Children’s Cancer Services

Debate between Lord Fox and Lord Markham

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

Debate between Lord Fox and Lord Markham

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.

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[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.

Strikes (Minimum Service Levels) Bill

Debate between Lord Fox and Lord Markham

Committee stage
Thursday 9th March 2023 Lords Chamber

[Lord Fox (LD)]

I have not been participating in this group, but I have been for the rest of it. I am intrigued by that answer. I am wondering how a private company would know that it falls within the remit of the Bill. Is the first time it would find out when it is required by the Government to deliver a work order to its employees? Will there be some other form of formal notification that may fall within the ambit of this legislation when it commences?

[Lord Markham (Con)]

I thank the noble Lord. This again relates to consultation. In all of these circumstances, for services that we think could be critical, we would go through the 12-week consultation process, followed by the 12-week implementation period. That is how the private company in this example would know there was a possibility of becoming involved in this, and there would be the consultation process to consider the matter fully.

On whether this is compatible with Article 4, again, we are talking about only circumstances where people potentially going on strike would cause a threat. We have circumstances like that already: the police and the military are not allowed to strike, and it is not considered that that conflicts with Article 4. So I do not think there is a read-across in the same way—

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[Lord Markham (Con)]

I am well versed only in the area of health, and I will defer to my noble friend to deal later with that. I am replying specifically on health.

[Lord Fox (LD)]

The Minister needs to understand that we are taking the whole Bill in this Committee, not just the health part—we are thankful that he has come to speak to that part. But we are trying to understand how we have train services at one end and resuscitating people on the verge of death at the other, and we are trying to find a common legal structure that fits them all. Does the Minister agree that there is a big difference between the minimum service level on a commuter line from Croydon and the minimum service level in an accident and emergency hospital? Can he explain how we are supposed to square those two issues within the framework of this legislation?

[Lord Markham (Con)]

I thank the noble Lord. I believe that there will be a group of amendments specifically on transport later on. That will be the opportunity to answer those questions. I have been drafted in—dare I say it—at the last moment, because it is a very important issue and I wanted personally to talk about the health aspects, which I am attempting to do, so please forgive me if I try not to stray into other areas. There will be the opportunity to discuss transport later on.

The noble Lord, Lord Allan, asked who wants this. It is a backstop power. Trusts will never need to use it if they do not want to. I believe that most trusts, and I hope all, have excellent relations and are able to make sure that these provisions are never used or needed.

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[Lord Markham (Con)]

Correct. I emphasise once more the process set out here: if it were decided that there was that threat, that is the point at which we would go into consultation. That is the thinking behind the process. We would have to believe that in such an area there would be a threat to life and limb, and would then go into consultation on minimum service levels. I hope that this has been helpful. It has been helpful to me as well, as ever, to see the value of the Lords. I am a big believer in critical challenge.

[Lord Fox (LD)]

The Minister will get plenty of that here.

[Lord Markham (Con)]

The noble Lord never disappoints me. I always say, from my business life, that two plus two equals five. Whenever you try to develop a new service or product, you need critical challenge along the way; you take points on board and you add to it, and you end up with a better product. I thank noble Lords sincerely, and I think they know me well enough to know that I will continue to take their input as we go through this process. I hope there is an understanding by noble Lords that we are trying to strike a reasonable balance here between the right to strike and the right to protection of life and limb, and that, in those circumstances, we cannot support these amendments.