Puberty-suppressing Hormones

Debate between Baroness Bennett of Manor Castle and Baroness Merron

Monday 16th December 2024 Lords Chamber

[Baroness Merron (Lab)]

My noble friend is right to raise the second point. It is a whole range of interventions, and that is certainly something that we have very much in mind for consideration, for the reasons that we have heard in the Chamber this evening and the points that my noble friend makes. In respect of timings, it is a planned pathway study and that includes a clinical trial component. It is, as I said, to build evidence. I am glad to say that it remains on track to commence recruitment early in 2025, but only after there has been ethical approval. When that is granted, that is when the final study protocol will be ready, and I know that noble Lords will have a lot of interest in that. We will be issuing further updates in early 2025, and if there are any particular questions, noble Lords are very welcome to raise them with me.

[Baroness Bennett of Manor Castle (GP)]

My Lords, my question follows on from that of the noble Baroness, Lady Walmsley, about the scale of the trial. I also note the report from the experts at the Council of Europe, which the noble Baroness referenced. In the other place, the Secretary of State said in response to my honourable friend Carla Denyer that the clinical trial would be “uncapped”, and the Minister repeated that word this evening. However, an article published yesterday in the Metro, arising from various freedom of information requests and headlined, “Trans Youth ‘Languishing’ While Waiting Six Years For Gender Healthcare”, said:

“If a trans young person joined the waiting list for gender-affirming healthcare on the NHS today, they would have to wait 308 weeks for a first appointment”.


In that context, I am struggling to understand where the Government will secure the resources from to run a trial to provide the resources needed to have this uncapped clinical trial allowing access to puberty blockers.

[Baroness Merron (Lab)]

In view of what the noble Baroness said, it is quite important to consider that the children and young people’s gender services waiting list currently has 6,237 people on it. I certainly agree that waiting lists for these services are too long. We are committed to changing that, which is why I outlined the timetable for the new gender services and the opening of the new centres. They will increase clinical capacity and reduce waiting times for sure. On the point the noble Baroness raised, there is a commitment to the clinical trial, and I am glad there is. As we have brought forward this legislation in an absence of evidence, it is incumbent on us, as a Government, to follow through on what the previous Government started in train, which is to use a clinical trial to provide the evidence. Otherwise, the debate would remain uninformed and not evidence-based, and that cannot be helpful.

Government Policy on Health

Debate between Baroness Bennett of Manor Castle and Baroness Merron

Tuesday 10th September 2024 Lords Chamber

[Baroness Merron (Lab)]

I thank the noble Baroness for sharing her experience of consulting widely. It is certainly entirely legitimate for government departments to do just that. However, those who do not have a formal role are not required to declare interests; it is different for those who have a formal role. Requiring them to do so would mean, for example, us sending forms in advance to Cancer Research UK before it comes in to talk to us about cancer and to assist us. Would we want that? We would not. Of course, where there is a formal role, we absolutely do that.

It is probably worth saying that a particularly high-profile invitation went from the Secretary of State to the noble Lord, Lord Darzi. He will report shortly on the true state of the National Health Service. He does not have a specific role in the department but he has been invited by the Secretary of State to assist; I believe that he will assist both your Lordships’ House and the other place.

[Baroness Bennett of Manor Castle (GP)]

My Lords, when the Green Party consults on health policy, among the organisations it consults are the Socialist Health Association, Keep Our NHS Public and 999 Call for the NHS—all organisations that are greatly concerned about the continuing privatisation of the NHS. Can the Minister tell me whether the Secretary of State or she herself have had meetings with any of those three organisations since coming into government?

[Baroness Merron (Lab)]

I cannot answer that, I am afraid. I would be very happy to look at it for the noble Baroness.

Coronavirus: UK Deaths

Debate between Baroness Bennett of Manor Castle and Baroness Merron

Monday 29th July 2024 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

I thank noble Lords. Following on from the question from the noble Earl, Lord Clancarty, about long Covid, and of course continuing new cases are arising even from apparently initially mild infections, we also face the threat that I hope the Government are watching closely of H5N1 in terms of other respiratory diseases, and we know it is only a matter of time before another respiratory pandemic faces us. What steps are the Government taking to look at air filtration and ventilation systems to provide a better public health system that is more resistant to future diseases in schools and other public buildings and perhaps to provide ways for people to assess in premises they visit how good the ventilation and filtration is for them to be able to go into those environments?

[Baroness Merron (Lab)]

The noble Baroness offers some helpful suggestions as to areas that we can be looking at, but this for me all comes under the headline of resilience and certainly we are monitoring potential emergencies, including the one that the noble Baroness refers to. I can assure her also that preparedness will not just focus on respiratory means of passing on disease but will now look at all of the five routes of transmission, and I feel that will make us a much more resilient country.

Online Safety Bill

Debate between Baroness Bennett of Manor Castle and Baroness Merron

Committee stage
Thursday 22nd June 2023 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, as the noble Lord, Lord Clement-Jones, said in introducing this group some time ago, it is very diverse. I shall comment on two aspects of the amendments in this group. I entirely associate myself with the remarks of the noble Lord, Lord Allan, who really nailed the problems with Amendment 266, and I very much support the amendments in the name of the noble Baroness, Lady Kennedy of The Shaws; I would have signed them if I had caught up with them.

The noble Baroness, Lady Fox, talked about causing alarm and distress. I can draw on my own experience here, thinking about when someone randomly starts to post you pictures of crossbows. I think about what used to happen when I was a journalist in Bangkok, when various people used to get hand grenades posted into their letterbox. That was not actively dangerous—the pin was not pulled; it was still held down—but it was clearly a threat, and the same thing happens on social media.

This is something of which I have long experience. In 2005, when I was the founder of the feminist blog Carnival of Feminists, I saw the kinds of messages that the noble Baronesses have referred to, which in the days before social media used to be posted as comments on people’s blogs. You can still find the blog out there—it ran from 2005 to 2009—but many of its links to other blogs will be dead because they were often run by young women, often young women of colour, who were driven to pull down their blogs and sometimes were driven off the internet entirely by threatening, fearsome messages of the type that the noble Baroness, Lady Kennedy, referred to. We can argue about the drafting here—I will not have any opinion on that in detail—but something that addresses that issue is really important.

Secondly, we have not yet heard the Government’s introductions to Amendment 268AZA, but the noble Lord, Lord Clement-Jones, provided us with the information that it is an amendment to create the offence of encouraging or assisting self-harm. I express support for the general tenor of that, but I want to make one specific point: so far as I can see, the amendment does not have any defence or carve-out for harm-reduction messages, which may be necessary.

To set the context here, figures from the Royal College of Psychiatrists say that about one in 10 young people self-harm at some stage in their youth, and the RCP says those figures are probably an underestimate because they are based on figures where medical professionals actually see them so the number is probably significantly higher than that. An article in the Journal of Psychiatric and Mental Health Nursing from 2018 entitled “Self-cutting and harm reduction” is focused on in-patient settings, but the arguments in it are important in setting the general tone. It says that

“harm reduction in all its guises starts from the premise that the end goal”—

that is, to end self-harm entirely—

“is neither necessarily nor inevitably abstinence”,

which cannot be the solution for some people. Rather,

“the extinction of some particular form of behaviour may not be realistic for, or even desired by, the individual”.

So you may find messages that say, “If you are going to cut yourself, use a clean blade. If you do cut yourself, look after the wound afterwards”, but there is a risk that those kinds of well-intentioned, well-meaning and indeed expert messages could be caught by the amendment. I googled self-harm and harm reduction, and the websites that came up included Self Injury Support, which provides expert advice; a number of mental health trusts and healthcare trusts; and, indeed, the royal college’s own website.

The noble Lord, Lord Allan of Hallam, was trying to address this issue with Amendment 268AZC, which would allow the DPP to authorise prosecutions, but it seems to me that a better approach would be to have in the government amendment a statement saying, “We acknowledge that there will be cases where people talk about self-harm in ways that seek to minimise harm rather than simply stopping it, and they are not meant to be caught by this amendment”.

[Baroness Merron (Lab)]

My Lords, as the noble Baroness, Lady Bennett, said, it seems a very long time since we heard the introduction from the noble Lord, Lord Clement-Jones, but it was useful in setting this helpful and well-informed debate on its way. I am sure the whole Committee is keen to hear the Minister introducing the government amendments, even at this very late stage in the debate.

I would like to make reference to a few points. I was completely captivated by the noble Lord, Lord Moylan, who invoked the 10 commandments. I say to him that one can go to no higher order, which I am sure will support the amendments that he and his colleagues have put forward.

I will refer first to the amendments tabled by my noble friend Lady Kennedy. At a minimum, they are interesting because they try to broaden the scope of the current offences. I believe they also try to anticipate the extent of the impact of the government amendments, which in my view would be improved by my noble friend’s amendments. As my noble friend said, so many of the threats that are experienced online by, and directed towards, women and girls are indirect. They are about encouraging others: saying “Somebody should do something terrible to you” is extremely common. I feel that here is an opportunity to address that in the Bill, and if we do not, we will have missed a major aspect. I hope that the Minister will take account of that and be positive. We can all be relaxed about whether the amendments need to be made, but the intent is there.

That part of the debate made a strong case to build on the debate we had on an earlier day in Committee about violence against women and girls, which was led by the noble Baroness, Lady Morgan, and supported by noble Baronesses and noble Lords from all sides of the House. We called upon the Minister then to ensure that the Bill explicitly includes the necessary amendments to make it refer to violence against women and girls because, for all the reasons that my noble friend Lady Kennedy has explained, it is considerably greater for them than for others. Without wishing to dismiss the fact that everybody receives levels of abuse, we have to be realistic here: I believe that my noble friend’s amendments are extremely helpful there.

This is a bit in anticipation of what the Minister will say—I am sure he will forgive me if he already has the answers. The noble Lords, Lord Clement-Jones and Lord Allan, referred particularly to the coalition of some 130 individuals and organisations which have expressed their concerns. I want to highlight those concerns as well, because they speak to some important points. The groups in that coalition include the largest self-harm charity, Self Injury Support, along with numerous smaller self-harm support organisations and, of course, the mental health charity Mind. Their voice is therefore considerable.

To emphasise what has already been outlined, the concern with the current amendments is that they are somewhat broad and equivalent to an offence of glamorising self-harm, which was rejected by the Law Commission in its consultation on the offence. That followed concern from the Magistrates’ Association and the Association of Police and Crime Commissioners that the offence would be ambiguous in application and complex to prosecute. It also risks criminalising people in distress, something that none of us want to see.

In addition, the broadness of the offence risks criminalising peer support and harm reduction resources, by defining them as capable of “encouraging or assisting” when they are in fact intended to help people who self-harm. This was raised by the noble Baroness, Lady Finlay, today and in respect of her Private Member’s Bill, which we debated very recently in this Chamber, and I am sure that it would not be the Minister’s intention.

I would like to emphasise another point that has been made. The offence may also criminalise content posted by people who are in distress and sharing their own experiences of self-harm—the noble Baroness, Lady Finlay, referred to this—by, for example, posting pictures of wounds. We do not want to subject vulnerable people to litigation, so let us not have an offence which ends up harming the very people it aims to protect. I shall be listening closely to the Minister.

Health and Care Bill

Debate between Baroness Bennett of Manor Castle and Baroness Merron

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

[Baroness Bennett of Manor Castle (GP)]

My Lords, I am also aware of the hour, and offer Green support for the amendment of the noble Baroness, Lady McIntosh. We are talking here about a cost-benefit analysis. Some of the costs on which I would focus, and their impacts, go beyond the narrowly medical impacts of the people who consume the water. The question I raised in Committee was whether people today actually consume tap water, and whether they will continue to do so. I made the point that 90% of people drank tap water in 1978, but that figure had fallen to 73% by 1998. I do not believe that there have been detailed national figures since then.

I thank the noble Lord, Lord Kamall, for writing to me in response to that debate and providing a set of figures which the Government had researched. I will note two of the figures which the Minister cited in that letter. One was a 2010 Ipsos MORI survey in the West Midlands showing that two-thirds of surveyed people supported water fluoridation if it was going to improve dental health. That, of course, shows that a third of people are not supporting it. This is the group about which I am concerned—a group which I have encountered many times and in many parts of the country. I do not agree with all their concerns, but that is a fact.

I noted that the Minister also cited a north-east survey from 2021 where 60% of people backed water fluoridation. As the noble Baroness, Lady McIntosh of Pickering, said, we are talking about people not having a choice about consuming that water, unless they choose to buy bottled water. Anyone going to a supermarket in Sheffield, particularly in its poorer areas, will see people buying bottled water in very large quantities. One of my concerns, and where I hope the cost-benefit analysis would come in, is looking at the sociological issues. The Government should be doing a great deal more to promote the consumption of tap water and to discourage the use of bottled water. However, as the Bill currently stands, it risks pointing us in the opposite direction.

The noble Lord, Lord Storey, talked in Committee about how Liverpool City Council had very successfully engaged in a targeted programme to address the most vulnerable communities and ensure that dental health was improved. It demonstrably was improved.

The Minister said, “Oh well, any local authority can do the same thing.” I point out to him that local authorities’ budgets are enormously overstretched—something we have addressed in the social care elements of the Bill in particular. Would the Government consider perhaps taking the money that might be spent on fluoridation and giving it to local authorities for targeted campaigns to reach the children who need it most?

[Baroness Merron (Lab)]

I thank the noble Baroness, Lady McIntosh, for moving this amendment. I feel that we have discussed these issues at considerable length at previous stages of the Bill, so I do not wish to go over old ground, other than to say that the Royal Society for Public Health, the British Dental Association, the Chief Medical Officer and many others are very much in favour of greater fluoridisation because, on balance, there is strong scientific evidence that it is an effective public health intervention. In other words, it is the single most effective way to reduce oral health inequalities and tooth decay rates, especially among children, and it is, as your Lordships’ House knows, recommended by the World Health Organization. On all these positive points, I am very much inclined to agree, and do not feel that the amendment before your Lordships’ House would be helpful to support that intervention.

Health and Care Bill

Debate between Baroness Bennett of Manor Castle and Baroness Merron

Lords Hansard - Part 1 & Committee stage
Wednesday 9th February 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to follow everyone who has spoken in this group. I thank the noble Baroness, Lady Chakrabarti, for so powerfully and clearly introducing this amendment, to which I was pleased to attach my name. The case has been overwhelmingly made, so I will not go over the same ground but will add a couple of points and draw some things together.

It is interesting that we started the day with the ARIA Bill. Concern was expressed from several quarters of your Lordships’ House about public money going into ARIA and whether we would see public returns from that money. As the noble Baroness, Lady Chakrabarti, said, what we have seen so often is the socialisation of costs and the privatisation of profits in so many areas of research and knowledge.

I draw to the attention of any noble Lord who has not seen it a very useful briefing on this amendment prepared jointly by Just Treatment, STOPAIDS, Global Justice Now and Universities Allied for Essential Medicines. That brings out two points, and it is worth looking at the national and the international. We have tended to focus on the international. Nationally there are some fascinating figures. The NHS pays more than £1 billion a year for medicines, but two-thirds of the upfront costs of producing those medicines come from public funding.

That is the national side. Looking at the international side, we have talked about and focused very much on Covid, but we really need to think about the fact that we are now in the age of shocks, in a world that is environmentally extremely disturbed. That is certainly a factor in the appearance of Covid; we have seen SARS and MERS, and there is Ebola out there. We need to build resilience into our world. We are talking about changing so many different things, and whether it is supply chains, medical supply chains specifically, or anything else, we really need to think about preparing for that different world, with the focus on resilience, rather than on private profits as it has been.

The noble Lord, Lord Crisp, asked an interesting question: why do we see the UK, the EU and Switzerland lining up against the rest of the world? The answer is there in profits, in an ideology that says, “We have to organise everything for private profits and somehow the benefits will trickle down.” It is interesting that today Michael Gove has gone on the record as saying that trickle-down has not worked; it is a failed ideology. Of course, there is also the impact of those profits being fed into our political system and the influence that that money and that lobbying have.

I will finish with this final thought. The noble Baroness, Lady Chakrabarti, said—and I think this reflects what other noble Lords, particularly the noble Baroness, Lady Lawrence, and the noble Lord, Lord Crisp, said—that we have been utterly wicked in our behaviour towards the global south in the Covid pandemic in failing to ensure that it has crucial vaccines. We have also, as has become obvious with omicron, spectacularly shot ourselves in the foot. I say to those who will not accept moral arguments for this amendment: please look at the practical self-interest. No one is safe until everyone is safe.

[Baroness Merron (Lab)]

My Lords, I thank my noble friend Lady Chakrabarti for raising the crucial matter of countries and peoples left behind in terms of the opportunity to have a necessary vaccination programme available to them. My noble friend Lord Campbell-Savours spoke of the importance of supporting innovation, which is one of the ways in which we can ensure that, while my noble friend Lord Howarth rightly said that the subject requires exploration outside of the Health and Care Bill—something also commented on by the noble Lord, Lord Crisp, who emphasised, as do I, the need for the political will to make progress.

There is no doubt, as we have heard today, about the gravity of the issues at stake and the need to resolve them. It is the case that where public funding is provided there must be conditionality, although of course that may be complex to refine into legislation. There are of course additional issues when funding is also coming from the private sector along with a need to ensure a balance of interests. It would certainly be helpful to have a stipulation that avoided placing undue bureaucracy and restraint on smaller developments and small-scale research. We do not want to see the pace of research slowed down with researchers tied up in lengthy proposal writing, contract negotiations and legal agreements.

As my noble friend Lady Lawrence has said, we know that the pandemic is not over until it is over everywhere, so the amendment raises the opportunity to explore whether the immediate waiver of intellectual property rights would mean an end to the pandemic everywhere. It is relevant to assess what contribution or otherwise intellectual property rights make to the promotion of technological innovation and the transfer and dissemination of technology. There is an advantage for producers and users of technological knowledge and the consideration of rights and obligations, and that needs to be considered in the round.

In respect of the response and actions to a pandemic declared by the World Health Organization, while I understand the intention behind the amendment, in order to be consistent I would comment with some caution about the Secretary of State being compelled to immediately take actions, particularly without any form of oversight—something that we will return to later in Committee.

However, I hope that today we can obtain some reassurances from the Minister about the Government’s intentions and plans in order that we can find a way forward so that low-income countries and their peoples have access to vaccines both now and in future.