(1 day, 21 hours ago)
Lords ChamberMy Lords, I will speak particularly in support of Amendments 181, 45 to 49, 58 and 222. It is a privilege to follow the noble Baroness, Lady Hollins, and the noble Lord, Lord Griffiths, whom I thank for sharing their personal stories. They are a reminder to us that this debate touches some of the deepest things within us, and not only should we be kind to each other but we ought also to be kind to ourselves.
I declare my interests as set out in the register, and particularly that I am vice-president of Exeter Hospice Care, chair of the UK Commission on Bereavement, and patron of AtaLoss. Your Lordships will know that, however many amendments there are to this Bill, I do not feel it will ever be safe. But I want to speak on this group because I believe that these amendments are at the heart of the issue of motivation. I remain concerned about the fact that there is currently no real, deep investigation of the motivation for assisted dying.
Amendment 181 is critical for us in monitoring. Even if there were no further restriction on what the motivation is for assisted dying, just knowing and recording it is extremely important because it can give us understanding of why people choose assisted dying, especially if we are serious about properly funding the care and support for people who are dying.
If we are recording the reason why people choose assisted dying, this means that we can highlight reasons why people choose it that do not fall within the aim of this Bill. For example, there is currently no mechanism in the Bill to stop someone receiving an assisted death if they are in pain because they cannot access palliative care. I hope that all of us would believe that, if somebody in that stage of their life wants to live, they should have access to the palliative and social care support that they need.
Professor Katherine Sleeman, the Association for Palliative Medicine and the Royal College of Psychiatrists highlighted the importance of identifying and addressing unmet need. We have already heard about the pressure on our palliative care service. We know that only 30% of hospices are funded by the Government. We have begun to hear about the beds that are closing and the redundancy programmes that are in place. We also know that if hospices are only 30% funded through government funding, 70% comes through voluntary giving. That is unequal across the country, and therefore palliative care services in hospices in areas that are more deprived are likely not to be as good as those in areas where there is higher socioeconomic activity. It is important for us to begin to identify whether there are reasons for people accessing assisted dying that are not within the aim of this Bill. Therefore, asking this question of a person in the preliminary discussion is the bare minimum of what is needed here.
Amendments 45, 46, 47, 48, 49 and 58 all strike at what many other noble Lords have spoken about today: that pressure, coercion, influence, encouragement, whatever word is most legally appropriate, is subtle and complex. When asked about the meaning of pressure during the Select Committee, the Royal College of Psychiatrists cited
“expectation or the worry of letting someone down”.
In a sense, for me, that gets to the heart of why it is so important that we define these feelings and decide what we think about them. We have also heard not only how hard it is to define the term we want to use but how hard it is to spot it. We heard examples of how we are not spotting coercion already today.
We have also heard how hard it is to train. Certainly, one of my concerns in the discussion of the Bill so far has been that often our focus is on medical staff, but actually people spend much more time with support assistants, with nurses, with occupational therapists and a whole range of people, not just medical staff. Often, if somebody wants to talk about dying, it is not with the doctor but with the person who has spent more time with them, and that is a whole array of people. Therefore, training is much broader than I think we often see it.
It is also true that I suspect most of us at times feel obliged to, or a responsibility for, our family. There will be some point in our life, whether through illness or otherwise, when we have felt a burden to others. The reality is that our decisions do not live within a vacuum; they are shaped by the many currents of our life, which are different at different stages. I believe that the Bill’s supporters have decided that the policy intent is that, even if somebody chooses assisted death to save their family the cost of care, that is okay as long as it is their decision and free from coercion. Amendments 47, 48, 49 and 58 demonstrate why this is not okay. They get to the heart of how subtle coercion is. It is not just personal. As we have already heard, it can be society-wide. Discrimination in healthcare provision and failure to resource palliative care or adult social care adequately are examples of this. Indeed, describing indignity as the loss of physical function, or of incontinence, or the reliance on care, is another societal example of this. We need to remind ourselves that each person is of immeasurable value which cannot be diminished by illness, disability or care costs.
I turn finally to Amendment 222, in the name of the noble Baroness, Lady Hollins. Though we have been rightly focusing on the person at the centre of making a choice about their death, as we have heard, death affects so many more people than the person who has died. The National Bereavement Alliance has said that the needs of family members, including children, both before and after death, must be considered and met. We know that people who are bereaved unexpectedly are more likely to experience complex and prolonged grief, which is associated with worse physical and mental health, including suicidal ideation. The bereavement sector forum convened by AtaLoss highlighted the risk that the kind of grief associated with assisted death is very similar. It warned that the impact of failing to address it with the right support will bring costs not just on acute services and social care but on individual people.
That complex grief is also well documented in Canada. The Bill has encouraged helpful conversation about death and dying, but we must make sure that the Bill is clear on guidance and support for many families and friends who are involved with somebody who has requested assisted dying. The work of the UK Bereavement Commission highlighted that people still do not have access today to the bereavement support that they need, and there remains a lack of understanding of the cultural and faith considerations that many communities require for death. I hope that Amendment 222 will be an opportunity for us to be proactive about making sure that family, friends and loved ones can access the bereavement support they require.
I think it might be appropriate to hear from somebody who is not against the Bill. We have heard endless interventions.
My Lords, I want to respond to the noble Lord, Lord Griffiths, who is a member of the Labour Party. With respect, I would like the Committee to listen.
Lord in Waiting/Government Whip (Lord Lemos) (Lab)
Does my noble friend Lady Hayter want to make one point? Then we can hear from the noble Lord, Lord Polak.
My one point is that it would very nice if somebody who supports the Bill could also have a hearing.
It is a shame, because I have a particular and important point to raise in response to the noble Lord, Lord Griffiths.
I will. I was given six months to live 37 years ago. I do not often share this personal issue. I stand here today as living proof that prognosis is not certainty. Estimates are sometimes wrong and sometimes wildly wrong. That experience shapes my approach to this legislation and underlines why safeguards matter so profoundly.
When I spoke at Second Reading, I made it clear that I was against the premise of the Bill, and that remains my conviction. However, if the House decides that the Bill should proceed, it must do so with the strongest possible protections, and I support many of the amendments that were mentioned, particularly Amendment 46 in the name of the noble Baroness, Lady Finlay.
In listening to the debate, I was particularly moved by the noble Lords, Lord Evans, Lord Carlile and Lord Deben, and by the noble Baroness, Lady Fox, on the issue of coercion and encouraging. I actually pay tribute to the noble and learned Lord, Lord Falconer, on this whole issue, which is so difficult. I understand. I think that he is plastering over gaping wounds in the Bill. In fact, I think he must have more plasters than my local pharmacy. I will return to this properly when I speak to my own amendments, but I want to say that this vital piece of legislation is not fit for purpose, no matter how many amendments or how many plasters. I think we need to look.
I shall end with just these words: when we debate matters of life and death, we do so with the utmost seriousness. I believe that those who brought forward the Bill are acting from the highest motives, and I respect that, but in moments such as these, I know the whole House feels the absence of the wise counsel of the late Lord Sacks. He reminded us that purity of motive does not guarantee rightness of outcome. Our responsibility here is clear: to ensure that the law we craft is robust, precise and overridingly safe.
My Lords, this has been something of an unbalanced debate, so I hope it might be possible to hear from someone who supports the Bill. I was particularly anxious to come before the noble Lord, Lord Polak—for whom I have a lot of respect; we agree on many other issues—to respond very soon after the right reverend Prelate the Bishop of London. She was very honest when she said that she did not support the Bill, and I think she said that it was unamendable. Here we are, however, discussing amendments.
The noble Lord, Lord Carlile, spoke earlier about whether we should discuss a form of wording on which we could all agree. The question then would be: if we can agree a form of wording, would he then support the Bill? My feeling is that these amendments are not about making the Bill acceptable so that those putting them forward could then support it but are a way of trying to stop our discussion and proper scrutiny, because they do not want the Bill to go ahead.
(1 week, 1 day ago)
Lords Chamber
Lord Shinkwin (Con)
My Lords, I apologise, but I rise to raise a procedural issue crucial to the reputation of your Lordships’ House. When I blocked out my diary for the Fridays scheduled for Committee on this Bill, I did so in good faith. I assumed not only that your Lordships’ House would recognise the value of the views of Members with lifelong lived experience of disability, but that steps would be taken to ensure that those views were heard on an equal and non-discriminatory basis. That would be entirely in keeping with the Equality Act 2010, which placed on organisations a legal duty to make reasonable adjustments on account of disability in, among other things, the way in which they work.
In the belief that your Lordships’ House and the Government will appreciate the crucial importance of our being seen to set an example and uphold the law, which we passed and which we expect others to abide by, I emailed the Government Chief Whip and wrote to the Prime Minister to explain that, because of my disability, I need to leave by 3 pm in order to catch my flight home. I requested an assurance that the House would not sit beyond 3 pm, which is of course the time by when the House normally rises on a sitting Friday. Regrettably, I have been given no such assurance. Instead, the Government are using a procedural technicality as a feeble fig leaf for discrimination against me as one of the House’s Members—one of its few Members—with lifelong disability. I do not believe it is beyond the wit or the will of the Government, or indeed your Lordships’ House, to ensure that we rise by 3 pm so that I can participate today and on other sitting Fridays on an equal and non-discriminatory basis. Given that not one organisation of or for disabled people supports this Bill, surely it is right that all of us—every one of us—are enabled to do our duty of subjecting this monumentally significant Bill to the forensic scrutiny it requires.
In conclusion, do we really want to send the message to those who are following our proceedings today, “Do as we say, not as we do”? That would be shameful and it would be unworthy of your Lordships’ House. For our own sake, I urge the House not to discriminate against me as one of the very few Members born disabled. I therefore ask that the House rises by 3pm.
My Lords, I have every sympathy with the noble Lord, but I would like to thank the Chief Whip, the noble Lord, Lord Kennedy, for his willingness to listen and to be flexible, especially when I, together with a number of colleagues, asked for the Second Reading to be split into two days. In the Chief Whip’s remarks yesterday, he talked about convention and tradition, and so we are to rise at 3 pm or thereabouts. I place on record that, as a modern Orthodox Jewish Member of your Lordships’ House, sitting on Fridays in the winter is deeply problematic. Shabbat begins today at 3.54 pm; on 5 December, it will begin at 3.35 pm and on 12 December at 3.33 pm. Your Lordships will know that, by 3.54 pm today, I and others will need to be ready for Shabbat, and I will be in synagogue.
Keeping with my tradition, as the House will follow its tradition, there will be times, therefore, over the coming weeks that I and some others will be absent— I hope that that does not occur when I have an amendment in my name to speak to. I am grateful for the indulgence of the House, but I felt it really important to place this matter on the record as we begin Committee, which will take place only on Fridays.
Lord Ahmad of Wimbledon (Con)
My Lords, I suppose it would be apt for me to complete the Holy Trinity of faith. We have started with the Christian faith, we have heard a Jewish dimension and we have heard about equality and opportunity. As a member of the Islamic faith and as a practising Muslim, I say that, while I fully respect the House and I am grateful to the Chief Whip and the Leader, it is important that we reflect all traditions.
One of the main challenges that I have with this Bill is the lack of consultations with different communities. As many noble Lords will be aware, Friday is also a sacred day for Muslims, particularly in the middle of the day with the Jummah prayer. I just flag that point. I of course respect the organisation and the business of the House, but ask that there is time for those who practise the faith and choose to offer prayer by congregation in the middle of the day. Following on in support of my noble friends Lord Shinkwin and Lord Polak, I think that the diversity of our country, the diversity of the House and the respect of all traditions and faiths is something that should be borne in mind.
(5 months, 1 week ago)
Grand CommitteeMy Lords, I also congratulate the noble Lord, Lord Booth, on securing the debate. After listening to his story, I am rather glad that we were able to listen to him today. I have also listened to grieving families, passionate campaigners and dedicated cardiologists, each of them urging us to act more boldly on the issue of sudden cardiac arrest in the young.
Earlier this year, I had the privilege of co-hosting a symposium with the Italian embassy and Ambassador Lambertini. We brought together leading cardiologists and sports scientists from the UK and Italy to share insight, evidence and experience on preventing sudden cardiac death in young people. Tragically, it is not a marginal issue. Every week in the UK, at least 12 young people—children, students and athletes—die from sudden cardiac arrest. That is the equivalent of a full secondary school wiped out every year. What is more disturbing is that 80% of those young people had no prior symptoms. They were seemingly healthy, vibrant and active. Sport can exacerbate hidden conditions, putting young people at three times greater risk, yet 80% of these deaths occur in sleep, which means that defibrillators, while essential, cannot be the whole answer. We must move from crisis response to prevention.
I have campaigned alongside Mark King, who tragically lost his son Oliver at just 12 years old during a swimming lesson at my old school—King David High School in Liverpool. Together we pushed for greater access to defibrillators in schools and public venues, but even more pressing is the need for screening to detect these conditions before they claim a young life. One mother, Hilary Nicholls, shared with me the story of her daughter Clarissa. She was just 20 years old, full of promise, physically active and with no diagnosed heart condition or health issues. Her sudden death from an undiagnosed cardiac condition was devastating. Tragically, her story is not unique, so the case for widened access to ECG screening is clear.
In elite sports such as football and rugby, we have mandatory screening in place, led by UK-devised international ECG protocols. But, beyond elite sport, there is a vacuum. Students, grass-roots athletes and local community clubs are largely left unprotected. Compare that to Italy, which I recently travelled to with Hilary to see the model in action. For over 40 years, it has had a mandatory pre-participation screening programme. Young people must present a certificate before taking part in organised sport or joining a gym, and the result is an 89% reduction in sudden cardiac deaths. While I acknowledge that there are different views across Europe on the rigidity of such systems, the outcome speaks for itself. Italy shows us what can be done when there is political will, public buy-in and healthcare alignment. I also pay tribute to CRY—Cardiac Risk in the Young—and its chief executive, Steven Cox, for the excellent work the charity does in raising awareness. It has been doing so since it was founded by Alison Cox in 1995.
I do not propose a copy/paste solution, but I urge the Government and my noble friend the Minister to act on what we already know. What is needed is modest and actionable: first, more specialist training to interpret ECGs in fit and active young people; secondly, increased local capacity to carry out screenings in schools, universities and community sport—I urge the Minister to meet Hilary to look at some of the remarkable programmes in testing that Clarissa’s friends have put in place at Cambridge University; and, thirdly, greater education around cardiac health, defibrillator use and prevention woven into our schools and clubs.
We must listen to families; we must act on evidence; we must catch the condition before it catches our children. These are preventable deaths. Let us not look back in five years and say that we could and should have done more. Let us act now to save young lives.
(7 months, 2 weeks ago)
Lords ChamberI am not aware of the specifics around that point, but we will be very pleased to look into that because we do not want people to be inconvenienced and distressed even further.
My Lords, the Minister will know that, in the Jewish community, we bury our deceased within 24 hours. I have not noticed any change in that since September—so perhaps that fact will help her.
I am grateful to the noble Lord. He is of course aware that, as the former chief executive of the Board of Deputies of British Jews before coming to this place, I worked on this very area to ensure that there were swift responses and burials for the faith communities that require them. That continues to be a great focus of our work.
(2 years, 1 month ago)
Lords ChamberMy Lords, it is a great honour to follow the right reverend Prelate. In the same way, it was a great honour to have been a member of the Adult Social Care Committee. I pay tribute to the noble Baroness, Lady Andrews, and the other members of the committee who took me along with them.
It was a learning experience for me, and there are one or two points that I would like to pick up. I notice that the noble Baroness, Lady Barker, is, sadly, not in her place. The thing I learned from her is something that we do not always think about: she talked a lot about the issue of ageing without children. I thank God that I have family and that we looked after my mother, who I will come on to in a minute. It is something that you do not appreciate until you hear it. The noble Baroness is a great champion for understanding that this will affect many, many people across the country. I was glad to learn that from her.
Similarly, I was very much a supporter of the suggestion, as mentioned by the noble Lord, Lord Bradley, that we ought to have a commissioner for care and support. Just as the noble Baroness, Lady Barker, is a champion for her issue, we need a champion who can help my noble friend the Minister and other members of the Government to focus on this. Otherwise, it gets trodden down and nobody really takes responsibility; it is too big and, in the end, nothing really happens.
I made a plea last time I spoke on this subject and I make no apologies for repeating it. Looking around the House, I say to everybody: the one thing I learned is that it is important to take politics out of social care. Let us get politics out of it and let us try to help.
In the end, for me, it was an experience that suddenly became practical. During the time that we were sitting as a committee, my mother took ill in Liverpool; she sadly passed a few months ago. What is overridingly important is to have something that we missed—we did not understand what to do as a family; I have just made a note to call it a “guide for the ignorant”. We need a guide so that, when people find themselves in a situation like this, they know what to do, who to ring, where to go, who to ask. Currently, it is a lottery.
As it happens, I am from Liverpool and the organisation there was pretty impressive. There was a STARS scheme, which the Marie Curie centre had put on, and they came in to see my mum four times a day while she needed help. Without that, I do not know what we would have done. I live here, my sister lives in London and my mum was in a flat in Liverpool.
The experiences we had throughout were horrendous. As I have said once before here in the House, we experienced the best and the worst. The worst was when a nurse was assessing my mum—who could not speak any more—to see what the next stage of care would be. The nurse was in Maidenhead, or somewhere in Kent, and she was in Liverpool, unable to speak, and they did it on Zoom. It was a relic of Covid, of course, but it was no help to my mum at all. It took weeks before they had to pass on their report, from Margate, to a panel of three people who had never met my mother, to decide what sort of care she would get. It is mad. I repeat: we need a guide for the ignorant. The Government need to provide something like this so that people know where to go.
To conclude that story, the Marie Curie hospice in Liverpool was amazing; the people there were amazing. They cared for my mum for three and half months, which is pretty unusual in a hospice. They could not have been nicer. I remember after she passed, I thanked them for everything they had done and then I said, “But where is the gold watch? She has been in a hospice for three and half months”. They were amazing and I shout out to them.
In conclusion, it was a deep honour to have been a member of the committee chaired by the noble Baroness, Lady Andrews, and I learned so much. Following the point made by the noble Baroness, Lady Fraser, I ask the Minister to explain the role of data and patient records, and how we can use technology to support people to stay in their homes as long as possible.
(2 years, 7 months ago)
Lords ChamberMy Lords, it is an honour to follow the noble Baroness, Lady Campbell. I learned so much from her. It was also an honour to have served on the Adult Social Care Committee under the expert chairmanship of the noble Baroness, Lady Andrews, and I also pay tribute to the excellent support staff that we had. When I joined the committee, I thought it would be an important learning experience in an area that I was not particularly familiar with. However, as we met and listened to witnesses, it became apparent that this was not an academic exercise but, sadly, a practical guide for me and my family, as it is in one way or another for every family in the country.
I will concentrate on just one area of the report, on page 45 with the heading “Navigating the social care system: a constant fight”. Paragraph 147 states:
“Whether it is trying to get support for themselves or for the person they provide care for, unpaid carers often find that they are left to their own devices when it comes to navigating the adult social care system”.
As stated in our report, witnesses found it difficult to organise formal support for the person they care for.
Because of the difficulty of accessing care and support, social workers and local authorities are seen as gatekeepers, and there is little trust in the system’s ability or willingness to provide help. How sad, as my noble friend Lady Fraser said, that some unpaid carers told us that they live in fear of assessments which they see as a process designed to minimise their needs so as to deny them support.
I totally understand. My mother is suffering from brain cancer and has 24/7 care at home in Liverpool. We have experienced, and are experiencing, both some of the best and the worst that the system has to offer. On the positive side, the care and attention of the Marie Curie Hospice in Woolton, Liverpool, led by the deeply sensitive and professional palliative care doctor Dr Mark Mills and his team, has been exemplary. While mum is at home, the staff at the hospice have been an enormous comfort and help, not just to my mum but to my sister and brother too.
On the other hand, the experience we have had with the local authority assessors has been woeful. On 9 February, my mother was assessed by a nurse via Zoom. The nurse was in Kent and my mother was over 200 miles away, unable to communicate, in her bed in Liverpool. The assessment was to decide what the immediate next step for her care plan should be. The report, compiled by a nurse who has never met my mother, was then to be sent to an unknown panel of people who also have never met her to decide the best course of treatment and care. This absurd assessment was executed over a three-hour Zoom call seven weeks ago, and as I stand here today, we have heard nothing. The system is sadly broken. As we speak, we should consider that people up and down the country are battling to understand an incomprehensible system at the same time as trying to care for their loved ones as best they can.
During the committee’s deliberations, we understood that we were not going to be able to change a system that desperately needs an overhaul, but we were attempting to move the dial a little to bring some clarity to people doing their utmost to care. Our committee has made 36 recommendations, and that only scratches the surface. Each one is important. My own experiences have made me think more carefully, for example, about the point forcefully and powerfully made by the noble Baroness, Lady Barker, about people without children ageing. Like the noble Baroness, Lady Andrews, and the noble Lord, Lord Bradley, I urge my noble friend the Minister to look carefully at recommendation 9, where we ask the Government to establish a commissioner for care to bring about a more accessible adult social care system. I concur with the suggested actions on page 45 of the Archbishops’ report that assessment and budget planning should be simple and consistent, and that care planning services should be focused on what matters to people.
I appeal across this House to all parties and to none to help that commissioner to take the politics out of care. We must come together to find and implement an urgent solution so that people up and down the country can fulfil with dignity what the late Lord Sacks wrote in his book Celebrating Life—that the supreme act of caring is to make a difference to someone else’s life. In his book the Dignity of Difference, he said, “To care is to look into the face of the other and see their uniqueness, their vulnerability and their pain”.
(2 years, 10 months ago)
Lords ChamberThis is the whole point and the way that we are moving; the real decision-makers running their local areas should be the ICBs. They know their areas and the needs of the people—including people with special needs and learning disabilities—more than anyone. It is absolutely their responsibility to understand the needs in their areas and to ensure that they are provided for under the commissions.
My Lords, unpaid carers throughout the country are, more than often, working 24/7. The Care Act 2014 requires local authorities to deliver this high-quality care, including support for unpaid carers. How confident are my noble friend the Minister and his department that local authorities will undertake carers’ assessments for unpaid carers?
From my experience I understand that this is a very important part of their remit and role. As we are all aware, the unpaid carer role is vital and historically has probably not been recognised as much as it should have been.
(3 years, 2 months ago)
Lords ChamberThe Government have been committed to ensuring that there is equality for disabled people, including plenty of initiatives in other sectors—transport, building new homes and offices, and retrofitting—but the issue of personal assistance is a particularly difficult one in the context of social care having been treated as a Cinderella service for years. Some of the initiatives that we are putting in place, such as the proper qualifications and recruitment from overseas, sadly do not yet apply to personal assistants because of the rules. We are looking at those barriers and hopefully will be able to tackle them.
My Lords, I am a member of the Adult Social Care Committee in your Lordships’ House, chaired by the noble Baroness, Lady Andrews. We are looking at the invisibility of the unpaid carer, but it was timely that yesterday we went to Real, a charity in Tower Hamlets. It was a humbling and educational experience in which the difficulties and issues within the social care system for disabled people were brought to us. The difficulty of accessing PAs was very clear. My noble friend the Minister highlighted the problem in one of his answers. He said that maybe we need go to DWP or maybe we need it to be here. It needs to be coherent. To help those people, it needs to be one person, one Minister, one department dealing with this matter.
My noble friend makes a very important point. I have found this to be the case with a number of initiatives that I have been working on in my department. Quite often, I will have a joint meeting on an issue—with someone from BEIS, for example—and I then realise that they have to go and talk to someone else outside of the room. When I have been involved in such initiatives, I have always insisted that whoever else across government has a role or interest in them is in the room with us. This is clearly another example of what should be happening. It should be jointly DHSC and DWP. Rather than thinking about whose responsibility it is, we should work together to find a common solution.
(3 years, 5 months ago)
Lords ChamberIf noble Lords will excuse the pun, one of the heartening things in answering this is that, when I received briefing on this, it is really important and interesting how we are working across government. It is not only in the Department of Health; we are working with the Department for Transport on transport locations, DCMS on sports grounds, the Department for Education on education settings and other departments. This is really a cross-government initiative.
My Lords, I was privileged to be at a meeting with Jamie Carragher and Mark King of the Oliver King Foundation and Secretary of State Nadhim Zahawi only a few weeks ago. At that meeting with some senior civil servants, he more than indicated that the Department for Education would be very keen to ensure that defibrillators will be in every single school and will not be waiting for the rebuild that has been mentioned. I urge the Minister to go back to the Department for Education and ensure that this happens. The Oliver King Foundation was founded because Mark King’s son, Oliver, passed away at 11 or 12 at a swimming baths in my old school in Liverpool because there was no defibrillator. The point about sports places is right. Can he go back to the Department for Education, get this commitment which I have heard with my own ears and make sure that every school has a defibrillator as soon as possible?
I thank my noble friend for his question. I know he has a long-term interest in this area. Of course I will go back to my department and talk about this. The important thing is making sure that we have more locations, that there is awareness and that people are educated in how to use defibrillators and in wider CPR.
(3 years, 9 months ago)
Lords ChamberMy Lords, the Government should embrace this amendment. I want to concentrate on the traceability argument of goods, and in particular cotton imports. Without good traceability, the genocide convention obligations cannot be met.
To date, I have had two very poor replies on cotton traceability from the noble Lord, Lord Grimstone of Boscobel, at Question Time on 21 October, and a Written Answer on 24 January. Of course, as has already been said, we are miles away from the policies of the United States Government, who have taken a proactive approach to imports from regions of China where we know human rights abuses take place. As has been said, on 23 December, President Biden signed the legislation into law.
It simply cannot be left to commercial companies to satisfy themselves. It is crucial to understand the geographic origins of products and conditions of production. The two things are intertwined and they both need to be dealt with. There has to be a robust methodology that is reliable even when working with partners that may be untrustworthy or unco-operative. The use of middlemen such as commodity traders and the practice of blending fibre from multiple sources create additional difficulty.
Traceability—both what is termed as upstream, starting at the farm, or downstream, to map products back to their origins—is currently used. However, full visibility of the supply chain using these methods is impossible, and especially so in restricted areas such as Xinjiang Uyghur Autonomous Region. It is just impossible to do in the normal way you would look at traceability. If the Minister is in doubt about this, his department should read the report from the Center for Strategic and International Studies of November last year entitled:
“New Approaches to Supply Chain Traceability (implications for Xinjiang and Beyond)”.
My conclusion from that is that paper-based traceability and supplier information is a non-starter for effective due diligence.
In addition, there is abundant evidence that the Chinese Communist Party, which owns China, actually launders Xinjiang cotton, either semi-finished or blended, into international supply chains. This is set out in considerable detail in the November 2021 paper by Laura T. Murphy of Sheffield Hallam University entitled:
“Laundering Cotton: How Xinjiang Cotton is Obscured in International Supply Chains”.
In 2019, it was established that 85% of Chinese cotton was from Xinjiang. That means that cotton from the Uyghur region of China accounts for 22%—a fifth—of cotton worldwide. What was once grown or reared retains details of its origins—in a way, this is the test. However, it takes more than a paper trail to identify as such. It requires forensic work; chemical, isotope and genetic tracing and other methods that I will not list here are all crucial.
I will give a good example. From 1,000 garment samples collected across the world in high-street fashion shops involving nearly 50 brands, Oritain Global Ltd detected that in Vietnam, Cambodia and Bangladesh, the cotton in the garments had a mixture from Xinjiang of between 6.5% and 25%. Chinese cotton was 41% consistent with Xinjiang. Some 10% of samples of products tested in the UK were consistent with Xinjiang cotton. The UK has a high rate of imports from Bangladesh, where 25% of the cotton was from Xinjiang. It is worth pointing out that India has zero consistency with Xinjiang; India has cleared out Chinese cotton fabrication.
As to the practicalities for the health service, in 2019, the UK imported furniture, bedding and mattresses from China to the tune of £2.3 billion and imported apparel and clothing accessories to the tune of £3.7 billion. Has the NHS used beds and mattresses containing cotton from China or from suppliers using connections with China or other countries known to have a mixture of Xinjiang cotton? Where did all the Nightingale equipment appear from so quickly? As I asked last week, without any warning, how much China cotton is involved in NHS uniforms and accessories? Others have mentioned face masks, but as I pointed out last Thursday, more nurses means more uniforms.
Has the NHS supply chain used Oritain’s element analysis to check, or is it just relying on suppliers’ paperwork to check what would be only part of the supply chain? Companies and Governments need a degree of independence in assessing traceability and to not rely on companies doing it themselves. Some of the supply chains are five or six levels removed, so they cannot possibly have faith in each level and know the details from manufacturers, middlemen, traders, and agents. With the best will in the world and good corporate responsibility, checking the paper trail of five, six or seven levels will not work.
As I said earlier, the way to do it is to work on the basis that a product that was once grown or reared holds signs of its origins, and today’s advanced technology can do it. The technology of element analysis used by Oritain claims that it can tell the difference between two tea estates with a dirt road between them—it is so good and effective. For those who want more, I suggest the long read in the Guardian of 16 September 2021, which is where I came across the use of the technology. I have since met with senior reps of Oritain Global Ltd to better brief myself. Modern forensic technologies must be used, as is now required in the USA. The United States is using these technologies. Why are they not being used in the UK? The NHS, as the largest employer in Europe, should have a leading role.
It is not normal for the origin of cotton to be stated on labels. Of those 1,000 products which I mentioned were checked by Oritain last year, only 3% had the information on the label and, as a warning, the higher quality a product which attracts higher prices is more likely to be consistent with Xinjiang than cheaper items, so you must be really careful what you are looking at. Non-disclosure is almost the norm and of those who do disclose there is a high percentage of non-compliance, so labels and paperwork are not the answer.
Technology is the answer, and the ball is in the Government’s court. The old-fashioned gentlemen’s agreements and systems we are used to will not work. Modern technology is thought to be 95% accurate in identifying where an item was grown or reared. Only with that degree of information can the NHS satisfy the convention obligations. Otherwise, it will not work. The Government ought to embrace the amendment and then the new technology.
My Lords, I pay tribute to my noble friends Lord Blencathra and Lady Hodgson, the noble Lord, Lord Alton, and the noble Baroness, Lady Kennedy of The Shaws, for tabling this important amendment. My noble friend Lady Sugg referred to last Thursday. That was 27 January, when the world came together for Holocaust Memorial Day in memory of the millions murdered under Nazi persecution. Members in the other place stood up and pledged “Never forget, never again”, while we in your Lordships’ Chamber sadly did not find a way to mark the day. Today, I repeat that promise.
Since the start of the pandemic, it seems that millions of pounds-worth of healthcare equipment have been procured from Xinjiang, despite the reports of the appalling treatment of the Uighurs. Will the Minister tell us whether our pandemic response benefited from procured equipment exported from Xinjiang?