Infected Blood Inquiry: Compensation Scheme

Debate between Lord Reid of Cardowan and Earl Howe

Wednesday 22nd May 2024 Lords Chamber

[Earl Howe (Con)]

My Lords, I have no doubt that the same thought has occurred to many of your Lordships. The systemic moral failings exposed by Sir Brian Langstaff in relation to infected blood raise profound questions about the defensive culture of government and the public services at every level. The findings of this recent report undoubtedly have a resonance with a number of findings in other reports on high-profile calamities, and this issue merits deep reflection and honest thinking across government and the public sector.

[Lord Reid of Cardowan (Lab)]

My Lords, as a former Secretary of State for Health, I associate myself completely with the expressions of regret and apology issued by the Prime Minister, the leader of the Opposition and, indeed, my noble friend Lady Primarolo today. As far as compensation is concerned, as Secretary of State I managed to give some financial assistance to those suffering from hep C, but only by reversing a very long-standing policy against huge resistance. It has been noted that civil servants are sometimes unwilling to change. What has not been noted is that one institution in government has the right to prevent such things being done but does not carry responsibility if there is a mistake: the Treasury. I warn the Minister now, if he is here after 5 pm today, that the Treasury will always try to find a way, because it does not recognise moral compulsion—but that should be as important to us as legal liability.

[Earl Howe (Con)]

My Lords, I am sure that the noble Lord’s words will resonate with anyone in this Chamber who has had the privilege of ministerial responsibility. Having said that, I do not think we should necessarily point the finger solely at the Treasury when it comes to the responsibility that lies at every level of government in this terrible disaster.

Levelling-up and Regeneration Bill

Debate between Lord Reid of Cardowan and Earl Howe

Report stage
Thursday 13th July 2023 Lords Chamber

[Lord Reid of Cardowan (Lab)]

I am trying to follow the Minister’s logic, but I am afraid that my intellectual capacity prevents me doing so. I therefore ask a simple question. By all logic of his argument, there should be no hybrid Select Committee meetings in this House, yet there are. Does he think that that therefore devalues those Select Committee meetings?

[Earl Howe (Con)]

That point is very similar to one made by the noble Baroness, Lady Hayman, and my noble friend about an option of virtual attendance in case of illness or disability—as we have in this Chamber—but that option is on an exceptional basis. With great respect, that is a far cry from the terms of the amendment that my noble friend has tabled. We know what effective debating looks like: it is when we can stand in this Chamber and look each other in the eye—as at present—as active participants.

No limits are placed on authorities broadcasting their meetings online, and I would encourage them to do so to reach as wide an audience as possible. However, I hope that my noble friend Lady McIntosh and other noble Lords who have aligned themselves with her position will understand why I am coming at this from the point of view of a principle: that it is our duty to safeguard democracy as fully as we can and not to short-change it. I hope therefore that my noble friend will not feel compelled to oppose that principle by dividing the House today.

Questions for Written Answers

Debate between Lord Reid of Cardowan and Earl Howe

Monday 22nd February 2021 Lords Chamber

[Earl Howe (Con)]

My Lords, it is clearly far from ideal that some Members of this House, including the noble Baroness, have waited as long as they have for Written Answers. In ordinary circumstances, it would be completely unacceptable. I am sorry that it has happened. All departments have been under pressure during the Covid emergency; even so, I can tell the House that in January this year 84% of Written Questions from your Lordships were answered on time. It is perhaps worth my saying that it is open to any noble Lord who is unsatisfied with an Answer they receive to ask a follow-up Question.

[Lord Reid of Cardowan (Lab) [V]]

My Lords, I thank the Minister, but this is not just an isolated complaint; it has become more of an established pattern that is not confined to Written Questions, important though they are. Select Committee reports are now routinely overdue. I am afraid it cannot all be blamed on Covid-19; complaints about delays in Questions predate it, as do the consistent overruns in responses to Select Committee reports, from as far back as the 2015-17 Session. This is now a systemic problem. Will the Minister institute a thorough review into this matter and report back to your Lordships’ House?

[Earl Howe (Con)]

My Lords, I am grateful to the noble Lord and shall certainly take his comments on board and transmit them to members of my Front Bench and the usual channels. I am aware that there is concern about the matters he raised, which run more widely than simply Questions for Written Answer.

Army: Divisional Manoeuvre and Deployment Training

Debate between Lord Reid of Cardowan and Earl Howe

Tuesday 8th January 2019 Lords Chamber

[Earl Howe]

With respect to the noble Lord, in effect it has done so. Exercise Saif Sareea in Oman, for example, which the noble Lord will be aware of, demonstrated very capably the Army’s ability to deploy in strength overseas with partners. I can reassure the noble Lord that the training the Army undertakes, both in the field and by way of simulation, is fully up to the standards he would expect and enables the Army to be confident of its ability to field a division.

[Lord Reid of Cardowan (Lab)]

My Lords, the essential prerequisite for putting an Army into the field is the capacity to recruit enough soldiers. Without that, you can do very little. We now have the smallest Army since the Napoleonic wars. We have a reduced target of 80,000, which we have failed to meet by several thousand, and we have just launched a campaign through newspapers and the media to recruit snowflakes. This must terrify the Russians. Who is responsible for this? Is it Ministers, civil servants or the outsourced company that has failed so miserably to produce our soldiers?

[Earl Howe]

My Lords, the responsibility for Army recruitment lies chiefly with the Army itself in conjunction with Capita, with which it has a partnership agreement. I completely accept that Army recruitment figures have fallen seriously short of target. A great deal of work is going on to remedy that. Encouragingly, the number of applications to join the Army over the last year is at a five-year high. The challenge now is to improve the conversion rate between those who apply and those who join, and there are signs of progress in that area as well.

Armed Forces: Investment

Debate between Lord Reid of Cardowan and Earl Howe

Monday 22nd January 2018 Lords Chamber

[Earl Howe]

My Lords, as my noble friend knows, this House returns to the subject of defence at regular intervals, but I will of course convey his request to the usual channels. I, for one, would be more than happy to take part in such a debate. I am of course aware of the disquiet to which he refers; I have been made aware of it across your Lordships’ House over many weeks. However, the exercise that we are doing is very important: it is to make sure that we have Armed Forces that are fit for the future, not the past.

[Lord Reid of Cardowan (Lab)]

My Lords, the Minister declared that the central area in this is agility—those were his words. Agility runs through three essential elements: air mobility, marines and naval mobility, and cyber, which now permeates all defence. Can he therefore guarantee that there will be no cuts to the marines, no cutbacks to air mobility, and that cyber will be an integral part of the first major report rather than a separate issue dealt with by a department other than defence?

[Earl Howe]

My Lords, as I have made clear in this House, there is no question of this country abandoning its amphibious capability or cyber, quite the opposite: there is a £1.9 billion programme across government to boost our cyber capabilities. However, as I said last Thursday, the NSCR may result in our reprioritising how we allocate our resources to emphasise the most effective capabilities for the world in which we operate.

Counter-Daesh Update

Debate between Lord Reid of Cardowan and Earl Howe

Tuesday 7th November 2017 Lords Chamber

[Lord Reid of Cardowan (Lab)]

My Lords, I am sure that on the sad and sensitive case that has been mentioned the Foreign Secretary would benefit from the Minister’s wisdom. The Foreign Secretary today admitted that, in his testimony to the Foreign Affairs Committee on Mrs Nazanin Zaghari-Ratcliffe, his remarks “could have been clearer”. We may think that is rather a generous interpretation and description of his testimony. However, leaving that aside, can the Minister explain why the Secretary of State for Foreign Affairs, having said that today, refused either to apologise or, more importantly, to accept the invitation extended to him in the House by a member of the Foreign Affairs Committee, Mike Gapes, to write and correct his transcript if he had misspoken. We know that we can all misspeak in front of committees and elsewhere. However, the opportunity is there to change that record by correction. He was given the invitation today and I do not understand why he did not accept it. Can the Minister impress this upon him? If he leaves it uncorrected through his own free will, he will compound the initial problem. It may well be, as the noble Lord, Lord Campbell, said, that it cannot be changed now in consequence, but at least it can be changed on the record. The wisdom of the Minister would be useful in speaking to the Foreign Secretary on this matter.

[Earl Howe]

My Lords, I will ensure that the noble Lord’s remarks are conveyed to the appropriate quarter and I thank him for them. In my right honourable friend’s defence, he has been as keen as anybody to emphasise to the Iranians that there are obvious humanitarian grounds for the release of some of our dual nationals. He has pressed consistently for consular access and has done everything that he feels appropriate to reunite those detainees with their families. It is important that noble Lords understand that while he may indeed have misspoken—and I will put that to him; I am sure that it has been put to him—he has in the background been doing what I am sure all noble Lords would wish.

Report of the Iraq Inquiry

Debate between Lord Reid of Cardowan and Earl Howe

Wednesday 6th July 2016 Lords Chamber

[Earl Howe]

With respect to the noble Baroness, we are dealing with two very different situations. It is not the business of Sir John Chilcot to comment on issues of that kind. Indeed, there is an opportunity for the noble Baroness to make points of that sort during the debate that is continuing later today. I shall have to reflect on what she said but I do not have a ready answer at the moment.

[Lord Reid of Cardowan (Lab)]

My Lords, as a member of the then Cabinet, along with my noble friends, I first express my condolences, with everyone else, to the Armed Forces and congratulate them, as my noble friend Lord West said, on carrying out their duty to the country. When I say that, I mean every member of the Armed Forces, up to and including the Chiefs of Staff and the Chiefs of the Defence Staff, who have committed their lives to this country and to doing their duty. We should accord that. They are people who have risked their lives themselves.

I do not like commenting on a report that I have not read in full and I freely admit that I have not had time to do that—it has not stopped others, of course, in the other place. I simply urge one thing on the Government: in congratulating John Chilcot and his team on the report they have produced, can we make a judicial distinction—I do not mean in a legal sense—between legitimate criticism of processes or other failures and what are political judgments? There is a danger that the Government will get themselves into a position regarding political judgments, which is what are exercised on intelligence and what are exercised, for instance, on the question of whether something was the last resort. Whether sanctions could have worked, or whether there were other diplomatic means, was very much in the minds of the Cabinet. Our political judgment was that they would not be sufficient to deter what we believed was the spread of chemical and biological weapons over there, not under democratic control, while over here, the other element of threat—intention—had been shown to be absolutely constrained at 9/11.

I welcome the report, I will study it carefully and we will learn the lessons, but at the end of the day it is elected Ministers who must exercise the judgment on some of these questions.

[Earl Howe]

First, I express my agreement with what the noble Lord has rightly said about the Chiefs of the Defence Staff and the Chiefs of Staff generally during the Iraq war and immediately afterward. They are all men of the highest ability and we owe them our gratitude, as much as we owe to the men and women in the field. I also agree that there is a distinction to be drawn between the processes of decision-making and the political judgments that are made. I simply point out that, in my view at least, the strength and integrity of the process underpins the reliability of the political judgments.

Counter-Daesh: Quarterly Update

Debate between Lord Reid of Cardowan and Earl Howe

Tuesday 24th May 2016 Lords Chamber

[Earl Howe]

My noble friend has strayed slightly from the anti-Daesh theme of the Statement, but I can tell him that we are concerned that al-Qaeda is regaining some of its former footholds in Afghanistan. Indeed, the Taliban has made recent gains as well, particularly in Helmand. This is something that we and our allies are looking at very closely. The Afghan armed forces have risen to the challenge that has faced them, but we are in no doubt that that challenge is increasing.

[Lord Reid of Cardowan (Lab)]

My Lords, the Minister mentioned that the Government had received criticism for their proactive countering of the Daesh and jihadist narrative and ideology. My own view is that the Government are absolutely right and deserve the support of this House. This phenomenon will not be defeated by force of arms alone: countering both the narrative and the underpinning ideology of the jihadists is an essential component in countering radicalisation, recruitment and ultimately their operational effectiveness.

The Minister mentioned the flow of jihadist recruiters to Syria. He did not say anything about the returnees. Will he say a quick word about what action is being taken to ensure the protection of the United Kingdom from those returning from Syria and, in particular, surveillance or deradicalisation programmes?

[Earl Howe]

My Lords, I agree with the noble Lord about the Prevent strategy. Currently, the greatest threat comes from terrorist recruiters inspired by Daesh. Our Prevent programme will necessarily reflect that by prioritising support for vulnerable Muslims and working in partnership with British Muslim communities and civil society groups. I do not have up-to-date information about the extent to which we have been able to intercept and assist—in the right sense—those returning from the Middle East, but I shall gain data from the Home Office, if I may, and write to the noble Lord about that.

Warships

Debate between Lord Reid of Cardowan and Earl Howe

Monday 11th April 2016 Lords Chamber

[Earl Howe]

My Lords, the programme has already been announced in the SDSR but, broadly, the “Queen Elizabeth” aircraft carrier itself will be in service by the early 2020s and we will have a number of F35s deployed on that ship. Indeed, we have accelerated the procurement programme for those aircraft.

[Lord Reid of Cardowan (Lab)]

My Lords, what strategic assessment has been made of the UK’s capacity for warship building with the potential closure of Port Talbot steel? If no such assessment has been made, does that mean that we intend to rely on other, friendly nations such as China to supply the steel for British warships?

[Earl Howe]

My Lords, the capacity of British industry to service our warship building requirements will be very much centre stage in Sir John Parker’s work on the shipbuilding strategy. As regards Port Talbot, I am sure that the noble Lord will know that the Government are committed to doing all they can to work with Tata to explore how we can support the company to secure a buyer for the plant and put in train a turnaround plan. We are working with the Welsh Government to do that. There is good news today on Tata’s plant in Scunthorpe, where a deal has been secured, but I assure the noble Lord that we regard British steel manufacturing as of vital importance to this programme.

Armed Forces: Future Force 2020

Debate between Lord Reid of Cardowan and Earl Howe

Thursday 25th February 2016 Lords Chamber

[Earl Howe]

My Lords, there are a number of pinch points in the armed services, but, broadly speaking, they are in areas where there are skills shortages in the wider economy. Medical expertise is one of those skills, but there are also areas specific to military organisations, such as logistics and intelligence. We are taking a multifaceted approach to tackling those shortages—for example, financial retention incentives, extensions and continuance of service, targeted recruitment incentives and a direct entry scheme—but there is no single bullet. I am aware that medical services represent a challenge, but one that I think we are slowly winning.

[Lord Reid of Cardowan (Lab)]

My Lords, it no doubt makes sense to leverage the private sector, especially in a fast-changing environment such as cyber, as the Minister said, but it raises a question, does it not? If we are relying on reservists, who by definition are not always available, to provide essential skills, who is providing the skills for the skills gap when they are not available?

[Earl Howe]

My Lords, as I am sure the noble Lord will know, the Royal Navy and the Royal Marines have an approach whereby they tend to train those already in regular service, but there is also a reliance on reserves. It is a question of getting the balance right in each discipline.

National Security Strategy and Strategic Defence and Security Review 2015

Debate between Lord Reid of Cardowan and Earl Howe

Monday 23rd November 2015 Lords Chamber

[Earl Howe]

My noble friend puts his finger on a central issue that we have been wrestling with over these past months. It is impossible to predict the threats that we will face in 10 or 15 years. We know that there are many uncertainties. The national security strategy sets out a quite different threat picture from that of 2010. In particular, the threat from terrorism has increased substantially and aggressive Russian behaviour means that state-based threats are more prominent. As the Statement said, we cannot choose between conventional defences against state-based threats and the need to counter threats that do not recognise national borders. We have to tackle both. We have attempted in this document, I hope successfully, not just to address the threats in order of priority but to plan for an array of capabilities that will make us much nimbler on our feet, more flexible and able to respond globally to any threat that materialises. My noble friend is right to put his finger on cyber and drones as new elements of this strategy. We must invest in these things but we must also ensure that the skilled manpower is there so that the equipment can be utilised to its best effect.

[Lord Reid of Cardowan (Lab)]

My Lords, I welcome the Statement as being better than the 2010 so-called strategic defence review. My welcome is therefore conditional. I have scanned through the document and much of it is filling in the gaps that were left some years ago, for instance, on the maritime patrol aircraft. May I ask the Minister a couple of questions? First, what is the difference between the rapid deployment brigades—I use “rapid” advisedly, because they will not be at full capability for 10 years—and 16 Air Assault Brigade, which was formed in 1999 after the last and only genuine strategic defence review, which was conducted by my noble friend Lord Robertson? If there is no substantial difference, why has it taken all this time over the last five or six years to decide to get the capabilities and to put them in effect for the future?

Secondly, is it not the case that the addition of 1,900 intelligence professionals at the centre will unfortunately be off-set if we reduce police numbers in the community, since the police act as a bridge between central intelligence—SIGINT and communications intelligence—and human intelligence, which is gained from trust by being in the neighbourhood? Finally, why does “innovation” not appear at any stage, particularly as regards cyber? Cyber now permeates everything from our weapon systems through our critical national infrastructure to central finance in London. The chief characteristic of cyber is constant entrepreneurial innovation and if we do not instil that at the centre of our processes, in procurement as well as in operations, we will fall behind in cyber. We are spending just under £2 billion there; the Chinese are spending $180 billion over the coming period.

[Earl Howe]

My Lords, the noble Lord asked me three questions. The first was about the rapid deployment strike capability. The Army is able to deploy a division now with sufficient notice and has been able to for some while. During the time of the noble Lord, Lord Robertson, as Defence Secretary, he was instrumental in ensuring that capability. This division could consist of an armoured infantry brigade, 3 Commando brigade and 16 Air Assault Brigade as well as forces from other nations. This SDR is investing in improving the readiness level and upgrading the capabilities of the division, so that by 2025 we will be able to deploy a division comprising two armoured infantry brigades and a strike brigade, in addition to our high-readiness forces of 3 Commando Brigade and 16 Air Assault Brigade.

The noble Lord, Lord Reid, also mentioned intelligence and expressed a fear that this capability might be off-set by reductions in numbers in community policing. The SDSR document does not cover community policing, which is a matter for local forces, as he knows. We will no doubt be hearing news of that as the effects of the SR are made known. I cannot comment on that today but I can say that we will protect absolutely the counterterrorist police we need to ensure national security and that the funding for that will be ring-fenced. He also said that innovation was not mentioned. I will just refer him to part B of chapter 6 of the document, which is entitled “Innovation”, and is on page 73 and the following.

Syria and Iraq: Airspace

Debate between Lord Reid of Cardowan and Earl Howe

Thursday 22nd October 2015 Lords Chamber

[Earl Howe]

I have already referred to the memorandum of understanding, which, as I have said, is a major step forward in terms of avoiding unwanted incidents over Syrian airspace. The protocols to which I referred include maintaining professional airmanship at all times, the use of specific communication frequencies, and the establishment of a communication line on the ground. But it is worth noting that, by and large, the reconnaissance effort that the coalition is putting in is directed to the east of Syria, whereas the Russian action is largely in the west of that country.

[Lord Reid of Cardowan (Lab)]

My Lords, I join with the condolences that the Minister extended to the families and the loved ones of those who have died in our services and others.

Some three months ago, when I asked the Minister whether the Government considered ISIL or Assad the greatest threat, he unhesitatingly responded that the greatest threat was ISIL—a view with which I agree. Does it not make sense to shoot the wolf nearest the sledge first? In other words, whatever the controversy of wider discussions with Russia and Iran and whatever our differences with them, will he bear in mind when considering this question the wise words of Winston Churchill when criticised for a working alliance with Josef Stalin and the Soviet Union: “I dare say that if Herr Hitler invaded hell, I would have a good word to say for the devil”? In other words, can we maximise those forces that share our view about the greatest threat being ISIL?

[Earl Howe]

My Lords, in considering that question we need to remember that Assad is a man who has barrel-bombed his own civilians and caused untold suffering among the Syrian population. He cannot form part of any eventual permanent solution to the conflict, and for that reason we cannot countenance taking any action which might serve to strengthen the current Syrian regime.

Syria

Debate between Lord Reid of Cardowan and Earl Howe

Thursday 17th September 2015 Lords Chamber

[Earl Howe]

My Lords, we are aware of reports that Russia may have deployed military personnel and equipment to Syria. We are monitoring those reports very closely. Any unilateral military support to the Assad regime, for any purpose, is, in our view, destabilising and counterproductive. This is, after all, the same regime that is causing a humanitarian crisis through aerial bombardment of its own people, forcing thousands of people to flee. They cannot be a partner against ISIL. Therefore, any attempt by the Russians to achieve that is, in our view, misguided. We are, however, in diplomatic contact with the Russians, and we make our views clear.

[Lord Reid of Cardowan (Lab)]

My Lords, before the Government come back to Parliament in a few weeks’ time with, as we understand, a proposal for military action, can the Minister make sure that they outline their grand strategy, by which I mean not only the purpose of military action but the diplomatic, financial, humanitarian, political and military aspects of the overriding grand strategy? One reason why the Government failed last time to get agreement on military action in Syria was that there was a belief in this House and elsewhere that it was not part of an overall grand strategy, or at least that it had not been explained to Members of Parliament.

[Earl Howe]

My Lords, I take fully on board the comments of the noble Lord, with his immense experience in this area. The Prime Minister has made it clear that in order to facilitate further action in Syria he will return to Parliament; but, as he has said, it would be better if there were consensus in the House supporting such action. His views have not changed on that. What has changed is the growing evidence that ISIL poses a threat to us here in Britain. It is right for parliamentarians to be thinking about these issues and what more we can do, but I recognise that it will be vital for the Government to present a coherent case for action in Syria if that is what we decide is best.

Syria: UK Military Involvement

Debate between Lord Reid of Cardowan and Earl Howe

Tuesday 21st July 2015 Lords Chamber

[Earl Howe]

I fully agree with my noble friend. In a nutshell, one could say that service personnel are either embedded or they are not. The value to our people from being embedded with the United States Navy is the key skills that they are acquiring to operate the Queen Elizabeth class carriers when those come into service later in the decade. The experience gained by flying and supporting US fixed-wing aircraft will allow the pilots to retain the suitably qualified and experienced person status needed to operate the F35B.

[Lord Reid of Cardowan (Lab)]

My Lords—

Armed Forces: Airborne Maritime Patrol

Debate between Lord Reid of Cardowan and Earl Howe

Thursday 4th June 2015 Lords Chamber

[The Minister of State, Ministry of Defence (Earl Howe) (Con)]

My Lords, we have been clear for some time that the right point to look again at the requirement for a maritime patrol aircraft is in the forthcoming strategic defence and security review, the SDSR. That decision will be informed by the latest threat assessments and the conclusions come to in recent years. We continue to embed around 30 former Nimrod air crew in the maritime patrol communities of allied air forces in order to reduce the time and risks associated with regenerating a capability.

[Lord Reid of Cardowan (Lab)]

My Lords—

[Lord Empey (UUP)]

Steady on. Does the Minister not agree with me that one does not need a review to know that, as an island nation with a sea-borne nuclear deterrent capability, we are not even in a position to secure our own deterrent, because we do not have the capability to do so? I understand that all things have to be reviewed, but this is such a no-brainer. It is obviously of great concern if we cannot protect our own sea lanes against an increasingly aggressive Russian naval force. Will the Minister go back to his right honourable friend in the other place and say that we should be proceeding now to prepare the necessary facilities to ensure that we have adequate protection for our nuclear deterrent as well as for our shores?

[Earl Howe]

My Lords, I absolutely do not accept that we cannot protect our own sea lanes. We have acknowledged that we have a capability gap, following the decision not to bring the Nimrod MRA4 into service, but at the same time we made it clear that we chose to accept that gap because we knew that we could mitigate it through employment of other assets, as well as through co-operation with allies. Even taking operational activity into account, we remain of the view that the SDSR is the right context in which to take a decision of this significance.

[Lord Reid of Cardowan]

My Lords, does the noble Earl accept that there is an ingenuity in the MoD in producing euphemisms? I was once told that something was being put not into mothballs, but into a “state of extended readiness”. When he mentions the capability gap, will he accept that the maritime patrol aircraft and its facilities is not an optional add-on for a nuclear deterrent but an essential component providing surveillance, security and secrecy of location? What is the point of having a continuous at-sea submarine-based nuclear deterrent if it does not have those features? This has all the hallmarks not of a minor housekeeping problem for the MoD but of a major strategic blunder.

[Earl Howe]

My Lords, I emphasise again that this matter will be looked at very closely in the context of the SDSR—indeed, some preparatory work has already been done. I do not accept the noble Lord’s contention that we are without protection in this important area. We have the use of other military assets, as I said, including Type 23 frigates, submarines and Merlin anti-submarine warfare helicopters, and we rely on the assistance that we get from our allies and partners.

NHS: Funding

Debate between Lord Reid of Cardowan and Earl Howe

Monday 17th November 2014 Lords Chamber

[Earl Howe]

I agree with my noble friend that the primary purpose of the Better Care Fund is clearly to make care better, but it is also a major step forward in making our health and care services more sustainable, and moving to a preventive model that delivers care closer to home and keeps people healthy in the community. GPs have a major part to play in this and I am encouraged by the extent to which they are now engaging in the task of addressing the BCF.

[Lord Reid of Cardowan (Lab)]

Will the noble Earl correct the inadvertent misleading of the House by the last noble Lord who spoke? The obligation for doctors to serve at weekends and in the evenings was not removed in 2004 but many years before—as it happens, under the Conservative Government. What happened in 2004 was that although they were not serving at weekends or in the evenings, as had been allowed by the previous Conservative Government, doctors were spending an increasing amount of time on the bureaucracy of finding a replacement doctor. That bureaucratic burden was what was removed from them. Will he confirm that that was the case, not for the first time but for the second time, because I asked him last year and he confirmed that by 2004 almost 90% of doctors had already opted out of night work and weekend work?

[Earl Howe]

The noble Lord has huge experience in this area and his outline is of course right, in that before 2004 we had largely a system of co-operatives in which GPs could elect to work out of hours if they wished. The 2004 contract gave individual GPs and GP practices the option not to do that. While there was no obligation to move away from out-of-hours care, many GPs have chosen to do that.

Ebola

Debate between Lord Reid of Cardowan and Earl Howe

Monday 13th October 2014 Lords Chamber

[Earl Howe]

My Lords, I believe that the WHO itself has acknowledged that its response could have been swifter. It is easy to say this in hindsight, but I am sure that the noble Lord’s view on that is shared by others. Nevertheless, the WHO has not been slow in rallying support for efforts in the three countries affected. It is now working energetically with many developed countries to provide support, and I would not wish to criticise the WHO in those respects.

On the disposal of corpses, the noble Lord makes an important point. We know that many cases of Ebola in the three countries have arisen as a result of people being in contact with the corpses of people who have died from the disease. That has been as a consequence of the cultural traditions in those countries, which are very hard to displace or persuade people not to follow. It is nevertheless part of our effort in Sierra Leone that we should inform people there that their burial customs need to be set to one side for the duration of the epidemic. This is a very difficult thing to do, for understandable reasons, but that is the effort we are making and it is bearing fruit.

As to the programme for building 700 beds, I do not have a precise date to give the noble Lord but if I receive advice before the end of this debate, I shall tell him.

[Lord Reid of Cardowan (Lab)]

My Lords, manifestly, this is a terrible disease, not only in its nature but in its scale. According to the rate of growth indicated by the Minister, within around six months we could be looking at between 150,000 and 500,000 deaths, and between 2 million and 5 million suspected cases. Let us hope that that does not occur. However, in view of that, may I ask him one question about screening and entry? I welcome the fact that there is to be extended screening at Heathrow, Gatwick and the Eurostar terminal—two airports and one train station. Manifestly, this does not cover anything like the potential entrants to this country from those regions. With cheap travel and so on, I understand the difficulties in covering every airport, particularly as people break their journeys and do not come directly. However, is it not possible, given the use of so many biometric passports and the technology introduced to UKBA, somehow to target at least people from that area as potentials for screening, wherever they arrive in this country, rather than limit the coverage to three geographical in-ports? Does the Minister have any information on whether this hypothesis has even been tested?

NHS: Out-of-Hours Services

Debate between Lord Reid of Cardowan and Earl Howe

Monday 29th July 2013 Lords Chamber

[Earl Howe]

CCGs, where relevant, are receiving support from local area teams of NHS England.

[Lord Reid of Cardowan]

My Lords, may I gently advise the Minister against complacency? Many of these changes in the NHS will take time to show whether they are beneficial or otherwise. Anecdotally, the successor of NHS Direct—111—appears to be in turmoil, both practically and commercially. The deterioration in accident and emergency services is getting exponentially greater; trolley waits are back, and predicted potentially to reach crisis point. Sir Bruce Keogh’s report, if read carefully, identifies as underpinning many of the problems in the major hospitals a chronic shortage of skills and finance. Can I please ask the Minister not to accept this with any degree of complacency and to introduce some scheme of forensic appraisal of 111 and some of the other issues which are arising from what looks increasingly like a costly and disastrous reorganisation of the NHS?

[Earl Howe]

The last thing I would ever wish to be is complacent, and I certainly am not. Whenever problems and concerns arise, we take them extremely seriously. I do not think anyone takes issue with the concept of 111. Unfortunately, however, we have seen problems arising in a few isolated cases. I emphasise that the vast majority of the country is receiving a good service. Incidentally, there is no evidence that attendances at A&E have been affected by the rollout of 111; in fact, attendances have not increased since 111 was introduced—the figures have actually gone down.

NHS: GP Services

Debate between Lord Reid of Cardowan and Earl Howe

Tuesday 21st May 2013 Lords Chamber

[Earl Howe]

The noble Lord, Lord Laming, has summed up the situation extremely well. I am sure he knows that Sir Bruce Keogh, the NHS medical director, is currently looking at how NHS services across the piece can be provided seven days a week in a much fuller way than they are at the moment. Access to GPs out of hours is part of that wider consideration and NHS England is working with the royal colleges and professional organisations to develop a set of standards that will apply to seven-day services. Some trusts are already thinking about treating patients at weekends for non-urgent operations and procedures. We want to encourage that trend.

[Lord Reid of Cardowan]

My Lords, can I correct a serious misrepresentation and misconception that is constantly made regarding the GPs’ contract, and which has been made in the past few moments? The GPs’ contract for 2003-04 did not remove the requirement of a doctor to work out of hours. That was removed a decade earlier under the previous Conservative Government; indeed, by 2000 a huge percentage of doctors had already opted out. The GPs’ contract was to try to make sure that GPs were not spending part of their normal day bureaucratically chasing up a replacement doctor to take their place. It removed that bureaucratic imperative but it did not remove the right of a doctor to refuse to work out of hours. That was the case with some 70% to 80% by the end of the previous Conservative Government, before the GPs’ contract. That is a very important distinction.

[Earl Howe]

My Lords, I certainly did not mean to mislead the House and if I have done so in any way I apologise. The summary given by the noble Lord is broadly right. Under the old general medical services contract, GPs had a 24-hour responsibility for their patients, although most GPs delegated responsibility to GP co-operatives or commercial providers. At the beginning of 2004, as I recall, only a small proportion of GPs actually provided out-of-hours services themselves. However, 24-hour responsibility continued to be unpopular with GPs as they felt it was discriminatory, which is why the contract was renegotiated at that time. It has brought about a growth in GP co-ops, with more use of telephone triage and more patients offered emergency consultation with a primary care centre. But that has resulted in fewer home visits and I think that point in particular is one that is exercising many people.

NHS: Clinical Commissioning Groups

Debate between Lord Reid of Cardowan and Earl Howe

Wednesday 16th January 2013 Lords Chamber

[Earl Howe]

I am very grateful to my noble friend for her kind remarks. The information I have in my brief is as I have stated, in that the indicators reflecting deprivation are quite broad. However, it is for ACRA, the independent committee, to review those indicators to see that the measures are representative and accurate. I am grateful to my noble friend for pointing us towards some other indicators which could be relevant, and I shall make sure that her ideas are passed to the appropriate quarters.

[Lord Reid of Cardowan]

My Lords, when the Minister says that the decisions on these allocations are, of course, not taken by Ministers, that is correct. However, can he confirm that it is equally correct that the criteria by which those decisions are made are influenced, judged and promoted by Ministers? Is not the most important thing that he said today that the primary determinant of this should be need? Here I declare an interest, because I had to address this when I was Secretary of State for Health. During the period 1979 to 1997, there was almost an indirect, inverse relationship between increases in funding for areas and their social and health deprivation. I am sure that had nothing to do with the coincidence of voting patterns in those areas of social and health deprivation, but it would be reassuring if he could tell us that that is not likely to happen during the term of this Government.

Health: Stroke Care

Debate between Lord Reid of Cardowan and Earl Howe

Monday 13th February 2012 Lords Chamber

[Earl Howe]

My Lords, the unwarranted variations in services are quite clearly unacceptable. The value of the CQC report is that it shines a spotlight on where variations in care need to be addressed. We believe that that will help all stakeholders involved in improving opportunities for people who have experienced a stroke. As regards post-hospital care, on which the noble Baroness rightly focuses, the accelerating stroke improvement programme, which is quite new, is already doing very good work. It was developed specifically to improve care in areas where progress needs to be faster, and that work will most certainly continue.

[Lord Reid of Cardowan]

My Lords, has the Minister yet had a chance to reflect upon this morning’s report that illustrates that survival rates and the reduction in the death rate from strokes, cancer, heart attacks and many other serious diseases have improved considerably over the past few years? By any standards, when comparing productivity in terms of quantity and quality, there has been a huge increase in productivity. Since the premise behind the Health and Social Care Bill was that there had been little or no increase in productivity in the National Health Service, will he share with us his reflections on that report?

[Earl Howe]

The premise of the Health and Social Care Bill is rather different from the one that the noble Lord cites. We believe that there is a damaging and avoidable variation in care across the country. Of course the outcomes in many areas of clinical care have improved immeasurably, as he rightly says, over the past few years—not least in heart attack and stroke. However, we still have some way to go and clinical commissioning, we believe, will take us in the right direction. Stroke features in two of the domains in the NHS outcomes framework, representing work that we have put in train: domain 1, “Preventing people from dying prematurely”; and domain 3, “Helping people to recover from episodes of ill health or following injury”. It is those measures to which the NHS will be held to account.

NHS: Waiting Times

Debate between Lord Reid of Cardowan and Earl Howe

Tuesday 3rd May 2011 Lords Chamber

[Earl Howe]

My Lords, I agree with my noble friend completely. That is why we are quite clear that general practitioners have to take much greater direct responsibility for out-of-hours care. At the moment they can, if they choose, divorce themselves from that responsibility and I think that was a retrograde move. Equally, we are clear that we should encourage general practitioners to look at ways of avoiding unplanned emergency admissions to hospital in the first place. That will reduce pressure on A&E.

[Lord Reid of Cardowan]

My Lords, I declare an interest as the person who introduced the 18-week target and limit. Clinical outcomes and efficiency are important but equally important are the pain and distress of the patients—and often their families—in waiting a long time. The Minister refers to things being no worse than in the past but in the past the waiting time after diagnosis—not counting the first consultation with a consultant or GP—to operation was two years and three years for the whole patient journey. That has now been reduced to 18 weeks and six weeks after diagnosis. Does the Minister accept that it would be a tragedy, inflicting huge pain and distress on many people, if that was now to be abandoned?

[Earl Howe]

My Lords, I agree with much of what the noble Lord said. There is no doubt that great strides were made under the previous Government to reduce waiting times. That is entirely to the advantage of patients. However, the noble Lord will know that, as I mentioned earlier, the NHS constitution still retains the right for treatment within 18 weeks and the contracts between commissioners and providers still retain the financial penalties if the 18-week target is broken.

Blood and Blood Products

Debate between Lord Reid of Cardowan and Earl Howe

Monday 10th January 2011 Lords Chamber

[Earl Howe]

My Lords, the noble and learned Lord, Lord Archer, is himself to be thanked and congratulated on the immense amount of work he did to inform the thinking of the previous Government and the current Government in these matters. I immediately echo his tribute to the work of so many people—people, as he said, of all political parties and none—who enabled us to gain a proper understanding of these issues. I am also well aware that the noble Baroness, Lady Thornton, was working very hard up to the time of the last general election to see whether a better package could be delivered. I was particularly pleased to hear her support for this series of announcements.

The noble and learned Lord asked me about the benefits for deceased victims and whether these were the only anomaly that we sought to correct. We identified two principal anomalies in the situation that has pertained hitherto: the first was the one to which he referred in relation to those who died prior to 29 August 2003, which was an arbitrary cut-off date; and the second was the clear imbalance of benefits for those who suffer hepatitis C as a result of receipt of contaminated blood. There was a gap to be filled there, and we were even clearer on that having read the scientific report that we received. We therefore sought to redress that particular imbalance. There are a number of other new elements in the package, but I have identified the two main ones that stood out to us.

The noble and learned Lord asked why we were choosing to use charitable trusts as the mechanism for payment. We feel that the arrangements have worked well so far through charitable trusts and we do not think it appropriate for these benefits to be paid through the Department for Work and Pensions. It is not really in the department’s remit to do that; it is there to pay benefits and certainly not to decide on discretionary payments. We hope and believe that the victims who are currently in receipt of the benefits have good relationships with the trustees of all the funds.

As for the practical arrangements for paying these new sums, if there are queries we will endeavour to answer them. As I have indicated, we are directing people towards the Skipton Fund as the point of information on this, but the package that my right honourable friend announced today should be regarded as the final one because we believe that it settles the outstanding issues that we needed to address.

[Lord Reid of Cardowan]

My Lords, I thank the Minister and welcome the Statement today. As a former Health Secretary, I took some interest in this matter, but, like the Minister, I would like to congratulate my colleagues who have been involved in the issue in recent years. The one thing that I came to understand was that this was not only an intractable problem but an increasingly intractable problem. There are two reasons for that: first, as time passed, the human tragedy of the people afflicted became more and more obvious; and secondly, the scientific evidence became more and more complicated and difficult for the Government to avoid.

I have two quick questions. First, we have finally reached a stage which may not be completely the end and may not be completely satisfactory, but which is much fairer than the previous one. But does he accept that if there is a disparity between Scotland, England and Wales in terms of the treatment of victims and there is seen to be inequality and unfairness, it will detract greatly from any value that this has created? Secondly, as my noble friend and colleague Lord Morris said, although this goes a long way, there may still be outstanding issues. Will he not close the door completely to further discussions that could arise in the light of further scientific evidence?