Procurement Act 2023

Baroness Brinton Excerpts

Tuesday 15th October 2024 Lords Chamber

[Baroness Twycross (Lab)]

This Government are absolutely committed to using every means possible to recoup the public money that was lost in pandemic-related fraud and contracts that have not delivered. In July, the Chancellor announced that the Government would appoint a Covid counterfraud commissioner, who will be appointed by open competition for a fixed term. I am pleased to say that applications closed on 30 September and the Chancellor will announce the commissioner in the coming weeks. I hope that noble Lords will welcome this measure to address some of the shocking instances of pandemic-related fraud and awards of contracts that happened in the past.

[Baroness Brinton (LD)]

My Lords, it was a pleasure to work cross-party on the Procurement Act, but my party objected to the NHS and the Ministry of Defence being granted an exception from having to follow the Act. Avid readers of the Health Service Journal will see that about once per week the NHS is being taken court to by its suppliers for its new procurement rules. Will the Government now review the recent NHS procurement rules in the Health and Care Act 2022 to see if they are up to the standard that the rest of the public sector is required to follow?

[Baroness Twycross (Lab)]

In passing the Health and Care Act 2022, Parliament recognised that healthcare services delivered to NHS patients and service users, such as 999 emergency ambulance services and cancer-screening services, had particular issues and challenges which necessitated special procurement measures. Consequently, as the noble Baroness made clear, the Procurement Act does not include special provisions for those healthcare services.

Public Procurement: Data Offshoring

Baroness Brinton Excerpts

Tuesday 8th October 2024 Lords Chamber

[Baroness Twycross (Lab)]

As my noble friend will appreciate, the Ministry of Defence took these reports extremely seriously. In response, on 6 September this year, Maria Eagle, the Minister of State for Defence, confirmed that both the MoD and Rolls-Royce Submarines had conducted an investigation into the matter. The Minister assured that the investigation found no evidence that Belarusian nationals had access to sensitive information and concluded that no change to the MoD procurement policy was required. The Ministry of Defence has set a policy of using Secure by Design. This is a modern approach whereby senior responsible owners, capability owners and delivery teams are accountable and responsible for delivering systems that are cybersecure. This includes ensuring new systems being bought or built carry out due diligence on the security of their systems.

[Baroness Brinton (LD)]

My Lords, my dental practice changed its IT supplier a year ago. After going online to confirm an appointment and agree the usual dental practice use of my data, I was invited to check the IT supplier’s data. Seven layers down, it appeared that I gave permission for all my medical data to be used by the UK company, its parent US company and all its commercial subsidiaries. The practice has now got a new IT contractor. How well aware are clinical practices and surgeries of this underhand technique by major digital contractors?

[Baroness Twycross (Lab)]

The noble Baroness makes a really important point. I will speak to my noble friend Lady Merron, to make sure it is taken forward through DHSC. The Government are quite clear that government data is owned by the Government and any commercialisation should be agreed with His Majesty’s Government.

Product Regulation and Metrology Bill [HL]

Baroness Brinton Excerpts

2nd reading
Tuesday 8th October 2024 Lords Chamber

[Baroness Brinton (LD)]

My Lords, it is a pleasure to follow the noble Lord, Lord Lansley, and I am glad he started referring to international products. Given the earlier contribution by the noble Lord, Lord Frost, I am reminded of this House’s scrutiny of the Biocidal Products (Health and Safety) (Amendment) Regulations 2022. The noble Baroness, Lady Stedman-Scott, told the Grand Committee that there was a huge backlog in processing chemical standards given that we lost access to the EU chemical standards database. As a result, the Health and Safety Executive’s chemicals division had to have its budget increased by 39%. On those figures alone, any sensible Government would want to be able to use existing standards—in this case, the EU’s standards—not least because any organisation manufacturing products in the UK that sell in the EU will have to conform to them. I have not had time to check what the HSE chemicals division’s budget is now, but over five years from 2018 to 2022 it increased by 39%.

I was also delighted to hear the maiden speech of the noble Baroness, Lady Winterton. With her wit and experience, she is already being heard very seriously and with some smiles in this House. I wish her well.

As noble Lords have heard, these Benches support the scope of the Bill and the secondary legislation. Others have already explained how necessary it is, but, along with my colleagues, I have some concerns and I will try not to go over the points they have already made. The Government’s delegated powers memorandum says at paragraph 5:

“We judge it essential to be able to respond quickly to an evolving evidence base on product safety and metrology issues”.


I want to focus on those powers being used in a slightly different way and I hope that the Minister can give your Lordships’ House some reassurance that emergency procedures made available to Ministers will not be used on this Bill, as happened on many others over the previous eight years—not least, as we heard from the noble Lord, Lord Russell, on the issue of leaving the EU.

I also saw it at first hand when I was the Lib Dem health and social care spokeswoman from January 2020. The emergence of the pandemic inevitably meant that there was obviously a need to introduce emergency statutory instruments but, to be frank, using the emergency powers completely negated the importance of Parliament being able to scrutinise affirmative SIs before they are introduced. Between January 2020 and March 2022, the Government laid 118 affirmative Covid SIs, of which 66 were introduced by emergency procedures, meaning that they were implemented before either House had any chance to see them, let alone debate them.

The Hansard Society Covid statutory instrument dashboard website is a brilliant resource for this period—perhaps I am extremely sad, but it really is extremely useful. It also noticed that those SIs implemented using the emergency procedure were more likely to have to be amended or revoked, which was perhaps not surprising because of the speed of response needed and the fact that there had been no time to scrutinise them. I hope the Minister will give the House some reassurance that emergency procedures would be used only in true emergency.

I say that because it has become something of a habit inside Whitehall to use them. I had a call from the Paymaster-General in August, informing me that the SI relating to the redress scheme for the infected blood compensation scheme was laid in the middle of August. We do not debate it until the end of this month. We have a debate on the inquiry and the redress scheme generally next week but we have to wait to the end of the month, which is two months after the SI was implemented. I really am keen to hear from the Minister on that.

I turn to one of the examples that was repeatedly raised in the preparation of the Bill and was the subject of my noble friend Lord Redesdale’s Private Member’s Bill—lithium-ion batteries. I pay tribute to my noble friend Lord Foster for his many years’ work in this area. I declare my interests as a vice-chair of the APPG on Fire Safety and Rescue and a vice-president of the LGA. The APPG on Fire Safety and Rescue, the National Fire Chiefs Council and almost everybody involved in manufacturing safety equipment for the fire service want urgent regulation of the use of lithium-ion batteries.

E-bikes and e-scooters present one of the fastest-growing fire risks. In London on average there was a fire every two days last year. There were 143 e-bike fires, three deaths and around 60 injuries. This year, up to the end of August, London Fire Brigade has so far recorded 127 e-bike and e-scooter fires. The real problem is the intensity of the lithium-ion fires, both the heat and the length of the flame. It is not even a flame; it is more like a firework. If you have ever seen a video of such a fire, it is never forgotten. Temperatures get up to 1,000 degrees and substantial damage can be done.

We also need regulation for those who use products with lithium-ion batteries that do conform to very strict regulation. I have a travel wheelchair that uses lithium-ion batteries. It complies with IATA regulations but I have been refused permission to go on a plane because the pilot has the final say on whether or not you can take medical devices on board. He said he was not having any lithium batteries on his plane at all and did not care whether they were IATA-certified. Having regulation would enormously help those of us who rely on these things. It cost me €900 to get back from Bucharest that night.

I also think that lithium-ion batteries stand as a proxy for everything that the Bill is trying to achieve. Many of the e-bikes and e-scooters in these fires have had different batteries or converters bought in an online market and added to the machine, so regulation is vital, as is compliance and ensuring that there are enough people to be able to find out where these are. The below-the-radar sales of these batteries, which often look identical to ones which comply with current safety regulations, mean they can be hard to track down.

It also takes us into what I think is a grey area of the Bill and I have not heard anybody else talk about this: at what point do the product regulations apply to individuals as opposed to businesses or people working in businesses? The Bill sets out those people covered by the regulations in Clause 2(3) and, helpfully, paragraphs (a) to (g) explain those with particular responsibilities and roles, but Clause 2(3)(h) refers to

“any other person carrying out activities in relation to a product”.

Does this include individuals who may have bought an e-bike online as an individual, changed the battery to one bought elsewhere online and then after a couple of years decided to sell it on through eBay, which has a mixture of professional sellers and individuals?

I am trying to find the boundaries here because if the answer is that individuals are included, communications to the public about their new responsibilities when they buy and sell will become vital. But if the answer is no, how will the Bill prevent what is happening at the moment, which is individuals buying and adjusting products from a global marketplace, often untraceable, where the UK has no ability to scrutinise or take action? How would this be enforced? If it is helpful, I do not necessarily need an answer now but would appreciate a letter from the Minister before we go into Committee.

I am very interested in who will be the statutory consultees and wonder whether we might have access to lists—again, before we move on to Committee—because there are some professional associations that might be very obvious to include if you are in the fire industry but not necessarily obvious to the Department for Business.

I turn briefly to the creation of criminal offences through affirmative statutory instruments, which has already been referred to. I want to pick up on the earlier comments from the noble Lord, Lord Lansley, about medical devices, which are specifically disapplied in the Bill because of the Medicines and Medical Devices Act. Can the Minister explain why this Bill has a maximum imprisonment of up to two years, whereas the Medicines and Medical Devices Act, which covers at least as sensitive and dangerous issues, has provision for conviction and jail sentences of up to 51 weeks only? Why have those different figures been used?

It was good to hear the Minister say that the Attorney-General had been involved. Is there a formal consultation with the Ministry of Justice once these regulations are drafted? I remain concerned that our court system is really congested at the moment and if there were, for example, a particularly large, concerted campaign to bring people to justice, that might involve breaking gangs, frankly, even 30 or 40 extra people in prison over a short period would put real pressure on our prisons. What can the Minister say on that?

Finally, we need this Bill but we must have access to affirmative instruments in plenty of time to be able to scrutinise them.

--- Later in debate ---

[Lord Leong (Lab)]

I am coming back to that in the later part of my winding speech.

National emergencies such as Covid-19 highlight the importance of ensuring that our product regulation framework allows for flexibility in times of national emergency. This enabling Bill will allow the Government, in response to an emergency, to temporarily disapply and modify product regulation while maintaining high safety standards, thereby providing a faster process by which critical products are able to reach the market in order to sustain an adequate supply of such products.

[Baroness Brinton (LD)]

I apologise, but that was not my question. My question was: will the Government make sure that, if emergency powers are used, both Houses of Parliament are kept informed prior to that happening?

[Lord Leong (Lab)]

I will get back to the noble Baroness in writing. I see the time flashing, so I might have to write to other noble Lords in response to their questions. Let me conclude.

I would like to thank everyone across this House for their contributions in today’s debate. I specifically thank my counterparts on the Opposition Benches, the noble Lords, Lord Johnson of Lainston and Lord Fox. This is not the first time that we have sat across from each other in such debates, albeit in different spots. I look back fondly on our debates during the passage of the CPTPP Act last year. I hope and expect that debates on this Bill will be as good-natured and as enlightening as those were.

I should like to stress my willingness to meet noble Lords to discuss further the detail of the Bill. I take the firm view that dialogue is essential to building public and parliamentary support.

To sum up, this Bill allows us to keep pace with new technologies, gives us the tools to stop dodgy suppliers placing dangerous goods on the market and allows us to make sovereign choices as to how we diverge or align with the EU and other trading partners. It gives enforcement bodies the tools they need to tackle modern problems facing the transit of goods coming across our borders, be they land, maritime or digital. Finally, it will allow us to update the legal and technological framework that underpins economy and trade. This Government will never compromise on safety. The Bill is essential to strengthening the rules and regulations needed to protect consumers, businesses and the public.

Conversion Therapy Prohibition (Sexual Orientation and Gender Identity) Bill [HL]

Baroness Brinton Excerpts

Friday 9th February 2024 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, it is always a pleasure to follow the noble Baroness, Lady Donaghy, who rightly focused on the poor mental health service that is available at the moment, which is not helping adults and young people who seek guidance and reassurance. I thank my noble friend Lady Burt for opening this Second Reading debate in such a clear way, explaining the limited scope of the Bill, and my noble friend Lady Featherstone for reminding us of the legislation she helped steer through Parliament, including the first ever transgender equality action plan in 2011.

I was moved by what the noble Lord, Lord Paddick, said about how his life has been affected by his treatment by those in his church; I have a friend who was in much the same position. I was also moved by the reminder from the noble Lord, Lord Cashman, of the devastating effect on LGBTI people when others impose upon them their views about who they are. This Bill is not about free speech but about those in a position of power over the individual imposing their personal view—a priest or a doctor, most commonly—rather than what the noble Lord, Lord Robathan, said, which was right, about the need for patient-led therapy.

I want to use my time to highlight one medical conversion therapy case, which I hope gives some clearer lines for those who say that the Bill is wrong. I have talked to Mr B, an adult transgender man in Wales who came out 10 years ago. At that time in Wales, in order to get a GRC, transgender people had to be seen by a psychiatrist. For eight years he was constantly delayed and ignored by the hospital. Worse, the psychiatrist he did see during that period announced at the start of the process that he did not believe he was transgender and that he would only recommend antidepressants and would not initially permit any discussion of transgender matters at all.

Mr B says that this treatment over a number of years made his mental health considerably worse. Then, the psychiatrist told him he should have ECT for his severe depression. This psychiatrist and another he saw were absolutely against making a referral to the gender identity committee, and he could not progress without its approval. This is the exact opposite of the affirmative and curious responses the noble Baroness, Lady Hunt, outlined so effectively: this was definitely the furious response. At this point, Mr B was suicidal; years of constant challenge and denial had taken its toll. The hospital doctor even said it was not their job to stop him killing himself. But this case was even worse. The psychiatrist wrote to Mr B’s GP with an inaccurate account of the sessions, as well as keeping inaccurate medical records at the hospital. Finally, after eight years, he saw a doctor at the same hospital who was a gender specialist: someone who, in the description of the noble Baroness, Lady Hunt, was affirmative and curious.

This is not just Mr B’s view of his own case. He was brave enough to make a complaint to the Welsh ombudsman, who was clear in his judgment:

“The Ombudsman found that there were failures [by the Betsi Cadwaladr University Health Board] to conduct an appropriate assessment in 2017, that an assessment in 2018 failed to identify that Mr B met the criteria for a referral, and that a challenge to the 2018 assessment outcome was not dealt with appropriately. He also found that Mr B had been misled to believe that a referral had been made when it had not, and was not kept fully informed about the process of referral or the decisions the Health Board was making. Finally, the Ombudsman found that the records did not reflect the appropriate diagnostic terminology (which might have contributed to the confusion around Mr B’s eligibility for referral) and demonstrated that clinicians failed to refer to Mr B using his preferred name and pronouns.”


I quote from the ombudsman at length because I think the detail of it might help to understand when things cross a boundary. The judgment goes on to say:

“The Health Board agreed to apologise to Mr B and offer him £2000 within 1 month, in recognition of the distress caused to him as a result of these failings. As the referral process had changed since the time of the events, it also agreed to remind relevant staff of the current appropriate referral process for individuals who require gender healthcare. The Health Board also agreed to provide training to relevant staff within 6 months, on the current NHS approach to diagnosis and symptoms relating to gender healthcare, trans-inclusive diversity awareness and meeting the needs of transgender individuals”.


Mr B was very brave to take a case that had caused him so much distress. However, we know there are still doctors who do not approach transgender patients with affirmation and curiosity, nor do they have an open and thoughtful discussion to explore through a patient-led process. The Bill says that practice that has intent to change or suppress a person’s gender identity must be evident. Mr B’s experience is one such shocking case.

Ten years on, Mr B is contented living who he is and is loved by friends and family. His experience at his local hospital should not happen to others in the future. His case highlights why the Bill is necessary.

Infected Blood Inquiry: Government Response

Baroness Brinton Excerpts

Tuesday 19th December 2023 Lords Chamber

[Baroness Chapman of Darlington (Lab)]

My Lords, we are grateful to the Minister for reading the Statement out this afternoon, and we very much welcome it.

Someone dies every four days as a result of this scandal. Time is passing. Each week, more families are left to grieve. The campaign led by victims, by their families and, in Parliament, by Diana Johnson, and the vote in the other place to amend the Victims and Prisoners Bill, forcing the Government to establish a body to administer compensation in anticipation of the final report of the inquiry, are no doubt focusing Ministers’ minds. I had hoped that the Statement that the Minister helpfully read out would provide some assurance that the Government are proceeding with this work. Can the Minister clarify what they are doing in anticipation of the completion of the passage of the victims Bill to comply with its new Clause 40?

It is clearly the will of Parliament that the Government make progress quickly. They could, for example, set about appointing a chair and members of the compensation awarding body. They could begin conversations with devolved Governments about how to work together to ensure fairness across the United Kingdom. Much could be done ahead of the final report. Can the Minister inform the House when these steps will happen? We are pleased to hear that the Government are establishing specialist psychological support, but can she explain why this will not be available until next summer?

We pay tribute to the bravery and determination of the victims of this scandal and their families. These Benches would gladly work on a cross-party basis to ensure that a scheme can be agreed and implemented as soon as possible to provide certainty to those infected and affected.

The Minister said that the Government are appointing clinical, legal and social care experts to advise the Cabinet Office on detailed technical considerations in the new year. It is not clear from the Statement what this will involve or what technical considerations are meant. Can the Minister elaborate? Is it the Government’s view that primary legislation will be needed to establish the body to administer the compensation? If so, this could also be done in January, given the cross-party support that exists. When do they plan to introduce any necessary legislation?

There is no need to wait for the victims Bill to pass, given the clarity of the words of the Minister of State in the Ministry of Justice that the Government would

“put in place the necessary legislative framework and timescales for a delivery body for compensation for the victims of infected blood”.—[Official Report, Commons, 4/12/23; cols. 136-37.]

In the light of this Statement, when does the Minister anticipate that payments can start to be made?

We cannot undo what has happened. We cannot bring people back, but we can, through a fair compensation scheme, recognise the wrong that has been done to so many families and individuals. We can provide the financial support that is due. But I reiterate that we do not have the luxury of time. We have a moral duty to act, which the Government accept, and Parliament has demanded. I look forward to the Minister’s response.

[Baroness Brinton (LD)]

My Lords, I would like to pick up from where the noble Baroness, Lady Chapman, left off. We need to occasionally remind ourselves of the history of this. I thank the Minister for repeating the Statement and thank the various campaign groups that continue to persevere for justice and compensation and to ensure that we are kept informed about the current situation.

I particularly thank Colette Wintle and Carol Grayson for their briefing and their amazing campaigning over the years. They reminded us that the history of this started in 1991 with the HIV litigation, when the Conservative Government blocked compensation. In 2003, the Skipton Fund was set up, but that was blocked by the Labour Government. In 2009 and 2010 there were other incidents that were also blocked by that Government. In 2012, the coalition Government also blocked compensation, delaying things for a further decade. This year, given that Sir Brian Langstaff’s second interim report made it absolutely clear that compensation should be set up and run from now, it is extraordinary to have a three-page Statement, in which the first page says all the right things but the second and third pages then put it into the long grass.

It is good news about Clause 40 in the Victims and Prisoners Bill. It had its Second Reading in your Lordships’ House yesterday and, had we heard the details of the Statement before that, some of us might have changed our speeches. It is almost as if Ministers have not yet seen Sir Brian Langstaff’s recommendation on 5 April. To remind your Lordships’ House, he said:

“I recommend that a compensation scheme should be set up now and it should begin work this year”.


The Statement says that the Government will work through everything before starting the scheme. Can the Minister say on what grounds they are going specifically against Sir Brian’s recommendation that the scheme should start immediately? Time is not on the side of the victims or their families.

From these Benches, we too welcome the proposals for a bespoke psychological service for people infected by and affected by the infected blood products. But can I ask the Minister if there is new funding for this? There has to be funding outside the existing mental health budgets, which are severely under strain. If there is not, it will just put further pressure on an overwhelmed service and lead to further distress for people who believe that it will be available to help them when it is not. Even worse, others who have been waiting years for urgent mental health services will find that they cannot get them.

It is important because, as the Factor 8 scandal campaign has said, in a recent case of a young man whose father, mother and sister all died of AIDS when he was three years old, he has received nothing. He gets no ongoing support and struggles deeply with his mental health. Factor 8 says that it is “unimaginable” that his case is not

“described as ‘one of those most severely impacted’”.

There is also reference to setting up a group of experts. Who is appointing these experts? It would be normal for the chair of the compensation panel to choose their experts. There would usually be two panels —one would be medical advisers and one would be legal advisers. There is, of course, the important element of making sure that there is the voice of the people affected. Can the Minister say whether this is being done by the Government in advance of the panel being set up?

It would really good if we could have some speeding up of this process. There is no time, as everyone has said—but we have been saying this for close to 30 years, and it needs to be actioned now.

[Baroness Neville-Rolfe (Con)]

My Lords, I thank the noble Baroness for her comments about cross-party support because, after all, this dreadful scandal dates back, I think, 40 years and has involved many different Governments. She is also right that we have to recognise what has gone before us and do the right thing. It has been an awful scandal and, even more, it has left a stigma—particularly in the days before HIV and AIDS were properly understood—on all those involved. She is right to say that the amendment to the victims Bill has helped to focus minds on this issue.

Obviously, the Government recognise the strength of feeling across the House and the importance of what this amendment seeks to achieve. We are working through the implications as drafted and considering the question of primary legislation and, having this amendment, what is the right vehicle.

As I said, the inquiry’s final report is expected in March 2024. There was, I suppose, a small ray of light in the last day or two, as the inquiry said it would announce the date of its report on 17 January. The Government have already made it clear that, within 25 sitting days following the publication of that report, we will provide a full response to Parliament with an Oral Statement on the next steps. That gives us a better timetable than we have had before. I understand, of course, the points made about speed, and I look forward to being able to fill in on them.

I reiterate the news about the bespoke psychological service for people infected and affected by infected blood products and the appointment—I hope, imminently —of clinical leader and social care experts. The role of social care experts will be to advise on technical issues that require a high level of relevant knowledge in order to make informed choices in responding to the inquiry’s eventual recommendations on compensation—things such as tariff schedules. These experts will be independent and will be appointed solely to advise on technical issues. Our feeling is that it is right to get on and make those appointments: the Minister for the Cabinet Office was very clear about that. That probably means that it is not possible to do the chair and the experts at the same time. He made it clear that that process was ongoing, would be communicated early in the new year and that he was working, as it were, right over Christmas on this important issue.

In relation to the psychological support service in England, I understand the concerns that the service cannot go live until early summer 2024. The reason for that is that we need time to recruit suitably experienced and qualified staff and for all the necessary arrangements to be made for them to start seeing patients. What is good about the scheme is that access is anticipated to be primarily by people referring themselves. There may be onward referrals from GPs and hospitals, but people will not be reliant on that.

The noble Baroness, Lady Brinton, was right to run through the history of this again and remind us of that and of individual cases. I am the process of reading Caroline Wheeler’s book on this blood scandal in preparation for today and have been shocked by the individual cases. I commend that, and think it has been influential in this whole matter. We have made a Statement because we promised to do one before Christmas and, as I have said, the Minister for the Cabinet Office is working relentlessly on moving these schemes forward so that we are in the best possible stage of readiness for the final report when it emerges.

Minister for Disabled People

Baroness Brinton Excerpts

Tuesday 19th December 2023 Lords Chamber

Asked by

[Baroness Brinton]

To ask His Majesty’s Government why the status of the Minister for disabled people was downgraded from that of Minister of State to that of Parliamentary Under Secretary of State.

[The Minister of State, Cabinet Office (Baroness Neville- Rolfe) (Con)]

All Ministers speak with the authority of the Government, and it is for the Prime Minister to decide how responsibility is allocated. The role of Minister for Disabled People has been undertaken at both Minister of State and Parliamentary Under-Secretary of State level in the past. The new Minister has been at the Department for Work and Pensions since 2019 and has the ability to get things done and extensive experience of the issues that disabled people face.

[Baroness Brinton (LD)]

My Lords, disabled people are horrified by the Prime Minister’s decision. DWP estimates that 16 million people have a disability— that is one in four—and they face multiple barriers in their lives beyond DWP. It is harder to get a job— 29 percentage points less—their financial position is much worse, they have to spend much more on energy, and other barriers remain for health, education and transport. The former role of the Minister of State for Disabled People could focus on influencing change but the new PUS is covering a large portfolio including housing benefit, the military covenant and youth. Why have this Government once again downgraded support for disabled people?

Procurement Bill [HL]

Baroness Brinton Excerpts

Consideration of Commons amendments
Monday 11th September 2023 Lords Chamber

Moved by

[Baroness Brinton]

Leave out “agree” and insert “disagree”.

[Baroness Brinton (LD)]

My Lords, I start by thanking the Minister for our meeting last week. I have listened carefully to what she has said today and during that meeting; I am afraid that she has not convinced me that the procurement rules for the NHS would be as strong, clear, transparent and accountable as we find in this Procurement Bill. My Amendments 1A and 81A would ensure that the NHS is included.

During the passage of the Health and Care Act 2022, the very short Clauses 79 and 80 gave the NHS exemption from this Bill, with procurement rules to be introduced in secondary legislation by the Health Secretary. Seventeen months on, this still has not happened. When she spoke just now, the Minister relied on government Amendment 82. However, in the consultation—it is, I believe, still open—the NHS provider selection scheme that she referred to sets out some general principles only. During an earlier stage of this Bill, in response to my earlier amendments, the noble Lord, Lord True, referred to clinical contracts being exempt. However, that is not so; in fact, I note that, today, the Minister has been referring to healthcare. Every single time I ask a Minister a question, the definition changes.

In the NHS provider selection scheme, the flexibility rests with NHS bodies to make their own decisions about which scheme they use. The consultation document says:

“This is intended to remove unnecessary levels of competitive tendering … the Provider Selection Regime is intended to make it straightforward to continue with existing arrangements for service provision where those arrangements are working well and there is no value for the patients, taxpayers, and population in seeking an alternative provider”.


Those phrases—“remove unnecessary levels of competitive tendering”, “working well” and “no value in seeking an alternative provider”—are worrying, frankly. The problem, as we have discussed at length in our debates on this Bill, is that poor practice creeps into a culture where people believe that things are working well. The rules that this Bill sets out are there to ensure that every public body putting out a tender has carefully thought through what is appropriate, not just working well.

There is evidence that the current practice in NHS procurement has a mixed record, whether at the highest level or right down at the level of local trusts and CCGs, which is often covered by the specialist press. Despite a blunt National Audit Office report in 2011 on value for money in NHS procurement, the experience during the pandemic showed that some of the deep-seated culture of things not being value for money and not being completely open and transparent continues. The NAO has commented on this and the NHS recognised it in its response paper, Raising Our Game, in which it said:

“Recent reports suggest NHS procurement is lagging behind industry procurement performance”.


Unlike Ministers, the Civil Service and staff at many other public bodies, who are constrained by conflict of interest rules, it is possible for NHS staff, including directors, to use a revolving door to move from the NHS and join a company that contracts with the NHS without a gap. Last year, a deputy director and the head of AI at NHS Digital both left and immediately joined the technology firm Palantir just as it was bidding for further contracts, some without open tendering; Palantir is known to be bidding currently for the federated digital platform contract, which is worth an estimated £360 million and is due to be awarded imminently. Only 10 days ago, the chief operating officer of the NHS left on a Friday and joined Doccla, the virtual ward company that is bidding for substantial NHS contracts, the following Monday. It was also reported in July this year that NHS Digital had spent £7 million on “irregular” payments to external contractors while, last year, the Treasury flagged “irregular” spending by the Department of Health and Social Care and the NHS worth £1.3 billion. Let me say that again: £1.3 billion. Last year, the Technology and Construction Court found that staff from three CCGs in the south-west had manipulated a £2 million contract knowing it to be improper.

Many of these incidents are not reported widely. I thank in particular the Health Service Journal and other technology and health reporters for shining a light on this poor practice, even if it is not regular, wherever it has happened. This is not about those individuals nor the contracting companies. It is about the culture of procurement in the NHS. My amendment would ensure that by including the NHS in this Procurement Bill it would share robust regulations with other bodies and would be accountable and transparent even if there is a need for some subsequent special arrangements for complex clinical contracts. Not doing this will not change the culture of NHS procurement but including it in this Bill will. I beg to move.

--- Later in debate ---

[Baroness Neville-Rolfe (Con)]

My Lords, I begin by sharing my appreciation for the number of incisive contributions we have heard in the course of this short debate. It is always a pleasure to debate these things here. Of course, they have now been reviewed in the other place, as my noble friend Lady Noakes said, and there was a long discussion, including a long Committee stage attended by my friend in the other place Alex Burghart. I particularly thank noble Lords for all the work that has gone into this across the House, including these important provisions.

My noble friend Lord Lansley is correct that the objective in Clause 12 applies to cover procurement. The NPPS clause allows an NPPS to cover all procurement, but in practice its scope will be determined by the contents of the statement. In my opening remarks I explained at some length the position on the coverage of the NHS. I will come back to one or two of the questions from the noble Baroness, Lady Brinton.

I particularly thank the noble Baroness, Lady Hayman, for all that she said. Concerning principles that need to be considered by Ministers in preparing the NPPS, these principles are already covered through other commitments and legislation, as I have already set out. The amendment is therefore not necessary, as my noble friend Lady Noakes said. In addition, our fundamental view is that the Government of the day should not be constrained by the Bill in their ability to prescribe something more specific. They are free to do so—and I think this is the charm of the Bill—through the NPPS rather than through primary legislation. The Bill is about clarity and simplicity, not layering rules on rules.

To understand how it works in practice, I refer my noble friend Lord Lansley—I think I have already discussed this with him—to the current non-statutory NPPS, which covers innovation and social value. Attempting to drive innovation, which I am as keen on as he is, in every single procurement will not always be relevant or proportionate. Our Bill drives innovation through, for example, our new competitive flexible procedure, pre-market engagement and our duty for contracting authorities to have regard to reducing barriers for SMEs—which will also benefit social enterprises, as the noble Earl, Lord Devon, referred to. Future NPPSs will also be subject to parliamentary scrutiny and consulted on as appropriate.

The consideration of environmental targets and objectives relating to social value in preparing the NPPS, and the other principles set out in this amendment, are duplicative and would render the Bill more complex and confusing for contracting authorities and suppliers. Singling out specific objectives for Ministers to consider will create the impression that they trump others, which could unduly constrain flexibility for a Government to set priorities in future, which they will do through the NPPS. This is a principle seen in other legislation, where you have framing legislation and then statutory guidance.

Finally, regarding environmental considerations—as highlighted in discussions during the REUL Bill debates, although perhaps I should not remind noble Lords of those as they took a long time—Ministers will now be under a legal duty to have due regard to the environmental principles policy statement when making policy, including the development of policies in accordance with the Bill.

On the NHS amendments championed by the noble Baroness, Lady Brinton, I am grateful for the meetings that we have had but I believe that they stem from a confusion. NHS bodies are contracting authorities and therefore already covered by the Bill; we had a good conversation about mixed contracts and so on, which I think was helpful to us both. It would be inappropriate to remove the power to make the provider selection regime regulations, especially given the benefits that they will bring to patients.

In response to a question about the definition of healthcare services, the scope of services in the PSR has been consulted on and will be further supported by reference to a list of common procurement vocabulary codes, set out clearly in the PSR regulations. An indicative list of those codes was included in DHSC’s recent consultation on the PSR.

The noble Baroness made a point about conflicts of interest. Our Bill strengthens existing legal duties on conflicts of interest and embeds greater transparency throughout the commercial life cycle. This has been welcomed and, I think, is important. Furthermore, the provider selection regime regulations will clearly set out provisions for the effective management of conflicts of interest. The PSR is designed to ensure transparency across all procurement decisions to which it applies, including how the decisions were made. This transparency will help ensure that there is proper scrutiny and accountability of decisions to award contracts for healthcare services.

Finally, an independently chaired panel will provide expert review and advice concerning decisions made under the PSR, helping to ensure that procurement processes are transparent, fair and proportionate. I very much hope that that additional information about our plans for the PSR will enable this debate about just how these two regimes, both of which have been discussed constructively and at length in this House, fit together, and that noble Lords feel able to support the government amendments and withdraw the amendments that they have put forward.

[Baroness Brinton (LD)]

My Lords, I thank everybody who has spoken in this brief debate. I particularly thank the noble Baroness, Lady Noakes, for at least agreeing with the principle, even if she cannot support me in the Division Lobby, because it is really important.

For all the reasons that the Minister outlined, we are where we are. When we were working on the Health and Care Bill, it was absolutely evident that the secondary legislation changes would be outlined quickly thereafter—I am looking at others who were in the Chamber at the same time—and agreed by last autumn. We are now 17 months on and there is no sight of them at all.

The Minister outlined the NHS provider selection scheme and all its arrangements. That it is not looking for a culture change worries me most. In my earlier speech I gave examples of the behaviour of three senior managers at three CCGs, which the public would not have known about if the losing company had not gone to the Technology and Construction Court. This revealed that it is all too easy, where the culture is poor, for people to believe that the rules are being followed when they are not.

I appreciate that we have a point of difference on this, but on our Benches we believe that there is much benefit in this Procurement Bill and do not understand why the NHS is excluded. It is perfectly possible to include some special arrangements for it, but nothing has happened since the Health and Care Act was enacted. At the moment, nothing we are hearing from the NHS is about that culture change. On that basis, I wish to test the opinion of the House.

Covid-19 Inquiry: Judicial Review

Baroness Brinton Excerpts

Tuesday 6th June 2023 Lords Chamber

[Baroness Neville-Rolfe (Con)]

I thank my noble friend for his wise advice and the background. We miss him on the Front Bench, and it is good that he has come to talk to us today. As evidence of his point, materials are carefully considered. One of the issues under debate was the Sarah Everard processes. In this case, a message that appeared unconnected to Covid was initially redacted, but it was then identified as potentially relevant as part of the additional counsel review, which the noble Lord referred to, so the Cabinet Office then provided it to the inquiry proactively. A process is going on, and a large team is working away at this. All along, our legal team in the Cabinet Office looking after the inquiry has tried to agree on sensible arrangements. We have entered a JR, but we remain hopeful and willing to agree the best way forward with the inquiry, if that is possible.

[Baroness Brinton (LD)]

My Lords, one of the strengths of a judge-led public inquiry is that it is able to look at everything, including the emerging wider context and competing pressures facing those who have to come to some very difficult decisions. Inquiries such as the Leveson inquiry, that on Hillsborough and, more recently, IICSA have all had confidential information and have had to decide what to redact. I was peripherally involved in the latter of those as a witness, and it was somewhat nerve-racking to hand over personal information, but I was utterly confident that the decisions would be made in the interests of the inquiry.

As the health spokesperson on the Front Bench during Covid and just before it first struck in January and February 2020, I note that there are a large number of issues, including the Government disbanding the pandemic preparedness group to leave more space for Brexit. NERVTAG and SAGE minutes between January and February changed very quickly, and it is illuminating to read them. But it was concerning to read that the Prime Minister missed the first five COBRA dates, and there were reports that he was not working on weekends during that early period. In addition to those reasons, some of what the inquiry needs to look at includes why the UK did not follow the World Health Organization guidance on testing and protection from the start, and why the UK Government sent PPE to China just at the point that the experts were saying that our health people needed it. We had health staff in bin bags because we did not have any PPE in this country.

For all these reasons, I ask the Minister whether she believes that the inquiry really needs to see the detail of that correspondence. It may look irrelevant from the outside, but, in terms of emerging contexts and competing decisions, it becomes vital to what happened and whether people lived or died.

[Baroness Neville-Rolfe (Con)]

The Government set up the inquiry for exactly the sorts of reasons that the noble Baroness outlined. These questions need to be answered. As I said, the Government are making available all relevant information—anything related to Covid or decisions about it is being made available. The judicial review is on a narrow technical point about unambiguously irrelevant items, and I assure the noble Baroness that the Government seek to ensure that the inquiry and its chair have all the information and access to witnesses that they need, to ensure that the very important questions that the chair is asking are answered. That is why we are having an inquiry. Of course, we want it to get on, and we look forward to learning the lessons as soon as possible.

Civil Contingencies Act 2004 (Amendment of List of Responders) Order 2023

Baroness Brinton Excerpts

Monday 23rd January 2023 Grand Committee

[The Minister of State, Cabinet Office (Baroness Neville-Rolfe) (Con)]

My Lords, this order was laid before the House on 6 December. I think we are all agreed on the importance of improving UK resilience, and the recently published resilience framework illustrates the need for clear responsibilities in order to drive planning activity across the risk life cycle.

This instrument will do exactly that by creating the legal basis for improved co-operation, information sharing and integration between the Meteorological Office and the Coal Authority and the wider list of categorised organisations operating at the local level across the UK. It will deliver these important changes by making both organisations category 2 responders as defined under the Civil Contingencies Act, in turn bolstering the planning activities conducted by local resilience forums in England—a further commitment of the new resilience framework.

This will ensure that these bodies are well integrated within wider emergency planning frameworks and able to collaborate in the development of localised risk assessments and to contribute information and expertise to support local resilience forums in planning for and responding to emergencies. Both organisations hold information and experience that is integral to the process of civil protection. The Meteorological Office is able to support effective management of severe weather risks, and the Coal Authority is positioned to ensure that due consideration is given to the unique risks presented by our industrial heritage.

I was amazed by this: approximately 25% of property across the UK is located on the coalfield, and the Coal Authority responds to a wide range of incidents, including, but not limited to, subsidence, sudden ground collapses, emissions of water or gas and coal tip slips, as well as metal mine pollution incidents, for which it also has responsibility. As we all know, extreme weather and flooding, which we have increasingly experienced, often heighten the likelihood of risks materialising in these areas.

The Civil Contingencies Act, also known as the CCA, was introduced in 2004 following a review of emergency planning arrangements as a result of the fuel crisis and severe flooding in 2000, as well as the outbreak of foot and mouth disease. The Act establishes a framework for civil protection in the UK. It imposes a clear set of roles and responsibilities on organisations with a role to play in preparing for and responding to emergencies.

Category 1 responders are organisations that collectively form the core of local emergency preparedness and response. These include emergency services, local authorities, health bodies, HM Coastguard and government agencies. Category 1 responders are subject to the full set of statutory civil protection duties, including assessing risks to inform contingency planning, warning and informing the public, and putting in place business continuity arrangements.

Category 2 organisations, which include the Health and Safety Executive and utilities and transport operators, are co-operating bodies and, although less likely to be involved in the heart of planning work, are heavily involved in incidents that affect their own sector. Category 2 responders have a statutory duty to co-operate and share relevant information with other category 1 and 2 responders. The Act and regulations made under the CCA create the basis for these organisations to collaborate through local resilience forums where all responders can come together to ensure effective multiagency emergency preparation and response.

Regulations made under the CCA also place a duty on responders to help co-ordinate risk assessment at their local level through the production of the community risk register, which ensures that local resilience forum members hold a consistent understanding of the hazards and threats across their area.

The CCA is reviewed every five years. The most recent post-implementation review was laid before the House in March 2022 and proposed the categorisation of the Met Office and the Coal Authority as one of its key recommendations. The Met Office and Coal Authority perform important functions in preparing for, and responding to, risks associated with extreme weather events and the coal-mining legacy. Recent examples include several heatwaves in 2022, a number of floods in recent weeks and, in the past few days, a sinkhole that has, sadly, opened up in Caerphilly. The two organisations have significant expertise and technical knowledge in their respective fields and provide critical support, such as severe weather warnings, hazard assessments, training and response planning.

While these organisations already work closely with local partners, our consultation and engagement indicated that, without their integration within the legal framework, this was taking place in an inconsistent or ad hoc way. Categorising these organisations will ensure that they are able to share information and co-operate with local resilience forums across the UK in a more regulated and structured way. This will ultimately improve the preparedness of local partnerships to respond to incidents related to coal mines or severe weather and strengthen their ability to protect the public and save lives.

This instrument is being made using powers set out in Section 13(1) of the Civil Contingencies Act, which allows a Minister of the Crown to amend the list of categorised responders. It will add the Meteorological Office and the Coal Authority to the list of responders under the Act. Importantly, these amendments do not add significant financial burdens to the Meteorological Office or the Coal Authority as these organisations are already equipped to perform these additional duties under their current budgets, with a de minimis impact assessment having been completed in December 2022.

These provisions will be implemented across the UK, and we have consulted officials from the devolved Administrations throughout the process. We also formally notified each Administration via ministerial letters of our intention to lay this instrument. Noble Lords will be glad to hear that all devolved Administrations were supportive of the inclusion of these agencies as categorised responders for the whole United Kingdom. I therefore thank each Administration for their engagement and collaboration. I hope that colleagues today will join me in supporting the draft regulations. I commend them to the Committee and beg to move.

[Baroness Brinton (LD)]

I thank the Minister for her helpful introduction to this statutory instrument. It is an excellent proposal to include the coal providers and the meteorological service as category 2 responders. The actual legislation is barely half a page. The rest of the documentation, both the Explanatory Memorandum and the evidence base, are extremely helpful in explaining how the emergency provision is supposed to operate in practice and the difference between the responsibilities of a category 1 and category 2 responder.

I want to raise an issue about how well that is working in practice—and I declare an interest that my grand-daughters were born very prematurely and very small and, this time five years ago, the smallest of them had been allowed home from hospital only after the first eight months of her life, with a ventilator to operate when she was asleep at night and during the day. Nobody was allowed to look after her who had not been trained by the hospital because, if the ventilator failed, there would obviously be very serious consequences. They also provided a heart monitor. At the time, my son and daughter-in-law were told to let their utility supplier know that they required emergency support in the event of a power cut. There was one such power cut—and, when you have a sick baby home from hospital for the first time, you are watching the minutes ticking by and knowing that the battery on your child’s ventilator and heart alarm is going to run down fairly swiftly.

My son rang the utility emergency number, which confirmed that they were on the register, that it was only their estate in south London that had gone out and that, in due course, a generator would be brought to them. An hour and a half later, the story was still the same. My son had to take the decision to remove my granddaughter and all her kit—which filled the car—and bring her to us, where we did have power and were able to ensure that she was safe. I therefore have a particular interest in the emergency supply of electricity, not just for vulnerable people but for those whose lives depend on it.

When there was concern in the autumn about possible blackouts this year, no matter how unlikely, to make sure that the arrangements under the CCA would work for this small group of people, children and adults who have to rely on literally life-saving equipment to keep them alive I asked Energy Ministers and Health Ministers about the registers, which are still held by the utility providers, which are category 2 providers. Disabled groups have also been asking about them. Grant Shapps gave evidence at a BEIS Select Committee meeting that arrangements are there but these individuals need to make emergency arrangements for themselves, which has not been the case in the past and which I found quite extraordinary. For clarity, the register is called the priority services register. That is the one for all vulnerable customers, but it does not distinguish the level of emergency need—and therein lies the problem. In the event of mass power cuts, it is clearly impractical for any energy supplier to provide electricity generators to lots of people at short notice, but asking residents who fall into that category to make that provision for themselves is a further problem.

What has become more worrying, and the reason why I raise this now, is that utility suppliers are telling these individuals that they need to talk to their doctors, who have absolutely no role in this at all. It is clear to many people that the utility suppliers do not understand their role in managing the register. I have also talked to two directors of public health, who are key players on any health issues in local resilience forums and have a particular role in a civil contingency situation, such as a major power cut. They say that they cannot get the right information from the energy suppliers about who it is who needs that extra care. All the focus is on the vulnerable elderly who might get cold. The particular group of people that I refer to seems to fall through the net.

Can the Minister investigate for me how this is meant to work and confirm whether the Secretary of State for BEIS was correct in his assertion in the autumn that the responsibility now lies with the individuals concerned—which seems extraordinary? Can she also confirm whether it is clear to local resilience forums what they should be doing and where they should get their information from regarding this particular group of people?

To end on a happier note: my granddaughter no longer uses a ventilator at night—it took three years—and I must say that all the support that she has had from everyone has been brilliant. But we are a family who really understand the consequences of a major power cut and how life-threatening that can be for a small but very vulnerable group of people.

--- Later in debate ---

[Baroness Brinton (LD)]

I thank the Minister very much for her generous response. When she writes to me—perhaps we might even be able to meet on this—could she draw a distinction between the general category of vulnerable people and those who are highly impacted by whatever the emergency is? In the case I gave it was utilities.

[Baroness Neville-Rolfe (Con)]

Indeed. The noble Baroness made it very clear in her contribution that that was exactly the problem: vulnerability comes in different clothing and different categories. We should look at that as part of our resilience work; otherwise, there will be repeated disappointments of the kind she helpfully brought to the attention of the Committee.

Preparing for Extreme Risks (RARPC Report)

Baroness Brinton Excerpts

Thursday 12th January 2023 Lords Chamber

[Baroness Brinton (LD)]

My Lords, I declare my interest as a vice-president of the Local Government Association and as vice-chair of the All-Party Group on Adult Social Care. I was also health spokesperson for my party from January 2020, when my leader said that there was not much on the health agenda, and I retired from that post at Christmas. It is always a pleasure to follow the noble Lord, Lord Berkeley, and his very practical speech—I have just deleted a large section that I had about the strategic nature of support in the Government’s response because there is no point repeating it. I congratulate the noble Lord, Lord Arbuthnot, and his committee on this extremely important report, on the evidence they heard and the recommendations they have made. As the noble Lord, Lord Hunt of Wirral, said, it is an exceptional report.

For those of us who have been on councils through elective office or had Front-Bench responsibilities, or been in business, having full risk assessments and risk preparedness plans reviewed and updated on a regular basis is an absolute must, even if it is not business as usual to manage the unusual. My thanks also go to the Cygnus Reports organisation website, run by Moosa Qureshi, an NHS doctor who uncovered many other pandemic exercises in the run-up to 2020 that were not published.

The key lesson in both the report and our experiences of the Covid-19 pandemic is that cultural change to partnership working is needed across government, especially but not only with those who have a statutory responsibility to provide responses, whether or not to extreme risks. My noble friend Lord Thurso also highlighted this risk.

From these Benches, it is much regretted that there is not a clear commitment by the Government to the office for preparedness resilience or to a chief risk officer. The Government’s saying

“fold into … reform for our internal risk management structures”

can be read in a number of ways. Will the Government undertake to create both the office and the role of chief risk officer? Too many of the Government’s responses to recommendations use the words “agreeing with this principle”. I am afraid that would allow the Government to dilute these recommendations.

Pandemic planning is a perfect illustration of what went wrong in early 2020. The Government appeared to follow only Exercise Cygnus, which was for influenza. What was not mentioned is that in the preceding seven years there were seven exercises and reports, and that it took Dr Qureshi a series of legal challenges to government to be able to see and publish them. The first, in March 2015, was a report on Ebola preparedness. The second was Exercise Alice on MERS, published in February 2016. Then there was Exercise Northern Light, published in February 2016; a report on Exercise Typhon, a Public Health England command post exercise in 2017; an Exercise Broad Street high-consequence infectious disease report in 2018; Exercise Cerberus, a Public Health England national exercise, also in 2018; and a report on Exercise Pica, the NHS primary care preparedness and response to the influenza pandemic, on 5 September 2018. I read that list in full because it is clear that work was going on behind the scenes. The problem is that it was not used when we came to the pandemic.

The UK became aware at the end of 2019 of the emerging infectious disease that became known as Covid-19 from Wuhan, but it really took until March for actions to start, not least in advice to the public. As the noble Lord, Lord Arbuthnot, outlined, that was a real problem. In February, as the health Front-Bencher for the Lib Dems, I talked to the Local Government Association and to directors of public health, who were already trying to manage cases arriving back in the UK after the February half term, especially those who had been to northern Italy for skiing.

Directors of public health were asking for help and strategic support from Public Health England and NHS England, and they moved ahead fast, with local partners, to set up volunteers to help those who were at risk of isolation and the reorganisation required inside councils to ensure that priority services worked. Yet, entirely separately, the Department of Health and Social Care suddenly announced its own nationally recruited volunteer scheme—there was much confusion all round.

I talk about the need for a change of culture because this is still happening. Ministers ran campaigns this summer to encourage autumn vaccination in preparation for winter illness surges, including influenza and Covid. But it appears that, despite knowing that all the experts were warning that this would be a very tough winter—it is already tough, and we have not even got to what is usually the worst time of year—resilience arrangements were unfortunately not put in place for strep A, for example, until there was a very public shortage of antibiotics. Why were they not ordered in excess this year? Children are ending up in ICU and, sadly, losing their lives much earlier in the winter season than expected. An Ebola response report from 2015 said that a review of surge capacity would be required around paediatrics.

In addition, this week the Secretary of State talked about the high number of influenza and Covid patients in hospital. Many of those patients acquired Covid in hospital, which was probably not unassociated with the extraordinary government decision to relax the mask mandate. During the outbreaks of diphtheria—a notifiable disease under the Public Health Act—and scabies, there were notable delays to the Home Office engaging, first, with the UKHSA and with local directors of public health. I remind the House that directors of public health have a statutory duty under the Public Health Act to start working immediately on any notifiable disease. It took too long for that to happen.

The large number of reports that I outlined earlier showed that the department, Public Health England and now the UKHSA were fully aware of the risks of a rapid spread of highly infectious diseases, including Ebola, Lassa fever and influenza, but they did not follow this. Are all these previous reports being used to assess in the current review inside government—assuming there is one—how to handle the pandemic, which is not yet over, by the way? We also have 9,000 Covid cases in hospital; many of them are the very vulnerable people who were asked to shield during the pandemic. The problem with the Secretary of State for Health and Social Care saying that the pandemic is over and we have all learned to live with it is that arrangements have not been made for this group of people, who remain extremely vulnerable.

The excellent book Pale Rider: The Spanish Flu of 1918 and How it Changed the World, by Laura Spinney, notes in its final chapter that excess deaths continued for some years afterwards—some were due to flu, but they were mainly due to lung disease and heart disease. The most worrying part is that, within three years, most public bodies were back to business as before, and all of the lessons were lost.

Comprehensive risk planning and assessment, with a dedicated team that is not distracted by changes of Ministers, general elections, et cetera, are not just vital for a future pandemic: organisations that plan effectively for high risks can adapt plans for unseen and unpredicted extreme risks. When I was a group leader on Cambridgeshire County Council in the late 1990s, we had severe flooding, chemical leakages and other crises. Our bunker came into use, and the local resilience forum got under way. When foot and mouth disease hit in 2002, the LRF was able to swing swiftly into action for the county on a totally unexpected pandemic, this time with animals.

The noble Lord, Lord Rees, my noble friend Lord Thurso and others were right to say that the Treasury should provide proper resources for that, and not treat it as part of an annual budget which can be cut when times are tight. Covid has shown us over the last three years that, to save a modest amount in extreme risk planning, billions of pounds have been spent and hundreds of thousands of lives lost.

However, I want to end on a positive note, because the Government’s creation of the resilience framework is an encouraging first step. We hope that, above all, it lays the foundation for a new way forward and that the Government will also accept the two outstanding recommendations, not least because that is the only way we will get the cultural change we need.