Medical Devices (Amendment) (Great Britain) Regulations 2025

Baroness Merron Excerpts

Thursday 8th May 2025 Lords Chamber

Moved by

[Baroness Merron]

That the draft Regulations laid before the House on 3 March be approved.

Considered in Grand Committee on 6 May.

Motion agreed.

Care Quality Commission: Mental Health Care Waiting Times

Baroness Merron Excerpts

Thursday 8th May 2025 Lords Chamber

[Lord Davies of Brixton]

To ask His Majesty’s Government how they intend to respond to the results of the survey undertaken by the Care Quality Commission, showing that people are waiting too long for mental health care.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, it is unacceptable that too many people are waiting too long for mental health care, as the Care Quality Commission survey makes clear. Mental health is a key priority for this Government. We are already transforming services, including through introducing new models of community-based care, recruiting 8,500 mental health workers and expanding mental health support teams so that we can provide access to specialist mental health professionals in every school.

[Lord Davies of Brixton (Lab)]

I thank my noble friend the Minister for her reply, and I welcome the progress that is being made. As she will be aware, yesterday the NHS Confederation published a report, based on research by the Centre for Mental Health, setting out urgent tasks that need to be undertaken. I know that she understands the need for parity of esteem; that could be marked by her giving the recommendations early consideration with a favourable turn of mind.

[Baroness Merron (Lab)]

I am aware of the very helpful report that my noble friend refers to. I acknowledge the challenges highlighted in that report and will certainly take into account the points it makes. I regularly meet with and listen to the sector on what we can do to improve outcomes and transform mental health services, and this report will of course feed into that.

[Baroness Tyler of Enfield (LD)]

My Lords, the NHS planning guidance for 2025-26 reduced the overall number of targets, including those for mental health, and the guidance given was of a fairly generalised and vague nature. In the absence of any such targets, what specific incentives are currently in the system for ICBs to prioritise improvements in mental health services?

[Baroness Merron (Lab)]

As the noble Baroness says, we reduced the number of targets on the basis of the recommendation by the noble Lord, Lord Darzi, that having so many targets was not delivering the results that we want. We have had to think boldly and innovatively. Since July 2023, NHS England has included waiting time metrics for referrals to urgent and community-based mental health services. I am looking at how we can drive improvements in quality and in the data to help services, particularly those with the most lengthy waits. I will also review the 2021-22 clinical review of standards to consider what else can be done to put mental health on a more equal footing, which it absolutely deserves.

[Baroness Wyld (Con)]

My Lords, what are the Government doing to improve access to perinatal mental health services? The Minister will appreciate the urgency, given that suicide remains a leading cause of maternal death.

[Baroness Merron (Lab)]

It is particularly appropriate that the noble Baroness raises this issue, as it is Maternal Mental Health Awareness Week. Yesterday I was very glad to attend an event organised by the Maternal Mental Health Alliance, where I spoke to women about their experience and what has made—or not made—a difference to them. I know we are looking forward to a debate on this later in the year, but 41 maternal mental health services have already been set up to provide care for women with moderate, severe or complex mental health difficulties, and more than 62,000 women are reported to have accessed a specialist community perinatal mental health service or a maternal mental health service. Additionally, 165 beds have now been commissioned across England in 20 mother and baby units, providing in-patient care to women. But yes, we need to do more.

[Baroness Gohir (CB)]

My Lords, in some NHS trusts, autistic patients with learning needs and poor mental health are automatically opted into video and phone appointments, despite their communication needs. It feels as if the needs of the NHS and doctors working from home are prioritised over patient care. I know this from experience, because my son was repeatedly given video and phone appointments, even though I kept saying I wanted him to be seen in person. What can the Government do to ensure that there is a uniform approach across trusts, that patient care is prioritised and that guidelines are adhered to?

[Baroness Merron (Lab)]

I thank the noble Baroness for raising her experience with her family. It is clear that patients are individual people and they need to be cared for and communicated with in the way that is appropriate to them. So I am sorry to hear what she reports; that is not what we expect. If she has not already provided the details, I will be pleased to look into the matter she raises, because it has repercussions across the whole system, as she rightly says.

[Baroness Berger (Lab)]

My Lords, the overwhelming majority of mental health conditions start in childhood and adolescence, and we need to do everything to give those children and young people the very best start in life. Yet, regrettably, we know that there are 35,000 children in this country who have been on a waiting list for two years or more. I listened closely to my noble friend on the excellent work that this Government are doing with the support teams in schools, but for those children and young people who have met the threshold for services, what more can be done to alleviate these unacceptable waits?

[Baroness Merron (Lab)]

I pay tribute to my noble friend for her contribution in supporting awareness and improved mental health, not just for young people but in maternity settings and across all mental health services. This morning I was at Alexandra Park School, where I saw what I regard as the exemplar for what my noble friend is talking about, because we need to prevent mental ill-health in young people. That is why we are extending the mental health support teams to ensure that every school has that available. While that is being developed, funding is available for mental health leads in schools. We are also working with local areas to ensure that they meet their obligations to the local community, which of course includes young people. I also feel that our Young Futures hubs will make a big difference. I agree with her: we have inherited a difficult position, but I assure your Lordships’ House that we are working to make progress, particularly for young people.

[Baroness Blackwood of North Oxford (Con)]

My Lords, what assessment has the department made of the benefits and risks of the growing trend that is being reported of those who are unable to access affordable mental health care therefore turning to AI platforms such as Grok and ChatGPT, which are of course unverified for this use?

[Baroness Merron (Lab)]

As the noble Baroness says, it is very important that people use the right support. Otherwise, there is immense danger in going for what is perhaps less suitable. To my knowledge, we have not made a particular assessment, but I will pick up the noble Baroness’s point, because it is very right. On a more positive note, we are—and I am particularly—looking at what support we can develop in a digital and online sense to support people, not just on waiting lists but to prevent ill health and assist in their recovery.

[Lord Kamall (Con)]

My Lords, given that there is a waiting list for mental health care, including community-based services, and given the many competing demands on public finances, what can the Minister tell the House about conversations that her department and local ICBs may well be having with local community non-state civil society organisations, including those that offer music, art, talking drama, dance and other therapies, to help those on the waiting list?

[Baroness Merron (Lab)]

As the noble Lord is aware, I regard the contribution of the community sector—the third sector—as absolutely crucial here. I personally work very closely, like the department more generally, both to improve our practice and to recognise the difference that the creative arts, for example, can add to people’s mental well-being, as the noble Lord says.

[The Lord Bishop of Leicester]

My Lords, in my own city of Leicester, some excellent work is being done with minority-ethnic communities in particular to help with access to mental health services. Nevertheless, significant inequalities remain. What more is being done to address those inequalities, particularly as they relate to people whose first language is not English?

--- Later in debate ---

[Baroness Merron (Lab)]

What the right reverend Prelate raises is absolutely key: tackling inequalities in mental ill-health is so important. We know that some groups are more excluded than others, and this is taken into account in the preparation of the 10-year plan, which will be published over the next few months. I hope the right reverend Prelate will, like me, find that the 10-year plan addresses how we will tackle inequalities over the coming years—it will do so—because that is a key point.

Medical Devices (Amendment) (Great Britain) Regulations 2025

Baroness Merron Excerpts

Tuesday 6th May 2025 Grand Committee

Moved by

[Baroness Merron]

That the Grand Committee do consider the Medical Devices (Amendment) (Great Britain) Regulations 2025.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, this is a short—I hope—but technical SI, so it may be helpful to the Committee if I give some context. The Medicines and Healthcare Products Regulatory Agency regulates medical devices in the UK and helps to ensure that those products are safe and perform as intended. That includes ensuring that the legislation governing them is appropriate and keeps pace with advances in science and technology.

The 2002 regulations transposed relevant EU directives into domestic law and is now therefore considered to be assimilated EU law. The regulations contain references to several specific pieces of assimilated EU law that will form part of the regulatory framework for Great Britain. This is an important step towards delivering the Government’s 10-year health plan, in terms of the development of legislation apart from this SI. We need safe and effective medical technologies to achieve the shifts that will help build an NHS fit for the future, to take us from hospital to community-based care, from analogue to digital solutions and from treatment to prevention.

As we know, since the 2002 regulations were introduced, technology has advanced significantly. The MHRA has therefore set out plans to make a number of updates to the regulations—separate to the SI we are debating today, of course—to further improve patient safety and access to medical devices, as well as to keep the UK as an attractive market for medtech innovators. I assure noble Lords that, as part of this, there continues to be considerable engagement with the sector, not least because life sciences manufacturing is vital to the UK’s economic growth. In 2021-22, there were almost 119,000 people employed at life sciences manufacturing sites across the country. We will support the sector to flourish, in line with our growth agenda.

The MHRA is taking a phased approach to the implementation of the future medical devices regulatory framework in order to support system readiness and to minimise the risk of supply disruption for UK patients. A key piece of secondary legislation was made in 2024 to ensure that there is appropriate oversight of a device once it is in use. The further secondary legislation, to which I have referred, is expected to come into force in 2026. That legislation will update the regulatory requirements for devices before they are put on the market and will introduce key measures such as implant cards, unique device identifiers and an international reliance scheme for medical devices; in other words, it will take us forward to the place where we need to be.

In the meantime, the statutory instrument that we are here to debate will help provide continuity for the regulation of medical devices until the subsequent statutory instruments to which I have referred are put in place. I assure noble Lords that this instrument does not make changes to the current regulatory requirements. Instead, by maintaining the regulatory status quo, it will help ensure a smooth transition to a future regulatory framework that protects patient safety, improves access to transformative technologies and supports innovation.

This statutory instrument amends the Medical Devices Regulations 2002 to remove the revocation date of four pieces of assimilated EU law, so that they can continue to apply in Great Britain until such time as they are replaced with the updated law to which I have referred. The measure was consulted on from November last year to January this year. Of the 287 responses to the consultation, 83% were in favour, while a further 12% had no opinion. If this statutory instrument were not agreed to and the provisions expired in May—in other words, this month—there would be a significant gap in the regulatory framework, as well as risks to patient safety.

I will now give the Committee an overview of the four pieces of assimilated EU law for completeness; I know that noble Lords will be interested in this. First, the decision on common specifications for in vitro diagnostic medical devices sets out specifications that certain IVD devices must meet in order to demonstrate compliance with essential requirements.

Secondly, the regulation on electronic instructions for the use of medical devices establishes the conditions under which instructions for the use of medical devices may be provided in electronic form, instead of in paper form.

Thirdly, the regulation on devices manufactured utilising animal tissue, as well as their derivatives, sets out requirements to be met before those devices can be placed on the market.

Finally, the regulation on the designation and the supervision of approved bodies sets out further requirements relating to those bodies, which assess applicable medical devices for conformity with the regulations.

Although we are revoking the sunset dates instead of replacing them—not least because we do not wish to use up any more parliamentary time with debates on short, technical SIs such as this—the Government do not intend for this assimilated EU law to be kept in place indefinitely. I hope that will be a helpful and welcome reassurance. This SI serves as a temporary measure to maintain the status quo until more permanent measures are in place. In the meantime, this is important assimilated EU law that must continue to be complied with.

That will also ensure that unnecessary EU divergence is minimised, which is particularly important in this instance because, as noble Lords will be aware, Northern Ireland continues to operate under the EU framework for medical devices under the terms of the Windsor agreement. More broadly, I reassure the Committee that the regulations for Great Britain do, where appropriate, align with global best practice. As noble Lords will, I hope, be aware, the Government’s aim is to ensure patient safety while minimising unnecessary regulatory burden.

In conclusion, I am glad to say that the UK is a prime location to research, develop and manufacture pharmaceutical and medtech products. We want to continue to attract medtech manufacturing investments that deploy the latest innovations, are highly productive and are consistently high-quality. Key to achieving this objective is proportionate regulation, and implementing regulatory changes must be done in a sensible and measured manner.

As I have set out, the continuation of this assimilated law is necessary to prevent significant disruption to the current regulatory framework and, consequently, negative impacts on patient safety. I beg to move.

[Baroness Finlay of Llandaff (CB)]

I thank the Minister very much for her introduction to this tide-over regulation, which is as it has been portrayed to us. I should declare that my son is involved in medical technology, in cardiology; you could say that our family has a bit of skin in the game, although I do not understand the technology that he is developing— it is so complicated.

I have just a couple of questions. As the new regulations are eventually developed, can the Minister confirm that there will be no more regulatory burden on those trying to innovate and that we might lessen the bureaucratic burden on them? Will there be compatibility reading across to the FDA regulations? The American market, which is subject to a lot of debate at the moment, is a potential market for devices developed in this country overall. In that process, can there be the assurance that we also do not jeopardise our European market, or the Far East on the global scale? We will need to export the technology that we develop.

--- Later in debate ---

[Lord Kamall (Con)]

My Lords, I thank the Minister for introducing this statutory instrument. I want to be clear that we on these Benches recognise the need for this measure, since, without it, key regulatory provisions would expire at the end of this month, as the Minister explained. That would create uncertainty and risk disruption to the oversight of medical devices in Great Britain.

We understand that this instrument is, in essence, a stopgap, as the Minister said, and that the MHRA’s consultation, particularly with small and medium-sized enterprises and clinicians, demonstrated strong support for continuity. But while the measure preserves the status quo for now, it has provoked some questions about the Government’s long-term strategy. I am grateful to the Minister for reassuring us that this is definitely a temporary stopgap and that they are looking for a longer-term and more pro-innovation solution than when we were in the EU.

As the Minister said, this revokes the sunset clauses in four areas in particular: performance standards for diagnostic devices, electronic instructions for use, the regulation of devices containing animal tissue and the designation and oversight of approved bodies. These are not mere technical footnotes; they are essential to ensuring safety, clarity and public confidence in the medical device sector, so we understand that revoking their expiry is necessary to avoid disruption.

Can the Minister add any more detail at this stage to what she has already said? This first phase, focusing on pre-market regulation, is expected in 2026. What further reforms are expected to follow? I know that she explained some of that in brief—I suspect that she did not elaborate as much as she could have for reasons of time—but can she say a bit more about the future plans for this regulation? If she cannot now, perhaps she will write to me, because that was a very welcome move. I was going to ask lots of questions about whether the short-term fix will remain in place for the long term, but the Minister has reassured us. Nevertheless, perhaps she could set out some more details either today or in writing.

I do not believe in regulatory divergence for divergence’s sake, but let us be clear that neither should we agree with regulatory alignment for the sake of regulatory alignment. I understand the concerns of the noble Lord, Lord Rennard, but I recall that, when I was a Health Minister, many a supplier—regardless of whether they supported the UK leaving or remaining in the EU —asked me, “Now that we’ve left, can we take advantage of our independence and develop a more pro-innovation approach than the EU?” In technology—I spent 14 years in the European Parliament—the EU was known as an area for regulation; if you wanted innovation, that was in the US. We have to get a better balance between the two. Whereas the EU focuses more on the precautionary principle and less on innovation, perhaps we can get a better balance in this country, so that we do not align for alignment’s sake.

The Minister also mentioned Northern Ireland. As we know, as a result of what noble Lords, said there are some concerns in Northern Ireland but, given that the EU is seen as an area generating regulation, should the EU impose additional regulatory burdens on businesses in Northern Ireland? What steps will the Government take to support them to protect their competitiveness? That is one of the concerns I know from the most pro-innovation businesses in Northern Ireland.

Finally, on international trade, not strictly within the remit of these regulations, so I hope the Minister and her officials will forgive me—this does not have to be answered straight away—has the Minister or the department assessed the impact of recent US tariffs on medical device imports? Does the UK import a substantial number of medical devices from the US? I know that we talked about the importance of the US as an export market. Will these tariffs have an impact on medical devices from the US, particularly those that have been made with components imported from outside the US into the US before being re-exported? Does that have a price implication? Have the Government made any assessment of the implications for availability, cost and affordability, particularly for NHS procurement? Clearly, as the noble Lord, Lord Rennard, and others said, there is the impact on medical device suppliers exporting to the USA. Has any assessment been made of that market? Across the House, we all want a thriving life sciences sector in this country, but we should be assessing the impact of the proposed tariffs. I know some of them have been in abeyance.

I recognise that I have asked many questions, and I do not expect the Minister to have all the answers straight away, despite the advances of iPad technology and wireless communication. Maybe one day that will extend to telepathy. Perhaps the Minister can write to me on the questions that she is unable to answer today. In drawing my remarks to a close, I will be clear that noble Lords on these Benches support this measure as a necessary step to prevent regulatory disruption, but the real test follows. I hope the Minister, in answering the questions, is able to share a clear timeline for the programme for reform as we hopefully move towards a more pro-innovation approach.

[Baroness Merron (Lab)]

I am grateful to noble Lords for their valuable contributions and the way in which they have raised issues relating not just to the statutory instrument before us but this whole area of important work. I am also grateful for the support more broadly on the need to get the legislation right in order to protect patients, get the best medical technology within our grasp and support innovation. I am sure we will return to this subject. I will respond to a number of the points, and I will come back to noble Lords on anything significant that I have not responded to.

I reiterate that this SI is essential if we are going to prevent what I would call significant disruption. The words used were “a stopgap”. I think that is a fair legal term in this setting. It will preserve the status quo as we progress to more comprehensive regulation, which I know is what noble Lords are interested in.

The noble Baroness, Lady Finlay, asked for an assurance that we would not jeopardise not just the European market but other markets because we need to export technology. That is a fair point. I can say in response that over recent years we have learned important lessons from the implementation of new medical devices regulations in the EU as well as the global approach to regulation. How has this informed our approach to regulatory reform? It is why the Government are taking a phased approach to the delivery of these regulations to support the sector and adapt to the changes. It is also the reason why we are in continued discussion and are working closely with the sector.

We recognise the benefit of international harmonisation of medical device regulations in order to reduce, as we would all like, unnecessary regulatory burden or duplication of assessment for manufacturers, which is something that has been raised many times with me and I am sympathetic to. This means that, where sensible, we will align with the regulations of other jurisdictions, including those in the EU. Any reform to assimilated law will be to support domestic priorities and the Government’s national health and economic growth missions.

The noble Lord, Lord Rennard, raised a number of points. He raised the issue of products being subject to EU and UK regulations and whether this would make tech companies less likely to innovate. I believe the noble Lord also argued that we should be in line with the EU, and he raised the important issue of Northern Ireland. On these points, we will seek to align with international best practice and EU regulations where they are sensible, support manufacturers and support where we want to get to on patient safety and the contribution of medical technology.

On Northern Ireland, the MHRA is the competent authority for devices placed on the Northern Ireland market. It continues to have oversight of medical devices across the whole of the UK. We will continue to monitor any risks to the supply of devices to the whole of the UK market. I can give the assurance that, at present, the supply is stable and processes are in place to identify alternatives if needed. My final reassurance is that the SI before us today will not have any impact on the supply of devices to Great Britain or Northern Ireland.

The noble Lord, Lord Kamall, also raised a number of key points and requested more detail on what further reforms are expected to follow. He also raised regulatory alignment, making the point that, in his opinion, the EU can be more cautious and asking how we as a country can be more innovative. The noble Lord also asked about Northern Ireland and about the impacts that US tariffs have in respect of medical devices.

On plans for regulatory reform, the MHRA has published plans to introduce several SIs to amend the framework for medical devices. The post-market surveillance SI, which will come into force in June as noble Lords may recall, represented the first significant step in this reform. That legislation will put in place strengthened legal requirements for how manufacturers monitor and report on their devices once they are being used.

In November last year, the MHRA launched a consultation on further aspects of regulatory reform which will inform a subsequent pre-market SI that introduces, among other things, a new international reliance scheme, measures to improve traceability of implantable medical devices, more risk-proportionate changes to the classification of certain devices and the prohibition of misleading claims. We expect that legislation to come into force in 2026. I think that all those will put us in a much better place than we are currently, because they will allow us to keep pace with changes in the market.

The MHRA also continually monitors the UK’s medtech landscape for developments that could affect patient safety and the implementation of regulations. Details of further regulatory proposals will be communicated when available, and I look forward to bringing those before your Lordships’ House.

On US tariffs, there are ongoing discussions, and I will not seek to pre-empt them. The MHRA will monitor any impacts once they become clearer. That is very much under a watching brief.

I hope I have demonstrated the need for these regulations, not just for the public currently but as being key to the forthcoming 10-year plan. I hope that the Committee will agree that we are continuing with this assimilated law to prevent significant disruption to the current framework and to ensure that patients, device users and the economy are all protected.

Motion agreed.

Prosthetics for Amputees

Baroness Merron Excerpts

Thursday 1st May 2025 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I thank the noble Lord, Lord Mackinlay, for securing this debate and for giving your Lordships a tremendous opportunity for a very informed and meaningful debate. Having listened as the Minister, which I did very closely—I assure noble Lords that I will also review the points that were raised—my summary is that the case is well made. The current service is not where it needs to be and we have some way to go. That has been the theme throughout.

I associate myself with the comments of the noble Lord, Lord Kamall. The noble Lord, Lord Shinkwin, also spoke about those who rely on prosthetics as well as orthotics. The fact is that they cannot play a full part, reach their potential and lead a reasonable live without the right services and support. I wanted to set out those general points.

We have heard a lot of powerful and personal testimonies today. I particularly thank the noble Baroness, Lady Ludford, who spoke of her dear late husband, and the noble Lords, Lord Mackinlay and Lord Shinkwin, for bringing colour to this very important debate. I absolutely agree that all those living with limb loss deserve the right care, as do those with disabilities, because everybody should lead independent fulfilled lives.

I was interested when the noble Lord, Lord Mackinlay, started by outlining the various reasons for limb loss—running from war to diabetes to cancer to, of course, sepsis. I have heard and understand the call, particularly from the noble Baroness, Lady Ludford, for greater attention to be given to sepsis, as it is a killer of so many.

I will make some general points, which I hope will be helpful. First, we are committed to improving access for patients to the right prosthetics at the right time. That is why the Secretary of State for Health and Social Care, Wes Streeting, was delighted to meet with the noble Lord, Lord Mackinlay, and those affected by limb loss a few months ago to hear their first-hand experiences of the services that are and are not being provided. During the meeting, the Secretary of State also heard about variation in practice across the country and the need to improve personalised care. I will come back to this point later, but the noble Lord, Lord McColl, spoke about the importance of fit, which is so obvious, but this is about getting the right thing for people’s needs. People are individuals and it is important to recall that.

The noble Lord, Lord Shinkwin, talked about the isolation for those with disability and I absolutely take that on board. The NHS in England cares for around 60,000 patients with amputation or limb difference, around 25,000 of whom are seen annually. I highlight that care is delivered in 35 centres that provide specialist prosthetic services across England with multidisciplinary teams. On the point about isolation and practicality, a multidisciplinary approach is absolutely right.

We need to consistently and fairly account for varied clinical circumstances and patient preferences. To state the obvious—I think it is worth doing so—the needs of an adult who has lost a limb caused by diabetes will be very different from the needs of a child with sudden limb loss caused by a traumatic and tragic event. It is hard, and the literal point from the noble Lord, Lord McColl, was that one size does not fit all. We need the engagement of those with lived experience so that healthcare services can meet those varying needs.

On the matter of taking action—because I think we can see that we are not where we want to be, and I freely acknowledge that—we have committed to reforming elective care equitably and inclusively for all adults, children and young people. I know that noble Lords appreciate and have identified that prosthetics are complex and intricate devices, and they have also rightly spoken about cost—and, might I add, value for money. For example, a multi-grip device can cost more than £20,000, while at the same time some 70% of patients may decide—and by that I do not mean that they decide freely but that they may be in a position whereby they have to decide—to abandon their upper limb prosthesis. Our health service has to ensure that the right prosthesis is available for the patient, not just because of value for money but because of the trauma associated with being offered a solution that just does not work. The noble Lord, Lord Mackinlay, spoke powerfully about that.

Currently, patients often wait 12 months or more to access advanced prosthetics. On the practical side, that is to ensure that they have recovered from surgery and are able to use them. However, I have to acknowledge that there are a number of cases where earlier access to advanced prosthetics is clinically suitable yet is not happening.

When it comes to action, I am therefore pleased to say that, because of the Secretary of State’s meeting with the noble Lord, Lord Mackinlay, in November, there is a review of the clinical commissioning policy relating to multi-grip hand and upper limb prosthesis. The aim of the review is to reduce timelines as far as possible and shift to a much-improved patient-focused service. NHS England is starting that work with an audit of the latest clinical data on uptake and patient outcomes. We can expect to see the result of that this summer. To the noble Lord, Lord McColl, that will of course include the matter of literal fit, which he rightly spoke of.

Furthermore, this month NHS England will issue updated standards and expectations for prosthesis care across the 35 regional rehabilitation centres. There will be a greater emphasis on services for children and young people and prenatal consultations for congenital limb loss as well.

The point about workforce came up; I think all noble Lords spoke of it, and rightly so. I smiled at the noble Lord, Lord Kamall, only because he is more than aware as a former Health Minister of the challenge that we have and the absolute need to address that issue. To improve access times to prosthetic services and get the right services in place, it is clear that we have to increase the capacity and retention of the prosthesis workforce.

I was very interested that the noble Lord, Lord Mackinlay, referred to craft industries and the fact that they are reducing and have done over many years—because of course they provided the possibility of skills and no longer do so in great numbers. But I thought that it was a very important reflection, as is the fact that prosthetists and orthotists are the smallest group, I am afraid to say, among the 14 allied health professionals in the NHS, and there are very significant staff retention issues. A report by the Health and Care Professions Council found that 12.8% leave within four years of registration.

We are faced with a small number of people entering the profession and limited places that offer the relevant degree. To put that in context, only 43 students graduate each year from a joint prosthetics and orthotics degree, of which approximately 25% follow a career in prosthetics and 75% in orthotics. I think that lays out the reality.

To address this capacity challenge, a new degree course in prosthetics and orthotics has been established at Keele University, complementing the three existing courses at Derby, Strathclyde and Salford universities. As I hope noble Lords are aware, we are working at pace to publish a refreshed long-term workforce plan to deliver the health service fit for the future on which the 10-year plan is focused. As part of that, we have a national retention programme. I say none of these things because everything is all right; I say all these things to show the direction we are taking.

The question was raised by the noble Lord, Lord Kamall, about how we attract the best engineering students to input into this field, and I thought that that was a very strong point. In addition to expanding routes and apprenticeships, and the new workforce plan, those who are eligible students can get a non-repayable grant of a minimum of £5,000 a year, and prosthetists and orthotists can get a grant of an extra £1,000 a year.

Noble Lords have spoken much about the need to harness modern-day technology and how the current techniques that are used may be out of date. I very much share the need to continue to embrace technology, including by making research grants available, and I hope we will see more activity in that.

I thank noble Lords not just for their time today but their insight and experiences. It has been a very moving and very practical debate, in my view, and one that I look forward to taking forward to get the right steps in place.

Dementia and Alzheimer’s Treatments

Baroness Merron Excerpts

Thursday 1st May 2025 Lords Chamber

[Lord Evans of Rainow]

To ask His Majesty’s Government what steps they are taking to advance the development of dementia and Alzheimer’s treatments.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, the Government are committed to advancing the development of dementia treatments having invested £496.4 million over the past five years through the National Institute for Health and Care Research and UK Research and Innovation. Additionally, the Dame Barbara Windsor Dementia Goals programme, with up to £150 million of associated funding, aims to speed up the development of new treatments for dementia by accelerating innovation in biomarkers, clinical trials and implementation.

[Lord Evans of Rainow (Con)]

I thank the Minister for that helpful response. Finding a cure for dementia is the challenge of our time. Some drugs now available delay the onset of dementia. They are available privately, but not on the NHS. The NHS says that the assumed costs of administering the drugs are too high. Can the Minister look into this matter to see whether she can clear any barriers to making the new drug lecanemab accessible to everybody on the NHS?

[Baroness Merron (Lab)]

I understand the point the noble Lord is making; I was glad to have the chance of a discussion with him yesterday. I also thank him for his campaigning on such an important matter. I share his view about the need to ensure speed and efficacy. To that point, I say to him that since March this year, as part of the regulation action plan, NICE and the MHRA have been building on the systems we already have in place to make sure that there is rapid access. To prepare for a new generation of dementia treatments, NHS England is working closely with regulators to ensure that arrangements are in place to support the adoption of any new licensed and NICE-recommended treatments as soon as possible. As the noble Lord will understand, it is important that we have the right treatments that do the job and are available. On some of the more recent ones, I understand the disappointment, but the fact is that no disease-modifying treatments are currently available. However, science is developing, and I am sure we will discuss this further.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, more than 150 treatments are in the Alzheimer’s medicine pipeline. Can I encourage the Minister, along with her ministerial colleagues in the Department of Health and Social Care, to take all steps to ensure that the UK remains globally competitive as a centre for dementia clinical trials?

[Baroness Merron (Lab)]

My noble friend raises a very important point. In terms of trials, I will certainly be signing up—and I encourage noble Lords and their friends and families to do likewise—to Join Dementia Research, which is a collaboration between NIHR and a number of excellent charities, including the Alzheimer’s Society and Alzheimer’s Scotland, to take part in trials. There is no need to be a particular age or to have a diagnosis of dementia. I hope that noble Lords will join me in supporting this endeavour.

[Baroness Finlay of Llandaff (CB)]

My Lords, the commission on palliative care that I am currently involved in has found that by integrating services for patients with dementia, such as in the York Frailty Hub, the number of admissions to hospital can be decreased. People can stay at home with families supported and they can carry on living well within limited capabilities while we wait for new treatments and, hopefully, prevention to come along. Will the Minister meet me and Professor Mike Richards to go through some of the details of our findings? They have huge implications in saving finances for the NHS and improving care of patients.

[Baroness Merron (Lab)]

That is a very helpful offer which I will be pleased to accept. I compliment York on its initiatives, which set a very high standard. I will also discuss the points that the noble Baroness has raised with Minister Kinnock, who is the responsible Minister in this area.

[Lord Scriven (LD)]

The previous question shows how the rollout and co-ordination of good practice are really important. Therefore, in light of the 50% staffing cuts to NHS England, can the Minister clarify the plan for the national dementia team which sits within NHS England? Will its core funding and capacity be protected or cut?

[Baroness Merron (Lab)]

We are abolishing NHSE. It is the biggest quango, and we are finding immense duplication. At this stage, I cannot comment on the exact matter to do with the team, but I can say that dementia work continues to be a very high priority, as I hope the noble Lord heard from my commitment to the noble Lord, Lord Evans. Indeed, we are keen to support not just those at risk of dementia but those who care for them. This is an expanding area of work. We have much good practice to draw on and we are extremely active, as the noble Lord has heard, in developing research to move further forwards more quickly.

[Lord Kamall (Con)]

My Lords, I thank my noble friend Lord Evans for raising this issue. We know that, often when a new drug is developed, even though some patients may benefit, it may initially be too expensive for NICE to recommend, based partly on a cost-benefit analysis. We know that eventually the price falls to a level which the NHS can afford and which can then be seen as good value for taxpayers. Given that this happens with many new drugs, have the Government considered convening a group of philanthropists, foundations, charities and other civil society organisations that might be willing to fund treatment for some, if not all, patients when new but expensive breakthrough drugs such as those my noble friend Lord Evans referred to are available but are considered too expensive initially?

[Baroness Merron (Lab)]

We are very open to all sorts of creative ways of dealing with the matter, but it is important to say on the drugs that we are discussing that lecanemab and donanemab can only slow the progression of the disease by between four and six months. The challenge is not just whether it is available on the NHS but how helpful it is. We have a lot of progress to make, and that is why we are committed to ensuring that new treatments can quickly become available and that prevention is key.

[Lord Turnberg (Lab)]

My Lords, I have of course signed up for the dementia survey and I recommend it. One of the commonest forms of dementia is vascular dementia and we can do quite a lot to prevent it and treat it when it is caused by high blood pressure and diabetes. It requires quite a bit of surveying the population. How far have we got with that?

[Baroness Merron (Lab)]

I am glad that I will be joining my noble friend in signing up as a volunteer. Certainly, the Lancet commission of last year said that some 45% of dementia cases are estimated to be preventable or delayable. That report is going to inform our actions as we look to the future. Perhaps it is helpful to clarify to your Lordships’ House—I am sure that many of us have experience of this—that the NHS health check for adults in England aged 45 to 74 is designed to do exactly as my noble friend says and identify early signs of various conditions which are contributory factors.

[Lord Markham (Con)]

A lot of the challenges in testing the efficacy of some medicines lie in measuring the progression of the disease. That is mainly done verbally and, as we all know, people have good days and other not-so-good days, so measuring the progression and impact of the treatment is hard. As the Minister will be aware, things such as retina scans are showing quite promising measurements in terms of the onset and progression. What are we doing in research in that area?

[Baroness Merron (Lab)]

I will be pleased to write to the noble Lord on that specific point, but it might be helpful if I say on the point raised earlier by the noble Lord, Lord Kamall, that investment in discovery science by the UK Dementia Research Institute, for example, included the recently announced Shingrix study in partnership with GSK and Health Data Research UK, and we are also working via the Dementia Translational Research Collaboration. I am sure that the noble Lord will be aware of the NIHR dementia trials network, which offers people with dementia the opportunity to take part in early clinical trials irrespective of where they live. The summary of all this is that we have some way to go, but we have made considerable progress in investment and plans for the future. I will take into account the noble Lord’s point.

Self-harm: Young People

Baroness Merron Excerpts

Monday 28th April 2025 Lords Chamber

[Lord Lemos]

To ask His Majesty’s Government what up-to-date information they have on the level of self-harm among young people under the age of 18; and what plans they have to address the problem.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, published data from NHS England shows that in 2023, 9.4% of 8 to 16 year-olds and 36.8% of 17 to 24 year-olds had tried to harm themselves at some point in their lives. We are committed to identifying children and young people, and adults, who have self-harmed or who are at risk, for tailored or targeted action, which also forms part of delivering the suicide prevention strategy for England.

[Lord Lemos (Lab)]

I thank the Minister for her helpful response, but is she aware of recent research for the WHO? More than a third of 15 year-olds said that they had deliberately self-harmed—one in two girls and one in five boys—but the gender gap is closing. Almost one in four of both girls and boys self-harmed in the last week, and nearly 90% of self-harm incidents involving12 to 17 year-olds are unreported. Perhaps the Minister could outline the Government’s plans for turning around this worrying and worsening trend.

[Baroness Merron (Lab)]

I definitely share my noble friend’s concern about what is a worrying trend, and I can confirm that I am aware of the research to which he refers. In addition to the suicide prevention strategy, we are providing access to a specialist mental health professional in every school in England. We are rolling out Young Futures hubs and recruiting 8,500 mental health workers, and we continue to fund and benefit from the multi-centre study of self-harm to inform the development of policy and clinical practice, in order to tackle the very real and serious problem that my noble friend describes.

[Baroness Tyler of Enfield (LD)]

My Lords, we know that self-harm is most common amongst 15 to 24 year-olds, particularly young women. As we have already heard, there are so many challenges in accessing the mental health support that young people need that often, they cannot get it before their mental health problems get worse. The Minister already referred to the rollout of Young Futures hubs. Can she tell the House when there will be such a hub in every local area, to ensure that young people can access the support they need at the earliest signs of emerging mental health problems?

[Baroness Merron (Lab)]

The noble Baroness is quite right that it is unacceptable that too many children and young people are not receiving the mental health care they need. Our determination to change that, as she says, is about rolling out Young Futures hubs in communities. We are at an early stage of developing the plans, and I very much look forward to continuing to work across government to deliver this and to updating your Lordships’ House.

[Baroness Owen of Alderley Edge (Con)]

My Lords, there has been an alarming number of so-called sextortion cases targeting teenagers who, tragically, have gone on to take their own lives. Are the Government working with schools to tackle the stigma that children sadly feel, and to give them the confidence to report this abuse?

[Baroness Merron (Lab)]

The noble Baroness makes a very strong observation. The statutory guidance on relationships, sex and health education is under review, and we are working closely with the Department for Education on that review. I emphasise again the funding of the multi-centre study of self-harm, whose work is vital in getting to the core of the issues the noble Baroness raises.

[Lord Laming (CB)]

My Lords, the Minister will, I know, agree that self-harm needs to be taken very seriously indeed. Access to child and adolescent mental health services has got worse. I am told—I hope that it is wrong—that in some parts of the country access is delayed for more than a year. Can the Minister assure the House that this is being addressed?

[Baroness Merron (Lab)]

I can indeed assure the noble Lord and your Lordships’ House that this is being addressed, and I recognise the situation that he refers to. Early intervention on mental health is vital if we want to stop young people needing to reach for crisis support. Following on from my previous answer, there is no doubt that schools and colleges play an extremely important part, and that is why we have made the commitments on action that I previously outlined.

[The Lord Bishop of Derby]

My Lords, last month, Susannah Hancock, a member of the Youth Justice Board, published her independent review into placement for girls in custody. Many of the professionals that she consulted through that review identified self-harm by girls in secure settings as one of the biggest areas of concern. In the 12 months to September 2024, 55% of all self-harm incidents in the youth custody service involved girls, although they make up only 1.6% of the total average population in these settings. Can the Minister assure me that her department intends to collaborate with the MoJ to act on the report’s partnership recommendation to ensure greater consistency of good practice in responding to girls in custody who self-harm, including developing clear and consistent protocols on whether and how restraint is used, in order to prevent further traumatisation?

--- Later in debate ---

[Baroness Merron (Lab)]

The right reverend Prelate makes some key points. I can certainly assure her that I am working with the MoJ on the area she describes, where risk is indeed high, despite the numbers. We must be very alert to that.

[Lord Kamall (Con)]

My Lords, we all know the importance of evidence in driving and developing better policy. Regarding the data, what do we know, what gaps in knowledge are the Government aware of and what are they doing to fill those gaps to drive better policy?

As an aside, how is the department working with, say, local community civil society projects, which may well be working in local communities with people who have self-harmed and survived or who are in danger of self-harming?

[Baroness Merron (Lab)]

The role of civil society is crucial. I have had a number of very helpful meetings and visits, including most recently with the Samaritans. We very much believe that that sector supports the delivery of not just the national suicide prevention strategy, of which tackling self-harm is part, but tackling self-harm where it is not linked directly with suicide.

I refer the noble Lord to the work being undertaken by the multi-centre study of self-harm, which I know will be of interest. It has a long-standing research programme to keep an eye on—more than keep an eye on—and examine self-harm trends, and the findings also inform NICE clinical guidance. Recent research has looked at different ethnic minority groups, the characteristics and outcomes for children under 13 who self-harm, and patterns and risk factors for self-harm among university students—and that is just a snapshot.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, those of us who are not experts but have some direct experience of this problem know that self-harm is not just one thing; it can come in a number of forms. One of the problems for families is that it is not always easy to spot, at least not initially. Can my noble friend say in what way families are being supported to identify and then help young people who are beginning to exhibit signs of self-harm?

[Baroness Merron (Lab)]

My noble friend is right: it is crucial that, where they are able to, friends, family and communities assist those at risk and those who are actually self-harming. The recommendation is that people should not hesitate to speak to a GP or access the free listening services that are available through not just the NHS but the Samaritans, for example.

[Baroness Kidron (CB)]

The publication of the online safety children’s code by Ofcom last week received mixed reviews from many and a howl of fury from both Ian Russell and the Children’s Commissioner. Can the Minister say what the Government make of the fact that the children’s code makes no provision whatsoever for live streaming, nor for deliberately extending its use, both of which increase harm and were identified in the evidence of Ofcom itself?

--- Later in debate ---

[Baroness Merron (Lab)]

That is a matter, as the noble Baroness knows, for my ministerial colleagues in DSIT, and I will gladly raise her comments with them. Obviously, the Online Safety Act requires all sites in scope to rapidly remove illegal suicide and self-harm content and proactively protect users from illegal content. I am aware of the differences of opinion that the noble Baroness refers to, and I will gladly take that up with my colleagues.

Mental Health Bill [HL]

Baroness Merron Excerpts

3rd reading
Wednesday 23rd April 2025 Lords Chamber

Relevant documents: 10th and 18th Reports from the Delegated Powers Committee. Welsh Legislative Consent sought.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I will make a brief statement on the devolution status of the Bill. The majority of the Act that the Bill amends extends to England and Wales. An initial legislative consent memorandum was laid in the Senedd following the Bill’s introduction. Following further amendments to the Bill, supplementary legislative consent memorandums have been laid. I thank the Welsh Government for their constructive engagement, and I am pleased that they are recommending consent. The Senedd will hold a vote on legislative consent before the end of the Bill’s passage through Parliament.

Clause 30: Periods for tribunal applications

Amendment

Moved by

[Baroness Merron]

Clause 30, page 41, line 24, at end insert—
“(c) in paragraph (e), for “six months” substitute “three months”.”Member's explanatory statement
This amendment is consequential on clause 29(2) of the Bill and changes the period within which an application to the tribunal may be made where a patient is transferred from guardianship to a hospital to align that period with the initial detention period in relation to the patient.

[Baroness Merron (Lab)]

My Lords, this is a minor and technical amendment which would reduce from six months to three months the period within which an application to the tribunal may be made, where a patient is transferred from guardianship to a hospital under Section 19.

We are making this change to ensure that the relevant period within which transferred guardianship patients can make an application to the tribunal aligns with the relevant period for Section 3 patients. This is consequential to the changes that the Bill makes in Clause 29 to reduce from six months to three months the initial detention period for patients admitted for treatment, as part of our intention to provide patients with faster access to tribunals to review relevant decisions about their care. I beg to move.

Amendment agreed.

--- Later in debate ---

Moved by

[Baroness Merron]

That the Bill do now pass.

[Baroness Merron (Lab)]

My Lords, it has been an extraordinary honour and pleasure to take this Bill through the House with my noble friend Lord Timpson. As we are all aware, numerous aspects of the Mental Health Act 1983 are not serving us today. Over the decades, we have seen racial inequalities, inadequate care for individuals with learning disabilities and autism, and insufficient empowerment of patients who have not had an adequate voice.

Reform to the Mental Health Act is therefore long overdue. Many of the processes in the Act are out of step with a modern mental health system and with society at large. It has been a privilege to advance these reforms to deliver the Government’s manifesto commitment to modernise the Act to give patients greater choice, autonomy, enhanced rights and support, and to ensure that everyone is treated with dignity and respect throughout treatment, while ensuring that patient and public safety is paramount.

As noble Lords will be aware, this Bill is the product of the combined effort, over many years, by Members of both Houses and many outside Parliament who have worked for change and to whom thanks are due. I express my sincere gratitude to members of the former Joint Committee on the Draft Mental Health Bill: the noble Baroness, Lady Buscombe, as chair, as well as my noble friends Lord Bradley and Lady McIntosh of Hudnall, and the noble Baronesses, Lady Barker, Lady Berridge and Lady Hollins. The work and careful consideration that went into their rigorous scrutiny of the draft Bill, along with the constructive recommendations made, have undoubtedly strengthened it.

I pay tribute to the former Prime Minister, the noble Baroness, Lady May, who identified the need for modernisation and set up the independent review of the Act in 2017, chaired by Sir Simon Wessely and supported by the noble Baroness, Lady Neuberger, as one of the vice-chairs. Without this, we would not be here today.

I extend my heartfelt thanks to all Peers who have engaged with the Bill’s reforms. In addition to those previously mentioned, gratitude is due to both Front Benches—to the noble Lord, Lord Kamall, the noble Earl, Lord Howe, the noble Lord, Lord Scriven, and the noble Baroness, Lady Tyler. I am grateful to all noble Lords from across the House who have spoken during the various stages of the Bill and engaged with me and my officials over the past few months.

Because I would like to think that I am wise, I also thank my Whip, my noble friend Lady Blake, and my previous Whip, my noble friend Lord Cryer. I thank the Chief Whip and the whole of the Whips’ team and the team in the Leader’s office, including Ayeesha Bhutta and Michael Bleakley. My appreciation, as ever, goes to the clerks, doorkeepers and staff of the House.

I extend my heartfelt gratitude to all the officials who have played a crucial role in the progression of this Bill, and hope your Lordships’ House will indulge me while I give them the honour of mentioning them by name, because I believe they deserve it. Special thanks go to Phillip Dunkley, our Bill manager, and his dedicated team, Callie Mulligan, Sam Monday, Emily Bouldero and Rhys Jose. I am deeply appreciative of the Bill’s senior responsible owners, Kathy Smethurst and Caroline Allnutt, as well as the DHSC officials, including Esther Horner, Hannah Coaker, Alice Devlin, Matt Siddons, Tabitha Mufti, David Nuttall, Jennifer Rhodes, Megan McIvor and Mihiri Seneviratne, and their teams.

Additionally, I want to acknowledge the invaluable contributions of the Government Legal Department officials, Matt Smith, Lizzie Rattee, Nicky Richardson and Tim Spencer Lane, and their wider team, along with my private office staff, including Carl Plane and Yetunde Agaga, as well as Diggory Bailey and Victoria Griggs from the Office of the Parliamentary Counsel.

While I cannot list every individual, I express my appreciation to all officials who have played a part, including officials from the Ministry of Justice. Their unwavering support and dedication have been instrumental in the successful advancement of the Bill, and their work with Peers—as noble Lords across the House will testify—has been exemplary. I am confident that this legislation will make the Mental Health Act fit for the 21st century and give greater and better support to people when they need it. I look forward to it receiving support in the other place. I beg to move.

[Lord Kamall (Con)]

My Lords, as the Minister has said, debating the passage of the Bill through your Lordships’ House has been a pleasure. We have seen a genuine spirit of constructive engagement with a Bill that we all acknowledge will help patients who encounter mental health services, as well as a cross-party desire to improve the Bill. This was not a particularly political Bill; we found alliances across political lines and did not play political games. We wanted to improve the Bill and make sure that patients receive the best possible care. That is a wonderful demonstration of the value of this House.

I extend my thanks to all Peers who took part. I also thank the members of the pre-legislative committee whom the Minister acknowledged. Like the Minister, I acknowledge my noble friend Lady May of Maidenhead, the former Prime Minister, who we have to thank for beginning the process that led to this Bill. My noble friend identified the issue of racial disparities in the use of community treatment orders and wanted to reduce the involvement of police where they are not needed. Even though my noble friend was unable to be in her place to speak to her amendments on Report, I am grateful to all noble Lords who supported them, and I am delighted that the House has decided that they should be inserted into the Bill. We look forward to how that will be debated in the other place.

It was also welcome to see the House rally behind my noble friend Lady Berridge’s amendment to ensure that the process for appointing nominated persons for patients under 16 aligns with the Children Act 1989. My noble friend was crystal clear that there has to be consistency between different Bills, and that we do not want people falling between Bills and into harm’s way. She highlighted this and gave some harrowing examples of what could happen if we do not align these Bills. We have to make sure that we align them as much as possible.

I also thank the noble Lord, Lord Scriven, and the noble Baroness, Lady Tyler, for their dedication to improving community treatment orders and addressing racial disparities. Noble Lords will remember that this is probably the issue that was closest to my heart, and we probed the Government heavily on it. There are still too many racial disparities. We understand that it is a complicated issue, but the Government assured the House that they are looking into the data around this. What do they know? What do they not know? How will they fill that gap and what will they do to address racial disparities? I hope that is something that all noble Lords can agree on.

Of course, I have to thank my noble friend Lord Howe for his stalwart support and advice on this Bill, and for his experience not only of parliamentary procedure but of previous iterations of this Bill. I appreciate his sagacity, and I am grateful whenever he agrees to work with me on Bills—sometimes to curb my schoolboy enthusiasm and keep me on the right path. I am grateful that he has agreed to work with me on the Tobacco and Vapes Bill, which your Lordships will debate later today.

I also thank the Minister—and of course her noble friend, the noble Lord, Lord Timpson—for taking time at the Dispatch Box, and for the fact that the Minister and her officials were always available to meet us to try to iron out some of the disagreements or find compromises. That is very much appreciated by all noble Lords in this House. I thank Ben, the special adviser in her office, for his input, and, in our office, our adviser Jamie Tucker, who was amazing in his understanding of the Bill.

I will end by mentioning a quote that was sent to me and my noble friend Lord Howe from the charity Blooming Change. On hearing that the House had voted in favour of my noble friend’s amendment on mandatory debriefing for mental health patients, a younger person told the charity:

“I genuinely for the longest time felt like I didn’t matter, to anyone or anything, that the universe didn’t need to hear my voice, that what I went through didn’t matter. It took so long to build my confidence and to find my voice … I’m glad I decided to use my experiences to fight for change and I’m so happy our words have made a difference. We will keep fighting for more changes, little by little”.


As the Bill now progresses to the other place, I hope all Members involved will heed those wise words.

Tobacco and Vapes Bill

Baroness Merron Excerpts

Wednesday 23rd April 2025 Lords Chamber

Moved by

[Baroness Merron]

That the Bill be committed to a Committee of the Whole House, and that it be an instruction to the Committee of the Whole House that they consider the Bill in the following order:

Clauses 1 to 16, Schedule 1, Clauses 17 and 18, Schedule 2, Clause 19, Schedule 3, Clauses 20 and 21, Schedule 4, Clauses 22 to 40, Schedule 5, Clause 41, Schedules 6 and 7, Clauses 42 to 64, Schedule 8, Clause 65, Schedule 9, Clauses 66 to 83, Schedule 10, Clause 84, Schedules 11 to 13, Clause 85 and 86, Schedule 14 and 15, Clauses 87 to 126, Schedule 16, Clauses 127 to 140, Schedule 17, Clauses 141 to 145, Schedule 18, Clauses 146 to 151, Schedule 19, Clauses 152 to 156, Schedule 20, Clauses 157 to 159, Schedule 21, Clauses 160 to 170, Title.

Motion agreed.

Tobacco and Vapes Bill

Baroness Merron Excerpts

2nd reading
Wednesday 23rd April 2025 Lords Chamber

Moved by

[Baroness Merron]

That the Bill be now read a second time.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I beg to move that the Bill be now read a second time, and it is an honour to do so.

The evidence, despite perhaps some lingering myths and misperceptions, remains stark and compelling: smoking remains unequivocally the number one preventable cause of death, disability and ill health in our nation. Progress has been made, but this is not a problem of the past. Smoking continues to cast a long shadow over our society, remaining a significant public health challenge with persistent rates of prevalence. Every year we witness the loss of approximately 80,000 lives in the UK directly attributed to smoking.

The impact of smoking reverberates throughout lifetimes, increasing the risk of a whole range of conditions from stillbirth through to significantly higher rates of dementia, stroke, heart attacks, lung diseases and many cancers. Smoking also results in a significant loss of productivity in the wider economy and places a considerable burden on our healthcare system. In total it is estimated to cost society approximately £21.3 billion annually.

To correct this course, this Bill will create a smoke-free generation, making it an offence to sell tobacco products to anyone born on or after 1 January 2009, meaning those who turn 16 this year, and younger, will never legally be sold tobacco in the UK. This will gradually end the sale of tobacco products across the country, protecting future generations from the well-documented and evidenced harms of smoking.

In turning our attention to vaping, we face a nuanced challenge. Vapes are less harmful than smoking and absolutely have a strong role to play as a cessation aid for adult smokers seeking to quit. In fact, clients of stop smoking services who have used a vape to quit have had the highest success rate of any group. Nevertheless, a concerning increase in youth uptake should not be ignored. In 2023, one in four children aged 11 to 15 tried vaping, often drawn in through appealing sweet-like flavours and colourful packaging.

In response to this challenge, the Bill includes measures which address the rise in youth vaping and other nicotine products. We will ban advertising and sponsorship, and implement regulations concerning the flavours, descriptions, ingredients, packaging and point-of-sale displays of these products. The intention here is clear. We will ensure that the marketing of vapes can no longer target minors. However, it is imperative that the Bill strikes a necessary balance, ensuring that vapes remain an accessible option for adult smokers looking to transition away from dependence on tobacco, while clamping down on youth vaping.

The public understand the importance of this Bill and what it aims to achieve. Some 69% support a smoke-free generation policy, while 82% of adults support banning names of sweets, cartoons and bright colours on vape packaging, and 81% support banning the advertising and promotion of vapes at the point of sale.

This Bill is the product of the combined effort of Members of both Houses and many outside Parliament over the course of many years. A key manifesto commitment of this Government is to create a smoke-free generation, and this Bill has rightly received support from across the political parties. I express my thanks to many—over, as I said, many years—but I particularly thank the former Prime Minister, the right honourable Rishi Sunak MP, who committed to the original form of this Bill. I also thank my ministerial colleague, Ashley Dalton MP, and the members of the All-Party Parliamentary Group on Smoking and Health. Many others have also informed and motivated the action by this Government.

As we turn our attention to the substance of the Bill, I want to highlight its core aims. At its heart, the Bill is about safeguarding the health of our population. Its fundamental principle is to address the cycle of addiction and societal disadvantage. It is a key component of our broader health mission: a commitment to shift from treatment to prevention. Under our Plan for Change, the Government are committed to ensuring a sustainable health system that moves healthcare from hospital to the community, from analogue to digital and from sickness to prevention.

The Bill incorporates a UK-wide approach, reflecting the need for change across our four nations. Health is a devolved matter, so the Bill has been developed in close partnership and collaboration with the Scottish Government, the Welsh Government and the Northern Ireland Executive. This ensures not only greater consistency across the nations but a more enforceable regime across the UK.

In addition to creating a smoke-free generation, the Bill will amend the existing powers to designate certain outdoor settings as smoke free. This will offer greater protections to those at risk from the harms of second-hand smoke. Any such extension will be carefully considered and subject to consultation. In England, the Government will consult on banning smoking outside locations frequented by children and vulnerable people, such as schools, hospitals and playgrounds, but not outdoor hospitality or wider open spaces. Private outdoor spaces are out of scope of the powers in the Bill.

In addition, the Bill provides regulation-making powers to address the entire life cycle of tobacco, vaping and nicotine products, enabling the Government to set appropriate product standards to protect consumers. The introduction of a pre-market registration scheme will provide comprehensive oversight of manufacturers and the products they introduce to our stores. Retail licensing provisions then facilitate ongoing monitoring and modification of retailer practices, strengthening enforcement and ensuring adherence to the measures we put in place.

It is important to acknowledge, as I know many noble Lords do, the dynamic nature of the products we are discussing and the fact that our scientific understanding of their long-term impact continues to evolve. Therefore, the Bill allows for the highly technical details of the regulatory regime to be set out in subsequent regulations that are well placed to adapt to emerging evidence and market innovations.

This is not just about the Bill. The Bill is part of a wider effort across government to address the challenges of smoking and youth vaping. The Government are actively supporting current smokers who wish to quit. We are increasing funding for local stop smoking services by an additional £70 million in 2025-26 and delivering national action, such as the national smoke-free pregnancy incentives scheme and the vaping Swap to Stop scheme.

The Department for Environment, Food and Rural Affairs has laid legislation that will see the ban of single-use vapes from 1 June this year, addressing a key factor in youth vaping as well as environmental concerns. Moreover, to discourage non-smokers and young people from starting vaping, and to generate revenue for public services, the Government will introduce a vaping products duty, which will come into force from 1 October 2026. In order to continue to incentivise smokers to quit and keep the differential in price, duty rates on all tobacco products were increased by 2% above inflation in the Autumn Budget, with further additional increases for hand-rolling tobacco to reduce the gap with cigarettes.

We recognise the importance of robust enforcement of our new laws and regulations, so the Government have announced £10 million of new funding in 2025-26 for Trading Standards to tackle the illicit and underage sale of tobacco and vapes, and to support implementation of the measures in the Bill. In total, we will invest £30 million of new funding in 2025-26 for enforcement agencies, including Trading Standards, Border Force and HMRC.

I extend my gratitude to noble Lords on all sides of the House for their ongoing support for the Bill and for getting it to this stage. The time to act is now, which is why this is priority legislation for this Government and why we have gone further than the previous Government. I look forward to the collegiate and constructive debate that I know will follow from my engagement thus far, and I will seek to respond to the main questions and themes. I beg to move.

--- Later in debate ---

[Baroness Merron (Lab)]

My Lords, I am grateful to all Members of your Lordships’ House who have contributed to what has been a thoughtful and wide-ranging debate on a very important issue.

Today’s debate has been very well supported. I hope that noble Lords will understand that I will not be able to cover in my summary every issue that has been raised, but I will endeavour to respond to as many of the themes and questions as possible. Of course, I will be happy to have further discussions with noble Lords, and we will have the opportunity for these ahead of and during future stages of the Bill. I too look forward to Committee.

It seems many hours ago since my noble friend Lady Thornton spoke of the measures in this Bill being a further step along the way. I share that view, which has been expressed by a number of other noble Lords, particularly those in what I shall politely call the cohort of former Health Ministers. I do not know what the collective term is, but I am sure we will work on that. I am in that cohort, and I too worked towards the initial smoking ban in 2007. As a Public Health Minister, I introduced the display regulations we are now so used to. When we introduced the original ban in 2007, no one could have dreamed of the challenges we have today, including vaping; this was not something we had considered. It was also important to go with the public, which is why I was keen to outline the public’s support in my opening remarks.

I am grateful for the challenge. I have heard many concerns being expressed today, along with outright opposition to the Bill. I have also heard much support for the Bill, although there are rightly questions about the measures in it. Many noble Lords have been supportive, including the noble Lords, Lord Lansley and Lord Stevens, who assisted me by anticipating some of the arguments that will be deployed. The noble Baronesses, Lady Redfern and Lady Smith, and many others, were also very supportive.

I am grateful to my colleagues on both Front Benches for taking a line similar to the one I am about to take in respect of the Chief Medical Officer’s views. These include:

“If you smoke, vaping is safer; if you don’t smoke, don’t vape.”


I am also very grateful to noble Lords who were good enough to join me yesterday at a briefing with the Chief Medical Officer and officials, which I certainly found helpful. I know that others did too.

I understand that there are different perspectives on a number of issues, and I now turn to some of the points that were raised. I heard concerns about the smoke-free generation policy from a number of noble Lords, including the noble Lords, Lord Scriven, Lord Brady, Lord Naseby, Lord Sharpe, Lord Teverson and Lord Moylan. However, the reality is that smoking leads to significant harm. A clear majority of smokers regret ever having started. My noble friend Lord Browne spoke about this, as did the noble Lord, Lord Vaizey, who recounted his own personal experience. Many people struggle to give up due to the addictive nature of nicotine.

I am grateful to a number of noble Lords for sharing their personal experiences, which brought colour and a human touch to our debate. These included the noble Lords, Lord Jopling and Lord Rennard, my noble friends Lady Rafferty, Lady Ramsey and Lord Griffiths, and the noble Baroness, Lady Morgan.

However, let us remember that the harms of smoking extend beyond the individual. They impact on non-smokers, especially children and pregnant women, through second-hand smoke. This policy will be the most significant public health measure in a generation. It will build on the previous steps I spoke of, such as the 2007 indoor smoking ban, with the goal of safe- guarding the health of future generations from preventable and serious harm. That is why we are bringing the Bill forward.

The noble Baroness, Lady Fox, decried the Bill on a number of levels, including—she must forgive me if I am wrong on this—that it is Tory legislation. Actually, this is a Bill on which we are agreed across the House and across parties. Of course there are questions, but a wise Government and wise Opposition Benches acknowledge good when they see it. That is where we are today.

A number of noble Lords suggested raising the age of sale to a particular age—for example, 21 or 25—as a potential way to address smoking. As the noble Lord, Lord Bourne, put so well, that would not stop young people starting to smoke. The whole point is that, once you have started to smoke, the challenge of giving up is tremendous, because it is an addiction. Introducing a particular age could have a positive impact but it will not fully achieve the ambition of a smoke-free UK. Our goal is to go further, to break the cycle of addiction. We want to drive smoking rates down to 0%. That is why we have suggested a smoke-free generation.

On the practicalities, implementation is absolutely key. On ID checks, the majority of retailers sell tobacco and vapes responsibly—I acknowledge that. They follow the recommended practice and regularly ask for ID from customers. The Bill provides powers to specify in regulations the steps that may be taken to verify a customer’s age, to provide clarity and to support retailers. The noble Baroness, Lady Walmsley, spoke to this point. We are exploring how we can enhance age verification with digital verification services, providing an opportunity to securely verify age, both in person and online.

With regard to the products in scope, the Bill captures all tobacco products, as tobacco is uniquely harmful. There are around five times more people smoking non-cigarette tobacco, such as cigars, than a decade ago, and the greatest increase is among young adults. To the noble Earl, Lord Howe, and the noble Lord, Lord Vaizey, I would say that this is why the Bill, importantly, captures all tobacco products and must not be watered down to exclude certain products.

The noble Earl, Lord Lindsay, and the noble Lords, Lord Strathcarron, Lord Scriven and Lord Brady, referred to other products outside of this range. I again call upon the words of the Chief Medical Officer: there is no safe level of tobacco consumption. That is what sets it apart from other products that we might feel are harmful. There is no safe level, not even a little bit; that is the key. Therefore, cigars, shisha and heated tobacco are all in scope. To the point raised earlier about heated tobacco, there is evidence from laboratory studies of its toxicity, and there are, as noble Lords have spoken of, less harmful tobacco-free products to support people to quit, rather than heated tobacco.

A number of noble Lords raised points about the growth in illicit sales. The noble Lords, Lord Dodds, Lord Blencathra, Lord Naseby, Lord Scriven, Lord Howard and Lord Murray, the noble Baroness, Lady Hoey, and the noble Earl, Lord Leicester, were concerned that the Bill’s ambitions could be undermined in this respect. As other noble Lords have said, history shows that when we have introduced targeted tobacco control measures, the size of the illicit market has not increased. As the noble Lord, Lord Bichard, told the House, it has in fact continued to fall. When the age of sale increased from 16 to 18, the number of illicit cigarettes consumed fell by 25%.

On the point raised by the noble Baroness, Lady Walmsley, the Government are cracking down on the demand for illicit trade, as well as the supply, with the joint strategy with HMRC and Border Force backed up by over £100 million of new funding over five years.

I am grateful to the noble Lord, Lord Bichard, for articulating support for those who work in trading standards as well as acknowledging their worth, and I share his views on that. As these were points raised by the noble Lords, Lord Moylan and Lord Udny-Lister, it might be helpful to reiterate that we have announced £10 million of new funding in 2025-26 for trading standards to boost the workforce and tackle the illicit and underage sale of tobacco and vapes.

A number of questions were raised about whether driving down the smoking of tobacco could lead to an increase in the smoking of cannabis. As the noble Lord, Lord Kamall, accurately said, the Bill is not banning the smoking of anything—it is in reference only to tobacco and vapes. I also ought to say that we are not aware of any link between the rates of smoking cannabis and the rates of smoking tobacco. I know that noble Lords are more than aware that cannabis is, of course, illegal.

On the matter of abuse against retail staff, raised by my noble friend Lady Carberry, we are working closely with retailers and will utilise the long lead-in time to best support them in preparing for and implementing these changes. That includes rolling out information campaigns for both the public and retail workers. We will not stand for violence and abuse against shop workers; everyone has the right to feel safe. To protect hard-working and dedicated staff who work in stores, this Government will introduce a new offence of assaulting a retail worker.

On the issue of smoke-free places, in England we intend to consult on extending smoke-free outdoor places to outside schools, children’s playgrounds and hospitals, but not—I say to my noble friend Lord Faulkner —to outdoor hospitality settings or wider open spaces such as beaches. This is because—and it might be helpful to the noble Baroness, Lady Bray, as an assurance—we judge that this adequately balances a range of priorities by protecting the most vulnerable while ensuring that businesses are not financially impacted.

There was a lot of discussion about the rationale for the broad powers, including within the Bill. Noble Lords are right to point to the high number of regulation-making powers that the Bill takes. I have no doubt that noble Lords have enjoyed or will enjoy scrutinising the 96-page delegated powers memorandum, which sets out in full the detail of the rationale for each and every one of the powers. I recommend it as good reading. Concerns were particularly raised by the noble Earl, Lord Howe, the noble Lord, Lord Blencathra, and the noble Baronesses, Lady Hoey and Lady Meyer. I assure noble Lords that each of these powers has been carefully considered and aims to ensure that the Bill establishes a clear regulatory regime for tobacco, vaping and nicotine products, and that we have worked very closely with the Attorney-General’s Office to get it in the right place.

As the noble Baroness, Lady Northover, spoke to, given the need to adapt to emerging scientific understanding and to market innovations, it is crucial that the details of the regime are set out in regulations, to ensure sufficient flexibility. In addition, most of the regulations require significant technical detail, which is more appropriate for secondary legislation.

As some noble Lords referred to, the Bill is UK-wide, so certain powers are being repeated for each part of the UK. Equally, the Bill restates or amends a number of existing powers from across tobacco control legislation, to bring it together in one place. That will help to make legislation more useful and accessible.

I can assure noble Lords that the Bill provides a statutory requirement to consult on regulations, and we are working constructively with retail associations and the Local Government Association to help shape the early design of the scheme. The noble Lord, Lord Mott, was right to say that we should support responsible retailers, who are the majority and who want to do the right thing. They do not want to be undermined by those who are not being responsible. I put that to the noble Lord, Lord Udny-Lister, who was concerned about impact.

On the matter of balance in respect of vapes, there was a useful debate, both in the Chamber and at a meeting I held with the Opposition Front Bench, about the matter of flavours. To avoid unintended consequences on adult smoking rates, the scope of restrictions will be carefully considered and consulted on. The noble Earl, Lord Howe, raised the issue of exemptions from the advertising ban for public health purposes. We are clear that healthcare providers can continue to provide advice about vaping as a smoking cessation tool. For example, pharmacists could display public health campaign messaging or provide advice to customers about vaping as a smoking cessation tool. I wish to say to my noble friends Lady Mattinson and Lord Hanworth, as well as the noble Earl, Lord Russell, that we will keep emerging evidence under review, and have already commissioned a 10-year study to investigate the long-term effects of vaping on the health of 100,000 young people, which I hope will be helpful.

On the matter of filters and the environment, I understand and am sympathetic to the concerns raised by noble Lords, including the noble Baronesses, Lady Grey-Thompson and Lady Bennett. The environmental harm of items with tobacco butts is evident, as it is the most littered item in the UK. Ultimately, the best way to tackle this littering is through reducing smoking rates, but we are where we are. Local authorities already have powers to tackle littering, including through the ability to issue fixed penalty notices of up to £500. We are working closely with Defra to take a systematic approach to what is indeed something of a blight.

On the matter of age and the concerns, including twins born either side of midnight, should such a thing ever happen, I remind noble Lords that other policies already do this, such as universal credit increases, NHS screening programmes and access to vaccines.

On the “polluter pays” levy, raised by the noble Lords, Lord Crisp and Lord Young of Cookham, my noble friend Lord Faulkner and the noble Baroness, Lady Walmsley, the Government’s present preference is, as I think noble Lords are aware, to continue with a proven and effective method of dealing with tobacco products through increases in tobacco duties, to incentivise those who currently smoke to quit, and to generate finances that can be put back into public services.

I am most grateful to the noble Lord, Lord Bethell, for his support for the Bill and appreciate the intentions behind his suggestion to be smoke-free by 2040.

On the points about the Windsor Framework, I have heard the concerns about the application of smoke-free generation policy in Northern Ireland from the noble Lords, Lord Dodds and Lord Weir, the noble Baroness, Lady Hoey, and my noble friend Lady Ritchie. I have met the Northern Ireland Health Minister, and we continue to work well with his office. I assure noble Lords that we are content that the measures intended to apply to Northern Ireland are consistent with the obligations in the Windsor Framework.

In closing, I am most grateful to all noble Lords who have contributed to this debate. This is a landmark Bill, and it will be the most significant public health intervention in a generation, so I beg to move.

Bill read a second time.

Funerals: Death Certificate Delays

Baroness Merron Excerpts

Thursday 3rd April 2025 Lords Chamber

[Viscount Stansgate]

To ask His Majesty’s Government what steps they are taking to reduce reported delays in holding funerals because of changes in the provision of death certificates.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, the death certification reforms are increasing scrutiny of deaths and patient safety, and supporting the bereaved. We are taking steps to reduce the time to register a death, through active monitoring of the reforms, using weekly data from the ONS to target the challenges and the necessary support. We are also working with faith groups and the funeral sector to identify and reduce any obstacles, and sharing any concerns we receive with NHS England so that they can be swiftly resolved.

[Viscount Stansgate (Lab)]

I thank my noble friend for that Answer. When my dad died—incidentally, he was born 100 years ago today—it was possible to arrange his funeral in two weeks. That is not now possible. I have talked to the National Association of Funeral Directors, and I understand that there is a lot of confusion around the country about the new procedures, although everyone understands why they are there. Is there more that could be done in hospitals or by GPs to help families who are having to cope with the unfamiliarity of the new procedures at the time of their own grief? More widely, might it be possible for the Government to start considering regulating the funeral profession, as has happened in Scotland?

[Baroness Merron (Lab)]

I am sure that we all wish to pay tribute to the memory of my noble friend’s late father. I appreciate the points that he has made. It is not the case that delays to funerals can be identified and formally linked with the changes in death certification. My noble friend raised a lot of points, many of which are valid. In a bereavement, it is more important than ever that any official processes—as well as the funeral sector itself—work as seamlessly and sensitively as possible. I assure my noble friend that not only are we driving improvement by implementing the death registration reforms but we are very focused on supporting the bereaved. On my noble friend’s point about regulation, I am not aware of any plans at present.

[Lord Scriven (LD)]

My Lords, to solve a problem, first you have to accept that it exists. Everyone involved in funerals, from the GPs doing the certification to the funeral directors, say that there is a direct link between the extra time to deal with funerals and the reforms. The reforms were needed, but can the Minister clarify the number of medical examiners required in each region—because regional variation exists—to prevent lengthy delays in funeral arrangements? What assessment have the Government made to ensure that the current number of medical examiners is sufficient to meet regional demand?

--- Later in debate ---

[Baroness Merron (Lab)]

I do not have the figures to hand, but I would be very pleased to write to the noble Lord. As I said, this is a complex area. The reforms were introduced in September, and it is very difficult to make before and after comparisons. Since 2001, a long-term trend has shown an increase in the median time between death and registration, and that cannot be attributed to death certification reforms. In addition, the reforms are about the introduction of statutory medical examiners as opposed to the non-statutory arrangements that existed before—and there was even more regional variation before September than we are finding now. I assure your Lordships’ House that I am working very closely with officials to understand the reasons for this so that we can take more action.

[Lord Kamall (Con)]

My Lords, I thank the noble Viscount, Lord Stansgate, for the conversation we had about this Question. As we all know, when a loved one passes away, it is a distressing time, and surely delays can only add to that distress. I am sure that noble Lords understand why these reforms were brought about in the first place: they were introduced after a qualified doctor, Harold Shipman, murdered his patients and signed the death certificates himself. In a recent Written Answer on these delays, the Minister for Public Health in the other place said:

“The expectation on doctors and medical examiners is clear … they should complete certification as quickly and efficiently as possible, and the Government is working with all stakeholders to make sure this is the case”.


Can the Minister explain to your Lordships what that means? Is the department simply asking them to complete the certificates, or is it identifying blockages or misunderstandings in the system to help unblock them in order to speed up the process?

[Baroness Merron (Lab)]

The noble Lord’s observations are correct. As I said, it is so important to be timely and sensitive at a time of bereavement. Governments and Ministers have been working to bring in the system over the last 50 years—in fact, it has been overdue for reform for that long, so I am very glad to have taken this action. Introducing this robust system means working with medical examiners as well as the bereaved, so that we hear from them about what has happened. We also work very closely across government, including with the MoJ and the Home Office. As the noble Lord will know, the medical examiner system is led by NHS England through the office of the National Medical Examiner. I reiterate that delays are not due solely to this introduction; it is very important to unpick this issue. We now have better data and get weekly reports, which is helping greatly.

[Baroness Finlay of Llandaff (CB)]

My Lords, at the Commission on Palliative and End-of-Life Care, chaired by Professor Sir Mike Richards, we have heard from medical examiners and the bereaved. It is clear that the ability for the bereaved to speak to a medical examiner and go through things in detail is very supportive. However, the delays in notifying the cause of death and transferring the case notes seem to be from the doctor who had seen the patient. The medical examiner cannot start until both those events have happened, and at that point their work begins. So the increasing digitalisation of the health service and of notifications could speed up these processes. Does the Minister agree that the digitalisation proposals from the noble Lord, Lord Darzi, will bring about those changes and simplify the process?

[Baroness Merron (Lab)]

I agree that those changes—the move from analogue to digital, which will be outlined in the 10-year plan—will indeed help in this area, as well as many others.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, clearly, this is a complex and difficult issue, and there does not seem to be any one reason why these delays have started to extend. Can the Minister tell the House whether there are any financial implications for people who have to wait much longer for a funeral to be arranged, given that they are not cheap to begin with?

[Baroness Merron (Lab)]

I am not aware of the specifics around that point, but we will be very pleased to look into that because we do not want people to be inconvenienced and distressed even further.

[Lord Polak (Con)]

My Lords, the Minister will know that, in the Jewish community, we bury our deceased within 24 hours. I have not noticed any change in that since September—so perhaps that fact will help her.

[Baroness Merron (Lab)]

I am grateful to the noble Lord. He is of course aware that, as the former chief executive of the Board of Deputies of British Jews before coming to this place, I worked on this very area to ensure that there were swift responses and burials for the faith communities that require them. That continues to be a great focus of our work.

[Lord McCrea of Magherafelt and Cookstown (DUP)]

My Lords, in Northern Ireland, the practice is that funerals are held three days after death. Does the Minister think that anything can be learned from that?

[Baroness Merron (Lab)]

We are always happy to learn from the practices of other Governments, and we will continue to work on speed and, as I said, to keep distress and delay at a minimum.

[Lord Rook (Lab)]

My Lords, I point to my entry in the register of interests as an Anglican priest. I am particularly glad that my noble friend the Minister mentioned the challenges for faith communities and the important role that ministers of religion have not only in conducting funerals but in supporting families with grief and loss. Obviously, a delay to those things can cause family stress and tension. What are the Government doing to engage Muslim communities, which particularly feel the stress and pressure of this issue given their obligation to have swift funerals?

[Baroness Merron (Lab)]

I pay great attention to this area, as I mentioned in my response to the noble Lord, Lord Polak. I met faith group leaders in December, and we have worked very closely with faith groups to develop the medical examiner system. The faith groups are very supportive of the reforms, have broadly welcomed the implementation and continue to work with us to identify any issues, for which I am very grateful. Data from regional medical examiner offices in England, although unpublished, indicate that 88% of requests for urgent scrutiny—the group we are talking about in the faith communities—were met. Indeed, in Wales the corresponding figure has been assessed to be 99%. I assure all noble Lords that we are working extremely hard to make sure that the system reduces any unnecessary delays, and we will continue to do so.