Health and Care Bill

Baroness Hayman Excerpts

Lords Hansard - Part 2 & Committee stage
Thursday 13th January 2022 Lords Chamber

Moved by

[Baroness Hayman]

15: Clause 5, page 3, line 15, at end insert—
“(d) how the decision is likely to contribute to—(i) compliance with the duty imposed by section 1 of the Climate Change Act 2008 (UK net zero emissions target),(ii) adaptation to climate change, and(iii) meeting other environmental goals (such as restoration or enhancement of the natural environment).”Member’s explanatory statement
The purpose of this amendment is to include, as part of NHS England’s duties, a requirement that when making a decision about the exercise of its functions, it must have regard to how any decision is likely to contribute to the UK’s climate change and environmental goals.

[Baroness Hayman (CB)]

My Lords, in moving Amendment 15 I will speak also to Amendments 43, 101 and 153 in my name. I also support Amendments 201 and 210 in the name of my noble friend Lord Stevens of Birmingham. I am grateful to him, the noble Lord, Lord Prior of Brampton, and the noble Baroness, Lady Young of Old Scone, for adding their names to my amendments. I should declare my interest as co-chair of Peers for the Planet, and my regret that I was not able to be present at Second Reading of the Bill.

I doubt that this debate will mirror the length and enthusiasm of so many participants around the Committee in the outstanding earlier debate. However, I should say that the issues that prompt these amendments are equally serious. The Government spent much of last year in preparation for the COP 26 climate meeting and all year, before and since, they stressed the gravity of the climate crisis that the country and the world face, the importance of making progress internationally and on our own domestic targets, which are statutory, and the importance of taking action across all departments and all sectors of the economy and the country’s activities.

The aim of these amendments is to embed consideration of the UK’s climate change and environmental goals throughout the Bill, in much the same way in which the noble Baroness, Lady Thornton, described how earlier amendments attempted to integrate throughout the Bill the issue of inequalities. I am disturbed, despite the Government’s commitments and despite the experience with other Bills—I look at the noble Earl, Lord Howe, who knows well that we have had similar debates on the Financial Services Bill. Those ended happily, and I hope that we can do the same on this Bill. But it is disturbing that we are still getting legislation through the House as if we were not in the midst of a climate crisis and as if we did not have the most challenging targets on net zero, biodiversity and environmental change.

We turn to the NHS. I suggest to the Committee that the NHS has a vital role to play if the Government are to achieve their key strategic priority of net zero by 2050. The NHS is responsible for approximately 5% of the UK’s carbon emissions and around 40% of all public sector emissions. Recognising that, and with the outstanding leadership of my noble friend Lord Stevens of Birmingham, the NHS has committed to an ambitious net-zero plan. It was the first national health service to make net-zero commitments, and at COP 26 last year 14 other countries followed the NHS’s lead and set net-zero emissions targets for their own health services, illustrating how important domestic action can be on the global stage.

My amendments seek to integrate that overarching NHS plan into the new structures set up in this Bill and to join the dots between high-level policy and the new integrated care boards and care partnerships. They seek to embed climate and environmental considerations into the responsibilities and activities of NHS England, ICBs and ICPs, so that, throughout the NHS, climate action, environmental goals and climate adaptation are taken into account.

I should make clear that contributing to the achievement of net zero is important for the NHS not only in contributing to national targets for reducing the volume of emissions; it is also an important element in improving public and individual health. Rising global temperatures and air pollution, for example, directly contribute to rates of major diseases, including asthma, heart disease and cancer. Again, the link to the earlier debate about inequalities is very clear.

The Government themselves have recognised the link between reducing emissions and improving health, talking in their own net-zero strategy of the

“physical and mental health benefits”

of that strategy. The Climate Change Committee, in its progress report to Parliament last year, spoke of

“significant, tangible improvements to public health”

from reaching net zero. These views were echoed in the report from the Academy of Medical Sciences and the Royal Society, A Healthy Future: Tackling Climate Change Mitigation and Human Health Together, which was published last year. It is in the interests of the health of the country, as well as of the Government achieving their targets, to ensure that the NHS plays its part.

As I said earlier, the NHS itself has recognised the importance of this issue on both those counts and is committed to taking action, but we need to embed that commitment throughout the structures of the service. If my amendments are agreed to, this Bill can contribute by providing strategic direction and a clear policy framework at all levels of the NHS.

Amendment 15 adds to the list of the wider effects that NHS England has a duty to have regard to when making a decision about the exercise of its functions. Having heard the Minister respond to the earlier debate, I know that this will not necessarily be an attractive proposition to him, but I think it is important. If Amendment 15 is agreed, in addition to the matters set out in Clause 5, NHS England would have a duty to have regard to how its decisions are likely to contribute to the UK’s climate change and environmental targets.

Noble Lords will recognise that the wording is broader than simply the achievement of our statutory net-zero commitments, but it may reassure noble Lords, and Ministers in particular, to know that it mirrors the terms of an amendment the Government introduced after a similar debate on the Skills and Post-16 Education Bill. Importantly, the wording includes the “adaptation to climate change” necessary to build resilience within the healthcare sector and protect the health of our current and future populations. This reflects the recognition in the NHS’s own net-zero strategy and adaptation report that climate breakdown may affect the healthcare system with increasingly adverse environmental conditions. It is sobering to note that, over the last 15 years, at least 15 hospitals have experienced major flooding incidents, causing disruption to patient services or hospital support services. Attention to vulnerability in this area needs to be an important focus for NHS England.

Amendment 101 would impose a similar new duty on integrated care boards to contribute to the same three objectives set out in Amendment 15, ensuring that trickle-down of policy objectives through the system.

Amendment 43 also deals with integrated care boards, mandating that their constitutions must provide for a member to be designated—not appointed, I should make clear, but for an appointed member to be designated—as having responsibility for climate change and the environment. This would reflect the NHS’s net-zero plan, which highlights the importance of

“ensuring that every NHS organisation has a board-level net-zero lead”.

This amendment implements that part of the plan in relation to the new framework of ICBs, created in the Bill, and having a board-level lead is an approach which has proved successful in other sectors.

--- Later in debate ---

[Baroness Hayman (CB)]

My Lords, I am extremely grateful to all Members who contributed to this debate, which got slightly more feisty than I expected it to do in some areas. I am sure that the Committee will be grateful if I do not respond on the issue of electric charging points in your Lordships’ House, which has concerned me for four years, but there are one or two important things to be said here. There are two dangers. One danger—I fear the Minister nearly got there—is to suggest that those who are concerned about climate are not concerned about fairness or inequality and do not realise the dangers, on everything from heating to electric vehicles or whatever. However, there is not that layer of people who are concerned only with the climate in theory. Most of us who are active in this area are extremely concerned about a fair transition and the implications of individual policies.

The other false dichotomy is that either you work on the absolutely granular local stuff or you make highfalutin legislation that is not relevant to anyone. We need both. We need to go throughout the system. We are legislators. Legislation matters and words matter. Sometimes legislation matters because Governments and policies change but legislation is there in statute—the words are on the page.

Of course I will seek to withdraw my amendment and of course I will have conversations with the Minister, but it is essential that we tackle this, the most serious of issues facing the world. Covid is the crisis of our time but the climate is the crisis of our age and we absolutely need to address it at all the levels that we can—and there are many. As I say, we are legislators and we can start some of that trickle-down. We have a responsibility to monitor and ensure that we end up with exactly the level of granularity that we need—and that we learn from the local. I am happy to delay conversations with the Minister for a later date. I beg leave to withdraw my amendment.

Amendment 15 withdrawn.