Cabinet Manual: Revision (Constitution Committee Report)

Baroness Barker Excerpts

Friday 16th December 2022 Lords Chamber

[Viscount Stansgate (Lab)]

My Lords, I am delighted to take part in this debate and have looked forward to it with the same sense of excitement that has just been expressed. I commend the Select Committee for its excellent report and my noble friend Lady Drake for the clear and comprehensive way in which she outlined its contents.

I hope the House will allow me to start with a personal tribute. In the short time since I was elected to this House, this is the first time I have had the pleasure of seeing the noble Lord, Lord Hennessy of Nympsfield, in his place. I hope I might call him my noble friend because, over many years, he has been one of the astute observers of what we might call the Westminster village, and his expertise and analysis has been universally acknowledged. His books and writings have made a tremendous contribution to our understanding of the constitution. I find, after the comments of the noble Lord, Lord Howell, that I am not the only person in the Chamber who feels that the noble Lord, Lord Hennessy, and Walter Bagehot would have found in each other the same sense of expertise in analysing the political world in which they lived. The way in which the noble Lord has promoted the “good chaps” theory of government is so important, particularly when we have lived through a period when that has been so severely breached, and we are still living with the consequences today.

I am not a member of the Constitution Committee, nor a former Cabinet Secretary or Minister. I am a Back-Bench Member of this House, but I am taking part in this debate because I have an interest in how this country is governed—this debate, if nothing else, is about how the country is governed.

I went to talk to a sixth form not all that long ago. I brought along a copy of the Cabinet Manual and said, “Here you are: you might like to look at this because it explains, in ways you may not realise, how this country works—or is supposed to.” I regret to say that they had never heard of it. Yet I feel that the document, and the updated document we all hope will result from this debate, should be available in schools, because it is part of our constitution.

I pay tribute to Gordon Brown for having been the one who, as Prime Minister, triggered this and to the noble Lord, Lord O’Donnell, for having drafted, written and produced it. The then Prime Minister of course continues to have an interest in the architecture of our constitution, and we will hear more about that in the future. I note that it is the view of the noble Lord, Lord O’Donnell, that the lack of an effective enforcement mechanism means that contravention may be merely political—there is no sense in which there is anything more formal than that. Of course, “merely” political can encompass a great deal of things. I am taken back almost 50 years to when I first came across a then secret document, Questions of Procedure for Ministers, which was a precursor to the Ministerial Code. I can report that it of course caused a great deal of tension between the then Prime Minister and a member of the Cabinet. Noble Lords do not have to listen to my account of it; they can read all about it in someone’s diaries.

I congratulate the committee on its report. It is not very long, but it encapsulates all the major issues arising. I hope that today’s debate will help to shape the way in which the Cabinet Manual can be updated and retain its role as a valuable document.

I hope that the House will not mind my regretting that it has taken a year and a half for this debate to come forward. I know that that is the fate of many Select Committee reports. Nevertheless, you could argue that the delay has enabled us to have an even more rounded view of the areas in which the Cabinet Manual needs to be updated. After all, since the Select Committee report was originally published, we have had three Prime Ministers and countless other examples of Ministers changing, with the greatest number of Ministers in a department in a single year. We have, I think uniquely, two resignation honours lists pending, and in an updated manual a place might be found for what you would do about that.

However, there is a broad consensus, which I endorse, that the most appropriate time to bring to a conclusion a review of the Cabinet Manual is in the gap between one Parliament and the next. That is certainly more sensible than doing it over the Summer Recess. Can you imagine someone trying to do it in the Summer Recess of 2019 or 2022? They would have found that most of their work was outdated by the time they had finished it.

I note that the Leader of the House, in his then capacity of Minister of State in the Cabinet Office, has said that the Government intend to publish an updated manual before the end of this Parliament. I wonder whether it will be sneaked out on Christmas Eve in 2024—we shall have to wait and see. There are a range of issues that the committee has identified as important enough to be included. A prime example is the repeal of the Fixed-term Parliaments Act, which I never liked or supported, and the way in which we have restored the essential flexibility to our parliamentary democracy. There are other examples as well. I cannot be the only Member of this House to take the view that the attempt of the then Prime Minister to prorogue Parliament for six weeks in 2019 was an astonishing breach of every convention encapsulated in the Cabinet Manual. There was nothing remotely “good chaps” about that.

Another example—there are several, and some have been mentioned in other speeches—obviously, is the effect of devolution in the 10 or 11 years since it took place. There is the fact that, in triggering Article 50, Parliament in the end needed to be involved; that needs to be reflected in the manual, too. Parliament’s role in agreeing military conflict and treaties needs to be updated. There are the obvious changes as a result of our leaving the European Union, some of which we do not yet know. I might add a couple of extra vignettes for the House. One was the need to update paragraph 1.8 of the Cabinet Manual, relating to counsellors of state, which, as the House knows, had to be updated because it was realised that the definition of “counsellors of state” as the next four people in line to the throne had become unworkable in the current circumstances. Anyway, we have now changed that and put it right. It might even refer to efforts to influence the size of the House and reduce it.

I know that it has been the opinion of many distinguished Cabinet Secretaries that this is an executive document and ultimately the preserve of the Prime Minister, but that should not preclude Parliament—and I mean both Houses—from playing a meaningful role in updating it. It is essential that Parliament updates it; the appropriate committees should have the right to be consulted and should reach a view on what the proposed update should be. I hope that the Leader of the House in his reply will at least convey an assurance that that will be undertaken.

Finally, I personally hope that one result of this debate will be to inject the Cabinet Manual with a renewed lease of life. I do not want it to be a polaroid snapshot; I want it to be a valuable document that continues to play a useful part in our efficient constitution, and not let it decay into becoming part of our dignified constitution.

[The Deputy Speaker (Baroness Barker) (LD)]

My Lords, the noble Lord, Lord Howarth of Newport, is taking part remotely, and I invite him to speak.

[Lord Howarth of Newport (Lab) [V]]

My Lords—

[The Deputy Speaker (Baroness Barker) (LD)]

My Lords, we cannot hear the noble Lord, Lord Howarth. I suggest that we move on to the noble Lord, Lord O’Donnell, and come back to the noble Lord, Lord Howarth, when the technical problems have been resolved.

--- Later in debate ---

[Lord Berkeley (Lab)]

My Lords, I too congratulate my noble friend Lady Drake and the committee on this fantastic piece of work. It has also set alight a lot of wonderful comments from noble Lords in this debate, particularly about the need to move on from the era of “good chaps”. Nowadays many of us are not good and we are certainly not all chaps. We have to move on from that.

I want to give a small example of a failure of the Ministerial Code which reflects a complaint against the Prime Minister of the day. Maybe the noble Lord, Lord Hennessy, will have solved the problem when we hear more about his ideas, but it seems to me that we are ending up with the Prime Minister being judge, jury and defence. That does not help public trust.

I wrote to the Cabinet Secretary in July 2021, asking him to investigate allegations that Ministers had failed to comply with paragraph 1.3 of the Ministerial Code, by failing to give

“accurate and truthful information to Parliament”,

knowingly misleading Parliament and failing to be

“as open as possible with Parliament”.

I was complaining about the Department for Transport. It was very helpful, because the Cabinet Secretary passed the letter to the department for a reply, which was of course not very helpful, because it was a long letter of defence.

I thought I would have another go and asked the Cabinet Secretary what he was going to do about that. He said that he could not do anything because

“the decision to investigate matters, and on the appropriate action to be taken, lies with”

the Prime Minister. So I wrote to the Prime Minister, but of course I did not get a reply. I could try again a year later, but it comes back to the fact that, under the code, the Prime Minister is responsible for taking action, and he did nothing.

Other noble Lords have mentioned other failings and the allegations of Ministerial Code breaches within the last five years. I got rather a long list from the Library when I asked, which I found rather depressing. Noble Lords will know all about them: Michael Fallon, Priti Patel, Damian Green, Amber Rudd, Mark Field, Matt Hancock. I am not going to go into what each one of them was alleged to have done because it does not really matter—well, it does matter, but that is not the point of what I am trying to say now.

The worst examples were the allegations against the then Prime Minister about the cost of his wallpaper and things like that. Again, the subject does not matter particularly, but the question I have is about who deals with this. Who deals with the allegations of failure to comply, misleading Parliament, and so on? Is it the independent adviser or the ethics adviser? I do not think the present Prime Minister has either of those at the moment; maybe I am wrong about that, but if he has, we have not heard much about it. Who is responsible for making sure that these people’s advice is independent? Who enforces this?

When he comes to respond, my question for the noble Lord, Lord True, is this: who is actually in charge of deciding what the Prime Minister does and whether he or she responds, and of ensuring that action is taken? As my noble friend said in relation to the succession Bill a couple of weeks ago, it is all right if the Prime Minister is a good chap, or whatever the female equivalent might be, but some Prime Ministers, and some monarchs, have been seen to go mad, or something has gone wrong, and we need to have a way of solving this problem, even when the final decision is alleged to be at the top level. That is why I have great hope in the new ideas from the noble Lord, Lord Hennessy—maybe they will solve the problem.

[The Deputy Speaker (Baroness Barker) (LD)]

My Lords, we will try to re-establish a connection with the noble Lord, Lord Howarth of Newport.

Health and Care Bill

Baroness Barker Excerpts

Lords Hansard - Part 2 & Report stage
Monday 7th March 2022 Lords Chamber

[Viscount Colville of Culross (CB)]

My Lords, I too am very pleased to support Amendment 151A and the following amendments. I also read the letter from the noble Lord, Lord Kamall, to Peers following the debate on this in Committee. He said that it was

“difficult for regulators to keep pace with advertising code breaches without the cooperation of platforms who hold significant data on the process, and host the services”.

That seems to me a recognition of their responsibility in the ad process. As the noble Lord, Lord Black, said, ads create the vast majority of the platforms’ revenue and so they are responsible for controlling their content.

I read a recent survey on the effect of online advertising on young people, which was carried out by the healthy living charity, Global Action Plan. It showed that the average teen sees on Instagram alone one ad every eight seconds. That is the equivalent of 444 ads per hour. The survey also revealed that Facebook’s ad manager directly targeted young people with risky and unhealthy advertising, including for fast food and alcohol. It was the platforms’ data and algorithms which directed these ads, and they need to be made responsible for any restrictions on HFSS advertising as quickly as possible. There are other, more insidious forms of online advertising, such as product placement in digital content, especially among influencers. All these should be made the responsibility of the platforms to control. I hope the amendments will do just that.

I was glad to hear that the Government are looking at the online advertising programme, but I, like many noble Lords, am concerned by the laggardly start. Can the Minister say when she thinks the consultation will conclude? I hope that will happen quickly, because every day, thousands of young people are going to be harmed by the delay. I also ask the Minister to guarantee that platform liability for hosting product placement and others sorts of insidious advertising will be in scope of the consultation.

[Baroness Barker (LD)]

My Lords, at this late hour, I simply want to express my support for the noble Lord, Lord Hunt, and Amendments 154 and 155 in his name by making three simple points. First, we are learning all the time about the importance of nutrition and health. We are also understanding increasingly how poor nutrition can have a devastating effect on recovery and health inequality. It is therefore remarkable that in both hospitals and, more particularly, care homes we have no standards or training for the people involved in the preparation and delivery of food. That is a serious omission.

Therefore, it is time for us to move away from the traditional way in which care catering has developed, which is by scandal and omission, turning it round into a positive by developing new standards of training. We also need to try to get particularly teachers in colleges to get young people to understand that catering in care settings is far more complex then catering in restaurants. Within the NHS we have the opportunity to drive some world-beating standards on nutrition and care, and that is all that we are asking for by asking for this framework and these amendments.

[Lord Grade of Yarmouth (Con)]

My Lords, I am tempted to express my concern that the computer of the noble Lord, Lord Moylan, may have been hacked by the noble Lord, Lord Krebs, with the coincidence of the Grenade bar being at the heart of their contributions to this debate.

That said, I offer a word of warning about the imposition of a hard deadline for the implementation of the advertising ban. However desirable a deadline, it is actually impractical. I do not seek here to delay anything; I accept totally that the argument about the futility of an advertising ban has been lost, and we move on to the implementation. A deadline of 1 April—and all the delegated powers—creates a huge number of time-related consequences following that. Advertising, as well as the delegated powers and the need to produce and consult on guidance on secondary legislation, is a consequence of this. Companies will have no time to assimilate what the new rules mean for their advertising campaigns. Advertising campaigns can take up to a year from conception to final production. The Government have yet to publish the secondary regulations consultation, which will lay out exemptions, such as how SMEs are defined for the purposes of the restrictions.

Once the Bill becomes law, which will not happen for several months, Ofcom—that wonderful organisation —will then need to delegate to the relevant regulator, which, according to the amendments, will not happen until two months after the Bill receives Royal Assent. The designated regulator—most likely the ASA, as we heard—will then need to hold a consultation on the details of the guidance and process the consultation responses before putting out final guidance, which will then take several months. Only once this final guidance is published will brands be able to implement it when it comes to their marketing campaigns.

Some noble Lords may argue that the Government have already made clear what are permissible and what are not identifiable HFSS products and that industry and businesses can prepare around this. The questions and detail of the guidance are far more complicated than that. Industry has a plethora of unanswered questions that need to be resolved and which will take time, covering everything from how liability will apply to third-party delivery companies to the definition of transactional content and what rules might mean for loyalty apps. I hope that your Lordships will reject Amendments 149, 151 and 153 to avoid a chaotic transition to the new rules.

I finish by speaking in support of my noble friend Lord Black’s Amendment 151A and the resulting amendments. My noble friend laid out the case extremely well and I hope he will seek the opinion of the House on this matter. I can add nothing to the arguments that he and other noble friends have laid out. If there is a vote, the simple choice of the House is: do we want to let these monolithic, monopolistic platform giants carry on getting away with murder in this country? They have been allowed to get away with stealing copyrights, they do not regard themselves as publishers, and they create more harm—which, one hopes, the online safety Bill will seek to amend.

This is discriminatory legislation, which makes a difference between two people doing the exactly the same thing: the broadcasters, who will be liable, and the online platforms, for which there is no parity at all. It is about time we recognised that we must deal with these people and regulate them properly and sensibly. This is a perfect opportunity, and I hope your Lordships will support the amendment.

Health and Care Bill

Baroness Barker Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

[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.

Health and Care Bill

Baroness Barker Excerpts

Lords Hansard - Part 2 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, I have Amendment 176, the second amendment in this group, and two other amendments. I shall start with Amendment 176 which is concerned with the treatment of thyroid patients who continue to be denied liothyronine, otherwise known as T3, as the most appropriate treatment for them. For some patients, the standard treatment is not effective. T3 has proven to be a much better treatment, but tragically, a few years ago the manufacturers grossly inflated the cost of T3 by a massive 6,000%. Understandably, NHS England and its associated prescribing advising machinery strongly discouraged the use of the drug and, as a result, many patients had T3 withdrawn and suffered quite considerably or had to fund it privately or source it from abroad. Happily, the price of T3 has come down by 75%, although it could go down further, but I believe it is no longer categorised as a high-cost drug.

The problem is that clinical commissioning groups still treat it as a high-cost drug, so the situation is still very difficult for patients who need it—those for whom the standard treatment is not appropriate. The current guidance states that T3 can be prescribed to patients who have unresolved symptoms on the standard treatment if it is initiated or confirmed following a review by an NHS consultant endocrinologist. A statement in July 2021 restated NHSE guidance, but it has not been followed by clinical commissioning groups. A survey done recently by UK thyroid charities, to which I pay huge tribute, says that 44% of CCGs have not fully adopted the national guidelines or are wrongly interpreting them.

What are we to do? What is the situation here, where we have clear guidance that is not being followed? This goes back to our previous debates about the various mechanisms being brought in to ration treatments, against national guidance or technology appraisal advice from NICE. It is the same issue. I am not expecting the Minister to issue a direction but I am expecting him to tell CCGs and, in future, integrated care boards to get off their backsides, start implementing the guidance properly and realise that this is no longer such a high-cost drug. I appeal to him to do something about that.

I also hope that the Minister will do something about hospital catering. I confess to your Lordships that I am president of the Hospital Caterers Association, where I work very closely with some great professional staff who have to work with their hands tied behind their back. Often they do not have the resources to provide the high-quality food that everyone wants and expects.

During Covid we saw in many local NHS facilities a determination to do everything possible to improve nutrition for both patients and staff. Miraculously, hot food was made available to staff overnight, which, as noble Lords know, seems to have been beyond the capacity of the NHS for many years. I do not know why I am looking at the former Chief Nursing Officer as I say this; I think it is an appeal for support.

This clause is highly welcome as I believe it will lead to higher standards, but my amendments would enable the caterers to deliver on them. The first key point is this: they need the resources to be able to do it. The amount of money spent on hospital food per day at the moment is simply not sufficient. Secondly, we need more training for staff. The training programmes have disappeared, and we need to get them back in to give staff the opportunity to show what they can do. Thirdly, we need to make sure that NHS trusts and foundation trusts are fully on board with bringing forward these regulations. There is no doubt that the efficiency programmes have taken their toll on the budgets for hospital catering and that, equally, the old-style national training schemes fell away and have not been replaced. The pay grade of qualified chefs and cooks needs to be reviewed to reflect the importance of their role. This issue is important in terms of the standards of food and nutrition for our patients and for the well-being of our staff.

My final amendment in this group is Amendment 264. What links all these amendments is that we need more consultants appointed—a small effort to enable us to improve the efficiency of the system. I remind the Committee of my GMC connections in relation to this. The amendment would add the Royal College of Surgeons of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow, and their associated dental faculties, to the colleges that may be involved in the appointment of NHS consultants. My amendment was inspired by the Royal College of Surgeons of Edinburgh, which noble Lords might be surprised to learn has an office in Birmingham because many consultants who work in the English NHS are members of the Scottish colleges.

There seems to be a lacuna in the current regulations. According to the National Health Service (Appointment of Consultants) Regulations 1996 and subsequent guidance issued by the department in 2005, only the Royal College of Surgeons in England is permitted to review surgical consultant job descriptions and send a royal college representative to the advisory appointment committees when it comes to the appointment of consultant surgeons. Other elements of my amendment apply to the appointment of physician clinicians, and the Royal College of Physicians of Edinburgh and the Royal College of Emergency Medicine are also supportive. Although the process and guidance apply only to NHS trusts, foundation trusts are encouraged to follow it.

The Minister has yet to accept any amendment to the Bill. The usual line from the Government is, “We will do this when legislation is available to do so.” Here is a great opportunity for the Minister, as we are here on day 6 of Committee, to get up and say that he is going to accept my amendment.

[Baroness Barker (LD)]

My Lords, in following the noble Lord, Lord Hunt, I declare an interest as the patron of the National Association of Care Catering, a position that I took over from the noble Baroness, Lady Greengross. I admit that, when I had this great honour thrust upon me, I had little idea what I was getting into—and I have discovered a world of highly dedicated, professional people whose contribution to the health of the nation is very much overlooked. I managed to attend their national conference in Nottingham last October, and I have to say that it was one of the most harrowing afternoons I have spent, as they talked about what they had gone through as the people who supply catering not only in hospitals and acute hospitals but in care homes, as well as doing meals on wheels.

I will pick up one point that the noble Lord, Lord Hunt, made, on training. He is absolutely right that this area has suffered a great deal because of various changes not just to training in the NHS but to the training in higher education. We do not have a recognised qualification in care catering in this country, yet these are people who have to produce food for people who have dysphagia, multiple food intolerances and dementia, people who quite often are suffering from malnutrition when they come into hospital, and people who have allergies and often suffer from dehydration. The people who have worked in this field, and some of them have worked in it for many years, suffer a deep sense of frustration, which is that when young people in school or college show an aptitude for or a willingness to go into the world of catering, they are directed towards restaurant catering, because that is where the teachers and lecturers think the money is to be made. Actually, catering for people with difficult medical conditions is a lot more complicated.

I say to the Minister that I am also really impressed by the specialist companies that work in this field—those that produce specialist menus and enable people to order ingredients for complicated menus in complicated settings, as well as those that manufacture cutlery and crockery and vessels that can be used by people whose interaction with that sort of thing is hampered. These can bring a dignity and focus to something that is much overlooked—but talk to dieticians and you will increasingly understand the importance that food plays in maintenance of health and recovery.

I do not know whether or not this will make it into the Bill, but will the Minister go back to the department and ask whether his officials might meet some of the people who do a remarkable and much overlooked job, day in, day out, and who these last two years, perhaps more than anybody else in the NHS, deserved the clap, if only people knew what they had done?

Health and Social Care

Baroness Barker Excerpts

Thursday 9th September 2021 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

I can say to my noble friend that the Health and Care Bill will come to this House when we come back, which will allow a lot of debate on this subject matter. He will be pleased to know that, now we have returned, we have many more opportunities for Back-Benchers to put down the titles of debates they would like to bring before the House. I am sure he will take advantage of that.

[Baroness Barker (LD)]

My Lords, can the Leader of the House explain why employers in freeports are exempt from paying the levy for some employees?

House of Lords: Remote Participation and Hybrid Sittings

Baroness Barker Excerpts

Thursday 20th May 2021 Lords Chamber

[Baroness Barker (LD)]

My Lords, there are two main reasons why I wish to speak in this debate. The first is that, due to some truly appalling experiences very early on during the teething problems of introducing the new system, I, my noble friend Lord Clement-Jones and Members from all Benches came together in a rather insurrectionary way to gather the experiences of Peers of the new virtual system and, subsequently, the hybrid system. Since then, we have continued to engage as a group, particularly with the technical staff of the House who are responsible for the digital systems. It has been extremely helpful for the staff and certainly for the Members. It is on that basis that I want to talk about some of the things that we have identified.

It is absolutely clear from the Constitution Committee report that the hybrid system is not as good as having an entirely real-life setting, but we can take some things from the experience of the past year. We should not mischaracterise what has happened during it. In the midst of a crisis, we worked with the tech companies on systems that were never designed for a Parliament but for a commercial setting. While I agree with those who talk about the distinctions of a Parliament, and of this Parliament and this House in particular, we are not the only democratic organisation in the world having to deal with the new reality. I would stress that we are pre-eminently placed to work with tech companies to develop what will, in future, have to become more participatory and democratic systems. In order to do that, we should continue to work with them.

Over the past few weeks, through the IPU, I have taken part in discussions with women parliamentarians all across the world in different circumstances. It is interesting that there were an awful lot of prejudicial views about how remote working might help women to be participants in parliaments. In some ways, remote working was good and beneficial—in some cases it made it physically safer for women to participate in politics—but there were other respects in which it was not, and women found themselves having to take on even more domestic duties while they tried to fulfil their professional duties.

My plea in all this—particularly to the noble Lord, Lord Cormack—is that we proceed not on the basis of prejudice but on the basis of informed evidence about an evolving situation. I have taken part in several training courses which have been run by our digital staff. I am one of the very few Members of this House who has done so. I did it because when somebody offers me free training, I want to learn, and I go along. There is much about the new systems, and many benefits to them, that noble Lords simply do not know about. Take Zoom, for instance. We had a technical session provided to us by Zoom itself—that shows what ability we have as a House to call upon the providers of these services and to shape them. It is now possible for Members of the House of Commons, not for us, to convene meetings of up to 500 people in their constituency and ask Ministers to come along and be interrogated by them. That is opening up democracy. It may not be as satisfactory as having the poor Minister stand in front of constituents quaking as people call for their blood, but it none the less has a potential benefit.

My one point in this debate is that the staff, technical staff and Members of the House have done things with the best of intentions and to the best of their ability, but it has all been very piecemeal. There is no strategic body in place which has the job and the resources to make informed decisions about how we develop things in future in order to do the unique thing that we have to do, which is to scrutinise government. I hope noble Lords will have taken to heart what my noble friend Lord Newby said about dealing with different stages of legislation in different ways. I hope that noble Lords will also understand and appreciate that much of the work that many of us do in Parliament, while contingent upon us being Members of this House and on what we do in the Chamber, is done elsewhere. When we are building systems for our debates in this House, we have to take that into account.

This is probably the biggest transition this House has faced since the move from quills and parchment to pen and paper. All I am asking is that we approach it in a way that is informed, is not built upon prejudice, and sees change as something of which we do not have to be fearful and as necessary. The rest of the world out there is going through these changes too, and if we do not, we will be left behind.

Coronavirus Bill

Baroness Barker Excerpts

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Wednesday 25th March 2020 Lords Chamber

[Baroness Bennett of Manor Castle]

My Lords, first, I want to follow up on a point I made yesterday and compliment the noble Lord, Lord Bethell, and through him the Government. I asked about MOTs; this morning, there was an announcement of a six-month extension, so thank you.

We have already heard some accounts of the terribly difficult situations that people around the country are in. I will begin with another, that of a woman in Lincolnshire with an autoimmune disease. Under the Government’s recommendations, for her health and well-being and to protect our NHS resources, she should remain at home and self-isolate for 12 weeks. However, she needs an abortion. She also has at home a two year-old with a heart condition—another reason why she should not leave the house—but she must leave the house and go to a clinic or approved place to take the first of the pills for an early medical abortion under our current law. I am sure that every Member of your Lordships’ House will agree that this is a terrible situation. It is also an utterly medically unnecessary situation.

Taking the pill at a clinic is not a medical necessity; the provision is in the 1967 Abortion Act—an Act that was passed 25 years before medical abortions were even introduced. In the next 13 weeks, based on the average figures, 44,000 women will have to travel to a clinic—to an approved place—to take that pill, which is utterly medically unnecessary. In countries such as the United States, Australia and Canada, it is possible for women to take both the pills necessary for an early medical abortion at home.

This amendment provides for—and I stress this—temporary modifications to the Abortion Act 1967. It provides for a woman to take both those pills at home, as happens in the countries I mentioned, and it removes the two-doctor rule whereby two doctors have to sign off on an abortion. Only a small number of doctors and health professionals provide these services. We have discussed time and again in your Lordships’ House just how much pressure our medical professionals and NHS services are under and how precious a resource those doctors are, most of whom do other services as well.

The amendment calls for allowing nurses and midwives, who are already professionally qualified and who do much of the work now, to certify these abortions to allow them to go ahead. One nurse, midwife or doctor would then report back to the Chief Medical Officer as usual. There are some points to stress about the general provisions of the Bill that perhaps we have not talked about very much. The Bill, and this amendment, would give the Government the power to switch provisions on and off as they wish. They can also do so regionally—again, we have not talked about this very much—or the nations can do so according to the needs of place and time. If, for example, there was a real problem with provision in the south-west, the Government could take a small-scale decision for a particular place and time to make sure that abortions are available for the people who need them.

The argument for having this provision—as with many such provisions—is that it is about protecting everybody. If 44,000 women have to make extra journeys, it means more chances for the coronavirus to spread. We would be playing into the virus’s hands. We have all heard, seen and have been using the slogan “Stay at home. Save lives”; this provision allows that to happen. We would be protecting our precious medical professionals. The people who are increasingly operating remotely need to be able to operate through telemedicine remotely. We would be protecting NHS resources, which we know there is already enormous pressure on. If people are not able to secure an early medical abortion, they will seek surgical abortions, which will put much more pressure—absolutely unnecessary pressure—on the NHS.

I ask the Minister to accept and incorporate this amendment into the Bill. Doing that will not force the Government to do anything; it simply creates the possibility for the Government to act. As the noble Lord, Lord Adonis, who is not in his place, said, we will not be here for a very long time to make other legal changes. We would expect that to be the time of maximum pressure from the virus, so please can this temporary change be put in place to deal with this crisis?

[Baroness Barker (LD)]

My Lords, I have attached my name to this amendment, which has support on Benches across the House. In moving this amendment, the noble Baroness described exactly what this is: a power that the Government could and should take unto themselves in order to use it if necessary. Why do we think it might be necessary? “We” includes the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and the Faculty of Sexual and Reproductive Healthcare—all the providers and people within the health service who know this piece of work better than anybody else. Why do we need it? As of this morning, 25% of BPAS clinics are closed because they do not have the staff to open. That means things are becoming much more difficult for women. Yesterday, women in York needed to travel two miles to secure an earlier medical abortion. As of today, they will have to travel 40 miles.

--- Later in debate ---

[Baroness Barker]

Can the Minister concede that we are tabling this amendment because of how the NHS and medical services are affected by the Bill. We are not asking for any change in the criteria for abortion. We are asking simply for the process of the administration of decision-making to change.

That is being done right across the whole of the health service. The Minister has explained that telemedicine is being rolled out at a surprising rate. I do not understand why an experienced clinician or a midwife cannot make the judgments that he was talking about via video. They see women all the time and they will be able to make the same judgments. I do not understand that. If the Government do not accept this proposal, I ask him to accept that they should at least be under an obligation to continue to meet very regularly with the Royal Colleges and the organisations involved in this situation day to day, and they should be willing to come back with the power to make this change under a separate piece of legislation—because if, in seven weeks’ time, there is a clear pattern of women being failed, we cannot let it continue.

[Lord Bethell]

I completely recognise that the noble Baroness’s intentions are totally and 100% benign. She has the interests of the women concerned at heart. That intention is completely clear to me and I utterly endorse it. Where there is a difference of opinion and where we have taken a huge amount of advice—we have worked with the scientific advice in the department —is in the fact that the changes being offered are a fundamental change to the way abortions are regulated and administered in this country. Those regulations and administration arrangements have been worked on for years and are subject to an enormous amount of consensus. Her point on monitoring the situation is exactly the one that the noble Baroness, Lady Watkins, made earlier. I commit the department to monitoring it. We will remain engaged with the Royal College of Obstetricians and Gynaecologists and other stakeholders. She is absolutely right that we can return to the subject with two-monthly reporting back, and it can be discussed in Parliament in the debates planned on a six-monthly basis.

Working Group on Independent Complaints and Grievance Policy

Baroness Barker Excerpts

Thursday 8th February 2018 Lords Chamber

[Baroness Evans of Bowes Park]

On the noble Baroness’s second point, about inappropriate behaviour, she is absolutely right, which is why we are procuring external experts, one with specific expertise in sexual violence and sexual harassment and another to look more at bullying and harassment. They will have the expertise and knowledge to help those who wish to complain work out what they want to do and to give them support and guidance. That is part of why we are going externally to deliver these services: to make sure we have experts who can help victims and complainants navigate the process.

On vexatious claims, the noble Baroness is absolutely right: it was a concern raised within the working group and by various people who gave evidence. Obviously, confidentiality throughout the process will be key. As the Statement made clear, we will also make sure that both victims and alleged perpetrators have access to the information available and to support, advice and representation if they need it. That way, we can make sure that everyone is able to put their case forward and that both parties can respect whatever decision is ultimately made and deal with its outcome, be it the perpetrator having a sanction imposed or the victim feeling that they have had their case properly heard.

[Baroness Barker (LD)]

My Lords, like other noble Lords, I welcome the Statement and the report. The noble Baroness was very clear that the new procedure will apply to behaviour not just in this place but elsewhere—I think she referred to elsewhere in connection with a person’s role as a parliamentarian. Can she add some more information and detail to that? Also, how will people who believe themselves to have been victims of abuse elsewhere be enabled to access the new procedures, which, as I understand them, will operate largely within this building? How will people from outside access the new service?

[Baroness Evans of Bowes Park]

One issue that we were unable to resolve within the group because it was complex was around constituents and constituency offices. On that side of things, there is further work to be done, because it was clear that it is a complex area. Obviously, underpinning all this is a new behaviour code which everyone will sign up to. That will be around behaviour within one’s role, which will obviously apply to behaviour outside Parliament.