Health and Care Bill

Baroness Finlay of Llandaff Excerpts

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

[Lord Bethell (Con)]

My Lords, I support Amendment 266 in the name of the noble Baroness, Lady Merron, and Amendment 293 in the name of my noble friend Lord Lansley for all the reasons that my noble friend just articulated. I will not repeat them as he put them so very well. However, I would say to the Minister that, coming from the innovation space, I can see that the technologies for both cosmetic surgery and non-surgical cosmetic interventions are improving all the time. There is an incredibly rapid pace of change. They are set to continue to get better and better, so the marketplace is getting more sophisticated and their popularity is also exploding. We have been briefed on evidence about the role of social media in promoting non-surgical cosmetic interventions in particular. This is exciting, because it is great that people have access to these interesting products, but also extremely worrying, because not all the surgeries and non-surgical interventions are successful. It is the right time for the Government to intervene, so that we have a register of cosmetic surgical practitioners and a much clearer regulatory regime for non-surgical interventions.

I am pro cosmetic surgery. As a young boy, I had an inherited condition of having very big, sticking-out ears, which my father had and my cousins and aunts have, and it was miserable. I had them pinned back and I am very grateful that that happened. It meant that I could be a much more confident person as I grew up. I am pro cosmetic interventions; if people want to use the benefits of medicine to improve their confidence in the way they look, I applaud that. However, standing next to my noble friend Lady Cumberlege, I am also aware of Bruce Keogh’s extremely good report and the very large number of interventions that have not gone well. I know that the Minister’s instincts are not to intervene unless absolutely required and my suggestion to him is that we have hit that moment. The marketplace is exploding and now is the right time to intervene.

[Baroness Finlay of Llandaff (CB)]

My Lords, as I address Amendment 266, I should declare that I am a vice-president of the Chartered Institute of Environmental Health. I stress that this amendment has been supported by the Beauty Industry Group, which represents 10 industry organisations—two voluntary registers for cosmetic practitioners, the Mental Health Foundation and others.

There are currently significant gaps in our regulatory system. Environmental health and licensing professionals work at a local authority level. They inspect, register and license premises for a very limited set of procedures, such as acupuncture, tattoos and piercing. Even for these procedures, however, there are no nationally set training programmes or qualification requirements for somebody to practise. For the riskier beauty procedures, such as the injectables, there are only voluntary registers of accredited practitioners. They have some approved education and training but that is not mandatory.

That means that there are many unaccredited practitioners on the high street providing services to people directly with no checks. A licensing scheme, as outlined in the amendment, would provide appropriate qualification and competency standards for practitioners wishing to practise, which is key to improving safety. The amendment as drafted is an open power for the Secretary of State, so it is easily amended as new procedures come online and on to the marketplace. The weakness of existing legislation in the area is that it fails to cover many of the newer treatments that are now popular.

When things go wrong, it is the NHS that has to pick up the pieces. Infections, injuries, scarring, burns and allergic reactions from a range of procedures often all end up in the NHS, sometimes with people being hospitalised and disfigured. Injection of fillers—or botulinum toxins—into blood vessels can cause dying back of tissues as well as blindness when administered by people who really are not adequately trained and certainly not registered. That means that there is no recompense for people damaged by these practitioners, who have no medical insurance or qualifications. In addition, there are unauthorised advertisements that breach advertising standards. There are strict laws around prescription-only medicines such as botulinum toxin, but these advertisements seem to bypass those.

Among members of the public who have had cosmetic procedures, alarmingly, three-quarters were given no information about the product, volume, brand or batch number of whatever was being used and just under three-quarters were not asked anything at all about their psychosocial or mental health or any body image issues. It is a vast and complex area and there are gaps in regulations. We need a national framework of standards with qualifications that can be recognised, so that there is a clear badge for members of the public.

To briefly address Amendment 297, I suggest that it is not needed because dermatological surgery and plastic surgery are subsections of medical practice and already registered with the General Medical Council. This gets nearer to credentialling than to requiring a separate qualification. These are doctors. They are highly trained, they have gone through a recognised training programme and they have been often examined as part of their exit from their training in whatever procedure they are undertaking.

I remind the Committee that, in a recent letter from the right honourable Michael Gove, he said that he is considering a licensing scheme. I hope the Government will see that this amendment would allow such a scheme without tying the Government down, and I hope that they will accept it, as well as Amendment 264 from the noble Lord, Lord Hunt, for which I should declare that I am an honorary fellow of the of the Royal College of Physicians of Edinburgh and the Royal College of Emergency Medicine. I think the contents of the amendment would go wider than simply surgical procedures. The Royal College of Emergency Medicine was established as a separate medical college in 2008, but the guidance and regulations were written prior to that, so they are completely out of date for what is now emerging as a major specialty across medicine. That amendment would rectify a lacuna.

Health and Care Bill

Baroness Finlay of Llandaff Excerpts

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

Moved by

[Baroness Finlay of Llandaff]

36A: Schedule 2, page 137, line 23, leave out “one member” and insert “two members”
Member’s explanatory statement
This amendment would strengthen minimum clinical representation on Integrated Care Boards by ensuring there are at least two primary care members.

[Baroness Finlay of Llandaff (CB)]

My Lords, I must declare that I am an elected member of the BMA ethics committee and a past president. The BMA has been particularly concerned about ICB membership. I know we have already debated this, so I expect this group to be quite quick—I am sure the Committee would also hope that.

The Bill sets out a core minimum membership of integrated care boards, but this does not go far enough. We have just discussed not being prescriptive, but there are dangers in that. There is no guarantee of clinical leadership on the board and there is a real danger of undercutting truly representative clinical leadership by failing to retain some of the positive elements of clinical commissioning groups. Clinicians are already demoralised and a failure to give space to their voice and enthusiasm will only worsen this.

ICBs should have clinical representation from primary care and this amendment suggests that there should be two people for this, given the wide area that the boards cover and the very different types of practice within each area. Boards also need a secondary care clinician who is in a front-line, not a management, role and a public health representative. As we have already discussed, without public health representation on the board, there is a real danger that the evidence of health gain and the potential to reduce inequality will not be adequately voiced. The board needs public health input to be able to act as a population health organisation.

Some boards have acknowledged the shortcomings and allocated additional positions for general practice, secondary care and public health within their draft constitutions, but others have not. They appear to be ignoring the voice of the very people who work in front-line healthcare. Unless these voices are heard, along with the voice of public health, there is a real danger that the boards’ decisions will be distant from the reality and that they will become bad decision-makers themselves by losing clinical trust and confidence. I hope that the Government will rethink and ensure that the boards are able to have members who can provide a solely professional view of the whole population for whom the board has responsibility. I know we have already debated much of this, but I want the Government to think again, given the dangers of a further demoralisation in both primary and secondary care. I beg to move.

[Baroness Walmsley (LD)]

My Lords, it is essential that the board have available to it the skill set that you find in people at the clinical front line. I was interested to see that, putting the amendments from the noble Baroness, Lady Finlay, together, we have three people who are not representing one of the big acute hospitals, and one who is. Given the danger referred to by a number of noble Lords that the big acute hospitals will continue to have more influence in an integrated system than perhaps they should, that is a good element of putting the two amendments together.

As I said, it is important that clinical knowledge and experience be available to the board, but I would like to know that there is a balance and that this does not overwhelm other skill sets which all of us want to see represented; that became clear in the discussions we had last week about who should be on the board. With that caveat—the noble Baroness, Lady Finlay, might respond to that if she chooses to withdraw her amendment—I offer qualified support to what she is suggesting.

--- Later in debate ---

[Baroness Finlay of Llandaff (CB)]

I am most grateful to both the noble Baronesses, Lady Walmsley and Lady Thornton, for their comments, which I share. In the previous debate, I argued that we should have people from the allied health professions, and I do not dissent from that. This is not to replace them at all. I also completely recognise the Government’s comments that we need talent and a skills set. Having a balanced board means that you have to have the range of skills. Some people may bring several skills to the table, but they do not automatically bring them because they have a label on their head saying where they come from.

The other difficulty that we will face is that boards need to have contemporaneous experience in an area—and people go out of date remarkably quickly in different areas. The pandemic has shown how some areas have changed enormously in a very short space of time. The representations that I have had from the BMA, at a professional level, have been about how we make sure that the ICBs will be up to date with that contemporaneous input coming through all the time. I am glad to hear that the Minister plans to discuss all of this further. With that, I beg leave to withdraw the amendment.

Amendment 36A withdrawn.

Covid-19

Baroness Finlay of Llandaff Excerpts

Thursday 6th January 2022 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

The virtual wards are different from the Nightingale surge hubs. The hubs will create up to 4,000 beds if needed, and will be facilities that take patients who, although not fit for discharge, need minimal support and monitoring while they recover. The virtual wards involve people who are able to return home to have treatment through virtual interaction with medical professionals. They are different things done in different ways for different patients in different situations so that they can be properly treated in an appropriate manner.

[Baroness Finlay of Llandaff (CB)]

Can the noble Baroness explain to the House how the messaging is being reviewed, given that we have some areas of great resistance to vaccination? There is extensive anti-vax propaganda going out through the internet, which picks up the transmission of one internet message such that once one logs into that one gets bombarded with messages? Is there a way of intercepting those and countering them through the same route? There are patients in their 40s whom I have heard of almost at first hand who have been desperately sick and said that they were too frightened to be vaccinated because of that type of messaging.

There is also false reassurance now that omicron is mild. It is a mild disease most of the time in those who have been vaccinated and boosted, but in the unvaccinated what appears to be a simple cold might be a killer disease. That message does not seem to be getting out to the public. Nor is the message about the symptomatology presenting differently, so that if people have not lost taste they think that they do not have Covid.

[Baroness Evans of Bowes Park (Con)]

The noble Baroness of course makes incredibly important points. We already know that about 60% of those in intensive care have not been vaccinated. We know that unvaccinated people are up to eight times more likely to be hospitalised. The noble Baroness is absolutely right about the importance of this, which is why we are pushing the constant message about getting boosted. She will, I hope, be pleased to know—I am not saying that this solves the problem by any stretch—that we have seen more people coming forward to have their first jabs. There was an increase of 44% in the seven days to 22 December, compared to the previous seven days, which is a move in the right direction. However, the noble Baroness is absolutely right: we need to work with social media companies and are continuing to do so to identify and remove dangerous disinformation about vaccines, and make sure that we are getting our positive messages out.

We have allocated £22.5 million to help areas with low vaccine take-up. We recruited vaccine ambassadors, who speak 33 languages between them, to promote take-up across the country. We have a community vaccine scheme to target the 60 local authorities with the lowest uptake and use local networks to promote accurate health information. So we are trying to use a range of sources in order to try and either address the disinformation or the nervousness that is preventing people from coming forward.

House of Lords: Remote Participation and Hybrid Sittings

Baroness Finlay of Llandaff Excerpts

Thursday 20th May 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, I am delighted to follow the noble Baroness, Lady Bowles of Berkhamsted, to whose thoughtful words I say, “Hear, hear”. Our thanks must go particularly to all those working tirelessly across the House to enable us to function for a year. As a pilot group of Deputy Speakers, we rehearsed with Andrew Makower and Simon Burton how virtual proceedings would work. Then we moved on to a hybrid House. Form aimed to follow desired function to work as best it could—and work it has. We have shown legislatures worldwide what can be done by working differently, which is why I decided to speak remotely today.

The excellent opening remarks of the noble Baroness, Lady McIntosh of Hudnall, summarised a balanced perspective. We should not fool ourselves: Covid-19 in the Chamber would have brought a high mortality and morbidity rate. As we come back together, the worst scenario would be a highly infectious variant that escaped vaccine immunity and ripped through our number and the staff.

This House needs diversity and has shown inclusiveness this year, in the Chamber and beyond. We have used technology to outreach in new ways. To have true parity, we must work in a way that enables everyone to contribute their expertise, as my noble friend Lady Campbell of Surbiton demonstrated so clearly. That means changing our approach, not putting the old barriers and hurdles back in place.

Remote voting avoided crowded voting Lobbies. Voting by whipping does not apply to Cross-Benchers, and I believe that my colleagues on these Benches have taken great care to listen and decide how they vote. We should maintain electronic voting and thereby maintain social distance as we vote.

PeerHub has proven itself to be a valuable resource with much background information; it has been well designed. By contrast, the new parliamentary website introduced in recent months is not easy to use.

There have been procedural changes of benefit. My noble and learned friend Lord Hope of Craighead referred to having longer for Oral Questions, fairer allocation of speaking slots and concise questions. For those of us with longer travelling time, the earlier start is very welcome—the day away means one cannot go into work locally. We should not be taking decisions late at night; we have all seen Peers flagging, the later the hour. Also, I recall having one or two-minute speaking times long before the pandemic. The noble Baroness, Lady McIntosh of Hudnall, encapsulated the wish to retain the best aspects of the rapid learning and the changes imposed on us by the pandemic for those of us who do not want to go backwards.

Finally, the noble Baroness, Lady Taylor of Bolton, wisely cautioned against rushing. Our work sets an example to the country—how we worked before is a bygone era. In risk-planning, we should consider the previously unthinkable and not throw away the lessons learned. In the face of an emergency, we adapted and used technology; it may not have been perfect, but neither was what went before.

Covid-19 Update

Baroness Finlay of Llandaff Excerpts

Thursday 13th May 2021 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

As I have said, the inquiry will be a thorough examination across the breadth of our response. Obviously, the situation in care homes has been at the forefront of our minds throughout this pandemic. It is not for me to make commitments, but I cannot believe that this would not be something the inquiry looks at. I am sure that it will be and that relatives and those who work in care homes will be called to give evidence.

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare that I have been involved in the All-Party Parliamentary Group on Coronavirus. If this is to be a UK inquiry, can the noble Baroness confirm that the terms of reference will be developed with the devolved Administrations and that they will be involved, not just consulted; that they will be involved in the appointment of the chair, with a panel on which they are represented; and that they will be involved in the appointments of other members of the inquiry?

[Baroness Evans of Bowes Park (Con)]

Decisions as to whether the inquiry will comprise a panel in addition to a chair will be made in due course, but I can certainly confirm that we want to learn the lessons of the pandemic as four nations together, just as we recover together. That is why, as I say, we have already begun discussions with the devolved Administrations, because we want this to be a UK-wide inquiry. We have gone through this together and we want to come out of it together.

His Royal Highness The Prince Philip, Duke of Edinburgh

Baroness Finlay of Llandaff Excerpts

Monday 12th April 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, it is a great privilege to speak today in recognition of the enormous contribution to our country made by His Royal Highness The Prince Philip, Duke of Edinburgh, and in so doing to offer sincere and heartfelt condolences to Her Majesty the Queen and all his family. For our modern times, Her Majesty and His Royal Highness have represented stability, perseverance, family values and a deep commitment to a strong moral compass, in touch with the reality that has been the lives of others, even though they were living so differently from the rest.

In Wales, His Royal Highness’s actions in 1966 at the time of the Aberfan disaster are etched into the hearts of those who still grieve for the children who died, and who saw that he recognised the overwhelming tragedy that had struck, in particular for those parents—their sentence to live with to their dying day.

When I had the privilege of being seated next to His Royal Highness at lunch, there was nothing superficial or trivial about our conversation. He quizzed me about end-of-life care and pain control, recounting some deaths he knew of personally. It was a conversation that came about because of my work. It was an honour to be invited to the British embassy in Paris for the centenary of the entente cordiale celebrations with the director of the cancer centre Centre François Baclesse in Caen, who was establishing palliative care services in Normandy with education courses. When he was introduced to Her Majesty and His Royal Highness, Professor Heron was overwhelmingly impressed that, despite a day that had been packed with engagements, His Royal Highness showed knowledge of and interest in the new technology developments and computerisation innovations being spearheaded across France. Professor Heron called me this weekend with fond memories of how important His Royal Highness’s enthusiasm and humour were, treasuring mementos of that day. Those cordial links between Normandy and Wales have endured.

Today, in expressing thanks for an amazing life lived to the full and for the service given to the nation over decades by His Royal Highness, we are able to express to Her Majesty and all his family how aware we all are of that deep loss and gnawing emptiness of grief at the finality of life’s close. To them all, our deepest condolences are sincerely offered.

Covid-19 Update

Baroness Finlay of Llandaff Excerpts

Tuesday 3rd November 2020 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

Yes, they have.

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, financial support is essential to compliance with lockdown. At the start of the Welsh lockdown, the Government declined the Welsh Government’s request for early access to the job support scheme, despite Wales offering £11 million towards it, and declined a request to widen eligibility for the job retention scheme. Now that the job retention scheme has been extended and includes workers recently made redundant, will support be backdated to 23 October for Wales and be guaranteed for future lockdowns, if needed, in the devolved nations?

[Baroness Evans of Bowes Park (Con)]

As we have made clear, the furlough scheme is a UK-wide scheme, and, as the Prime Minister said, we will always be there for all parts of the UK.

Covid-19

Baroness Finlay of Llandaff Excerpts

Wednesday 23rd September 2020 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

I can certainly assure the noble and gallant Lord that such considerations are at the forefront of everyone’s mind. The noble Baroness, Lady Walmsley, talked about the impact on mental health generally; of course, many of us have not seen some of our relatives for a long time, which is very painful for them and for those of us who cannot see them. I assure him that we are considering that very carefully. It is why we are trying to take packages of measures that continue, at this point, to allow social contact, because we know how important it is. However, we will obviously have to take action if we cannot stop the virus continuing to increase, because it is critical that we save as many lives as we can.

[Baroness Finlay of Llandaff (CB) [V]]

The Statement drew attention to the fears of those who were on the shielding list and those who are shielding others. What additional practical support is being reactivated to ensure that those people can remain Covid safe? In relation to businesses and private rentals in the commercial sector, what are the Government doing about the exorbitantly high commercial rentals that are destroying local businesses, whose profits have fallen at the moment?

[Baroness Evans of Bowes Park (Con)]

The noble Baroness will be aware that, in the announcement yesterday, the advice remains that the clinically extremely vulnerable do not need to shield at the moment, although this will be kept under review. Obviously, if things change, packages of support will be looked at. Local directors of public health are also able to offer specific advice for clinically vulnerable residents. Of course, in local lockdown areas there will be different packages of support, so that is absolutely something we will consider as and when the guidance changes. In relation to rents, I am afraid that I will have to write to the noble Baroness as I do not have information on that particular issue.

Business and Planning Bill

Baroness Finlay of Llandaff Excerpts

Report stage & Report stage (Hansard) & Report stage (Hansard): House of Lords
Monday 20th July 2020 Lords Chamber

[Lord Faulkner of Worcester (Lab) [V]]

My Lords, yesterday’s press release from the Ministry of Housing, Communities and Local Government stated:

“People using pubs, restaurants and cafés will soon have greater freedom to choose non-smoking outdoor areas”,


a laudable objective that is consistent with the cross-party Amendment 15, which I have signed, along with the noble Baronesses, Lady Northover and Lady Finlay of Llandaff, and the noble Lord, Lord Young of Cookham, and which is identical to the one we debated in Committee last week. Some of your Lordships may take the view that had we not raised the issue of smoking in areas covered by pavement licences, the other amendments in this group might never have seen the light of day today. Indeed, if it had not been for the noble Baroness, Lady Northover, raising the subject at Second Reading, that would probably be the case.

As I indicated in Committee last week, our amendment enjoys strong cross-party support from the Local Government Association, which represents local councils in England and has asked the Government to make pavements smoke-free. Birmingham Labour councillor Paulette Hamilton, vice-chair of the LGA’s community well-being board, is urging your Lordships to give councils the power to extend smoke-free areas to include pavements, so that

“this alfresco summer can be enjoyed by everyone.”

She added:

“Councils have worked hard to help hospitality businesses reopen, including relaxing requirements and making changes to roads and pavements to enable pubs, cafés and bars to operate outside safely with more outdoor seating. Pavement licensing should not be a catalyst to increase smoking in public places, putting people at greater risk of ingesting second-hand smoke when they are enjoying a drink or a meal.”


This view is shared by the Conservative leader of Oxfordshire County Council, Ian Hudspeth, whom I quoted in the debate last Monday, and who has set the laudable target of a smoke-free Oxfordshire by 2025.

On 15 July, the Welsh Government committed to bringing in new laws to ban smoking in hospital grounds and schools under the Public Health (Wales) Act 2017, to

“protect the public from second-hand smoke and de-normalise smoking in the eyes of young people.”

They are on course to bring in a smoking ban for the outdoor seating areas of restaurants and cafés, which is supported by nearly two-thirds of adults in Wales, according to a survey by ASH Wales.

My final point arises from my supplementary question to the noble Lord, Lord Bethell, earlier this afternoon. Noble Lords may recall that I asked him whether today’s proposed guidance for smoke-free areas outside pubs and restaurants would be agreed with the DHSC, published before the House rises and subject to parliamentary scrutiny. Rather to my surprise, he did not answer any of these rather important questions, and later in the session, when the noble Baroness, Lady Walmsley, asked them again in the same form, she did not get a reply either. What is going on? Have the Government not yet made up their mind, or does the MHCLG refuse to acknowledge that this is a public health issue, let alone that it has anything to do with the Government’s aim to make England smoke-free by 2030? I still think that our amendment is the best of the three on offer, and I will be disappointed if the House does not agree to it this afternoon.

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, Amendment 15, to which I have added my name, seems to be the best way to avoid the Government throwing away the hard-won gains in public health that smoking reduction strategies have achieved to date. There is now clear evidence of the benefits from our legislation, which has banned smoking in public places. The benefits of ending passive smoking are to the heart, the vascular system and the lungs. The strongest evidence of the health benefits of making places smoke-free is in those working in pubs. The Smoke-free Premises and Vehicles (Wales) Regulations 2020 will extend the smoking ban to outdoor areas of hospital grounds, school grounds and local authority playgrounds.

European Union (Withdrawal Agreement) Bill

Baroness Finlay of Llandaff Excerpts

Report: 2nd sitting (Hansard) & Report stage & Report: 2nd sitting (Hansard): House of Lords
Tuesday 21st January 2020 Lords Chamber

[Lord Morris of Aberavon (Lab)]

My Lords, I support the amendment moved by the noble and learned Lord. I do not know from whom I am quoting, but the Joint Ministerial Committee is a “poor thing, but our own.” It has not worked very well, because it has not met very frequently. There has been no programme, its membership has varied, and it has not been a particularly effective arrangement so far. Hence, in my view, it is important that it should be put on to a statutory basis, in which case a report would be made to both Houses of Parliament and we would know where we stood. So far, we do not know.

The devolved Administrations never know when the current Joint Ministerial Committee will meet. It is important, for the sake of the union, to achieve a consensus where possible. In our discussion yesterday on another amendment in the name of the noble and learned Lord, it was obvious that there had been no discussion with the Welsh Assembly. I fear that the Minister’s reply to our debate was less than persuasive. There is an alternative arrangement that could have been used under Section 109 for an Order in Council that would result in a consensual as opposed to an imposed change. Hence, I very much support the amendment in the hope that there will be a change of heart in Westminster.

I fear that there is still a denial in the Westminster establishment that devolution has taken place at all. It has been there for a long time now and it is part of our establishment. Legislators, particularly those who draft Bills for the Government, should recognise that the devolved Administrations have been set up within the United Kingdom and are there to further the union. I would hope that if this amendment is accepted, it would strengthen the union and put the committee on a proper basis, and then there would be an expectation of regular, frequent meetings with serious and senior representation of the Westminster Government.

[Baroness Finlay of Llandaff (CB)]

My Lords, I am most grateful to the noble and learned Lord, Lord Morris of Aberavon, for his words in support of this amendment, which has my name attached to it. I reiterate the words of my noble and learned friend Lord Thomas of Cwmgiedd, who has made it clear that we are seeking to persuade the Government to think again.

I want to respond to some of the comments made by the noble Lord, Lord Howarth of Newport. Our amendment is not prescriptive; it simply requires that if there is a forum, it should meet regularly, but it does not stipulate how often it should meet. Meeting means face-to-face discussion, and the forum is there to discuss the means of mitigating the impact on the constituent parts of the United Kingdom of the economic and security aspects envisaged in the future relationship. It is to avoid problems arising in the future.

We have already heard that negotiations with the EU are likely to result in agreements that have a very direct impact on many aspects of devolved competence. I would like to highlight just a few of these, some of which are very close to my heart.

The first is the capacity of Welsh universities to access EU research funds and collaborative projects in the future. Over the last 20 years, access to these funds, and to the networks they have generated, has proved critical to boosting the research capacity of Welsh higher education institutions, including medical research. Indeed, a finding from Cardiff University made headlines yesterday about new ways to manage cancers. We have been reliant on, and have built on, the funds we have accessed. The interaction between projects funded by research and development framework programmes and those funded by structural funds has been particularly important, as the Welsh Government have demonstrated in their publication on research and development after Brexit. Whether and how the UK, and therefore Wales, can access these funds will be determined by the negotiations with the EU.

The second aspect—whether there will be any reciprocal arrangements in future between the EU and the UK to access health services—is again a matter for the negotiations. I would support such arrangements, but it needs to be recognised that if such commitments are made by the UK Government, it is the Welsh NHS that will have to pick up the cost of treatment provided in Wales.

The third issue is procurement rules. Procurement is a devolved matter, and the Welsh Government are certainly interested in strengthening the way in which procurement can support, rather than undermine, local purchasing. But we know that the EU, as part of the insistence on maintaining a level playing field, will start from the position that its approach to procurement must continue even post Brexit. Wales needs to have a voice in the discussion within the UK negotiating team about any trade-off between flexibility on procurement and unfettered access to the EU market.

I could give many more examples: the future of state aid rules governing the assistance which the Welsh Government may give to Welsh businesses; access to European markets for Welsh agri-food products, such as lamb, beef and seafood; and whether or not Welsh students and pupils will have access to the Erasmus+ programme of student exchanges—to name but a few.

The key point is that the Welsh Government and the Senedd will be bound by the outcomes of the negotiations, which will begin in only a few weeks. We have already heard that Ministers of the Crown have the powers to force the devolved institutions to comply if they disagree with these outcomes. In these circumstances, it surely makes sense for the Government to start from the position where the default is to reach agreement with the devolved Administrations in the approach to negotiations. Otherwise, I fear that the result will be bitter and very prolonged conflict between the devolved institutions and the Government, which would seriously threaten the union itself.

[Baroness Randerson (LD)]

My Lords, I support the amendment and respectfully disagree with some of the sentiments expressed by the noble Lord, Lord Howarth. The Government can no longer afford the luxury of an underdeveloped and informal arrangement with the devolved Administrations. The proposed JMC needs to function properly and to meet regularly—ideally, frequently—to deal with the details of EU negotiations and future relationships with the EU.

If the Government want to maintain the union, which I believe they strongly do, they will need to treat the devolved Administrations with the respect that they deserve. Not least it is an issue of common sense. It is often not obvious to civil servants and Ministers here what impact their negotiations will have on the devolved Administrations. Very often it is simply a sin of omission: a failure to understand the full detail and significance of devolved powers and their impact on the countries concerned. That is understandable; after all, no one can be an expert in everything.

I have argued for years that the EU, as the origin of many rules and regulations and a source of funding, has taken the party-political edge off decisions it makes. As they are made on an EU-wide basis, they are not regarded as having party-political significance. Once that ends, I believe that the party politics will become quite vicious if we do not provide for proper channels of negotiation and discussion. The noble Baroness, Lady Finlay, has laid out that issue very ably. She also talked about the impact on many aspects of life in Wales. She referred in some detail to universities. I declare an interest as chancellor of Cardiff University, but I am aware that it looks constantly and in detail at the impact of each negotiation on the life of that university, on research funding and on research partnerships with institutions in Europe.

There is also the impact on Wales of the proposed, and rather confused, arrangements for Northern Ireland. As that agreement works its way through—I point out to noble Lords that the Government seem to have no understanding of what it means—it is bound to have a strong impact on Wales. The Minister will know that I am not given to flights of nationalist fantasy, nor is there any sympathy on these Benches for independence, either in Scotland or in Wales. However, bearing in mind again the words of the noble Baroness, Lady Finlay, I urge the Government to be careful what they wish for. I am well aware that there are many, both at official and at ministerial level, who still regard devolution as a bit of nuisance, yet another hurdle to be overcome and an unnecessary level of complexity, but it is well established and in Scotland nationalist sympathies are very strong. They could grow stronger in Wales if this is not sorted neatly and effectively.

At the very least, officials and Ministers here often do not understand the full implications of the decisions they make. That is what is behind this attempt by the Government to write the devolved Administrations out of the picture. It is easier to ignore them than to pay them particular attention. I say to the Government that if they succeed in ignoring the devolved Administrations, they may well live to regret it.