Health and Care Bill

Baroness Finlay of Llandaff Excerpts

Lords Hansard - Part 1 & Report stage
Monday 7th March 2022 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, I rise briefly to offer support from the Green group for both these amendments. In Committee, I spoke extensively on the issues around creative health, and I will not repeat any of that. I just note that, looking at the Government’s response, I get no sense that they have got the point that this is not an additional “nice to have”—something that is done after you have done the medical stuff—this has to be a core part of allowing people to get well again, and keeping people well.

On Amendment 184ZB, it is interesting that the Covid pandemic has seen a really large increase in private medical provision, such as testing on our high streets, et cetera. Now that they are there, those businesses will be looking out for different procedures to keep them going, and it is really important that we have full transparency about the advice that people are getting at those kinds of places.

[Baroness Finlay of Llandaff (CB)]

My Lords, I say very briefly that I hope the Government will look favourably on this amendment from the noble Lord, Lord Howarth, and others. I hope that they will build into a review an assessment of the cost efficacy because as well as all the positive aspects that we have heard about, we must remember that, if you can decrease medication prescribing, you will decrease not only costs but adverse side-effects, which also have a cost. All these initiatives tackle the problem of loneliness, isolation and not having contact with other people—people who may be able to empathise with the way that you feel about your condition when you are undertaking a common activity with them. That can become particularly important for the psychological well-being of patients as well as their physical improvement.

[Baroness Merron (Lab)]

My Lords, I congratulate my noble friend Lord Howarth on bringing this subject before your Lordships’ House again. I am grateful to noble Lords from all sides of the House for providing their support for embedding the conditions and opportunities for art, creativity and culture in improving public health. These amendments provide something of a focus for action and I hope will be regarded seriously as such.

We know that the practices relating to creative health can be very effective and good value for money. Some 20% to 30% of all visits to the doctor are for non-medical reasons; for example, social isolation or loneliness. Therefore, the potential that we have in the United Kingdom is huge. Indeed, evaluation of the Arts on Prescription scheme suggested an average return of £2.30 for every £1 spent.

These amendments support the idea that art-based approaches can help people to stay well, recover more quickly, manage long-term conditions and experience a better quality of life. I hope that the Minister will be able to take these amendments on board.

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[Baroness Masham of Ilton (CB) [V]]

My Lords, I will speak to Amendments 169 and 181. I have my name down for Amendment 169 on the licencing of cosmetic procedures. During the passage of this Bill, I have had my eyes opened to just how enormous this industry is and how a great many people are putting themselves at huge risk. I have heard of some disturbing cases in which procedures with collagen have gone wrong. At a conference about plastic surgery and cosmetic procedures, one-third of the attendees were from the plastic surgery field and two-thirds from cosmetic procedures, which shows how popular this is becoming.

All Members of your Lordships’ House taking part in these amendments share the desire that these procedures should be registered and safe. I am very pleased that the noble Lord, Lord Kamall, has accepted that this matter needs addressing and making safe. I thank him and his team for the hard work that they must have gone through in producing these amendments.

Amendment 181 is a very practical and important amendment, which I could not resist supporting and speaking to. It would reduce bed-blocking—a most unfortunate problem for a busy hospital that needs all its acute beds for ill patients, and frustrating for patients who still need rehabilitation but not in acute beds. These patients cannot go home because their accommodation is not suitable for their needs; for example, they might have to use a wheelchair and they need time to get organised. One of the problems is the time that it takes to get necessary adaptations completed. Housing authorities and social services need to work together with health authorities. If suitable rehabilitation accommodation is available, it can also be used for patients who need specialised treatment that is a long distance from their home. St James’s hospital in Leeds has a hotel for such patients, and incorporated into the hospital is a Marks & Spencer food shop; this is a very valuable service. I hope that the Minister will agree that these provisions should be available throughout the country.

[Baroness Finlay of Llandaff (CB)]

My Lords, I am most grateful to the Government for tabling Amendments 153A and 157A; I will not be moving my related Amendment 169. I should declare that I am married to an academic dermatologist, and that I am vice-president of the Chartered Institute for Environmental Health.

I am very grateful to the officials with whom I have had many discussions over the issue of cosmetic procedures. These government amendments are a welcome step in the right direction, by ensuring that individuals who carry out cosmetic procedures such as Botox fillers, threads under the skin and so on will have to meet consistent safety standards. Anything that breaches the barrier function of the skin—going through the live layer of cells of the epidermis—can cause inflammation, introduce infection and cause scarring and other reactions. The government amendments are most welcome because they are broad-reaching and tackle the real problem of people doing things to other people with no proper training and in premises that are not even properly inspected and licensed.

Perhaps I could just ask the Government two questions on this. First, when we had discussions we were considering the use of the term “energy-based device” to cover all the different modalities that can be used to get different types of radiation, whether as heat or whatever, through that layer—the barrier of the epidermis. That phrase would have captured such things in future regulations. Can the Minister assure me that subsection (2)(e) of the proposed new clause will also cover forms of energy not in the wording of the amendment, such as radio frequency and ultrasound devices, which are currently in use on the high street for cosmetic skin-tightening purposes? The idea is, of course, that they produce a small amount of scarring and tighten the skin, but if that goes wrong then you have a problem.

Secondly, can the Government confirm that, in order to obtain a licence, practitioners will be required to meet the agreed standards for training and education and that, in order to maintain their licence, they will be required to undergo appraisal and report adverse events so that such events can be collated and appropriately followed up on?