Covid-19: Test and Trace App

Lord Clement-Jones Excerpts

Monday 22nd June 2020 Lords Chamber

Asked by

[Lord Clement-Jones]

To ask Her Majesty’s Government, in the light of the announcement made on 18 June regarding the switch in technology for the NHSX Covid-19 Test and Trace app, what is their assessment of (1) the operational impact, (2) the financial impact, and what lessons have been learned.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, we remain optimistic that high-tech can help our fight against this horrible disease, but we have learned that consumers want a personal touch rather than a text exchange, that tools that assist outbreak management are our immediate priority and that the challenges of proximity detection have confounded many Governments around the world. That is why we are working with the best companies to build the best app that meets the needs of the British people.

[Lord Clement-Jones (LD) [V]]

My Lords, I hope that the Minister understands the anger at the Government’s and NHSX’s sheer incompetence and lack of humility in what was rightly called a fiasco by the Daily Mail last Friday, and that their go-it-alone approach and attempt to shift the blame on to tech companies simply will not wash. Is it not time that the Government just accepted that we cannot develop our own app and went straight to adopt the available interface, or API, behind the off-the-shelf, decentralised app now in widespread use? Such apps have been introduced in Germany, Italy, Switzerland and Denmark, where they appear to be working well, and are close to release in Holland, Ireland, Latvia and Estonia. They would help travellers avoid quarantine this summer, and many of us were urging this on the Government back in April?

[Lord Bethell]

I want to say a profound thanks to those at NHSX, NHS Digital and others who have worked so hard on the NHS app. They have made phenomenal progress and their hard work is hugely appreciated. I also want to say a profound thanks to those at Apple who are working with us to design an app that suits the British public. Both teams have faced enormous challenges and I look forward to their working together to overcome them.

Covid-19: Contact-tracing App

Lord Clement-Jones Excerpts

Wednesday 6th May 2020 Lords Chamber

Asked by

[Lord Clement-Jones]

To ask Her Majesty’s Government what action they are taking to (1) protect the privacy of users, and (2) provide oversight, of the National Health Service’s COVID-19 contact-tracing application and, in particular, whether the application will meet Apple’s privacy standard for Bluetooth.

The Question was considered in a Virtual Proceeding via video call.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, we have put privacy at the heart of the app and the way it works. It is designed so that you do not have to give up your personal details to use it. We have worked in partnership with both the National Cyber Security Centre and the Information Commissioner’s Office throughout. We continue to hold discussions with Apple and Google. The app uses only software development tools and mechanisms that are supported by Apple and Google.

[Lord Clement-Jones (LD)]

To be effective, achieve widespread adoption and ensure our safety, the new app needs to gain public trust. So, why have the Government developed a go-it-alone, centralised app which is not optimally privacy-preserving, not interoperable with the apps of other countries—not even Scotland, it seems —not fully compatible with the Apple and Google Bluetooth protocol, and has no mandatory oversight, time limit on its use or public data impact assessment?

[Lord Bethell]

My Lords, it is not a go-it-alone app; others are following our lead on this. It is interoperable, and we are working with other countries to make sure it is. Testing with the public has turned out to be extremely positive and we look forward to publishing the audit shortly.

Queen’s Speech

Lord Clement-Jones Excerpts

Thursday 9th January 2020 Lords Chamber

[Lord Clement-Jones (LD)]

My Lords, since we have just had the 12 days of Christmas, I want to use my five minutes to suggest 12 digital priorities for action by this new Government in the context of the Queen’s Speech—I will do so in shorthand, necessarily.

The first priority is action on online harms and internet safety. Will the Government bring forward a draft Bill for scrutiny, and designate Ofcom as the regulator to ensure the necessary work on codes of practice? Will they commit to bring back age verification for adult sites and widen it to cover social media platforms? Will they comply with the revised AVMS directive?

The second priority is to speed up the broadband rollout. What timescale is envisaged in the pledge to accelerate the rollout out of gigabit-capable broadband? Is it 100% by 2025, as promised by the Prime Minister in his leadership campaign?

The third priority is a moratorium on facial-recognition technology. The Home Office’s own Biometrics and Forensics Ethics Group has questioned the accuracy of live facial-recognition technology and noted its potential for biased decision-making. Will the Government agree to a moratorium as a vital first step before regulation?

The fourth priority is the control of algorithmic decision-making. The Government have published a guide to using artificial intelligence in the public sector. What plans do they have to monitor its use and ensure that there is compliance?

The fifth priority is data governance. There is increasing concern about access and security of personal data. Look at the current Travelex case: even sharing by the NHS gives rise to concern. We need to go well beyond the GDPR, with much more control over our personal information through personal data accounts, hubs of all things and data trusts. Will the Government continue to fund work on this by the Open Data Institute, the Alan Turing Institute and others?

The sixth priority is changes to corporate governance. AI can and should contribute positively to a purposeful form of capitalism which is not simply about the pursuit of profit. It is imperative that boards have the right skill sets in order to fulfil their oversight role and take accountability. Will the Government develop corporate governance for the Al age as part of their proposals on company audit and corporate reporting?

The seventh priority is a new approach to employment, skills and retraining. Whatever the scale of disruption by AI to the jobs market, retraining will be a lifelong necessity. What can the Minister tell us about the rollout of the national retraining scheme? How does it relate to the national skills fund? Have the Government considered the idea of personal learning accounts? How will the Government encourage greater diversity in the training and recruitment of AI specialists to minimise bias in training data and decision-making?

The eighth priority is the strengthening of data and digital competition, especially in digital advertising. When is the Government’s response to the Furman report going to emerge? With which regulator will the new digital markets unit sit?

The ninth priority is the adoption of international norms on ethics. What is the Government’s intention going forward with AI principles, such as those developed by the OECD and G20 last year and the potential of AI to help solve the UN’s sustainable development goals?

The 10th priority is the reform of digital taxation. The Government plan to introduce a digital services tax, ensuring that tech giants pay their fair share. Will this support and build on the OECD’s proposals? What are the Government’s intentions in that respect?

The 11th priority is ensuring better digital understanding and media literacy. Do the Government’s plans include teaching on how to use social media responsibly and provide advice and support for parents on how to help their children protect themselves online?

The final priority is a strong digital trade policy. Will the UK put the digital economy at the heart of its trade policy? Crucial areas such as data adequacy, tech skills from overseas, the EU digital services Act, data sovereignty and the US CLOUD Act will all need to be tackled in our trade policy. I hope that many, if not most, of these priorities will also be the Government’s priorities. If they are, they will get support from these Benches.

Queen’s Speech

Lord Clement-Jones Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Lord Clement-Jones (LD)]

My Lords, yesterday my noble friend Lady Bonham-Carter covered a range of aspects of arts and creative industry policy, so I will focus on digital policy during today’s debate—but I hope my noble friend will have the benefit of a reply to her questions from the Minister at the end.

Digital technology and communication are now prevalent throughout our society and economy and are having a profound impact on all our lives, but it is clear that major differences with this Government of timing and priority for action are now emerging for many aspects of digital policy. This is the case above all on age verification. The Secretary of State has announced a huge delay in a policy which we debated in this House at length. I strongly agree with my noble friends and the noble Baroness, Lady Howe: this is a truly shocking and unfortunate decision. All the adult sites were preparing to install these robust mechanisms. What is the Government’s real aim? Is it to let these adult sites off the hook? Have they somehow decided that age verification is not workable? If that is not the case, when should we expect the introduction of this crucial policy? How will this impact on the anticipated age-appropriate design code when age verification is used as the default protection mechanism? How will the Government respond to the obligations of the revised Audiovisual Media Services Directive, which will enter into force in September 2020? The Government need to urgently reconsider this matter.

As regards online harms, it is widely agreed that tech companies should no longer be able to avoid responsibility for content on their sites. We agree that a statutory duty of care, properly framed, can protect the safety of the user and, at the same time, respect the right to free speech, allowing for a flexible but secure environment for users. The task of regulation in this area should fall to Ofcom. With its clout, experience of drawing up codes in sensitive areas affecting freedom of expression, understanding of how technology and content converge and experience of co-operating with other regulators, it is the most sensible choice. Given the complexity of the issues, and the need for clear definitions, we welcome the prospect of pre-legislative scrutiny of a draft Bill setting out the new regulatory provisions. Indeed, on these Benches, we suggested it. How do the Government intend that this is carried out? When can we expect the draft Bill, and will it designate Ofcom as the regulator so that it can start preparations?

Competition regulation for the digital industries needs to be substantially strengthened so that the importance of data as an asset is recognised and we prevent data monopolies that form barriers to innovation. We need to build on the recommendations in the Furman review, which recommended a new digital markets unit to ensure that we are abreast of these issues. When is the Government’s response to that report going to emerge? With which regulator will the new unit sit? Have the Government made a decision?

Online gaming and e-sports are becoming immensely popular hobbies for individuals of all ages, especially for our younger generation. They provide a positive outlet for creativity and a level of global communication the likes of which have not been possible for the generations before them. But we must also consider the negative consequences of new forms of online gambling for young people, such as loot boxing. What are Government doing in response to the loot box phenomenon? How are they responding to the Digital, Culture, Media and Sport Committee’s recent recommendation for a ban on these for children? Will they carry out a review of their impact?

In recent days, live facial recognition technology has been described as potentially Orwellian by the Metropolitan Police Commissioner, and deeply concerning by the Information Commissioner. The Home Office’s own Biometrics and Forensics Ethics Group has questioned the accuracy of live facial recognition technology and noted its potential for biased outputs and biased decision-making. The Science and Technology Select Committee recommended an immediate moratorium on its use,

“until concerns over the technology’s effectiveness and potential bias have been fully resolved”.

In this light, will the Government support my Private Member’s Bill, shortly to be introduced, enforcing a moratorium on this technology—pending a review—to assess the right form of regulation?

Even more prevalent than this technology is the use of algorithms in decision-making by public bodies. One in three councils is now using computer algorithms to make decisions about benefit claims, despite evidence emerging that some systems are unreliable. Are we not endangering public trust in artificial intelligence in a major way? When will this Government regulate this kind of decision-making by algorithm?

Fear and lack of trust in technology are very strongly related to the future of jobs and skills. AI in particular will have significant implications for the way in which society lives and works. The future.now initiative, recently launched by the Lord Mayor, Peter Estlin, recognises that there are some 17.3 million people in the UK without the necessary skills for work—but, despite this, the Government’s national retraining scheme is only at pilot stage. What can the Minister tell us about the rollout of the national retraining scheme?

In terms of the skills we should be nurturing, as a number of noble Lords have said, it is very clear that these should be not just tech skills, such as maths and coding, but social and creative skills. Are the Government taking on board the recommendations of the Durham commission, which so cogently set out the case for creative skills?

Above all, the black cloud of Brexit looms over the thriving tech and digital sector. What can the Government tell us about their preparations to seek data adequacy, which is so important for the tech and digital industries?

Healthcare (International Arrangements) Bill

Lord Clement-Jones Excerpts

Report stage (Hansard): House of Lords
Tuesday 12th March 2019 Lords Chamber

Moved by

[Lord Clement-Jones]

14: Clause 4, page 2, line 38, at end insert—
“( ) The processing of personal data in accordance with subsection (1) must comply with—(a) the seven Caldicott principles outlined in the Caldicott Committee’s Report on the Review of Patient-Identifiable Information and subsequent reports;(b) the Government’s Data Ethics Framework.”

[Lord Clement-Jones]

My Lords, I beg to move Amendment 14, and your Lordships will be pleased to hear that I will be brief.

During the passage of the Bill, considerable concerns have been raised by a number of noble Lords about the use and sharing of data within the NHS. It is a hotly contested subject, and one of the best briefings on it is from our Library, prior to a debate on 6 September initiated by the noble Lord, Lord Freyberg. It unpacks a number of the concerns and issues about data within the NHS, and I am sorry that I have been unable to be at Second Reading or in Committee to expand on some of those issues.

During our Select Committee inquiry into artificial intelligence, there were a number of witnesses who talked about the use of data in the NHS, and we drew a number of conclusions, namely that the data was not in good shape to be utilised for beneficial purposes such as research, diagnosis and screening. That is another issue, however; what concerns noble Lords is the question of sharing. Now that we have seen Amendment 1 pass, maybe we will deal only with countries where there is a level of data adequacy which gives us an assurance about the use of NHS data. As the King’s Fund said last year in its report, Using Data in the NHS:

“National policy has to keep a balance between responding to legitimate public concern about the security and confidentiality of data and enabling data to be shared and used by NHS organisations and third parties. It is also essential that NHS national bodies are transparent with the public about how patient data is used”.


It went on to suggest that the level of opt-outs for patients would be key to the quality and validity of future research, and that NHS England and NHS Digital should keep this under review. One of the issues in the NHS is that there are several organisations responsible for NHS data. It is not just NHS England, NHS Digital, the National Information Board and Public Health England. The Caldicott Guardian—the national guardian for health and care—has a responsibility as well. It is quite a disparate, rather balkanised issue.

I was reassured on reading what the noble Baroness, Lady Manzoor, had to say when she responded, as the Minister, to this set of amendments in Committee:

“Under the Bill, personal data can be processed only in accordance with UK data protection law, namely the Data Protection Act 2018 and the general data protection regulation, which will form part of UK domestic law under the EU withdrawal Act 2018 from exit day”.


I am not going to go into all the questions about data adequacy and so on. I take what she said as quite reassuring, but it was less so when she later responded to what was then Amendment 23—this amendment is identical. She said:

“I assure the Committee that the Government are committed to the safe, lawful and responsible processing of people’s data”.


However, she then said:

“As the noble Baroness, Lady Jolly, and my noble friend Lord O’Shaughnessy noted, the Caldicott principles and the Government’s Data Ethics Framework are admirable standards to apply to the handling of patient data. Both of these non-legislative frameworks are in line with the Data Protection Act and the GDPR, which are enshrined in the Bill”.—[Official Report, 19/2/19; cols. 2261-63.]


That is not unequivocal in terms of those standards applying. As the Minister knows, we discussed this between Committee and Report. I had hoped to receive correspondence from her, but sadly I have not done so. She may need to repeat whatever text of the letter she may be able to find in her outbox. I hope she can give the House reassurance that the national data ethics framework and the Caldicott principles will apply to any sharing of data. The data ethics framework is a cross-government standard, of course, but the Caldicott principles are specific to the NHS. It is important to make sure they apply both domestically and internationally.

[Lord O'Shaughnessy]

My Lords, I am grateful to the noble Lord, Lord Clement-Jones, for giving the House the opportunity to talk about this issue again. He has been deeply involved in this topic and, as he said, I spoke on it in Committee. Compliance with this country’s very robust data protection rules is critical in general and particularly important in healthcare. This was discussed in the debate instigated by the noble Lord, Lord Freyberg; it has been a topic of conversation in this House, both in and out of the Chamber, on many occasions.

The noble Lord talked about the number of bodies that have some responsibility: he called it balkanised. It is important that we do not create a balkanisation in the law, even if a small one is in operation. One set of law should take precedence over all data protection, security and connected issues. That is, and should be, the Data Protection Act 2018. This means that there are operational guidelines, frameworks, principles and so on about how these ought to operate within individual contexts. That is precisely where the Caldicott principles come in. They take a general piece of legislation and translate what good practice in interpreting it ought to mean in a health setting. In that sense, it is important to say that we should not put those principles in a legislative setting. They are interpretive of the core, primary legislation and may need to change over time. They may need to adapt; there may be an eighth principle as we get into interesting questions about the value of data and so on.

It is important to recognise that the Caldicott principles bring to life what the Data Protection Act ought to mean in health settings. It would be a mistake to create competing law. Of course the Government agree with the noble Lord about the importance of giving force to the principles. That is one reason why we supported the Private Member’s Bill brought into this House by my noble friend Lady Chisholm to put the national data guardian on a statutory basis. I hope that that gives him the strength of reassurance about the way that the framework is constructed, which is not to create an opportunity to do funny stuff at the edges, but rather to make sure that there is primacy of one set of legislation.

[Lord Clement-Jones]

My Lords, the noble Lord used the expression, “giving force”. If those principles are given force, it means that the Government treat themselves and put on the record that they are bound by those principles. That is what giving force would mean in those circumstances, because these are novel circumstances set out in the Bill. That kind of reassurance is needed with the data ethics framework.

[Lord Patel (CB)]

My Lords, I had amendments that the Minister responded to at the Dispatch Box and I accepted her explanation at the time. Now I take the point that the noble Lord, Lord Clement-Jones, is trying to raise, that those principles that she enunciated about data protection included the Caldicott principles. As that reassurance was given at the Dispatch Box, I think it will cover the issue.

[Baroness Manzoor (Con)]

My Lords, I thank the noble Lord, Lord Clement-Jones, and the noble Baronesses, Lady Jolly and Lady Thornton, for tabling Amendment 14 and raising the issue of the lawful and responsible processing of data. I start with an apology to the noble Lord, Lord Clement-Jones. My noble friend Lady Blackwood did write to the noble Lord, and I am sorry that he has not yet received the letter. We will endeavour to send him another copy as soon as possible.

As my noble friend Lord O’Shaughnessy said—and I reassure the noble Lord, Lord Patel, that—data sharing is a necessary and crucial aspect of maintaining effective complex reciprocal healthcare arrangements, and the Government are committed to the safe, lawful processing of people’s personal data. There are, as the noble Lord said, safeguards in place in respect of processing personal data for the purposes set out under the Bill, for which the Bill makes express provision. The Bill makes it absolutely clear that it does not authorise the processing of data that contravenes UK data protection legislation.

Data processing will be permitted only for the limited purposes set out in the Bill. Personal data will be processed in accordance with UK data protection law—as the noble Baroness, Lady Thornton, observed—namely, the Data Protection Act 2018 and the general data protection regulation, which will form part of UK domestic law under the European Union (Withdrawal) Act 2018 from exit day.

I assure the noble Lords, Lord Patel and Lord Clement- Jones, and the noble Baroness, Lady Thornton, that the Caldicott principles are an important part of the governance of confidential patient information in the NHS and a guiding mechanism for organisations in how they should handle confidential patient information on a practical level. The NHS is expected to adhere to these principles.

Since 1999, NHS bodies have been mandated to appoint a Caldicott Guardian. These principles are therefore ingrained in the current operation of the NHS and confidential patient data handled by the NHS for purposes in relation to reciprocal healthcare will be subject to these principles. The principles are consistent with the requirements of the GDPR and a breach of the Caldicott principles would most likely amount to a breach of the GDPR and the Data Protection Act 2018. The principles are not intended for statute but are of real practical and operational importance when confidential patient information is processed. This will be the case when confidential patient information needed for reciprocal healthcare arrangements is processed.

It is also worth noting that reciprocal healthcare arrangements will not normally involve the processing of confidential patient information, except in particular circumstances, such as facilitating planned treatment. However, where this information is processed through reciprocal healthcare arrangements under the NHS, it must comply with UK data protection legislation. NHS organisations, as they do now, will be required to adhere to the Caldicott principles. The data ethics framework that the noble Lord, Lord Clement-Jones, mentioned sets out collective standards and ethical frameworks for how data should be used across the whole public sector, as well as the standards for transparency and accountability when building or buying new data technology. Where the framework refers to personal data, it consistently cross-refers to the principles in the GDPR, which is the relevant legislation that policymakers must consider when processing personal data.

Personal data processed for the purposes of reciprocal healthcare arrangements would therefore also take into account the data ethics framework. In addition, from 1 April 2019, the National Data Guardian will be put on a statutory footing and will therefore be able to issue formal guidance and informal advice to organisations and individuals about the processing of health and adult social care data in England. This will provide patients statutory independent oversight of the use of health data, with health bodies being required by law to have regard to the guidance issued by the National Data Guardian. This is another way in which NHS organisations in England which are processing data in respect of reciprocal healthcare will be monitored and personal data can be further protected as necessary.

It is important to note that express reference to these principles in the Bill would not provide any additional protections for personal data or confidential patient information, as the standard of protections required is the same as the existing data protection legislation already provided for in the Bill. I am grateful to the noble Baroness, Lady Thornton, and others for their support in observing this. Furthermore, as I have said, these principles already apply to NHS organisations and will continue to do so in respect of reciprocal healthcare. As a result, it would be inappropriate to put these in the Bill and I am therefore unable to accept the amendment. However, the Government have listened carefully to concerns surrounding the list of persons who can lawfully process data as a part of implementing new reciprocal healthcare arrangements under the Bill and have tabled an amendment on this issue.

Currently, the list of authorised persons under the Bill includes the Secretary of State, Scottish Ministers, Welsh Ministers and a Northern Ireland department, NHS bodies and providers of healthcare. Of course, over time, public bodies change, are reformed and refashioned, and functions are transferred between them in consequence. Clause 4(6)(e) gives the Secretary of State the ability to respond to such changes so that systems can operate efficiently and data can follow in an appropriate and lawful way to enable such operation. We propose, however, subjecting any regulations that add to the list of persons authorised to process data for the purposes of the Bill to the draft affirmative procedure. This would allow Parliament the opportunity to scrutinise authorised persons handling personal data while ensuring that the Government have the ability to guarantee that future agreements are administered in the most efficient way possible.

The Government are firmly committed to the safe, lawful processing of personal data, and to ensuring that patients have enforceable protections under data protection legislation. I hope, given my assurances that any data processing under the Bill would comply with the Caldicott principles and the data ethics framework as appropriate, that the noble Lord will feel able to withdraw the amendment.

The noble Baroness, Lady Thornton, kindly mentioned the factsheet. Of course, if it is useful, we would be very happy to put this in the Library. Officials do a tremendous job and I am very grateful to them. I hope, with the assurance I have given noble Lords, and the fact we are providing greater scrutiny, that the noble Lord feels able to withdraw the amendment.

[Lord Clement-Jones]

My Lords, that was exactly the kind of robust response from the Minister that I was hoping for. It is very rare that I listen to a government response and nod all the way through, so I thank her for that very careful response, both on the Caldicott principles and the framework for data ethics, and for going into the accountabilities, and the affirmative procedure guarantee at the end—that was a bouquet. It is not that we on these and other Benches do not understand the value of NHS data and the real importance of that balance. This is not designed as a negative approach to the use of NHS data; it has huge potential benefits, but we have to make sure that it is kept within that ethical framework. The Minister has demonstrated that that kind of culture is ingrained—or is certainly expected to be ingrained—in the NHS and that Caldicott Guardians, post 1 April, will be very much on the case. In those circumstances, with pleasure, I beg leave to withdraw my amendment.

Amendment 14 withdrawn.

Queen’s Speech

Lord Clement-Jones Excerpts

Thursday 29th June 2017 Lords Chamber

[Lord Clement-Jones (LD)]

My Lords, I am afraid that there is precious little to welcome in the Queen’s Speech for our arts and culture and our creative industries. The Creative Industries Federation, in its Brexit report published last autumn, reinforced by its recent report, Our Red Lines on Brexit, rightly stated:

“Talent and skills are fundamental to the UK’s creative success. It is vital we continue to cultivate our own talent as well as to attract the best and brightest from around the world.”


The UK is a creative hub. The freedom of movement of people to work and travel across Europe without the need for visas has both facilitated and fuelled an exchange of culture, creativity and expertise, as well as generating commercial and artistic opportunities. Our immigration system must continue to enable easy access to critical skills and talent from both EU and non-EU countries. Freedom of movement for the sector is essential, as my noble friend Lady Bonham-Carter has emphasised. Brexit must also not be allowed to interfere with an IP regime that has worked well for our creative industries. To date, the UK has worked closely with the EU and its member states to reduce copyright infringement and the proliferation of counterfeit goods. The current standards of IP protection need to be maintained with continuing co-operation on enforcement of IP generated in the UK.

We need to maintain our influence within the EU to ensure the continuation of territorial licensing of rights. We want to see initiatives such as Follow the Money being pursued at both UK and EU level. We want the UK to have an influential role in the development of the EU digital single market, including the new copyright directive. TV channels, too, must be able to continue to operate in the EU on the basis of origin in the UK, and UK content to qualify as EU, otherwise our status as a creative hub is at risk. The creative industries should also be at the heart of the Government’s education, employment and industrial strategies. My noble friend Lady Bonham-Carter has dealt comprehensively with the need for focus on arts education, creative training and skills development, not least in terms of flexibility in the apprenticeship levy.

In our UK industrial strategy, we must support small and start-up creative businesses. Creative enterprise zones should be established to grow and regenerate cultural output across the UK and measures taken to counter the threat posed by gentrification and property development to vital artistic and artisan communities such as the Old Gas Works in Fulham. Grassroots music venues are also under threat. We need to address the barriers to finance faced by small creative businesses. I commend our manifesto proposal for a new allowance to help those starting up a new business with their living costs in the crucial first weeks and reforming entrepreneur’s relief to enable investors to retain more of their money on exit, provided that it is reinvested in new projects.

There are many other important issues being faced by our creative industries and artists. My noble friend Lady Bonham-Carter made clear our views on the issue of Channel 4 as well as on the establishment of a BBC licence fee commission. We still have unfinished business from the Digital Economy Act. I welcome the incorporation of the general data protection regulation into UK law and in principle the proposal for a digital charter, along with the prospect of an online safety strategy. But will the Bill and the charter be guided by the report published today by the Royal Society and the British Academy proposing a stewardship body for data governance?

We also need to respond to the threat of illicit IPTV streaming. What can the Minister say about progress on the call for evidence? Do the Government really understand the need for urgent action in this area? On these Benches, we are extremely conscious of the power of platforms and aggregators on the internet. YouTube’s failure to pay properly for its right to stream music is a continuing cause for concern. Rights holders should not have to send literally hundreds of millions of notices to search engines to remove links to infringing content. We need to ensure that any code of conduct on search and copyright between search engines and the creative industries is underpinned by statutory powers of enforcement. FOBT stakes, mentioned by the noble Baroness, Lady Sherlock, is another matter for action. So much needs to be done in all these cases, but I can see very little that the Government have indicated they wish to do.

I add a few closing words on higher education. I declare an interest as the incoming chair of Queen Mary University of London. The jury is still out on the recent Bill, now an Act, the new regulatory structures which have been created and the TEF ratings, about which I share the reservations expressed earlier by my noble friend Lady Garden. However, I strongly welcome Sir Michael Barber as the incoming chair of the Office for Students. He said in his recent speech to Universities UK:

“We need to transform expectations of what is possible and see universities become ever more powerful engines of opportunity”.


We are facing many challenges in the higher education sector, not least as a result of Brexit, but that is exactly the ambition our universities should be adopting.

Pharmacies: Funding

Lord Clement-Jones Excerpts

Wednesday 2nd March 2016 Lords Chamber

[Lord Mawhinney (Con)]

My Lords—

[Lord Clement-Jones (LD)]

My Lords—

[Noble Lords]

This side!

--- Later in debate ---

[Lord Prior of Brampton]

The noble Baroness makes a very important point. There are many delayed discharges from hospital because people are waiting for their medications and many hospitals do not have the automation within their in-house pharmacies to meet the demand to which she refers. The big driving force going through healthcare and community pharmacy today is one of integration, which means that community pharmacies must in future work more closely with their local hospitals and GPs.

[Lord Clement-Jones]

My Lords, we all have heard what the Minister has to say, but is not the Government’s policy totally inconsistent in that community pharmacists are being encouraged to do more but, as these drastic cuts are being put into effect, they can only do less?

[Lord Prior of Brampton]

I think the noble Lord has misunderstood what I said. Interestingly, 40% of all community pharmacies are in clusters of more than three within 10 minutes’ walk. There has been a proliferation in the numbers of community pharmacies at a time when we want a deeper integration of community pharmacy with primary care in particular.

Autism

Lord Clement-Jones Excerpts

Monday 17th June 2013 Lords Chamber

[Earl Howe]

My Lords, we will certainly consider the idea of an innovation fund during the course of the review. We have allocated some central funding already to support the implementation of the autism strategy, for example in commissioning a range of training products from expert bodies to support local areas and professionals. I hope the noble Lord will agree that the strategy and the statutory guidance that goes with it mark a great step forward for adults with autism in England. We now need to take an honest look at how it is all working and come up with further ideas and actions as necessary.

[Lord Clement-Jones]

My Lords, I declare an interest as president of Ambitious about Autism. Can my noble friend confirm that the Government’s review of the adult autism strategy will pay close attention to the kind of day support services, such as the NAS’s Horizons service, which the recent Deloitte report, Ending the Other Care Crisis, has demonstrated not only leads to increased quality of life and reduced dependency but has clear economic benefits?

[Earl Howe]

My noble friend draws attention to a very important strand of support for people with autism. Many people with this condition can benefit from small amounts of advocacy, help and support often through less formal support networks and not necessarily through the local authority. We will certainly be looking at that area.

National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013

Lord Clement-Jones Excerpts

Wednesday 24th April 2013 Lords Chamber

So the panoply of arrangements that we now have means that despite clinical evidence, a competitive market is being forced upon the NHS. I am oblivious of any assurances given by Ministers to Parliament. People in the system believe that a market is required. That is why CCGs will operate defensively, because of a fear of being brought before the courts if they do not put out services to competitive tendering. I believe that we face the prospect of NHS services being placed in the middle of a costly bidding war with private companies, with discrete services cherry picked for profit, while the NHS is left to run the more complex and expensive services with less money. How can that possibly be in the best interest of patients? It cannot, and we should reject these regulations. I beg to move.

[Lord Clement-Jones]

My Lords, I was prepared to disagree with a substantial proportion of the speech by the noble Lord, Lord Hunt of Kings Heath, but I was certainly not prepared to find myself disagreeing with 100% of it, which is the position I find myself in. It is of course regrettable that the original regulations were published late and have had to be revised. As the Secondary Legislation Scrutiny Committee has pointed out, the draft guidance is not yet available and I am sure that this would have allayed many of the fears expressed about the impact of the new regulations. However, it is clearly important that it is subject to extensive consultation and, in the circumstances, it is entirely understandable that it is not yet available.

Especially as I was heavily involved in seeking assurances from my noble friend Lord Howe on the competition aspects of the Health and Social Care Act this time last year, I want to explain some of the background to the revised regulations and why we on these Benches firmly support them. Some weeks ago, I read the original form of these regulations, and we took the clear view that they would need to be changed. In perfectly good faith, they had been too restrictively drafted and did not appear to fulfil the commitment given to noble Lords during the passage of the Health and Social Care Act last March that local GP commissioners would not be forced to put services out to tender.

As a result of our concerns, my noble friends Lady Jolly, Lady Williams of Crosby and I met Health Ministers on the first day that the House returned after the February half-term Recess to discuss the issue. It became clear that some of the problems with the regulations were due to the difficulties of ensuring that the UK abides by European law on competition and tendering; but that the language used in the regulations was, in some cases, inaccurate and in others did not properly reflect the provisions of Section 75 of the Act. Health Ministers agreed with our view that the regulations’ wording at the time could lead CCGs and others to the incorrect belief that they were required to tender for all services. They therefore agreed to work with some of us to redraft the regulations. The new regulations that have been published are a result of those discussions.

The most important change to the regulations clarifies the role of Monitor in regulating and policing contracts entered into by CCGs. The new Regulation 15(2) states very clearly that:

“Monitor may not direct a relevant body”—

that is, a CCG of the NHS commissioning body—

“to hold a competitive tender for the provision of health care services for the purposes of the NHS”.

That makes it absolutely clear that CCGs cannot be forced by Monitor to go out to competitive tender. A number of other changes have been made to clarify how CCGs should decide whether to go out to tender. In particular, there are changes to Regulation 2. This sets the overriding objectives of the CCGs when commissioning. The first and foremost objective states:

“securing the needs of the people who use the services”.

As a result of the changes agreed, Regulation 2 now makes it absolutely clear that CCGs should consider the benefits that providing services in an integrated way can have on their quality and efficiency. Bundling of services is clearly envisaged, indeed encouraged, and the BMA should be entirely reassured on this point. These objectives in Regulation 2 determine how CCGs exercise their powers, including those under the much disputed Regulation 5, which sets out the circumstances in which a contract can be awarded without a competition. Under Regulation 5, it is expressly provided that there may be only one provider capable of delivering the kind of integrated service that the CCG wants to secure for its patients, in which case commissioners would not be forced to put services out to tender.

Many people have expressed their concern that this part of the regulations would make commissioners tender more services than they do now, and this is due to the reference to commissioners having to tender services unless they feel they can be provided by only “one capable provider”. However, there are many proper and valid reasons why commissioners might feel services can be provided by only “one capable provider”. They are, for example, if the commissioner is satisfied that the local hospital needs to maintain a certain number and mix of patients to provide a safe and effective service; if only one provider is able to meet the clinical quality and safety standards required; where only one provider is capable of giving access 24 hours a day, seven days a week; where highly specialised care is involved; and, crucially, where a range of integrated services needs to be delivered. Similarly, nothing under the regulations could force commissioners to fragment services against the interests of their patients.

Moreover, the rules in the regulations simply and accurately reflect the rules that are already imposed by EU law on the NHS. These rules were put in place long before the coalition came to power in May 2010. Procurement guidance for PCTs issued in March 2010 under the previous Labour Government—here is the cover of that PCT procurement guidance—had to conform with it and as result stated, inter alia, in paragraph 2.24 that:

“PCT boards must act transparently and without discrimination and be able to demonstrate rationale for decisions on whether or not to competitively tender. In particular”—

and these are the salient words—

“where the commissioner decides to procure through single tender the rationale must demonstrate that there is only one capable provider to deliver the services and, therefore, that could provide better value for money”.

Incidentally that wording was repeated word for word in subsequent guidance in July 2010. I urge your Lordships to compare that wording with the current Regulation 5. The fact is that the criticism and concern directed at Regulation 5 could equally well have been directed towards the Labour Government's guidance, which, I must emphasise, was the guidance on the procedure and law applicable to PCTs when tendering. In fact the changes to the original regulations ensure that the new rules allow as much discretion as possible within existing EU law. Indeed, CCGs are now in a stronger position than PCTs were under the 2010 Labour Government guidance. The chief executive of the Association of Chief Executives of Voluntary Organisations, Sir Stephen Bubb, has said:

“These regulations will enable charities to do more in partnership with the NHS, not less, and the result will be better services for NHS patients. The regulations should be passed, without falling victim to another political slanging match, so that NHS commissioners and charities can get on with the job of improving the health services made available to the public”.

I also urge your Lordships to read Department of Health legal opinion, which makes the position absolutely clear.

Health: Cancer Drugs Fund

Lord Clement-Jones Excerpts

Wednesday 13th March 2013 Lords Chamber

[Earl Howe]

No, my Lords, negotiations are now in train with the pharmaceutical industry with a view to introducing a value-based pricing scheme for medicines licensed after 31 December this year. That is still the Government’s intention.

[Lord Clement-Jones]

My Lords, as regards the introduction of value-based pricing, can the Minister confirm whether cancer patients will be consulted about the definition of value within that concept? Can he confirm that the impact on quality of life will be included in the assessment of value?

[Earl Howe]

My Lords, we consulted on our proposals for value-based pricing between December 2010 and March 2011, and as part of that process a number of patient organisations contributed their views, which were reflected in the Government’s response to the consultation, published in July 2011.