Terminally Ill Adults (End of Life) Bill
Debate between Baroness Nicholson of Winterbourne and Baroness Berridge(2 days, 21 hours ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Berridge (Con)
My Lords, Amendment 174 is in my name, and I am grateful to the noble and learned Lord for the meeting on this issue. This amendment states:
“Any interpreter provided under subsection (4) must be aged 18 … or over”.
It is a probing amendment.
If you put two lawyers in a room and give them wording from the NHS guidance saying that it is “inappropriate” to use children, you would have a fascinating discussion about discretionary versus mandatory, and that is the point behind this amendment. It might be that a different age, say 16, is appropriate, but since meeting with the noble and learned Lord, I have looked at certain guidance from particular NHS hospital trusts. Leicestershire Partnership NHS Trust states that you “must not” use children. The Milton Keynes University Hospital trust says that children “should not” be used as interpreters. So we have overall NHS guidance using the word “inappropriate”, which seems to imply discretion, but then we have certain hospitals—I obviously have not checked them all—using mandatory language. It is important that we consider whether, in this scenario, there should be any discretion to use children, whether they are under 18 or, as I say, under 16.
The TIA process should be mandatory, because it is a substantial process. This is the communication of a profound state of affairs. It includes numerous complicated stages, from a preliminary discussion to different co-ordinating doctors. It involves a Mental Capacity Act assessment and could involve the discussion of quite sensitive information about the administration of lethal substances and their potential complications. It is a serious and, as we have said, irrevocable decision.
My submission to the Minister is that it should not be an option that interpreting lies in the hands of a child, but that we should provide for qualified, skilled adults to be present and to provide that service, so that any relative, including children, can sit, support and have their own potential needs met. Is the noble and learned Lord satisfied that this should be a service provided by the National Register of Public Service Interpreters?
This is not a small problem. The census in 2021 shows that around 7.1% of people in the UK speak English as a second language and around 5% do not speak English well at all. The NHS website states that there are 1 million people who do not speak English well at all, who will need assistance with communication. If we do not provide this within the Bill, it might be that relatives, particularly children, are used in situations where the interpretation services are underfunded in that area—it is local commissioning that provides interpretation services.
I acknowledge that noble Lords may want the lower limit of 16, which some hospitals use, but I find it interesting to note that the limit may in the past have been too low. The former Member of the other place, Sajid Javid, talked about this. He said of his mum:
“I used to go to the doctor’s surgery with her—not because I was ill, but because I had to interpret for her. I was six or seven and an interpreter”.
I believe we should make sure that children in our jurisdiction are not placed in that situation.
From the evidence that was given to the Commons Public Bill Committee by Dr Jamilla Hussain, who is a palliative care specialist, we know that this issue disproportionately affects ethnic-minority communities, though not solely, of course. There are numerous reports of poor communication and interpretation that lead to adverse health effects and life-threatening illnesses being more prevalent in those communities. It would be the safest way possible if we put something mandatory into the Bill that does not allow for the possibility of situations where a young person feels they cannot say something, having been alongside their parent or guardian for many years. Putting something mandatory can actually protect those young people.
In relation to other clauses in the Bill, we have spoken about the profound effect on young people’s brains and development—I believe this is relevant and not repetition—of traumatic events such as the death of a close family member. That casts a new light on the possible neurological impact that interpretation by a child for a relative seeking assisted dying could have; it could give rise to further health conditions as they develop. Reports state that, if a child’s hypothalamic-pituitary-adrenal axis is faced with traumatic stress—in this instance the loss of the primary carer—it can lead to long-term functional and structural changes in key areas of the brain’s development. This can contribute to various psychopathologies, obviously including PTSD. Putting something mandatory into the Bill, so that children cannot be placed in this situation, is important to make it clear for all NHS hospitals which may have to deliver this.
It goes to a conceptual point, raised when I met the noble and learned Lord, about autonomy and choice. There are circumstances in which we limit autonomy and choice, particularly with children; we say that it is better for us all, as the legislature, to have taken a decision to protect those children. It should be mandatory that those under the age of 16 in this context are not taking part in the process of interpretation. It may be that, as we discuss this, there are situations and circumstances, such as terminal illness and advice about treatment, where it should be mandated that children are not involved as interpreters.
Baroness Nicholson of Winterbourne (Con)
My Lords, I will speak in support of my own Amendment 171, where I am suggesting that there is an adjustment to insert “hearing or visual impairments”. I declare an interest on both. First, I am a vice-president of Mary Hare School for deaf children, which is one of the world’s most wonderful schools for deaf children, not just in the United Kingdom but internationally; I have been a vice-president for a very long time, as were my parents before me. I do not speak on its behalf. Secondly, my other interest is that I recall my darling mother, who was completely deaf, completely blind and 100% paralysed for 13 months before she died, because of an unfortunate slip-up in an operation. It was, I am afraid, just one of those things. I therefore understand the needs of looking after someone who is 100% disabled, fully blind and fully deaf.
Gender Recognition Act 2004
Debate between Baroness Nicholson of Winterbourne and Baroness Berridge(5 years, 5 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Berridge (Con)
My Lords, it is deeply regretful that there has been vilification on both sides of this debate. We hope to move on from this consultation and that both sides can respect the differing views. The consultation made it clear that health service provision was a concern; there is specific training now through the Royal College of Physicians to ensure that medical practitioners are more alert to the issues of transgender people.
Baroness Nicholson of Winterbourne (Con)
My Lords, I thank the Minister for the excellent educational material on sexual education for children in schools, which her department recently published. En passant, I congratulate the noble Baroness, Lady Falkner, on her nomination as the next chair of the Equal Opportunities Commission. This material brings into sharp relief the previous advice that the Government seem to have been given by the Equal Opportunities Commission, which led the Department for Education to publish a decade-long sequence of materials, which vary greatly from the current new guidance. Is the Minister willing to have a meeting with me to discuss the detailed points of issue that I have raised?
Baroness Berridge (Con)
My Lords, I, too, congratulate the noble Baroness, Lady Falkner, on her appointment. I would be happy to meet with the noble Baroness. It is key to remember that the relationships and health education guidance that the department has put out was put out partly in response to the IICSA inquiry, which recommended that relationships education was a way to protect children so they would know what was a healthy relationship and when someone was perhaps approaching them for ulterior motives.
BAME Students: Pupil Referral Units
Debate between Baroness Nicholson of Winterbourne and Baroness Berridge(5 years, 11 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Berridge
The noble Lord makes an important point. We are aware that educational outcomes for students in alternative provision are not high enough, but last year 85% of all state-funded schools did not permanently exclude any pupil. The Government support head teachers having the power, as a last resort, to exclude pupils, but that should not be a ticket into education that is less than excellent. In fact, 83% of alternative providers were judged by Ofsted to be good or outstanding. That is only slightly less than overall for schools, which is 86%, and more than for secondary schools. Although there are issues, I pay tribute to the workforce in the alternative provision sector who are doing an excellent job dealing with behavioural and educational issues.
Baroness Nicholson of Winterbourne (Con)
My Lords, is the Minister willing to consider a mandatory physical check-up—particularly of teeth, eyes and ears, for example—for excluded students, not only BME ones? I speak as a former foster parent of a BME student. I recall well the wish not to be difficult and therefore not to talk about having, perhaps, a simple pain which could be sorted out.
Baroness Berridge
The noble Baroness raises an interesting issue. Children in AP settings will often have been placed there by the local authority, which has various safeguarding duties. If a student in its care cannot be educated due to health reasons, I would expect it to take the appropriate course of action.
Higher and Further Education: Rural and Coastal Areas
Debate between Baroness Nicholson of Winterbourne and Baroness Berridge(6 years ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Berridge
My Lords, the Social Mobility Commission made mention of the Government’s opportunity areas. That programme has been extended; there will now be a total of £90 million. Many of those areas, including Blackpool, Hastings and Whitby, are part of that programme. We are pleased to know that that programme is also in Opportunity North East, where there is specific funding. A number of factors affect access to the best education provision, and we are particularly looking at the transport offer. A discounted rail ticket has been introduced for 16 and 17 year-olds. From 2021, apprentices and jobseekers will benefit from discounted bus travel as well.
Baroness Nicholson of Winterbourne (Con)
Might the Minister look into coastal towns provision for disabled students? It may not be a question of the provision from the Government; universities may not be implementing the law. I give the example of Anglia Ruskin University, which has superlative education provision access for disabled students—compared with Hull University, which is more than inadequate; I believe it is actually breaking the law. Might the Minister be willing to have a word with me sometime on this?
Baroness Berridge
My Lords, my noble friend is correct that universities are bound by the Equalities Act and should make provision for students with special education needs and disabilities. Funding is available for them to do that, but I am happy to meet her at an appropriate time.