(7 years, 2 months ago)
Lords ChamberMy Lords, the noble Lord makes a very good point. Small companies are often reticent to take on big ones, in the fear that they will lose business in the future. Making that relationship easier is one of the reasons why we are appointing the Small Business Commissioner. Where public contracts are involved, we have a mystery shopping service, which enables small companies to ask the Government, on their behalf, to verify late payment and understand why it is taking place.
My Lords, this argument has been going on, under successive Governments, for the last 30 years at least. Where is the real resistance to change and intervention by government coming from? Nothing ever changes.
My Lords, there is a natural reluctance for any Government to get in between supplier and customer in commercial relationships. If there is a problem, it is much better if it can be sorted out. As my noble friend Lord Hamilton pointed out, there are ways of getting redress. I am not sure what the figures are, but I imagine that, going back 30 years, you would find that the average number of days outstanding for commercial debts has come down considerably.
(7 years, 10 months ago)
Lords ChamberMy Lords, I bow to my noble friend’s expertise on the subject of laundry but there is no doubt that the instructions on these machines talk about cleaning the filters and removing the lint from the filters. That is clearly important. However, there is a problem in this particular machine that does require modification. There is no doubt that if everyone registered the product when they bought it, many of the recall problems that we are facing would be addressed. But only 47% of those who buy these tumble-dryers actually register the machine in the first place.
My Lords, how does the Minister respond to the idea of a single register of UK product recalls, as proposed by Andy Slaughter MP in an Early Day Motion in the other place?
My Lords, there is no doubt that recall can be improved and this issue is being considered by the working group, which has given its interim findings to my honourable friend in the other House, Margot James. It is due to give its final report in March, when we will be able to respond more fully to the noble Lord’s question.
(7 years, 10 months ago)
Lords ChamberOn the latter question of whether the bank may invest overseas, I understand that it is already considering projects in India and east Africa. One purpose of introducing private capital into the Green Investment Bank is to give it more flexibility to develop the business in future.
The question of the noble Baroness, Lady McIntosh, was about the possibility of the bank being broken up for profit-taking. Is that possible, or will it remain completely intact?
My Lords, no business would say that it will be intact for ever. Interestingly, the Green Investment Bank manages an investment fund of £800 million. It is the biggest investment fund in the renewable sector in the UK. It has a whole series of investments in that fund, and of course some will be sold in future.
(8 years, 4 months ago)
Lords ChamberMy Lords, I am sure that junior doctors will reflect on the new economic situation in which we find ourselves, and I hope very much that they will not resort to the strike action that has been taken in the past.
My Lords, what assessment has been made of the number of resignations there might be from the health service arising out of imposition?
The noble Lord refers to resignations. Does he refer to the resignation of the chairman of the junior doctors committee?
I am not aware that there have been any resignations directly related to the junior doctors dispute.
(8 years, 5 months ago)
Lords ChamberThere are of course many products which do have tamper-proof packaging and we cannot debate all the ones the noble Lord mentioned. It seems to me entirely reasonable that this particular product should be tamper-proof. If a child were to swallow nicotine in these kinds of volumes it would have a very serious impact. It is entirely reasonable to have tamper-proof packaging.
The Government have asked the MHRA, local authorities and others involved in the enforcement of these regulations to develop a compliance regime together with the businesses which are currently in this industry. We will take a pragmatic approach to implementing the new notification system. Notification fees are low—£150 per product and £60 annually as a top-up—and are set to recover costs only. The MHRA has also developed guidance that minimises the burden on business.
E-cigarettes are not harmless. Nicotine is both toxic and addictive and there are unanswered questions about the effects of longer-term use. It is better to vape than to smoke but it is far better to do neither. These regulations reduce the risk of harm to children and protect against the renormalisation of tobacco use. They provide assurance on relative safety for users and legal certainty for businesses that wish to sell these products across the EU. I also underline that the regulations have the full support of the four nations of the UK, as well as many of those in the health community that have been involved in tobacco reduction, including ASH, Cancer Research UK and the British Medical Association. The Royal College of Physicians agrees in its report on the need for regulation of e-cigarettes to protect the public, and states that although e-cigarettes are estimated to be in the order of 95% less harmful than smoked tobacco, they are not harmless.
Moving forward, the Government are committed to a full review of the functioning of the regulations, including—
It is possible. There is always a possibility when there is a regulation that a black market will develop, and for the very high-strength products, which had to be regulated by the MHRA—the ones above 20 milligrams—there is a risk that there will be a black market. I think I recall that the noble Lord said earlier that a black market had already developed in this product. We are trying to bring some minimum quality standards, at least, into this market so that people who are thinking of moving from smoking to using e-cigarettes can have confidence that the product they use is regulated to a minimum standard.
I remind noble Lords that new and important tobacco control measures are also contained in these regulations. I have not talked about them specifically because they are slightly off the main point of this debate. The regulations will be reviewed within five years of entering into force. I also commit, here and now, to commissioning Public Health England to update its evidence report on e-cigarettes annually until the end of this Parliament and to include within its quit-smoking campaigns consistent messaging about the safety of e-cigarettes.
Clearly, there are strong arguments on both sides of the debate. As I said, I am not an instinctive regulator by any means but I feel that these regulations are proportionate. They do not go over the top, are entirely sensible and are backed by the RCP and all the major charities in this area. I hope that my noble friend Lord Callanan will not wish to push this to a vote, but of course that is entirely his decision.
(8 years, 7 months ago)
Lords ChamberMy Lords, perhaps I might ask two very brief questions. First, I recognise the undertaking that the Conservative Party gave in its manifesto, but were the BMA—or the junior doctors, more widely—consulted prior to the general election on their views on seven-day working? That is quite a simple question. If they were, what was their response in that consultation? Secondly, following the Written Questions that I tabled recently on information that the Government might hold on the position of junior doctors, why do the Government not keep statistics on doctors’ resignations from the National Health Service and on the emigration of doctors who cede their posts in the United Kingdom to take up posts overseas? Why are those vital statistics not available, particularly when we are going into this very difficult period?
My Lords, first, the need for a seven-day service has been recognised by the medical profession for a number of years. I remember reading the Future Hospital report four or five years ago in which the Royal College of Physicians talked about a seven-day service. Of course, it was the academy of the royal colleges that produced the 10 clinical standards that underpin a seven-day service. The issue is not whether or not there should be a seven-day service; the more serious issue that has been raised is whether we have the resources to deliver a seven-day service. We argue that we are putting enough resources into the NHS to do that. So I think that the principle of a seven-day service, certainly for urgent and emergency care, if not for elective care, is well accepted by the medical profession.
Interestingly, on the point about the number of people leaving—the resignations that the noble Lord referred to—I was pretty horrified to hear about the son of someone on the noble Lord’s Benches who had left the NHS to go to work in America two years ago, I think. He described a pretty torrid time working in the NHS as a junior doctor. To cap it all, when he went, there was no exit interview. No one was really concerned or knew that he had gone. That is just another illustration of the fact that we have not sufficiently respected or valued junior doctors in the NHS.
(8 years, 8 months ago)
Lords ChamberMy Lords, the 999 service runs in parallel with the 111 service. If you have an emergency, you should ring 999; if you have an urgent request you should ring 111 and a decision will be made then on whether to call an ambulance. Interestingly, of the 27% of people who ring 111 who would otherwise have gone to A&E, only 8% are actually referred to A&E.
My Lords, the Minister’s response is astonishing. Has he not been reading in the national media the repeated reports of a breakdown in the service all over the country? Has he not read these reports? I am astonished by his responses.
There have been a number of terrible tragedies. The most recent of these was William Mead, a very young baby who died as a consequence of not getting the right treatment quickly enough. NHS England has done a root-cause analysis. Some of the problems lay within 111 but others were with the out-of-hours service and with diagnosis by the GPs concerned. The noble Lord is wrong to say that the 111 service is not operating well throughout the country. Some 90% of all those who use 111 believe they get a good service from it.
(8 years, 11 months ago)
Lords ChamberMy Lords, I certainly cannot give a guarantee that this is an isolated incident. Often in the past we have taken these awful events when they happen and tried to say that they are isolated. The fact is that there are many trusts that the CQC has characterised as requiring improvement, so I cannot give my noble friend an assurance that this is an isolated incident. However, I can reassure him that our inspection procedures are much more robust than they used to be.
My Lords, we have had repeated references to unexpected deaths, but no details. What are the causes of these unexpected deaths?
Avoidable deaths are estimated at some 10,000 a year. “Unavoidable deaths” is the phrase that I think I used, which are estimated at some 10,000 a year. That is not out of line with what is found in other countries, such as America and Germany. However, it should not be accepted, which is why the Secretary of State has asked Bruce Keogh to produce these new statistics for every trust, starting from next spring.