Mental Capacity (Amendment) Bill [HL]

Lord McFall of Alcluith Excerpts

Report: 2nd sitting (Hansard): House of Lords
Tuesday 27th November 2018 Lords Chamber

Amendment 30 agreed.

[The Senior Deputy Speaker (Lord McFall of Alcluith)]

I should notify the House that if Amendment 31 is agreed, I cannot call Amendment 32 by reason of pre-emption.

Amendment 31

Moved by

Health: Treatment Rationing

Lord McFall of Alcluith Excerpts

Tuesday 26th April 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the success that this country has had on smoking reduction has been pretty exceptional. The strategy on obesity that the Government will announce soon will mark a new priority in addressing the problems of obesity. I do not think there is any evidence to suggest that the reductions to which the noble Lord referred are having any discernible impact on the number of people receiving support on smoking cessation and obesity reduction before surgery.

[Lord McFall of Alcluith (Lab)]

My Lords, selective dorsal rhizotomy, the spinal injuries operation for young people with cerebral palsy, has been not only restricted but withdrawn in both England and Scotland. Numerous paediatric neurosurgeons have given testimony to the near-miraculous benefits of such surgery, which transforms the lives of young people who were previously thought to be wheelchair-bound for their lifetime to one of mobility and independent walking. Therefore, will the Government reconsider this decision, write to me and put a copy in the Library so that this issue is transparent and young people who need this surgery, and whose families are desperate for it, can have the same chance as everybody else in the National Health Service?

[Lord Prior of Brampton]

My Lords, I cannot answer the noble Lord’s question now, but I agree to his request to write to him and will place a copy of my letter in the Library.

NHS: Food Banks

Lord McFall of Alcluith Excerpts

Thursday 26th November 2015 Lords Chamber

[Lord Prior of Brampton]

I do not think that anyone is saying that the food banks in the hospitals in Birmingham and Tameside are their top priority, I just think that it is a very human reaction of people working in those hospitals who want to help very vulnerable people who are being discharged.

[Lord McFall of Alcluith (Lab)]

My Lords, more than a year ago I visited Drumchapel citizens advice bureau and the food bank there to see what the situation was. I have now looked at the updated figures. In a two-year period from 2012 to 2014, referrals for benefit changes and delays went up from 127 in 2012 to 1,192—an increase of almost 850%. Is it not time for an independent investigation into what is now becoming a very worrying and scandalous situation in this country?

[Lord Prior of Brampton]

It is interesting that the use of food banks is increasing not just in England but in America, Canada, Germany and across Europe. The policy response of this Government is that we should focus on a strong economy, more jobs and the national living wage.

Primary Care: Targets

Lord McFall of Alcluith Excerpts

Tuesday 13th October 2015 Lords Chamber

[Lord Prior of Brampton]

I cannot confirm that a number of the pilots have been cut back because of a shortage of GPs. I assure the noble Lord that we are committed to having an additional 5,000 doctors and a further 5,000 professionals working in general practice by 2020. That is a key priority for the Government.

[Lord McFall of Alcluith (Lab)]

My Lords, the number of 80 year-olds today—3 million—is estimated to double by 2030. According to the King’s Fund, this will be the biggest challenge facing society. In particular, the issue of caring for frail, vulnerable adults with complex needs is crying out for attention. What future planning will the Government do to address this human bombshell?

[Lord Prior of Brampton]

The noble Lord makes a very perceptive point. Demography is driving healthcare. The whole thrust of government policy is to treat as many people as possible outside acute hospital settings. Over the next five, 10, 20 years, I expect to see a far greater share of the health budget going to primary and community care, and a lower percentage to acute care.

NHS: Whistleblowing

Lord McFall of Alcluith Excerpts

Tuesday 30th June 2015 Lords Chamber

[Lord Prior of Brampton]

The duty of candour should clearly take precedence. It should be seen in the context of an agenda to improve patient safety in hospitals; if we are not open about our mistakes, we will not learn from them.

[Lord McFall of Alcluith (Lab)]

My Lords, the experience of whistleblowers in the NHS is not for the faint-hearted, with lip service paid to internal hotlines. To ensure the maximum protection for genuine whistleblowers with no retribution whatever, is it not time that a legal duty of care towards them is imposed on NHS trusts?

[Lord Prior of Brampton]

The Government have taken a lot of action to help protect whistleblowers. I think that there is a limit to the law in this regard and the changing culture is more important. The Small Business, Enterprise and Employment Act 2015 places an obligation on NHS employers not to discriminate against people who have blown the whistle or raised concerns. I believe strongly that the law has a role to play in this but that we need a fundamental change of culture in the NHS.

Standardised Packaging of Tobacco Products Regulations 2015

Lord McFall of Alcluith Excerpts

Monday 16th March 2015 Lords Chamber

[Lord McFall of Alcluith (Lab)]

My Lords, I want to provide a few anecdotal points in this debate today. I was prompted by the remarks made previously about criminals engaging in illicit cigarettes. Eight or nine years ago, I went on a parliamentary visit to China and saw for myself the number of sophisticated cigarette factories that the Chinese were closing down every week. In China, 25 to 30 factories were closed every week. But in the UK, the total number of Customs representatives that we had patrolling China was exactly one, and that person was based in Hong Kong. I say that if the Government want to crack down on this illegal trading, which is supposed to be producing about one in three illicit cigarettes in London, they have to tackle it very robustly at HMRC level. That is the lesson that we have to learn from this.

I was a smoker when I was young. The noble Lord, Lord Geddes, made the point that plain packaging on cigarettes did not have any effect on him. It did not have an effect on him because—I say this with due respect—that was a number of decades ago. At that time, there was a culture of smoking. All of us smoked at the time; I smoked when I was in school. In fact, we smoked Woodbines. If anyone has seen the Woodbine packaging they will know that it was not very attractive, so the more sophisticated ones went on to Benson & Hedges or Marlborough. We had a particularly nasty teacher in the school, who was a smoker. He could detect the schoolboys who were smoking. He smelled our hands, called us smoky beasts, took our five Woodbines or whatever off us, and gave us a belt at the same time—not very fair. But lots of us were engaging in smoking, because that was a good thing to do.

I was brought up very short when my late father had to enter hospital with vascular problems. I visited the Western Infirmary in Glasgow—this was about 50 years ago—and to this day, I remember the name of the consultant and I remember the brutal message that he gave me. The consultant’s name was Mr Gray—Mr Reid, sorry. Mr Reid—I wrote it down, but that is what happens when you get into the House of Lords—said to me, “Your father is suffering from severe vascular problems and he will most likely have to have his legs amputated”. Indeed, he had both his legs amputated. Mr Reid asked me whether I was a smoker, to which I said yes. He said, “Listen, my boy, you look round every bed in my ward and you will see no one other than smokers, so the lesson I have for you and your friends is that the sooner you stop smoking the better”. That stayed with me. I did stop smoking and it was the best thing that I did in my life.

I commend the noble Earl for the work that he has done and say to him that this legislation has come not a day too soon.

[Baroness Tonge (Ind LD)]

My Lords, I cannot resist putting in my oar at this stage, very briefly. I have been associated with the anti-smoking campaign for many years, in the Commons and in the Lords. I gave up smoking in 1974, I think—the noble Lord, Lord Walton, will correct me—when the report was published on the links between smoking and lung cancer. I had taken up smoking as a teenager—I say this to support all those people who say that packaging is important in attracting young people to start to smoke—and was taught to smoke by my brothers and their friends in somebody’s back garden because they did not want a sister who choked and did not know how to do it. I do not think that we used the word “cool” in those days, but they wanted me to be cool and be able to smoke. It must have been a very rich friend of my brother, because the cigarettes that he produced to teach me were those wonderful multicoloured ones with gold tips—I think that they were called cocktail cigarettes; I shall not mention the brand. I had never seen anything quite so attractive in my life and, for a while, I was seriously hooked on them until I found out how much they cost. I then investigated something called Black Russian, which were even smarter, if that was possible. I as a teenager then knew perfectly well that it was not just the packaging but the appearance of the cigarettes that was attractive. They were very smart to be able to handle because they were different colours—some noble Lords are smiling; they obviously remember them.

What is important about this measure is that it tackles the appearance of cigarettes, which should be uniform. I wholeheartedly support it. I am glad that I gave up smoking all those years ago. I hope that the majority in this House will support the regulations.

NHS: Clinical Negligence

Lord McFall of Alcluith Excerpts

Tuesday 20th January 2015 Lords Chamber

[Earl Howe]

My Lords, potentially, independent sector providers may elect to be members of the negligence scheme, although only in respect of their NHS services. Therefore, only NHS-related liabilities would be covered in those circumstances. It is a pay-as-you-go pooled scheme, and I do not therefore have the figure that my noble friend requested. If I can get the figure disaggregated for him, I would be happy to write. In answer to his last question, I take it that he is asking whether the provider would be allowed to continue treatment, having been found to be negligent or having admitted negligence. That decision would be clinically led, with the patient exercising choice in each individual case.

[Lord McFall of Alcluith (Lab)]

My Lords, may I suggest an examination of the area of clinical governance? I and my family are not alone in having a negative experience of a disjointed, rather than an integrated, clinical governance network, where communication between departments and individuals was virtually non-existent. The admirable Reith lecturer, Dr Atul Gawande, examined the concept regarding why doctors fail, and one of the main reasons he came up with was that policies that fragment a unified system rather than cohere the system were in the interests of neither patients nor the NHS, as can be seen with these claims.

[Earl Howe]

The noble Lord makes a series of good points. He may be interested to know that part of the series of pledges that form the Sign up to Safety campaign, which hospitals can apply for, can include the principles of being transparent with people—including about any mistakes that have been made and what is being done to tackle safety issues—and collaboration, by taking a leading role in supporting local collaborative learning, so that the system genuinely can work together and learn together.