(3 years, 4 months ago)
Lords ChamberI understand that the noble Lord, Lord Krebs, has withdrawn so I now call the noble Baroness, Lady Finlay of Llandaff.
My Lords, I have my name on several of these amendments—namely, Amendment 150A and Amendments 156A to 156M—and I support the others in this group.
Following the 1952 smogs, the Clean Air Act, as we have already heard, came in in 1956 and cut coal smoke from homes. In the 1970s, the output from power stations was high in sulphur dioxide, causing acid rain. Now, there is a lot of research to show that a major source of different particles is exhaust fumes from burning liquid fossil fuels. In 2018, the World Health Organization recognised the effects of these ultra-fine particulates, which are implicated in about 8.8 million excess deaths—around 13% of all deaths globally.
The report The Lifelong Impact of Air Pollution, from the Royal College of Physicians, has shown that it costs £20 billion in the UK alone, through 40,000 deaths per annum, ranging from heart disease, asthma, chronic obstructive pulmonary disease, lung cancer, diabetes and dementia—which are all linked to atmospheric pollution.
Our death rates from asthma are the worst in Europe. Three people die every day in the UK from asthma. It costs us £1 billion a year and there are more than 5.5 million people having treatment for asthma now. People with a genetic predisposition to asthma living by main roads have worse outcomes. It does seem there are some groups in the BAME community who have a particular genetic predisposition to a type of asthma that is particularly liable to lead to death. There have been 12,700 asthma deaths in England and Wales since 2010.
The role of atmospheric pollution was shown clearly and graphically by Professor Stephen Holgate to map against Ella Adoo-Kissi-Debrah’s very severe asthma attacks, including her final and fatal attack, with spikes of nitrous oxide and particulates corresponding clearly to her severe exacerbations. These particulates from fossil fuel exhausts also cross the placenta into the foetus, resulting in a higher incidence of asthma and impaired brain development.
This means it is essential that we tackle this on every front to come into line the WHO guidance as a minimum. We cannot tolerate continuing to allow particulate air pollution, and we must harness positive behaviour and change behaviours. The impact, in fewer heart attacks, strokes and deaths from asthma and lung cancer, would be phenomenal. That is why I added my name to Amendments 156A to 156M, because there is a need to give local authorities the power that they need to protect their own populations.
I will turn briefly to speed restrictions, so comprehensively introduced by the noble Baroness, Lady Sheehan. I endorse every point that she made. Let us not forget that 20 million children have their homes and schools in areas of high air pollution, particularly from traffic.
The report The State of the Evidence on 20mph Speed Limits, by Dr Adrian Davis from Bristol, provides a comprehensive review of the literature. Dropping the speed limit from 30 mph to 20 mph decreases particulates from petrol and particularly from diesel, as well as decreasing nitrous oxide and CO2 emissions from diesel cars. Road traffic is responsible for 80% of particulate production, and diesel produces tenfold more particulates than petrol. When children are sitting in a car in a traffic jam, their exposure is even higher because cars draw in the surrounding air, which is laden with exhaust from other vehicles.
It has been estimated that a cut from 30 mph to 20 mph on urban roads would result in a drop of over 115 deaths from particulates alone, quite apart from the lower death rate in accidents. When traffic is less aggressive and moving more smoothly in urban areas, there is almost no significant delay in getting somewhere but the whole driving experience is calmer and safer. I should declare that I experience this, because I live in the Cardiff pilot area that has dropped from 30 mph to 20 mph and the benefit is tangible. I hope that the Government can support these amendments.
I understand that there has been a slight change in the order of speakers. I call the noble Baroness, Lady Finlay of Llandaff.
My Lords, I am most grateful for this slight change being allowed for the convenience of the House.
I am glad to be able to speak in support of these very important amendments. I added my name to Amendment 152 in the name of the noble Lord, Lord Whitty. As he said, we are doing exactly what we were advised to: we are bringing this issue back in the passage of the Environment Bill.
I will not repeat what I said on the Agriculture Act—it is all there on the record already—but I did point out in Committee of the then Agriculture Bill last year that synthetic chemical pesticides were originally developed as chemical warfare in the 1930s and 1940s. These highly toxic substances have now been used in farming for more than 75 years. They carry warnings on them, such as “risk of serious damage to eyes”, “possible risk of irreversible effects through inhalation” and even “may be fatal if inhaled or ingested”. In 1975, the then Ministry of Agriculture, Fisheries and Food stated:
“The repeated use of pesticides, even in small quantities, can have cumulative effects which may not be noticed until a dangerous amount has been absorbed.”
Here we are, 46 years later, and I am not sure that we have heeded that warning.
Although spraying equipment and the protection of employees doing the spraying is regulated, residents in an area downwind from any spraying have no protection in law at all. These pesticides are known to cause different cancers and have been thought to be associated with birth defects and a wide range of diseases, particularly neuroendocrine and autoimmune conditions. All this is a mounting cost to the NHS but, more importantly, it destroys people’s lives and the quality of their lives.
Amendment 152 aims to provide protection to residents. These airborne droplets in pesticide vapour can settle on the ground and be revaporised in subsequent high heat or windy weather conditions. Several studies have shown pesticides being transported in the air for many miles from where they were originally applied, which then exposes babies, children and pregnant women to these chemicals. We cannot carry on allowing the next generation—whether in utero or after they have been born—to be poisoned by chemicals that are often used as a convenience in farming rather than being absolutely essential.
I also strongly support Amendment 254. Without our pollinators, we will have no food. This Bill is the place to protect this essential part of our food chain.
(3 years, 4 months ago)
Lords ChamberMy Lords, to add to that, I listened carefully to the Minister when he spoke about the person holding the qualification, but my concern relates to the qualification itself. If somebody holds a qualification that was mutually recognised in the EU, has not yet come to this country but wishes to in five years’ time, will that qualification remain recognised as it would have previously or is there a possibility of additional hurdles being put in place for that person coming in? I go back to the term “grandfathering” and whether the recognition that existed will continue, or whether it continues only up to date for those people who are currently on a register in this country and possibly have settled status. That was not clear, or perhaps I did not understand it.
I invite the Minister to reply to both speakers.
(5 years, 8 months ago)
Lords ChamberMy Lords, I point out that if Amendment 4 is agreed, I cannot call Amendment 5 by reason of pre-emption.
My Lords, I listened to the first part of the debate today, and I add my welcome to the Minister to her new post. I regret that I was unable to be here at Second Reading because of a commitment that I could not cancel, and I declare that I am a member of the European advisory group to the Wales Assembly Government. I added my name to the amendment because the Bill goes far beyond its purported remit by providing the ability for the Government to create new policy relating to healthcare agreements with countries outside the European Union, the EEA and Switzerland.
We all understand that there is need for speedy passage of the Bill because of the approaching deadline, but the question arises: why not restrict it to the problem that it has to solve? Given that the purpose of the Bill is to ensure that reciprocal healthcare arrangements are in place once we have left the EU, it is appropriate that the Secretary of State’s powers are limited to do just that and nothing more. As I understand it, that is what the amendment is intended to, and does so for three reasons, because it aims to achieve three things.
First, it aims to ensure that UK patients in the EU and vice versa can continue to access healthcare easily, including those with long-term conditions. Secondly, our NHS is protected from a dramatic increase in demand for services that a failure to reach an agreement could generate. We anticipate that 190,000—some figures say 180,000—UK pensioners in Europe are currently reliant on reciprocal healthcare. They may otherwise have to return to the UK for treatment if healthcare agreements are not replicated. Thirdly, the General Medical Council has already pointed out that the medical profession could be deemed to be at breaking point. Those working in healthcare need to be able to focus on providing care rather than on cost-recovery and complex administration.
I have questions for the Minister on that. In the event that we do not have an agreement and cannot get reciprocity, as we would like, how will the identity for eligibility be confirmed? How many people will need to be employed to make the relevant checks? Do the Government plan to issue current NHS cards that must be presented to prove eligibility, and would such NHS eligibility be incorporated in visas to work, study or be resident here?
Clause 2 authorises the Secretary of State to make regulations,
“in relation to the exercise of the power conferred by section 1 … for and in connection with the provision of healthcare outside the United Kingdom … to give effect to a healthcare agreement”.
I fully accept the Minister’s sincere confirmation that this is not a trade Bill, but I have a question about that. We have had firm confirmation here but, in the other place, something contrary was said and recorded. Which has precedent? Does what was said in the other place take precedence over any assurances given here? I accept that they are given after the event but, as far as I am aware, we have not received anything in writing or had placed before us anything from the Minister to say that that was not the case.
Another issue, raised in previous debates by the noble Baroness, Lady Jolly, concerns the risk of the Bill being used as a political tool to promote a global healthcare strategy by enabling the Secretary of State to make arrangements with countries across the world, without restrictions on the terms under which that would happen. As a clinician working in the NHS, my concern relates simply to overburdened NHS services. At the same time, I understand that the Welsh Government have not yet provided a consent Order in Council on the Bill. Has there been consultation? How do the Welsh Government anticipate the Welsh NHS coping in the event of no deal and the failure of reciprocal arrangements?