Health and Care Bill

Baroness Masham of Ilton Excerpts

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

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

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

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

My Lords, many people are fearful and dismayed about the disastrous, inhuman situation in Ukraine. The threat of a nuclear attack and a third world war frightens many people. Added to this, many disabled and elderly people here in the UK are also frightened. Many vulnerable people feel that, if the assisted dying law is changed, they could be pressured into assisted dying because they feel that they are a nuisance and because they need looking after. Whatever the noble Lord, Lord Forsyth, says, this Bill should be about care, not killing. There should be compassion and palliative care for all those people who need it.

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

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

Health and Care Bill

Baroness Masham of Ilton Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

[The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)]

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, I support all these amendments but will speak to Amendments 276 and 277, to which my name is attached, requiring health warnings on cigarettes and inserts in cigarette packs containing quitting advice.

My father used to smoke, as very many people did in the war. At the age of 52, he died of coronary thrombosis; I always felt that smoking caused his death. In addition, one of my best friends who smoked died early. At this very time, my housekeeper is in St James’s University Hospital in Leeds receiving treatment for cancer. The other day, she scolded herself for having smoked. Smoking causes serious disability as well as premature death; far too many people have died because of smoking.

I strongly support the Government’s Smokefree 2030 ambition. The measures in the amendments will help put us on track; they are well-evidenced, cheap to implement and easy to enforce. Health warnings on cigarette packs have progressively increased in size over time and, most recently, their impact has been enhanced by the removal of colourful banding. Warnings on cigarettes is the logical next step, and it will have particular impact in preventing children and young people starting to smoke. Hundreds of children start smoking every day in the UK. Children are much more likely to have access to individual cigarettes than full packs, meaning that warnings on cigarettes are likely to be particularly effective in preventing youth uptake. This measure has strong public support. Adding health warnings to cigarettes and cigarette papers is a simple measure with minimal cost which would help deliver the Government’s Smokefree 2030 ambition.

Amendment 277 would give the Government powers to require that health information messages be inserted in cigarette packs. This is not a novel idea; it has been a legal requirement in Canada since 2000. They are proven to work, and there is already good evidence from Canada on which messages are most effective. If the Government could give an assurance today regarding the increased use of health warning inserts—they already have the power to do this—these amendments might not be necessary and we could save time on Report. If not, Amendments 276 and 277, which are by no means the only measures needed to address this terrible addiction, would be a small and significant step in the right direction. I commend them to the Committee.

[Lord Young of Cookham (Con)]

My Lords, it is a pleasure to follow the noble Baroness, Lady Masham, who spoke in favour of Amendment 276, which replicates a Private Member’s Bill I am endeavouring to pilot through Parliament; we will see which of us has the fastest track towards the statute book. It is also a pleasure to follow the noble Lord, Lord Faulkner, who has campaigned against the damage done by tobacco for as long as I have known him, and I agree with every word he said.

I will speak to Amendments 272 to 275, which are in my name but supported by all parties. They apply the polluter pays principle to tobacco manufacturers. In view of the lateness of the hour, I will curtail my remarks as much as I can. The principle that the polluter should pay has been accepted by Conservative Governments for over 30 years, starting with the landfill levy to promote recycling, running through the sugar tax on soft drinks to tackle obesity, and referred to only on Wednesday this week by my noble friend Lord Greenhalgh in the debate on building safety, advocating a levy on the construction industry to finance remediation.

Health and Care Bill

Baroness Masham of Ilton Excerpts

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

[The Deputy Chairman of Committees (Baroness McIntosh of Hudnall) (Lab)]

I call the noble Baroness, Lady Masham of Ilton.

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

My Lords, I shall speak to Amendments 178, 266 and 293. Amendment 178, which was tabled by the noble Lord, Lord Sharkey, is important for people with rare and less common diseases. The amendments could be a lifeline for people who have rare conditions who use products that may be the only substances that work. There is an enormous selection of rare conditions. It can be a desperate situation when some medicines are developed but take a long time to be given the all-clear by NICE. Some medicines are not available in England on the National Health Service but are available in other countries, sometimes even in Scotland. That is devastating and frustrating.

I support Amendments 266 and 293, on the cosmetic surgery industry, which must be made safer. It is extraordinary that this business is only partially registered. Many people who have such a procedure take for granted that the practitioner will be registered and fully insured. There have been some disastrous results when things go wrong with a beauty procedure. I know of some plastic surgeons who work only in the National Health Service, as they do not want to be tarred with the same brush as uninsured cowboys. Amendments 266 and 293 deal with a wide selection of cosmetic procedures, some of which are psychologically important to many people. There is wide interest in making this trade safe and getting it registered. I hope the Minister realises that this is an important matter that needs putting right.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I have Amendment 176, the second amendment in this group, and two other amendments. I shall start with Amendment 176 which is concerned with the treatment of thyroid patients who continue to be denied liothyronine, otherwise known as T3, as the most appropriate treatment for them. For some patients, the standard treatment is not effective. T3 has proven to be a much better treatment, but tragically, a few years ago the manufacturers grossly inflated the cost of T3 by a massive 6,000%. Understandably, NHS England and its associated prescribing advising machinery strongly discouraged the use of the drug and, as a result, many patients had T3 withdrawn and suffered quite considerably or had to fund it privately or source it from abroad. Happily, the price of T3 has come down by 75%, although it could go down further, but I believe it is no longer categorised as a high-cost drug.

The problem is that clinical commissioning groups still treat it as a high-cost drug, so the situation is still very difficult for patients who need it—those for whom the standard treatment is not appropriate. The current guidance states that T3 can be prescribed to patients who have unresolved symptoms on the standard treatment if it is initiated or confirmed following a review by an NHS consultant endocrinologist. A statement in July 2021 restated NHSE guidance, but it has not been followed by clinical commissioning groups. A survey done recently by UK thyroid charities, to which I pay huge tribute, says that 44% of CCGs have not fully adopted the national guidelines or are wrongly interpreting them.

What are we to do? What is the situation here, where we have clear guidance that is not being followed? This goes back to our previous debates about the various mechanisms being brought in to ration treatments, against national guidance or technology appraisal advice from NICE. It is the same issue. I am not expecting the Minister to issue a direction but I am expecting him to tell CCGs and, in future, integrated care boards to get off their backsides, start implementing the guidance properly and realise that this is no longer such a high-cost drug. I appeal to him to do something about that.

I also hope that the Minister will do something about hospital catering. I confess to your Lordships that I am president of the Hospital Caterers Association, where I work very closely with some great professional staff who have to work with their hands tied behind their back. Often they do not have the resources to provide the high-quality food that everyone wants and expects.

During Covid we saw in many local NHS facilities a determination to do everything possible to improve nutrition for both patients and staff. Miraculously, hot food was made available to staff overnight, which, as noble Lords know, seems to have been beyond the capacity of the NHS for many years. I do not know why I am looking at the former Chief Nursing Officer as I say this; I think it is an appeal for support.

This clause is highly welcome as I believe it will lead to higher standards, but my amendments would enable the caterers to deliver on them. The first key point is this: they need the resources to be able to do it. The amount of money spent on hospital food per day at the moment is simply not sufficient. Secondly, we need more training for staff. The training programmes have disappeared, and we need to get them back in to give staff the opportunity to show what they can do. Thirdly, we need to make sure that NHS trusts and foundation trusts are fully on board with bringing forward these regulations. There is no doubt that the efficiency programmes have taken their toll on the budgets for hospital catering and that, equally, the old-style national training schemes fell away and have not been replaced. The pay grade of qualified chefs and cooks needs to be reviewed to reflect the importance of their role. This issue is important in terms of the standards of food and nutrition for our patients and for the well-being of our staff.

My final amendment in this group is Amendment 264. What links all these amendments is that we need more consultants appointed—a small effort to enable us to improve the efficiency of the system. I remind the Committee of my GMC connections in relation to this. The amendment would add the Royal College of Surgeons of Edinburgh and the Royal College of Physicians and Surgeons of Glasgow, and their associated dental faculties, to the colleges that may be involved in the appointment of NHS consultants. My amendment was inspired by the Royal College of Surgeons of Edinburgh, which noble Lords might be surprised to learn has an office in Birmingham because many consultants who work in the English NHS are members of the Scottish colleges.

There seems to be a lacuna in the current regulations. According to the National Health Service (Appointment of Consultants) Regulations 1996 and subsequent guidance issued by the department in 2005, only the Royal College of Surgeons in England is permitted to review surgical consultant job descriptions and send a royal college representative to the advisory appointment committees when it comes to the appointment of consultant surgeons. Other elements of my amendment apply to the appointment of physician clinicians, and the Royal College of Physicians of Edinburgh and the Royal College of Emergency Medicine are also supportive. Although the process and guidance apply only to NHS trusts, foundation trusts are encouraged to follow it.

The Minister has yet to accept any amendment to the Bill. The usual line from the Government is, “We will do this when legislation is available to do so.” Here is a great opportunity for the Minister, as we are here on day 6 of Committee, to get up and say that he is going to accept my amendment.

Health and Care Bill

Baroness Masham of Ilton Excerpts

Lords Hansard - Part 2 & Committee stage
Tuesday 18th January 2022 Lords Chamber

[The Deputy Chairman of Committees (Baroness Fookes) (Con)]

The noble Baroness, Lady Masham, is now able to speak and I invite her to do so.

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

My Lords, I am pleased to see that the noble Lord, Lord Hunt of Kings Heath, is taking part today. He has been involved in a family emergency, which shows how important grandparents are in the care of children.

I have added my name to some of the amendments in this group but support them all. The Bill will be improved if the patient voice is included in both the integrated care boards and integrated care partnerships by Healthwatch, which could collect data from different sources representing patients. There should be co-operation and working together throughout the NHS, co-operation with the CQC and better integration throughout so that standards are kept high across the country.

The recent report, chaired by the noble Baroness, Lady Cumberlege, First Do No Harm, also demonstrates how important the patient’s voice is. As Healthwatch is spread so thinly at the moment across England, it will have to be bolstered so that it can do the job. The Bill should set clearer expectations for local systems on the need to use the views and experiences of their local communities to inform decisions. The aim is to establish Healthwatch as an independent body rather than a sub-committee of the CQC. The voice of patients will provide so much first-hand experience, and public involvement is so important to help improve standards throughout the country.

Patients can highlight good experiences and services that need improving. Often, communication needs improving, as does hospital food, which differs across the health service, waiting times, late diagnosis, ambulance provision and many other concerns. Many patients want to give something back to the health service when they have had to use it. Being a dedicated member of Healthwatch could be a solution. I hope the Government will appreciate the benefit of the public working with them rather than against them.

Tributes: Sir David Amess MP

Baroness Masham of Ilton Excerpts

Monday 18th October 2021 Lords Chamber

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

My Lords, we never discussed politics: David knew mine and I his, and it was always like that over the years we worked together. He succeeded me as chair of the Industry and Parliament Trust in 2014, having been a board member himself for a number of years previously. I always valued his contributions, if not always the way he put them.

I well recall him saying to me before one meeting, with that lovely crinkly smile on his face and his eyes twinkling, “Now, Angela, this isn’t going to take too long, is it?” The agenda was huge.

Nick Maher, the trust’s chief executive, told me a lovely story which epitomised David. He was introducing the Lord Mayor of London at an event and said, “I would like to introduce the lord mayor. Of course, none of us can aspire to be lord mayor because we don’t have enough money and didn’t go to the right school.” The room went very quiet. That was so David. You never really knew what he might say next. I know that Nick would also want me to say that David would always go that extra mile for the IPT, was adored by the staff there and worked enormously hard for the trust, which he continued to chair until 2017.

We also worked together on the British Parliamentary Committee for Iran Freedom. David was passionate about the Iranian resistance movement, and we shared many platforms together over the years. His commitment to everything he campaigned for was inspiring.

He was a kind, funny and thoughtful man, dedicated to his beloved Southend, which I often teased him about as I had worked at the airport there in my younger days. He was totally without malice or nastiness and always charmed everyone with whom he came into contact. It is almost impossible to believe that anyone would want to harm him, let alone attack him so brutally and fatally. He was a true parliamentarian, who lived for his family and for his constituency—in that order—and his loss to us is deeply felt and incredibly painful.

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

My Lords, as many people were, I was especially shocked and saddened when I heard of the terrible murder of David while he was helping his people. I had the privilege of working with him on liver disease and hepatitis C. He was always cheerful and good to be with. We shared an interest in animals and the same faith. We are the poorer for having lost two very good Members of Parliament while they were doing their work. I send my heartfelt condolences to his family. Could priests be allowed to attend a crime scene so that they can give the victim their last rites, especially when they are dying?

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, I open to the House.

Salisbury Incident

Baroness Masham of Ilton Excerpts

Wednesday 14th March 2018 Lords Chamber

[Baroness Evans of Bowes Park]

My noble friend is absolutely right: ensuring the safety of our citizens is one of the primary functions and roles of the Government. We believe that what has been presented today is a robust but proportionate diplomatic response to this unlawful use of force against the UK by the Russian Federation. There are further measures that we stand ready to deploy at any time should we face further Russian provocation.

[Baroness Masham of Ilton (CB)]

My Lords, have extra specialised nurses been drafted into Salisbury District Hospital, as the victims will need very careful nursing 24 hours a day?

[Baroness Evans of Bowes Park]

I am not sure. I would have to get back to the noble Baroness as to whether additional nurses have been brought in to work in Salisbury District Hospital. Certainly advice has been provided to GPs, acute hospitals and emergency departments, and all individuals who have been assessed have been discharged.

Mid Staffordshire Foundation Trust Inquiry

Baroness Masham of Ilton Excerpts

Wednesday 6th February 2013 Lords Chamber

[Lord Hill of Oareford]

My Lords, at the moment I cannot give the specific assurance my noble friend would like because the Secretary of State for Health has to look at all the recommendations, working out how to respond to them and the most sensible way forward. However, it is clear that the standards would need to carry weight and be recognised as doing so. I know my right honourable friend the Secretary of State will reflect on that and that my noble friend Lord Howe will have heard the points the noble Lord has made.

[Baroness Masham of Ilton]

My Lords, can the Leader assure me that there will not be bullying and that there will be kindness? Kindness does not cost money. Nurses should be kind and treat patients with dignity.

[Lord Hill of Oareford]

My Lords, I could not agree more. One of the things that are most distressing when one strips away everything to do with structures is the lack of common humanity. That is the most extraordinary thing. I agree very much with the noble Baroness about the importance of compassion.