Health Bill

Baroness Sater Excerpts

Committee stage
Wednesday 11th November 2026 Lords Chamber

[Baroness Chisholm of Owlpen (Non-Afl)]

My Lords, feeling invisible, constant uncertainty, high rates of distress, caregiver burnout: these are only four of many problems facing those suffering from rare disease. That is why my name is on the amendments from the noble Baroness, Lady Grey-Thompson, and the noble Lord, Lord Sharkey. We have heard from the noble Baroness, Lady Grey-Thompson, about the importance of impact assessments. I am vice-chair of the Specialised Healthcare Alliance, along with my fellow vice-chair, the noble Baroness, Lady Sater, and the noble Lord, Lord Sharkey, is chair. It plays an important role in specialised services. I support the requirement for an impact assessment before any specialised service is delegated to ICBs. All that the noble Baroness, Lady Grey-Thompson, said makes a brilliant case for this.

I am really concerned that we still lack an overarching assessment of what the Bill could mean for specialised services as a whole. We need to have assurances on how the Government will assess and monitor the cumulative impact of changes on specialised services. I hope the Minister can reassure us on this point.

I strongly support what the noble Baroness, Lady Grey-Thompson, said about the importance of annual reporting. In fact, that is already standard practice in other major areas of the health service—for example, the newly established National Cancer Board. Surely the Minister must see that how important the tool of annual reporting is for driving accountability and improvement in cancer services. In which case, surely the same principle should apply to specialist services.

My name is also on Amendment 74 in the name of the noble Lord, Lord Sharkey, on the importance of clinical leadership. Given the number of people affected and the complex conditions involved, there is a strong case for a senior clinical leadership to provide strategic oversight across care, research and policy. The Future for Rare campaign, which the SHCA supports, is calling for a national clinical leader for rare conditions in each UK nation. Given the Government’s commitments to appoint a dementia tsar and a national clinical head for brain cancer, does the Minister agree that a similar role for rare conditions merits consideration? I look forward to the Minister agreeing to these very small but very important amendments.

[Baroness Sater (Con)]

My Lords, I will speak briefly in support of Amendment 74, to which I added my name, and I fully support all that has been said by my friend, the noble Lord, Lord Sharkey, and my noble friend Lady Chisholm. I declare an interest as a vice-chair of the Specialised Healthcare Alliance. I also put on record my support for Amendments 57 and 73 tabled by my friend, the noble Baroness, Lady Grey-Thompson. She made some very compelling points, particularly on the importance of proper scrutiny, transparency and accountability as we move towards these new commissioning arrangements. It is vital that we understand the impact of these changes and have the means to monitor whether they are delivering the right outcomes for our patients.

On Amendment 74, there is just one further point I would like to raise: the importance of patient and public involvement. While much of this debate has focused on clinical expertise, it is important that we recognise that clinical reference groups are also a key mechanism for patient and public involvement. If they are removed without a credible alternative, that patient voice risks being diminished. These voices are incredibly important. Through my work with the Specialised Healthcare Alliance, I hear at first hand from our coalition of nearly 400 patient organisations, campaigning on behalf of people with rare and complex conditions, just how important this involvement is.

There is no substitute for hearing directly from those with lived experience. Their perspectives are invaluable, and it is important that they continue to be heard as these new arrangements take shape. Will the Minister therefore set out how the Government intend to maintain and, ideally, strengthen patient and public involvement in specialised commissioning? In particular, I would welcome clarity on what role the new offices for the pan-ICB commissioning will play in supporting that engagement and ensuring that the voices of patients and their organisations continue to be heard.

I hope the Minister can provide some reassurance on this because, ultimately, the voices of patients and those who represent them must remain at the heart of specialised commissioning. I look forward to hearing the Minister’s response.

[Lord Harlech (Con)]

My Lords, I have been listening with great interest, and I am still none the wiser as to why my amendment has been crowbarred into this group. But I suppose it is quite apt to be discussing the medical situation of Reserve Forces personnel on Armistice Day. I declare my interest as a serving officer in the Army Reserve.

Amendment 279QE would require a health body, when dealing with an individual, to make arrangements to establish and record whether that person is a serving member of the Reserve Forces and then to have due regard to that individual’s need to meet the medical and dental fitness standards required for call-out. This amendment was debated at the Committee and Report stages of the Armed Forces Bill and I bring it here because, with respect, the reasons given for not accepting it do not survive examination. I should add that those answers came from the Ministry of Defence rather than from this department. I saw the noble Baroness, Lady Antrobus, in her place earlier and thought that perhaps the MoD had put her up to knock this one back again.

The first reason given was that the amendment risks undermining the principle that National Health Service treatment follows clinical need rather than employment status. My proposed new section says the opposite in subsections (2) and (7). More concretely, this Bill does not itself proceed on that principle without qualification. Clause 12 substitutes a new Section 3B into the National Health Service Act 2006, allowing regulations to require the Secretary of State to arrange

“services or facilities for members of the armed forces or their families”,

and subsection (4) of that new section defines them as including the Reserve Forces. The Bill before this Committee, therefore, already contemplates commissioning by reference to service status and names reservists when it does so.

Nor is the principle novel in practice. On Report on the Armed Forces Bill, the noble Lord, Lord Stevens of Birmingham, reminded the House that from 1953 until at least 1997,

“certain classes of veterans from the First and Second World Wars received priority treatment for certain conditions”,

and that today

“merchant seafarers receive fast-track access for routine care under the Dreadnought Medical Service on offer at St Thomas’ Hospital so they can get back to sea”.—[Official Report, 20/10/26; col. 608.]

Health and Care Bill

Baroness Sater Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Sater (Con)]

My Lords, I draw the attention of the House to my interests in the register. In particular, I am chair of the Queen’s Club Foundation and president of Tennis Wales. My purpose in speaking during Second Reading is to highlight the growing importance of sport, recreation and physical activity as essential components of the proactive health policy sought in many of the measures in the Bill. My noble friend Lord Moynihan and I have been working on this important issue. He was keen to speak today and offers his apologies as he is in Wales for long-standing school governor meetings. However, he will be with us in Committee.

The background to our concern, also shared by my noble friend Lord Hayward, is the notable move that sport and recreation has made from isolation from government policy up until the 1990s to taking centre stage in both health and education policy-making. Indeed, there is hardly a department of state where sport and recreation do not feature as an important strand of policy-making. While this debate is not about schools, who can deny that making sure that physical literacy is at the centre of modern educational policy is vital in the decade ahead? Participation levels have remained stubbornly low in the UK. Despite winning the right to host the Olympic and Paralympic Games in London 2012, the excitement in the build-up as we prepared to host the games from 2005 to 2012, and the much-fought-for sports legacy which was meant to raise the bar for sports participation across the country, our levels of participation and enjoyment of an active lifestyle have actually fallen as a percentage of the population.

The Key Data on Young People material recently published by the Health Foundation makes compulsive reading. What is known and appreciated is that the risk factors for later mortality are laid down in the teens and early 20s. The major risk factors leading to mortality or illness in later age are directly related not just to tobacco use or alcohol, for example, but to obesity and a lack of physical activity. If we take action and reverse this trend, physical activity can and must become a major factor in redirecting our health policy away from simply addressing illness to preventive work aimed at improving levels of physical fitness, well-being and mental health.

Covid has now changed the picture for the worse. In January this year, experts expressed deep concern that the coronavirus pandemic has had a huge impact on children’s physical activity levels. New figures from Sport England show that the majority of young people failed to meet the recommended 60 minutes of daily exercise in the 2019-20 academic year. That was a decrease of almost 2% compared with the previous 12 months. Almost a third of children—2.3 million—were classed as inactive as a result of lockdown restrictions, not even doing 30 minutes per day. That was up by 2.5%.

There appears to be little evidence that we have returned to pre-pandemic levels—an essential starting point to address 15 years of flatlining, growing obesity, growing inequalities and a crisis of fitness among young people. The Bill provides us with the opportunity to address this fundamentally important challenge. In Committee, we intend to introduce amendments to the Bill to ensure that the original plans for an Office for Health Promotion are enshrined in legislation, so that participating in sport and physical activity is at the heart of the Government’s plans and that people can and should enjoy healthier, happier and more productive lives.

On 29 March this year, the Government issued a press release announcing the welcome news that the Office for Health Promotion would be up and running by the autumn. The Prime Minister publicly welcomed the move, as we did. He said:

“The new Office for Health Promotion will be crucial in tackling the causes, not just the symptoms, of poor health and improving prevention of illnesses and disease … Covid-19 has demonstrated the importance of physical health in our ability to tackle such illnesses, and we must continue to help people to lead healthy lives so that we can all better prevent and fight illnesses.”


However, this welcome news—which I saw as a watershed step in the right direction by the Department of Health, underpinning, as it did, the vital importance of seeing sport and recreation as an inherent part of wider policy initiatives for social prescribing, physical and mental well-being and a fitter population more capable of tackling obesity and sickness, as well as a preventive policy for a healthy lifestyle—has been dropped.

In its place, an Office for Health Improvement and Disparities was formed. I say “in its place”, because the words of the Prime Minister had been erased from descriptions of the substitute body taking the place of the Office for Health Promotion. Mention of physical activity was completely deleted, resulting in the stark absence of any reference to its vital importance.

Whatever the final shape of the approach taken, I believe a key division in the Department of Health, bringing together the policy strands of active lifestyles, health and well-being, should be at the heart of British policy formation, and could achieve far-reaching benefits for all members of our community, particularly the hard-to-reach groups. My noble friends Lord Moynihan and Lord Hayward and other colleagues who share similar views look forward to exploring ways in which this can be achieved when we return to the Bill in Committee early in the new year.

Office for Health Promotion

Baroness Sater Excerpts

Thursday 29th April 2021 Lords Chamber

[Baroness Sater (Con) [V]]

My Lords, I declare my interests as set out in the register. I warmly welcome this new and important government initiative to establish an Office for Health Promotion, leading national efforts to improve the public’s health, particularly through promoting physical activity. Given that we know that physical activity can lead to better health and well-being, has my noble friend had any discussions yet on how the promotion of physical activity will be measured, to help ensure that these improved health outcomes can be achieved?

[Lord Bethell (Con)]

My Lords, there is already considerable co-ordination between the department, DCMS and DfE on exactly that. I highlight the money that has gone from the tax on soft drinks to contribute to funding outdoor activity in schools, which has had an enormous impact. My noble friend is entirely right that physical activity is linked to better health outcomes; that is why it will form part of the agenda for the Office for Health Promotion.

Organ Donation (Deemed Consent) Bill

Baroness Sater Excerpts

2nd reading (Hansard): House of Lords
Friday 23rd November 2018 Lords Chamber

[Baroness Sater (Con)]

I thank the noble Lord, Lord Hunt of Kings Heath, for his sponsorship of this Bill. I also pay tribute to all those here and in the other place for their tireless endeavours so far on this important matter. That it has cross-party support in both Chambers is also very welcome and will, I hope, facilitate smooth passage into law.

My Lords, the briefing for this debate has been clear and informative, so I will not take up time telling the House that which they already know. The stats are deeply distressing and concerning, as many noble Lords have mentioned today. As the noble Lord, Lord Patel, mentioned, three people die each day due to a lack of suitable organ donation. Over 6,000 people across the United Kingdom are actively waiting for transplants that will save or significantly prolong their lives. On average, those from ethnic minority backgrounds may wait much longer than others for a suitable match.

It was as a trustee of the British Lung Foundation that I became aware of the crucial need for and success of organ transplants and their transformational effect on not just those whose lives they saved, but their families and friends as well. The saying “a new lease of life” never rang more true. But I confess, my support for the British Lung Foundation may not have come about had I not witnessed my own mother succumb to emphysema some years before. It was heartbreaking to watch my much-loved mother’s most vibrant life deteriorate, to the extent that she struggled to simply breathe. An organ donation would not have saved her, but what we do know is that today there are hundreds of people afflicted with lung disease, and many whose condition could be improved or life saved by a transplant. It is right that we do all we can to finalise and pass this very necessary Bill, but also provide the sustainable environment in which it will need to operate.

I was pleased to note that the money resolution for this Bill was passed in September. It is important recognition of the additional work an opt-out system would require and the costs that will need to be borne by the NHS and its blood transfusion authority, for example. I recognise and respect the absolute right of individuals to opt-out of organ donation, and we must make it easy for those people to do so. Establishing the practical infrastructure for those who do wish to follow through is also vital. Funding for these elements is indeed key. The United Kingdom has a very low level of organ donation consent—a sobering point which illustrates a great and profound need for a public awareness and education campaign on this subject. Both here and in the other place, attention has previously been drawn to the example set by Spain, whose noteworthy successes in this field include both educating its people and reaching families who wish to override consent previously given.

When considering the Bill’s financial implications, I would encourage the Government to continue reflecting on the huge importance of public awareness. It is at the age of 18 that a person becomes eligible to determine whether or not they opt out of organ donation. In order to make an informed decision and ensure their wishes are carried out, they must be able to speak with ease about it to their families, friends, teachers, doctors, faith leaders and so on. The only way to ensure that everyone is comfortable having this conversation is by giving them the knowledge they need through open, transparent and easily accessible means. Public health campaigns have had significant impact and huge success in the past, but invariably they require co-ordination across government portfolios and the money to back them up. It would be devastating to win the day but lose the battle because of a lack of information.

I am delighted the Government are supporting the Bill. I feel grateful to be able to play some small part in furthering the cause today and I look forward to supporting the Bill going forward.