7 Lord Stevens of Birmingham debates involving the Leader of the House

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Health and Care Bill
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Defending the UK and Allies

Lord Stevens of Birmingham Excerpts
Monday 15th January 2024

(11 months, 1 week ago)

Lords Chamber
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Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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That is fortunate.

As we have heard, the action taken by the Royal Navy and the Royal Air Force was clearly both justified and necessary. Although the Prime Minister’s Statement is careful, for diplomatic reasons, to say that action was unrelated to other events in the Middle East, it clearly is related to the malign influence of Iran on the Houthis, as far as Hamas is concerned, and in the threat that Hezbollah poses to Israel on its northern border. As Israel confronts hundreds of thousands of Hezbollah missiles aimed at its northern border, with over 100,000 Israeli citizens evacuated and Hezbollah still not having pulled back above the Litani river, as required by UN Security Council Resolution 1701, what further pressure can western powers, including His Majesty’s Government, bring to bear on Iran to get the Hezbollah terrorists to cease and desist?

Lord True Portrait Lord True (Con)
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My Lords, it is quite clear that the behaviour of the Iranian regime, including the actions of the revolutionary guards, poses a significant threat to the safety and security of the United Kingdom and our allies. Indeed, Iran’s direct threats to dissidents in the UK are also concerning. There have been at least 15 credible threats by the regime against people in this country. We have sanctioned more than 400 Iranian individuals, but the noble Lord is quite right to say that, although Hamas alone was responsible for carrying out the attacks, Iran bears responsibility for the actions of groups such as those he has referred to and the Houthis, who it has long supported politically, financially and militarily. As I said earlier in my response, my noble friend the Foreign Secretary called his Iranian counterpart directly on 31 December and made it clear that Iran must use its influence with groups to prevent escalation, including in the Red Sea. We will hold Iran to account for any further escalation from these groups, which it continues to support. We will continue to work to disrupt Iranian activity, including attempts to smuggle to the Houthis, by working with our international partners in those operations.

Higher Education (Freedom of Speech) Bill

Lord Stevens of Birmingham Excerpts
Baroness Smith of Newnham Portrait Baroness Smith of Newnham (LD)
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My Lords, I realise that people have been declaring interests at various points during proceedings. As an academic I assumed, having declared my interests at the start of proceedings on Monday for the same Committee that I did not need to rehearse them again. If necessary, I am happy to rehearse my interests at Cambridge University and associations with other higher education organisations.

The noble Lord, Lord Triesman, has begun to flesh out slightly that there is a difference between two types of funding. There is research grant funding which might come from UKRI, where one would imagine it should be funding blue-sky thinking. The ideas in the amendments proposed today—whether they have appropriate wording or not—are that people’s academic freedoms should not be damaged, everyone should have an equal chance to secure funding and that should not be constrained in any way, for example, by one’s political beliefs. It is difficult for anyone to refute that suggestion. However, if an academic proposes to do research for a third party, where that party is looking for findings in a certain area and wants certain things to be done, if they are then engaged in a contract the person providing funding might reasonably say “Actually, I don’t wish this research to be funded”.

This goes back to “unintended consequences”. I wonder whether these amendments work for the contracts or consultancy that academics might be undertaking, which is quite different. If you undertake consultancy, its funder might not want to publish the findings because they do not meet what they expected. It is quite difficult to see how you could constrain a funder in that way, when it is a different sort of research funding to that which a university or UKRI might provide to individual academics. I am not opposing the amendments but I wonder whether some of these things need to be explored a little further.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, I should take the noble Baroness’s prompt and declare my interest as an honorary fellow at Balliol. I was prompted to speak by what has just been said in respect of the amendment from the noble Lord, Lord Sikka. He makes a very important point but, were this to progress beyond Committee, it would require very careful attention to the wording so as not to produce completely counterproductive results.

I was looking it up as the noble Lord was speaking, and I think I am correct in saying that, in 2019, about a quarter of R&D was via the higher education sector and about two-thirds was through the business sector. There is a sort of make-buy boundary, a decision, for a lot of research funders as to where they will get their research done. It just happens to be a contingent fact that quite a lot of that is done through the university sector, but it need not be. As worded, the amendment would capture, for example, conversations that the Wellcome Trust or Cancer Research UK would want to have with individual academic research teams, particularly about their research methodologies. Those are very productive conversations that improve the quality of research. So I understand the thought, but the precise mechanism perhaps warrants further attention.

More broadly, I oppose Amendment 34 from the noble Lord, Lord Moylan, specifically in relation to its suggestion that statute should be interfering in the discretion that universities have in grant funding allocations where the amendment says that universities would no longer be able to take into account in those grant allocations the lawfully held principles that individual researchers might adhere to. I get the bit about political opinion, but the “principle” bit is, I think, potentially quite problematic. One of the many dictionary definitions of a “principle” is “a general scientific theorem with numerous special applications across a wide field”. If you do not believe in the scientific basis of cell biology and have a particular “principled” adoption of homeopathic beliefs in bio-miasms, you will be driven in a particular direction. It seems to me that universities have a responsibility to say no to putting homeopathy funding on an equal basis with anything else. We want them, in pursuit of their distinctive mission to advance knowledge and education through structured debate and evidence-based reasoning, to be able to say no so that research on certain “principled beliefs” can be disbarred.

This comes back to the confusion that we touched upon on Monday. The Minister dealt with this point in respect of the employment of academics but, when it comes to the grant funding, we cannot have a situation in which universities’ hands are tied and they are not able to make judgments as to the merit on which those grants are allocated across their institutions. It is the inclusion of the phrase “the principles” of the contending grant application that ensures that, unfortunately, Amendment 34 as currently worded is fundamentally flawed.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, I really welcome the contributions of the noble Lords, Lord Sikka and Lord Moylan, on their amendments, because this issue of money is important and it is a good way of getting the discussion going—or not just to discuss for the sake of it.

What I cannot get my head around is how in any way you can legislate on this. I cannot see a way of doing it, even though I think I have added my name to one of the amendments. But it is important to discuss this. As I listened to the noble Lord, Lord Sikka, I thought he made a very strong case for the problem of corporate funding of research if it distorts outcomes. Nobody wants that, but I do not necessarily know that I do not want any corporate funding of research—so the question is how you deal with it.

It is also the case that, these days, some of the big players in terms of funding are charities or NGOs. We mentioned the Wellcome Trust, which I worked with for many years. It is true that the Wellcome Trust would often say, “These are our priorities this year” and you knew that, if you wanted a Wellcome Trust grant, you had to fit your research into those priorities. That had a distorting impact—I am not suggesting it was corrupt in any way, but you knew that was the way that you would get the money. I certainly know people who shifted their focus in order to get the grants.

This is important in terms of academic freedom. I wonder if the popularity of politicians saying, “The evidence shows”, and evidence-based policy being fashionable incentivise a tendency towards politicised research outcomes. There is a sense in which a lot of academics have wanted to be in on the policy discussion, often with outcomes predetermined. There have been times when I have said to Ministers, “Where’s the evidence for that?”, and they have said, “We have commissioned the evidence”—but they were announcing the policy. Do not tell me that it has not happened before because it happens all the time. They have commissioned the evidence from a university, in fact. I am just saying.

The reason why I think it is important that research is completely separate from that is because there is a place where academic freedom is under the surface and genuinely under threat, although I do not know whether the law can change that. I know of two people who put in for research on detransitioning—to raise that issue—and they were told there was just not a cat in hell’s chance of getting any funding for that because it was going to be too controversial. Whether we like it or not, the broad problems around some of the other issues in terms of what you can and cannot look at are affecting what is funded in terms of research, particularly postgrad research. There are a lot of complaints about that when you meet postgraduates.

By the way, that does not mean I do not appreciate what the noble Lord, Lord Stevens, said. It is also the case that people can for ever more moan that they are not getting their research funded when it is actually no good, and that actually, you do want academic judgment. I am just pointing out that politics enters into it.

The one thing that I am really concerned about is that UKRI, which after all distributes billions of pounds of research money, produced a draft equality, diversity and inclusion strategy—my favourite topic—earlier in the year, in January, which is a cataclysm of management-speak and right-on political outlooks. You could write it; you know exactly what it is going to say and do. A lot of it is about its staff, which is fine. I have no objection to that. But I worry when it starts basically to express its political aims. You have to question its impartiality.

As far as I am concerned, in the sciences the money should be given to the best science that advances knowledge; it is not humanities research, which is likely to give us interesting insights, and so on. But UKRI demands of people that apply for it that they deliver on the diversity and equality outcomes. A lot of people who read that immediately thought, “How do I prove that?” That is a layer of work that you have to do that you do not need to do. The document sounds quite threatening: “If you don’t tell us when you apply for this that you’re going to deliver on these things, you won’t get it.” So great science is sidelined in the name of equality, diversity and inclusion. That is something that we have to watch. I do not know if the Bill can do anything. I am hoping it will create a climate of discussion about the importance of academic freedom that will counter some of these trends and some of the secret censorship that goes on behind the scenes.

Higher Education (Freedom of Speech) Bill

Lord Stevens of Birmingham Excerpts
Lord Grabiner Portrait Lord Grabiner (CB)
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My Lords, is this not another example of why it would be helpful to have a definition provision in the Bill? If there was one, “academic staff” and “members” could be defined, and there would not be any debate about who did or did not fall into one or other of these categories.

In this context, it is worth bearing in mind another point. All universities, as institutions, will have either statutes—as in Cambridge, Oxford and some other universities, such as Durham—or their own constitution. You would glean from the constitutional documents of the institution who is a member of the academic staff and who is a member. We are a bit in the blind here, because in order to determine whether person X is a member of the academic staff or person Y a member of some institutional college, you will have to look at the constitutional documents of the organisation to find the answer. It would be quite helpful to have it in the Bill as well, so that there could not be any misunderstanding. Also, we could end up protecting through the Bill people who, strictly speaking, might not fall within the relevant definition of a particular institution. In that sense, the Bill could improve the position of individuals who are, to use a loose expression, associated sufficiently with the world of academia and who are deserving of cover here.

For example, there is a big difference in Cambridge. Once you are a student in a college, you are a member of that college for life. That may not be true in other universities—I do not know. For example, it probably was not true at the LSE; I do not remember. It is certainly true of any college in Oxford and Cambridge, so it is a bit unsatisfactory not to have a sufficiently clear definition applicable to everybody.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, picking up that last point, I support the amendments in this group that expand the definition of what constitutes an academic, but I wonder whether the Minister in his response can provide reassurance on the interaction between the academic freedom requirements of the Bill and the ability of universities to ensure high academic standards. Most of the amendments before us relate to the question of what constitutes freedom of speech, rather than academic freedom per se. I think the Minister said a moment ago that nothing in the Bill prevents bad science on campus. The corollary of that should be that nothing in the Bill should prevent universities preventing bad science on campus.

We cannot have a situation in which the academic freedom protections are used to allow those who do not believe that smoking causes cancer to continue at a medical school or those who believe in creationism to lecture in the physics faculty rather than the theology faculty, to cite a well-known example. Indeed, the University of Manchester had the discretion to take action against its PhD student who, noble Lords may have observed, is pursuing a thesis on paedophile masturbation, which is deemed not to meet sufficient academic standards. Yet under the definition of academic freedom here, those views could affect the likelihood of that person’s promotion or securing different jobs at the provider.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, if a science department employs people who do not believe in science, that does not seem to me to be a free speech issue. Even with the PhD thing, they can have those views in the bar and nobody will care, right? It is about what they teach. I am not suggesting that people should be able to carry on doing their job if they are not able to do their job, but they should probably never have been employed or signed up for the PhD in the first instance.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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The noble Baroness is making precisely the point I was seeking to draw out. As we discussed at Second Reading, freedom of speech is not the same as academic freedom. We need to make sure that, in protecting both appropriately, we do not stand in the way of the kind of management action that it would be reasonable for universities to take. In a nutshell, we are saying that universities are not a single space. There is a space for freedom of speech, particularly in respect of students, but the classroom is a place for verified expertise. Perhaps in his response the Minister can give us the assurance that nothing in the Bill will stand in the way of universities continuing to exercise that function.

Baroness Chakrabarti Portrait Baroness Chakrabarti (Lab)
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My Lords, first I need to apologise—I forgot to declare my interests in the debate on the previous group. I refer to my academic interests as set out in the register. I also forgot to thank the Minister and his colleagues for the meeting they had with many of us last week, which I for one found very helpful in trying to unpack such a complex area.

This is a vital group of amendments in probing the class of people protected by the new duty, which dovetails with what will come later—the new statutory tort. I suspect that, in replying, the Minister will try to give comfort that the class defined in new Section A1(2) is intended to be a very wide class and to cover tenured and non-tenured academic staff, postgraduate teaching students, et cetera. I am instinctively for that.

I would even go further and say that universities are vital centres of the communities in which they are situated. They have a wonderful economic and cultural impact in the towns, cities and rural areas where they exist. One of the many things that they contribute is public lectures and meetings, where people who have never even attended university themselves get the opportunity to come and hear from world-class academics and other speakers. That is all wonderful, but it creates challenges in relation to these very divided times we live in.

One of the smaller questions that I put to the noble Earl’s team last week—for me, this is a grey area; I am not an expert in education law—is the relationship between subsections (2) and (3) and whether there is potentially an even wider group of people who may be protected and therefore have the benefit of the statutory duty. To be clear, and to go back to my comments in the first group, I want freedom of expression to be protected for the broadest group of people in our society, subject to the caveats and balancing exercises in Article 10. If a member of the public comes to a public lecture, I do not want them to be unnecessarily censored, manhandled or thrown out just for having a different point of view, even though they are not a member, staff member or student of the university. I am confident that that is properly protected by Article 10. The beauty of Article 10 is that it does not really invite lots of financial damages and therefore does not cause too much of a nightmare for the university. However, now we are talking about a statutory tort and pecuniary damages, so we have to be a little bit careful about whether the point in subsection (3) about

“securing that … the use of any premises … is not denied to any individual or body”

is not too broad in relation to bodies which are not even constituent parts of the university.

I know that the noble Earl’s team have views about that, and I certainly believe that the Government’s intention is that only the people covered by new Section A1(2) get access to the statutory duty. Subsection (3) is not intended by the Government to throw the statutory duty wide open to anybody who is thrown out of a meeting for heckling, et cetera; but I urge caution, because this clause will be read expansively, not least because of the duty in Section 3 of the Human Rights Act to which the noble Earl referred in his earlier remarks. Maybe he will have something to say about that.

Even if every heckler who is ultimately thrown out will not be protected, because subsection (3) is not intended to expand upon subsections (2)(a) to (2)(d), we have quite an issue—that is, quite an expansive category of beneficiaries under “visiting speakers”. I am absolutely clear that to make sense, “visiting speakers” here must mean putative visiting speakers, otherwise there is no point to this paragraph. So many of the stories noble Lords have complained about are about people who could have come, would have come, were invited, were nearly invited but were never quite invited because of the atmosphere there, or were denied. So, I am quite clear in my own mind that in subsection (2)(d), “visiting speakers”, must and will include—and will be found by a court to include—potential, putative speakers.

I put the scenario to the noble Earl last week of the meeting that takes place to discuss the speaking programme. A controversial name is mentioned, and the decision is ultimately made that that person is not to be invited because of fear of controversy. People are tweeting after the meeting, because that is what people on Twitter do—I am not in that category—and we now have potential litigation from the putative speaker, whatever level of controversy they excite.

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Moved by
5: Clause 1, page 1, line 17, leave out “securing that” and insert “not denying”
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Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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The noble Lord, Lord Willetts, sends his apologies for an unforeseen family emergency, so I will formally move Amendment 5 and speak to Amendments 7, 8 and 38 to 41.

Given that these originate with the noble Lord, Lord Willetts, noble Lords can be assured that they are pragmatic and constructive amendments that will not necessarily detain the Committee for terribly long. Their aim is simply to make clear that universities should be allowed to move events around the campus without cancelling them, on the grounds that it should be reasonable to move a controversial and possibly noisy event so that it does not occur, for example, next to an exam hall at exam time. It is reasonable to move an event so that it happens on a part of the campus that makes event management easier or so that it does not conflict with other events at the same time.

Some people may argue that these flexibilities might mean the surreptitious or indirect cancelling of events, but other parts of the Bill address this concern. Indeed, to pick up the point that the noble Baroness, Lady Chakrabarti, made earlier, in fact they may make it easier to invite people and expand the number of speakers invited to campus, knowing that these flexibilities exist. Per the rest of the Bill, universities and student unions would remain liable to sanction if they had in fact cancelled an event, not merely moved it, and the Office for Students would be able to respond to a complaint.

In a nutshell, these practical amendments that we hope the Government might consider as the Bill progresses would simply provide sensible if narrow discretion to universities and student unions to decide where and when events happen.

Lord Mann Portrait Lord Mann (Non-Afl)
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My Lords, my Amendment 6 is on the same principle: unintended consequences. The Government would be very foolish not to listen in and to amend the Bill accordingly.

When I was a student leader, I had a range of tactics. With this Bill, I could put those tactics into play very easily. At the moment I go around a huge number of universities in another role; I was at one this morning. A week ago I was at a very prestigious one, in the vice-chancellor’s office. I did a recce in preparation and spotted a meeting room. If I was at that university, or knew someone in a society at that university—such as, let us say, the anarchist society—I would get invited there and, if I wanted to be disruptive, have a rolling meeting. The meeting would simply continue and continue. Some activists and campaigners would do that. They may not glue themselves to the door, because that would be criminal damage and they would be removed, but it would be possible to keep a rolling meeting going. I can recall one that was kept going for six weeks, not in the vice-chancellor’s office but in the registrar’s office. That is possible. I suggest that that would be an unintended consequence of this.

There are also groups that could get themselves invited in with the sole aim of maximising disruption, in order that they get their meeting broken up—in essence, they get thrown out—and then they can sue. This would be, by definition, extremist groups on the fringes. That would be, and has been in the past, a tactic employed. There was a whole period of time when various extremist activists were trying to do this. With this Bill, they would have a perfect opportunity. So this small tweak, giving that flexibility to a university, would have a profound impact.

There is one other good reason. If one wanted to be politically aggressive, when booking a room one could insist that an anti-Israel meeting, to use one example, was located in a room next to a synagogue or the Jewish chaplaincy. That would seem egregious to me. It could be—this happens a lot in the United States at the moment—directly in and among the Jewish student accommodation, the Hillel accommodation, which would be more than egregious. To give universities the flexibility for that bit of common sense, which they apply routinely in these isolated examples, would be a way of stopping those unintended consequences and would help the Government in their objective and their free speech proposals.

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Earl Howe Portrait Earl Howe (Con)
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We are coming later on to a group of amendments that could well encompass the noble Baroness’s question about the Prevent duty, but my answer to her now is that the planning of an event involves a number of considerations: the security costs; whether it impacts in any way on the Prevent duty; whether it impacts in any way on the public sector equality duty; and so on and so forth. This is a set of issues relating to an event that might be considered controversial that will need to be looked at altogether in the round. I cannot say whether there will be a separate set of papers, but if I receive advice on that point, I will certainly write to the noble Baroness.

To conclude, we want these provisions to offer a safeguard to groups that might come under serious security pressures, while also giving providers, colleges and student unions the independence that they need. I hope I have reassured noble Lords on these issues and sufficiently addressed the concerns raised.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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I beg leave to withdraw Amendment 5.

Amendment 5 withdrawn.

Higher Education (Freedom of Speech) Bill

Lord Stevens of Birmingham Excerpts
Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, I declare my interest as an honorary fellow of Balliol, my former interest as head of the largest employer of graduates in this country, and perhaps even my future interest as the parent of an 18 year-old, hopefully heading off to university next year.

Parliament is right to want to protect academic freedom and free speech on campus. We have heard specific cases of concern today, and there is a problem that needs to be nipped in the bud. But we do not need battle slogans from the culture wars. Any legislative proposals need to be carefully calibrated because there are complex and competing considerations.

We have heard today that conflicts over academic freedoms stretch back through history. The noble Lord, Lord Wallace, started the clock at 1968, the noble Lord, Lord Moylan, mentioned the Reformation, and the right reverend Prelate the Bishop of Coventry mentioned St Augustine. I am reminded that our oldest university, Oxford, predates Parliament itself and Magna Carta. In 1377, John Wycliffe, translator of the Bible, found himself no-platformed by Pope Gregory and dismissed from the university. As a student, I remember looking out at the Martyrs’ Memorial, where Cranmer, Latimer and Ridley were “cancelled” by Mary Tudor as they were burned at the stake. In 1683, the books of John Milton, our greatest advocate for freedom of speech, were not subject to a trigger warning but burned in the Bodleian. So history tells us that these debates go back a long way.

History also teaches us that the greatest threats to academic freedom have generally come not from within universities but from overbearing theocracy and an overreaching state. This remains true around the world today, and it is not a left-versus-right issue. The Republican Governor of Florida is currently trying to rig academic appointments and gag professors. Authoritarian regimes of all ideological hues cannot stand independent universities, which is why China, Hungary and Iran all score badly on the global Academic Freedom Index. Subject to the important points made by the noble Lord, Lord Johnson of Marylebone, and the noble Baroness, Lady Shafik, this is why Clause 9 is, in my view, right in principle to require transparency about our universities’ international funding from countries that do not respect academic freedom.

However, that concern about government intrusion is also why we should be judicious, nuanced and restrained before we impose more state regulation and political control on our universities. As was pointed out, in your Lordships’ recent debate on the Schools Bill, a number of former Conservative Education Ministers objected to a centralising power grab by the Department for Education. This Bill suggests that that was not a one-off aberration.

Since this is Second Reading, it is worth considering the underlying principles at stake. First, we need to consider whether the Bill yet satisfactorily combines free speech protections on the one hand with safeguards for academic rigour on the other. Universities promote academic free inquiry because it contributes to their distinctive mission, which is to advance knowledge and education through structured debate, based on reason and evidence. Unlike Speakers’ Corner in Hyde Park, Twitter or the op-ed pages of a newspaper, universities have a distinctive responsibility to instil respect for established facts and evidence-based knowledge. It is a fundamental epistemological misconception to argue that the mission of universities places them under some sort of obligation to give airtime or credence to those who argue, for example, that there were no gulags in the Soviet Union, that vaccines cause autism, that the Protocols of the Elders of Zion are genuine or that intelligent design explains the origin of the universe. I say to the noble Baroness, Lady Fox: that is not viewpoint diversity, that is crank conspiracy and licensed idiocy. The Minister for Higher Education asserted in the Commons that this is not what this Bill will produce. Here, in your Lordships’ House, we should consider perhaps clarifying amendments to ensure that it does not.

The second question is the one my noble friend Lord Macdonald raised a moment ago: are universities striking the right balance between challenging discussion and inclusive participation? If not, will the Bill help or hinder? Universities have to weigh conflicting goals and legal obligations. Universities are right to try to ensure equal participation for all their students, because in an academic setting, it is the quality of reasoning and evidence that counts, not whether you are Jewish, black, female or gay. White supremacists and religious fundamentalists who regard some students as inherently inferior are, therefore, themselves intrinsically incompatible with the proper functioning of a university.

On the other hand, many academics worry that claims for identity-based protection are increasingly being weaponised, with the risk that universities become so-called sanctuaries for comfort. This afternoon, we have heard statistics from the Higher Education Policy Institute survey quoted extensively. I will repeat a particularly salient data point raised by my noble friend Lord Macdonald: 36% of students believe academics should be fired if they teach material that heavily offends some students—a proportion which has doubled in the past six years. There is also accumulating scientific evidence, including from randomised controlled trials, that trigger warnings and the like may actually harm, rather than protect, survivors of past trauma. So we need a course correction if we are to avoid spiralling towards the poisonous antagonisms now paralysing so many US college campuses. In doing so, however, we need to tread with care. As the Bill stands, a new politically appointed commissar in the OfS would be handed sweeping powers to oversee free speech and academic freedom in this country. The Bill has completely inadequate safeguards on how that post is appointed and how the new role will operate.

Furthermore, as the noble Lord, Lord Willetts, rightly argued, if the OfS is to have new regulatory oversight powers, there is no need to create competing, costly and complex alternative mechanisms via the courts. The Department for Education’s revised impact assessment, at page 24, laughably and ludicrously pretends that creating a new statutory tort will cost nobody anything ever. In the real world, Clause 4, as currently drafted, will ensnare our universities in vexatious, partisan and pointless litigation for years to come. At a time when universities’ real-terms tuition funding is being so heavily squeezed, every extra pound they have to spend on lawyers is a pound less for students. As we heard earlier, at a time when the courts in this country are already overwhelmed—with thousands of rape cases, violent crimes and civil claims waiting years to be heard—it makes no sense to divert scarce judicial resources to second-guessing both the Office for Students and universities themselves.

In summary, my view is that the Bill is going to need thoughtful and sensitive amendment to avoid doing more harm than good.

Health and Care Bill

Lord Stevens of Birmingham Excerpts
Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022

(2 years, 9 months ago)

Lords Chamber
Read Full debate Health and Care Act 2022 View all Health and Care Act 2022 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: HL Bill 114-IV Marshalled List for Report - (14 Mar 2022)
Baroness Northover Portrait Baroness Northover (LD)
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My Lords, briefly, I support these amendments; my name was on an amendment at an earlier stage. I hope that the Minister will have managed to persuade other parts of government that they will not achieve a smoke-free 2030 in the UK unless they move further and faster on tackling an industry built on promoting ill health and death—the reverse of what the health service seeks to do.

The Department of Health has come a long way in this area, with much cross-party working, and I know that the noble Earl himself has been part of that cross-party support in tackling the terrible health consequences of smoking. I have a sense of déjà vu, as I think others might. Over the years, the noble Lord, Lord Naseby, has been a rather lone voice on the other side. From time to time FOREST, which makes it plain that it is funded by the tobacco industry, kindly sends me its brief, no doubt inadvertently, and I recognise some familiar phrases that have just been voiced. I noted the rueful expression of the noble Lord, Lord Naseby, as the noble Lord, Lord Young, took apart what he had said about the levy.

The Government say that they are committed to delivering a smoke-free 2030, but keep putting off the action required. Not all parts of government are fully aligned to this in the actions taken. The steps proposed in the amendments are designed to help the Government achieve what they say they wish to do. I therefore commend them to the House.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, I want to make just a small factual supplement to the contribution from the noble Lord, Lord Naseby. In fact, it was a Conservative Government in 1957 who introduced the pharmaceutical price regulation scheme or PPRS, and that scheme has been sustained ever since by Conservative, Labour and coalition Governments. As the noble Lord, Lord Young, pointed out, if it is deemed appropriate to have a form of price and profit regulation for the medicines industry, which delivers products that are essential and life-saving, it does not seem too far a stretch to think that an equivalent mechanism might be used for an industry whose products are discretionary and life-destroying.

Lord Lansley Portrait Lord Lansley (Con)
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My Lords, I was not intending to intervene, but I was prompted to do so not least by the noble Lord, Lord Stevens of Birmingham. That the PPRS has been sustained by Governments, albeit amended from time to time, should not lead us to the conclusion that all products should have their pricing and regulation controlled by government. I do not think that the analogy runs at all, so we should ignore the PPRS for these purposes.

My noble friend on the Front Bench whom I believe is replying to this debate and I were in a coalition Government with the noble Baroness, Lady Northover, and we were pretty clear then. I remember a decade ago creating a bit of a storm by saying that I wanted to end up with a smoke-free England. We have reached a point now where there are tobacco companies which think that we are going to arrive at that position, and so we should. I do not think that this debate is about whether we achieve that; it is about the mechanisms by which we do so.

If my noble friend reiterates the Government’s intention, willingness and sense of urgency about bringing forward measures, as I hope he does, I would not bind the hands of the Government with these amendments. Frankly, even if they were passed, nothing would happen unless and until the Government bring forward legislation for the purpose. It would be better for us to have the debate and make the position clear. I do not disagree with the arguments presented by the noble Lord, Lord Crisp, and others—when we were in government, we implemented things such as the ban on display in shops and preventing the availability of cigarettes to youngsters through vending machines, which I think was one of the most important things we could do. We made progress; we need to make more. We need the Government to come forward with proposals for that, but these amendments are not necessary if the Government say that they are willing to make progress.

Health and Care Bill

Lord Stevens of Birmingham Excerpts
Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I will speak to Schedule 17 generally and in support of Amendment 244 in the name of the noble Baroness, Lady Finlay. In doing so, I declare my wife’s interest as a board director of Tesco and Diageo.

I will focus my comments on the amendments supported by my noble friends Lord Vaizey and Lord Moylan. In doing so, I seek to address all the amendments they have put forward, which seek to: extend the implementation period for the new restrictions; introduce brand advertising exemptions; and bring in effectiveness reviews and sunset clauses, and all the other clauses that seek to water down the really important measures in the Bill on junk food advertising. I recognise that the noble Baroness, Lady Boycott, has already gone through some of these amendments in detail, so I do not want to go through that again. However, I am aware that my noble friend Lord Vaizey and other noble Lords have brushed off the Government’s obesity strategy as wrong-headed and doomed; indeed, the noble Lord, Lord Clement-Jones, has shared his view that the measures in the Bill are disproportionate.

I want to reflect for a moment on what we are trying to do here. As a country, we have got into a situation where, by every measure, we are seriously overweight. The worst affected are our children. We have heard, both in this debate and many times in this Chamber, that two in five children are overweight. The worst-affected children are the poorest children, who are twice as likely to be overweight. In thinking about the environment our children are being brought up in—this question of environment is absolutely critical—what are our values as a nation if we knowingly create an environment that encourages children to develop addictions to foods that we know will hurt them, adversely affect their moods, hold back their learning, reduce their self-worth and damage their health for years to come?

Through the pandemic, we have seen that now is the time to lean into this ongoing national disaster. The measures in this Bill are necessary because they are an essential condition for an overall change in the direction of travel of childhood obesity prevalence. The challenge is going from an increase in the weight of our children of around 1% per year to a decrease of 4.2% per year. That is an astonishing mission and a massive challenge. No country has ever undertaken such a thing.

However, I am not convinced that we can just hope that our primary schools will do all the heavy lifting to achieve this. Somehow, as a country, we have to change the way in which we run our lives. This will require a change in the environment in which our children learn about, engage with and buy food—and that includes the media they consume. If we fail, for every year that this is not achieved, the rate of change needed in future years will grow, and thousands more children will be exposed to the physical and mental health impacts of obesity.

The noble Lord, Lord Krebs, talked eloquently about how, 20 years ago, the Hastings report had this research nailed. There is now a sense of urgency, which is why these measures are needed. It is why we cannot seek to extend the implementation periods for new restrictions; this will just drag them out indefinitely and undermine the seriousness of the programme. It is why we cannot give brand advertising an exemption that clearly leaves the door wide open for the same old advertising in different ways. It is why we should not commit to effectiveness reviews that will become a rear-guard action to unpick these regulations, nor commit to sunset clauses that will give industry false hope that somehow the Government will just give up on these measures or the problem will go away.

To reach the 2030 target, it is absolutely crucial that the Government continue with these plans to restrict junk food advertising on TV and—as the noble Viscount rightly said—online, and do not waste any more time. It is also crucial that we introduce fiscal measures to speed up reformulation at the same time, making healthy eating more accessible to everyone. It is absolutely clear from our data that any delay in action or the implementation of proposals to address childhood obesity will have a significant impact on the ability of the Government to achieve their ambition. More children will grow ill and live shorter lives.

I hear—loudly and clearly—the concerns of my noble friends Lord Vaizey and Lord Moylan, and the noble Lord, Lord Clement-Jones. I hear their concerns about the science, the research and the public health epidemiology that underpin these measures. I do not agree with their scepticism but I do hear their concerns, so let me pick off a couple of them.

My noble friend Lord Vaizey expressed scepticism about the effectiveness of these measures. He is right that these advertising restrictions will not work on their own. Obesity is a complex issue and no one single policy can solve it. However, small steps matter. It can take as little as 46 extra calories a day for children to gain excess weight, and seeing just one minute of HFSS adverts leads to children eating an extra 14 calories a day on average.

As I said earlier, this question of environment is absolutely critical. I accept that we need population-level structural policies to address the social and economic drivers of obesity, to then address the growing inequalities between the most and the least-deprived children. That is why the levelling-up White Paper earlier this week that tackles housing, education, deprivation and many other aspects of British life was critical to this debate and forms the context in which we should discuss these measures. It is also why my noble friend should not feel that the broadcast and food industries are in some way being uniquely scapegoated. This is a national programme that will touch on many lives.

My noble friends are right to express concerns about the fortune of the broadcast and internet industries, two jewels in Britain’s creative industries and employers that drive local economies. I want to reassure them. I once worked in the media industry and have not forgotten the intense competition for advertising and the existential battle with big tech, but my noble friend Lord Vaizey spoke as if many of these companies would find that all communication by these companies on all their products to all their target markets would somehow be terminated forthwith and that the British public service broadcast industry would be thrown into destitution. That is just not quite right. Cancer Research UK found that ITV, Channel 4, Channel 5 and Sky One derive a small proportion—just 8% of their total ad revenue—from adverts for HFSS foods.

It is true that almost two-thirds of HFSS product adverts aired between 6 and 9 pm fall within the category that UKHSA has identified as the highest contributors of sugar calories in people’s diets, a fact that I found quite alarming, but under a 9 pm watershed broadcasters would have lost only 5% of their total advertising revenue if all HFSS adverts were removed completely, without anything in their place. Noble Lords should know that over three-quarters—79%—of potential revenue loss from removing HFSS adverts could be mitigated against by companies advertising their existing non-HFSS products instead of promoting their HFSS products. Healthy foods can still be advertising.

It is just not right to call these measures appalling and crude or ridiculous and blunt. To change the environment in which our children make decisions about food is critical for this national mission, and to contribute to a campaign to improve the health of children is a commendable aspiration for these government measures.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, perhaps channelling the noble Baroness, Lady Deech, from this morning, I congratulate the Government on including in the Bill these measures to tackle childhood obesity. As we have heard, with one in four children not just overweight but clinically obese, we are storing up huge problems for the future because we know that what starts in childhood continues into adulthood. In that sense, diet is destiny. Unfortunately, obesity is the new smoking. We know that it is the cause of avoidable heart attacks, strokes, 13 different types of cancer, and respiratory disease, and causes a far higher risk of dying from Covid. Clearly action is needed, and the Bill makes a start.

If anything, these measures, which are certainly proportionate, may be overly targeted. Some of the criticisms levelled at the Bill should have given rise to amendments to extend its scope to deal with some of the loopholes or to level the playing field into other digital aspects that people are concerned about. That would have been a constructive response to legitimate concerns. Instead, I cannot help feeling that this morning we have heard from opponents who are simultaneously arguing that the measures in the Bill go too far and at the same time will not be effective enough, and to ensure that this becomes a self-fulfilling prophecy they have included amendments which would essentially fillet the Bill of its active ingredients.

These are familiar tactics. This is the tactic of deny, dilute and delay. The first is denying, claiming to us as parents that ads and marketing make little meaningful difference to kids’ consumption; but on the other hand we have companies—presumably rational economic actors—spending maybe hundreds of millions of pounds every year on the basis that exactly the opposite is true. Like Schrödinger’s cat, which is simultaneously dead and alive, it seems that junk food advertising and marketing simultaneously does and does not work. What is at stake here is not quantum physics but the physical and mental health of millions of children.

Lord Vaizey of Didcot Portrait Lord Vaizey of Didcot (Con)
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Given the noble Lord’s extraordinary expertise, having worked all over the world, does he know any example of any country where a junk food advertising ban has had an impact on obesity? This is a genuine question.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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As the noble Lord will know, the genuine problem that we have in this country is that unfortunately we are a world leader in childhood obesity. It therefore falls to us to take world-leading action to respond to that.

Even classical economic liberals will accept that children are not sovereign consumers. The noble Lord, Lord Vaizey, in his earlier remarks, said that there was no evidence that advertising leads to increased consumption. My noble friend Lord Krebs has comprehensively rebutted that point but, to underline the matter, I say that studies of children’s ventromedial prefrontal cortices—the areas of their brains associated with reward valuation—suggest that watching food commercials systematically alters the psychological and neurobiological mechanisms of children’s food decisions. Even small but sustained reductions in at-risk children’s calorific content provide demonstrable physiological benefit.

By the way, this figure of 1.7 grams or 3 grams, as my noble friend Lord Krebs pointed out, is a mistaken application of epidemiological maths—that is, dividing the assumed totality of calorific reduction against the totality of children on an even basis, when in fact the children who will disproportionately benefit are those who are disproportionately exposed and disproportionately obese.

Systematic evidence reviews conclude that

“screen advertising for unhealthy food results in significant increases in dietary intake among children.”

Therefore, once we have had the denial, the second tactic is to dilute the regulatory effort—to insert loopholes, to neuter regulators, to drive a coach and horses through what is proposed. We have a number of amendments which seek to do that. They pretend, as the noble Baroness, Lady Boycott, pointed out, that advertising to children of a smaller item is not in practice also advertising the identically packaged larger item. They exempt ads for certain bars which by themselves may contain half of a child’s maximum daily recommended sugar intake. They give a green light to brand advertising, even where children perceive the fast food or confectionary brand and its associated unhealthy products as essentially the same. Widespread evidence shows that current narrow restrictions on children’s exposure to harmful junk food ads are routinely breached, and frankly these amendments seek to repeat the trick.

Even more absurdly, Amendments 245A and 250ZA would restrict harmful advertising only on a Saturday and Sunday. The noble Baroness, Lady Boycott, pointed out that those of us who are parents know that our kids are not exposed to screens only on a Saturday or Sunday; it turns out that Monday, Tuesday, Wednesday, Thursday and Friday are also days of pressure for those of us trying to be responsible parents. Or are we asked to believe that rising obesity in pre-school and school-age children does not happen on school days? If so, these amendments imply the discovery of a phenomenon unknown to medical science: weekend-only obesity.

Finally, when denial has been disproved and the dilution tactic has been debunked, the amendments try for delay—for more time to lobby for a weakening of the political will, to live to fight another day. “Lord make us pure, but not yet”; even St Augustine would blush at these amendments. Nor for that matter do government Amendments 249, 252 and 254 have anything to commend them. We have heard this morning a strange contradiction between the acknowledged urgency of the spiralling health crisis affecting our children versus the long and leisurely gap that some still want before further action is taken. These preventive measures were first announced by the Government in 2018. Three years is more than long enough to prepare and adapt. The Government’s goal is to halve childhood obesity by the end of the decade, but we are nowhere near being on track. We had better get on with it because, as the saying goes, children may be only a fifth of our population but they are 100% of our future. In the past, the blocking tactics of deny, dilute and delay have often succeeded—but today, perhaps not, because young people and parents want change, and because today, in this Bill, the Government are showing resolve; so too should we, my Lords.

Lord Black of Brentwood Portrait Lord Black of Brentwood (Con)
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My Lords, I will speak to Amendment 245, tabled by my noble friend Lord Vaizey, and to others in this group to which I have added my name. I declare my interests as a director of the Advertising Standards Board of Finance and deputy chairman of the Telegraph Media Group, and note my other interests in the register. I am also a vice-chairman of the ITV APPG.

This does not need repeating: I support the Government’s aim to tackle childhood obesity, but I am wholly opposed to their proposals to tackle it through an advertising ban. I believe that even now, at the 11th hour, they should think again, because it is disproportionate and based on scant and frankly implausible evidence. It will damage the creative economy, which is already under such stress, and it will have unintended consequences, like so much legislation that impacts on the media.

Also—and this is a very important point—it sets a hugely dangerous precedent for the Government to interfere with advertising freedoms, which are a fundamental aspect of freedom of expression. This is bad legislation.

As we have heard so often, the reduction in calories will be minimal, but this ban will take £200 million out of the media and creative industries when they can ill afford it and when they are in a life-and-death struggle with the all-powerful platforms. My noble friend Lord Bethell said that it would take out only 8% of revenues. When you are in day-to-day combat with the platforms for advertising revenue, 8% of revenues is a huge amount of money. More than 265 news media outlets have closed over the last 15 years, and many more will follow if the burden of regulation is increased, not cut in the way it should be.

This ban will not impact just broadcasters; it will disproportionately affect news publisher websites, too. This blunderbuss of a ban will reduce freedom of choice for advertisers and harm the ability of news media publishers to monetise content online, which is crucial for their long-term survival. At the same time, astonishingly, it will allow the tech platforms to continue to derive enormous amounts of revenue from HFSS advertising.

Here is the great irony: the platforms have a significant audience of children, because that is where children go to get their news, but they will not be impacted. News publisher websites have only a de minimis child audience but will suffer directly as a result of this policy—and they will do so at a time when the entire industry is under great stress, as countless reports, including the Government’s Cairncross and Furman reviews, the report from our own Communications and Digital Committee and a comprehensive report from the CMA, have demonstrated. In winding up, could my noble friend explain why news publishers are caught but the platforms are not? It is, as somebody famously said, “voodoo economics”.

Even at this late stage, I hope the Government will think again and drop these ill-thought-out restrictions. In case they do not—I am a practitioner of the art of realpolitik and I know this ban may end up going through—as we have heard from a number of noble Lords, we must at least make sure the policy is workable. That is the job of this House and this Committee because, at the moment, the measures are not fit for purpose.

As noble Lords know, during my career I have had one or two encounters with the issue of regulation, and I am clear that, for regulation to work properly, it must have a number of inherent qualities. First, you cannot rush regulation. Stakeholders from those affected need to have their input and they need time to adapt. That is what the amendments in this group, starting with Amendment 245, are all about. This is not just delay for delay’s sake; it is delay because that is what the real world demands. When this Bill becomes law, that is just a starting point. As my noble friend Lord Vaizey said, you have to designate a regulator, then the regulator has to implement it and there has to be public consultation on code changes. That long process could easily take the rest of the year and possibly longer.

Once that is all complete, in the real world, advertisers, agencies and media owners will need time to assess how the system is going to work in practice. This is a very complicated part of the creative economy, as the noble Lord, Lord Clement-Jones, said. You cannot just flick a switch and expect everything to change at once. It will take at least a year for all those involved in the advertising supply chain to adapt, review processes, set new legal procedures in place and so on—leaving aside the impact on the creative aspects of their work. That is why I genuinely believe that this Bill must not come into force until one year after the final publication of the rules and guidance from the appointed regulator.

A judicious approach to implementing the rules is one characteristic of sensible regulation. Another is certainty, which is what Amendment 247 and others are about. The Bill quite rightly focuses on ads where an identifiable HFSS product is shown, with brand advertising and sponsorship exempt. I applaud that, but the Bill is not crystal clear on the point. Within the creative industries, there is a huge amount of uncertainty, which is the enemy of effective regulation, about what is and is not permitted. I believe the terms of the exemption should be set out in the Bill, not least so that, if this or a future Government wish to revisit the matter, they must come back to this House to set out why they are doing it and to seek our consent. Given the potential harm this legislation could cause and the precedent it sets, that must be right.

The final aspect of sound regulation must be the measurement of its effectiveness. Regulation that does not work—and I am afraid that I am sure this will not—should not remain on the statute book simply for the sake of it. If it is found wanting—or, worse, damaging—it should be repealed. This is too important an issue to leave to chance. We should therefore know now what metrics the Government will use to measure the success of these restrictions, the definitions they will employ and how data will be collected. Will they measure the impact on the creative economy as well as on obesity? We should know. If those metrics are not met, the restrictions should fall at the end of the review period.

In the absence of dropping this legislation—I notice some reports that its demise might be part of Operation Red Meat, which we are hearing so much about, and let us hope so—our job is to ameliorate its worst aspects and ensure that it is sound and workable. These amendments do that, and I hope they will find widespread support across the Committee.

Health and Care Bill

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Baroness Tyler of Enfield Portrait Baroness Tyler of Enfield (LD)
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My Lords, I have added my name to Amendment 165 in the name of the noble Lord, Lord Hunt. This is a small but important group of amendments.

I have added my name to the amendment because I am interested in what is happening to primary care and particularly the voice of GPs in the new arrangements. Frankly, we are not hearing much about them. As it stands, the legislation will place NHS trusts and foundation trusts in quite a privileged position in deciding how plans are made and resources allocated. I am not quite sure where the voice of GPs comes into the new arrangements. I understand that NHS England has commissioned a review of the role of primary care in the NHS structures, but my understanding is also that it will not report until after the Bill has been passed if we continue with the current timetable. Frankly, by then, it will be a bit late to make sure that we have got the arrangements absolutely right.

It is right that primary care commissioning is undertaken at a local level by people with relevant knowledge and skills, and with the necessary experience of what primary care needs to look like at locality level. That is why it is right that the new place-based partnerships are to be given that commissioning role. However, like the noble Lord, Lord Hunt, I think it is important that these primary care commissioning arrangements are established in statute, because it is only if that happens that Parliament will be clear about the accountability arrangements and the governance and leadership. It is also important that there is real transparency in the system. At the moment, it all feels a bit opaque. I hope that the Minister can give some assurances on this point.

Lord Stevens of Birmingham Portrait Lord Stevens of Birmingham (CB)
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My Lords, I just wanted to respond to the last set of very important questions that have arisen. It is fair to say that the Bill increases the accountability for commissioning primary care services locally, as compared with its predecessor, the 2012 Act. That is because one consequence of having GPs represented on the clinical commissioning groups was that clinical commissioning groups could not, therefore, be the commissioners of local primary care services, at least in statute. One had the paradox that the most local of all the services in the NHS was stripped out from the local commissioning bodies, the CCGs, and instead given nationally to NHS England, as a work-around to deal with the conflict of interest that GPs would otherwise have had in commissioning themselves on the CCGs.

In practice, the CCGs have been given the ability to influence those local commissioning arrangements but, to be clear, that is not the accountability mechanism set through the 2012 Act. What this Bill does is to improve the position, in that it is local integrated care boards that have that local commissioning responsibility for GP and other family health services, as compared with NHS England nationally.

Baroness Walmsley Portrait Baroness Walmsley (LD)
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My Lords, we have been reminded many times during the debates in Committee of the aims of the Bill to improve the health and well-being of the population, to improve the quality of care and to use NHS resources sustainably through integration, co-operation and collaboration. Of course, the point at which these resources are used at the coalface, known as “place” in the Bill, is in these place-based organisations. To ensure integration at this level, we are told that the ICB must create an integrated care partnership, otherwise known as a place-based integrated care board, which probably has an acronym as well. There is, however, very little detail about those, despite their crucial importance, and these amendments from the noble Lord, Lord Hunt, are an attempt to put a bit of flesh on those bones.

I put my name to Amendment 166, but I could just as easily have put it to Amendment 165. Amendment 166 says that, within the place-based partnership, there should be mandated a provider network board with duties delegated to it by the ICB. It would be under parliamentary scrutiny and have an obligation to meet in public. These networks already exist and exert considerable influence, but it is essential that they operate in this new integrated care system under a regulated constitution, with obligations to consult and financial provisions. This amendment would ensure the transparency, for which the noble Lord, Lord Lansley, called, over how well integration is operating at this very important level so that there can be proper control and accountability and scrutiny as to where the money is being spent and whether it is achieving the duties placed on all these systems by the Bill.