Infrastructure and Projects Authority

Lord Harris of Haringey Excerpts

Wednesday 10th October 2018 Lords Chamber

[Lord Harris of Haringey (Lab)]

My Lords, the noble Lord has given a very interesting answer, but he did not address the central question that my noble friend asked: what did Ministers do in response to those red/amber ratings in this case?

[Lord Young of Cookham]

As I said in my initial reply, the reviews are primarily aimed at the project leaders. They give them advice on how to identify risks and take mitigating action to ensure that those risks are circumvented to ensure that the project hits the relevant milestones. There might be occasions when Ministers have to intervene, for example, if some legislative change is needed or if fresh estimates and more money are required from the Treasury, but for the most part the reviews are aimed not at Ministers but at departmental leaders. As someone who has been a Minister, if I was in charge of a project that had a red tag attached to it by the IPA, I would take a very close interest in its progress and make sure that it was delivered.

Prisons: Rehabilitation

Lord Harris of Haringey Excerpts

Thursday 6th September 2018 Lords Chamber

[Lord Harris of Haringey (Lab)]

My Lords, we are all grateful to the noble Lord, Lord Bird, for the opportunity to debate this important issue. My interest stems from being asked in 2014 by the then Minister for Prisons to review the 87 self-inflicted deaths of young people in prison between April 2007 and the end of 2013. Every one of the young people who died and whose cases we examined was someone’s son or daughter, sister or brother, partner or even parent. Each of the deaths represented a failure by the state to protect the young people concerned. That failure is all the greater when you look at the investigations into those deaths because the same criticisms occur time and again. Lessons have not been learned and not enough has been done to bring about substantive change.

My review concluded that all young adults in custody are vulnerable. Some had chaotic lives and complex histories; others had been subjected to child abuse, exposed to violence or repeated bereavement; many had been in foster or residential care; and often their lives had been further compounded by mental health issues. In the 87 cases we examined, many of the young people’s problems and vulnerabilities, including mental health issues, had been evident from an early age. Why did so many of them end up in custody?

The cases keep coming. There have been 195 deaths in prison so far this year, of which 49 have already been designated as self-inflicted and another 66 are awaiting classification. That was in the first nine months of this year alone—that is a lot of deaths—and nine of those deaths were of young people aged under 24. It is worth emphasising something for those who believe in the myth of the prisoner’s holiday camp. Let us be clear: prisons and young offenders’ institutions are grim environments, bleak and demoralising to the spirit. The experience of living in a prison or YOI is not conducive to rehabilitation. What is more, when coupled with current impoverished staff regimes, this makes the experience particularly damaging to developing young adults.

Recent reports from the Chief Inspector of Prisons suggest that despite ministerial promises of more investment and better conditions, the current state of our prisons is getting worse. When I did my review, it was clear that young adults in prison were not sufficiently engaged in purposeful activity and their time was not spent in a constructive and valuable way. In many of the 87 cases examined, the vulnerable young adults were going through a period of particular distress that might have passed had they not spent so much of their time banged up in their cells with nothing to do other than stare at potential ligature attachment points. At the time of my report, the Prison Service centrally did not know how many functional safer cells, where ligature attachment points have been removed, existed. Does the Minister have that information now? If not, why not? Nor did the Prison Service know how many hours prisoners spend out of their cells on purposeful activity. Does the Minister have that information now? Again, if not, why not?

A central recommendation of my review was that a named individual should take responsibility for the individual prisoner and her or his journey through the prison—someone who would take personal responsibility for the health, education, social care, safety and rehabilitation needs of each individual prisoner. They would have a small enough caseload that they would know the individual prisoner and deliver the right package of services for their needs. Since my review, Ministers have talked about a 1:6 ratio. Could we have the figures? What is the current ratio of officers to prisons and do the officers concerned have the opportunity to develop a meaningful and sustained relationship with the prisoners whom they are supposed to be assisting towards rehabilitation?

The other central recommendation was that much more needs to be done to support young people long before they ever get into trouble. I repeat, these are young people whose problems had been evident from an early age, so why was nothing done before—long before—they ended up in custody? If we do not get this right, we will waste the billions of pounds referred to by the noble Lord, Lord Bird, and we will not secure lives or rehabilitate individuals. We will simply make the situation worse.

Terrorism: Emergency Communications

Lord Harris of Haringey Excerpts

Thursday 5th July 2018 Lords Chamber

Asked by

[Lord Harris of Haringey]

To ask Her Majesty’s Government what steps they are taking to improve communications for use in the event of a terrorist incident or other major emergency.

[Lord Harris of Haringey (Lab)]

My Lords, I should start by referring to my various interests in the register, in particular my role as UK co-ordinator for the Electric Infrastructure Security Council. I am grateful to the distinguished list of noble Lords who have put their names down to speak.

Less than two weeks ago, Michael Dowden, the London Fire Brigade watch manager for North Kensington gave evidence to the Grenfell Tower inquiry and said:

“For me … to facilitate and change a stay-put policy to a full evacuation was impossible. I didn’t have the resource at that time. We’re looking at 20 floors above the fire … I just don’t know how that could have been done with the resources we had in attendance at that moment in time”.


Tragically, the technology to deliver that message to those waiting in their flats exists and, had it been adopted in this country, could have been used on that terrible night.

I have spoken to Michael Hallowes, who is sitting below the Gallery watching this debate, who tested Australia’s “emergency alert” for just such an emergency at the 37-storey Department of Justice building in the heart of Melbourne back in 2012. He drew a warning polygon on the system’s mapping tool over that building, which detected the presence of 5,736 mobile devices. The location-based SMS alert that followed reached over 90% of those devices within 12 seconds, delivering the alert successfully to people on every floor. The system’s configuration also meant that the alert was kept to just that building. This technology could undoubtedly have saved lives in Grenfell Tower. It could also have been used to reduce the panic and stampedes in Oxford Street last November as people responded to erroneous reports that gunshots had been fired.

We know that social media play a huge role in the event of a terrorist incident or indeed any other emergency. Sometimes, of course, the result is that misinformation is spread, as members of the public caught up in an event and the media try to make sense of what may be a very confusing situation. It is essential that civic agencies are able to provide a swift and authoritative voice during such events.

Three months ago I raised this matter in your Lordships’ House and the noble Lord, Lord Young of Cookham, said that,

“the Cabinet Office has been requested to provide Ministers with … An initial analysis of what a scheme might look like and what delivering a scheme might entail … for May 2018”.—[Official Report, 16/4/18; col. 981.]

In a later answer, the noble Lord admitted that this timetable had been set by him that morning in preparation for my Question in the afternoon—I am grateful to him for doing that. But my questions now are: has that analysis been completed—we are now in July, not May—and when will action be taken?

The legal duty exists in Part 1, Section 2(1)(g), of the Civil Contingencies Act 2004, which requires category 1 responders to,

“maintain arrangements to warn the public, and to provide information and advice to the public, if an emergency is likely to occur or has occurred”.

This technology was tested by the Cabinet Office five years ago. As I have said, it is already in use in Australia, but also since 2012 in the United States, the Netherlands and elsewhere.

Therefore, my questions to the noble Lord are as follows. Which Minister and which government department will be leading on this going forward? Have the police and the other emergency services identified their operational requirements and, if they have not, will Ministers be asking them to do so as a matter of urgency?

I would like to move on to the replacement of the current system for communications within the emergency services. The police, fire and ambulance services must have reliable communications between control rooms and personnel in the field. This is currently delivered by a radio system known as Airwave—a system which the National Audit Office pointed out has served the emergency services effectively in dealing with life-or-death situations—but now it needs upgrading and improving, in particular to enable it to handle data better in addition to voice communications.

In 2011, the Government took a decision to replace this system with what is to be known as the “Emergency Services Network”. Unlike Airwave, it will not have its own exclusive part of the spectrum; instead, it will share it with a commercial 4G network—in this case, EE. This puts all our communications eggs in one basket: it creates a single point of failure. If, for whatever reason, the 4G network goes down, so do the communications for the emergency services.

At this point, we were supposed to be half way through the rollout of the new system, but the NAO pointed out less than two years ago a number of rather significant facts: the ESN is inherently high risk and such an approach has not been used nationwide anywhere in the world; the ESN is “technically cutting edge”; no suitable hand-held and vehicle-mounted devices that will work with ESN existed at the time of the NAO’s report; the ESN requires the percentage of Great Britain’s land-mass covered by EE’s network to rise from 70% to 97%; and, as the NAO said,

“the programme has adopted a timeline for delivering ESN that is very ambitious”.

What could possibly go wrong? Not surprisingly, the programme is running behind schedule. Can the Minister tell us the current timeline for the rollout? What are the extra costs for each month of delay, and, perhaps more significantly, why do so few senior officers in the police, fire and ambulance services seem to feel confident that it will all work as promised?

The present arrangements are based on a series of contracts that expire next year. As I understand it, there are 105 contracts with the emergency services around the country and 307 with other public sector organisations. These will be replaced by one single contract managed by the Home Office. I repeat: one single contract managed by the Home Office—that instantly inspires confidence.

The individual providers will have a call-off arrangement with EE, but this is much more limited than the contract that they currently have with Airwave and gives those services very little direct recourse for poor service. Is the Minister satisfied that a local police force or a local ambulance service will have the leverage they need to get the quality of service required to keep the public safe in their area without recourse to separate expensive investment in back-up facilities?

We all know what it is like using the mobile phone network, particularly at times of high demand. The question that has to be answered is: will emergency services personnel have priority over other commercial users of the network? I am told that software and protocols are being developed to enable this to happen. Perhaps the Minister can tell us how this will work and, very specifically, whether the prioritisation will mean that existing users will be bumped off the service if it is needed by the emergency services.

My understanding is that the prioritisation being offered is that, if it is a choice between the emergency services provider coming on to the system and someone who wants to initiate a call—perhaps to a loved one to say they are all right or are on the train—the emergency service provider will get priority. But what about those people who are already using the system, either making an extended phone call or, more significantly, using a lot of data to stream music videos? Will they be bounced off the system in an emergency? My understanding is that they will not, and I think that is a significant weakness.

All of this assumes that the 4G network is operational and is not disrupted by the emergency itself. At the beginning of my speech, I mentioned the work I do on infrastructure security. I will not go into this at length, but there are a number of “black sky” events that could, for example, produce a widespread power failure. Under those circumstances, the 4G network would be viable for at best two to four hours before the batteries in the cell-site masts run down.

This brings me back to the concerns I expressed earlier about the single point of failure and to the last point I want to touch on: the High Integrity Telecommunications System. HITS is intended to be—again I quote the Minister,

“a resilient communications solution providing a voice and data link to 47 fixed sites across the UK. It is intended to provide failsafe communications in times of national crisis, connecting local responders and the Devolved Administrations with COBR”.

The Civil Contingencies Secretariat says in its information pack that this is a “resilient and independent” network that,

“will still function when the main networks (such as landlines and mobile phones) are unavailable or degraded”.

The collapse of the 4G network is acknowledged as a real risk. The existing contract for this system ends in March. When I asked the Minister about this a few weeks ago, I was told a review was “currently under way”. Is this urgent enough if the contract expires in less than nine months?

Connecting with 47 fixed sites was always a very limited aspiration—I understand it is one for each police force. Originally, this was supplemented by transportable terminals that could be deployed to specific locations in addition to the fixed sites. These were withdrawn at the end of 2013, are no longer available and have not been replaced. I have spoken to those involved in emergency planning around the country and their view is that the existing HIT system is approaching obsolescence and is inadequate for maintaining central co-ordination in the event of the sort of crisis for which it was designed. Can the Minister tell us what the plans are for the future of HITS and when decisions will be taken?

I apologise if some of this speech has appeared to be rather technical, but let me be clear: effective emergency communications in a time of crisis are vital. It is genuinely a matter of life and death, and it is essential that as a nation we get this right.

Terrorism: Public Alert Technology

Lord Harris of Haringey Excerpts

Monday 16th April 2018 Lords Chamber

Asked by

[Lord Harris of Haringey]

To ask Her Majesty’s Government when they will authorise the use of public alert technology for mobile phone systems for use by the police and emergency services in the event of a terrorist incident.

[Lord Young of Cookham (Con)]

My Lords, the Cabinet Office has been requested to provide Ministers with advice from the police and other emergency services about the scenarios where a national alerting scheme could improve public protection. An initial analysis of what a scheme might look like and what delivering a scheme might entail is scheduled for May 2018.

[Lord Harris of Haringey (Lab)]

My Lords, I am grateful to the Minister for that reply, if somewhat bemused by it. Three trials were organised by the Cabinet Office and conducted in 2013, which is nearly five years ago. There was then a report from the Cabinet Office saying that the trials had been extremely successful, and it made a series of recommendations. Why is it taking so long to implement a scheme that could save lives by alerting people to an emergency and to the advice of the emergency services?

[Lord Young of Cookham]

I begin by commending the noble Lord on the report he did for the Mayor of London, which had a number of recommendations —127—on how better to deal with terrorism, of which this was one. I reassure the noble Lord that the Cabinet Office is taking this seriously; I had a meeting with officials this morning at which I set out a timetable for the next phase in this approach. I agree with him that there is a real potential to reduce harm to people and mitigate damage to property if we make progress with a national alerting scheme, but there are some real issues—technical, political and administrative—that need to be addressed before we can make progress with the scheme.

Digital Forensic Services

Lord Harris of Haringey Excerpts

Monday 12th March 2018 Lords Chamber

[Lord Young of Cookham]

The review I referred to, asked for by the Attorney-General, will identify solutions to some of the problems that the noble Baroness just referred to. It is the case that in recent years there has been an explosion in the use of social media in court cases. This has put enormous pressure on the digital forensic services. The regulator is aware of these issues. I hope that the review I have outlined, which is looking at these very issues, will come up with proposals and solutions that the Government can then take forward. I entirely agree that no one should be convicted because inadequate research has been done into relevant email and social media sources.

[Lord Harris of Haringey (Lab)]

My Lords, more than 20 police forces have had to bail out key forensic science services because of the decision of the Government in 2012 to close the highly regarded national Forensic Science Service. Will those police forces be compensated, and precisely what benefits have accrued from the decision to break up the national Forensic Science Service?

[Lord Young of Cookham]

The Forensic Science Service was closed in 2012. It was losing £2 million a month. Although this was not the reason for closure, there were real issues about the quality of some of its work, with multiple requests for case reviews and retesting. Increasingly, police forces that did not have their own in-house capacity were going to alternative service providers other than the FSS. It is not the case that the closure of the FSS has led to some of the issues that we have been discussing today.

Class 4 National Insurance Contributions

Lord Harris of Haringey Excerpts

Wednesday 15th March 2017 Lords Chamber

[Lord Young of Cookham]

I am grateful to my noble friend. I think there is something for all the political parties to learn in terms of setting up policy reviews well in advance of the 2020 general election and involving party members and other people, as appropriate, as they develop their policies, rather than leaving things to the last moment. I therefore take heart from what he says. I am sure that we will all learn from what has happened today.

[Lord Harris of Haringey (Lab)]

My Lords, many of those who are self-employed are also registered for value added tax. I declare an interest as such a person. However, the Government, with effect from 1 April, will introduce a flat rate for limited-cost businesses under the VAT flat rate scheme. This will have an immediate effect for many people in that position of increasing the money they pay to HMRC by a margin of 2% or 3%—in some cases more—of their turnover. Is that consistent with the spirit of the Conservative manifesto?

[Lord Young of Cookham]

I assume those measures have already been approved by both Houses of Parliament, if they are going to come into effect next month.

Health and Social Care

Lord Harris of Haringey Excerpts

Thursday 15th December 2016 Lords Chamber

Moved by

[Lord Harris of Haringey]

That this House takes note of the case for effective service user representation in health and social care, and of the case for enhancing the independence and capacity of Healthwatch England and of local Healthwatch groups.

[Lord Harris of Haringey (Lab)]

My Lords, I am sure the whole House will want to begin by placing on record again its condolences to the noble Lord, Lord Prior of Brampton, who would under other circumstances have been replying to the debate. We are sorry he is not here because of both the circumstances and what he would have brought to the debate as a former chair of the CQC.

I begin by declaring some personal history. For 12 years I was director of the Association of Community Health Councils for England and Wales, which was then the statutory body representing the interests of NHS users at national level and supported a network of 200 or more member community health councils. That is what I bring to the debate.

I apologise in advance if my remarks are coloured by that experience, but it is good to start by considering why patient involvement matters. It begins with the interaction between patients and clinicians, or service users and those who are caring for them. The Eurobarometer qualitative study on patient involvement, produced by the European Commission in 2012, summarised this well, saying that better communication is the central idea of patient involvement:

“For patients, this meant practitioners explaining to them the diagnosis and treatment. For practitioners, it meant patients describing symptoms and keeping them updated”.

The objective is a partnership between the clinician and the patient. There is evidence that where such partnerships exist they improve the outcomes of treatment because the patient is more committed to the treatment proposed and understands it better.

Patient involvement is also critical to service design and organisation. Those responsible for a service often have little understanding of what it is like to use the service in question—although, I have to say, they think they do. The reality is different. A senior clinician or senior manager inevitably ends up being treated differently if they suddenly become a service user.

At the risk of boring your Lordships, I mention a personal anecdote, which one or two may have heard before. This point of not knowing what the service is really like was brought home to me rather forcefully almost 30 years ago. After speaking at a conference, I began to feel increasingly unwell. To cut a long story short, shortly afterwards I found myself at my local accident and emergency, being prodded by a junior doctor, who was clearly completely baffled—as, indeed was I—as to what might be wrong with me. He then did what a junior doctor always does under those circumstances: he follows the protocol, which is to say, “So tell me, Mr Harris, what do you do for a living?”. I know that I should under those circumstances have lied in the interest of getting the true personal experience, but what I actually did was say, “Well, in fact, I’m the director of the Association of Community Health Councils”. The junior doctor then went behind the curtain. Of course, it is a fallacy that you cannot hear what is going on on the other side of that curtain. I could hear him phoning the consultant: “I think you should come down, sir. He says he’s the director of the Association of Community Health Councils”.

That, of course, is the experience when any senior clinician or senior manager is taken into a casualty department or tries to use a service. The reality is that services are better if they reflect the needs of the users of that service, which is why putting patients first at the centre of the NHS has been the mantra underpinning every government statement on the NHS since it was founded in 1948. The noble Lord, Lord Lansley, who is about to speak, will recall using very similar words during his time as Secretary of State. Incidentally, on the issue of personal experience, I seem to recall seeing all sorts of statements on what various clinicians would like to do to the noble Lord if they ever found him in their care, but fortunately that never happened during his period of brief notoriety in that role.

The most recent iteration of this mantra was probably NHS England’s five-year forward view, which advocated involving communities and citizens,

“directly in decisions about the future of health and care services”.

Since 1974, successive Governments have supported different models of involving the public in shaping services and of representing the voice of service users. First there were community health councils, until they were abolished in 2002 and replaced by patient and public involvement forums, which were in turn replaced by Local Involvements Networks—LINks—in 2008. They in turn bit the dust with the arrival of Healthwatch as part of the Health and Social Care Act 2012.

That Act had a tortuous passage through Parliament. Somewhere along the way, the model intended for Healthwatch at local level was changed. Those changes were given very little parliamentary scrutiny despite my personal best efforts, when I warned that the late changes to the Bill risked weakening the new bodies by starving them of resources and laying them open to conflicts of interest with local councils, which were to be their paymasters. The arrangements for Healthwatch England would inhibit its independence and effectiveness.

I am sorry to say that the concerns I expressed then have been borne out. Healthwatch England remains a sub-committee of a regulator, the CQC, a body that is already overstretched and to which requests for action and, from time to time, criticism may be directed by Healthwatch England or local Healthwatch. For Healthwatch England to be located there compromises its independence and must limit its scope to highlight when the CQC is not being as effective as it should be. Recent changes appear to have made Healthwatch England’s relationship with the CQC even more subservient, with changes to the chair and chief executive being used as an opportunity to make the role even more subordinate to the CQC.

I am grateful to have received in advance of this debate a letter from David Behan, chief executive of CQC, seeking to reassure me of the independence of Healthwatch England from the CQC, but in it he records:

“The National Director for HWE will be line-managed and accountable to myself as the CQC Chief Executive”—

apparently a new distinction. He further states:

“The HWE Chair is already accountable to the CQC Chair”,

and that the strategy of Healthwatch England has to be submitted to the CQC board for endorsement. That hardly sounds like independence.

Healthwatch England is reasonably generously resourced for what it does, with a budget of £4.5 million, but in 2015-16 it could not spend that and used only £3.7 million, a 17.3% underspend. A very small proportion of that goes on developing and supporting local Healthwatch. Nor does local Healthwatch feel that Healthwatch England is there for them and they have little scope to influence it or its work.

Healthwatch England also seems to fail in capturing and articulating the views and concerns of local groups, so much so that a private company, Glenstall IT, has stepped into the void by collating reports and publications of local Healthwatch groups, something you might have expected Healthwatch England to do, and selling the digest back to 2,000 health and social care professionals. The fact that Healthwatch England is not doing the job means that a private company has come in to sell it back to the people funding the system.

What about the resourcing of local Healthwatch groups? In 2013-14, the Department of Health passed over £43.5 million to be included in the local authority block grant to fund local Healthwatch organisations, but the total funding given to local Healthwatch groups in that year amounted to only £33.5 million—£10 million had disappeared along the way. That is before taking into account the cost of the cumbersome arrangements for competitive tendering and commissioning through third parties imposed by those late changes to the Health and Social Care Bill.

While there was £33.5 million in 2013-14, that fell to £31.8 million in 2015-16 and again to £29.9 million in this financial year—a third less in cash terms than the DoH thought was necessary and had handed over three years earlier. I warned the Department of Health that this would happen and that other pressures on local authority budgets would produce this squeeze, yet it acquiesced in allowing the money to go across unring-fenced. Was this a deliberate attempt to hobble patient representation and independent local scrutiny?

There is a big variation in the funding of individual local Healthwatch groups. Bristol provides £400,000, while Manchester only £80,000. Are the needs of the citizens of Manchester for effective patient representation one-fifth of those of the residents of Bristol, whose population is 50,000 less? Some areas have seen big cuts year on year: Barnsley down 25%; Blackpool down 50%; Bradford down 25%; Ealing down 25%; Harrow down 40%; Hounslow down 50%; Leicestershire down 30%. I could go on.

Some of the reductions are of course a consequence of the enormous continuing pressure on local council finances, but how much is it a consequence of local Healthwatch having a role in monitoring local social care provision—the responsibility of the same local authority that fixes their budget and may perhaps not like the criticism that an effective local Healthwatch group might occasionally have to make? Local authorities have a conflict of interest here and I am told of a number of local Healthwatch areas where this has had a deadening effect, particularly on the willingness of paid staff members to criticise those who provide their monthly paycheques.

One example is of a 30% reduction in funding imposed on Oxfordshire Healthwatch by Oxfordshire County Council, which seemed to follow, as night follows day, from criticisms that the local Healthwatch had made of the county council record on social care—precisely the job that Healthwatch was created to do. As one of its board members tells me, “The cut inflicted on us drove us to relinquish our strategically located premises close to the CCG headquarters and move to the cheapest possible accommodation on the edge of a farmyard in remote countryside. We have had to cut back on project work, assistance for voluntary groups and a range of community engagement activities. All this arose because our funding was not independent and ring-fenced, and was routed through a body we had criticised”.

In Manchester, the city council swallowed most of the Healthwatch budget, leaving what has been described to me as, “a puny organisation. They are not very effective and they don’t relate to any of the other patient organisations”. As the King’s Fund put it in its review carried out for the Department of Health:

“Local Healthwatch organisations are very small in comparison to the potential scope of their statutory activities, and the population and services they cover”.

The effectiveness of the input that local Healthwatch can provide is critical at present, as the sustainability and transformation plan process rolls forward throughout the country. According to NHS England, this process is supposed to be about building and strengthening local relationships, and service users should be at the heart of the process.

How has this worked out? Frankly, it is very variable. In some areas—Sheffield, Staffordshire and Bath—there is good involvement, but not in others. In Berkshire, Devon and County Durham, local Healthwatch was neither involved nor consulted. In Liverpool, local Healthwatch complains that the process has not been open or transparent. Its chair says, “We have not yet had the opportunity to review or scrutinise the detail of the plan”. In the East Riding, there has been no involvement. The MP for Tottenham had to ask a Parliamentary Question to find out who was consulted during the development of the STP for North Central London. None of the local Healthwatch groups was part of the transformation board. As one local Healthwatch rep from elsewhere in the country put it, “The STP thing is a nightmare. They think we patient reps are just a box to tick and the patronising attitude from some is breathtaking”.

Local Healthwatch also has the important power to enter and view services, but the King’s Fund study for the Department of Health found that this power was used in a wide variety of ways, with some of the case study sites doing none because they were unclear about what would justify an enter and view visit. Many local Healthwatch groups only carried out visits on a prearranged basis. Some saw it as a routine part of their intelligence gathering, while others felt it was only justified when “serious or multiple concerns are raised”. Clearly, there is no guidance and local Healthwatch organisations are left time and again to reinvent their own wheels.

As one local Healthwatch activist put it to me, “Too many of us do little E&V. What they do is announced and done by employed staff who have a vested interest in not rocking the boat”, because their salaries are paid by those they are inspecting. All this comes at a time, as the CQC admitted recently to the Health Committee, when it is struggling to manage inspections of establishments every other year. Local Healthwatch could provide an enormous resource to supplement and inform inspections by the CQC, but its potential enthusiasm is simply being stifled.

None of this should be taken to imply that the work done by hundreds, maybe thousands, of local Healthwatch volunteers is not valuable. I am aware, of course, of the many dedicated staff supporting them, but the reality is that the Department of Health has set up a deliberately flawed system. In the name of localism there is allowed to be an enormous variation in how local Healthwatch organisations structure their governance, as highlighted in the King’s Fund review. As a result, there is a lack of clarity in who speaks for local service users. Is it the board, is it its members, is it the host organisation, is it the staff or is it the volunteers? As a result, the authority of that voice is undermined. The King’s Fund criticised the lack of transparency of local Healthwatch and, as one volunteer put it, its structure and governance should follow the same pattern everywhere and not be determined on the whim of a local authority or a private host company.

It could be so different. As the King’s Fund review said:

“Some of the challenges that local Healthwatch face could be addressed through greater support, advice and shared learning on how to operate effectively”.

The tragedy is that Healthwatch has enormous potential. It could be a tremendous force for good in enabling health and social care services to be much more effective and user-centred. It should not be a box-ticking exercise or provide a woolly voice, but provide effective scrutiny with real influence and a real ability to involve the public. That is what the vast majority of those engaged in Healthwatch activities want to do but, alas, their ability to fulfil that role has been hampered by the cack-handed way the system was established, by the department’s failure to prevent the erosion of funds and, just possibly, by the fact that too many local and national service managers would prefer a quiet life, without having to respond to an effective user voice. I beg to move.

--- Later in debate ---

[Lord Harris of Haringey]

My Lords, I am enormously grateful to all noble Lords who have contributed to today’s debate. I am particularly grateful to the noble Baroness, Lady Chisholm, for standing in at short notice and speaking from the Front Bench, and to my noble friend Lord Tunnicliffe, who at even shorter notice has stood in for our Front Bench, who are also away for reasons of illness and other matters.

This has been an interesting debate, and lots of important points have been made. I particularly welcome the point made by the noble Lord, Lord Lansley, that shared decision-making in terms of the individual should happen anyway, irrespective of the structures in place. He outlined—and I do not dispute it—that when he was Secretary of State the Government’s objectives in creating Healthwatch were good, and the intention was to improve the system. It is just a question of how well it has worked subsequently. He asked a very valid question about why the Labour Government abolished community health councils. That is a question that I certainly asked at the time. I am sure that, had he been in his place, my noble friend Lord Hunt of Kings Heath, who was the Minister at the time, may well have wanted to comment on those matters. The fact that the arrangements that were then put in place were felt not to be working only a few years later suggests that perhaps the model was not absolutely right.

My noble friend Lady Pitkeathley, along with a number of other contributors, talked about the whole point of the involvement of patients being that it challenges the existing power structures and orthodoxy, which therefore produces a backlash. She also made the point, which I agree with, that in the Bill that ultimately became the Health and Social Care Act, the creation of Healthwatch was potentially a ray of hope in terms of how things would progress.

The noble Baroness, Lady Brinton, quite rightly reminded us of the role of the voluntary sector and the way in which users can shape the different patient pathways that are available. That too is something that often gets neglected. The noble Baroness, Lady Masham of Ilton, talked very pointedly about the lack of local knowledge about Healthwatch and its role, as well as the suspicion that is growing about the STP process—which could be extremely important, because it is intended to be transformational—in terms of the lack of openness and transparency. It is an important process, which is why it was so vital that health service users and social care service users were fully involved in the process.

My noble friend Lady Warwick of Undercliffe talked about how the role of local Healthwatch could be critical and said that it was one of the few organisations that really has an overview across the health and social care divide. She highlighted the concerns about the changed relationship between Healthwatch England and the CQC. She also reminded us, very importantly, of the potential role of housing associations. The noble Earl, Lord Listowel, talked about the value of senior people listening to service users. That is the essence of most of the models that have existed over the years—senior people directly hearing the voices that are there. The noble Baroness, Lady Watkins, also made that point when she talked about challenging the orthodoxy. She made interesting points about how users should influence and shape things.

I was very amused by one element of the speech made by the noble Baroness, Lady Walmsley, because she said it was not the Liberal Democrats who had said that the structure should work through local authorities. In that case, I am beginning to wonder whose idea it was. The noble Lord, Lord Lansley, speaking 10 years ago about the previous system, said that LINks may “struggle to be credible as long as they are funded through local government”. Just a few years later, he felt impelled by something or someone—we now know it was not the Liberal Democrats—to say that the new system should be funded through local government, with the consequences that I have described.

The noble Baroness, Lady Chisholm, in her reply, tried to reassure me about the relationship between Healthwatch England and the CQC, and reiterated what I already see as the accountability lines which render independence slightly more difficult. She then told us that the CQC would in future be deciding the funding of Healthwatch England, which seems to put even more into question the way in which that independence would operate. She also talked about local councils’ accountability for how much they allocate to Healthwatch England. This is very important, but the sanction Healthwatch England has available—which I think we have discussed before in your Lordships’ House—is that it can send a letter to the council lead saying it is not good enough. As a former council leader, I know what response I always gave to letters saying that something that my local authority was doing was simply not good enough.

In conclusion, I am grateful to all noble Lords who contributed to the debate. There is a great warmth around the House about what could be achieved by Healthwatch, both locally and nationally, and the message going back to the Department of Health must be that it is important to build on the Healthwatch network. If it really wants to get this right, and deliver what all your Lordships have said they want to happen, then it needs to resource local Healthwatch organisations properly through a freestanding Healthwatch England. I suspect we might then well find that we have a system which genuinely delivers a user voice and influence into the centre of health and social care in this country.

Motion agreed.

Parliament and Central Government: Relocation

Lord Harris of Haringey Excerpts

Tuesday 29th November 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

I am surprised the noble Baroness says that. That is what we are doing with devolution. We are not interfering. That is the whole point: for it to go out into the communities for them to be in charge of what they want.

[Lord Harris of Haringey (Lab)]

My Lords, is there not a nasty tone in some of this debate, of people attacking our capital city? Given that the people of London subsidise the rest of the country to the tune of billions of pounds each year perhaps it would make sense if, before we go down the road of automatically deprecating London, we remember that it would be a very satisfactory outcome as far as the people of London were concerned if the principle of devolution were followed and London had full fiscal autonomy.

[Baroness Chisholm of Owlpen]

The noble Lord certainly has a point. London is our capital, but I do not think noble Lords were denigrating it when they were talking about moving things to the north. Our capital is very important, and that is why I think we feel that this is where government should be.

Policing and Crime Bill

Lord Harris of Haringey Excerpts

Committee: 4th sitting (Hansard - part two): House of Lords
Wednesday 9th November 2016 Lords Chamber

[Baroness Wheatcroft (Con)]

I support the amendment. I cannot claim to be an expert on sport, but my noble friend Lord Moynihan most certainly is. His sporting legacy to this country is extraordinary, not least the performance of our team in the London Olympics, which was engineered by his work as chairman of the British Olympic Association, but also the extraordinary performance of our team in Rio. At first glance, the amendment appeared to be radical but, having heard the argument, I understand that we are lagging behind on this important front. That is not the right position for this great sporting nation to be in.

Beyond that, I fear that by not taking strong action against the use of drugs in sport, we are sending the wrong message to our youngsters, who look on sport as a career opportunity and wonderful thing, and to those who play sport as their great heroes. If people are banned from sport for a year or two and then come back, that seems to be acceptable. A prison sentence would be in a different league. That would send a message to our youngsters that this is something that they should not tolerate, and certainly not toy with. That is a very important message for this House to send. I support the amendment.

[Lord Harris of Haringey (Lab)]

My Lords, I, too, support the amendment. Like the noble Baroness, Lady Wheatcroft, I do not claim to be an expert in or have anything much to do with sport under most circumstances, but the amendment moved by the noble Lord, Lord Moynihan, is extremely important. This is about the confidence of the public and the importance to them of feeling that the sporting events they watch or participate in are genuine and not distorted in the way described. It therefore sends a powerful signal and if it indeed brings us back into line with other countries around the world, it is an extremely important thing for us to be doing.

My question—the noble Lord may have answered it in his remarks but if so I did not catch it—is: how broad are the sporting activities which the amendment covers? He talked about international sporting events, and we all have memories of what happened in the recent Olympics, in particular with the Russian team. However, as I understand it, the amendment covers all competitive organised sporting events where they are subject to a governing body. I should be grateful for that clarification and the extent to which it extends right the way through, because the governing bodies of the sports of which I have some knowledge are increasingly seeking not only to arrange the high-profile events but to encourage more people to participate at a lower level in local, regional or county events. It may be less likely that performance-enhancing drugs are used in those environments. However, I assume that this legislation is intended to pick up on those issues as well. It would be helpful if we had that clarity because it is important for people to have confidence in all sporting activities in this country, not just those at the highest level.

--- Later in debate ---

[Lord Harris of Haringey]

I sometimes wonder about the priorities of this House and of government in considering these sorts of issues. I think most of those who know me recognise that I am fairly hawkish on counterterrorism, but the number of people in this country who have died as a consequence of terrorist acts since 2005 is less than the number of people who die in a single year because of drunk-driving between the limits that are currently against the law and those proposed by the noble Baroness.

Let us go back over all the legislation since the current limit was introduced—the noble Baroness, Lady Berridge, took us back to what it was like in those times when we were all much younger—and consider how many pieces of legislation, full Bills, have been brought forward by the Home Office to deal with the threat from terrorism. It is usually about one a year, sometimes more—full Bills containing lots of new offences. Yet there is clear evidence that these new limits would reduce the number of deaths, they are fairly straightforward to administer and yet we keep waiting and putting off the decision. That seems to me an issue that we should all address, and we should be conscious that sometimes we have double standards. I will continue to argue for stronger counterterrorism, but it is rather striking that we do not resolve something like this, which would make a real difference, and would stop the wrecking not only of the lives of the families of those who have died but also of the lives of those who cause the deaths.

[Lord Kennedy of Southwark]

My Lords, Amendment 214C, moved by the noble Baroness, Lady Berridge, and supported by the noble Baroness, Lady Jones of Moulsecoomb, and my noble friend Lord Brooke of Alverthorpe, reduces the legal alcohol limits in England and Wales to match the limits introduced by the Scottish Government on 5 December 2014.

My noble friend Lord Harris made a particularly powerful point in respect of deaths caused through drink-driving. I am very supportive of this amendment, as I think we need tough laws on drinking and driving that are effectively enforced.

I also think that it would be quite good to have the same limit across the whole of Great Britain, and ideally the whole of the United Kingdom. This would make it much easier to understand for everyone concerned. I am also not against having a lower limit for commercial drivers and novices.

There is clear evidence that a reduction in the drink-drive limits would save lives. No one has said that is not the case. We have the highest limits in Europe. Only Malta has the same drink-drive limit we have in this country. The limit introduced by the Scottish Government is the same one that is in force in Austria, Belgium, Croatia, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Latvia, Luxembourg, the Netherlands, Portugal, Slovenia and Switzerland. So the case is powerful. In none of these countries is there a problem with the limit being effective.

The second amendment in the group, again in the name of the noble Baroness, Lady Berridge, and my noble friend Lord Brooke, seeks to create a lower limit for novice and professional drivers. Again, I think that this is something we should consider. Many countries have this. That is certainly the case in many of the countries I read out, including Ireland and North Ireland. I think that it is important, if you are a professional or a novice driver, to have a lower limit.

I passed my driving test 36 years ago. I remember getting my first car—you are let loose and you are in there on your own. If you think about it, you are not very experienced at that point. Therefore it would be a good to enforce a lower limit. The fact is that our limits are comparatively high. I hope the Minister will respond to the amendment moved by the noble Baroness, Lady Berridge. It is very good, and I hope that we will get a positive response from the Government. If not, I hope that the noble Baroness will bring it back on Report. I assure her that if she wants to test the opinion of the House at that point, we will support her.

--- Later in debate ---

[Lord Harris of Haringey]

Since we are having open season during this intervention in the Minister’s speech, could we also deal with why other countries’ records are worse although they have tighter limits? This debate is not about behaviour in France, or in Estonia, and I do not want to get into a pre-Brexit rant about the behaviour of foreigners, or anything like that. If those countries felt that the problem was so bad that they needed to take even tougher measures, that is a matter for them. We are talking about proposals that would save lives in this country at the present time. That is what these amendments are about.

[Earl Attlee]

I hope the Minister will finish by saying that when we get the statistics from Scotland she will study them carefully and possibly review the policy. But claiming that lowering the limit will reduce fatalities is an assertion, and it is not necessarily the case. We need to wait for the evidence, particularly relating to fatalities caused by those people who are far over the limit. I do hope the Minister will say something useful about how she will take full account of the statistics we will shortly get from Scotland.

[Lord Harris of Haringey]

My Lords, we are in Committee and we can do what we like. The noble Baroness, Lady Berridge, put the argument very clearly in relation to the number of deaths that occur as a result of people who have more drink in their blood than the limit she is proposing but less than the current limit. If those deaths could be prevented that would be a net gain.

[Earl Attlee]

My Lords, I understand the argument but the difficulty is that those offences could just be caused by people making a stupid mistake and I am not sure that lowering the limit would solve the problem.

--- Later in debate ---

[Baroness Chisholm of Owlpen]

I am grateful to my noble friend Lady Berridge for explaining the purpose of her amendment. The Government are mindful that forced religious marriage may be a deliberate attempt to avoid financial consequences in the event of the break-up of the marriage. The existing position is that the financial orders provided for in the Matrimonial Causes Act 1973 are available only where a marriage is capable of legal recognition in England and Wales and where it is being brought to an end—or where judicial separation is ordered. However, where a marriage is not capable of legal recognition, parties have the same recourse to the court as unmarried cohabiting couples on the breakdown of the relationship. This applies to the division of any property and to financial provision for any children the couple have.

For those in a marriage that has no legal validity, the pressure from families and communities to stay together is no less strong because of the fact that the marriage has no legal consequences. It does not make it any easier for an individual to escape an abusive relationship, and we share my noble friend’s concern that it leaves women in particular vulnerable to hardship when the relationship breaks up, since there is no recourse to the court for the financial orders available to divorcing couples. The Government take this issue very seriously, and it is central to the independent sharia law review launched by the current Prime Minister in May this year. The Government will wish to consider the issue further in light of the findings from the review.

None the less, the law governing marriage, divorce and matrimonial property is complex, nuanced and finely balanced, reflecting as it does the wide range of personal circumstances in which people find themselves. The amendment would introduce a disparity with unmarried cohabitants and with those who are in unregistered marriages that are not forced. There is no evidence at this stage that the amendment—

[Lord Harris of Haringey]

I understand the point the Minister is making about consent, difficult precedents, cohabitation and so on. But we are talking about a specific circumstance here, which is about coercion. These are not proper arrangements, because somebody has been forced into marriage against their will. That is the context we are talking about. We are not talking about a sort of touchy-feely cohabitation relationship which then breaks down, but about somebody who has been forced into an arrangement of this sort, which is totally inappropriate and wrong in law.

[Baroness Chisholm of Owlpen]

I was not suggesting that, just that there are difficulties—other reasons why it could be more difficult to bring in. That is not to say that we are not keen to look further at this issue. However, because we want to consider the findings of the sharia law review, I ask my noble friend to withdraw her amendment so that we have a chance to do that.

Electoral Fraud

Lord Harris of Haringey Excerpts

Monday 12th September 2016 Lords Chamber

[Baroness Chisholm of Owlpen]

As I said in answer to my noble friend Lord Cormack, we have no plans for that. In fact, the Australian system has not been absolutely perfect. There are still quite a lot of people who do not vote. It is not failsafe.

[Lord Harris of Haringey (Lab)]

My Lords, the Minister talked about the integrity of the voting system, and that is obviously something that we all want to see. Why, then, are the Government pressing ahead with boundary changes on an electoral register which they know is out of date given that so many extra people registered in time to participate in the European referendum? Would it not be better for the integrity of the voting system to use a register which is more current than the one they have chosen to use?