Coronavirus Bill

Lord Newby Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Lord Newby (LD)]

My Lords, we meet today in truly extraordinary and worrying times. The pace at which the pandemic has spread and the range of measures which are now widely accepted as necessary to fight it are unprecedented. As a result, we are not just faced with this Bill but must consider how we as a Parliament operate in the weeks and months ahead. If we are to work effectively, we have to reconsider all our ways of doing things.

We on these Benches of course support the Bill but, as we do so, we need to be clear what we see as the role of Parliament in the period ahead. It seems to us crucial that we maintain our role of scrutinising legislation and holding the Government to account. This is partly because the Government are being asked to exercise, on a daily basis, the judgment of Solomon. We fear that they lack a Solomon, so we think it vital that Ministers remain answerable to Parliament for their decisions. But Parliament also has a major part to play in improving public policy development, by feeding into the process and drawing to the Government’s attention what is really happening on the ground across the country, and by probing their responses.

While we on these Benches are fully supportive of the House adjourning early for the Easter Recess, we do not support an extension of that Recess beyond our planned resumption date of 21 April. If by then the situation in respect of self-isolation and social distancing remains broadly as it is today, which seems highly likely, we will need to look at how we conduct our business to ensure that the House can operate effectively.

Many service-sector companies have closed their offices altogether yet are carrying on their business by use of the phone, internet and conference calling. I believe that your Lordships’ House should do the same to the maximum extent possible, particularly as almost half our number will—or should—be unable to attend by virtue of their age, while others have underlying health conditions which makes their attendance impossible or, at the very least, imprudent. We will need to change our ways.

In my view there is, for example, no reason why committees should not sit via videoconferencing straightaway. I believe that we should also look at ways in which the business in the Chamber could be done differently. If a radio station can do it, I do not see why Members should not be able to phone or email in their Questions for Oral Answer, for example, or why some speeches could not be submitted in writing in advance, for inclusion on the record. On our return, to allow us to ask Questions in a timely manner while minimising the demands on ministerial time, we should also have half an hour of Covid-19 questions at a convenient point after the Prime Minister has done his daily press conference. If the frequency or timing of these press conferences changes, we could obviously adapt to reflect this.

The alternative is an unsatisfactory preponderance of coronavirus Questions on the Order Paper and a daily series of requests to the Lord Speaker for Private Notice Questions. We have raised these suggestions via the House of Lords Commission and the usual channels, and are having very constructive engagement with them. I believe the same process is now taking place in the House of Commons.

I realise that for some Members all these suggestions will produce the kind of shocked response associated with a Bateman cartoon but, unless we move in this direction, proper scrutiny will simply be impossible. Scrutiny will be particularly important because of the wide-reaching measures which the Government are adopting. They are measures which we support in principle. As a result of today’s Bill, the Government will gain large new powers exercisable by statutory instrument, which should be debated, and further new powers will need to be taken to implement yesterday evening’s announcement. We have only to look at the extraordinary, irresponsible action of Sports Direct today to see that exhortation of not just individuals but of companies will be inadequate. I too would like to know what legal basis the Government will use to introduce these necessary powers.

Other legislation is already being introduced giving the Government new powers by statutory instrument. For example, on Saturday a regulation was made under the Public Health (Control of Disease) Act 1984 to close all restaurants, cafés, bars, cinemas, theatres and virtually every other premises where people meet. They came into force the same day, have a lifespan of six months and, in theory, need parliamentary approval, but such approval obviously requires Parliament to be in session. The same will apply to all the other SIs which are required, and the Government may well find that they need more primary legislation to be introduced at short notice before this crisis is over, so we need to find ways to do this with the country in lockdown and we need to do so quickly.

We accept the need for today’s Bill and the need to pass it speedily. We do not propose to divide the House but this is a very long and complex Bill and, as is always the case, it raises very many specific questions to which no answers have yet been provided. In saying that, I am not criticising the Government. I have huge sympathy for the challenge the Minister faces in explaining an unprecedented raft of business, and I would not want him to think that in making that point I am being critical, but the country wants to know and needs clarity on many issues, and Parliament is the best way of doing that.

However, our proceedings today and tomorrow do not in reality allow us to subject this Bill to the normal scrutiny that we would expect so, like the Opposition, we on these Benches will limit our amendments to a relative handful on which we wish to probe the Government. There are a lot more issues that we would in ordinary circumstances raise, but in the course of a day—tomorrow—it is simply impossible to do so.

The issues that we will raise are as follows. On social care, we want to ensure that the Government provide local authorities with the resources necessary to provide appropriate levels of care for those discharged from hospital, particularly those with complex needs. On social security, we want to suspend the sanctions regime, which we believe could bear down unfairly on those who are ill. We want to give local authorities the power of direction they will need if they are to implement government policy effectively. We want to scrutinise the civil liberties implications of the increased detention powers. We want to examine the scope for providing much better levels of support for the self-employed, and we want to ensure that your Lordships’ House plays its full part in considering the extension of the emergency powers beyond the initial six months. My colleagues will explain our detailed concerns on these points during the course of today’s debate.

This is an unprecedented Bill to deal with an unprecedented crisis. Over the coming months, every aspect of the way that we do things in Britain will come under strain. As in wartime, we will have to change the way that we do things, and when it is all over things will not revert to business as usual. Some things will have changed for ever, and the way that we do business here will assuredly fall into that category. I am sure that everyone in your Lordships’ House wishes the Government well as they grapple with coronavirus. But democracies never give the Executive a blank cheque. As a Parliament, we must retain our critical faculties and, if we do so, it will help the Government and the country to get through this crisis together.

Opticians Act 1989

Lord Newby Excerpts

Monday 8th February 2016 Lords Chamber

Asked by

[Lord Newby]

To ask Her Majesty’s Government whether they will amend the Opticians Act 1989 to allow certain adjustable-focus eyewear to be sold over the counter as is already the case with reading glasses.

[Lord Newby (LD)]

My Lords, adjustable-focus eyewear are pairs of glasses that allow consumers to adjust the focus of each lens separately. They achieve the desired focus for each eye by turning a dial located at the side of each lens. The quality of definition achieved is extremely good, and to demonstrate this I am wearing a pair of these glasses this evening.

[Noble Lords]

Hear, hear!

[Lord Newby]

They are produced by Adlens, an Oxford-based company. They are sold in some 57 countries worldwide, but the largest markets are Japan, where some 650,000 units have been sold, and the US, where some 500,000 units have been sold, many without a prescription. They are particularly valuable for people whose eyesight varies from day to day—for example, diabetics or those who have had cataract surgery—but they have many other uses, such as emergency substitutes for glasses that have been lost or damaged until permanent replacements are produced, or as a spare pair while travelling. They sell for approximately the same price as a pair of high-end ready-to-wear reading glasses—a few tens of pounds.

The concept of an individual adjusting the power of the lens in glasses until it reaches an optimal level is already the way in which we decide on the strength of the glasses that we get, the only difference being that, if I go to an optician, it is the optician who presents a series of lenses before my eyes and asks, “Which is better, lens one or lens two?”. With these glasses, I physically make the adjustment myself. So we are talking about a product that is quite cheap, of extremely high quality and for which there is an obvious demand. So far—but only so far—so good.

The logical next step for Adlens would be to sell its glasses in pharmacies and supermarkets in the UK in the same way in which reading glasses have now been sold for 27 years. In order for this to happen, an exemption needs to be specified under the Opticians Act 1989 to allow them to be sold without a prescription. Framing such an exemption is relatively straightforward and so, having seen a demonstration of the Adlens glasses, I suggested while in government that an amendment to that effect might be made to what is now the Deregulation Act 2015. I contacted the right honourable Oliver Letwin, the Minister in charge of the Bill. He, in turn, contacted the General Optical Council for its advice. The GOC is the standard setter for the optical sector. Its response was stark. The risks to the public of allowing adjustable eyewear to be sold without prescription was so grave, it believed, that it claimed:

“We do not believe that the proposed changes warrant further consideration”.

The council formed this view without seeking or obtaining any expert evidence whatever.

Undeterred, Adlens sought a meeting with the GOC staff, which took place in June last year. The GOC agreed at the meeting to commission an expert report on the Adlens glasses and Dr Charman of the University of Manchester was duly appointed and reported last October. His conclusions were broadly that the glasses worked well; that the risks were the same as for over-the-counter sales of fixed-focus spectacles with similar powers; and that there was no fundamental reason why Adlens glasses with the same characteristics as reading glasses should not be made available over the counter. However, he also made the point that Adlens needed to rebut the argument that such sales might result in fewer people having a full eye examination where they needed one on health grounds.

The GOC standards committee met on 8 October to consider Dr Charman’s paper. It turned a very balanced and positive assessment into a litany of objections, some of which were, frankly, ludicrous. My favourite was the following:

“It was noted that these products were originally developed for use in the developing world – it was felt that a solution for a developing world problem was not transferable for the UK”.

This statement was made, despite the fact that more than 1 million pairs of the glasses have been sold in Japan and the USA. However, buried among the criticisms, the GOC agreed that,

“if the product were restricted to 0 to +4 D”—

the D is for dioptres—

“(as ‘ready readers’ currently are) the view of the Committee was that this might be acceptable, as it would reflect the parameters of the current legislation”.

The GOC objections have subsequently been endorsed by the Optical Confederation, the trade body for the sector. Its concerns, when boiled down, essentially amount to two. First, if sold over the counter, the product would reduce the number of people who have eye tests and that therefore a number of eye diseases would go undiagnosed. Secondly, if used for driving, they would be unsafe.

On the first objection, the evidence shows that, since over-the-counter reading glasses became available in 1989, the number of eye tests has been on a steadily rising curve and has continued to rise steadily over the past 15 years, despite the growth of online contact lenses and online glasses. The GOC basically believes that restricting access to eyewear will force the public to have their eyes tested more regularly. However, this approach has failed in almost every public health initiative to which it has been applied, whether for the management of hypertension, obesity, diabetes or alcohol abuse. If we want people to have their eyes tested more often, the evidence suggests that the way to do so is by consumer education programmes such as the National Eye Health Education Programme, the Think About Your Eyes campaign and the EyeSmart campaign.

As for the second objection, there is no evidence that the product is unsafe to use while driving. There have been literally zero reported cases of driving accidents in Japan and the USA involving the million-plus consumers who wear variable focus eyewear. Indeed, when this issue was contested in court in Arizona in a case brought last year by the State Board of Dispensing Opticians, evidence submitted by Adlens persuaded the Assistant Attorney-General to support its arguments and the board of opticians to abandon their action. The case was lost simply because the evidence did not support it.

If I were a cynical type, I would think that some of the arguments put forward by the GOC and the Optical Confederation were designed to maintain the current rules in order to require people to go to an optician who did not need to do so. That may be harsh, but throughout my discussions with the industry there seems to be a distinct lack of interest in putting the interests of consumers first. There is certainly no appetite for reform and without a big push from the Government, reform simply will not happen.

The judgment which now needs to be taken boils down to what I think of as the paracetamol test. Paracetamol is a product which can be purchased cheaply over the counter to treat pain in a manner which is effective for the vast majority of its users. It can however, if abused, kill you and, as the instructions helpfully point out, it can cause many other potentially harmful side effects. We tolerate this situation because we believe that, on balance, over-the-counter purchase of paracetamol is hugely beneficial to consumers. There is no evidence whatever that adjustable eyewear can have the same deleterious effects as paracetamol if abused. I therefore believe that they do pass the paracetamol test and that it is in the consumer interest for them to be sold in the same way as reading glasses.

Can the Minister confirm that a decision about the type of amendment to the Opticians Act which I am seeking is at the discretion of the Government and cannot in effect be vetoed by the General Optical Council? Secondly, will the Department of Health now review the matter? Thirdly, subject to their being satisfied that the risks of making the proposed change are greatly outweighed by the disadvantages, will the Government agree to bring forward at an early legislative opportunity the amendment to the Opticians Act which I seek?

Health and Social Care Bill

Lord Newby Excerpts

Monday 19th March 2012 Lords Chamber

[Lord Noon]

My Lords, I speak in support of Amendments 1 to 6. I add my thanks to the Minister for his support in seeking to improve this Amendment, which I believe has been done in a number of ways. I should also declare an interest in these matters as chair of the Noon Foundation, which provides financial support to charities and other not-for-profit organisations, including those caring for people in end-of-life situations, such as the Marie Curie Cancer Care charity.

As a philanthropist and a businessman, I understand very well the importance of having a level playing field. We all know the immense value that is provided by charities, social enterprises and small voluntary agencies. I believe that they form the bedrock of our society. They provide essential support and care to those who are most in need, and do so on a daily basis.

The VAT issue for me is very clear. As someone who provides funding for charitable work, I do not want to see those funds taken up paying VAT that was not charged to the NHS when it provided the service. However, we need to go beyond VAT and look at all the barriers faced by the not-for-profit sector. As a business man, I understand the significant risks taken on in any new enterprise. There must be adequate time to accumulate capital, contracts must be fair and any additional undertaking such as the transfer of staff must be fully funded. So why should we expect any less of the charitable and not-for-profit sector? Is it fair that those organisations which exist solely for the benefit of those they serve should be penalised for not being wealthy private enterprises?

Even an issue such as insurance can be difficult. Most of these organisations rely on volunteers, people who have chosen to freely give their time because they want to give something back to society. However, as more services are taken on with a wider range of activities, the risks increase and so too do the insurance premiums. These increased costs are not always taken into account in contracts and can represent an excessive and increasing burden for charities.

However, this is not only about levelling up the playing field to be fair; this is about the kind of healthcare organisations we want to see thrive. At a time when government resources are severely challenged and shrinking—we cannot hope to manage solely on charitable donations—bringing the not-for-profit sector more firmly into mainstream provision of services is one of the ways in which we can continue to provide much needed care, but this will work only if we ensure that these organisations can enter the market fairly and with fully costed and supported service contracts.

In supporting these amendments, the Government are accepting that this is a vital issue and they have made a commitment to provide a report with recommendations within a set timescale. This represents a significant move in the right direction and I commend the amendments.

[Lord Newby]

My Lords, I strongly support the noble Lords, Lord Patel and Lord Noon, in seeking to promote the role of the not-for-profit sector within the NHS, as indeed I do across the whole of the public sector. They have given reasons why within the NHS, particularly at this point, the not-for profit sector can play a valuable role. As the noble Lord, Lord Patel, pointed out, there are a number of serious technical problems facing the sector in successfully bidding for contracts, and he has dealt with some of them.

I remind the House that least week Royal Assent was received for the Public Services (Social Value) Bill which requires all procurers, including those in the NHS, to consider the social value of a tender as well as its financial value, in such explicit terms, for the first time. This is one of the pieces of the jigsaw which I hope will mean that the not-for-profit sector finds it easier to successfully bid for business. The Bill lays a requirement on the public sector, but the problem is whether the public sector will implement the Bill and take the provision seriously. It would be relatively easy for it not to.

Therefore, I and other noble Lords, including the noble Baroness, Lady Thornton, who have been supportive of this principle and the Bill, seek to ensure that the Government put in place specific measures to ensure that procurers take account of the Bill rather than it simply lying idle on the statute book. When we debated this issue at an earlier stage in your Lordships’ House, the Minister suggested that it might be possible to refer to this in the draft commission of procurement regulations, and I hope that he will be able to confirm today that that is the Government’s intention.

[Lord Warner]

My Lords, I commend the Government on making a move in the right direction with these amendments. At earlier stages in the Bill, I tried to raise the whole issue of barriers to entry for new providers of services. This amendment helps in some respects but the noble Lord, Lord Newby, made an extremely important point. How will we know whether the culture has changed not just in relation to not-for-profits and social enterprises but for new providers, sometimes from inside the NHS? There is a deep conservatism—with a small “c”—about how the NHS goes about allowing new players to come into the game. We need the Government to give assurances that they will keep a close eye on this. As I put forward in a previous amendment, they must get Monitor to keep a close eye on the extent to which anti-competitive behaviour by the existing NHS stops new providers from whatever source—not-for-profit, social enterprise, charities, the private sector and from within the NHS—being able, when they offer a better solution to patients’ problems, to make their pitch for an alternative way of doing business.

Health and Social Care Bill

Lord Newby Excerpts

Monday 27th February 2012 Lords Chamber

[Baroness Tyler of Enfield]

My Lords, the hour is late but I wish briefly to explain why I have added my name to this amendment moved so compellingly by the noble Lord, Lord Mawson, whose credentials in this field are second to none.

In Committee it was argued that the Bill, as currently framed, could have serious unintended consequences both for social enterprises and for the wider voluntary and community sector. In my remarks, I want to focus on the wider voluntary and community sector. The basic concern expressed was that staff working on the NHS Commissioning Board, and indeed more widely, would interpret the Bill to mean that capacity building and other measures to support the development both of social enterprises and of voluntary and community organisations would be outlawed. A consequence of this would be to make it harder for charities and community groups, which are often very small with tiny management capacity, to provide the services and support that many people, particularly the most vulnerable and the hard-to-reach, rely on.

I know that many charities and community groups are particularly effective in reaching out to the people whom the statutory sector finds hard to reach and they then can advocate on their behalf and indeed can help provide an authentic user voice in the system. In Committee the Minister gave assurances that essentially these concerns were unfounded and that the Government will,

“ensure that procurement practices do not unfairly restrict the opportunities for charities, voluntary organisations and social enterprises to offer health and care services”.—[Official Report, 28/11/11; col. 108.]

When I followed this up afterwards with very helpful officials at the Department of Health, they said that the NHS Commissioning Board would be publishing guidance on this issue for commissioners. That guidance I am sure will be helpful but is it enough? There is always a danger that guidance will not be adhered to, will be misinterpreted or indeed will not be seen.

I want to refer very briefly to my own experience in this field. Until a month ago I was chief executive of the charity Relate. Our local centres which are very small with very limited management capacity found themselves in a commissioning exercise in relation to the talking therapies part of the NHS services. It was not an encouraging experience, to be frank. These local centres often found that potential NHS commissioners would wrongly assume or argue that the local Relate centres would be quite unable to mesh with the NHS’s systems, data, outcomes measurement or requirements. Often this simply was not the case but it reflected a lack of understanding on the part of the commissioners. I know that this has been the experience of a number of other charities both big and small.

In conclusion, this modest amendment would be more effective than simply guidance in preventing these unintended consequences. I very much look forward to hearing the Minister’s concluding remarks.

[Lord Newby]

My Lords, it is with very considerable diffidence that I rise to speak at this hour and for the first time on this Bill. Tomorrow we have, I hope, the Third Reading of the Public Services (Social Value) Bill which I introduced at Second Reading in your Lordships’ House. That Bill will require all public bodies, including health service bodies, to consider the broader social value of tenders when deciding whom to place the tenders with. At one level, therefore, it could be argued that these amendments might not be necessary. What concerns me is what happens after, as I hope will be the case, this Bill passes tomorrow. What change will take place in the health service and elsewhere? One of the absolutely key changes that has to take place is the one set out in Amendment 64B; namely, that weightings must be attached to social value at the point at which companies, social enterprises, charities and so on are submitting their tenders. Unless the procurement regulations are changed to provide for such weightings it will be very difficult to have the kind of change in culture and practice which the Public Services (Social Value) Bill seeks to achieve.

I wonder whether the noble Earl, who has already very helpfully in a debate on a previous amendment committed the Government to giving guidance in respect of one matter, will be prepared to commit the Government now to the extent that the Department of Health would require NHS bodies commissioning services covered by the Public Services (Social Value) Bill to include within the tender document a weighting in respect of social value.