(4 years, 11 months ago)
Lords ChamberI pay tribute to the noble Baroness and the way she has worked on this issue. She raises an important point: as she knows, we require more evidence on this issue to understand the long-term impacts of the medical interventions in children which she outlined. That is why we asked for information on this topic in the recent call for evidence and we are currently analysing the results.
My Lords, there are a number of children who have had sex-change operations who later on bitterly regret it. I have seen some of these people in fertility clinics; some also have complications after surgery. The decision to undergo gender reassignment is a very grave one. Are the Government satisfied that these decisions are being taken with sufficient care?
The noble Lord outlined the very point articulated by the noble Baroness, Lady Barker. Obviously, we would never want children to have to go through something they might later regret, or which they feel has been imposed upon them and can destroy the rest of their lives. That is why we did the call for evidence and why we will proceed carefully and responsibly in this sensitive area.
(6 years, 2 months ago)
Lords ChamberOf course, Sally Davies will be advising on the review. The scheduling of cannabis will be looked at with a fresh pair of eyes, being mindful of the international research on this subject. In talking about the benefits of cannabis-based medication for epilepsy and multiple sclerosis and as pain relief in some forms of terminal illness, the noble Lord has precisely laid out the point of the review. It will look at all the benefits to be gained in all areas of medical consideration, but it will be clinically and scientifically led. As I said, I think that today the Home Secretary has prompted a first in the consideration of cannabis and its medical benefits.
My Lords, perhaps I may take odds with my noble friend Lord Rosser on the Front Bench because there are times occasionally when members of the Opposition should congratulate the Government on what they are doing. This is a good decision which is urgently needed. To be fair to the Government, 20 years ago I chaired the Science and Technology Select Committee when we had an inquiry into the medicinal purposes of cannabis and, before our report was even published, the then Home Secretary in a Labour Government refused to take any notice of what we had said and published his comments in the newspapers. So we are making progress here.
It is good to see that the noble Lord, Lord O’Shaughnessy, is also on the Front Bench with the Minister because this is an important issue which the Department of Health should also consider. I am glad that there is joined-up government in this consideration.
Given my experience from that committee, it might be worth while looking at our original report, which is still relevant. The people that we saw again and again who were suffering from these terrible conditions were absolutely clear that they did not want to get high. They were all suffering from spasms and other problems and wanted relief of their serious symptoms. That can be regulated through the medical profession because, after all, sensible medical practitioners have access to all kinds of drugs which, if used wrongly, are dangerous.
I hope the Government will continue with their plans and that the review will not take an age to complete.
I thank the noble Lord for his words of congratulation. The history that he tells is interesting. Successive Governments have not done this and today is an historic day in the advancement of a substance that may prove to have huge benefits for all kinds of conditions. I worked with sufferers of multiple sclerosis for 10 years and the use of cannabis-derived products—and now Sativex—helped to ameliorate some of their spasms. They did not want to get high; they just wanted to stop the spasms that happened day and night.
I recommend that we look at the original report because I bet there will be a bit of déjà vu when we do. I thank the noble Lord for his comments and his sound advice.
(8 years, 8 months ago)
Lords ChamberMy Lords, this is a really important question. On a recent visit to Zambia, I saw some of those orphaned children being taken care of predominantly by grandparents, particularly grandmothers. We found that, through programmes such as social cash transfer programmes, we are helping to keep children in school and receive an education. However, that does not really respond to the wider issue of ensuring that those children are supported throughout their childhood, and we work very closely with a number of NGOs on the ground to ensure that children have access to good healthcare and education.
My Lords, does the Minister agree that these questions are rather predicated on the notion that HIV will remain a fatal illness? Does she not agree that one of the key issues is to improve research into retroviruses and viruses such as HIV, for which, in time, there is every chance of finding effective cures?
The noble Lord is right that we should look for zero HIV infection, but while we are working towards that—investing and researching—we still of course have the wider issues to comprehend.
(10 years, 2 months ago)
Lords ChamberAll areas are being looked at. There has been research into gassing but at the moment we are finding that this method has significant practical challenges. The noble Lord can be assured that further research is being taken forward in this area, although as yet it does not involve live badgers or active setts.
My Lords, given that Professor Rosie Woodroffe has said that badger culling is unequivocally ineffective and extremely inhumane, can we have clarity from the Government that culling will not continue under any future circumstances? Can we also have an assurance that, wherever possible, scientific advice will be followed? For example, the noble Lord, Lord Krebs, has shown that the mathematics relating to this issue are absolutely plain.
(10 years, 7 months ago)
Grand CommitteeMy Lords, what other religion argues that its animals should not work on the Sabbath? And we do not “seethe the kid in his mother’s milk” because that seems cruel somehow. I would argue that the notion of animal protection is stronger in Judaism than in any other world religion.
I want to speak purely as a scientist. We have heard a number of assertions here which are not scientific. With all due respect to the noble Lord, Lord Trees, death is not caused by exsanguination; it is due to interruption of the blood supply to the brain, which is immediate and has been measured. The problem with EEG measurements—electrode recording—is that they have been shown to be unsound. Indeed, the only way that you could detect pain would be by positron emission scanning of the brain, which clearly does not show any activity at all within two seconds once the blood supply has been cut. I would also argue that shechita is a much more humane method than stunning. Contrary to what some have said, it is a better method of killing animals because there is less suffering. Animals have to be calm and they are not manhandled roughly.
The noble Lord, Lord Trees, is not the only one who has been to an abattoir. They are not pleasant places. It is never pleasant to see any kind of animal killed under any circumstances, but the truth is that under the Home Office Act we would not be allowed to slaughter laboratory animals with stunning because it would not be regarded as a proper way of culling an animal in a laboratory. It would have to be done by a method which is much closer to cutting the blood supply to the brain.
I emphasise that what has been said about pain is another assumption. Of course animals may move after the brain is severed but the brain itself does not perceive pain if it is damaged and, in fact, none of the organs below the skin has pain fibres. You have some pain fibres in your trachea but they are very small. The evidence that animals suffer severe pain after one cut with an extremely sharp knife is extremely arguable. The truth is that, once you are unconscious, nobody knows what the perception of death or pain is.
(11 years, 1 month ago)
Lords ChamberMy Lords, by 1944 some 6 million people had died in Auschwitz in appalling conditions. Sometimes the question is asked—it might have been asked earlier this afternoon in another debate—“Where was God in Auschwitz?”. Perhaps the answer might be, “Where was man?”. However, there could be another answer. Perhaps it came from a place that fed Auschwitz: Theresienstadt.
During its life, Theresienstadt housed between 120,000 and 150,000 individuals, all but about 22,000 of whom died in Auschwitz. For them, God was in their music. In that remarkable place, people were starving. They had no proper water supply and sanitation. They lacked almost every accompaniment of humanity, but they celebrated their humanity by singing Verdi’s “Requiem”. It was conducted by Rafael Schächter, one of the Jewish composers in Theresienstadt. Towards the end of the life of the camp, the composer Viktor Ullmann composed an opera called “Der Kaiser von Atlantis”, a satire on Hitler. It is a short opera that lasts for less than an hour. In it, pretty well every human emotion is described, including love, hope, longing and sadness. Interestingly, the one thing that is missing is anger, even though the chief singer is der Kaiser: Hitler. What we cannot forget is that Ullmann never saw the production, because when the Nazis saw it in rehearsal, they banned it, and of course Ullmann and his librettist ended up in Auschwitz, where they perished.
I shall talk about music only and declare an interest as chairman of the council of the Royal College of Music. I suggest that music is central to this debate. In some respects it is one of the most basic of the arts, because it is the closest to being unrepresentational in a way. One of the great things about music is that it expresses all humanity. It expresses longing, sadness, anger and humour, it looks at joy, as my noble friend has already mentioned, it looks at sadness and at love and, in the case of Theresienstadt, it looked at hope as well. It is a basic civilising influence on our population.
When you look at music in scientific terms, you see that it affects different parts of the brain. For example, memory is enhanced by listening to music. Recent studies using magnetic resonance imaging scanning show that different parts of the brain, including the hippocampus, expand when we listen to or play music, whether we are musicians or non-musicians. When it comes to dexterity, the motor cortex at the top of the brain is also enhanced. The auditory cortex is enhanced as well; most importantly, Broca’s area, which is on the left side for a right-handed person and central to language, is also very closely linked to music. Perhaps that is one of the reasons why so many musicians have been amazing linguists.
These things are developed by people who use and play music, particularly schoolchildren. I want to speak mostly of schoolchildren in this instance. Although we think that musicians are born and not made, it turns out that this is not the case. Recent evidence in a beautiful German study clearly shows that pretty well anybody who is given enough time and practice can compete with the best opera singers, and that their brain can expand in the areas that are needed. That has been demonstrated in scanning.
On a lighter note, a pop video made by One Direction was launched on the web this week. On the first day of launch, it received 14 million hits, which was extraordinary. One Direction are delightful young men. They are responsible. I think that they are altruistic, although I do not know that for certain, my impression is that they are. At many levels, they are an interesting role model for young people and you can see that they are massively followed by them. It is a pity that we do not have that same following for classical and other music which have so much depth in terms of our learning experience and give us wealth, not financial wealth, of course, but wealth in how we perceive the world and react to it and the wealth that is in our humanity and relationships.
For schoolchildren, music and learning music do not foster just memory and probably better intellectual capacity, although, in spite of the rumours, not intelligence, but they certainly foster collaboration and, as the noble Baroness, Lady Bakewell, has said, empathy, which is obviously important. These things are really important to children, and the lack of musical education in schools is great concern in our society at the moment.
The Minister may not have figures to hand at the moment, but perhaps they can be dug out. Under the previous Government there was the singing initiative, which I not think is anything like adequate enough. In music, it would be better if far more schoolchildren had access to instruments because that increases that collaboration in a new way. They help understanding of the structure of music and increase dexterity. It would be of interest to know what the Government are doing about the number of schools, particularly primary schools, which have access to musical instruments.
Finally, as someone who supports the Royal College of Music and other areas in musical education, will the Minister tell us how the Government view the outreach programmes that conservatoires are doing to spread music among young people? The Sparks programme run by the Royal College of Music takes primary school children, and there is no question that children who come from very different backgrounds achieve amazing success. They collaborate and play music so well that it is difficult to believe they have not been learning music for a great deal longer than they have. Many conservatoires have a junior department which is closer to more, if you like, adult children. It would be helpful if the Minister in her summing up could affirm support for those sorts of activities, which I believe are really important to the health of the nation.
(11 years, 1 month ago)
Lords Chamber
To ask Her Majesty’s Government what measures they are taking to mitigate the health risk caused by air pollution in London.
The Government have invested more than £1 billion in measures that will help to improve air quality, including incentives for low-emission vehicles and sustainable transport. In London, the mayor is responsible for working towards national air quality objectives. The Government work with the mayor and London boroughs to improve air quality and help support the health needs of people across the capital.
My Lords, I am sure we are grateful to the Mayor of London for the initiatives he has taken, even though their implementation seems to be rather slow. However, is the noble Baroness aware that the WHO has calculated that there have been something like 29,000 premature deaths due to air pollution in the United Kingdom? Will she be kind enough to let me have details of the like-for-like figures, by region, for people dying as a result of air pollution compared with those dying as a result of obesity, alcohol or smoking?
The noble Lord is quite right to give the figure of 29,000 premature deaths per year because of pollution. I will get him the information that he requires from the department.
(12 years, 1 month ago)
Lords ChamberMy Lords, I am sure the whole House is deeply grateful to the noble Baroness, Lady Brinton, for introducing this debate on a most important subject. It is good to hear the noble Lord, Lord Alderdice, praising Matthew Gould, the British ambassador, for his work in Israel and for his trying to cement relationships and do good diplomatic things for our country.
There is a huge amount of vilification of Israel, and often that vilification is expressed in the way certain statistics are presented. Sadly, we have heard some pretty misleading statistics this evening. It turns out that the Palestinians have 125 cubic metres of water per year, which is 351 litres per head per day. Given that the average American family needs between 200 and 300 litres, that is quite a lot of water. It is slightly higher in Israel at about 421 litres per day. More water will be used where there is industry and increasing agriculture, as the noble Baroness, Lady Brinton, pointed out, will also increase water usage.
Israel has had a legal agreement with the Palestinians since 1995. It was signed in Washington and was also signed by the European Union, Norway, Russia and the United States. It is interesting to point out that on 13 June Alex Kushner, the representative of the Israeli water authority, met with Dr Shaddad Attili, the Palestinian representative. The meeting was held in a very co-operative, pleasant and agreeable fashion and it was clear there was a lot of agreement between them. The problem is that, whatever might be said at this level, the situation that we should like to see with the various authorities in Palestine does not always follow. Unfortunately, disorganisation means there are huge problems with water. For example, none of the speakers has mentioned that some 6,000 wells have been illegally drilled in the country, which has resulted in the sewage that is referred to.
I find it difficult to understand how anybody could accept that Jews are poisoning wells. This almost sounds like the medieval blood libel. There is absolutely no reason for Israelis to poison wells and poison the aquifer; there is nothing to gain from that. The problem is that most of the sewage in Gaza certainly comes from Gaza. Israel has offered all sorts of help to Gaza, including pipes, technology and so on. Certainly, desalination would be expensive at around $400 million, and there is the issue of how you get that and continue it with the lack of power in Gaza. None the less, there is a total failure by anybody else to help the Gazans in their situation at present. It is shocking that the pollution that affects Israeli water by spilling over the border is so often seen as something that Israel has caused; it is something that is very much at the feet of the Palestinians.
I want to say only this in this very short debate. If we really want to see a peaceful solution, and a two-state solution to which the noble Lord, Lord Alderdice, has referred as being one that we can promulgate and support, it is crucial that we make certain that we do not vilify one side or the other. While we allow ourselves to be persuaded by inaccurate and often misleading statistics, we reduce the cause of peace. We make it more difficult for there to be an accommodation between the two sides. It is extremely important at this time that we are careful and accurate in our assessments of what is happening in the Middle East.
I was in Israel only a few weeks ago; I will be there again this coming weekend. I am there rather more frequently than my noble friend Lord Warner. I have been on both sides of the divide, and I have to say that Israel is trying very hard to make certain that the water supplies are kept intact, that the sewerage issues are controlled and that the damage is repaired.
(12 years, 8 months ago)
Lords ChamberMy noble friend is absolutely right. We owe a huge amount to the organisations in the United Kingdom, not least Cancer Research UK, which is a major player internationally. She is also right about early diagnosis. That is how you start to bring deaths down; you make sure that you diagnose early enough so that you can intervene in a way that is going to be much more effective. Noble Lords might like to know that there will be a first ever national cancer campaign on bowel cancer to flag up the symptoms to people in the hope that they seek diagnosis at a much earlier stage, because if it is caught early it is completely curable.
My Lords, the complex paper by Professor Pritchard also looks at the costs of delivering cancer care. One of the points made very clearly in that paper is that the cost of drugs delivered under the NHS is considerably less. We pay far less for the excellent results that we get than Germany, Spain, Italy and France do—as much as 40 per cent less, in some cases. Given that, and given that independent assessments of the health service show that the British health service has some of the best value for money in the world, why did the Prime Minister say that we cannot go on as we are and introduce the current Health and Social Care Bill?
I fully agree that the National Health Service is very cost-effective and that it has been an extraordinary service. However, we have many challenges coming down the track, as the noble Lord will be acutely aware—not least our ageing population, which needs to be supported, particularly at home and in the community where appropriate, and not immediately taken into hospitals, where interventionist care may not be in the best interests of those patients. Therefore it is extremely important that there is more clinical judgment on the best interests of each patient and how these things are organised, and that they are not simply driven forward by the way in which provision is organised at the moment, which is very much focused on secondary institutions.
(12 years, 11 months ago)
Lords ChamberMy Lords, in January 1944 the American VI Corps of the Fifth Army was engaged in a bitter struggle at the Anzio beachhead when a doctor, Henry Knowles Beecher, ran out of morphine. In his field station with these desperately wounded patients, his nurse in desperation decided to put up a drip for each patient and tell them that inside the saline drip was a powerful pain reliever. The remarkable effect on these soldiers was such that very few of them complained of the pain, the amputations and the other horrific surgery that they were undergoing. Beecher founded in consequence the randomised control trial, which—the Minister will be aware—led to our partial understanding of the placebo effect. It was very clear that the communication with those patients was the key issue.
Since that time, Dr Bensing in the health service’s research department in Utrecht has looked at the growing tendency in medicine towards the business-like interview between patient and doctor, and has taken video tapes over some 20 years showing that. They show a gradual deterioration in the kind of care that is going on—probably throughout Europe. Bensing’s work is really very interesting. This is not due simply to a placebo effect. There is a very important publication from as long ago as 1976 by Patel and Daley showing that 77 per cent of hypertension patients’ condition improved simply by talking to the doctor and the doctor listening to them in great detail. It is obvious that this was not a placebo effect because in the main these patients did not require drugs afterwards to suppress their hypertension. Most of them required at least a reduction in drugs and some needed no drugs at all. What is impressive about the study is that that effect continued for at least six months or a year.
That is something that we will come back to during our discussions on the health Bill. Communication between the patient and the professional is vital. We run the risk of losing it with nurses who cannot speak English and who have been trained in a different way. I am particularly concerned about nurses coming from the eastern bloc of Europe—for example, from Romania or Bulgaria. Having been extensively in the far east of Europe when we were still in the Cold War with my research, I am well aware of the limited communication even in their own language that healthcare professionals had. If we are not careful we will increase that in our health service.
I hope that we will make sure that that, plus the fact that record-keeping is not fully understood by those nursing staff, are aspects that we will fight on in the European Union. I know that the Minister is caring and responsible, has high integrity and communicates and listens brilliantly. I understand that it is not entirely his problem because he has to communicate with BIS to represent our views in Europe. As he knows, Europe has already threatened our health service in other ways and I hope that we can make the strongest case possible to ensure proper communication between patient and carer.