Menopause

Baroness Gale Excerpts

Tuesday 18th October 2022 Lords Chamber

[Lord Markham (Con)]

Yes. The noble Baroness will be aware that only 55% of women showing symptoms felt able to talk to GPs about it and another 30% felt that there were delays in diagnosis. Clearly, more work needs to be done. I know that it is part of the core curriculum—that is not the proper phrasing; please excuse me. The whole point of appointing a women’s health ambassador is to make sure that every avenue and channel is used to maximise access, whether at the level of GPs or as part of the education or formularies.

[Baroness Gale (Lab)]

My Lords, what consideration has been given to allow women who need treatment for the menopause to have free prescriptions, as they do in Wales, for example, where no one has to pay for any prescriptions, and in Scotland and Northern Ireland? Only in England are there prescription fees. Free prescriptions would be a great help to women and would remove a financial barrier to accessing treatment.

Puberty-blocker Drugs

Baroness Gale Excerpts

Thursday 10th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

Well, my Lords, it is not appropriate for me to comment on those who have brought these cases, and outstanding judicial proceedings exist and are in place at the moment, so it is not possible for me to comment from the Dispatch Box in response to the noble Baroness’s remarks. All I can say is that the NHS, NICE and the Tavistock all have the interests of patients at their heart; we are not ideological about that. We are absolutely committed to the best interests of patients, and I would be glad to write to the noble Baroness to answer in any way that I can the questions she asked.

[Baroness Gale (Lab) [V]]

Is the Minister aware that the ruling and the NHS England response to it have caused significant uncertainty and distress among young people and families currently supported by the Tavistock clinic and those on its waiting list? Can the Minister say what steps the Government are taking to ensure continuation of care for young people currently in the care of the Tavistock who are affected by the NHS England response to the court ruling?

[Lord Bethell (Con) [V]]

I am sure that the noble Baroness’s testimony is entirely right, and it concerns me that anyone has any concerns in this matter. I reassure her that the Tavistock is doing absolutely all it can to reassure current patients and those who are on the referral list; its communications have been excellent throughout. The provision of puberty-blocker services to existing patients has continued, and it will remain in close contact with those patients as the review plays out.

Smoking

Baroness Gale Excerpts

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, the government Green Paper published on 19 July is an extremely complex proposal. That is why we are considering it in great detail. It addresses the urgent need to tackle the disproportionate amount of smoking in deprived areas and among marginal communities. We are engaged with those communities to figure out what will work best. When we have those answers, we will publish our reply.

[Baroness Gale (Lab) [V]]

Does the Minister agree that reducing smoking in pregnancy is essential to achieving a smoke-free generation, yet rates of smoking in pregnancy have not declined significantly since 2015? Financial incentive schemes are being effectively used to support pregnant women in Greater Manchester to give up smoking, including younger and more disadvantaged women. What further steps do the Government intend to take to reduce rates of smoking in pregnancy and will this include the national rollout of an incentive scheme?

[Lord Bethell [V]]

The noble Baroness points to the knottiest and most difficult of the challenges of giving up smoking. It is extremely sad that anyone should contemplate smoking during pregnancy, but this is one of the most durable and knottiest problems. I commend the use of creative and innovative schemes such as the one in Manchester to which the noble Baroness alludes, but more needs to be done, because prevention is better than cure.

NHS: Targets

Baroness Gale Excerpts

Thursday 6th February 2020 Lords Chamber

[Baroness Gale (Lab)]

My Lords, it is a great pleasure and privilege to follow my noble friend’s maiden speech and I congratulate her on it. It will be the first of many such speeches in your Lordships’ House that we will all have the pleasure of hearing.

I have followed my noble friend’s career over many years and watched her progress both in the Labour Party and in local government. She is a formidable campaigner and a straight talker. She has a no-nonsense approach to whatever she undertakes, as I am sure noble Lords will have noticed in her maiden speech.

Like me, she was born and brought up in the Rhondda Valley, which no doubt gave her a good grounding in local politics. She has a keen interest in education and worked as a teacher in Brixton in south London, was head of drama and media studies at Hartridge High School in Newport, and head of the performing arts faculty at Hawthorn High School in Pontypridd, with over 35 years’ experience in front-line education. She was an external examiner for the WJEC and AQA examination boards for over 25 years and became principal examiner for A-level theatre studies.

She also has an interest in local government, as she mentioned. She has served as a Newport councillor since 2004 and by 2016 she was elected leader of Newport Council—the first woman to hold such a post. Those of us who are involved in Welsh politics will appreciate what an achievement that was: for a woman to be elected leader of a local council.

But it did not stop there. By 2017, my noble friend had been elected leader of the Welsh Local Government Association—again, the first woman to hold such a post. That was even more of an achievement, as the Welsh Local Government Association has been dominated by men for so long—I could say “centuries”, because it feels like that; we waited for so long to get a woman in post. In 2018, my noble friend was invited to become a Fellow of the Royal Society of Arts, an award granted to individuals whom the RSA judges to have made outstanding achievements in social progress and development.

My noble friend has certainly smashed her way through the glass ceiling of Welsh politics and has been an example and an encouragement to women in Wales. I know that she will continue to be so as she begins her life in your Lordships’ House.

I thank my noble friend Lord Hunt for bringing this important debate before us today. I intend to focus on two NHS priority areas that impact people with Parkinson’s: mental health and dementia. I declare an interest, as I co-chair the All-Party Parliamentary Group on Parkinson’s.

Up to 40% of people with Parkinson’s will have depression, and up to 31% of people with the condition will experience anxiety. In 2017, in response to reports from Parkinson’s UK information and support staff, the APPG on Parkinson’s held an inquiry into the experiences of people with the condition who have anxiety and depression. The inquiry and subsequent report, published in 2018, found that people with Parkinson’s wait months, and sometimes years, to see a mental health professional once a problem has been identified; that the difficulty of diagnosing a mental health problem in someone with Parkinson’s is compounded by a lack of guidance for health professionals; and that there are complexities in the referral process, as a Parkinson’s professional must send an individual back to their GP so that they can refer them on to a mental health professional, which creates further, unnecessary delays. Professionals who presented evidence to the inquiry described communication barriers between departments, difficulties accessing patient notes, and a shortage of mental health professionals with the knowledge and skills to meet the specific needs of people with Parkinson’s. The mental health support received through improving access to psychological therapies, or IAPT, is not tailored to the needs of people living with Parkinson’s, and specialists such as neuropsychologists and neuro- psychiatrists are in short supply, leaving many people with Parkinson’s accessing IAPT services that are not tailored to their needs.

It is almost two years since the release of our report, and we are yet to see progress on several of the recommendations, which included funding research on effective mental health interventions for people with Parkinson’s, training in Parkinson’s for talking therapists working in IAPT services, and the publication of data on how mental health services for people with Parkinson’s are performing.

Every two years, the UK Parkinson’s Excellence Network, started by Parkinson’s UK to link up professionals who treat people with the condition, conducts an audit on the quality of Parkinson’s services. While the audit is not mandatory, an increasing number of services are taking part to track how they are improving. The results of the 2019 audit were released last week. They showed that, from 2017 to 2019, there was a reduction in the number of people with Parkinson’s being reviewed each year by their neurologist or elderly-care consultant, and less than 20% of these services were offering multidisciplinary clinics.

The results around mental health show how improvements are needed in screening and access to referrals. Almost a fifth of Parkinson’s services across the UK could not refer psychiatric services. The Excellence Network will now support Parkinson’s professionals to deliver an action plan to improve their services ahead of the next audit cycle, which will happen next year. Parkinson’s UK is currently interviewing people with Parkinson’s-related dementia and their carers about their experience of the health and social care system. Initial findings show that carers are struggling with some of the more distressing symptoms of Parkinson’s-related dementia, such as challenging and aggressive behaviour. They also show that NHS support for people with Parkinson’s-related dementia drastically reduces after entering a care home, and that social care staff do not generally understand the condition, leaving families and carers to step in and explain how they should provide care.

Acknowledging the importance of social care to an effective NHS, can the Minister say what progress the Government have made towards a future funding solution for social care, so that people with Parkinson’s dementia are not continually let down?

The NHS

Baroness Gale Excerpts

Thursday 5th July 2018 Lords Chamber

[Baroness Gale (Lab)]

My Lords, I thank my noble friend Lord Darzi for bringing this important debate before us today and for the wonderful story he told, making us realise how much we must cherish this precious asset we have. The improvement in women’s health since 1948 has been absolutely amazing. I have the time to mention just three measures: the oral contraceptive pill, the Abortion Act 1967, and the improvements in the treatment of breast cancer.

The pill was introduced in the UK and became available on the NHS in 1961, but it was for married women only at that time. That all changed in 1974, when family planning clinics could prescribe single women the pill: it was a very a controversial decision. Now it is taken by 3.5 million women in Britain between the ages of 16 and 49. It gave women, for the first time, the freedom to control their own fertility and it was a great liberation for them. It avoided unwanted pregnancies and a woman could decide when to have children. It proved to be a great advantage in so many ways. Women could now plan their lives, in terms of their education and their job development, and could choose when and if they wished to get married. It changed our society and allowed women the freedom that women of earlier generations could not have dreamt of; that was all because of the National Health Service.

The Abortion Act 1967 allowed women to have safe, legal abortions under the NHS and did away with the illegal back-street abortions that many desperate women turned to because there was no alternative. In 1990 the time limits were lowered from 28 weeks to 24 weeks for most cases because medical technology had advanced sufficiently to justify the change. The Act does not apply to Northern Ireland, but at the last general election the Labour Party manifesto said:

“Labour will continue to ensure a woman’s right to choose a safe, legal abortion—and we will work with the Assembly to extend that right to women in Northern Ireland”.


We are committed to ensuring that women in Northern Ireland will have the same rights as women in the rest of the UK. I trust the Government are equally committed.

Screening was introduced for breast cancer in 1988 in the United Kingdom and now women aged 50 to 70 are offered tests every three years; older women can ask for one. More than 55,000 women are diagnosed with breast cancer each year in the United Kingdom, but the good news is that more women than ever are surviving breast cancer thanks to better awareness, better screening and better treatments. Around five out of six women diagnosed in the United Kingdom today will be alive in five years’ time, compared with three out of six 40 years ago. The charity Breast Cancer Now has an ambition that by 2050 everyone who develops breast cancer will live. It believes that its research will allow it to achieve its ambition to stop breast cancer taking lives. Combined with the work that the National Health Service is carrying out in research and medical advancements, I think this is possible.

Everyone in this country can give thanks to the National Health Service, especially for the advancements in women’s health. I give thanks to the National Health Service for bringing about such a great improvement in women’s health.

Abortion (Disability Equality) Bill [HL]

Baroness Gale Excerpts

Report stage (Hansard): House of Lords
Friday 24th February 2017 Lords Chamber

[Lord Elton (Con)]

My Lords, after that intervention I need say very little indeed. I share with everyone else my admiration for the noble Lord, Lord Winston, as I have for my noble friend Lord Shinkwin. However, while it would be helpful to have the noble Lord’s assurance as to what is meant by these terms, that is not sufficient. It has to be on the face of the Bill because that is what the law will be. Otherwise it will be decided by the courts, which would mean there is no certainty. The purpose of good legislation is bring certainty, not doubt.

[Baroness Gale (Lab)]

My Lords, we have had a thorough debate on this amendment and I thank my noble friend Lord Winston, who has such great expertise in this field, for his clarity in explaining why he wishes to move this amendment.

This is a sensitive matter with strongly held views on both sides. The noble Baroness, Lady Tonge, mentioned a woman’s right to choose: many people hold that view. My noble friend Lady Massey said that this was not a political issue. I agree that it is not a political issue. Whenever these matters are debated, in both Houses, Members have to make up their own mind; I think that that is the right thing to do. The term “back-street abortionist” has been used several times this afternoon. Many of us remember those days and absolutely no one wants to go back to a time when women were put at such great risk.

The noble Baroness, Lady O’Loan, mentioned Northern Ireland. We may be debating that later, on other amendments, but I take her point. The arguments have been well rehearsed on both sides of the debate today and from the Front Bench I can say only that the Opposition still fully support the Abortion Act 1967.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, I start by joining other noble Lords in congratulating my noble friend Lord Shinkwin on steering the Bill through its Lords stages so far and on his engagement with noble Lords on the Bill. It raises important and sensitive issues about disability rights and abortion and it is quite right and proper that these are discussed and scrutinised at length by your Lordships. I am also grateful to the noble Lord, Lord Winston, for his amendment and for the scientific authority which he brings to the issues. I commend all noble Lords for the quality of the debate we have had on this amendment.

As I set out in Committee, the issue of abortion is a matter of conscience for noble Lords, as the noble Lord, Lord Alton, and the noble Baroness, Lady Massey, reminded us. The decisions that we take on this transcend the normal political or partisan divides and it is for that reason that the Government have taken and continue to take a neutral position on this issue and on the Bill. The Government do not, therefore, have a position on the amendment of the noble Lord, Lord Winston, or on those that will follow in the House today. I do not intend to comment on subsequent amendments unless there are specific points that noble Lords wish to put directly to me and to which I can respond.

I do, however, wish to make one point that I believe is germane to the issues under discussion in this amendment and, indeed, in the Bill in general, and that is that it is vital that we have accurate statistics on and evidence for the reasons for termination of pregnancy. Officials are working directly with hospital staff to improve reporting on abortions. We have also reminded all doctors involved in abortion care of their legal responsibility under the Abortion Act 1967 and the Abortion Regulations 1991 to submit form HSA4, the abortion notification form, within 14 days of a termination.

Overall, between 2013 and 2015, there was an 18% increase in the number of reported ground E abortions. While we obviously cannot claim that this increase is solely the result of increased reporting of these abortions, as opposed to increased instances, we do know that this is the case in some of the units that officials have been working directly with. The department will continue to monitor carefully levels of underreporting of abortions for foetal abnormality.

The noble Baroness, Lady Stroud, asked about palliative care for babies. I fear that I do not have that information to hand but I will be happy to write to her on the issue.

Health: Neurological Services

Baroness Gale Excerpts

Tuesday 31st January 2017 Lords Chamber

Asked by

[Baroness Gale]

To ask Her Majesty’s Government what progress they have made in improving neurological services in England.

[Baroness Gale (Lab)]

My Lords, I am very pleased to have the opportunity of debating this matter and thank all noble Lords who are taking part. I declare an interest as co-chair of the All-Party Parliamentary Group on Parkinson’s. Quality neurological services are vital to help people manage Parkinson’s. It is a complex and debilitating condition for which there is no cure. These services are also vital to people with motor neurone disease, epilepsy, migraine, multiple sclerosis and myriad disorders of the brain, spinal cord and nervous system that affect more than 12 million people in England.

I want to focus on the opportunities to improve services, in particular, those initiatives, often proposed or driven by clinicians and expert organisations, which now rely on the political will of Ministers, the Department of Health and NHS England if they are to succeed.

A long-running, major issue for neurology in England is the lack of leadership. A significant amount of NHS and social care money is inevitably spent on neurology. Between 2003 and 2013, there was an increase in funding of 200%, yet there was no accompanying improvement in services. A national clinical director of adult neurology post was created and filled in 2013 following a recommendation in the Public Accounts Committee’s 2012 report. Although the postholder was contracted for just two days a week, he is widely acknowledged to have made significant progress by encouraging better co-ordinated working and mapping service provision. None the less, the PAC heard in evidence for its follow-up report four years later that the NCD for neurology role was likely to end in March 2016. There was no transparency around the decision. No consultation was conducted, and no impact assessment was made available. I tabled Questions on this issue and was given assurances in Written Answers that strategic clinical networks for neurology would be able to do some of the work. Soon after receiving those assurances, it was announced that the funding for those networks was also to be withdrawn.

In the period of confusion and uncertainty that followed and in the absence of any other proposals, it was the Neurological Alliance—a collective voice for more than 80 organisations—that took the initiative and suggested an alternative structure called the National Neurological Advisory Group. This group comprises a range of stakeholders giving their time and expertise voluntarily. It includes the Neurological Alliance, the Association of British Neurologists and the Society of British Neurological Surgeons. NHS England provides the secretariat. NNAG is already working on a strategy for improving neurology services which is to be published shortly. With the NCD of neurology role gone, it is essential that this new group be supported by the Department of Health and NHS England, over and above the secretariat being provided.

Commissioners hold the key to patient care. During the 2012 Lords debate about neurology services, the Government voiced real optimism about the new opportunities provided for patient care by the new commissioning system. In reality, commissioners are confused by the split of responsibility between specialised commissioning, which is the responsibility of NHS England, and other treatments and services, which are the responsibility of the clinical commissioning groups.

This confusion is heightened in the context of commissioning neurological services, as contradictory guidance is given in the materials meant to help decipher this responsibility. The Neurological Alliance has identified situations where neither NHS England nor the local CCG has accepted responsibility for a neurology service, leaving local people without treatment and support. A survey of CCGs by the Neurological Alliance, to which 90% responded, highlights the seriousness of the problem: 85% had not assessed local costs relating to the provision of neurological services; 80% had not assessed the prevalence of neurological conditions in their area; and 80% had not assessed the number of people using neurology services locally. It would seem that the majority of local health commissioners lack a comprehensive understanding of the health needs of an average of 59,000 people in their local populations with neurological conditions. As a result, they simply do not know what neurology services should be commissioned to improve patient outcomes.

A survey by the Neurological Alliance in 2016 showed that almost 20% of patients waited more than a year to see a neurological specialist after seeing a GP. The survey suggests that the problem has worsened, with over 42% of people seeing their GP five times or more before being referred to a neurological specialist, an increase of nearly 10% from 2014. When the PAC heard evidence on the issue of access to neurologists for its 2015-16 report, it was told that not only were there not enough but the existing neurological people were not well dispersed, leaving areas of England without any appropriate provision. The PAC concluded that better deployment of existing neurologists should happen to counter this and that other clinical staff, such as specialist nurses, might do some of the work if services were redesigned. This would be very difficult for specialist nurses. As I know from Parkinson’s nurses, for example, they already have a heavy workload and there are not enough of them; it would be very difficult for them to take on this extra work.

Care plans remain a serious problem. The Department of Health set NHS England the objective that all neurological patients should be offered a personalised care plan for 2015, and yet only 12% of patients have a written care plan. This results in unco-ordinated care. Parkinson’s UK frequently hears of people without access to a multidisciplinary team which would usually co-ordinate care for its patients. Without this team, people with Parkinson’s have to interact with many health and social care professionals across primary, secondary and tertiary care, which leads to duplication of services and support, while wasting NHS resources and providing a poor outcome for that person.

Data are central to driving up the quality of neurological services and the outcomes for patients. Excellent work is being done by, for example, the Neurology Intelligence Network, which identifies and collates indicators of adult neurological conditions. One example of its work is its neurology-focused “commissioning for value” packs produced by the Right Care team, which will give commissioners a huge and much needed opportunity to use local data to identify key improvement areas for neurology services. The right data and intelligence are often vital to support research to develop better treatments and, one day, hopefully, a cure for Parkinson’s and other neurological conditions. Supporting quality in neurology services means supporting research, all of which will boost care outcomes, which is what people want and deserve.

I have posed a number of questions that need to be addressed and I hope that the Minister can respond to them tonight. However, in order to explore them further, will the Minister be prepared to meet with me and others with an interest in this subject at a later date? I look forward to the Minister’s response and to the contributions of other noble Lords.

Abortion (Disability Equality) Bill [HL]

Baroness Gale Excerpts

Committee: 1st sitting (Hansard): House of Lords
Friday 27th January 2017 Lords Chamber

[The Lord Bishop of Durham]

My Lords, I was unable to be present at Second Reading but my noble friend the right reverend Prelate the Bishop of Bristol spoke on this matter, welcoming the Bill, and I add my support. I also welcome the amendment because I believe that, as others have already said, such a review would be very helpful.

One reason has just been demonstrated, although the noble Baroness would not have known this at the time; that is, the figure she quoted for the number of abortions that took place in this category after 24 weeks is different from the one that I have been supplied with. That said, the number is not hugely different. The point is that a relatively small number of abortions take place in category E after 24 weeks. If I understand it correctly, the noble Baroness’s amendment would apply not just after the 24-week period but to the Act as a whole. That review would be very welcome because we do not know exactly what is going on.

The Bill is primarily about the rights of the disabled. It is really important that we move to recognising that if we believe viability is at 24 weeks, it is 24 weeks for all foetuses and none should be excluded from that. That is why I support the Bill as a whole.

[Baroness Gale (Lab)]

My Lords, I thank my noble friend Lady Massey for moving this amendment. It has been welcomed across the House, which is a good sign that we can have a really good debate on this. It is a sensible amendment as it asks the Secretary of State to,

“undertake a review of the impact of this Act on disabled children, their families and carers, and the provision of support services”,

with,

“a report of the review to be laid before each House”.

As other noble Lords have said, Acts of Parliament are seldom, if ever, reviewed, so no one knows whether or not they are working. This amendment will ensure that Parliament can at least understand how the Act is working.

My noble friend Lady Hayter said at Second Reading:

“Despite the contribution that disabled people make to national life and their human right to equality of treatment, there are, sadly, still huge hurdles in the way of many of them being able to pursue a full, and indeed fulfilled, life”.


She went on to comment on the lack of adequate resources to meet the additional needs of people with disabilities and made this very important point:

“Of course, all this is not helped by the Government’s welfare reforms”.—[Official Report, 21/10/16; col. 2558.]


There are approximately 12 million people living with disabilities, impairment or limiting long-term illnesses in the UK today. Of these, 5.7 million are of working age, 5.2 million are over 65 and 0.8 million are children. It is recognised that raising a child with disabilities costs up to three times as much as raising a child without disabilities. Twenty-one per cent of children in families with at least one disabled member are in poverty, a significantly higher proportion than the 16% of children in families with no disabled member.

The Government revealed in the Autumn Statement that they had set aside £360 million over six years to ensure that families with a disabled child will receive child disability tax credits in future. However, the payments will be backdated only to April, meaning that individual families may have lost out on entitlements totalling up to £20,000 over the past five years. This is a big loss. The recent UN committee investigation into the rights of disabled people in the UK said that a range of measures introduced since 2010, including the bedroom tax and cuts to disability benefits and social care budgets, had disproportionately and adversely affected disabled children. These are big cuts for people suffering from disabilities. Cuts to the employment support allowance work-related activity group will take more than £1,500 a year away from 500,000 disabled people—this from a fund that was designed to help people stay in or find work. These cuts will reduce support for disabled people by £650 million a year.

An analysis from the TUC found that the Government are years behind schedule on their manifesto commitments to halve the disability employment gap. At their rate of progress, it will take until 2030. The research forecast that by 2020 just over half of disabled people will be in work, which is 11% less than the Government promised. There is no doubt that disabled people are suffering, and will suffer, from the cuts made by government so there is much more to do in this field.

That is why the Labour Party is calling for a complete overhaul of the current system. We are undertaking an intensive consultation exercise, with disabled people at the heart of shaping our approach, through our disability equality roadshow. It is why I am grateful to my noble friend Lady Massey for bringing this important amendment before us, which allows us to highlight the difficulties that people with disabilities have to face now and in the future. Can the Minister take note of the needs of disabled people, which are much greater than those of non-disabled people, to find ways of giving a lot more assistance than they receive at present?

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, I congratulate noble Lords on the quality of debate on this amendment and recognise the broad welcome that it has received from all the speakers. I also join noble Lords in paying tribute to my noble friend Lord Shinkwin for bringing forward the Bill and raising the issue of disability rights and their effect on abortion, and in commending the noble Baroness, Lady Massey, on the clarity and conviction with which she made her case today.

Like all issues of conscience, the issue of abortion is one that divides opinions in ways that transcend the usual political boundaries because of the very personal reasons that parliamentarians have for their beliefs. It is for that reason that Governments remain neutral on such issues. The role of government in issues of conscience is to implement the law as decided by Parliament. On that basis, were this amendment to be carried and the Bill passed, the Government would of course carry out the proposed review in order to monitor the impact of the legislation, and we would indeed report to Parliament in due course.

The amendment proposed fits well with the overall determination of successive Governments to improve the lives of disabled people and their families. That has been a cornerstone of the approach of this Government and the previous Conservative-led Government. The Children and Families Act 2014 introduced a new statutory framework for local authorities and clinical commissioning groups to work together to secure services for children and young people who have special educational needs and disabilities. The support available to families includes early intervention programmes that aim to help the child develop, as well as providing support to the family from health visitors, midwives and others.

I also recognise that this amendment would improve the evidence base available for policymakers. There is of course a general desire in this Government to have more evidence-based policy-making, which the amendment would clearly aid. But, in the end, this is an issue of conscience, so noble Lords are free to decide their views according to their ethical or religious beliefs.

Smoking-Related Diseases

Baroness Gale Excerpts

Wednesday 14th September 2016 Lords Chamber

[Baroness Gale (Lab)]

My Lords, I thank my noble friend Lord Faulkner for bringing this important debate before us tonight. Action by successive Governments to reduce the harm caused by tobacco has been highly effective, but much remains to be done. The timely publication of a new comprehensive plan is of vital importance.

I will focus my comments on the need for the plan to contain specific recommendations to further reduce the harm that tobacco causes to children and young people. For many, particularly in deprived communities, the harm of tobacco begins before birth. The ambitions set out in the previous tobacco control plan, including driving down smoking rates among young people and pregnant women, were achieved. However, one in 10 pregnant women still smokes at the time their baby is born, and smoking remains the single biggest modifiable risk factor for poor birth outcomes. Children born to mothers who smoke, and children who live with smokers, are also far more likely to become smokers themselves than those from non-smoking households. Smoking and smoking-related disease is passed down through generations.

The Public Health Minister has recently written to the Smoking in Pregnancy Challenge Group—a partnership of charities, royal colleges and academics—confirming that ambitions on smoking in pregnancy will be renewed in the new tobacco plan. I am delighted by that news and hope that the Minister can confirm today that all the ambitions will be reviewed and renewed in the new plan when it is published.

We have a duty to our children to protect them from an addiction that takes hold of most smokers when they are young. Each day, hundreds of children take up smoking, starting out on a path that will lead to smoking-related disease and premature death. I echo the call from other noble Lords for the Government to publish a new tobacco control plan without delay.

National Clinical Director of Adult Neurology

Baroness Gale Excerpts

Thursday 9th June 2016 Lords Chamber

Asked by

[Baroness Gale]

To ask Her Majesty’s Government why the National Clinical Director of Adult Neurology post was ended, and what assessment they have made of the consequences of that decision.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, the reduction in national clinical directors resulted from NHS England’s review of its clinical advisory resource. This review sought to refocus capacity on areas where major programmes were being taken forward and in areas identified as priorities for improvement. NHS England will still be able to access neurological clinical advice in future. From 1 July 2016, clinical expertise will be provided by NHS clinical leads, the neurology clinical reference group, royal colleges and wider engagement.

[Baroness Gale (Lab)]

While I thank the Minister for his response, I am very disappointed. I am sure he is aware that there has been no transparency whatever, and no consultation on making this post redundant. He will be aware that the Neurological Alliance and the Public Accounts Committee have urged that this post should remain where it is. There was great rejoicing when the post was created three years ago and great disappointment that it has now been ended. Will the Minister agree to meet the Neurological Alliance so that we can have a full discussion and a full understanding of why this post was made redundant? Nobody seems to understand it, as it has all been done very quietly. I hope that this is not just a cost-cutting exercise.

[Lord Prior of Brampton]

My Lords, I am of course very happy to meet the Neurological Alliance with the noble Baroness. I just say this: if the medical director and board of NHS England cannot make decisions about where they should get their clinical advice, one is bound to ask what on earth the point of them is. There are certain decisions that must be made by NHS England and Bruce Keogh, its medical director, came to this decision. I think it is a decision that he should make, not politicians.