Allowances

Baroness Fraser of Craigmaddie Excerpts

Wednesday 27th March 2024 Lords Chamber

Those who live outside London deserve respect too, and they are finally getting it.

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I too declare an interest as I come to this House every week from Scotland. It astounded me from the moment I was introduced that there was no such scheme to compensate for overnight accommodation, so I too welcome the report.

I have one question. I do not understand why Members of this House who travel from the various parts of the UK should be subject to different rules from those for Members of the other place. The overnight rating, while welcome, is considerably less than Members of the other place receive. The kind of accommodation to which it applies is not as extensive as IPSA sets out for MPs. I do not really understand why those of us who come to this House from other areas should be treated differently from MPs.

I remind your Lordships that this is an allowance that can be claimed, and there are many colleagues who choose not to claim it. I would hope that it would be claimed only by those of us for whom it really makes a difference to our attendance here, rather than by those who seek to claim it just because they can. I thank my noble friend for the report, but I do not understand why we have not followed the IPSA guidance.

[Lord Newby (LD)]

My Lords, we on these Benches very much welcome this scheme. I would say to the noble Baroness, Lady Fraser, that we do not want to go down the IPSA route on anything. Everything is different, and once we start trying to draw comparisons, we get into real difficulty.

It is very important that this House is as diverse as possible. It is heavily skewed towards London and the south-east. Money is not the only reason, but we should be doing whatever we can to ensure that everybody, wherever they live and whatever their circumstances, can participate.

I fully accept that the scheme is not perfect, but it is better. Nobody I have spoken to has come up with a scheme that everybody would agree is perfect. This scheme will relieve real problems for a significant number of Members who, in some cases, have been out of pocket by coming to your Lordships’ House. This is clearly not acceptable, and the scheme goes a long way towards dealing with that. From these Benches we heartily welcome it.

Queen’s Speech

Baroness Fraser of Craigmaddie Excerpts

Tuesday 10th May 2022 Lords Chamber

[Baroness Fraser of Craigmaddie (Con)]

My Lords, I second my noble friend’s Motion for an humble Address.

I am very aware of the immense honour that I have been given today, and while your Lordships have been enjoying Prorogation and what was hopefully a convivial lunch, I have felt the pressure of being the after-lunch entertainment. However, I am fortunate to follow my noble friend Lord Sherbourne of Didsbury who, with his exceptional speech, has fulfilled the duty of amusing your Lordships far more ably than I possibly could.

Certainly, the silver lining of this responsibility today is that in the preparation, I have had the good fortune and opportunity to get to know my noble friend Lord Sherbourne, whose stellar reputation for being a man you want standing by your side in challenging times goes before him. He is a man who knows what he likes, particularly in the culinary sphere, and I discovered that, when on official UK government business abroad, in countries where perhaps the cuisine might be a little exotic, he always had a secret supply of Mars bars, cashew nuts and Evian water to keep him going. I hope he has enjoyed suitable refreshments over lunch today, and I thank him for his kindness and support.

I also pay tribute to my noble friend Lady Sanderson of Welton, in whose daunting footsteps I follow this afternoon. She has had the misfortune to end up sharing an office with me, but her patience, advice and directions to this newcomer have been very welcome, and I am fortunate to be able to refer to her, in its fullest sense, as my noble friend.

I am delighted to see so many of you here today. It was in the debate following the gracious Speech last year that I made my maiden speech, but it was only a hybrid proceeding and numbers in the Chamber were still restricted, so, compared with today, it was empty. I live in hope that my future contributions to debates will attract such a full audience. Having joined your Lordships’ House during the strange times of Covid, I have very little concept of what it is to be normal in this place. For me, the Bishops’ Bar was where I went to pick up lateral flow tests, so I hope your Lordships will forgive me if I take a little longer than usual to pick up your ways and traditions.

My brief from the Chief Whip for this afternoon was to keep it light and “don’t be controversial”. I am doing my best, but it might prove a little difficult for someone who describes herself as a Scottish Tory Peer and a woman. I shall leave it to your Lordships to decide which of those descriptions, if any, is the most controversial. Thinking of women whom I admire from this place, I was particularly proud to attend my first State Opening of Parliament wearing a robe that was kindly lent to me by my noble friend Lady Sater—and which had previously belonged to Baroness Trumpington. I was told not to be crude, as well.

Like my noble friend Lord Sherbourne, I was drawn to the fact that this is Her Majesty’s Platinum Jubilee year, and it was a privilege to hear the Duke of Rothesay—as we call him in Scotland—read the gracious Speech. It strikes me that after 70 years, despite the remarks of my noble friend Lord Sherbourne, our generation probably do not appreciate the relative rarity in our country’s history of a Queen’s Speech, as opposed to a King’s Speech.

My research also led me to the proposer and seconder of the Motion in November 1952. I was given the impression that it was tradition for the seconder to be a younger Member. I appreciate that the definition of “younger” is rather loose in your Lordships’ House, but, in 1952, Viscount Buckmaster fulfilled the task. He described himself as being “in the autumn” of his “political life”, and opened his remarks by noting,

“I was privileged to be present at the Diamond Jubilee and so witnessed the end of the reign of one Queen—that of Queen Victoria—and now I am privileged to witness the beginning of a reign of another Queen, Her Majesty Queen Elizabeth II.”—[Official Report, 4/11/1952; col. 11.]

I am clinging for comfort to the fact that, when I fill out the Members’ survey in your Lordships’ House, I am still in the lowest of the age categories offered.

Turning to the gracious Speech, it was noted that we are in challenging times. I commend our commitment to supporting the people of Ukraine; surely none of us present in the other place to hear the address of President Zelensky will forget his bravery and fortitude. I, like many others, will continue to do all that I can from this House to ensure that we support the Government to fulfil this promise, not only through our Armed Forces and NATO but in the way we welcome Ukrainian refugees to the United Kingdom and in how we support organisations in Ukraine and neighbouring countries to help the most vulnerable victims of this war.

As a leader of a health charity, I was also pleased to note the commitment to reducing Covid backlogs in the NHS and provisions for the reform of the Mental Health Act. The opportunity to build on the Health and Care Act from the last Session and to put mental health on a par with physical health cannot be wasted.

As I like to highlight Scotland at every opportunity, I was pleased to hear my hometown of Glasgow mentioned, thanks to COP 26. The commitment to improving transport links across the UK not only will benefit the venerable members of the association of Scottish Peers but is important to supporting the very structure of our precious United Kingdom. The gracious Speech laid out a full programme of legislation for the whole of the United Kingdom, and I look forward to the expertise of this House engaging in some of the more technical aspects. I know there will be others, not just me, who are extremely excited at the prospect of many hours discussing GDPR reform.

Finally, I think I have at last understood why the Chief Whip asked me to second the Motion today, as it prevents me saying anything further in this debate over the coming days about Channel 4 and the importance of its commissioning to the independent production sector in Scotland.

Despite the challenges ahead, I look forward to this Session with optimism and hope. The Platinum Jubilee is an extraordinary historical moment, and how wonderful it is that we in this House have the opportunity to serve our United Kingdom and shape our future history. In this spirit, I beg to second the Motion.

Health and Care Bill

Baroness Fraser of Craigmaddie Excerpts

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

[Baroness Fraser of Craigmaddie (Con)]

My Lords, in this rather large group of amendments, I shall take us from catering to my Amendment 242 on professional regulation. I thank the noble Baroness, Lady Finlay, for adding her name. I draw your Lordships’ attention to my registered interests, in particular as chief executive of Cerebral Palsy Scotland. I am involved with the employment of regulated allied health professionals.

Clause 142 gives the Secretary of State far-ranging powers to alter the professional regulatory landscape, with the potential to make significant changes to how certain health and care professions may be regulated, including the power to remove professions from, or bring professions into, statutory regulation.

The UK model of regulation for healthcare is rigid, complex and needs to change to better protect patients, to support our health services and to help the future workforce meet future challenges. The case for reform has been acknowledged.

Whether a health and care profession falls under regulation is a major decision affecting not only the professions themselves but employers, patients and service users who place their trust in those professionals. My Amendment 242 is a probing one. I want to explore some of the issues that will be particularly important for the Government to consider as and when they might seek to use these extended powers.

I want first to thank my noble friend the Minister and the Bill team for the time they have taken so far to discuss the issues around my amendment. We are all agreed on the importance of encouraging greater collaboration between regulators, with the ability to share data and intelligence, but I remain to be convinced that the legislation is being used to reduce regulatory silos, which is crucial to reducing regulatory failures in the future.

I want to be clear that I am not advocating for a single super regulator, which would be a step in the wrong direction, not to mention complicated, disruptive and expensive. I would rather harness the best elements of professional regulation and give the regulators the tools to work more closely together and share best practice more consistently.

I accept that work is being done in the department on various regulatory reform initiatives. These are all important, but it strikes me that they are all focused on individual regulators and amend specific operational issues, rather than looking at the landscape as a whole and what could be achieved.

We have sadly seen all too many reviews and inquiries which have identified regulatory silos as a key factor in why something went terribly wrong. My noble friend Lady Cumberlege’s First Do No Harm report highlights the issue starkly, but the Paterson inquiry, the Sir Robert Francis report on Mid Staffs, the Shipman inquiry and others have all underscored the value of greater collaboration between regulatory bodies, sharing data and intelligence as well as adopting shared professional standards. Reducing and removing silos is also good for professionals and employers, with benefits in terms of intra-professional learning and for professional and patient safety.

I am grateful to the Health and Care Professions Council for its briefing, but I was concerned to note something which regulators have stressed to me: that due to their tightly defined duties, they have often been forced to resort to informal memorandums of understanding to try to make the system work better. That is piecemeal and inefficient— frankly, I would be extremely disappointed if the Minister in his response was to rely on such MoUs to fix the issue.

Do not the powers in this Bill offer a chance to look at things differently: a whole system regulatory approach rather than a set of silos? Amendment 242 identifies some principles and considerations that I believe the Government would find beneficial in developing this more collaborative landscape.

Maintaining regulatory independence is crucial. The Government have rightly recognised this in other legislation recently, but I would welcome confirmation from the Minister that this remains a cornerstone of any future regulatory reform proposals. I would be grateful for reassurance that no regulatory reform would be undertaken by the UK Government without working with the devolved Administrations to ensure that it worked for all parts of the UK.

I particularly want to highlight the benefits of multi-profession regulation, which, as the CEO of an organisation that relies on a range of expert allied health and care professionals registered with the HCPC, I see at first hand, supporting improvements across professions that are increasingly interconnected. As the Minister is aware, the HCPC regulates 15 professions, so is able to utilise common frameworks and outcome-based standards. This approach could, and should, be spread among all the professional regulators.

This is particularly important as the Government, NHS England and NHS Improvement seek to create a more flexible workforce with an ability to move between professions, work as multidisciplinary teams and support career progression. From my own experience, I know that this is positive, but we need our regulatory system to keep up with innovations in delivery. Can my noble friend the Minister therefore tell us about how we can harness the benefits of multi-profession regulation and how he anticipates this will influence the Government’s thinking in terms of reform? Collaboration and the development of a system-wide approach to overcome fragmentation and silos is critical to the future success of regulation. It is an enabler of better care, and a collaborative structure would generate considerably higher and richer levels of data.

Finally, this holistic approach would offer an opportunity to create consistent criteria for making decisions about which professions may be brought into or taken out of regulation. Could the Minister put it on record today that the issues in the amendment are principles that would govern the future use of the powers within Clause 142, that they are all principles that the Government are actively considering and that no decisions on regulatory change would be taken if the criteria set out in this amendment were not met? Once again, I thank him and his team for his engagement so far, and I look forward to his response today. I hope we can continue discussions between now and Report.

[Lord Patel (CB)]

My Lords, I rise to speak to Amendment 243 in the name of the noble Baroness, Lady Merron, and Amendment 264 in the name of the noble Lord, Lord Hunt of Kings Heath.

Yesterday I was chastised—wrongly, in my view—for speaking at length. Such boldness requires training in speaking up, confidence in being right and using authority. The comments came from a government Whip, who happens to be a registered nurse. As a doctor, I am used to that. When a nurse speaks up, patient safety improves, health equity improves, collegial relationships are stronger—again, as a doctor I can vouch for that—and healthcare systems improve. This is because of their training. Not recognising legally the status that the title of “nurse” brings to those that are highly trained and qualified and on a nursing council register is wrong.

We all know what a nurse is; a nurse is highly trained, highly competent, can do the job well and is on a nursing register. Anybody else is not a nurse. It is right, therefore, that we recognise this and give it a legal status. Furthermore, the NHS and health providers should not employ anyone as a nurse who does not meet the above criteria. I understand that last year there were 195 advertisements for nurses in the NHS which did not say that the qualification of being registered was necessary. In my view, that is wrong. I strongly back this amendment, and I look forward to the contribution of my noble friend Lady Watkins.

Turning to Amendment 264 on the appointment of consultants in surgery, I am a fellow of the Royal College of Surgeons of England, the Royal College of Surgeons of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow, so I speak on behalf of all surgical colleges. Let me give your Lordships an example: there is a surgical post empty in Birmingham. A highly qualified person, who was well-trained in Scotland and holds a fellowship of the Royal College of Surgeons of Edinburgh, is a key candidate for application but cannot be appointed because the Royal College of Surgeons of England cannot provide an assessor. On the other hand, there is a surgical vacancy in Glasgow, and the top candidate is a fellow of the Royal College of Surgeons of England but can be appointed without a Royal College of Surgeons of England assessor being there. That is a total anomaly.

A person can be appointed who is fully trained in Scotland, is a fellow of the Royal College of Surgeons of Edinburgh, works in Cambridge, applies in Cambridge, but you cannot have an assessor from the Royal College of Surgeons of Edinburgh. In all other specialties—the Royal Colleges of Obstetricians and Gynaecologists, of Ophthalmologists, of Radiologists, of Psychiatrists, of Anaesthetists, and in public health—the assessor can come from any part of the United Kingdom. This anomaly can be stopped very easily. I agree with the noble Lord, Lord Hunt of Kings Heath, that it is not a big deal; just change it in legislation. I do not know who opposes it.