Health Bill

Baroness Coffey Excerpts

Committee stage
Wednesday 11th November 2026 Lords Chamber

Moved by

[Baroness Coffey]

48: After Clause 11, insert the following new Clause—
“Support for helping people stay and get back into workIn the National Health Service Act 2006, after section 1C insert—“1CA Duty to support people to stay and get back into workIn exercising functions in relation to the health service, the Secretary of State must have regard to the need to offer workplace health provision support to—(a) small and medium sized employers, and(b) institutions and providers within the National Health Service, considering the need to support the workforce of—(i) small and medium sized employers, and(ii) the National Health Servicein order to tackle ill health and reduce work days lost to sickness.””

[Baroness Coffey (Con)]

My Lords, this amendment should be pretty topical because, according to the Government, the country is facing a NEET crisis. A lot of this is driven by people with poor mental health or a lack of mental well-being. In my time as a Cabinet Minister, looking after DWP and, for a short time, health, I long felt that if the NHS had to pay for the health benefits, a lot more attention would be given to getting people better, getting people well and recognising that it should be a duty of the Secretary of State for Health and Social Care to do what they can to help people get better.

In this probing amendment, the duty is about support to help people stay in and get back into work. I have gone into particular detail about occupational therapy or occupational health—whatever the latest term is. Apparently, nowadays it can be seen as bad to use the phrase “occupational health”, because employees may feel that this is their way to being fired. That is not the intention of good occupational health, and nor is it the outcome desired with occupational therapy.

I know that small employers struggle, and it is going to get more challenging. I think there is a duty on the NHS, and the Secretary of State—by effectively taking over all the functions of the NHS—will have an absolutely key role to play. Amid all the other duties and functions they are taking on, this one should really be at the top of their agenda.

There is no special reason why all of a sudden there is this NEET crisis. When I was Secretary of State, I had the lowest-ever youth unemployment figures, both seasonally adjusted and actual, in terms of people claiming benefits and people economically not working, so I know this can be done. It takes a lot of drive and effort. During Covid we were also helped with aspects such as getting the kick-start Bill going. By the way, I commend the current Secretary of State on managing to persuade the Treasury on the latest scheme to not have additionality as something that has to be proved. I appreciate that may not always economically be right, but sometimes the bureaucracy, as I explained to the Covid inquiry, meant that very good jobs were being set aside because of a lack of clarity or a lack of understanding.

This builds a lot on what Sir Charlie Mayfield has been doing for the Government; I appreciated the recent briefing organised by the Employment Minister, Andrew Western, at which Sir Charlie spoke. It is about how we help employers in particular to make sure that it is more straightforward for people to stay in work. As we know, it is not just about getting people back into work; it is about helping them stay in work and, once they come back in, trying to make sure that they succeed. Today is not the day to get into the whole PIP discussion—it is about how health can support this.

I have long believed—and there is no particularly easy way of saying this—that actually prescribing a job could be one of the nicest things that a doctor would ever do to somebody who is unwell in one aspect or another. As we saw in jobcentres, a lot of young people are lonely and not confident, and that spirals into a different way of doing things. Quite often, work coaches would end up being like the big brother, big sister or auntie who encourages people to stop looking at their feet and look at them, and to re-engage. That is what we are seeing in quite a lot of the challenges we have. Meanwhile—and I have some sympathy with this—healthcare professionals are saying, “We don’t want to be the gateway to benefits”. Nobody is asking them particularly for that to be their principal role; what I am sure everybody would like is a healthy society and particularly a healthy young population—but there is no doubt that small and medium-sized employers need some help on how to make that happen.

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[Baroness Hyde of Bemerton (Lab)]

I thank the noble Lord for those points. I recall that I did not answer substantively his point on neighbourhood health, and the further point he has raised cuts to the heart of that. I am very optimistic, as a former lead member in a local authority and now a Minister in this place, about the opportunity of neighbourhood health. It is a great moment to get away from the model of a clinical box and viewpoint and work holistically across a wide range of services. Let us continue to look under that bonnet together, because we are driving at the same aim here: improved health for all our communities, outside the silo of DHSE.

[Baroness Coffey (Con)]

My Lords, I am grateful to my noble friend Lord Singh of Solihull for his amendment and for the other contributions made. I respect the noble Baroness, Lady Bennett of Manor Castle, but—it will probably be the same the other way around—I do not agree with what she has asserted today. I think work is a good thing.

I am grateful to the Minister for her reply. As I expected, sadly, the Health Minister did not contribute in this debate, which somewhat sums up the situation we have within government. It is my understanding that the noble Baroness, Lady Hyde of Bemerton, is a Government Whip—I did not know that she had a policy role in the Department of Health and Social Care.

[Lord Hunt of Kings Heath (Lab)]

Nonsense!

[Baroness Coffey (Con)]

Why is the noble Lord saying that?

[Lord Hunt of Kings Heath (Lab)]

The noble Baroness is being extremely discourteous. It is the tradition in this House that, when a Bill is going through, duties of the Government Benches are shared by Ministers and Whips, and my noble friend is doing it very well.

[Baroness Coffey (Con)]

I am not disputing that the noble Baroness spoke very well. I am just saying what I feel it shows about this key issue. Sir Charlie Mayfield’s review is nothing new; it is great that he agreed to do it and has the clout, but it is no different from reports that came out in the last year. It is great that Alan Milburn is engaged—I hope he will bash heads together to get something really powerful done, and he has the clout to do that. I am flagging that, sadly, the Department of Health and Social Care and the NHS more broadly tend to not really get engaged. I thank the noble Baroness, Lady Hollins, for her contribution in that regard.

The NHS has a challenging time ahead with its own employees, and so does business. That is why working together will be absolutely vital.

Finally, noble Lords have talked about friendships. There is a workforce survey used by the best companies in the world: Gallup’s Q¹². The most important question is question 10: “Do you have a best friend at work?” Initially, that can be quite a difficult thing to get through. Here we are on Armistice Day; people who serve their country often do so because they have their friends and comrades and the camaraderie. That matters at work too. That is why, building on what my noble friend Lord Singh of Solihull said, we need to look at this carefully. I hope the Department of Health gets far more engaged than simply the DWP programmes we have heard about today, which I still hope will continue to do well. With that, I beg leave to withdraw my amendment.

Amendment 48 withdrawn.

Moved by

[Baroness Coffey]

49: After Clause 11, insert the following new Clause—
“Promoting access to dentistry equitablyIn the National Health Service Act 2006, after section 1C insert—“1CA Duty to promote access to dentistry equitablyIn exercising functions in relation to the health service, the Secretary of State must have regard to the need to ensure provision of dentistry across England accessible to all regardless of wealth or geography.””

[Baroness Coffey (Con)]

My Lords, I have tabled an amendment about dentistry. With the agreement of others, I degrouped it so that we could have a short but focused debate on what is a key part of healthcare but one where access is so variable across the country that it is really struggling.

I appreciate that the Government have made some changes to the dental health contract. Three years ago, when extra UDAs—units of dental activity—were offered around the country, only one dentist in my own county of Suffolk took up the opportunity. That dentist was in Lowestoft. A couple of years ago, an adult could get added on and get routine NHS dental care at seven dentists within a mile of this place. At that time in Suffolk, you had to go about 35 miles to be able to access that if you were not already registered with a dentist. At the same time, we saw a lot of the dental providers for which people pay insurance pulling out of many rural areas. That is why I have been careful to put “access … equitably” in the amendment. Later amendments, tabled by the noble Baroness, Lady Pidgeon, refer to the “dental deserts” of which I am well aware.

I am pleased to announce some progress. In Suffolk, you now have to go only 12 miles to get to two dentists where you can see an NHS dentist. After that, it is another 23 miles to potentially see three more. Meanwhile, here in London, near the House of Lords, where no dentist is taking anybody on unless they are eligible for free dental care within a mile, you can find 14 dentists within two miles. That difference is happening not solely in Suffolk or London but right across the country.

A lack of dental provision has many significant impacts. It is not quite the same as not being able to get an operation. Things can be done in different ways, urgent care may well be available, and it does not necessarily stop people working. But it impacts their daily lives. As I said, I appreciate that the Government have done more, but I am not convinced that they have gone into the level of detail to make sure that the National Health Service is happening nationally when it comes to dentistry.

I would like to understand more from the Government on what they are doing on the measurement of access and on UDA distribution across the country. I appreciate that if you live in a rural area, you are not necessarily going to have 15 dentists within two miles of where you live. I get that. But it feels very focused on our major cities, where there is availability right now but it is very difficult to access, especially when providers are also withdrawing their private practices for people who pay insurance.

I will be interested to hear from the noble Lord, Lord Hunt of Kings Heath, about his “state of dentistry” report, which is definitely worth doing. I encourage the Government to do that even if they do not want to put it in this Bill. I am very conscious of dental deserts. With that, I beg to move.

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[Baroness Merron (Lab)]

Yes, I will be very pleased to include reference to that. I would probably use the word more broadly—the infrastructure that is necessary to support the dental activity—but I take the point and I will do my best to assist.

[Baroness Coffey (Con)]

My Lords, I thank the Minister for her comprehensive response. There is something in what she said about a dental team. Many noble Lords have talked about children. Dental therapists are unsung heroes and heroines who are perfectly qualified to undertake a lot of the work that has been mentioned today, particularly when dealing with children. The challenge is that too many dentists will not allow dental therapists to practise. I have asked them for reasons why, and there are certain things they cannot and are not allowed to do with NHS paperwork. Dentists also talk about liability, in terms of insurance.

We need to open this up much more widely. I encourage the Minister to speak to the Minister for Health Innovation, who I believe is responsible for dentistry, to see what more could be done. Too many children’s teeth, never mind older people’s, are just being ruined when they do not need to be. It does not need to be a dentist who goes into a nursery to look at these things; there are perfectly well-qualified people who can undertake that.

I will likely return to the issue of dentistry on Report, but, with that, I beg leave to withdraw my amendment.

Amendment 49 withdrawn.

Moved by

[Baroness Coffey]

50: After Clause 11, insert the following new Clause—
“Promoting access to ambulance services equitablyIn the National Health Service Act 2006, after section 1C insert—“1CA Duty to promote access to ambulance services equitablyIn exercising functions in relation to the health service, the Secretary of State must have regard to the need to ensure provision of ambulance services across England accessible to all regardless of wealth or geography.””

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[Baroness Coffey (Con)]

My Lords, we have got a Holy Trinity now. We have dealt with how we encourage people to get into and stay in work, we have talked about dentistry, and now we are going to talk about more things to do with urgent care.

This amendment is about promoting equitable access to ambulance services. I feel passionately about this: it was something I dedicated a lot of my time to as an MP, trying to improve access at local level. It was when I learned about how often, on a regional basis, we would see actual manipulation of where ambulances were placed in order to make sure targets were hit—but it did not mean that patients were served well.

There are a number of issues in regard to ambulances, and I pay tribute to many first responders. In the statistics, recorded nationally, a volunteer responder turning up is the same as having a paramedic arrive. In the East of England Ambulance Service, which had started to show improvement but is now really struggling —again—ambulances are quite regularly sent without any qualified paramedics in them.

I come back to the point that this situation can be very serious. Quite often, outside our major cities, for example in the east of England, if you have a stroke or a serious heart issue, you have to go to Cambridge for the best treatment. Stuff has happened along the way to try to make sure that you can stop en route, in places such as Ipswich and Norwich, in order to get something along the way. A stroke is something that causes the greatest harm, in terms of people having a good quality of life later. Of course, having a wide range of first responders across the country is a very useful way to help people who have had either a cardiac arrest or a heart attack, to keep them alive. But the difference in your quality of life depends on how quickly you get treatment when you have had a stroke; it is a real life changer.

One of the things I am conscious of is that we have many rural areas around the country. Something more needs to be done to help rural communities. It also happens to be the case—particularly thinking of coastal areas—that a lot of tourists rely on emergency services when they are on holiday. That is not taken into account in some of the funding measures, as far as I am aware.

I am pleased that we have seen an increase in the number of paramedics, but, reflecting on the point referred to earlier by the noble Baroness, Lady Hollins, on clinical staff in the NHS, it is paramedics who have the highest sickness rates. I think it is more than double —perhaps even treble—how often an average hospital doctor or consultant sadly ends up being off ill. It is not the Cinderella of the NHS, but it is certainly a part of the service that has been forced into mergers over the years, and there is huge reluctance among NHS leaders to break them apart in a way that would perhaps help patients. Indeed, we are effectively seeing many more mergers happening around England, which is going to be a real struggle, particularly for rural communities.

I am grateful to the Minister for sending the letter today about what will be happening. ICBs are taking on dentistry as part of their statutory duties, but there was no reference to what would be happening with ambulance services. I know it is common practice that one ICB tends to do the commissioning on behalf of all ICBs in that area, because they are currently constrained by the fact that they do not have any choice in where they get their ambulance service. I am not suggesting that we go for some free-market approach. We need a sensible, well-connected way of dealing with these emergencies. It would be useful to hear what the Secretary of State’s plans are for the next phase of NHS provision across the country.

I share the concerns, reflected in other amendments in this group, about people suffering corridor care. I look forward to trying to better understand the amendment from the noble Baroness, Lady Pidgeon, regarding 12-hour admissions to A&E. It has become terrible how patients are not being seen, especially when that can be a matter of life and death. I hope that we will have some further useful discussions on this important blue-light service and recognise the contributions made by paramedics and community first responders right across our country. I beg to move.

[Lord Scriven (LD)]

I know the noble Baroness likes to be absolutely correct. She said that the highest rate of NHS staff sickness was among ambulance paramedics. It is actually ambulance support staff, which does not include paramedics. I am sure she would like to correct the record.

[Baroness Coffey (Con)]

I am grateful to the noble Lord for doing that. That is not in the information that I have, but I completely accept what he has said. It is unusual in the NHS that the average number of sickness days lost to non-clinical staff is more than double that to clinical staff, but I completely understand the noble Lord’s point.

[Lord Patel of Bradford (Non-Afl)]

My Lords, Amendment 72, in my name, addresses a straightforward concern: patients being made to wait for assessment or treatment because of an administrative or financial rule when clinically appropriate care could be provided sooner. My amendment would prohibit minimum waiting times imposed across the NHS in England for administrative, financial or capacity-management reasons. It would apply to both commissioners and providers, including through contracts and activity plans. It would protect clinical decisions about when an assessment, investigation or treatment should take place. A patient may need to wait for a clinical reason, but they should not be made to wait because a commissioner has imposed a minimum waiting period to manage budgets or activity.

That is already happening. An investigation published by the British Medical Journal on 9 September found that nearly half of England’s integrated care boards had introduced some form of minimum waiting time. It reported minimum waits of 16 weeks for routine procedures in Shropshire, Telford and Wrekin, and West Yorkshire, and for cataract treatment in south-east London. Can the Minister confirm whether these policies remain in place and whether the Government consider them acceptable when clinically appropriate care can be provided sooner?

The situation is even starker for ADHD and autism assessments. For example, published information from West Yorkshire’s ICB confirms a minimum wait of two years from referral for assessments with independent providers. The ICB says that this is intended to make waiting times fairer and to manage financial pressures, but the central question remains: why require someone to wait two years if an appropriate assessment could be provided sooner? An assessment can help someone understand their difficulties and get appropriate support. A two-year delay can have consequences for their education, employment and family life.

The ICB allows urgent assessments where certain specified clinical criteria are met. Those urgent exceptions are important, but what happens when the criteria are so restrictive that they exclude patients whom clinicians believe are at serious risk? I present this point from a practical perspective. I heard only last week about a concern in another ICB area. Clinicians there identify patients whom they believe are at risk of serious harm, including self-harm and suicide, yet those patients appear to fall outside that ICB’s tightly drawn criteria for urgent assessment. When clinicians raised these concerns, the responses reported include directing patients to NHS 111 and suggesting that referrals could be returned to their GP if the provider is concerned about managing the clinical risks while they wait. Of course, NHS 111 and GPs have important roles in helping patients access urgent support, but that does not answer the clinicians’ concern that these patients need an earlier specialist assessment.

This concerns the restrictions on funded activity rather than a fixed minimum wait time, but it raises a serious question: are urgent criteria being drawn around the available budget rather than the clinical needs of the patient? Surely there must be a prompt clinical review and a clear, funded route to appropriate care for patients whose clinicians identify serious risk, even when they fall outside the ICB’s specified categories.

I recognise that commissioners face very difficult financial choices, but making patients wait when appropriate care is available does not remove their need for care. Their condition may worsen and they may need more help from other services while they wait. I have three concerns about policies that impose these minimum waits: harm to patients, fairness and transparency.

First, on harm to patients, someone waiting for a hip replacement, cataract surgery or diagnostic test may be living with pain, unable to work or drive, or losing their independence. Their life does not go on hold because a waiting time clock has started. If their condition worsens, they may need more help from their GP, social care or emergency services. Meanwhile, capacity that could have been used to treat them sooner may grow unused. How is that a sensible use of NHS resources? In responding to the BMJ investigation, the Royal College of Surgeons warned about deliberately delaying patients who are ready for treatment. The Royal College of General Practitioners also questioned blanket minimum waits while patients could be treated sooner.

Secondly, on fairness, access to care should depend on clinical need, yet a patient in one ICB area may be required to wait at least 16 weeks while someone with the same needs in a neighbouring ICB area faces no such rule. Surely that is the definition of a postcode lottery. What does “patient choice” mean if someone chooses an appropriate provider who could see them sooner but a commissioning rule prevents it?

Thirdly, there is transparency. In Written Answers to Dr Luke Evans MP on 22 June, the Government said there was

“no formal national policy supporting minimum waits”,

but they confirmed that the NHS standard contract allowed local commissioners to set what they called “activity planning assumptions”. Whatever the label we use, if a contractual rule stops a patient receiving care sooner, its effect must surely be open to scrutiny. Yet the Government also said that NHS England did not collect information on which ICBs impose minimum waits, which services were affected or their impact. How can the Government judge these policies without that information? Patients should know why they are waiting and be able to challenge a rule that unnecessarily delays their care.

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[Baroness Merron (Lab)]

I have already made reference to what the priorities are: need and patient safety. I assure the noble Lord that I reflect on everything noble Lords say, and I certainly believe that I have already given that assurance.

[Baroness Coffey (Con)]

My Lords, this group of amendments has been informative, as have noble Lords’ contributions. I think that the noble Lord, Lord Patel of Bradford, may be referring to situations where a minimum is being deployed for people who have expressed their view that they would like to use an independent provider to tackle the issues, and I think that something is not quite right there. But we also have to be realistic. NHS England and all the trusts have to live within their means and not every area can be bailed out, as continues to happen at the Nottingham University Hospitals Trust and the Liverpool University Hospitals NHS Foundation Trust, which is in the recently published figures.

Obviously, whether it is about an ambulance or going to an urgent treatment centre or SDEC, I am conscious that the philosophy in the NHS up until fairly recently was that it was very proud that it had far fewer beds per person on average compared to other parts of Europe, on the basis that people would often get their operation, be dealt with and go home safely that same day. Thus, the thinking was that not quite so many beds were needed.

I welcome the reference to Sir Chris Whitty’s report, particularly in the context of rural communities. But without further ado, I beg leave to withdraw my amendment.

Amendment 50 withdrawn.

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[Baroness Bennett of Manor Castle (GP)]

My Lords, it is a pleasure to take part on this group and to utterly applaud the three speeches we have already heard. I have not signed any of these amendments, because I wanted to leave space for others. Speaking as an old newspaper editor, “Green signs amendment about climate and environment” is a bit like “Dog bites man”, so I wanted to ensure that we had the maximum impact from other signatures. We have already heard the case made powerfully for this, but I want to make a couple of additional points and to follow on from what the noble Lord, Lord Crisp, said about priorities.

I have encountered many individuals in the NHS who are doing spectacular work in reducing the NHS’s carbon emissions. The Minister is not currently in her place, but I will say to another Minister that I encourage her to visit County Durham and Darlington NHS Foundation Trust, where tremendous work is being done, particularly on reducing the impact of acute care. Sometimes with acute care there is a feeling that we have to do the emergency stuff and we cannot do anything here. Actually, what we have seen is that in looking at where the use of intravenous drugs can be reduced and tablets used instead, clinical outcomes are improved and the amount of plastic use is significantly reduced. When you really start to look at what you are doing and how you can do it better, you can improve both clinical and environmental outcomes. That is just one example that I happen to know about.

It is important that the people who are doing this know that they have support from the centre and that this is an NHS priority, because they are putting time, energy and attention into this. Unless we see support from the centre by saying that this is a priority, it is hard for them to get the resources and support they need to make change happen. We know that any large organisation has a large sense of inertia, and delivering change needs support right through the organisation. As the noble Lord, Lord Crisp, said, the climate emergency is a health emergency as well, and there are so many ways in which these two factors interact.

On the amendment from the noble Baroness, Lady Boycott, looking at resilience to climate and environmental degradation risks, I want to cross-reference it to the joint intelligence chiefs’ report on the impact of environmental degradation on our food security. Are we thinking about the food security of the NHS? We have to be able to feed the patients, but there is also a great deal of feeding of staff that has to happen in the NHS. How much have NHS institutions looked at how secure their food supply is? That is something that the joint intelligence chiefs, not known as radical green activists, have said is really an issue. I note in passing that we still have not seen the publication of that full report, which is very disappointing.

There is another issue that I think everyone is very aware of after this summer. I note that my honourable friend in the other place, Hannah Spencer, has a Private Member’s Bill about working conditions and having a maximum working temperature, which, whatever that might be, has been exceeded in many of our NHS institutions over the past summer. We have seen staff collapsing as a result of the heat in their workspace. That has to be considered unacceptable, but what is it doing to patients if staff are collapsing from heat?

[Baroness Coffey (Con)]

My Lords, this is another interesting group. I want to follow on from the initial amendment from the noble Baroness, Lady Hayman. I have more of an interest in thinking of the Environment Act and the targets there and reducing waste. This is a story about how much single-use plastic is used in the NHS.

I spent a month in hospital a few years ago and, for me to have a shower every day, a nurse used to get a bin bag or two and then strap them around my arm, basically because I could not get water on a particular cannula. I was a bit surprised by that, because you could just buy from Amazon a whole bunch of sleeves that can be dried and reused. I am sure there is some clinical reason that they could cite—I was struggling to find out why—just because I was in hospital. I did exactly what I have just mentioned when I went into recuperation at home. Instead of just thinking about straws or plastic cups, the NHS has a real opportunity to do a lot more thinking about what it uses, what needs to be thrown away and what could go back to somewhere else. I am not suggesting that people reuse syringes and the like, but the NHS could think more carefully, instead of this single-use culture.

Building on that, the amendment tabled by the noble Baroness, Lady Boycott, is also highly relevant. I am very conscious that we did not make much progress in getting hospitals built, sadly. Some of this was, frankly, due to an argument going on between local hospitals, the NHS, the Treasury and so on about what was going to be built. The purpose of moving to a modular basis of building is to have something that is scalable and that should be a lot more resilient in the future. The reason I mention that is that we still have the challenge of hospitals that have a RAAC risk and the unfortunate delay in their construction being replaced. I think there are five around the country—it so happens that three of them are in East Anglia—that will not now be happening until, I think, 2033.

One of the simpler things that we can learn from the continent, where we have seen extreme weather—indeed, we have been experiencing it more regularly ourselves—is design, thinking about heat, as has been mentioned. Indeed, that month I spent in hospital happened to be during a particularly hot summer, and I bought my own fan so I could try to keep cool. It was regularly removed because it had not gone through the electricity checking system and therefore obviously had a dodgy plug that was going to blow up the entire hospital. There are areas like that where intelligent design, thinking through not only the use of materials but the design of hospitals in future, is going to be vital.

I appreciate that this is not just about hospitals. Quite rightly, noble Lords have referred to what is happening in terms of quality of housing. This Bill can play a role in trying to get embedded, right across the country in our NHS settings but also at home, that real change and transition. Whether it is about having more shutters, making that much easier to operate and, if you have them at scale, much cheaper to deploy, or whether it is about thinking carefully about design and whether every NHS building has to be BREEAM Excellent —my personal view is the answer to that is no—it would certainly reduce a lot of cost. By and large, BREEAM Excellent tends to prefer air conditioning to aspects of simpler design. I am very pro air conditioning, but that does not mean it is needed quite everywhere.

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[Baroness Hyde of Bemerton (Lab)]

I believe I was in the House; it was after the King’s Speech. I will absolutely go away and review that debate and take it back.

[Baroness Coffey (Con)]

I have just looked at the other amendments and can find “plastic” referred to only in terms of infant feeding material, so I just wanted to get a sense of which amendment we are talking about. I did not quite catch which one the Minister referred to.

[Baroness Hyde of Bemerton (Lab)]

There is a group of amendments beginning with Amendment 111, which includes an amendment with a reference to single-use plastic. It is grouped in the medicines and medical devices section. I believe it was de-grouped; it was originally in this group and now is in the group beginning with Amendment 111. I know nothing will stop noble Lords discussing the things they want to in that group, irrespective of the content of the amendments.