Health and Care Bill

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Consideration of Commons amendments
Tuesday 5th April 2022 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, I support Motion B1 in the name of the noble Baroness, Lady Cumberlege. I will be brief and not repeat what others have said. However, it is worth noting that in the Statement on the Ockenden report, the Secretary of State for Health said:

“I am also taking forward the specific recommendations that Donna Ockenden has asked me to. The first is on the need to further expand the maternity workforce.”—[Official Report, Commons, 30/3/22; col. 819.]


That phrase could be repeated for every part of the NHS and social care workforce, so I believe that has changed the situation since the other House debated this issue.

The public are asking what the national insurance levy is for if not to increase the number of professional staff in training. We are turning away people who want to be paramedics and nurses, as my noble friend has just said, who want to train locally. Of course we should undertake ethical overseas recruitment as well, but we need both. I firmly believe that this amendment needs the full support of this House.

[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a great pleasure to follow the noble Baroness, Lady Watkins, and to ensure that full support for Motion B1 has been presented from all round your Lordships’ House, including the Government Benches. The Green group also supports Motion C1 particularly strongly, and Motions D1, F1, G1 and L1, but I will speak briefly only to Motion B1 because it is so crucial.

In introducing this group the Minister spoke, as the Government often do, about the record numbers of staff in the NHS. I do not think anyone has yet mentioned the NHS staff survey conducted between September and November. Just 21% of nurses and midwives thought that there were enough staff in their unit to do their job properly and provide an adequate standard of care; almost 80% thought there were not enough. The noble Baroness, Lady Tyler, referred to the Ockenden report: that helped to highlight that, despite the fact that the Government have been trying to recruit more midwives, in the last year the number of midwives has actually gone down.

We really have to ask ourselves why the Government are so opposed to this amendment when there is such strong support for it around this House and among all the key bodies around the country. It may be that the Government have an ideological objection to the word “planning”, or that the Minister does, but this is about the future of our NHS and all the evidence says that this is an essential amendment. Surely the Government are not going to let ideology stand in the way of the future of our NHS.

I finish by commenting on the typically wonderful introduction to this group from the noble Baroness, Lady Cumberlege, who referred to the strong civil society campaign. The hashtag for it on Twitter is #StrengthInNumbers, and that says so much. We need the numbers and the facts so that we can get the numbers of staff in the NHS.

Health and Care Bill

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Lords Hansard - Part 1 & Report stage
Tuesday 1st March 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I am delighted to contribute to this rich and important debate, and particularly to speak to Amendments 10 and 13 in my name.

Commenting on the words of the noble Baroness, Lady Meacher, about the importance of public health, I would stretch that much more broadly than the examples that she gave. It really ties to the previous group, where we were talking about how climate change and the nature of the environment are related to health. A public health approach really is talking about ensuring that we have a healthy environment, that we prevent illness and malfunction. If we do not have that approach in the ICBs, that is a real problem.

I agree with the noble Lord, Lord Bradley, that government Amendment 31 is useful but not sufficient to deal with the issues that are raised by this group of amendments. The Green group very much agrees with Amendments 9 and 12 and will support them should we get to that point.

I declare my interest as a vice-president of the LGA and the NALC, which may be relevant here. In speaking to Amendments 10 and 13, I declare exactly where I come from. It was the Royal College of Nursing that persuaded me that these amendments should be here. It is very much the college’s case that I now present.

To begin with a little bit of history, as part of the statutory regulations of the Health and Social Care Act 2012, it was mandated that registered nurses would be part of the governing body of clinical commissioning groups. If we look at Regulation 11 of the National Health Service (Clinical Commissioning Groups) Regulations 2012, we see that a CCG governing body must have at least one registered nurse within its membership. This will be lost if it is not required within the leadership of the integrated care boards.

This ties to a point made by the noble Lord, Lord Bradley, that sometimes there are very powerful forces in medicine. It also relates to the points made by the noble Baronesses, Lady Thornton and Lady Brinton, about the powerful force of private interests in medicine. Other truly important voices often get swept aside. It is worth noting that in the NHS in England, registered nurses are more than 49% of all professionally qualified clinical staff. They have a unique relationship with patients and clients which gives them a different insight to other professionals on how the service works, and in ensuring that measurement of performance reflects the interests of patients and clients.

In representative volume terms alone, the case here is very clear. Registered nurses lead, innovate, and deliver the largest proportion of care, and their leadership brings critical expertise, advice and challenge into boards. Without this clinical leadership, there is a risk that service design and delivery become a matter of financial accounting, without proper attention being given to quality and outcomes for patients and clients, or that there is a focus on the heroic interventions rather than on day-to-day care or on the importance of rehabilitation, on which we heard a lot of debate in Committee and which is an area to which our registered nurses bring particular skills.

It is not my intention to move these amendments, but I hope that the Government will listen to the case being put by what is a hugely important professional body and a hugely important body of professionals, and that we see action taken after this debate to make sure that registered nurses are represented.

[Baroness Watkins of Tavistock (CB)]

My Lords, I rise to speak to the amendments in my name and to support those of the noble Baroness, Lady Hollins, who earlier described the need to standardise the knowledge and experience of commissioners, given the potential significance of their decisions.

The Government rightly suggest that there must be some flexibility so that integrated care board membership best reflects the competences needed to commission for local populations. However, unless regulations stipulate essential criteria for members’ collective skills, knowledge and experience, we risk falling into old habits of medical paternalism. That will undermine efforts towards more integrated, holistic care and mental health needs may be given cursory regard. The voices of nurses—as so ably outlined by the noble Baroness, Lady Bennett of Manor Castle—and other professionals will not be heard.

I would like to share with the House a well-known quote in organisational management: “Every system is perfectly designed to get the result it gets”. We now have the opportunity to safeguard the diversity of experience in each integrated care board by establishing a minimum standard, imposed either by regulation or by statutory guidance, to ensure the system gets the result that best meets commissioners’ needs for local patients and populations across the country.

Health and Care Bill

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Lords Hansard - Part 2 & Committee stage
Monday 31st January 2022 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, delayed transfers in care is an ongoing challenge for health and social care services, made worse with the pandemic. We need to remember that hospitals are for assessment and treatment. As other noble Lords have already said, extensive stay in hospital is not good for your health.

In February 2020, there were over 155,000 delay days in hospital, costing a significant amount of money. A majority of the delays—21%—were caused by delays in packages of care in patients’ own homes, while 18% were due to delays in receiving further non-acute NHS care. With over half a million emergency admissions in the same month, intervention is urgently needed to reduce systematic pressures and maintain safe and timely discharge.

I therefore particularly support Amendment 289 to optimise existing space and develop new accommodation for hospital patients who no longer require acute treatment. There are a range of options, including community hospitals, NHS nursing homes, contracts with not-for-profit social enterprises and, as my noble friend Lady Greengross has said, independent sector companies.

However, these issues are not new. I have in my hands a paper by Sir Cyril Chantler for the King’s Fund, The Potential of Community Hospitals to Change the Delivery of Health Care. The salutary point about this excellent paper is that it was written in 2001.

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise very briefly, since I attached my name to Amendment 289, in the name of the noble Baroness, Lady Greengross. She set out the reason for the need for this service, but I just want to say explicitly—particularly given the next group of amendments—that I do not believe that independent providers, for-profit providers at least, would be the way of doing this, given the many problems that we have seen in social care, which are highlighted in the next group.

We still have, in some places at least, community hospitals and facilities in communities. These are things that ideally would be developed by the community for the community, being run for public good not private profit.

Environment Bill

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Committee stage
Monday 21st June 2021 Lords Chamber

[The Deputy Chairman of Committees (Baroness Watkins of Tavistock) (CB)]

We will return to the noble Lord later. We now move to the noble Baroness, Lady Bennett of Manor Castle, and after her the noble Viscount, Lord Trenchard, as the noble Earl, Lord Caithness, and the noble Lord, Lord Rooker, have withdrawn.

[Baroness Bennett of Manor Castle (GP)]

I rise to speak to Amendments 8 and 56, in the name of the noble Baroness, Lady Scott of Needham Market, to which I have attached my name, though I will also offer my support to Amendment 9, in the names of the noble Lord, Lord Lucas, and the noble Baroness, Lady Boycott, about connecting people with nature. It is clearly much connected to Amendments 8 and 56.

In introducing this amendment, the noble Baroness, Lady Scott, focused on the need to win support for the Bill by allowing people to access nature. I will also focus on the public health elements, and the fact that we now have increasing awareness—with particular credit to many campaigners over the years, and to many researchers who have helped us understand this—that for the human microbiome, mental health or general well-being, exposure to, involvement in and being in nature is good for people’s health. The noble Baroness, Lady Scott, was talking about access to small spaces. I will talk much more broadly, and I fear that perhaps I will scare the horses a little here, but I want to draw noble Lords’ attention to the degree of the desire for access to nature that exists out there. I put it to your Lordships’ Committee that we very much need to create more space because there is a push for very great openness.

In talking about that, I will refer, and offer my support, to something known as the Right to Roam campaign. It highlights that, in England, 92% of the countryside and 97% of rivers are not accessible to the public. We often talk about “these overcrowded islands” and how difficult it is for people to get to open space. But some parts of these islands are not very crowded at all. The Right to Roam campaign is calling for an extension to the Countryside and Rights of Way Act, so that people will have much broader and easier access to open space, including hundreds of thousands of acres of woodland, meadows, rivers and their banks. The Countryside and Rights of Way Act 2000 gave access to 8% of England. That is mountain, moorland, commons and some downland heath. By the very nature of those spaces, they tend to be very remote. They are not easy to access, particularly with our extraordinary lack of public transport in rural areas—in fact, they are almost totally inaccessible to people who do not have access to a car. There is a real postcode lottery, and a clear inequality and unfairness in our current arrangements.

Domestic Abuse Bill

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Committee stage & Committee: 4th sitting (Hansard) & Committee: 4th sitting (Hansard): House of Lords
Wednesday 3rd February 2021 Lords Chamber

[The Deputy Chairman of Committees (Baroness Watkins of Tavistock) (CB)]

I have received requests to speak after the Minister from the noble Baroness, Lady Bennett of Manor Castle, the noble Lord, Lord Paddick, and the noble Baroness, Lady Hamwee. I call the noble Baroness, Lady Bennett of Manor Castle.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, I thank the House for the opportunity to ask this question, which applies to all these amendments but particularly to Amendment 139, to which my noble friend Lady Jones of Moulsecoomb is a signatory. She was unfortunately unable to take part in this debate.

My noble friend would have referred to the fact that the Covert Human Intelligence Sources (Criminal Conduct) Bill allows blanket legal protections for undercover police and informants. The forthcoming overseas operations Bill creates similar new protections against prosecution for military personnel acting overseas. The Government have fought intensely for these protections against prosecution for the police and the military; they have fought against many attempts in your Lordships’ House to reduce or check these protections. In that context, how would the Minister explain—having granted such broad protections to the police and military, even in cases of fundamental wrongdoing—why the Government should refuse what are comparatively far more limited legal defences for survivors of domestic abuse, particularly with such well thought-out and well drafted amendments by the noble Baroness, Lady Kennedy of The Shaws?

Business of the House (Virtual Proceedings and Topical Questions for Written Answer)

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Tuesday 21st April 2020 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I join other noble Lords in thanking the staff, in particular, who are operating under such difficult conditions, as we know the whole of society is at the moment, and also Members of your Lordships’ House who have worked very hard on this. I particularly applaud the arrival of the new topical Written Questions. That is an excellent innovation that I hope will continue into the future.

I am sure that over the recess most noble Lords have, like me, been learning a whole new alphabet soup of videoconferencing technologies. I have been holding a great many meetings with local Green parties, explaining the work of the House of Lords. One of the things I explain when I do that is that, although they might not know it, the House of Lords is actually an anarchist collective. I am of course referring to the fact that when we are conducting Oral Questions and Private Notice Questions it is not a chair who decides who speaks; the whole House makes the decision collectively. That brings me to two points that I would perhaps have tabled as amendments under different circumstances. That is obviously not practical today, but I would like to put them on record.

The Green group and the noble Lord, Lord Wigley, who cannot be here today, have jointly put forward proposals for the allocation of Oral Questions. It is obvious that we cannot operate in the same manner as we do in the House, but it would maintain some of the democratic nature of traditional Oral Questions if those asking supplementaries were voted for by the whole House, rather than being selected by the usual channels—the term “usual channels” is one we might want to reflect on. That is something we might look at in our new procedures.

The other thing I wanted to raise is of particular concern to the Green group, although I suspect that it is an issue for other groups, too. On Oral Questions, the guidance says that for each session:

“Non-affiliated peers and Bishops will be allocated 1 question”.


I clarified with the Whips Office that “each session” refers to each Question. Can that be confirmed?

Secondly, I point to the rather odd grouping, even within the traditions of your Lordships’ House, of Lords spiritual and temporal together. Your Lordships’ House often enjoys the benefits of hearing from the spiritual Lords, whatever I might think of their presence here, but if they come in on an Oral Statement, that leaves no space for the Green group, for Plaid or for other non-aligned Peers. That is a problem that those changing our future procedures should take a look at.

I thank everyone for their work. It is a work in progress and I ask that we consult widely to make sure that what we have is as democratic as possible and that we do not see the coronavirus taking away what democracy we have in this House.

[Baroness Watkins of Tavistock (CB)]

My Lords, I support the Motion and join in the thanks to all the staff who have made it possible. I particularly want to raise that at the end of the previous sitting I was quite distressed when some Members of the House felt that closing early and looking to the future was not necessarily the best thing. I said at the time that we were at the beginning of a public health crisis that we could not imagine. In the last three weeks our imagination has become reality.

The fact is that we will be modelling to the rest of society that we are trying to do our jobs, and fulfil our roles and our responsibilities, in the best way we can. While I would like it to be more public in the next two weeks, I think our duty in public health terms is illustrated today. It will be an incrementalist approach that we can improve as we go along, but I wholeheartedly add my thanks to those who have made it possible, and in particular to staff in care homes and the NHS, who need our support at this time.

Business of the House

Debate between Baroness Watkins of Tavistock and Baroness Bennett of Manor Castle

Wednesday 25th March 2020 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I endorse the remarks of the noble Lords, Lord Adonis and Lord Oates. As I referred to in an earlier debate, the coronavirus has existed as an organism—as a species—for three months. When we talk about coming back in about a month’s time, we are talking about 25% of the entire existence of this virus. Of course, it will be the worst 25%. We face massive challenges. We have essentially thrown out the rulebook in many areas in the past couple of days. It is extremely disappointing —an understatement—that we will not be here to ask questions to address this directly. I understand the remarks about access for Front-Benchers but those of us with smaller representation also have important questions to ask.

[Baroness Watkins of Tavistock (CB)]

My Lords, I stand in support of the recommendations made by the Leader of the House. We cannot underestimate the public health challenge that we face. I am in day-to-day contact with, among others, very senior nurses, including Ruth May at NHS England. It is our duty to reduce the spread of the virus by taking this time out. For example, I live 260 miles away. I would come back next week if we were sitting, of course, but I would probably stay in London for another weekend rather than return. We need to demonstrate that we will hold the Government to account. The Bill, which we should finalise this afternoon, will enable us to do that. I also believe that there is absolutely no reason why Parliament could not be recalled before 21 April if it were appropriate to do so.