Healthcare (International Arrangements) Bill

Debate between Lord Winston and Lord O'Shaughnessy

Committee: 1st sitting (Hansard): House of Lords
Tuesday 19th February 2019 Lords Chamber

[Lord O’Shaughnessy]

My Lords, the reason is that the statute by which we are able to strike reciprocal healthcare agreements—the regulations stated in the Explanatory Notes—comes from the body of EU law. Without that we are not able to have reciprocal agreements with anyone, so in that sense we are replacing the source of our law with a different source. It does not follow that with the law we have in place, we should restrict ourselves to having arrangements with a subset of the countries where we could do so.

[Lord Winston (Lab)]

I have the greatest respect for the noble Lord, Lord O’Shaughnessy, who we feel did a great job while he was in the department as a Minister, but does he not see that this is indeed a Brexit Bill? Out there in the community, people voting in the referendum said, “Take back power”. It was about taking back control and the paradox in this amendment—it may be irony, I am not quite sure which—is that we are not taking back control. Parliament will not have the control, which is what the people wanted at the time of voting for Brexit. That is fundamentally wrong and inappropriate, therefore I am quite certain that this amendment is appropriate.

[Lord O’Shaughnessy]

That is a separate issue. As I said at the beginning, the issue here is actually in two parts. The first is whether we ought to use the new legislation to strike deals with a subset of countries, those with which we already have reciprocal deals through our membership of the EU, or to strike broader ones. The secondary question is: what ought to be the correct process for Parliament to provide scrutiny of the kind of deals that are set up, either to provide continuity with the ones that we have under the EU or with new partners? Those are different questions. It is up to this Committee to make its decision about what it feels is the appropriate route to go forward, but it is important to expose that those are different and separate questions and we ought to consider them as such.

Perhaps I may respond to the point made by the noble Baroness, Lady Andrews, and others about trade. It is absolutely not the case that this is some Trojan horse for privatisation of the NHS, as the noble Lord, Lord Brooke, said, or anything else. My noble friend the Minister made that completely clear in her letter, as I used to in the letters that I once sent the noble Lord as well. Consider this: one of the reasons that we have deep reciprocal healthcare agreements with EU countries is due to the fact that we are part of a large trading bloc called the European Union. It is perfectly normal for partners engaged in economic, social, cultural, scientific and other activities to have these kind of agreements, partly because they facilitate the movement of people from one to another, whether on holiday or for work and other things.

I would hope, regardless of whether we were leaving the European Union or not, that we would want to have these kind of agreements with our partner countries throughout the world. Regardless of one’s views on Brexit, we ought to want to do that. It is not something that we have the legal basis to do at the moment and the Bill gives us that. I want to correct the impression given by the noble Baroness, Lady Andrews, which I do not think is fair, that this is somehow a Trojan horse for some sort of nefarious agenda. That is absolutely not the case; it is about taking a broader view of the kind of relationships that we currently enjoy with the EU and want to enjoy with other countries, whether they are Commonwealth partners or the overseas territories and Crown dependencies noted by my noble friend Lord Ribeiro.

I hope that I have described clearly what I believe the intent is in this regard. It is absolutely noble and will facilitate the broader movement of people throughout the world.

Human Fertilisation and Embryology (Parental Orders) Regulations 2018

Debate between Lord Winston and Lord O'Shaughnessy

Wednesday 12th December 2018 Grand Committee

[Lord O’Shaughnessy]

I am very grateful to all noble Lords who have spoken. One of the great joys of working in this House is that we are privileged to have access to such expertise, be it scientific, policy or legislative. We have had a very good, if short, debate in which there were some interesting questions which I shall try to answer. The noble Lord, Lord Winston, made a point about tracing the genetic parents in the case of a donated gamete. I shall read out what it says in my pack to make sure that I get the wording right and then I am going to make an addendum which I think is also correct.

If a child is conceived via an HFEA-licensed clinic with donor gametes, it may be able to access information about the donor in line with the responsibility of the clinic to provide information under the HFE Act, but this would depend on the parents informing the child of the circumstances of their birth. Of course, that would be so that the child was aware that they could ask, but at the point at which they became aware, via their parents or anyone else, they would then have a right to that information. I think the point the noble Lord made was that however the line goes to the genetic forebear, the child would have the right to pursue it. Of course, it would rely on the child being aware of the circumstances of their birth and so on, and we cannot force that on somebody, but they would be able to trace it.

[Lord Winston]

Does that mean that the birth certificate would be like a normal birth certificate under those circumstances?

[Lord O’Shaughnessy]

Yes, because the court retains a copy of the original birth certificate. I am going to need to clarify this because it is tricky and there is a danger if I try to describe it now. I do not want to do that. I think the noble Lord is asking for clarification, but I am going to need to write to him, if he will accept that, to clarify the situation.

[Baroness Barker]

I hope I am going to be helpful. If I am right, I think that at the point at which a parental order is given, a new birth certificate is issued. That rather mirrors the procedure under adoption, which is the same. The point is that a child always has the right to find out their genetic history but they may not know the means of their birth. From all the things that I have listened to in this House, that makes them probably like a good 40% of people who were not adopted or the result of fertilisation but who have a different father from the one they thought they had; I do listen.

Health: Endoscopy and Bowel Cancer

Debate between Lord Winston and Lord O'Shaughnessy

Monday 2nd July 2018 Lords Chamber

[Lord O'Shaughnessy]

I thank the noble Baroness for raising that question and am sorry to hear about her mother. As she will know, bowel cancer is unfortunately the third-most prevalent cancer and the second-biggest killer, and we need to go a long way to improve treatment. I have already mentioned the increase in the number of endoscopists, and that will help. There are also plans to make sure that existing staff within the cancer workforce have the necessary specialist skills. The size of the cancer workforce has increased over the last few years but there is a goal to dramatically increase it further. We know that the test that the noble Baroness mentioned is much more effective and can be administered much more easily. The rollout will take place from December this year.

[Lord Winston (Lab)]

My Lords, there is an increasing interest in capsule endoscopy, which of course is less invasive as it does not require an instrument to be put down into the abdomen. However, it requires training, which the medical literature clearly shows is insufficient. Can the Minister indicate whether the NHS is planning to provide more training for the provision of capsule endoscopies? Also, what is the risk of a large number of false positive results with all these endoscopies?

[Lord O'Shaughnessy]

I will have to write to the noble Lord with an answer to his question about the type of endoscopy he mentions, as I do not have the details of it. The risk of false positives is one reason that we have to be extremely careful with screening programmes of all kinds, whether it is the faecal immunochemical test or an endoscopy. As he knows, whatever screening programmes are implemented, the National Screening Committee tries to reduce the number of false positives wherever possible.

Health: Online Services

Debate between Lord Winston and Lord O'Shaughnessy

Monday 23rd April 2018 Lords Chamber

[Lord O'Shaughnessy]

That is an excellent point: the entire country is preparing for the advent of the GDPR on 25 May. We are engaged in a large programme of work with the Information Commissioner’s Office and others to ensure that everyone working in the health and care services understands their obligations and informs patients accordingly.

[Lord Winston (Lab)]

My Lords, a large number of reproductive clinics publish their wares by advertising on the London Underground, often at great cost, sometimes making claims about their treatments. If I did that as a doctor, I would be struck off the register. They get round it because they are private clinics. Is that appropriate? Does the Care Quality Commission have any involvement in this process, and should it?

[Lord O’Shaughnessy]

I would have to look at the specific clinics that the noble Lord is talking about. The subject of the report was those providing online services. One of the things it discovered was that certain regulatory issues are unique to the provision of online services, an example of which is when the data is held offshore and what that means for regulation. As the CQC says in its report, it is reviewing its regulations to make sure that it can account for the unique aspects of online provision, so that the critical aspects, whether they are about truthful advertising or other aspects, are dealt with properly.

Health: Flu

Debate between Lord Winston and Lord O'Shaughnessy

Monday 30th October 2017 Lords Chamber

[Lord O'Shaughnessy]

My noble friend is absolutely right. Back in September, Simon Stevens, the head of the NHS, warned about the impact of the flu epidemic in Australia and New Zealand. The feedback on that was that the particularly vulnerable groups were the over-80s and five to nine year-olds. We have talked about helping younger children through school-based immunisation. We also have the highest uptake in Europe of over-65s getting flu jabs. There is clearly more to do because around one-third of people still do not.

[Lord Winston (Lab)]

My Lords, will the Minister reconsider his statement, in answer to the Question, that the NHS has never been better ready for a flu outbreak? The problem with viral infections, like pandemics, is that they are completely unpredictable and often hit in a way that we never expect. They remain one of the biggest single threats to humanity. I hope he understands that this unpredictability is a very real issue with all these infections, including influenza, as history has shown us.

[Lord O'Shaughnessy]

The noble Lord is, of course, quite right: we cannot know what will hit us. However, we can prepare in advance as much as possible. That was the sense I meant to convey—namely, that a huge amount of preparedness has gone on for not just flu but the winter. That work started in the summer—earlier this year than ever before. The flu vaccination on offer covers the strains that Public Health England thinks are most likely to come, but, of course, we cannot predict exactly what will happen.

Gene Editing: Agriculture and Medicine

Debate between Lord Winston and Lord O'Shaughnessy

Monday 27th March 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness is quite right to talk about the important therapeutic benefits that can come. I do not think this has anything to do with Brexit, other than the fact that the UK has been and continues to be a leader in the world of genomic sequencing, which of course enables us to identify the genetic issues that lead to some of the diseases and illnesses she has described. Within our regulatory framework, it is possible to use gene editing for therapeutic reasons but in ways that do not impact on inheritability, which is of course ethically an incredibly difficult question.

[Lord Winston (Lab)]

My Lords, can the Minister confirm that the Government have no plans to extend gene editing to germ cells, as was suggested in the Times only three weeks ago, with the idea that we could wipe out genetic disease using gene editing? This seems an extremely dangerous idea, given that there are epigenetic and other issues with gene editing, which may not be quite as precise and effective as is sometimes claimed.

[Lord O'Shaughnessy]

The noble Lord is quite right to make that point. So-called germline gene editing, which creates the opportunity to pass on changes to later generations, is highly controversial. It is illegal in this country and there are no plans to change that position.