Terminally Ill Adults (End of Life) Bill

Lord Deben Excerpts

Committee stage
Friday 14th November 2025 Lords Chamber

[Lord McCrea of Magherafelt and Cookstown (DUP)]

The noble Lord knows that I am not a proposer of the change of words. I am dealing with capacity. Therefore, I am also dealing with the fact that professionals within the field have stated that to use the Mental Capacity Act for a decision to end one’s life is an entirely novel test and uncharted territory for which there is no experience or precedent. That is not my statement; that is the statement of professionals within the field. They say also that to decide to use it for the decision to end one’s life is an entirely different and more complex determination requiring a higher level of understanding than assessing capacity for treating decisions.

Capacity can fluctuate in terminally ill patients due to physical fatigue, illness, medication or delirium, making the irreversibility of the decision risky under this framework. Therefore, I ask this Committee to think carefully in trying to base its whole argument on this being good legislation because mental capacity is the deciding factor.

[Lord Deben (Con)]

I wonder whether I can help the Committee. I think we may be discussing two rather different things, so I suggest that we decide which of them to discuss.

There is the discussion as to whether the word “capacity” really includes all the things that people are pressing for when they use the word “ability”. That is the point that the noble Lord, Lord Pannick, was clearly making when he expressed the nature of the word “capacity” as used in law. It is perfectly understandable that people would want to say, “Here is a word that we use. It’s a word which is defined and has been defined over a long period of time. Therefore, it’s stood the test of time”. I understand the noble Baroness, Lady Andrews, who rightly mentioned the amount of time that had been taken to deal with that.

--- Later in debate ---

[Baroness Fraser of Craigmaddie (Con)]

I thank the noble Baroness for her intervention. Every suicide is a tragic situation, and I am sure that all of us would wish to help that person. But that is not what the Bill is about. It is about whether we find a method where they have a settled will to make a decision—to make a choice.

[Lord Deben (Con)]

Is the difference not absolutely fundamental? The Bill allows the state to enter into this discussion and allows somebody in fact to kill somebody else. That is wholly different from suicide, and the noble Baroness is wrong.

Terminally Ill Adults (End of Life) Bill

Lord Deben Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Deben (Con)]

My Lords, the House will know that I have a moral position on this, but I am not going to talk about that.

This has been a most remarkable debate, and all of us from both sides have learned from what has been said. What has come out of it seems to be, first, that this is a very difficult issue. Secondly, although other countries have tried to do this, no one has produced an example of saying, “That’s where it works”. Instead they say, “That needs to be changed” or “There’s a problem”. Yet we are trying to debate this serious matter on a Private Member’s Bill that was inadequately dealt with in the Commons and has been criticised seriously by two of our expert committees.

What we are trying to do is momentous because we are seeking to depart from what has always been our attitude—apart from the question of capital punishment, which I fought against for many years—by empowering the state to kill. You can argue that, but let us realise just how serious it is.

I was an MP for 40 years and met wonderful people in both my urban and rural constituencies, but I also met people who felt that their old relations were a terrible burden and were spending money that would be much better left to them. I do not think we can ignore that fact, and I disagree with my friend, the noble Lord, Lord Dubs, when he suggested that somehow or other this was inconceivable. I put it to the House that not only is it conceivable but it is increasingly dangerous, because many families who have never seen any real money now see an aged relative who has a house worth £200,000 and more. There is a temptation for those people, whom I know and have met, to say to that person, “You really have a duty to save this money for your family. You know that Roger’s got a real problem and you can help him. This is what you should do”. No doctor is going to be able to analyse what has happened over a long time; the incident that we are discussing is very often at the end of a long period, when people come to that decision with that kind of pressure.

I am sorry that that is the case, and it is the case in a society that has far too many people about whom it has been suggested, because they do not work, are not worth anything. We must recreate the worth of all of us and the place that we all have in society. I am an individualist and a Tory, but I have to say that I see individuals as living in a society, and that means that we have responsibilities. It may be—I say this with due humility—that the contribution to society that someone in great pain may make is to protect vulnerable people by bearing that, in order that they will not be destroyed.

Ultra-processed Food

Lord Deben Excerpts

Thursday 26th October 2023 Lords Chamber

[Lord Markham (Con)]

Obviously, I am always happy to look at all the research because this is a vital area. This is the fifth time we have discussed it in the last three and a half months, so I apologise for any repetition. We are ever vigilant on this area but, as the contributors to yesterday’s debate showed, the research is mixed. The key things to get behind are the bad features of ultra-processed foods that are high in sugar, salt and saturated fat.

[Lord Deben (Con)]

My Lords, I will ask a very simple question. Was it not true that, before we had the link between smoking and lung cancer, we did have evidence of an epidemiological connection? The problem here is that we have no direct link, but it does seem that there is a connection that we do not yet know is causal. Will the department be very careful not to ignore that evidence simply because it is very inconvenient for scientists if their whole history of understanding nutrition is undermined by it?

[Lord Markham (Con)]

Absolutely—we have to be understanding of the latest research in cause and effect. The evidence I have been shown so far is that it is about the features within those ultra-processed foods—are they high in fat, sugar or salt? Those are the things that are causing the harm. If we find links to the processing itself, we will act on that.

NHS Industrial Action: Government Preparations

Lord Deben Excerpts

Tuesday 13th December 2022 Lords Chamber

[Lord Markham (Con)]

My understanding, based on the long time that this has been in place, is that this is an annual review. April is now quite close; for that April review, it can take into account all the factors, including what happened to inflation during the year. I expect it will take all that into account, quite rightly, in what it comes up with for that next pay review. It is a long-established principle that it is there to do this. I trust it to get the right answer in time for April.

[Lord Deben (Con)]

Will my noble friend be very careful to stick by the case being put forward? We know that those arguing it want to hide behind some discussion of the mechanisms in order not to say what they really think about the pay rises. The Government have a responsibility to stick by the system. If we lose that, it will be the Minister who makes decisions always, which is what we have tried to avoid since the 1980s.

[Lord Markham (Con)]

I agree. Clearly, there are difficult choices; if we changed the position, we would have to take money away from other parts of the system, such as the elective care fund and other front-line services, which we clearly do not want to do. It is absolutely right that we let the experts guide us in this, as all Governments have done for more than 30 years.

Brexit: Medicine Supply and NHS Staffing

Lord Deben Excerpts

Thursday 5th September 2019 Lords Chamber

[Lord Deben (Con)]

My Lords, the Government have claimed that they have done a detailed account of what would happen if we were to leave the European Union, as far as the health service is concerned. Why have they not published that detailed account, why do we not know any of those details and why is the whole country being kept in the dark on all these issues? The Minister has the facts. Can we please have them now, so that we know what we are debating about?

[Baroness Blackwood of North Oxford]

I do not believe that the noble Lord is presenting an accurate picture of the case. We have been very clear with the public, and a lot of information has been published on the MHRA website, on GOV.UK, on nhs.uk and in a number of other places, regarding the information about the analysis of the impact of no deal on patients and on the NHS. We have been very clear about the risks that we think there may be to the supply of medicines due to temporary disruption at the border and the mitigating measures that we have taken to ensure that the supply will continue uninterrupted to patients and to the healthcare system. If the noble Lord wishes to have more information, I am sure that he would be very happy to write to me, and I will place a copy of my reply in the Library.

Food Additives, Flavourings, Enzymes and Extraction Solvents (Amendment etc.) (EU Exit) Regulations 2019

Lord Deben Excerpts

Tuesday 9th April 2019 Lords Chamber

[Lord Deben (Con)]

My Lords, are we not very lucky that they managed to put off the date as long as this, otherwise this SI would not have come before us? I just wonder how many SIs are hidden behind this one that would not have been passed in time. It seems pretty remarkable that we are talking today—after the date that the Prime Minister promised that on any basis whatever we were going to leave—and are dealing with this very important matter. It just draws attention to the absolute barminess of the whole process. To be doing this after what we did earlier in the week seems remarkable.

I do not envy my noble friend who has to defend this. When she says there are no changes, there is, of course, a fundamental change in that every small business in Britain that is exporting to the rest of Europe has to get itself passed by both the British and the rest of Europe. Although my noble friend rightly said that she did not believe this will stop people importing things, it could easily stop people exporting things. Indeed, the whole Brexit operation is designed to shoot the exporter in the foot and to enable the importer to have unrestricted access.

My first question is whether my noble friend can conceive of any circumstance in which the British would have different rules from the rest of the European Union on, for example, cocktail cherries. I hope the House has seen that there is a specific reference to cocktail cherries in this SI. I do not know why cocktail cherries should have this applied to them; it would be difficult to eat enough of them to be severely damaged in any way other than what always happens if you eat too much fruit. The issue is this: can we imagine circumstances in which we had a different regime from the rest of Europe?

What we are proceeding to do today is decide that the UK will test and check everything and do it again—or perhaps not. Perhaps what we are really going to do is say, “We accept everything that the rest of Europe says but we’re not going to have any part in it at all”. Is this not the fundamental issue about the whole Brexit concept—that the only way Brexit would work would be on the basis that we did everything that we do today but we did not have a say in it? I know this is very unfair on my noble friend but it seems important to me that we do not let any of these SIs go past without reminding your Lordships and the public of the fundamental lunacy of this whole policy.

That brings me to the cost and resources. The FSA has been starved of resources; the cuts have been significant. Yet the public are increasingly interested in food safety, and there is a good reason for that. We have lived through a whole lifetime in which food has fallen in price but we are now in a world in which food will be rising in price, by the very nature of the emerging middle classes throughout the world and the fact that resources right across the board are less and less available. In these circumstances, because there is more money to be made by fraud, we are likely to have more of it. The FSA is going to have a great deal more to do even without this additional work being placed upon its shoulders.

It is important for my noble friend to reassure the House that the full costs, both to local authorities and to the FSA, will in fact be provided by the Government. This is another example of the mathematics of Brexit never having been properly explained, because none of this came into the arguments about how much we were going to save by leaving the EU. We still need to have that fundamental reassurance. It is not unreasonable to ask the Minister to give us examples of when our independent FSA is going to make different decisions from the rest of Europe and, if so, how that would deal with the import/export problem to which I have adverted.

No doubt we will have to pass this—and are we not lucky that we have an opportunity to do so?—but, frankly, it is yet another example of the sheer waste of time that we are all involved in due to this Alice in Wonderland position in which we seriously think that a nation 22 miles off the coast of the rest of Europe is actually going to have a different safety arrangement for food products that are, and have to be, freely traded within the EU.

[Baroness Blackwood of North Oxford]

I thank noble Lords for this fascinating debate. I want to be the first to wish the noble Baroness, Lady Walmsley, a happy birthday, and I thank the noble Lord, Lord Deben, for disclosing to the House his passion for cocktail cherries.

Our approach to EU exit when it comes to the FSA is underpinned by three principles. The FSA has been working hard to ensure that UK food remains safe and is what it says it is; that the high standard of food and feed safety and consumer protection we enjoy in this country is maintained when the UK leaves the EU; and that from day one a robust and effective regulatory regime will be in place, meaning that business can continue as normal.

As has been debated, this instrument was subject to parliamentary scrutiny through the affirmative procedure and requires affirmative approval. It needed redrafting and I would like to go into some detail on that, given that the issue was raised by the noble Baroness, Lady Wheeler. Some drafting errors were identified. I have been advised that they were minor. They mainly related to drafting style, rather than content. That is why the instrument was withdrawn. The errors have been rectified and the amended draft was brought back today. They related to an error in Regulation 16(b), where an obligation to inform the authority—the FSA or the FSS—of the receipt of an application for a product to be included in the list of products authorised for smoke flavourings was not included. That has been addressed. The FSA felt that the changes were minor, including a correction to remove a quotation mark at the end of a definition, which had been overlooked.

It was also said that the draft required elucidation relating to the requirement for definitions of appropriate authority and the authority prescribed for certain regulations. The FSA felt that this was not necessary as definitions are inserted by other draft EU exit regulations, but this has been actioned to make sure that it is absolutely as it should be. A final comment was about the failure to comply with proper legislative practice. This related to whether some text should be presented as a footnote instead. Again, the FSA considered that this was not required when originally drafting the instrument, as it replicated how the text was presented in the European Union (Withdrawal) Act 2018. However, the comment was taken on board and the amendment has now been made. I hope that clarifies what the amendments were.

I turn to the questions raised by the noble Baronesses, Lady Walmsley and Lady Wheeler, about the FSA’s preparedness and about funding, which was also raised by my noble friend Lord Deben. Extra funding—£14 million last year and £16 million this year—has been allocated to the FSA to help it prepare for the additional requirements it will have to take on board. This has enabled it to put in place some additional risk assessment tools and risk management experts and to replace some EFSA procedures on which it previously relied. It is important to understand that the FSA has always had a robust risk assessment system in place and has always undertaken evidence-based risk management decisions for the future of food and feed safety issues. It has now built into its capacity the ability to provide robust risk assessment and management advice post exit, using the additional funding provided. That is why we have been able to provide reassurance as these SIs have gone forward, and this has been taken into account as we have prepared for negotiations going into the implementation period, whether in a deal or no-deal scenario.

Obviously, we are considering what kind of relationship we will have with EFSA and what the situation will be regarding the RASFF. At this point, no decision has been made about our future relationship with EFSA, because it will be subject to forthcoming UK-EU negotiations. However, departments have undertaken an analysis to understand the impact that withdrawal from the EU will have on our relationship with EFSA and the EU agencies. This is why the FSA has ensured it has robust risk assessments in place, no matter what the scenario may be. However, it is our preference to have a close relationship with EFSA and access to the RASFF. That is the ideal scenario, which we will be working towards.

The noble Baroness and my noble friend Lord Deben raised the consultation with industry. It is important to point out that this was a thorough six-week consultation, undertaken by the FSA, which took place in September and October last year. Late responses were also taken into account. There was significant support for the approach the FSA has now taken with the SIs. That is why we are confident that the industry and stakeholders will be able to take on board the approach taken in this and other SIs, which have been fully debated in the House. That approach has also involved the devolved Administrations, and the FSA will continue to have close working relationships with the Administrations in Scotland, Wales and Northern Ireland as we go forward. That is why we are confident that, in practice, it will be possible to make arrangements and operate a framework for food and feed safety regulations across the UK, whatever exit scenario we have.

The noble Baroness, Lady Walmsley, asked about contingency arrangements should there be changes in regulation within the EU. If noble Lords support these regulations they will be on course to come into force this week. But if there is a short delay to food law they will not be fully operable, amendments to authorised products could not be made and urgent action might be required on unsafe food. The Food Safety Act and already corrected retained EU law would then continue to provide food safety protection for consumers, and enforcement action could be taken against the placing of unsafe food on the market. I hope that reassures the noble Baroness on that point.

I thank noble Lords for their consideration of these regulations, and I hope I have answered their questions. As I said, the Government’s priority is to ensure that the high standards of food safety and consumer protection we enjoy in this country are maintained when the UK leaves the European Union. This instrument performs an important part of our preparations for a functioning statute book on exit. Food additives, flavourings, enzymes and extraction solvents are important parts of substances referred to as “food improvement agents”. We must ensure we have the correct protections in place to protect public health after exit. This instrument makes no change to public policy—pace my noble friend Lord Deben—and I hope noble Lords will therefore accept it as it stands.

European Qualifications (Health and Social Care Professions) (Amendment etc.) (EU Exit) Regulations 2018

Lord Deben Excerpts

Thursday 7th March 2019 Lords Chamber

[Viscount Bridgeman (Con)]

My Lords, I apologise for my discourtesy in not being present at the beginning of this debate. A number of years ago, with the very great help of our noble friend Lord Howe, we secured the requirement from the Commission that healthcare professionals coming to this country from the European Union be subject to language tests before registration, and not the other way round, as in the previous arrangement. Can the Minister confirm that this valuable requirement will be kept in place under the new regulations?

[Lord Deben (Con)]

My Lords, I trust that the House heard with great pleasure the Minister’s comments on how major an advantage this whole arrangement in the European Union has been to us. We should not be discussing any of these SIs without reminding people that our membership of the European Union has been a huge advantage to us, and that what we are doing at the moment is picking apart something which is to our advantage, for reasons which are increasingly difficult to understand. We should not allow any of this to go past without constantly reminding the Government that they are leading this country into a position in which it will be poorer and less advantaged than when they came to power. A historic responsibility will lie on their shoulders, and we should remind them of that constantly.

My concern in this whole debate is that we are being asked to discuss this SI under a double falsehood. The first is the argument that we need it because we might crash out of the European Union, but that we need not be too worried because we will not crash out. The second difficulty is that, if we do not crash out of the European Union, we are legislating for a series of things which will be there in the course of further negotiations. Even if what is referred to at the moment as the Prime Minister’s “deal” were to be accepted—and it is manifestly not satisfactory—it is not a deal at all. It is an agreement to go on discussing to get a deal. During that period of time, what we are discussing here will be there in the background. There have been a number of occasions on which Opposition spokesmen have rightly pointed out that the trouble with these things is that if they are in the background while we are negotiating, they have a real effect. We have to take this very seriously.

Nor should we pass over the problem we are presenting ourselves with. We are saying that, to get the best advantage out of this ludicrous foot-shooting activity, we are going to make sure that every European Union national can come to this country to do what we want them to do without there being any difficulty. Of course, we cannot do any of the things that have made that particularly valuable in addition; we are not going to share the information both ways, which is what the European Union enabled us to do. Rather like the noble Baroness, Lady Thornton, I have a real concern that the IMI system will not continue. The idea that you can happily forget about it because it happens to be convenient, and do the things you can do because they happen to be convenient, seems to me an abnegation of responsibility which I find extremely difficult to accept.

The noble Baroness, Lady Jolly, rightly referred to the additional matter of the electronic alert system. We will not be alerted to the very professionals we most want to know about, because we will have decided that, because Britain is so ultimately different from everywhere else, we will not have this association. I know it is not the fault of the Minister, who is having to defend the ridiculous situation in which we find ourselves, but it is for this House to remind people all the time of what this really means.

Then we go on to the fact that these regulations are in conformity with the withdrawal Act, which says that we are not going to use it to create any new legislation, but merely take into national legislation things that would not be in it if we left the European Union without any agreement. The trouble is that this is not actually possible, because we have to have regulators making decisions. They are now going to make decisions under a new regime—in that sense it is a new regime—and I very much want to hear the response to the noble Baroness, Lady Thornton, on how we make sure the regulators make, roughly speaking, the same decisions across the whole range, and how we make sure that those regulators do not make decisions that extend or change the position we are in now. The latter would be contrary to the undertakings given by the Government.

However, the word that I very much worried about when the Minister used it was “flexibility”. She said that no longer being in the European Union would give us a flexibility on the establishment of professional qualifications which we did not have up until now. I do not think that flexibility can possibly be accepted within this SI, because that genuinely changes the position from what it was before. It may be that it is convenient for the Government to talk about flexibility as an advantage. I find it pretty difficult to see what that advantage would be. What would be the point of being flexible in changing our arrangements in such a way that they were out of line with the arrangements of our neighbours, when we rely upon those neighbours for such a high proportion of our professionals? It seems to me that flexibility is one of those convenient words used by the Government and those who believe in Brexit to suggest that there are some advantages hidden here which we have not yet got hold of. I do not think that there are, or that it would be legal for us to use flexibility under this SI, because it is specifically not supposed to introduce into our legislation anything that we have not had up to now.

I am afraid I will move on to something that I constantly say; that there is no impact assessment here. Why is there not? This is the real reason I say to the Minister that this is unacceptable. The reason there is no impact assessment is that the Government want us to believe that there is no impact. It is very inconvenient for the Government to say that the impact is that we will no longer have the advantages we had before leaving the European Union. They ought to be listing those advantages and explaining what the impact on us will be. But they are not doing that, because that would make more and more people aware of the lunacy of the measures we are now taking, and the ridiculous position in which Brexit places us.

But then there is another question. If you do not have an impact assessment, you also do not appear to have any idea about how much it will cost. I am afraid that I am a Conservative, and I am always interested in costs—I like to know how much it costs. I know that that is a disadvantage in the whole Brexit discussion, because the one thing we never get is the cost. It is amazing, is it not? We have a Conservative Government who never talk about the costs of Brexit, which is an absolutely ludicrous position for us to be in. Let us ask ourselves—I repeat the words of the noble Baroness, Lady Thornton—“What burden? What resources? What cost?”

One of my difficulties is that I have had the misfortune to have had to sit through a large number of these SIs, and every time you ask about the cost, the Minister concerned explains—charmingly, and with considerable aplomb—that the costs are negligible.

[Baroness Thornton]

Negligible.

[Lord Deben]

I have got it right this time. That is what they say. In every individual case, negligibility may well be the truth, but what is negligible in one case, when added up with a lot of other “negligible” costs, ends up being rather expensive. I am amazed at the number of things you can do with negligible cost. We are filled with these SIs—with all the things that we can do for nothing. I ran businesses, and I have to say that I do not know anything you can do in business which does not cost you something. I would love the Government to explain to me how they are managing to move whole areas of control and regulation over to British regulators without any cost. I would be able to apply that to my businesses and it would be extremely valuable, because all I know is that the moment you change or move anything, it costs money.

I want to know not only how much it costs but whether we have the resources for it. It is also said that we have these organisations that are perfectly capable of doing all this, as if this is an easy thing to do, when in fact it is not only difficult, but if we get it wrong, we are endangering people’s lives. Clearly, we have not worked out what the cost of doing this is; I just do not understand whether we have the human resources and the trained resources to do it. After all, we have shown so far that we cannot run the National Health Service without large numbers of people coming in from outside. I would like to understand whether we can regulate all this without some additional resources, and if so, we ought to know exactly what resources we will need and how much they will cost.

I am sorry that I have to say this to the Minister with such vigour, but it needs to be said; otherwise, this House looks pretty damn stupid. We look as if we are sitting around, having a gentle argument about what is the programme for catastrophe. This is what we are talking about: how a nation decides how to put itself into a very much less favourable position than it is in at the moment. Sometimes people say, “Ah, but Britain will manage—look what it did during the war!” But we did not ask for the war; we did not say that we wanted it. It happened, and we said that we had to fight it. Here we are asking for it, and are seriously sitting around planning for it. We are asked to do that with a degree of politeness and charm, and courtesy and care, when we ought to be very angry indeed that any Government should even suggest that we need SIs like this.

[Lord Warner (CB)]

My Lords, it is a positive delight to follow the noble Lord, Lord Deben, as I have done on a number of occasions in the past few months in debates on other SIs which have been considered in Grand Committee. The one thing I would say about the noble Lord is that he has been masterly in the consistent way in which he has expressed himself. I do not altogether share his high assessment of previous Conservative Governments on costings, but we will let that one pass.

Brexit: Food Standards Regulations

Lord Deben Excerpts

Tuesday 4th September 2018 Lords Chamber

[Lord O'Shaughnessy]

I can tell the noble Lord that we will be maintaining the same standards of safety and protection. We will be seeking not just continuity but equivalence. We may want to go further in other areas. Of course, this will be for discussion with the House. The ongoing role of the Food Standards Agency will be as it is now, to make sure that public health and consumers’ interests continue in relation to food. There is no need to issue a ministerial direction or anything else to ensure this because it is its legally given role and one it will continue to fulfil.

[Lord Deben (Con)]

Is the Department for International Trade aware of these facts? It appears to be thinking of agreements—were we to leave the European Community—in which we would have to accept the much lower food standards of countries like the United States.

[Lord O'Shaughnessy]

There are no suggestions that there should be lower food standards. Obviously, after we leave the European Union, the Food Standards Agency will carry out any risk assessments. There are no proposals to change these rules; we will continue with them. Of course, there would be a proper scientific and evidence-based assessment if there were such suggestions.

National Health Service (Pharmaceutical and Local Pharmaceutical Services) (Amendment) Regulations 2017

Lord Deben Excerpts

Thursday 19th October 2017 Lords Chamber

[Baroness Seccombe (Con)]

My Lords, I am fortunate to live in a lively Warwickshire village. There are two doctors with their own pharmacies, but every time I want something as simple as paracetamol I have to get the car out and drive eight miles to the nearest pharmacy. Last week, I was thrilled to see that the closed HSBC bank had a sign above it saying “pharmacy”.

I understand that in an NHS with increasing demands for funds it is not sensible to have pharmacies—each of which costs the NHS, on average, £220,000 a year—in abundance every few yards in urban areas. However, in rural areas it can be more than difficult to buy those essentials we rely on, especially if you do not have a car and there is an infrequent bus service. I congratulate the Government on being selective in supporting pharmacies that make life easier for country people while encouraging those small businesses to expand their basic service. In another village, I recently saw a sign in the window saying, “Opening hours: 6am to 9pm Monday to Saturday, and 9am to 5pm on Sunday”. What a service.

Last Saturday, I went inside the empty pharmacy and met Steve, the new pharmacist who is planning to open next week. He is enthusiastic to get going. So to him and all independent pharmacists who are free to flourish and to respond to the needs of the community, I say good luck, as they provide a really worthwhile service to the community. I am sure noble Lords will understand why I am not able to support this Motion.

[Lord Deben (Con)]

My Lords, I declare an interest as chairman of the Climate Change Committee. I intervene only because one of the largest uses of vehicles is for health reasons. I hope my noble friend will not mind if I say that the Department of Health has perhaps not shown itself to be quite as central to the solution of our problems with climate change as other departments have. I hope this is going to change, and I am intending to bang on his door quite a lot until it does because this is a central issue.

This debate has shown that it is a useful one to have. I am not sure I want to enter into the party politics of it but there are quite good arguments about how many extra community pharmacies there have been, and there is certainly no doubt that the Government have shown themselves to understand this. No doubt there are other arguments, but the issue for me is proximity and propinquity. I am thinking not just about rural areas, although I live in a rural area and I understand the point very strongly; for many people in urban areas who do not have access to motor cars and where bus services are exiguous, the fact that they can walk to a pharmacy or ask others to do so if they themselves are unable to, is an important part of the kind of service that we need. It is disappointing that in the various collections of data we have not spent a bit more time looking at how many journeys are made and how many hours’ worth of diesel are used by people in accessing the health service. We know exactly how many journeys by lorry carry food—it is about 42% of all the lorry journeys in Britain—so we know a lot about these things, but I am not sure we know enough about what happens in the health service. When we are making these judgments, we have to make them in a holistic way.

So I do not apologise for the fact that on this, as on many other issues, I shall try to dramatise the fact that we should not be making decisions without asking ourselves, “What is the issue here in trying to meet the requirements which are now statutory?”. By 2050 we have by law to cut our emissions by 80%. We have to meet by law the fourth and fifth carbon budgets, and we have just issued the clean growth plan which is designed to deliver that end. There is nothing in any of that on the contribution of the NHS. It is time we asked the NHS to recognise that part of its role is to ensure that people’s access is as convenient as possible, not just for their convenience or because it saves money for other bits of the NHS, but because we as a community have to look at our statutory requirements to meet our climate change targets.

I hope that my noble friend will accept this as a preliminary thrust on the subject of the health service’s contribution to what we need to do. Indeed, in doing it, it is of course a circular system. Many of the problems the NHS has to deal with result from the subsidiary effects of pollution. It is not a matter not just of changing our climate but of the pollution at a much lower level physically but very high-level in terms of air pollution, and the damage that that does to health. I do not think this is something the health service can avoid and I hope my noble friend will take it into account.

[Lord Shipley (LD)]

My Lords, I should like to ask the Minister to clarify four issues. First, does he agree that community pharmacies are for many people the most accessible healthcare location, particularly where there are no GP surgeries locally; that community pharmacies in those situations can take pressure off GPs, and that in fact overall community pharmacies can take pressure off accident and emergency? Both GPs and A&E are experiencing rising demand.

Secondly, I am not clear whether the Government have responded to the Murray review and whether they plan to be clear what they think about that review, which was published in December last year. What policies do they have for community pharmacies as a consequence of that review?

Thirdly, we have heard about rural areas. I agree entirely with what has been said, but I shall talk in addition about deprived urban neighbourhoods where few people have cars. Has the department done an impact assessment on deprived communities’ access to health and care services, because I think it is material to this debate, particularly in the context of my fourth question? Do the Government accept that many pharmacies have cash flow problems? Many do, and I understand that it will be much worse from next month. What exactly is the Government’s grand plan? I cannot see one at the moment.

Mental Health Services: Children and Adolescents

Lord Deben Excerpts

Monday 17th July 2017 Lords Chamber

[Lord O'Shaughnessy]

I accept the point that the noble Baroness makes. Unfortunately, we are starting from a low base, over many years, in mental health provision, and that is what we are trying to rectify. She will know that the Prime Minister is deeply committed to this agenda. Let me point to a couple of issues. First, there is the introduction of the first waiting time standards—and indeed there are positive early data on meeting those stretching standards—as well as an increase in the number of beds available for those suffering from the most severe episodes of mental illness.

[Lord Deben (Con)]

My Lords, this is an area which has been not only underfunded but not cared about for a long time, and we have got to get it right. Someone has to stand up for these people because in their own home circumstances they do not have the kinds of opportunities and support that many others do. Will the Minister commit himself personally to make this worth fighting for? This issue is perhaps in the front-line of human rights in Britain.

[Lord O'Shaughnessy]

I completely agree with my noble friend and I commit myself personally to this issue. He may know that I have opened up primary free schools which focus on improving mental health and well-being, so I feel this personally. He mentioned children coming from chaotic homes, which is true in some instances. However, it is not always true. Mental illness can strike anyone, and all families and schools need to be prepared for it. Another commitment in the manifesto, about which there will be more detail in the Green Paper, is the introduction of a single point of contact in schools so that there is a champion, if you like, for any child who needs to access mental health services that go beyond the school gate.