Children’s Wellbeing and Schools Bill
Baroness Walmsley Excerpts(2 weeks ago)
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Baroness Walmsley (LD)
My Lords, I will speak to Amendment 53 in my name and that of my noble friend Lady Tyler of Enfield. It is designed to ensure timely implementation of the single unique identifier, otherwise known in the Bill as the consistent identifier.
Timely access to high-quality and personalised education, health and social care services is fundamental for good childhood outcomes and reducing inequalities. Important information on children’s needs and outcomes is, as we know, held by many different services across health, local authorities, police, education and beyond, but so often these services have not communicated with each other and crucial parts of the jigsaw around a child’s life have not been fitted together by professionals interacting with the child. Sometimes that results in tragic cases, as the Minister mentioned earlier.
Clause 4 inserts two new sections into the Children Act 2004 on information sharing. This includes a provision to introduce a consistent identifier for children, which is to be welcomed. Many Peers from around the House, including my noble friend Lady Tyler, argued strongly for the introduction of a single unique identifier for children during the passage of the Health and Care Act 2022, in which I also took part. We know that too many serious safeguarding case reviews—especially the heartbreaking and harrowing ones that hit the headlines—have said that better data sharing between services is urgently needed to properly safeguard children and improve their wider health and well-being outcomes. This very welcome clause is intended to provide a clearer legal basis for sharing information to promote the welfare of children and prevent them falling through the gaps. Through the introduction of this unique consistent identifier, it will be much easier to match records and share information confidently.
Implementation within this Parliament of this crucial measure, as promised in the Government’s manifesto, is paramount. We cannot run the risk of it being lost in a subsequent Parliament if it is no longer considered a priority. That is why many in the sector, particularly children’s charities, are working together to scrutinise the planned timescales and implementation plan.
As things stand, there is a risk that full implementation of this identifier will not take place before the next general election. The NHS and local authorities might be using a common identifier by 2029, but schools, early years settings and the police might not. Partial implementation would fundamentally undermine the benefits of a single identifier. Either all services should be supported to use it soon, or the purpose will be lost and children will continue to be at risk. Hence Amendment 53 would ensure that full implementation of this part of the Bill takes place before the next election, as set out in the Labour manifesto.
I will say a brief word about some of the other amendments. I also have concerns about other possible vulnerable members of the family, as the noble Baroness, Lady Barran, raised. I look forward to hearing reassurances on that from the Minister.
On Amendment 69 in the name of the noble Baroness, Lady Spielman, which has not yet been introduced, it sounds to me like a good idea that the data should be consistent, so that those accessing it will understand exactly what it means. I am concerned it might turn into a tick-box exercise, although I hope that would not be the case. I look forward to hearing what the Minister has to say.
Baroness Spielman (Con)
My Lords, Amendment 69 would make provision for a common open data standard for those with responsibilities for individual children. I will start with a couple of wider comments. Like the noble Baroness, Lady Longfield, as chief inspector at Ofsted, I reported each year, for many years, on the concerning shift of local authority spend into acute services and away from early help and targeted support. The reasons why that was happening seemed fairly simple: resources were constrained and these were the statutory services, so it was logical for local authorities to prioritise their spend on those.
I was therefore surprised when the Minister cited this concerning shift as a reason for the changes proposed in the care review and in the Bill. There are potentially much simpler solutions, such as rebalancing the obligations or providing funding. Yet this Bill creates a lot of additional structures, duties and complexity, which could unintentionally take more resources and time away from front-line work, which I know everybody would like to prioritise. I would like to get more sense of the thinking as to how the Bill can enable all the players in an extremely complex system, rather than simply direct and control from the ministerial office.
A particular missed opportunity is data and the value of a common open data standard to help facilitate sharing at individual level, but also to make it easier to aggregate and analyse. Every service working with vulnerable children has its own data system. Typically, a number of proprietary systems are available in each sector; each of those is set up and works in different ways. There are no common data standards for the bodies involved. This makes it genuinely hard. There have been obligations to share data between the different parties for very many years, yet every serious case review points out failures in data sharing, almost without exception.
It is right that we have privacy by default, so it is a hard decision each time you decide it is important to share information and override privacy. The process of sharing is itself time-consuming and expensive, because these systems do not work to any common standard. There would be potential improvement in the management of individual cases if we can reach the kind of common open data standard that is being developed and used in other sectors.
In the care review, everybody realised quite how hard it often is to put together a national picture with data about social care. The understandable protection around individual children, and the kinds of disconnect that have already been referred to, mean that information about those who are causing harm, or the children or others who are collateral damage in the same situation, is not necessarily neatly joined up. It is genuinely hard to find out about types of abuse and all its different aspects, and who is implicated. This is a real problem; it should not be down only to journalists armed with FOIs to go hunting for things that we should already know about and be acting on.
As chief inspector, I served until the end of 2023 on the national implementation board for the care review. I was sitting alongside the eminent professor, Sir Anthony Finkelstein, who is a data systems expert and gave me valuable input into the framing of this amendment.
Data was an important strand of the initial care review and the report, and an important part of the initial plan for its implementation, but it seems to have got largely lost. So, I have put forward this amendment to bring this strand to the fore. The Minister should make sure that this opportunity is not lost to enable all the players in this complex system. By making this provision now, she will have the flexibility to set a sensible, reasonable and proportionate timescale for all these proprietary providers to start creating the kinds of alignment that can help us going into the future to do the best for all children.
Children’s Wellbeing and Schools Bill
Baroness Walmsley Excerpts(2 weeks, 2 days ago)
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Baroness Walmsley (LD)
My Lords, as one of the many qualified teachers in your Lordships’ House, I will speak to Amendment 14 in the names of my noble friend Lady Tyler—who cannot be with us today—me and others. Before I do so, I warmly welcome the noble Baroness, Lady Longfield, to this Committee. I know that as the Children’s Commissioner she was so very committed to all these issues, and I know she is supporting the amendments of the noble Baroness, Lady Armstrong, today.
I was involved with the legislation that set up the UK Children’s Commissioner in the first place and was involved in making sure that the commissioner “must” have regard to the UN Convention on the Rights of the Child, not “may”, as was in the original version. That is relevant to what I will say about Amendment 14.
The intention of Amendment 14 is very simple: to ensure that those making decisions affecting children and young people seek and take into account their wishes and feelings, if they wish to give them, and to support them to do so. I welcome the Government’s ambition to be a child-centred Government and support the important steps taken in the Bill to strengthen the systems intended to keep children safe, yet there is more that the Bill could do to be truly child-centred. Specifically, it currently fails to embed meaningful consideration of the child’s wishes and feelings. I would like to strengthen it, hence this amendment.
As noble Lords will be aware, more than 30 years ago, in 1991, the UK ratified the UN Convention on the Rights of the Child. In doing so, we recognised that children have a distinct set of rights that uniquely value all that it means to be a child. Article 12 of that convention sets out the right of every child to express their views freely and to have those views given due weight in all matters affecting them, including the family conferences we are talking about. They must be afforded that chance to express their views, wishes and feelings. The word “should” in Amendment 13 is not quite good enough in that respect.
In short, it recognises that children are experts in their own lives. I believe that children under 16 are perfectly capable of this, so I do not support the bit of Amendment 12 that limits this to over-16s. As long as they have appropriate support and understanding, many young children can be very articulate about what they think.
The amendment seeks to ensure that the systems designed to protect and support children and those who work with them are founded on the basis that we can hope to truly understand what is in a child’s best interests only by hearing and giving heed to their experiences and unique perspectives—the voice of the child, as we often call it.
As we know, in cases of abuse and neglect, giving children the opportunity to express their views is a critical factor in building trust and keeping children safe. Children themselves tell us that they are not routinely heard when decisions are made that affect them. Indeed, research undertaken with children and young people for the Children’s Charities Coalition’s 2024 Children at the Table campaign found that 62% of UK children think that politicians do not understand the issues that affect them, and almost three-quarters feel that children are not listened to by politicians. Let us listen and hear them today.
That is why I consider Amendment 14 to be so important. It would ensure that local authorities, in offering family group decision-making, are required to ascertain children’s wishes and feelings and give them due weight when making decisions related to that decision-making. It would also provide for a clear entitlement for the child to be supported to participate in the family group decision-making meeting. Where this is not in the child’s best interests, it would provide for the local authority to ensure that the child’s wishes and feelings are appropriately represented, for example by an independent advocate. Some effort will have to be made by somebody who really understands these things to ascertain those wishes.
The Bill currently requires local authorities to seek the child’s views. I welcome the Government’s recognition of the importance of listening to children in the context of family group decision-making, including by the Minister in response to a similar amendment in the other place. But this duty falls short of the gold standard of the Children Act to seek and—importantly—give due weight to the wishes and feelings of the child in different contexts, including children in need assessments, child protection and any decisions relating to a child in care, or possibly going into care. We know from serious case reviews and inquiries that where children are not listened to, it can have devasting consequences.
Wishes and feelings are broader than views. Amending the Bill in this way would mean that those children who choose not to express their views—perhaps they are younger or shyer, are non-verbal or lack capacity—will still have their feelings taken into account when decisions are being made about their safety and where they might live. Passing Amendment 14 would do all that.
Lord Farmer (Con)
My Lords, I rise to speak to Amendment 18 in my name and to Amendments 7 and 14, which have just been ably spoken to by the noble Baronesses, Lady Armstrong and Lady Walmsley. Amendment 7 is also supported by the noble Baronesses, Lady Longfield and Lady Drake, and Amendment 14 by the noble Baronesses, Lady Bennett of Manor Castle and Lady Tyler of Enfield, who is not in her place.
This group is primarily about family group decision-making, so I will speak to Amendments 7 and 14 first. The Government have avoided referring to family group conferencing per se, presumably because they want to allow for evolution of good practice of the family group decision-making model. But as I said at Second Reading, the evidence base on which they are relying for this legislation assumes faithful implementation of what we know makes a difference.
One key aspect of family group decision-making is that it is not a one-off meeting. If it were, this could become a token effort to bring together all those with family or other close relationships to the child. Currently, however, the Bill makes provision only for the offer of a family group decision-making meeting.
Rather, family group decision-making involves a process with careful preparation that typically goes way beyond a single meeting, as Amendment 7 would require. When the child is supported to be involved in an initial meeting, as Amendment 14 specifies, they might flag that key people are missing, or their input might throw up previously unforeseen issues that need attending to before important decisions are made concerning their future.
Support is required because many children will be daunted by being involved in a family group decision-making meeting. They might even say that they do not want to be there but regret not being involved later on. When there have been long-standing difficulties in a family, they might be concerned about revealing secrets, getting into trouble or making things worse.
Safety planning—a key aspect of any process involved in rehoming a child—can also be delicate and difficult and should certainly not be rushed. The pressures on local authorities are unlikely to ease anytime soon, and the legislation should not be written in such a way that short cuts are taken and the family’s involvement is marginalised to speed things up. That cuts across the spirit of the whole approach, which is the coming together —and, we hope, the strengthening and developing— of a relational network for the good of the child at the centre.
Children’s Wellbeing and Schools Bill
Baroness Walmsley Excerpts(1 month ago)
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Baroness Walmsley (LD)
My Lords, I too congratulate my noble friend Lord Mohammed, and the noble Lord, Lord Biggar, on their maiden speeches. The noble Lord, Lord O’Donnell, is absolutely right about the child well-being problem, which is why I focus my interventions on the well-being aspects of the Bill, including children’s rights and voices and physical, mental and emotional well-being—specifically, their nutrition and protection against physical or sexual violence.
Research shows strong links between poor well-being and child poverty. Children from low-income homes often go hungry or have a very poor diet. That is why the Government must use all their levers to ensure that children are properly nourished. The Healthy Start scheme has helped young families buy fruit, veg and milk for their children. However, uptake is low as many eligible families have never heard of it, let alone applied for it. The value of the vouchers has not kept up with food inflation, and this must change. Will the Government welcome an amendment from me to auto-enrol eligible families to ensure that children get their entitlement?
The second lever is the food served in schools. I welcome the new school breakfast clubs, but they must serve healthy food. It is important to distinguish between a breakfast that fills the tummy and one that nourishes. The school food standards have not been reviewed for 10 years, and they hardly mention breakfasts. Does the Minister believe that current school food standards are strong enough to guarantee that children will be getting nourishing food in breakfast clubs? Will she welcome an amendment to update the school food standards, as recommended by the report Recipe for Health of the Lords committee, which I had the honour to chair, including clear rules on what a nutritious school breakfast must look like?
Breakfasts are not the only problem. There are still children who meet the narrow entitlement for free school meals but do not get their free meal, so we also need auto-enrolment here. The quality of school lunches is often poor and may not comply with school food standards, and neither is there any proper monitoring of and compliance with the existing standards. What are the Government planning to do about that? Perhaps we can do something during the passage of the Bill.
On violence against children, children still do not have equal protection against assault as we, as adults, have. It is time that the “reasonable chastisement or punishment” defence, which can be used in court, is removed, as in Scotland and Wales. I am delighted to see a great deal of support for this change here and in the new intake of MPs in another place. Some 90% of social workers, 77% of healthcare professionals, 75% of teachers and 51% of police also support the change. Social workers say that the current legal position makes their safeguarding work more difficult, and it is unclear for parents. The current law is discriminatory because it says you can hit a child as long as it does not leave a mark on the skin. What about dark skin or one that does not bruise easily? Will the Government bring equality and clarity to the law by accepting amendments to remove the defence referred to only recently by the perpetrator in the tragic case of Sara Sharif?
Sexual violence has lifelong effects: people live with unwarranted guilt and difficulty in making healthy relationships. The IICSA has recommended that knowledge of or reasonable suspicion that a child has been sexually abused must always be reported to the relevant authority. The Government claim they intend to enshrine this in law. I look forward to reassurance from the Minister, but I am not sure that a duty of candour will be enough. If I am not reassured, the Minister will be hearing more from me and others as the Bill progresses.
Gavi: Covid-19
Baroness Walmsley Excerpts(5 years ago)
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Baroness Sugg
My Lords, Gavi itself will help fund equitable access to and the distribution of vaccines. That is why it is so important that the world comes together to ensure that it gets the funding it needs.
Baroness Walmsley (LD)
My Lords, health systems in the countries where Gavi operates programmes are very stretched, and routine vaccination programmes are suffering from movement restrictions. What assessment have the Government made of the risk of a re-emergence of the diseases which have been suppressed or even eliminated through Gavi’s work?
Baroness Sugg
My Lords, we are concerned about a resurgence. In addition to helping health systems respond to Covid-19, Gavi is helping poor countries adapt immunisation programmes. In areas where childhood immunisation services are disrupted, Gavi is planning an immunisation catch-up campaign to reach unimmunised children.
Tokyo Nutrition for Growth Summit
Baroness Walmsley Excerpts(5 years, 4 months ago)
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Baroness Walmsley (LD)
My Lords, I thank the noble Lord, Lord Collins, for securing this important debate this evening. I strongly suspect that there will be considerable agreement with what he just said from across the House. I certainly agree with him.
Malnutrition is the main driver of illness and poor human potential worldwide and the UK has been a leader in taking action against it. We have to admit that while asking for more, as we always do. Action on nutrition is one of the most cost-effective things we can do to help us achieve the sustainable development goals and to maximise the potential of the global population. Value for money is £16 for every £1 spent on nutrition. As it happens, such action is closely linked to the other global crisis, climate change: improve one and you beneficially affect the other. The scale of the problem is enormous, as we have heard, with over 20% of children stunted and unable to reach their education potential, and very susceptible to illness.
It is, of course, children who suffer most because of their vulnerability, but it is also girls and women who are particularly susceptible to anaemia and consequently give birth to underweight babies, thereby perpetuating the problem. We have long known that if you support a woman’s health, you benefit a family, and this is a cost-effective way of benefiting the economy of fragile countries. However, we must not forget malnutrition in older people who are more likely to lack the finance necessary to feed themselves properly and who often lack influence in their community, so get forgotten. I am told that one in three older people in hospital in this country is malnourished.
It is tempting to think that malnutrition is something that happens somewhere else and is the responsibility only of the contributions of DfID. However, malnutrition includes undernutrition, shortage of micronutrients and obesity; one in three children globally suffers from one of these three, including here in the UK. Actually, I strongly suspect that it would be a good deal worse if it were not for the existence of food banks, the wonderful school breakfast initiative, the nutrient standards of school meals and the availability of free school meals. I congratulate those local authorities that ensure that children on FSM also get fed during the holidays. Although the main focus of this debate is the Government’s pledges at the Tokyo Nutrition for Growth summit, what action are they taking to address child and elder malnutrition, in all its forms, in the UK?
As we have heard, the current DfID funding for nutrition around the world ends this year. We all hope that the Minister will be able to go a little further when she replies than she did in answer to the Oral Question from the noble Lord, Lord Collins, earlier this month and say whether the Government will up their game a little and pledge £800 million a year for the next five years. Could the Minister also say what analysis has been made of the most effective nutrient-sensitive and nutrient-specific programmes so that we know that the money is being spent on what works best?
As a fellow of UNICEF, I have always been a great admirer of its child nutrition programmes. Part of that is the programme on breastfeeding which also takes place in the UK as the Baby Friendly Initiative. The wonderful thing about breastfeeding is that it helps to protect the mother from breast cancer as well as nourishing the child at minimal cost and risk. It also provides the child with valuable immunity from common diseases. Exclusive breastfeeding for six months and carrying on until 11 months could prevent over 800,000 child deaths and 20,000 maternal breast cancers. What are the Government doing both here and abroad to promote breastfeeding? To protect poor mothers from spending scarce resources on breast milk substitutes, are we providing education about the benefits of breastfeeding? I echo the plea from the noble Lord, Lord Collins, to make sure that we work with partners to ensure the enforcement of the International Code of Marketing of Breast-milk Substitutes.
Talking of working with partners, despite all we do, it is clear that the UK cannot solve malnutrition alone. However, we have already set an example and can do a lot to encourage others. Part of that would be to make the early pledge at the July event in Tokyo that the noble Lord, Lord Collins, asked for and show commitment at the top level by the presence of the Prime Minister.
What plans do the Government have to match fund or co-finance nutrition initiatives to support nutrition plans in the most fragile countries? Will the Minister commit to programmes which strengthen the resilience of food production in poor countries in the light of the effects of climate change? It is much healthier for populations to eat their own normal, fresh diet rather than have to rely on dried food brought in by aid organisations in response to famine, war or natural disasters.
Our track record on these matters is something we can be proud of, but there is much more to do. Therefore, we need the Minister’s assurance that the UK will continue to make a major contribution to tackling the scandal of child and elder malnutrition across the world and start this new decade with a major announcement in Japan in July.
Independent Inquiry into Child Sexual Abuse
Baroness Walmsley Excerpts(6 years, 6 months ago)
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Baroness Williams of Trafford
The noble Lord is absolutely right: a response is required and will be forthcoming very shortly. On top of that, the Government are acutely aware of the age and declining health of so many former child migrants. We are, as I say, committed to providing a considered response to the inquiry’s recommendations as soon as possible.
Baroness Walmsley (LD)
My Lords, does the Minister accept that every week the Government delay in taking a grip on this issue means more young people having their lives destroyed? When they are considering their response, will the Government take account of the mounting evidence, added to only this week by evidence about the Catholic Church, that unless people are forced to report child abuse to external agencies, and report only within the agency concerned, very often these organisations will cover it up because they are afraid of reputational damage? Will the Government take that into account?
Baroness Williams of Trafford
I totally accept the noble Baroness’s point—I have just made it myself—that nobody wants to see any further delay, certainly given the age of some of these former child migrants. On reporting sexual abuse to external agencies, the noble Baroness is absolutely right: unless there is a proper system of support for these allegations, there is then further opportunity for internal cover-up.
Universal Sustainable Development Goals
Baroness Walmsley Excerpts(6 years, 6 months ago)
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Baroness Walmsley (LD)
My Lords, I congratulate my noble friend Lady Suttie on the comprehensive and powerful way in which she introduced this debate today.
I will start by quoting a sentence from a briefing I received this week, prior to this debate:
“Failure to act on climate change now will significantly increase the difficulty of achieving many other SDGs, and will have serious consequences for the stability of global financial systems”.
This sentence could have come from any briefing from any organisation campaigning on climate or environmental matters, but it did not—it came from the Institute and Faculty of Actuaries. It cheered me a lot, because it indicated to me that climate change has developed from being something that only a few biologists and physicists were worried about to a mainstream issue that rightly concerns people in all walks of life. And of course it should, because it is affecting all of us right now, and will affect our children and grandchildren even more in future. The actuaries are quite right that action on climate change can assist us in achieving many of the other SDGs, from education to poverty, from water and sanitation to equality. They also reinforce my view that we need to bring forward our climate change objectives, from 2050 to 2030. We have not much time, and giving permission for fracking is the last thing we should do.
The fact is that, even if we achieve the target of no more than a 1.5 degree rise in mean global temperature, given the rise we have already had, we will still have to face major negative climate events, changes in habitats, loss of biodiversity, poverty and mass movements of people. If we exceed that target, we will reach the tipping point beyond which we cannot stop it and, if that happens, I fear for the future of our species, as well as the rest of life on earth. So, even if we take a selfish point of view relating to our own species’ survival, it is absolutely vital that we do everything we can to slow down and halt global warming. Every degree of change in global temperature makes it more difficult for the diverse life on this planet to survive. That should matter to all of us.
The interdependence between human life and that of other species was illustrated very well in an item on Radio 4 yesterday, when they interviewed a researcher who had identified a gene in a species of fish which enables it to repair faults that arise in its own heart. Her work on this may help us understand, and indeed treat, heart disease in human beings. We rely on other species not only for our food, our clothing, our shelter, our arts and culture, cleaning up the air we breathe and reducing CO2 but for our health. The natural environment contributes to our well-being and mental health, as well as our economy. For these and many other reasons, we must halt climate change and not do a Donald Trump and stubbornly deny that it has anything to do with wildfires in Florida or, of course, flooding in Yorkshire. Can we hear about the Government’s progress on action against climate change?
The interrelationship between the various SDGs has been well illustrated to me in visits I have made to other countries. On a visit to India with UNICEF—one of those frontline NGOs referred to by the noble Lord, Lord Judd, and of which I have the honour to be an honorary fellow—I was shown women earning money maintaining the pump on the village well or manufacturing sanitation products. Through this work, they gained dignity and earned money to send their children to school, and the village got clean water and sanitation. When the children went to school, as well as education they got access to clean, safe toilets and clean water, lessons in hygiene and soap to wash their hands before lunch, and a child measurement programme that measured their development and identified malnutrition. In the homes, I saw stoves that used gas produced by biomass from animals and human waste, which prevented the women getting respiratory problems, which they used to get from burning smoky wood to cook indoors.
In Madagascar, I saw the devastation of vast areas of highly diverse primary forest caused by burning trees to make charcoal for cooking, in a country with more sunshine than you could ever hope for and the highest percentage of unique indigenous species in the world. Species such as lemurs and special kinds of woods on the red endangered list were being illegally exported to China, against the Government’s best endeavours. The problem is that you cannot blame the people for using what is there to survive. They are some of the poorest in the world and need to cook, eat, shelter and provide for their families, so they will sell what they can, use whatever is available for cooking and overharvest endangered species for food or medicine, without realising that they are killing the goose that lays the golden egg. It is for developed countries such as ours to use the expertise we have to help them make the most of the riches they have around them, their unique habitats and biodiversity. But here in the UK we face many of the same things. In our case, 15% of our species face extinction, mainly because of habitat loss and climate change. We may not know the value of what we have lost until it is gone.
Many charities and universities are taking up the challenge. In Madagascar, we saw a project run by Kew Gardens, one of the world’s leading botanic gardens working in plant conservation in this country and around the world. It is protecting a valley of primary indigenous forest using local labour, trained by expert botanists from Kew, to protect their environment. They earned some money for this, which alleviated their poverty and allowed them to avoid some of the environmental depredations. Kew needs money to provide the benefit of its experts to developing countries and to our own environment. In that respect, I am concerned that the government grant to Kew has been reduced. I wonder whether the Government can give me any hope that this situation might be reversed in the light of the work Kew does to help with the UK’s contribution to SDG 15 on life on land, goal 13 on climate action and goal 11 on sustainable communities.
I also saw a UNICEF project where children were rescued from the streets, having been left there by parents who could not afford to feed them. UNICEF was educating, feeding and clothing them but also trying to reunite them with their families and help them to get work. Here in the UK, as my noble friend Lady Suttie mentioned, we have thousands of children in food insecurity, whose parents rely on food banks and on breakfast clubs and holiday lunch clubs at schools. Universal school lunches in primary schools has been a great success and contributed not only to children’s nutrition and physical health but to their education and mental health. Will the Government expand that programme? Poverty is caused by low wages or employment or benefit uncertainty. The Minister might like to use this opportunity to explain the current status of the review of universal credit.
These few examples illustrate how interlinked the various sustainable development goals are, both here and abroad. Can the Government say what attention they are paying to the links between action on the goals and the individual goals? Sometimes spending on one can bring dividends in several other areas. After I had written the above, I saw the WWF briefing and its recommendations to the Government for the voluntary national review. I was interested to see recommendation 3:
“The VNR should look at interlinkages between the goals, identify accelerators and develop plans to take them forward”.
All I can say is that I agree.
This brings me to where I think the UK has failed most seriously in the way the SDGs have been implemented at home. We are not alone on this earth; we are not the only country and we are not the only species, and although we should help other countries, we need to do it all at home as well. Goal 3 is good health and well-being. Goal 10 is reduced inequalities. In this country, we have a shocking level of poverty, as clearly illustrated recently by the UN’s rapporteur on poverty, and a high level of health inequality. We have a poor rate of perinatal mortality and child obesity and, as announced this morning, 10 times as many children suffering from type 2 diabetes than was originally thought. Finally, we now even have falling life expectancy. These two failures are closely linked. They are also linked to goal 1, eliminating poverty; goal 2, zero hunger; goal 4, quality education; goal 7, affordable clean energy; goal 8, decent work and economic growth; goal 11, sustainable communities; and goal 13, climate action.
I think I have made my point: the health of the nation is a whole-government responsibility. I have long proposed a special high-level Cabinet committee on the health of the nation to which all other departments must report when developing new policies. Do they contribute to the health of the nation, or do they damage it? If they damage it, the department should think again. I still hope that the new Secretary of State for Health, with his understanding that the NHS will not be sustainable unless we focus more on prevention of ill health, will eventually come to the same conclusion. If he is not persuaded by me, perhaps he will be persuaded by this debate, which will show where we are failing and why it would be in the interests of all our people, now and in the future, for us to take a holistic view of health and well-being.
The evidence shows that poor people do not eat well; they live in areas with higher air pollution, in houses which are often cold, damp and expensive to heat because they are poorly insulated. Because of their disadvantages, they achieve less in education and so are less well equipped with the knowledge of how to promote their own health and to get a good, stable job. Their access to junk food is high and their access to good public services is low. Their local authorities are so pressed for cash that they have had to close sexual health services, weight management services, drug, alcohol and smoking cessation services, swimming pools, sports centres and children’s centres. All these impact most on the poor and particularly affect their health—QED.
Will the Government now act to improve our performance against goals 3 and 10 by addressing goals 1, 2, 4, 7, 8, 11 and 13?
Drugs Licensing
Baroness Walmsley Excerpts(6 years, 11 months ago)
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Lord Rosser (Lab)
I thank the Minister for repeating the Statement made earlier in the House of Commons, and endorse the views expressed in it of sympathy for Billy Caldwell, Alfie Dingley and others like them, and for their parents, who, as the Statement says, have been under unimaginable stress and strain.
With yesterday’s Urgent Question in the other place on the medical use of a cannabis-based medicine uprated to today’s Statement on drugs licensing, this appears to be another example of the Government making decisions on the hoof, in a flap and in response to embarrassing media stories, rather than being a proactive Government who make measured, fully thought-through proposals to address developing issues before they hit the national headlines. Despite this, we still welcome the Home Secretary’s statement that the Government will look more closely at the use of cannabis-based medication in healthcare in the UK, and that they will review the scheduling of cannabis. As the Minister said, what started this off was the case of a 12 year-old boy suffering from severe epilepsy, whose cannabis-based medication was confiscated on arrival at Heathrow from Canada—a decision now modified by the Home Secretary. It contains THC, the primary psychoactive constituent of cannabis, which is illegal in this country but not in a number of other countries, including Germany, the Netherlands, Italy and much of America.
Yesterday, the Government said that the Chief Medical Officer for England had been asked to establish a panel to advise on an individual-case basis on when medicinal cannabis-based products should be prescribed. How many such cases per month do the Government anticipate the panel having to adjudicate on and advise, and against what criteria will that advice be given? What fresh instructions have been issued to officials over allowing through or confiscating cannabis oil and other medicinal cannabis products as from now at our borders and entry points in the light of the Billy Caldwell case? Through what procedure and process will an individual case reach the expert panel? How many instances have there been during the past 12 months of cannabis oil needed for medical use being confiscated at our borders and entry points, and how many of those cases were reviewed by the then Home Secretary, and with what result, under the powers which have apparently just been used by the current Home Secretary? What is the Government’s estimate of the time it will take for the two-stage review just announced by them to conclude its work?
The Statement says:
“If the review identifies that there are significant medical benefits, we will reschedule”.
In other words, the Government do not yet know whether there are such significant benefits. In which case, against what criteria or evidence will the expert panel of clinicians being set up to advise Ministers on any individual applications to prescribe cannabis-based medicines—based firmly on the medical evidence, as the Statement says—make its judgments? I ask that because the Government believe that a two-stage commission is needed to decide whether there is even a case for any change on scheduling in the light of the available evidence.
I come back to the Statement and the words:
“If the review identifies that there are significant medical benefits, we will reschedule”.
Would that apply if the Advisory Council on the Misuse of Drugs came to the conclusion that there were also significant harms from rescheduling, which is what the ACMD is apparently being asked to consider under stage 2?
Finally, a recent report in Private Eye, under the heading “Pot and Kettle” and referring to the Alfie Dingley case as does the Statement, stated:
“A UN report this month found that the UK is in fact the largest producer of legal cannabis in the world—responsible for almost half the global total … As … the drug reform think tank Transform, said: ‘The government is denying that cannabis has medical uses but at the same time licensing production of the world’s biggest medical cannabis production and export market”.
Is that report correct?
Baroness Walmsley (LD)
My Lords, I, too, welcome the Statement and thank the Minister for making it. I thank her also for her efforts in this cause and those of her noble friend Lord O’Shaughnessy, who is in his place. I welcome the fact that Professor Sally Davies will now review the mountain of evidence for the medicinal and therapeutic benefit of cannabis-based medicines. She will undoubtedly find that the fact that there are no legally recognised benefits is quite wrong and must change. By what means will Professor Davies hear evidence from the many patients who already know about the benefits? Their doctors know the benefits, too. If she does not already, I am quite sure that Professor Davies will soon know them as well.
I also welcome the fact that the Government will reschedule cannabis when Professor Davies demonstrates those benefits. It should never have been scheduled as a drug without any medical benefits in the first place. Can the Minister estimate how long this process will take, as thousands of patients await the outcome in pain and discomfort?
While we wait for this to be done, it is very welcome that the Government have set up an expert panel to advise Ministers on any applications to prescribe cannabis medicines. It is outrageous that the Dingley family’s heroic doctors should have been put through the wringer by the inappropriate processes which the Home Office has imposed on them during the past four months.
I cannot say how delighted I am that Alfie Dingley and Billy Caldwell will get their medicines at last. However, it should not have taken four months since the Prime Minister promised Alfie’s mother, Hannah Deacon, when she visited No. 10 with me and a group of Peers and MPs, that her son would get a licence for his cannabis medicines on compassionate grounds and speedily. During that four-month period Home Office officials were trying, mistakenly, to operate a system for licensing which was not intended for such cases but was intended for normal clinical trials. It became clear very quickly that the system they were trying to use was not fit for purpose, yet they persisted. I would like to be assured that a system that is fit for purpose will be put in place. Will the Minister give me that assurance? It should not have taken a child, Billy Caldwell, being put in a life-threatening situation for the Government to take this action but I am delighted that they now have.
During the campaign I have been convinced of the Minister’s good faith in this matter but, frankly, although she is always welcome in her place, it should be a Health Minister standing there at the Dispatch Box. I am delighted to see the noble Lord, Lord O’Shaughnessy, in his place listening to this debate. Drug licensing is a health matter, not a Home Office matter and clearly the Secretary of State for Health and Social Care agrees with that, so how will the Department of Health and Social Care be involved in the new arrangements outlined in the Statement and those that will inevitably follow?
Yesterday the Prime Minister said a system is already in place for the medicinal use of cannabis and that government policy would be driven by “what clinicians are saying”. The system has failed thousands of patients, but it is good news that the Government are now trying to put that right, and I thank the Minister for that. Can she say whether expert evidence from countries such as the Netherlands, where cannabis medicines have been safely used for some time, will be heard during the review?
Baroness Williams of Trafford
My Lords, I did not do it yesterday, but I welcome the noble Lord, Lord Rosser, back to his place. It is such a pleasure to be debating with him. The first question he asked me was about whether we are doing this on the hoof given the Alfie Dingley case. We are not. One of the noble Lord’s further questions was about why it took so long between Alfie Dingley’s family coming forward and him being issued with a licence today. That is because the correct process was followed. Noble Lords would expect the correct process to be followed. The reverse of this is that a child gets given the wrong drug and becomes very ill. The correct process was followed here. The Home Office and the Department of Health and Social Care have worked extensively together over the past three months to ensure that Alfie has been well cared for, and the licence for his drugs was issued today.
The noble Lord asked how many people would be on the panel. I cannot say. It was announced today, and numbers and people will be announced in the coming week. He asked about the criteria the panel will use for who will be issued with drugs. I assume that there will be clinical experts on the panel and that they will base their criteria on their clinical judgment of the benefits.
On stuff being confiscated, I hope that people do not present at the border with drugs that are not yet licensed, and will come forward to the panel for consideration and for drugs to be issued if that is appropriate. The noble Lord asked how long the review will take. Cannabis is a very complex substance, as noble Lords probably know. It will be a complex review, but the Home Secretary expects an interim report to him within three months.
The noble Lord asked about the expert panel and the advice that it will give. Again, the proper process will be followed. It will be a scientific process with clinical judgment at its heart. He also made the Private Eye point about the UK being the largest producer of cannabis. I do not think that the Government are saying that there are no benefits to be had from cannabis; they are saying that cannabis as a whole plant is currently classified as a Schedule 1 drug, as we have discussed previously. However, as we have seen, constituent parts of it have huge benefits, particularly in the areas of MS and, now, epilepsy.
The noble Baroness, Lady Walmsley, asked for details of the review. We are working through those. I certainly know, because my noble friend has just told me, that Sally Davies will be carrying out a literature review. There are findings from across the world. Much work has been done on this and that will be very informative.
The noble Baroness also made the point about the Dingley family being put through the wringer. Again, it was important that the proper process was followed, and it was. A licence application needed to be made. It was made and I am very pleased to say that Alfie Dingley’s licence was issued today. She asked for an assurance that a system fit for purpose will be put in place. The answer to that is firmly yes: the system has to have longevity. This has been a very big and important step for the Government today.
Cannabis-based Medication
Baroness Walmsley Excerpts(7 years, 3 months ago)
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Baroness Williams of Trafford
With respect, I point out to the noble Lord that the Question is specifically about the medicinal use of cannabis for a very specific case. The noble Lord is probably straying on to the legalisation of drugs in a controlled way. I am not going there today because I have not been asked a question about it, but I have had many debates about it and the Government remain of the view that such drugs remain illegal.
Baroness Walmsley (LD)
I am grateful to the Minister for her commitment to explore every option. Is she aware of the legal opinion from Landmark Chambers making it clear that there is an exception under Section 30 of the Misuse of Drugs Act 1971, which allows that a licence for possession of a controlled drug can be permitted for medical purposes? Will she make use of that exception to save this little boy’s life?
Baroness Williams of Trafford
Well, I hope that I made it absolutely clear that we would explore every legal avenue that we could, and that both the Policing Minister and the Home Secretary would look at all legal avenues within the regulatory framework, so I hope that she takes comfort from that.
Women: Events Industry
Baroness Walmsley Excerpts(7 years, 4 months ago)
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Baroness Williams of Trafford
My Lords, I think the noble Baroness has made the point that I was trying, perhaps not very articulately, to make. A gagging clause will not, in and of itself, protect an employer or someone who is, say, employing, a waitress for an evening. In fact, it will go further than that and void that contract or agreement.
Baroness Walmsley (LD)
My Lords, does the Minister agree that if you want to influence the behaviour of men you should start when they are boys? That is why it is very important that the curriculum for PSHE lessons includes elements that ensure that young people leaving school understand that both genders should be properly respected.
Baroness Williams of Trafford
The noble Baroness makes a very good point. It is only in educating our children through PSHE, relationships and sex education that that culture of respect towards one another, the opposite sex, and, for young girls, towards themselves, will change.