Ambulance Pressures

Debate between Baroness Brinton and Baroness Henig

Tuesday 19th July 2022 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, I start by paying tribute to our ambulance and paramedic staff, as well as the ambulance call handlers. They are doing the absolute best they can despite the circumstances, and we owe them an enormous debt of gratitude.

There is no doubt that our ambulance services are at breaking point. Record-long ambulance waits are leaving vulnerable patients stuck in the heat outside hospitals, waiting for the treatment they need. There was a new first over the weekend, as temperatures rose, when patients inside ambulances were in a hospital car park for over 24 hours because A&E was full and there were no beds in the hospital.

This is not a recent crisis. Among many incidents reported in the press, a couple of months ago a senior NHS trust doctor in Gloucestershire rang 999 having had a suspected stroke, and was told to get a family member to drive her to hospital because no ambulance could get to her for at least an hour and there would then be a considerable delay after that. There are daily reports of people dying waiting for ambulances or in the back of an ambulance outside A&E.

Frankly, this Government have run ambulance services into the ground, with every single target being missed for the most severe cases. For months, they have failed to act on warnings that ambulance services are struggling to maintain a safe and timely service. The Government need to get a grip of this emergency. Even Liz Truss, one of the contenders to be the next Prime Minister and a very senior member of Cabinet, said in the ITV leaders’ debate on Sunday that ambulance waiting times in her rural constituency were “appalling”. Surely now is the time for Ministers to finally commit to commissioning the CQC to conduct an investigation into the causes and impacts of ambulance service delays, which would not just look at the very front line but take a whole, systemic approach.

One of the solutions proposed by the Secretary of State in the Statement is more use of 111 to ease pressure on call handlers receiving 999 calls, but there is already a major problem with 111: it takes much longer to get through and sometimes calls are not even answered. Not getting through to 111 will exacerbate waiting times and not help get them under control, because it risks piling even more pressure on our ambulance services, as desperate people whose conditions have worsened struggle and then turn to 999 instead. Can the Minister say what extra staffing and training there will be for the 111 service? Specialist training will be needed, because staff do not receive the highly specialised training that the 999 service call handlers do.

We need to remember that this is not just about ambulances, but they are the very visible evidence of a broken health and social care system. We on these Benches, and others around your Lordships’ House, have regularly been asking questions about our ambulance and A&E services, under pressure for well over the last six months. For years, we have also highlighted the shortage of hospital beds compared with other OECD countries. In 2021, the UK had 2.3 beds per 1,000 people, compared with France at 5.7 and Germany at 12.6. It was a mistake to cut so many beds. So will the Government undertake to fund thousands of extra beds to stop handover delays at A&Es, so that ambulances can get back on the road as soon as possible?

All of this is compounded by the lack of training and education places for doctors, nurses and other vital healthcare professionals, such as physios, occupational therapists, and speech and language therapists. Will any of the long-term plans to provide finance and support to enable hospitals to recruit and train more specialist healthcare staff be brought forward? Otherwise, we will just continue to lurch from crisis to crisis.

Finally, as the Statement notes, the Met Office has issued the first ever red warning for extreme heat, at a time when all 10 of our ambulance services in mainland England are already at the highest level of alert. The news this afternoon is of a number of serious fires in London and elsewhere; Hertfordshire, my local area, has had 240 calls to its fire service, which is many more than usual. Temperatures peaking at over 40 degrees centigrade just demonstrates that the pressure on ambulances, A&E and our wider NHS is likely to increase from injuries sustained by firefighters and those caught up in the fires.

The Statement talks as if the only effect is on people currently in hospital. The effects of climate change will make heat waves more frequent and intense in the future, so I ask the Minister what the Government are building in to help the NHS tackle the problems arising from these heat incidents, which sadly we must now plan for on a regular basis.

Health and Care Bill

Debate between Baroness Brinton and Baroness Henig

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, the noble Lord, Lord Forsyth, has introduced his amendment very clearly, so I will be brief and say that I will also support him if he chooses to call a Division.

The majority of the British public support the legalisation of assisted dying. In a Populus poll of more than 5,000 people in 2019, 84% of respondents said they supported giving dying people the right to an assisted death. I am pleased that the noble Lord, Lord Forsyth, has managed to praise the Scottish Parliament system that has enabled my colleague Liam McArthur to have time for his Bill in its Parliament.

As the noble Lord, Lord Forsyth, has said, it is important to note that the amendment would not actually change the law on assisted dying. What it would do is to ensure that some proper parliamentary time is made available, as in Scotland, within 12 months of the Bill passing into law, to ensure that there can be a planned and proper debate with the wider public and with MPs and Peers that is just not possible in the Private Members’ Bill process that we have in our Parliament.

It is important to note that the amendment does not require government to support the legislation through Parliament, merely to ask for the time, and that this procedure has happened before with Section 16 of the European Union (Withdrawal) Act 2018. I hope that the Minister will change the Government’s mind on this so that the noble Lord, Lord Forsyth, does not have to call a Division.

[The Deputy Speaker (Baroness Henig) (Lab)]

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

Health and Care Bill

Debate between Baroness Brinton and Baroness Henig

Lords Hansard - Part 1 & Report stage
Monday 7th March 2022 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely; I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, the noble Lord, Lord Hunt, introduced his Amendment 144B on complaints about care services very well. He is absolutely right: this is a muddle. Are people to go to the CQC or to a particular home when they wish to make a complaint? Any complaints system where the person making the complaint feels in a less strong position than the organisation to which they are complaining, or indeed—sometimes they might even put this strongly—which is wielding power over them is a complaints system that will not work. I hope that the Minister will understand this, and will respond and ensure, first, that there is a clear and understood system, and, secondly, that if some funding needs to be restored to the CQC to take us back to where we were, that will happen.

I want to speak particularly to two of the issues covered in this wide-ranging group of amendments: the licensing of cosmetic procedures and medical practitioners’ financial and non-pecuniary interests. I also have sympathy for the other two, on registration of social workers and hospital rehabilitation accommodation.

The amendments laid by the Minister, beginning with 153A, on the licensing of cosmetic procedures by local authorities and, indeed, Amendment 169 in the name of the noble Baroness, Lady Finlay, on cosmetic procedures, which I have signed, set out models for registration for those who work using devices that breach the skin and who are not covered by medical registration or, currently, by any effective regulation. I know that considerable discussions have taken place between Committee and Report, and it is welcome that the Government have felt that they can now lay their own amendments, signed by the noble Baroness, Lady Merron, and the noble Lord, Lord Lansley. I look forward to hearing the comments of the noble Baroness, Lady Finlay, on those amendments.

Amendment 184ZBB in the name of the noble Baroness, Lady Cumberlege, which I have signed, brings us back to the debate on medical practitioners’ financial and non-pecuniary interests. Our debate in Committee highlighted the problem that the financial and non-pecuniary interests arrangements do not match those that many others in the public sector have to make, where the registration body holds the information. The GMC has said once again that it does not particularly like the style of this amendment and would prefer the records to be held directly by the employer. However, I believe the argument that the registration body, which also has the power to take action, should be the place where these are kept.

I hope that, regardless of whether a vote is called, the Minister will take this away and look at it in more detail. We need an open, transparent and clear system of registration of financial and non-pecuniary interests.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely; I invite her to speak.

Building Safety Bill

Debate between Baroness Brinton and Baroness Henig

Committee stage
Thursday 24th February 2022 Grand Committee

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely, and I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, I wish to speak briefly to the amendments in this group, particularly in relation to the issue of perpetrator pays for fire hazard remediation—work that must be carried out speedily to ensure the safety of the inhabitants of the building. Amendment 24 and others, introduced by the noble Lord, Lord Young of Cookham, sets out the removal or alteration of offending work that contravenes fire safety regulations. It is interesting to note that he joins a group of former Ministers who are now trying to remedy the problems that were around during their time as Ministers. I think we should thank them not just for their humility but for their acknowledgment, through their amendments, that change is needed even more urgently than ever.

The noble Lord is right that his and other non-government amendments in this group are critical to delivering what the Government want to achieve, despite their own proposals being inadequate. I echo his point that if the Government think that things can be done more effectively to achieve the objectives that he outlined, I suspect that the Grand Committee would want to hear them.

The Minister spoke earlier of his surprise about the mechanisms of current building work guarantees and the role of insurers and warranties. Insurers have, rightly, made it clear that they are not responsible for this crisis. Insurance is not eligible in the event of defective work, and insurers never sign off work; they rely on the assurances of the companies they are insuring that the work is safe. The practical problem is that too many companies have relied entirely on their insurers. In my former professional life as a Cambridge college senior bursar, I have been that client who has sat in the middle and watched arguments about who should pay for defective work on blocks of flats, including works on a fire hazard in a medium-rise building.

The problems we faced as a college, even though they were with student accommodation, were absolutely nothing compared to the problems that leaseholders and renters in blocks of flats face. Talk to any of the current leaseholders living in blocks known to be unsafe: even with waking watches overnight, families are constantly on edge, and too many face the threat of worthless homes that are unsaleable until the perpetrator pays principle is fully brought into effect. I think “perpetrator pays principle” will be one of the next speech therapist phrases that people have to articulate; it is quite difficult to get your mouth around. The current government proposals do not take into account too many leaseholders who, like those in high-rise cladding buildings, are also not responsible for the defective work done by others.

Amendment 118 makes it clear that those who should pay, in the event of a block of flats having fire hazards, are those who did the work itself. The Government’s current proposals do not go far enough and still leave too many loopholes for those living in unsafe flats. This is the moment that legislation can and should make it absolutely clear that the perpetrator is responsible and must effect the remediation work and pay for it. In the event of a gap between that work being necessary to be carried out and it being agreed that the perpetrator should pay, the Government should indeed step in to help out.

Health and Care Bill

Debate between Baroness Brinton and Baroness Henig

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, the noble Lord, Lord Blencathra, has outlined why there is an urgent need to address the NHS procurement rules in the light of possible genocide and other clear human rights abuses. We have a duty as a nation and as a society to ensure that goods used in our publicly owned NHS are not tainted with modern slavery or linked with behaviours that may lead to genocide.

This is not hypothetical. In November 2020, the noble Lord, Lord Alton—who I look forward to hearing speak shortly—asked the noble Lord, Lord Bethell, the then Health Minister, about Medwell Medical Products, which has a factory in Fenglin town, in Jiangxi province, noting that Uighur Muslims made up 25% of the workforce, despite being forced to live in separate accommodation from other workers. This was reported at the time by the excellent investigative paper, Byline Times. At the time, the noble Lord, Lord Bethel, said that the Government had not entered into an agreement directly with Medwell but that the central distribution warehouse in Daventry did have a record of receiving PPE masks produced by Medwell Medical Products. A spokesman for the Department of Health and Social Care said to Byline Times:

“We expect all suppliers to the NHS to follow the highest legal and ethical standards and proper due diligence is carried out for all Government contracts.”


This is an extraordinary response. Any contractor to the Government, even in an emergency such as a pandemic, must follow the commitments that the Government have given internationally to ensure that goods used by the publicly owned NHS are not tainted with human rights abuses. If companies such as Marks & Spencer can do it for their clothes supply chain, we can too.

In July 2020, the New York Times reported that Uighur Muslims—a minority subject to widespread persecution in China, including being put into detention camps where they are forced to undergo communist indoctrination—were being employed in the factories of medical suppliers under a specific Chinese Government labour programme. The Speaker of the US House of Representatives said at the time:

“We must shine a light on the inhumane practice of forced labor, hold the perpetrators accountable and stop this exploitation. And we must send a clear message to Beijing: these abuses must end now.”


As the noble Lord, Lord Blencathra, said, just over a year afterwards, in December 2021, the Americans passed the Uyghur Forced Labor Prevention Act into federal law.

UK Health Ministers’ responses in 2020 were, perhaps typically of this Government, aimed at prevarication and deflecting responsibility. This amendment does exactly what the noble Lord, Lord Blencathra, said, and what any self-respecting Government should do. It makes it absolutely plain that procurement must be

“consistent with the United Kingdom's obligations under the Convention on the Prevention and Punishment of the Crime of Genocide”,

and that

“procurement is not consistent if a Minister of the Crown has assessed that there is a serious risk of genocide in the sourcing region.”

The amendment also sets out conditions under which the risk should be investigated if the chair of a relevant Select Committee of either House of Parliament requests an assessment.

The amendment is very straightforward and clear. Perhaps the Minister can explain which parts of it he has problems with. It actually helps the Government, especially after the discoveries of the PPE provided by Medwell Medical Products and the supply chain—we suspect there are many other such companies as well. If the Minister is not minded to accept the amendment, can he explain to the House how NHS procurement can be protected from these human rights breaches, including possible genocide, in the future, and what guarantees there are that the department sees the supply chain details? I hope he will also agree to a meeting with the speakers in the debate on this amendment.

Health and Care Bill

Debate between Baroness Brinton and Baroness Henig

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, the amendments in this group, so ably introduced by the noble Lord, Lord Crisp, aim to restrict the powers of the Secretary of State to limit the capital spending of NHS foundation trusts and to ask for the reinstatement of the 2019 agreement. It is important to note that these amendments do not remove the powers as a whole but tighten them to avoid changes by the Secretary of State to funding that would delay capital works which are needed and urgent on health and safety grounds.

Health and Care Bill

Debate between Baroness Brinton and Baroness Henig

Lords Hansard - Part 2 & Committee stage
Tuesday 18th January 2022 Lords Chamber

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely, and I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, I am speaking in support of the amendments in the name of the noble Baroness, Lady Bennett, starting with Amendment 46. After many helpful discussions both today and earlier on in Committee looking at membership, structures and representations of ICBs, these amendments take us back to the first principles and ask your Lordships’ House to look at what should be in scope for the provision of NHS services. This is a really valid question.

The noble Baroness, Lady Bennett, referred to maternity services, but if I were to pick one of the services listed in Amendment 169, it would be dental services. There are millions of people in the country who cannot access an NHS dentist. The result is a worsening of dental health, which is especially worrying for children and young people. I am sorry to say that, over the years, Ministers have ignored the wider needs of the public regarding dental services. I think the point about specifying the provision of services such as this puts a very particular duty on the Secretary of State to force Ministers to make sure that they are also holding other parts of the health service to account.

The amendments turn our focus on to whether we still have an NHS that is a public health system or one that perhaps is paid for mainly by the public but run by a disparate number of bodies, including unaccountable private companies increasingly not based in the UK. They are particularly important in light of the report today in the press that the Secretary of State is planning to create the equivalent of school academies for failing hospitals and says that there will be a White Paper in due course. Just as an aside, do we need yet more reforms? Surely it would have been better to have a full range of Green Papers with an overarching vision of what the NHS in the 21st century should look like and how the structures should work. We are now waiting for two White Papers, while the passage of this Bill is irrevocably changing the structures of our NHS system.

Today’s announcement rings a number of alarm bells because there is an analogy with the education sector that is quite helpful. I remember that, in the 1990s, academies were going to be free from local authority control and that that, on its own, would inevitably make them improve—but that has not been the case. Various reports over the last 20 years have shown that a number of failing schools taken into multi-academy trusts and free schools have remained low performing. Structures on their own do not necessarily resolve this. Indeed, some multi-academy trusts have failed in their entirety, and one of their issues is the lack of public accountability—because Ministers have direct responsibility in the public realm for academies, and I worry that the Secretary of State may be proposing the same. If I was a senior leader in NHS England, I would be very concerned about that.

I am grateful for the earlier comments of the noble Earl, Lord Howe, on the need for Ministers to have the ability to appoint and, presumably, remove senior personnel on ICBs. But would the Secretary of State have responsibility for these academy equivalents and give them the right to access separate funding for capital expenditure and special projects? I raise this because part of the problem that we have at the moment is a diversity of funding mechanisms, structures and strands, which often take the eye of a leader—whether a Minister or one in the NHS—away from the provision of services.

The foundation of a public system was essentially removed by the 2012 Act, and, as the noble Baroness, Lady Bennett, said, the Constitution Committee suggested that there needed to be an interim remedy. It is important that we have reassurance that this Bill will not weaken it any further at all. I hope that the Minister can reassure your Lordships’ House that the Government want to protect the provision of NHS services, as part of a truly public health service.

Domestic Abuse Bill

Debate between Baroness Brinton and Baroness Henig

Report stage & Lords Hansard
Monday 8th March 2021 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, the amendments in this group seek once again to put parental alienation both in capitals and in the Bill. The noble Baroness, Lady Meyer, has again outlined her reasons for this. However, I do not hear any difference in objective from the amendments tabled in Committee. Those of us who oppose the amendments believe that adding parental alienation to the Bill is redundant because the alienating behaviours that she referred to are already caught in the definitions of coercive control. Further, the Government have agreed to add a phrase about alienating behaviours to the statutory guidance, which will sit alongside some of the other patterns of behaviour in domestic abuse.

As was mentioned in Committee, there are already problems in our family courts with one parent—often but absolutely not always the father of the child or children—alleging such behaviour. Unfortunately, as outlined in the Ministry of Justice’s harm panel report, fear of false allegations of parental alienation means that survivors and children of abusive and coercive relationships are suppressing evidence for fear that the charge of alienation will be made against them. Indeed, it is becoming such a worry in the family courts that even their solicitors are advising them against such evidence. There can be a history of abusive behaviour, especially coercive control, that is not presented formally to the family courts. This can include violence, restraining orders, criminal convictions and long-term patterns of such behaviour. Perpetrators of such fixated behaviour can often sound convincing and their ex-partners are often terrified of their behaviour, even in a court hearing.

In Committee, the noble Baroness, Lady Helic, and I went through some of the history of the development of parental alienation syndrome, which I will not repeat today, since we are now on Report, other than to say that there is evidence from the family courts of some abuse of a parental alienation defence. There are also some questions to be asked about the role of so-called experts in this area. Practice direction 25B, on the duties of an expert, the expert’s report and arrangements for an expert to attend court, is very clear on the requirements, including registration with a UK statutory body or having appropriate academic qualifications. The expert must also have completed the training. There are concerns from contested cases that some experts in this area might not have met this high bar, so I ask the Minister what checks there are to ensure that all expert witnesses meet practice direction 25B.

That is also why the noble Baroness, Lady Helic, and my noble friend Lord Marks have tabled Amendment 44. We need to ensure that the courts are aware of the implications of a whole range of behaviours, especially in some of these egregious cases where there might have been some controlling, abusive, coercive and even alienating behaviour. The definition of coercive control—after many years of campaigning by organisations such as Women’s Aid and others, it is thankfully now a crime—is

“an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten”

the victim. That seems to fit very well the definition that the noble Baroness, Lady Meyer, has been seeking. I hope that, on this basis, she will withdraw her amendment.

[The Deputy Speaker (Baroness Henig) (Lab)]

I call the next speaker, the noble Lord, Lord Winston. No? We shall move on, then, to the noble and learned Lord, Lord Mackay of Clashfern.