Government Policy on Health

Lord Wallace of Saltaire Excerpts

Tuesday 10th September 2024 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, to set out some key points in respect of the right honourable Alan Milburn, he has no formal role in the department. Therefore, the conflicts of interest the noble Lord referred to do not even arise. The main thing I would like to set out is that it is very important to make a distinction between the areas of business and meetings in the department about generating ideas and policy discussion—it is those in which Mr Milburn has been involved, at the request of the Secretary of State—and the very different meetings about taking government decisions. If I might summarise it for your Lordships’ House: Ministers decide, advisers advise.

[Lord Wallace of Saltaire (LD)]

My Lords, I declare a certain puzzlement at this Question. I recall, when the Conservatives were in office, reading regularly on the front page of the Times that donors had been talking to the Prime Minister or various Cabinet Ministers about government policy and expressing strong views on which direction they should take in various areas. As an academic, I am also well aware of the extent to which expertise comes into government through informal channels.

On one now famous occasion, which was not reported at the time, a number of experts on the Soviet Union whom I knew well were invited by Margaret Thatcher to an informal seminar in No. 10 to advise on whether the Foreign Office or Margaret Thatcher’s advisers were correct in their attitude to the Soviet Union. A number of the academics suggested that the Third Secretary of the Communist Party, then a man called Gorbachev, was a good person to get to know. Mrs Thatcher took their advice rather than that of her advisers and it had a remarkably positive impact on British foreign policy. Do the Government accept that all informal contact with outside experts is desirable and that it is a good thing, where possible, that it should be reported?

[Baroness Merron (Lab)]

It is right that people from outside government come into departments to lend their expertise and share their views and that Ministers make decisions without those people involved. That was the line I was trying to draw. The Secretary of State for Health is very fortunate to be able to turn to every living former Labour Health Secretary, from the right honourable Alan Milburn through to my noble friend Lord Reid, Andy Burnham and many others, because all of them have offered to roll their sleeves up and assist us. Perhaps I could remind your Lordships’ House that, between them, they delivered the shortest waiting times and highest patient satisfaction in the history of the National Health Service. I hope that we will be able to do justice to their experience.

King’s Speech

Lord Wallace of Saltaire Excerpts

Thursday 9th November 2023 Lords Chamber

[Lord Wallace of Saltaire (LD)]

My Lords, the 2019 Conservative manifesto, on which this Government’s programme was based, devoted well over a page to constitutional reform, democratic accountability and the rule of law. This King’s Speech is entirely silent on the subject, except for the promise to focus on long-term decisions instead of the repeated short-term changes in policies and Ministers from which the UK has suffered in the past four years.

The Prime Minister’s introduction to the briefing on forthcoming Bills gives the game away. His reiteration that “integrity, professionalism and accountability” will mark his Government’s approach underlines the absence of these qualities under his immediate predecessors. Since 2017, the constitutional conventions that structure the way Britain is governed have been seriously damaged by competing factions and populist politicians within the Conservative Party. Boris Johnson claimed to govern by “the will of the people”, that dangerous phrase, rather than by parliamentary consent. Ministers challenged the rule of law. The Commons has been sidelined to a point where, in the last Session, it sat for fewer hours per week than the officially part-time House, this Chamber. Constitutional guardians established by former Conservative and Labour Governments have been ignored or overruled, or their independence threatened. These include the Committee on Standards in Public Life, the Independent Adviser on Ministers’ Interests, the Advisory Committee on Business Appointments, the House of Lords Appointments Commission and the Electoral Commission. The Covid inquiry is now informing the public of the chaos that has characterised this Government, the disregard for rules and due process, and the errors and corruption to which all this has led.

Decent Conservatives must be as worried about this move away from constitutional democracy as the rest of us, and I hope they share our concern around the decline of public trust in Westminster politics to which it has led. Multiple studies of public attitudes indicate that trust in national politics and politicians in Britain is now lower than any comparable advanced democracy except the United States, and that it has sunk further since the Covid lockdown and the Johnson premiership and now hovers between 5% and 10% in an otherwise disillusioned and disengaged public. The comment of the noble Lord, Lord Hayward, on the two most recent by-elections—that the winners on a low turnout were disengaged non-voters rather than the Labour Party—ought to concern and worry all of us.

It ought also to concern partisans of the current Government that, in answer to public opinion pollsters, voters say that they trust local government significantly more than Downing Street and Westminster, trust judges and courts far more than politicians and Ministers, and trust the Civil Service more than the Ministers who so often rubbish it. Oh, and a majority trust the BBC as a source of unbiased news a great deal better than they trust the Government’s information services.

The only Bill in the agenda set out for this Session that touches on our structures of democratic government is the Economic Activity of Public Bodies (Overseas Matters) Bill. That seeks to tighten even further detailed ministerial direction of what directly elected local councils may do. I suggest that this is totally unacceptable to democratic accountability.

Local government has been the nearest governing body to which most of our citizens relate, dealing with issues that affect their communities and daily life. Local government has been undermined, reorganised and starved of financial resources for many years. The Covid inquiry has heard that Ministers bypassed the network of public health officers across England’s cities and towns, who could have managed the response to the epidemic, in order to outsource Covid testing to multinational companies—with disastrous results. Any incoming Government should make the revival of local democracy an urgent priority to rebuild public trust and effective local administration.

This exhausted Government have abandoned their promise to strengthen our constitution, so it will be up to whichever Government emerge after the election to take up the task of rebuilding our constitutional safeguards and attempting to rebuild public trust. They should do their best to build cross-party consensus—I note that the noble Lord, Lord Lexden, talked about the desirability for good policy—on the changes that are needed, rather than impose the partisan perspectives that right-wing think tanks such as Policy Exchange have urged on this Government. In opposition, after all, Conservatives will discover again that electoral dictatorship is hateful when imposed against them, and may then support reform.

The Constitution Unit has provided a list of rapid changes that any new Government could introduce; for example, a cross-party business committee for the Commons to loosen the Government’s control of the timetable, statutory status for constitutional guardians, cuts in the size of the Government’s bulging parliamentary payroll, and tighter rules on political finance. The Institute for Government has also proposed a Joint Committee on the constitution to oversee executive adherence to constitutional rules. I am very glad to hear that our Constitution Committee will examine that proposal further.

If all the next election leads to is a change of government, without significant changes in how we are governed and our democracy works, public distrust of Westminster will fester. Where this King’s Speech is silent, the next Government must commit to a broad reform programme of our overcentralised and Executive-dominated structures, to rebuild competence and trust in constitutional democracy.

NHS Procurement: Palantir Contract

Lord Wallace of Saltaire Excerpts

Thursday 22nd June 2023 Lords Chamber

[Lord Markham (Con)]

I think I said that we wanted the best supplier to win; I will check and correct the record if I mentioned quality only. Quality is very important because the contract has to be good, of course, but the price has to be right as well. There are a number of criteria. Again, we will hold a session so will be able to take noble Lords through the whole process. I am confident that, at the end of that process, people will feel confident that we have reached a decision on the best supplier across all the criteria.

[Lord Wallace of Saltaire (LD)]

My Lords, press coverage of this contract has indicated that an alternative British consortium was prepared for this contract. Can the Government confirm whether they examined alternative bidders, in particular British ones, given that the issue of trust in the use of data is an important one? As the noble Baroness remarked, trust in Palantir as a supplier is absent from substantial chunks of the NHS.

[Lord Markham (Con)]

Again, it is important to say that the whole point of this transition arrangement was to allow us to have an open bidding process across loads of suppliers, knowing that, when they were able to put their solution in place, their transition arrangements were in place. That opened up the field to British suppliers and suppliers from around the world. We have had an open process, which has been going on for a number of months now and continues. We expect a contract award around autumn time and I can assure the noble Lord that we have looked at a whole range of suppliers to make sure that we get the best outcome.

Social Care Sector: Private Equity

Lord Wallace of Saltaire Excerpts

Thursday 27th January 2022 Lords Chamber

[Lord Kamall (Con)]

I will look into that. I thank the noble Baroness for raising that important point. As I have said a number of times—noble Lords are probably bored of hearing me say it—we take the quality of care seriously. We know that the social care sector has been, frankly, abandoned for far too long, which is one of the reasons that we have brought forward the Health and Care Bill, to make sure that we have integration across the whole of people’s life path and that they are not just forgotten towards the end of their lives.

[Lord Wallace of Saltaire (LD)]

My Lords, is the social care sector not one in which mutuals and charities are more appropriate providers than private equity companies? My family has benefited enormously from an excellent charity running a number of care homes, but I am conscious that some charities have moved out of the sector. Would the Government not like actively to encourage non-profits to be involved more widely in this sector?

[Lord Kamall (Con)]

The noble Lord makes a very important point about mutuals: they play an incredible role. Indeed, at the founding of the NHS, one of the sad things was that the state pushed out many mutuals. The number of friendly societies and mutuals went down. It is important that we make sure that we have enough mutuals in the economy.

Covid Contracts: Judicial Review

Lord Wallace of Saltaire Excerpts

Monday 1st March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord puts it extremely well, and he takes me right back to those days. I remember making a public call for help with diagnostics, and an NHSBSA call centre was overwhelmed by 5,500 calls in a week—triaging them took nearly a month. The noble Lord is entirely right: getting through all of those who sought to help was an enormously difficult task, and those who proved to be effective assistants were not always the obvious ones. I could share anecdotes of surprising people who came forward and gave tremendous help, while those who you would think could help simply did not have what we needed. Those were extremely complicated times, and I pay enormous tribute to the officials who saw us through them.

[Lord Wallace of Saltaire (LD) [V]]

My Lords, the Minister has been explaining how the centre was overwhelmed by the number of offers. In the early stages, why was it not dealt with by a greater degree of local decision-making and autonomy? Local authorities and hospital trusts were bypassed in this, as in a number of other areas, such as test and trace. Would it not have been much better to have allowed small companies and local authorities to bargain with each other about these offers in the first place?

[Lord Bethell (Con)]

That is a reasonable question, and, in fact, that was our starting point: the noble Lord will remember that, at the beginning of all of this, we supplied PPE to 252 NHS trusts and no one else—everyone else sorted out their own PPE. The reason we had to change was that this was a global crisis: borders were shut, factories closed down and every country in the world was desperate for PPE. There was no facility for a procurement manager at an NHS trust, let alone a small social care home in the West Country; those avenues were all shut. That is why it took a massive national effort to secure PPE. We now have a portal that supplies more than 50,000 different NHS and social care units; as I explained earlier, we have an enormous stockpile to secure that. This has been one of the big learnings of the pandemic: in order to have resilient supply chains, there needs to be some national muscle to make sure that it works properly.

Covid-19: Contact-tracing App

Lord Wallace of Saltaire Excerpts

Wednesday 6th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right to be concerned about the vulnerable and our approach. I completely share those concerns. It is a massive challenge, but that does not stop us embracing the advantages of technology where millions of transactions can be done in a day which could never be done by more manual processes. An enormous amount will be invested in trying to reach out to those who are isolated, vulnerable or digitally excluded to ensure that they have details of our track-and-trace arrangements. Hiring an enormous army of track-and-trace experts has already begun, and details can be seen on my Twitter feed of how volunteers who have the right qualifications can join those efforts.

[Lord Wallace of Saltaire (LD)]

My Lords, if we are moving to a centralised app, what assurances do we have about how long the data will be stored? I see references to use for research purposes in various documents. Will there be careful safeguards about the deletion of the data after a certain period?

[Lord Bethell]

I reassure the noble Lord, Lord Wallace, that sunset arrangements will form part of the conditions of the app and that they will be published shortly.

Blood Safety and Quality (Amendment) (EU Exit) Regulations 2019

Lord Wallace of Saltaire Excerpts

Wednesday 19th December 2018 Lords Chamber

[Lord O'Shaughnessy]

There is a schedule, which is set out in the Act, and we have good debates, as we did on these regulations. It is about making sure that we do everything that a responsible Government should do. If the noble Lord was in this position, would he be doing anything different? Of course he would not.

[Lord Wallace of Saltaire (LD)]

Many of us now doubt that it is possible to get through the mass of legislation, including subordinate legislation, required for an orderly Brexit between when we return in January and the end of March. We fear that the Government will attempt to push it through by one emergency procedure or another. This will not be an emergency; it will be the result of the constant postponement of decisions by Her Majesty’s Government. The only way out seems to be for the Government to ask for a postponement or extension of the Article 50 procedure.

Childhood Obesity: Yoga

Lord Wallace of Saltaire Excerpts

Thursday 21st June 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord is quite right: it is not just sugar that is eaten but sugar that is drunk as well. The sugar levy has been a significant success. Half the drinks it applied to have been reformulated to reduce their sugar, saving 45 million kilograms of sugar being consumed each year. We have more to do on sugar reduction beyond fizzy drinks. We did not hit our target in the first year but we will take further action to make sure that we do so.

[Lord Wallace of Saltaire (LD)]

My Lords, is the Minister aware of recent research by the Institute of Education of University College London that shows that communal singing in primary and secondary schools has a strong calming effect and improves concentration, discipline and everything else, yet many schools are losing their music teachers, leaving no one in the school with any music qualification? I declare an interest as a trustee of the VCM Foundation.

[Lord O’Shaughnessy]

I understand that the noble Lord is a member of the parliamentary choir, so he is a living example of the benefits of communal singing, or maybe not. I am sure he is very tuneful. The noble Lord is quite right: singing and, indeed, all arts are good for the soul and should be part of the school day.

Smoking: Vaping

Lord Wallace of Saltaire Excerpts

Tuesday 19th December 2017 Lords Chamber

[Lord O'Shaughnessy]

My noble friend is quite right to point out that vaping is a British success story as an anti-smoking aid, and it has made a huge contribution not just to noble Lords but to around 2.5 million e-cigarette users, half of whom used to smoke. There is, of course, as he will no doubt be aware, a court challenge going on at the moment. It is under consideration by the CJEU, and we expect a judgment in the summer of 2018, so I am unfortunately not in a position to comment until we have that judgment.

[Lord Wallace of Saltaire (LD)]

Could the Minister possibly encourage his colleagues to consider publishing a list of EU regulations which are there primarily because British lobbies with the support of British Ministers have pushed them on to the EU? I am thinking in particular of animal welfare, as well as a lot of health and smoking regulations. It would help to educate opinion in this country as to what sort of regulations might be likely to diverge after we leave, and which will not.

NHS: EEA Doctors

Lord Wallace of Saltaire Excerpts

Tuesday 12th December 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble and learned Lord will know that a variety of reports have been published. I am sure that he has taken the opportunity to sign in and read them, which is very welcome, and I encourage all noble Lords to do that. One of the greatest things that we have to do is look at workforce issues. I come back to the point about being able to provide reassurance to people who are thinking of leaving but have not yet done so. I stress that we have more EU and EEA people working in the NHS, which is a very welcome thing and I hope they take comfort from that.

[Lord Wallace of Saltaire (LD)]

My Lords, over the weekend a number of Ministers, including the Secretary of State for DExEU, said that these agreements are fine but that nothing is settled until everything is settled. That seems to be not quite the reassurance that everyone would want. Is it possible for the Government to go further and say that they will offer a guarantee to all EU citizens working in the National Health Service that, whatever else happens, they will continue to be welcome? I am conscious that the figures on nurses and midwives are not as good as those for doctors at present and that we are in severe danger of having a short-term gap in the number of nurses and midwives, which would be very serious.

[Lord O'Shaughnessy]

I point the noble Lord to the Prime Minister’s letter, in which she talks about the fact that the rights will be written into law as we leave the EU. He is right to point out the position of nurses and midwives; that is the only category where fewer EU staff are working in the National Health Service year on year. However, as we have talked about many times in the House, new language tests may have had a critical role in that and that is something we are reviewing it to make sure that we can continue to welcome nurses from abroad.