(5 years, 3 months ago)
Lords ChamberMy Lords, my noble friend Lady Bull outlined some of the problems very clearly. I want to build on the comments made by the noble Lord, Lord Oates. On reciprocal healthcare, we must remember that 27 million people hold a UK-issued European health insurance card. If the 190,000 UK pensioners who live elsewhere in the EU were to return to the UK, the cost of their healthcare alone would be between £500 million and £1 billion per year. Yet nowhere have we seen provision for this kind of movement happening.
The BMA has just published a document—I declare my interest as a past president—entitled A Health Service on the Brink: The Dangers of a “No Deal” Brexit. It is littered with questions that should have been answered during the years since the referendum. We have nearly 22,000 European graduate doctors in the UK, a third of whom have said they are considering leaving. We need reciprocal arrangements for their qualifications. We have 10,000 medical vacancies already. If a third of those doctors go, we will have even more. When people turn up with their sick child or another family member, and have an even longer trolley wait than they have now, or when their relative dies because they cannot get the healthcare they need, the headlines will change dramatically. Sadly, I worry that some implications for individuals in our society have not hit home, in part because we have not told them, openly and honestly, what the implications are.
I have been privileged enough to be a member of the European Advisory Group to the Welsh Government. As the noble Lord, Lord Wigley—I would say “my noble friend”—knows only too well, the concern over farmers is enormous. The concern over fair distribution of food in the event of shortages, because of our rural areas, is huge. We have many SMEs that create component parts, which will almost certainly become non-viable in the event of no deal. Our ports have been trying hard to make provision for the future, but the sudden catastrophe of no deal will jeopardise our economy in Wales. As is known, Wales already has socio- economic problems that go back a long way through our history.
Finally, when considering the implications of no deal, remember all those groups that we will suddenly drop out of. The European Reference Networks look at rare diseases. They are the eyes and ears looking at where disastrous epidemics, pandemics and new diseases are emerging. Without that intelligence, strange conditions will just turn up in emergency departments around the country, with no information ahead of time. For those and many other reasons—the debate has been long and interesting—I strongly endorse the comments made by my noble friend Lady Bull and support this legislation.
May I ask my noble friend about implications for the structural funds from the European Union? I understand they have been helpful to Wales in the past. Is she confident that they will be replaced?
I am grateful to my noble friend for that question because, no, I am not confident that they will be replaced. I know that the Welsh Government have asked the Westminster Government for evidence that the funding will come through. A Statement was made by the Minister about CAP funding for farmers, but many other areas are of concern. People in Wales may not have been as aware of some of the implications as they might have been, nor of how important that infrastructure funding has been in previous years.
(7 years, 3 months ago)
Lords ChamberMy Lords, I offer my support for these amendments in considering the particular needs of young people in care and leaving care. Most young people leaving care do so by the age of 18—many are still under that age—and they have to run their financial lives. There is a duty on the local authority to provide support but many of them are plunged, too early in their lives, into the sorts of responsibilities that such education would help them to deal with more effectively. Half of children from run-of-the-mill families are still with their parents up to the age of 20, so I can see particular benefit from these amendments for vulnerable young people who may have to look after themselves very early in their lives.
My Lords, first, I declare my interest as chair of the National Mental Capacity Forum. I join in the comments of my noble friends Lady Coussins and Lord Listowel in welcoming the spirit of these amendments. Perhaps I may flag up, as I would be glad to have it on the record, that these amendments may not go far enough for those who have difficulty with financial issues.
Capacity impairments are related not only to mental ill-health. They may be related to frailty and there may be fluctuating mental capacity. For a group of people with communication difficulties, since banks are closing and local branches are no longer there, there is no one with whom they can communicate. If they have speech difficulties, they certainly cannot communicate well over the phone. They may have a mobility tremor, for example, which makes it difficult for them to use the internet without assistance, yet they may want to manage their affairs with a degree of privacy, which they can do in a face-to-face consultation with somebody in a bank.
In addition to impaired capacity and disability issues, there is another difficulty we increasingly see, particularly among the older population: coercion, which may be from other family members and a form of elder abuse. It can be very subtle indeed. I had a meeting this morning with Building Societies Association representatives, who are certainly detecting coercion in face-to-face encounters. But I also asked them whether there is any evidence of detecting coercion in the online systems that are in place. There is none, which becomes worrying. Although this group is right on the borderline of impaired capacity, they are inhibited from exercising their capacity because they are frightened of being intimidated by others.
Another group of concern is those with addictive behaviours such as the hypomania the noble Lord, Lord McKenzie, referred to in his opening remarks. For example, people may have a gambling addiction—a very defined addiction—and be increasingly enticed into spending more or doing a great deal of shopping during the night, when they are hypomanic. The control options on accounts should really be strengthened, so that someone can put them on but not have the ability to take them off themselves without a consultative delay period. The problem is that when they are hypomanic, they think it very reasonable to spend or gamble massively, but later they realise they did not have the capacity to do so. I hope the Government will look very favourably on these amendments and that when we come back on Report, they might even consider extending them a bit further.
(13 years, 1 month ago)
Lords ChamberI thank the noble Lord. I can see the difference and I thank him for that helpful correction.
Before the Minister resumes his speech—I am sorry to do this, but I would like clarification. From what he has said, I understood that under this amendment the Secretary of State will not have a comprehensive duty, so that if Health Education England finds that the National Commissioning Board and the clinical commissioning groups are not making provision for education within the commissioning process that they set in place, the appeal would not go to the Secretary of State. I am not sure who the educational providers would appeal to if Health Education England found that it could not function because the commissioning process was not allowing for education.