Motability
Lord Walton of Detchant Excerpts(8 years, 8 months ago)
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Baroness Altmann
The Government are absolutely committed to supporting disabled people but the disability living allowance was inconsistent and subjective whereas the personal independence payment assessment is more consistent and fairer.
Lord Walton of Detchant (CB)
My Lords, is the Minister satisfied that the individuals chosen to assess the nature and significance of the disability of disabled individuals are properly qualified and trained to carry out such assessments, and that in doing so they employ well-defined and reproducible criteria?
Baroness Altmann
My Lords, the Government are satisfied that those who carry out the personal independence payment assessments are qualified to do so—and indeed, reports suggest that the assessments are running better than the previous DLA regime.
Mesothelioma Bill [HL]
Lord Walton of Detchant Excerpts(11 years, 4 months ago)
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Lord Alton of Liverpool
My Lords, in moving Amendments 2, 20, 21, 22, 23 and 24, I join other noble Lords who have expressed their thanks to the noble Lord, Lord Freud, the Minister, for doing an incredibly tough job over the last year or so. It has been very well done. I am very grateful for his remarks earlier.
The Minister said that if the Bill were delayed—none of us intended to do that—it could cause further problems in due course. Nevertheless, I just hope he accepts that that is no reason for curtailing due parliamentary process in any way. Of course, it is up to the Government to decide what to do in another place. If your Lordships decide to include amendments to the Bill here, it will not be Members of another place who precipitate the ping-pong; it will be the Government.
With those words, I refer the noble Lord to the all-party support for this group of amendments, and to the letter that was sent to him and other Members of your Lordships’ House, signed by some 22 Members. They include some of the leading authorities on medical research and the law and others with first-hand knowledge of a fatal disease that claims 2,400 lives annually and is predicted to kill a further 56,000 British citizens between 2014 and 2044. Dr Mick Peake, the clinical lead at the National Cancer Intelligence Network, is right when he says, “We must make every effort not to miss this opportunity to lead the world in this area and to finally make significant inroads into this dreadful disease for patients and their families”.
The amendments before your Lordships seek to impose a levy of no more than 1% to raise funds to support research into the causes and treatment of mesothelioma, and have the wholehearted support of the British Lung Foundation. I thank it, and especially my noble friends Lord Walton of Detchant and Lord Pannick, and the noble Lord, Lord Avebury, who are co-sponsors of the amendments, and noble Lords who spoke in Committee and who through constraints of time might be unable to do so again today.
At the conclusion of Committee, it was the Minister who encouragingly said:
“Well, my Lords, I feel like adding my name to the amendment”.
As recently as Monday, I met the Minister again—once again, I am grateful to him and his team of officials for the time and courtesy they have unfailingly given—to see whether we could find a way for him to translate that desire into a reality. I have offered to withdraw this amendment if the Government undertake to introduce their own at Third Reading, or indeed in the other place, and that offer still stands. Although I feel that the noble Lord has been a victim of the Whitehall curse, I want to put on the record that he has been deeply committed to ensuring more support for research. However, as he told us in Committee:
“I have hit a brick wall at every turn”.
It is Parliament’s job to demolish such brick walls.
Although new figures published yesterday show that the MRC has made a helpful increase in funding for mesothelioma research, the sums are still very modest and should be seen in the context of years and years of virtually no state funding. When viewed alongside the two cancers of closest mortality in the UK—myeloma and melanoma—the funds for mesothelioma still lag considerably behind. Unlike many other forms of cancer, rates of mesothelioma are still rising. The United Kingdom already has the highest mesothelioma mortality rates in the entire world, yet there is little by way of effective treatments and at present no chance of a cure.
This shocking situation was underlined by the Minister himself, who candidly told us in Committee:
“Something very odd is happening here when so little money has gone into research in this area”.
In Committee he agreed that,
“There needs to be a kick-start process to get research going”.—[Official Report, 5/6/13; col. GC250.]
That is precisely what this amendment does. It is a kick-start.
In a letter sent by his department to all Members of your Lordships’ House on Monday, the Minister reiterated his support for increased support for research, but said that, “unfortunately, the mechanism proposed is just not viable”.
With the assistance of the British Lung Foundation, I took the precaution of asking Daniel Greenberg QC to draft this amendment with me. I did so not simply because he is the editor of Craies on Legislation, Stroud’s Judicial Dictionary, Jowitt’s Dictionary of English Law, Westlaw UK Annotated Statutes and editor-in-chief of the Statute Law Review, but perhaps most importantly because he was parliamentary counsel from 1991 to 2010. Clearly, he knows a thing or two about drafting legislation, and presumably the Government would not cast doubt on the viability of the reams of legislation that he drafted for them.
The Minister will forgive me but in the nearly 35 years since I entered Parliament, I have heard the phrases “not viable” or “technically defective” as the refuge of last resort whenever we run out of good arguments. If the argument for a levy lacked viability, it would cast doubt on the whole principle that underpins this Bill, which is based on the imposition of a levy.
The Minister will recall that before Committee he was briefed to oppose the amendment on the grounds that there was no precedent for hypothecation and to raise that other old bogey of “legal obstacles”, the Human Rights Act. To answer those objections, noble Lords gave the noble Lord the precedent of Section 123 of the Gambling Act 2005, Sections 24 and 27 of the Betting, Gaming and Lotteries Act 1963, the HGV Road User Levy Act 2013, and other industry levies, including the fossil fuel levy, the levy on the pig industry to eradicate Aujeszky’s disease and the Gas Levy Act 1981. As my noble and learned friend Lady Butler-Sloss and my noble friend Lord Pannick made abundantly clear, the idea that such a levy was an infringement on the Human Rights Act is, frankly, risible. Indeed, my noble friend Lord Pannick said:
“It would be quite fanciful to suggest that there is a legal reason not to support an amendment”.—[Official Report, 5/6/13; col. GC 247.]
None of those shadow-boxing parliamentary arguments will do. They are simply not worthy of an issue that has lethal consequences for so many of our countrymen. Why has mesothelioma research had this Cinderella status? Why does it require Parliament to put it right? Why has it for so many years received little or no state funding? In Committee, the Minister provided clues. He said that mesothelioma,
“was an unfashionable area to go into and therefore the people who wanted to make their careers in research turned to other cancers. As a result, good-quality research proposals were not coming in and therefore the research council did not feel that it could supply funds. That is the reason and it has been the reason for decades”.—[Official Report, 5/6/13; col. GC 253.]
The advisers to the Minister at the DWP have written that there is no lack of necessary skills for research into asbestos-related diseases but that there are perverse incentives to tackle what are perceived as more tractable research questions or tumour types that are considered easier to study and, where possible, to build on past progress. They said that research bids that were seen as likely to fail were not being presented. Therefore, it is not a lack of capacity in the field that is the problem; as my noble friend Lord Kakkar outlined in Committee, many eminent researchers are interested in mesothelioma research. High-quality bids have been in short supply in the past decade precisely because leading academics knew that it was pointless putting time and effort into preparing a bid that was unlikely to succeed.
Dr Robert Rintoul, consultant respiratory physician at Papworth Hospital and chief investigator of the recently launched mesothelioma tissue bank, told me that if more funding is made available, big labs will suddenly get interested in mesothelioma, which will increase the quality of research grants. Dr John Maher, honorary consultant immunologist at King’s College Hospital, said, “As I write, we have a clinical-grade viral vector ready for use, an optimised and patentable manufacturing process and a recently licensed GNP manufacturing facility available to generate cell products. However, there are no realistic prospects of obtaining funds to undertake such work in mesothelioma in the near future”. There clearly is no question that further investment in mesothelioma research is urgently required.
We have heard from the Minister that this will peak in two years’ time, but listen to this stark warning from Dr Stefan Marciniak, the honorary consultant physician at Cambridge University’s Institute for Medical Research, who told me that there will be a continued increase in cases worldwide well into this century owing to the ever-increasing use of asbestos in the BRIC countries, and that carbon nanotubes share frightening similarities with asbestos-like minerals and could lead to a second wave of mesothelioma. That is why we need urgent research
I am delighted to see the Minister and his noble friend Lord Howe on the Front Bench today. The Minister will be sponsoring a reception later this month on mesothelioma research for an invited audience of some 40 people. I know that he will agree that such meetings, welcome though they are, are not enough and certainly not a substitute for statutory obligations. By themselves, such initiatives are unlikely to lead to the sea change in investment that is needed to ensure that the recent advances in mesothelioma research are sustained. If we do not seize this legislative moment, all the talk will vanish into the ether. It will be the informal approach that lacks viability, not this amendment.
As my noble friend Lord Walton of Detchant suggested in Committee, the amendment proposes that the funds be administered by a competent third party, which would have no difficulty in investing in all the different types of research that are so urgently required. We need both a statutory levy on the insurance firms and a greater effort from our public research institutions in dealing with a disease that will kill more than 2,000 people every year in the United Kingdom. It is vital that we as legislators grapple with the source of so much misery and suffering, which is the reason, after all, for the millions of pounds of compensation payments for which the Bill provides.
The amendment proposes a commendably simple approach and, crucially, has not been opposed by the insurance industry, whose representatives I met last week. No letter has been received by Members of your Lordships’ House from the industry opposing this very modest amendment.
Having listened to suggestions made in Committee by the noble Lord, Lord McKenzie, and others, we explicitly provide in the amendment for the scheme—a levy of no more than 1%—to be proportionate. The supplement reflects insurers’ market share, as the main levy contained in the Bill already does.
In the face of a vicious disease that according to the Government’s figures will claim the lives of some 56,000 more British citizens and the lethal nature of which we have known about since the Merewether report of 1930, it would be nothing short of a national scandal if we did not seize this rare legislative chance to offer those who have faced the blight of this horrific disease something better than what has gone before. I beg to move.
Lord Walton of Detchant
My Lords, I have been pleased to add my name to this amendment, so forcefully and ably proposed by my noble friend Lord Alton. This is an appalling and tragic disease. Although my specialty was never respiratory medicine, in the course of my professional career I saw many people suffering from mesothelioma and recognised to the full its utterly devastating effects. Indeed, one such person was a professional colleague of mine who was a consultant neurologist. One of the disease’s most unfortunate features is that, after exposure to asbestos, particularly blue asbestos, the incubation period is extraordinarily long. People sometimes do not develop the disease for many years after exposure. Indeed, I recently learnt of an 87 year-old man who had developed mesothelioma for the first time, having worked at the age of 40 as carpenter cutting up sheets of asbestos. That is one of its appalling features, and its effects are utterly distressing. It is not a localised cancer that grows in a single location where a surgeon can remove it; it is a diffuse involvement of cancerous tissue that grows over the surface of the lung, between the lung and the chest wall. It gradually begins to strangulate the lung and eventually causes respiratory failure. It is a devastating disease—I need say no more.
However, as my noble friend has said, research on this topic is extraordinarily limited. I speak as someone who had 14 years’ involvement with the Medical Research Council, ending up as a member of the council for four years. At that time, we received research grant applications from a huge number of notable doctors and scientists seeking to research particular conditions.
The MRC, as part of its policy, used to identify priority areas which it saw as requiring further research effort, but it did not identify single diseases such as mesothelioma. It talked about problems of mental health, and about problems of ageing. Even the notable Cancer Research UK campaign, which has been a massive contributor to research in cancer in the broadest sense, has not identified single-disease conditions as having a particularly high priority in its programmes.
It is interesting that the British Lung Foundation and four leading insurance firms three years ago reached an agreement under which they collectively granted £1 million a year for three years to invest predominantly in mesothelioma research. The results were impressive. New researchers from other fields who had never thought of working on mesothelioma started to take an interest. This led to the creation of Europe’s first mesothelioma tissue bank, storing biological tissue and funding work to identify the genetic architecture of the disease.
My experience as a doctor, having been involved with a huge number of different charities funding research over the years, is that the existence of charities that are established to support research on single diseases has been immensely valuable and important in attracting new scientists into the field for which they have provided funds. One has to think only of the British Heart Foundation, which has given a massive impetus to work on heart disease. Without the money which the Multiple Sclerosis Society has collected over all the years, we would never have had the same effect.
In my research field of neuromuscular disease, had it not been for the work of the Muscular Dystrophy Campaign there is little doubt that we would not have reached the stage that we now have, where research on exon skipping has led to the introduction of a drug for the treatment of the most severe form of the disease. Those are massive developments, but they came about because funds had been raised by individual charities and groups specifically for research in that disease.
As my noble friend said, until this recent initiative by the British Lung Foundation, the funding for research on mesothelioma had been miniscule. Unfortunately, the funding by the BLF and others has now run out. The sole purpose of the amendment is to persuade the Government to accept that a tiny percentage of the levy which they already lay on insurance companies for the support of patients with this condition and their families should be specifically devoted to research. That could make a massive contribution to the future of patients with mesothelioma and to the development of an effective treatment in the foreseeable future.
The Government cannot protest on the grounds of hypothecation, because the levy under Clause 13 is already hypothecated. They cannot just say that people working on mesothelioma can apply to the Medical Research Council. Of course they can, but the crucial point about the levy is that it would provide funds that will attract scientists to work on that highly intractable problem. The fact that it is intractable is not an excuse. It deserves more attention, it deserves funding, and this group of amendments is one way to make certain that that funding will be made available and that scientists will be attracted to work in this field.
Lord Walton of Detchant
Before the Minister sits down and before my noble friend responds, perhaps I may ask the Minister this question. Let us suppose that, in the light of the developments and proposals that he has outlined, the insurance industry—the ABI—decides, in the goodness of its heart and bearing in mind the importance of this problem, that it wishes to make an ongoing and regular contribution to research in this field. Would the National Institute for Health Research be precluded from accepting non-government funds or would such funding have to be channelled, for example, through the cancer research campaign?
Earl Howe
A very great deal of the research conducted in this country is funded by different sources. It is funded by the Government, charities, universities, and industry. Nothing in the arrangements that I have outlined precludes a joint arrangement for funding mesothelioma research, which is why I welcomed the indication that the noble Lord, Lord McKenzie, gave about the ABI and the possibility of augmenting whatever funds are forthcoming from the MRC or the NIHR. That is an important point to make. I think I have said enough. The ball is in the noble Lord’s court.
Lord Alton of Liverpool
My Lords, this is not about throwing money at problems. That is certainly something that I have always eschewed throughout the whole of my time in politics. You have to demonstrate the case and there is a case here. If 56,000 of our countrymen are going to die of this disease over the next 30 years or so, we have to find adequate resources to tackle mesothelioma. That is not being done by this Bill. We have a rare opportunity to do something about it.
Lord Walton of Detchant
Before my noble friend sits down and eventually decides what action he proposes to take, I wish to ask him whether he feels that the important developments referred to by the noble Earl, Lord Howe, relating to forthcoming meetings between the Medical Research Council, the NIHR and other organisations, might not—at the moment—be a useful way forward?
Lord Alton of Liverpool
I am grateful to my noble friend and yes, of course I am delighted that those meetings are going to happen. The noble Earl was kind enough to say that perhaps the debates that have been precipitated on this issue in Committee, at Second Reading and again today have helped to bring that about. However, the moment will pass and all of us who sit in this House know that once the legislative vehicle has moved on, the opportunity to make something happen disappears into the ether. That is why I intend to press this to a vote and to test the will of your Lordships’ House.
Mesothelioma Bill [HL]
Lord Walton of Detchant Excerpts(11 years, 5 months ago)
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Lord Wills
My Lords, I support my noble friend’s amendments on this issue. I first became aware of this terrible disease shortly after I was elected as the Member of Parliament for Swindon North. A man came to my surgery in the exact circumstances that my noble friend has described. He was absolutely distraught because his wife had just died from this terrible disease, which she had contracted from washing his clothes. Every day, he came back from the railway works in Swindon and gave his work clothes to his wife. She washed them and, as a result, she died from this disease. It seems completely wrong, as a matter of natural justice, that people in these circumstances should be denied any access to justice under the terms of this Bill.
Like my noble friend, I hope that the Minister will surprise us pleasantly by accepting these amendments, although I fear that we may be disappointed. If we are disappointed and the Minister relies—as I understand he may well be advised to do—on the dangers of creating a precedent by accepting these amendments, I hope that he will be able to say in exactly what circumstances he thinks such a precedent will be created. Given the very particular nature of this disease, its particular virulence and the very particular way in which it is contracted, can he say precisely what precedents he thinks will be created by accepting my noble friend’s amendments?
In the mean time, I hope that the Minister will at least agree to look again at these amendments, which seem to be absolutely consistent with the basic principles of natural justice, and I very much hope that they will find their way into this Bill in one way or another.
Lord Walton of Detchant
My Lords, I rise to support Amendment 8. I spent the greater part of my professional life practising medicine in the north-east of England. Even though I practised largely as a neurologist, I saw many patients with mesothelioma, many of whom had worked in the shipyards on the Tyne and the Wear, and who had been exposed to asbestos. However, I also saw, not under my direct care but under the care of colleagues, some women who developed mesothelioma because they had been involved in washing the clothes of their husbands, who had been exposed to asbestos—clothes which were deeply impregnated with asbestos fibre. For that reason, I would say that this issue does not rest just on the balance of probabilities; in my view, it is beyond all reasonable doubt that they developed mesothelioma because of that activity.
Lord Alton of Liverpool
My Lords, like my noble friend Lord Walton of Detchant, in my time as a Liverpool Member of Parliament I also came across shipyard workers from the River Mersey who, sadly, had contracted mesothelioma. I also saw tunnellers, masons and others who had come to surgeries to talk about what compensation schemes might be available.
I vividly recall meeting a man and his wife, and she came back to see me just weeks later when she was a widow, he having died. The rapidity with which people can die after prognosis is alarming, and of course it is a fatal disease. It is suspected that another 56,000 people will die of mesothelioma before this terrible curse is ended.
Lord Walton of Detchant
My Lords, it is a pleasure to follow the noble Lord, Lord Alton, particularly in the light of the lucid and forceful way in which he has proposed this amendment. I have added my name to the amendment because I believe very strongly that, as he has pointed out, the amount of funding in this country that has been devoted to research into mesothelioma, its causation, its development and its treatment has been miniscule. I join him in paying tribute to the contribution over the years made by the voluntary organisation, the British Lung Foundation, in examining ways in which research into this wretched disease can be conducted. However, the Government’s contribution to this research—for instance, through the Medical Research Council, of which I was once a member—has been minimal. Therefore, I am very much in favour of the principle underlying this amendment.
I used to teach my medical students that while there are plenty of incurable diseases in medicine, there are none that may not have their effects modified by pharmacological, physical or psychological means. Mesothelioma is almost an exception to that rule, although it is clear that in the early stages of the disease certain physical mechanisms can alleviate some of its worst effects. The tragedy of mesothelioma is that the deposits of this cancerous process are laid down in the pleural cavity, between the surface of the lung and the internal surface of the chest wall. Gradually, as those deposits increase, the actual flexibility of the movement of the chest wall—in the muscular contractions which are responsible for our involuntary taking in and expiring of air—is slowly but progressively lessened, so that in the end the patient is almost subject to the feeling of having a straitjacket around their chest that prevents them from respiring. Eventually, it is fatal. Happily, there are mechanisms with drugs, sedatives and many other things that can help to ease the terminal phases. Nevertheless, the end result is tragic and appalling for anyone who has witnessed it.
A colleague of mine who was a consultant neurologist developed mesothelioma—the result, it appears, of being as a youth a keen club cricketer in villages in County Durham. It turned out that the changing room in which he regularly changed before appearing on the cricket field was lined with asbestos. That was eventually thought to have been the source from which he acquired this disease. It is a tragic condition and it deserves close and careful attention.
I also used to teach my medical students that today’s discovery in basic medical science brings tomorrow’s practical development in patient care. As yet, there has been no such basic discovery in the science underlying the causation and development of mesothelioma and, as yet, no drug has been discovered that is capable of reducing that progressive, cancerous deposit and the progressive process of strangulation. That is not to say that there have not been some limited discoveries that have benefited individual patients, but much more is needed.
I know what the Minister will say: that an amendment such as this has no place in a Bill or a statutory instrument because it is, in a sense, permissive. I can understand fully the view that he is going to take in that regard. However, I do not believe that it is beyond the wit of man, and certainly not beyond the wit of the Minister, to achieve some kind of Machiavellian political intervention or manipulation enabling the principles underlying this amendment to be fulfilled in law.
Although I have given my name to Amendment 31, I must say that I disagree with its last phrase. It says that,
“the funds raised through this charge shall be remitted to a competent research institution to fund research to find new treatments for mesothelioma”.
It should say “a competent research-granting organisation”. What could be better than the Government’s own research arm, the National Institute for Health Research, which is chaired by the Government’s Chief Medical Officer, Sally Davies? It could be the perfect example. I hope very much that the Government will find the means to fulfil the principle underlying this crucial amendment in managing to persuade these insurance companies— perhaps “persuasion” is not exactly the right word; it might need something a bit firmer to get the money out of those bodies—to enable the National Institute for Health Research to fund crucial research on this devastating disease. It deserves everything that we can put into it and a great more than we are already doing.
Baroness Butler-Sloss
My Lords, I, too, have put my name to Amendment 31. It is with some hesitation that I rise to speak after the two formidable speeches that we have just heard. Having put my name to the amendment, though, I want to say something to support it. It is indeed a modest amendment but it has enormous potential advantages for important research seeking new treatment and a possible cure. We have already heard from the noble Lord, Lord Walton of Detchant, what he thinks could be done and why it needs to be done. Of course, I defer to him.
As one of three judges in the Court of Appeal, I heard a number of these cases, and each story was tragic. Although I was a judge for 35 years, these stories have remained with me. We know that currently there is no cure. We know that currently the treatment is poor compared with that for other forms of cancer. It is crucial and urgent that we have proper research. As the noble Lord, Lord Alton of Liverpool, has said, it is a scandal that this is so poorly supported, when it is a killer but other forms of cancer can be treated and people can live for a long time. Sufferers die two years after the diagnosis—it is like motor neurone disease, and even that, as I understand it, gets more research funding than this does. It is extraordinary that the people who suffer from it are not properly regarded by the state or indeed by insurers. It is high time that the lack of financial support should be remedied with this Bill, at least to some extent.
I very much support the principle of the amendment. Like the noble Lord, Lord Walton of Detchant, I do not entirely support the wording. I do not think that matters because we are not going to vote on it today, and if the Government can come up with better wording and be supportive, that is exactly as it should be. The amount of money that would be raised under the present scheme is a modest £1.5 million. It would be much better if the Government felt able to match it; that would be valuable.
I was entertained by the reference by the noble Lord, Lord Alton of Liverpool, to the Gambling Act, which shows a very useful precedent. It is just possible that if some law were passed in this Bill, we could then to go the insurers on a voluntary basis and say, “If you don’t, it will be backed up by primary legislation”. So we want it there as a spur. If that can be done in gambling, I really do not see why it cannot be done in mesothelioma.
Health: Needlestick Injuries
Lord Walton of Detchant Excerpts(12 years, 5 months ago)
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Lord Walton of Detchant
To ask Her Majesty’s Government what measures they propose to take in order to implement the provisions of European Council directive 2010/32/EU, which is designed to prevent sharp (so-called needlestick) injuries, prior to the implementation date of 11 May 2013.
The Parliamentary Under-Secretary of State, Department for Work and Pensions (Lord Freud)
My Lords, the Government have asked the Health and Safety Executive to prepare regulations to transpose directive 2010/32/EU, to come into force on 11 May 2013. However, most sharps injuries arise from the failure to comply with existing well established standards. Therefore, the issue is not a gap in the law but in compliance. The HSE will consult on the proposed regulations and seek views on how all healthcare stakeholders can contribute to raising awareness of the required standards.
Lord Walton of Detchant
My Lords, I thank the Minister for that reply. I have seen the Answers that he sent to my noble friend Lady Masham in response to her Written Questions. Is he aware that a considerable number of healthcare professionals injured by hypodermic needles are failing to report those incidents for fear that they have been infected with HIV or hepatitis B or C, which could have a serious adverse effect on their subsequent employability? Does the draft impact assessment prepared by the HSE deal with how individuals infected in that way can safely continue to practise within the NHS?
Lord Freud
My Lords, I am not aware of underreporting. The reporting figures are actually rather low. In the past decade, fewer than 10 people have reported getting infected from being hit by a needle or other sharp object. Usually the infection, particularly more recently, is hepatitis B or C.
Welfare Reform Bill
Lord Walton of Detchant Excerpts(12 years, 9 months ago)
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Baroness Howe of Idlicote
My Lords, I, too, would like to press the point about the neutrality of the cost that the noble Baroness, Lady Meacher, has stressed. If I may say so, I think that we all owe the noble Baroness, Lady Meacher, a huge debt for the way in which she has pursued these issues and, equally, for the way in which the Minister has responded. I hope very much that when he is considering again, he will bear in mind the number of women—and it is women, I am afraid—who are on their own left to cope with children in this situation. That is a particularly important point, I would argue.
Lord Walton of Detchant
My Lords, I had not intended to contribute to this debate, but I wish to speak briefly. As a neurologist with a long experience of caring for children with many forms of disability, I am fully aware of one important issue: that the nature of the disability may be relatively non-progressive—for example, in patients with cerebral palsy. The needs of children with cerebral palsy vary and change as they grow older. The problems faced by their carers—often a single parent, or both parents—become more demanding as the child grows older and is heavier and more difficult to manipulate.
As the noble Baroness, Lady Thomas, said, think again about patients with muscular dystrophy of the most severe kind. Boys with Duchenne muscular dystrophy, by the time they are seven, eight or nine years of age, are still mobile and still go to a normal school but walk with increasing difficulty. By the time they are 10 or 11, they are often confined to a wheelchair. In past years, many of those boys died in their teens. Nowadays, with vastly improved care, with improvement in their respiratory support and so on, they pass through that period of transition from childhood into adulthood, where their disability is greater and more demanding. Unless they are given proper support by carers and the support that they need in terms of respiratory support and suchlike, the demands on their parents become much greater. Furthermore, it is important to recognise that proper care and support in the home prevents a large number of emergency admissions to hospital, with major burdens on the National Health Service.
I was reassured at the beginning by what the Minister said. Can he assure us that the actual mechanisms of these three grades of support, and that important change from childhood into adulthood, are properly met by the provisions of this Bill? Will he also assure us that the recognition that disability is not static and that demands on the carers vary is fully taken account of in the decisions that are being made?
Lord Newton of Braintree
My Lords, I had not intended to intervene either. I will do so very briefly because I have made my points at earlier stages of the Bill. My principal point, as I said to the noble Baroness, Lady Meacher, at the end of last week, was that I did not expect to be able to vote for her amendment because, while I thought that the cause was good, writing this kind of thing into primary legislation was not. That is reinforced by the points that have just been made. I see the noble Lord, Lord Walton, nodding; I am not sure that the noble Baroness, Lady Hollis, will be nodding. The very point that the degree of disability does not directly relate to the costs incurred is actually a point of not trying to write all this stuff in concrete into primary legislation, together with the variability to which the noble Lord, Lord Walton, has referred. So I very much hope that the noble Baroness will not press her amendment to a Division, even though I strongly support the general aim that she has in mind. I want to pay my own tribute to the part that she has played in focusing on this issue.
Welfare Reform Bill
Lord Walton of Detchant Excerpts(12 years, 9 months ago)
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Lord Wigley
My Lords, I support this amendment. I am not going to repeat what I said at Second Reading, in Committee and at Report stage, save to emphasise once again that as a family who lost two severely handicapped boys we know the impact of cost when there is disability in the family. Although at their latter stages they would undoubtedly have had the highest available support, at earlier stages they would probably not under the definitions now current. There are thousands of children and families who will most certainly miss out.
We are told that Disability Rights UK is very concerned about the impact that this will have on families with disabled children and particularly, as in our case, on those with more than one disabled child. It is concerned about the effect that it will have on the longer-term life chances if they grow up in poverty. The Minister said at Report stage that,
“the impact of the reform of disability payments on the number of disabled children living in relative poverty will be negligible”.—[Official Report, 12/12/11; col. 1055.]
Negligible—that is not the assessment of others. The Children’s Society estimates that over 40 per cent of disabled children already live in poverty. The Minister conceded at Report stage that we are talking about taking £200 million and redirecting it. What will be the effect of taking £200 million off those who already are very near to poverty? That is surely not acceptable.
The Minister emphasised at Report stage the provisions of the transitional arrangements being made, but he conceded that as inflation bites—and it is still running at 5 per cent—the value of this will erode, which will be a real loss to these most vulnerable people. If this issue is to be considered further, as the mover of the amendment requested, and the Government give it further thought, we must keep the issue alive by adopting the amendment today. Otherwise we will lose the opportunity. I beg the Government either to accept this or to come back with their own amendments in another place and bring them here—or, alternatively, I suggest that we as a House ensure that they are carried.
Lord Walton of Detchant
My Lords, I, too, wish to speak relatively briefly to this important amendment. In the course of my neurological training and in my career, I spent some time assessing children with cerebral palsy who attended the excellent Percy Hedley centre in Newcastle upon Tyne and received outstanding treatment. However, when I saw the varying degrees of disability produced by this group of conditions—a group of immense variability—and saw the effect that the condition of these children had on their families, sometimes leading to family breakdown, as the noble Baroness, Lady Browning, said, I became increasingly concerned about the evidence of the disability and the resultant poverty which developed in many of these families.
Some of my personal research was dealing with a progressive disease—Duchenne muscular dystrophy—where young boys born apparently normal would begin at about the age of three to have difficulty in walking. They then began to have problems with falling frequently and getting up from the floor, and progressively became increasingly disabled so that many of them were taken to a wheelchair by the time that they were aged 10. I saw the effect that this had when not just one but two boys might be affected in an individual family, and the problems faced by those parents were immense. I shall never forget one mother saying to me, “I see my son die a little every day”.
I am not talking just about static conditions such as cerebral palsy—although even in cerebral palsy as the child becomes older, the disability may remain neurologically non-progressive—but about the problems that begin to emerge over schooling and a whole series of other issues, which become increasingly important and increasingly matters for concern. I could go on about my personal experience in the field of neurology and paediatric neurology but I would simply say that this is a very worthwhile amendment, and one which deserves your Lordships' support.
Lord Newton of Braintree
My Lords, I wonder whether I might intervene briefly. I am in a slightly awkward position, and it may not surprise the House to know that I have been approached by all parties to this argument, either to say something on their side or to shut up. I am going to make a slightly ambivalent speech which will leave a lot depending on the Minister. I fully support the concerns that have been expressed by the noble Baroness, Lady Meacher, by my noble friends Lady Thomas of Winchester and Lady Browning, and by others. The Government need to listen to this and take heed, and come forward with proposals which address these concerns.
In the light of what I said last week, it will not surprise the House to know that I do not think that setting benefit rates or benefit relationships in concrete in primary legislation is sensible. I would prefer that we leave it for Ministers to decide in regulations, as the Bill provides, provided it is clear that they are going to put something sensible in those regulations and that we shall have a proper opportunity to scrutinise them. It will follow from that that I want a positive response from the Minister before deciding what I am going to do.
I will make one further point, which picks up on what the noble Lord, Lord Walton, was saying. The other thing that strikes me about setting things in concrete is that this is a world in which things change very fast, because of medical advances. He referred to Duchenne muscular dystrophy. I think I have more knowledge of cystic fibrosis, where the world has moved on hugely in the past 20 or 30 years—not least because of work done at the hospital of which I used to be chairman, the Royal Brompton—and that is happening all over the scene. Conditions that were immediately life-threatening or life-limiting at a very early age are now more treatable, and life is longer. Anything that ties us down to an inflexible framework for dealing with these problems is probably not the right way forward.
That, though, is simply a view that I express to the House. My fundamental point is that this is better dealt with in regulations, provided we can ensure that the Government will do that. I look forward to hearing what my noble friend has to say.
Unemployment: Young People
Lord Walton of Detchant Excerpts(12 years, 11 months ago)
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Lord Freud
My Lords, we are, as a priority, looking at how to help youngsters back into the workplace. That is what our youth contract, which was announced on Friday, is about. It is about trying to do the important things, which are work experience, apprenticeships and getting people work through a subsidy to employers.
Lord Freud
My Lords, we clearly need to rebuild the apprentice structure in this country—or at least build it, as was never particularly strong compared with countries such as Germany. We are very actively looking at how best to do that.
Lord Walton of Detchant
My Lords, to follow up the question of the noble Baroness, Lady Armstrong, is the Minister aware that the newspapers in the north-east reported over the weekend that properties to a value of £130 million owned by One North East, the regional development agency that is being abolished, are being sold and that the money derived from those sales will revert to the Treasury? Would not this money be better spent on doing something about youth unemployment in the north-east?
Lord Freud
My Lords, we have just announced putting in an extra £1 billion boost to youth unemployment and that money has to be found from somewhere. The Autumn Statement may be examined with great interest as regards how the money has been shuffled to get that support for youngsters, within an overall spending envelope that it is vital to maintain in order for us to keep low interest rates in this country.
Synthetic Biology
Lord Walton of Detchant Excerpts(14 years, 5 months ago)
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Lord Freud
My Lords, I thank the noble Lord for that slightly back-handed compliment. I confess that synthetic biology is not perhaps the central part of my expertise. However, I am pretty confident that the rules and regulations governing this area, which is very important for the future, are robustly under control.
Lord Walton of Detchant
My Lords, the achievement by Dr Craig Venter, who has synthesised a chromosome and inserted it into a cell that is subsequently capable of replication, is clearly an important scientific development. It is so important that the implications of this discovery for the future are very substantial. Bearing in mind the regulations already in existence—to which the Minister referred—would it not be wise even at this stage to invite the Medical Research Council, the Royal Society and the Academy of Medical Sciences to comment on the implications of this discovery for human and animal biology?
Lord Freud
My Lords, a process will start in September to look at the regulatory controls around this area. During that period, there will be a full consultation leading to changes to the regulations in order to reinforce protections, particularly around artificial cells. If all goes to plan, these should be ready by next April.