NHS: General Medical Practitioners

Lord Hunt of Kings Heath Excerpts

Monday 20th November 2023 Lords Chamber

[Lord Evans of Rainow (Con)]

The right reverend Prelate the Bishop of St Albans asks an important question but the recovery plan introduced new measures to support international medical students, who make up more than half of all doctors in GP training, so if we were to stop those students coming over we would be in real trouble ourselves. On his wider point he is absolutely right, but it is not just GPs and doctors; it is also healthcare professionals in social services and elsewhere.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I declare an interest as a member of the GMC. On the increase in training places in medical schools, which is of course very welcome, does the Minister agree that this will not come off unless we increase the number of people training the GPs? Will he arrange for discussions between himself, the GMC, medical schools and NHS England to ensure that we get enough people to come in as trainers to enable even the modest workforce projections that are in the plan for medical schools to be put into action?

[Lord Evans of Rainow (Con)]

I absolutely agree with the noble Lord. If he is inviting me to do something with that, I will certainly take it back to the department based on his question.

Levelling-up and Regeneration Bill

Lord Hunt of Kings Heath Excerpts

Consideration of Commons amendments
Monday 23rd October 2023 Lords Chamber

[Earl Howe (Con)]

The House will have heard the noble Baroness’s comments, but I draw the distinction between the roles of the two kinds of committee.

Incidentally, the amendment would open up the possibility of councils moving to an entirely remote model of council meetings—something that noble Lords perhaps should ask themselves whether they would favour. My noble friend will doubtless have noted that the Government’s majority in the other place when the amendment was put to the vote was very substantial.

[Lord Hunt of Kings Heath (Lab)]

My Lords, how far would the noble Earl take this principle in relation to public bodies? I am a member of the GMC. We meet half in person and half remotely. Many other national bodies, some in receipt of government funding and others independent like the GMC, operate in the same way. Would his department say that the principle he is enunciating should be extended throughout the public sector? If not, why not? I do not understand the logic of the Government’s position.

[Earl Howe (Con)]

My Lords, we have been over this issue almost ad infinitum in Committee. We are not in Committee anymore; we are at Lords consideration of Commons amendments. I hope the noble Lord would agree that we are past the stage of arguing the niceties in the way he invites me to do.

Finally, in his Motion ZE1, the noble Lord, Lord Bach, seeks to insist on his original amendment. I can only reiterate the points in my opening that PCC powers would transfer to an elected mayor only after that individual has become democratically accountable at a local level. The example he sought to cite as a fait accompli is nothing of the kind, for the simple reason that there needs to be an election before the Mayor of the West Midlands could hope to become a PCC. If the transfer is to happen in the West Midlands, the mayor could exercise the PCC functions only if elected to do so at the next election, so there is no compromise of the democratic mandate of the elected mayor to exercise the functions. The choice of who would exercise the PCC functions in the West Midlands would remain in the hands of the people of the West Midlands if the transfer were to happen.

Commencement at Royal Assent enables the Government to adhere as closely as they can to the Gould principle of electoral management, whereby any changes to elections should aim to be made with at least six months’ notice. As the noble Lord knows, the Government wish these provisions to have legal effect in time for the local elections in May next year. His amendment would frustrate that policy intention. I hope he will forgive my pointing it out, but doubtless he will have noticed that the Government’s majority on this issue in the other place was very substantial: 153. I hope that on reflection he will be content to accept the assurances I have given and will not move his amendment in lieu.

Levelling-up and Regeneration Bill

Lord Hunt of Kings Heath Excerpts

Committee stage
Wednesday 22nd March 2023 Lords Chamber

[Baroness Stuart of Edgbaston (CB)]

My Lords, this amendment adds a new clause after Clause 77 and amends Section 67 of the Local Democracy, Economic Development and Construction Act 2009. It deals with constitutional arrangements of statutory bodies consequential on electoral changes. In essence, it provides for an order to be made to alter the constitutional arrangements of a statutory body if required as a consequence of an electoral change, and the order can be made under the Local Democracy, Economic Development and Construction Act 2009. The important thing is that the statutory body itself would be able to make such an order.

I will briefly give some illustrative explanation as to why this is required. The amendment deals with an old constitutional anomaly that can arise when boundaries are redrawn following Electoral Commission reports. One such example is the case of local ward boundary changes for Malvern Hills District Council and the consequential impact on the Malvern Hills Trust, which has elected conservators and is charged with protecting and managing the Malvern Hills and the surrounding commons. The Boundary Commission has changed the Malvern Hills District Council ward boundaries. As a result we will have two wards, with some residents who can vote for conservators and pay the levy while others cannot. This is not an ideal situation, and will probably be subject to judicial review and legal challenge for the returning officer as a consequence. This amendment would allow for the changes to be brought about by the Malvern Hills Trust, and it would bring its boundaries in line with the district lines.

In moving this amendment, I declare an interest: I am a resident of Malvern Hills District Council, and my late father-in-law was a Malvern Hills conservator.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I support the noble Baroness. The Malvern Hills are of course an outstanding place of beauty in the West Midlands, and it is important that the trust is allowed to do its job as effectively as possible. This is yet another example of the way in which the Boundary Commission has been forced do its work, because of the constraints put upon it, where it goes across natural boundaries. In the case that the noble Baroness raised, the management of the Malvern Hills Trust is vital. It is also clearly important that residents have confidence in the arrangements of the trust and in the fairness of any levies they may have to pay. I hope that the Minister may be prepared to take a look at this and possibly come back on Report with a sympathetic response.

[Baroness Pinnock (LD)]

My Lords, I am grateful. The problem has a wider resonance than the Malvern Hills Trust, although that is important. Coterminosity of local government and parliamentary boundaries is important, as is coterminosity of local government and National Health Service boundaries and, in this case, of the integrated care boards. If the Minister has any influence in other government departments, I ask her to impress on them the significance of residents who may be split between integrated care boards, like residents where I live in the Kirklees district of West Yorkshire, who are now being moved into a new Wakefield parliamentary constituency. This creates more problems than we sometimes recognise. Coterminosity and looking at the local implications of the lines we draw on a map are important and ought to be done only following detailed consultation with local people.

[The Parliamentary Under-Secretary of State, Department for Levelling Up, Housing & Communities (Baroness Scott of Bybrook) (Con)]

My Lords, Amendments 178C and 509ZA, tabled by the noble Baroness, Lady Stuart of Edgbaston, seek to enable any statutory body to amend by order its constitutional arrangements consequential on an electoral changes order made under Part 3 of the Local Democracy, Economic Development and Construction Act 2009. That legislation enables the Local Government Boundary Commission for England to implement by order recommendations for changes to an area’s electoral arrangements.

I am aware of the specific case at the moment where such a statutory body, the Malvern Hills Trust, considers that the new warding arrangements established by an electoral review order in respect of Malvern Hills District Council is incompatible with its constitutional and governance arrangements as provided for in several private Acts dating back to 1884. It is understandably concerned that such changes might raise questions about the ongoing legality of its constitutional and governance arrangements, and it wishes for something that it can address itself in a timely way.

I fully understand why the Malvern Hills Trust might wish to be granted powers to alter the constitutional or governance arrangements to ensure that they remain lawful and relevant to changing circumstances. However, I regret that we cannot support the amendments to the Bill. While they have the intention to resolve a specific local constitutional issue, the amendments are of general application to any statutory body affected by an electoral review carried out under Part 3 of the 2009 Act. In a practical sense, it is difficult for us to estimate how many bodies may be affected and wish to pass orders of this sort, or the impact on parliamentary time in dealing with them.

As drafted, the amendments would allow for secondary legislation to make amendments to primary legislation using the negative resolution procedure—the lower level of parliamentary scrutiny—and we do not think that this is appropriate. If the amendments were redrafted so that the orders were subject to the affirmative procedure, the potential would remain for significant impact on parliamentary business and on getting vital government business done.

More fundamentally, we cannot accept that it is right or prudent for the Bill to contain provision to allow for non-governmental bodies to be able to make orders that would amend primary legislation, as is the intention of the amendments. That must rightly be the role of government Ministers, except in exceptional circumstances, as with the Local Government Boundary Commission for England.

The commission is a parliamentary body accountable to the Speaker’s Committee. Such powers are appropriate in the case of the commission, given its status and vital independent role in ensuring fairness and confidence in the local government electoral system. Even if the scope of the amendment were narrowed so that any order could be made only by the Secretary of State, I am afraid that we could not accept it. While I understand that the purpose is to have a provision of general application, the concept used of the statutory body seems to be unclear. For example, does the definition of a statutory body include a local authority? On the face of it, this seems to be the case. If this is so, introducing this new provision would potentially create—

[Lord Hunt of Kings Heath (Lab)]

My Lords, I understand the Minister’s response, which seems to come in heavy on what is a pretty small objective. If it is difficult to do in this way, what could her department do to sort it out?

[Baroness Scott of Bybrook (Con)]

If the noble Lord can wait one minute, I shall say what the Government are prepared to do.

For all these reasons, I ask the noble Baroness to withdraw her amendment—but the Government have been talking to senior officials of the trust to understand the issues that they face as a result of the electoral changes order. We have discussed various options that they can pursue, which include the Charity Commission making a scheme under Section 73 of the Charities Act 2011 and for the trust itself to pursue a private Bill to make the amendments that it thinks necessary. We are also exploring whether the Secretary of State has the vires to make an order in consequence of an electoral changes order, to amend or modify primary legislation, such as the Malvern Hills Act 1924. So we are working with the group. In realisation of that, I hope that the noble Baroness will withdraw her amendment.

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[Baroness Taylor of Stevenage (Lab)]

My Lords, I will speak next as I have an amendment in this group. I thank the noble Lord, Lord Ravensdale, for his excellent speech on his amendments and for meeting with me and the noble Baroness, Lady Hayman, to discuss the Bill. I was pleased that he mentioned Peers for the Planet; I am not yet a member of that group but I will be a very enthusiastic joiner. The noble Baroness, Lady Hayman, has greatly encouraged me in that respect.

The noble Lord, Lord Ravensdale, spoke about giving local authorities the tools that they need. That is also an important part of my Amendment 179A in this group, which I will speak to. The noble Lord, Lord Ravensdale, referred to the Skidmore review and the Climate Change Committee’s work—which are both crucial to his and my amendments in this group—and to having a net-zero test running through the planning system. That is absolutely crucial, and now is the opportunity to do just that.

We have spoken before about the fact that there are some key strategic omissions from the Bill. Ensuring that climate change is fundamentally enshrined in law in the planning process is one of the most critical. My amendment is designed to address this too, by including it as one of the key purposes of the planning process. Over 80% of councils have now declared a climate emergency, with a pledge to net zero sitting alongside that, so surely it is time that the Government and legislation caught up and helped provide the tools to do that. The amendments in this group are designed to set out: first, an overall purpose for the planning process; secondly, to make absolutely sure that that includes the sustainability of all development; and, thirdly, to ensure that every individual development proposal is assessed to ensure that it is part of the solution to climate change, not adding to the problem.

As far back as November 2021, the Local Government Association commissioned a wide-ranging report to show how critical the local contribution to climate change could be. There are many important contributions recorded in that report, including one from Richard Blyth, head of policy at the Royal Town Planning Institute, who said:

“Collectively local activity and investment (for example on housing, infrastructure, water management) will only contribute positively to the ambition to leave the environment in a better state if there is a shared spatial framework for improving local environments”.


He pointed out that the Environment Act could take this only so far, but some of the measures it contained risked adding to the piecemeal landscape of environmental plans without clear directions for economic decision-making. The noble Lord, Lord Ravensdale, referred to the piecemeal approach that results from some of the provisions in the Environment Act. The only way of ensuring that a holistic approach is taken to environmental issues is to ensure that all the relevant issues are built into local plans and considered for each development, whether that is water, flooding, soil, air quality, transport, access to open spaces, biodiversity, energy, waste or the whole-life carbon impact of buildings. These should all be part of the consideration of planning.

Net zero can be achieved only if decarbonisation happens in every place, everywhere across the country. These amendments would incorporate in the Bill plans for an overarching clause that would do just that. At the moment, if the overarching framework of the national management development plan, whatever it contains in relation to net zero—I am probably not the only one in this Committee who fears that this will be nowhere near ambitious enough in response to the climate emergency—does not have a corresponding network of local plans setting out clearly how development will take a radically new and ambitious approach to this, we will, I fear, continue to move at the current snail’s pace.

Local plans also need to reflect the needs of mitigation of climate change. In a paper from the University of Strathclyde by Dr Hawker and Dr Wade, they say:

“In particular, local planning decisions around land use and infrastructure must be made with acknowledgement of their implications for living with climate change. For example, increasing green spaces can support drainage in urban areas, helping to alleviate future flood risks”.


We have seen some magnificent examples in recent years—for example, pocket parks in high streets, which help with flooding issues—but they are by no means common enough yet. Local authorities often hold large building portfolios, including social housing. If they can be supported with long-term future funding, they can take action now to ensure that properties are energy efficient and much more cost effective for residents.

At Second Reading in the other place, the Secretary of State’s contention was that proposals in the Bill would strengthen environmental protection. He explained that a National Planning Policy Framework document would be published in July—that is July last year—setting out how environmental outcomes were to be driven. As far as I know, that document has not yet been published by the department. So, while we await specific policies on specific aspects of tackling environmental outcomes, fundamentally writing climate change into both development planning and mitigation measures for the planning system of the future is the only way of ensuring that they reach every part of the UK. If we do not do so in this Bill, we will have missed a huge opportunity to align the planning system with the climate change goals that should be right at its heart.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I have added my name to Amendments 179 and 271 from the noble Lord, Lord Ravensdale. I thank him very much for bringing them to your Lordships’ Committee. I will make three quick points.

First, I do not understand why the Government are not using this Bill as a vehicle to embed the approaches that they have signed up to on net zero and climate change targets more generally. Surely this is the ideal legislation to ensure that our planning system supports what the Government say they wish to do.

Secondly, the noble Lord quite rightly mentioned the Skidmore review, which is very telling, and we have also heard from the Climate Change Committee. However, the National Audit Office’s report should not be ignored. It said that

“there are serious weaknesses in central government’s approach to working with local authorities on decarbonisation, stemming from a lack of clarity over local authorities’ overall roles, piecemeal funding, and diffuse accountabilities”.

The Government need to listen to the National Audit Office, because that is based on its expertise in monitoring and evaluating what local authorities are doing and the confrontations they are having on some of these issues due to flaws in the current local planning system and arrangements.

Thirdly, my background is mainly in health, and there is no doubt that unlocking economic growth through planning reform, as was highlighted in the net zero review, could achieve real health benefits by fully aligning our planning system with climate change and nature targets. The point has been made by the UK Health Alliance on Climate Change, which says that a healthy neighbourhood can also be a powerful levelling-up tool, leading to better mental and physical health and well-being outcomes through active travel, social connectivity and access to green spaces. Statistics published by the UN only a few days ago show that life expectancy in this country has deteriorated dramatically in comparison with many other countries since the 1950s. We were then one of the top countries for life expectancy; now we are in danger of dropping out of the top 30.

There is such a persuasive argument for tying in strong public preventive health with what must be done on climate change and net zero. Surely the planning system is one of the most powerful levers that we can use to make it happen. I hope we will come back to this very important matter on Report.

Higher Education (Freedom of Speech) Bill

Lord Hunt of Kings Heath Excerpts

Report stage
Wednesday 7th December 2022 Lords Chamber

[Lord Patten of Barnes (Con)]

I will add to the comments of the noble Baroness, and declare an interest as the chancellor of a moderately well-known university.

A university does not need legal advice in this case to defend freedom of research or expression; all it has to do is stop its subscription to the QAA—the Quality Assurance Agency for Higher Education—which only recently produced advice on the curriculum which was like a parody of an article in the Daily Mail. Among other things, it included the decolonisation of not just music—I entirely endorse what the noble Baroness has just said—but the maths curriculum. Clearly, the people who wrote it had never heard of Arabs, Indians or the Mayan civilisation, which was doing advanced mathematics before Christopher Columbus arrived. All that any university has to do is what Oxford has done—withdraw its subscription to the QAA, which is now pretty well on its last legs anyway. I regard the QAA’s advice to universities as in many respects the most dangerous assault in the last few years on freedom of expression and research at universities. It is crazy time—it is critical race theory canonised. Universities should denounce it with great enthusiasm.

[Lord Hunt of Kings Heath (Lab)]

My Lords, the noble Lord raises a very important point, but is it not the case that many public institutions—including, I am afraid, this House in the past—have signed up to various highly controversial charters and indexes which require a standard of behaviour from the people covered by those institutions? At a national level, many of these bodies are cowed by aggressive minority interests into establishing and setting out these programmes.

For an individual employee working in those situations, it can be very intimidating to say, “I don’t agree with the Stonewall equality index and don’t see why my institution has signed up to it”. I am glad to say that this House, after a lot of pressure and with weasel words, eventually decided not to continue its membership, but many other organisations vie to have a high rating from it. That leads to behaviour and conditions in which it can be very intimidating for individuals who do not agree with the view taken. This is what this issue is really about and why it is so important. I hope the Minister will be very forthright in response.

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Moved by

[Lord Hunt of Kings Heath]

11: Clause 1, page 3, line 13, after “activity,” insert “including measures to be taken to ensure that a person is not prevented from speaking by attempts to drown out or silence a speaker,”
Member’s explanatory statement
This amendment, which relates to the code of practice to be maintained by governing bodies, is designed to ensure that in their duty to take steps to secure freedom of speech the code of practice must cover measures to be taken to ensure that a person is not prevented from speaking by attempts to drown out or silence a speaker.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I will move Amendment 11 and speak to Amendments 15 and 25, alongside my noble friend Baroness Morris. I also want to speak in support of Amendment 16, being moved by my noble friend Lord Collins. We will shortly come to a very important debate on Clause 4. It seems to me, whatever the outcome of that debate, that at the end of the day and at the heart of the Bill, we are trying to encourage behaviour in our universities which will ensure the freedom of speech that noble Lords have spoken about. I think that it is the codes of practice that will have a pivotal role in ensuring that, backed up by whatever sanctions we eventually decide are necessary, whether we have Clause 4 or not.

I will focus on the codes of practice that each university—and each student union—has to agree to. The OfS is enabled to ensure that those codes of practice are acceptable within the terms of its overseeing of university registration and that they are appropriate to each student union as well. The OfS has a responsibility in the Bill—I think it is a very good responsibility—to publish good-practice advice. I see this as a wholly constructive approach, encouraging the best behaviour you can expect within those institutions.

The concern that my noble friend and I raised in Committee was the extent to which academics and speakers can expect protection in the face of action that is designed to intimidate them and prevent them speaking. We know from the experience of a number of academics—in particular women academics—that such intimidatory action can take the form of open letters demanding that an academic be sacked, vexatious complaints, petitions to publishers demanding that work be withdrawn, campaigns of defamation, smears, demands to prevent an academic being platformed, attempts to prevent events going ahead by threatening trouble if they do, and disrupting events that do go ahead. As I said, the targets of these tactics typically are women academics.

I say to the noble Lord, Lord Wallace of Saltaire, whom I respect enormously, “Where have you been?”, when there has been such trouble for some academics on many of our campuses. We cannot sweep that under the carpet; it is a reality. Professor Kathleen Stock suffered horrific abuse and her university completely failed to defend her until almost the last moment. That was a graphic demonstration of why this legislation in the end is required.

I was very grateful to the noble Earl, Lord Howe, for meeting us to discuss this. What he essentially said, if I may paraphrase it, is that the Bill will protect the right of speakers to put forward controversial or unpopular ideas, and that it will also protect the right of those who do not agree with them to speak up. I absolutely agree with that. But it should not mean that higher education institutes should simply stand passively by while, for instance, hecklers attempt to disrupt planned events that are lawful.

I have seen it argued that such attempts to silence speakers are themselves a form of free speech. But I think that that confuses the right to protest with the right to silence others. Speech that is intended merely to silence the speech of others, far from contributing to knowledge and learning, surely narrows the scope of the educational sphere.

The amendments we have put forward try to make it explicit that the codes of practice of universities and student unions must cover the measures that must be taken to ensure that a person is not prevented from speaking by attempts to drown them out or silence them. They have become known as the “hecklers’ amendments”.

I would like some assurance from the noble Earl that the OfS in its responsibility for the continued registration of universities and in its oversight and monitoring of student unions will give its attention to this matter and that it understands that the issue will be very important to the success of the Bill. I beg to move.

[Baroness Morris of Yardley (Lab)]

My Lords, I rise briefly to support this amendment, to which I have added my name. I will try not to repeat everything that my noble friend Lord Hunt said but will emphasise some of his points.

I too was grateful for the meeting with the Minister. It was very helpful, and I think there was a great understanding of our view and of the problems the Government are having with putting this into legislation. I completely accept that the law has to protect both those who wish to express a view and those who wish to express a contrary view. In some ways, as my noble friend said, this is a “hecklers’ amendment”, but we are old enough both to have done some heckling and to have been the subject of heckling in past years. However, most of the time I was heckling or being heckled, it was not with the intent of stopping somebody else being heard; that is the crucial point.

Universities should be places where there is freedom to put forward a view and freedom to oppose it. I would never want a law of silence, where somebody’s view has to be listened to in silence. If there is an intention to make sure that the opposite point of view, which is legally held, is not heard, that is not the purpose of universities in this country. It never has been and it never should be. There are too many examples of that border being crossed.

Professor Stock has received a lot of publicity and rightly so—she felt obliged to lose her job. However, I have worked with academics who express an interest in sex and gender, and maintain the view that sex is a biological thing and that that should govern the law, and their lives have been made a misery. It is a long time since I have been to a university and talked to academics expressing that view when they have not told stories about it being miserable to be an academic because there is not the environment in which they can openly express their views. They are not people who want to impose an alternative point of view; the idea of putting forward a view is to engage in debate, not to make others say, “Yes, you’re right. Let’s move on.” Engaging in debate is at threat.

I can see that it is difficult to put that into law. It would be impossible; we would be here all day. I hope that putting this into the code of practice gives a clear message to the leaders of our universities that they have to take action, because, quite frankly, some vice-chancellors have not been doing their job on this. They have hidden quietly for too long and not stood up to protect their academic colleagues when they should have done. If that message can go forward in the code of practice, we might begin to reverse this tide.

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[Baroness Barran (Con)]

My Lords, I will address this group of amendments relating to codes of practice and the guidance under the Bill. I thank all noble Lords for their thoughtful and considered remarks.

Amendments 11 and 15 tabled in the name of the noble Lord, Lord Hunt of Kings Heath, would require higher education providers, colleges and student unions to include in their codes of practice specific measures

“to ensure that a person is not prevented from speaking by attempts to drown out or silence a speaker”.

Amendment 25 would require the Office for Students to include in any guidance it issues under new Section 69A, in Clause 5 of the Bill, guidance on such measures.

The purpose of the Bill is to protect freedom of speech within the law. As part of that freedom, individuals have the freedom to speak on topics of their choice, as well as to engage in peaceful protest against such speech, as the noble Lord clearly stated. These aspects of freedom of speech both need to be protected. The Bill does not give priority to one individual over another. This means that providers, colleges and student unions must take “reasonably practicable” steps to ensure that speakers who are speaking within the law, as well as those who wish to protest in disagreement with those views, are able to speak—and are not, in the noble Lord’s words, forced to stand by passively.

I should be clear that the Bill means protest in the form of speech, writing or images, including in electronic form. It does not include, for example, tying oneself to a railing or blocking a street—activities that are not speech and therefore not covered by this legislation, but are clearly covered by other legislation.

I reassure your Lordships that we expect event organisers to plan for what to do in the event of disruptive protests. The duty to take “reasonably practicable” steps does not mean that such disruption has to be tolerated. In fact, the duty to take such steps, as regards the speaker at the event, means that action should be taken to deal with such disruption. That might mean that security should be provided or that a protest outside a venue should be set back sufficiently from the windows.

The codes of practice are already required under the Bill to set out “the conduct required” of staff and students in connection with any meeting or activity on the premises. I hope that addresses the question from the noble Lord, Lord Triesman, about whether this applies to individuals. These amendments are not necessary as the issue is already covered by the Bill.

Equally, we expect the OfS to consider these practical issues and to provide advice about how providers, colleges and student unions can fulfil their duties, as well as share best practice that they identify—again, a point raised by the noble Lord, Lord Hunt of Kings Heath.

I trust that your Lordships are reassured by what I have said about how the Bill will operate and will agree that these amendments are not needed.

Amendment 16 tabled by the noble Lord, Lord Collins of Highbury, seeks to ensure that clear guidance is issued by the Secretary of State within three months of the passing of the Bill to help student unions to comply with their new duties. The publication of guidance for student unions is already covered by the Bill. Section 75 of the Higher Education and Research Act 2017 is amended by paragraph 9 of the Schedule to the Bill. Section 75, as amended, will provide that the regulatory framework which the Office for Students is required to publish must in future include

“guidance for students’ unions to which sections A5 and A6 apply on their duties under those sections”.

This must include

“guidance for the purpose of helping to determine whether or not students’ unions are complying with their duties under sections A5 and A6”.

The guidance may in particular specify what the OfS considers that student unions need to do to comply with those duties under new Sections A5 and A6, and the factors which the OfS will take into account in determining whether a student union is complying with its duties. It is worth noting that Section 75 requires consultation on the regulatory framework before its publication, and it must therefore be laid before Parliament, giving proper transparency.

In the new regulatory regime that the Bill will establish, including under Section 75, it would be wrong for separate guidance to be published by the Secretary of State rather than the regulator—the OfS. It would also, in practical terms, be too tight a timescale to require publication within three months of Royal Assent. There will be a great deal of work to be done on implementation, including setting up a complaints scheme team, drafting the new complaint scheme rules, drafting guidance, consulting on the changes to the regulatory framework and making those regulations; as your Lordships know, that will take time.

I hope my explanation has satisfied the concerns of the noble Lord and that the House will agree that the Bill deals with these issues appropriately as it stands.

[Lord Hunt of Kings Heath (Lab)]

My Lords, that has been a very helpful debate and I thank all noble Lords who have taken part. My noble friend Lady Morris suggested that some of us might have taken part in heckling in the past. I have to confess that I took part in one of the first university sit-ins at Leeds University in 1968, when—led by one Jack Straw, who was then president of the Leeds University union—we heckled Mr Patrick Wall, an MP at the time.

The noble Lord, Lord Grabiner, made a very important point about drawing the distinction between quite legitimate heckling and the kind of intimidatory action that we saw taking place in relation to a number of women academics. The noble Lord, Lord Macdonald, is absolutely right: I agree that there are elements of criminal behaviour. The problem is that universities were very weak. I really regret that the Bill has been necessary, but I am afraid that the lack of backbone shown by so many university leaders is why we are here today.

I agree with noble Lords that this is not a matter for primary legislation. Indeed, I am not quite sure how you would ever draft anything like it. We tried in Committee but I think one has to accept that it is not possible. The codes of practice and the oversight of OfS, though, are clearly crucial to the success of this legislation, so this has been a very good debate.

In relation to Amendment 16, I very much hope that the OfS will take note that any guidance it issues needs to be fully understandable by students within the student union. Having said that, I beg leave to withdraw my amendment.

Amendment 11 withdrawn.

COP 27

Lord Hunt of Kings Heath Excerpts

Tuesday 15th November 2022 Lords Chamber

[Lord True (Con)]

Again, my Lords, the Government say—it is not always popular—that we are in the period of transition and we need to be flexible and adaptable. I am not commenting on any specific schemes or proposals. Obviously, our intention is to do the very best we can to secure resilience and a greater degree of independence at home. The noble Lord is absolutely right to say that with that comes jobs. I believe that there are already some 430,000 jobs in low-carbon businesses and their supply chains across the country, which is not widely enough recognised outside your Lordships’ House. Since November 2020, nearly 68,000 green jobs across the UK economy have materialised or been supported or secured for the future by government policy. However, there is a balance, and as I said in response to an earlier question, we are reflecting on the broad spectrum of energy need at this time, particularly given the tragic situation with the Russian aggression in Ukraine.

[Lord Hunt of Kings Heath (Lab)]

My Lords, may I come back to the issue of nuclear power stations? The Minister was a mite critical of the last Labour Government. He will remember that in 2008, the decision was made to go back to new nuclear. Since then, progress has been agonisingly slow because of the lack of funding, and we have only Hinkley Point in development. Can I take it from the Statement—the Prime Minister has emphasised the importance of building new nuclear power stations—that not only must Sizewell C go ahead, as the noble Lord has said, but we must have a very big sustainable programme of new nuclear development?

[Lord True (Con)]

Again, I am sorry if I was mildly critical of the last Labour Government. When I hear my Prime Minister being criticised for going to COP 27, I might note that Mr Blair did not once go to COP during his period as Prime Minister. The noble Lord must not tempt me to stray into these party matters; he was a bit guilty of that.

A fundamental point that your Lordships are making to me, and which I want to take away, is that whatever happened in the past, we have to work together across your Lordships’ House—and as broadly as possible, I hope, cross-party—to ensure clean, safe secure energy for all in the future. That is our intention, and we have committed up to £1.7 billion to enable one nuclear project this Parliament, with £700 million available for Sizewell C to provide clean, reliable energy to homes. Nuclear energy is part of the equation, and I am sure that further announcements will come on that front.

Higher Education (Freedom of Speech) Bill

Lord Hunt of Kings Heath Excerpts

Committee stage
Monday 31st October 2022 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, it is a great pleasure to follow the noble Lord. In this very short but interesting debate we have already seen the problem that the Government are essentially seeking to address—a failure of leadership in many of our universities—through legislation that, given the amendments we have seen today, I suggest will be very hard to implement.

I remain unconvinced that this is the right way to tackle what is undoubtedly a problem in our universities. I first came across this when meeting Professor Kathleen Stock, who was subjected to horrific abuse in her own university for simply saying that your biological sex cannot be changed by feelings of identity, which I think are quite unexceptional and certainly legal remarks. Many other women academics in universities have felt threatened and censored for the simple act of trying to engage in these kinds of debates, particularly in relation to women’s sex-based rights. Unfortunately, many universities have allowed abusive behaviour to go unchallenged.

It seems to me that, at the heart of it, there is a question as to whether, even at this late stage, we can look to universities to put their house in order. I think that that would be a much more appropriate way forward than seeking to implement what I am convinced will be wildly impractical legislation. Already, our very civilised debate over what we mean by free speech suggests that this will be a huge problem when it comes to implementation.

The recent survey by the Higher Education Policy Institute showed a distinct shift in attitude by students, who it says

“have a very different conception of academic freedom and free speech norms than earlier generations”.

It suggests that these may have

“swung too far in one direction, with relatively few students recognising the unavoidable trade-offs involved with ever-greater restrictions on legal free speech.”

HEPI has come up with a list of things that it thinks universities might take forward, which seem very sensible to me. They include:

“reassessing formal procedures, such as existing codes of practice … ensuring consistent good practice, such as balancing controversial speakers with others … giving students improved information on academic norms, including in freshers’ weeks”.

I still think it might be better if the OfS, HEPI and the universities were allowed to work this through together. I suggest to the Minister that, if I were him, I would delay the date on which the Bill came into force to give universities time to try to change the culture and atmosphere within universities. This would be a much more practical and effective way of going forward.

However, if the Government are determined to press ahead, they clearly need to answer a lot of questions about the practical implementation of what they are proposing and the guidance to be given to universities. This is the reason for my Amendment 25. The question is how far intimidatory tactics against people speaking in universities are to be allowed under this legislation. We have seen intimidatory tactics. They can take a range of forms, including open letters demanding that an academic should be sacked for what they have said, vexatious complaints, petitions to publishers demanding that work be withdrawn, campaigns of defamation and smears, demands to prevent an academic being platformed, attempts to prevent events going ahead by threatening trouble if they do, and disrupting events that do go ahead. The targets of these tactics are typically women who believe that sex matters and have the courage to say so.

One possible response to these kinds of attacks is to frame the attempt to silence as itself a form of free speech, but this confuses the right to protest with a right to silence others. Speech that is merely intended to silence the speech of others, far from contributing to knowledge and learning, narrows the scope of the educational sphere. I argue that to frame attempts to silence as equally valid speech ignores the educational purpose of the university.

The amendment would explicitly exclude attempts to silence the speech of others from the scope of the core “secure” duty in the Bill and would require universities to take positive steps to mitigate the effects of those exercising what has been described as the “heckler’s veto” without disproportionately affecting the right to lawful protest. It would also clarify that the use of what I have described as the heckler’s veto to silence legitimate debate and dampen academic freedom on campus is not in itself protected speech.

This is a probing amendment because I want to hear what the Government have to say about our concept of free speech, how far it goes and what is to be done with intimidatory tactics. However, I am still left with the sense that the Bill as it stands is unworkable and will be an absolute nightmare for universities to implement. If only universities had shown leadership in the last few years this would not have been necessary.

Health and Care Bill

Lord Hunt of Kings Heath Excerpts

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

Moved by

[Lord Hunt of Kings Heath]

162: After Clause 164, insert the following new Clause—
“Appropriate consent to transplantation activities when travelling abroad
(1) Section 32 of the Human Tissue Act 2004 (prohibition of commercial dealings in human material for transplantation) is amended in accordance with subsections (2) to (6).(2) In subsection (1), after paragraph (e) insert—“(f) travels outside the United Kingdom to a country or part of a country where explicit consent is not required for the legal donation of controlled material which does not meet the criteria in subsection (1A)(a) to (c) and receives any controlled material, for the purpose of transplantation, without—(i) the free, informed and specific consent of a living donor, or(ii) the free, informed and specific consent of the donor’s next of kin, where the donor is unable to provide consent;(g) travels outside the United Kingdom to a country or part of a country where explicit consent is required for the legal donation of controlled material and receives any controlled material for the purpose of transplantation where the material was obtained without—(i) the free, informed and specific consent of a living donor, or(ii) the free, informed and specific consent of the donor’s next of kin, where the donor is unable to provide consent;(h) travels outside the United Kingdom to a country or part of a country and receives any controlled material for the purpose of transplantation for which, in exchange for the removal of controlled material—(i) the living donor, or a third party, receives a financial gain or comparable advantage, or(ii) where the controlled material comes from a deceased donor, a third party receives financial gain or comparable advantage.”(3) After subsection (1) insert—“(1A) The Secretary of State must publish an annual assessment of countries where, explicit consent is not required for the legal donation of controlled material, determining whether each of those countries—(a) provides a formal, publicly funded scheme for opting out of deemed consent for donation of controlled material,(b) provides an effective programme of public education to its population on the deemed consent system and the opt-out scheme which delivers a high level of public understanding of both, and(c) is not considered to be committing Genocide by resolution of the House of Commons.(1B) In paragraph (h) in subsection (1), the expression “financial gain or comparable advantage” does not include compensation for loss of earnings and any other justifiable expenses caused by the removal or by the related medical examinations, or compensation in case of damage which is not inherent to the removal of controlled material.(1C) Subsection (1E) applies if—(a) an act which forms part of an offence under subsection (1) takes place outside the United Kingdom, but(b) the person committing the act has a close connection with the United Kingdom.(1D) For the purposes of subsection (1C)(b), a person has a close connection with the United Kingdom if, and only if, the person was one of the following at the time the acts or omissions concerned were done or made—(a) a British citizen;(b) a British overseas territories citizen;(c) a British National (Overseas);(d) a British Overseas citizen;(e) a person who under the British Nationality Act 1981 was a British subject;(f) a British protected person within the meaning of that Act;(g) an individual ordinarily resident in the United Kingdom;(h) a body incorporated under the law of any part of the United Kingdom;(i) a Scottish partnership.(1E) Where this subsection applies, proceedings for the offence may be taken in any criminal court in England and Wales or Northern Ireland.”(4) In subsection (3), after “subsection (1)” insert “(a) to (e)”.(5) In subsection (4), after “subsection (1)” insert “(a) to (e)”.(6) After subsection (4) insert—“(4A) A person guilty of an offence under subsection (1)(f) to (h) shall be liable—(a) on summary conviction—(i) to imprisonment for a term not exceeding 12 months,(ii) to a fine not exceeding the statutory maximum, or(iii) to both;(b) on conviction on indictment—(i) to imprisonment for a term not exceeding 9 years,(ii) to a fine, or(iii) to both.”(7) In section 34 of the Human Tissue Act 2004 (information about transplant operations), after subsection (2) insert—“(2A) Regulations under subsection (1) must require specified persons to—(a) keep patient identifiable records for all instances of UK citizens who have received transplant procedures performed outside the United Kingdom; and(b) report instances of transplant procedures performed on UK citizens outside the United Kingdom to NHS Blood and Transplant.(2B) Regulations under subsection (1) must require NHS Blood and Transplant to produce an annual report on instances of UK citizens receiving transplant procedures outside the United Kingdom.””Member’s explanatory statement
The amendment is aimed at ensuring that in relation to organ tourism, there must be informed consent with no coercion or financial gain for the donation of organs. Thus prohibiting organ tourism which involves either forced organ harvesting or black market organ trafficking.

[Lord Hunt of Kings Heath (Lab)]

My Lords, this was debated two weeks ago, but I know that the noble Earl, Lord Howe, wishes to say a few brief words to your Lordships’ House. With the permission of the House, I will say very briefly, without seeking to open the debate, what the amendment does. It is to amend the Human Tissue Act to prohibit UK citizens from travelling to countries such as China, although the wording in the amendment is not country-specific, for the purpose of organ transplantation. The restrictions are based on ensuring that there is appropriate consent, no coercion and no financial gain.

Forced organ harvesting in China is the crime of forcibly extracting organs from prisoners of conscience, killing the victim in the process. The harvested organs are sold to Chinese officials, Chinese nationals or foreigners for transplantation. This is a very modest amendment, doing our bit to try to prevent this obnoxious habit. I beg to move.

[Earl Howe (Con)]

My Lords, I am very grateful to the noble Lord, Lord Hunt, for allowing me to say in a few sentences why the Government advise noble Lords not to support the amendment.

Reason number one is the effect on patients. In my submission, very sick patients who may be taken overseas for a transplant but are not fully made aware of how their organ was sourced should not have to face prosecution when they return to the UK. The existing legislation rightly targets those who buy and sell organs, not recipients who may have been quite unaware of any commercial dealing taking place. If we target the organ recipient, we will find that those who legitimately receive organs overseas—incidentally, individuals who are more likely to come from ethnic-minority backgrounds—will be deterred from seeking follow-up treatment for fear of being treated like a criminal suspect.

Reason number two is that the mischief the amendment seeks to address is dwarfed by the considerable burdens it would impose on the NHS. All the information indicates that we are dealing, at worst, with tiny numbers of illegal transplants performed overseas. The amendment would require officials, whose focus should be on promoting legitimate donation, to research and write a report every year on the status of every other deemed consent system in the world and on the public understanding of each scheme. That is not a drafting criticism but a necessary consequence of what the noble Lord seeks to achieve. In my view, it is an unreasonable ask and a hugely disproportionate use of resources.

To address the issue at first base, we will take forward the excellent suggestion from the noble Baroness, Lady Finlay, to work with NHS Blood and Transplant. My noble friend Lord Kamall has already instructed officials to engage with it on how we can help clinicians make their patients aware of the health risks, the risk that they may be exploiting others and the risk of breaking the law if they travel abroad in search of an illegitimate transplant. I truly think that is a better way forward, and I invite the noble Lord to change his mind about pressing his amendment.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I will not detain the House. It is time for the House to make a decision. I am very grateful to the Minister for picking up the point made by the noble Baroness, Lady Finlay, in relation to NHS Blood and Transplant. In the end, it may be a small gesture but it is an important gesture—a mark against this obnoxious habit. I would like to test the opinion of the House.

--- Later in debate ---

Moved by

[Lord Hunt of Kings Heath]

164: After Clause 164, insert the following new Clause—
“Vaccine damage payments
Within 6 months of the passing of this Act, the Secretary of State must establish an independent judge led review into the operation of the Vaccine Damage Payments Act 1979 and the adequacy of payments offered to persons seriously injured, or bereaved, consequent upon vaccination against any of the specified diseases to which the Act applies.”Member’s explanatory statement
The Vaccine Damage Payment Act is now more than 40 years old and the aim of the amendment is to ensure that a judge led review takes place into the operation of the Act.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am speaking to my Amendment 164 but I also strongly associate myself with Amendment 180 in the name of the noble Baroness, Lady Cumberlege.

In Committee, I raised concerns about a small number of individuals and families who have paid the highest personal price for the success of the Covid vaccination programme, suffering bereavement or serious injury as a direct consequence of adverse reactions to vaccination. We have the Vaccine Damage Payments Act 1979, which was intended to provide a safety net for such individuals by providing a modest ex-gratia payment to those injured or bereaved in recognition of the fact that their injuries and losses flowed directly from “doing the right thing” by having the vaccine for the benefit of society as a whole.

The scheme is 40 years old and no longer fit for purpose. The maximum payment is capped at £120,000, which is far too little to provide proper financial support for families who have maybe suffered the death of a main income earner. The current scheme also requires that all eligible applicants in the UK must meet what is called the 60% disablement criterion. This criterion is antiquated, counterproductive and unfair: many applicants could have significant injuries and may be disabled up to 59% and yet, on the basis of the current scheme, they would have no access to funds.

The current system takes far too long to provide the payment. The causal connection between certain injuries and Covid vaccination is now accepted, I believe, by clinicians and regulators. However, despite providing death certificates that identify Covid-19 as a cause of death and medical reports confirming Covid-19 as the cause of injury, the scheme still estimates that it will take more than six months to begin to process claims submitted under the scheme more than 12 months ago.

In Committee—I thank Ministers for another meeting yesterday to discuss this further—the noble Earl explained that responsibility for the operation of the scheme has transferred from the DWP to his department and the NHS Business Services Authority has taken over the operation of the scheme. This is very welcome and I am glad that it has happened. However, this is not an issue that will disappear any time soon—Covid is not an issue that is disappearing. Further vaccinations will come along and there will unfortunately be adverse effects for a very small group of people, in the interest of the greater good.

I believe that the scheme offers too little, too late, to too few and I have three asks of Ministers. First, I ask that Ministers and the NHS Business Services Authority engage with the families affected. It would be valuable if Ministers and senior executives at the NHS Business Services Authority were to meet some of the families. I know that Sarah Moore of Hausfeld will be happy to facilitate this, and I pay tribute to her. Secondly, I ask that everything that can be done is done to speed up the process of meeting claims. Thirdly, on behalf of the families and individuals, I ask the Government to consider undertaking a review of the scheme in the light of current experience and particularly look at the 60% criteria bar and the £120,000 limit which has not been updated for a number of years.

The vaccination programme has been a wonderful success both in this country and globally. It is very unfortunate that inevitably there will be a small group of people damaged in the process. I think we owe it to them to have a generous scheme. I beg to move.

[Baroness Cumberlege (Con)]

My Lords, my amendment is grouped with the amendment in the name of the noble Lord, Lord Hunt, whose persistence I admire concerning those who have suffered vaccine damage. My amendment is slightly different, but it is along the same lines in that it is about unintentional outcomes and redress for those who have suffered.

My amendment requires the Secretary of State to bring forward proposals for redress schemes to help those who have suffered avoidable harm linked to the three medical interventions that were examined in the report from the Independent Medicines and Medical Devices Safety Review, which I chaired. These are hormone pregnancy tests—the most common being Primodos—the epilepsy drug sodium valproate and pelvic mesh, which was used to treat stress urinary incontinence and pelvic organ prolapse.

I will be brief, but I make no apology for bringing this before your Lordships’ House again because the case for these schemes is so compelling. These are people who, through no fault of their own, have suffered terribly and had their lives changed for the worse and in some cases completely ruined—all because of mistakes, errors of judgment, oversights and a refusal to listen across the healthcare system. In each case—Primodos, valproate and mesh—harm could and should have been avoided. If that does not underline the moral and ethical case for providing some help, then I really do not know what does.

I believe that my noble friend the Minister and his colleagues are genuinely sympathetic to the plight of these women and their children, but I sense that they are hesitant. I urge them to overcome some of this reluctance and act now. The suffering is immense, it is continuing even today, and very sadly people are dying before they receive the help they need. I remind my noble friend that these redress schemes are not the same as compensation. We are not talking about large sums of money. We are talking only about modest funds to help with the challenges of daily life: to pay for mobility aids, a respite break, travel to hospital. This is help that they do not and cannot access at the moment from the NHS, social services or elsewhere.

In Scotland, the Government there have acted. A scheme was set up to provide help to women suffering from mesh complications. It is modest: it was given a £1 million budget and women had to apply to it to be eligible. But it was welcomed, and it has helped. That is the kind of help I have in mind. Sums of that scale are barely noticeable in the context of the hundreds of billions we spend on health and social care, yet these small sums would mean so much to so many.

Are there concerns that this might set a precedent and that before we know it dozens of other groups of people who have suffered will all want the same? I do not believe so. That has not happened in Scotland. Thalidomide did not lead to an avalanche of other groups requiring help. We have existing schemes to help others who have been harmed. If the Government really believe that compensation is the better way for these people to get help, they are mistaken. The fact is that many have tried to obtain compensation through the courts. It is time-consuming, costly, stressful, adversarial and, worst of all, it simply has not worked.

The three groups that Amendment 180 is designed to help are small in number—not millions of people, not hundreds of thousands. I do not believe that an unwelcome precedent would be set. I do not believe that these schemes would cost the earth. The cost would be modest and can be contained and managed. I believe the benefits will outweigh the cost and that we have a moral and ethical duty to help these people. They have suffered for years and in some cases for decades. Surely the measure of a decent society is how well it looks after those who have suffered harm, especially where that harm could and should have been avoided.

I have met hundreds of people who have suffered; even today I get a lot of emails, phone calls and letters. We have heard from many more people. I am clear that help is both needed and deserved. People should not be made to wait any longer. I hope that my noble friend the Minister will agree.

--- Later in debate ---

[Earl Howe (Con)]

My Lords, I will turn first, if I may, to the amendment in the name of the noble Lord, Lord Hunt of Kings Heath, on the Vaccine Damage Payment Scheme, and start by thanking him for his campaigning on this issue, and for the informative debates we have had today and in Committee.

As we discussed in Committee, since the NHS Business Services Authority took over responsibility for the Vaccine Damage Payment Scheme from the Department for Work and Pensions in November 2021, we have started to find ways to improve the operation of the scheme. The most important thing the NHS Business Services Authority is looking do to is to improve the claimant journey on the scheme, and that means making engagements with claimants more personalised, as well as giving claimants access to more general support. The crucial part of this drive is to reduce response times, which the authority knows has been a cause of dissatisfaction, particularly during Covid; in other words, the whole process is being modernised.

The NHS Business Services Authority has done its best to hit the ground running. Since taking over in November, it has already contacted all applicants to update them on their cases and it has also allocated additional resource to the operation of the scheme. I can assure the noble Lord that the department will further engage with the NHS Business Services Authority to ensure that these service improvements, greater digitisation in particular, really do make headway. There is already regular dialogue on this.

With all this enhanced activity happening, I do not think this is right time to establish an independent review into the VDPS. As the noble Lord will know, reviews take significant time and they carry substantial costs to the organisation, not just financial but in terms of leadership focus and energy. Instead, we think it is a better use of resources to focus on making the changes that we know need to happen; that is, to improve the claimant’s journey, and to modernise the process for claimants, as well as scaling up the capacity of the VDPS. We will keep the progress on these under regular scrutiny, and I am sure we will report regularly to this House as we do so.

I will address the noble Lord’s three key questions. First, I should be happy to facilitate a meeting with representatives of the families, and my honourable friend Maria Caulfield, who is the Minister with direct responsibility for the scheme, will be pleased to see them. Secondly, as I have already indicated, reducing response times is one of the NHS Business Services Authority’s key objectives. Thirdly, the noble Lord asked whether the Government would undertake a review of the scheme. I simply remind the noble Lord that the scheme has been revised many times since its inception, which shows that it is reviewed regularly as a matter of course, but perhaps it is worth my making the point that the VDPS is not a compensation scheme; nor is it designed to cover all expenses associated with severe disablement, which are catered for from the public purse in other ways. I hope that is helpful to the noble Lord, and that on the basis of those assurances he will feel able to withdraw his amendment.

Before I address the detail of Amendment 180, I would like to again put on record my thanks to my noble friend Lady Cumberlege for her continued commitment to the issues she has so powerfully spoken about, and the diligence and dedication of the IMMDS team, and the brave testimonies of those who contributed to the IMMDS review. As my noble friend knows, the Government have accepted the majority of the report’s nine strategic recommendations and 50 actions for improvement, and are taking forward work to improve patient safety. This includes establishing specialist mesh removal centres, the ninth of which opens in Bristol this month, and work to improve the care pathways for children and families affected by medicines during pregnancy.

We remain committed to delivering improvements in patient safety across the board. We are focusing government funds on initiatives that directly improve future safety. For this reason, the Government have already published their decision that redress schemes will not be established for people affected by hormone pregnancy tests, sodium valproate or pelvic mesh. I realise that was a disappointing decision for my noble friend, and I am always very sorry to disappoint her, but, for the reasons I have given, I ask her not to move Amendment 180 when it is reached.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am very grateful to the noble Earl, Lord Howe, the noble Baroness, Lady Brinton, and my noble friend Lady Wheeler for their support. I empathise with the comments of the noble Baroness, Lady Cumberlege, and her report, which was far-reaching. Having met some of the women who were affected, I know how keenly the noble Baroness, Lady Cumberlege, feels about these issues. It is disappointing that the Government have rejected this particular request, although they have accepted many of her recommendations. It leaves the groups of women whom we have met to continue with their long, hard campaign, but they will continue, and one day a Government will agree to give them some of the support that they deserve.

On my own amendment, I pay tribute to the work of the NHS Business Services Authority. I am very glad that it took over responsibility for the scheme, and I wish it well in speeding up the process of claims. I am grateful to the noble Earl for facilitating a meeting between representatives of the families and the Minister—that is very welcome indeed. All I would say is that as the Business Services Authority continues its work, it is bound to come across issues in relation to the operation of the scheme, and I hope the Government will reflect on that and look at further improvements to the scheme. Having said that, I beg leave to withdraw my amendment.

Amendment 164 withdrawn.

Moved by

[Lord Hunt of Kings Heath]

165: After Clause 164, insert the following new Clause—
“Secretary of State: Duty to promote and ensure the full integration of self care for minor ailments within the health system
(1) The Secretary of State, in exercise of his or her functions, must promote self care for minor ailments and prepare a national self care strategy to integrate self care fully into the wider health system.(2) The national self care strategy referred to in subsection (1) must include measures to—(a) improve inequalities in health literacy,(b) enhance the understanding of primary and secondary age children on how to self care,(c) introduce self care modules in healthcare professionals’ training curricula and continuing professional development,(d) make best use of, and expand, the Community Pharmacist Consultation Service,(e) improve access to effective self care treatments,(f) enable community pharmacists to refer people directly to other healthcare professionals,(g) ensure better support for Primary Care Networks (PCNs) to deliver self care,(h) evaluate the use of technologies developed during the COVID-19 pandemic to promote greater self care, and(i) accelerate efforts to enable community pharmacists to populate medical records.”Member’s explanatory statement
This amendment would ensure that the Secretary of State promotes self care for minor ailments and publishes a national self care strategy to fully integrate it into the wider health system.

[Lord Hunt of Kings Heath (Lab)]

My Lords, Amendment 165 requires the Secretary of State to

“promote self care for minor ailments and prepare a national self care strategy”.

I hope that Ministers will just agree to this, without very much debate.

Self-care is defined as

“the actions individuals take for themselves, on behalf of and with others, to develop, protect, maintain and improve their health.”

It is an important but often overlooked part of the primary care pathway.

Given all the pressures that there are on the health service and that there are going to be over the next 30 to 40 years, surely we should do everything we can to encourage self-help for minor ailments. During Covid, the importance of self-care in reducing the burden on GPs and A&E became very self-evident. Since the outbreak started, people with minor ailments were not able to visit their GP in the traditional manner and learned, or at least practised, self-help behaviours instead. A survey carried out by PAGB, the consumer healthcare association, during the first national lockdown indicated that the pandemic has had an impact on people’s attitudes to self-care. Some 69% of people who would not have considered practising self-care prior to the pandemic said that they were more likely to do so after their experience of lockdown.

Interestingly, if the Government were prepared to run with this strategy, there are all sorts of behaviours that they could start to encourage. They could ensure that individuals understand or are willing to practise self-care; ensure a cultural shift among healthcare professionals toward well-being, enabling people to self-care; ensure that the system is supported to encourage self-care where appropriate, with pharmacies, of course, playing a big role in that; encourage the use of digital technology; enhance the national curriculum on self-care for schoolchildren; and introduce self-care modules in healthcare professionals’ training curriculum.

I come back to the point that the Minister and noble Lords know that the health service is currently under huge pressure, not just because of the backlog. Already before the pandemic, the health service was really struggling to meet its targets. The demographics, the growing older population and all these factors suggest that the NHS will struggle hugely to cope with the pressure on it over the next 20, 30 and 40 years. Surely some part of the strategy to deal with this is to encourage all of us not just to look after our own health more but, where we can, to self-help. I would have thought that message would have been accepted with alacrity on the Government Front Bench. I hope the Minister will be able to say that this is very much taken to heart and that the Government really will start to drive the new strategy. I beg to move.

[Lord Clement-Jones (LD)]

My Lords, I rise briefly to support Amendment 165, in the name of the noble Lord, Lord Hunt, and thank him for putting it forward. Self-care has an important role to play in supporting people to manage their own health needs, and also in alleviating an unsustainable demand on GP and A&E services. As the noble Lord described, prior to the coronavirus pandemic there were some 18 million GP appointments and 3.7 million visits to A&E every year for conditions which people could have looked after themselves or sought advice from a pharmacist. It is estimated that this was costing the NHS in the region of £1.5 billion a year.

During the coronavirus, again as the noble Lord described, surveys have shown a much greater willingness among members of the public to self-care for these self-treatable conditions. But it is vital that appropriate policies are put in place to ensure that, as we emerge from the pandemic, people who can self-care continue to do so. It is evident now that self-care can help address many of the challenges we face in the NHS today, but to do so we need to address some of the system barriers to self-care, as described in this amendment, and unlock the important behavioural shifts that enabled people to self-care during the pandemic.

In particular, I will highlight how the NHS can make much better use of digital technologies and community pharmacists to enable people to self-care. We need to make better use of the technologies that the NHS has embraced over the course of the pandemic, such as the Covid-19 symptom checker on the NHS website. The digital triaging technology should be used to support the expansion of the community pharmacist consultation service to enable people to follow an algorithm online to get a referral for a consultation with a local pharmacist. It is critical, if we are to optimise the role of pharmacists—I am a big supporter of community pharmacists—that we give them the digital tools and information they need to support people. At present, a pharmacist cannot routinely record the advice or medication they give people, despite receiving training. The NHS must address the question of interoperability in IT systems, so that pharmacists can have access to read and to input into people’s medical records and enable pharmacists to be a core part of an individual’s primary healthcare team.

6.15 pm

The pandemic has highlighted how quickly the NHS and patients can adopt technological and digital changes. Realising the Potential: Developing a Blueprint for a Self Care Strategy for England, a document launched last October, is an excellent blueprint for this. A whole range of organisations, including NHS clinical commissioners, the RCN, pharmacy organisations, the Self Care Forum and, of course, the PAGB, have worked together to develop this blueprint for a comprehensive national self-care strategy to support the introduction of self-care policies throughout the NHS in England. It contains policy proposals and case studies, in particular in relation to digital technologies, which set out how the NHS can fully embed self-care and pharmacy into primary care.

I hope the Minister today will outline how the Government are ensuring that the NHS can adopt these proposals, which learn from the pandemic, and will expand them to support individuals to enable self-care.

[Baroness Penn (Con)]

My Lords, I thank the noble Lord, Lord Hunt, for bringing forward a debate on this issue. I reassure him and other noble Lords that the Government absolutely agree that supporting people to maintain their health and well-being and to manage self-treatable conditions is a vital part of delivering a comprehensive health service. Indeed, much of what the amendment seeks to achieve is already government policy. However, I do not agree that requiring the Secretary of State to prepare a single national strategy would add value. Instead, we are threading self-care through a wide range of work, reflecting the range of areas that it impacts upon.

A good deal of work is already under way. The community pharmacy contractual framework for 2019 to 2024 five-year deal sets out how community pharmacy will support the NHS long-term plan. Community pharmacies, which provide easy access to the NHS, are already required to support patient self-care, signpost to other parts of the NHS and local services as necessary, and help people to live healthily.

I am especially aware of the interest the Proprietary Association of Great Britain has shown in this area. The Department of Health and Social Care officials have met with it to discuss its blueprint for a self-care strategy in England and will continue to engage with it about further supporting self-care throughout our healthcare system.

We do not think placing an additional duty on the Secretary of State would be the right way to support this work, as it would take it out of the NHS long-term plan, where it belongs as part of a holistic approach to the provision of a health service. It could risk making it more disjointed rather than integrated in its approach, but noble Lords made a really important point about demand on our health service and the role that self-care has in this. Prevention was a key theme of a speech by my right honourable friend the Secretary of State last week and, clearly, elements of self-care and prevention go hand in hand with each other, particularly in the use of new technology.

Noble Lords also made an important point about how we can use self-care, particularly at community pharmacies, to reduce pressure on GPs and A&E departments. All community pharmacies are required, as I said, to provide support for self-care. To ensure that people get directed to the right support for their health needs, we have introduced referral systems from NHS 111 and GPs to pharmacies for advice and treatment for minor illnesses. We are also exploring expanding referrals from other settings, including urgent treatment centres and A&E to community pharmacies.

I hope that gives noble Lords some reassurance that we place an importance on self-care, as part of our health service. That will only increase in future and work is under way in multiple areas of the health service to do that. I hope, therefore, that the noble Lord is able to withdraw his amendment.

[Lord Hunt of Kings Heath (Lab)]

I am grateful to the noble Lord, Lord Clement-Jones, and my noble friend Lady Wheeler for their support, and to the Minister. I am glad to hear her recognition of the importance of community pharmacy, and about the meetings between officials and the PAGB. That is very welcome.

I agree that the interrelationship between self-care and prevention is important—as is, may I say, personal responsibility. I also agree that the pressure we face in the system is such that this is important for the future. The Government may not want a strategy but, at some point, setting out their aim in this area and giving the right signals to us as individuals, but also to the system, would be very helpful. I beg leave to withdraw my amendment.

Amendment 165 withdrawn.

--- Later in debate ---

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I hate to disagree with the noble Lords who have spoken against this amendment, almost as much as I loathe supporting the noble Lord, Lord Forsyth, on anything. But, for me, this is a matter of democracy. Public opinion is constantly moving on this, and it becomes more and more supportive as the public understand the issues involved. It is partly the duty of the Government to explain exactly what it is about. Having a proper debate like this is something we should all support.

Personally, I want this on the statute book before I need it. I have five grandchildren, and I try to talk them all into pushing me over a cliff if I were to get too ill. As soon as their mothers told them that it was illegal, they refused me. The idea remains that this is something which many of us want for ourselves, because we fear being incapable. Therefore, I support Amendment 170.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I would like to put a point to the noble Lord, Lord Forsyth. He said that his amendment simply provides time for Parliament to consider an assisted dying Bill. I note that proposed new subsection (2)(a) also says that the Secretary of State should

“respect that this is a matter of conscience”.

But a draft Bill is a draft Bill. It will be prepared by a government department; instructions will be given by solicitors, after consultation with Ministers, to parliamentary counsel; and that Bill will eventually be approved by Ministers in the relevant department and put before Parliament. There will be a Minister in charge of the Bill. Whatever mechanism is chosen—maybe a Joint Select Committee of both Houses—to consider the draft legislation, the Minister will be in charge and will be seen by the public to be driving through a Bill. If the noble Lord had said in his amendment that more time should be given for the Private Member’s Bill, I would have supported it. Businesses managers clearly need to take account of the obvious wish of this House to have more time to debate it—

[Lord Forsyth of Drumlean (Con)]

I do not want to prolong the debate but, for the sake of clarity, I will say that the issue here is that this is a complex subject—as has been pointed out. It is a Private Member’s Bill, and the Government would provide support for that. It is not a government Bill, and it is not being piloted by the Minister. This is clear from the amendment. It could not be, because the Government then would not be neutral, as they should be, on a matter of conscience.

[Lord Hunt of Kings Heath (Lab)]

I am very grateful to the noble Lord for his intervention. However, his amendment says:

“The Secretary of State must, within the period of 12 months beginning with the day on which this Act is passed, lay before Parliament a draft Bill”.


In my book, a Minister laying before Parliament a draft Bill is in charge of that Bill.

[The Lord Bishop of Durham]

My Lords, I agree with those who have already spoken opposing the amendment. First, the amendment is not appropriate as a use of the legislative process accompanying this Bill through your Lordships’ House. There is a question of purpose. If opportunity for debate is the goal, we must underestimate neither the significance of the Bill of the noble Baroness, Lady Meacher, in October and the thorough, careful and considered debate, nor the possibilities of calling for Committee. I would also support that time being given in this House. There are important constitutional questions which arise if the amendment enacted by this House does in fact instruct the Secretary of State in the other place to propose and introduce a draft Bill—as the noble Lord, Lord Hunt, has just outlined. If that is not the case—and if the noble Lord, Lord Forsyth, is not advocating for this draft to be introduced—what is the purpose of the amendment?

Secondly, I am aware that the language of the amendment has some real problems. One example is “terminally ill”. We debated the importance of language at Second Reading of the Assisted Dying Bill. The phrase “terminally ill” is understood in a whole range of different ways in different parts of the world. Is there any guidance offered on the definition or scope behind the language in the draft Bill attached to the Secretary of State’s instruction?

The complexity of the issue in question is so great—and the lives of the people who are facing a personal debate of this kind, and feel that they would be particularly impacted, are so important—that this cannot be how we legislate on their behalf. We are on Report, so I was disturbed that the noble Lord, Lord Forsyth, intervened when he did.

Health and Care Bill

Lord Hunt of Kings Heath Excerpts

Lords Hansard - Part 2 & Report stage
Monday 7th March 2022 Lords Chamber

[Lord Krebs (CB)]

My Lords, I shall speak in support of the amendments in the name of the noble Lord, Lord Bethell, to which I have added my name. I do not really need to say anything more than has already been said. We know that this country, according to the World Obesity Atlas published last week and supported by the World Cancer Research Fund, is now top of the European league table for projected levels of female obesity by 2030 and joint top for projected levels of male obesity. Sadly, it is probably already too late to stem this trend, but by acting now on these measures we might be able to protect the next generation. That is why I support the idea of having a firm deadline by which time the measures will be introduced.

I actually wanted to speak in slightly more detail about Amendments 148, 150 and 152 in the name of the noble Lord, Lord Moylan. As he explained, they are really just one amendment.

I promise you that this was not set up, but I have in my hand the very Grenade bar to which the noble Lord, Lord Moylan, referred. I wish to explain why this Grenade bar should definitely not be excluded. I am grateful to Dr Emma Boyland, of the University of Liverpool’s Institute of Population Health, for giving me a briefing on the Grenade Carb Killa bar—this particular one is high-protein, low-sugar, white chocolate and salted peanut. I bought it at the weekend from Holland & Barrett, in its health food section; it is marketed and advertised as a healthy product. Is it a healthy product? The answer is no.

First of all, no age group in this country is short of protein. We simply do not need to eat more protein. So the fact that this bar is high-protein is completely irrelevant in terms of health benefits. Secondly, remember that HFSS is high fat, salt and sugar. The bar may be low-sugar, but what about fat? It contains two-thirds of the recommended daily limit of the intake of saturated fat; it is definitely high in fat. It also contains more salt than a bag of salted crisps. Is it right to exclude something that is fatty and salty from the definition of HFSS? I am convinced it is not right, and therefore I completely reject the argument of the noble Lord, Lord Moylan. These products should not be excluded from the measures proposed in Schedule 18 to the Bill.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I have two amendments in this group—Amendments 154 and 155—though they are rather different from those discussed in the debates that we have just heard. I declare my interest as the president of the Hospital Caterers Association.

We have heard a lot about the risk of obesity, but we also know that many patients coming into NHS hospitals come in with nutritional issues, where good food and good nutrition could very much help them on their way to recovery. The research has indicated problems where patients are not feeding properly.

We are very grateful to Ministers for the meeting we had with the Hospital Caterers Association and the National Association of Care Catering, with the noble Baroness, Lady Barker. We are very grateful too that Clause 161 sets out specifications for hospital food standards.

There are just two quick points I want to make. First, it is a great pity that we do not have a similar process in relation to the care sector—care homes, in particular. One of the amendments relates to that: we want to see the provisions extended to the care sector. We also want to ensure that staff working in the care sector are suitably trained and that there is a suitable framework to ensure there is a high level of professional staffing.

My second point relates to the National Health Service. Although lip service has always been paid to good standards of hospital food and nutrition, unfortunately the boards of NHS organisations have often found it difficult to provide the resources to enable that to happen. The suggestion in my first amendment is, in fact, that a board-level director should be appointed to oversee this to ensure that the standards laid out as a result of the Bill, when it becomes law, will be put into practice. Alongside it go similar provisions in relation to ensuring that we have high-quality staff who can take advantage of a focused approach to training, which, at the moment, has been missing because a lot of the national infrastructure for training for staff in the NHS in the ancillary services has been neglected.

I hope that, following the discussions we had with Ministers, the noble Baroness will be able to be positive in relation to this tonight.

Living with Covid-19

Lord Hunt of Kings Heath Excerpts

Tuesday 22nd February 2022 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

The noble Baroness is absolutely right that throughout the crisis we have led the way on data reporting, and have ensured that data is always available to the public. UKHSA will keep the content and frequency of reporting on Covid—including the GOV.UK dashboard—under close review, to ensure that statistics are being produced of the appropriate quality and transparency, and that they remain useful and relevant in accordance with the code of practice for statistics. So we will continue to publish information.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I refer to the SAGE advice, from the last meeting, that the Leader mentioned. It was said that some people may take the removal of free and accessible testing as a signal that they should continue to attend workplace social gatherings while showing Covid symptoms. What is the Government’s response to that? Why are they getting rid of free testing?

[Baroness Evans of Bowes Park (Con)]

We have always made it clear that as we move through Covid we would move away from free testing, and that is what we intend to do. As there are now high levels of immunity across the population as a result of vaccination and natural infection, future testing and isolation will play a less important role in preventing serious illness, and, as I have said in response to the noble Baroness and the noble Lord, we will be working with retailers to establish and develop a private market for lateral flow tests.

Health and Care Bill

Lord Hunt of Kings Heath Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

Moved by

[Lord Hunt of Kings Heath]

265: After Clause 148, insert the following new Clause—
“Regulation of the public display of imported cadavers
(1) The Human Tissue Act 2004 is amended as follows.(2) In subsections (5)(a), (6)(a) and (6)(b) of section 1 (authorisation of activities for scheduled purposes) after “imported”, in each place it occurs, insert “other than for the purpose of public display”.”Member’s explanatory statement
This amendment would ensure that imported bodies for display would need the same consent requirements as bodies sourced from within the UK.

[Lord Hunt of Kings Heath (Lab)]

My Lords, in moving Amendment 265 I will also speak to Amendment 282. I am glad to have the support of the noble Lords, Lord Ribeiro and Lord Alton, and the noble Baronesses, Lady Finlay and Lady Northover, for our endeavours.

Article 3(2) of the Universal Declaration on Combating and Preventing Forced Organ Harvesting states:

“The killing of vulnerable prisoners for the purpose of harvesting and selling their organs for transplant is an egregious and intolerable violation of the fundamental right to life.”


My two amendments seek to prevent UK citizens’ complicity in forced organ harvesting by amending the Human Tissue Act to ensure that UK citizens cannot travel to countries such as China for organ transplantation and to put a stop to the dreadful travelling circus of body exhibitions that sources deceased bodies from China.

As noble Lords know, I come from Birmingham, where in 2018 an exhibition called Real Bodies by Imagine Exhibitions visited the National Exhibition Centre. It consisted of real corpses and body parts that had gone through a process of plastination, whereby silicone plastic is injected into the body tissue to create real-life mannequins or plastinated bodies. The exhibit advertised it as using

“real human specimens that have been respectfully preserved to explore the complex inner workings of the human form in a refreshing and thought-provoking style.”

But those deceased human bodies and body parts are unclaimed bodies with no identity documents or consent, sourced from Dalian Hoffen Bio-Technique in Dalian, China. Notably, Dalian labour lamp from 1999 to 2013 was notorious for its severe torturing of Falun Gong practitioners, as the noble Lord, Lord Alton, has reminded the House on many occasions.

The commercial exploitation of body parts in all its forms is surely unethical and unsavoury, but when it is combined with mass killings by an authoritarian state, we cannot stand by and do nothing. In 2019, the China Tribunal, led by Sir Geoffrey Nice QC, stated:

“The Tribunal’s members are certain—unanimously, and sure beyond reasonable doubt—that in China forced organ harvesting from prisoners of conscience has been practiced for a substantial period of time involving a very substantial number of victims.”


Most recently, further evidence was heard during the course of the Uyghur Tribunal, including from Sayragul Sauytbay, who testified during the June hearings that she discovered medical files detailing Uighur detainees’ blood types and results of liver tests while she was working at a Uighur camp. In June this year, 12 UN special procedure experts raised the issue of forced organ harvesting with the Chinese Government in response, as they said, to “credible information” that

“Falun Gong practitioners, Uyghurs, Tibetans, Muslims and Christians”

are being killed for their organs in China.

The recent findings of the Uyghur Tribunal, again chaired by Sir Geoffrey Nice, were profoundly disturbing. We discussed some of this in our debate on genocide only a few days ago, but I think it bears repeating. The tribunal concluded:

“Hundreds of thousands of Uyghurs—with some estimates well in excess of a million—have been detained by


Chinese

“authorities without any, or any remotely sufficient reason, and subjected to acts of unconscionable cruelty, depravity and inhumanity … Many of those detained have been tortured for no reason, by such methods as: pulling off fingernails; beating with sticks; detaining in ‘tiger chairs’ where feet and hands were locked in position for hours or days without a break; confined in containers up to the neck in cold water; and detained in cages so small that standing or lying was impossible … Detained women—and men—have been raped and subjected to extreme sexual violence … Detainees were fed with food barely sufficient to sustain life and frequently insufficient to sustain health, food that could be withheld at whim to punish or humiliate.”

This is the context in which we debate these amendments. I feel a sense of, shall I say, sadness, at least, that this is the opening day of the China Winter Olympics.

Currently, human tissue legislation in this country covers organ transplantation within the UK itself, but it does not cover British citizens travelling abroad for transplants, and British taxpayers’ money has to pay for anti-rejection medication for those people who then come back to the UK and go to the National Health Service, regardless of where the organ was sourced. According to the excellent NHS Blood and Transplant, between 2010 and 2020, there were 29 cases on the UK transplant registry of patients being followed up in the UK after receiving a transplant in China. This is a billion-pound business in China, using the bodies of executed prisoners—mainly prisoners of conscience.

The Human Tissue Act 2004 has strict consent and documentation requirements for human tissues sourced in the UK, but it does not restrict human tissues from abroad in this way; it is merely advisory. My amendments seek to amend the Human Tissue Act in the following ways.

First, they would prohibit a UK citizen from travelling outside the UK and receiving any controlled material for the purpose of organ transplantation when the organ donor or the organ donor’s next of kin had not provided free, informed and specific consent. Secondly, they would prohibit a UK citizen from travelling outside the UK and receiving any controlled material for the purpose of organ transplantation when a living donor or third party receives a financial gain or comparable advantage; or, if from a deceased donor, a third party receives financial gain or comparable advantage. Thirdly, it would provide for the offence in Section 32 of the Human Tissue Act 2004 to be prohibited even if the offence did not take place in the UK, if the person had a close connection to our country. Fourthly, it would provide for regulations for patient-identifiable records and an annual report on instances of UK citizens receiving transplant procedures outside the UK by NHS Blood and Transplant. Finally, it would provide for imported bodies on display to have the same consent requirements as those sourced from the UK.

Article 4 of the Universal Declaration on Combating and Preventing Forced Organ Harvesting says:

“All governments shall combat and prevent forced organ harvesting by providing for the criminalisation of certain acts and facilitate the criminal prosecution of forced organ harvesting both at the national and international levels.”


I believe we must take action internationally and in the UK to do all we can to prevent this abhorrent practice. I know from the success we had in the medicines Bill that a change in the law of this country has a much wider impact; it gives great encouragement to those brave people fighting these practices in China and globally. I very much hope the House will support this. I beg to move.

[Lord Ribeiro (Con)]

My Lords, I apologise for not speaking in the Second Reading debate, for reasons of ill health.

It is a pleasure to follow the noble Lord, Lord Hunt, who has set out the case against genocide most convincingly. As he said, there is a risk of repetition, as we covered so many of these issues in the Medicines and Medical Devices Bill in 2020 and in the noble Lord’s Organ Tourism and Cadavers on Display Bill only last year. I said then that the Human Tissue Act 2004 made it clear that written consent was required while the person was alive before donated bodies or body parts could be displayed.

The Government were supportive of our amendment in the Medicines and Medical Devices Bill and the noble Baroness, Lady Penn, who I am pleased to see in her place, said the Government would undertake

“to strengthen the Human Tissue Authority’s code of practice”.—[Official Report, 12/1/21; col. 705.]

The noble Lord, Lord Bethell, who was here earlier, stated in summing up that the new code laid before Parliament in June 2021 was clear that

“the same consent expectations should apply for imported bodies and body parts as apply for such material sourced domestically.”

In relation to exhibitions such as “Real Bodies”, which the noble Lord, Lord Hunt, mentioned and to which our Amendment 265 applies, the noble Lord, Lord Bethell, said

“it would need proof of the donor’s specific consent to be displayed publicly after death. If it failed to provide such proof”,—[Official Report, 16/7/21; cols. 2123-24.]

that would prevent a licence being issued. In relation to organs for transplantation, our Amendment 282 makes it clear that consent must be given and that there must be no evidence of genocide in the country from which the organs are sourced.

As a former president of the Royal College of Surgeons, I associate myself with the statement of December 2021 on the abuse of Uighurs in China made by the British Medical Association and the presidents of the Academy of Medical Royal Colleges—of which the Royal College of Surgeons is a member—the Royal College of Anaesthetists and the Royal College of Pathologists. It said:

“We … and the organisations we represent, in advance of the report of the Uyghur Tribunal, express our grave concern regarding the situation in China and the continuing abuse of the Uyghur population … as well as other minorities.”


The UN special rapporteurs have continued to raise concerns surrounding organ harvesting from Uighurs in China, which the evidence overwhelmingly suggests continues to this day, with hearts, livers, kidneys and corneas being the most commonly taken.

In January this year, the BMA condemned the appalling involvement of doctors in China in what was a fundamental abuse of human rights and genocide against the Uighurs. It urged Her Majesty’s Government to exert pressure on the Chinese Government to stop these inhumane practices and to allow the UN investigators into Xinjiang region. The Minister may wish to comment on the Government’s response.

I will leave your Lordships with a quote from Dr Zoe Greaves, chairman of the BMA ethics committee. She said:

“It is a doctor’s duty to help improve health and ease suffering, not to inflict it on others. The use of medical science and expertise to commit atrocities is abominable and represents an appalling antithesis to every doctor’s pledge to ‘first, do no harm’”.

--- Later in debate ---

[Earl Howe (Con)]

I noted that the amendment tabled by the noble Baroness is closely modelled on the current law in Scotland. Because of that, it fails to account for the significant differences between how Scotland, and England, Wales and Northern Ireland, regulate the storage and use of human tissue. In England, Wales and Northern Ireland, that storage and use is regulated by the Human Tissue Authority. In Scotland, there is no equivalent body and the amendment is silent as to what impact it would have on the authority, especially given the challenges involved in managing the great quantity of tissue that would be retained.

I am aware that many Scots share my concerns about consent for retaining tissue. A recent petition to the Scottish Government highlighted the anguish faced by a grieving mother on learning that she did not have the choice to have some of her child’s remains returned to her. She was upset at how long it took for those remains even to be located, so although this amendment would apply only to adults the same kind of issues would apply.

[Lord Hunt of Kings Heath (Lab)]

My Lords, it has been a very good debate. First, I say to the noble Baroness, Lady Finlay, that I sympathise with her Amendment 297H, but clearly it is a sensitive area. The noble Lord, Lord Alton, mentioned Alder Hey; I had ministerial responsibility at the time, and it was very traumatic meeting the parents of children who, in the end, had body parts buried up to three times or more because of the dreadful way in which both the hospital and university managed the situation, as well as the pathologist himself. On the other hand, the reasons put forward by the noble Baroness seem very persuasive, and I hope there will be a continuing debate on this with the Government.

As far as my two amendments are concerned, I am very grateful to the noble Lord, Lord Cormack, the noble and right reverend Lord, Lord Sentamu, the noble Baroness, Lady Finlay, and my noble friend Lady Thornton for their support. As the noble Lord, Lord Ribeiro, said, the concession given by the noble Baroness, Lady Penn, on behalf of the Government during discussions on the then Medicines and Medical Devices Bill was highly significant both for this country and for the message it gave globally. The debate today, and the amendments, are as much about global messages as UK legislation.

As the noble Baroness, Lady Northover, said, we cannot say that we do not know; we do know. The noble Lord, Lord Alton, sat through many of the harrowing sessions of the Uyghur Tribunal and the evidence—before a hard-headed panel—is absolutely convincing. There can be no doubt that this is an abhorrent practice and, as my noble friend Lady Thornton said, it may not be on the same scale but these wretched exhibitions that take place are a product of those abhorrent practices. She has persuaded me that my amendment is rather soft and needs to be hardened up. I look forward to her helping me to get the wording right.

The noble Earl, Lord Howe, referred to the HTA code of practice; I think we need to go further than that. On organ tourism, I will obviously study very carefully the issues that he raised about my amendments, but we have the figures from NHS Blood and Transplant: I think 29 people have come to the NHS for help following a transplant abroad, which gives us some clue as to the numbers but clearly it is not the whole picture. At the end of the day, you come back to the issue of ourselves and China. Clearly, there is huge ambiguity in our policy, whether that is to do with security, trade or human rights. Some of that ambiguity is understandable, given the scale and size of the Chinese economy—we understand that—but I do not think there is any room at all for ambiguity about this country making a strong response to these appalling practices. Having said that, I beg leave to withdraw my amendment.

Amendment 265 withdrawn.

--- Later in debate ---

Moved by

[Lord Hunt of Kings Heath]

267: After Clause 148, insert the following new Clause—
“Vaccine damage payments
Within 6 months of the passing of this Act, the Secretary of State must establish an independent judge led review into the operation of the Vaccine Damage Payments Act 1979 and the adequacy of payments offered to persons seriously injured, or bereaved, consequent upon vaccination against any of the specified diseases to which the Act applies.”Member’s explanatory statement
The Vaccine Damage Payment Act is now more than 40 years old and the aim of the amendment is to ensure that a judge led review takes place into the operation of the Act.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I will also speak to Amendment 268. I indicate in advance my support for Amendment 288 in the name of the noble Baroness, Lady Cumberlege. The amendments are all linked, in a sense, in trying to find a way of ensuring that patients damaged in one way or another through the National Health Service are dealt with in the most open, transparent and sympathetic way. Each amendment tackles the issue differently but, in the end, there is a sense that we have not got it right and that we need to do very much better.

--- Later in debate ---

[Earl Howe (Con)]

I appreciate of course my noble friend’s remarks, and I undertake to bring them to the attention of my right honourable friend the Secretary of State.

[Lord Hunt of Kings Heath (Lab)]

My Lords, this has been a very good debate, again, and I am grateful to the noble Earl, Lord Howe, for his sympathy. I really support the plea from the noble Baroness, Lady Cumberlege, for more thought to be given to the specific area of redress for the three groups of patients she mentioned. Any of us who have met some of the women involved—I think in particular of the women I have met who have been affected by surgical mesh issues—will be taken with the huge damage that has been done to their lives and well-being. I think they deserve listening to.

I will also say that I was very grateful to the noble Baroness, Lady Hodgson, for her support and for the information she brought to your Lordships, and to the noble Baroness, Lady Walmsley, and my noble friend Lady Wheeler, who pinpointed the need for action in this area.

--- Later in debate ---

[Earl Howe (Con)]

My Lords, I rather wish it were my noble friend Lord Kamall handling this group because he is the Minister, and I am not. However, what I can do is undertake to bring the request of the noble Lord to his attention—I am sure I do not have to—and I am sure he, in turn, will wish to respond as soon as possible to that request.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I know how generous the noble Lord, Lord Kamall, has been with his time. I can but hope for a sympathetic response and beg leave to withdraw my amendment.

Amendment 267 withdrawn.