All Baroness Blackstone debates involving the Department of Health and Social Care

Mon 14th December 2020
3 interactions (101 words)
Wed 9th December 2020
3 interactions (38 words)
Thu 22nd October 2020
3 interactions (67 words)
Mon 14th September 2020
3 interactions (98 words)
Tue 24th March 2020
3 interactions (838 words)
Tue 22nd October 2019
3 interactions (899 words)
Thu 16th July 2015
3 interactions (327 words)
Thu 23rd October 2014
3 interactions (43 words)

Covid-19: Vaccines and Pregnancy

Baroness Blackstone Excerpts
Monday 14th June 2021

(5 months, 2 weeks ago)

Lords Chamber

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Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
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My Lords, my noble friend made a clear case for the importance of improving the way in which patient data is collected and analysed in this country. It is something that we are working on at the moment. She highlights a very difficult situation. A third of women do not know that they are pregnant, of course, and, when they are pregnant, their data is first caught at the hospital where they decide to have their birth. Those databases are not easily linked. We do not have a countersignal for pregnancy at the moment; it is therefore not an acute priority. However, I take my noble friend’s point and will look into it further.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, I declare an interest as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. The RCOG survey found that more than half of those who declined the vaccine did so because they were waiting for more information about the safety of the Covid-19 vaccination during pregnancy. Will the Government, as a matter of urgency, issue guidance to all pregnant mothers explaining that the vaccination will not harm their unborn babies? Will they also provide facilities for pregnant women to be vaccinated at antenatal clinics as a mechanism to increase the take-up of vaccinations by pregnant women?

Lord Bethell Portrait Lord Bethell (Con)
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I am extremely grateful for those constructive suggestions from the noble Baroness. We have a very large amount of materials specifically for pregnant women, including guidance for pregnant women and a guide for women who are of childbearing age, pregnant or breastfeeding; those are widely distributed by GPs. However, as I said, a lot of pregnant women do not know that they are pregnant, so it is not possible to reach all of them all the time. At the moment, our priority is to ensure that those aged over 50 take their second jab. We will sweep up other demographics, and we will make that a priority when we reach it.

Women’s Health Strategy

Baroness Blackstone Excerpts
Tuesday 9th March 2021

(8 months, 3 weeks ago)

Lords Chamber

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Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
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My Lords, my noble friend touches on two very important points. He is entirely right that mental health has previously been underrepresented in the strategies of our healthcare. I hear loud and clear noble Lords who repeatedly make the case for a greater focus on mental health, and I take that message back to the department as much as I can. I reassure him that mental health will be very much a priority in this area. The two facts—that it is often women who are connected with mental health issues and that it is women who are often overlooked—are probably connected. It is extremely challenging for us to get women from ethnic minorities, for instance those from a Gypsy or Roma background—that is such a good example—fully engaged in our healthcare strategy. If the noble Lord has any suggestions or recommendations for how we can better engage with them, I invite him to submit evidence to the consultation.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, I draw attention to my interests as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. I warmly welcome this Statement, but we know that women’s healthcare is too often fragmented and unco-ordinated. So how will the Government ensure that their different strands of work on women’s health—this strategy, the sexual health strategy and the violence against women and girls strategy—are all properly aligned and based on a life course approach to women’s health, avoiding the creation of even more fragmentation for women?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the question of fragmentation does not affect women alone; it is a problem across the healthcare system. However, the noble Baroness is entirely right: some of the conditions that afflict women in particular are not properly prioritised, and, therefore, the pathways connected with them are not as developed as they should be. That is the kind of challenge that we wish to address. However, the overall macro point is this question of listening: have we really listened to women—their symptoms, needs and health priorities—or are we behind the curve on that? I suspect that, too often, the health priorities that women would like to see emphasised simply have not been heard by the system.

Ockenden Review

Baroness Blackstone Excerpts
Monday 14th December 2020

(11 months, 2 weeks ago)

Lords Chamber

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Department of Health and Social Care
Baroness Fookes Portrait The Deputy Speaker (Baroness Fookes) (Con)
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I do not see the noble Baroness, Lady Altmann, in her place, so I call the noble Baroness, Lady Blackstone.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, I declare an interest, as set out in the register, as the chair of the trustees of the Royal College of Obstetricians and Gynaecologists. As the Minister has admitted, this report makes shocking reading, so what steps will the Government take to monitor the improvements they are pledging for maternity services right across the country to avoid the tragedies that are revealed by this review? Will the Government commit to publishing the findings of any future evaluation and, in particular, data on the avoidable deaths and long-term disabilities that result from failures in the care of women during childbirth?

Lord Bethell Portrait Lord Bethell (Con) [V]
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My Lords, policy officials at the DHSC are working with both the CQC and NHS England on improving our surveillance and the publication of data, as the noble Baroness rightly points out. A key development in this area is the work by HSIB to investigate each and every death and major incident in maternity suites. That provides an absolutely invaluable resource to understand where and when things go wrong. We will continue to publish those reports as they happen and will learn lessons from their insights.

Covid-19 Vaccine Rollout

Baroness Blackstone Excerpts
Wednesday 9th December 2020

(11 months, 3 weeks ago)

Lords Chamber

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Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
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I am enormously grateful to the noble Lord for his clear and heartfelt offer of help, and I completely endorse his comments. The collaboration between the NHS, the Government and business has been at the heart of our entire response to the pandemic. This collaboration has been termed the “triple helix”—a phrase that I like very much indeed. It is going to be at the heart of our building back of the healthcare system in the years ahead. On the noble Lord’s kind offer, I remind him that when someone takes any medical treatment, including a vaccine, they have to have the space to take stock and recover from the excitement of the vaccine, and they have to be supervised in that space by someone with some kind of clinical experience. So, while his offer is kind, it is likely that vaccine distribution will be in locations where we can put clinical supervision.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, do the Government intend to create some kind of vaccination passport, which will allow people to attend events across the UK and to travel to and from the UK without quarantine, if they have been vaccinated?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the noble Baroness raises an extremely intriguing prospect. If it is indeed the case that those who have been vaccinated are not themselves contagious and cannot transmit the disease, there is the possibility that the vaccination will enable them to do things that might not be open to other members of the public. However, it is too early to call that one. We do not have the scientific evidence to demonstrate that the vaccine stops any infectiousness. We are working hard to try to understand that better. If it can be proved, we will look at an enable strategy.

Covid-19: South Yorkshire

Baroness Blackstone Excerpts
Thursday 22nd October 2020

(1 year, 1 month ago)

Lords Chamber

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Department of Health and Social Care
Lord Lexden Portrait The Deputy Speaker (Lord Lexden)(Con)
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The noble Baroness, Lady Pidding, who is next on the list, has withdrawn , so I call the noble Baroness, Lady Blackstone

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, what steps are the Government taking to increase NHS lab capacity for testing in areas suffering from new restrictions? What advice has been given to care homes in those areas to alleviate the appallingly inhumane denial of access of families to their elderly relatives? For example, will regular testing be made available to those visiting their desperately lonely and sometimes confused relatives in care homes?

Lord Bethell Portrait Lord Bethell (Con)
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I pay tribute to NHS colleagues who have done an enormous amount to increase NHS lab capacity, and would be happy to share the numbers with the noble Baroness. We have written to care homes to emphasise the critical importance of the pastoral visits to which she refers. There is no question of a care home shutting out visitors if it can be avoided and we are putting regular testing in place to protect care homes. We are looking at providing regular testing for visitors and hope to make progress on it.

Covid-19 Update

Baroness Blackstone Excerpts
Monday 14th September 2020

(1 year, 2 months ago)

Lords Chamber

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Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
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My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, given the intrusive and damaging effects, especially on family life, of the decision to limit social contacts to six people, can the Minister say why it was decided to apply this both inside and outside, rather than to follow the Welsh Government’s position of applying the new ruling only to meetings inside? Does he agree that medical evidence suggests that the chance of contracting the virus outside is tiny in comparison with inside, and that, with regard to his quest for simplicity, nobody is so simple that they cannot tell the difference between inside and outside.

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I agree that everyone can tell the difference between inside and outside, but everyone also has eyes, and may have seen, as I have, how people crowd together in the forecourts and beer gardens of Britain. If they were all standing on draughty hillsides with the wind blowing the disease around, that would be one thing, but the simple fact is that our prevalence has gone up—the evidence speaks for itself—and that is why we need to be clearer about this simple measure.

Medical Teaching and Learning: Ethnic Diversity

Baroness Blackstone Excerpts
Tuesday 14th July 2020

(1 year, 4 months ago)

Lords Chamber

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Department of Health and Social Care
Lord Bethell Portrait Lord Bethell
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The noble Baroness put her point well, although the broadband deficiencies meant that I did not get all of it. I emphasise that this area of policy work is very much the focus of the drafting of the People Plan, which will put a spotlight on a number of the areas of our human resources, including BAME people, and we look forward to the publication of that plan.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab) [V]
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My Lords, while the curricula of medical schools are for them to determine, could the Minister tell the House whether any meetings between the Medical Schools Council and Ministers have taken place recently? Will he ensure that a meeting is arranged in the near future to hear from the medical schools what they are doing, first, to improve the representation of Afro-Caribbean staff and students and, secondly, to ensure that teaching and research properly explore those conditions to which the BAME community is especially susceptible? Black lives really do matter.

Lord Bethell Portrait Lord Bethell
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The noble Baroness asks a very specific question; I cannot, I am afraid, answer precisely on what meetings there have been with the medical councils, particularly during the busy Covid period. All I can say is that there is ongoing and regular engagement with the medical schools that focuses very much on the key issues that she describes. Diversity and Inclusion: Our Strategic Framework 2018-2022, from Health Education England, is a very explicit and specific programme of works in which we engage all those in health education. As I mentioned, we are working extremely hard on our recruitment campaigns to ensure that they reach communities otherwise not reached.

Covid-19: Mental Health Services

Baroness Blackstone Excerpts
Thursday 2nd July 2020

(1 year, 4 months ago)

Lords Chamber

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Department of Health and Social Care
Lord Bethell Portrait Lord Bethell [V]
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My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab) [V]
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My Lords, there is increasing evidence that the mental health of children and young people has been badly affected by the Covid-19 lockdown. Given that the provision of mental health services to this age group was already inadequate, why has progress in implementing plans in the Green Paper on child mental health been so poor, particularly in the rollout of child mental health teams? What steps will the Government now take to rectify that?

Lord Bethell Portrait Lord Bethell [V]
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The noble Baroness is likely correct that the epidemic has had a particular effect on children and young people. The evidence on this is not crystal clear, but that is the strong instinct of all those in the field. I personally welcome the reopening of schools, which will have a particularly beneficial effect on those children who at present are stuck at home and do not have the support of the school system. Mental health services for young people are part of our long-term plan, with the additional £2.3 billion of spending on mental health. Our ambitions in that area remain enormous.

Coronavirus Bill

(2nd reading (Hansard))
Baroness Blackstone Excerpts
Tuesday 24th March 2020

(1 year, 8 months ago)

Lords Chamber

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Department of Health and Social Care
Baroness Harding of Winscombe Portrait Baroness Harding of Winscombe (Con)
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My Lords, I begin by declaring my interest as chair of NHS Improvement. At my pre-appointment hearing two and a half years ago, I said I would be very cautious about speaking on health matters while in this role, but I hope noble Lords will forgive me for doing so as I feel in these extraordinary times it would be wrong not to speak.

First, I express my deepest sympathy for those who have already lost loved ones because of Covid-19 and I send my very best wishes to those currently in hospital or with relatives in hospital or at home fighting the disease. I shall speak today about why this Bill matters so much, why it matters to our NHS people and why it matters to all of us. I shall start by reading a statement from my noble friend and sort of job-share partner at NHS England and NHS Improvement, my noble friend Lord Prior, who is not in his place today as he and I are endeavouring not to be in the same room at all and are working shifts. My noble friend says: “In its extraordinary history of over 70 years, the NHS has never faced such a momentous challenge. Our country has never depended so heavily on its most loved and respected institution. I”—in fact, we—“know that the remarkable people who work for and with the NHS will more than do their duty; they will do their absolute best. It is a privilege and an honour for me”—us—“to work with them.”

As my noble friend says, our NHS people will do everything in their power to look after us and care for us: our consultants, paramedics, healthcare assistants, junior doctors, nurses, midwives, porters, cleaners, scientists, physios, engineers technologists and procurement teams. There are so many professions, I cannot list them all, as I mean everyone working in our health and care system. There are those directly employed in the NHS, but those working in social care, volunteers, the voluntary sector and, yes, even the independent healthcare sector They are all our National Health Service right now, and my goodness they are working hard and fast to face up to this challenge. They need us to help them. They need us all in this country to play our part, as the Prime Minister said last night. They need us to play our part personally in abiding by the rules the Government have set out, and they need us to play our part practically in sourcing personal protective equipment, making ventilators, expanding testing capacity and coming to work with them, if we have the skills. They need us to care for them, to make sure that they can eat at the end of a long and challenging shift, that they can get to and from work and that their loved ones are okay while they are at work, and they need us to support and cherish them when things go wrong.

They need all of this, and they also need us in this House to play our part constitutionally by passing this Bill to give the Government the powers they need to guide us through this immensely challenging time and to provide our NHS people with the support they need so they can save lives. There are powers in this Bill that many noble Lords have said that in normal times all of us in this House would wish to question, challenge and test, but this is not a normal time. Our NHS people need us to act now. Time is not on our side, and they need all of us to join in this fight with them because right now, this is the ultimate national effort from our NHS, that most cherished British institution. Right now, we, all of us, are the National Health Service in one united effort from everyone in the country, with healthcare professionals in the front line backed up and supported by the whole country, as a genuine united National Health Service.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, like many others in this debate, I pay tribute to the many thousands of people who are working immensely hard to counter the effects of the coronavirus.

This huge Bill gives unprecedented power to the Government. Whether all these powers will be needed is uncertain. There are still questions about the severity of the disease and its future trajectory. The CMO has assessed a death rate of 1%. New research from the University of Oxford suggests 0.7%. In Germany, where far more testing has been done, it is 0.3%. We know that in the UK the average age of death from the virus is 78.5 years, and it is a fair assumption that, very regrettably, of those who succumb, quite large numbers would have died anyway. The measures in the Bill and those already taken, exacerbated by last night’s announcement, are leading to massive fear and anxiety in much of the population. More must be done to explain the demographics, reduce unnecessary fear and protect mental health. We in this House might need to worry about our survival but, fortunately, most of the population does not.

The other general point I want to make concerns the economy. A global recession will lead to the death of many children in poor countries, and it is undisputed that the supply of goods and services will be greatly reduced: first, by closing down production with large lay-offs; and, secondly, by restrictions imposed to keep a large part of the workforce at home. At the same time, in the UK, huge amounts of money are being pumped into the economy for understandable reasons. Are the Government assessing the serious implications for high inflation in the medium term? Will they be considering price controls at a later date?

I turn now to my main focus: how we sustain our education system and protect our children and young people from long-term damage as a result of school closures and the cancellation of public exams. History will judge whether or not the wider measures that have been taken to combat the coronavirus were proportionate. My view is that the decision to cancel GCSEs and A-levels was disproportionate and made without sufficient preparation and the requisite advice on what would be put in place instead. While recognising, as I really do, how difficult it is for the Government in these circumstances, answers are desperately sought by teachers, parents and pupils. Many pupils have said that they feel “gutted”; having spent the past two years working hard to reach their potential and get good grades, they feel cheated that they have been denied the opportunity to do so.

The Government have said that alternative assessments will be just and fair. Teachers will have to draw on many sources, including predicted grades, class work and mock exams results. I am sure that they will do their best. Nevertheless, there are bound to be large variations in the judgments they make. Some will be generous, and others tougher, so it will not always be just and fair. Moreover, universities will face difficult decisions about who to admit; at least a collapse in international student numbers could allow them to admit more home students and veer towards a generous admissions policy. But, given that all secondary schools will be open to allow the children of key workers to be looked after, I think it is a pity that 16 to 19 year-olds cannot work at home until the exams begin, and then come to school to take them. I believe that that is what should have happened.

The other concern about many children being forced to remain at home is the likely outcome of increased social inequality. Schools do not just educate children; they also provide them with a safe haven, a structure to their day and a chance to be creative and to learn about sharing. Schools are a leveller, in that they provide a similar environment for all their pupils, in contrast to the huge inequality in their homes. I am not sure how head teachers will define vulnerable children—presumably it will include those with disabilities, those who have been abused and those who are in children’s homes—but it is doubtful that they will be able to embrace the 4 million children who live in poverty and the many children who live in appalling accommodation, with overcrowding and limited resources.

When the schools reopen, will the Government provide extra resources to schools with many disadvantaged pupils, to allow them to give additional help, particularly to those who have suffered most from possibly many months of being unable to go to school? Will PGCE students be able to complete their courses this summer, to ensure an adequate supply of new teachers?

To conclude, ways must be found to ensure that the drastic decision to close our schools indefinitely does not have life-changing consequences for children and young people, such as increasing their vulnerability to gang violence and crime, as well as to mental illness and anxiety, while trashing our hopes for more social mobility.

Baroness Ludford Portrait Baroness Ludford (LD)
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My Lords, the only bright spot in this crisis is that experts are being listened to; long may that continue.

Obviously, the overarching concern is that the powers in the Bill should last no longer than is strictly necessary, should not overreach and should not set unwelcome precedents—one thinks, for example, of the reduction to one doctor for the exercise of Mental Health Act powers and the problems around care assessments. Moreover, the powers should not impact unfairly on disadvantaged minorities or marginalised groups, and should not go further than can be truly justified. It is not entirely clear why the Civil Contingencies Act or the Public Health Acts were insufficient in various areas.

In Schedule 21, there is a test of necessity and proportionality which is strangely absent from Schedule 20—the one that affects directions to people. From these Benches, we will therefore table an amendment to require that all the powers in the Bill should be exercised in accordance with the principle of necessity, proportionality and non-discrimination, respecting the European Convention on Human Rights and other human rights instruments. We also want the Government to keep the powers under frequent review and to publish reasons and explanations for any measures introduced under the Bill.

Although the right to life—Article 2 of the ECHR—underpins the response to this pandemic, human rights issues under several articles of the convention are engaged: Article 5 on the right to liberty; Article 8 on the right to family life, as relating to isolation, quarantining and restriction of family visits; Article 11 on freedom of assembly and association, relating to the prohibition of public meetings and gatherings. These are just some of the examples. I am glad that the Joint Committee on Human Rights, chaired by the right honourable Harriet Harman—I declare an interest as a member—is conducting an inquiry into the human rights implications of the response to Covid-19.

There have been shocking cases of victimisation and blaming of certain people due to their perceived ethnic or national origin, particularly those of Chinese and other east Asian appearance. The power for local authorities not to meet some assessed care needs and to avoid the duty to conduct a care needs assessment will impact on the vulnerable. The Government should, at a minimum, notify the Council of Europe and the United Nations, as stewards of the ECHR and international human rights instruments respectively, that the UK is enduring a national emergency, and of the measures being taken. Do they in fact need to formally derogate? Perhaps the Minister could tell us.

People need to be able to assess, scrutinise and, if necessary, question and challenge the Government. It is not helpful to have a Minister on Twitter call someone by a rather vulgar term because they had the temerity to raise questions about the Government’s approach, as happened yesterday. Apparently, there have been no advertisements on social media. I am on only Twitter so I do not see Facebook, Instagram or any of the others but, considering that a lot of money was spent on Brexit no-deal ads on social media, this omission seems anomalous.

Assessing Schedules 20 and 21 is a bit difficult, as we do not yet know how the Government will give effect to the measures heralded in the Prime Minister’s announcement last night. I imagine that is still being worked through. Schedule 20 does raise a lot of concerns. Where are people to be directed or detained? Is a police station envisaged or just home? What screening is to take place, especially given the lack of current testing capacity? Will there be any judicial authorisation of detention or any provision for appeals? What about people who, for one reason or another, do not have a home to go to—the street homeless, sofa surfers, victims of domestic abuse, some immigrants and refugees, who get little or no support? Surely imposing isolation and quarantining restrictions on people living in abusive or dangerous environments would place them in an impossible situation. As concerns Schedule 21, are the closure of premises regulations issued just last Saturday under the public health Act—they were mentioned by my noble friend Lord Newby—to be revoked in the same way as the February regulations on direction and detention of persons are repealed by this Act in Schedule 20?

I want briefly to mention one or two other things. I entirely agree with the noble Lord, Lord Falconer, and the right reverend Prelate the Bishop of Rochester, who raised issues about funerals and religious beliefs as concerns the need for burial and not cremation. As someone who organised my late husband’s funeral just five months ago, and a memorial service four months ago, this is very important to me. I will perhaps have more chance tomorrow to raise concerns about immigration powers as they affect people in immigration detention as well as in prison. Also, the fear of data sharing with the Home Office could deter people from seeking health treatment. Will the Home Office undertake to suspend that data sharing?

There are also some concerns about video hearings in court. Much as one accepts that they are necessary in the circumstances, various safeguards would be required. There are also concerns about changes to the Investigatory Powers Act and the extension to 12 days for a warrant. From experience, we know that there is a ratchet effect of expansion of state powers, as terrorism legislation has shown. We will need to be vigilant to prevent spillover.

Queen’s Speech

Baroness Blackstone Excerpts
Tuesday 22nd October 2019

(2 years, 1 month ago)

Lords Chamber

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Department of Health and Social Care
Lord Howell of Guildford Portrait Lord Howell of Guildford (Con)
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My Lords, it is a pleasure to follow the noble Lord, Lord Kakkar, who always speaks with great authority and wisdom on health, and on scientific research and innovation, which are key to our future and the whole health service. I normally burden your Lordships with my views on international and overseas affairs and the shifting world order, having had the privilege to be the first chair of your Lordships’ Committee on International Relations. I chose to intervene instead on this present set of topics for three reasons.

We are living on an angry planet, to pinch a heading from the Times leader this morning. From Chile to Hong Kong, Lebanon to Venezuela, every part of the Middle East, every European capital to our own streets, e-enabled protest, organised on an unprecedented scale and driven through communications technology that is constantly changing rapidly, has become the norm. This anger affects all the issues we are discussing.

Oddly, there is little or nothing in the gracious Speech about turbulent outside world events, except of course the eternal Brexit, despite their major impact on our lives and issues here at home. In particular it is a great pity—indeed, I find it rather shocking—that there is no mention of the Commonwealth in the gracious Speech, considering its central importance to the UK’s future world role, our internal and domestic cohesion, our care systems and many of our public services, and the importance to Her Majesty personally of the modern Commonwealth network. To have included a reference would have been no more than good manners, but manners, courtesy and vision seem all to be victims of the present Brexit debate.

My second reason for seeking to speak today is that the internal good health of our democracy and society, aspects of which we are discussing, is essential to our external impact and influence, and safeguarding of our world interests. The inner health of our society is currently, as several speeches have emphasised, not as good as it should be. We really cannot go around pressing on other countries our Westminster model, our welfare state model, our elderly care model or our education model if they do not work well here. As my noble friend Lord Dobbs said in a brilliant speech at the beginning of our debate on the humble Address,

“if we are to offer lessons to others, we must relearn those lessons ourselves”.—[Official Report, 14/10/19; col. 9.]

A third reason for my intervening today is that it had passed through my mind that our situation, both nationally and internationally, would be rather different this week from last week and the gracious Speech, which now seems rather a long time ago. I thought that, by now, the deal would be settled. Foolish me. I should have realised that frustration is the name of the game, and I am afraid that it is going to go on. I read that Mr Jacob Rees-Mogg wants it settled in three days. It occurs to me that we should perhaps consult the Bible to learn about getting things done in three days.

The issue that I want briefly to discuss out of today’s list is pensions, workers’ benefits and employment. I extend that to savings, workers’ benefits and rights and security generally. These have all come into the Brexit debate, especially workers’ rights: there is a constant fear, vocalised much by the Opposition, that they will be watered down if we are outside the European Union. In an interview on the “Today” programme this morning, Nick Robinson reached a new low in ignorance combined with interruptive boorishness with Mr Jenrick, the Housing Secretary. The subject was rights and benefits. I also watched a much more polite and effective Andrew Marr on this issue. Neither Robinson nor Marr have grasped the difference between the big business, corporatist type of legislation for workers, mostly coming from the EU, and the small-business-friendly social and employment legislation that we need and which is far better suited to both workers and business in the digital age. In the digital age and a service-dominated economy, we can do far better for working people, employer-employee relations and secure retirement than the old corporatist model, which is shaped largely by big companies’ lobbies, philosophies and pressures in Brussels. It is not a question of watering down but of a different and far better deal for millions of workers in the highly disruptive age we are living in, which will become more disruptive still. We must break away from the heavy, big-business, corporatist approach of the old EU.

The pensions system is very much part of this story. I welcome the new safeguards, as have some of my colleagues, but I fear that pensions reform of this kind does not go half far enough for what is needed in a modern and unified society. We talk about an economy which works for everyone, but it is simply not happening and my own political party needs, as do all major parties, to redesign its stances from the bottom up to meet these fundamentally democratic needs: a genuine sharing of capital ownership and the security and dignity that go with it, on a scale not hitherto contemplated. We cannot build a party of the future on out-of-date and out-of-relevance ideologies from the past.

We will thrive only as an open nation committed to and interwoven with an utterly interdependent world. We must have our own modernised and flexible welfare and support arrangements for a disruptive and dangerous world which is being totally transformed. The gracious Speech had ambitions, but it seems drafted with too little of this in mind. We have to up our game if we are to meet the colossal challenges coming fast towards us.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, the Minister in opening quoted from the gracious Speech, stating that Ministers would,

“ensure that all young people have access to an excellent education, unlocking their full potential and preparing them for the world of work”.

This is a worthy aim, but given government policy, it is unlikely to be achieved. I expected the Minister to tell us that funding for schools would increase as a result of spending round pledges. She told us about the budget for early years, too, and for universities, but further education, as so often, did not even get a mention.

The position in further education is dire: its funding has been slashed by £3.3 billion since 2010. At least in the spending round the Government have recognised that FE colleges do need more money, but an extra £400 million is a paltry sum against the magnitude of the cuts. The Chancellor said that he had attended an FE college and knows how important they are. That is good news—he is one of the few Tory politicians who has done so—but come on, Mr Javid, that sum will not be nearly enough for FE to unlock the full potential of young people and prepare them for the world of work.

Before I discuss FE colleges’ resources, I will comment on the curriculum for 16 to 19 year-olds across school sixth forms and colleges. In this country, we have a disastrously overspecialised learning environment for young people taking school-leaving examinations at 18. No other education system has anything like the specialisation associated with A-levels. Like the noble Lord, Lord Storey, I will mention Mr Gove. As Secretary of State for Education, he took a step backwards when he returned to the three-subject A-level norm, dropping AS-levels which have encouraged the study of four subjects in the first year of the sixth form. If only he had made the progressive step of going in the other direction, towards five subjects at AS-level, followed by four at A-level. Even this approach is some way from the hugely preferable international baccalaureate, which allows the study of six subjects. The universities must share some of the blame, because their conservatism in sticking rigidly to offers of three A-levels has discouraged a broader range of subjects.

Many people lament the dramatic decline in the study of foreign languages. In a world where English has become the global language, it is harder to motivate young people who have English as their mother tongue to study them after the age of 16. They are also unlikely to be chosen when competing with a range of science subjects and mathematics, or with English and the humanities, when students are so constrained in their choices. The three-subject straitjacket also means that many able young people are not studying the important subject of mathematics after 16; many others are studying no humanities subjects either. We are forcing young people into a horribly unbalanced education at a time in their lives when they should be learning more broadly. I challenge the Government to do something about this, and I hope to hear about it in the Minister’s reply.

I turn to further education colleges which, as well as providing A-level programmes, are the vitally important institutions for the development of vocational skills for 16 to 19 year-olds—as well as for adults, which I will not touch on today. Many people welcomed the Government’s industrial strategy and their wish to tackle our low levels of productivity with more emphasis on skills training. How are we going to make any inroads into this problem if we starve the institutions with a central role in developing these skills? After cuts averaging 30% per annum between 2009 and 2019, the Institute for Fiscal Studies called FE the “biggest loser” in the austerity programme, and so it was.

To cite another important commentator, the Children’s Commissioner’s recent report showed that, by 2020, real-terms spending per 16 to 18 year-old will drop to the level it was 30 years ago. This means that we are spending the same amount per student aged 16 to 19 as we were in 1990, despite rising costs. It must be remembered that the spending review increase for FE is for one year only, in 2020-21, whereas the schools have a three-year settlement. Why should there be a difference? Why is the promised extra funding for FE so small? I ask this against a background where 16 to 18 year-olds in England get an average of 15 hours of contact time a week, compared with 25 for students of that age in other OECD countries. This amounts to 600 fewer hours over a standard two-year course—hardly the way to improve our relative productivity position and, thereby, our competitive success.

There is also a failure to meet another government priority: to promote greater social mobility. Many of the most disadvantaged young people do not stay at school after 16, and many will never gain a university place. FE colleges can have a vital role in providing a route to the skills needed for a rewarding career and to becoming socially mobile.

In conclusion, funding is a fundamental challenge in FE, as the Augar committee made clear. Will the Government now make a firm commitment to the sector of £5,000 per student per annum? Only then will FE teachers receive the pay they deserve and students get the quality of education and training that they need.

Lord McNally Portrait Lord McNally (LD)
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My Lords, the great Freddie Trueman once played in a match against Oxford University. The young student coming out to face him was immaculate in his whites and absolutely perfect in his approach to the delivery to come. Trueman bowled and hit the middle stump; the wicket went clattering down. The young man adjusted his cap, walked past Trueman and said: “A damn fine ball, Trueman”. “Aye; it was wasted on thee”, said Freddie. I feel a bit like that speaking today, because this gracious Speech is a sham. The Times gave it away the day after the Speech, with its headline:

“Queen’s Speech sets out PM’s election manifesto”.

We are playing charades while the real battle takes place down the Corridor in another place. Even this afternoon, the Prime Minister, acting like Violet Elizabeth Bott, is threatening to pull the Brexit Bill if he does not get his way. The Government’s media claque grows ever more hysterical as Parliament resists being bounced into agreeing to a Brexit which is light years away from what was put to the country in 2016. I understand the desire of the noble Lord, Lord Willetts, to get on with things, but this decision will have an adverse impact on the prosperity and well-being of the people of this country for decades to come. It has been presented to the country with all the integrity of a second-hand car salesman trying to flog a car with a dodgy milometer and no logbook. To make the first priority of the Government, in the first line of the gracious Speech,

“to secure the United Kingdom’s departure from the European Union on 31 October”,

is no way to deal with the deep divisions Brexit has caused. On these Benches we will continue to argue for a people’s vote, with a clear choice between the Johnson deal and remain.

Noble Lords’ contributions today have been of high quality, exposing the gaps in this election manifesto in disguise. I will refer to one or two of these. The online harms Bill was not directly mentioned in the gracious Speech, but a parallel statement assured us that a draft Bill will be published shortly and be subject to pre-legislative scrutiny, which I welcome. In the meantime, I urge the Government to reconsider their decision not to provide immediate protection for children from online pornography. I was astounded to see in last Sunday’s Observer an article quite out of the blue and with no explanation, with the headline:

“Farewell the ‘porn block’—a PR exercise and lousy policy”.

That did no justice to the work that has been done by my noble friends Lady Benjamin and Lord Clement-Jones, the noble Baroness, Lady Kidron, and others. It is a strange article for the Observer. There has also been an ambiguous attitude on the Labour Benches. I look forward to a clear statement of Labour’s policy on protecting children from porn. There is a real risk that we will talk for years while the danger is immediate. I urge this House to do what we can while we can, then get on with the pre-legislative scrutiny.

The gracious Speech, because it is designed to give some red meat to the Tory law and order campaign, has lots of promises of tougher and longer sentences in the fight against crime. But there is no mention of the strategy espoused by Michael Gove when he received the report on prison education by Dame Sally Coates in 2016, and endorsed by David Gauke less than a year ago, which determined to,

“put offenders on a path to employment as soon as they set foot in prison”.

The approach mirrors the attempt by my successor as chairman of the Youth Justice Board, Charlie Taylor, to run an education-led facility for young offenders. I make this reference because I believe that within our education policy rest a lot of the solutions to the problems facing the criminal justice system.

There is no mention in the gracious Speech of the need to extend the powers of the Freedom of Information Act to cover private companies carrying out outsourced public functions, as recommended by the Information Commissioner. Likewise, the gracious Speech is silent on the ongoing failure of the Conservative Party to carry out the recommendations of the Leveson inquiry into our press. The recent treatment of Ben Stokes, Gareth Thomas and the Duchess of Sussex is clear evidence that the press is still up to its bad old ways.

Finally, and returning in a way to education and to the theme that the noble Lord, Lord Howell, mentioned, we have to set in train the education and training to allow all our citizens, but particularly our young people, to be able to handle new technologies and new ways of receiving and giving information. I very much welcome the announcement today of the House’s Democracy and Digital Technologies Select Committee, under the chairmanship of the noble Lord, Lord Puttnam, but here again there is a real, live and present danger to our democracy. What worries me about the point the noble Lord, Lord Howell, made is that although we may say that small is beautiful, the power is still in the hands of the big corporations and they are misusing that power.

Health and Social Care Act 2012

Baroness Blackstone Excerpts
Thursday 5th July 2018

(3 years, 4 months ago)

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Department of Health and Social Care
Lord O'Shaughnessy Portrait Lord O'Shaughnessy
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I am sure that the Chancellor will have taken that view on board and he will reveal his decisions in the Budget.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
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My Lords, have the Government made any estimates of the cost of the extensive and in some cases overintrusive regulatory system? The Minister has rightly said that the Government are looking for savings in the NHS. Surely this is an area where savings can be made, as well as that of questionable surgical procedures.

Lord O'Shaughnessy Portrait Lord O'Shaughnessy
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That is one of the areas we need to look at to make sure that there is proper regulatory reform. It does not necessarily require legislation, primary or secondary. There are actually fewer managers in the NHS today than in 2010. We have tried to transfer responsibility to clinical staff. But if the NHS identifies any barriers, we are committed to looking at them.

NHS and Adult Social Care

Baroness Blackstone Excerpts
Wednesday 5th April 2017

(4 years, 7 months ago)

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Department of Health and Social Care
Lord O'Shaughnessy Portrait Lord O'Shaughnessy
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The noble Baroness makes an incredibly important point. Despite the ageing population, the fastest-growing part of the adult social care budget is, I think, for adults with learning difficulties. She is quite right that there needs to be a comprehensive approach. That is why additional funding is going in to support not just older people but working-age adults too.

Baroness Blackstone Portrait Baroness Blackstone (Lab)
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My Lords, I declare an interest as the chair of the board of Great Ormond Street Hospital. I was also a member of the Select Committee. I want to pick up on what the Minister said just now about public health—which, if I may say so, I thought was rather complacent. The public health budget has been cut year after year over the past decade. Will he give the House an assurance that this budget will not only be protected but enhanced? Unless that is done, the terrible crisis we have in obesity will not be prevented, and many other areas of public health such as smoking, drugs and alcohol will not be addressed properly.

Lord O'Shaughnessy Portrait Lord O'Shaughnessy
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The budget for all health services has been set out now for the spending review period until 2021. I completely agree with the noble Baroness about the importance of these kinds of activities. We are, of course, moving to a system where local authorities are able to retain their business rates. They have primary responsibility for the delivery of much of the public health services and we are trying to put them on a long-term financial basis so that they will be able to continue with the kind of work she has highlighted.

NHS (Charitable Trusts Etc) Bill

Baroness Blackstone Excerpts
Friday 26th February 2016

(5 years, 9 months ago)

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Lord Crisp Portrait Lord Crisp (CB)
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My Lords, I have very little to add to that extremely eloquent and clear speech, which sets out precisely what the Bill is about and why it is so important. Indeed, the Bill is sensible, practical, simplifying, and in essence we should just get on with it in your Lordships’ House. However, I will say a little about NHS charities and their importance, although I will not detain your Lordships’ House for too long.

All of us in this House will be familiar with the work of some of these charities and the way in which they provide facilities; however, they are also able to do things which the NHS cannot do as regards making improvement and change. I will pick out three particular areas. Charities can very often fund innovation in ways which the public sector cannot always do. Secondly, they can support staff, which is incredibly important, particularly at times like now, when the NHS is under such pressure; and they can also do what the great charity across the water from us here, Guy’s and St Thomas’ Charity, does, which is not just to look at the hospital but at the community itself as well, to develop and support innovation and community service. Those are all ways in which charities have modernised and innovated in recent years, and this Bill is very important in bringing about less bureaucracy and more scope for them to do those things.

There is one other way in which charities are moving in this direction globally, nationally and, I hope, within the NHS. When I am not in your Lordships’ House, I am quite often engaged in development activities in Africa. We are very well aware that charities are extremely important in Africa, but alongside those charities it is equally important to enable people, giving them the tools to look after themselves and develop their own solutions to their problems. I hope that in future NHS charities will go even further by developing the way in which they help the NHS to adjust during this current massive period of change.

I am delighted that my noble friend Lord Bird is to speak in this debate. I wonder whether he will have something to say about the very important question of how people can do things for themselves rather than just rely on charity. I think that the two things go together. This Bill will be a great help in ensuring that NHS charities have the freedom to use their imagination and creativity to support the development of health and social care in this country.

Baroness Blackstone Portrait Baroness Blackstone (Lab)
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My Lords, I declare an interest as the chairman of the Great Ormond Street Hospital board, and I want to give the reassurance that I am not Captain Hook in disguise.

I thank my noble friend Lady Massey of Darwen for taking forward this Private Member’s Bill in this House. I especially thank Wendy Morton, the Member of Parliament for Aldridge-Brownhills, for introducing the Bill in the House of Commons and for her very hard work in helping the passage of the Bill through the other place.

In advance of what the Minister is to say, I also thank him and the Government for their support for the Bill. I say that in particular since, as my noble friend Lady Massey of Darwen has already said, back in 2014 I attempted to make an amendment to the Copyright, Designs and Patents Act 1988, but without success. So it is a great pleasure that it looks as though as we are going to be successful today.

I want to say a little bit—I feel that I am obliged to do so and I want to do so—about the enormous value of the charity to the hospital’s work. It cannot be overstated. I thank the charity and its special trustees for the enormous amount of hard work that they put in to raise funds. Its current strategy is to try to raise £500 million over the next five years, and I want to say a bit about how vital this is by giving a few examples of the support that the charity gives the hospital.

We are now working to complete what will be called the Premier Inn Clinical Building. It will fit seamlessly with the Morgan Stanley Clinical Building, which was opened in June 2012, to complete what we call our Mittal Children’s Medical Centre. It is truly state of the art. It houses a new surgery centre, a high-specification respiratory ward and a high-dependency area, where the most unwell children can be carefully helped back to better health. The cost to deliver this is scheduled to be around £300 million, and the charity is still working to raise the final amount to make that happen.

Research is absolutely fundamental to everything that a hospital like Great Ormond Street does. If we have to be innovative, we have to be not just the hospital that does research but a research hospital. I shall give one example, which had some publicity last year, of a world first. One year-old Layla was cured of her leukaemia thanks to a gene editing technique developed and used by Professor Waseem Qasim. He designed a new treatment that uses what are called molecular scissors to edit genes and create designer immune cells programmed to hunt out and kill drug-resistant leukaemia. Research like this is made possible only thanks to charity-funded specialist laboratories dedicated to gene therapy research. Our new centre for research into rare diseases, which will be completed in 2018, will take forward a lot of that really innovative, life-changing research. Again, the money for that is being raised through the charity.

The charity also helps the hospital by securing extremely expensive equipment, such as a 3T magnetic resonance imaging machine and scanners that allow us to take much clearer and more detailed pictures of children’s bodies than was ever possible before. That allows faster and more accurate diagnosis, followed by better treatments for the children.

Treating children at home is something that we are also trying to develop at the hospital. Every parent with a very sick child longs for that child to go home, and every very sick child longs to go home. If we can release them from hospital and get them home faster, that makes a huge difference to them. One example of this is that we are now able to allow home dialysis to take place—again, thanks to charity funding. We have been the first hospital in Europe to offer home dialysis for children with serious kidney conditions. Before that, children had to come into the hospital a minimum of three times a week, spending four hours having dialysis. Home dialysis allows them hugely greater freedom and has dramatically improved their quality of life. Those are just a few examples.

I want to finish by asking a question of the Minister. I wonder whether he can clarify the details of the commencement of the provisions of the Bill. As I understand it, a number of NHS charities are still in the process of converting to independent charities. How long will it take for these conversions to be completed, and is it or is it not correct that they have to be completed before Clauses 1 and 2 and Schedule 1 can come into force? I would be really grateful if he could clarify that.

I end by thanking the many supporters of the charity—some of whom, indeed, are probably in this House—from the corporate sponsors to the big celebrity donors, but, above all, the many, many members of the public who support us by giving regular donations over many years.

Last of all, in his absence, I should thank JM Barrie for his extraordinary legacy when he donated the copyright to the hospital in 1929. “Peter Pan” has raised large sums of money, which has been put to wonderful use. It is now important that this legacy is safeguarded by passing this Peter Pan and Wendy Bill.

Baroness Barker Portrait Baroness Barker (LD)
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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.

NHS: Reform

Baroness Blackstone Excerpts
Thursday 16th July 2015

(6 years, 4 months ago)

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Department of Health and Social Care
Lord Prior of Brampton Portrait Lord Prior of Brampton
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My Lords, I thank the noble Lord and the noble Baroness for their comments. I was quite depressed listening to the noble Lord opposite. We had a debate in this House last week and we talked about a sense of political consensus on the NHS. I start by saying—rather personally—that, having listened briefly this morning to his right honourable friend Andy Burnham in the other place misquote me out of context from the debate that we had last week, I thought that there was no hope of a non-partisan approach to the NHS. For the avoidance of any doubt from anybody, and as I think I made pretty clear in last week’s debate, I believe fundamentally and passionately in a universal, tax-funded healthcare system—the NHS—that is free at the point of delivery and based on clinical need, not ability to pay. Having looked back on it, I do not remember uttering a word in that debate that would question that statement. Therefore, I hope the noble Lord opposite might have a word with his right honourable friend in the other place to make it absolutely clear that playing cheap party politics has no place in our discussions about the NHS.

Turning to the comments about my right honourable friend the Secretary of State for Health’s Statement today, seven-day services are in many ways at the heart of it. Thousands of people are dying because we do not provide seven-day services in hospitals. We cannot carry on with a system with thousands of people dying. It is not just that thousands of people are dying. The health of thousands of people is deteriorating in our hospitals over the weekend.

This is an anecdote, which may be unfair. However, two years ago, I met a radiologist walking down the corridor in an NHS hospital on a Friday morning. His wife had been admitted through A&E. She had abdominal pains. He could not get her a scan. She was going to have to wait in that hospital until Monday. Had it been a bank holiday, she would have had to wait in that hospital until the following Tuesday before she had that scan. That is an anecdote, but we know that it is happening all the time. It is unacceptable.

So I ask the noble Lord opposite to be more enthusiastic about this. Of course it will be difficult. This Government are putting in £8 billion of new money. This is more money than his party was prepared to offer before the election. It is the same amount of money that the noble Baroness’s party was offering to put in. This is £8 billion of additional money that we are putting into the NHS. It is a critical part of our strategy. It was laid out in our manifesto and is in the NHS Five Year Forward View that we would make seven-day services a main plank of these reforms. For those people who think that this cannot be afforded, put yourself in the position of a chief executive of an NHS hospital that works four and a half days a week because theatres stop work at lunchtime on Friday. Often, they do not start again until Monday lunchtime because every bed is taken up when they come in to work on Monday morning. Across the country, thousands of consultant surgeons, theatre staff and anaesthetists are hanging about on Mondays because they cannot start their work. This is because there is not a bed in the hospital because the flow of patients through that hospital came to a grinding halt on Friday. The noble Baroness is right that this is not just a hospital issue but about joined-up care. You cannot get the discharges out of the hospital unless social care, the physios and the OTs are working—the whole system needs to be working. Seven-day working is not only right for patients but will enable our hospitals to work much more efficiently.

I will pick up a few other issues. I remember when the 2003 contract was voted on by consultants. In my view, it was a disastrous contract, which deprofessionalised many professional consultants. They voted against it the first time and voted for it, grudgingly, only the second time. They voted for it because their pay went up by 28% as a result of it and they could opt out of providing care over weekends and outside normal hours—of course they voted for it. Looking back on it, some of the noble Lords and Baronesses opposite will maybe accept that it was a disastrous contract. It deprofessionalised a deeply vocational profession and fundamentally changed the culture of the NHS—a culture that we are now trying to change once again.

I welcome the comments of the noble Lord and the noble Baroness about Sir Robert Francis’s report on whistleblowing. We want an open culture, in which whistleblowing is a thing of the past. I agree with the noble Baroness that whistleblowing is not a great name. It would be great if we never heard about whistleblowing ever again because people felt able to raise their concerns in a proper, central and safe way and knew they could raise them without fear of any detriment to their employment prospects. The proposals put forward by the Public Administration Select Committee, which have been taken up by the Secretary of State for Health, are absolutely right. We need a safe place for when things go wrong.

I turn to the Rose report. Leadership is fundamental. Around a hospital, one ward will be doing well and one will not because there is a good ward sister in the first one; one hospital will be doing well and one will not because of good local leadership in the former. Leadership is absolutely fundamental, and I subscribe to all the comments that my noble friend Lord Rose has made in his report.

The noble Lord’s comments about the TDA and Monitor are harsh. David Bennett and others in those organisations have done a very good job in very difficult circumstances. We are fundamentally changing the roles of TDA and Monitor. Together, they are now, as the name suggests, an improvement agency first and a regulator second. The new role of the TDA and Monitor in NHS improvement will fundamentally change the way we approach performance management and improvement. The Secretary of State for Health alluded to the contract that the TDA recently signed with Virginia Mason, one of the safest hospitals in the world, which is one way of bringing best world practice into the NHS.

I will conclude on the context. Times are difficult in the NHS and we should not pretend differently. This Government are absolutely committed to seeing this transformation programme through. The noble Lord opposite said he did not know anybody who thought that we could achieve the £22 billion in savings that are set out in the NHS Five Year Forward View—he knows me.

Baroness Blackstone Portrait Baroness Blackstone (Lab)
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My Lords, I declare an interest as the chairman of the Great Ormond Street Hospital Foundation Trust. Before I put my questions to the Minister, I will just make one brief comment on his remarks about the Opposition. I have no idea what the shadow Secretary of State for Health said in another place, but I will defend what my noble friend Lord Hunt has just said. He said that he agreed in principle with a great deal of the Statement, but it is legitimate for the Opposition to ask questions about how a Statement of this sort might be implemented, which is what he was doing.

I have two questions, the first about bureaucracy. The Minister said that he wished to see a reduction in bureaucracy. As a chairman of a trust, I entirely identify with that. However, some of the bureaucracy is in the regulators, and I hope that his attack on bureaucracy will cover the regulators. The Government are about to set up another outside agency, which will put further bureaucratic pressure on those who are delivering services upfront. Anything he can do to try to reduce that would be helpful.

My other question concerns seven-day services. Again, I entirely endorse what the Government wish to do with respect to seven-day services—if anything, they are overdue—but there are questions to be asked. What is the timetable for this, if it is only going to apply to new consultants? It will take a very long time to introduce seven-day services if only new consultants are going to go on to the new contract requiring them to work at weekends. I understand why the Government are doing that, but it will make for a very long delay. What steps will the Government take to try to encourage existing consultants, who will be far greater in number than the flow of new consultants, to adjust to a new approach where seven-day services are introduced in the interests of patients?

Lord Prior of Brampton Portrait Lord Prior of Brampton
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I can only agree with the noble Baroness on bureaucracy. The new body that we are setting up to look at incident reporting, as recommended by the PAC, will only look at big incidents so will not be an added bureaucracy for the day-to-day running of a trust. I am always struck by the figure that nurses spend only between 70% and 80% of their time dealing directly with patients because they are dealing with bureaucracy. The bureaucracy argument falls into two parts: it is partly about the way hospitals run their affairs and partly about external regulators. We believe fundamentally in intelligent transparency. I see the CQC, for example, as less a regulator and more a means of providing intelligent information to boards of hospitals and to patients. But I take on board what the noble Baroness says. We will do everything we can to reduce the level of bureaucracy.

As far as the timetable is concerned, junior doctors will switch over much more quickly than consultants, because they turn over much more quickly. It will take time for consultants to move over to the new contract, but we hope that we can make it more attractive to consultants and that it will be more of what I would call a professional contract, so that existing consultants will switch over to it as well as new consultants. We will have to watch that very carefully.

NHS: Five Year Forward View

Baroness Blackstone Excerpts
Thursday 23rd October 2014

(7 years, 1 month ago)

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Department of Health and Social Care
Earl Howe Portrait Earl Howe
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One of the great features of the Government’s reforms is to put clinical leaders in charge of designing the way that care is delivered throughout the country. That point is often overlooked. It is, of course, the quality of that leadership that we should focus on. That quality is variable and why NHS England, Health Education England and partners in the system are looking as carefully as they can at how to improve that quality of leadership. I direct the noble Lord’s attention to certain passages in the Forward View, which talk about the need for all the bodies in the system to work together: NHS England, Monitor, the NHS Trust Development Authority, the Care Quality Commission, Health Education England, NICE, Public Health England—all working together to achieve greater alignment and greater common purpose in the way that these proposals are implemented.

Baroness Blackstone Portrait Baroness Blackstone (Lab)
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My Lords, on the subject of the prevention of obesity, can the Minister say what steps the Government are taking to introduce a tougher regulatory environment for food companies whose products are damaging the health of many thousands of people in this country?

Earl Howe Portrait Earl Howe
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Many food companies—not all, but many of the larger ones—have already taken steps, for example, to reduce the levels of salt and saturated fat in their products. We need to go further. This has been done by the previous Administration and the current Government on a voluntary basis. We think that that has worked well. Nevertheless, we have never excluded the possibility of regulation, where we think that it is justified. At present, we believe that there is sufficient scope to make progress without regulation, but that is a matter we will keep under review.