European Union (Withdrawal) Bill

Baroness Altmann Excerpts

Committee: 8th sitting (Hansard - continued): House of Lords
Monday 19th March 2018 Lords Chamber

[Baroness Lister of Burtersett (Lab)]

My Lords—

[Baroness Altmann]

My Lords—

[Baroness Oppenheim-Barnes (Con)]

My Lords—

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[Baroness Lister of Burtersett]

My Lords, I want to say a few words—a very few, I promise—in support of the amendment. Decent public health provision is of special importance to people living in poverty and people living in deprived areas, whether we are talking about the impact of the daily cocktail of pollution referred to recently by the Chief Medical Officer of England and mentioned by the noble Lord, Lord Warner, as a prime example of why the amendment is needed; the incidence of obesity referred to by my noble friend Lady Blackstone; preventable stillbirths; or life expectancy, where some recent statistics have been very worrying. In the Longevity Science Panel study published last month, the life expectancy gap between England’s richest and poorest neighbourhoods has widened since 2001, and it identified income inequality as the biggest factor. Recent data from the Office for National Statistics indicate that life expectancy of the poorest girls in England has fallen for the first time on record since the 1920s.

These are stark examples of how health and illness follow a social gradient. Campbell Robb, chief executive of the Joseph Rowntree Foundation, was quoted in the Independent as saying:

“These figures should serve as a wake-up call: we need action to loosen poverty’s grip on the health of our nation”.


I hope that the Government will take note of this wake-up call and, as a minimum, accept the amendment, which sets out important guiding principles for public policy as we exit the European Union.

[Baroness Altmann]

My Lords—

[Baroness Oppenheim-Barnes]

My Lords—

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[Baroness Oppenheim-Barnes]

I would just like to put the opposite view. Some of the regulations that we have had to accept from the EU on health matters were likely to be completely unhelpful and possibly even make matters worse. I remember when people were concerned about harmful additives in food and parents, in particular, wanted to know more, so the EU produced a regulation in which the information was to be given in tiny letters, smaller than anything else on the label. You had the vision of a busy mother with a child on each arm who possibly needed her glasses to read what it said. She would get a completely opposite view because the writing was so small: she would think that it was the good thing that they should have when in fact it was trying to warn her against it. I was unable to get that amended at the time. That was just one small example of such misinformation or lack of information. I am looking forward, when we complete everything and achieve Brexit, to redrafting a number of these regulations that we had to accept to make them much more sensible for those who are rightly concerned about these matters.

[Baroness Altmann]

My Lords—

[Lord Brooke of Alverthorpe (Lab)]

My Lords, it is this side. I have been waiting patiently on this side. I am grateful to the noble Baroness; you will have your chance.

I support the amendment of the noble Lord, Lord Warner, signed by several other noble Lords. The UK is a leader in public health. We have done extraordinarily well on the world stage and within Europe. I trust that the Minister will have no problem with the advice from his colleague, the noble Lord, Lord Deben, to incorporate this into the Bill. There is no real reason why it should not go in. It should go in because that would send a wider message about what life might look like in future.

Post Brexit, the Government will have to negotiate about 760 treaties on different subjects with 168 countries. Many of these will affect people’s health in a variety of ways, many of which have been mentioned: food safety, environmental standards and chemicals.

I suspect that these negotiations—particularly with the United States—may affect the NHS. Given the fact that the NHS was a central part of the Brexiteers’ argument, it is very important to keep a close eye on this. It is possible that the UK may be vulnerable to industry lobbies when we are negotiating alone, not in concert with others from Europe. It is also possible that there may be other pressures. We have just heard from the noble Baroness, Lady Oppenheim-Barnes, who indicated that we should look at existing standards and change them. I suspect that many people who are interested in seeing a low-cost, Singapore-style economy will be pleased to see many of those weakened in future.

It is interesting to look at the lobby groups which have been involved in the Canada-EU negotiation, to see where they came from, what they were after and what they tried to secure. Many of those groups were involved in the failed negotiation between the USA and the EU. As has been mentioned, their interests revolve around alcoholic spirits, the quality and standards of meat, pesticides and chemicals. I have been seeking to find out who is lobbying the Government regarding the negotiations for a deal with the USA. From all accounts, there is a significant interest from the health sector, which is an extraordinarily big part of the USA economy. Compared with most other countries in Europe, the NHS is quite unique. We are the one remaining country with a virtually totally state-run health service with—as yet—minimal amounts sectored out, sourced out or privatised.

There is a view that, as part of a trade deal with the Americans, when seeking to get better deals in other areas, we might have to let something go—as you do in any negotiation. I am pleased to see that the Minister is shaking his head, saying that we are not going to negotiate on the NHS in a trade deal with the Americans in order to have the freedom to get deals in other areas when we could do better for our manufacturing business elsewhere. If that is the case, why do the Government not come out more firmly on this? They could make a start by accepting the amendment.

As other noble Lords have mentioned, this year is the 70th anniversary of the National Health Service. The amendment also provides the Government with an opportunity to affirm for future generations their commitment to universal healthcare free at the point of use and funded through general taxation. The negative impacts of privatisation on health service efficiency and quality are now well evidenced in many areas. Publicly run health services must not be opened up to further competition and no “ratchet clause” or negative listing should preclude the return of privatised public services to a state operation. A reverse could take place. If the NHS is safe in our hands, let us have a true red line written into the sand on this issue. We could make a start by seeing the Government’s commitment. Will they accept the amendment or not? We can then start moving towards firm commitments: not just mealy words then finding flexibility introduced into the negotiations allowing further encroachment and privatisation of the National Health Service.

[Baroness Altmann]

My Lords, I rise to support the amendment and to point out to the Minister that it gives him an opportunity. I know that he and the Government care deeply about public health. This amendment gives him the chance to reassure the Committee, and the wider public, that the Bill will do no harm to the precious public health. It is supported by more than 15 medical organisations, and I thank the Faculty of Public Health for its very informative briefings.

The amendment deliberately uses the language of Article 168 of the Lisbon treaty, so there is a body of jurisprudence through which it can be interpreted. The UK can be proud of its high standards of public health protection, safeguarded by legislation, policy and practice. I hope that the Government and my noble friend will seriously consider accepting this amendment to help provide the reassurance that, if we leave the EU, we will do no harm to public health. The amendment places a duty not only on the Government and the devolved authorities but on the arm’s-length bodies that can so often be involved in the detail of public health standards. This Bill is where constitutional stability and certainty needs to be established within our legal system, so I hope that the Minister will respond positively.

[Lord McKenzie of Luton (Lab)]

My Lords, I welcome this opportunity to join with others on this important amendment in support of the noble Lord, Lord Warner. I draw attention to my entry in the register of interests as the president of the Royal Society for the Prevention of Accidents. I will focus on the importance of public health prioritisation in easing the extreme pressures on our A&E departments, in promoting, improving and safeguarding the health of the nation’s workforce and its productivity, and in preventing unnecessary burdens on society and families caused by unintentional death and serious injury.

Currently, an average of 14,000 people die every year in accidents, and accidents remain the biggest single killer of children and young people up to the age of 19. While the UK has made incredible strides over the past century in reducing accidents at work and on the road—giving the country the enviable safety records it has today—unintentional death and injury at home and at leisure is on the increase, with around 6,000 people being killed in their own home each year. In 2010, a total of £11.5 billion was spent by the health and social care sectors on fall-induced fractures alone. This will, of course, rise if today’s problems go unchecked.

Despite the overwhelming evidence that unintentional injury is one of the biggest public health issues facing society today, accident prevention is afforded woefully inadequate focus on the public health agenda. We need a major investment in falls prevention programmes in order to promote healthy ageing and thus ensure that older people are kept out of the health and social care systems for as long as possible, allowing them to enjoy later life to the fullest.

We also need to ensure that we are protecting the most vulnerable at the other end of the age spectrum: the under-5s. A disproportionately large number of young children visit A&E departments, while at least one child under the age of five is killed in an accident every week. This amendment will help as we strive to meet these challenges. It is my hope that it will encourage assessment of public health priorities, and of distribution of resources in line with this. Local authorities must be empowered to discover where their greatest health challenges lie, and properly assisted when they look to tackle them.

As for Europe, the accident prevention community in the UK has learned a lot from its colleagues on the continent, as they have learned a lot from us. RoSPA is a leading member of the European Association for Injury Prevention and Safety Promotion—EuroSafe—and also hosts the European Child Safety Alliance. It also continues to work with the European Agency for Safety and Health at Work in ongoing efforts to drive down occupational accidents and ill health. The latest Health and Safety Executive estimated cost to UK business of injuries and ill health from current working conditions stands at a staggering £14.9 billion, with 31.2 million working days lost each year. While there is still more to be done, much can be learned from the excellent workplace health and safety practice displayed by employers across the country—and, indeed, across the continent—as we look to reduce accidents that happen to people when they are in the home and at leisure.

It is to be hoped that this amendment will go some way to addressing concerns of an impending deregulatory agenda which has the potential to erode decades of research and creation of solid, evidence-based regulation that ensures that the population can work and live their lives unhindered by unintentional injury. While we hear much about the red tape of such regulation hindering business and productivity, we know that the opposite is in fact true: good, proportionate regulation is good for the workforce and good for business.