and not prioritised for vaccinations. The whole family was not being prioritised for vaccinations to protect the people with Down syndrome in their homes.
Edward Timpson
I think all of us are very moved by what my hon. Friend has had to say. Does she agree that her point about the battles she described demonstrates how important it is that, as the Government develop the guidance—I know my hon. Friend the Minister will very much have regard to this point—they involve the experiences, views, opinions and, I suspect, recommendations of those who have Down syndrome, or their parents, carers and supporters, so that they form the best possible guidance to deliver the right type of support at the right time and in the right way? That might then mean that those battles are much reduced and hopefully eradicated in future?
Siobhan Baillie
I thank my hon. Friend for his contribution not just in that intervention, but in his speech. I loved the Shakin’ Stevens stories. I defer to his expertise as a former children’s Minister. That is why the Bill will do so much good. Even the fact that we are having this long debate today with so many colleagues is incredibly moving. I am pleased to see that the Minister is as equally moved as me and that it is not just me with the tissues on these Benches.
These problems have existed under multiple Governments, so parties of all political colours should hang our heads but also want to see improvements. We all know, from our surgeries and inboxes, that parents of disabled children who have to come to see their MP are often completely exhausted. They are exhausted by the fights to get things for their children that they know they should already have or have seen other children have. They also know that they have no choice but to continue fighting. I know that MPs of all political colours try to help, but we have to get better at getting the legislation and the policy right so they do not get to that stage.
The Government are trying really hard to make improvements to legislation and to the system and the practicalities for people with disabilities. The Minister with responsibility for disability, the Minister of State, Department for Work and Pensions, my hon. Friend the Member for Norwich North (Chloe Smith), is absolutely excellent and I have real confidence in her ability and commitment to secure change.
As part of my small role in trying to push through those changes, I sit on the Work and Pensions Committee, and we have been doing an inquiry into things such as personal independence payments. During the inquiry, we heard from an excellent representative from the Down’s Syndrome Association. She gave a few examples of things we can change that directly impact people with Down syndrome. She explained that it is usually the parents making welfare and disability applications.
We have heard today from a number of hon. Members that, thankfully, those with Down syndrome are living much longer. Their life expectancy is no longer 30 years, but 60 years. That means that their parents are also significantly older, and we must bear that in mind. The constant drive for digital-only application is welcome in many respects and will mean there is a record, so hopefully we will not have the constant losing of paperwork that many families have to deal with. However, there are many elderly families and elderly parents who cannot cope with that, and we must build that into our systems.
Separately, there is a new in-person assessment approach to PIP, which can throw up some interesting results—unintended, in some cases. Where previously a family could sit down and do a written submission about what they needed and what they wanted changed in their PIP, doing an in-person assessment is very reliant on the person with Down syndrome.
My nephew Rhys’s favourite word is yes, because he gets a positive response to it. If someone says to him, “Do you play for Reading Royals?”, he will say yes. “Do you run for a bus?” He will say yes. One thing that my sister said made her nearly jump up and down was something like, “Do you have your own life partner or girlfriend?” He was saying, “Oh yes, oh yes.” She said, “No, no, no! He absolutely doesn’t.” We must bear that in mind when we create those policies and programmes, because it will not always work for everybody.
I welcome all the focus on and learning about people with Down syndrome today. I am still learning—I think we all still need to learn from people with Down syndrome and listen to them.
Ruth Edwards
I hope Madam Deputy Speaker will forgive me, given the circumstances, but I have just been interrupted by a text message from my constituent Matt Barney, a hardworking councillor in Leake and Ruddington. He tells me that his cousin, Heidi Carter, is with us today in the Public Gallery. She has Down syndrome and campaigns to reduce the age limit at which abortion of babies with Down syndrome is permitted. I wanted to take this opportunity to thank her for all her work and to welcome her here.
Siobhan Baillie
I am grateful for that intervention. I am thrilled—I have seen you listening intently, and it is wonderful to have you here today, Heidi.
I will draw to a close, but I believe we must all learn from people with Down syndrome. We will genuinely be a better society for having done so. I commend my right hon. Friend the Member for North Somerset and I thank charities such as the Down’s Syndrome Association—there are many charities that I should have had a big list of, and I apologise that I do not. I also love the Down Syndrome Swimming GB Twitter and Instagram accounts, and enjoy following them.
I thank the Government for listening and taking action. I look forward to seeing this Bill progress to Royal Assent.
Jo Gideon (Stoke-on-Trent Central) (Con)
We have had some amazing contributions today. First, I obviously thank my right hon. Friend the Member for North Somerset (Dr Fox). This is an incredibly important Bill. At the beginning of the debate, he said that the narrowness of the Bill was important to getting it through as a private Member’s Bill, and I want to reflect on that.
I have my own private Member’s Bill, the Button Batteries (Safety) Bill, for exactly the same reason: when we talk about protecting the vulnerable, sometimes we have to be very specific. Following the tragic death of Harper-Lee Fanthorpe at the age of two after swallowing a button battery, I hope my Bill will protect more children by making parents, carers and others aware of the dangers. I was lobbied by others to broaden my Bill to include things such as magnets, because they are also things that young children ingest. The more vulnerable the children, the more likely they are not to recognise the dangers of things such as button batteries, so I have been campaigning long and hard on that important issue.
I recognise that it is important to focus on the key issue. In this case, that is the rights of people with Down syndrome, and my right hon. Friend the Member for North Somerset makes a very good point about life expectancy. I do not know whether Members saw “Call the Midwife”, where it looked at how Down syndrome was viewed back in the ’50s and ’60s and how far we have come in understanding and on life expectancy. It means we have to protect, as well as ensuring that there is much better preparation, I guess, for a longer life—and that preparation starts in school. As chair of the all-party parliamentary group on youth affairs, I have looked at the issues with education. Sadly, only one in four young people with Down syndrome finds themselves in mainstream education.
Mr Mohindra
My hon. Friend mentioned APPGs. Does she agree that the role of APPGs is important in ensuring that we have an informed debate? They give colleagues and professionals the platform to go in depth into topics, so that when we are discussing them in this place we come from a position of experience and knowledge.
Jo Gideon
I absolutely agree. The key thing is that APPGs by their very nature are cross-party. On issues such as those we are discussing today with this Bill—this is a cross-party topic—the more that we can find consensus, the better it is for the people we represent.
Looking at schools, the Bill asks for a curriculum tailored more towards children with Down syndrome and for more teachers to be trained to understand how to teach children with the condition and the specific learning profiles of that condition. It is a fact that Down syndrome pupils in mainstream schools achieve on average at two years above the academic level of those in special schools.
Having said that, there are some fabulous special schools, and I want to give a shout-out to Aurora Hanley School in Bucknall in my constituency. There is some wonderful work going on. I also want to mention Stoke and Staffordshire Down syndrome social group, who have posted a lot about this issue. They meet regularly at the Bridge Centre in Birches Head, and they make a difference to about 50 families. It is a massively important contribution that everybody can make.
Dr Fox
Is the very point that my hon. Friend makes about the lack of knowledge one of the key reasons why the amendment to the Bill is so important? It will mean there is a named individual on the integrated care board who can act as an advocate, but also spread knowledge to other members of the integrated care process about the condition and the needs and wants of those involved.
Jo Gideon
My right hon. Friend makes a hugely important point. The integrated care boards will have a huge amount of responsibility for care across the board, and the understanding of the specific needs of those with Down syndrome requires a named lead. It is essential, because otherwise, sadly, the detail may get lost in the breadth of what the boards have to cover.
Brendan Clarke-Smith (Bassetlaw) (Con)
My hon. Friend mentions education and ensuring that those with Down syndrome have access that is adequate for their needs, whether in a special school or a mainstream school. Does she agree that it is vital that these choices are offered and that parents and people are fully informed of what is available for them? It is important that we provide a choice that is the best for their needs and that we make sure it is available to them?
Edward Timpson
As a fellow member of the Health and Care Bill Committee that looked at the new integrated care systems that are being introduced, my hon. Friend will know that they have been delayed slightly until April this year. Does not that present an opportunity for the Minister to write to all the chairmen and chief executives of the interim boards, or those who have been appointed to the new interim care boards about the Bill; and, hopefully, for them to act in due course so that they are prepared for the guidance that is coming and can inform the wider board about that at the earliest opportunity?
Jo Gideon
I thank my hon. Friend. It is absolutely right that the integrated care boards and the Health and Care Bill need to accommodate what is suggested in this private Member’s Bill. The integrated care boards, as I have said, will have a huge breadth of responsibility. Unless we are quite specific on certain duties, they may get lost and that cannot be allowed to happen.
Jonathan Gullis
I would like to associate myself with my hon. Friend’s comments regarding the fantastic organisations based in the great city of Stoke-on-Trent. I give a particular shout-out to Watermill School, based in the Stoke-on-Trent North, Kidsgrove and Talke area, which is being extended as part of a £7.5 million refurbishment to increase our SEND provision in the city, which is sorely lacking at present.
My hon. Friend specifically mentioned the education of teachers. As someone who spent eight and a half years in the teaching profession in state schools both in London and in Birmingham, I am sad to say that, at no stage, as a head of year or as a frontline teacher, was I ever given training about engaging with and looking after a child with Down syndrome. In fact, with some learning needs, the teacher would have that conversation only if they had a child in their class or year group with that learning need. It is simply not right, and nor is it fair on those young people, who deserve to have their full potential unlocked. Does she agree that, as part of the legislation that my right hon. Friend the Member for North Somerset (Dr Fox) is putting forward—this fantastic legislation—we need to have a serious conversation with the Department for Education, working with local authorities, not just about what type of training is done at the start of term or when a student enters a school, but about how the continuous training and development of teachers happens all year round?
Jo Gideon
I thank my hon. Friend. I absolutely agree. I think we need to look at the whole pathway from education to work, as we said earlier.
I would like to mention a very interesting and important project that I was involved with a few years ago in a very isolated community in the Brecon Beacons called Myddfai. The challenge was to create sustainable employment and regenerate a very isolated village. As part of the project, we created a trading company, and within that trading company we were able to employ a number of young people. I am glad to say that, eight years on, there are still young people employed there today, some of whom have Down syndrome. Members can see if they look on the website, myddfai.com, how happy they look in the photographs. It is really satisfying to see how the right employment can fulfil.
Lia Nici (Great Grimsby) (Con)
My hon. Friend is making an excellent speech. Talking about employment, does she agree that this landmark Bill identifies that people who have Down syndrome have specific needs and that employment is a vital part of everybody’s life, as is having rewarding, independent living and good employers? We need more employers to consider people with special needs.
Jo Gideon
My hon. Friend makes a good point and we touched on it earlier. An understanding of what support is needed specifically is probably not good enough in the world of employment, education and local authorities as statutory providers. What this Bill will do, I believe, is put a duty of care on everybody, but also a duty of education. In my experience, employers genuinely want to be helpful to everybody in their communities, but there is a role for all of us to play in understanding what additional support might need to be provided to people with Down syndrome. I am sure that there are good local examples, but it is challenging for employers if they do not have that knowledge. We should consider that as part of the duty to develop personal development paths for young people with Down syndrome.
Lia Nici
What my hon. Friend says is vital. Does she agree that Members of Parliament are well placed to be that conduit with education organisations and employers to help and guide them, and to give them confidence in how to get help to ensure they can employ and support people with Down syndrome in their workforce?
Stuart Anderson (Wolverhampton South West) (Con)
I thank my right hon. Friend the Member for North Somerset (Dr Fox) not just for bringing forward the Bill but for his work behind the scenes. All too often, we see the work that goes into a speech of three, four or five minutes in the Chamber, but my intake in particular could learn a lot from him and his experience in getting cross-party support for the Bill and having a reasoned debate on such a valuable topic.
It is delightful to see cross-party support in the House for levelling up outcomes for people with disabilities, including those with Down syndrome. As the Member of Parliament for Wolverhampton South West, I am committed to championing health and wellbeing for my constituents. We always see that as doing things such as eating your five a day or making sure that you have a walk, exercise or do different park runs. I took it to the extreme last year—my hon. Friends would not forgive me if I did not mention this—when I ran the world’s toughest mountain race in six days in Wales for two good causes: the Wolves Foundation for communities across all areas of Wolverhampton; and the campaign to prevent veterans’ suicides, which is a subject close to my heart. I ran that with a paralysed foot.
I have previously talked about when I was shot and how I went on to have a military career. I had a physical disability and was told that it would never be possible to do that. At the time, I did not think I would do it, but I did. However, in Wolverhampton and across the country, many groups, communities and people with Down syndrome face unique challenges every day of their lives and they need careful planning.
Craig Williams
Before my hon. Friend runs away from the point that I wanted to make, he ran through the most glorious constituency of Montgomeryshire but, as I said earlier to my right hon. Friend the Member for North Somerset (Dr Fox), the Bill sadly does not apply to the great constituencies that he ran through. Will he join me in imploring the devolved Administrations to look to my right hon. Friend as inspiration and introduce similar legislation?
Stuart Anderson
I thank my hon. Friend for his intervention. I believe that I ran through his constituency on day 3. In Machynlleth, we encountered our first shops and we were able to get some lollies as we passed through; it is a beautiful area. Yes, that should be considered across the devolved Administrations as well. I would welcome that.
We need to think about the careful planning that allows people to continue to live a normal life, day in, day out. It is not straightforward or easy. A lot of consideration has to be brought in. It is right that the provision is planned according to the individual’s needs. I am glad that a commitment has been made to consult widely on proposed guidance as the Bill is taken forward, ensuring that the voices of those with Down syndrome and their families and carers are heard, and that the guidance is fit for purpose.
Jonathan Gullis
Education investment areas were announced in the “Levelling Up” White Paper. I suggest that the Bill, brought forward by my right hon. Friend the Member for North Somerset, has influenced Government policy in a wider spectrum. Education investment areas will see up to £30 million funding over the next three years for councils to offer up to 10,000 additional respite placements for children and young people with special educational needs, including young people who have Down syndrome. For local authorities seeking the money—the great city of Stoke-on-Trent is lucky enough to be one of the 55 announced to have secured an education investment area—this is a really good way to help with that education and with understanding the needs of parents and care givers.
Stuart Anderson
My hon. Friend raises a valid point. It is about understanding those needs. I am delighted that investment has been rolled out across the country in many areas that vitally need it. That is welcome. He mentions local authorities. I have a question of this Bill. I have worked closely with others on the armed forces covenant, being an armed forces champion prior to coming to the House and having sat on the Select Committee on the Armed Forces Bill. The covenant has due regard, as does the Bill, to health, housing and education. It would be good for the Minister to expand on how the Bill will link with those areas.
Alongside the Bill, I welcome the steps taken by the Government to consider ways to improve outcomes for children and young people through the SEND review. I am delighted that the Government have confirmed an extra £1 billion to help local authorities, schools and other providers to deliver better support for learners with complex needs. At this stage, it would be remiss of me not to mention the hard work that all education providers across the country have delivered, but particularly the SEND schools. My constituency has Penn Hall, Tettenhall Wood, Penn Fields special school, Broadmeadow and Wightwick Hall. I visited all but one during the lockdown and covid period, when we could, to work with them in what was the most complex and challenging time for anyone. They did outstandingly, and how they delivered that is a credit to the children, the parents, the teachers and the cultures in those schools. Funding for these schools has increased by 13% on last year, meaning high-needs funding stands at £9.1 billion in 2022-23. This will benefit learners from early ages up to the age of 25, as well as those in alternative provision due to exclusion, illness or other reasons.
Another issue that needs to be looked at is guidance on potential barriers to work. Fewer than two in 10 people with learning disabilities are in employment. My constituency has the highest youth unemployment in the country. I recently held a jobs fair in the constituency with more than 50 different providers and several hundred people looking for work. Every single one of those providers had a job vacancy, and we were putting people together. Wolverhampton has the lowest youth employment, and with two in 10 people with learning disabilities currently out of employment, that will significantly impact communities in Wolverhampton. We need to look at that.
Despite falling in most areas across the west midlands, the disability employment gap remains too high. We have to work on this across the country, because levelling up is for all areas. Everyone should have an equal opportunity to work, so I am pleased that the Government are committed to seeing 1 million more disabled people in work by 2027. That is exceptional, but I think we should do more to push it. They have made good progress already, but as I said, we can always do more. I welcome the Government’s commitment to double down on that work, particularly the £339 million of funding in each of the next three years, which will continue to establish disability employment schemes such as the work and health programme and access to work scheme, through which many disabled people can benefit from grants worth just over £62,000. That goes to covering the costs of specialist equipment to help them to do their job. There are many complex needs that we have to factor in and work with.
To return to Wolverhampton, I am delighted that a pilot scheme is running at the University of Wolverhampton, which is at the heart of our community and is spread across our city centre and many surrounding areas. It offers a passport to students who already receive extra support to capture information about the adjustments that they benefit from to avoid repetition and disclosures when they start work. Thousands more could benefit if the scheme was rolled out across the country.
As the work gets under way, I ask the Minister to ensure that disabled people, including those with Down syndrome, are front and centre of levelling up. This week, we heard the levelling up announcement, and Wolverhampton certainly did well through the towns fund, the future high streets fund and the levelling up priorities. We also have the National Brownfield Institute. If it is not working in communities, however, it is not working. We have to ensure that levelling up truly works for everyone, and the Bill is a great way to achieve that.
Lia Nici (Great Grimsby) (Con)
I congratulate my right hon. Friend the Member for North Somerset (Dr Fox). As a newbie and a Back Bencher I still cannot quite believe that I am in the same place as him. This is a truly landmark Bill, and it has been fantastic to learn from him how such a Bill can be formed to make a real difference in human beings’ lives.
I am chair of the apprenticeship diversity champions network, and one of our aims is to get more people with learning difficulties and disabilities into apprenticeships and long-term work. The Bill will help to get employers to understand that people with Down syndrome are very able to work in their workplaces. After this debate, in National Apprenticeship Week next week, I will write to the top 100 apprenticeship providers to say that they need to think about employing more people who have Down syndrome and who have learning difficulties and disabilities more widely.
I do hate the term “disabilities”. It should be “differences” or “diversities”, because everybody can do some things and not others. I have felt for a long time that the word “disability” does a disservice to our fellow human beings. I feel blessed that, as I was growing up, my mother retrained as a social worker. She went to university, while she was working full time as a catering manager, to become an assistant social worker and went on to become a fully qualified one.
My mother specialised in learning difficulties and disabilities, so in my teenage years I had lots of discussions with her and learned about the different types of disabilities. She was and still is passionate about people with difficulties and disabilities having as full and independent lives as possible, which I have taken to heart and always thought about. We all want to be independent and to have fruitful and enjoyable lives, including work lives. If employers are watching or listening to this, or reading about it afterwards, they should start to think about taking on people who have Down syndrome, because they can add a fantastic extra dimension.
Jonathan Gullis
My hon. Friend is a doughty champion not just for Great Grimsby but for skills and apprenticeships across our country. She worked in the further education sector before entering this place, which goes to show the breadth of talent and life experience that we now have on both sides of the Chamber. Does she agree that that makes this a much more representative, diverse and better House of Commons?
Lia Nici
I thank my hon. Friend for his support and for his passion about education. We have many conversations about it, although I was worried at one point that he was going to say that I was teaching in further education before he was born, which, worryingly, might actually be true. We will brush over that.
I urge employers to think about taking on people who have Down syndrome. As the Bill is so specifically about Down syndrome, it will allow the message to be communicated much more widely to employers.
There is another reason I feel that this is a landmark Bill. Let me use a metaphor. One of my first jobs when I was 18 was as a barmaid in a country pub not far from Grimsby called the King’s Head, in a little village called Keelby. In the 1980s, pubs were part of their communities. They still are now, although perhaps not as much, sadly. One resident of the village—I will not use his proper name, as I have not asked his family’s permission, but we will call him Bob—lived across the road from the pub. He came into the pub every night and was welcomed by everybody. He had his own special tankard hanging up. When Bob came in there was a particular orange juice that he liked to drink at a particular strength—I had to learn how he liked his drink—and he had a pint with everybody. How England is embracing people with Down syndrome with the Bill is very much like how Bob was embraced in the pub. He was greeted as an equal, and joined in conversations and played pub games. It was very much part of his life. He was working at the time. Is it not lovely to think about how the country and, we hope, the wider United Kingdom can embrace the Bill?
As my right hon. Friend the Member for North Somerset says, it is important to have a named person in the ICS and care sectors.
Brendan Clarke-Smith
I endorse my hon. Friend’s comments about disabilities, and particularly that we all have different needs and should be looking to embrace that. I found out when I was 18 that I was dyspraxic, and it helped explain a lot of things for me. I still have a bit of a challenge with my positioning in the Chamber sometimes.
The way that we view special educational needs and other needs has changed a lot in this country over the years. Does my hon. Friend agree that the Bill is a great opportunity to showcase the talents and contributions of people with Down syndrome in this country, and that we can take that attitude forward so that the United Kingdom is a world leader in this regard?
Lia Nici
My hon. Friend is absolutely right. The Bill will help to take away some people’s fear. As I said at the beginning of my speech, I feel blessed because I have been able to learn about people with learning disabilities and people with Down syndrome since I was a young teenager, and I have also worked with people with learning difficulties and disabilities. Realising that they have the same or similar goals to everyone else—to find somewhere nice to live, to be independent, to find somebody they love and to have a good job—is the crux of all this. I hope that the specific mention of Down syndrome will take away the fear about what it means to have it, and that we will be able to have an open conversation in the village pub that is England and the wider pubs of the UK. That will mean that we can start to talk about it and not be scared of it. A lot of people are scared. They do not understand and they might not have ever met anybody who has Down syndrome. We in this place, with the fantastic guidance of my eminent right hon. Friend the Member for North Somerset, will enable that to happen.
Feryal Clark (Enfield North) (Lab)
I pay tribute to the right hon. Member for North Somerset (Dr Fox) for introducing this important Bill. I also pay tribute to all the hon. Members who have contributed today and thank them for the wonderful personal accounts that we have heard, especially from the hon. Member for Stroud (Siobhan Baillie), who told us about her sister and nephew.
As we have heard, there are about 47,000 individuals in the UK with Down syndrome. We know that they are at increased risk of some medical conditions, more susceptible to infections, and more prone to hearing and visual impairments. It is recommended that those individuals should have extra health checks in early life and regular health reviews thereafter. They may also need ongoing support for different aspects of life both in childhood and as adults. People with Down syndrome and their families are often reported as struggling to access services such as speech and language therapy, additional support in school and appropriate levels of social care. I very much welcome the measures in the Bill that seek to address those challenges.
I also support the Bill for personal reasons. At the same time I became a mother about eight months ago, some friends of mine, Sevcan and Richard, had a baby boy called Asher. He is a bundle of joy and he also has Down syndrome. In the very short time that Asher has been in this world, he has had many challenges and many operations. I see Asher’s family already struggling and having to fight for him, and I see them getting ready to continue that fight, like the families mentioned by so many hon. Members today.
The experience of Asher’s parents has given me an insight into the challenges faced by families with Down syndrome children, and it was that insight that encouraged me to stand for election as the vice-chair of the all-party group for Down syndrome. As vice-chair, I know the impact that properly informed and resourced services can have on those living with Down syndrome. Too often they are forced into provision or services that are just not suitable for their needs. That means they are unable to access the support they need, whether that be education, healthcare or housing.
Being unable to access those services properly means the life experiences and the quality of life of people with Down syndrome can be seriously affected. By ensuring that the relevant authorities—the NHS, schools or local authorities—have the correct guidance, we will have a very real impact on the experience of those living with Down syndrome. It is incumbent on all of us as policy makers to ensure that people in this country, regardless of who they are, can live as full lives as possible. I am pleased that the Bill is taking the steps to better enable people with Down syndrome to do so. For that reason, I am pleased to support the Bill today and I look forward to it progressing in the other place.
The Minister for Care and Mental Health (Gillian Keegan)
I start by congratulating my right hon. Friend the Member for North Somerset (Dr Fox). It has been a pleasure to work with him, the Bill Committee and all the other teams. He has done outstanding work in introducing the Bill and navigating it through its Commons stages. I personally have learned a lot from him.
This is truly a groundbreaking Bill that will make a real difference to the lives of people with Down syndrome across the country. It highlights the hugely important role of private Member’s Bills and what can be achieved when MPs from across all parties work together. I extend my personal thanks to the Bill’s sponsors, all Members who have been instrumental in getting us this far and everybody who has spoken today and brought to life why this matters. It has been wonderful to hear the stories of Mark, Rhys and his mum Alice—the Shakin’ Stevens fan—and Asher and the beginning of his journey. Hopefully this Bill will help Asher’s parents to avoid some of the struggles that other families have been through. It is so positive to see such unanimous support for this Bill, which has been a joy throughout its passage.
I thank all the members of the all-party parliamentary group on Down syndrome, of which the hon. Members for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) and for Enfield North (Feryal Clark) are the chair and vice-chair. They have campaigned for equal access and service provision for people with Down syndrome, and they have supported the Bill’s passage.
I especially thank the people with Down syndrome, many of whom are in the Public Gallery with their families, and the representative organisations that have campaigned tirelessly on improved support for the 47,000 people across the UK with Down syndrome. I also thank my constituents who have written to me and the many families I have met at the Apuldram centre and at Aldingbourne in my Chichester constituency. It has been great to share their journeys and hear their stories.
I feel really fortunate to be the responsible Minister when this Bill is before Parliament. I support the Bill wholeheartedly. It will be instrumental in improving the lives of people with Down syndrome by tackling inequalities in access to services. It is not right that such disparities exist, and I have seen at first hand in my own family the challenges that people with Down syndrome can face in accessing the support they need.
On Second Reading and in Committee, I spoke about my family’s experience. Although my nephew Joseph is thriving, and his school, St John’s School in Chigwell, is helping him to thrive, there is no doubt that there have been challenges along the way. I have watched my sister-in-law, Sara—I know she is watching me now—and my brother Marcus battle for the support that Joseph needs.
I want everyone to get the right support at the right time and in a way that works for them. That is why this Bill, for the first time, will require the Government to publish guidance on how authorities should meet the specific needs of people with Down syndrome.
David Duguid (Banff and Buchan) (Con)
I congratulate my right hon. Friend the Member for North Somerset (Dr Fox) on introducing this Bill, which has huge support across the House. Does the Minister agree that, when the Bill passes, it will be an example for the communities that suffer from other genetic and chromosomal disorders and learning disabilities? They might not be as common or as well known as Down syndrome, but they are no less impactful on those families.
Gillian Keegan
My hon. Friend makes a very good point, which has been raised by my hon. Friend the Member for Stourbridge (Suzanne Webb) and my right hon. Friend the Member for Scarborough and Whitby (Sir Robert Goodwill), who have previously mentioned specific genetic conditions. We will definitely consider overlaps and linkages between these conditions and Down syndrome through the consultation on the development of the guidance. Even though, as has been stressed many times, this Bill is specifically drafted to increase its chances of being passed, many groups will benefit from the work to develop this guidance.
I also thank my right hon. Friend the Member for North Somerset for the two amendments he tabled in Committee to ensure that the guidance is laid before Parliament on publication and to amend the Bill’s long title. I was pleased to accept both amendments on behalf of the Government. Laying the guidance in Parliament, as my very experienced right hon. Friend explained, will ensure it has the proper scrutiny.
I also thank my right hon. Friend, other hon. Members and stakeholders for providing invaluable feedback, on Second Reading and in Committee, on ensuring the implementation of the guidance in practice. Of course, the guidance must be acted upon for us to see real change for people with Down syndrome. That is why we have committed to having a named lead on integrated care boards who will be responsible for the implementation of the guidance in practice. The named lead will ensure that the right services are in place at local level and that people with Down syndrome are able to access those services. That will be a much-needed voice. We are determined that the guidance will be implemented fully and as intended at local level. This will lead to tangible improvements in the lives of people with Down syndrome, and I am personally very committed to that.
At the heart of the Bill is guidance for the relevant authorities—local authorities, and education and health authorities. I am clear that to ensure that the guidance is fit for purpose, we will consult widely and in an open and inclusive way. We will seek views from people with Down syndrome and their families, from the voluntary sector and from others who support people with Down syndrome to ensure that it reflects their needs and experience. We will work with stakeholders to ensure that the guidance remains fit for purpose. This is a real opportunity, and we do not intend to miss any aspect of it.
Once the guidance is published, the Government will keep it under regular review and update it periodically. As I said, we also recognise that people with genetic or chromosomal conditions other than Down syndrome may experience similar problems to people with Down syndrome, so we will definitely look at that and consider how the guidance can help some of those groups more broadly during the process.
I know from the debates during the passage of the Bill that employment is a really important consideration, on which we have not done well enough to date. We will continue to explore any steps required to make sure that people with Down syndrome who want to work can find work that is right for them. Fundamentally, we must make sure that people with Down syndrome maintain good health and receive the right education to support their transition into work. The Bill is an important and meaningful way of achieving that aim. It will provide those lasting foundations for people with Down syndrome to be successful.
Additionally, we are delivering a wide range of employment initiatives, such as dedicated disability employment advisers at our Jobcentre Plus sites. All these schemes, including the Access to Work fund and so on, will help to ensure that people with a learning disability have better opportunities in the workplace. Again, that is something that I am personally committed to.
Lia Nici
I thank my hon. Friend for the plans that are being put in place, but are there plans to ensure that people who work in the Department for Work and Pensions have the relevant training to understand the specific needs of people with Down syndrome and to help get them into work?
Gillian Keegan
I regularly meet the Minister for Disabled People and the Minister for Employment—the three of us are often together—to talk about how we can optimise opportunities for many people across our society, but particularly those with learning disabilities. The numbers are not good enough, and we know that we have more work to do. As I said in Committee, I will return to the issue of employment in developing the Down syndrome statutory guidance. We know that good work helps people to live happier, healthier and more independent lives.
On scope, as healthcare, education and housing are devolved matters, the Bill and guidance will cover England only. However, I know that there is real commitment to improving outcomes for people with Down syndrome across the whole of the United Kingdom, and I look forward to working with my counterparts in the devolved Administrations as we develop the guidance so that we can ensure that there is consistency of approach and inclusion for people with Down syndrome across the whole of the UK.
It has been a pleasure to work with my right hon. Friend the Member for North Somerset in supporting the Bill on behalf of everybody with Down syndrome and their families, including my own. Its passage so far represents the very best of the parliamentary process, with MPs working together cross-party for a common purpose. I very much look forward to the Bill’s successful passage through the Lords, which Lord Kamall will oversee. He will have heard the pleas from many Members about timing, to try to coincide with World Down Syndrome Day on 21 March. I commend the Bill to the House.
Dr Fox
With the leave of the House, may I say what an absolute joy it has been to find this bolthole of consensus in the psychodrama that seems to be British contemporary politics? I thank colleagues for their very kind words today; to get to this level of flattery in the House of Commons, one normally needs to be dead. [Laughter.]
I remind colleagues of the point made by my hon. Friend the Member for North Devon (Selaine Saxby) that this Bill is not about a medical condition, Down syndrome, but about people with Down syndrome, who have a right to dignity and individuality and to make the choices for their own lives that we all take for granted.
I want to thank the many people who have made today possible. I thank the National Down Syndrome Policy Group, and all the other voices in the Down syndrome community, including the carers and families whose input has been invaluable. I thank the officials at the Department of Health and Social Care, who have done outstanding work behind the scenes to bring us to the point that we have reached today. I especially thank the Minister. We have been so lucky to have a Minister in the shape of my hon. Friend the Member for Chichester (Gillian Keegan). Not only is she an outstanding Minister in her own right, but her family background and understanding of the issue have been crucial in helping to provide the necessary momentum within Government. Indeed, I thank the Government as a whole, and in particular the Secretaries of State who signed off the two very important amendments. I am sure that they entirely understood the precedents they were setting, and it was therefore—as they would say in “Yes, Minister”—all the braver of them to do so.
I thank my own staff in the House of Commons, and I thank my constituency assistant Annabel Tall, who began much of this process when she brought her son Freddie to see me at my constituency surgery, shedding light—many colleagues will have had this experience—on the difficulties that parents can have in fighting fire on so many fronts on behalf of those whom they love. I hope that means that in some sense we have gone full circle today.
I thank all colleagues for their support, for their contributions, for the encouragement that they have given, and for their advocacy of this whole process in the House of Commons, in the constituency and in the media. It has been a real example of what we can achieve together—and that includes the all-party parliamentary group on Down syndrome, which provided so much support.
None of us are passengers in our own lives or in the society in which we live, and change is always within our grasp if we choose to seize it, especially those of us who are in the uniquely privileged position of being able to make the laws in our own country. I thank all those who have chosen that path today. The real heroes of this debate, however, are not those in the Chamber or those who make the laws pertaining to Down syndrome, but all those who have fought, struggled, and overcome the challenges that they have faced without our help for far too long.
Question put and agreed to.
Bill accordingly read the Third time and passed.
Madam Deputy Speaker (Dame Eleanor Laing)
I am delighted to say that the Ayes have it.
National Health Service Co-Funding and Co-Payment Bill
(2 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate
Sir Christopher Chope (Christchurch) (Con)
I beg to move, That the Bill be now read a Second time.
It is a great pleasure to introduce the Bill. Its proposals are not really novel, because co-funding and co-payment within our national health service already exist. Indeed, the NHS website, under the heading “When you need to pay towards NHS care”, states:
“Patients often need to pay towards the cost of:
prescriptions
dental care
eye care
wigs and fabric supports”.
It goes on to say:
“The money raised helps fund the NHS.”
The payments in respect of those items are co-payments. Sometimes they are fully funded by the individual, sometimes partially funded, and sometimes there are exemptions, but the money raised from the co-payments then goes into co-funding, and it helps to fund the NHS. Of course, other items could be added to that list.
It is necessary to pay towards NHS care when it is described by some bureaucrat as social care and not healthcare. We know that an enormous amount of bureaucratic time is taken up with trying to argue that people are not in receipt of continuing healthcare, but are actually in receipt of social care. If they were in receipt of continuing healthcare, they would not have to pay for it—it would be free—but because it is deemed to be social care, they have to pay towards it either in full or in part under the system that is in place. The Government have now said that they wish to bring together the health and social care sectors. If they are to do that, then surely they need to be thinking through the issue of means testing and co-funding and co-payment as it relates at the moment to social care.
If we are to have this system, let us make sure that it works. This NHS document makes it clear that a person is not allowed to pay towards the NHS in various other sectors. Why are they are not allowed to pay towards the NHS? Our NHS is, by all accounts, still short of resources. Why do we not do everything in our power to encourage more contributions towards healthcare in this country from private individuals? Is that not a reasonable objective? It seems as though the NHS policy is to prevent people contributing towards their own NHS costs unless they fall into the categories to which I have referred. That is really the essence of this debate. I will not be able to get this Bill on the statute book in the next quarter of an hour, but I hope that I will be able to open up a debate that has been closed for far too long.
Several hon. Members rose—
Sir Christopher Chope
No, I will not give way. I just want to make my point.
Today is World Cancer Day. This morning, the Secretary of State launched a new document, talking about a 10-year plan for cancer. That reminds us that the NHS is free at the point of delivery, but it is not often free, or even available, at the point of need. Those are two separate propositions. Often, when people talk about how wonderful our NHS is, they omit to point out that, very often, the NHS is not available at the point of need. That is highlighted by the fact that there were 50,000 fewer cancer diagnoses across the UK during the pandemic, and that, during that time, NHS cancer treatments fell by some 6%. We have information now that compares OECD figures, and it shows that, in the United Kingdom, in 2019—before the pandemic—the rates of fatalities from cancer were 216 per 100,000 people. In the United States, which has a very different system from ours, it was 178 per 100,000 people. In Australia, it was 180 per 100,000 people, and, in Mexico, it was 118 per 100,000 people. The OECD average across 38 countries was 191, so we are an outlier in this country with our NHS in having much higher death rates from cancer than comparable economies and, indeed, much higher death rates than economies that are much less successful economically than our own.
We also have a pretty poor show in terms of diagnostics. We have fewer diagnostics with computerised tomography, magnetic resonance imaging and positron emission tomography scanners—CT, MRI and PET scanners—than the average OECD country, by which I mean the 38 countries to which I have referred. The average in the OECD is 45 scanners per 1 million population. In this country, it is only 16 per 1 million population. Is that not a scandal? When we look at the gargantuan waste within certain aspects of the NHS machine, it brings home the gravity of those figures and why we need to draft more resources into the NHS, including resources from the private sector.
Sir Christopher Chope
Wait a moment.
That could include, for example, all those facemasks with ear loops that had been ordered at a cost of £155 million. If the NHS did not want them, because it insists on having better-quality facemasks with head loops, surely it could have sold them off to try to get some income from the private sector, but it did not: it just wrote that money off. Similarly, because of an official error in drawing up the specification for hospital gowns, it wasted £70 million on them.
There is no reason to be complacent about the state of our NHS. That is not to say that there is not some fantastic work carried out by people who work in the NHS across the country. In many respects, the NHS is a centre of excellence.
Mr Gagan Mohindra (South West Hertfordshire) (Con)
Will my hon. Friend give way?
Sir Christopher Chope
No—I am just coming on to a constituency case, and my hon. Friend may be able to intervene on this point.
I do not know whether the person in question knew I was raising this matter in the House, but at 8.19 am today I received a letter from a lady whose mother is one of my constituents. She says,
“My mother has avoided Covid for two years by staying home, she is going to be 81 tomorrow.
She had urgent surgery on Monday on her spine. She now has COVID. Everything I have heard about her treatment by all at the hospital is dreadful. She is currently sharing a ward with people who are all being sick.”
She then makes some rather rude, disparaging remarks about the NHS, which I will not share with the House, and says:
“I know there is an option to go private, but let’s face it that’s for the wealthy upper class”,
and asks why we do not give people more choice without having to bankrupt them. She goes on to say:
“Is anyone in the UK seriously looking at the state of the NHS and working to make real, positive change?
Thanks and Regards”.
She is saying that we must not be complacent. We must start addressing those very real concerns.
I am conscious of time, so I will refer to an answer I received on 2 February from my right hon. Friend the Minister for Health. The question was:
“how many staff in his Department will be permitted to work from home after 1 February 2022; and if he will make a statement.”
I think there is a lot of concern that some staff in the NHS are not at their posts and are working from home when they should not be.
What answer did I get?
“The Department is transitioning to a new model of hybrid working. Staff are expected to work partly in the office and partly from home, with a minimum of four days a month in the office unless there is a business or wellbeing reason not to do so.”
A minimum of four days a month in the office? I thought at first I had misread it, and they were talking about a maximum of four days a month working from home. How is it that our NHS, which we are told is the envy of the world, can manage with so many of its staff working from home rather than from their workplace?
What is this new model of hybrid working and why are we transitioning to it? Why has nothing been done before? If we had had action before, perhaps so many of my questions to the Department of Health and Social Care would not have gone unanswered—for example, a question due for answer on 5 January. I am delighted to see the vaccines Minister on the Front Bench. The question was:
“To ask the Secretary of State for Health and Social Care, how many (a) deaths and (b) adverse reactions have been officially recorded against covid-19 vaccinations; and how many have been examined to establish the cause and/or trigger.”
That is a fundamental question to which the Government should have an answer. Now, however, a month later, on 4 February, the question that should have been answered on 5 January has still not been answered. If some of those staff had not been working from home, perhaps they might have got round to answering that question.
Another question that was due for answer on 5 January was:
“To ask the Secretary of State for Health and Social Care, for what reason his Department has taken over responsibility from covid-19 vaccine manufacturers for negligence claims arising from their vaccines causing serious illness or death; and when he plans to return producer liability to those manufacturers.”
Again that is an example of where, if the responsibility is taken away from the manufacturers, the taxpayer will end up footing the bill. Have we had an answer to that question due on 5 January? No, we have not.
My final example of the consequences of too many people working from home and not answering questions from parliamentary colleagues is:
“To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 21 December 21 to Question…on Coronavirus: Immune Thrombocytopenic Purpura, what steps his department is taking to investigate the 427 suspected cases of major thromboembolic events with concurrent thrombocytopenia; and if the Government will make it its policy to those affected by those suspected cases of the availability of the Vaccine Damage Payment Scheme.”
I have not had an answer to that either, even though it was due on 13 January and is directly relevant to all the issues about vaccine confidence that many hon. Members take very seriously.
Not long ago, an article was published in the British Journal of General Practice, “Patient co-payment for general practice services: slippery slope or a survival imperative for the NHS?”, that asks:
“Is universal zero cost at point of general practice care a time-expired and unaffordable NHS sacred cow? Is it time to question the unquestionable?”
In a sense, that is what the Bill does: questions what has, hitherto, been unquestionable.
The article continues:
“International observers of the NHS note increasing despondency within the general practice workforce,”—
and not just within the workforce, but among their patients—
“with much talk of a broken system tracking an unsustainable trajectory. The increased patient demand is exacerbated and compounded by the burdensome opportunity and transaction costs of a powerful, centrally orchestrated, and financially-incentivised framework. This framework is designed to drive (or buy) ‘quality’ through a complicated and time-consuming matrix of accountability measurements. As the columns of this Journal and many others…have detailed, the combination of increased demands from patients and an onerous system of accountability has led to widespread and serious workforce stress, demoralisation, and flight to early retirement.”
The article then describes the situation in New Zealand, where it says:
“There is strong support from general practice to retain co-payments both as a mechanism to manage demand and as a way to encourage self-management of minor ailments.”
Why are we not considering that in the United Kingdom? We know that GPs are under enormous stress and that people feel deterred from going to the GP or that their GPs refuse to see them, which is contributing to the examples of undiagnosed cancer that I referred to earlier.
Sir Christopher Chope
I will not, because I am afraid that there are only 30 seconds left. I hope that this short speech will open up a proper debate on a really important issue. We cannot keep ducking it.
Jonathan Gullis (Stoke-on-Trent North) (Con)
It is a pleasure to talk about my love for the NHS. I was born with a cholesteatoma in the right ear. Thanks to the NHS, I was able to be seen at the age of seven, which meant that the bones that had deteriorated in my inner ear—
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Sir Christopher Chope (Christchurch) (Con)
On a point of order, Madam Deputy Speaker. I do not normally whinge about the Government objecting to my private Member’s Bills, but I wish to on this occasion because on 28 January I tabled a question to the Department for Levelling Up, Housing and Communities asking why the Government’s policy is to object to the Mobile Homes Act 1983 (Amendment) Bill having a Second Reading. The Minister replied on 2 February; I will not read out the first part of his answer, which is not relevant:
“The Bill printed on 24 January 2022 set out a new proposal to change the pitch fee review inflationary index from the Retail Price Index to the Consumer Price Index.”
That is, of course, Government policy.
“We will consider the proposal in detail and make a statement at the Bill’s Second Reading.”
Well, we have had the Bill’s Second Reading today. I proposed the Second Reading of the Bill and, through you, Madam Deputy Speaker, I would like to hear from the Government as to what statement there is. Having seen that answer to my question, I assumed that the statement was going to be, effectively, no objection and that the Bill was then going to be able to get its Second Reading. That has not materialised.
Madam Deputy Speaker (Dame Eleanor Laing)
I thank the hon. Gentleman for his point of order. I am not sure he is factually correct. The Bill has not had its Second Reading. He introduced the Bill and said, “Now.” The Government Minister objected. I accepted the objection and asked the hon. Gentleman to name a date for the Second Reading of the Bill, which he did. I think he said 25 February. I might be wrong on that date, but my recollection is that he said 25 February. It is therefore quite clear to me that the Bill will come forward for Second Reading on 25 February.
I must also say, however, that some Members might not quite, due to their inexperience, understand the concept of an objection to a Bill under the private Members’ Bill process. That does not apply to the hon. Gentleman because he has probably objected to more Bills than any other Member in history.
Sir Christopher Chope
Further to that point of order, Madam Deputy Speaker. I think I have also had more Bills to which an objection has been made than any other Member, but I will leave that on one side. When Second Reading today was blocked, I moved that the Second Reading be put over to 25 February. Normally, no Bill receives a Second Reading, if there is a debate, until after the Government have spoken and after there has been an opportunity for a vote on it. So I had assumed, from the answer I received from the Minister, that the Government were going to make a statement at the—
Madam Deputy Speaker
Order. I have heard the hon. Gentleman’s point of order, and I have to correct him. I do not think for one moment that he assumed anything of the kind because he knows this process better than anyone. I will not entertain his point of order any further as it is now 2.38 on a Friday afternoon. The hon. Gentleman has made his point more than once. It will have been heard. We will come back to this matter on 25 February.
Sutton Decentralised Energy Network
(2 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Watch Debate Read Debate Ministerial Extracts
Elliot Colburn (Carshalton and Wallington) (Con)
Colleagues in this House will have heard me speak many times about the problems facing residents living in New Mill Quarter in Hackbridge and the issues surrounding the Sutton Decentralised Energy Network, or SDEN. Before I go on, may I particularly welcome that it is this Minister who is on the Front Bench? The Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Sutton and Cheam (Paul Scully), will know much of what I am about to say, as my constituency neighbour and as the MP for the second half of Sutton, which we both represent.
For the benefit of the House, I would first like to go over some of the background to SDEN. It was set up in 2016 and is still wholly owned by Sutton Council. It was set up to provide heating and hot water to properties, as part of a heat network, across Sutton but also neighbouring boroughs. The energy for this project was to be generated by the Beddington energy recovery facility—in other words, an incinerator that is the largest polluter in the London Borough of Sutton. Put simply, the incinerator will burn waste, and the energy produced will provide heating and hot water to nearby properties.
The first phase of this project was to provide energy to New Mill Quarter, which is a new build estate in Hackbridge. It is still partly under construction, but when it is completed it will total approximately 800 properties. Residents started moving into New Mill Quarter in 2019, but since then they have been absolutely plagued by problems, with a number of issues surrounding technical aspects of SDEN as well as management by Sutton Council causing financial and mental distress to the residents who live there. I would like to go over some of the issues they have been facing in more detail.
The first and most important issue has been the extremely regular blackouts that have occurred. One resident tells me that, since 2019, they have had a total of 26 heating and hot water blackouts, and two incidents that required call-outs from the London Fire Brigade because of problems to do with the technical nature of SDEN. Until fairly recently, SDEN promoted its services as “100% 24/7 resilient”, but as residents living at New Mill Quarter can attest, the service is anything but resilient, as they continue waking up to freezing cold homes on a regular basis. I was particularly shocked at a meeting, which the council tried and failed to block me from attending, when it was claimed that residents should not have expected it to be 100% resilient, despite the marketing material claiming that it was, as this was clearly just a promotional piece of literature. I personally fail to see how this does not fall foul of the law, but I do not have time to go into that right now, so I will move on.
The regular blackouts have been particularly difficult during covid-19, as of course people were ordered to stay in and work from home, but many of them suffered regular outages of their heating and hot water while they did so. For most of us, hot water and heating blackouts would occur very infrequently—once in a blue moon—if the boiler is on the blink or a heat system does not work. But for residents in New Mill Quarter, it really is a daily guessing game as to whether or not they will wake up to have any heat or hot water. Many residents are having to pay extensively for additional or alternative heating devices, but in response to this, SDEN has only offered residents a pitiful compensation package of just £54.
The second issue with SDEN surrounds the pricing model. The council was again so keen to keep information about the pricing model quiet that it took freedom of information requests and a ruling from the Information Commissioner to even get hold of it. What it actually revealed is that residents in New Mill Quarter are indeed paying above average energy prices, despite claims from SDEN that they are on parity. The pricing structure of SDEN is split into two categories: a variable rate, which is the usual daily rate; and the standing charge, which covers maintenance and repairs. Based on the pricing model that has been provided by SDEN—finally—the New Mill Quarter Residents Association has calculated that the costs were likely higher than the market by £2.9 million across the entire estate over the term of the contract.
The final issue—again, potentially one of the more important parts of this—is that residents can do absolutely nothing about this. They are trapped by the infrastructure that is there, because properties in New Mill Quarter do not have individual heating sources such as boilers or heat pumps. They cannot vote with their feet and switch energy providers, so ultimately SDEN has a monopoly on energy in New Mill Quarter, and residents are tied into a 25-year contract that they cannot get out of.
Since becoming the MP for Carshalton and Wallington, I have basically had to deal with SDEN issues since day one, so I have been curious to look at whether these were exclusive to SDEN, but sadly it appears they are not. There are other case studies from across just the capital here in London. I hear that the Pembroke Park estate in Hillingdon has suffered failures, as have the Oval Quarter in Lambeth, New Festival Quarter in Tower Hamlets and multiple estates in Southwark, all of which have suffered hot water and heating outages. But nothing in my research comes even close to the absolute shambles presided over by Liberal Democrat-run Sutton Council.
Thanks to a motion in Sutton Council by the Conservative group, an independent review into the financial model of SDEN was conducted. The Chartered Institute of Public Finance and Accountancy conducted the review over the summer, and its findings were nothing short of shameful. It concluded that Sutton Council had made false assumptions in its financial modelling to gain approval for its heat network. It was essentially a fake news business document. The model falsely included 75 dwellings that do not exist and funding grants that were never obtained. The report concluded that SDEN was “not financially stable”. To improve the financial resilience of SDEN, the report suggested two things: increases in the tariffs charged to customers, who are already paying above the market rate for energy prices; and, revising the funding available from the taxpayer to pick up the pieces.
The second thing I want to look at is the fact that SDEN is dependent on the Beddington incinerator to operate, but that creates a paradox. SDEN claims to be a low-carbon energy provider, but SDEN was used as a condition to get approval to build an incinerator, which is the largest polluter in the borough. Those two statements just do not add up. The heat network relies on the burning of waste to keep it going, yet the Lib Dems are claiming that they can increase recycling rates this way. Incineration is not conducive to our net zero targets, and it is the Government’s policy to phase out incineration in their waste minimisation strategy.
As recycling levels increase, along with “reduce and reuse”, the amount of waste that the borough produces, and the amount of waste that other boroughs send to SDEN to burn, will inevitably reduce. That can mean only one of two things: either SDEN will have to import waste to the Beddington incinerator to keep it operational, or the incinerator will become obsolete, as there is no waste to burn, and therefore homes will be left with no source of heating. I do not think the latter is likely any time soon, because the operators of the Beddington incinerator, which was approved by the Lib Dem council in 2013, are now looking to expand its capacity. They are applying for an increase in the amount of waste it can burn, and much of that will be imported from outside the borough. More waste equals more vehicle movements, equals more incineration, equals more air pollution, equals more carbon emissions.
To add insult to injury, there has been a complete lack of any understanding, empathy or action from the Lib Dem-run council, including the Lib Dem councillors representing the area, which may explain why it seems most of them are jumping, like rats leaving a sinking ship, rather than daring to face their electorate for re-election in May. The Lib Dems are still touting this scheme as a huge success—as proof of their competence and a demonstration of how well they run things. If this is how they run things, it is no wonder that more and more lifelong Lib Dem voters are telling me that they simply cannot put them back into the council in May.
This is where we need the Government to try to help. This relatively new form of energy is almost entirely unregulated, so new consumer protections are needed. I welcome the work that BEIS is doing to regulate heat networks. I support the decision for Ofgem to act as the regulator, with Citizens Advice acting as advocate for customers and the energy ombudsman responsible for resolving disputes. We need regulation and consumer support as soon as possible. To reach our net zero ambitions, heat networks are set to increase by 800%—that is a lot of growth in a short period of time.
To protect and help current and future heat network customers, regulation needs to be expedited. People are trapped in homes, unable to sell due to the well-known issues with heat networks. The regulators need to have enough bite to resolve the issues that customers are experiencing, including, importantly, providing compensation for historical complaints, ensuring that these projects can be future-proofed.
Some problems are yet to be addressed. In the case of SDEN, there have been failures by the public sector local authority and the private sector developer/energy provider, which needs cross-departmental support. Sutton Council, as I have already said, established this heat network under false pretences and has failed to manage its finances, so I would be grateful to hear how BEIS and the Department for Levelling Up, Housing and Communities can work together to ensure that rogue and incompetent local authorities are not failing consumers and to prevent them from conducting these projects without legitimate financial models. Wider conversations need to be had about how we can liberate the heat network market so that they are not monopolised, to the detriment of customers trapped in long-term contracts.
SDEN has been a catastrophic failure. It was founded on fantasy, it is not working and now local residents are going to be asked to foot the bill for this vanity project. At the heart of this are residents trapped with nowhere to go. They cannot change provider because of the monopoly of heat networks such as SDEN, so we need tougher regulation. We need the energy price cap to apply to heat networks, and when things go wrong we need compensation and assurances that incompetently run councils, such as Lib Dem-controlled Sutton, are not the final arbiter.
The Lib Dems are not going to help these residents. They just do not care. I hope that the Government can step in with tougher regulations to protect SDEN customers from the disaster that they have been left with.
The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (Paul Scully)
I congratulate my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) on securing this important debate today. I think we are at well over three figures now for the number of times he has stood in this place and raised matters to do with Carshalton and Wallington.
My hon. Friend has had to mention SDEN far too many times. Residents in New Mill Quarter have had to suffer and I have seen a lot of the comments that have been made, although not as many as he has as a dogged champion for those residents. Local Facebook groups and newsletters that I have read as a Sutton Member of Parliament call out for someone to come in and sort the situation out. In May, we will have that opportunity.
I am sorry to hear about my hon. Friend’s constituents, including those at New Mill Quarter, who have been experiencing all those issues with their heat network. I sympathise with them for the difficulties that must cause and agree with my hon. Friend about the need for protections for heat network consumers.
The experiences of constituents that we have heard highlight the importance of the Government’s commitment to regulate the heat networks market within this Parliament. Heat networks are vital to our net zero ambitions. As we have set out in the heat and buildings strategy, they are the only way that we can unlock large-scale renewable and recovered heat sources such as energy from waste, waste heat and heat from rivers and mines. When they are deployed effectively, heat networks can bring together greater heat efficiency than individual gas boilers, lower costs for consumers, unlike what we have just heard, and support for local regeneration. We recognise when we hear examples such as this that we need to regulate the market to ensure protections for heat network consumers.
In 2017, the Government commissioned a survey to quantify consumer experiences with heat networks in England and Wales. Those results showed that consumers connected to a heat network generally receive a good service and are as satisfied as non-heat network consumers. They also showed that on average a heat network consumer is likely to pay £100 less a year for heating and hot water than consumers on other utilities. We can see that heat networks per se can be a good thing, but unfortunately, as we have just heard, they are clearly failing residents in Carshalton and Wallington and in New Mill Quarter in particular.
We acknowledge the 2018 report from the Competition and Markets Authority, which, like my hon. Friend, considered a number of examples from around the country and showed that a significant minority of heat network consumers experienced high prices, frequent outages and a lack of transparency. We committed to the CMA’s recommendation of regulating the market, consulted on establishing a heat networks market framework and in December published the Government response to the consultation in which we confirmed that we would appoint Ofgem as the heat networks regulator.
The document includes summaries of responses received, and sets out our proposals on consumer protection, regulating the carbon emissions of heat networks, and technical standards. That will include introducing consumer protection rules to combat cases of detriment, such as the outages being experienced by residents of New Mill Quarter. We want heat network consumers to have comparable levels of service and protection to those using electricity and gas.
As part of the market framework, we will introduce quality of service standards requiring notification periods for planned outages and compensation for all outages. Consumers will have access to an independent redress scheme and a consumer advocacy body, which will provide a consumer helpline and priority services for consumers in vulnerable circumstances. The regulator will have powers to enforce price transparency, introduce guidance on fair pricing, set requirements on cost allocation, and conduct investigations into heat networks where prices are disproportionately high.
Finally, consumers will be provided with a minimum level of easily accessible information and guidance on heat networks at the pre-contractual stages of property transactions and during residency. There will be requirements on the provision of heat supply agreements and billing information.
We are preparing to introduce that legislation to regulate the market, but measures are already in place to improve standards for heat network consumers. Heat Trust provides an independent, market-led voluntary standards scheme. Consumers on heat networks registered with Heat Trust benefit from terms of service similar to those in the gas and electricity markets. They are also able to access the energy ombudsman if they have a complaint against their heat supplier. In 2019, the Department for Business, Energy and Industrial Strategy wrote an open letter to all heat networks encouraging them to register their schemes with Heat Trust. We continue to encourage schemes to sign up, raise standards now and prepare for regulation. We also support the Heat Networks Industry Council’s work to establish the consumer protection agreement and the heat network emergency responders group in response to the covid-19 pandemic. We encourage heat suppliers to sign up to this agreement, and we have written to signatories urging them to do more to tackle outages and improve compensation standards for outages.
Though these schemes have benefitted many consumers, we recognise that regulation is needed to drive up consumer standards across the heat networks market. I therefore reiterate our commitment to regulation, as pushed for by my hon. Friend. We have introduced several schemes to support heat network deployment. The Government’s heat networks investment project has made £320 million of capital funding available for investment in heat network projects through grants and loans in England and Wales. This will be succeeded by the green heat network fund in 2022, which will support and incentivise the use of low-carbon heat sources in heat networks. Both of these investment projects ensure adequate consumer protection measures are in place by requiring projects to demonstrate Heat Trust standards or equivalent levels. This ensures that we only support heat networks that deliver fair pricing and are that well-designed, efficient systems.
Furthermore, we have been carrying out work on improving performance across a number of existing heat networks. This provides an evidence base for the development of the heat networks efficiency scheme, which will part-fund operational performance improvements and carbon emissions reductions in existing systems. Further details will be announced later this year.
I was really interested to hear my hon. Friend’s description of what has happened in Sutton. He has raised this on a number of occasions with my hon. Friend the Secretary of State, while he was Energy Minister, and with the new Energy Minister. BEIS officials were concerned about the issues raised by customers connected to phase 1 and so asked the council how the grievances were addressed before approving phase 2 funding. Sutton Council clearly had to recognise that there were service interruptions in 2020 as a result of technical failures caused by the housing developer during the network installation phase of the New Mill Quarter development in Hackbridge. At the time, it apologised and made goodwill compensation payments to all affected customers as part of the apology. The move in the primary heat source connection from temporary to permanent at the Beddington landfill gas site was successfully completed in March 2021.
This is an interesting point: I have seen my hon. Friend’s videos on social media around New Mill Quarter talking about the outages that were happening just last month. However, the council has given us figures that say that, since the heating network was connected to the primary heat source, its reliability has significantly improved, with an availability rate of 99.8% being achieved from March to September 2021. However, the residents I have heard from, and the story that my hon. Friend tells, suggest a different story entirely.
We have to remember that councils do not exist to install heat networks or to install incinerators in one of the most polluted roads in London. They exist to provide a service for their residents who elect them in the first place. They would be nothing if it was not for the people they serve. They should be there to make sure that they keep people warm, to give them hot water and to get rid of their rubbish in an environmentally responsible way. That is their purpose. The incinerator and the heat system are mechanisms to achieve all that, but they are not a means of it themselves.
The council needs to be responsive to its electorate and to those residents. It is disappointing to hear my hon. Friend talk about the lack of empathy and sympathy being shown to them. If it is the council that is providing that service directly, rather than a third party, then it should be more responsive and it should be serving those residents. I hope that, in May, those residents will be able to reflect on that in their consideration, because councillors need to be accountable. If we are to devolve power to local authorities—I am, and always have been, a big fan of devolution—it is really important that residents are able to pull councillors up, so that they do not get arrogant and they do not get complacent. Residents should remember that they will be voting in councillors who will be there for the next four years. Four years is a long time—just think how long ago 2018 seems. Over the next four years, we want to make sure that those residents in New Mill Quarter get the hot water and the heating that they have paid for—it is a service—so they need councillors who will be far more responsive.
Let me have a final word on the incinerator. When I was the leader of the opposition on Sutton Council, I remember speaking about incinerators to one of the previous environment spokesmen on the council. When one was brought in, so much of the debate on pollution was actually about vehicle movements. It is disappointing that, despite burning 70% of the waste of the boroughs that it serves in the south-west London partnership, it does not have enough to feed it. My hon. Friend was absolutely right to talk about the circular nature of the argument in the bid, which included some dubious numbers. It is not appropriate that the talk now is of more vehicle movements in that area. We need to be really careful about that, which goes back to the responsiveness that I was talking about.
In the round, it is essential that heat network consumers are provided with clean and reliable heat at an affordable price. It can work; it does work in other parts of the country. As I have said, it is a real marker of our net zero ambitions, which is why we are developing a heat networks market framework that places consumers at its heart, delivers sustainable investment in the sector, and maximises heat networks’ potential economic and environmental benefits. We committed in the energy White Paper to legislate for this market framework by the end of this Parliament, and we are working closely with industry and consumer groups to ensure that the regulation delivers positive outcomes for consumers.
I conclude by once more congratulating my hon. Friend on being such a champion for his area, on securing this debate and on raising some really important issues for the residents of New Mill Quarter and beyond.
Question put and agreed to.
Ministerial Corrections
(2 years, 9 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text
Digital, Culture, Media and Sport
(2 years, 9 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Ms Dorries
Finally, manufacturers will be required to be completely transparent about how often, and for how long, their products will receive security updates and patches. According to the current guidance that is being commonly issued, if we update our computers regularly when asked to do so and use two-step verification, 90% of cyber-attacks can be avoided. The requirement for manufacturers to be transparent about how often their product will receive security updates is intended to help consumers to know at which point they will need to do that.
[Official Report, 26 January 2022, Vol. 707, c. 1031.]
Letter of correction from the Secretary of State for Digital, Culture, Media and Sport:
Errors have been identified in my speech on Second Reading.
The correct information should have been:
Ms Dorries
Finally, manufacturers will be required to be completely transparent about for how long their products will receive security updates and patches. According to the current guidance that is being commonly issued, if we update our computers regularly when asked to do so and use two-step verification, 90% of cyber-attacks can be avoided. The requirement for manufacturers to be transparent about for how long their product will receive security updates is intended to help consumers to make an informed choice when purchasing a product.
Treasury
(2 years, 9 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lucy Frazer
We have cut tax for low-income families by introducing the universal credit taper rate, saving working families £1,000 a month.
[Official Report, 2 February 2022, Vol. 708, c. 373.]
Letter of correction from the Financial Secretary to the Treasury, the right hon. and learned Member for South East Cambridgeshire (Lucy Frazer):
An error has been identified in the response given to the hon. Member for Ealing North (James Murray) at Report stage of the Finance (No. 2) Bill.
The correct response should have been:
Lucy Frazer
We have cut tax for low-income families by reducing the universal credit taper rate and increasing the work allowance, saving working families £1,000 a year.
Written Statements
(2 years, 9 months ago)
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Modernising Communications Offences: Law Commission Review
(2 years, 9 months ago)
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The Parliamentary Under-Secretary of State for Digital, Culture, Media and Sport (Chris Philp)
I wish to inform the House that the Government will be accepting the recommended harm-based communications offence, false communications offence and threatening communications offence, as laid out in the Law Commission’s “Modernising Communications Offences” report, published in July 2021.
The offences will be brought into law through the online safety Bill, which we are committed to introducing to Parliament as soon as possible.
These new offences will help ensure that the criminal law is focused on the most harmful behaviour while protecting freedom of expression. The current offences are sufficiently broad in scope that they could constitute a disproportionate interference in the right to freedom of expression. The new offences will protect freedom of expression and, in the case of the harm-based offence by increasing the threshold of harm to serious distress, will ensure that communications that individuals find offensive, such as the expression of a view they do not like or agree with, will not be caught. In addition, the court cannot find someone guilty of the harm-based offence or false communications offence if they have a reasonable excuse. A reasonable excuse would include if the communication was or was intended as a contribution to the public interest.
We have also accepted the Law Commission’s recommendation to include a press exemption within the general harm-based communications offence and the knowingly false communications offence. While we do not expect the new offences will capture communication made by the media, including this press exemption demonstrates the Government’s commitment to upholding media freedom.
The Government will repeal the existing communication offences, including section 1 of the Malicious Communications Act 1988 and sections 127(1) and (2) of the Communications Act 2003, as recommended by the Law Commission.
Alongside the online safety regulatory framework, the offences will help deliver the Government’s objective of making the UK the safest place to be online.
In addition, as the Prime Minister has indicated, we welcome the recommended offence on cyber-flashing and are carefully considering it.
The report recommends a further three offences. The Department for Digital, Culture, Media and Sport and the Ministry of Justice are carefully considering the remaining offences and accompanying recommendations, including the hoax calls offence, an offence for encouraging or assisting self-harm and an offence for epilepsy trolling. We will continue to assess these offences and issue a full response to the Law Commission later this year.
I would like to express my sincere thanks for all the work that the Commission has carried out as part of this review over the past four years.
[HCWS590]
Health Disparities
(2 years, 9 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
The pandemic has shone a light on the unacceptable disparities in health outcomes that exist across the country. The Government are committed to reducing health disparities, addressing the gap in healthy life expectancy that exists between different communities and building on the positive action set out in the levelling up White Paper.
I am therefore pleased to announce that we will take bold action on health disparities through a health disparities White Paper, aiming to break the link between people’s background and their prospect for a healthy life.
We will publish our plans in spring 2022 and look forward to engaging with stakeholders and partners to address this critical agenda.
Linked to the health disparities White Paper, I would also like to announce two reviews with a focus on health disparities:
Independent review on tobacco control
Firstly, I have asked Javed Khan to lead an independent review into smoking in support of the Government’s bold ambition to be smoke free by 2030.
While the Government have made good long-term progress in reducing smoking rates, there are still nearly 6 million smokers in England, and an estimated 64,000 people died from smoking in 2019 alone. Smoking is one of the largest drivers of health disparities and causes a disproportionate burden to our most disadvantaged families and communities.
As a leading figure in the UK public and voluntary sectors, Javed Khan will bring a wealth of experience to help determine what more can be done to drive down smoking rates. The review will support the Government to identify the most impactful interventions to reduce the uptake of smoking, and support people to stop smoking, for good.
The independent, evidence-based findings will inform both the health disparities White Paper and the Government’s new tobacco control plan, which will be published later this year. Javed Khan will report back to the Government in April 2022.
Independent review into medical devices
Professor Dame Margaret Whitehead will lead an independent review of the health impact of potential ethnic bias in the design and use of medical devices.
Professor Dame Margaret Whitehead has vast experience in tackling health inequalities, and for many years has led the work of the World Health Organisation’s Collaborating Centre for Policy Research on the Determinants of Health Equity.
The review into the design and use of medical devices in the UK aims to:
Identify systematic inequalities in medical devices registered for use in the UK.
Make recommendations on how inequalities should be tackled.
Consider what systems need to be in place to ensure emerging technologies are developed without ethnic inequalities.
Improve global standards to better healthcare and tackle disparities.
I look forward to the outcome of both reviews so we can continue to level up across society and make sure everyone—no matter where they live or come from—can live a long, healthy life.
[HCWS591]
Essex Mental Health Inquiry: Indemnity
(2 years, 9 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)
It is normal practice, when a Government Department proposes to undertake a contingent liability in excess of £300,000 for which there is no specific statutory authority, for the Minister concerned to present a departmental minute to Parliament giving particulars of the liability created and explaining the circumstances; and to refrain from incurring the liability until 14 parliamentary sitting days after the issue of the minute, except in cases of special urgency.
I have today laid a departmental minute proposing to provide an indemnity that is necessary in respect of a Department of Health and Social Care established non-statutory, independent inquiry into the care and treatment pathways and the circumstances and practices surrounding the deaths of mental health inpatients in Essex.
The Essex Mental Health Independent Inquiry has been established to investigate deaths which took place in mental health inpatient facilities across NHS Trusts in Essex between 1 January 2000 and 31 December 2020. It will draw conclusions in relation to the safety and quality of care provided locally and nationally to mental health inpatients.
In January 2021, the Minister of State for Patient Safety, Suicide Prevention and Mental Health announced the establishment of the inquiry—HCWS729, 21 January 2021—to be chaired by Dr Geraldine Strathdee CBE. The indemnity will cover the entire duration of the inquiry’s work, from January 2021 until when the inquiry submits its final report, expected in 2023, and for an unlimited period after that date. However, we believe there is a low risk of the indemnity being called upon beyond five years of the inquiry having reported. The indemnity will cover the chair and all other members of the inquiry team, against any liability, including any legal or other associated costs, arising from any act done, or omission made, honestly and in good faith, when carrying out activities for the purposes of the inquiry in accordance with its terms of reference.
The indemnity will only apply to acts done or omissions made during the course of the inquiry and will exclude personal criminal liability, negligence or reckless acts. There will be no cap placed upon the indemnity, so the maximum exposure is strictly unlimited. However, any losses are not expected to exceed a value of £3 million based upon the best estimate currently available at this stage of the inquiry’s work. If the liability is called, provision for any payment will be sought through the normal supply procedure.
The Treasury has approved the proposal in principle. If, during the period of 14 parliamentary sitting days beginning on the date on which this minute was laid before Parliament, a Member signifies an objection by giving notice of a parliamentary question or by otherwise raising the matter in Parliament, final approval to proceed with incurring the liability will be withheld pending an examination of the objection.
[HCWS589]
Northern Ireland: Resignation of First Minister
(2 years, 9 months ago)
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The Secretary of State for Northern Ireland (Brandon Lewis)
I wish to inform the House that Paul Givan has resigned as the First Minister of the Northern Ireland Executive. This decision is extremely disappointing and I want to make it clear that the Government want to see a return to ministerial roles immediately, to ensure the necessary delivery of public services for the citizens of Northern Ireland.
The Government’s priority is for a strong, functioning Executive delivering a better, more prosperous, shared future for the people of Northern Ireland. We want to continue to build on the Belfast (Good Friday) agreement’s promise of a stable, co-operative power-sharing Executive, built on respectful relationships with a shared commitment to serve all the people of Northern Ireland.
The last two years since the New Decade, New Approach agreement restored devolved Government in Northern Ireland have demonstrated the potential that can be unlocked when the political parties in Northern Ireland work together. We must not return to a state of political deadlock and inertia.
The Government recognise the impact that the Ireland/Northern Ireland protocol is having on the ground, and we have been clear for some time that the protocol has been causing a serious unbalancing of the delicate and hard-won political stability in Northern Ireland. We remain fully committed to fixing the problems with the protocol and to protecting the Belfast (Good Friday) agreement in all its dimensions.
I have spoken to Northern Ireland party leaders and the Irish Government, to encourage a return to stable devolved Government in Northern Ireland. The Government hope that Northern Ireland's political leaders will quickly take the necessary steps to restore the stability in the devolved institutions that the people of Northern Ireland deserve. In addition, the Northern Ireland (Ministers, Elections and Petition of Concern) Bill currently before Parliament will aid and underpin stability.
[HCWS588]
House of Lords
Wellbeing of Future Generations Bill [HL]
Friday 4th February 2022
(2 years, 9 months ago)
Lords ChamberRead Full debate Wellbeing of Future Generations Bill [HL] 2021-22 View all Wellbeing of Future Generations Bill [HL] 2021-22 Debates Read Hansard Text
Lord Ashton of Hyde (Con)
My Lords, I have it in command from Her Majesty the Queen to acquaint the House that Her Majesty, having been informed of the purport of the Wellbeing of Future Generations Bill, has consented to her place her interest, so far as it is affected by the Bill, at the disposal of Parliament for the purposes of the Bill.
Motion
Lord Bird (CB)
My Lords, I thank the many people who have been involved in the life of this Bill. It started very much as an imitation of our Welsh friends’ and cousins’ Well-being of Future Generations (Wales) Act. This Bill was inspired by that. I remind noble Lords that it was also inspired by the fact that I came into the House to prevent poverty and not to make the poor slightly more comfortable than they were before I came in. I have always started from the premise that what is important is finding preventive methods, methodologies and systems that allow us to intervene before the problem presents itself. As we always seem to be living and treading on the mistakes of the past—past interventions, past actions, past acts and past activities—it is important that we look again at how we can prevent the future from being a poor version of the present and the past.
Therefore, I thank all the people who got behind this. The APPG for Future Generations has been sterling, as has the steering committee. I also thank my office, whose members are up there somewhere. They have worked very hard and led me on this. They have pushed me, cajoled me and supported me to ensure that we were in places where we could influence the decision-makers. I spent a lot of time talking to members of the Government. It is surprising that certain departments are very much for the idea of a future generations Bill becoming an Act. Obviously, there are others who will find it difficult.
I thank the many Peers from all sides of the House who have said to me that this is a very good Bill, which we must see go through to the other place and not get kicked into the long grass simply because the Government cannot make the time. I cannot think of anything else to say except thank you very much and God bless you all.
Lord Watson of Invergowrie (Lab)
My Lords, we are all indebted to the noble Lord, Lord Bird, not only for bringing this Bill forward and thus allowing the important issues that it encompasses to be debated in your Lordships’ House but for displaying today the customary flourish and passion that he brings to his contributions. That noble Lords endorse the need for such a Bill was clear at Second Reading, when 36 spoke in a debate that lasted in excess of two hours. With very few exceptions, the Bill’s aim to ensure that government policy-making takes into account the interests of future generations was warmly welcomed.
I will not repeat any of the arguments, but I will repeat a line that I used at Second Reading. The question should not be what the cost will be of pursuing the actions called for in the Bill but rather what the cost will be of not doing so. The Government adopted a strong stance at COP 26 and worked hard to build support for it, surprising many of us who had not anticipated that they would do so. That demonstrated an understanding of the issues that were facing future generations and the need to act decisively now. A positive response today by the Minister would not only reinforce that forward-looking approach by the Government but would allow this Bill to move to another place with a fair wind behind it. I very much hope that, here and in another place, the Government are equal to that challenge.
Lord Blunkett (Lab)
My Lords, I will not delay the House but I just want to reinforce the words of the noble Lord, Lord Bird, and my noble friend Lord Watson. I had the privilege of speaking at Second Reading. On a day when the figures of young people being referred to the child and adolescent mental health services should disturb us all, the future of our generations—of our young people, our children and grandchildren, our nephews and nieces—and the importance of prevention and early intervention should be at the top of the agenda. I can see no reason why the Government would oppose this Bill.
Health and Care Bill
Friday 4th February 2022
(2 years, 9 months ago)
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Lord Ashton of Hyde (Con)
My Lords, before we commence proceedings on the Bill, I will outline the plan for today. We will shortly begin the eighth day in Committee on the Bill. There is no other business, but we will take a short break around 2 pm. We will sit until 7 pm. At the outset, I thank the staff of the House for supporting this additional lengthy Friday sitting, both those here in the Chamber and those who do the enormous amount of work that goes on behind the scenes to get the House up and running.
I fear that noble Lords know what I will say next. I do not want to deny the House the fullest chance to scrutinise this Bill. As over 40 hours have been devoted to that end, not even my fiercest critics could say that time for debate has been curtailed. However, we still have a lot of amendments to get through. I know, based on the experience of last Wednesday, that good progress can be made. I know that the Front Benches will work to ensure that their contributions are concise and to the point and I hope that all noble Lords will do the same.
We should perhaps bear in mind the late, great Nicholas Parsons and make our speeches without repetition, hesitation or deviation and perhaps for just a minute. This is a self-governing House, so all I can do is ask and implore noble Lords to respect the conventions and courtesies of the House to ensure effective and efficient scrutiny of this legislation.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, before calling the first amendment, I indicate that the noble Baroness, Lady Brinton, will be taking part remotely.
Clause 141: Provision of social care services: financial assistance
Amendment 237
“(c) after subsection (2) insert—“(3) No financial assistance provided under this section may be used for the purposes of—(a) repaying debt;(b) paying interest on debt;(c) making distributions to shareholders.””Member’s explanatory statement
This amendment ensures that financial assistance given by the Secretary of State is not distributed to shareholders or used to repay debt obligations.
Baroness Bennett of Manor Castle (GP)
My Lords, I will also speak to Amendments 238 and 239 in my name. Predatory and rent-seeking financial practices by investment firms and hedge funds, which are often based in tax havens and have extremely complex ownership structures, have placed unmanageable financial and human costs on the UK care sector. I first learned about this issue in 2016 from the brilliant Centre for Research on Socio-Cultural Change, which was then based in Manchester but is sadly no longer extant. Since then, the issue has become a staple on the pages of the Financial Times. If any noble Lord does not know about this issue, I urge them to look up “UK social care” on ft.com. They will see there a long string of stories from a publication that does not generally represent my side of politics saying how much of a problem this is.
I also note that, last week, the noble Lord, Lord Sikka, not currently in his place, initiated an Oral Question that highlighted some of the worst abuses in financialised care homes, from HC-One siphoning off 20% of its revenues to offshore affiliates through intra-group transactions to—as was highlighted by the noble Baroness, Lady Brinton, who may raise this again later—the industry average of 16% of the money going not to care but to the financial sector. The crisis is here and was further highlighted by the recent “Panorama” report.
What is lacking, however, and I have been looking for them since 2016, is solutions. How do we change this situation? It is worth pointing out that this is not how things have always been. Back in the 1980s, the NHS was generally known as a world leader for geriatric care, as it was then known, picking up half of the care sector for older people. In 1982, there were only 44,000 private care home beds. By 1994, there were 164,000. The number of charity, non-profit, local authority beds plummeted and the private sector came in or displaced the public.
The amendments to the Health and Care Bill that I am presenting today rely on the work of the All-Party Parliamentary Group on Limits to Growth. Its excellent report covers these issues in much more detail than I have time to do today and I urge noble Lords to look at it. The group worked on and produced these amendments.
Amendment 237 takes what I think could be a deeply dangerous element of the Government’s Bill, which has received little attention thus far. It is the provision allowing for government support of private care facilities. This is not possible now. Amendment 237 would add the provision that these funds cannot be used to make payments on debt obligations for for-profit bodies or in distributions to shareholders—huge payouts that were highlighted in last week’s debate.
However, that takes us further, and it is interesting that the government amendment—I suspect unintentionally—actually gives us a way forward to start to unwind the privatisation, as there is a potential problem. We have already seen two major private care home crashes: Southern Cross in 2011 and Four Seasons Health Care in 2019. When—I will not say if—more crash, how do we start to move towards worker co-operatives, social enterprises, local authority homes and charity-run homes? How do we ensure that people can stay in those homes safely and be cared for, and not see the money siphoned off into offshore tax havens? We can use Clause 141 with this amendment for potentially very positive, even revolutionary, purposes.
Amendment 238 picks up a point that I often make that a foundation for tackling our out-of-control financial sector and ensuring that fair taxes are paid by companies is country-by-country reporting. The amendment requires any related companies within the same corporate group that are registered offshore to be under the same financial reporting and publication requirements as those bodies registered in the UK. That means that expenditure on dividends, directors’ fees, interest payment and similar would have to be fully and transparently declared. I have to ask the Minister: what does he have against transparency in the financial sector? What could the Government possibly have against seeing exactly where the money goes—whether it is the money of older, vulnerable people in our society or the state money that is supporting them? That is all that this amendment does; it demands that transparency.
These two amendments are not a total solution—I do not have a panacea for the situation—but they are a start, and that is why they combine with the third amendment in this group, Amendment 239, which calls for a review. It is a very simple, obvious amendment of a type often seen in your Lordships’ House. I note that I am joining the former Conservative Health Secretary Jeremy Hunt, who also recently called for a review of the funding. We see some unusual alliances in this House; this is an unusual alliance between the two Houses.
As we all know and has just been highlighted, the many hours of this debate have focused on what a mess the care sector is. These are the most vulnerable members in our society, and a significant part of that mess is because money is being siphoned away from their care. We can use the Bill, with these three modest amendments, to start to turn around that situation. I beg to move.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite her to speak.
Baroness Brinton (LD) [V]
My Lords, I support Amendments 237, 238 and 239 in the name of the noble Baroness, Lady Bennett of Manor Castle, which aim to ensure that private providers are regulated, especially those using obfuscatory financial structures, instruments with inter-company loans and large amounts of debt. They should be fully transparent about those arrangements. She was right to highlight the excellent reporting of the Financial Times on this, along with the financial editors and journalists of other papers.
The typical small business social care home owner does not fall into the category I have just described. The problem in the sector is the private equity providers who decided to start buying up care home groups because they felt that the assets could be milked to provide healthy-looking returns for them. This differs from those homes borrowing in order to, perhaps, buy new homes to enlarge their group; what is happening here is purely financial instruments to benefit the directors and investors. Typically, private equity-backed providers spend around 16% of the bed fee on complex buyout debt obligations. The accounts of Care UK show that it paid £4.1 million in rent in 2019 to Silver Sea Holdings—a company registered in low-tax Luxembourg, which is also owned by Care UK’s parent company, Bridgepoint.
These kinds of buyouts are also associated with an 18% increase in risk of bankruptcy for the target company. In the case of Four Seasons Health Care, heavy debt payments contributed to the company’s collapse into administration in 2019. Two of the other largest care home providers in the UK, HC-One and Care UK, have also undergone leveraged buyouts and, as a result, their corporate group structures remain saddled with significant debts. Some of these types of company are also struggling to provide the best possible care with their overall CQC scores—so it is affecting the lives of the most vulnerable patients.
The Office for National Statistics says that 63% of care home residents are paid for by the public purse. Surely the Government must have a duty towards the public purse. It is not acceptable for the public purse to pay for these complex financial arrangements that are intended to provide not care or capital for the growth of a care business but purely a larger return for directors and shareholders. These amendments would provide for transparency and accountability and an assurance that the public purse and the private payer are not being taken for a ride.
Baroness Tyler of Enfield (LD)
My Lords, I support these amendments from the noble Baroness, Lady Bennett. I thank her for putting them forward. The care sector is both complex and very little understood. Back in 2020, there were approximately 15,000 care homes in the UK, run by approximately 8,000 providers. Some were very small; others were providing very large networks of homes—it is a mixed economy. These figures are a couple of years old but, at that time, 84% of homes were run by the private sector, including by private equity firms, both British and offshore.
Funding is a complex mix of private funders, local authorities and the NHS. I was very grateful to the noble Baroness, Lady Bennett, for highlighting the work that the Financial Times has done, because I was first alerted to this issue by an investigation that the paper did back in 2019 which revealed how Britain’s four largest privately owned care home operators had racked up debts of £40,000 per bed, meaning that their annual interest charges absorbed eight weeks of average fees paid by local authorities on behalf of residents. Many have argued, and I absolutely agree, that this sort of debt-laden model, which demands an unsustainable level of return while shipping out profits of 12% to 16%, often to tax havens, is entirely inappropriate for social care.
I want to make it clear that I do not have an ideological problem with the private sector being involved in the care sector and providing care homes—provided that they are good quality—but I have a real problem with the financial models used. Most fair-minded people in this country, not least those whose loved ones are in care homes, would, frankly, be horrified if they knew how the money—either theirs, if they are self-funded residents, or indeed the money of hard-pressed local authorities—was being used and where it was being siphoned off to.
I greatly support amendments to increase transparency and reporting. Frankly, I would like to see the regulator being a lot tougher and a lot more proactive in this area, so I very much support the review in the amendment put forward by the noble Baroness.
Baroness Altmann (Con)
My Lords, I support the thrust of the amendments laid by the noble Baroness, Lady Bennett. I fully agree with her that there is a systemic problem in the care home sector.
In 1991, the community care Act reforms meant social care was transferred from a public sector function—or NHS function when it came to nursing homes—to what was called a mixed market. But, having observed the worsening care crisis, the financial engineering, the periodic failure of large care home operators and the inadequacy of regulation or oversight of their financial backing, I cannot help but urge my noble friends on the Front Bench to look urgently at the need for much greater controls. Southern Cross and Four Seasons Health Care have been in and out of insolvency or near bankruptcy for the past few years, but there are still inadequate controls on their ownership structure.
Lord Blunkett (Lab)
My Lords, I will take to heart the strictures of the Government Chief Whip and see whether I can speak in a minute without repetition. Way back in the 1970s, I was chair of social services in Sheffield, at a time when all residential care was under the auspices of the local authority. We then believed that what we were doing was in the interests of the people being cared for, the families that required support and the care workers. I want to make a very simple point: as well as the taxpayer being exploited, as well as those being cared for being exploited, we are also seeing the exploitation of workers on the lowest possible pay whom we are desperately trying to recruit, and we owe it to all those people to get this right.
Baroness Thornton (Lab)
I thank my noble friend Lord Blunkett for speaking very briefly and giving us some very wise words. The noble Baroness, Lady Altmann, is absolutely right that the system is inadequate. I am grateful to the noble Baroness, Lady Bennett, for tabling these amendments and opening up this discussion. They address the issue of ownership of the organisations that provide social care. We know that almost all social care provision, residential and domiciliary, is not in the public sector and has not been for some time. We also know that the current system is wholly dysfunctional, as the noble Baronesses, Lady Bennett and Lady Brinton, said. It does not work for the service users, for the staff or even for the providers, which go bust fairly regularly, as the noble Baroness, Lady Altmann, described. Of course, it used to be a money spinner for hedge funds and others that got involved to asset strip and leverage profits and remuneration at the expense of service users, both individual self-funders and taxpayers and ratepayers who were paying for other residents.
I have always taken the view that this sector would benefit from an enormous influx of social enterprises and co-operatives. Where social care, domiciliary care and residential care are provided through social enterprises, community enterprises and co-operatives, they are sustainable, they keep their staff and they invest their surpluses back into their social purpose, so everybody gains. To suggest that the Government will fix social care through this legislation is laughable, because the existing market solution cannot be fixed. So we have sympathy with these amendments and fully understand the intent that the noble Baroness, Lady Bennett, outlined for us.
I am interested to know how the Minister will respond, because it is quite clear that something must happen in this sector because it is so unsatisfactory. I suspect that if the Government are not going to move on this, we may have to return to this later in the Bill.
Earl Howe (Con)
My Lords, I appreciate the way that the noble Baroness, Lady Bennett, introduced these three amendments and I am grateful to her for the clear explanations she gave for them. I will take them sequentially, beginning with Amendment 237.
This amendment seeks to place restrictions on the power for the Secretary of State to provide financial assistance to bodies engaged in the provision of social care services. It would prevent use of the power for the purposes of repaying debt, paying interest on debt and making distributions to shareholders.
To begin with a general but important point, it is incumbent on all Ministers and public servants to ensure that public money is used effectively for the greater good, and that purpose is implicit in the power contained in Clause 141. However, I fear that this amendment could make the proposed power unworkable in practice. If we look at the way the amendment is worded, any adult social care provider with a trade creditor of any kind would be caught, as would any organisation with an overdraft facility designed to support day-to-day working capital. A company’s working capital, by its nature, is money that is used to fund day-to-day operations in general, and one cannot associate a particular pound with a particular business activity. Furthermore, any private company would be prevented from paying dividends, as it would be logically impossible to disassociate the long-term effects of the assistance from the ability of the company to pay such dividends.
The pandemic has demonstrated the need for speed and flexibility in providing support to the care sector. We do not intend to use the power in the way the noble Baroness fears, but we have designed it in such a way as to provide the maximum flexibility to respond in times of crisis; each individual case will be considered on its merits. Placing additional restrictions through this amendment would impede our activity to provide emergency support to critical providers.
Any future use of this power, whether for emergency purposes such as those we have seen in the pandemic or to deliver specific policy on a national basis, would be subject to the usual scrutiny and safeguards around use of public funds, as set out in Treasury guidance on Managing Public Money and Accounting Officer Assessments. As with any use of public resources, the power would be exercised with a clearly defined purpose, with strict criteria applied in practice relating to the use of the funding to ensure that it delivers maximum value for money.
I turn now to Amendments 238 and 239. Amendment 238 seeks to undertake a review of the financial regulation of companies providing social care, with a view to ensuring that it supports the effective provision of social care. Amendment 239 aims to increase the financial transparency of offshore corporate groups providing social care.
We are committed to ensuring that we have a sustainable care market. This was made clear in People at the Heart of Care: Adult Social Care Reform White Paper, published in December. It is vital to ensure that people have a wide range of high-quality care and support options to choose from, supported by a workforce that is empowered to deliver high-quality care. With that in view, we have already set out a number of planned actions to support the effective provision of social care services.
As the Committee will be aware, under the Care Act 2014 it is the responsibility of local authorities to shape their local markets to ensure that a diverse range of high-quality, sustainable care and support services is provided. We consider that they are the ones best placed to understand the needs of their local populations.
Maintaining quality and high standards is vital, and that means regulation. The Bill introduces a new duty on the CQC to assess local authorities’ delivery of their adult social care responsibilities. Alongside existing duties on the CQC to monitor, inspect and regulate health and care services, this will drive up quality so that everyone can access the care they need, wherever they live.
We are also committing £1.4 billion of funding over three years to support local authorities in moving towards paying providers a fair cost of care. This funding will strengthen the capacity of local authorities to plan for and execute greater market oversight and improved market management to ensure that markets are well positioned to deliver on our reform ambitions, to address underinvestment and poor workforce practices and to provide a stable base for reform of adult social care.
In addition, we are investing at least £500 million over the next three years to begin to transform the way we support the social care workforce. This funding will go towards continuous professional development, so that people can experience a rewarding career with opportunities to develop and progress, now and in the future.
The noble Baroness stressed the importance of transparency in the market and I understand the points she made, particularly about overseas-registered companies. The Department for Business, Energy and Industrial Strategy is continuing to finalise the draft registration of overseas entities Bill, which underwent pre-legislative scrutiny in 2019, to align with the broader reform of Companies House and our plans to verify the data it holds. The Joint Committee concluded that
“this draft legislation is timely, worthwhile, and, in large part, well drafted.”
In their July 2019 response, the Government accepted many of the committee’s recommendations, such as ensuring that Companies House is given adequate resources and introducing a reporting facility. The Government have been exploring how best to implement these recommendations and others, such as civil sanctions. We are also considering how verification will work with this register. The Department for Business, Energy and Industrial Strategy is amending the draft Bill in line with the committee’s recommendations and will introduce it when parliamentary time allows.
As the noble Baroness, Lady Tyler, said, adult social care is a mixed economy. The majority of adult social care providers are private companies. Like other sectors, many private businesses employ debt as an ordinary part of their capital structures or funding arrangements.
Baroness Bennett of Manor Castle (GP)
My Lords, I thank the Minister for his courteous and comprehensive response, which was very useful. I very much thank all noble Lords who took part in this debate, which was a powerful exploration of the issues.
The noble Baroness, Lady Brinton, talked about assets being milked. If we think about what we are actually talking about here—some of our most vulnerable citizens—and what is happening to them, that is a really crucial point. The noble Baroness, Lady Tyler, talked about a stunning figure: £40,000 of debt per bed. If you think of that physically, visually, that is just unsustainable—a word the Minister himself used.
I particularly thank the noble Baroness, Lady Altmann; I hope the Government will listen to their noble friend. She made a comparison with the insurance sector and stressed that this is about people’s most basic security. These care homes—people’s homes—being ladened with debt in the circumstances we are talking about is supremely insecure.
I thank the noble Lord, Lord Blunkett, for raising the plight of workers. These are people who, both through the pandemic and just in their everyday lives, have gone above and beyond the call of duty to care for people. They do really difficult jobs paid at the absolute base level.
I actually take some comfort from the Minister’s response. I take his point about how Amendment 237 is worded on debt. It is meant to address the kind of debt held in hedge funds, not debt to the local linen washing service or something, and I will think about how that might be addressed in different terms.
I pick up what the Minister said about dividends. I suggest that, should a care home chain be rescued by the Government in a state of great financial crisis, it should pay that rescue money back before it pays out any dividends. The Minister talked about the use of public funds, and I could almost feel the House restraining itself, since we are in constructive Committee form, from giving any reaction at that point. If the Government wish to avoid future scandals, the transparency offered by these amendments or something like them would be an ideal way for them to do that.
We were discussing yesterday in Grand Committee the Registration of Overseas Entities Bill—how long it has taken, how much we have been waiting for it and how crucial it is. This is picking one sector, producing a trial run to see how it works and taking it forward immediately in an emergency situation where we cannot wait many years for change.
This has been a very useful debate. I note the expressions of support from all sides of the House, and I reserve the right to take this issue forward on Report. In the meantime, I beg leave to withdraw the amendment.
Baroness Thornton (Lab)
My Lords, Clause 142 seeks to amend Section 50 of the Health Act 1999 in relation to making changes to the professional regulatory landscape through secondary legislation. It will simultaneously widen the scope of Section 60 and extend the Secretary of State’s powers. At the moment the Government have powers to bring new professions into regulation or make modifications through secondary legislation but can remove a profession from regulation only through primary legislation. The clause enables the removal of a profession through secondary legislation and makes it clear that a profession would be removed from regulation only when it was no longer required for the purpose of protecting the public.
I went and had a little look at the record. I am sorry the noble Earl is no longer here today, because in 2009 I was in Grand Committee, as the then Health Minister, and we were discussing the regulation of psychologists. I have to tell the Committee that that was not an uncontroversial matter. We had gone through whole series of regulatory reforms that year, as noble Lords who have been following these matters will be aware. I said at the time that
“the reforms set out in this draft order aim to enhance public confidence in the ability of the healthcare regulatory bodies to protect the public and deal with poor professional standards.”—[Official Report, 5/5/09; col. 510.]
The debate we had that day included the noble Earl, Lord Howe, who, at the time, was in my position now, as it were. He also welcomed the fact that the regulatory regime was in existence and, although he rightly had questions about the regulation of psychologists, which was indeed a controversial matter at the time, he did not question the need for public scrutiny of professional regulation.
That is why I have tabled the Motion that clause 142 not stand part. I am left wondering what exactly the yardstick will be, what criteria will be used to determine when there is no longer a need to protect the public and who will decide those criteria. Does professional regulation not also help to facilitate consistent common standards? What is lacking at the moment is any sense of the principles that will be allowed to inform decisions to bring professions into regulation or remove them. Will patients’ organisations, representative bodies or regulators be consulted on any new criteria applied? I can tell the Minister that in 2009 we went through weeks and weeks of discussion and consultation about every single independent regulatory body that this House helped to establish.
I suggest that the system works and there is absolutely no need to change it, though perhaps the Minister can tell me why there is such a need. Moving the power to abolish professions to secondary legislation is not putting scrutiny and transparency at the forefront. I have to say that doing so without putting any indication on the record of which professions are being considered does not instil confidence that this power grab has been considered properly or is in fact needed at all. The implications for the devolved nations, particularly Scotland, are also important but it was clear from discussions in another place that they had not been addressed. Perhaps they have by now, and the Minister would like to tell us what the outcome of that consultation is.
At the risk of repetition, there is a consistent theme in the Bill of seeking greater powers for the Secretary of State without parliamentary oversight, for reasons that are quite unclear. I beg to move.
Baroness Pitkeathley (Lab)
My Lords, I declare an interest as a former chair of the Professional Standards Authority. I was happy to go down memory lane with my noble friend on the Front Bench.
When thinking about professional regulation, we always have to bear in mind—I hope the Minister will be able to convince the House that this is what the Government bear in mind—the protection of the public. It is never about the glorification or protection of a profession; it is always about the protection of patients and the public.
The Professional Standards Authority developed the concept of right-touch regulation, whereby you identify the problem before the solution, quantify and qualify the risks, get as close to the problem as possible, focus on the outcome and use regulation only where necessary. I draw the House’s attention to the very successful project of accredited registers, which the Professional Standards Authority has developed in order to have, as it were, regulation at a lesser level than the very tight regulation that is necessary for some professions. You should keep it simple; the system is far too complex at present. You should check—as we always must with legislation, but it seems to me that we do it far too seldom—for unintended consequences. You should also review and respond to change, and the Government are doing just that with the proposals.
However, I must echo the caution of my noble friend on the Front Bench regarding the new powers for the Secretary of State to deregulate as well as regulate professions. We know that the risk profile for different occupations changes over time and a more agile method of responding is sometimes necessary. I hope that is what the Government have in mind. However, I emphasise, and I hope the Minister will reassure me on this, that a commitment to keeping patients safe must guide any decisions made to deregulate professions. There must be a robust and independent process to ensure that decisions are made after a clear assessment of risk—and I emphasise “independent”.
If the Secretary of State has the power to abolish regulators by secondary legislation, will there not be a threat to the independence of the regulators? If they know that the Secretary of State can abolish them at a stroke, as it were, might they become too focused on pleasing—or, rather, on not antagonising— whichever Government are in power, instead of, as I have stressed, working always and solely in the public interest? I hope the Minister will assure the House that that is the Government’s intention.
Lord Young of Cookham (Con)
My Lords, Clause 142, which comes under the heading “Professional regulation”, deals with the regulation of healthcare and associated professions. One of the objectives of the Bill is to integrate health and social care, and I very much hope that under the heading “associated professions” it will be possible to look at the registration and regulation of social care as well as those who work for healthcare.
Noble Lords may remember a brief exchange three weeks ago at Question Time when I asked the Government what plans they had to regulate and register social care. I was grateful for the reply, which outlined the welcome support being extended to the social care workforce. It also mentioned a skills passport, but the Minister was silent on the issue of a register.
I pressed the Minister and pointed out that Scotland, Wales and Northern Ireland already have a registration scheme for their social care workforce, and that if we are truly to integrate health and social care, as the Bill seeks to do, we need to have parity of esteem between health staff and social healthcare staff with improved pay, working conditions and career opportunities—much of which was mentioned in the debate we have just had. A registration scheme could facilitate the professionalisation of the social care workforce.
We then had an interesting exchange, in which the Minister mentioned a voluntary register and the need to assess the skills of the existing workforce, 56% of which has no qualifications. He said that he was consulting on whether registration should be mandatory and was concerned that mandatory registration might cause people to leave the sector. However, I do not believe that that has been the experience in other parts of the UK.
Lord Bethell (Con)
I will also speak briefly in support of the register for social care workers, and I very much echo the words of my noble friend Lord Young. During the pandemic, we faced a huge challenge in identifying who social workers were. That meant that we struggled to distribute PPE, to get testing to the right people, to allocate and reallocate responsibilities when we tried to move away from itinerant service, and to create the vaccine prioritisation list. In the longer term, the question of the education of social care workers is absolutely essential, and a register is imperative to do that. In contrast with the NHS, the lack of a register of social care workers is a real impairment to the modernisation of social care working. For that reason, I ask the Minister to say a little more about his consultation and think very carefully about a mandatory register.
Baroness Walmsley (LD)
My Lords, last week, when we debated the call for a separate list of properly qualified cosmetic surgeons, I received a briefing from the GMC about the forthcoming new system of professional regulation. I asked the Minister when this would be forthcoming, but I fear that he was not able to give me a clear answer. This matter has been hanging around for a very long time, but, when I scrutinised Clause 142, I saw that there was another problem: in future, the regulation of healthcare professionals can be made through secondary legislation—and whether this would be agreed by the negative or affirmative procedure is not clear.
The Explanatory Notes make clear that subsection (2)(e) —the powers to remove certain professions from regulation—
“includes the currently unenacted provisions concerning social care workers”.
Like the noble Lord, Lord Young of Cookham, I want to ask the Minister about this, because many noble Lords, including me, have been asking that social care workers have the opportunity to obtain qualifications that would provide them with registration and a career path to better pay and conditions—but this sounds like the opposite to me. Perhaps the Minister can explain this and tell the House when the new regulatory system will be ready. The 2017 report of your Lordships’ House’s Select Committee on the long-term sustainability of the NHS said:
“The current regulatory landscape is not fit for purpose. In the short term, we urge the Government to bring forward legislation in this Parliament to modernise the system of regulation of health and social care professionals”—
I emphasise “social care professionals”—
“and place them under a single legal framework as envisaged by the 2014 draft Law Commission Bill.”
That was five years ago.
I have also received a briefing from the Health and Care Professions Council. It appears from this that the HCPC has a rather different view from the GMC: it wants the new professional regulation of health and care professionals to be collaborative and innovation focused. It believes that the current system is “siloed”, and it is looking for multiprofessional regulation, which, it believes, better reflects current working practices in the NHS. I am not an expert in this matter, so I express no opinion on that, but I am looking for some clarity from the Minister on which direction the new regulation system will take and the evidence that this will be better than before and contribute to better quality and safety of care for patients. I would also like to know when it will happen, because Clause 142 appears to me to open the door to a fight between different regulators, which would not be helpful.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
I thank all noble Lords who spoke in this debate. As a number of noble Lords have acknowledged, the case for reforming professional regulation has long been acknowledged, and stakeholders have long expressed concern that having nine separate professional regulatory bodies is confusing for the public. So our response in 2019 to the public consultation on regulatory reform reflected the desire for fewer regulatory bodies to deliver benefits to the professional regulation system.
In the 2020 consultation Regulating Healthcare Professionals, Protecting the Public, we committed to a review of professions that are currently regulated in the UK to consider whether statutory regulation remains appropriate for these professions. A consultation seeking views has been published, and it will close at the end of March this year. We also commissioned KPMG to carry out an independent review of the regulatory landscape, and it submitted its report at the end of last year. Officials and others are now poring over the findings to consider how best to respond. However, as with any use of Section 60, a public consultation will be carried out on any legislation made under these powers, and this would face scrutiny through the affirmative parliamentary process.
On the core criteria and principles, the professions protected in law must be the right ones, and the level of regulatory oversight must be appropriate and proportionate to the risks to the public. This is why we have sought a number of views on the criteria for determining whether statutory regulation is appropriate. As I said, we will wait for the outcomes.
These proposals have been developed in partnership with the devolved Administrations, and we will continue to work in partnership with Scotland, Wales and Northern Ireland in taking forward any proposals for using these powers. This will also be subject to affirmative parliamentary approval.
Clause 142 provides additional powers that would widen the scope of Section 60 of the Health Act 1999 and enable the Privy Council to make additional changes through secondary legislation, as was acknowledged. Subject to consultation, we are aiming to enable the professional regulatory landscape to become more streamlined and work more flexibly. We think that this clause will make it easier to ensure that the professions protected in law are the right ones and that the level of regulatory oversight is proportionate to the risks to the public. The Government keep the professions subject to statutory regulation under review. As I said, as part of our work to reform healthcare professional regulation, we are continuing to consult.
As I said, any secondary legislation made using the new powers would be subject to Schedule 3 of the Health Act 1999, public consultation and the affirmative parliamentary procedure, thus ensuring that there is clear parliamentary scrutiny and transparency in relation to any changes made by secondary legislation in this area.
I also refer back to the questions on the social care register, which I discussed at length, both before and after the recent Oral Question. When I spoke to officials about why the register cannot be compulsory, they said that this was fair, given the demographics of some of the people in the skilled sector, who quite often have some suspicions of authority and a lack of trust—we have seen that with vaccine take-up, for example—and so there were concerns about making it compulsory at this stage. It is voluntary. They want to understand the range of qualifications across the sector. There are a number of different qualifications, and, in professionalising the sector better, they want to make sure that they are consistent at all the various levels in our education system—levels 2, 3, 4, 5, 6 and upwards—to make sure that those qualifications are mutually accepted and recognised to make social care an attractive career and vocation.
For these reasons, I ask that Clause 142 stand part of the Bill.
Baroness Thornton (Lab)
My Lords, I thank the Minister, but that was not a satisfactory response, I am afraid. The only word I heard that justified these extra powers being taken was “streamlining”, and, frankly, that is not good enough. It seems to me that the Secretary of State should not be taking powers to put forward the abolition of regulatory bodies on the basis of a public consultation and statutory regulation. The Minister must understand the difference between primary legislation and statutory instruments—that is the crux.
The reason for that is about the independence of the bodies we have, such as the General Medical Council and the General Dental Council. Those bodies need to feel that they cannot be subject to abolition at the whim of a Secretary of State. They have to be sure that they are protected by primary legislation in Parliament, and the Minister has not given me or the Committee an explanation as to why that should change. That independence is very important and precious.
On the issue of social care, I found the Minister’s explanation a bit patronising. It seems to me that, if we are to value social care and the people who work in it, we need to strive to give them the equality of regulation and supervision that the medical professions have. I realise that there is a journey and a process but, to me, that has to be the aim because it is the only way we can give that profession and the people who work in it the equality of regard that they deserve.
Lord Kamall
“Human fertilisation and embryologyStorage of gametes and embryos
Schedule (Storage of gametes and embryos)—(a) contains amendments to the Human Fertilisation and Embryology Act 1990 which make provision relating to the storage of gametes and embryos, and(b) makes transitional provision in relation to those amendments.”Member’s explanatory statement
This new Clause introduces a new Schedule relating to the storage of gametes and embryos.
Lord Kamall (Con)
My Lords, in moving this amendment I will also speak to the Amendments 313A, 314A and 315A standing in my name. Before I start, I thank the noble Baroness, Lady Deech, for her many years of advocacy on reproductive health and look forward to hearing the points she will raise today. I am grateful for the productive meeting that we had a few weeks previously and welcome the noble Baroness’s support of the government amendments tabled in my name.
As many noble Lords will be aware, fertility preservation is achieved through the freezing and storage of gametes or embryos; it is an increasingly common procedure in the UK. The Human Fertilisation and Embryology Act sets limits on the length of time that frozen gametes and embryos can be stored for. The current statutory storage limit is 10 years, with the possibility of an extension up to a maximum of 55 years for those who are certified as prematurely infertile. Extended storage limits were introduced to help those people who became prematurely infertile preserve their fertility, with the hope of starting a family in the future. This would include children who may have undergone treatment for childhood cancers.
However, this approach appears to discriminate between those who have a medical need to freeze their gametes and embryos, and those who do not. This message was clear in response to our 2020 public consultation, and we accept that the current approach creates unfairness. Therefore, we are introducing a new scheme for all who currently freeze or wish to freeze their gametes or embryos. The new scheme will consist of 10-year renewable storage periods up to a maximum of 55 years for everyone, regardless of medical need. It is for these reasons that I ask noble Lords from across the House to support the government Amendments 243A, 313A, 314A and 315A in my name.
Baroness Deech (CB)
My Lords, Amendment 280 stands in my name and that of the noble Baroness, Lady Barker. I declare an interest as former chair of the HFEA.
Let me start by offering the Government what must be a rare and welcome tribute in these troubled days for bringing forward an amendment that reflects compassion and efficiency. They listened to the consultation and have picked up the result of at least two years of campaigning, in a way that I can only admire. As the Committee can see, my own miserable little drafting of Amendment 280 was really only an entry to allow the Government to do their own complicated drafting, which of course I will accede to—and there will be no need for my amendment.
I am profoundly grateful to the noble Lord, Lord Kamall, and, before him, the noble Lord, Lord Bethell, and the noble Baroness, Lady Blackwood, all of whom helped this along. It has the support of the Royal College of Obstetricians and Gynaecologists, the British Fertility Society, Progress Educational Trust and the specialist lawyers Natalie Gamble and Emily Jackson. Everyone is behind this amendment, and I am profoundly relieved that it has come forward just in the nick of time, because there was a possibility that later this summer women whose eggs were frozen for 10 years, and who took advantage of the two years’ extra time given them, might have run out of time.
This amendment will bring the UK’s law in line with advances in science and changes in modern society, and it will give individuals greater reproductive choices. It will also give patients more time to make important decisions about planning their family. On behalf of hundreds, maybe thousands, of women, let me express my gratitude to the Government for something that will be helpful in many years to come. I give my wholehearted support to the amendments in this group.
Baroness Barker (LD)
My Lords, it has been a great privilege to work alongside the noble Baroness, Lady Deech, and I can only admire the persistence with which she has stayed on this issue to get the change which so many people have wanted for so long, and for such good and compelling reasons. I am but one of several Members of your Lordships’ House who have taken part in debates on assisted reproduction over many years.
It was a privilege to discuss these matters in the presence of Baroness Warnock, who was responsible for setting the ethical framework, all those years ago, to which we still refer when dealing with these matters. She was a remarkable person and one of the most important things she did was to foresee that science, knowledge and society would change. What she did was to set down a basic ethical framework, to which we could return as knowledge and scientific understanding increased. This provision is one such part of that.
Other issues in the field of reproductive medicine are equally deserving of our attention. For example, we are starting to uncover the extent to which LGBT people face unfair discrimination when it comes to access to assisted reproductive technology. If, in a heterosexual couple, one of the partners happens to be HIV positive but it is undetectable, and therefore untransmissible, the couple will not be disbarred from receiving treatment; that is not so for lesbians and gay men.
In the last week, some of us who work on these issues have been engaging on the issue of access to telemedicine. In this field it is true, as it is right across the NHS, that it is important to make these services more widely and easily accessible to women by using telemedicine. I hope the Minister might confirm that on another important aspect of women being able to control their fertility, in access to abortion services, we may see the extension of the highly successful scheme which has been run throughout the pandemic to enable women to have consultations and receive treatment at home. In that vein, and in the hope that we may fairly soon have a more comprehensive review of advances in reproductive medicine, which is needed across the piece, it is very pleasing today to welcome this amendment.
Baroness Altmann (Con)
It is a pleasure to follow the noble Baroness, Lady Barker, and I too commend the noble Baroness, Lady Deech—my noble friend, really—for all her work in this area. I particularly thank my noble friends the Minister and Lord Bethell, who I know have listened carefully and responded in the most compassionate and caring way. They have done a great service for many women across the country. I thank my noble friend for these amendments.
Baroness Thornton (Lab)
When the Minister and I were discussing government amendments, on this issue I said: “If Baroness Deech is happy with this, then I am happy with this,” and indeed I am.
Lord Kamall (Con)
I can confirm that that conversation did take place. When we were dividing up the groups for today, I thought about offering this to someone else. One of my noble friends turned to me and said, “You’re going to be bashed around enough today, Syed, at least take something you’ll get a bit of credit for.” But I cannot take credit: that has to go to the noble Baroness, Lady Deech, and the many noble Lords who have pressed this issue. The noble Baroness has also demonstrated the power of persistence and continuing the argument in a constructive way. On many of the other issues noble Lords believe in strongly—even if they feel that the Government may not be listening today, or that we are not sympathetic—I hope they will continue to be persistent.
On the general point that the noble Baroness, Lady Barker, made about reproductive health, I ask her to be more persistent. One of the great things about technology, not only digital but science and biology, is that often, it challenges the basis on which legislation was made. That is one thing we always have to be open to. Thanks to advances in technology, we are able to bring forward this amendment today. I will not say much more; I just hope that noble Lords agree that the time is right to change the legislation because of the progress made since the 2008 Act. I beg to move.
“(2) The Secretary of State must, no later than one year after this Act is passed, consult on including alcoholic products in the definition of less healthy products for which advertising will be restricted, and publish a report on the consultation.”Member’s explanatory statement
This amendment would require the Secretary of State to consult on including alcohol in the proposed advertising restrictions for less healthy food and drink and publish a report.
Baroness Finlay of Llandaff (CB)
My Lords, this is a very broad group. As part of the Government’s obesity strategy, Clause 144 and Schedule 17 introduce advertising restrictions on less healthy food and drink, a 9 pm watershed for TV and on-demand services and the prohibition of paid-for advertising online. I declare my interest as chair of the Commission on Alcohol Harm. I will speak only to my amendment, which addresses the problem that currently, the definition of “less healthy food and drink” does not include alcohol beverages as it was drawn from the 2001 Nutrient Profiling Technical Guidance.
The amendment requires the Government to consult on including alcohol in the proposed advertising restrictions, because alcohol is the leading cause of death and ill-health among 15 to 49-year-olds in England. Under the Bill, adverts for sugary soft drinks will be restricted but adverts for alcoholic drinks will not, even though they can be very obesogenic. To quote from the Government’s own obesity strategy, they recognise that
“alcohol is highly calorific … It has been estimated that for those that drink alcohol it accounts for nearly 10% of the calories they consume … each year around 3.4 million adults consume an additional day’s worth of calories each week from alcohol, that is nearly an additional 2 months of food each year.”
The calorie load of 100 millilitres of 40% spirit is 244 calories, compared to just 42 calories in 100 millilitres of coke. A pint of beer has the same calories as a Mars bar and a glass of wine equates to three Jaffa cakes.
Some sweet alcohol products contain more than 100% of the daily recommended sugar intake in a single serving. There is significant evidence that children exposed to alcohol marketing drink more and drink earlier than they otherwise would, and early-age drinking is linked to higher risk drinking and even alcohol dependence in adolescence and early adulthood.
Existing advertising codes are failing. In the past month more than 80% of 11 to 14 year-olds have seen alcohol advertising. Almost 60% of 11 to 17 year-olds had seen alcohol adverts on television and more than 40% saw alcohol adverts on social media platforms. One-fifth had interacted with alcohol marketing online in the past month, despite being underage and therefore not allowed to buy alcohol. These adverts achieve their aim. Children as young as 11 can identify, reference and describe brands and logos of various alcohol companies—which leads them to start drinking more and earlier—making these images most attractive. Ten to 15 year-olds are exposed to more TV alcohol marketing than adults.
Alcohol itself is linked to more than 200 diseases and conditions, including seven cancers, is obesogenic and should be classified as a less healthy product. It should be included in the advertising restriction codes proposed, because the current self-regulatory codes are clearly failing. Children would accept this. The Children’s Parliament investigators and the Young Scot health panel have recommended a TV watershed for alcohol advertising. I beg to move.
The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)
The noble Lord, Lord Howarth of Newport, should be taking part remotely. If the noble Lord is there, would he like to speak? We will continue with the debate and when we can get hold of him, we will bring him in.
Baroness Boycott (CB)
My Lords, I declare my interests—there are a lot of them in terms of food, but this is for a specific reason: I am a trustee of the Food Foundation, chair of Feeding Britain, a patron of Sustain, an adviser on the national food strategy and chair of VegPower. I also work with Cancer Research and the Obesity Health Alliance.
We welcome the Health and Care Bill, which contains provisions to limit adverts of unhealthy food and drink on TV and online to protect children’s health. I also support the amendment tabled by the noble Baroness, Lady Finlay, on alcohol, which is not covered in my amendment. She is completely right about the fact that such advertising encourages people to drink—something I know a lot about, to my cost—and put on weight.
These provisions are found in Schedule 17 of the Bill. All the different charities and NGOs I have worked with have argued for this for many years and we are incredibly pleased that the Government have made these provisions part of the Bill. They have been supported by all of us, and the Obesity Health Alliance and all cancer charities. So, I am shocked—we all are—and puzzled that during this Committee, quite a lot of amendments have been tabled in the names of the noble Lords, Lord Moylan and Lord Vaizey of Didcot, that would directly weaken or delay these proposals. As far as I know, and I have worked in the food business for a long time, I have not seen their names associated with campaigns to do with children’s health—in particular, around obesity.
I want quickly to explain what these amendments would do. Amendments 245, 255, 256, 257 and 317 would delay implementation of the various restrictions—for example, blocking the 9 pm TV watershed until a full calendar year after Ofcom publishes the technical guidance. This would delay the planned implementation by at least six months. We all appreciate that the food and advertising industries will need time to review the technical guidance, but this is just too long.
Amendments 245A and 250ZA would limit the restrictions, so that they apply only at weekends, but kids do not watch TV only at weekends. Amendments 247, 250A and 253A would enshrine exemptions for brand adverts if specific products are not displayed; for example, McDonald’s could advertise lettuce. The Government have already stated that brand advertising will be exempt from some of these restrictions, so why do we have to go further?
Amendments 248 and 251 would exempt certain unhealthy products from the restrictions, including
“chocolate confectionery in portion sizes smaller than 200 kcal”.
The amendments conflict entirely with the purposes of the policy, which is to limit children’s exposure to the advertising of products that are high in fat, sugar and salt. Quite frankly, some products of under 200 calories can contain more than half of a child’s recommended daily sugar limit.
Lord Vaizey of Didcot (Con)
My Lords, I support the amendments in my name and I may also comment on some of the amendments that I have signed. I am delighted that my noble friend Lord Ashton mentioned Nicholas Parsons at the beginning of this debate. I will try to avoid repetition and hesitation, but the reason I am delighted is because Nicholas Parsons was an Old Pauline and I am president of the Old Pauline Club—I just want to put that on the record. I refer to my registered interests, particularly my work with the media boutique bank, LionTree.
I confess that I am still slightly smarting from the remarks of the noble Baroness, Lady Boycott, who seemed to imply that it was inappropriate for me to put down these amendments because I had not been campaigning for children’s health. The reason I put down these amendments is because I have always campaigned for and supported the importance of public service broadcasting. One unkindness should not follow another, but I wondered as I looked at the noble Baroness—who was an extremely distinguished newspaper editor—what she would have done if the Government were legislating to eradicate HFSS advertising from newspapers. I am sure that she would have stuck to her principles. The thought occurred to me that I might bring back an amendment on Report to ban it from newspapers, so that that would at least ensure that the fourth estate paid attention to this important issue and the impact that it will have on our media. I am afraid that that would probably lose me the support of my noble friend Lord Black, so I may have to think twice about that.
It will be quite clear from the direction of my remarks that I think these proposals are wrong-headed and extremely damaging for our public service broadcasters. I gather that the Government’s own impact report assesses that they would reduce calorie intake in children by 1.7 calories—that is, as noble Lords will know, either a Tic Tac or half a Smartie, depending on your predilections. However, it is estimated that they would cost broadcasters some £200 million a year.
In the debates that I take part in on the future of our media, we rend our garments thinking about how our public service broadcasters will compete against the likes of Netflix, Disney+ and Amazon Prime. We think about the importance of public service broadcasting provided by companies such as ITV and we talk about the potential privatisation of Channel 4, which is a government flagship policy. But as the Government move Channel 4 towards the marketplace, these amendments will hobble it and its income.
What depresses me most of all, and where I think we would have common ground with those who very rightly campaign against obesity and put in place strategies, is that these clauses are a fig leaf and a complete red herring. They are an excuse for the Government to say that they are taking action on obesity when these measures will have zero impact on obesity. What is so galling is that they are based on no proof at all—they have become a sort of mantra for the Department of Health. I fought these proposals when I was a Minister at DCMS, and it depresses me that DCMS has not had the clout to see them off this time round.
There is an absence of a comprehensive policy on school food and on education about nutrition in schools. By the way, at the risk of annoying all sides in this debate, I am not a libertarian or a non-regulator. I supported the sugar tax and I would support measures that looked at, for example, the prevalence of takeaways, particularly in low-income areas; I would look at how supermarket promotions are undertaken; and I would look at the content of food and the prevalence of processed foods. But if noble Lords look at, for example, Leeds or Amsterdam, where obesity rates have fallen, they will see that it was because of interventions in primary school to the food children were eating and the education they were receiving.
Where an advertising ban has been implemented as an excuse for an anti-obesity policy, it has comprehensively failed. At the risk of being trolled in both French and Canadian on Twitter, I gather that, in Quebec, which has had a ban for 40 years, the Québécois have gotten fatter, faster, than the rest of Canada. Nowhere has an advertising ban had an impact on obesity.
Of course, further evidence of why this ban will not work is that there has been no analysis of who sees advertising on our public service broadcasters. Some 95% of TV viewing before 9 pm is by adults, and Ofcom has concluded that a 9 pm ban could be disproportionate. It also—I am surprised by the remarks of some noble Lords—shows a comprehensive misunderstanding of how advertising works. If you are going to eat a burger, you are going to eat a burger—unless you live in Leeds and have been well educated in your primary school. The purpose of the advertising is to encourage you to eat a McDonald’s burger rather than a Burger King burger; it is not simply to increase the number of burgers eaten.
When this ban comes in—I am sure it will; it has its own illogical momentum—you will see in-store promotions in supermarkets and, worst of all, price promotions. If McDonald’s cannot persuade you through an advert to eat its burger rather than a Burger King burger, it will persuade you to eat its burger because it is 99p, whereas Burger King’s burger is £1.29. It will reduce the opportunity for our food producers to advertise healthy products and it completely misses the opportunity to look how our technology has become so advanced that it can target adverts in a much more sophisticated way, working with industry and broadcasters rather than introducing this appalling and crude ban which will hit our broadcasters in the face.
I turn to the amendments in my name. The first point of them, to a certain extent, goes with the grain of the government amendments, which is to say that we need flexibility on implementation. If you are going to implement this ban, advertisers and broadcasters need time to come to terms with it. As things stand, the ban is due to come in at the end of this year, on 1 January 2023. As I said, the Government have allowed some flexibility, because they know there will have to be secondary legislation, consultation, a process of designating the regulators, and guidance, before the final version is published.
However, these government amendments give no clear timetable. Businesses need one, with time to understand the secondary legislation and the final detailed regulatory guidance. They need time for their marketing teams and agencies to absorb and fully understand the changes required. They cannot just implement them the day they are published. New rules require familiarisation, to allow for internal review processes, legal guidance and interpretation. As many noble Lords know, it can take up to a year or even more to plan, develop and execute an advertising campaign, and companies are already trying to plan for 2023 with many unknowns. It is a lengthy and costly investment, and involves issues such as how you position your business for the long term. Companies do not want to get this wrong and be forced to pull their advertisements or face the Advertising Standards Authority adjudicating against them.
Let us say that the Bill becomes law two months from now. It would then have to go through the following process before the advertisers know the final shape of the rules. Ofcom must be designated as the regulator, and it must then designate the day-to-day regulator—it is likely to be the Advertising Standards Authority, but Ofcom will have to consult on that. If it is the Advertising Standards Authority, that must then ask the Committee of Advertising Practice to put together the new rules to go in the advertising codes. Of course, the Committee of Advertising Practice will have to run a public consultation on this. All this will take until at least the end of the year, at which point the Government presumably expect industry to have got it immediately and be ready to act.
Here are just some of the gaps in knowledge the industry faces. For example, new Section 321A(2)(a) in Schedule 17 contains an exemption from the watershed and online advertising bans for small and medium-sized businesses. They can continue to advertise food products, including HFSS, but larger companies cannot. A consultation is forthcoming, but how do you determine the size of the business? Could a global business still be an SME if it has just a few employees in the UK? What about the now ubiquitous third-party delivery companies? Where does their liability sit? On the application of the Nutrient Profiling Technical Guidance, it is vital to understand what products will be defined as HFSS for advertising and promotions—but this is guidance, not law. When will the guidance be updated and published so that companies can calculate the NPM scores for their products? Will a standard online calculator be shared? Because this is guidance, there will be no parliamentary scrutiny of how this has come about.
Lord Moylan (Con)
My Lords, it is a great pleasure to follow my noble friend Lord Vaizey of Didcot. Might I say, before I get into my stride, that certain noble Lords may have received an email that emanated a week or so ago from what I call the “cold dip” wing of the Conservative Party. Essentially, the message was, “Those rotters Vaizey and Moylan are out to spoil our whizzo scheme”. This is not true, in my case. Unlike other speakers, I declare that I have no interests to declare. I am not aligned with the food industry, the advertising industry, the broadcasting industry or any of the charities that wish to restrict, ban or control various foods and drinks. That seemed to cause a little upset to the noble Baroness, Lady Boycott, who seemed to think that because I could speak in a disinterested fashion I was somehow precluded from taking part in the debate, but I hope noble Lords will not agree that is the case.
I have put my name to a number of amendments in the name of the noble Lord, Lord Vaizey. The ones I have signed up to are essentially to do with giving enough time to implement the ban, if it is brought into effect, and I hope that they are accepted. I note that the Government have brought forward amendments of a similar character; they improve the Bill, but they do not go as far as they should. But it is a good sign, and it shows that what we are engaged in here is improving the Bill, not trying to destroy it.
I will add a particular word in support of my noble friend’s Amendment 247A, which seeks to make the identification of HFSS food a matter that would be subject to parliamentary scrutiny. In effect, what the Government are seeking through this schedule is a power to make binding law—with all the apparatus of fines and other enforcement—by way of mandatory guidance that will not be subject to parliamentary scrutiny. Instead, business planning and investment will always be at the whim of civil servants with no recourse to Parliament. That is not a situation that, in other circumstances, your Lordships’ House would feel comfortable with. We should apply the same standards here and insist that, with Amendment 247A, parliamentary approval is required before these punitive measures can be amended.
The other amendments in this group in my name cover a wide range of issues, but all of them are aimed at helping business plan for and implement the bans that the Government contemplate. That said, I noted last Friday that “Red Box” in the Times was reporting a change of heart by the Prime Minister on the whole policy of introducing the advertising and promotions ban. If this is true, we can happily move on and ignore Schedule 17, since all the evidence—including the Government’s own impact assessment—shows that the policy will, as my noble friend said, have a minuscule effect. The Government’s own assessment suggests that there will be a reduction of fewer than three calories a day. I ask my noble friend the Minister to confirm, when he wraps up, whether or not this planned change of policy is in hand.
Amendments 247, 250A and 253A in my name deal with the question of whether the ban applies to brand advertising and sponsorship—already mentioned by the noble Baroness, Lady Boycott, and my noble friend Lord Vaizey. This concerns advertising when no product of an unhealthy character is included in the advertisement or sponsorship statement. Putting the brand advertising exemption into the Bill is important for business—businesses which are looking for certainty as they are already planning advertising campaigns which will run after 2023.
The exemption for brand advertising was confirmed in Committee in the other place when the Minister there said:
“Products are deemed identifiable if a person could reasonably be expected to identify the advertisements as being for that product. This means that brand advertising is not in scope of the restrictions, as the purpose of the restrictions is to prohibit identifiable products.”—[Official Report, Commons, Health and Care Bill Committee, 26/10/21; col. 676.]
He made similar remarks on Report. This is helpful but putting the exemption into the Bill—alongside the other exemptions—would mean, should the Government wish to revisit this exemption in the future, that they would be obliged to return to Parliament to set out their reasons for doing so and seek the consent of both Houses.
The noble Baroness, Lady Boycott, commenting on this, seemed to say “Why do we need all this paraphernalia? Let’s just trust the Government and go with what they say”. I almost fell off my Bench when I heard her say that. So often in this House we are saying quite the reverse; we are saying let us not trust the Government and insist that, if we want something to happen, it should be on the face of the Bill. That is all I am saying. I believe the Government of course, and in my own small way I trust the Government—but Governments change. If we believe in this, let us see the Government put it on the face of the Bill. This has been called for by the Delegated Powers and Regulatory Reform Committee and the Constitution Committee, which have signalled their dissatisfaction with this way of proceeding.
I turn to Amendments 249A, 252A and 257A in my name, which concern how the Government will assess the effectiveness of the ban. I am assuming, perhaps optimistically, that all noble Lords will agree that the restriction on freedom of expression involved in the Government’s policy should be continued only if it is seen to be effective in its purpose of reducing calorific intake. Indeed, that is the Government’s view, because the Bill contains a five-year review of the effectiveness of the restrictions, in line with better regulation principles, but it is not clear how “effectiveness” will be judged.
The purpose of my amendments is to seek some clarity on the issue now, as we adopt the new rules, so that the effectiveness criteria are not shaped retrospectively in five years’ time. This needs to be done now, in the interests of transparency and to enable the collection of data. It also needs to be done if the industry is to respond by changing its product mix—something which the noble Baroness, Lady Boycott, said she hoped for and looked forward to, and said there was evidence of its having done so in advance. But unless it understands in advance the criteria by which the ban will be judged effective, how can it possibly begin the process of changing the product mix to meet those criteria? The lack of impact of the ban is clear, but the criteria judging how it will be assessed effectively need to be addressed right at the outset.
There is also the question of what the Government will take into account in assessing those criteria. Their impact assessment envisages that the policy will likely reduce calorie consumption by around three calories a day, which is roughly equivalent to half a gram of butter, or one-five-hundredth of a standard pack of butter. This is so small as to be insignificant in terms of health benefits, yet the policy will undoubtedly have wider economic benefits, including on competition, innovation, prices, media revenues, advertising and the wider creative industries. Are the Government going to assess this wider picture?
Lord Clement-Jones (LD)
My Lords, I rise to speak to a number of amendments in this important group focused on the Government’s proposals in Schedule 17. I will speak first to Amendments 247A, 249ZA, 249ZB, and so on, tabled by my noble friend Lady Walmsley and me. I am grateful for the support of the noble Lord, Lord Vaizey, too. These arise from the 15th report of the Delegated Powers and Regulatory Reform Committee of 16 December—already referred to by the noble Lord, Lord Moylan—supported by the 9th report of the Constitution Committee of 7 January and its clear recommendation about Schedule 17. Alongside the Secondary Legislation Scrutiny Committee, both committees have expressed strong views as to the increasingly skeletal nature of current government legislation and the increasing tendency not just to avoid detail in primary legislation but to avoid secondary legislation through issuing guidance which does not come before Parliament. The House debated this aspect on the first day of Committee, when noble Lords made clear their views about the skeletal nature of the Bill.
The DPRRC says in paragraph 20:
“The merits of restrictions on food and drink advertising are not within our remit; but the method of implementing the policy is.”
The committee goes on to say, in paragraph 23:
“Legislation, which of its nature affects the legal rights and liabilities of people, should not be capable of being altered by guidance.”
It concludes, in paragraph 26:
“We consider that the power to define a food or drink product that is ‘less healthy’ should be exercised solely through the making of regulations and not also through the making of guidance.”
Explicitly, under paragraph 1 of Schedule 17 amending the Communications Act 2003, new Section 321A(3)(c) provides that
“a food or drink product is ‘less healthy’ if … it falls within a description specified in regulations made by the Secretary of State, and … it is ‘less healthy’ in accordance with the relevant guidance”.
This crucial guidance is the nutrient profiling model, over which Parliament has exercised no scrutiny. It has been in place since 2011 and it can be changed by the Government without any parliamentary debate or input from affected businesses. The NPM is a tool used by Ofcom and the Committee of Advertising Practice to give food and drink products a score, which determines whether products can be advertised during children’s television currently and in non-broadcast media, including print, cinema, online and social media. At the very least, the definition of “less healthy”—giving rise as it does to such severe economic consequences for broadcasters, manufacturers and online media—should be contained in secondary legislation, which, as the DPRRC noted, should normally be introduced by the affirmative procedure. The Constitution Committee entirely endorsed the conclusions of the DPRRC.
Much has changed in the last 10 years. It would be a travesty if such important new provisions having such a major impact on broadcasters and manufacturers were based on out-of-date guidance and not subjected in any way to parliamentary scrutiny. I hope that the Government will accept that secondary legislation is the only legitimate way forward. I also hope that the Minister will not try to satisfy us with the consultation on the NPM that took place in 2018. That has still not seen the light of day and still would not be subject to parliamentary scrutiny, however onerous its new provisions were—for example, they could in future include free sugars in fruit juices and smoothies.
I have also tabled Amendments 248B and 253C. Many in the food industry are concerned that the new definition of food or drink SME introduced by paragraph 1 of Schedule 17 is based purely on employee numbers and could create a competitive disadvantage for UK businesses. As currently drafted, large multinational businesses could be exempt from the restrictions by reason of having less than 250 UK-based employees. This may inadvertently encourage companies to divert manufacturing abroad in order to qualify as an SME. To ensure a level playing field and to protect UK manufacturing, the amendment substitutes an SME definition that also includes a turnover threshold, currently of not more than £36 million, in line with the definition of medium-sized company in Section 465 the Companies Act 2006.
I have also signed and support amendments spoken to variously by the noble Lords, Lord Vaizey and Lord Moylan, which propose: provisions to allow further time for implementation of the provisions of Schedule 17; the sunset clause, which provides the necessary post-legislative scrutiny; explicit exemptions for brand advertising; and ensuring a level playing field for liability for the online platforms. I also support my noble friend Lady Walmsley’s consultation amendment, Amendment 259A.
Above all, I support the amendments spoken to by the noble Lord, Lord Vaizey, in spirit, designed to change the watershed. I sponsored the Private Member’s Bill that banned tobacco advertising 20 years ago, so I am not averse to strong action on advertising where necessary, where the evidence of harm is there. I absolutely support a national obesity strategy and believe we have a serious problem. Campaigns such as the Daily Mile and Eat Them to Defeat Them are the way forward, alongside the sugar tax, targeted interventions and nutrition education. However, I believe that Schedule 17, as it currently stands, is disproportionate in what it seeks to do.
As we have heard, the Government’s own impact assessment of March 2019 confirms the minimal impact on obesity of these measures, but they represent a demonstrable threat to broadcasters and to jobs and investment across the country. The impact assessment estimated that a pre-9 pm TV watershed ban would reduce children’s calorie intake by 1.7 calories a day—it is there in black and white. At the same time, it sets out that children’s exposure to such advertisements has declined by 70% since the rules were tightened in 2008. The latest BARB data suggests that the decline is accelerating far beyond that predicted previously.
So while exposure levels have declined significantly, childhood obesity levels have risen. It seems extraordinary to proceed with that policy as regards television, when the evidence is that it will do little to address obesity. Given that the most likely response of the industry will be to move to alternative in-store price promotions, this is not surprising. These are not subject to any government restrictions and this was what much of the food and drink sector told the strategy consultants OC&C it would do in the event of a pre-9 pm ban.
The Obesity Health Alliance states that
“evidence shows children who already have a weight classed as overweight or obese eat more in response to advertising.”
To put this in context, overweight and obese boys consume between 146 and 505 excess calories per day, while the figures are 157 to 291 for girls. Using the Government’s own numbers and methodology, overweight children would still lose just 2.63 calories per day. Such a small reduction will make no meaningful difference to health outcomes.
The impact assessment predicts a £171 million loss to broadcasters in advertising revenue, and it is here that I have my most fundamental concerns: the proposals will have a major detrimental impact on the funding of public service broadcasters and news media. That is the key problem. The Government, in their consultations, relied heavily on the idea that broadcasters would be able to mitigate most of the impact of the ban. I have explored that proposition carefully and it is not the case. Broadcasters cannot easily shift existing HFSS advertising from pre to post-9 pm slots. Non-HFSS advertisers will resist being moved out of post-9 pm airtime since this would reduce the impact of campaigns and make them relatively more expensive.
Broadcasters make the strong point that they do not have a queue of advertisers who currently have no TV space waiting patiently in the wings for slots to become available, nor brands with other products unable to get enough space. ITV has experienced four years of successive decline in TV advertising revenue, so the pre-9 pm ban will cause great damage to commercial public service broadcasting, which is already under pressure. In the circumstances, the compromise watershed suggestion put forward by the noble Lord, Lord Vaizey, and supported by the commercial public service broadcasters, to cover the viewing times for children seems eminently reasonable. Again, I hope the Government will reconsider.
Lord Krebs (CB)
My Lords, on the one hand, I am strongly in favour of the government proposals in Schedule 17 to bring in further curbs on the promotion and advertising of junk food by introducing a 9 pm watershed and a ban on paid-for advertising online. I also support the amendments in the names of my noble friends Lady Boycott and Lady Finlay of Llandaff. On the other hand, I strongly oppose a raft of amendments in this grouping that we have heard a lot about in the last half an hour or so that seek to dilute or delay the measures in various ways. I do not have time to go through each one in detail, but if the Government were to accept any of them, it would be children, particularly those from disadvantaged backgrounds, who would suffer the consequences.
Before I move on, I want to try to find an area of common ground with the noble Lords, Lord Vaizey, Lord Clement-Jones and Lord Moylan. I agree with the implication of what they have said that this is not a single-fix magic bullet. Promotion and advertising of food makes a contribution to the obesity crisis, but there are many other factors, whether education, school meals or in-store promotions, which the noble Lord, Lord Clement-Jones, just referred to. I do not think anybody would claim that this is going to solve the crisis, but the question is: would it make any difference at all? We have heard various arguments that it would not, but I want to refer back to the evidence.
I first came across this nearly 20 years ago when I was chairman of the Food Standards Agency. We commissioned an independent review by Professor Gerard Hastings of the University of Strathclyde on the impact of the promotion and advertising of food on children’s diets. It showed incontrovertibly, with the range of evidence available, which was partly observational and partly experimental, that, yes, it does affect children’s diets. It affects not just brand loyalty but preferences for categories of food—chocolate versus apples, for example. In a way, that is blindingly obvious because, if it had no effect, why on earth would the food industry spend so much money doing it? We do not really need to have research to show it, but nevertheless the research is absolutely clear cut. Other reviews since then have supported the Hastings findings.
The second point I want to make is about the various objections that come from the food and advertising industries that this will have a negative impact on revenues and broadcasting. If noble Lords want to look at the analysis on this, I suggest they read pages 39 to 42 of Henry Dimbleby’s National Food Strategy Part One, where he thoroughly debunks the arguments we have heard. I will read a quote from the report, from John Hegarty, founder of the leading brand agency, Bartle Bogle Hegarty—I gather it created the Audi slogan “Vorsprung durch Technik” and is very well known. He said:
“Advertising junk food … is no longer a decent thing to do. Instead of fighting the new 9pm watershed rule, the advertising industry should be using its power to help fight the health crisis. We all have our part to play in encouraging food companies to invest in healthier meals, and encouraging the public to buy them.
No one is against profit – but profiting from illness and misery is not a sustainable business model.”
That is from the advertising industry itself.
I have talked about evidence and the impact on industry. My third point is really about inequality. Two days ago, we had the levelling-up White Paper, which contains a number of missions. One of the missions is to reduce health inequalities by 2030, and as we know, they are absolutely staggering. According to the King’s Fund’s latest analysis, males from the least deprived areas in the United Kingdom have a healthy life expectancy of 71 years; from the most deprived areas, they have a healthy life expectancy of 52 years. The White Paper states:
“we will act now to deal with one of the biggest contributors to ill health: poor diet and obesity.”
Whatever one thinks the average effect of these measures might be across the country, we must bear in mind that those effects will not be borne equally by different parts of society. The people who will bear the brunt if we do not implement these measures will be the poorest and most disadvantaged children in the country.
I thank the noble Lord, Lord Bethell, who, a week ago last Monday, organised a moving and interesting session with an organisation called Bite Back 2030. I hope he will not mind me quoting a little from that session. The facts and figures are absolutely mind-boggling. The raw statistics are that, in the UK, 15 billion junk food adverts are pumped out every year—in other words, 500 adverts per second—targeted mainly at young people. That is one of those numbers that is so outlandish that it is hard to grasp. That is why I found that the personal accounts of the young people and teenagers we heard from told a richer story. I will give your Lordships an example.
Dev Sharma, who I think is a 16 year-old boy, said:
“junk food advertising is part of my life”.
It is on bus tickets, Spotify, Instagram, YouTube, et cetera. Particularly chilling for me was the fact that Domino’s Pizza sends him an advert every day at 4 pm, just as he is leaving school and is really hungry, like any teenage boy. That is when he is at his most vulnerable, and he is being persuaded to buy calorie dense junk food then. Another witness, Becky Odoi, talked about “subliminal conditioning” of young people, and Yumna Hussen said that food companies are preying on young people when they are most vulnerable.
These are not my ideas; they are the ideas of the young people on the receiving end. I could go on at greater length, but I think I have made my point. I strongly disagree with the amendments that would dilute these measures, and I strongly support the measures. I regret that the Government’s own amendments introduce the possibility of delaying implementing the measures, and I ask the Minister to confirm that the Government do not intend such a delay. They will not be the total solution, but they will play a significant part in tackling the obesity crisis in this country, which, in the longer run, is a far bigger health crisis than Covid. We must not get distracted by the short term from looking at the long term.
Baroness McIntosh of Pickering (Con)
My Lords, I am delighted to follow the noble Lord, Lord Krebs, and pay tribute to the work he has done in this area. I shall speak to Amendment 257C, but I shall first make just one general comment on something to which he alluded, and which follows from the earlier remarks of the noble Baroness, Lady Boycott. We are working in a vacuum at the moment, and it would be extremely helpful if the Government could say when they will publish their food strategy, drawing on the excellent work done by Henry Dimbleby, who is the main adviser to the Government on this.
I support and have appended my name to Amendment 257C in the name of the noble and learned Lord, Lord Hope of Craighead. He is unable to be here today, which he regrets greatly. The offending part of the Bill in this regard is on page 241, in proposed new Section 368Z18 on the guidance the Government intend to draw up from time to time. Subsection (2) states:
“The appropriate regulatory authority must consult the Secretary of State before drawing up or revising the guidance.”
Subsection (3) states:
“The appropriate regulatory authority must publish the guidance and any revised guidance in such manner as they consider appropriate for bringing it to the attention of the persons who, in their opinion, are likely to be affected by it.”
I draw the Committee’s attention to the Constitution Committee’s report on the Bill, and the following statement on Clause 144:
“This is a Henry VIII clause, enabling the Secretary of State to modify an Act of Parliament, an Act of the Scottish Parliament, a Measure or an Act of the Senedd Cymru, or Northern Ireland legislation. The Secretary of State is required to consult those he or she considers appropriate before making regulations via the affirmative resolution procedure.”
The Constitution Committee concludes:
“The House should consider amending Schedule 17 to require either the consultation of the relevant devolved administration or the consent of the relevant devolved legislature if the Secretary of State were to use this power to enact regulations modifying devolved legislation.”
I speak as a non-practising member of the Faculty of Advocates and must say that it is a source of concern to all of us who have an interest north of the border, west of the border in Wales or in Northern Ireland that, sadly, the Government are developing a history of not consulting the devolved Administrations where appropriate.
Regarding Amendment 257C, which is, in my view, a probing amendment, I put it to the Minister that the clause gives the Secretary of State the power to alter the legislation of devolved Administrations by regulations, as set out in the guidance to which I referred. The Committee will be aware that the Sewell convention does not apply to the exercise of delegated powers, so there is no obligation on the Government to seek consent. In its very helpful report on the Bill, the Constitution Committee suggests that, given the nature and extent of this power, consent should nevertheless be sought. There is nothing in the Bill to respect the spirit of the convention, not even a duty to consult. How do the Government square that with the respect they should give to the devolved Administrations, especially in view of my right honourable friend Minister Gove’s initiative on intergovernmental relations and the levelling-up agenda, to which the noble Lord, Lord Krebs, referred and which I, for one, support?
I conclude by asking my noble friend what precisely the Government intend to do, or what action they would be willing to take, to address this issue when the power in the guidance is being exercised.
Viscount Colville of Culross (CB)
My Lords, I declare an interest as a freelance television producer. I speak in support of Amendments 253ZA, 255A, 255B and 257B, which all attempt to give some parity in HFSS advertising restrictions between broadcasters and platforms. I apologise for having not been able to speak on Second Reading.
The noble Lord, Lord Clement-Jones, has already spoken about the reduction in broadcasters’ advertising revenue as the platforms take an ever-increasing share of the market. The restriction in the Bill on television advertising further tilts the playing field in their favour. What concerns me is that this part of Schedule 17 is about the media which disseminate HFSS advertising taking responsibility for it, yet once again the platforms are allowed off scot free. My concern is the complete absence of tech companies’ responsibility for the content of ads appearing on their video-sharing platforms—mainly YouTube, but also Facebook video and Snapchat’s vertical video service. This is the media to which children are migrating. Enders Analysis estimates that by 2027, children will spend more than half their viewing time looking at content on these platforms—an average of 85 minutes per day per child. Clearly, this is where advertisers and brands are going to push HFSS products.
Yet, as noble Lords know, the digital space is the Wild West. Last year, the digital task force produced its excoriating report on the near-monopoly control of digital advertising by the big platforms. The report also mentioned the opacity of the programmatic interface, which allows advertisers to target products at specific users. Of course advertisers are themselves responsible for where they place their ads. This marketplace is the basis of the platforms’ wealth, but it is where they shirk any possibility for the content of ads. I am sure that, if platforms were made legally responsible for imposing restrictions on HFSS advertising, they would soon insert filters—or, better still, humans—into the process, much in the same way as we are seeing them do in content mediation.
Lord Bethell (Con)
My Lords, I will speak to Schedule 17 generally and in support of Amendment 244 in the name of the noble Baroness, Lady Finlay. In doing so, I declare my wife’s interest as a board director of Tesco and Diageo.
I will focus my comments on the amendments supported by my noble friends Lord Vaizey and Lord Moylan. In doing so, I seek to address all the amendments they have put forward, which seek to: extend the implementation period for the new restrictions; introduce brand advertising exemptions; and bring in effectiveness reviews and sunset clauses, and all the other clauses that seek to water down the really important measures in the Bill on junk food advertising. I recognise that the noble Baroness, Lady Boycott, has already gone through some of these amendments in detail, so I do not want to go through that again. However, I am aware that my noble friend Lord Vaizey and other noble Lords have brushed off the Government’s obesity strategy as wrong-headed and doomed; indeed, the noble Lord, Lord Clement-Jones, has shared his view that the measures in the Bill are disproportionate.
I want to reflect for a moment on what we are trying to do here. As a country, we have got into a situation where, by every measure, we are seriously overweight. The worst affected are our children. We have heard, both in this debate and many times in this Chamber, that two in five children are overweight. The worst-affected children are the poorest children, who are twice as likely to be overweight. In thinking about the environment our children are being brought up in—this question of environment is absolutely critical—what are our values as a nation if we knowingly create an environment that encourages children to develop addictions to foods that we know will hurt them, adversely affect their moods, hold back their learning, reduce their self-worth and damage their health for years to come?
Through the pandemic, we have seen that now is the time to lean into this ongoing national disaster. The measures in this Bill are necessary because they are an essential condition for an overall change in the direction of travel of childhood obesity prevalence. The challenge is going from an increase in the weight of our children of around 1% per year to a decrease of 4.2% per year. That is an astonishing mission and a massive challenge. No country has ever undertaken such a thing.
However, I am not convinced that we can just hope that our primary schools will do all the heavy lifting to achieve this. Somehow, as a country, we have to change the way in which we run our lives. This will require a change in the environment in which our children learn about, engage with and buy food—and that includes the media they consume. If we fail, for every year that this is not achieved, the rate of change needed in future years will grow, and thousands more children will be exposed to the physical and mental health impacts of obesity.
The noble Lord, Lord Krebs, talked eloquently about how, 20 years ago, the Hastings report had this research nailed. There is now a sense of urgency, which is why these measures are needed. It is why we cannot seek to extend the implementation periods for new restrictions; this will just drag them out indefinitely and undermine the seriousness of the programme. It is why we cannot give brand advertising an exemption that clearly leaves the door wide open for the same old advertising in different ways. It is why we should not commit to effectiveness reviews that will become a rear-guard action to unpick these regulations, nor commit to sunset clauses that will give industry false hope that somehow the Government will just give up on these measures or the problem will go away.
To reach the 2030 target, it is absolutely crucial that the Government continue with these plans to restrict junk food advertising on TV and—as the noble Viscount rightly said—online, and do not waste any more time. It is also crucial that we introduce fiscal measures to speed up reformulation at the same time, making healthy eating more accessible to everyone. It is absolutely clear from our data that any delay in action or the implementation of proposals to address childhood obesity will have a significant impact on the ability of the Government to achieve their ambition. More children will grow ill and live shorter lives.
I hear—loudly and clearly—the concerns of my noble friends Lord Vaizey and Lord Moylan, and the noble Lord, Lord Clement-Jones. I hear their concerns about the science, the research and the public health epidemiology that underpin these measures. I do not agree with their scepticism but I do hear their concerns, so let me pick off a couple of them.
My noble friend Lord Vaizey expressed scepticism about the effectiveness of these measures. He is right that these advertising restrictions will not work on their own. Obesity is a complex issue and no one single policy can solve it. However, small steps matter. It can take as little as 46 extra calories a day for children to gain excess weight, and seeing just one minute of HFSS adverts leads to children eating an extra 14 calories a day on average.
As I said earlier, this question of environment is absolutely critical. I accept that we need population-level structural policies to address the social and economic drivers of obesity, to then address the growing inequalities between the most and the least-deprived children. That is why the levelling-up White Paper earlier this week that tackles housing, education, deprivation and many other aspects of British life was critical to this debate and forms the context in which we should discuss these measures. It is also why my noble friend should not feel that the broadcast and food industries are in some way being uniquely scapegoated. This is a national programme that will touch on many lives.
My noble friends are right to express concerns about the fortune of the broadcast and internet industries, two jewels in Britain’s creative industries and employers that drive local economies. I want to reassure them. I once worked in the media industry and have not forgotten the intense competition for advertising and the existential battle with big tech, but my noble friend Lord Vaizey spoke as if many of these companies would find that all communication by these companies on all their products to all their target markets would somehow be terminated forthwith and that the British public service broadcast industry would be thrown into destitution. That is just not quite right. Cancer Research UK found that ITV, Channel 4, Channel 5 and Sky One derive a small proportion—just 8% of their total ad revenue—from adverts for HFSS foods.
It is true that almost two-thirds of HFSS product adverts aired between 6 and 9 pm fall within the category that UKHSA has identified as the highest contributors of sugar calories in people’s diets, a fact that I found quite alarming, but under a 9 pm watershed broadcasters would have lost only 5% of their total advertising revenue if all HFSS adverts were removed completely, without anything in their place. Noble Lords should know that over three-quarters—79%—of potential revenue loss from removing HFSS adverts could be mitigated against by companies advertising their existing non-HFSS products instead of promoting their HFSS products. Healthy foods can still be advertising.
It is just not right to call these measures appalling and crude or ridiculous and blunt. To change the environment in which our children make decisions about food is critical for this national mission, and to contribute to a campaign to improve the health of children is a commendable aspiration for these government measures.
Lord Stevens of Birmingham (CB)
My Lords, perhaps channelling the noble Baroness, Lady Deech, from this morning, I congratulate the Government on including in the Bill these measures to tackle childhood obesity. As we have heard, with one in four children not just overweight but clinically obese, we are storing up huge problems for the future because we know that what starts in childhood continues into adulthood. In that sense, diet is destiny. Unfortunately, obesity is the new smoking. We know that it is the cause of avoidable heart attacks, strokes, 13 different types of cancer, and respiratory disease, and causes a far higher risk of dying from Covid. Clearly action is needed, and the Bill makes a start.
If anything, these measures, which are certainly proportionate, may be overly targeted. Some of the criticisms levelled at the Bill should have given rise to amendments to extend its scope to deal with some of the loopholes or to level the playing field into other digital aspects that people are concerned about. That would have been a constructive response to legitimate concerns. Instead, I cannot help feeling that this morning we have heard from opponents who are simultaneously arguing that the measures in the Bill go too far and at the same time will not be effective enough, and to ensure that this becomes a self-fulfilling prophecy they have included amendments which would essentially fillet the Bill of its active ingredients.
These are familiar tactics. This is the tactic of deny, dilute and delay. The first is denying, claiming to us as parents that ads and marketing make little meaningful difference to kids’ consumption; but on the other hand we have companies—presumably rational economic actors—spending maybe hundreds of millions of pounds every year on the basis that exactly the opposite is true. Like Schrödinger’s cat, which is simultaneously dead and alive, it seems that junk food advertising and marketing simultaneously does and does not work. What is at stake here is not quantum physics but the physical and mental health of millions of children.
Lord Vaizey of Didcot (Con)
Given the noble Lord’s extraordinary expertise, having worked all over the world, does he know any example of any country where a junk food advertising ban has had an impact on obesity? This is a genuine question.
Lord Stevens of Birmingham (CB)
As the noble Lord will know, the genuine problem that we have in this country is that unfortunately we are a world leader in childhood obesity. It therefore falls to us to take world-leading action to respond to that.
Even classical economic liberals will accept that children are not sovereign consumers. The noble Lord, Lord Vaizey, in his earlier remarks, said that there was no evidence that advertising leads to increased consumption. My noble friend Lord Krebs has comprehensively rebutted that point but, to underline the matter, I say that studies of children’s ventromedial prefrontal cortices—the areas of their brains associated with reward valuation—suggest that watching food commercials systematically alters the psychological and neurobiological mechanisms of children’s food decisions. Even small but sustained reductions in at-risk children’s calorific content provide demonstrable physiological benefit.
By the way, this figure of 1.7 grams or 3 grams, as my noble friend Lord Krebs pointed out, is a mistaken application of epidemiological maths—that is, dividing the assumed totality of calorific reduction against the totality of children on an even basis, when in fact the children who will disproportionately benefit are those who are disproportionately exposed and disproportionately obese.
Systematic evidence reviews conclude that
“screen advertising for unhealthy food results in significant increases in dietary intake among children.”
Therefore, once we have had the denial, the second tactic is to dilute the regulatory effort—to insert loopholes, to neuter regulators, to drive a coach and horses through what is proposed. We have a number of amendments which seek to do that. They pretend, as the noble Baroness, Lady Boycott, pointed out, that advertising to children of a smaller item is not in practice also advertising the identically packaged larger item. They exempt ads for certain bars which by themselves may contain half of a child’s maximum daily recommended sugar intake. They give a green light to brand advertising, even where children perceive the fast food or confectionary brand and its associated unhealthy products as essentially the same. Widespread evidence shows that current narrow restrictions on children’s exposure to harmful junk food ads are routinely breached, and frankly these amendments seek to repeat the trick.
Even more absurdly, Amendments 245A and 250ZA would restrict harmful advertising only on a Saturday and Sunday. The noble Baroness, Lady Boycott, pointed out that those of us who are parents know that our kids are not exposed to screens only on a Saturday or Sunday; it turns out that Monday, Tuesday, Wednesday, Thursday and Friday are also days of pressure for those of us trying to be responsible parents. Or are we asked to believe that rising obesity in pre-school and school-age children does not happen on school days? If so, these amendments imply the discovery of a phenomenon unknown to medical science: weekend-only obesity.
Finally, when denial has been disproved and the dilution tactic has been debunked, the amendments try for delay—for more time to lobby for a weakening of the political will, to live to fight another day. “Lord make us pure, but not yet”; even St Augustine would blush at these amendments. Nor for that matter do government Amendments 249, 252 and 254 have anything to commend them. We have heard this morning a strange contradiction between the acknowledged urgency of the spiralling health crisis affecting our children versus the long and leisurely gap that some still want before further action is taken. These preventive measures were first announced by the Government in 2018. Three years is more than long enough to prepare and adapt. The Government’s goal is to halve childhood obesity by the end of the decade, but we are nowhere near being on track. We had better get on with it because, as the saying goes, children may be only a fifth of our population but they are 100% of our future. In the past, the blocking tactics of deny, dilute and delay have often succeeded—but today, perhaps not, because young people and parents want change, and because today, in this Bill, the Government are showing resolve; so too should we, my Lords.
Lord Black of Brentwood (Con)
My Lords, I will speak to Amendment 245, tabled by my noble friend Lord Vaizey, and to others in this group to which I have added my name. I declare my interests as a director of the Advertising Standards Board of Finance and deputy chairman of the Telegraph Media Group, and note my other interests in the register. I am also a vice-chairman of the ITV APPG.
This does not need repeating: I support the Government’s aim to tackle childhood obesity, but I am wholly opposed to their proposals to tackle it through an advertising ban. I believe that even now, at the 11th hour, they should think again, because it is disproportionate and based on scant and frankly implausible evidence. It will damage the creative economy, which is already under such stress, and it will have unintended consequences, like so much legislation that impacts on the media.
Also—and this is a very important point—it sets a hugely dangerous precedent for the Government to interfere with advertising freedoms, which are a fundamental aspect of freedom of expression. This is bad legislation.
As we have heard so often, the reduction in calories will be minimal, but this ban will take £200 million out of the media and creative industries when they can ill afford it and when they are in a life-and-death struggle with the all-powerful platforms. My noble friend Lord Bethell said that it would take out only 8% of revenues. When you are in day-to-day combat with the platforms for advertising revenue, 8% of revenues is a huge amount of money. More than 265 news media outlets have closed over the last 15 years, and many more will follow if the burden of regulation is increased, not cut in the way it should be.
This ban will not impact just broadcasters; it will disproportionately affect news publisher websites, too. This blunderbuss of a ban will reduce freedom of choice for advertisers and harm the ability of news media publishers to monetise content online, which is crucial for their long-term survival. At the same time, astonishingly, it will allow the tech platforms to continue to derive enormous amounts of revenue from HFSS advertising.
Here is the great irony: the platforms have a significant audience of children, because that is where children go to get their news, but they will not be impacted. News publisher websites have only a de minimis child audience but will suffer directly as a result of this policy—and they will do so at a time when the entire industry is under great stress, as countless reports, including the Government’s Cairncross and Furman reviews, the report from our own Communications and Digital Committee and a comprehensive report from the CMA, have demonstrated. In winding up, could my noble friend explain why news publishers are caught but the platforms are not? It is, as somebody famously said, “voodoo economics”.
Even at this late stage, I hope the Government will think again and drop these ill-thought-out restrictions. In case they do not—I am a practitioner of the art of realpolitik and I know this ban may end up going through—as we have heard from a number of noble Lords, we must at least make sure the policy is workable. That is the job of this House and this Committee because, at the moment, the measures are not fit for purpose.
As noble Lords know, during my career I have had one or two encounters with the issue of regulation, and I am clear that, for regulation to work properly, it must have a number of inherent qualities. First, you cannot rush regulation. Stakeholders from those affected need to have their input and they need time to adapt. That is what the amendments in this group, starting with Amendment 245, are all about. This is not just delay for delay’s sake; it is delay because that is what the real world demands. When this Bill becomes law, that is just a starting point. As my noble friend Lord Vaizey said, you have to designate a regulator, then the regulator has to implement it and there has to be public consultation on code changes. That long process could easily take the rest of the year and possibly longer.
Once that is all complete, in the real world, advertisers, agencies and media owners will need time to assess how the system is going to work in practice. This is a very complicated part of the creative economy, as the noble Lord, Lord Clement-Jones, said. You cannot just flick a switch and expect everything to change at once. It will take at least a year for all those involved in the advertising supply chain to adapt, review processes, set new legal procedures in place and so on—leaving aside the impact on the creative aspects of their work. That is why I genuinely believe that this Bill must not come into force until one year after the final publication of the rules and guidance from the appointed regulator.
A judicious approach to implementing the rules is one characteristic of sensible regulation. Another is certainty, which is what Amendment 247 and others are about. The Bill quite rightly focuses on ads where an identifiable HFSS product is shown, with brand advertising and sponsorship exempt. I applaud that, but the Bill is not crystal clear on the point. Within the creative industries, there is a huge amount of uncertainty, which is the enemy of effective regulation, about what is and is not permitted. I believe the terms of the exemption should be set out in the Bill, not least so that, if this or a future Government wish to revisit the matter, they must come back to this House to set out why they are doing it and to seek our consent. Given the potential harm this legislation could cause and the precedent it sets, that must be right.
The final aspect of sound regulation must be the measurement of its effectiveness. Regulation that does not work—and I am afraid that I am sure this will not—should not remain on the statute book simply for the sake of it. If it is found wanting—or, worse, damaging—it should be repealed. This is too important an issue to leave to chance. We should therefore know now what metrics the Government will use to measure the success of these restrictions, the definitions they will employ and how data will be collected. Will they measure the impact on the creative economy as well as on obesity? We should know. If those metrics are not met, the restrictions should fall at the end of the review period.
In the absence of dropping this legislation—I notice some reports that its demise might be part of Operation Red Meat, which we are hearing so much about, and let us hope so—our job is to ameliorate its worst aspects and ensure that it is sound and workable. These amendments do that, and I hope they will find widespread support across the Committee.
Lord Grade of Yarmouth (Con)
My Lords, I speak in support of my noble friend Lord Vaizey’s amendments. He said all I could possibly say to support them. This is a shocking piece of bodged legislation, which needs the support of these amendments to make it fairer and more proportionate, practical and sensible.
At the heart of all this legislation and all the speeches today, I think we are all agreed, is that unhealthy food is the real villain here. It is not the messengers, the advertisers or the media; it is the people who create the formulations that are doing so much harm and increasing obesity at a scary rate, which we can all unite in trying to fight. I am afraid that the noble Baroness, Lady Boycott, is in for a terrible disappointment if she thinks that just banning ads in some form on television is the answer to all our problems. Many Governments—
Baroness Boycott (CB)
I never said—and other noble Lords who oppose these amendments never said—that the single act of banning junk food advertising at certain times on television will solve the obesity problem. When McKinsey did a survey on what needed to be done, eight or nine years ago, it came up with 81 different measures the Government needed to undertake. This is just one of them. It happens to be an important one that the Government have put forward, and I believe the Committee should support it.
Lord Grade of Yarmouth (Con)
I will continue. Successive Governments throughout my too many years in the media, faced with intractable social problems, have turned to bashing television, television advertising, violence on television, the Troubles and so on. I remember Prime Minister Thatcher introducing a measure that banned direct speech by duly elected Members of Sinn Féin, thinking that it would in some way contribute to the end of the Troubles. The list is endless, and this is yet another one.
The Government have missed the target. The target is the manufacturers of unhealthy foods. I ask the Minister whether, at the end, she will kindly give us a sense of what the Government are doing to get to the heart of the problem, which is the reformulation of these unhealthy foods. It is no good blaming the messenger and the media; you have to get to the heart of the problem, and at the heart of the problem are products that have too much sugar and other harmful—maybe even addictive—contents in them.
I will conclude, in the interests of brevity, by expressing my great sympathy for the Front Bench in having to defend this ghastly piece of legislation.
Lord Lansley (Con)
My Lords, I am pleased to follow my noble friend Lord Grade. The point he made relates to my own experience in that, when the nutrient profiles in question were introduced in January 2011, I was Secretary of State. They were very much in the context of precisely the programme that I think he is looking for. It was about the reformulation of foods in the manner that had been done in relation to salt and to do the same for sugar and fats and the voluntary removal of transfats, which I think has essentially been accomplished. I have to say to my noble friend and the Committee that we have to be very careful because a lot of progress was made, but much more could have been made on a voluntary basis with the industry.
The nature of the attack made upon the Government and the industry was that, I paraphrase, “You’re working with the industry and, therefore, your activity is undermined by that fact.” It was rejected by many of the organisations that were seeking to achieve a public health objective. That was misplaced, and I am very disappointed that it happened like that. It would be a justifiable approach only if less healthy foods—HFSS foods or, for that matter, alcohol—were in the same position as tobacco. We do not deal with the tobacco industry because there is no safe level of tobacco consumption; we deal with the food and drink industry because there are safe levels of food and drink consumption.
My noble friends are nodding merrily, but I have to warn them that I actually agree with the Government’s proposals, partly because I think they are capable of being implemented in some respects in ways that meet some of the objectives that my noble friends are setting out. They can put practical timetables in place. They can give clear guidance about identifiable products, as distinct from brand sponsorship and the like. I do not like sunset clauses if we do not have to have them—if we have too many of them, as my noble friend Lord Moylan suggested, we would be clogged up with re-legislating all the time—but the Government can, by regulations, significantly change this.
I support the Government partly because they are clearly being attacked for doing too little and attacked for doing too much, so they are probably doing about the right thing. I think they are doing the right thing because we all know—the noble Baroness, Lady Boycott, said it—that obesity, and perhaps especially childhood obesity, is a multifactorial problem, so we must have multifactorial solutions. The one thing I would not accept is the proposition that I have sometimes heard from Governments of all persuasions: something must be done; this is something; therefore, it must be done. We need to implement many responses to this major public health issue—the noble Lord, Lord Stevens, is quite right—and we must tackle it as if it really matters. It is one of those missions that a mission-led Government should be seeking to achieve. It will need a wide range of different responses, of which this is one. All of them should be examined carefully to see whether they are evidence-based and effective.
I have to say that it is very difficult to say what is effective in this context because, for example, although we know that children who consume relatively more less healthy foods have a less healthy diet and are more likely to be obese, if we look at all the correlations, there are quite a lot of children who have a poor diet but it is not necessarily particularly heavy in less healthy foods. There are a lot of children whose poor diet is directly the consequence of their poverty, as my noble friend Lord Bethell said. The idea that we will see direct cause and effect is difficult to accomplish, but that does not mean we should not try. So, for public health reasons, I support what the Government are setting out to do.
I shall make one final point. The lead amendment in this group was tabled by the noble Baroness, Lady Finlay, and we have a later group on alcohol labelling. I have to say to her that I think that, in this context, her amendment is misplaced, first, because I think it derives from the idea that alcohol is like tobacco. For only a small minority of people is it necessary not to drink at all; most people who have a low or moderate alcohol consumption are at low risk. Secondly, she dismissed with a wave of the hand the codes and what has been achieved. I do not think that is fair. I think the alcohol marketing code has made a difference in relation to alcohol. I wish there was an HFSS marketing code that had been similarly effective because, where alcohol is concerned, the Health Survey for England 2019 said that, in 2003, 45% of eight to 15 year-olds had consumed an alcoholic drink and that, by 2019, that had dropped to 15%. These things can move in the right direction. We just need to make them do so. It does not automatically follow—
Baroness Finlay of Llandaff (CB)
Will the noble Lord clarify some of his statement about young people? We know that there are specific cultural groups among young people who do not drink at all, which has brought the average down, just as we know that there is a spectrum in poverty and obesity. Does the noble Lord feel that the current guidelines or whatever are working, given that there were 7,000 deaths from alcohol liver disease in 2020 and that there has been a 400% increase in the number of deaths from alcohol liver disease since 1972? If this had been working really well, we would not be seeing these increases. At the moment, we have a catastrophically large number of people dying from alcohol liver disease, which has got much worse during lockdown.
Lord Lansley (Con)
The noble Baroness is drawing me into what is a very important debate, but I do not think it is this one in this group. We will come on to it perhaps on Amendment 259 at a later stage. I do not disagree that we have not succeeded where alcohol consumption is concerned, but the nature of the problem has manifested itself more recently, especially in smaller numbers of people consuming alcohol, some not at all, but those who do very often doing so through binge drinking, which is exactly what is giving rise to what we are all most concerned about, which is the significant harm that is resulting for those people. We need to think behaviourally about the nature of the problem in order to find behaviourally what is the nature of the solution.
I need to stop, but I shall raise just one point with my noble friend on the Front Bench. I started with nutrient profiling. Nutrient profiling is terribly important. The noble Lord, Lord Clement-Jones, made the point that we do not get to look at that, but what it says is terribly important. As I understand it, we are due for a revision, but we have not yet seen it. There was a 2013 study that looked at our nutrient profiling and compared it to that of the WHO and five European countries. It concluded that, in relation to a large number of processed and packaged foods, under our system 47% would be able to be advertised to children, while under the WHO system it was 32%. There is a significant difference in what one puts into the nutrient profiling. It is not an objective truth, and putting alcohol in it completely misses the point, since it is not constructed around that proposition. I ask my noble friend to tell us a bit more about the nutrient profiling process, the timetable, the evidence and how we are going to put it together to meet the objectives under the Bill.
Baroness Stowell of Beeston (Con)
I will be very brief. I declare my chairmanship of the Communications and Digital Committee. A lot of powerful speeches have been made all around the House today and clearly, we are all united in our care and concern for the issue of child obesity. The complexity of what is proposed in this legislation has been illustrated to such an extent that there is a case for delaying implementing these measures so that it is got right.
But the main reason for my decision to speak in this debate is the issue of fairness, equal treatment and the difference in the way these regulations apply to broadcasters and to the online platforms. The noble Viscount, Lord Colville, and my noble friend Lord Black of Brentwood have already spoken in some detail about the inequality of treatment between broadcasters and news publishers, and the online platforms.
I spell out clearly that what we are talking about here is that responsibility for the control and compliance of advertising that appears on television or radio rests with broadcasters, which can be sanctioned severely with huge fines by regulators if they allow anything that is non-compliant to air. But responsibility does not rest with the online platforms, which take far more in profit from the advertising they publish on their sites than any broadcaster is able to. They are equally able to control what appears on their platforms, as the noble Viscount powerfully described. Could my noble friend the Minister therefore explain why the Government are not ensuring parity between broadcasters and the likes of Google and Facebook at the point of legislation, to ensure parity in the way this will be applied?
Also under the heading of fairness, I say that, in the case of the small manufacturers of the products affected by the advertising ban, I support the amendment tabled by the noble Lord, Lord Clement-Jones, which ensures that the definition of “SME” in the Bill does not provide a loophole exempting large international manufacturers from these advertising restrictions just because they have a small workforce in this country.
Baroness Bennett of Manor Castle (GP)
My Lords, I feel the need to balance the sides of this debate. I attached my name to Amendment 244 in the name of the noble Baroness, Lady Finlay. I associate myself with everything said by her and the noble Baroness, Lady Boycott, in particular, as well as the noble Lord, Lord Krebs, who gave powerful and well-evidenced presentations of why we need to see action here. Given the time and the fact that I have a train to catch, I will be brief.
The noble Lords, Lord Black and Lord Moylan, talked about freedom of speech—the freedom of the advertisers to push on to children whatever they want to push. I put against that the freedom to flourish and live a healthy life with a decent lifespan. The figures quoted by the noble Lord, Lord Stevens, illustrated that that is not being achieved and there is a deep inequality in our society.
The noble Lord, Lord Lansley, talked about how difficult it would be to measure or separate out the impact of these measures. We are in a hugely obesogenic environment. We have this huge problem with obesity not because human nature has suddenly changed and people have lost self-control, but because they are bombarded and barraged from all sides with ultra-processed pap, which we should stop all advertising of. I do not think that “High in fat, sugar and salt” goes far enough. There is evidence that under-11s—primary school kids—cannot distinguish between adverts and editorial content, so we have to protect them.
Finally, the noble Lord, Lord Black, asked about the international comparisons. Perhaps one of the most obvious ones is Norway, which brought in a ban somewhat similar to this in 2012. It has struggled for the reasons outlined by many noble Lords. Indeed, a study was produced by Oslo Metropolitan University last year, using the categorisation of the WHO European Office for Prevention and Control of Noncommunicable Diseases. Eight out of 10 adverts that young people in Norway were seeing online were for unhealthy food. That is a problem, but it is an argument not for doing nothing but for tackling the whole obesogenic environment that our young people are growing up in, with demonstrable effects. Norway, which has taken similar action to that which we are talking about today, as have Spain, Portugal, Slovenia, Latvia and Lithuania—that is just a shortlist—has half the level of childhood obesity that we do, and it regards it as a serious problem.
Lord Naseby (Con)
My Lords, I apologise to the House that I did not take part in the Second Reading debate; I am afraid that my wife was in hospital at the time. I was a trainee and marketing manager with Reckitt Benckiser—Reckitt & Colman in its early days—which is obviously associated with Colman’s foods and Robinsons drinks. As my career developed, I changed from the company side to the advertising agency side and was responsible for a fair amount of food advertising for the next 15 years. I am particularly proud of Jacob’s Club biscuits, which are full of chocolate—more than any other chocolate biscuit. So, I suppose I have a heritage to declare in that area.
I have supported a number of the amendments that my noble friends Lord Vaizey and Lord Moylan have tabled, and I also listened to my noble friend, in this case, on the Liberal Benches. But I will not talk about them because they have been more than covered; I will keep it quite simple.
We are thinking and talking about a major industry in the UK: the food and drinks industry—not the alcohol side. It has co-operated with previous Governments of both dimensions—or three dimensions, if you include the joint one with the Conservatives—so it has had a long history of involvement. It declares and has indicated that it is helping to reduce child obesity, and it has performed on this, so it is not as if it is resisting anything. It is very important that there is a good working relationship with a dynamic industry like this.
As I see it, the tragedy is this. The ISBA, IAB, IPA and the Food and Drink Federation have worked closely with previous Governments and succeeded in coming a long way in trying to tackle obesity. The industry has demonstrated that by the number of initiatives that have taken place, which have been mentioned already: projects like The Daily Mile and Eat Them To Defeat Them. It has put forward a proposal to Her Majesty’s Government, although I will not go into it because it is fairly technical: targeting filters, based on robust audience data. Some of your Lordships are particularly tech-oriented; I am not, but I am advertising-oriented. When an industry puts forward a proposal of a high-tech nature that will achieve the objectives that the Government of the day want, and set in the first place, it seems to me very strange when that approach is totally rejected.
It goes deeper than that, because unless Her Majesty’s Government listen to my noble friends and think long and hard about their amendments, this will undermine public health policy. Manufacturers have been working in partnership with government for years—over two decades—to reformulate products, reducing salt, sugar and calories and offering smaller portion sizes. Now, all of a sudden, my Government have decided that they will not work with the industry but will handicap it. That will even affect the future, because it will stifle the investment we want in this country, particularly at this time. Finally, this will undermine the Government’s ambition for the UK to be a digital leader.
I ask my noble friend on the Front Bench to have another look at what the industry offered. Yes, it is high-tech and yes, it is quite difficult for us normal humans to really get a hold on what it is about and how it actually works, but, after 25 years in the communications world before I entered the other place, I believe, and hope, that my noble friend on the Front Bench is broad-minded enough to go and have another look at what was on offer, before the sword of Damocles falls on this aspect of allegedly helping to reduce poverty.
Lord Moynihan (Con)
My Lords, the great Nicholas Parsons, who is the Chief Whip’s go-to source of quotations for today, also said:
“The saddest thing about getting old is seeing my cricket bat in the corner and wondering if I will ever play again.”
I am sure that Amendment 297C in my name and those of some colleagues, who I will come to in a moment, would have been warmly welcomed by him, as I hope it is across the Committee. If accepted by the Government, it will ensure that many more cricket bats are rehabilitated with a wipe of linseed oil and put to good use again.
I did not want to interrupt the excellent debate, so I have waited until this point to come forward with my amendment, but I say to the noble Lord, Lord Stevens, that if there was ever an amendment in this group to tackle obesity, this is the one. I declare my interests as set out in the register.
Amendment 297C stands in my name and those of the noble Baroness, Lady Morris of Yardley, from the Labour Benches, the noble Lord, Lord Willis of Knaresborough, from the Liberal Democrat Benches—who admirably chaired the National Plan for Sport and Recreation Committee, which recently published a unanimous report that recommended a requirement for a national plan for sport, health and well-being to be placed in primary legislation—and the noble Baroness, Lady Grey-Thompson, who has been campaigning with me for this change in the law for well over 20 years.
Of course, the Select Committee of your Lordships’ House ceased to exist on the publication of its report. However, unusually, after hearing 76 witnesses in public evidence sessions and reviewing 163 pieces of written evidence, in addition to four round tables, we were unanimous in our hope that this Health and Care Bill could be amended, to reflect the views from all sides of the House, to include a statutory responsibility on the Secretary of State for Health to draft and publish a national plan for sport, health and well-being. The Minister for Sport would be moved from DCMS to the Department of Health to oversee the process of preparing the national plan, presenting it to Parliament and undertaking the additional functions that the Minister for Sport’s office currently undertakes with a very small staff of just 33, who work on sport and recreation, as set out in the Minister’s written reply to me on 29 July. Despite DCMS’s good work, participation rates in sport and recreation in this country are lamentably low and add to the problems of obesity.
Our rationale for encouraging the Prime Minister to make such a move was more than the obvious natural fit that sport and recreation sit more appropriately with health and well-being than with data protection, cybersecurity and the TV licence fee; more than the natural policy fit between sport and health; more than an attachment to a department on the fringes of government, established courtesy of David Mellor’s charm in persuading his good friend John Major to create the department in the first place; and more than a recognition that a Minister at the heart of government could position sport and recreation where it should be: an essential component of a fit and healthy nation, as part of preventive care, health and well-being.
The purpose of our amendment is to create a catalyst for change. The status quo simply does not work. We heard evidence from the Deputy Prime Minister of New Zealand, where the Minister of Finance is responsible for setting out a well-being budget that fully includes and embraces sport and recreation in that portfolio.
In the context of the UK, the three key elements of our amendment include focusing on outcomes that meet the needs of present generations, at the same time as thinking about the long-term impacts for future generations; taking a holistic—not the current siloed—approach to the subject; ensuring that society is fitter, healthier and happier; and increasing sports participation rates by at least 10% per annum, which happens on the continent, as opposed to the static levels of participation since 2005 in this country and the major lost opportunity to deliver a participatory sports legacy from London 2012. We face a crisis of obesity, as we have heard in this excellent debate. We have to take action now. We also face a crisis of inactivity, and we need a national plan.
Secondly, we need to break down departmental and agency silos and work across government to assess, develop and implement policies that improve sport, health and well-being. Efforts to increase levels of participation as a percentage of the population have simply failed, and that should be the most important outcome for the Minister for Sport at DCMS. In our view, it requires the major clout that comes with a central, large department of state to co-ordinate and deliver cross-departmental initiatives. There is hardly a department of state now that does not have to promote policies in sport and recreation—including, for example, the Department for Transport, which recently announced a £2 billion package to create a new era for cycling and walking, equal to the total amount of money spent by Sport England on all sport and recreational activities, outside Covid, over the last eight years.
Thirdly, we need to track progress with broader measures of success, including the health of people, communities, the environment and public finances. This is exactly what the Prime Minister said when launching the office for health promotion on 29 March last year. Our amendment backs the Government’s announcement of that day, which stated:
“New Office for Health Promotion will lead national efforts to improve and level up the public’s health … It will help ministers design and operationalise a step change in public health policy”.
Above all, it said that the
“New approach will see action across government to improve the nation’s health by tackling obesity, improving mental health and promoting physical activity”.
The Prime Minister had this to say:
“The new Office for Health Promotion will be crucial in tackling the causes, not just the symptoms, of poor health and improving prevention of illnesses and disease.”
Backing his words is all we are asking for. He went on:
“Covid-19 has demonstrated the importance of physical health in our ability to tackle such illnesses, and we must continue to help people to lead healthy lives so that we can all better prevent and fight illnesses.”
The then Health and Social Care Secretary, Matt Hancock, said:
“Good physical and mental health are central to our happiness and well-being. Yet so much of what keeps us healthy happens outside of hospital and the health service. By establishing the Office for Health Promotion we will bring health promotion into the heart of Government, working to the Chief Medical Office, so we can level up the health of our nation, working across national and local government.”
For reasons unknown, the cross-governmental approach to improving the nation’s health by tackling obesity and promoting physical activity was quietly dropped last summer. The office for health promotion was reorganised and rebranded as the Office for Health Improvement and Disparities, which retained all the objectives of the office for health promotion, save the essential component of promoting physical activity. Let us add that essential goal, so strongly backed by the Prime Minister and the Government at the time. This amendment would do that, and would add this core objective to the work of the OHID.
In the interests of time, I will not argue the case for all the issues that need to be covered by a national plan, some of which are set out in the amendment. I also will not go into detail, further than to say that my noble friends and colleagues who have worked on this, not least the noble Baroness who will follow me, will cover some of those issues in this debate in Committee. In conclusion, the case is admirably set out in detail by the noble Lord, Lord Willis, and his committee, in the excellent, unanimous Select Committee report. In that spirit, I commend the amendment standing in our names to the Committee.
Baroness Grey-Thompson (CB)
My Lords, I draw your Lordships’ attention to my declaration of interests: I am chair of ukactive and a board member of the National Academy for Social Prescribing, and I also sat on the Select Committee which the noble Lord, Lord Moynihan, mentioned. My name is attached to Amendment 297C.
Lord Willis of Knaresborough (LD)
My Lords, I first apologise for not being present at Second Reading. It is unusual for me not to be there when a health Bill is being discussed, but I have had a lot of personal family problems.
Never, in the years I have been in both the Commons and the House of Lords, have I been as proud of a committee as I have been chairing the one on sport and recreation. I thought the committee would look very narrowly at sport and recreation and what could be done for them, but it ended up with a set of proposals that are quite revolutionary, which state something really quite different about the way forward, not only for sport and recreation but for the NHS itself. I am deeply indebted to the noble Lord, Lord Moynihan, for his leadership as our special adviser and for his membership of the committee, and of course to the noble Baroness, Lady Grey-Thompson, and the noble Baroness, Lady Morris, who is not here today, whose experience of working in the Department for Education was invaluable. As we heard earlier in the debate, that department has a crucial role to play in developing some of these key policies.
Like the noble Baroness, Lady Grey-Thompson, I would have preferred for this proposed new clause to be debated as a separate entity, but perhaps it was fitting that it was grouped with amendments that have a common theme, because despite the disagreements between various parts of the House on the previous set of amendments, they are all based around the same issue of how we get a healthier nation. It was incredibly rewarding to see that.
It might seem quite obvious that during the Health and Care Bill in the House of Lords we should be talking about health matters and improving health, but I have to say that, together with the 2012 Bill, so much of this legislation is about shifting the chairs again; it is not about looking at the future health of the nation. There will be marginal improvements from the bureaucratic changes in the Bill, but I was looking at what we can do to make a fundamental difference, and we will not do that until we change the fact that, as the noble Lord, Lord Stevens, said in that debate, the NHS is currently a repair-and-maintain service. It cannot go on like that because the money will run out and the number of people serving it will run out. We have to change it to a prevent-and-improve service, and that is what the new clause proposed by Amendment 297C is about.
It proposes just a minimum of reorganisation: for instance, simply moving sport from DCMS to the Department of Health is not a massive reorganisation. With moderate investment—nowhere in our report do we spend time talking about massive investments to get change; this is really about changes of attitudes—it has the potential to change the way in which the NHS operates to a very different mode of making sure that people do not get ill, as the noble Lord, Lord Stevens, quite rightly said. Indeed, the previous amendments were all about that too. Those amendments rounded on obesity and childhood obesity, and that is an area that we should be tackling; there should be masses of things in this Bill which are about supporting that, not just the odd one or two. Making people active from the cradle to the grave, or near the grave, seems to me the right thing to do.
Other amendments in this group rightly observe that what people eat and drink is related to their health outcomes. Given the alarming levels of obesity we have heard about this morning, I am very supportive of some of those, and particularly what the Government are doing in advertising. I fully support their approach, though clearly it is not a once-and-for-all idea.
How is it possible that the UK is world-leading in elite and professional sports, that 3 billion people across the world watch our Premier League matches in over 187 different countries and that, as the noble Baroness, Lady Grey-Thompson, has consistently said, at Olympics after Olympics we are near the top of the league in terms of our elite activities, yet for decades we have failed at grass-roots level to get more people from more diverse backgrounds to be more active, despite all the investment that successive Governments have made?
With one-third of the adult population at the moment getting less than 150 minutes of moderate activity each week; with schoolchildren doing consistently less activity both at school and at home; with PE marginalised in the school curriculum and no longer inspected by Ofsted while, as we heard in our evidence, many primary school teachers get less than three hours’ training in a three-year degree course, which is shameful, so physical literacy in most of our primary schools means nothing, frankly, because it does not appear on the league tables; with access to facilities ever more difficult; with local authorities closing swimming pools and leisure centres to save resources; and with transport non-existent for large parts of the day for large swathes of the community, we have become one of the most lazy, inactive nations in the modern world. Those sections of the population with the poorest diets and the worst levels of deprivation are, not surprisingly, the least active, too, and of course the pandemic has disproportionately affected all the target groups.
My colleagues and I sought in our report not to blame Governments, local authorities or sports and recreation providers, who have worked hard to maintain facilities. This is not a party-political amendment at all; all the groups on the committee were totally united. All the empirical evidence that we looked at shows the huge benefits from being active: improving learning at school; improving mental health; building up resilience and resistance to disease; and, above all, making people happier and more positive in life.
What is more, investing in active lives, as the Health Foundation research demonstrated, would save countless billions of pounds of future NHS spending by placing sport, physical activity and well-being at the heart of government within the Department of Health; by establishing in law an office for health promotion, sport and well-being to replace the Office for Health Inequalities and Disparities—whatever that means—with the same personnel as initially proposed by the Prime Minister himself; by making the Minister for Public Health, Sport and Wellbeing responsible for preparing the national plan that the noble Lord, Lord Moynihan, has so ably proposed, a plan that is at the centre of government policy in New Zealand, Australia, Norway and Sweden; by ensuring that the school curriculum places physical literacy alongside numeracy and literacy as a core subject; by making it mandatory for local authorities to provide active-life facilities; and by ensuring that the duties of care and safeguarding, so brilliantly articulated in the earlier review by the noble Baroness, Lady Grey-Thompson, are actually given legal enforcement status, years after they were proposed. We can begin by addressing the physical well-being of this nation. There need be no massive new bureaucracies. Using existing organisations, centralising policy and using the office for health promotion would be a game-changer.
If the noble Earl, Lord Howe, is a supporter of the levelling-up agenda, and I am pretty sure that he is a strong supporter, how better to make his mark than by supporting this amendment? It goes right to the heart of those government policies. If you are going to level up, level up at the start and make sure that we have an active nation.
Baroness Walmsley (LD)
My Lords, I regret that I cannot follow the edict of that late, great Liberal Democrat, Nicholas Parsons, and speak for only one minute. The Committee knows that it is my habit to speak very briefly, but unfortunately I cannot do that on this occasion, although I will do my best. It is my duty as a member of the APPGs for health, obesity and a fit and healthy childhood to scrutinise this legislation and the large raft of amendments that have been made to it.
The intention of Clause 144 is of course to reduce the rise in childhood obesity, an objective with which we all agree. An early attempt to do this via legislation was the UK soft drinks industry levy, the so-called sugar tax, which was introduced in 2018. Before the levy was introduced, it had already resulted in over 50% of manufacturers reducing the sugar content of their products after it was announced in March 2016, the equivalent of 45 million kilograms of sugar every year. That was the intention: to reformulate, not to raise tax. Since then it has continued to be highly effective in encouraging reformulation. In the 12 months following its introduction, the consumption of soft drinks rose by 7.7% as people chose healthier options, so neither the food industry nor the TV advertising industry suffered at all.
Baroness Merron (Lab)
My Lords, today we have had a very extensive and impassioned debate, and we have heard in your Lordships’ House challenge and counter-challenge. I will seek to pick up the main broad points that we have heard about. What we cannot turn away from is the fact that two in five children in England are above a healthy weight when they leave primary school, while last year saw the fastest increase in childhood obesity on record.
Children with obesity are five times more likely to become adults with obesity, increasing the risk of developing conditions including type 2 diabetes, cancer, and heart and liver disease. As we heard from the noble Lord, Lord Krebs, the incidence of this is not equally spread. As we observe from the levelling-up White Paper, there is a huge need to tackle poor diet and obesity in order to reduce health inequalities and the damage that obesity causes, both in childhood and adulthood.
I welcome the provisions in the Bill that help people to make informed choices about what they eat and drink, but this should not be misunderstood. Choice can only really be choice if there is no distortion, and if those making the choices have the information they need. They need to be able to make decisions and be supported in doing that. When I look at the Government’s analysis, which suggests that a watershed on TV and online that introduced restrictions to prohibit advertisements for products high in fat, sugar or salt being shown before 9 pm could lead to 20,000 fewer obese children, I think that this is something that should not be dismissed. This is about not only the direct outcome but shifting the environment, so that we can manage the challenges we all face in supporting good health.
Baroness Penn (Con)
My Lords, this has been an important and engaging debate. There has been consensus that childhood obesity is one of the biggest health problems this nation faces—and maybe not just a health problem. We have also talked about the impact of inequality and broader life chances. The latest national child measurement programme data, from 2020-21, showed that some 40% of children leaving primary schools in England were overweight or living with obesity.
That is why, as part of our ambition to halve childhood obesity by 2030, it is imperative that we reduce children’s exposure to less healthy food and drink product advertising on TV and online. To be clear, the Government know that this is not a silver bullet, and this action alone will not solve the problem; it is part of a multifaceted plan. I can reassure my noble friend Lord Grade and the noble Baroness, Lady Walmsley, that this includes working with manufacturers on reformulation and to produce healthier food. Indeed, we are clear that products that are reformulated to pass the MPM will be able to be advertised, and we hope this provides a motivation for brands to do so. Obesity is a complex problem that builds over time through frequent excessive calorie consumption. Through this one action, as part of a wider programme, we estimate that we can remove up to 7.2 billion calories from children’s diets per year in the UK.
Turning to specific amendments and looking first at what should be covered by these priorities, I will speak to Amendments 253B, 254A, 254B, 247A, 249ZA, 249ZB, 250B, 252ZA, 252ZB, 248, 248A, and 251. We believe that the current approach to defining food that is less healthy provides sufficient legal certainty and is consistent with other healthy weight restrictions and policies. For example, it is used in a similar way in the promotions and placement restrictions for less healthy food and drink, which were made law last December.
It is important to provide detail in the Bill on the two-step criteria to determine what is less healthy, in order to ensure that the primary legislation is sufficiently clear. The nutrient profiling model has been used by Ofcom since 2007 to determine what can be advertised around child-specific programming on TV, although outside the statutory framework. The technical guidance of January 2011, which provides the steps to calculate the nutrient profiling model score, is an existing document that has been specifically developed and used to support industry since it was published. Its substance is not changeable at the discretion of the Secretary of State and, as an additional safeguard, the Government have already amended Schedule 17 to include a statutory duty to consult in the event that a change is proposed to the meaning of “the relevant guidance”.
I can assure noble Lords that the current approach would allow healthier products, which may contain fruit, nuts and seeds or be a source of protein, to not be caught by restrictions, while still restricting those which are less healthy overall. However, that will also need to be underpinned by secondary legislation, which the Government will be consulting on shortly, and the points your Lordships have raised will be considered as part of this.
The proposed amendment to permit the advertising of confectionery of less than 200 calories could mean that adverts for chocolate confectionery products could still be permitted on TV before the watershed and online, given the likely difficulty in determining portion sizes in such adverts. This would undermine the policy and send out the wrong message to consumers and producers.
In response to Amendment 244, we do not believe it is necessary to consult on whether alcohol should be included as a “less healthy” product, as these provisions are aimed at reducing the exposure of children to less healthy food and drink advertising. Unlike alcohol, less healthy food and drink products are not age-restricted at the point of purchase. In addition, as noble Lords have noted, there are other measures in place that address the advertising of alcohol.
Turning to Amendments 247, 250A and 253A, I assure noble Lords that brand advertising is out of scope of the restrictions, as these clauses focus on identifiable products. Including an exemption in the Bill for something that is already out of scope would have no legal effect and therefore may cause undue confusion.
I turn to Amendments 248B, 251A and 253C on who will be covered by these proposals. We intend to define food and drink SMEs as businesses with 249 employees or fewer, as outlined in our consultation response. By doing this, the Government want to ensure consistency with other similar definitions, such as for out-of-home calorie labelling. We will consult on the secondary legislation defining food and drink SMEs shortly, but this approach will allow Ministers to act promptly to change the definition of food or drink SMEs in future, should it be necessary.
I turn to platform liability and other questions regarding the watershed hours in Amendments 250ZA, 253ZA, 254A, 255A, 255B, 257B and 253AA. Platform liability is incredibly important. During the 2020 consultation, we considered whether other actors in the online advertising supply chain should have responsibility for breaches alongside advertisers, but concluded that this was not the right place for this broader issue, given the far-reaching impacts for the industry. However, I reassure my noble friend Lady Stowell, the noble Lord, Lord Clement-Jones, and many others that the Government intend to consider platform liability as part of the wider online advertising programme.
On the question of when these restrictions should apply, Ofcom’s research—
Baroness Stowell of Beeston (Con)
I am so sorry to interrupt my noble friend, but can she please give us a timescale for that?
Baroness Penn (Con)
I believe it is being conducted this year, but I will check that and come back to my noble friend and all other Members of the Committee, because I know there is significant concern on that point.
On the timing of the restrictions on television, Ofcom research suggests that children’s viewing peaks in the hours after school, with the largest number of child viewers concentrated between 6 pm and 9 pm. In this period, half of children’s viewing takes place during adult commercial programming. We do not therefore believe that introducing advertising restrictions only on the weekend is sufficient to meet our policy objectives.
We are committed to ensuring that businesses are supported now and when the regime comes into force. We will, of course, consult on the secondary legislation and guidance, which should give stakeholders more clarity. However, in response to Amendments 245, 255, 256, 257 and 317, we believe that the overall policy direction has been set out effectively and we do not think that there is a need to add the kind of gap between publication of final guidance and implementation, as proposed by my noble friend’s amendment.
In response to Amendments 249A, 252A and 257A, I can assure your Lordships that we will conduct a post-implementation review five years after implementation. This is intended to be based on the variables set out in the impact assessment, published in June 2021. However, the Government believe that further tying down of the criteria at this stage would be counterproductive. We will also use this opportunity to look at any displacement of advertising to other media not covered by the restrictions, such as outdoor advertising.
However, in response to Amendment 244A, there is insufficient evidence at this stage of the influence of further national advertising restrictions in other media on calorie consumption in children, which is why these restrictions focus on TV and online only. We would also advise against adding a sunset clause, as it would pre-empt this evaluative work and could undermine compliance. We have heard quite a bit from noble Lords about the need for certainty on the Government’s approach in this area. I say to my noble friend that a sunset clause on these regulations would undermine that case.
Lord Grade of Yarmouth (Con)
Before my noble friend sits down, can she give the House some sense of what the Government would regard as success as a result of the advertising ban? Is there some target of reduction that they expect to see at the end of five years as a result of this ridiculous ban?
Baroness Penn (Con)
I believe that I said that the criteria for measuring the success of this policy have been set out in the impact assessment. I will happily send that to my noble friend. I do not think that it is a finalised list. We have discussed in this Committee the difficulty of assessing success, so we would not want to preclude new research or information that would help us to assess our approach better in future.
My noble friend was right in anticipating that I was about to conclude. This has been a substantial group of amendments—
Lord Lansley (Con)
Before my noble friend sits down, can I ask her about the nutrient profiling technical guidance? What is the timetable and process for its review?
Baroness Penn (Con)
My noble friend was of course eagle-eared—I am mixing a metaphor—in that I did not address his point on that. I can tell him that, in 2016, the Government commissioned Public Health England to review the UK NPM algorithm that has been in place since 2004, to ensure that it aligns with dietary recommendations from the Scientific Advisory Committee on Nutrition, particularly for free sugars and fibre. I am afraid to say that my next line is that the outcome of that review will be published in due course.
Lord Clement-Jones (LD)
I want to follow up on that question. It was in 2018 that the consultation took place; is the Minister aware of that? We are now four years down the track and nothing has come out.
Baroness Penn (Con)
The date that I have for the commissioning of the work is 2016, which means that we are even further down the road on that piece of work. I am well aware of the time that has passed since then. I will undertake to see if I can provide any update beyond “in due course”, but I do not want to raise noble Lords’ hopes too far on that.
I hope that I have been able to provide noble Lords across the Chamber with assurances as to our plans and, therefore, that noble Lords will feel able not to press their amendments.
Baroness Finlay of Llandaff (CB)
My Lords, we are three hours and 49 amendments on and I am sure that everyone in the House will join me in saying that we have enjoyed hearing from the noble Baroness the Minister now that she is back in Committee with us.
It is perhaps a crumb of comfort to those who have been worried about advertising and the outcomes that Norway’s ban since 2013 has shown that other products moved into the space and there was not a total loss of income. Quebec has had the least rise in childhood obesity in Canada since its ban. I will not comment any more on that other than to say that we have all recognised that obesity is a serious problem that needs to be addressed. The Wild West digital space of the platforms needs to be addressed quite urgently and will be more difficult, but I hope that this will not deter the Government from their action to tackle obesity.
For my amendment, I just remind the House that alcohol adverts are tempting young people into early consumption. It is a highly obesogenic and highly addictive substance, which is why my amendment was there. I am disappointed that the Government are not even considering incorporating it in the list of substances, but I beg leave to withdraw my amendment.
Baroness Penn
“(1A) OFCOM must ensure that the prohibition provided for by the first standards set by virtue of subsection (1) takes effect from the beginning of 1 January 2023.”Member’s explanatory statement
This amendment ensures that the watershed on television advertising of unhealthy food and drink will not apply until 1 January 2023.
Baroness Penn
“(4A) The Secretary of State may, before the date specified in subsection (1A), amend that subsection so as to substitute a later date for the date that is for the time being specified there.”Member’s explanatory statement
This amendment allows the Secretary of State to defer beyond 1 January 2023 the date when the watershed on television advertising of unhealthy food and drink begins to apply.
Baroness Penn
Member’s explanatory statement
This amendment ensures that the watershed on advertising of unhealthy food and drink in on-demand programme services will not apply until 1 January 2023.
Baroness Penn
“(5A) The Secretary of State may, before the date specified in subsection (1), amend that subsection so as to substitute a later date for the date that is for the time being specified there.” Member’s explanatory statement
This amendment allows the Secretary of State to defer beyond 1 January 2023 the date when the watershed on advertising of unhealthy food and drink in on-demand programme services begins to apply.
Baroness Penn
Member’s explanatory statement
This amendment ensures that the prohibition on online advertising of unhealthy food and drink will not apply until 1 January 2023.
Baroness Penn
“(6A) The Secretary of State may, before the date specified in subsection (1)—(a) amend that subsection so as to substitute a later date for the date that is for the time being specified there, and(b) make corresponding amendments to the references to that date in subsections (10) and (11).”Member’s explanatory statement
This amendment allows the Secretary of State to defer beyond 1 January 2023 the date when the prohibition on online advertising of unhealthy food and drink begins to apply.
“(3) The Secretary of State must, no later than one year after this Act is passed—(a) publish a report on alcohol labelling, considering the question of whether to require the following on alcohol product labels—(i) the Chief Medical Officers’ low risk drinking guidelines,(ii) a warning that is intended to inform the public of the danger of alcohol consumption,(iii) a warning that is intended to inform the public of the danger of alcohol consumption when pregnant,(iv) a warning that is intended to inform the public of the direct link between alcohol and cancer, and(v) a full list of ingredients and nutritional information; and(b) lay the report before Parliament.(4) A Minister of the Crown must arrange to make a statement to each House of Parliament setting out in detail any steps which will be taken to implement the findings of the report prepared under subsection (3).”Member’s explanatory statement
This probing amendment requires the Secretary of State to report on the alcohol labelling consultation.
Baroness Finlay of Llandaff (CB)
My Lords, these amendments also relate to alcohol. Amendment 259 is about alcohol labelling to prevent harm and Amendment 296 concerns dealing with the harm when someone has become addicted to alcohol. I shall cut what I was going to say dramatically because of the time spent on other amendments earlier today.
Labelling is the way we inform the public of what they are getting. About 70 people die every day from alcohol-related causes in the UK. Alcohol is responsible for 12,000 cancers every year. Covid has compounded this harm, with deaths from alcohol now at the highest rate since records began. There is more information on a carton of orange juice than a bottle of beer. Awareness of the health risks of alcohol is very low. Just one in five people can identify the low-risk drinking guidelines and less than one-quarter know that alcohol can cause breast cancer. Alcohol is linked to the worst pregnancy outcomes and serious lifelong impacts for a baby, yet one in three people are unaware that it is not safe to drink in pregnancy. It has been estimated that 41% of pregnant women consume alcohol.
Alcoholic drinks are also extremely calorific, as we have heard. We have already spoken about the number of calories those who drink take in and I will not go there again, but calories need to be included on the labelling. People have a right to know what they are consuming, but they cannot make informed choices about their drinking. Voluntary inclusion of information on labels has not worked and has been very low: 70% of labels do not include the CMO’s low-risk drinking guidelines, over 70% do not list ingredients and only 7% display nutritional information, including calories. The public want the information. In July 2020, the Government agreed to consult on requiring calories and drinking guidelines to be on alcohol labels, yet here we are all this time later and we are still waiting for the consultation to even be launched.
Amendment 296 refers to treatment services. Alcohol addiction is a complex problem, with many factors driving and perpetuating harmful drinking. People who are trapped by alcohol dependence need help to move towards recovery. The benefits for the health service are reductions in emergency service call-outs and unnecessary hospital admissions, and the benefit for everyone is a reduction in avoidable deaths. These are the outcomes by which the effectiveness of any measure can be assessed.
Many people who require alcohol dependency treatment also have problems with other substance abuse, mental health, domestic abuse and homelessness. It is alarming that, during the pandemic, only 20% of people who need help for problem drinking have been able to access it and there has been a significant and sustained increase in the rate of unplanned admissions for alcohol liver disease. Since 2012, there have been real-term funding cuts in alcohol treatment services, yet every £1 invested in alcohol treatment yields £3 in return; that rises to a return of £26 after 10 years. Only 9% of people with alcohol dependence account for 59% of in-patient alcohol-related admissions. So, a cohort of more than 54,000 people accounts for 365,000 admissions and more than 1.4 million bed days, at an estimated cost of £858 million a year. There are also significant pressures on the treatment workforce because there is a shortage of psychiatry trainees.
I hope that these amendments are self-explanatory, and that the Government will look favourably on doing something about the problem of alcohol harm. I beg to move.
Lord Scriven (LD)
My Lords, I rise to support Amendments 259 and 296 in the name of the noble Baroness, Lady Finlay of Llandaff. I speak on behalf of my noble friend Lord Shipley, who, unfortunately, cannot be here today but has added his name to those amendments.
The amendments are on the Marshalled List to push the Government to move faster on something that the public want that has now been shown to be effective, particularly alcohol labelling. A recent YouGov poll showed that 71% of the British public want to know the number of units in an alcoholic drink, 61% want to know the calorific content and 53% want to know the amount of sugar in alcohol. There is clear public support for this, so it is interesting that we have not moved faster.
Baroness Walmsley (LD)
My Lords, I have been in this House for 22 years and I have been asking for this for at least 20 of them. It really is time that the Government got on with it. At the time, I was told that most wine comes from abroad and we cannot legislate for what is put on the labels, but it cannot be impossible to put information on the shelf labels or online. If people do not know what they are putting inside their bodies, they cannot moderate it.
Lord Sentamu (CB)
My Lords, I support this amendment. I will tell a true story of a teetotal preacher who harangued his congregation that nobody should be drinking because it is dangerous, damages our health and damages everything else. “Alcohol should be banned,” he said, “and the best thing to do is go and drown it in the river.” Unwittingly, he then said, “Our final hymn is ‘Shall We Gather at the River?’ The beautiful, the beautiful river.” He did not see the contradiction in what he said. This amendment is full of clarity, clarifying areas that need to be put fairly clearly. The obligation that it puts on the Secretary of State and, incidentally, all of us is very clear. Because of the real danger in what overdrinking does to a lot of people, I say: no, we shall not gather at that river, that beautiful, beautiful river.
Baroness Merron (Lab)
My Lords, it is a pleasure to follow the noble and right reverend Lord, who reminds us of our obligations to assist with alcohol-related ill health. I thank the noble Baroness, Lady Finlay, and the noble Lord, Lord Shipley, for putting these amendments before your Lordships’ House today. The first is a probing amendment about the need to report on the consultation on alcohol labelling. It is absolutely right to raise this: consumers have a right to know what is in their drinks, to make informed choices about what and how much they drink. Currently there are no legal requirements for alcohol products to include health warnings, drinking guidelines, calorie information or even ingredients. Research by the Alcohol Health Alliance found that over 70% of products did not include the low-risk drinking guidelines, and only 7% displayed full nutritional information including calories. I certainly add my voice to welcoming the forthcoming consultation on alcohol calorie labelling. When can we expect to see this, and what is the reason for the amount of time that it has taken to bring it forward?
Amendment 296 requires the Secretary of State to make a five-yearly statement on the cost efficacy of alcohol services. As we know, rigorous impact evaluation is absolutely key to good policy-making and improving the lives of those who use alcohol services. At present, the Government cannot say that they are meeting their responsibility to tackle alcohol harm with the requisite financial commitment and in the right places. Perhaps the Minister will tell your Lordships’ House what evaluation measures are already in place.
Of course, the background to all this is that, since 2012, there have been real-terms funding cuts to alcohol services of over £100 million. Pre pandemic, only one in five dependent drinkers was believed to be in treatment, leaving a shocking four out of five without help. The pandemic has only worsened the situation. I hope that the Minister will agree that there is a need to do better to ensure that we know how policies and services help or hinder the treatment of problem drinking, in order that efforts and resources can be targeted to where they work best.
Earl Howe (Con)
My Lords, I pay tribute to the noble Baroness, Lady Finlay, for her work as chair of the Commission on Alcohol Harm. I thank her for this opportunity to set out the current state of play on the Government’s alcohol policy. I am the first to acknowledge the seriousness of the harms caused by the consumption of alcohol, which she pointed out.
Effective alcohol labelling is an important part of the Government’s overall work on reducing alcohol harm. I am pleased to tell the noble Baroness that the legal powers available to the Government are already sufficient to enable us to consult and report on alcohol labelling. The kind of power proposed in her probing amendment is highly prescriptive, and, from a purely practical point of view, would not allow for sufficient flexibility in the consultation process, which could make the process less effective.
As she knows, as part of the Government’s Tackling Obesity strategy, published in July 2020, the Government committed to consult on whether mandatory calorie labelling should be introduced on all pre-packed alcohol as well as alcoholic drinks sold in the out-of-home sector. I repeat that commitment today, and, as part of our public consultation, we will also seek views on whether provision of the UK Chief Medical Officers’ Low Risk Drinking Guidelines, which includes a warning on drinking during pregnancy, should be mandatory or continue on a voluntary basis. The noble Baroness, Lady Merron, asked when we might expect that consultation to be forthcoming. I am afraid I can say no more than “in due course” at this stage, which I realise is not wholly enlightening, but it is as far as I can go at the moment.
Turning to Amendment 296, which proposes additional reporting and government statements, we do not think a new reporting requirement is necessary. The Office for Health Improvement and Disparities already publishes annual data on estimated numbers of alcohol-dependent adults within local authorities in England. Health commissioners can use this data to estimate local need and appropriately plan their alcohol treatment services. Outcomes for local authority-funded alcohol treatment services are already published at local and national level via the national drug treatment monitoring system. The Office for Health Improvement and Disparities also provides a number of data tools to enable local areas to compare their performance against other areas and nationally, including the public health outcomes framework, local alcohol profiles for England and the spend and outcomes tool.
On funding, local authorities are currently required to report on their spend on alcohol services annually to the Department for Levelling Up, Housing and Communities. Through the “why invest?” online guidance, the Office for Health Improvement and Disparities already produces data and information on the return on investment for alcohol and drug treatment. The guidance includes cost savings data on treatment interventions in primary and secondary care and on specialist and young people’s treatment services. There is a strong programme under way to address alcohol-related health harms and their impact on life chances, and to reduce the associated inequalities which the noble Baroness emphasised, including an ambitious programme to establish specialist alcohol care teams in hospitals and to support children of alcohol-dependent parents.
Throughout the Covid-19 outbreak, drug and alcohol treatment providers continued to support and treat people misusing drugs and alcohol. OHID supports local authorities in this work by providing advice, guidance and data. OHID is developing comprehensive UK guidelines for the clinical management of harmful drinking and alcohol dependence. These aim to develop a clear consensus on good practice and to improve the quality of service provision. The work is expected to be completed later this year.
Finally, we are currently developing a new commissioning standard for drug and alcohol treatment which aims to increase the transparency and accountability of local authorities on how funding is spent. It will include requirements to commission services—
Lord Sentamu (CB)
I am sorry to disturb the Minister in mid-flow. He described this amendment as prescriptive. Seat belts became prescriptive, and most people now wear their seatbelt. There was no question of an in-between. Smoking was another, and the effect has been to improve our public life. Without clarity—and we still will not have options—how will the Government achieve what wearing seatbelts and not smoking have achieved in terms of health? Alcohol needs to have similar treatment.
Earl Howe (Con)
The noble and right reverend Lord makes an extremely cogent set of points. I criticised Amendment 259 only on the grounds that it was overprescriptive. Surely, what we want in any consultation is a broad enough question to put to the public and those who have expertise in this area. If we make it too narrow—I said “overprescriptive” rather than “prescriptive”—we are in danger of introducing a lack of flexibility. That was my only point there.
I was just mentioning the development of a new commissioning standard. It will include requirements to commission services to meet a wide range of individual needs, and services will be monitored against these. I hope that information provides the noble Baroness and the Committee with a useful update on where we are with this important agenda and will enable her to feel reasonably comfortable in withdrawing her amendment.
Baroness Finlay of Llandaff (CB)
I am most grateful to the Minister, and particularly to the noble and right reverend Lord, Lord Sentamu, for pushing on the point of whether the amendment was overprescriptive or adequately prescriptive. Given that, and the rather disappointing remark that the consultation will happen “in due course”, I will withdraw my amendment but am minded to return to something like it on Report if we do not have even a provisional date for when the consultation might start. We seem to have been waiting for it to start for a long time. With that, I beg leave to withdraw the amendment.
Lord Hunt of Kings Heath
“Regulation of the public display of imported cadavers
(1) The Human Tissue Act 2004 is amended as follows.(2) In subsections (5)(a), (6)(a) and (6)(b) of section 1 (authorisation of activities for scheduled purposes) after “imported”, in each place it occurs, insert “other than for the purpose of public display”.”Member’s explanatory statement
This amendment would ensure that imported bodies for display would need the same consent requirements as bodies sourced from within the UK.
Lord Hunt of Kings Heath (Lab)
My Lords, in moving Amendment 265 I will also speak to Amendment 282. I am glad to have the support of the noble Lords, Lord Ribeiro and Lord Alton, and the noble Baronesses, Lady Finlay and Lady Northover, for our endeavours.
Article 3(2) of the Universal Declaration on Combating and Preventing Forced Organ Harvesting states:
“The killing of vulnerable prisoners for the purpose of harvesting and selling their organs for transplant is an egregious and intolerable violation of the fundamental right to life.”
My two amendments seek to prevent UK citizens’ complicity in forced organ harvesting by amending the Human Tissue Act to ensure that UK citizens cannot travel to countries such as China for organ transplantation and to put a stop to the dreadful travelling circus of body exhibitions that sources deceased bodies from China.
As noble Lords know, I come from Birmingham, where in 2018 an exhibition called Real Bodies by Imagine Exhibitions visited the National Exhibition Centre. It consisted of real corpses and body parts that had gone through a process of plastination, whereby silicone plastic is injected into the body tissue to create real-life mannequins or plastinated bodies. The exhibit advertised it as using
“real human specimens that have been respectfully preserved to explore the complex inner workings of the human form in a refreshing and thought-provoking style.”
But those deceased human bodies and body parts are unclaimed bodies with no identity documents or consent, sourced from Dalian Hoffen Bio-Technique in Dalian, China. Notably, Dalian labour lamp from 1999 to 2013 was notorious for its severe torturing of Falun Gong practitioners, as the noble Lord, Lord Alton, has reminded the House on many occasions.
The commercial exploitation of body parts in all its forms is surely unethical and unsavoury, but when it is combined with mass killings by an authoritarian state, we cannot stand by and do nothing. In 2019, the China Tribunal, led by Sir Geoffrey Nice QC, stated:
“The Tribunal’s members are certain—unanimously, and sure beyond reasonable doubt—that in China forced organ harvesting from prisoners of conscience has been practiced for a substantial period of time involving a very substantial number of victims.”
Most recently, further evidence was heard during the course of the Uyghur Tribunal, including from Sayragul Sauytbay, who testified during the June hearings that she discovered medical files detailing Uighur detainees’ blood types and results of liver tests while she was working at a Uighur camp. In June this year, 12 UN special procedure experts raised the issue of forced organ harvesting with the Chinese Government in response, as they said, to “credible information” that
“Falun Gong practitioners, Uyghurs, Tibetans, Muslims and Christians”
are being killed for their organs in China.
The recent findings of the Uyghur Tribunal, again chaired by Sir Geoffrey Nice, were profoundly disturbing. We discussed some of this in our debate on genocide only a few days ago, but I think it bears repeating. The tribunal concluded:
“Hundreds of thousands of Uyghurs—with some estimates well in excess of a million—have been detained by
Chinese
“authorities without any, or any remotely sufficient reason, and subjected to acts of unconscionable cruelty, depravity and inhumanity … Many of those detained have been tortured for no reason, by such methods as: pulling off fingernails; beating with sticks; detaining in ‘tiger chairs’ where feet and hands were locked in position for hours or days without a break; confined in containers up to the neck in cold water; and detained in cages so small that standing or lying was impossible … Detained women—and men—have been raped and subjected to extreme sexual violence … Detainees were fed with food barely sufficient to sustain life and frequently insufficient to sustain health, food that could be withheld at whim to punish or humiliate.”
This is the context in which we debate these amendments. I feel a sense of, shall I say, sadness, at least, that this is the opening day of the China Winter Olympics.
Currently, human tissue legislation in this country covers organ transplantation within the UK itself, but it does not cover British citizens travelling abroad for transplants, and British taxpayers’ money has to pay for anti-rejection medication for those people who then come back to the UK and go to the National Health Service, regardless of where the organ was sourced. According to the excellent NHS Blood and Transplant, between 2010 and 2020, there were 29 cases on the UK transplant registry of patients being followed up in the UK after receiving a transplant in China. This is a billion-pound business in China, using the bodies of executed prisoners—mainly prisoners of conscience.
The Human Tissue Act 2004 has strict consent and documentation requirements for human tissues sourced in the UK, but it does not restrict human tissues from abroad in this way; it is merely advisory. My amendments seek to amend the Human Tissue Act in the following ways.
First, they would prohibit a UK citizen from travelling outside the UK and receiving any controlled material for the purpose of organ transplantation when the organ donor or the organ donor’s next of kin had not provided free, informed and specific consent. Secondly, they would prohibit a UK citizen from travelling outside the UK and receiving any controlled material for the purpose of organ transplantation when a living donor or third party receives a financial gain or comparable advantage; or, if from a deceased donor, a third party receives financial gain or comparable advantage. Thirdly, it would provide for the offence in Section 32 of the Human Tissue Act 2004 to be prohibited even if the offence did not take place in the UK, if the person had a close connection to our country. Fourthly, it would provide for regulations for patient-identifiable records and an annual report on instances of UK citizens receiving transplant procedures outside the UK by NHS Blood and Transplant. Finally, it would provide for imported bodies on display to have the same consent requirements as those sourced from the UK.
Article 4 of the Universal Declaration on Combating and Preventing Forced Organ Harvesting says:
“All governments shall combat and prevent forced organ harvesting by providing for the criminalisation of certain acts and facilitate the criminal prosecution of forced organ harvesting both at the national and international levels.”
I believe we must take action internationally and in the UK to do all we can to prevent this abhorrent practice. I know from the success we had in the medicines Bill that a change in the law of this country has a much wider impact; it gives great encouragement to those brave people fighting these practices in China and globally. I very much hope the House will support this. I beg to move.
Lord Ribeiro (Con)
My Lords, I apologise for not speaking in the Second Reading debate, for reasons of ill health.
It is a pleasure to follow the noble Lord, Lord Hunt, who has set out the case against genocide most convincingly. As he said, there is a risk of repetition, as we covered so many of these issues in the Medicines and Medical Devices Bill in 2020 and in the noble Lord’s Organ Tourism and Cadavers on Display Bill only last year. I said then that the Human Tissue Act 2004 made it clear that written consent was required while the person was alive before donated bodies or body parts could be displayed.
The Government were supportive of our amendment in the Medicines and Medical Devices Bill and the noble Baroness, Lady Penn, who I am pleased to see in her place, said the Government would undertake
“to strengthen the Human Tissue Authority’s code of practice”.—[Official Report, 12/1/21; col. 705.]
The noble Lord, Lord Bethell, who was here earlier, stated in summing up that the new code laid before Parliament in June 2021 was clear that
“the same consent expectations should apply for imported bodies and body parts as apply for such material sourced domestically.”
In relation to exhibitions such as “Real Bodies”, which the noble Lord, Lord Hunt, mentioned and to which our Amendment 265 applies, the noble Lord, Lord Bethell, said
“it would need proof of the donor’s specific consent to be displayed publicly after death. If it failed to provide such proof”,—[Official Report, 16/7/21; cols. 2123-24.]
that would prevent a licence being issued. In relation to organs for transplantation, our Amendment 282 makes it clear that consent must be given and that there must be no evidence of genocide in the country from which the organs are sourced.
As a former president of the Royal College of Surgeons, I associate myself with the statement of December 2021 on the abuse of Uighurs in China made by the British Medical Association and the presidents of the Academy of Medical Royal Colleges—of which the Royal College of Surgeons is a member—the Royal College of Anaesthetists and the Royal College of Pathologists. It said:
“We … and the organisations we represent, in advance of the report of the Uyghur Tribunal, express our grave concern regarding the situation in China and the continuing abuse of the Uyghur population … as well as other minorities.”
The UN special rapporteurs have continued to raise concerns surrounding organ harvesting from Uighurs in China, which the evidence overwhelmingly suggests continues to this day, with hearts, livers, kidneys and corneas being the most commonly taken.
In January this year, the BMA condemned the appalling involvement of doctors in China in what was a fundamental abuse of human rights and genocide against the Uighurs. It urged Her Majesty’s Government to exert pressure on the Chinese Government to stop these inhumane practices and to allow the UN investigators into Xinjiang region. The Minister may wish to comment on the Government’s response.
I will leave your Lordships with a quote from Dr Zoe Greaves, chairman of the BMA ethics committee. She said:
“It is a doctor’s duty to help improve health and ease suffering, not to inflict it on others. The use of medical science and expertise to commit atrocities is abominable and represents an appalling antithesis to every doctor’s pledge to ‘first, do no harm’”.
Baroness Northover (LD)
My Lords, the noble Lord, Lord Hunt, has introduced Amendments 265 and 282 on this appalling subject extremely effectively and I wish to make clear the support for both those amendments from these Benches. I am also sympathetic to the different but separate Amendment 297H on tissue being retained for research, educational and audit purposes, which would bring legislation in England and Wales into line with that in Scotland and which I am sure the noble Baroness, Lady Finlay, will address shortly.
To return to the issue of human abuse—it is more than the abuse of tissue—this subject has been much debated in your Lordships’ House and I pay tribute to the noble Lords, Lord Hunt and Lord Alton, and others for making sure that we do so and for ensuring that step by step we make progress. I also pay tribute to the noble Baroness, Lady Penn, for listening and engaging, for her responsiveness when dealing with the issue and for helping to take it forward in earlier legislation. However, we all know that there is a distance to go.
As the noble Lord, Lord Hunt, said, these amendments seek to protect UK citizens from complicity in forced organ harvesting and organ trafficking. Amendment 282 prohibits UK citizens from travelling to countries for the purpose of organ transplantation. The restrictions are based on ensuring appropriate consent, with no coercion and no financial gain. If appropriate consent is not given, the country supplying the organ must have a legitimate opt-out system in place and must not be considered to be committing genocide, as now determined, as the Government have moved to agree, by resolution of the House of Commons. This will be based on an annual assessment by the Secretary of State.
We cannot say that we do not now know about forced organ harvesting. We also have the reports of both the China Tribunal and Uyghur Tribunal and much other evidence. I pay tribute to the FCDO for engaging in relation to the Uyghur Tribunal. As the noble Lord, Lord Ribeiro, mentioned, UN human rights experts have called on the Chinese Government to allow independent monitoring by international human rights bodies. If China had nothing to hide, it would accede. We have previously debated the conclusions of the China Tribunal and referred briefly to the Uyghur Tribunal. In 2020, the China Tribunal reported:
“Forced organ harvesting has been committed for years throughout China on a significant scale”.
As I said, more recently we have had the Uyghur Tribunal reports, which give a lot more detail. A number of countries, including Spain, Italy, Belgium, Norway and Israel, have already taken action to prevent organ tourism to China. We surely must do the same.
Amendment 265 aims to put a stop to real human body exhibitions being put on display in the UK when the cadavers do not have proof of identity or consent, such as those sourced from China. Again, the noble Lord, Lord Hunt, laid this out clearly. Almost a decade and a half ago, exhibitors in New York were forced to add a disclaimer stating that these bodies came from China and could have come from prisons, which clearly rubbished the idea that people had willingly donated their bodies for such displays.
Once again, certain countries, including France and Israel, and certain US cities have banned such body exhibitions from coming into their territories. We have high standards for dealing with human tissue in this country, as noble Lords are aware. Various noble Lords here today, including the noble Lord, Lord Hunt, have played a part in producing those. We need to make sure that we do not become complicit in what happens elsewhere, particularly—as we speak—in China. The noble Lord, Lord Alton, and others have made it crystal clear that we know what happens. I therefore commend these amendments.
Lord Alton of Liverpool (CB)
My Lords, I am raising my voice to speak in favour of Amendments 265 and 282. Following the noble Baroness, Lady Northover, and the noble Lords, Lord Ribeiro and Lord Hunt of Kings Heath, I hope that it demonstrates to the Minister that there is widespread concern from all parts of your Lordships’ House, especially in support of these amendments. It also gives me the chance to thank the noble Lord, Lord Hunt, for the leadership that he has given on this issue. He has been dogged and focused, insisting that we ensure that this country never becomes complicit in one of the greatest crimes committed against humanity. I join the noble Lord, Lord Ribeiro, in thanking the noble Baroness, Lady Penn—like others, I am pleased to see her back in her usual place. During the course of the earlier legislation, she was not only receptive in dealing with the issues that we raised, but organised meetings for us at the department with officials. I thought that the attitude that was shown at that time was exemplary and I am grateful to her.
It disturbs me that, although the United Kingdom signed the Council of Europe Convention against Trafficking in Human Organs, unlike 11 other European countries the United Kingdom has not ratified it. I would be grateful if the Minister, when he comes to reply, could say why we have not and whether we have any intentions of doing so. In addition, though, the signature of the United Kingdom has the following reservation:
“In accordance with the provisions of paragraph 3 of Article 10 and paragraph 1 of Article 30 of the Convention, the Government of the United Kingdom reserves the right not to apply the jurisdiction rules laid down in paragraph 1.d and e of Article 10 of the Convention.”
Given all that we now know and what has been said in your Lordships’ House this afternoon, I wonder whether we are going to persist with that reservation. The reservation means that the United Kingdom does not have to take legislative or other measures to establish jurisdiction over any offence established in accordance with the convention when the offence is committed by a UK national or a habitual resident of the United Kingdom, unless it is within our own territory. Therefore, in short, the reservation means that even if it were to be ratified, it would not prohibit citizens of the United Kingdom from partaking in unethical organ tourism.
Let us not forget why the Human Tissue Act was created in the first place. Thousands of families, some in my former constituency in the city of Liverpool, had devastatingly found their deceased family members, including children, had had their body parts and organs removed and kept in National Health Service facilities without consent. The Liverpool Alder Hey scandal created a public outcry and it was our parliamentary duty to respond and take appropriate legislative action, as we did.
Today, throughout China, forced organ harvesting of prisoners of conscience is taking place. What legislative action are we going to take concerning that? The predominant victims have been Falun Gong practitioners, the Buddhist spiritual meditation group that, at its peak in 1999, had an estimated 100 million adherents in China. The former CCP leader, Jiang Zemin, set up the 610 Office and gave the order to—his word—eradicate Falun Gong. It is believed by many experts that, while young Falun Gong organs gradually became less available over the years, the CCP—the Chinese Communist Party—began to also target Uighurs, as we have heard this afternoon, for forced organ harvesting, with the same torture methods, blood tests and organ scans happening in the Uighur camps as those in the Falun Gong camps. There are also some lines of evidence of Tibetans and Christians in China, referred to by the noble Lord, Lord Hunt, suffering the same fate. I should declare my interest as the vice-chair of the All-Party Parliamentary Group on Uyghurs and as a patron of the Coalition for Genocide Response.
For those who had any doubts about China’s state-sanctioned organ harvesting, it is worth noting that as early as 1994 Human Rights Watch reported that
“it has become increasingly evident that executed prisoners are the principal source of supply of body organs for medical transplantation purposes in China”,
and that
“executions are even deliberately mishandled to ensure that the prisoners are not yet dead when their organs are removed.”
Dr Enver Tohti, a Uighur doctor whom I have personally met and taken statements from, described to me that he had been required to remove organs and ordered to “cut deep and work fast” on a victim who was still alive. The theft of organs has been described as an almost perfect crime, because no one survives. Just this week Dr Tohti was interviewed by the London Evening Standard, from which I quote:
“Driven well out of town, he recalls: ‘There was a small hut and two surgeons there waiting. They said, “wait here and come around when you hear gun shots”. Time passed and I started to hear the noise of people shouting, chanting, whistles blowing, trucks running, then gun shots, many rifles shooting at the same time. So, we got in the van and came around the mountain to find 10 corpses in prisoners’ clothes with shaved heads on the left side slope of the mountains.’ He was called away from the corpses to the body of another man in civilian clothes and was told ‘that is yours’, and ordered to remove the liver and kidneys. The man was not dead. ‘I had no choice but to harvest the organs,’ he said.”
It is extraordinary, as we heard from the noble Lord, Lord Hunt, that on this day of all days, when what are now known as the “Genocide Games” are beginning in Beijing, we should be having this timely debate in your Lordships’ House. Not since 1936, when the Nazi games were held in Berlin and the world saw Hitler use the Olympics to promote his hideous ideology, and most Jewish German athletes were barred from taking part in the Games, have we seen the Olympic ideal so scandalously debased.
However, forced organ harvesting is just one of many human rights abuses taking place in China. Other noble Lords have referred to Sir Geoffrey Nice’s Uyghur Tribunal, which met here in Westminster in Church House. I sat through many of its hearings and, during our recent debate on this Bill concerning genocide and the purchasing of equipment and medical supplies from places such as Xinjiang, I heard harrowing accounts from those who gave evidence to that tribunal. Sir Geoffrey Nice QC—the prosecutor in the Milosevic trials, who knows more about these issues than probably any other living person—and his panel came to the conclusion that what is happening in Xinjiang amounts to genocide. As the noble Baroness, Lady Northover, has said, so has the House of Commons—and, indeed, so has our Foreign Secretary, Liz Truss, who has said “it is a genocide”.
Uighurs and other ethnic minorities have suffered torture, rape and forced abortion and sterilisation by the CCP, but the crime does not end there. There is a further twist to this infamy. Anonymous plastinated corpses taken from Chinese prisons have been paraded, as the noble Lord, Lord Hunt, told us earlier, in a carnival of horrors at money-making exhibitions, a final sneering insult to these victims. In 2018, after the exhibition that the noble Lord referred to, I wrote to the Times, along with Professor Jo Martin, president of the Royal College of Pathologists, and 55 others. We said:
“We believe that the legislation requires reform.”
However, I would go further—here, I agree with the noble Baroness, Lady Thornton, who it is good to see in her place—and ask why on earth we allow these things at all. There should be a complete prohibition by law.
I conclude by returning to the opening ceremony of the Beijing 2022 Winter Olympic Games. The Olympic charter states:
“Olympism seeks to create a way of life based on the joy of effort, the educational value of good example, social responsibility and respect for universal fundamental ethical principles.”
The irony of that is beyond belief. This simply should not be acceptable, at least to those corporations and companies that are sponsoring the Games in Beijing, such as Coca-Cola. The China Tribunal stated:
“Governments and any who interact in any substantial way with the”
People’s Republic of China
“should now recognise that they are, to the extent revealed above, interacting with a criminal state.”
We must do more to stop these human rights abuses. I wholeheartedly support the amendments, which are not country-specific but would serve to close the loopholes in the Human Tissue Act so that the United Kingdom could do its part in preventing collaboration in these appalling crimes.
Baroness Finlay of Llandaff (CB)
My Lords, I declare my interest as an elected member of the BMA ethics committee, which looked at these issues and was involved in producing the statement quoted earlier by the noble Lord, Lord Ribeiro. I strongly support these amendments and cannot see any reason for anyone not to. They set a basic moral standard. As the noble Lords, Lord Hunt, Lord Alton and Lord Ribeiro, and the noble Baroness, Lady Northover, have laid out, the arguments they have given us are in many ways only the tip of the iceberg. There is so much more than could be said.
Our Human Tissue Authority’s guiding principles have a code of practice which has consent, dignity, quality, honesty, and openness as key pillars. These principles should reflect not only how human tissue is sourced from within our own nation but how we treat human tissue and organs from overseas. There is overwhelming evidence now that in China, Falun Gong practitioners and Uighurs, Tibetans and house Christians are being killed on demand for their organs. There is no consent, no dignity and no transparency. Only yesterday I received a letter from a woman whose mother had been a Falun Gong practitioner, and who has been in prison and effectively disappeared. She has no idea where her mother is; she has not heard from her. That is happening all over this population.
I will not repeat the statement that has already been read out, but I just hope that the Government can see that we have a moral obligation to accept these amendments. I hope that they will do so.
Amendment 297H, in my name, is supported by the Royal College of Pathologists. Post-mortem examinations here are subject to careful legislative control and we have the Coroners (Investigations) Regulations 2013, which oversee post-mortems. When a post-mortem happens, it happens without the consent of the next of kin, of course, because there are questions around the cause of death. The coroners’ statistics for England and Wales in 2020 show that 79,400 post-mortem examinations were ordered by coroners. A fifth included histology and a quarter included toxicology samples being taken.
When the coroner’s work is complete, the tissue samples and any fluids taken—the tissue being in the form of blocks and slides—must be destroyed unless specific consent has been provided by someone in a qualifying relationship. However, consent is logistically very difficult to obtain in practice. The McCracken review of the Human Tissue Act in 2013 recommended that:
“Consideration should be given (inter alia) to reducing the scope so that microscope slide and tissue block samples and bodily products such as saliva, urine, and faeces are excluded”.
The Government accepted this recommendation, but the issue has not subsequently progressed.
There are some real difficulties with post-mortems. A post-mortem is effectively a snapshot of the deceased at the point of death. It is only by going back into the clinical records that the pathologist gets some picture of what happened pre-mortem, and many of the other factors. But at the end of the day, it is often subjective in terms of determining the likely cause of death for the report that is then signed off. In Scotland, tissue blocks and slides are deemed to be part of the clinical record and therefore do not have to be destroyed after the procurator fiscal’s investigations are complete. However, no whole organs can be retained in Scotland without explicit consent. In the light of Alder Hey, it is important to stress that point.
Changing to a system that reflects Scottish law could be beneficial because it would provide information about the cause of death if new circumstances came to light months or years after an investigation was complete. Indeed, we have recently had the case of the Farquhar family, where the evidence of long-term poisoning probably came to light many years after the person had died. Crucially, forensic deaths can be masked by natural disease processes and storage of tissues and fluids as part of the medical record would help clarify these at a later date when new information came to light. In a way, that is essential for completion of justice.
In addition, genomics research is rapidly developing, so the family may want to access the tissue later on as disease processes become more clarified. Metabolic storage disorders such as Fabry or Gaucher disease have been examples of this.
The tissue blocks from post-mortems are usually larger than the small pieces of tissue in a biopsy from a living person. That is particularly relevant where you want a piece of the heart or the brain, because a large biopsy from a living person would be impossible. There is also a third use of these tissue blocks and slides, which is as teaching material for autopsy pathologists. There is now a real shortage of teaching material, not only for pathologists who are in training but for ongoing audit of pathology processes.
So this amendment would bring the Human Tissue Act in line with the position in the Human Tissue (Scotland) Act 2006, where tissue samples as blocks and slides, but not—I stress not—organs, automatically become part of the person’s medical record after a post mortem. Explicit consent to keep them does not have to be sought from a grieving family, but it would allow justice in the long term to be pursued if necessary, and it would allow better development of autopsy pathologists.
Lord Cormack (Con)
My Lords, I apologise for missing the first minute—but it was only the first minute—of the splendid speech of the noble Lord, Lord Hunt. I am delighted to add my support to his initiative, most splendidly supported by my noble friend Lord Ribeiro. We entered this House on the very same day and it was very good to hear what he had to say. Of course, the noble Baronesses, Lady Northover and Lady Finlay, and the noble Lord, Lord Alton, all have an impeccable record on these matters.
Earl Howe (Con)
I hope that my noble friend will forgive me but, as he was not here at the beginning of the debate, strictly speaking it is not permitted for him to speak. If he could make his remarks brief, I am sure that would be appropriate; I do not want to stop him mid-flow.
Lord Cormack (Con)
Well, I certainly was going to make my remarks brief, and I am sorry that I was detained for one minute. I just want to give my wholehearted support to these amendments. There is no more despicable trade than the trade in human organs and no more despicable practices than those that are going on in China at the moment, simultaneously with the opening of the shameful Games. I very much hope that my noble friend, who so politely interrupted me, will be able to give us a very supportive statement when he comes to wind up this debate.
Lord Sentamu (CB)
My Lords, I also stand to support Amendments 265 and 282. I am grateful to the noble Lords, Lord Hunt, Lord Ribeiro and Lord Alton, and the noble Baronesses, Lady Northover and Lady Finlay.
I declare an interest as, quite a number of years ago now, I was one of those who signed up to say that, at the moment of death, all my organs will be left to the National Health Service for any scientific work that may be required. I carry a card, but it says that my organs should be kept in this country and not exported anywhere else, because I have no trust that they would not be used for purposes for which they were not intended.
When I was doing philosophy in Cambridge, Professor Williams posed a question. He said “Surprising things happen—that they are no longer surprising. Comment.” Noble Lords who have done philosophy will know how complicated that question is.
In Uganda, Idi Amin was known for the people that he feared most. He would cut off their heads, put them in the fridge, and put their organs in another fridge. People did not believe this, and he was overthrown. His treating of the human body like something you simply dispose of was horrific. No wonder a lot of people died under that terrible Government of his when he was in power. What we are being asked is: should the standards in this country also be somehow given over to other countries so that they can learn? But we too have got to be very careful that our standards are as high as the tissue Act says.
We live in a world that is so perilous at times, and where some people may disappear and you never see them. In Uganda, quite a number of leading people disappeared and, up to today, we do not know where they went. The thing is, they would be put in drums of acid and their bodies would be dissolved. Surprising things happen—that they are no longer surprising. May we be so vigilant. These two amendments do the job, so I hope that the Minister when he responds will have heard the urgency in the speeches, but, most of all, in the amendments themselves.
Baroness Thornton (Lab)
My Lords, can I say how much I agree with my noble friend Lord Hunt, the noble Baroness, Lady Northover, and the noble Lords, Lord Ribeiro and Lord Alton? They know I have been with them on this journey throughout. I probably would go a bit further than my noble friend Lord Hunt’s Amendment 265, because I believe that this country should follow the example of France and ban the exhibition of plasticised cadavers and human body parts.
In 2019, we had an OQ on this, which many noble Lords here today took part in. I said at that time that there is an
“ethical issue at play here”
and that it seemed that the businesses that had
“the exhibitions which use plasticised cadavers and foetuses for supposedly educational purposes could use modern materials and production to create the same exhibits. That begs the question: why use cadavers and human body parts at all? If the answer is that people want to see such things and will pay to do so, I remind noble Lords that people used to flock … to see public executions until 1868.”
It is an ethical issue. I am afraid that the noble Baroness answering that debate at the time said that
“the ethical position is not one for government.”—[Official Report, 27/2/21; cols. 228-29.]
Well, I would say that this debate shows that the ethical position is absolutely one for government.
Earl Howe (Con)
My Lords, I begin by thanking the noble Lord, Lord Hunt of Kings Heath, and many other noble Lords for bringing these amendments relating to these important and sensitive issues to the Committee today.
Amendment 265 seeks to prohibit the use of imported bodies or parts of bodies for the purpose of public display without the specific consent of the donor. The Government share the concern motivating Amendment 265 that bodies may in the past have been displayed in public exhibitions without the donors’ consent. We therefore committed in this House, during the passage of the Medicines and Medical Devices Act, to address this concern, and have since worked closely with the Human Tissue Authority to strengthen its code of practice on public display, which was laid before Parliament last July. The code now guarantees that robust assurances on consent for all donor bodies, including imported bodies, are fully received, assessed and recorded, before the authority issues any licence for public display. The Government therefore do not believe that this amendment is necessary.
Lord Ribeiro (Con)
My Lords, would it be possible to collect data to substantiate what my noble friend has said about the reduction in people going overseas to get organs for transplantation? Can we get some figures to be absolutely clear that the numbers are reducing and not continuing, as some of us fear?
Earl Howe (Con)
I expect it is possible to capture some data but, of course, there will always be cases of people going overseas who are invisible to those who collect data, and we can never guard against that.
Lord Alton of Liverpool (CB)
I will follow the noble Lord’s point. Even though it may be impossible to collect credible data on people leaving who are not going to say they are going overseas to collect organs, when they return—as the noble Lord, Lord Hunt, pointed out—many of them will receive treatment and care inside the National Health Service as a result of having an organ that has not come from within the United Kingdom. That is data that could surely be collected.
Earl Howe (Con)
The noble Lord makes a very good point and, if I may, I will investigate the feasibility of doing that and what systems are in place to capture that kind of data.
I am grateful to the noble Baroness, Lady Finlay, for her Amendment 297H, which covers the retention and use of tissues after coroner post-mortem examinations. I of course share the commitment to promoting education and research. However, I am afraid I do not believe that this amendment represents the right approach to supporting this aim. I appreciate that the noble Baroness emphasised that she was referring to blocks, slides and urine samples; the amendment refers to tissue samples. The advice I have received is that it is important that we remain committed to the principle that consent is fundamental to how we treat the remains of the deceased. I remember the passage of the Human Tissue Act; the noble Lord, Lord Alton, was absolutely right in what he said earlier about that. All of us should have a choice about what happens to our bodies after we die, and if we cannot exercise that choice, those close to us should be able to.
Post-mortems can already be distressing to the families of the deceased. Denying them a say as to what happens to the remains of their loved ones will compound that distress—often unnecessarily, as many of the retained tissues will never be put to use.
There are three other defects, as I see them, in the amendment; I am concerned that it would allow tissues to be stored indefinitely; it would allow for an overly broad interpretation of what constitutes a tissue sample —that is, in fact, my main concern; and it does not address the considerable challenge of how to effectively catalogue, audit or access the large amount of new material that would have to be retained.
Having said that, I believe that under the current consent-based model we can and should do more to encourage the active identification of tissues that could serve an important purpose, and to communicate the significance of retaining this tissue to the deceased’s family when seeking their consent. I understand the force of what the noble Baroness is trying to achieve and there may be different ways of doing that.
While I am grateful to noble Lords for their amendments in this area, I respectfully ask them to withdraw or not press them at this stage.
Baroness Finlay of Llandaff (CB)
Will the Minister undertake that the Government ask the Scottish Government about their experience of retaining tissue blocks and slides? Only tissue blocks and slides—not, I stress, organs—are being retained as part of the clinical record, so that we have some information about problems that have arisen. Also, given that the Government accepted the McCracken review, how do they then intend to implement that acceptance? If you accept the need to have consent, there has to be a process by which consent is obtained. You cannot ask for consent prior to the post-mortem because the post-mortem is a judicial process.
Earl Howe (Con)
I noted that the amendment tabled by the noble Baroness is closely modelled on the current law in Scotland. Because of that, it fails to account for the significant differences between how Scotland, and England, Wales and Northern Ireland, regulate the storage and use of human tissue. In England, Wales and Northern Ireland, that storage and use is regulated by the Human Tissue Authority. In Scotland, there is no equivalent body and the amendment is silent as to what impact it would have on the authority, especially given the challenges involved in managing the great quantity of tissue that would be retained.
I am aware that many Scots share my concerns about consent for retaining tissue. A recent petition to the Scottish Government highlighted the anguish faced by a grieving mother on learning that she did not have the choice to have some of her child’s remains returned to her. She was upset at how long it took for those remains even to be located, so although this amendment would apply only to adults the same kind of issues would apply.
Lord Hunt of Kings Heath (Lab)
My Lords, it has been a very good debate. First, I say to the noble Baroness, Lady Finlay, that I sympathise with her Amendment 297H, but clearly it is a sensitive area. The noble Lord, Lord Alton, mentioned Alder Hey; I had ministerial responsibility at the time, and it was very traumatic meeting the parents of children who, in the end, had body parts buried up to three times or more because of the dreadful way in which both the hospital and university managed the situation, as well as the pathologist himself. On the other hand, the reasons put forward by the noble Baroness seem very persuasive, and I hope there will be a continuing debate on this with the Government.
As far as my two amendments are concerned, I am very grateful to the noble Lord, Lord Cormack, the noble and right reverend Lord, Lord Sentamu, the noble Baroness, Lady Finlay, and my noble friend Lady Thornton for their support. As the noble Lord, Lord Ribeiro, said, the concession given by the noble Baroness, Lady Penn, on behalf of the Government during discussions on the then Medicines and Medical Devices Bill was highly significant both for this country and for the message it gave globally. The debate today, and the amendments, are as much about global messages as UK legislation.
As the noble Baroness, Lady Northover, said, we cannot say that we do not know; we do know. The noble Lord, Lord Alton, sat through many of the harrowing sessions of the Uyghur Tribunal and the evidence—before a hard-headed panel—is absolutely convincing. There can be no doubt that this is an abhorrent practice and, as my noble friend Lady Thornton said, it may not be on the same scale but these wretched exhibitions that take place are a product of those abhorrent practices. She has persuaded me that my amendment is rather soft and needs to be hardened up. I look forward to her helping me to get the wording right.
The noble Earl, Lord Howe, referred to the HTA code of practice; I think we need to go further than that. On organ tourism, I will obviously study very carefully the issues that he raised about my amendments, but we have the figures from NHS Blood and Transplant: I think 29 people have come to the NHS for help following a transplant abroad, which gives us some clue as to the numbers but clearly it is not the whole picture. At the end of the day, you come back to the issue of ourselves and China. Clearly, there is huge ambiguity in our policy, whether that is to do with security, trade or human rights. Some of that ambiguity is understandable, given the scale and size of the Chinese economy—we understand that—but I do not think there is any room at all for ambiguity about this country making a strong response to these appalling practices. Having said that, I beg leave to withdraw my amendment.
Lord Hunt of Kings Heath
“Vaccine damage payments
Within 6 months of the passing of this Act, the Secretary of State must establish an independent judge led review into the operation of the Vaccine Damage Payments Act 1979 and the adequacy of payments offered to persons seriously injured, or bereaved, consequent upon vaccination against any of the specified diseases to which the Act applies.”Member’s explanatory statement
The Vaccine Damage Payment Act is now more than 40 years old and the aim of the amendment is to ensure that a judge led review takes place into the operation of the Act.
Lord Hunt of Kings Heath (Lab)
My Lords, I will also speak to Amendment 268. I indicate in advance my support for Amendment 288 in the name of the noble Baroness, Lady Cumberlege. The amendments are all linked, in a sense, in trying to find a way of ensuring that patients damaged in one way or another through the National Health Service are dealt with in the most open, transparent and sympathetic way. Each amendment tackles the issue differently but, in the end, there is a sense that we have not got it right and that we need to do very much better.
Baroness Cumberlege (Con)
My Lords, I have Amendment 288 in this group. I thank the noble Lord, Lord Hunt, for the way that he has introduced this group of amendments; he is quite right that there is a lot of synergy between them.
Before I get to my subject, as it were, I will address litigation. We have been working very hard with NHS England and others to introduce the rapid resolution and redress system—RRR—for maternity services. The damage done to babies costs a huge amount of money. It is very rare, but some of the settlements are now over £10 million per baby, so this issue really needs to be addressed. The noble Lord is right that, when litigation comes in with force, it causes enormous trouble and heartache for those involved in it. We know that, when it is based on clinical negligence, the trouble is that the learning disappears or is suffocated. If we had a system that gave rapid redress and resolution, we would learn so much more from the cases that come to court.
Amendment 288 requires the Secretary of State to bring forward proposals for a redress scheme to help those who have suffered avoidable harm linked to the three medical interventions that were examined in my Independent Medicines and Medical Devices Safety Review: hormone pregnancy tests—the most common of which is Primodos—the epilepsy drug sodium valproate and pelvic mesh, which is used to treat stress urinary incontinence and pelvic organ prolapse.
Baroness Hodgson of Abinger (Con)
My Lords, I support Amendment 268, to which I have added my name, and thank the noble Lord, Lord Hunt, for moving it so eloquently. I also support the two other amendments in this group.
I declare my interest as chair of ISCAS—the Independent Sector Complaints Adjudication Service—and because I have been involved personally in two clinical negligence situations. The first involved a death. We did not take legal action but tried to get answers. Answers were very difficult to obtain because all the papers that the hospital had disappeared. On the second, we had to take legal action.
Amendment 288 will, as discussed, do exactly what it says on the tin. It will ensure an independent review of the process for handling clinical negligence. The present situation where the only solution is to resort to law to get damages is far from satisfactory. Where a patient sustains damage, as my noble friend Lady Cumberlege so eloquently explained, the impact on them and their family is utterly devastating. In some cases, there is a need to get damages, because the situation means that there are ongoing costs for ongoing care, as we have just heard. They need financial help in these situations. Legal cases can often take years to settle. The one that I helped with took five or six years going over and over what happened, going to endless meetings, going to meetings with the lawyers and chasing the lawyers, who seemed to have dropped it. It was unbelievably stressful. I cannot think that anybody would want to go down that route unless they really had to. For the patient, if they are still alive, or the relatives, it means reliving and reliving the incident on top of coming to terms with the damage that has been inflicted.
Moreover, I understand that the costs of medical negligence have quadrupled in the last 15 years to £2.2 billion in 2020-21, equivalent to 1.5% of the NHS budget. I understand that about 25% of this goes on legal fees. I believe we urgently need to find a better way to deal with these cases, rather than resorting to the law. Not only do long, drawn-out legal wrangles put patients through years of unnecessary stress, but huge legal fees eat into the resources that should be available for front-line care.
An independent review would hopefully be able to examine and deliver a more satisfactory solution for patients and the NHS alike, and I hope the Minister can support this amendment.
Baroness Walmsley (LD)
My Lords, I certainly support these three amendments so ably introduced by the noble Lord, Lord Hunt, and the noble Baroness, Lady Cumberlege. The beauty of their presentations is that they not only outlined the terrible suffering that can be caused by the things we are discussing but came up with very reasonable solutions to make the situation better. That is what we always try to do in your Lordships’ House.
My noble friend Lord Storey put down Amendment 297E in this group. Because he was unable to make it today, I do not intend to speak to it. I do not think that would be appropriate in case he wishes to bring it back on Report. I think he would be happy to support all three of the other amendments, in particular Amendment 268 from the noble Lord, Lord Hunt.
I was interested to hear the noble Baroness, Lady Hodgson of Abinger, say just now that clinical negligence costs £2.26 billion per year. That is about the same as the whole budget of the Ministry of Justice and, as a result, hardly anybody can get legal aid these days. That is a very good reason why we should look carefully at the performance of NHS Resolution. There is clearly no incentive for the NHS lawyers to get things through quickly, because they are being paid anyway. The fact is that there is no equality of arms; I have said this on this subject before. It should be a principle of justice in this country that there is equality of arms, but in this case there is not—so I very much support the noble Lord, Lord Hunt.
Baroness Wheeler (Lab)
My Lords, this is an important group and there is little to add to the expert contributions on the amendments, which have been spoken to so comprehensively. We have always championed the need for patients’ voices to be heard and listened to in the care and treatment they receive, and are doing so in pressing for the patient voice to be properly embedded in the new structures established under the Bill.
When appalling safety incidents occur, such as those so graphically spelled out in the First Do No Harm report from the noble Baroness, Lady Cumberlege, we need not only to ensure that there are effective systems to make sure that victims receive the care, treatment and proper financial compensation needed but to enable the NHS to acknowledge and learn from what has happened, both to prevent further harm and to promote future patient safety.
In opening this group, my noble friend Lord Hunt made a strong case for an urgent, expert-led review of the 40 year-old Vaccine Damage Payments Act in the light of major developments and growth in vaccine usage and, of course, huge gains in population health and ill-health protection as a result. But the small numbers of individuals and their families who sustain serious injury or adverse reactions to vaccines—now to the fore as a result of the highly successful Covid vaccination programme—need legislative protection and a scheme that is up to date, fit for purpose, properly resourced and based on compensation levels and criteria that fully reflect the needs of today’s victims.
I am sure the noble Lord, Lord Storey, would have made an equally strong case for the repeal of the NHS Redress Act, a slightly younger 16 year-old scheme for adverse health incidents, which is out of date and also not fit for purpose.
The noble and learned Lord, Lord Mackay, led an expert and informed debate in Grand Committee last December on the NHS clinical negligence scheme and its ever-escalating costs, which is reflected today in my noble friend Lord Hunt’s Amendment 268 and its call for a major review of the scheme, including consideration of the Law Reform (Personal Injuries) Act and repealing its Section 2(4).
Earl Howe (Con)
My Lords, this has been an important and moving debate. We should recognise that, behind the technical aspects of the topic, there are stories of real harm and life-changing events for people and families.
Amendment 267 would establish an independent judge-led review into the operation of the Vaccine Damage Payments Act 1979. I appreciate the spirit behind this amendment and agree that we need to ensure the vaccine damage payment scheme works as effectively as possible. We recognise that the scope and scale of the scheme has significantly changed since 1979; it has expanded from the original eight diseases to cover 18 and the payment value has increased from the original value of £10,000 in 1979 to the current level of £120,000.
Most recently, responsibility for the operation of the scheme transferred from the Department for Work and Pensions to the Department of Health and Social Care on 1 November last year. The NHS Business Services Authority has now taken over the operation of the scheme. It is looking to improve the claimant journey on the scheme in three main ways: increasing personalised engagement; reducing response times; and making more general support available to claimants. It has also allocated additional resource to the operation of the scheme. I can tell the noble Lord, Lord Hunt, that the department will further engage with the NHS Business Services Authority to progress service improvements and, in particular, greater digitalisation.
Our focus now must be on completing the transfer of the scheme, getting support to those who are eligible as quickly as possible and improving the claimant experience. Against that background, I am not convinced that an independent review at this stage would support these goals. Indeed, it might risk delaying progress.
I shall just comment on a couple of detailed points made by the noble Lord. The first is on the disablement threshold. The 60% disablement threshold is aligned with the definition of “severe disablement”, as per the DWP’s industrial injuries disablement benefit. It is not clear that this is a significant barrier to claimants. In 2019 and 2020, just one claim out of 151 was rejected due to the 60% disability threshold not being met. Of course, there is also the option for claimants to appeal the decision.
The noble Lord also expressed concern about the length of time that it was taking to settle claims. NHS Resolution aims to get to the right answer as quickly as possible in every case but, equally, each case has to be considered on its own merits, and it is important that a proper investigation is undertaken. The department keeps NHS Resolution’s performance under regular review and is satisfied that its approach to settling claims strikes the right balance in delivering timely resolution. Recent performance on time to resolution has been influenced by the pandemic—that is not meant to be an excuse; it is just a statement of fact—and the need to relieve pressure on front-line NHS staff. To mitigate this, NHS Resolution worked with a range of industry stakeholders to introduce a specific Covid-19 clinical negligence protocol to support the management of claims during this time. This collaborative approach has been widely welcomed in the written evidence to the HSCC inquiry on NHS litigation reform.
On Covid-19 vaccines in particular, clearly, they are new, and establishing a causal relationship between the vaccines and their purported side effects is not a straightforward matter and takes time. So, while we would like to have an accelerated process, it was vital that we did not make assessments before the scientific evidence reached a settled position, to avoid payments being made in error, or those who qualify potentially missing out on payments. The NHSBSA will be writing to claimants when there is an update on their claim, and we appreciate the continued patience of claimants at this difficult time.
I turn now to Amendment 268, also tabled by the noble Lord, Lord Hunt, and supported by my noble friend Lady Hodgson of Abinger. The Government already have robust arrangements for reviewing public bodies such as NHS Resolution. Our assessment is that NHS Resolution is a well-run organisation. The National Audit Office noted in its 2017 report the efficiency gains it has achieved, including significant progress in reducing unnecessary litigation through the use of mediation and alternative dispute resolution. In 2020-21, 74% of claims handled by NHS Resolution were resolved without formal court proceedings. In fact, very few cases—0.3% of litigated claims—actually go to trial. Of the 56 cases that went to trial in 2020-21, NHS Resolution achieved a judgment in favour of the NHS in 38 cases: roughly two-thirds.
I also draw the Committee’s attention to the work under way to manage rising clinical negligence costs—a topic very appropriately raised by the noble Lord, Lord Hunt. The department is working intensively with the Ministry of Justice, other government departments and NHS Resolution, and we will publish a consultation to address this issue. An independent review would duplicate this work and, in any case, legislation would not be necessary to establish such a review.
In 2017, the NAO identified the main drivers of the cost rise as, first, compensation payments; secondly, claim volume increases; and, thirdly, legal costs. Since then, the picture has changed: payments for compensation now drive the increase and are growing at rates above inflation. We share the noble Lord’s concern that existing legislation may mean that the state pays twice for care. While from our analysis we do not think it is likely to be a significant driver of increasing costs, we remain open to evidence. Furthermore, the Government recently submitted evidence to the Health and Social Care Committee inquiry on NHS litigation reform. We welcome the inquiry and look forward to its recommendations.
Turning to Amendment 288, I thank my noble friend for her and her team’s diligence and dedication and the brave testimonies of those who contributed to the Independent Medicines and Medical Devices Safety Review. Anyone who has read that review cannot fail to be moved by the evidence submitted to my noble friend’s team. I assure your Lordships that the review has been a powerful call to action. The Government have accepted the majority of the report’s nine strategic recommendations and 50 actions for improvement.
I understand my noble friend’s point about redress, but, at the same time, I believe it is important that we focus government funds on initiatives that directly improve future safety. For this reason, the Government have already announced that redress schemes will not be established for people affected by hormone pregnancy tests, sodium valproate or pelvic mesh. However, as my noble friend knows, in order to put patient safety at the heart of the system, we have established— thanks to her recommendation—the new patient safety commissioner. The appointment of the commissioner will put the patient voice at the centre of patient safety and deliver improvements in how the system listens to and responds to concerns raised by patients.
We are also improving the safety of medicines and devices and embracing the new opportunities to reform regulatory frameworks following the UK’s departure from the European Union. The Medicines and Medical Devices Act delivers further on our commitments to patient safety, embedding reform and delivering an ambitious programme of improvements for medicines and medical devices.
I hope I have provided at least some assurance and that noble Lords will feel able not to press their amendments.
Baroness Cumberlege (Con)
My Lords, I very much welcome my noble friend’s response. Of course he is right: we must always look to the future safety of our services. I am really grateful to Ministers and the department for what they have done in response to our report. It is not 100% yet, but we are nearly there, and I thank them for that.
But I am not talking about the future. I am talking about the people who are suffering now as a consequence of the treatment they received, not knowing that it would do them harm. So I ask my noble friend to take this away and think further on it. As I tried to explain, we have devised in the amendment a system that is not, as we said, an open cheque. It is not huge amounts of money; it is not huge numbers of people. It is to help those who are struggling with their lives as a consequence of the harm that has been caused to them. I just ask my noble friend to take this away and think further.
Earl Howe (Con)
I appreciate of course my noble friend’s remarks, and I undertake to bring them to the attention of my right honourable friend the Secretary of State.
Lord Hunt of Kings Heath (Lab)
My Lords, this has been a very good debate, again, and I am grateful to the noble Earl, Lord Howe, for his sympathy. I really support the plea from the noble Baroness, Lady Cumberlege, for more thought to be given to the specific area of redress for the three groups of patients she mentioned. Any of us who have met some of the women involved—I think in particular of the women I have met who have been affected by surgical mesh issues—will be taken with the huge damage that has been done to their lives and well-being. I think they deserve listening to.
I will also say that I was very grateful to the noble Baroness, Lady Hodgson, for her support and for the information she brought to your Lordships, and to the noble Baroness, Lady Walmsley, and my noble friend Lady Wheeler, who pinpointed the need for action in this area.
Earl Howe (Con)
My Lords, I rather wish it were my noble friend Lord Kamall handling this group because he is the Minister, and I am not. However, what I can do is undertake to bring the request of the noble Lord to his attention—I am sure I do not have to—and I am sure he, in turn, will wish to respond as soon as possible to that request.
Lord Hunt of Kings Heath (Lab)
My Lords, I know how generous the noble Lord, Lord Kamall, has been with his time. I can but hope for a sympathetic response and beg leave to withdraw my amendment.
“Age of sale for tobacco
(1) The Secretary of State must, no later than six months after this Act is passed, consult on raising the age of sale for tobacco from 18 to 21, and publish a report on the consultation.(2) The Secretary of State must lay the report before Parliament, and a Minister of the Crown must arrange to make a statement to each House of Parliament setting out in detail any steps which will be taken to implement the findings of the report.”Member’s explanatory statement
This new Clause would require the Secretary of State to consult on raising the age of sale for tobacco products to 21 and report to Parliament.
Lord Faulkner of Worcester (Lab)
My Lords, I move Amendment 270, and add my support to Amendments 271 to 279 in this group. I have added my name to each of these, and they will be spoken to by noble Lords in all parties in the Chamber and by the noble Baroness, Lady Masham. I pay particular tribute to them for all being present at this late hour on a Friday—but this is an important issue.
We have signed these amendments because we see them as important steps on the journey towards a smoke-free Britain by 2030, which is the aspiration the Government have identified. They are in line with the approach that has been repeatedly taken in your Lordships’ House in recent years, to reduce harm caused by tobacco smoking and which has been consistently supported by the noble Earl, Lord Howe, when he was answering for the department of health in earlier debates. His support for tobacco control measures has always been appreciated.
As recently as 14 July, your Lordships approved the Motion to Regret that I tabled, regretting that the draft pavement licences regulations were not revised to take into account the evidence of benefits of 100% smoke-free pavement licences. That was agreed by a majority of 30 in a Division.
The amendments in this group are based on the recommendations in the 2021 report of the All-Party Parliamentary Group on Smoking and Health; I declare an interest as an officer of it. The Public Health Minister in the other place has committed carefully to review these recommendations as she develops the forthcoming tobacco control plan. I suspect that we may hear a little more about that from the noble Earl.
The rationale for Amendment 270 is clear. Raising the age of sale would have a larger impact in reducing smoking rates among young adults than any other single intervention. Experimentation has been found to be rare after the age of 21, so the more we do to prevent exposure and access to tobacco before this age, the more young people we can stop from being locked into a deadly addiction from which they may never escape. Two-thirds of those who try smoking go on to become regular smokers and only a third succeed in quitting during their lifetime, with the remainder at serious risk of smoking-related disease, disability and premature death.
When the age of sale was raised from 16 to 18 in 2007, smoking rates among 16 and 17 year-olds declined by 30%. When the age was raised to 21 in the United States, there was a similar reduction there, which in the UK would equate to 100,000 fewer smokers aged 18 to 20, simply by making it harder for young adults to buy tobacco.
Raising the age of sale would also help to reduce inequalities. Compared with non-smokers aged 18 to 20, smokers in this age group are more likely to be from lower socioeconomic backgrounds. This means that the effect of increasing the age of sale would be particularly beneficial in poorer and more disadvantaged communities. The Government’s levelling-up White Paper, published earlier this week, rightly states on page 203:
“Tobacco is still one of the single largest causes of preventable mortality, and smoking rates remain high in some areas of the UK. In 2019, the UK Government set the ambition for England to be Smokefree by 2030. A new Tobacco Control Plan for England is due to be published in 2022, setting out how the UK Government will deliver on this commitment, with a focus on reducing smoking rates in the most disadvantaged areas and groups.”
Elsewhere, the White Paper states:
“These and other changes will contribute to narrowing the gap in Healthy Life Expectancy … between local areas where it is highest and lowest by 2030, and increasing Healthy Life Expectancy by five years by 2035”.
I hope that, with those very desirable aspirations, the Government may be able to accept these amendments or propose similar ones of their own on Report. These amendments are designed to help them to achieve what they want to do.
Raising the age of sale is simple and inexpensive to implement and enforce, as retailers are already required to check the age of young people trying to purchase tobacco, so it is not an additional regulatory burden. Raising the age to 21 would do more than any other measure to help achieve the Government’s ambition of a “smokefree generation” and has already proved effective in the US.
I shall conclude with a brief word on Amendment 271. This requires the Government to prohibit the free distribution of nicotine products to under-18s and to regulate the marketing of any novel nicotine products, not just e-cigarettes. Unsurprisingly, tobacco companies have shown themselves more than willing to exploit this loophole. Free vapes have reportedly been handed out without age checks in cities all around the country. After all, it is not illegal to do so, although it clearly contravenes the spirit of the existing regulations, which set the age of sale at 18. I hope the Minister will agree that the current situation is unacceptable and will take action now to prevent e-cigarettes and other nicotine products being promoted to children. Including all nicotine products, not just e-cigarettes, will ensure that any new nicotine products introduced into the UK in future will be properly regulated from the outset.
I commend all the amendments in this group to the Committee, and remind the Minister that all that Amendment 270 requires at this stage is a consultation and a report back to Parliament. Surely that is not too much to ask for a measure which has majority support among small tobacco retailers as well as the adult population, makes a major contribution to public health and reduces health inequalities. I beg to move.
The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)
My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely and I invite her to speak.
Baroness Masham of Ilton (CB) [V]
My Lords, I support all these amendments but will speak to Amendments 276 and 277, to which my name is attached, requiring health warnings on cigarettes and inserts in cigarette packs containing quitting advice.
My father used to smoke, as very many people did in the war. At the age of 52, he died of coronary thrombosis; I always felt that smoking caused his death. In addition, one of my best friends who smoked died early. At this very time, my housekeeper is in St James’s University Hospital in Leeds receiving treatment for cancer. The other day, she scolded herself for having smoked. Smoking causes serious disability as well as premature death; far too many people have died because of smoking.
I strongly support the Government’s Smokefree 2030 ambition. The measures in the amendments will help put us on track; they are well-evidenced, cheap to implement and easy to enforce. Health warnings on cigarette packs have progressively increased in size over time and, most recently, their impact has been enhanced by the removal of colourful banding. Warnings on cigarettes is the logical next step, and it will have particular impact in preventing children and young people starting to smoke. Hundreds of children start smoking every day in the UK. Children are much more likely to have access to individual cigarettes than full packs, meaning that warnings on cigarettes are likely to be particularly effective in preventing youth uptake. This measure has strong public support. Adding health warnings to cigarettes and cigarette papers is a simple measure with minimal cost which would help deliver the Government’s Smokefree 2030 ambition.
Amendment 277 would give the Government powers to require that health information messages be inserted in cigarette packs. This is not a novel idea; it has been a legal requirement in Canada since 2000. They are proven to work, and there is already good evidence from Canada on which messages are most effective. If the Government could give an assurance today regarding the increased use of health warning inserts—they already have the power to do this—these amendments might not be necessary and we could save time on Report. If not, Amendments 276 and 277, which are by no means the only measures needed to address this terrible addiction, would be a small and significant step in the right direction. I commend them to the Committee.
Lord Young of Cookham (Con)
My Lords, it is a pleasure to follow the noble Baroness, Lady Masham, who spoke in favour of Amendment 276, which replicates a Private Member’s Bill I am endeavouring to pilot through Parliament; we will see which of us has the fastest track towards the statute book. It is also a pleasure to follow the noble Lord, Lord Faulkner, who has campaigned against the damage done by tobacco for as long as I have known him, and I agree with every word he said.
I will speak to Amendments 272 to 275, which are in my name but supported by all parties. They apply the polluter pays principle to tobacco manufacturers. In view of the lateness of the hour, I will curtail my remarks as much as I can. The principle that the polluter should pay has been accepted by Conservative Governments for over 30 years, starting with the landfill levy to promote recycling, running through the sugar tax on soft drinks to tackle obesity, and referred to only on Wednesday this week by my noble friend Lord Greenhalgh in the debate on building safety, advocating a levy on the construction industry to finance remediation.
Baroness Northover (LD)
My Lords, I have put my name to Amendment 270, which requires the Government to consult on raising the age of sale for tobacco to 21, and which the noble Lord, Lord Faulkner, has just introduced. I also express my support and that of these Benches for all the anti-smoking amendments in this group. My noble friend Lord Rennard will speak on them shortly. Together, these amendments seek to close loopholes, strengthen regulation and provide a mechanism to reinstate vital funding for tobacco control and smoking cessation. Tackling tobacco and the tobacco industry has strong cross-party support, as the noble Earl well knows, having been very much part of that himself over the last 20 years. He will note the number of us speaking to support these amendments, even though only four can sign each one. He will also note the contribution made by his noble friend Lord Young, not only here but in his Private Member’s Bill, and he will no doubt note that there are very few voices—possibly one—who tend to speak against such measures.
I welcome the progress that the Department of Health has made in this area, and that of local government, but other parts of government are not always totally aligned. We found that with pavement licences—the noble Earl will remember this—in the now-termed Department for Levelling Up, even though the new White Paper on levelling up has, rightly, as the noble Lord, Lord Faulkner, pointed out, identified addressing health inequalities as vital, and addressing smoking as part of that. Two cities in the north have the highest smoking rates in the country: Kingston upon Hull, at over 22%, and Blackpool, at over 23%. The average in the south-east is just over 12%.
These amendments are designed to help the Government and the Department of Health take forward their very welcome apparent intention for the country to be smoke free by 2030. The Government say they are committed to delivering a smoke-free country by 2030 but keep putting off what they have themselves declared to be the “bold action”, promised in 2019, needed to deliver what they said was an “extremely challenging” ambition. The tobacco control plan promised in July 2021 has been delayed again. When will it be published? No doubt “in due course”.
Meanwhile, instead of those bold actions, according to a recent leak to the Sunday Times, the Secretary of State “plots vaping revolution”, by providing e-cigarettes on the NHS. I agree that vaping has a role to play in a comprehensive strategy to end smoking. Vaping doubles people’s ability to quit smoking compared with existing nicotine replacement therapy. However, as we know, smoking is highly addictive, and even doubling success means that only a small proportion of smokers who were trying to quit would remain quit at the end of one year. Vaping is not a magic bullet and, although it will increase quitting, it will not prevent youth uptake, as raising the age of sale would, as the noble Lord, Lord Faulkner, has indicated. He set out extremely cogently the evidence for why this measure would be highly effective. I will briefly focus on why it would be proportionate and justified.
The age of 18 is often considered to be the age at which someone acquires all the rights and obligations associated with adulthood. However, this is not the case, and there are several examples of rights or obligations which are acquired earlier or later than the age of 18. Raising the tobacco age of sale to 21 would be consistent with the flexible approach that we apply to other age-restricted activities: those prohibited to under-21s in England include adopting a child, driving a large passenger vehicle, and supervising a learner driver, for example. Thresholds change over time, as demonstrated by the Government’s support for a Private Member’s Bill, which I welcome, to raise the age of marriage from 16 to 18.
It is now accepted that the late teens through to the early 20s—ages approximately 18 to 26—are a distinct period of life: young adulthood, when young people may still need support and protection. It was the period during which I hoped that my sons would develop what I thought of as a judgment gene—a gene that my daughter seemed to have had from at least the age of four, but they noticeably lacked. For care leavers it was excellent, for example, when in recent years social care was extended from 18 to 25. That had long been needed.
As we know, smoking is highly addictive and uniquely harmful, and an addiction which, if not begun by the age of 21, is very unlikely to happen at all. Tobacco is the only legal consumer product which kills when used as intended, causing the death of more than 200 people a day in the UK. This means that a unique response is required to minimise the burden of preventable death and disease that smoking inflicts. The evidence is surely sufficient to proceed with raising the age of sale, therefore this amendment is simply a modest proposal requiring the Government to consult. I commend this proposal and the other amendments in this group.
Baroness Finlay of Llandaff (CB)
My Lords, it is a great pleasure to follow the noble Baroness, Lady Northover, because I would like to pick up almost where she ended, on raising the age for the sale of tobacco. That measure has been successfully implemented in the United States, where smoking among 18 to 20 year-olds has been reduced by nearly a third as a result, so I support Amendment 270.
On Amendment 271, which affects the sale of nicotine products to children, it is rather horrifying to realise that it is not illegal for free samples of e-cigarettes to be given out to those under 18, even though it is illegal for them to be sold to those under 18. Amendment 271 would cover this. It would also cover the novel nicotine products, such as Japan Tobacco International’s widely advertised nicotine pouches—I do not particularly want to use their name because I do not want to advertise them. Unlike e-cigarettes, the marketing of these products is currently completely unregulated, despite the high levels of nicotine, which is an addictive substance. A quick search on the internet to look at the questions around them reveals that it is admitted that they are highly addictive, that they could affect the development of the brain and that they could result in mood changes in the user as well, possibly making them emotionally volatile. These are loopholes in the law, which can easily be fixed by our Amendment 271.
In Amendment 278, the noble Lord, Lord Rennard, seeks to ban all flavours in smoked tobacco. Again, this is another gaping legislative loophole which has allowed tobacco manufacturers to flout the current flavour ban.
I have led on Amendment 279, which relates to the packaging and labelling of nicotine products such as e-cigarettes. A cursory search online for these reveals that widely available electronic cigarette e-liquids feature cartoon characters in garish, appealing colours, with child-friendly descriptors, including sweet names such as gummy bears. Such branding is clearly unacceptable; it is targeted at the young. It is therefore deeply disappointing to discover that an amendment giving the Government powers by regulation to prohibit child-friendly packaging was voted down by them in the other place. The Minister said then that the Government
“are committed to ensuring that our regulatory framework continues to protect young people and non-smokers from using e-cigarettes.”—[Official Report, Commons, 22/11/21; col. 88.]
The Government can prove their commitment by supporting Amendment 279, which requires the Secretary of State to consult and report to Parliament on e-cigarette packaging, in particular the branding elements designed to be attractive to children.
Lord Naseby (Con)
My Lords, I have never smoked and I have no wish to smoke, but I am a marketing man by profession. We have here a legal product, the consumption of which has been steadily falling, particularly in recent years, in every age group throughout the country.
Lord Rennard (LD)
My Lords, for decades, all the various weak arguments associated with the tobacco industry, opposing tobacco regulation, have been comprehensively and completely disproved by the effectiveness of that regulation at reducing the prevalence of smoking rates. Tonight, we will argue why we need to go further with measures of tobacco regulation to further reduce the prevalence of tobacco smoking. I will speak briefly on Amendments 276, 277 and 278.
It is topical that, this week, mission seven of the Government’s Levelling Up White Paper committed
“to narrowing the gap in Healthy Life Expectancy … between local areas where it is highest and lowest by 2030”.
As Ministers regularly acknowledge, half of that gap is down to smoking, so real commitment to levelling up means that immediate action must be taken on these issues.
The tobacco-related amendments in this group will assist the Government in their stated aim to reduce the prevalence of tobacco smoking to below 5% by 2030. Amendment 276 requires the Secretary of State to introduce health warnings on cigarette sticks and rolling papers, in addition to the existing pack warnings. The claim that there is not yet sufficient evidence to justify the policy is a very weak excuse for inaction, and similar claims were made before the introduction of health warnings on cigarette packs. That is why the tobacco industry opposed them so strongly. These warnings on the packs are proven to be effective in reducing the prevalence of smoking tobacco, saving the lives of some of the people who were addicted to tobacco.
What is effective on the pack must be effective on the product, and 29 different studies have concluded that this would be the case. Other countries are considering this measure, and there is no reason why this country should not again lead the way.
Amendment 277 requires the Secretary of State to mandate pack inserts advising smokers about how to quit, and we know that very many smokers do want to quit. When the Government announced their smoke-free ambition in 2019, they said they believed that there was a “positive role” for such inserts, which they would consider as part of their review of regulations on exiting the EU. But the Government have inexcusably held back so far, making the lame excuse that
“further research”
is supposedly required to
“establish the public health benefit”—[Official Report, Commons, Health and Care Bill Committee, 28/10/21; col. 813.]
before proceeding.
The best research would be to introduce the inserts—at worst a harmless policy and something the tobacco companies could easily pay for from the huge profits they make from shortening the lives of half their customers. As the noble Baroness, Lady Masham, said, pack inserts have been mandatory in Canada for two decades. They have been shown to enhance motivation to quit, increase quit attempts and sustain quitting tobacco.
Amendment 278 would close a loophole in current legislation. In May 2020, it was rightly recognised that menthol can hide the harsh taste of tobacco and make cigarettes easier to smoke and more appealing to children; that is why it was banned. However, a massive loophole allowed flavouring to continue. The Government’s response on this issue in the other place was that
“it is not clear how a ban on flavours would be enforced in practice, as it would include a ban on flavours that do not give a noticeable flavour to the product.”––[Official Report, Commons, Health and Care Bill Committee, 28/10/21; col. 815.]
However, this has not been a problem in either the Canadian provinces or our European neighbours, such as Germany and Finland, which have successfully implemented a complete ban on flavourings.
In the year after the ban on menthol cigarettes came into force, Japan Tobacco made more than £90 million in profits from selling 100 million packs of its so-called “menthol reimagined” brands, which, it argued, were entirely legal. The loophole must be closed. I hope that the Minister will confirm that the Government plan urgently to step up a gear on tobacco regulation and support the tobacco-related amendments in this group.
Lord Moylan (Con)
My Lords, I am aware that, in your Lordships’ House, any lack of zeal for persecuting smokers marks one out as an aberration, but some realism has to be brought to this debate. It is my understanding that the Government will rightly resist these amendments so, in the interest of brevity, I will leave it to my noble friend the Minister to give a detailed rebuttal of each of them. However, I have a few things to say.
Unless smoking tobacco is made illegal, which would only bring with it all the organised-crime consequences associated with illegal drugs, the UK will not be smoke-free by 2030 or any other foreseeable date. There is likely to be an irreducible demand for smoking among both a small core of regular smokers and a wider population of people who enjoy the occasional cigarette. A sensible policy would recognise this and seek to accommodate it. There are widely understood risks to health associated with smoking, of course, but, as we have heard in this Committee, so there are with fat, salt, sugar and even fluoride. Despite all that, we have the constant efforts of well-funded zealots to bully and humiliate smokers and place burdens in the path of businesses engaged in the manufacture and distribution of this lawful leisure product.
Each of these amendments falls into one of those categories in one way or another, despite the smoothly expressed words of those who tabled them about increasing public information and the like. The public are already better informed about the risks of smoking than about almost any other topic. The UK is already highly regarded globally for its success in reducing the number of smokers. Those who wish to give up smoking deserve some modest help from public authorities, I agree, but they can be helped in other ways—for example, by diverting into products with much lower health risks. However, the campaigners against smoking cigarettes have been almost as determined to kill vaping as an alternative—although, as was indicated by the speech of the noble Baroness, Lady Northover, even public health officials are now beginning to question whether the initial blanket opposition to vaping is preventing some people making the transition from smoking cigarettes.
A similar question arises now as non-combustible tobacco products increasingly come on to the market. These contain tobacco but it is not heated to the point of combustion, although they still deliver nicotine to the user. Most of the harmful effects of smoking come not from the nicotine as such but from the smoke. Non-combustible tobacco products do not give rise to any smoke. The Government should be able to say, and make clear in their tobacco control policy, whether there should not be distinct regulations covering, separately, combustible and non-combustible tobacco products. I hope that my noble friend the Minister will be able to assure me that this will be so on sound public health grounds.
Lord Crisp (CB)
My Lords, I imagine that your Lordships’ House and Parliament generally very often have a choice in terms of the rightful tensions between, on one level, supporting freedom of action and speech and, on the other, balancing that against harms to individuals and society as a whole from smoking. I know that I am on the latter side of the argument in this case.
It is also worth noting that this is not about just the risk that comes from smoking—risk comes from many sources—but rather the scale of the risk and the impact that it has across the whole of the health system. Despite everything else that has been said about public health, it is worth remembering that this is the biggest risk and that half of the difference in life expectancy between people in poorer neighbourhoods and those in richer ones is due to smoking. That scale is the issue that we are talking about.
I was pleased to add my name to the four polluter pays amendments led by the noble Lord, Lord Young. On the notion that a payment or levy based on income—not a tax—will be used for reducing smoking, providing smoking cessation clinics and improving public health, I believe that this is a different arrangement from that consulted on by the Government in 2015.
I will make several other quick points that very much fit in with what has been said. First, this is about what the Government need to do if they are going to level up under the ambitious plans that were set out only yesterday for delivering improvements in life expectancy and the differences in life expectancy around the country—that is really important, and something will need to be done about smoking if those plans are going to be achieved.
Secondly, this is also about poverty: the average smoker spends £2,000 a year on smoking, and some new research suggests that this leads something like half a million households around the country into poverty. I have not studied that, so I only say “suggests”, but it seems to me to be an important point.
Thirdly, perhaps at one level, this started off for people as a lifestyle choice, but it is actually an addiction. I speak as a former smoker who made an enormous effort to give up. The average number of attempts before you give up is around 30, but I think that I probably exceeded that, and I can tell you the day on which I finally succeeded. It is an addiction, and this whole business runs on addiction—not on the occasional cigarette or the cigar at Christmas—and we should never forget that.
Fourthly, I ask whether the polluter paying is right in principle or just pragmatic. In a sense, it does not really matter: it is pragmatic. Over the last five years, NHS smoking cessation treatment services have been cut: about £23 million a year was spent on such campaigns, but now it is less than £2 million. There is not a lot of money around at the moment, obviously, and this seems a very pragmatic solution for finding money to support smoking cessation services—in addition to the fact that I would see it as being right in principle.
Finally, there is real evidence that those smoking cessation services work. Therefore, it would be money well invested in the future health of our nation.
Baroness Merron (Lab)
My Lords, this has been an interesting debate, and we have heard various views. I thank my noble friend Lord Faulkner for leading on this group of amendments, and I thank noble Lords for putting forward their amendments and views so that we can explore how we respond to the challenge of smoking.
My first point leads on very neatly from the comments of the noble Lord, Lord Crisp. Smoking remains the leading preventable cause of premature death. As the noble Lord observed, it is a matter where we should consider the scale of the effect and the fact that this is about addiction. It is not about free choice but is something that we must assist people to overcome. While rates are indeed at record low levels, there are still more than 6 million smokers in England, and the need to reduce this number is particularly important now, as smokers are more at risk of serious illness from Covid.
The economic and health benefits of a smoke-free 2030 would be felt most keenly among the most disadvantaged. However, as we heard from the noble Lord, Lord Young, at current rates we will miss this target by seven years on average, and by at least double that amount for the poorest groups in our society. So it is vital that we motivate more smokers to quit while reducing the number of children and young people who start to smoke.
Within this group of amendments, noble Lords have suggested a broad raft of anti-smoking measures, including information inserts and warnings printed on rolling papers, a consultation on raising the age of sale to 21 and a “polluter pays” approach which argues that tobacco companies should pay for smoker treatment programmes. All these measures can be underpinned by broad cross-party support and public support. Certainly, the All-Party Group on Smoking and Health is very supportive of this group of amendments.
The pandemic has posed new challenges to us, and there is a new group of people who started smoking but who otherwise would not have done so. We have been promised a new tobacco control plan, and I hope that the Minister tells your Lordships’ House when we can expect it. The labelling and information interventions contained within this group of amendments have a strong evidence base from other countries, as well as from research in the UK. I hope that the Minister will be amenable to them.
Picking up on a few of the points raised within this group, it is very shocking to note that more than 200,000 11 to 17 year-olds who have never smoked previously have tried vaping this year. It is a very strange situation that e-cigarettes and similar products can be given free to somebody under 18 but they cannot be sold to them. We do not want to see a situation where young people are brought to smoking by smoking substitutes.
In reference to the amendment that proposes a United States-style “polluter pays” model to fund all these interventions, including the restoration of lost smoking-cessation services, the noble Lord, Lord Young, described practical ways in which this could come about. Certainly, the Minister in the other place did not close the door to this idea in Committee. I hope that we will hear from the Minister some agreement towards this.
Amendment 270 promotes a consultation on raising the age of sale, because we know that the older a person gets, the less likely they are to start smoking. If this is to happen, it requires proper consultation with relevant stakeholders, not least young people themselves, including those who are underage. It must be rigorous in checking what will work. Attitudes to the incidence of smoking have changed over the years, but the direction now is firmly one way, and that is to prevent ill health and premature death. This group of amendments contains proposals to keep us moving in this direction, to assist those who smoke and to prevent those who seek to smoke, particularly those at the younger end of the scale. I hope that this group of amendments will find favour with the Minister.
Earl Howe (Con)
My Lords, I am grateful to the noble Lord, Lord Faulkner, and other noble Lords for bringing this discussion on tobacco control before the Committee today. In responding to these amendments, I begin by emphasising the Government’s commitment to the smoke-free agenda. Over the past two decades, successive Governments have successfully introduced a strong range of public health interventions and regulatory reforms to help smokers quit and protect future generations from using tobacco. Our reforms have included raising the age of sale of tobacco from 16 to 18, the introduction of a tobacco display ban, standardised packaging for tobacco products and a ban on smoking in cars with children.
The Government are committed to making this country smoke free by 2030, and we will outline our plans in a new tobacco control plan to be published later this year. As part of our Smokefree 2030 programme of work, I am pleased to announce that we have launched an independent review into smoking. The review, led by Javed Khan OBE, will make a set of focused policy and regulatory recommendations to government on the most impactful interventions to reduce the uptake of smoking and support people to stop smoking for good. I am sure he will consider many of the policies raised by noble Lords in today’s debate as part of his review, which is expected to report in late April.
The action I consider vital for the Government is to conduct research and build a robust evidence base before bringing any additional measures forward, such as those outlined in Amendment 276, which would impose a duty on the Secretary of State to make regulations requiring tobacco manufacturers to print health warnings on individual cigarettes and rolling papers. This evidence-base principle also applies before raising a proposal, even through a consultation such as that outlined in the requirement in Amendment 270 to consult on raising the age of sale.
Several amendments that have been put forward by noble Lords are not required, because relevant legislation is already in place. For example, legislation is already in place that prohibits the sale of tobacco and e-cigarettes to under-18s, including proxy sales, as outlined in Amendment 271, and provision to enable this to be extended to all nicotine products. While we support proposals further to protect young people from these products, we do not have the evidence base at present to suggest that free distribution is a widespread problem. We challenged the industry on this, and it claimed that it is targeting only smokers who are over 18 when it gives free samples. Whatever one may say about that, there would undoubtedly be reputational damage to businesses if they did give out samples to minors. I am sure that evidence in this area will be gratefully received by the department.
When looking at further regulation of e-cigarettes, we need to assess which policies provide us with the best opportunities to reach our bold Smokefree 2030 ambition. Once we have fully considered the evidence, the most ambitious policies will be included in a new tobacco control plan. I do not in the least intend to sound complacent, but it is worth noting that in 2018 regular use of e-cigarettes among 11 to 15 year-olds remained very low, at 2%.
The noble Baroness, Lady Finlay, referred to nicotine pouches. There are existing powers in the Children and Families Act 2014 which allow us to extend the age-of-sale restrictions to include any nicotine products, such as nicotine pouches, so the proposed new clause is not strictly needed in relation to sales.
We recognise the need to address disparities in smoking across the country and we are committed to helping people quit smoking and to levelling up outcomes, as referenced in the recent levelling-up White Paper. There is already a lot of good work going on within both the NHS and local authorities in this area, but it is a theme that we will be developing in our tobacco control plan.
Lord Faulkner of Worcester (Lab)
My Lords, it has been a fascinating debate, which has taken a little over an hour. I thank all noble Lords who have taken part, particularly those who signed the succession of amendments we have been debating. We have heard marvellous speeches from each of them. A huge number of points have been made, which we need to take away and consider in terms of what we should do with amendments such as these on Report.
I am encouraged by the tone and content of the Minister’s reply. I am particularly pleased that he did not close the door on the possibility of some form of polluter pays levy on the industry. I shall read what he said quite carefully, but that is certainly how it appeared to me. The commitment to be smoke-free by 2030 is still there, but I think we all take the view that, if we are going to reach that target, we must do more now or we will miss it. The key to that is doing something about the problem of smoking among poorer people in more deprived parts of the country.
To argue that this is just another product that people can choose whether to start or stop is complete nonsense, as all the evidence has demonstrated over the years. Apart from the fact, as the noble Baroness, Lady Northover, pointed out, that it is the only product which kills a high proportion of its users if they follow the instructions exactly as set out by the manufacturers—that is not the case for gambling, incidentally, which can be dangerous but does not cause people to die in the way that tobacco smoking does—the point about the tobacco industry is that we are not dealing with a normal industry with normal ethics or morality.
That is why the Framework Convention on Tobacco Control was adopted by the United Nations in 2005. It is a supranational agreement that seeks
“to protect present and future generations from the devastating health, social, environmental and economic consequences of tobacco consumption and exposure to tobacco smoke”
by enacting a set of universal standards, stating the dangers of tobacco and limiting its use in all forms worldwide. We have done well in following the framework convention; it is important that we follow it in engaging with the industry, which is utterly unscrupulous, as anyone who has had any exposure to it over the years will know. It denied that smoking was dangerous or caused disease, then it denied that nicotine was addictive, then it denied that second-hand smoke was dangerous, and now it is saying that it is just another product.
These are important issues which need to be looked at and addressed. I take comfort from what the Minister has said. I shall read very carefully what he and other noble Lords have said in this debate but, for the moment, I beg leave to withdraw the amendment.
Baroness Cumberlege
“GMC register: interests
In section 2 of the Medical Act 1982, after subsection (4) insert—“(5) The register shall include a list of financial and non-pecuniary interests for medical practitioners, as well as their clinical interests and their recognised and accredited specialisms.””Member’s explanatory statement
This amendment requires the General Medical Council to include the financial and non-pecuniary interests of medical practitioners on its register.
Baroness Cumberlege (Con)
My Lords, I am delighted that the noble Baroness, Lady Finlay, is supporting me. She is a clinician of distinction and a palliative doctor, but so much else besides. She will know as well as any of us—those of us who are not doctors—that one thing is at the heart of good, safe care: trust. As patients, we place our trust in our doctors. We trust them to use their skills and knowledge to treat us, to cure us and to keep us healthy to live our lives. We trust our doctors with our bodies, our minds and our lives. That brings great power and great responsibility. Doctors must make decisions and take actions in our interests; that is what we trust them to do. We know that trust is fragile. It is said that trust arrives on foot but leaves on horseback.
Noble Lords who were in the Chamber for the debate on Amendment 288 will know the context of the Independent Medicines and Medical Devices Safety Review, which I chaired. The people—the children—who were harmed placed their trust in their doctors and the wider healthcare system. They were let down. The lives of many have been turned upside down as a result of the harm they suffered. One woman who had been terribly harmed by a pelvic mesh implant told us:
“As patients, we allow the medical profession access to our bodies, our thoughts and our lifestyles. All manner of information to better assist them in reaching decisions about the best course of treatment for us. We, the patients deserve the same, we should be aware of clinicians’ allegiances or involvements whether they be financial or other. So we too can reach informed decisions about who is best to treat us, and how they should treat us.”
Doctors do wonderful work, often in extremely difficult circumstances. Decisions they make are not always perfect—they cannot be; we know and accept that—but must always be led by the best interests of the person who is their patient, not by external factors and commercial interests.
Amendment 283 would require the General Medical Council to expand its register of doctors to include their financial and non-pecuniary interests, as well as their particular clinical interests and their recognised unaccredited specialisms. In doing so, it would implement one of the nine major recommendations we made in our review.
The concept of declaring interests is hardly new, not least to all of us in this place. We know that it is important. It brings transparency and accountability, and the public have a right to know. Who in a position of responsibility can have a clearer, more significant impact on someone’s life and well-being than a doctor or a surgeon? Maintaining information about doctors’ clinical interests and specialisms is a vital foundation of patient safety.
I was pleased that, in their response to the recommendations of the Paterson inquiry, the Government committed in principle to creating a single repository of the whole clinical practice of consultants across England, setting out their practising privileges and other clinical consultant performance data—for example, how many times a consultant has performed a particular procedure and how recently. This information should be accessible and understandable to the public. It should be mandated for use by managers and healthcare professionals in both the NHS and the independent sector. It would be a way of measuring outcomes and ensuring safety and quality. For all these reasons, we urgently need a register.
I have been extremely encouraged that the leading journal for doctors, the British Medical Journal, is in full support. It has written extensively about it. Its editor has spoken expertly on the subject at a meeting of the First Do No Harm All-Party Parliamentary Group. The BMJ found that current reporting of interests, which is meant to be done locally and held by employers, is at best patchy. Many hospitals do not keep the information and, when they do, it is hard to find and may be out of date.
We need a central register, one that is easily accessible and complete. The General Medical Council already holds the register of qualified doctors. Adding their financial interests to the register is not difficult; it can be done via the annual appraisal. Every doctor must undertake an annual appraisal to maintain their registration. I have spoken to the GMC about this, but it seems—shall we say—lukewarm.
Baroness Brinton (LD) [V]
My Lords, I support the noble Baroness, Lady Cumberlege, in her Amendment 283, which would include financial and non-pecuniary interests of medical practitioners alongside clinical interests and their recognised and accredited specialisms on a register. I particularly thank her for explaining exactly why this is so important for patients. Currently, the GMC does not require them to hold or publish that data, but it is the obvious place for it to be held—and then linked, as she explained, to local employers, contractors and organisations. Anything that reduces the complex maze for a patient or a member of the public trying to find out whether a doctor is being paid for doing some work or using particular devices, and might therefore have an interest, has to be one of the cornerstones of a truly accessible and accountable register of interests. In today’s data-rich society, patients and the wider community want to understand what interests a doctor may have, but which may not be obvious.
A website called whopaysthisdoctor.org at Sunshine UK—so-called, I presume, because sunlight is always the best disinfectant—was set up by number of doctors, including Ben Goldacre. It is a database where doctors who want to be transparent about their interests can declare and register them, and the public can see whether their doctor is listed. The problem, of course, is that those who do not want to make these declarations voluntarily may be those we most want to see. That is why the amendment would make it compulsory.
I thank the GMC for its helpful brief, in which it recognises that the
“current arrangements to register conflicts of interest fall short of delivering adequate transparency and assurance for patients.”
However, the GMC would prefer this register to be maintained just at a local level and
“published by a doctor’s employer, contractor or organisation”.
The noble Baroness, Lady Cumberlege, has already referred to the recommendations in the First Do No Harm review and the Government’s response, in which they said that it was proposed that information would be published locally at an employer level. However, I believe that there is also a golden thread from the obvious place to go, where doctors already have a duty to register other information, and that is the GMC.
Like the noble Baroness, Lady Cumberlege, I am keen to see action on this. Personally, I believe that the registration body is a good place to hold that data and, as she said, we need to start somewhere. But, frankly, we need to see progress on a register of interests. I hope the Minister can give your Lordships’ House some encouraging news on this.
Baroness Finlay of Llandaff (CB)
My Lords, I was—it is fair to say—flattered when the noble Baroness, Lady Cumberlege, asked me to co-sign her amendment, because I have admired all the work she has done, and I think her report, First Do No Harm, has had influence way beyond the group of patients she was looking at. Indeed, I was vice-chair of a NICE review, and we referred to it in terms of helping to empower the voice of the patients we had in that review process, which was, first, very important and, secondly, particularly helpful because they were very clear in their thinking, and they worked extremely hard.
I am also grateful to the noble Baroness, Lady Brinton, for referring to the General Medical Council’s briefing, because the GMC agrees that a solution to this needs to be
“Accurate, up-to-date, accessible and presented in a way that is useful for patients, so that they can have confidence in it”.
It also said that it must be “Enforceable”, and the GMC also wants it to be “Multi-professional”. However, I agree that we have to start somewhere. Your Lordships may think that the advantage of a local register is that it is more accessible, but the disadvantage is that doctors move around in different jobs, particularly trainees—but even consultants’ time in one post is now relatively short; it used to be a lifetime appointment.
It is important that, as a doctor, I am prompted to be completely open so that there can be no subliminal influence on my decision-making. The most dangerous influences are the subliminal ones—not the ones where you are completely open about what is going on. There has been a great clamp-down over recent decades on the pharmaceutical industry because of sponsorship and so on, and that has decreased influences on prescribing. But when it comes to using other products in medicine, the same can apply. I think that a register would help the profession itself in making clinical decisions. I do not see this in any way as inhibiting research; on the contrary, it would display who is research active and who is achieving results through their research.
A register would support the development of innovative healthcare and support novel thinking because it would be declared and open. It would also support the move that people should always publish their results, whatever they are.
Baroness Neuberger (CB)
My Lords, I support Amendment 283 in the names of the noble Baroness, Lady Cumberlege, and my noble friend Lady Finlay. Like my noble friend Lady Finlay, I want to say how grateful I am and how touched I was that the noble Baroness, Lady Cumberlege, asked me to add my support to this amendment. I also need to beg your Lordships’ indulgence: if we do go beyond 7 pm, which I sincerely hope we will not, it is actually the beginning of the Jewish Sabbath. I should not be here now, and I certainly cannot be here after 7 pm. I will pretend that I am just slipping out briefly, but I am vanishing at 7 pm whatever happens. Your Lordships will be very glad to hear that I am not going to talk until then.
When the noble Baroness, Lady Cumberlege, asked me to support the amendment, I said that I would consult with the medical directors at the two NHS trusts that I chair, the University College London Hospitals Foundation Trust and Whittington Health NHS Trust. I did exactly that, and I have never had emails back so quickly from the medical directors—there are four of them between the two trusts. The amendment was welcomed unreservedly; they really want this to happen. The medical directors had no doubt that this was both an ethical requirement and indeed something to be encouraged in how doctors think about their own practice. That is the point that my noble friend Lady Finlay made. It is something about the subliminal; it makes you start thinking differently and your reactions become different.
One of the medical directors pointed me to Patrick Radden Keefe’s superb book about Purdue in the United States, Empire of Pain, and said that in a way that is exactly the issue here. Some of the people clearly knew that what they were doing was totally wrong, but some did not realise that what they were doing was wrong, because they had not got the subliminal way of judging, because this was accepted practice. That is the really strong argument for this: we need to be able to encourage people to think differently. There are lots of doctors who desperately want it, as the medical directors at my two hospitals have made entirely clear.
I pay huge tribute to the noble Baroness, Lady Cumberlege, for her report First Do No Harm—as well as for the many other things she has done, but in particular for that report. It has changed the way that quite a lot of people think; it is quite hard to achieve that with a report and it is a very remarkable thing to have done. This is a national and international issue. We are concerned here only with the national, but we could—and should—set an international example of good practice.
After the Paterson review and First Do No Harm, this is now urgent. The GMC is obviously the right body to hold such a register, and I say so as a former member of the GMC. I was rather sad to see its somewhat lukewarm reaction in its briefing and I think that it has got this wrong. They are the right people to hold the register and to make it available to patients. The public must be able to access it. The employers, individual doctors, the Medical Royal Colleges and others must all play their part and, of course, other health professions must follow suit.
Let us start here. This needs to happen, and it needs to happen fast.
Baroness Thornton (Lab)
My Lords, I can only add to the last remark of the noble Baroness that this does need to happen. I can see why the GMC is so unenthusiastic, as it was in its briefing note, because it looks like it is probably about 300,000 people and that is a big job. However, the question that I ask myself is, if a large pharma or large manufacturer of medical products is having a national campaign that involves hundreds of clinicians across the country, how will we know that is happening if all the registers are local? It seems to me that that is absolutely the point. It has to be a national register and the GMC probably has to be persuaded. If it is not the GMC, we would have to set up something different, and that would probably be a ridiculous thing to do. So the noble Baronesses, Lady Cumberlege and Lady Finlay, are quite right: we have to make progress on this.
Baroness Penn (Con)
My Lords, I am grateful to all the noble Baronesses who have spoken in this group, and in particular to my noble friend Lady Cumberlege for all the work that she has done on patient safety. I have noted their points very carefully and look forward to the further discussion of transparency and scrutiny of healthcare professionals in the debate on the next group where, on the point that the noble Baroness, Lady Thornton, made about payments from pharma and so on, it is my understanding that it will be on industry to declare those nationally.
Baroness Cumberlege (Con)
My Lords, I thank so much the noble Lords who have supported this amendment. I always welcome the support of the noble Baroness, Lady Brinton, because she is clear, concise and very authoritative; she commented that doctors already have a duty and that we should see progress. As always, the noble Baroness, Lady Finlay, was accurate; she talked about accuracy and accessibility for patients, and said that the register really is so important because it actually safeguards doctors, a point that has been put to us by some doctors. The noble Baroness, Lady Neuberger, is a chair of one of our great hospitals in London, and I was so grateful for her contribution. She went to her medical directors and found out that they thought this was an ethical way forward and should be encouraged. I also thank her for her generous remarks about the report—I would just like to say it is not my report; it was the team’s report, and I had some really good people on the team. I thank the noble Baroness, Lady Thornton, who was right: it has to be a national register, not a local one, and it has to be accessible to patients.
In summing up, I thank the Minister very much for her comments. There is such feeling about this in the country that it would be very helpful if she could convene a meeting with me, my team and the GMC to discuss this together. I think that a little more persuasion—especially from sources such as those on the Front Bench—would make all the difference.