Children’s Cancer Services

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Wednesday 20th March 2024 Lords Chamber

[Lord Markham (Con)]

It is only now that the facts are starting to come to us. On something as important as this, we definitely do not want to be hurried into it. Normally, I would be saying at this Dispatch Box that I want to “go, go, go”, but on something as profound as this I want to make sure that we are not hurrying into it. All noble Lords will agree that we have a very good service in operation. For instance, I looked at the Royal Marsden’s stats on speed of treatment and diagnosis, and they are excellent. I am afraid I cannot give a timetable because, quite deliberately, I want to make sure that we do not rush into any decision until we know all the facts.

[Lord Fox (LD)]

My Lords, there seem to be two issues here. One is the seemingly inexplicable nature of the decision, but also the process by which it was made. Can the Minister please talk to his colleague, not only on a fact-finding mission about this decision, but about how decisions such as this are taken within the NHS, what issues are being considered, and which are considered more important than others? It seems to me that there is an imbalance in the decision-making process. Perhaps that is also an issue that needs to be addressed.

[Lord Markham (Con)]

I want to be fair to the NHS here. It has done an extensive study, with a lot of professionals rating extensive criteria, and they really did believe that in certain areas, the Evelina scored higher than St. George’s and the Marsden. It is a balanced decision; all I can do is absolutely promise noble Lords that we will take all those factors into account.

NHS Procurement: Palantir Contract

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Thursday 22nd June 2023 Lords Chamber

[Lord Markham (Con)]

As I said, there is a very clear benefit. We are going through the process of a very large £500 million contract for a data platform that will be key to the NHS. Everyone agrees on the importance of data in health work, but we want to make sure that we have an open process so that suppliers have a chance to win the contract. In any circumstance, you need to make sure that transition arrangements are in place; otherwise, the current supplier is the one most likely to win—if there is a concern about ongoing procedures. By having a transition arrangement in place—clearly, transition can work only with the current supplier—you are making sure that there is an open process for new bidders to come in.

[Lord Fox (LD)]

My Lords, the reason the Minster is able to call this contract “sensible” is that it follows on from a contract given to Palantir that was already granted without tender. This is compounding one after another. To return to my noble friend’s original point, can the Minister tell your Lordships’ House why all other public services will be subject to a Procurement Bill that hopes to deliver transparency, fairness and ethical purchasing, yet his department is exempting itself from the Bill?

[Lord Markham (Con)]

This went through the long-term plan in 2019, and the idea behind it all—it was debated a lot as the Health and Care Act went through—was to provide an approach which allows the flexibility in place here. What we are doing here is very good: I do not think anyone would want to see hospitals left in the lurch and the impact that would have on waiting lists. This makes sure that we have a robust situation in place so that we have an open tender, which we are going through the process of right now to get the best solution for the NHS—something which I think we all want.

--- Later in debate ---

[Lord Markham (Con)]

I thank the noble Lord for giving me an opportunity to clarify that absolutely. The answer is yes on both counts. If Palantir is not successful in winning the contract, no data will remain on its systems; it will be transferred over completely and, as the noble Lord says, whoever ends up winning the contract will be allowed to use that data only in an NHS context—that is, in no other context at all.

[Lord Fox (LD)]

My Lords, can the Minister clarify when he expects the large contract of nearly £500 million to be awarded?

[Lord Markham (Con)]

Round about autumn time. Currently, we think that the contract will be awarded in September and then finalised. The new database should in place by April. Having this transition arrangement until June gives us a safety net to make sure that everything is in place.

Covid-19 Update

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Wednesday 8th December 2021 Lords Chamber

[Lord Kamall (Con)]

Enforcement has been a constant concern throughout, and workers have been concerned about having to enforce. The police and certain transport operators may issue fixed penalty notices to those who refuse to wear a face covering when required to do so and are not exempt or do not have a reasonable excuse. This will be used only as a last resort. The fines will start at £200, which will be halved if paid within 14 days. For repeat offenders, the second offence will be £400, the third £800, the fourth £1,600, the fifth £3,200, and the sixth and subsequent offences £6,400. The price mechanism will be used as a deterrent, but I am sure that the authorities will exercise discretion, so they may give an informal warning first, as has happened. They can also take measures if members of the public do not comply with this law without a valid exemption. They can deny access to public transport services, and direct someone to wear a face covering or leave a service if they are not wearing one without a legitimate reason.

[Lord Fox (LD)]

My Lords, the Government are effectively outsourcing a lot of the policing of this to the businesses of this country—small, medium and large. Those businesses will not be able to do that unless they have a full understanding of what is expected of them, full public backing from the Government that they have to do this and details of how they will be helped. I understand that it is not the Minister’s portfolio, but I ask that he takes this to both BEIS and the Treasury and that we get quick answers for British businesses, which have to police vaccine passports and the use of masks all over this country for this policy to have any reason at all.

[Lord Kamall (Con)]

I thank the noble Lord; we had a conversation earlier about the importance of business and of informing businesses as quickly as possible, and the important role that they play. It is clear that the police and transport operators have fixed penalty notices. We know how sometimes it can be difficult for individuals, particularly in retail, to enforce the law—that they are worried about being seen as police officers. But we hope to make it clear that it is an offence not to wear a mask in places where you are required to do so, and we are issuing further guidance on that. I will take the matter back, as the noble Lord says, and get a cross-governmental response.

Health Incentives Scheme

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Thursday 28th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness. I would like to know on what basis she thinks I should take part—I hope I am not looking unhealthy. I also apologise to noble Lords if I have come across as prickly; maybe I just got too excited about this scheme. As someone who been quite critical in the past of schemes that do not work and who has looked at evidence behind such schemes, I am excited that this is a real pilot, as opposed to a one-size-fits-all national system. We can see what works and then roll it out. I also thank the noble Baroness for making me aware of the scheme in GP surgeries. Maybe the noble Baroness could do me a favour and send me some details, so I can look into it in more detail and see how we could roll it out.

[Lord Fox (LD)]

My Lords, in giving his answer, the Minister failed to answer one of the questions from my noble friend Lord Scriven on school sport. So perhaps we can give the Minister a second go at responding. When will the Government throw their full weight behind reviving, revitalising and extending school sport?

[Lord Kamall (Con)]

I have responded to questions, including the noble Lord’s question about sport in schools, which is of course incredibly important—we all benefited from that. One of the things I have to be clear about is which department it falls under. As I understand it, some of this does fall under the Department for Education, so if the noble Lord does not mind, I will write to him.

Queen’s Speech

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Thursday 9th January 2020 Lords Chamber

[Lord Fox (LD)]

My Lords, after what might be described as a sluggish arrival of Bills and legislation to your Lordships’ House over the past few years, the Queen’s Speech sets out a dazzling array of Bills and legislation, which the Chief Whip said he expects to keep us very busy. We should welcome the fact that we are moving to address legislation because it quite rightly deals with some very important issues for this country.

After the dazzling speeches of the noble Baroness, Lady Blackwood, and the noble Lord, Lord Griffiths, and with regard to the 70 other people who will follow me, I will have a self-limiting ordinance and will try to speak quickly and limit what I say around the business, energy and industrial strategy portfolio that I represent. Others on these Benches will of course cover other areas. I am trying with this speech, in the spirit of positivity, to get more information and some sense of how this legislation will flow and about some of the unanswered questions that have come up.

The noble Baroness, Lady Blackwood, spoke with great brio on the employment rights Bill. Indeed, if it is as good as she tells us it will be then I am sure we will all welcome it. However, I share some of the reservations that the noble Lord, Lord Griffiths, just set out, in that once these measures start to come before your Lordships, there will be a reining back. This is, as the noble Baroness knows, an area in which the EU has had a strong influence over the United Kingdom’s rules. We will be judging this Bill not just by what it contains but by when it comes. Perhaps the noble Viscount, Lord Younger, can give us some idea of the conveyor belt of these Bills and of what will be coming when. That will give us some sense of the priorities within the lump of Bills in this Queen’s Speech. The background notes for the Bill state that the purpose of the employment Bill is to

“protect and enhance workers’ rights as the UK leaves the EU”.

As far as I can see, the list of main elements of the Bill does not include the protection of retained EU workers’ rights. Perhaps the Government can clarify where they stand on that.

The financial services Bill aims to maintain the UK’s regulatory standards and ensure that we remain open to markets when we leave the EU. This is “remain” and “maintain”—in other words, we are pushing toothpaste back into the tube. I will avoid the obvious Brexit jibe here, but does the Minister think that we will in fact maintain the access we currently enjoy to the European financial services market? What grounds does the Minister have for that opinion?

The national security and investment Bill seeks to establish a notification system whereby businesses would flag transactions with potential security concerns. This is something we should all be concerned about, and indeed have been in the past. Given Her Majesty’s Government’s recent conduct—as Ministers will remember —around waving through the Cobham deal and its takeover by a US investor, I think I join other noble Lords in being sceptical about the Government’s intention. It is all very well increasing the Government’s powers and giving them the ability to apply conditions, or indeed to block deals, but if the Secretary of State chooses not to do that and to bend the knee to the market, then those powers are essentially useless. Perhaps the Minister can help me with a thought experiment: can the Minister name one British business that would be protected by this rule that would not, or could not, in fact be protected by existing legislation?

The science, space and research Bill is really important, and elements of this Bill have been perhaps the most trailed in the newspapers. I speak of the Government’s so-called ARPA approach to a big investment. We are told that there will be £800 million invested in something, and that that something will be in the north. The details will follow, no doubt, in this Bill. However, what has not been mentioned is the role of UK Research and Innovation. As noble Lords will remember, we went through a very long legislative process to establish UKRI. It was given a co-ordinating role in order to simplify and focus the research activities of this country. If noble Lords want to see how complex the current research and development funding structure in this country is, there is a report from the Science and Technology Select Committee that has one of the most mindbendingly complex box-and-wire diagrams imaginable. This seems to add more complexity and to call into question the role of UKRI. Can we have some clarification around that? In any case, £800 million does not reproduce the level of investment we are getting through the European Union, particularly through Horizon 2020 looking forward. Will Ministers also guarantee that, beyond the current assurances, which have been very well accepted by the research community, research organisations will have access to at least as much as the total funds that are coming from Europe?

While we are on the subject of UKRI, two words that have been all over other Queen’s Speeches we have heard but have not appeared in this one are “industrial strategy”. I do not see those two words in conjunction anywhere in the Queen’s Speech. Is this a slip of the drafting pen? When the current Chancellor of the Exchequer was briefly Secretary of State for BEIS, he proscribed the term. Are the Government proscribing the words “industrial strategy”, or are they merely hiding their light under a bushel? The Queen’s Speech does mention a couple of new sector deals. If there is not an industrial strategy, in what context are those sector deals to be delivered? I seek some clarity. Industrial strategy was, or is, the purview of UKRI, so what is its role going forward, particularly in the context of this ARPA-style research organisation that is coming? Where does industrial strategy lie? While we are in this area, what is the status of existing sector deals? Will they be honoured? Many of them stretch far into this Parliament and, indeed, probably beyond, so where are they and will they be honoured?

The Made Smarter review was very important in the area of revitalising regional economies, but it too was not mentioned in the Queen’s Speech, so what is its status? I shall not go into the details of the national infrastructure strategy Bill, but the area I would like the Government to focus on is energy strategy. It is absolutely clear, even before the targets we have set ourselves on zero carbon, that this country is bereft of an energy strategy. We absolutely need a stand-alone energy strategy, so can the Minister fill us in on when we might expect that process to start, when we might actually have that debate and when the industries that will have to deliver this strategy can actually start work? It is already too late in many cases, and we need to move. Leaving aside conversations about all the other elements of infrastructure, that should be top of this Government’s pile.

By any measure, this package is formidable in terms of objectives. I am sure that if this were “Yes Minister”, the civil servant would say, “Very ambitious, Prime Minister”, yet the election campaign stoked expectation even higher, and this will be the challenge. The noble Baroness, Lady Blackwood, talked about challenges. The challenge is going to be public expectation of delivery—that is the phrase du jour that we must use. Those expectations will have to be delivered in a difficult climate. Not only are all these Bills coming, but there is the small matter of free trade agreement negotiations going on, at least with the European Union, if not with other parallels. They are designed simply to reproduce what we have already or to deliver the equivalent economic basis. Meanwhile, economic growth, with all due respect to the other numbers trotted out just now, slowed to about 0.4% between the second and third quarters of 2019, with construction and manufacturing struggling in particular, and the service sector essentially holding its breath at the moment to see what happens.

National expectations have been pushed up, and we on these Benches will work hard with the legislation that comes our way and do our best to make sure that these Bills get the scrutiny that the country deserves.

National Health Service: Healthcare Advice

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Tuesday 16th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Baroness for that. I would be interested to know what jokes she has heard from Alexa in her family conversations. However, patients look on well-known search engines for medical advice and at the moment they may receive advice from all sorts of untested sources. NHS.uk is clinically based advice which has been approved by NHS England. The purpose of making that advice more available through the Open API, which is available through the developer system, is to ensure that that clinically based advice is more widely available and more readily searchable for patients. A reasonable point has been raised which is to ensure that the right advice reaches patients and that patients go through the right triage system, whether it is 111 or another system, but that is the intention of the programme. It will be carefully monitored and managed by NHSX, NHS England and the department.

[Lord Fox (LD)]

My Lords, there is a wider principle here. Even if effective, anonymised data is gathered and generated, where does the value lie in that data? Can the Minister tell us whether the Government have discussed and agreed with Amazon where the value lies and who gathers that value? On the overall principle, can the Minister tell us that when this data generates value, it is the NHS that benefits and not the private sector?

[Baroness Blackwood of North Oxford]

Amazon is not sharing any of the information that it gathers from third parties. It is not selling products or making product recommendations based on health information, nor is it building a health profile on patients. It has strict technical and operational safeguards in place so that Amazon employees will not have direct access to information that can identify any person or account. As I have already said, it does not have access to any health data based on this contract. No health data is being shared between the NHS and Amazon. Just yesterday we launched some new data-sharing principles which are designed to improved clarity around health data-sharing between the NHS and private companies so that we can improve public and clinician confidence on this issue.