Health and Care Bill

Lord Aberdare Excerpts

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Lord Moylan (Con)]

My Lords, pancreatic cancer is a terrible disease, as noble Lords know: 10,500 people in the UK a year are diagnosed with it, 9,000 people a year die from it and five-year survival rates in the UK rank us 29th out of 33 countries with comparable data. The Government recognise that this is not good enough, so they are commissioning an audit of existing services as a first step to improvement. That is wholly welcome but it is turning out to be a very slow business, with the first data expected in 2023 and no timetable for action to follow.

Amendment 167 in my name is intended to add a sense of urgency to that. I am grateful for the support it has received from the noble Lords, Lord Aberdare and Lord Patel, and the noble Baroness, Lady Hayman of Ullock. However, I turn my attention this evening principally to Amendment 166 in my name, which is also supported by the noble Baroness, Lady Finlay of Llandaff. It relates to improving the treatment of those diagnosed with pancreatic cancer and can be delivered immediately.

The end-of-life experience of pancreatic cancer sufferers includes huge difficulties in eating and digesting food, because of the lack of an enzyme normally produced by a healthy pancreas. Pancreatic enzyme replacement therapy, or PERT, is a simple tablet costing only £7 a day. It is fully approved by NICE and allows sufferers to eat, but it reaches only about 50% of pancreatic cancer sufferers. Why is that? The truth is that we do not know exactly and, pending the audit, may not be able to say exactly. But a likely reason is that diagnosis of pancreatic cancer occurs so late because the symptoms present so late that a prompt decision has to be made about those who might be saved by surgery and those for whom nothing can be done. The former go to specialists, who tend to be aware of PERT and prescribe it. The latter, on the whole, move into more general palliative settings, where it seems that knowledge and understanding of PERT is less widespread.

Amendment 166 obliges the Government to make increasing prescription rates for PERT a national priority, without waiting for the outcome of the current audit. It was tabled in Committee and got a somewhat dusty answer from the Government Front Bench, hence its return today. To say that emphasising PERT should await the outcome of the audit would be to condemn literally tens of thousands of people to unnecessary suffering at end of life so I think these amendments, especially Amendment 166, will find general support across the House. Happily, I understand that my noble friend the Minister will be able to offer certain assurances when he speaks that would make any such Division unnecessary.

Before I conclude, there is one extra step that the Government could make early progress on that would be welcome. It is in disaggregating the data about the prescription of PERT, which can be prescribed for conditions other than pancreatic cancer. While the Government and the National Health Service are able to point to figures showing slowly increasing PERT prescription rates, what they cannot do at the moment is to say whether it is being prescribed for pancreatic cancer or some other condition. Disaggregating that data will be an important job for the Government to do, even to make progress with their own audit. Some comments on that today would also be welcome so, for the moment, I beg to move.

[Lord Aberdare (CB)]

My Lords, I am pleased to speak in support of Amendments 166 and 167 in the name of the noble Lord, Lord Moylan, addressing pancreatic cancer, to which I have added my name. I shall be brief as he has already made the case for these amendments so strongly. Both amendments include deadlines: for guidance on pancreatic enzyme replacement therapy to be published within six months; for data on PERT prescription to be published within a year, and yearly thereafter; and for a report on the audit of pancreatic cancer services to be laid before Parliament within six months and updated six-monthly. The reason for these deadlines comes down to a single word: urgency.

On average, pancreatic cancer sufferers live for only six months following diagnosis and more than half of the 10,000 a year will die within three months. That is hardly enough time for them to say proper goodbyes to their family and close friends, let alone to put their financial and other affairs in order, so the usual government timescales of “in due course” or even “shortly” are nowhere near fast enough for action to improve their treatment. I hope we may hear something more encouraging from the Minister.

Some such improvements may help extend their lives, even if only by a matter of months, but others equally important, such as PERT, may make a significant difference to the quality of the time remaining to them, however short. PERT enables pancreatic sufferers to digest their food; in some cases, it may even help them to gain the strength needed to undergo life-saving surgery. It is recommended by NICE and widely available. It costs just £7 a day per patient. I find it shocking that, as the noble Lord told us, half of patients who need PERT are not being prescribed it, mainly because of lack of awareness among non-specialist staff. Surely the Government can and should investigate and address this with urgency, as required by Amendment 166.

Queen’s Speech

Lord Aberdare Excerpts

Thursday 19th December 2019 Lords Chamber

[Lord Lamont of Lerwick (Con)]

My Lords, it is my great privilege on behalf of the whole House to thank Her Majesty for delivering the gracious Speech from the Throne this morning. It is the second time that Her Majesty has done this service in a very short time. Her unstinting devotion to duty is an inspiration to all in public life and is admired all over the world. Over the decades she has been a rock of stability in times of great uncertainty, and we are profoundly grateful to our sovereign.

I also thank His Royal Highness the Prince of Wales for his presence. I have had the privilege of being a trustee of one of his charities, closely connected with the Prince’s Trust and the Prince’s Foundation. I have been astonished and deeply impressed by his attention to detail and the work that he puts into those charities. I thank him, too, for his public service.

I also thank all the staff: the doorkeepers, caterers, police, cleaners and everyone who, under Black Rod, has worked so hard for this second State Opening in just a few months. It must have involved a lot of extra work, not just because it is the second but because it has had a slightly different format. Again, we are very grateful.

When the Chief Whip rang to ask me to propose this Motion, he must have been telepathic. I was about to phone him to ask whether, when speaking in the four-day Queen’s Speech debate, he could not allocate me the very last position, as is his usual habit. I little imagined that he would make me the first speaker, which is a very great honour.

Our Chief Whip is a very courteous man and certainly a true gentleman. He gives the lie to Sir Robert Peel’s view that the job of Chief Whip is one which requires all the qualities of a gentleman, but no gentleman would ever accept the post.

I understand that this speech is meant to be uncontroversial, but I hope people will understand that it is rather difficult to avoid all mention of a certain event a week ago today—the election—which indeed gave rise to the gracious Speech. I shall endeavour to be like the returning officer in an Irish election who declared that he was perfectly fair: he was half way between partiality and impartiality.

I will say only this about what the Prime Minister called his “stonking victory”: he picked his moment, he risked it all and he won. He reminded me in his boldness of the lines of the 17th century Covenanter, the Duke of Montrose, who wrote a poem about risk in politics and war. He wrote:

“He either fears his fate too much

Or his deserts are small

That puts it not unto the touch

To win or lose it all.”

Well, the Prime Minister put it to the test and he won.

Of course, everyone now says that they foresaw the result. I was certainly not so sure, but I have always been extremely bad at predicting elections. The only time I ever won a political bet was in 1997 when I bet Bob Worcester, the chairman of MORI polling, who did not believe his polls, that his polls were correct and the Conservative Party would be annihilated. I won £100. It was not a lot of consolation as I was also annihilated in the election, by the former Member for Harrogate, now the noble Lord, Lord Willis, with whom I must say I am on perfectly good terms today.

Of course, losing an election is a painful business. Many good, hard-working MPs lost their seats and will be missed. Being an MP is not an easy job these days and they should all be thanked for their public service.

[Noble Lords]

Hear, hear!

[Lord Lamont of Lerwick]

There were many remarkable results in the election. I spent my teenage years—as did my noble friend Lord Cormack—living in Grimsby, a town with dreadful social problems. I often fantasised, and still do today, that Grimsby Town Football Club, the Mariners, would one day win the FA Cup—but I never fantasised that Grimsby would ever have a Conservative MP. Of course, if you support a football team, you do so whether it is playing well or badly. Alas, that is no longer true of political parties.

My contribution to the election was extremely meagre: a little broadcasting and some canvassing, including some telephone canvassing. Most of my calls were replied to by a disembodied voice saying, “This number is no longer in use”. It was difficult to get any sense of public opinion; one moment one was calling Scunthorpe, the next moment Exeter, the next Hull and the next Tonbridge. Early on, when not very conscious of where I was phoning, a voice said, “You don’t sound very local. What’s the name of the local candidate?” Bowled middle stump, I am afraid.

We were told to give our names when phoning. I decided to discard that advice and remain anonymous. I still remember an incident that was many years ago but lives on in my memory. I got into a taxi at Westminster. The driver said, “It’s Norman Lamont, isn’t it?” I said, “No, no, nothing to do with me. I do look a little bit like him. We’re often confused.” “Go on,” he said, “I know it’s you.” “Okay,” I said, “it’s me.” He said, “I saved your life once.” “How is that?” I asked. He said, “I was driving up St James’s Street with a passenger in the back of the cab. You were crossing the road outside the Carlton Club and he said, ‘A thousand pounds if you run the bastard over’.”

That was a long time ago, but voters can always be challenging. Gyles Brandreth has told some of my colleagues about how he was canvassing for his daughter in Kingston, and a voter asked him about the candidate’s qualities. Gyles replied by saying, “She’s very bright, hard-working, honest and committed to the public good. She will be a very good MP. And, may I add, she’s also my daughter.” Back came the reply: “Are you sure she’s your daughter?”

The important measure in the gracious Speech arises from the election: namely, the withdrawal Bill to give effect to our exit from the EU on 31 January. I made my maiden speech in the House of Commons in 1972 supporting our joining the EEC, as it then was. I never imagined that 45 years later I should find myself standing in this House supporting measures to reverse that decision.

The noble Lord, Lord Hennessy, once suggested that my own Euroscepticism came from the fact that I lived my early years in the Shetland Islands, which have close connections to Norway. Jo Grimond, the MP for Orkney and Shetland, once filled in a form that asked where his nearest railway station was, and wrote “Bergen”. Shetland was the only place that voted against membership of the European Economic Community in the 1975 referendum, but this had less to do with links to the Vikings and more to do with the fact that the Government distributed to every house a leaflet detailing the claimed advantages of the Common Market. The government leaflet had a map of the UK on the front but left Shetland off the map completely—not even in the usual insulting little box in the top right-hand corner. But, of course, Shetland was ahead of its time.

My own doubts about the EU arose when, as Chancellor, I was negotiating our opt-out from the single currency. I saw that the EU was morphing from being an economic association into an increasingly centralised political entity, and I did not believe that this would ever be acceptable to the British public when they finally understood what was happening. In 1994 I ruined the Tory party conference by saying that I personally doubted the claimed economic advantages of the European Union but one day we might have to consider leaving it because of the political direction in which it was going. However, I must say I never really expected to see that happen.

In my opinion, remainers in both the election and the referendum made a mistake in assuming that the argument could be won on economic grounds. Many people were never going to be convinced by arguments about the possibility of GDP being a few points lower after 10 years. For many more, this was an argument about accountability, democracy and, above all, identity. This election was the second people’s vote. My noble friend Lord Heseltine has said, very surprisingly, that the verdict should be accepted. Even Guy Verhofstadt, who once told an enraptured Liberal Democrat conference that the EU was an empire, said last week:

“Brexit will … happen. The British … have confirmed their referendum decision.”


Quite so. Indeed, the war is over. Grass should now be allowed to grow over the battlefield. It is time for the process of healing and reconciliation to begin. Of course, we all understand that there will be continuing arguments about the nature of our relationship with the EU, for example, the precise foreign policy relationship. Many noble Lords in this House who supported remain have much to contribute to that debate.

Apart from the legislation on Brexit, there is much in the gracious Speech that will be widely welcomed, most importantly the statement of the intention to ensure that every part of the UK can prosper and the emphasis on infrastructure—not just the money but giving more say over how it is spent back to communities. The intention to reach a consensus on care of the elderly is welcome as far as it goes, but I personally hope the Government will come up with a solution, because this is one of the most serious, pressing problems this country has—I am sure I carry all parts of the House on this. New sentencing laws to make sure that violent offenders spend longer in prison will be welcomed, as will the commitment to increase education spending per pupil. There will certainly be strong support on this side of the House for the repeal of the disastrous Fixed-term Parliaments Act 2011, which caused such unintended, unforeseen chaos.

Commentators have wondered how the Government will satisfy two different constituencies: the blue collar one in the north and a very different one in the south. This Speech shows exactly how, combining a strong social programme, a programme of renewal, a commitment to the unity of the UK and the restoration of UK sovereignty. This is the agenda of a truly one-nation Government. I beg to move.

Business of the House

Lord Aberdare Excerpts

Wednesday 4th September 2019 Lords Chamber

[Lord True]

No, I will not. I will not be sidetracked—

[Noble Lords]

Oh!

[Lord True]

I do not want to get into the issue of Prorogation, simply because of the time. But I spoke about Prorogation the last time we discussed these things. We all know that Prorogation is perfectly normal. There is always a Queen’s Speech. There has been one every year and the next Government will introduce a Queen’s Speech after the general election. In response to the noble Baroness, I will make the point that, if there were an election and a new Session, there would be more time to have such a Bill after that than there is in the next two days. There would be several days in which we could discuss it, not two days. It is not necessary to do it now. Indeed, after an election, if the party opposite won, we would not need a Bill because it would ask for an extension anyway—and if our side won, the Bill would not go forward. So the whole thing is entirely unnecessary, and this House is being asked to sign away hundreds of years of tradition on a pretext.

I support my noble friend. There are questions that the noble Baroness should answer. What does the Salisbury doctrine apply to? In her doctrine, we must defer to the Commons. Does self-regulation always mean a Motion from the Leader of the Opposition? Her guillotine says that if it passes, no one else may put any proposition to the House in the time that we are discussing this Bill, except the Leader of the Opposition. There are questions that need to be answered. I strongly support the view of my noble friend that we should take the Committee opportunity to get some answers from the Leader of the Opposition.

Careers Education

Lord Aberdare Excerpts

Wednesday 15th June 2016 Lords Chamber

[Baroness Stowell of Beeston]

Employers should play a big part in inspiring young people and see that as an important part of their responsibility. That is why we have invested so much in creating opportunities for apprenticeships and how we want to see employers playing their part not just in providing those apprenticeships but in making sure that, in schools, students and pupils understand what is needed for them to be successful in the world of work.

[Lord Aberdare (CB)]

My Lords, I meet a lot of apprentices, hardly any of whom appear to have been directed towards their apprenticeship by their schools or careers adviser. How will the government strategy ensure that students, teachers and parents are more aware of vocational career opportunities, such as apprenticeships?

[Baroness Stowell of Beeston]

I hope very much that this is part of the responsibility of the Careers & Enterprise Company—and I am sure that it is—which we funded to inspire young people and help them to prepare for the world of work. But I accept and understand the point that the noble Lord makes about ensuring that families and young people understand the range of opportunities open to them. In my maiden speech in your Lordships’ House, I talked about how it is important and vital that people understand that there are a range of routes to success, and it is not just about going through to university—as important as that is, and as important as it is that we make that available to as wide a group of people as we can. For me personally, this is a mission that I feel very strongly about.

Apprenticeships

Lord Aberdare Excerpts

Wednesday 4th May 2016 Lords Chamber

[Baroness Neville-Rolfe]

We will be publishing further proposals on funding and the logistics of this scheme in June. I note the noble Baroness’s points but we should focus on apprenticeships. I am a great one for focusing on an area and getting it done right, rather than trying to extend it right across the board of training, as she suggests. But of course we can learn from our experience.

[Lord Aberdare (CB)]

My Lords—

[Baroness Nye (Lab)]

My Lords—

[The Lord Privy Seal (Baroness Stowell of Beeston) (Con)]

My Lords, I think that it is the turn of the Cross Benches and then we need to move on.

[Lord Aberdare]

My Lords, Carolyn Fairbairn, the director-general of the employers’ organisation, the CBI, said last week that a radical rethink of the plans for the apprenticeship levy is needed if the Government are to meet their target of 3 million new apprenticeships, and that they need to be trialled before a full rollout. What is the Minister’s response to these concerns?

[Baroness Neville-Rolfe]

We have of course been trialling them through our trailblazer scheme, but the suggestion from the CBI that we should delay the levy and the new apprenticeships is a mistake. The year 2017 is a long way away. For decades, no Government, including ours, have sufficiently addressed the fact that business invests too little in skills development. Frankly, it is time we made the change.