Brexit: Import of Radioisotopes

Lord Tebbit Excerpts

Thursday 7th March 2019 Lords Chamber

[Lord O'Neill of Clackmannan (Lab)]

My Lords—

[Lord Tebbit (Con)]

My Lords—

[Lord Warner (CB)]

My Lords—

NHS: Nurse Retention

Lord Tebbit Excerpts

Wednesday 17th January 2018 Lords Chamber

[Lord O’Shaughnessy]

I acknowledge the importance of looking at pay, which is why it was so welcome that the issue was dealt with in the Budget, with the cap being lifted for nurses and other health professionals on Agenda for Change contracts. I agree that long-term sickness is a big concern and undoubtedly having an impact on some nurses leaving. That is why the return-to-practice programme that we have is so important. Several thousand nurses have been through it; it is about providing opportunities to come back into the profession in a supportive way for those who want to do so.

[Lord Tebbit (Con)]

My Lords, can my noble friend tell me how many of these nurses who have left the NHS are now working for agencies and still in the same hospitals, on the same wards, doing the same work but costing the taxpayer rather more money?

[Lord O’Shaughnessy]

In the last few years there has been an increase in agency spend. Of course, per nursing hour that tends to be more expensive. We have managed to reduce agency spend by increasing the availability of nursing banks. Those are the people employed on flexible contracts, which is very welcome for many nurses who are looking for—as they say in staff surveys—greater flexible working arrangements.

Social Care: Sleep-in Payments

Lord Tebbit Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

I am grateful that the noble Baroness has raised the compliance scheme. For those providers that enter it, the scheme offers the opportunity to take 12 months for self-review and then report to HMRC, which will then allow a further three months for the providers to pay. That gives a 15-month leeway compared with the usual default enforcement period of 28 days. There is clearly a balance to be struck between the financial challenges posed to providers and the money that staff, rightly, need to take. I think that the compliance scheme provides that balance so that we can do it in a way that is sustainable.

[Lord Tebbit (Con)]

My Lords, I declare an interest in that my wife requires 24-hour care. I am sure that my noble friend is aware of the impact of the backdating of this decision on so many people, not least charities such as Mencap, which will become seriously financially embarrassed unless some help is forthcoming. The amounts are enormous to such charities, but they are really pretty small beer compared with overseas aid, for example, and I hope the Government will look to their priorities in that respect.

Brexit: Health Policy

Lord Tebbit Excerpts

Wednesday 6th December 2017 Lords Chamber

[Lord Cunningham of Felling (Lab)]

My Lords—

[Lord Tebbit (Con)]

My Lords—

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

It is the turn of the Conservative Benches.

[Lord Tebbit]

Does my noble friend understand—I am sure he does—that on both sides of the channel we are all concerned about the rights of British people in the EU and EU citizens here to health service treatment free of charge? Of course, the numbers are different. Would it not make it much more equal if we could agree with our friends in Europe that after Brexit we would issue a similar number of cards entitling people to treatment—Brits and EU citizens? If there was a disparity, whichever side needed more cards could buy them from the appropriate Government.

[Lord O’Shaughnessy]

My noble friend is, as ever, a huge source of ideas and advice, for which I am grateful. This point about reciprocal health care is really important, because our reciprocal healthcare arrangements predate membership of the European Union. They worked in the interests of people in both the UK and the European Union and I have every expectation that they will continue in the future.

Royal National Orthopaedic Hospital: Redevelopment

Lord Tebbit Excerpts

Thursday 17th March 2016 Grand Committee

[Lord Tebbit (Con)]

My Lords, I congratulate the noble Baroness, Lady Dean, on securing this brief debate on the future of the RNOH at Stanmore. I first came to know the hospital some 30 years ago when my wife was transferred there from Stoke Mandeville to continue her rehabilitation from the injuries she had suffered in the attempt by IRA/Sinn Fein to murder Prime Minister Thatcher. Indeed, until this year when the deterioration in her health has made the journey there from our home in East Anglia too arduous for her, my wife had continued to be a patient at Stanmore.

Through those years, we have also seen the development of the splendid charitable trust facilities to provide for both able-bodied and disabled people alongside the hospital, and they are an important part of the whole complex. Less happily, we have also seen the inability of successive Governments to get on with the long overdue replacement of the tatty, inefficient buildings which have hampered the skilled and loyal staff in their offering of the treatment needed by patients, not least the spinally injured ones, from around London and the Home Counties. We know that the extent of recovery from serious spinal injury is critically dependent on whether the patient can receive immediate care in a specialist unit. That is why Stanmore is so important to London and the Home Counties. I have lobbied many Ministers for many years over this rebuilding programme. At least it is now a great comfort that the most pernicious proposal—and I use that word as I usually use words, in its literal sense—of a PFI has been rejected. They are the most awful device which has ever been created in an attempt to dodge the rules of public sector accounting.

It seems, at last, that something like the charitable finance initiative, proposed by Mr Laurie Marsh and others, to finance the rebuilding of the hospital out of the profits from residential development of surplus land, is now to go ahead. I am, however, still concerned that—if I read the briefings right—the development of the surplus land is expected to yield only £20 million. That seems a pathetically small sum of money to come from the sale and development of residential land in the Stanmore area. It is extraordinarily small, and I hope that the Minister will look very closely at how that sum has been reached. Finally, I give heartfelt thanks for the great kindness and the care which my wife received at Stanmore, and I say to my noble friend Lord Prior, come on, for goodness’ sake get on with it.

National Health Service: Workforce Race Equality Standard

Lord Tebbit Excerpts

Wednesday 24th February 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Baroness makes a good point. In a way the WRES focuses very much on the more senior grades in the NHS, but we need to focus on progression from band 4 into 5 and 6 as well. It is an important point that needs to be taken on board. As far as recruitment is concerned, it is very important that we have people from BME backgrounds on the recruitment panels. Getting the right people is crucial, and if that means going to external recruitment agencies when we have to, we should not rule that out.

[Lord Tebbit (Con)]

My Lords, can my noble friend say whether or not appointments in the National Health Service will continue to be made on the basis of the ability to undertake the duties of that post?

[Lord Prior of Brampton]

My Lords, the ability to undertake the duties of a post is absolutely fundamental. The tragedy is that so few people from BME backgrounds are encouraged to put their names forward. It is more important that we get the actual recruitment process right.

Human Fertilisation and Embryology (Mitochondrial Donation) Regulations 2015

Lord Tebbit Excerpts

Tuesday 24th February 2015 Lords Chamber

[Baroness Hollins]

Again, I do not think that is the point that I am trying to make. Maybe I am not being quite clear enough.

[Lord Tebbit (Con)]

Would the noble Baroness not agree that there is only one absolutely safe way to ensure that this disease is not handed down from generation to generation, and that is for those women who are carriers of the genetic fault not to have children? That may be an appalling thing for me to have said, many people would think, but there are many people who for various reasons cannot have children.

[Baroness Hollins]

That is a good point.

Supporters of the techniques simplify the impact of these proposed procedures by saying that mitochondrial donation is like changing a battery. Their argument runs that mitochondrial DNA relates only to power production in the cell but does not affect the DNA, which encodes our characteristics, and therefore that exchanging mitochondria should not be seen as ethically significant. In a debate last September, the honourable Member for Havant in another place summed up this position well when he said that the techniques represented,

“a change in the membrane of the cell so that the battery function continues, but it does not affect human identity even by 0.1%. That is why I do not believe that there is an issue of dignity or integrity of the individual”.—[Official Report, Commons, 1/7/14; col. 98.]

The Government underlined how important this point was to their policy in their consultation response when they said:

“Most importantly, mitochondrial donation techniques do not alter personal characteristics and traits”,

of the person, the implication being that if this technology were to affect personal characteristics then the Government would withdraw their support.

So the ethics and the safety of the science are inextricably linked. Unfortunately, it seems that we are still at the beginning of understanding the complex interactions between mitochondrial and nuclear DNA. Some recent empirical studies on animals have suggested that mitochondria indeed affect characteristics, and that there is a relationship between mitochondria and memory, temperament and behaviour. As a psychiatrist, I see temperament as a personal characteristic, and I think it was for that reason that the New Scientist withdrew its support for the techniques. In an editorial last year it said that,

“we may have seriously underestimated the influence that mitochondria have. Recent research suggests that they play a key role in some of the most important features of human life”.

I note that the Government’s own consultation document acknowledged the diversity of problems associated with mitochondrial disease, including learning disabilities, neurological problems, autonomic dysfunction and dementia, and that every person’s symptoms are different. The Government’s response to the consultation concluded that they do not alter personal characteristics. One problem that I have with the current proposals is the idea that mitochondria are mere batteries, which is what has been quoted in so many of the papers that have been circulated to Peers. The New Scientist leader comment in September last year said that most debate around the issue had worked on the assumption that mitochondria were simply cellular powerhouses. However, given their newfound influence over our bodies, the implications of this technology may be far more radical than we have assumed. The leader made the point that it seems that mitochondria, far from being passive power plants, influence some of the most important aspects of human life, from memory and ageing to combating stress and disease. They even have influence over the DNA in your cell nuclei and change and evolve during your lifetime.

I have been inundated by emails, as I am sure we all have, from people who are concerned. I had an email from a cell biologist working in California, Professor Paul Knoepfler, who contributed to the HFEA’s call for evidence. He said that,

“mitochondrial transfer might be proven safe, but then again it might not. From my perspective as an impartial (scientific) observer … putting myself at some risk by publicly opposing this technology … its approval at this time would be a … risky gamble with children’s health and lives”.

He says that many scientists have told him that privately they share his concern.

I have one question for the Minister: would he withdraw his support for the regulations if he thought that the role of mitochondria was more than mere power production? Would he then support the amendment of the noble Lord, Lord Deben, for further consideration of this matter?

Until recently, the Wellcome Trust had on its website a statement suggesting that the procedure would be able to go ahead in late 2014, when the science was ready. But is the science ready? I am not quite convinced yet. As noble Lords may be aware, I chair the BMA board of science, which has not yet discussed this matter. I have discussed my support for the noble Lord’s amendments with senior officers of the BMA, and perhaps I may clarify the BMA’s position. Its support for the principle of such reproductive technologies has been expressed as an ethical principle to allow the cautious exploration and development of such technologies. I have concerns about the timing of these regulations, and for that reason I welcome the opportunity to debate them presented by the noble Lord, Lord Deben.

NHS: Accident and Emergency Services

Lord Tebbit Excerpts

Wednesday 7th January 2015 Lords Chamber

[Lord Tebbit (Con)]

My Lords, I wonder whether my noble friend will give consideration to helping those people who could not get appointments to see their general practitioners, some of whose surgeries were closed for five days over Christmas, by allowing or encouraging hospitals to set up general practices alongside their A&E departments, which would be open seven days a week, 24 hours a day, for people who registered at the hospital general practice. That would mean more funds for the hospital and less funds for the general practices that chose to close up in that manner.

[Earl Howe]

My noble friend has made an extremely important point. I have visited hospitals where that very model has been in place, for example, in Luton, where I went not so long ago. More and more hospitals are adopting this suggestion so that when people turn up at A&E they can be triaged immediately into urgent and less urgent cases, often to be channelled through to the GP service.

Public Health Responsibility Deal

Lord Tebbit Excerpts

Tuesday 14th January 2014 Lords Chamber

[Earl Howe]

I am sure my noble friend Lord McColl would agree that one can go too far in that direction.

[Lord Tebbit (Con)]

My Lords, do the Government not accept that people ought to know that if they stuff themselves silly with high-calorie rubbish foods they will get fat? It is their responsibility. All the forums and other nonsense are merely trying to divorce people from the consequences of their own stupid actions.

[Earl Howe]

My noble friend is absolutely right to place his finger on a central point that, in the end, it is up to individuals to take responsibility for their own state of health.

NHS: Risk Register

Lord Tebbit Excerpts

Tuesday 15th May 2012 Lords Chamber

[Earl Howe]

I acknowledge that I did not answer that question and apologise to the noble Lord for not having done so last week. The whole issue of stakeholder support is one that the risk register addresses, as he will see from the document that we published. I do not recall the specific issue of waiting times to see one’s GP arising in the risk register for the simple reason that, although I acknowledge that it is currently a problem in some parts of the country, particularly London, that is not a direct result of anything that the Government are doing in our reform programme.

[Lord Tebbit]

My Lords, would my noble friend decline to take lessons in these matters from those who supported former Prime Minister Blair in not publishing a full and frank assessment of the intelligence reports on which he committed this country to a war?