Abortion

Baroness Barker Excerpts

Wednesday 6th June 2018 Lords Chamber

Asked by

[Baroness Barker]

To ask Her Majesty’s Government, in the light of the result of the referendum to repeal the eighth amendment of the constitution of the Republic of Ireland, what assessment they have made of its impact on the ongoing criminalisation of women seeking access to abortions across the United Kingdom.

[Baroness Barker (LD)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper. In doing so, I declare an interest as the chair of the All- Party Parliamentary Group on Sexual and Reproductive Health.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O'Shaughnessy) (Con)]

My Lords, under existing arrangements women across the United Kingdom have access to high-quality, safe abortion services. Parliament decided the circumstances under which abortion can be legally undertaken. It is accepted parliamentary practice that proposals to change the law on abortion come from Back-Bench Members and that decisions are made on the basis of free votes.

[Baroness Barker]

I thank the Minister for that Answer. Do the Government not think it is wrong that women in Northern Ireland can be coerced to continue with a pregnancy under legislation passed in 1861 by MPs, all of whom were men elected solely by men? Does he not agree that to overturn Sections 58 and 59 of the Offences against the Person Act would enable the men and women of Wales, Northern Ireland and England to determine under what circumstances women should be able to access safe, legal abortion?

[Lord O'Shaughnessy]

It has been the position of successive Governments that abortion policy and law is a devolved matter for Northern Ireland, to be decided by elected politicians in Northern Ireland on behalf of the people of Northern Ireland. That is our position: they should be the group that makes the decision.

Abortion: Misoprostol

Baroness Barker Excerpts

Tuesday 20th March 2018 Lords Chamber

[Lord O'Shaughnessy]

This is obviously a concern. There has been an increase in women buying online the drugs necessary for medical abortions, and that is something on which we are attempting to crack down. It is worth pointing out that 90% of abortions are NHS funded and therefore provided for in that way. The noble Baroness was talking about medical abortions at a late stage; it is worth pointing out that, actually, there has been an increase in the number or percentage of abortions that are happening at an early stage, which is obviously in the interests of women’s health.

[Baroness Barker (LD)]

The noble Baroness, Lady Eaton, mixed up two completely different things. She mixed up early medical abortions and late abortions. Can the Minister confirm that a 2011 court case brought by BPAS established that the Secretary of State has the power to allow early medical abortions to happen at home? If he agrees, and if the evidence from the Scottish trial is convincing and underpinned by the decision of the Scottish courts, will the Secretary of State then undertake to look at the development of a facility for legal abortion which may well be to the benefit of thousands of women in this country, particularly those who live in rural areas?

[Lord O'Shaughnessy]

I am aware of the opinion in that judicial review. It is worth pointing out that there is still uncertainty about the legal position. This is why we will watch the developments in Scotland carefully and proceed cautiously. It would be wrong of me to prejudge either the opinions that come from the court or indeed any evidence if this scheme does get up and running in Scotland.

NHS: Charitable Donations

Baroness Barker Excerpts

Thursday 22nd February 2018 Lords Chamber

[Lord O'Shaughnessy]

My noble friend makes an important point. Gift aid is a wonderful scheme that obviously has driven huge contributions. She is quite right that public sector bodies cannot provide the gift aid opportunity, which is why in the health sector those charities attached to hospitals exist. She makes an excellent suggestion for what councils should do and I shall take it up with my colleagues in that department.

[Baroness Barker (LD)]

Can the Minister tell the House whether integrated care trusts can have associated charities so that people can make donations not just to healthcare but to social care in their area?

[Lord O'Shaughnessy]

The noble Baroness asks a very interesting question. Clearly these are emerging organisations and most of the charities are attached to hospital trusts—although not exclusively: some are attached to primary care. None of these are yet quite in being. Once they are in being, this will be an excellent suggestion that we should take forward.

NHS and Social Care: Winter Service Delivery

Baroness Barker Excerpts

Thursday 25th January 2018 Lords Chamber

[Baroness Barker (LD)]

My Lords, I thank the noble Baroness, Lady Wheeler, for the opportunity, as the noble Baroness, Lady Pitkeathley, just said, to return again to this subject. I will not make a long speech as I would like to leave as much time as possible for the debate that will follow. On behalf of my colleagues on these Benches, I wish the noble Baroness, Lady Jowell, all the very best and ask her colleagues to convey that to her.

The noble Baroness, Lady Pitkeathley, is right: we have been back to this ground so many times. In preparing for this debate, I thought back to many of the debates that we have had in the past. The origins of the problem we are looking at go back to the National Health Service and Community Care Act 1990. In that Act, for the very first time, welcome things happened: we began to break down procedures within the NHS and to cost and quantify them. But the problem was that we made them into individual units of activity, and to this day, within the NHS, the systems that join up those individual units are failing. They fail completely when they have to be matched up with the social care system, which is completely different.

Those problems were identified and partially addressed in 2003 with the Community Care (Delayed Discharges etc.) Act, when the then Minister, the noble Lord, Lord Hunt of Kings Heath, was sitting there trying to answer questions from very talented opposition spokespeople such as me. We asked him a question that he never could answer, which was why the then Government thought that the answer to the problems in the NHS was to fine social services departments. I never understood that. We still have, within the whole system of discharge, a system of penalties.

[Lord Hunt of Kings Heath (Lab)]

Perhaps I can answer the noble Baroness. Surely the point is that both local government and the NHS were being properly funded at that point. Therefore it was entirely appropriate to have a system to encourage local authorities to do the right thing.

[Baroness Barker]

The issue that I think the Government were trying to solve was one for which we have never had any evidence: that of local authorities trying to game the system. It is correct that the overall amount of funding has gone down, but we have not had evidence of people gaming the system.

We have never had a system, or even part of a system, that incentivises GPs and those in charge of social care to prepare for winter pressures, invest in programmes that will see older people through the increased incidence of illness that we know happens in winter, and avoid unnecessary admissions to A&E. What has changed in that time is that we now have better data and better information systems, but in many ways we are still failing to take all that and improve those systems. At the moment we still have ambulance services being rated on completely different systems across the country so we cannot generate data.

The Government have done some things that are very welcome. Everyone agrees that the primary care streaming system, into which they put £100 million, is a worthwhile initiative. Unfortunately, the initial evidence is that it is failing simply because it takes people from another part of the system—GPs—and locates them in hospital. What are the Government going to do to properly monitor that system in its entirety as part of an overall approach to winter pressures, to see whether it is worth more investment or whether it simply takes resources from other parts of the system?

On the question of beds, we have a national system of monitoring general and acute beds and ways of measuring the overall occupancy rate. We do not have a method of assessing the number of beds in relation to need. For example, we can open up a load more beds, as the NHS always does at times of crisis, but if there are no more staff to look after the people in those beds then we are not really addressing the need. We need to refine the measurement of this so that we have a metric along the lines of “nurses per bed per day”. That is the point at which things become really bad. I remember talking to a nurse about a patient—actually my mother—and being told that she was far too good to be in hospital and would be going home. She died two days later, which was not a surprise to any of us. I say that because it is not an uncommon experience for patients.

We have been through this time and again. The one thing that we have failed to do is incentivise GPs to work with community organisations from the summer onwards to predict the people in their area who are going to be most at risk and to put in place very low-level, simple and low-cost packages of care for them that can be there very quickly when they are discharged. The biggest cause of delayed discharge is not the absence of social care but the absence of community nurses and NHS staff available to work in the community to ensure that we do not send people home only to see them return unnecessarily into acute care.

Social Care: Sleep-in Payments

Baroness Barker Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

I absolutely recognise the picture that my noble friend paints. We know the impact of the decision on backdated pay on those providers of social care of all kinds—charities, families and others. We are looking carefully at this, and there is a market analysis going on at the moment to find out the number of affected providers, the number of affected staff and the overall cost implications. Discussions are taking place with the European Commission to make sure that whatever route we take, we know it will be legally possible.

[Baroness Barker (LD)]

My Lords, these providers have been hit this year with a bill of £400 million. HMRC has given a one-month deferment of its decision, which is not enough time for them either to raise the money or to make alternative arrangements. Does the Minister agree that this can only be solved satisfactorily, without detriment to people with learning disabilities and people who are cared for, if there is a rescheduling of the liabilities? Are the Government looking, with HMRC, at drawing up a longer deferment schedule to allow them to raise the money?

[Lord O'Shaughnessy]

Again, I would point the noble Baroness in the direction of the social care compliance scheme that has been set up, which allows precisely that deferral of payments. It allows for a period of up to 15 months for assessments to take place while providers work with HMRC to provide the payment. I should also point out that although HMRC would usually levy fines in the case of underpayment of taxes after 28 days, those fines have been waived in these cases, as one would expect.

Older Persons: Care and Human Rights

Baroness Barker Excerpts

Tuesday 11th July 2017 Lords Chamber

[Lord O'Shaughnessy]

Rules affecting this House will, of course, be decided by its Members, who are probably the least likely group in the entire country to be ageist. The noble Lord is quite right to highlight this incredibly serious point. Any form of negative stereotyping or discrimination is, of course, wrong. I mentioned a couple of things that the Government are already doing and a lot is going on to counter any kind of discrimination. This Government have got more older workers into employment and are tackling the discrimination in the workplace that, unfortunately, still takes place.

[Baroness Barker (LD)]

My Lords, given the salutary experience of the general election, does the Minister now agree that the previous Conservative Government were wrong to kick the Dilnot commission recommendations into touch and that now would be the time to get that report back off the shelf, dust it down and hold proper discussions about the funding of long-term care?

[Lord O'Shaughnessy]

The noble Baroness is quite right that this is a nut we have to crack. The Government are going to begin consulting widely on proposals at the end of the year and this consultation will be on specific proposals rather than being open ended. As we have discussed in this House before, it is important that we do that in a spirit of consensus, because I do believe that there is a way forward which all parties can support.

NHS (Charitable Trusts Etc) Bill

Baroness Barker Excerpts

Friday 26th February 2016 Lords Chamber

[Baroness Barker (LD)]

My Lords, I thank the noble Baroness, Lady Massey, for introducing the Bill today with such clarity. In preparing for today’s debate, the words “history” and “innovation” kept coming into my mind. The charitable sector is full of some wonderful historical stories, and the legacy of charity law is that from time to time one comes upon them.

Back in a previous century, when the first ever law was passed requiring a charity to have a board of trustees, one Dr Barnardo thought that he had better be in compliance with the law. He gathered together a few of his friends and acquaintances for a meeting. These august people resolved that they would meet again upon the death of Dr Barnardo, and they duly waited until this great social innovator, who did remarkable things in a wholly independent way, was not there to be hidebound by a board of trustees upholding the law.

It is interesting to think about that on a day when we are to hear the maiden speech of the noble Lord, Lord Bird. As those of us who work in the charitable and voluntary sector know, he has been at the forefront of bringing about innovation and change, not just in what charities and the charitable sector do but in how they do it. He has been at the forefront of bringing to the world of philanthropy and good deeds the disciplines of business. In so doing, he has made it very clear to the sector that some of the old strictures under which charities used to work need to change and, in particular, that we must have different forms of organisations in order to pursue what we need to do. I am very much looking forward to hearing what the noble Lord is going to say.

The legislation talked about by the noble Baronesses, Lady Blackstone and Lady Massey, is, in a sense, historical. It arose when there was a limited form that a charity could take and when there were very strict laws about the ways in which charities could hold property. If they belong to a charity that is an unincorporated association, noble Lords may know that special holding trustees have to be appointed to hold property in trust. So it is quite right today that in trying to bring about the best of business and to free charities up to pursue what they do in the most effective way, we should begin to make the sorts of changes that are in the Bill. It is, I know, very technical stuff, but it means in practice a great deal, and it will make a great difference to the ability of a body to do its basic job.

I want to make one other point that I think is important at the moment. It has been a terrible year for charities. Charities have been in the firing line right, left and centre—sometimes quite fairly but other times not. Being a trustee at the moment is really difficult and I imagine will become more difficult, because, when money is tight, people begin to look in even greater detail at what charities do. There has never been a more important time to support trustees in their governance of charities. Charities and trustees play an important part in our civic and social life and, therefore, anything that helps and supports trustees to do their job properly is to be welcomed. In this Bill, sorting out the anomalies between a charity and the bodies with which it works can be only to the good.

I want to ask one technical question of the Minister. It is a question that has been around before; it arose in your Lordships’ House when the Bill setting up foundation trusts and so on was going through. A certain noble Lord, Lord Hunt of Kings Heath, was at the Dispatch Box when we bowled him this question from opposition: will this Bill in any way affect the reporting, and particularly the accounting, burden on charities? NHS charities have always had a double burden of accounting: they have to account for their work as charities but they also have to account for their income and expenditure within NHS accounts. If the Minister could supply an answer to that, I would be very grateful. This is a Bill for the future, as much as a Bill that takes account of anomalies in the past. I wish it well.

Four Seasons Group

Baroness Barker Excerpts

Monday 11th January 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, clearly, it is a matter principally for local authorities. However, the Government are making available in the spending review another £1.5 billion for the better care fund and allowing local authorities to raise a special precept of 2%. The oversight provisions of the CQC cover 45 providers, which cover some 20% of the market. It is intended that that will give early warning to local authorities of any likely collapse.

[Baroness Barker (LD)]

My Lords, can the Minister confirm that anyone who has their care package funded by a local authority is entitled to alternative provision? Anyone who is a self-funder under the law is entitled only to advice. Are the Government taking steps with local authorities to ensure that older people and their families are aware exactly what their entitlement would be in the event that their care home were to close?

[Lord Prior of Brampton]

My Lords, it is up to local authorities to have contingency plans in place in the event of the closure of a home in their area. As I said earlier, the Local Government Association has indicated that at least 95% of local authorities have contingency plans in place.

Junior Doctors Contract

Baroness Barker Excerpts

Friday 20th November 2015 Lords Chamber

[Lord Prior of Brampton]

The Secretary of State has said that he is open to conciliation. Frankly, it would be so much better if we could sort this out ourselves rather than go to conciliation, but he has said that he is open to it. If there is a terrorist attack, speed will be of the essence if people are severely injured. Junior doctors care hugely about their patients, so I think we have to rely on junior doctors to be available in hospitals in the event of some awful terrorist outrage, even if they are on strike. I will certainly draw to the attention of COBRA and the relevant authorities the question of the impact of terrorism on a demonstration by junior doctors.

[Baroness Barker (LD)]

My Lords, if, as appears to be the case, the Government’s proposals discriminate against junior female doctors who take time off to have children or against doctors who devote some of their time to research, will the Government be prepared to reconsider their proposals?

[Lord Prior of Brampton]

I probably did not make the situation clear enough. The Secretary of State said that there are no preconditions. If there are concerns about time off to have children or to carry out research, those are absolutely the kinds of issues that should be discussed around the table.

Gender-based Violence: Screening

Baroness Barker Excerpts

Monday 9th March 2015 Lords Chamber

[Earl Howe]

My noble friend has emphasised an issue which I am sure all noble Lords feel equally strongly about. The Department of Health has been quite clear that abortion on grounds of gender alone is illegal. We reissued that guidance last year in no uncertain terms. It is a pity if there is any misconception about that.

[Baroness Barker (LD)]

My Lords, health and well-being boards have a responsibility under the Health and Social Care Act to commission sexual and reproductive health services and HIV services. Are they being asked to include gender-based violence in the commissioning formats that they put forward to the NHS?

[Earl Howe]

Most certainly. Gender-based violence is one of the issues which sexual health clinics, and indeed all parts of the NHS, are now alert to. New guidance from NICE was issued in February last year on domestic abuse and how health and social care services and the organisations with which they work can spot and respond to abuse earlier in a more joined-up and preventive way.