Health and Care Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I feel I have to remind the House that we have had 95 hours of debate in recent years on this topic; and the implication that we have not debated this is a misrepresentation. The noble Lord, Lord Forsyth, has asked us not to talk about assisted dying but then actually did talk about some aspects. We are being asked to test the willingness in both Houses, but I remind the House that the Marris Bill started in the Commons, was debated there and was defeated there by 330 votes to 118. That is where a Bill like this should start.

It is true that, historically, there have been major changes. Those have been in Bills that started in the House of Commons, when the public understood what they were about. The public knew what capital punishment was, and they know what homosexuality is. These Bills started in the elected House, and they then came to this Chamber. That has been our procedure.

I would, though, like to challenge the claim that there is overwhelming support among the public. I think it is questionable. In the poll, when asked a bit more detail, 57% of the public did not understand what assisted dying is; 42% think it is your right to stop treatment, which is already a legal right; and 10% think it is hospice care. Dignity in Dying has said it wants to have the largest record of public support, yet to date it has less than 0.5% of the population of England and Wales signed up to this list. So I do think we have to look at some of the claims being made and think about them.

Whatever noble Lords think about assisted suicide and euthanasia, this amendment would set a dangerous constitutional precedent for any Government. It is surprising that the noble Lord, Lord Forsyth, with his deep respect for parliamentary processes and Governments being able to govern, has taken this approach, because this amendment would set a precedent enabling any Back-Bencher from any pressure group to disrupt a Government’s agenda. Does the noble Lord plan to bring judicial proceedings if his proposal is not tabled in a year? That is the criterion in the text of his amendment. A draft Bill leads to a Bill, assuming and forcing government support, before exploring evidence of the complexities of licensing doctors to provide lethal drugs.

We do indeed already have a Bill before us, and it is awaiting debate. The amendments laid are not vexatious. Based on the extensive evidence from abroad, they expose the problems with the proposals from the noble Baroness, Lady Meacher. Where assisted dying is legal, palliative care has dwindled, legislation has widened, the safeguards have been seen to fail, and non-assisted violent suicide rates rise disproportionately. Post-event reporting, as in her Bill, does not work because it relies on the clinician. I could go on, but I will not.

Yet surprisingly, no request was made for Committee until months after Second Reading, and no one seems to have sought to discuss the amendments that have been widely criticised by those who have spoken today. Some Members openly want the prognosis requirement to be dropped from the Bill to make legal drugs available on request. We have to at least know what the content of the Bill is even before we proceed. An 18 year-old with severe anorexia is already eligible under the Bill that is currently before the House. The answer to harrowing accounts of inadequate care is not to force the Government to draft a Bill that would allow doctors to supply massive overdoses of unevaluated lethal drugs to patients. Good, holistic, palliative care has been made a right in this Bill by this Government, and people should ask for it and insist on it.

This amendment is not the way to seek a careful analysis of the complexities of assisted suicide and euthanasia. It creates a constitutional headache for any future Government’s ability to govern. The procedure is to debate a Private Member’s Bill properly in Committee; and that Private Member’s Bill should start in the elected House.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I hate to disagree with the noble Lords who have spoken against this amendment, almost as much as I loathe supporting the noble Lord, Lord Forsyth, on anything. But, for me, this is a matter of democracy. Public opinion is constantly moving on this, and it becomes more and more supportive as the public understand the issues involved. It is partly the duty of the Government to explain exactly what it is about. Having a proper debate like this is something we should all support.

Personally, I want this on the statute book before I need it. I have five grandchildren, and I try to talk them all into pushing me over a cliff if I were to get too ill. As soon as their mothers told them that it was illegal, they refused me. The idea remains that this is something which many of us want for ourselves, because we fear being incapable. Therefore, I support Amendment 170.

Environment Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Report stage
Monday 6th September 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

I support Amendments 4 and 12, and I am most grateful to the noble Baroness, Lady Hayman of Ullock, for the superb way in which she introduced this group and encapsulated the strength of feeling about the importance of these amendments.

I remind the House that air pollutants reach every organ of the body. They affect growing foetal tissue, not just adults. They affect organs as they develop in children and throughout people’s lives. Very small particles are a particular problem because they stay suspended in the air for prolonged periods and have a propensity to penetrate the deep parts of the lung. Ultrafine particles are especially problematic because in many respects they behave like a gas. As particles become smaller—into the nano scale—their surface area increases exponentially, so chemicals carried on their surface are released into cells and become bioavailable as toxins in the mitochondria within cells. The damage goes throughout the body.

The WHO guidelines are health-based and due to be revised downwards. They will not remain at their current level for many years: they will get tighter, because large epidemiological studies have shown that there are no safe levels of pollutant exposure. I remind the Government that as far back as 2001 their own advisory committee on air quality stated:

“Impact analysis of policies or specific developments, whether for industry, transport, housing etc, should take account of the interlinkages of emissions of air quality and climate change pollutants”.


That has still not occurred.

To increase the relevance of air pollution controls in environments where people live and move around requires greater input that takes into account real-life exposures in different settings, especially urban environments where people work and live close to busy roads and the foci of traffic congestion.

It has been shown in the bay area of California that there is a direct link between health impacts and the levels of pollutants in the air. There are enormous impacts, even from a single two-hour commute in a car. That has been shown to increase human stress metabolism, with very clear differences between people with normal lungs and those who are asthmatic. People with asthma are particularly vulnerable to air pollution.

I stress that point because, in addition to the growing evidence that air pollutant exposure increases susceptibility to SARS-CoV-2 infection, as has already been said it enhances the severity of, and likelihood of death from, a lot of other lung diseases. It is all linked to the social determinants of health. Ella’s death illustrates the tragedy for many.

I remind the House again: the UK has the worst death rate for asthma in Europe and one of the highest incidences of asthma. I worry that short-term finance is driving resistance from the Government, because monitoring levels of these very small particles requires different equipment from that in use at the moment. To avoid doing this properly, however, is a real false economy. Quite apart from tragic deaths, there is the cost to the health service and social care. By installing equipment to measure particulates equal to or less than 10 micrograms per metre cubed, the Government will be prepared and able to set an example to other nations when the WHO guidelines change.

This amendment sets a quality target with a deadline far enough ahead to be achievable. Delay will simply mean that we will be playing catch-up, rather than providing the leadership that is desperately needed.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I have been working on the issue of air pollution for more than two decades. I thank Simon Birkett of Clean Air in London and Rosamund Kissi-Debrah, who are fantastic campaigners, and so tenacious. It moves me that I am able to present some of what they think and are fighting for. I also congratulate the noble Baroness, Lady Hayman of Ullock, on her excellent opening speech—it was far better than anything I can do, I am sure, though I will try.

Amendment 4, on which we may divide, is crucial: it could save your life. The other two amendments are great, because they will help with your health as you go through our filthy London streets, but Amendment 4 is basic. We have to reduce PM2.5. Exposure to these fine particles is the main cause of death for most people who die early from air pollution. These are tiny bits of soot and grit that are so small that they not only stick to the lungs but can pass through them. The noble Baroness, Lady Finlay of Llandaff, explained it much better. We must understand that this is incredibly difficult to control without targets.

Amendment 12 is also extremely important, because the World Health Organization is due to publish its updated air quality guidelines this month, possibly within days. I try never to use the words “air quality”, because we do not have air quality—we have air pollution. We have to remember that. It is filthy and harmful. Many countries around the world follow the previous World Health Organization guidance, which was issued 16 years ago, but we still have nothing. We have a public health crisis leading to tens of thousands of premature deaths and we have identified the main cause, but still we do nothing.

Incinerators can be built and ignore this pollutant. Heathrow can be expanded and ignore this pollutant. Local authorities and national government are making decisions that will potentially damage human health and increase these emissions, but we allow it because we ignore the scientific advice. That really should not be acceptable.

Environment Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Committee stage
Monday 28th June 2021 Lords Chamber

[The Deputy Chairman of Committees (Baroness Finlay of Llandaff) (CB)]

The noble Baroness, Lady Neville-Rolfe, and the noble Lord, Lord Rooker, have indicated that they do not wish to speak on this group of amendments. I therefore call the noble Baroness, Lady Jones of Moulsecoomb.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, this is an interesting group. I will stick to talking about Amendment 281 in the name of the noble Baroness, Lady Bakewell of Hardington Mandeville.

Nowadays, there is widespread recognition that animal testing is wrong and should be avoided. The expansion and development of human society has had huge impacts on all sorts of other species. Disruption to their lifestyles has been accidental and deliberate, and has resulted in suffering, death, and even extinction. Millions of animals are still abused every year in experiments that cause great pain and suffering. This is despite significant differences between the physiology of animals and humans, which can mean these experiments are ineffective or even pointless. I am sure that noble Lords know that biomedical researchers have often excluded women from clinical trials, even for drugs only for women, so how much worse to try to model on animals. A lot of non-animal technologies can be used instead, as can human tissue.

We must also not forget the harmful use of animals in education, where millions more animals are killed specifically for dissection and other educational experiments. Just as we would never think of killing a human so that trainee doctors can learn about anatomy, we should not be killing animals for people to learn. Again, technology can replace much of the need for using real animal specimens in education, but where dead animals are necessary, they can be sourced from animals that have died naturally or have been euthanised for humane reasons.

This is all about shining a light on our exploitation of other species and choosing a different course for our future. Hopefully, we are advanced enough to move beyond these barbaric practices and move positively forwards as stewards of the natural world.

Trade Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Committee stage & Committee: 3rd sitting (Hansard) & Committee: 3rd sitting (Hansard): House of Lords
Tuesday 6th October 2020 Grand Committee

[The Deputy Chairman of Committees (Baroness Finlay of Llandaff) (CB)]

I call the noble Baroness, Lady Jones of Moulsecoomb.

[Baroness Jones of Moulsecoomb (GP)]

One day, I am going to send round a notice about how to say my name—but it does mean that I start every speech with a smile.

Noble Lords have covered almost every issue that I was going to speak on today, so I will be like a sparrow under a bird table and hop around to find things that I feel particularly strongly about. Noble Lords have spoken about environmental protection, animal welfare and sentience, and public health. I thank the noble Lord, Lord Grantchester, for his kind comments about Amendment 74 in my name, which is basically about ensuring food standards, food safety, environment protections and so on—that is what you would expect from a Green, of course.

The noble Baroness, Lady McIntosh of Pickering, mentioned the good progress that we made on the Trade Bill before with the noble Baroness, Lady Fairhead. She worked with us and I thought that we found a way forward. The noble Lord, Lord Stevenson, was also involved. I realise that the noble Lord, Lord Grimstone, is not in the same place—his party now has a majority of 80-plus in the Commons and he therefore does not need to talk to us in the same way—but the fact is that almost all the speeches have been united on our need for such protection in the Bill. That is partly because we simply do not believe the Government. It is not about individual Ministers, for whom we have a great deal of respect, even a liking; we just do not trust the Government. They have proved again and again that they have no respect for either the law or Parliament. We therefore need protections in the Bill because if they are not there, we do not believe that they will happen.

It is a case of understanding that trade is not trade on its own; trade has an impact on virtually every area of our public life. A climate emergency is happening now. Parts of America are burning to death and parts of the Arctic are melting into the sea, never to be ice again in our lifetimes. We must understand that trade has an impact on that. There is no argument with that. Personally, I feel that there is no option but to embed these ideas for how to be a more sustainable country in the Bill—in fact, in every Bill that we debate.

Next year, we will host COP 26. The noble Baroness, Lady Boycott, asked an Oral Question today about sponsors and so on. The Minister came back and said, “Well, you know, we’re going to judge our sponsors and their short-term action plans and that sort of thing.” I am afraid that that is just not good enough. We do not trust the Government to judge anything as sustainable or climate-friendly. You have to go outside the Government to find people who understand what sustainability means and what the climate emergency is. We have an opportunity as a country to show some leadership. Quite honestly, we do not have leaders in the Government at the moment; we have children who bluster and act like clowns. It is all very embarrassing, I am afraid.

I mentioned the Government’s majority in the House of Commons. The fact is that that majority lets the Government off the hook, unfortunately, and absolves them of any meaningful scrutiny. However, we scrutinise here and we can tell you that this Bill is not good enough.

I am still hopping around under the bird table. My Amendment 74 would prevent the ratification of any trade agreement that does not comply with UK standards, or at least

“standards that are comparable in effectiveness to those of the United Kingdom”.

It is a simple, effective amendment. I hope that the Government will read it and see that I am trying to be helpful, not difficult.

I echo the noble Baroness, Lady Henig, who pointed out that we do not yet know what criteria the Government are using for their trade deals, that they have not given us any sort of meaningful policy intent or criteria and that we do not know how they will approach and evaluate trade negotiations and trade deals. I assume that that is because they do not know themselves, but it would be really helpful if we had some guidelines from the Government on how they will take these issues forward.

With that, I will finish. I am deeply, deeply furious about the way in which this Government are handling the whole country. I cannot blame the Ministers here but, as British citizens, we should all be thoroughly embarrassed.

Agriculture Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Report stage & Report: 2nd sitting (Hansard) & Report: 2nd sitting (Hansard): House of Lords
Thursday 17th September 2020 Lords Chamber

[The Deputy Speaker (Baroness Finlay of Llandaff) (CB)]

My Lords, the noble Baroness, Lady Jones of Moulsecoomb, had requested to come in, and I understand she has not been able to. Therefore, I now call the noble Baroness, Lady Jones, before the Minister responds.

[Baroness Jones of Moulsecoomb (GP)]

Thank you— I was scrubbed by mistake. I am sure your Lordships are very happy that I have been slotted back in.

Immigration and Social Security Co-ordination (EU Withdrawal) Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Committee stage & Committee: 1st sitting (Hansard) & Committee: 1st sitting (Hansard): House of Lords
Monday 7th September 2020 Lords Chamber

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I shall speak in favour of my Amendment 93. It is obvious that many of the amendments in this group are heading towards the same sort of thing, which is protection for people of all kinds as well as holding the Government to account for what they do. I support several of the amendments that have been spoken to, and I have been moved by some of the speeches from noble Lords.

My amendment is supported by over 50 organisations from all the devolved nations, including the Health and Social Care Alliance Scotland, Macmillan Cancer Support, UNISON and the Association of Camphill Communities. Amendment 93 would require an independent evaluation of the impact of the effects of the Immigration and Social Security Co-ordination (EU Withdrawal) Bill on the health and social care sectors across the UK. This would be made after consulting the Secretary of State for Health and Social Care, the Scottish Ministers, the Welsh Ministers, the relevant Northern Ireland department, service providers, those requiring health and social care service and others. One would hope that this would be automatic with any measure that a Government introduce as they really need to know whether it is working or not.

Proposed new subsection (1) would require the Secretary of State to lay a copy of the report before both Houses of Parliament no later than one year after this Bill is passed. Proposed new subsection (8) would require a Minister of the Crown to make arrangements not later than six months after the report has been laid before Parliament, for the report to be debated and voted on in both Houses.

My amendment is necessary to safeguard the interests of the many people who rely on the contribution of EU citizens and non-EU citizens for the provision of health and social care across the four nations. This of course includes disabled people, children and young people, older people, unpaid carers and those with long-term health conditions. I should perhaps declare an interest in that I am getting older and this might apply to me in a decade or two.

Prior to the UK leaving the EU, a number of studies had highlighted the significant adverse impact of Brexit on the health and social care sectors across the UK. These studies, and the initial information about the points-based immigration system provided in the Home Office’s policy paper, The UK’s Point-Based Immigration System: Policy Statement, suggest that the ending of freedom of movement and the introduction of a points-based immigration system will potentially have a major adverse impact on the health and social care sectors across the UK. I think every speech so far has highlighted that fact.

The proposed independent evaluation that would be introduced by Amendment 93 could play a key role in supporting the health and social care sectors across the UK, helping them to address a range of concern about the proposals. These include concerns that many health and social care workers from other European countries, and from non-European countries, would not meet the proposed income threshold under this system, and that the requirement to have a job offer is unnecessarily restrictive, and will create addition administrative burdens and cost for health and social care organisations trying to recruit staff from abroad. As we have heard, there is a lack of recognition of health and social care specific skills, experience and professional qualifications in the proposed points-based system. As a result, it does not recognise the skills and experience of the workers from across the EU, and from non-EU countries, to enrich health and social care support and services here. Nor does it value the sector and its growing importance as a result of demographic changes.

There is much wrong with the Government’s immigration policy, but health and social care will feel a particularly brutal impact. This independent analysis is required so that the Government can think properly about the needs of health and social care and develop policy accordingly.

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, I declare my interest as chair of the National Mental Capacity Forum. I speak to Amendments 2 and 66, to which I have added my name, and I strongly support Amendment 82, tabled by my friend Lord Patel.

The current proposals will exclude a group of workers we desperately need: carers for those with physical and/or mental disabilities, especially, as my noble friend Lady Masham highlighted, those with spinal injuries and similar severe physical constraints, and those with severe impairments of mental capacity for a wide variety of reasons. Many of these people are at a high risk of Covid and some will have been on the official shielding list. They wish to remain in their own homes and need care around the clock. For them, a live-in carer is the best option, but the annual salary of such a carer will fall below the level to accrue points in the system. That workforce just does not exist here. UK residents are not coming forward to train as live-in domiciliary carers.

Those carers already here are fearful that they will not obtain leave to remain. UNISON is calling for key workers to remain here and be eligible for NHS care—that is, to be exempt from the “no recourse to public funds” criteria—during the pandemic. Around 17% of the social care workforce is made up of migrant workers, with 115,000 European nationals and 134,000 non-EU nationals.

European Union (Withdrawal Agreement) Bill

Debate between Baroness Finlay of Llandaff and Baroness Jones of Moulsecoomb

Committee: 2nd sitting (Hansard continued) & Committee stage & Committee: 2nd sitting (Hansard continued): House of Lords
Wednesday 15th January 2020 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I should like to briefly follow that very powerful speech by my noble friend Lord Wilson of Dinton. The spirit of the amendment tabled by the noble Lord, Lord Wigley, is about consultation. It is about making sure that people behind the scenes know what is happening and can understand if they have to give something up rather than it being delivered on them.

The Senedd, the National Assembly of Wales, has responsibility for a set of devolved competences. When negotiations become difficult and tough, it is almost inevitable that at times people will have to give things up. If people in Wales, behind the scenes, know what is happening and understand why, they can support it. If something is just delivered on them as a fait accompli afterwards, trust is lost. There is a Chinese saying that I think we should remember: trust arrives on foot and leaves on horseback—and it is trustworthiness in behaviour that wins trust.

The Joint Ministerial Committee on EU Negotiations was set up with promises by the Government to seek consensus over approaches behind the scenes—yet, sadly, I understand that sometimes the committee had no more information than could be found in the previous day’s newspapers. Sometimes those attending were told that they could not be told more because it was not in the public domain. If there is a small group of people whom you are taking into your confidence and you trust them to observe that confidence, it is not helpful for them to be told, “You can’t be told what’s going on because it isn’t in the public domain”—because the role of that group is to share that confidential information and thinking before the next round of negotiations.

The spirit of the amendment tabled by the noble Lord, Lord Wigley, completely encapsulates a need: where devolved competences are at stake and will be deeply constitutionally affected, it is only right that the devolved Administrations are involved and that their thinking is sought early on, so that they can explain it both to their own legislatures and to the people who voted them into office.

[Baroness Jones of Moulsecoomb (GP)]

My Lords, I support Amendments 27 and 28, and I would have put my name to Amendment 40 had I seen it before the deadline. This is a sad day for me, not just because these amendments are necessary but because today I have disagreed very strongly with the noble Lord, Lord Howarth. We have sat together companionably for six years. He is like a human form of Wikipedia. He knows everything that there is to know about all noble Lords and this saves me from having to use my phone.

Returning to the amendments, I hope that Hansard has a copy and paste function, because, quite honestly, we have been over this time and again. Noble Lords have said the same things to the Government again and again, and at one point it seemed to have sunk in, because the European Union (Withdrawal Agreement) Bill last year contained a whole load of provision for parliamentary scrutiny. I know that the Minister will reply to us with his tried and tested lines that we have heard before—but, quite honestly, that is not enough. The election has changed things and now the Government have gutted the agreement Bill of all scrutiny. I say to the Minister that, just because his Government now have a majority in the other place, that does not make them right or mean that this is the right thing to do. It does not make them immune from parliamentary scrutiny. Our job is to hold the Government to account, and if they scrap us—well, actually, I have been trying to abolish the House of Lords for six years and it has not worked so far.

Is it not obvious that a lack of parliamentary engagement—a failure to bring the majority on board—is what led to the parliamentary deadlock when the final deal was secured? Instead of working with Parliament, the Government told us that there would be no running commentary and that the sharing of details would undermine the negotiations and so on. Scrutiny was deferred until the very last stages of the negotiations when, instead of it being a mere inconvenience, it culminated in a crescendo of chaos. Had the Government engaged constructively with Parliament, things could have turned out very differently. However, despite all those lessons, the Government are, once again, trying to sideline Parliament.

Over the coming weeks and months, much will be made of the Salisbury convention and the extent to which this House should exercise its powers and functions to scrutinise, correct and improve. My stomach slightly turned over when the noble Lord, Lord Howarth, said that we had to trust the Government. Well, actually, no, we do not. It is our job to trust when it is appropriate to trust and to distrust when we can see that they are going wrong. When the Government try to shut down scrutiny in the way they have with this amended Bill, it leaves this House with no choice but to exercise its constitutional might as far as that extends. The last stage of the negotiations was the easy bit. It is the next stage that is going to set out all our future concerns. That negotiation must be got right, and this sovereign Parliament absolutely must play its role in securing that for the national interest.