Long Covid

Baroness Merron Excerpts

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

The NICE guidelines start with the definitions as I have laid out previously, and the NICE definitions are aligned with the World Health Organization. On the noble Lord’s specific question, I will have to write to him.

[Baroness Merron (Lab)]

My Lords, the Equality and Human Rights Commission made an announcement on Twitter that it recommended that long Covid should not be treated as a disability. That would mean that those suffering from the condition would have to take their employer to a tribunal if they felt that they were being discriminated against. Can the Minister tell your Lordships’ House what his view is on how reasonable or not this is? What steps are being taken to promote understanding by employers of this debilitating condition and to encourage and guide them to be open to making changes in the workplace to support sufferers in continuing to work?

[Lord Kamall (Con)]

The noble Baroness makes a very important point. We are learning more about the different types of long Covid, how to treat them and what interventions they need. People will not always need to go to a primary or secondary care centre for their treatment; in fact, there is an app to help people who can be supported at home. In terms of general advice about disability or to employers, we are working across government as we learn more about this in order to give appropriate advice to employers.

North East Ambulance Service

Baroness Merron Excerpts

Monday 23rd May 2022 Lords Chamber

[Baroness Merron (Lab)]

My Lords, human tragedy permeates this scandal, which has seen up to 90 unnecessary deaths, gross negligence, cover-ups and public money buying the silence of staff. Quinn Beadle, who was just 17 when she tragically committed suicide, died because an ambulance worker failed to perform proper resuscitation. In the report that was then made to the coroner, North East Ambulance Service managers removed this detail. The Secretary of State said today that this and dozens more injustices will be investigated more fully. Will the Minister confirm that this will take the form of a formal inquiry, as it surely must? Will questions be asked of the Care Quality Commission, which, despite being tipped off two years ago, failed to flag or even spot this outrage?

[Lord Kamall (Con)]

I thank the noble Baroness for raising those concerns. I completely agree with the sentiments she expressed; this is completely uncalled for. As I said previously, my honourable friend Maria Caulfield pledged that there would be an investigation into this. As to whether it will be a formal inquiry, it is too early for me to give a direct answer, but I will go back to the department and as soon as I have more information I will write to the noble Baroness. I understand that these are historic incidents and that the CQC has said that its service is improving, but as more information is still coming out—even today when I had the briefing, not all the information was there—I will of course commit to write to the noble Baroness.

Pharmacy (Preparation and Dispensing Errors—Hospital and Other Pharmacy Services) Order 2022

Baroness Merron Excerpts

Monday 23rd May 2022 Grand Committee

May I also ask about the introduction of the statutory term of “chief pharmacist” with professional standards set by the GPhC? As I read the order, a defence for inadvertent dispensing errors cannot be called in aid if the service where it happened did not have a chief pharmacist responsible for the safe running of that service. Does that mean that if a service did not identify a chief pharmacist, or if he or she were not on the spot, the staff would be more exposed to discipline over errors than those working at a site where the work was supervised by a chief pharmacist? Will the Minister please explain?

[Baroness Merron (Lab)]

My Lords, I welcome the Minister’s helpful introduction and his acknowledgment of the delay in bringing this statutory instrument before us. These Benches welcomed the initial preparation and dispensing errors instrument when it came before Parliament in 2017. That welcome was in line with that of a number of organisations, including the National Pharmacy Association, the Pharmaceutical Services Negotiating Committee and the Royal Pharmaceutical Society. Today, we are very happy again to give that welcome to this statutory instrument, not least because it is entirely focused on patient safety and on improving safety for patients. It also brings parity across the pharmacy profession, something that has been much called for.

There were some 1 billion prescriptions dispensed last year. At this volume, it is, of course, impossible to avoid all errors, and it is certainly a credit to the pharmacy profession that they are statistically very few and far between. Most professional groups in the health service do not face criminal conviction and potential imprisonment for an inadvertent dispensing error, and therefore it would be quite wrong for pharmacists to be the only ones who do. It is therefore very welcome that this SI extends legal protections to pharmacists working in a range of locations, such as prisons, hospitals and care homes.

Those working in these settings are often under increased stress, and this has been exacerbated by the challenges of the pandemic. The Pharmaceutical Journal has found an approximate doubling of pharmacists reporting that they feel extremely stressed compared with recent years. In often very pressured circumstances, it is right that we, in the way we are discussing today, protect pharmacists—who are often people’s first point of contact with the healthcare system and too often victims of abuse—from unintended mistakes. Ensuring the right to legal defence against prosecution in cases relating to inadvertent error will undoubtedly remove some of the fear these clinicians feel when it comes to admitting errors. It will help to prevent and reduce patient harm through taking the wrong medication or dosage.

It will also assist in promoting a culture of transparency, as has been referred to already. That will help to inform future learning and improve protocols for the dispensing and preparation of medicines. I agree that this is very much a helpful step towards cultural change and towards a more positive and candid workforce, which, as we have already referred to, can only serve to make patients safer.

Of course, again, it is right that this SI extends only to inadvertent errors. Where they are wilfully negligent or intent on causing deliberate harm, those who are responsible will continue to face criminal prosecution. This is critically important and we certainly support that.

I move on to my outstanding questions on the SI. I am concerned that, of the 523,000 dispensing errors that occur each year, only 5% are reported. Does this not suggest that the 2017 legislation increasing protection for inadvertent errors has been largely unsuccessful in encouraging honesty? What more are the Government doing to increase that number? How will the Government further encourage individual pharmacists to feel safe to come forward if they have dispensed the wrong medication? I should like to understand further how the professionals affected by this legislation, especially those who are more isolated than those who have the benefit of a network of pharmacists easily accessible to them, are informed about these changes.

There is always so much more to do when it comes to patient safety, but this is a very welcome step forward. I look forward to the Minister bringing forward further improvements in due course.

[Lord Kamall (Con)]

I begin by thanking noble Lords for their questions. I shall try to answer as many as I can and, in the usual way, if I have missed any of them, I will go through Hansard and make sure I respond in more detail. The noble Baroness, Lady Walmsley, asked about deterrence. I have some statistics here. In 2021, a survey of community pharmacists found that 95% of pharmacists said that they report errors to improve practice and 80% to learn from mistakes. In response to her specific question about fear of prosecution as a reason not to report an error, it dropped from 40% in 2016 to 18% in 2021, largely attributed to the 2018 change in law. Therefore, we expect a similar drop in the fear of being prosecuted for the pharmacists covered by this order.

The noble Baroness also asked about the chief pharmacist. This is a statutory role that mirrors the statutory role of the superintendent pharmacist in registered retail pharmacies. This aims to strengthen the governance of pharmacy services by incentivising the creation of this role, if a hospital, prison or care home does not already have one, in order to benefit from these defences. However, to reflect the diverse arrangements in different health settings, organisations do not necessarily need a specific chief pharmacist role, but should ensure that the statutory functions of a chief pharmacist are included in the relevant individual’s job responsibilities if they want to benefit from the defences.

There was a specific question about where there is no chief pharmacist officer. I understand that, at the moment, existing pharmacists can have that duty extended to them, but I shall have to write to the noble Baroness with more detail. What is really important, as she acknowledged, is the duty of candour. We want to encourage an environment where people do not feel afraid to come forward in order to learn. Of course, there is always the right balance between those who have acted maliciously compared to those who have made a mistake. As the noble Baroness, Lady Merron, rightly said, when you are dispensing this number of prescriptions, statistically and probability-wise, there is probably bound to be some error.

To go back to the point about the chief pharmacist officer, given the flexibility, people do not need to adopt the statutory term of chief pharmacist as a job title; they can have the role of chief pharmacist assigned them. I just wanted to clarify that; if I have not been clear, I shall write to the noble Baroness.

I just want quickly to give a bit of a flavour of the errors to show how something might not necessarily be malicious but could be an error. A medicine intended for another patient could be dispensed to the wrong patient. The wrong medicine could be dispensed. An ingredient could have inadvertently been omitted or added when making up a medicine. A medicine could be dispensed at the wrong strength or in the wrong dosage form. These things happen, not intentionally but unintentionally, which is why we want to make sure that we learn from such mistakes.

Given that we have already introduced these offences for the majority of pharmacy professionals in the retail sector, it is right that we extend them to colleagues working in hospitals. By introducing this order, we are not only removing the fear factor for pharmacy professionals but helping to protect the patient under their care. We know from patients that it is important for them to know that, when an error is made, responsibility is taken and the service learns lessons. This legislation supports and incentivises that principle.

I am not clear whether I have answered every question, but I will check and write to the noble Baronesses as appropriate. I thank noble Lords for their interest and the positive debate today. I commend this draft order to the Committee.

International Healthcare Outcomes

Baroness Merron Excerpts

Thursday 19th May 2022 Lords Chamber

Asked by

[Baroness Merron]

To ask Her Majesty’s Government what assessment they have made of the report by Civitas International Health Care Outcomes Index 2022, published in April; and in particular, the factors that ranked the UK healthcare system 18th in a league table of 19 comparable countries.

[Baroness Merron (Lab)]

My Lords, the recent Civitas report—

[Noble Lords]

Oh!

[Baroness Merron (Lab)]

I shall start again. I beg to leave to ask the Question standing in my name on the Order Paper.

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

I assure the noble Baroness that I am only too happy to answer the Question standing in her name.

The Government value the use of robust international comparisons to help improve and reform health services, and work closely with the OECD in compiling such statistics. The Civitas report is based on data already known to the Department of Health and Social Care, which highlights both where the NHS is world-beating as well as where it needs to improve.

[Baroness Merron (Lab)]

My Lords, the recent Civitas report on international health outcomes does not make pretty reading, showing the UK to be the worst for stroke and heart attack survival. With the NHS and patients facing record waiting times and soaring turnover and vacancy rates in the workforce, and no corresponding social care proposals in the Queen’s Speech to alleviate pressure, will the Government finally commit to a proper workforce plan with projections of future need and a proper plan to meet those requirements?

[Lord Kamall (Con)]

I should refer Members to my interests. When I thought I had retired from politics a couple of years ago, I took up two posts: one as a professor of politics and international relations and the second as an academic research director of a think tank. That meant engaging with a number of think tanks across the spectrum, including Civitas—phew, I have got that off my chest.

I have always admired the noble Baroness for her diligence, particularly during the passage of the Health and Social Care Bill. Given that, I was puzzled by the premise behind the Question. It refers to the UK being ranked 18th out of 19 overall. I found no such ranking in that Civitas report when I was reading it for my homework last night.

St George’s Hospital: Patient Deaths

Baroness Merron Excerpts

Wednesday 18th May 2022 Lords Chamber

[Lord Kamall (Con)]

The noble and right reverend Lord raises a number of important points about consistency and the number of investigations. Their remits are often different, which can confuse the picture, and sometimes some of the investigating bodies are seen to extend beyond their remit, causing further confusion. In this case it is important to recognise the difference between the coroner’s inquest and the work of the independent mortality review. Coroners’ inquests are different, and an independent mortality review was not undertaken to determine the cause of death in individual cases or to attribute blame. It was all about processes, procedures and culture.

[Baroness Merron (Lab)]

My Lords, it is hard to imagine the trauma and pain that bereaved families have suffered, and the terrible impact on surgeons, the staff team and patients. It is concerning to read reports that junior doctors have been prevented from returning to work at the unit to keep them out of a toxic culture of inappropriate behaviour. Can the Minister tell your Lordships’ House what is being done to stamp out toxicity, not just in these tragic circumstances but in NHS workplaces more generally, and what assessment has been made of the problem?

[Lord Kamall (Con)]

Let me begin by agreeing with the noble Baroness on how important it is to recognise the impact that this has had on the bereaved families, and the uncertainty they have experienced. They thought it was going in one direction; clearly that was addressed by the coroner and now the coroner may apologise. When I was looking at this in more detail, I was sadly told not to discuss the culture because of ongoing investigations, but I commit to write to the noble Baroness, to make sure that I am not breaking any legal principles and that I give her a proper response rather than an inappropriate one now.

Health and Care Bill

Baroness Merron Excerpts

Consideration of Commons amendments
Tuesday 26th April 2022 Lords Chamber

Moved by

[Baroness Merron]

At end insert “, and do propose Amendment 29D in lieu—

29D: Page 42, leave out lines 14 to 19 and insert—
“(1) The Secretary of State must, at least once in every three years, lay a report before Parliament describing the system in place for assessing and meeting the workforce needs of the health, social care and public health services in England.
(2) NHS England and Health Education England must assist in the preparation of a report under this section.
(3) The organisations listed in subsection (2) must consult health and care employers, providers, trade unions, Royal Colleges, universities and any other persons deemed necessary for the preparation of this report, taking full account of workforce intelligence, evidence of trends in healthcare and demand for it, and workforce plans provided by local organisations and partners.””

[Baroness Merron (Lab)]

My Lords, I beg to move Motion A1 as an amendment to Motion A to insert the words as printed on the Marshalled List. My noble friend Lady Wheeler will speak to Motions D and D1 and I will focus my remarks on the issue of the health and social care workforce. However, before I do, I welcome the compromises reached on the reconfiguration of local services and on NHS procurement while avoiding modern slavery. I believe the constructive discussions that we have had have truly improved this Bill and I am grateful to noble Lords across the House and to the Minister for his efforts and commitment.

The importance of the workforce has been debated extensively, both in the other place and in your Lordships’ House. Once again, I am arguing for the importance of implementing a proper forward-looking plan. That I am doing this even after yesterday’s proceedings in the other place conveys just how strongly we feel on this issue. Over 100 organisations of healthcare professionals, think tanks, practitioners and patients have supported our efforts. They continue to press us to make the point that, without mandated forecasts of staff numbers, meaningful workforce planning—something that every other efficient organisation undertakes—cannot take place. They continue to despair at the Government’s now repeated refusal to demonstrate proper commitment to safely staffing our hospitals and other healthcare settings.

We all know that there is desperate understaffing. The staff know it; they feel the pressure and they see the adverse outcomes. The patients know it, often falling into a cycle of long waits, in pain and discomfort, because of staff shortages. Resolving this is quite straightforward. We need a national staffing picture, otherwise how will we know whether we are training enough staff to meet the needs of the country? Yet the Government continue to refuse to commit to producing such an assessment. They say that the necessary work has already been done, or is going to be done, but we, and stakeholders, vehemently disagree, and it is hard to follow the Government’s logic.

If the Secretary of State will not show leadership then NHS England must step up and produce its own requirements and projections, or the Local Government Association could commission such work across the country by local authority. Some way, somehow, every integrated care system and local authority will have to quantify their future workforce requirements and projections and plan for how these will be met.

The Government’s current drafting leaves open some serious questions. We do not know whether the plan will cover health and social care workforces. What is the intended timeframe of the commissioned NHS England plan, and will it be recommissioned once this period expires? Can the Minister confirm that robust data on staff numbers in our healthcare workforces will be published and, if so, when? I would be grateful for any clarification that the Minister can provide.

I deeply regret that the Government have felt unable to meet with parliamentarians—the Opposition, other political parties or indeed any of our experienced Cross Bench Members—even to discuss this issue. This is an irregular and unwarranted response. I hold out hope that, even at this late stage, the Government may see good sense in planning for the workforce that we need, instead of leaving it to chance. I beg to move.

--- Later in debate ---

I also remind noble Lords that at the beginning of the consultation we had an open meeting with the Minister for Care, Gillian Keegan, to answer all questions, including on the cap and the metering. Please let us grasp this opportunity or we could be waiting for another proposal. This proposal could wait, gathering dust on shelves for many years to come, like previous proposals. Let us grasp the opportunity and have the courage to address social care. I ask that noble Lords support our amendments.

[Baroness Merron (Lab)]

My Lords, in opening this debate, the Minister said that Motion A by and large did the job that Motion A1 seeks to do. I beg to differ, and so do more than 100 key organisations that work day in, day out on health and social care. Unless we plan and prepare to have the right workforce in place, it will continue to be the case that we do not have the right workforce, so what is happening now will simply continue. We will not be sure of safe staffing levels, nor have the people in place to give the levels of service that mean patients do not have to continue to suffer long and painful waits.

I remain deeply disappointed that on workforce, a central pillar of how we run our health and social care services, the Government have refused to even discuss this matter. I ask the House to agree to Motion A1.

Folic Acid Fortification

Baroness Merron Excerpts

Wednesday 6th April 2022 Lords Chamber

[Lord Kamall (Con)]

I understand the frustration that noble Lords have expressed. The same frustration is shared by officials in the department. When I asked officials, “What are the issues that you really need to get to the bottom of?”, one was the appropriate level of fortification. It is interesting that noble Lords seem to disagree with the department’s advice. Therefore, I will facilitate a conversation. Another issue is how that appears compared to other additions and fortifications put into flour. We want to get the right balance. The Government are committed to doing this and we will start as soon as the Northern Ireland elections are over.

[Baroness Merron (Lab)]

My Lords, all the research on adding folic acid to flour, including that by the Government’s independent Scientific Advisory Committee on Nutrition, shows that it is a completely safe measure with no unintended health consequences. In preparation for going down this route to protect newborn babies—which I really would urge the Minister to progress as soon as possible—what plans do the Government have to communicate the benefits of these measures and to reassure those who may have concerns, including parents, and parents-to-be?

[Lord Kamall (Con)]

This will all be part of the consultation, but once the policy has been decided on and fortification starts, clearly, we will be communicating to parents, families and others. If there is a risk—which noble Lords in their expertise seem to disagree with—we will have to identify that. The history of good intentions is littered with unintended consequences. We must be aware of those in our pursuit of increased folic acid in flour.

NHS: Abuse of Nurses

Baroness Merron Excerpts

Tuesday 5th April 2022 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for his question. When the NHS started investigating and digging deeper into this issue, the assumption was that it was often just members of the public. It is finding that it is individuals who have had a mental health crisis or are suffering from dementia or another neurological condition, rather than the classic perception of members of staff being abused by the public.

[Baroness Merron (Lab)]

My Lords, yesterday’s Health and Social Care Committee report emphasised that earlier diagnosis and prompt cancer treatment will not be possible without a plan to address gaps in the cancer workforce, including the need for nearly 3,500 additional specialist cancer nurses by 2030. Does the Minister accept that a workforce plan is essential to improving cancer diagnosis, research and treatment, and how will the Government attract new staff and improve staff retention by improving day-to-day working conditions, which must include preventing abuse and giving support where it does occur?

[Lord Kamall (Con)]

I hope the noble Baroness will appreciate that I have laid out some of the initiatives that are taking place, and which are not only trying to prevent abuses against members of staff and nursing staff but supporting staff to de-escalate them. On well-being and getting more nurses, the Government are committed to continuing to grow the NHS workforce. We are still committed to the figure of 50,000 more nurses and to putting the NHS on a trajectory towards a sustainable long-term supply in the future. We are working on a number of well-being schemes to ensure that nurses are supported and feel safer and more willing to stay in service.

Health and Care Bill

Baroness Merron Excerpts

Consideration of Commons amendments
Tuesday 5th April 2022 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I plan to address matters in the group that have not been addressed by my noble friends. They are workforce planning, reconfiguration and organ tourism.

First, on Motion K, on organ tourism, I congratulate the noble Lord, Lord Hunt of Kings Heath, my noble friend Lady Northover and others on their success in convincing the Government that something must be done about this dreadful trade. I also thank the Minister for listening.

On Motions B and B1, we support the noble Baroness, Lady Cumberlege, and will be right behind her when she leads us into the electronic Content Lobby on her Motion B1. It was made clear during earlier stages of the Bill that Peers across the House believe proper planning for training and providing a safe health and care workforce is essential. We also hear that almost 90% of trust leaders do not think the NHS has robust plans in place to deal with the workforce shortage. We are asking a lot of the NHS and care workforce at the moment; they are badly understaffed but, at the same time, are being asked to reduce the backlog of treatments that built up during the pandemic, while Covid-19 is still rampant in the population and thousands of patients are still in hospital with that as the primary cause.

In these circumstances, we have a desperate need for a reliable system to plan for and provide the staff we need, but nobody has confidence in the current system—if you can call it that. However, it seems that the Treasury has stuck its oar in. I find that rather odd, since neither the Bill as drafted nor the various amendments of the noble Baroness, Lady Cumberlege, have mandated the Treasury to fund the numbers of workers at every level who may be identified as necessary to deliver the health and care we need.

I accept that, when the yawning gap becomes clear between the numbers we have and the numbers we need for safe care, there would indeed be pressure on the Treasury to provide the money. However, it has been pointed out many times—including this afternoon, by the noble Baroness, Lady Cumberlege—that the NHS spends £6.2 billion every year on expensive agency staff, whose roles could be provided much more cheaply, and with better continuity for patients, by permanent employed staff. Considerable savings could be made to offset this.

It is significant that the Government are resisting the noble Baroness’s amendment. They know very well that the reviews she recommends would shine a light on the fact that the NHS and care systems do not know what they have got or need, and are badly short-staffed. The Government would be pressured to do something about it.

Since the Ockenden report, something else which is rather crazy has emerged. The Government have agreed to comply with all Ockenden’s recommendations, including on planning for and providing adequate staff in obstetrics and gynaecology. Hopefully, all maternity units will be safer in future, but it would be ridiculous to have a maternity unit adequately staffed in the same hospital as a cancer or stroke unit that was not. In voting for the amendment from the noble Baroness, Lady Cumberlege, we will attempt to save the Government from making such a dreadful and unnecessary mistake. We will be voting for safe health and care services in the future, in the interests of patients and staff alike.

On Motions C and C1, we support the amendment in the name of the noble Baroness, Lady Thornton, which she will no doubt speak to in a moment. In voting for this amendment, we will again be attempting to save the Secretary of State for Health and Care from getting himself into an awful pickle. There may be far too much temptation for a Secretary of State to use the powers in the Bill as it stands to meddle in matters far better decided by the professionals and local authorities on the ground. A clear process, which is rooted in local accountability, already exists for reviewing proposals for NHS reconfiguration—there is no call for the Secretary of State to be further involved except now and then if an election is in the offing. The Government have emphasised accountability throughout this Bill, but that accountability must be at the right level. Many of the decisions that might be made under the power that we are attempting to curtail today should be accountable to local people through those operating the local integrated care systems. By interfering, the Secretary of State may well corrode the very accountability that the Government say they want. We will be voting with the noble Baroness, Lady Thornton.

[Baroness Merron (Lab)]

My Lords, I sense a deepening of support in your Lordships’ House for the issues contained within this group. I start by thanking the noble Baroness, Lady Cumberlege, for introducing Motion B1. I also put on record my thanks to the 100 organisations which have indicated their support and got involved to make this an even better Motion for us to consider.

Yesterday’s Health and Social Care Committee report said:

“Neither earlier diagnosis nor additional prompt cancer treatment will be possible without addressing gaps in the cancer workforce”


through a workforce plan. The lack of staff, both currently and projected, is not restricted to the cancer workforce but extends to the total staff shortage of some 110,000 across the NHS as well as 105,000 vacancies in social care, while some 27,000 NHS workers voluntarily left the health service in just three months last year, the highest number on record.

As we have heard, just last week your Lordships’ House debated the Ockenden review, which I believe has provided great focus on the issue of workforce planning. The review shockingly laid bare the reasons why hundreds of babies’ lives were avoidably cut short or damaged and mothers died; to their great credit, the Government have accepted every one of the recommendations. The clear finding here is that we must safely staff our maternity wards, yet midwives are leaving the NHS in greater numbers than it is possible to recruit them. If the Ockenden review does not illustrate why we need a workforce plan then I do not know what does.

It is worth reflecting on what Motion B1 is not about, in case that offers some late reassurance to the Minister. Despite needing all of these things, it does not commit the Government to hiring thousands more doctors and nurses, nor does it commit to new funding for the NHS. It does not even commit the Government to finally publishing the workforce strategy that the NHS is crying out for—even though the NHS has not had a comprehensive workforce strategy since the Government’s plan was published in 2003.

What Motion B1 talks about is an independent review of how many doctors, nurses and other staff are needed in health, social care and public health, both now and for the future, and that the report, which must be brought before Parliament, must be informed by integrated care boards, employers, trade unions and others—people with expertise and a great contribution to make. This is not just a question of recruitment, important though that is, but one of retention. There is absolutely no way out of planning and preparation; without them, it is just not possible to magic up the necessary staff. Motion B1 is about facing up to the scale of the workforce challenge so that we can see safe and efficient health and care. These Benches will certainly be supporting Motion B1 if the will of the House is tested.

I turn now to Motion C1 in the name of my noble friend Lady Thornton. The inclusion of a clause about changes to reconfiguration shows that not all of the Bill was what the NHS was asking for. The powers in this clause are unnecessary and introduce a very considerable new layer of bureaucracy. Just about every commentator and representative group has said that this approach of an interventionist Secretary of State is quite wrong. As many have pointed out, the power that any proposal can be taken over by the Secretary of State takes us down a road of politicisation and will deter some from even trying to pursue necessary but controversial changes. It matters not that we are told that this power will be used only sparingly; if it is there, that will influence behaviour.

Given where we are in the parliamentary process, outright rejection of this provision would, of course, be problematic. Our alternative in this Motion is to say that, if the power is only rarely to be used—in exceptional circumstances, when intervention is justified—then the way to deal with this is to make that case to Parliament, to put it up for proper scrutiny and to show the evidence. If we are potentially to deprive people of their right to be consulted, then at least let Parliament do a proper job of examining this.

I now turn very briefly to Motions D1 and K. I thank the noble Lord, Lord Blencathra, for presenting Motion D1 today. It seeks to ensure that health service procurement of all goods and services avoids modern slavery; in other words, it takes us further than Motion D. I thank the Minister for the move forward contained within that Motion; however, if the noble Lord, Lord Blencathra, wishes to test the will of the House, we on these Benches will certainly be in support.

I congratulate my noble friend Lord Hunt and other noble Lords for their persistence in ensuring that Motion K is before us today. Again, I thank the Minister for being so responsive on this point. I hope that, in the votes that follow, your Lordships’ House will swiftly take the opportunity to ask that we might further improve this Bill.

[Lord Kamall (Con)]

I thank all noble Lords for their contributions and their constructive debate and engagement, not only this evening but throughout the process of the Bill. I thank noble Lords also for their agreement to the measures we have drawn up on organ tourism. I thank the noble Lord, Lord Hunt, for the way he pushed the Government, making sure that we were able to find a constructive way of closing that gap.

Down Syndrome Bill

Baroness Merron Excerpts

3rd reading
Friday 1st April 2022 Lords Chamber

[Baroness Merron (Lab)]

My Lords, the commitment to supporting people with Down syndrome has come through loud and clear in your Lordships’ House. I pay tribute to, and congratulate, Dr Liam Fox on introducing the Bill in the other place and the noble Baroness, Lady Hollins, for steering the Bill through your Lordships’ House with her characteristic professionalism and sensitivity. We are glad to follow her lead. From these Benches, we give our support to the noble Baroness in her endeavour, through this Bill, to support the 40,000 people with Down syndrome. They and their families, friends and communities will be appreciative—as are we—of the recognition and improvements brought about through this Bill.

I know that the noble Baroness, Lady Hollins, is keenly aware of the point raised in earlier debate that, in the focus on Down syndrome, noble Lords would not want to create a hierarchy of learning disability which may inadvertently create challenges for other learning-disabled people. I very much welcome the words of the noble Baroness today in this regard. It is also welcome that the department has given a commitment that new guidance will be formed in consultation with key stakeholders. I am keenly aware that this Bill is not the end of the journey but just one step along the journey. In conclusion, I congratulate the noble Baroness, Lady Hollins, on her tireless work for those with learning disabilities, and I wish the Bill all the very best as it continues its path.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, we have a remote contribution from the noble Baroness, Lady Brinton.