Health and Care Bill

Baroness Henig Excerpts

Consideration of Commons amendments
Tuesday 26th April 2022 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

Two noble Baronesses will be taking part remotely. I first call the noble Baroness, Lady Campbell of Surbiton.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, I strongly support Motion D1, to be moved later, in the name of the noble Baroness, Lady Wheeler. It attempts to salvage something of what we set out to achieve on Report. Noble Lords will remember that I was particularly keen to achieve a zero cap for working-age adults who have or who develop eligible care needs under the age of 40. This would enable them to save enough for an ordinary life, like other people.

Amendment 80S would allow regulations to decide how costs accrue under the Care Act, including local authority costs. Not to let them count is fundamentally unfair, adding years to the time it would take to reach the cap. The amendment ensures that the trailblazer pilots are assessed and reviewed by Parliament in the light of regional variations and the impact on younger disabled adults.

Disabled people are contributing to their care from benefits intended to cover the extra costs of disability. Four million disabled people in the UK are living in poverty and are particularly hard hit by the rising cost of living. Without some easing, they will remain trapped in poverty. The Minister has told us many times that the cap is proportionate and fair. He refers to the uprating of social care allowances, meaning the minimum income guarantee—what is left after being charged for care. In practical terms, it is minimal. To someone with the highest support needs and on the highest rate of disability benefits, it amounts to £4.55 a week. That barely keeps pace with the cost of living, let alone their extra disability costs, which are estimated at £583 per month. It is also far less than older people receive. Disabled people will be simply crushed by their rising debts.

If the Government’s proposals go through tonight, young disabled people will never participate in society as equal citizens, and those totally reliant on benefits will suffer even more financially—yet we know from the evidence that investing in social care to support disabled people improves their health, enhances their independence and reduces demand on welfare benefits.

The amendment in the name of the noble Baroness, Lady Wheeler, does not thwart the primacy of the elected House. Nobody says that the current system is acceptable, but these proposals from the Government are not the answer. The public are demanding better social care and support for all those who need it so that they can thrive as dignified human beings. The Government’s last-minute changes to their reforms, sprung on Parliament with no time for proper scrutiny, will not deliver the will of the people, who want investment in social care.

We must, and we will, continue our efforts to secure a better deal, especially for those young disabled people starting out in life, who simply want a life like anyone else. The least we can do tonight is support these reasonable and modest amendments, so that that can become a reality.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, I call the noble Baroness, Lady Brinton.

Health and Care Bill

Baroness Henig Excerpts

Lords Hansard - Part 1 & Report stage
Monday 7th March 2022 Lords Chamber

Amendment 142 not moved.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Campbell of Surbiton, may be moving the next amendment on behalf of the noble Baroness, Lady Bull. The noble Baroness, Lady Campbell, is taking part remotely and I invite her to say whether she wishes to move the amendment.

Amendment 143

Tabled by

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[Lord Hunt of Kings Heath (Lab)]

My Lords, there is a series of amendments in this group. My amendment does not really relate to the others in the group, but it is about an important issue.

In Committee, I raised the problem that a number of members of the public and the Relatives & Residents Association have brought to my attention: in a minority of care homes, if residents or relatives complain, the homes take retaliatory action in the form of making visits even more restrictive than they currently are and, in some cases, even evict, or threaten to evict, the person on whose behalf the complaint has been made. As I said, this is in a minority of homes— over the past few years I have been impressed by how many homes have continued to provide high-quality care in very difficult circumstances. None the less, this is an important issue.

In 2019, the Relatives & Residents Association was coming across at least one case a week of such intimidatory behaviour. We discussed this in Committee. The Minister said that she did not really think that the department had received much evidence of this, that in any case residents and their relatives and friends should complain to the home in the first instance, and that the Care Quality Commission would also pick up concerns.

This is a very confusing picture. If you go to the CQC’s website, you will see that it states:

“we do not settle individual complaints ourselves, but we still want you to tell us about your experiences of care.”

To most people, that is pretty confusing. If you are worried that a home is going to be intimidatory in its response to legitimate complaints raised, you are hardly likely to have confidence in its complaints system.

Up until about 2008, the CQC did take individual complaints but, due to a funding cut, it stopped doing so, even though, in Scotland, the equivalent body investigates specific complaints, and the predecessors of CQC investigated complaints. We know that there is huge pressure in care homes. We also know that some care homes are continuing extremely restrictive practices around relatives and friends being able to visit. This has become quite a serious problem in which, while they may not be in total lockdown, they come near to it, clearly more for the convenience of the home than for a public health reason. My amendment simply asks the CQC to go back to receiving and dealing with individual complaints in these cases. I hope that the Minister will perhaps be sympathetic to this. I beg to move.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely; I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, the noble Lord, Lord Hunt, introduced his Amendment 144B on complaints about care services very well. He is absolutely right: this is a muddle. Are people to go to the CQC or to a particular home when they wish to make a complaint? Any complaints system where the person making the complaint feels in a less strong position than the organisation to which they are complaining, or indeed—sometimes they might even put this strongly—which is wielding power over them is a complaints system that will not work. I hope that the Minister will understand this, and will respond and ensure, first, that there is a clear and understood system, and, secondly, that if some funding needs to be restored to the CQC to take us back to where we were, that will happen.

I want to speak particularly to two of the issues covered in this wide-ranging group of amendments: the licensing of cosmetic procedures and medical practitioners’ financial and non-pecuniary interests. I also have sympathy for the other two, on registration of social workers and hospital rehabilitation accommodation.

The amendments laid by the Minister, beginning with 153A, on the licensing of cosmetic procedures by local authorities and, indeed, Amendment 169 in the name of the noble Baroness, Lady Finlay, on cosmetic procedures, which I have signed, set out models for registration for those who work using devices that breach the skin and who are not covered by medical registration or, currently, by any effective regulation. I know that considerable discussions have taken place between Committee and Report, and it is welcome that the Government have felt that they can now lay their own amendments, signed by the noble Baroness, Lady Merron, and the noble Lord, Lord Lansley. I look forward to hearing the comments of the noble Baroness, Lady Finlay, on those amendments.

Amendment 184ZBB in the name of the noble Baroness, Lady Cumberlege, which I have signed, brings us back to the debate on medical practitioners’ financial and non-pecuniary interests. Our debate in Committee highlighted the problem that the financial and non-pecuniary interests arrangements do not match those that many others in the public sector have to make, where the registration body holds the information. The GMC has said once again that it does not particularly like the style of this amendment and would prefer the records to be held directly by the employer. However, I believe the argument that the registration body, which also has the power to take action, should be the place where these are kept.

I hope that, regardless of whether a vote is called, the Minister will take this away and look at it in more detail. We need an open, transparent and clear system of registration of financial and non-pecuniary interests.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely; I invite her to speak.

[Baroness Masham of Ilton (CB) [V]]

My Lords, I will speak to Amendments 169 and 181. I have my name down for Amendment 169 on the licencing of cosmetic procedures. During the passage of this Bill, I have had my eyes opened to just how enormous this industry is and how a great many people are putting themselves at huge risk. I have heard of some disturbing cases in which procedures with collagen have gone wrong. At a conference about plastic surgery and cosmetic procedures, one-third of the attendees were from the plastic surgery field and two-thirds from cosmetic procedures, which shows how popular this is becoming.

All Members of your Lordships’ House taking part in these amendments share the desire that these procedures should be registered and safe. I am very pleased that the noble Lord, Lord Kamall, has accepted that this matter needs addressing and making safe. I thank him and his team for the hard work that they must have gone through in producing these amendments.

Amendment 181 is a very practical and important amendment, which I could not resist supporting and speaking to. It would reduce bed-blocking—a most unfortunate problem for a busy hospital that needs all its acute beds for ill patients, and frustrating for patients who still need rehabilitation but not in acute beds. These patients cannot go home because their accommodation is not suitable for their needs; for example, they might have to use a wheelchair and they need time to get organised. One of the problems is the time that it takes to get necessary adaptations completed. Housing authorities and social services need to work together with health authorities. If suitable rehabilitation accommodation is available, it can also be used for patients who need specialised treatment that is a long distance from their home. St James’s hospital in Leeds has a hotel for such patients, and incorporated into the hospital is a Marks & Spencer food shop; this is a very valuable service. I hope that the Minister will agree that these provisions should be available throughout the country.

Health and Care Bill

Baroness Henig Excerpts

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

[Lord Blencathra (Con)]

My Lords—

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, we come to Amendment 213A. I inform the House that the noble Baronesses, Lady Brinton and Lady Harris of Richmond, will be taking part remotely.

Amendment 213A

Moved by

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[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, the noble Lord, Lord Blencathra, has outlined why there is an urgent need to address the NHS procurement rules in the light of possible genocide and other clear human rights abuses. We have a duty as a nation and as a society to ensure that goods used in our publicly owned NHS are not tainted with modern slavery or linked with behaviours that may lead to genocide.

This is not hypothetical. In November 2020, the noble Lord, Lord Alton—who I look forward to hearing speak shortly—asked the noble Lord, Lord Bethell, the then Health Minister, about Medwell Medical Products, which has a factory in Fenglin town, in Jiangxi province, noting that Uighur Muslims made up 25% of the workforce, despite being forced to live in separate accommodation from other workers. This was reported at the time by the excellent investigative paper, Byline Times. At the time, the noble Lord, Lord Bethel, said that the Government had not entered into an agreement directly with Medwell but that the central distribution warehouse in Daventry did have a record of receiving PPE masks produced by Medwell Medical Products. A spokesman for the Department of Health and Social Care said to Byline Times:

“We expect all suppliers to the NHS to follow the highest legal and ethical standards and proper due diligence is carried out for all Government contracts.”


This is an extraordinary response. Any contractor to the Government, even in an emergency such as a pandemic, must follow the commitments that the Government have given internationally to ensure that goods used by the publicly owned NHS are not tainted with human rights abuses. If companies such as Marks & Spencer can do it for their clothes supply chain, we can too.

In July 2020, the New York Times reported that Uighur Muslims—a minority subject to widespread persecution in China, including being put into detention camps where they are forced to undergo communist indoctrination—were being employed in the factories of medical suppliers under a specific Chinese Government labour programme. The Speaker of the US House of Representatives said at the time:

“We must shine a light on the inhumane practice of forced labor, hold the perpetrators accountable and stop this exploitation. And we must send a clear message to Beijing: these abuses must end now.”


As the noble Lord, Lord Blencathra, said, just over a year afterwards, in December 2021, the Americans passed the Uyghur Forced Labor Prevention Act into federal law.

UK Health Ministers’ responses in 2020 were, perhaps typically of this Government, aimed at prevarication and deflecting responsibility. This amendment does exactly what the noble Lord, Lord Blencathra, said, and what any self-respecting Government should do. It makes it absolutely plain that procurement must be

“consistent with the United Kingdom's obligations under the Convention on the Prevention and Punishment of the Crime of Genocide”,

and that

“procurement is not consistent if a Minister of the Crown has assessed that there is a serious risk of genocide in the sourcing region.”

The amendment also sets out conditions under which the risk should be investigated if the chair of a relevant Select Committee of either House of Parliament requests an assessment.

The amendment is very straightforward and clear. Perhaps the Minister can explain which parts of it he has problems with. It actually helps the Government, especially after the discoveries of the PPE provided by Medwell Medical Products and the supply chain—we suspect there are many other such companies as well. If the Minister is not minded to accept the amendment, can he explain to the House how NHS procurement can be protected from these human rights breaches, including possible genocide, in the future, and what guarantees there are that the department sees the supply chain details? I hope he will also agree to a meeting with the speakers in the debate on this amendment.

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Harris of Richmond, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Harris of Richmond (LD) [V]]

My Lords, the noble Lord, Lord Blencathra, has explained that Amendment 213A is an important statement of intent, if put in the Bill, by Parliament and the Government that, on behalf of the people of this country, we will take all the steps that we can to prevent procurement of goods made in places where there is evidence of likely genocide and where human rights abuses and modern slavery are thereby inevitable.

My noble friend Lady Brinton has just explained the problem of the sourcing of PPE from China and from companies that may be using Uighurs’ enforced labour. This is extremely worrying. Given that the Government have previously ignored an amendment passed in your Lordships’ House in the Trade Act 2021, despite rising international concerns about genocide against the Uighurs, it is vital that we remember the duty placed on nation states to use a deterrent effect.

In its judgment of 26 February 2007, in Bosnia and Herzegovina v Serbia and Montenegro, concerning the application of the Convention on the Prevention and Punishment of the Crime of Genocide, the International Court of Justice found at paragraph 431 that the duty to prevent arises

“at the instant that the State learns of, or should normally have learned of, the existence of a serious risk that genocide will be committed”,

as the noble Lord, Lord Blencathra, stated. The judgment continues:

“From that moment onwards, if the State has available to it means likely to have a deterrent effect on those suspected of preparing genocide, or reasonably suspected of harbouring specific intent … it is under a duty to make such use of these means as the circumstances permit.”


This amendment echoes that judgment by saying that all endeavours must be made to prevent and deter the procurement of goods from an area where genocide is suspected.

I am also concerned about legislation on slavery, also a scourge of our times, and hope that the Government will not rely on it as a possible alternative. As we have heard, the Modern Slavery Act 2015 merely requires companies with a turnover of £36 million or more to produce a modern slavery statement. The legislation does not prevent companies, or the Government themselves, procuring slave-made goods. The Foreign Prison-Made Goods Act 1897 makes some procurement illegal in certain narrow circumstances, but it is very old legislation and now considered largely defunct. I am grateful to a number of NGOs for their excellent briefings on this subject.

The former Foreign Secretary, Dominic Raab, said that torture “on an industrial scale” was being carried out in Xinjiang, even though his Government decided not to take action by creating import controls for Xinjiang. This Health and Care Bill offers the opportunity to return to the issue and to improve DHSC procurement policy.

Health and Care Bill

Baroness Henig Excerpts

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Crisp (CB)]

My Lords, my five amendments to Clause 54 follow on quite closely from the discussions we have just been having about direction. I am very grateful to the noble Baronesses, Lady Walmsley and Lady Morgan of Huyton, and my noble friend Lady Neuberger for their support for these amendments.

The Bill introduces a new power for NHS England to set capital spending limits for NHS foundation trusts. There are two points of context that are worth exploring here. First, obviously the Bill is all about integration, partnership and collective action, within which individual parties need to retain some autonomy as well as giving out more, or perhaps pooling, some sovereignty at the local level. We should also be aware that at the national level NHS foundation trusts’ capital comes within the overall capital allocated by Parliament, and so recognise that, at the end of the day, there needs to be some kind of reserve, backstop power to set foundation trusts’ capital limits.

It is all about achieving the right balance. I understand that three years ago, as part of the thinking behind these wider changes in the NHS when they were being developed, NHS England and NHS Improvement agreed with foundation trusts a set of proposals for this that were set out in the NHS’s 2019 legislation proposals. I am sure my noble friend Lord Stevens of Birmingham can comment on that as appropriate. This clause cuts right through these agreements.

My explanatory statement makes the terribly simple point that what I am trying to do here is to

“seek to deliver the legislative proposals agreed with NHS England and NHS Improvement in 2019.”

I do not see why that is not happening. So, my first question to the Minister is: please could he explain what has changed since 2019 and why the agreement that was struck then is no longer good enough for the current circumstances?

Secondly, these capital freedoms are important. NHS foundation trusts need to be able to invest in order to deliver their services. They need to be able to do so for their boards to be able to exercise their own accountability, and they need to be able to plan. There is also a slightly softer reason why these are important as well, which is about motivation. It is very clear that working efficiently to generate capital to create that freedom is a significant motivator for clinicians within these trusts. I say that as somebody who led two trusts—not foundation trusts—into trust status in the 1990s, and I know how big an issue that is in terms of the staff within these organisations.

So, against that background, these directions should be exceptional and not the rule, and these amendments set out quite clearly ways to make this work in practice. Amendment 188 states that any direction must be about an individual trust and for a specific region and not in any sense a blanket action. Amendment 189 says that it should be used only after all other means of managing a capital expenditure problem have been exhausted; it must be very much a last resort. Amendment 190 says that NHS England should account to Parliament for the action, giving the reasons—telling the story, if you like—and publishing them so that they can be seen very clearly. Amendment 191 makes it clear that any directions should cease after one year, and Amendment 192 is more minor tidying-up. This is a very clear set of amendments which would put in place the 2019 agreement. I see no reason why that should have changed.

I have three questions for the Minister. First, why is this a change from that agreement? What has changed? Why can we not just have that agreement? Secondly, does the Minister agree that this must be very much a last resort, and therefore needs to be hedged round with these sorts of amendments? Thirdly, will the Minister ask his officials to look at this again, perhaps with the involvement of representatives of NHS foundation trusts and NHS Providers, as indeed happened in 2019? I beg to move.

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, the amendments in this group, so ably introduced by the noble Lord, Lord Crisp, aim to restrict the powers of the Secretary of State to limit the capital spending of NHS foundation trusts and to ask for the reinstatement of the 2019 agreement. It is important to note that these amendments do not remove the powers as a whole but tighten them to avoid changes by the Secretary of State to funding that would delay capital works which are needed and urgent on health and safety grounds.

Covid-19 Vaccinations

Baroness Henig Excerpts

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for that point. I think noble Lords agree that it is really important that we make sure that we vaccinate as much of the world as possible. There is no point in us being vaccinated if we then travel to areas in the rest of the world where people are exposed. We are co-operating on a number of international programmes, including COVAX and others. One of my portfolio roles in the department is on international agreements and liaison. I have been speaking to a number of Health Ministers from a number of different countries about how we can help more. I have also been talking to some of the suppliers of the vaccines about how we can make sure that, where we do not order domestically, we can redirect some of those orders for international help. I completely agree with the sentiment of the question from the noble Lord that it is really important that we play our part in helping the international community.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, there are four remote speakers. I shall now call the second of them, the noble Baroness, Lady Harris of Richmond.

[Baroness Harris of Richmond (LD) [V]]

My Lords, I very much share the concern of the noble Lord, Lord Pannick. My doctor has recorded my booster jab—at least, I think it is my booster jab; it may be a third primary jab, I do not know—so I just want to know when it is going to appear on the NHS app. Because I was told quite specifically when I was jabbed that it would.

--- Later in debate ---

[Lord Kamall (Con)]

I am afraid I am going to have to repeat the answer I gave earlier to the noble Lord. We were made aware of this only today and as soon as I heard, I got hold of NHSX and asked what was happening because, clearly, a number of people are experiencing the same issue. We have chased NHSX and I hope that NHSX will fix it as soon as possible. If it does not, please chase me up.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely and I invite her to speak.

[Baroness Masham of Ilton (CB) [V]]

My Lords, what is the situation with vaccination against coronavirus for inmates and staff in UK prisons? Prisoners often get transferred to other prisons and they move in and out when released and recalled. Many live chaotic lives, but it is important that they all get vaccinated. Is there a system to see that this process is safeguarded, so that jabs are fully completed? Prison health must not be forgotten.

[Lord Kamall (Con)]

The noble Baroness raises a very important point. As far I am aware—I will confirm this—the population of prisons is being treated the same as the wider population in terms of encouragement to take the vaccines and the booster. I will double-check and write to the noble Baroness.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Thomas of Winchester, is taking part remotely and I invite her to speak.

[Baroness Thomas of Winchester (LD) [V]]

My Lords, will the Minister look into booster vaccines for vulnerable people such as me who need to be vaccinated at home? There is never any information about this cohort of people who are at the mercy of there being a healthcare professional from a local surgery available. There is a danger that they may be overlooked by surgeries, some of which might be overwhelmed at this time.

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[Lord Kamall (Con)]

The Government welcome advice from a range of stakeholders and have listened to SAGE and others throughout to balance their different views. In fact, I remember that when Jeremy Farrar was resigning he insisted that his departure should not be interpreted as a fresh disagreement with the Government. The Government listen to a range of views and balance them all.

[The Deputy Speaker (Baroness Henig) (Lab)]

The time for Back-Bench questions has now elapsed.

Covid-19 Update

Baroness Henig Excerpts

Tuesday 6th July 2021 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

We now come to the 30 minutes allocated to Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers.

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[Lord Bethell (Con)]

My Lords, I hear my noble friend’s words loud and clear. The Government have indicated that we will leave it to those who run the transport systems themselves and to local politicians. There is a good case for a degree of devolvement and subsidiarity in this matter. He is right that masks do perform an important role, but they are not a catch-all, and it is therefore reasonable to leave those who run the transport systems to make decisions for themselves.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the time for Back-Bench questions has now elapsed.

Alcohol Harm Commission: Report 2020

Baroness Henig Excerpts

Thursday 22nd April 2021 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

That is a tremendous challenge by the noble Baroness. I will do my best, but before I do, I congratulate the noble Baroness, Lady Finlay, on securing this important debate. I commend her on her commitment to reducing alcohol-related harm and I pay tribute to her and her team for spearheading the excellent report of the Commission on Alcohol Harm. I welcome the report’s recommendations and the opportunity to debate them. Before I make progress, I shall make a disclosure that my wife is a director of the company Diageo.

I acknowledge the report’s emphasis on wanting to change the conversation within society about alcohol and challenge alcohol’s position in our culture. Alcohol is not something which affects only the “weak” or “irresponsible”. It affects many people. We know that most people drink responsibly. I take on board the warnings of the noble Lord, Lord Smith, and the noble Baroness, Lady Fox, that we must be careful about overstating the specific dangers of alcohol or demonising those who drink responsibly. There is some good news in this area: we are seeing an overall decrease in the amount of people drinking, especially young people, which is highly encouraging. But we cannot avoid the fact that there are still those who drink at very harmful levels and where alcohol misuse leads to significant harms for the people involved and their families. I speak as one whose mother died of her alcoholism when I was of a young age, and I know from personal experience the huge impact that alcoholism has on those concerned and their families.

We recognise that there is still much work to be done. I completely agree with the rapporteurs that alcohol has large impacts on society that include costs to health, lost productivity and poor quality of life. Excessive alcohol consumption is the biggest risk factor attributable to early mortality, ill health and disability among 15 to 49-year olds in the UK—full stop. It is considered to be the third-largest lifestyle risk factor for preventable diseases in the UK, after smoking and obesity.

The Government are committed to supporting the most vulnerable at risk from alcohol misuse. We have an existing agenda on tackling health harms from alcohol, and I would like to touch on some of that today.

I completely hear the call of the noble Baroness, Lady Finlay, for a new government alcohol strategy. The Government have committed to publishing a new UK-wide, cross-government addiction strategy. This will consider a range of issues, including drugs, alcohol and problem gambling and will involve many departments at the same time. While each comes with its own set of issues, there are large amounts of common ground and significant benefits in tackling addiction in a comprehensive and joined-up way. The scope of this addiction strategy is still being developed, so this debate is most timely as we consider what more can be done to protect people from alcohol-related harms.

On alcohol labelling, the Government completely agree with the noble Baroness, Lady Randerson, that people have a right to accurate information and clear advice about alcohol and its health risks to help them to make informed choices. We have worked with the alcohol industry to ensure that alcohol labels reflect the UK Chief Medical Officer’s low-risk drinking guidelines. The industry has committed to complying with this requirement, and we are closely monitoring progress. As part of the Government’s latest obesity strategy, we committed to consulting on the introduction of mandatory calorie labelling on pre-packed alcohol and alcohol sold in the on-trade sector. This consultation will be launched this summer.

My noble friend Lady Jenkin raised the shocking statistic on alcohol-related violence, and I completely agree with her analysis. It is shocking to me that between 2016 and 2018 alcohol was a factor in 66% of violent incidents that took place in the street, pub or club and on public transport; this compares with 30% of violent incidents in the home. Between 2017 and 2019, one in five homicide suspects is recorded as being under the influence of alcohol at the time of the homicide, as is a similar proportion of victims. I have a deep wad of statistics that make extremely grim reading on this matter.

On the specific issue of domestic abuse, we are making progress. We know there is frequent co-existence of domestic abuse, mental health problems and the misuse of drugs and alcohol. Research indicates that in 34% of incidents of domestic violence, the victim perceived the offender to be under the influence of alcohol. The Domestic Abuse Bill will see better protections for victims and more effective measures to go after the perpetrators. We will reflect the importance of joining up domestic abuse, mental health and substance misuse services in the supporting statutory guidance. One action of this important Bill is to establish in law the office of the domestic abuse commissioner, with strong powers to tackle domestic abuse. The description of the commissioner’s role states that they must adopt a specific focus on the needs of victims from groups with particular needs, which could include mental health or substance misuse.

My noble friend Lord Ribeiro asked about restrictions on alcohol advertising. I remind him that there are already substantial restrictions on the advertising of alcohol, but we are working to review and improve them. The Government are working with industry to address concerns over irresponsible promotions, advertising and marketing relating to alcohol. Material in the Committee of Advertising Practice and Broadcast Committee of Advertising Practice codes relating to the advertising and marketing of alcohol products is extremely robust already, recognising the social imperative of ensuring that alcohol advertising is responsible and, in particular, that children and young people are protected. None the less, the Government are reviewing how online advertising is regulated in the UK, taking into account the many serious points made by my noble friend Lord Ribeiro and looking at how well the current regime is equipped to tackle the challenges posed by the development of online advertising.

The noble Baroness, Lady Masham, spoke so movingly about children and family life. The evidence is absolutely clear that growing up in a family affected by parental alcohol dependency can cause significant harm to children’s well-being and their long-term outcomes. Thanks to the personal testimony and campaigning of many noble Lords in the Grand Committee today, the Department of Health and Social Care and the Department for Work and Pensions have together invested £6.5 million on a package of measures, over three years, to improve outcomes and support for children whose parents are alcohol-dependent.

The noble Lord, Lord Rennard, asked pressingly on minimum unit pricing. There are no current plans to implement MUP in England. MUP has been in place in Scotland for less than three years and the Scottish Parliament will not consider its extension until April 2024, when much more will be known about the overall impact on consumption. We will continue to monitor the evidence as it emerges from Scotland and Wales. In the meantime, we are committed to reducing alcohol-related harm and so have already banned alcohol sales below the level of duty plus VAT. This means it will no longer be legal to sell a can of ordinary lager for less than 40p.

I close by reiterating the Government’s commitment to supporting the most vulnerable at risk from alcohol misuse. We already have a strong programme of work under way to address alcohol-related harms, and the new UK addiction strategy will provide an important opportunity to consider what more can be done. This activity will be informed by the best available evidence, including the report from the noble Baroness, Lady Finlay. I thank her very much for pushing so hard on this important issue and securing such a thoughtful, interesting and passionate debate today, and I thank all noble Lords who have taken part.

[The Deputy Chairman of Committees (Baroness Henig) (Lab)]

My Lords, the Grand Committee now stands adjourned until 4.30 pm. I remind Members to sanitise their desks and chairs before leaving the Room.

Covid-19

Baroness Henig Excerpts

Thursday 11th February 2021 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, I am enormously grateful for the questions from the two noble Baronesses. By way of introduction, both the noble Baronesses are entirely right that the variants of concern have been a massive game-changer and the reason for this profound inflection point in our approach to border control. Having invested so much in vaccine deployment, having got it right so emphatically, having been ahead of the world in the identification, development, purchase and now deployment of vaccines, and having got so many people who were at threat of sickness and death into a position of safety, it seems entirely right that we now protect the country from mutations that might escape the vaccine by taking tough measures on the border.

That is different from the situation of a year ago: we had comparable infection rates and were all facing the same virus, which did not seem to mutate for months on end. At that point, the priority was to keep our borders open in order to keep the flow of goods, medicines and essential supplies in the planes, trains and boats that are necessary to support Great Britain. But the variants of concern have completely changed that view. That is why we brought in this new, robust and emphatic regime. It depends, in very large part, on existing legislation, but I reassure noble Lords that our plans are to bring in new regulations, where necessary, at the earliest moment. I hope that that will be very soon.

The noble Baroness, Lady Thornton, asked about international surveillance. That is an important part of our overall plan. In Britain, as noble Lords know, we have the most advanced investment in genomic sequencing anywhere in the world, by far. We are hugely investing in a great dash on capacity, turnaround times, accuracy and the geographic distribution of that surveillance in the UK. But we are also investing in international systems. We have made an open-hearted, big and generous offer to the countries of the world to do genomic sequencing for them, wherever necessary. If anyone wants to send their specimens to the UK, to the Sanger at Cambridge, we will do that for them. We are sending machines, often from Oxford Nanopore, the British diagnostic company, to diagnostic centres in countries that have some genomic capability, to enhance their testing and speed up their turnaround times.

The noble Baroness, Lady Thornton, asked about the enhanced measures we are putting in place to check when people arrive in the UK. I can reassure her massively, because the system for the passenger landing form has been digitised and hugely enhanced. We have dramatically increased the amount of validation of the data put into the PLF. The pretesting certificates are linked directly to the PLF, and we are working on linking it to the hotel booking and testing forms. We are also putting in enhanced surveillance of those isolating at home, which includes phone calls, SMSs and an increased investment in police time to follow up where there may be suspicion of a breach. We are also making a crystal-clear communication to those who have access to private jet travel that we will not tolerate those who have the resources to pay the fines but feel that they can, or want to, get around these measures.

The application of the hotel quarantine measures to all countries—both red list and amber—is something that we keep under review. There is a rolling review of the red list, and we are putting in place the necessary infrastructure, should it be required, for a blanket hotel quarantine protocol on all travellers to the UK.

The noble Baroness, Lady Brinton, kind of answered the question on the number of hotels, for which I am enormously grateful. We have currently booked 16 hotels with 4,600 rooms. However, I reassure her that this is an on-call framework, and we will have access to a massively increased number of hotel rooms if that should prove necessary.

But I have to be clear: the signal from the British Government and the instruction from the Home Office and the Department of Health and Social Care is that there should be no need to travel other than under the most exceptional circumstances. We are not trying to encourage anyone to travel, and we expect the number of people travelling to and from the UK to remain at a low level for the foreseeable future. For those who are currently overseas and seek to return but are experiencing some hardship because they were not expecting, did not plan for and cannot afford the considerable cost of the hotel quarantine, we will publish schemes to spread the payment of that to help people out.

Regarding the legislation, the noble Baroness, Lady Thornton, made a big point of saying that a sentence of 10 years was too long for a breach of contract. I remind her that Section 1 of the Fraud Act 2006 creates a general offence of fraud and introduces a number of ways of committing it, including fraud by false representation and fraud by failure to disclose information. Committing fraud is a very serious offence. Not everyone who commits their first fraud will get a custodial sentence, but if people repeatedly breach these restrictions or put the lives of others at risk, it will be up to either the magistrates’ court or, ultimately, the Crown Court to decide on the sentence. The maximum sentence is 10 years and it is quite right that it should be. The noble Baroness, Lady Brinton, made a very good point when she referred to Taiwan, which I shall mention in a moment.

The noble Baroness, Lady Brinton, asked about the data flows on undocumented migrants and the temporary amnesty. I reassure her that it is absolutely our intention to get everyone in the UK vaccinated, whatever their status. We are completely status blind when it comes to distribution of the vaccine, but we need to know who you are before we inject you with drugs—that is a basic clinical need and one that we cannot avoid.

She asked specific questions about the flow of data and whether this would be a temporary amnesty or would last longer. I do not have access to the precise answer to that question but am happy to commit to write to her on that important point.

The noble Baroness asked about prisons. She is entirely right to be concerned. We have had a terrific track record on protecting prisoners from this disease over the year, but she is right that in recent weeks epidemics have emerged in prisons. We are working incredibly hard to deploy a very large amount of testing and, where necessary, implementing isolation, and the vaccine has been rolled out to those who are qualified.

Turning to Sitel managers, I assure the noble Baroness, Lady Brinton, that we are enormously thankful to all those who have contributed to the tracing operation. We balance the workload between a variety of providers, and Sitel is just one of several that we have. There is no question of our backing off from our tracing operations—quite the opposite. Test, trace and isolate remains an important part of our armoury and it only increases. In recent times, we have doubled up on our commitment to the Lighthouse labs, which have proved cost-effective, accurate and fast. The genomics turnaround in tracking variants of concern has been remarkably efficient. On tracing and VOCs, Project Eagle is working extremely well and I saw incredibly impressive numbers on that this morning. Pharmacovigilance around the vaccine is being supported by test and trace, and the creation of the NIHP is apace.

Finally, the noble Baroness, Lady Brinton, mentioned Taiwan. Given that I am married to a Taiwanese wife, I can absolutely bear testimony to the remarkable achievement of that island nation. Taiwan was hard hit in 2003 by SARS, a time I remember well, since my Christmas was cancelled. It learned the lesson and applied important measures. The island has the advantage of social cohesion, but both the stick and the carrot were thoughtfully used, as the noble Baroness rightly pointed out. It created a green list country with a remarkably low level of infection and death, and that is a lesson we can all learn from.

The public are doing their duty and absolutely understand the threat of variants of concern. It is incredibly impressive and I am optimistic for the future.

[The Deputy Speaker (Baroness Henig) (Lab)]

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers.

Vaccine Rollout

Baroness Henig Excerpts

Monday 25th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the JCVI looked at this very question in great detail. It is very conscious of discrimination, but its focus is on morbidity. Its judgment, which I entirely back, is that age, more than anything else, is the driver of morbidity. That is why the prioritisation is structured in the way that it is. Those who are CEV are also prioritised. Many of those who are most vulnerable and who also have learning difficulties will qualify under the CEV threshold. However, I have passed her arithmetic to the vaccine taskforce. She makes a very good point that those with learning difficulties and autism have a different life profile and die at an earlier age. I have asked the system to ensure that this arithmetic has been considered in the prioritisation list. I will be glad to reply to her when I have the answer.

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the time allowed for this Question has elapsed.

Medicines and Medical Devices Bill

Baroness Henig Excerpts

Report stage & Report stage (Hansard): House of Lords & Report: 1st sitting & Report: 1st sitting: House of Lords
Tuesday 12th January 2021 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

We now come to the group beginning with Amendment 4. I remind noble Lords that Members other than the mover and the Minister may speak only once and that short questions of elucidation are discouraged. Anyone wishing to press this or anything else in this group to a Division must make that clear in the debate.

Amendment 4

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