Healthwatch England

Baroness Hayter of Kentish Town Excerpts

Tuesday 26th April 2016 Lords Chamber

[Baroness Hayter of Kentish Town (Lab)]

My Lords, is this not just another attempt to bring the private sector into patient representation—just another example of the Government trying to place their business friends everywhere? The new guidelines on ministerial appointments give the Minister three bites of the cherry: to be able to suggest names; to meet some of the candidates before shortlisting to make recommendations to the panel; and then to have the final say. That is completely different from previous practice. If we really are to have an open process, should we not have the Minister involved only at the end, when the panel has made the decision?

[Lord Prior of Brampton]

I honestly do not think that the noble Baroness is correct. I really do not feel that this process has been politicised in the slightest. It is interesting that the chief executive of NHS England and the new chief operating officer were both previous special advisers to a Labour Government, so it is pretty hard to say that we are politicising appointments in the NHS.

Alcohol

Baroness Hayter of Kentish Town Excerpts

Wednesday 9th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, as I say, an independent assessment of the responsibility deal will be done by the London School of Hygiene and Tropical Medicine. It is important that the assessment is independent and certainly is not undertaken by the industry or, indeed, by the Department of Health. It is worth noting that the consumption of alcohol seemed to peak in 2005 and has declined slightly since then. I am not in any way minimising the appalling damage that alcohol does to the lives of many people, but consumption is coming down slowly.

[Baroness Hayter of Kentish Town (Lab)]

My Lords, the BMA concluded that the Government’s alcohol policy had been weak and ineffective due to an overreliance on working with the alcohol industry. Does the Minister concur with the BMA’s judgment that the responsibility deal has pursued initiatives that are known to have little effect in reducing alcohol-related harm and that the responsibility deal should now be abandoned?

[Lord Prior of Brampton]

My Lords, I can only repeat that we will have an independent review of the responsibility deal, at which point we will have objective evidence on which to assess it. I agree entirely with the noble Baroness that the health world, including the BMA and many of the royal colleges, takes a very strong view about alcohol. Many doctors see the appalling impact that it has on individual lives day in and day out, so we take their views extremely seriously.

Sex-selective Abortion

Baroness Hayter of Kentish Town Excerpts

Monday 7th December 2015 Lords Chamber

[Lord Prior of Brampton]

My Lords, I am afraid I cannot confirm or deny that. I will write to the noble Baroness.

[Baroness Hayter of Kentish Town (Lab)]

I thank the Minister for his original reply; it is one with which we concur—we do not have the evidence and, like him, we consider that the Act is sufficient as it is. Some of the stories are partly, I think, just about the lack of self-worth that some girl children sometimes feel; that is partly about their education and that of their mothers. Can the Minister say something about what the Government do to encourage greater self-worth among young women and, indeed, older women?

[Lord Prior of Brampton]

My Lords, I encourage anyone with an interest in this matter to read some of the case stories put together by Jeena International—they are really quite shocking. They are anecdotal, but they are very real for a small minority of women who lack self-worth. That is, tragically, part of some of the cultures in England and we must do everything we can to improve women’s self-worth. I think that, in the long run, that will be done by education, education, education.

Gender-based Violence: Women with HIV

Baroness Hayter of Kentish Town Excerpts

Wednesday 25th November 2015 Lords Chamber

[Lord Prior of Brampton]

I believe that some 103,000 people are HIV positive in England, of whom two-thirds are men. The majority of people who are HIV positive come from sub-Saharan Africa. The noble Baroness made the point that some who know they are HIV positive are not taking appropriate action and asked what we can do about them. It is also worth pointing out that some 18% of people who are HIV positive are ignorant of the fact. We have a very big communication programme ongoing to try and educate and inform these men, and we will continue putting the necessary resources into those programmes.

[Baroness Hayter of Kentish Town (Lab)]

My Lords, given that today is the UN International Day for the Elimination of Violence against Women, has the Minister taken a moment to see the associated ActionAid exhibition in the Upper Waiting Hall? In respect of women with HIV, the only survey we seem able to find about the prevalence of domestic violence is a 2013 one from Homerton, which showed that probably half of women with HIV reported experience of partner violence. Could the Minister undertake that there should be more research on this and that, if such a figure is found to be confirmed, everyone dealing with HIV women should be taught to be aware of their vulnerability to domestic violence?

[Lord Prior of Brampton]

I have not been to the Upper Waiting Hall to see the exhibition but will endeavour to do so if I have time after Questions this afternoon. The noble Baroness referred to the research done at the Homerton in 2013. I think the figure that study came up with was 52%. There has been a subsequent study but I cannot remember the name of it. It may not have been as extensive as the one done at the Homerton and put a figure slightly less than 52%—but it was still very significant. I will ask officials the status of that subsequent research to see whether we need more.

Health Service Commissioner for England (Complaint Handling) Bill

Baroness Hayter of Kentish Town Excerpts

Friday 13th March 2015 Lords Chamber

[Baroness Hayter of Kentish Town (Lab)]

My Lords, I congratulate the noble Baroness, Lady Finlay, on bringing the Bill to the House. I welcome it and the changes, which she outlined, that the ombudsman has already been making internally. I shall comment on the general complaints environment within which this falls.

As we know, public service delivery has become much more complex since the office of the ombudsman was established nearly 50 years ago. Many services are now delivered through a combination of public, private and third-sector providers, particularly in health and social care, where the boundaries between treatment and care and between providers are becoming blurred. Indeed, consumers often do not know whether they are patients or service users, who is providing the care, who has responsibility for the handover between health and social care when things go wrong or even whether their local authority retains responsibility for a care service provided by an independent organisation, albeit funded by the authority. Incidentally, the answer to the latter question is yes, the local authority retains responsibility.

Are we surprised when users or their families are confused about whom to complain to in the first instance or to which ombudsman to appeal should matters not be resolved? Social care is dealt with by the Local Government Ombudsman whereas health is dealt with by the Parliamentary and Health Service Ombudsman. The Public Administration Select Committee in the other place has helpfully explored these challenges. In April last year, it published a report whose very title tells a tale: Time for a People’s Ombudsman Service. It recommended the creation of a new, unified public ombudsman, which the current Parliamentary and Health Service Ombudsman and the Local Government Ombudsman welcomed. Those two ombudsmen—actually, women in both cases, which is perhaps why they co-operate so well—share the Select Committee’s ambitious vision for reforming the landscape.

A unified ombudsman would provide a streamlined and seamless service for users, covering all public services delivered both locally and nationally in England, and all the UK non-devolved services. That is an exciting possibility which could not only empower consumers, but also—by the gathering of all complaint data—enable trends and persistent faults and shortcomings to be identified, so that preventive rather than just restitutive action can often be taken.

The Government have commissioned Robert Gordon to carry out a review of the ombudsman landscape in the light of this report, and I look forward to reading his recommendations. Can the Minister tell the House when he anticipates receiving that report, and whether the Government favour the Select Committee’s approach?

There is a real impetus for change, which could benefit consumers as well as the health service and social care. I hope I might be in a position to urge a new Labour Government to consider legislation to create a modern, single public ombudsman service. Failing that, however, I will be back, urging the Minister to do so, for the sake of citizens but also to achieve better value for money.

Public Health England Advisory Board Membership

Baroness Hayter of Kentish Town Excerpts

Thursday 4th July 2013 Lords Chamber

Asked By

[Baroness Hayter of Kentish Town]

To ask Her Majesty’s Government what steps they are taking to ensure that women are represented on the Advisory Board of Public Health England.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe)]

In April 2013, we appointed four non-executive members to Public Health England’s advisory board. They each bring to this role a great range of experience. We will shortly advertise for further candidates to enhance the expertise available to Public Health England. We aim to ensure that, as far as possible, the advisory board provides an appropriate gender balance and representation from ethnic minority and disability backgrounds.

[Baroness Hayter of Kentish Town]

My Lords, I hope the House knows that in addition to the other two who sit on this board, this an all-white, all-male board. I am delighted that the Minister has admitted this in the sense that they are going to re-advertise. However, can he explain why No. 10 vetoed the highly respected and experienced woman who was recommended by the independent appointments panel? Could it possibly be because she sits on the Labour Benches in your Lordships’ House?

[Earl Howe]

My Lords, absolutely not. The noble Baroness to whom the noble Baroness refers is, in everybody’s eyes, a highly qualified person. It would be inappropriate in any case for me to comment on individual candidates, successful or unsuccessful. However, I can confirm, and I emphasise this strongly, that the recruitment campaign was managed in a way that completely complied with the principles of the Commissioner for Public Appointments’ code of practice. It was open and transparent, and appointments were made on merit against published criteria for the role.

Alcohol

Baroness Hayter of Kentish Town Excerpts

Thursday 2nd February 2012 Lords Chamber

[Earl Howe]

My Lords, my noble friend is ahead of me, and I will have to write to her.

[Baroness Hayter of Kentish Town]

My Lords, has the Minister seen the letter today from the churches and charities to the Prime Minister asking that there should be a minimum price on alcohol? Will he agree with that recommendation and do that rather than rely on the industry in this case?

[Earl Howe]

My Lords, as I have already said, we recognise that the irresponsible sale of alcohol at a loss or heavy discount is undesirable. We know that price is important in this equation but we also know that it is not the only factor that affects demand for alcohol. We need to find ways to change people’s relationship and behaviours with alcohol. We do not believe that the only way to do this is by more rules and regulations but the issue of price will be addressed in the forthcoming alcohol strategy.

Public Bodies Bill [HL]

Baroness Hayter of Kentish Town Excerpts

Wednesday 9th March 2011 Lords Chamber

[Lord Goodhart]

My Lords, I support what my noble friend Lord Norton said. The independence of the judiciary is a central and essential part of the constitution. In particular, the provision that would have enabled the Government to get rid of the Judicial Appointments Commission was plainly unconstitutional and could only have been dealt with by primary legislation.

[Baroness Hayter of Kentish Town]

My Lords, first, I declare an interest as chair of the Legal Services Consumer Panel, which is part of the Legal Services Board and thus funded indirectly by lawyers, although technically appointed by the Secretary of State. Although we are about to see the LSB dropped from the Bill, I will raise some issues. It will become clear as I speak why I need to do that.

The UK has a long and proud record of an independent Bar, and of independent solicitors. This is important for its own sake, but also because the Bar is the pool from which our judiciary is drawn. They are thus already known for their robustness and independence from political influence by the time they don their judicial wigs. Even before that, lawyers can freely represent clients who are prosecuted by the state or even represent clients taking action against the state safe in the knowledge that their licence and freedom to practise cannot be removed by the state, as it was given by the Bar Council or the Law Society, over which the state has no control.

It is that security that enables lawyers to feel quite free to represent clients without looking over their shoulder to see whether they will be jeopardising their future livelihood. It is very hard to emphasise how important this tradition has been both here and abroad. There were therefore concerns when it was decided that the role of the Bar Council and the Law Society in authorising and disciplining lawyers was to be overseen, and indeed authorised, by the Legal Services Board, which was set up by statute with its members appointed by an elected politician, or at least a member of the legislature—the Secretary of State.

Although they accepted that the era of full self-regulation was past and that some independent membership of relevant boards was required, lawyers here and abroad were wary of the Government taking over ultimate responsibility for effectively granting or removing the licence to practise, with the implication of the regulation of lawyers coming under government control. Nevertheless, when the LSB was set up, albeit funded by lawyers, there were many—I am sure sincere—assurances as to the independence of the Legal Services Board from political interference. Lawyers both here and abroad—because of course many are trained here—were assured that government Ministers would not remove a lawyer who could upset or challenge them. It is very much for that reason that I am delighted about the loss of Clause 11 and Schedule 7, which of course list the LSB. However, in the mean time, another part of government has taken a quite serious swipe at the LSB, as well as my own Legal Services Consumer Panel, and at the new Legal Services Ombudsman set up under the same 2007 Act.

On 8 October last year, just days before the 14 October announcement of the bodies to be abolished or amended by this Bill, all three bodies received letters from the Ministry of Justice saying that the Secretary of State had received a letter from Francis Maude, the Minister for the Cabinet Office, telling us that our three independent, stand-alone websites “will have to be closed” and that we would need to use “an approved government website”—in other words, a .gov.uk domain. It will not come as any surprise that all three bodies protested most strongly that, being independent of government, we would not be treated in that way. Elizabeth France, the chair of the Legal Ombudsman, wrote to the Minister of Justice on 25 October saying that there was no justification for an ombudsman, set up to demonstrate independence from government regulation and the profession and spending no government money, having a .gov address. As she stressed, other ombudsmen, whether it be the Local Government Ombudsman, the Pensions Ombudsman or the Financial Ombudsman, all have .org.uk URLs, signifying their independence from the sectors on which they adjudicate and their independence from government. Our three websites cost nothing to the public purse as they are funded by lawyers, so there is no public expenditure rationale for this. However, it raises serious constitutional issues about the independence of the governance of those bodies—something to which the Government seem a little deaf.

On 28 February, we had confirmation of the very welcome decision to drop Clause 11 and Schedule 7, as reported at col. 799 of Hansard, and indeed had the Minister’s declaration that:

“The Government absolutely recognise that some public functions need to be carried out independently of Ministers”.—[Official Report, 28/2/11; col. 798.]

Just days after that, on 2 March, guess what? We received another e-mail from the Ministry of Justice telling us, “You will need to close your website by 31 March 2011”. To my knowledge there is no legal basis for such diktat from the Cabinet Office and there is, of course, no saving of public money.

Food: Regulation and Guidance

Baroness Hayter of Kentish Town Excerpts

Thursday 7th October 2010 Lords Chamber

[Baroness Hayter of Kentish Town]

My Lords, I welcome this debate and congratulate my noble friend on having made it available for us today. I also pay tribute to his work. I had the great privilege of serving under his chairmanship of the National Consumer Council, and since then I have watched him develop that organisation into what has become the very successful Consumer Focus—a body which, as he said, works in this and a number of other areas. Its great success is a testament to his work in the very many areas in which he has been involved.

It is fairly obvious that nutrition is very good for individuals, but it is also very good for society. A healthy population learns better at school, it works better and it plays better. That is good for our economy and it is good for individuals. The public expenditure saving, particularly in the health service, is one which I should hope the Government are taking an interest in and, therefore, doing more to promote.

We have seen in this country a long-term interest in the quality of what we eat and drink, which includes the Fabians’ early work on cleaner water. Safe food was perhaps regulated much earlier than other areas of our lives, and more recently there has been regulation on the labelling and promotion of healthy options. However, all of that works only if it has the confidence of all the parties concerned, including the Government, the producers of food, the distributers of food, the doctors and public health specialists and, above all, the consumers. That brings us to the key question of how food standards and nutrition are to be regulated such that the consumer is absolutely sure that the consumer interest is at the heart of regulation. As my noble friend mentioned, we have already learned the lessons of what happened when the beef farmers denied any problem with their stock and when the Government sought to reassure or advise the public—it did not work. Parents want to know that their child’s health does not depend on a politician with many other interests to balance deciding the content of the dinner plate. Nor will parents necessarily believe the advice given out by politicians—sad though that may be to believe. Parents want guidance and rules to be determined in a way that puts child health and welfare above any other consideration.

That point is fundamental to all types of regulation, whether in financial services, in medicine, in legal services—I must declare an interest as chair of the Legal Services Consumer Panel—or in the regulation of actuarial work, on which I must also declare an interest as a member of the Board for Actuarial Standards. The great success of good regulation—what is admired by other countries that look at our UK regulation—comes where the end-user is at the heart of regulation. It is never in the consumer’s interest to regulate unnecessarily, but where market failures arise due to the lack either of information or of opportunities to shop around or, as perhaps in this case, because there is too long a production chain so that the consumer cannot influence the market, regulation is needed to protect the consumer and to give advice and guidance. That is as much the case in food as in financial or legal services. I hope that the Minister will reassure the House that consumer protection will remain the Government’s watchword as they take over responsibility for nutrition from the FSA and, indeed, elsewhere in their regulatory role. We want to hear from the Government that consumers will be part of the dialogue on policy development and that consumer trust in our food—both in the quality of the food and in its nutritional value—can, therefore, continue and, indeed, increase.

In closing these very short remarks, I will take up my noble friend’s comments about our having come to the end of the era of cheap food. I take his word on that point. That being the case, let me end by asking the Minister about the impact on, for example, a widow with six children, given the Government’s proposed cap of £500 a week on her income. What impact will that have on the nutritional standards and thus the health of her six children?