Terminally Ill Adults (End of Life) Bill

Lord Jackson of Peterborough Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[Baroness Falkner of Margravine (CB)]

My Lords, perhaps reference to the Companion will help reduce the noble Baroness’s confusion about my speech. The Companion says that, once the Chair has put the Question,

“a general debate on the clause may take place”.

I am highlighting problems with the clause. Clause 1 is the substance of the Bill and an equality impact assessment is fundamental to our understanding of whether it should stand part.

To come back to the letter, it refers to the possibility of generating comparative evidence on the wider matters, but that would not have produced sufficiently robust conclusions. The matter raised was that the EIA did not deal with any detail of all those certain protected characteristics because it focused on access to assisted dying. Access to assisted dying is not relevant to the safeguarding risks that we have all spent some eight days in Committee debating. The letter says:

“We intend to update both the Impact Assessment and the Equality Impact Assessment should the Bill receive Royal Assent, once detailed implementation work has been completed”.


That will be too little too late. It is of no assistance to Parliament in considering the Bill and its potential consequences. Indeed, the whole point of an EIA is that it is done before or at the time a decision is taken. I refer again to the Cabinet Office guide to making legislation. A failure to undertake a comprehensive EIA means a failure to comply with a public sector equality duty, as post hoc analysis cannot generally cure a failure to have due regard to equality implications at the time a decision is being made.

That is what the courts consistently emphasise. R (Blundell) v Secretary of State for Work and Pensions 2021 noted that post-decision equality analysis is not sufficient to fulfil the duty, as it is supposed to be a real, open-minded consideration of the equality implications, conducted with substance and rigour, not a rearguard box-ticking exercise.

In concluding, I say to the Government that an accurate assessment of how the Bill impacts people who share each of the nine protected characteristics does not betray that position of neutrality. In fact, it is the converse: withholding information is not an act of neutrality but the opposite of that.

The Constitution Committee published a report on the Bill on 11 September, lamenting that supporting documents, including the EIA, “were issued late” or were not available. In the other place, Ministers gave the excuse that the Bill was “highly dynamic” and likely to undergo significant changes during scrutiny, so it was important to wait until the committee concluded its work so that

“we know what it is that we are assessing the impact of”.—[Official Report, Commons, Terminally Ill Adults (End of Life) Bill Committee 30/1/25; col. 282.]

Now we are told that there is insufficient evidence to produce conclusions that are sufficiently robust. I suggest that the Minister review what both the EHRC and the letter submitted by 59 Members of this House have asked her to do and come back with some more positive news at an earlier date.

[Lord Jackson of Peterborough (Con)]

My Lords, I beg the indulgence of the Committee to raise what I think is an important point; I hope the Committee does not think it pedantic. I had not intended to speak but was prompted to by the excellent speech of the noble Baroness, Lady Falkner, and by my noble friend Lady Coffey’s reference to the lack of insight provided by the Government—I will not criticise the sponsor, the noble and learned Lord, Lord Falconer of Thoroton. This—our deliberations, scrutiny and oversight of the Bill—is a moveable feast, so we need information in real time.

My specific point is not just about freedom of information but about Written Questions that the Government have received and not answered. On 1 December 2025 my noble friend Lord Kempsell asked His Majesty’s Government a very reasonable Question. He asked, with regard to the Bill and its impact assessment,

“what assessment they have made of the effectiveness of judicial approval as a safeguard in countries with assisted suicide regimes, including the proportion of applications refused in those countries and the reasons for refusal”.

Two months on, that Question has not been answered. That is unacceptable, because scrutiny and oversight require us to have all the information in our hands, including comparative legal, regulatory and medical regimes.

By comparison, the very sensible Question from the noble Viscount, Lord Stansgate—I do not want to embarrass him because he is in the Chair—about the use of the Parliament Act was asked on 26 January and answered promptly on 29 January. The point is that there should be equality and a level playing field on Questions asked, irrespective of the position on the Bill of the noble Lord asking it.

[Lord Blencathra (Con)]

I am another Member who had not intended to say a single word on whether the clause should stand part; I am rather relaxed about it. The Government Whips must blame their noble friend Lord Rooker, who provoked me into commenting because I agree, once again, with every single wise word he said.

The noble Lord referenced the Delegated Powers Committee, of which he was a distinguished member at one point. I was the chair of the committee when we produced the Democracy Denied? report. It highlighted the fact that every Government over the past 30 years—Tory, Labour, Conservative-Lib Dem and Conservative again—took more and more powers away from Parliament via delegated powers. The delegated powers in the Bill are excessive and have rightly been criticised.

The noble Baroness is also right that no Government in any democracy in the world can function unless there are delegated powers; not everything can be in Bills. The questions here are: how many delegated powers are appropriate; and what will they contain? The trouble is that we have more than 40—48, I think—possible delegated powers, including Henry VIII powers. That seems excessive.

I pay tribute to the noble and learned Lord, Lord Falconer, for producing some amendments that would implement the delegated powers recommendations, but I think he knows that if he did not produce them, this House, on Report, would implement every single one of the delegated powers recommendations; we would gut those bits of the Bill that did not implement them. So, although he has generously provided some amendments regarding the delegated powers recommendations, he knows full well that this House will implement all of them in any case.

That is all I want to say on the Bill. Delegated powers under all Governments have been increasing and ought to be diminished. Although I have some concerns about the contents of the Bill, I have many more concerns about the 48 powers that will be written by civil servants in the Department of Health. At the moment, they are unable to tell the difference between a man and a woman; I do not want them writing up how I will die in future.

Tobacco and Vapes Bill

Lord Jackson of Peterborough Excerpts

Committee stage
Tuesday 11th November 2025 Grand Committee

Moved by

[Lord Jackson of Peterborough]

114A: After Clause 48, insert the following new Clause—
“Consultation and review of the generational sales ban for tobacco products(1) Before making regulations under this Part the Secretary of State must consult—(a) the retailers of a relevant product or representatives of the manufacturers of a relevant product;(b) the manufacturers of a relevant product or representatives of the manufacturers of a relevant product;(c) consumers of a relevant product or representatives of consumers of a relevant product;(d) any other persons that the Secretary of State considers appropriate to consult.(2) Consultation under this section must include a call for evidence.(3) The Secretary of State must have due regard to all views received as part of any consultation under this section.”Member’s explanatory statement
This amendment requires the Secretary of State to consult retailers, manufacturers and consumers on the practicality, enforceability and efficacy of the products in scope of the generational sales ban on tobacco products before implementing these regulations.

[Lord Jackson of Peterborough (Con)]

My Lords, this amendment is essentially about the product scope of the consultation. I will say at the outset that I am not a smoker, and I have no fiduciary or pecuniary interest in the sector, but I am sure the noble Baroness, Lady Walmsley, will be delighted to know that I am speaking on the basis of empirical evidence which informs my remarks. The focus is specifically on heated tobacco products. I hope noble Lords will not groan about that because, given that the noble Lord, Lord Vaizey, was not here to move his amendment, we have not really had a debate about the efficacy of the ban as it affects heated tobacco products.

The broad thrust of this amendment is about consultation. It would require the Secretary of State to undertake the most basic task of any Government, which is to consult those impacted—retailers, manufacturers and consumers—on the practicality, enforceability and efficacy of the products in scope of the generational sales ban on tobacco products. I will take those points in turn, with the caveat that I will be focusing on heated tobacco products.

Heated tobacco is not smoking. In fact, it is an effective aid, as my noble friend Lord Howe said, in stopping smoking. The generational ban is a misguided step, but if the Government insist on proceeding with it, they should follow the evidence and remove heated tobacco from the scope. I shall speak to that more later. I want to talk about the practicality of the generational ban. Leaving aside the philosophical debate, there are practical public health considerations that may have been reflected in the Bill if a proper consultation had taken place. The first is that, for those who already smoke, heated tobacco products are an effective smoking cessation tool. They have helped Members of this House and the other place to quit smoking. It is illogical to include them in the ban and the Government should commit today to consulting with consumers of heated tobacco products so that they may understand their utility more clearly.

The second public health point is that simply the number of people, especially young people, starting to smoke is now very low. It was 1% of 11 to 15 year-olds in 2021 according to Action on Smoking and Health. An even lower number, just 0.3% according to the same survey, are using heated tobacco products. All of this suggests there is no need for heated tobacco products to be included in the scope of banned products. There will always be outliers and the Government’s own impact assessment

“assumes some people continue to smoke despite it being illegal for effectively all ages to be sold tobacco by 2100”.

For these adults, it makes sense for all cessation products to be available so that the road that has worked for decades can be taken—smoking reduction policies that inform, nudge and dissuade rather than remove the rights of adults to make their own choices.

I want to talk about enforceability and the illicit trade and retailers, and all within the context of proper consultation or otherwise. We do not have to look into a crystal ball to imagine the consequences of this legislation, particularly the generational ban. The policy has already backfired in Australia where there is now a booming illicit trade fuelled by criminal gangs. We would be naive to assume the same situation could not happen here in the United Kingdom. A consultation with retailers would reveal the issues they already face with rising crime and illicit trade. This would undoubtedly worsen with confusing arbitrary rules for different legal products.

We should make these measures as simple as possible for retailers by categorising all smoking cessation products in the same way. That would be a useful start. We know that young people will still be able to get their hands on illegal cigarettes, just as we know that they are able to procure all manner of products that they should not be able to. Teenagers have always been resourceful; that is why it is important that we continue to make all possible smoking cessation tools available to all adults because, whatever the law says, there will be adult smokers born after 1 January 2009.

--- Later in debate ---

[Baroness Merron (Lab)]

I assure the noble Baroness that there is nothing paper about the exercise that we are undertaking, but I accept her point and I have on previous groups. This is not one size fits all; the issue manifests itself in different ways. I wanted to present an overall national position, but I of course understand. That is why we are looking at regulations and why we have a call for evidence, consultations and an impact assessment, so that we do not uniformly treat all areas the same. It is important that we remind ourselves, as I have done repeatedly, that tobacco is a deadly addiction. Stopping children from starting to smoke is the easiest way to reduce smoking rates, and that is at the core of the Bill.

[Lord Jackson of Peterborough (Con)]

Will the Minister give way? I am trying to be helpful. As the Minister has made some quite fair and emphatic comments about the toxicity of heated tobacco and its lack of efficacy in smoking cessation, would she be so kind as to put that in writing to me in order for members of the Committee to consider that as we go forward in the Bill?

[Baroness Merron (Lab)]

I will be happy to.

On Amendments 135A and 136A, tabled by the noble Lord, Lord Johnson, health is a devolved matter, as noble Lords are aware, so the implementation of retail licensing in Northern Ireland is ultimately a matter for the Department of Health in Northern Ireland. However, it is a shared view that it is important that details of our respective retail licensing schemes are informed by adequate consultation with all relevant stakeholders. That is why, in collaboration with the devolved Governments, we have launched a call for evidence that asks detailed questions about a number of matters that noble Lords have rightly raised. It is open until 3 December and asks detailed questions about the implementation of retail licensing, among other topics. I can say to the noble Earl, Lord Howe, and the noble Lord, Lord Johnson, that it asks how a retail licensing scheme can be implemented effectively. We encourage feedback on how existing businesses should be treated specifically, and I hope that responses will come forward.

I remind noble Lords that following the call for evidence there will be a consultation, so there is plenty of opportunity to consider all the important points that have been raised today. For example, we will ask whether there should be any exemptions from needing a licence and whether factors such as restrictions on the location and density of retailers should be features of the scheme. We believe it is important that such decisions are informed by expert views, and it would not be right to prejudge the evidence that we receive by putting in place different rules for one particular type of business, as the amendment suggests.

The absence of a retail licensing scheme, as I have spoken to on previous groups, represents a major gap in the enforcement of tobacco and vape legislation. All tobacco products are harmful, and it is right that we ensure that those selling the products are following the rules and acting responsibly. A retail licensing scheme will help to deter those who fail to do so, and I know all noble Lords are concerned to do that. With that, I hope noble Lords will be good enough not to press their amendments.

[Lord Jackson of Peterborough (Con)]

I thank all noble Lords who took part in this debate on my amendment. I particularly thank the noble Baroness, Lady Fox of Buckley—it goes without saying that of course I support her Amendment 114C—and my noble friend Lord Sharpe of Epsom. This debate and the previous group have shown that it is quite difficult to properly launch a generational ban in a monolithic way without disaggregating the different products, which are discrete products.

I fear that the noble Baroness, Lady Northover, did not actually read the amendment, because it specifically says it is not just for the benefit of retailers and manufacturers. Subsection (1)(d) specifically mentions

“any other persons that the Secretary of State considers appropriate to consult”,

which would include health bodies and charities. Subsection (2) says:

“Consultation under this section must include a call for evidence”,


which, presumably, the latter would also avail themselves of. These are wide ranging and permissive powers of consultation, and I hope she might reconsider when we come back on Report.

We have had a good debate on this issue, given that we did not have a specific heated tobacco product amendment per se. With the proviso that the Minister has given me an undertaking to provide the data on the efficacy of heated tobacco products, and a very straightforward undertaking to do more consultation on these key areas, I am happy to withdraw this amendment.

Amendment 114A withdrawn.

Puberty-suppressing Hormones

Lord Jackson of Peterborough Excerpts

Monday 16th December 2024 Lords Chamber

[Baroness Merron (Lab)]

In view of what the noble Baroness said, it is quite important to consider that the children and young people’s gender services waiting list currently has 6,237 people on it. I certainly agree that waiting lists for these services are too long. We are committed to changing that, which is why I outlined the timetable for the new gender services and the opening of the new centres. They will increase clinical capacity and reduce waiting times for sure. On the point the noble Baroness raised, there is a commitment to the clinical trial, and I am glad there is. As we have brought forward this legislation in an absence of evidence, it is incumbent on us, as a Government, to follow through on what the previous Government started in train, which is to use a clinical trial to provide the evidence. Otherwise, the debate would remain uninformed and not evidence-based, and that cannot be helpful.

[Lord Jackson of Peterborough (Con)]

My Lords, I welcome the Statement and congratulate the Secretary of State on the moral clarity and leadership that he has shown in balancing the evidence base with compassion. Perhaps I may press the Minister on a few points. An indefinite ban is not the same as a permanent ban. Is there a chance that the indefinite ban, which goes to 2027, may segue into a permanent ban as more information and evidence arise over the next few years?

Given that it is pretty well understood that puberty blockers have given rise to fertility problems, bone health issues and psychological health issues, I cannot understand the inconsistent policy of keeping children currently on puberty blockers in the system, when we know that there is no positive evidence base and only a negative one. I think that will affect many children.

My final point is about the eight new regional centres that will be set up. Will we be certain that the ideologically-driven zealots—clinicians who misuse their position and have prescribed unsafe puberty blockers for children and young people—will not find themselves in these new facilities? That is an important issue as we wait for the clinical trial and ruminate on the issues that the noble Baroness, Lady Cass, mentioned. We need to start again on this and to understand that there are more treatments available for the most vulnerable children, who we need to protect, than merely puberty blockers.

[Baroness Merron (Lab)]

I certainly agree with the noble Lord about the vulnerability of children and young people in this regard, which is why we are taking this action. His last point gives me the opportunity to say that we are committed to implementing the recommendations of the Cass review in full. That is a very useful guideline and tool for us to use.

I have no expectation that the situation that the noble Lord described in his third point will happen. Recruitment is subject to all the usual provisions, and I know that the gender services will seek to recruit very positively. If the noble Lord finds out anything else, I am sure he will raise it with me.

On whether the ban could become permanent, the review—at the risk of repeating myself—will report in 2027, as the noble Lord said. I believe that we should wait for that.

Bread and Flour Regulations 1998

Lord Jackson of Peterborough Excerpts

Wednesday 11th December 2024 Lords Chamber

[Lord Dodds of Duncairn (DUP)]

My Lords—

[Lord Jackson of Peterborough (Con)]

My Lords—

[Lord Kennedy of Southwark (Lab Co-op)]

My Lords, we will hear from the noble Lord, Lord Dodds, next.

Bread and Flour Regulations 1998

Lord Jackson of Peterborough Excerpts

Wednesday 11th September 2024 Lords Chamber

[Baroness Merron (Lab)]

I know that the noble Lord takes a great personal interest in these matters and has also campaigned very strongly. The area he refers to is being pursued because we want collective agreement on this across the whole of the UK, so that we can confirm that it is government policy with absolutely no qualifications, and that everyone is moving on the same timescale. I can confirm that we have notified the EU Commission and the WTO in order to fulfil international obligations and have thus far received no responses; that is why we are able to proceed with the next legislative steps.

[Lord Jackson of Peterborough (Con)]

My Lords, the Minister is a great asset to the Front Bench. This is a bipartisan issue, and I pay tribute to the noble Lord, Lord Rooker, for his excellent work over the years. When I was a Member of Parliament in the other place, Shine—formerly known as ASBAH—the charity for hydrocephalus and spina bifida, was located in my constituency. I say gently to the Minister that we have been campaigning on this issue for almost 20 years, and to my own Front Bench that there is no demonstrable, empirical scientific evidence of any substantial side-effects of putting folic acid into basic foodstuffs, and that it should happen. Finally, more than 30 countries have pursued this policy; they have tackled the enduring tragedy of spina bifida and hydrocephalus, and the impact they have on families. Therefore, can we please do this as soon as possible?

[Baroness Merron (Lab)]

I certainly hear the very welcome points that the noble Lord makes. As we progress, this will make us the first European country to mandate folic acid fortification of non-wholemeal flour. While some European countries, including Ireland, have voluntary fortification, mandatory fortification is not the case. I and my ministerial colleagues are keen to be in this position.

Foetal Sentience Committee Bill [HL]

Lord Jackson of Peterborough Excerpts

2nd reading
Friday 22nd March 2024 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, I commend my noble friend for tabling this Bill, which is on such an important issue. I had hoped that we would restrict our debate to empirical evidence on the merits of this modest Bill, rather than hear smears about right-wing dark money and conspiracies.

I will restrict my remarks to a few reflections on relevant studies on both sides of the debate and highlight the need for objectivity in this area, of a kind that could be provided by a suitably comprised committee.

[Baroness Kennedy of The Shaws (Lab)]

Why do noble Lords who are proposing and supporting this Bill assume that the Royal College of Obstetricians and Gynaecologists is not capable of researching in the way that the noble Lord describes? Why are they again attacking institutions that have expertise and do this constantly? It is like the attack on the Supreme Court. It is basically expressing contempt for the institutions that currently exist and doing precisely what they want, because they want to set up committees that I suggest would be weighted with people that they would choose.

[Lord Jackson of Peterborough (Con)]

I think that is a fatuous conspiracy theory again, but, if the noble Baroness satisfactorily answers my question about the involvement of Marie Stopes International and BPAS in the RCOG, I will gladly debate with her on the issues that she raises.

If I can continue—

[Baroness Thornton (Lab)]

I really must ask—

[Lord Jackson of Peterborough (Con)]

I will not give way.

[Baroness Thornton (Lab)]

I am not addressing the noble Lord. I am speaking to my colleagues on his Front Bench. I am very sorry, but shouting “you” and pointing is not the conduct that we expect in this House. It is in our guidance, so I ask the Government Whip to please remonstrate with his colleague not to behave like that.

[Lord Jackson of Peterborough (Con)]

I say to noble Lords that the noble Baroness, Lady Kennedy of The Shaws, had ample opportunity to make her points. She intervened on me and I put a very reasonable question back to her. Perhaps I can now continue.

Noble Lords may be aware of a fascinating peer-reviewed academic study published in 2010 of twins in the womb at 14 weeks of gestation. The study found that the twins’ self-directed hand movements were more calibrated than movements to the uterine wall, while movements towards the co-twin exhibited even greater care. The study determined that such deliberate actions could not be the result simply of spontaneous reflexes. The team behind the study concluded that these findings force us to predate the emergence of social behaviour. Another study published by a team of child psychologists and neuroscientists in 2006 found “surprisingly advanced motor planning” in foetuses at 22 weeks’ gestation, again pointing towards a sentience of the foetus during the second trimester of pregnancy.

These are precisely the kinds of studies that ought to be informing government policy, yet neither was cited in the RCOG reports on foetal sentience to which my noble friend alluded earlier. Some will no doubt argue that a committee is not required when we have the Royal College of Obstetricians and Gynaecologists to guide us, but, on the contrary, I would suggest that RCOG reports on foetal sentience highlight the need for objectivity in this area and there are a number of good reasons to be cautious about accepting the conclusions. The RCOG itself has now distanced itself from some of the conclusions in its 2010 report. For example, its updated 2022 report no longer asserts, as the earlier one did, that a foetus is in “continuous sleep-like unconsciousness or sedation”. The 2022 report also removed a section on responding to common questions that included answering the question, “Will the baby feel or suffer pain?” with “No, the foetus does not experience pain”. Seemingly, it is no longer sure.

Since the RCOG has rejected sections of its own report, it would seem wise not to assume that its 2022 update is wholly reliable either. In a letter published in the European Journal of Pain, Italian neonatologist and bioethicist Carlo Bellini, who has written extensively on foetal pain, has questioned the conclusions of the 2022 report, arguing that they were based on misrepresentations and incorrect extrapolations of research cited in their support. As a layman of course it is difficult for me to comment objectively on differing research, but what is clear is that government policy would be assisted by a committee that can provide objectivity in this debate and consider all relevant findings. In fact, this is something that ought to be supported by the RCOG.

Let me finish with a final reflection on why this matters beyond simply informing the abortion debate. A 2007 academic journal cited in Neurodevelopment Changes of Foetal Pain asserted:

“Exposure of the foetus and premature newborn to pain has been associated with long-term alterations in pain response thresholds as well as changes in behavioural responses relating to the painful stimuli”.


In other words, if a baby experiences pain before birth, it may impact its development and behaviour in later life. It is therefore imperative that we understand foetal sentience adequately so that any treatment of unborn babies is performed in a way that will not lead to long-term damage. I therefore strongly support my noble friend’s Bill.

Care of Critically Ill Children

Lord Jackson of Peterborough Excerpts

Monday 29th January 2024 Lords Chamber

[Lord Markham (Con)]

My understanding, now that the task force composition has been set up, is that this will be arranged shortly. I completely agree with the noble Baroness that these are important, as well as often heart-wrenching, matters, so urgency is required. As I have said, good progress has been made in a number of areas. Already, the MoJ is setting up a round table on this. The regional conflict managers have been established. We have training courses online so that communication can improve. A lot is being done, and the task force will push that forward further.

[Lord Jackson of Peterborough (Con)]

My Lords, the Minister will know that there is currently an imbalance between the resources available to the parents and guardians of children involved in end-of-life care—particularly time, money and legal advice—and that of public bodies such as NHS trusts. Compounding that issue is the routine use of secret transparency orders, which prevent scrutiny and oversight of court proceedings, particularly in the family court. Does the Minister agree with me in that respect: that secret justice is no justice at all?

[Lord Markham (Con)]

Clearly, the processes on these terrible cases have got to be as transparent as possible. As noble Lords probably know, legal aid is automatically available in all these types of cases to make sure that there is a level playing field. I also think we all believe that there is a case for seeing whether we can use mediation more as, obviously, courts should only ever be a last resort.

National Health Service: Key Targets

Lord Jackson of Peterborough Excerpts

Tuesday 16th January 2024 Lords Chamber

[Lord Markham (Con)]

One of the key learnings from last year, which goes back to the whole question about planning, was actually that if you put social care moneys in too late, you do not get nearly as effective spend. That is why we brought forward the £600 million discharge fund much earlier—actually, into the summer—so that local authorities and care providers could plan on that money. It is starting to make a difference. A key thing that noble Lords have heard me talk about is bed-blocking. Actually, we have seen a 10% reduction in bed-blocking since these measures have come into effect in the last few weeks. It is early days, but we are actually making progress.

[Lord Jackson of Peterborough (Con)]

My Lords, the number of over-85s is due to double over the next 30 years. Would my noble friend the Minister give some consideration to government funding for extra care facilities and at-home treatment, such as physiotherapy, in order that pressure be taken off acute district hospital beds in respect of older people?

[Lord Markham (Con)]

Funnily enough, I had this conversation in terms of productivity just today. The virtual wards—the 11,000 extra beds we have put in—are actually making a real impact on that, because of course it is much better that people can be treated in their own home, knowing they have the comfort of these virtual displays and treatment to look after them. We have 11,000 extra beds, with 72% utilisation, and, yes, it is really working.

NHS Long-term Workforce Plan

Lord Jackson of Peterborough Excerpts

Tuesday 4th July 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord is correct that it is essential. I emphasise that this is an NHS document, and the whole point is that it does not look to go “zoom” on recruitment. There is absolutely the understanding that this is a pipeline that has to be built brick by brick. There is no point front-loading the number of university places if, as the noble Lord mentions, there is no follow-up behind it in clinicians. The plan has been developed from the bottom up, including with clinicians and the trusts. There is an understanding that they need to build their own part of the pipeline towards this as well.

[Lord Jackson of Peterborough (Con)]

I welcome this ambitious and comprehensive workforce plan and I concur with other noble Lords on the issue of social care. On the specific issue of medical school places, while I strongly welcome and commend the Government for responding to the campaign of many people—including Policy Exchange and its excellent Double Vision report, published earlier this year—my concern is the waste of resources and the talents of those thousands of A-level students who do not get university places to study medicine. While I welcome the focus on degree apprenticeships and the regionalisation of medical education, is there any chance that we could speed up the process? Another eight years to double the number of medical places is an awfully long time—it is almost the equivalent of two Parliaments.

[Lord Markham (Con)]

As for the A-level point and those people not being able to go on to universities, that is what the different routes are about. The different pathways that we are talking about include nursing associate training places, which we want to see increased to 10,000, and similarly with physician associates. While we all understand that having a university education is a fantastic medical grounding, there are many other ways to get there. I am sure we all have very good examples of fantastic clinicians who did not have a degree.

Pharmacies: Medicines at Home

Lord Jackson of Peterborough Excerpts

Wednesday 17th May 2023 Lords Chamber

[Lord Jackson of Peterborough (Con)]

My Lords, on the subject of support services, is my noble friend the Minister aware of, and does he deprecate, the widespread practice of catheterising very elderly people who are only temporarily immobile or infirm? In the long term, that reduces their independence and adds to the cumulative costs to the state of their care, particularly to primary care, the NHS and local authorities.

[Lord Markham (Con)]

Yes.