Misuse of Drugs Act 1971 (Temporary Class Drug) (No. 3) Order 2015

Lord Colwyn Excerpts

Tuesday 22nd December 2015 Lords Chamber

[Baroness Hamwee (LD)]

My Lords, the House will be grateful to the Minister for managing, just about, to get through that presentation. I have one question and one request for him. My question is about the progress of the Psychoactive Substances Bill. He mentioned that it would be enacted in the new year but it seems to have become a bit stranded in the House of Commons, and I wonder whether he has any more detail than that.

My request relates to a completely different matter. It comes from a conversation with colleagues just outside the Chamber during the previous debate. Next time the Minister does one of his amazing walks for charity, can he tell us, as we would like to support him? I do not know whether he is going to the North Pole or the South Pole over Christmas. I prefer to think of him sitting by a fire with a big box of chocolates but I do not think that is quite his style. However, we are so impressed by what he does during recesses, when most of us slob about, that we would at least like to support him in that way.

[Lord Colwyn (Con)]

My Lords, my remarks will be brief. I ask my noble friend, who has responsibility for steering the Misuse of Drugs Act 1971 (Temporary Class Drug) (No. 3) Order 2015 through your Lordships’ House, whether the Government have kept to their undertaking to ensure that the Psychoactive Substances Bill does not infringe the rights of UK herbal practitioners to supply unlicensed herbal medicines, as permitted under paragraphs (2), (6) and (9) of Regulation 3 of the Human Medicines Regulations 2012, No. 1916, dated 14 August 2012.

In an answer to the noble Lord, Lord Hunt, in July this year, my noble friend wrote:

“The Bill team is working with the … (Medicines and Healthcare Products Regulation Agency) to make sure that the Bill does not criminalise activities in relation to medicinal products which are currently lawful under medicines legislation. This includes the activity that Michael McIntyre refers to—namely herbal medicines that do not hold a … (Traditional Herbal Registration) but are prescribed by herbal practitioners on a named patient basis”.

I ask my noble friend whether the current draft of the Bill ensures the continued rights of UK herbalists to supply unlicensed herbal medicines on a named-patient basis, as he promised. If the legal highs Bill were enacted without making provision for herbal practitioners, it would mean that their work was criminalised, which of course would be an unmitigated disaster.

[Lord Kennedy of Southwark (Lab)]

My Lords, I support the order before the House. As the noble Lord, Lord Bates, said, it would be in effect for a maximum of 12 months, by which time a decision would be made on whether MPA should be subject to a permanent ban. I shall not attempt to pronounce the name in full but will stick with the abbreviation. I am sure that the noble Lord will come back on the points made by the noble Lord, Lord Colwyn.

I echo the comments of the noble Baroness, Lady Hamwee, in respect of the work, and the walks, that the noble Lord does in the recesses. I will leave it there.

Queen’s Speech

Lord Colwyn Excerpts

Monday 9th June 2014 Lords Chamber

[Lord Colwyn (Con)]

My Lords, for the past 20 years I have been able to use the debate on the gracious Speech as a vehicle for my comments on the state of the NHS and dentistry. I hope that noble Lords will forgive me for extending that personal tradition this evening.

Progress towards the introduction of a new, more preventive, contractual basis for dentistry has been welcomed. Work continues on contractual reform, which forms a key component of the vision for the direction of NHS services. In April, my noble friend Lord Howe attended the BDA annual conference and announced the Government’s intention to move to a more advanced stage of reform, with selected practices—prototype pilots—testing whole variants of a possible new system, preceded by an engagement exercise. This exercise, aimed primarily at the dental community, is an opportunity to widen understanding of dental reforms within the profession and for it to contribute to the shape of the prototype pilots planned to start during 2015-16 and manage expectations about the pace and scale of change to be expected. He stressed the need to “get it right”. At first, different elements will be adopted by a select number of practices, with a view to rolling them out later on. He also stressed the importance of improving access and quality, and the need to take this into account. Capitation will be a central part of remuneration together with some payment for quality, related to activity in order to deliver a balanced system.

The pledges made to dentists and dental patients by successive Governments must now be confirmed and the final stages of contract reform completed. The work of the task group launched in 2012 to look at care for vulnerable and hard-to-reach patients must also be implemented. Care in settings such as residential homes and through reaching out to those who might not otherwise avail themselves of dental care is vital if we are serious about reducing the oral health inequalities that persist in this country. A focus on preventive treatment may not only yield long-term savings but improve the quality of life across the country. NHS England has a legal duty to commission dental services to meet local needs. More than 29.9 million people were seen by an NHS dentist in the 24-month period ending on 31 December 2013.

Searching questions have also been posed this year by the dentistry call for action. This consultation, which closed on 16 May, was intended to stimulate debate about how we could achieve the necessary transformational change if debate about the NHS is to go forward fit for the future. Vital in delivering that future will be the dental students of today, a group facing difficult challenges in recent years. The department must take the necessary steps to ensure that 2015 does not see a repeat of what has become the annual shortage of dental foundation training places for new graduates. This problem, which year after year denies new dentists the chance to pursue careers in the NHS, must be a priority.

Levels of pay for dental foundation trainees must be sorted out. It has been deeply worrying this year to see a proposed 8% reduction in the salaries, a proposal first ventured as one of a number of efficiency savings being sought by NHS England at the start of April 2014. The BDA moved quickly to condemn the proposal, warning that it would be seen as an attack on the most vulnerable members of the profession. Despite that warning, the Department of Health has signalled its intention to press on with the cut. The dental profession will be stressing in the strongest possible terms that the proposal is absolutely unacceptable. Cutting the salary for those beginning DFT in September 2014 is particularly unfair to those who have already accepted their place, expecting a higher salary than they now stand to receive. Dentists themselves face a postcode lottery on their earnings. An independent review body’s call for an across-the-board 1% rise for salaried and hospital dentists was rejected. Recent years have seen support for salaried primary care dentistry ebb away, with staff posts not being filled and facilities left to decline.

The workforce of consultants in dental public health requires strong positive action. In Answer to a Question that I put down on a possible extension of the current 12-month fixed-term contracts, answered as HL7006, my noble friend Lord Howe announced that Public Health England has commenced,

“a review of the number of dental public health consultants required to meet its statutory and non–statutory functions”.—[Official Report, 13/5/14; col. WA 476.]

Public health issues are crucial in the fight for improved oral health. Water fluoridation—a measure recognised among the dental community for its ability to improve oral health and narrow inequalities—is one whose full potential remains untapped, with many communities in England that might benefit from its introduction still going without it. It is important that we also reaffirm our commitment to the fight against oral cancers. There is growing recognition among the dental community of the value of extending vaccination against HPV to boys, and I encourage the Government to listen to that advice.

My time is up but the BDA agrees with the principle of business regulation. There must surely be a stronger role for the GDC in the regulation of bodies corporate. Since 2010, much progress has been made in the field of oral health and dentistry; that momentum cannot be allowed to falter. A new contract, a focus on prevention rather than cure and appropriate regulation could be essential in delivering a cost-effective and patient-focused dentistry, with stronger health outcomes for the British people.

Public Order: Busking and Live Music

Lord Colwyn Excerpts

Tuesday 21st January 2014 Lords Chamber

[Lord Taylor of Holbeach]

I hope I gave my noble friend a positive response to his request. The Government do not start from the position that busking requires regulation and control. Busking can brighten our lives; local action is necessary only to curb any excesses. I think that noble Lords will understand that that can occur. It is not about top-down government; it is about local authorities using the powers available to them. The guidance will certainly make clear the Government’s position on busking and street entertainment.

[Lord Colwyn (Con)]

My Lords, local authorities and private landowners take different approaches to busking, which can mean that licences are required in some places but not in others. Will my noble friend work closely with local government to clarify the current laws that apply to busking in different areas? I declare an interest as an occasional busker.

[Lord Taylor of Holbeach]

We have a diversity of talent in this House, and occasionally we have to draw on it. My noble friend makes a very important point: the Government have a role in helping local government to use and interpret its powers properly. The noble Baroness referred in her question to the same issue: making it clear what is considered to be sensible use of powers is a responsibility that the Government can usefully carry out.

Queen’s Speech

Lord Colwyn Excerpts

Tuesday 15th May 2012 Lords Chamber

[Lord Colwyn]

My Lords, there is no reference to the National Health Service in the gracious Speech but I should like to use the opportunity provided by this debate to update the House on the state of NHS dentistry. In May 2010, I stressed the importance of continuing the process of reform that started with the 2009 Steele review. In the coalition agreement, the Government committed themselves to introducing a new dentistry contact, which would focus on achieving good dental health, and to fully piloting any changes before introducing them.

Good progress has already been made. Since last September, 70 dental practices around the country have been piloting a new contract based on a capitation model, with an additional focus on the quality of clinical outcomes. The early feedback from these pilots has been positive: practitioners and the public are happy that more time is being spent with each patient and that there is greater emphasis on preventing oral health problems. These pilots were originally commissioned to run for a year but the Department of Health recently extended the programme until March 2013. This is a commendable approach. Extending the pilot period will allow more time to produce meaningful results, which will be of great use when developing the final proposals for the new contract.

I also spoke of the mounting challenges that dental practitioners face in the management of their practices, drawing particular attention to the additional regulatory burden that registration with the Care Quality Commission was about to impose on them. As we now know, the CQC was not ready to take on the registration of dentistry by the statutory deadline of April 2011 and experienced severe administrative and policy difficulties as it attempted to do so. Last September, the House of Commons Health Committee’s review of the CQC concluded that the pressures imposed by the registration of dentists led directly to a 70% drop in the number of inspections that the CQC carried out, compared to the same period in the previous year.

That report also recognised how frustrating the experience of registration had been for dentists. The CQC seemed to have little knowledge or experience of how dental practices actually operated, applying a one-size-fits-all model of registration that was more appropriate for social care than any other health service provider. When dentists contacted the CQC with queries about the process there seemed to be no one with the necessary expertise in dentistry to assist them, which frequently led to contradictory advice being given out. It was as a result of these difficulties that the CQC and the Government took the decision to delay the registration of GP practices. Dental service providers were already heavily regulated. Many dentists felt that CQC regulation of dentistry was not appropriate or proportionate and their registration experience has not persuaded them otherwise. Recognising that this is an issue, the Law Commission recently launched a consultation into how the regulation of health and social care professionals could be made simpler and more consistent.

By coincidence, I talked this morning at the launch of the British Dental Health Foundation’s National Smile Month to the Chief Dental Officer, Barry Cockcroft. He assured me that all was well with the general dental practitioner CQC registrations and that any remaining problems were with general medical practitioners. Perhaps the Minister could write to me—or ask his noble friend Lord Howe to write to me—to clarify the current situation concerning the CQC and medical and dental registrations.

Dentistry also faces great changes as a result of the Government’s health reforms, with the commissioning of dental services transferring to the national NHS Commissioning Board. Local expertise will still have a vital role to play in the commissioning of services, and the Government need to ensure that this expertise is appropriately utilised. The role of consultants in dental public health is particularly important as they will need to be accessible not only to the national Commissioning Board but to local health and well-being boards. The Department of Health is also developing proposals for local professional networks in dentistry to work alongside the local primary care commissioning teams in developing and delivering local service plans. These networks will enable the dental profession to influence local and national strategy and policy, ensuring that best practice and clinical expertise are embedded throughout the system.

The coalition has made a strong start in tackling the issues facing dentistry. There is still more work to do on contract reform, regulation and commissioning. I urge the Government to maintain their focus and continue working with the profession to deliver the best possible outcomes for patients.

Police Reform and Social Responsibility Bill

Lord Colwyn Excerpts

Monday 11th July 2011 Lords Chamber

193: Schedule 8, page 138, line 34, leave out from “private,” to “relating” in line 36 and insert “which the police and crime commissioner and the chief constable are both entitled to attend for the purpose of making representations”

[The Deputy Chairman of Committees]

I have to advise the House that if we accept Amendment 193, I cannot call Amendment 193A for reasons of pre-emption.

Amendment 193 agreed.