NHS: Preventive Medicine

Baroness Rawlings Excerpts

Wednesday 20th January 2016 Lords Chamber

Asked by

[Baroness Rawlings]

To ask Her Majesty’s Government how they intend further to incorporate preventive medicine into the National Health Service.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, the NHS five-year forward view set out a shared vision for the future of the NHS. It includes the long-standing aspiration for the NHS to focus as much on prevention and promoting wellness as managing poor health, working in partnership with local public health services through health and well-being boards.

[Baroness Rawlings (Con)]

My Lords, I thank the Minister for his positive reply. I never thought that I would quote in your Lordships’ House the leader of the Opposition in the other place. He asked the Prime Minister at Prime Minister’s Questions recently whether he had,

“forgotten the simple maxim that prevention is cheaper and better than cure”.—[Official Report, Commons, 16/12/15; col. 1545.]

I commend the National Health Service for shifting its policy from sickness and cure to wellness and prevention. Would the Minister, through the National Health Service, encourage private health insurance organisations to do likewise, thus evading certain serious sicknesses and not adding to the National Health Service’s overstretched budget?

[Lord Prior of Brampton]

My Lords, there is clearly a direct legal contractual relationship between a private insurance company and an individual. The NHS cannot interfere directly with that contract. There is no similar legal relationship between the NHS and the citizen, although there is clearly a social and moral contract between the two. As part of that contract the state agrees to provide free, high-quality healthcare. It is only right that the individual should accept personal responsibility for their health and well-being, and that of their family.

Health and Social Care Bill

Baroness Rawlings Excerpts

Tuesday 13th March 2012 Lords Chamber

Amendment 248 not moved.

[Baroness Rawlings]

My Lords, I remind the House that Questions will be at 2.30 pm. If necessary, we will interrupt an amendment at that point or just before.

Amendment 249

Moved by

--- Later in debate ---

Amendment 258 agreed.

[Baroness Rawlings]

My Lords, this might be a convenient moment for the House to adjourn until Oral Questions at 2.30 pm.

Health and Social Care Bill

Baroness Rawlings Excerpts

Thursday 8th March 2012 Lords Chamber

[Lord Campbell-Savours]

So that we can have it absolutely on the record, is the noble Lord saying that a teaching hospital in central London—

[Baroness Rawlings]

My Lords, we are on Report.

[Lord Campbell-Savours]

It is a very important question.

[Baroness Rawlings]

My Lords, it must be a brief question.

[Lord Marks of Henley-on-Thames]

My Lords, I believe that I have answered the question. I accept that it is important. We believe that the provisions that are now to be in the Bill, given the government amendments and an assurance that I hope to receive from the Government, will cover the position.

I was explaining that, when we tabled Amendment 220B, we believed that there should also be an individual arrangement for agreement with Monitor so that all considerations could be balanced when considering any substantial increase in private income. However, in discussions, the Government agreed to respond to amendments that Liberal Democrat Peers tabled in Committee on the involvement of governors. Those amendments that the Government now pursue—Amendments 220BZA and 220BZB—represent that response. They ensure that any increase of more than 5 per cent would have to be approved by the governors voting, as I say, by a majority. The governors have to be satisfied that the plans put forward by the foundation trusts for attracting private income would not interfere with the treatment or welfare of NHS patients. I suggest that that scheme represents a devolved, local scheme that is consonant with the structures in the Bill and the desire to keep local decision-making at a local level.

There may still be concern that the governors of individual foundation trusts will primarily have in mind the concerns of their own foundation trusts. However, under amendments that have been agreed, Monitor is now to have continuing powers of supervision and intervention over foundation trusts. If we are assured that in every case where the governors approve a proposal for an increase in private income in excess of 5 per cent Monitor will consider whether the interests of NHS patients as a whole are to be safeguarded, and if it is not so satisfied it would intervene, I suggest that that assurance will meet that concern. We will not move Amendment 220B but we seek that assurance from my noble friend the Minister.

--- Later in debate ---

[Lord Warner]

May I just correct the noble Baroness? I actually anticipated that the noble Lord, Lord Phillips, was going to jump up. I did not stop him jumping up. He chose to withdraw.

[Baroness Rawlings]

May I just remind the noble Lord that the Companion sets out that a Member shall not speak twice on an amendment on Report.

[Lord Hunt of Kings Heath]

My Lords, I have to say that we are seeing a reinterpretation of the normal procedure on Report. Nothing in the Companion prevents a noble Lord intervening and asking the Minister a short question. The fact is that by ploughing on and refusing to answer questions, the Minister is not serving the House appropriately.

[Baroness Rawlings]

I shall just read from the Companion:

“A member of the House who is speaking may be interrupted with a brief question for clarification. Giving way accords with the traditions and customary courtesy of the House. It is, however, recognised that a member may justifiably refuse to give way, for instance, in the middle of an argument, or to repeated interruption, or in time-limited proceedings when time is short. Lengthy or frequent interventions should not be made, even with the consent of the member speaking”.

[Baroness Northover]

My Lords, it may help the House if I continue, but I am very happy to give way to noble Lords who wish to ask questions once I have gone through the various elements.

Government Amendment 226ZG will enable HealthWatch England to make recommendations of a general nature to local authorities about the making of arrangements for local healthwatch organisations and, where HealthWatch England is of the opinion that local healthwatch organisations’ activities are not being carried out properly, to draw this to the attention of the local authority.

Amendment 226A, tabled by my noble friend Lady Cumberlege, would place a duty—I see Companions spinning all around the House, so while noble Lords are studying that—

Health and Social Care Bill

Baroness Rawlings Excerpts

Monday 19th December 2011 Lords Chamber

Schedule 18, as amended, agreed.

[Baroness Rawlings]

My Lords, I beg to move that the House do now resume. We are most grateful to noble Lords for their brevity. As a result, we have reached our target for today so noble Lords do not need to return after the dinner break this evening for further debate on the Health and Social Care Bill.

House resumed.

Health and Social Care Bill

Baroness Rawlings Excerpts

Tuesday 13th December 2011 Lords Chamber

[Baroness Rawlings]

My Lords, before we move to the next group of amendments, it may be for the convenience of the House if I remind noble Lords that we will interrupt the debate on this group at a convenient moment shortly before 2.30 pm. The House will then resume and, if necessary, adjourn before we take Oral Questions at 2.30 pm.

Amendment 260EB

Moved by

Public Bodies Bill [HL]

Baroness Rawlings Excerpts

Monday 28th March 2011 Lords Chamber

[Baroness Jones of Whitchurch]

My Lords, I am grateful to my noble friend Lord Whitty for continuing to champion the organisations that stand out as protecting consumer interests, and for the remarkable good sense that he has shown again this evening in defending Ofcom's independence.

During the passage of the Bill there have been several attempts by Ministers to make reassuring noises about the importance of Ofcom and its central role in the future of media regulation. This may well be the case, but I share my noble friend's concern that the thrust of these changes, far from giving Ofcom greater responsibility, will limit its power to intervene in crucial issues such as media ownership and changes to public broadcasting. Power appears now to be increasingly centralised in the hands of the Secretary of State.

As is the case with many other organisations for which changes are sought in the Bill, one is left to wonder about the cost savings that might occur if the Minister's department is serious about taking on those functions. I concur with the questions of the noble Lord, Lord Fowler, about the proposed savings expected from Ofcom in this context. The Government have trumpeted the increased transparency that will occur, but it remains unclear how we will be able to scrutinise the major decisions that will be taken in the department on issues such as media control. When it comes to transparency, give me Ofcom any day.

My noble friend repeatedly emphasised, in previous debates and today, the special status of the economic regulators and the need to protect their independent function. Again, the Government took steps in the past to reassure the House on this matter. However, like other noble Lords today, I am left wondering why they felt that it was necessary to put the remaining changes to Ofcom in the Bill, and whether this still represents a shift in power and authority away from independent economic regulators and back to the centre. If this is the case, it is a backward step both for the consumer and for the wider public, as well as being a cause for celebration for would-be media barons. I remain unconvinced of the need to change Ofcom's role through the formal mechanism of the Bill, and very much look forward to hearing the Minister’s justification of why it is necessary.

[Baroness Rawlings]

My Lords, I thank the noble Lord, Lord Whitty, for tabling these amendments and for giving the Government the opportunity to state clearly to your Lordships' House how they intend to use the powers in Clauses 4 and 5 to reform Ofcom. The noble Lord asked why Ofcom is included in Schedules 4 and 5 to the Bill. This is so that we can bring forward several small changes to some of its duties that will make certain that it will be able to fulfil its statutory duties as efficiently and effectively as possible.

The communications landscape has changed significantly over the past decade, since Ofcom was established by the Office of Communications Act 2002. It is sensible and timely that we now use this opportunity to make some changes. At a time when the public sector must become more efficient, it is right to amend or remove some of Ofcom's duties, which will result in a small reduction in its cost to the public purse. I confirm that Ofcom is comfortable with the proposed changes to its duties. In answer to the concerns raised by the noble Lord, Lord Hunt, in our last debate on these amendments, I can reassure him that the overarching responsibilities of Ofcom will not change, and that its independence will remain a fundamental principle of regulating the communications sector.

I note, too, that the noble Lord is concerned that the Government may look to introducing additional changes in years to come using the Public Bodies Bill. I can reassure him that we have no plans to make any additional changes to Ofcom’s duties other than the nine small changes that we propose to bring forward by order after the Public Bodies Bill receives Royal Assent.

Public Bodies Bill [HL]

Baroness Rawlings Excerpts

Wednesday 9th March 2011 Lords Chamber

[Baroness Royall of Blaisdon]

My Lords, we support the amendments because they would safeguard and promote the Welsh language. They are fundamental to the protection of the Welsh language in Wales and to good governance there. We hope that the Minister will be able to take them away and consider them before Report.

[Baroness Rawlings]

My Lords, we return to Wales. At this late hour, I am sure that noble Lords will appreciate my being brief, but this does not imply that we do not take the two amendments seriously.

The Government sympathise with the desire of the noble Lord, Lord Wigley, to make certain that support for the Welsh language, which is undertaken by many bodies providing public services in Wales, is not lost when roles are transferred from one person to another. This is not our desire and we are committed to making certain that this work is not undermined. However, where we differ with the noble Lord is on whether the amendments represent the best means of achieving this aim.

I shall first consider the noble Lord’s Amendment 166BZB, on Welsh language assessments. I understand that there are 18 bodies whose roles could be transferred under the Bill which currently have Welsh language schemes and services. If the roles of those bodies are transferred elsewhere, the Government will consider the options for maintaining these services. Ministers will conduct impact assessments when proposing to make orders under the Bill. The Bill will require them to consult a wide range of interested parties.

I turn to Amendment 166BZA, on the application of Welsh language requirements. Welsh Ministers already have the power to bring bodies within the scope of the Welsh language legislation. The precise duties which are imposed are then a matter for negotiation with the Welsh Language Board. In the Government’s view, these powers provide a more appropriate way of addressing this issue than the noble Lord’s amendment. Indeed, the amendment could even reduce Welsh language provision. We consider it more appropriate to assess what requirements are needed in the context of each specific transfer, using the powers available in Welsh language legislation and in the Bill.

I thank the noble Lord for bringing up this matter. Consultation is going on. I hope, therefore, that he will not wish to press his amendments.

[Lord Wigley]

I am very grateful for that response. On the second of the two proposed new clauses, that an assurance has been given that assessments of the impact of any changes on the Welsh language will be possible in many ways meets the point that I make in that clause.

On the first of the proposed new clauses, the Minister’s comments with regard to the powers of Ministers in the National Assembly for Wales reassure me that those powers can be used fully to ensure that there is no loss of Welsh language requirements. That was my interpretation of what the Minister said. If there are any aspects of the ongoing discussions to which she referred that bring out questions that have not been covered, perhaps there will be an opportunity to tie up those matters fully on Report. On the basis of the assurances that have been given tonight, I beg leave to withdraw the amendment.