(9 months, 2 weeks ago)
Lords ChamberMy Lords, I of course understand the point that the Minister is making—procedures in other countries and what is available in other countries by way of support are different—but should that stop us requiring part of the Government, the organisation in this country which has immediate, close responsibility, to take on a role of proper signposting, which may be to equivalent services? Partly, it is interpreting, but it is obvious that there is a lacuna here.
If there has been a homicide abroad and those families are living here, there is a real danger that the message will be that the Government think that that homicide does not matter as much as a homicide that happened here. The Government might say that they do not have the resources. I pointed out that it is about 80 homicides per year—the numbers are not huge—but those people who are so severely traumatised, retraumatised and carry on being further damaged by the experience often become enormous consumers of resources because of mental health services, because they are unable to work and so on, and eventually they may need benefits. There are all kinds of things that they may need. It is a false economy to look at it in terms of resources to the FCDO. I hope that the Minister will meet me and others to discuss ways that the victims’ code could be asterisked where there are things that may not be as appropriate if the homicide occurred here, but it would say that the lives of British citizens are of equal value wherever they are in the world and that whether it was a terrorist attack, a homicide here or a homicide overseas, those lives are of equal value.
(4 years, 1 month ago)
Lords ChamberAs the noble Baroness, Lady Whitaker, has been unable to be contacted, I now call the noble Baroness, Lady Hamwee.
My Lords, I put my name to the amendment on behalf of these Benches. To be saying at this stage—three months from the end of the transition period and very close to the practicable end date of the negotiations—that our draft agreement is still on the table, as was said at the previous stage, feels like a denial of reality, and I follow the noble Lord, Lord Kerr, in that comment. Like the noble Lord, Lord Randall, I will be interested to know the up-to-date position.
Certainly a prudent Government would look for a mechanism to plug the gap, as the noble Baroness, Lady Primarolo, said, in case the draft slips off the table or is just not picked up—and this is the mechanism. I am very glad to support it, as I did in Committee when I too had an amendment on family reunion. At that stage, the Minister said that the Government had acted in good faith and that she hoped that the EU would do the same. Like the noble Lord, Lord Dubs, I cannot say that I regard the draft agreement as adequate. The principal obligations are not obligations—they are discretionary—but, whoever should take the blame for the stalemate, we must not let asylum seekers be the losers by being caught in the middle. They are not illegal, not unless and until their claim is refused.
This is likely not to be the first time that I will be taking a different view from the Minister about pull factors, especially when the push factors are so significant.
Of course we agree on the importance of safe and legal routes. That is the most important thing. Our view is that what is safest is to provide legal routes and deprive criminals of the opportunity to exploit people. It may be that our routes to that differ somewhat—perhaps they are not the means that the Home Secretary is considering—but that is not really for today. As has been said, our current rules are inadequate. The Government refer to that well-known paragraph 319X of the rules as providing the route that allows children to join relatives recognised as refugees, but the scope is very narrow, there are many restrictions and substantial fees are payable. As I understand it, the data does not separate out the categories or the basis of application, and those who take that route are included in the Home Office’s figures with other routes. Including all those routes, there were only 30 successful applications in 2018 and 54 in 2019. It is certainly not an adequate substitute for a successfully negotiated agreement on family reunion or a change in the UK’s rules, at least until an agreement or agreements are negotiated, as the amendment provides.
Working with the UNHCR and resettling people from the Middle East is not something we want to see replaced. The noble Lord, Lord Judd, the noble Baroness, Lady Lister, and others referred to the numbers in this plight across the world. As the noble Lord, Lord Dubs, said, we cannot take everyone but we can play our part. It seems to us that it is a policy decision for the Government whether to make it an “and” rather than an alternative.
(4 years, 1 month ago)
Lords ChamberMy Lords, the comprehensive improvement plan is due this month, and the first day of Report on this Bill is the last day of this month. I had made a note, before the Minister said it, that Wendy Williams herself talked about the importance of not rushing the change, but I think we can look forward to the review before—albeit immediately before—we start on Report. I accept of course that changing a culture, like redirecting an oil tanker, is a long process. Indeed, changing culture is something that should go on and on; it is necessary that it should always be a current issue.
The noble Baroness, Lady Sherlock, talked about the importance of not getting the policy wrong; it is about both policy and practice. The obvious read-across from the experience of the Windrush generation is indeed the documentation, as my noble friend mentioned. Recommendations are good, but they will only be evidenced by actions. As the Minister has just acknowledged, the lessons learned from the unhappy experience of Windrush are transferrable. “Fairness” and “humanity”, she said; those are very good last words for today—they are very good words for always. On that note, I beg leave to withdraw the amendment.
My Lords, before we proceed to that point, I have a request to speak from the noble Baroness, Lady Lister of Burtersett.
(7 years, 7 months ago)
Lords ChamberMy Lords, I have tabled amendments in this group. I start by thanking the noble and learned Lord, Lord Keen of Elie, and his Bill team for having met with me and for dealing patiently with my queries. I know from that meeting that the Government are not minded to accept my amendments, but I would like the arguments to be put on the record.
I have listened carefully to the noble Lord, Lord Whitty. While I do not dispute at all that his amendments are well intentioned, I can see enormous difficulties arising in determining the threshold of the condition—how severe it has to be, which co-morbidities might be aggravating one another, which members of the family would be involved and so on. I am not sure from the way he argued for his amendment whether an email notification system against a set of clear criteria that had been pre-negotiated with the consent of the patient or family would meet the needs and be simple and straightforward. Would it be a communication system free from the risk of mining the patient’s clinical records? The reason I ask is that at the moment health bodies are not specified in the Bill, but if they were included, that would certainly need legislation because in effect it would override the common-law duty of confidentiality.
I know that at the previous stage the noble and learned Lord, Lord Keen, said that the Government were minded to consider bringing health and social care bodies within the scope of these powers in the future and that that would be done using a statutory instrument passed by the affirmative procedure. I appreciate that the Minister said that there would be wide consultation before that happened.
The difficulty is that in Clause 36(7) it appears that the duty of confidence, which could apply to the duty of medical confidentiality, could be removed if health is brought within the scope of the Bill. It could provide a legal gateway for sharing medical records for purposes that are not currently specified among a wide range of government departments and public service providers. The concern is that to date a special legal status has been afforded to health data in the common-law duty of medical confidentiality due to its sensitivity and the importance to the public of a confidential health service. This common-law duty of confidentiality protects health data over and above the safeguards provided by the Data Protection Act, so simply referring to the Bill’s requirement to comply with that Act when making disclosures does not maintain the current level of protection.
If the Bill proceeds unamended and the Government include health bodies in the list of specified bodies, which they could do by statutory instrument, I think that would be viewed as a serious assault on medical confidentiality because it would open up the power to share confidential information. Indeed, problems with the failure of the current safeguards in the system were aired this weekend over TPP, the IT system that many general practitioners use. In a way, that demonstrated that the current safeguards in place around the IT systems are, frankly, inadequate.
NHS Digital could be drawn into the Bill’s information-sharing powers. It holds vast quantities of confidential data, which would mean that the Bill could give the Government direct access to them without consent, because the process would override the current common-law duty. This needs to be considered in the context of the National Data Guardian, who has spoken about the need to build trust in the health system’s ability to handle data, and a real concern among many patient groups of the general mistrust that their very confidential data could be shared.
I believe that my amendments will not be accepted, but if they are not I hope the Government will be able to reassure me that if health data were to be brought into the Bill’s information-sharing powers they will not just be added to the current framework created by the Bill and then the duty of medical confidentiality deemed to be protected, but that there will be full public engagement and full parliamentary scrutiny prior to proceeding, and that the protections in place would include independent oversight and real-time monitoring of the data sharing. In Wales, the IT system overseeing NHS Wales has instituted real-time monitoring because there was concern that staff could have used their access rights to unprofessionally access healthcare records of people with whom they did not have a direct care relationship. I am afraid that human nature is that people are rather inquisitive about what may be happening to people they know, but those may be very sensitive and very private data. Therefore, they need the highest safeguards around them.
The problem is that once there is a data leak it really cannot be pulled back and closed. I hope the Government will provide the reassurance that, as well as the other aspects, there will be real-time monitoring and independent oversight of the whole process, with additional sanctions that will be of a high enough level to, I hope, act as a major deterrent for any breaches of any data-sharing agreement.
My Lords, we have Amendment 28AV in this group, which is also about the common-law duty of confidentiality. Obviously that includes doctor-patient confidentiality. We are with the noble Baroness in her concerns. Apart from wanting to see that duty preserved, the reason for the amendment is to seek confirmation that it is to be overwritten rather than preserved. I found subsection (7) quite difficult. When we were contacted by a member of the public who was clearly qualified to read the legislation with a query about it, it seemed appropriate to raise this because it is quite difficult to follow. Clearly, one should be quite certain about what we are doing.
(13 years, 4 months ago)
Lords ChamberMy Lords, I shall speak to Amendment 244, which unashamedly originates in Wales. Its aim is to make sure that “Licensed Premises Cumulative Impact (saturation) Policies” for local authorities have teeth and apply to off-licence premises, because at the moment they do not. The problem is the rise in alcohol consumption, in particular in our city centres, to which supermarkets have greatly contributed, with cheap alcohol often being a loss leader with price promotions. Young people buy alcohol to preload before going out, so they get intoxicated even before the beginning of the evening. They then tank up again on more alcohol from these outlets, because it is far cheaper than buying it on licensed premises. The problem is what to do in our city centres. The cumulative impact saturation policies do not have statutory status; they are only guidelines, so they are not enforceable and they are easily overturned by a legal challenge from retailers. I spoke about this at Second Reading and will not go through the argument again. However, the size of the problem in city centres warrants being addressed briefly.
We know that 60 per cent of liver disease is caused by alcohol abuse. Thirty years ago, that was seen in chronic alcoholics. Now it is seen in young drinkers who kill themselves with acute pancreatitis and liver failure. Individual human tragedies are known to everyone in the NHS: the student deformed for life, the student who falls under a train, the child burnt because somebody has got intoxicated and set fire to their home, or the 14 year-old who gets drunk and pregnant at a party. We have seen them all, and there is an increasing catalogue of these disasters. The other problem is the litter and environmental damage caused by alcohol misuse. Let us not forget that Damilola Taylor was killed not with a knife but with a supermarket lager bottle that had been left in the street.
In the UK, average consumption is now a staggering 9.7 litres of neat ethanol for every man aged 45 to 64. Sadly, women are rapidly catching up, with a 30 per cent rise in the incidence of heavy drinking in the past decade. In Cardiff city centre recently, a study asked people to be voluntarily breathalysed. One in three of the men and one in six of the women had damaging blood alcohol levels. The high-risk drinking patterns are concentrated particularly in ex-industrial heartlands such as the north-east, Humber and Yorkshire, and my own home, south Wales. Alcohol misuse accounted for 1,000 deaths in Wales in 2009, and the harm costs £1 billion annually—equivalent to £770 per Welsh household. Our trends in the UK are going in the opposite direction to those of many other countries. We have a rising incidence of liver disease deaths, but in France and Italy it is falling. Consumption by teenagers in England has overtaken that of teenagers in Spain and Italy.
The amendment would introduce a provision that “Licensed Premises Cumulative Impact (saturation) Policies” should include supermarkets and other off-licence premises. It will make it clear that they are included, with the result that managers of supermarkets and other off-licence premises will not be able to argue, as they have to date, that they are not included. It will also remove the current discrimination against licensed premises such as pubs produced by the current lack of clarity. Giving the impact policy statutory status would also allow revision and monitoring of the decisions taken.
The final part of the amendment includes a provision to ban the sale of alcohol in petrol station outlets. I have had representations about this and I recognise that in these outlets, drink is often purchased to consume later, and there is no evidence of a direct link between alcohol bought on those premises and drink-driving—although it appears to give a slightly inconsistent public message in relation to driving and alcohol. However, selling alcohol sometimes makes these outlets viable. I accept that this amendment is not perfect, and it may well be that it warrants refining in relation to that last part.
However, the other parts are important because it will finally allow local authorities to take decisions, empower the voice of people at a local level and make sure that those decisions are not challenged, as happened with Sainsbury’s in Cardiff by very highly paid barristers coming down from London with their managers and effectively driving a coach and horses through the guidance because it could not be enforced as it did not have statutory standing. It would also demonstrate consistency in those areas that are particularly bad hot spots of alcohol consumption, violence and crime, which are known to the local authorities in that area and would avoid inappropriately penalising rural areas where the sale of alcohol has to be managed in a different way. I commend the amendment to the House.
My Lords, my noble friend will speak to the substance of the amendments, but noble Lords may have noticed a minor flurry on these Benches when I went out to check whether there had been a reissue of the groupings and to see if I could find out just what was happening. We were not aware of the degrouping—that became clear before—nor of the grouping of the amendment to which the noble Baroness has just spoken with this amendment. I simply make a plea that if there are any further changes to the groupings in the list we are working to, noble Lords will use the informal arrangements of the House to make sure that we all end up speaking to the same group. That was in no way directed at the noble Baroness, who may have thought that this had all been sorted.
My Lords, I apologise to the Committee. I was part of the discussions, but I did not double-check that everybody knew. I apologise to the Benches opposite.