Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2026

Lord Addington Excerpts

Wednesday 15th April 2026 Grand Committee

[Lord Herbert of South Downs (Con)]

My Lords, I want to add to the comments and questions made by my noble friend Lady Harding about the potential impact of this regulatory change on horseracing. It is a very important sport, as the Minister responsible knows, and a sport that is already under considerable financial pressure, despite its tremendous popularity. There is concern about what the unintended consequences of this significant change may be, the bureaucratic burden that could be created by the extension of the CQC’s jurisdiction into event medicine and the cost, so I seek reassurance that Ministers are alive to these issues.

I want to raise a particular issue, which has also been raised by other noble Lords, about the possibility of exempting from registration the healthcare that is provided to athletes, performers and officials, as opposed to the healthcare provided to the public. I understand that that exemption exists already for treatment provided under arrangements between employers and employees, but not more widely. However, much medical provision might not be on an employer-employee basis and therefore would not be covered by the exemption. That would create an anomaly.

Ministers are of course right to draw attention to the importance of this issue, given the terrible events in the Manchester Arena nearly a decade ago, the awful loss of life and the very large numbers of people injured. But the extension of the CQC’s remit, as a consequence of the inquiry’s recommendation, was precisely to improve healthcare provision for the public. I am not aware that there was any perceived problem with healthcare provided for athletes and competitors—a much narrower group of people. That was not, of course, what the inquiry was thinking about when it proposed this extension, but the extension at the moment covers them, so there may be significant unintended consequences.

We know that one survey suggests that over a third of the doctors who currently provide medical cover for racing may not continue if required to register, because of the bureaucratic burden. There is obviously a tremendous reassurance job that has to be done, at the very least, but it seems that we also need to address the fundamental issue. I wonder whether the Minister would accept that there is a difference between the care that is provided for the public, which is what the inquiry was all about, and the arrangements for athletes and competitors, which are different and where there was not a problem that needed to be addressed. However, accepting that an event healthcare standard is a good thing, and that Ministers will look at the potential for exempting from registration healthcare provided for athletes, performers and officials on that basis, this instrument would seem to be commonsensical.

[Lord Addington (LD)]

My Lords, this is one of those debates where you think, “Who do I disagree with?” I am afraid that I have not disagreed with anything from anybody. As I speak for my party, it is important for me to restate that things went wrong with the treatment of the Manchester Arena disaster. We should do something about it—that would be great.

The problem here is that we seem to have gone far too wide. As the noble Baroness, Lady Finlay, asked, how far down do you go when covering an event? For instance, for small rugby union clubs—my own sporting background—you are lucky if there are three men and a dog watching. That is your crowd, but a local cup game could have a couple of thousand. Where does that support structure kick in? That is something that all amateur sport will confront from time to time. This is merely the first opportunity for the Minister to correct these perceptions. We need to have some cut-off points, going from when it is enough simply to have a first-aider within earshot to when we need better medical support and structure. When that changes and how they interact is really what the discussion here is about.

When it comes to sport, please let us not do anything that stops sporting events happening. There is a fear that we will do so inadvertently by providing a greater bureaucratic burden on providing help. We hope that the Government will not do that. I hope that the Department of Health will not do something that will make the country intrinsically less healthy. That is really what we are looking at.

Let us look at other specialist events. This is not an interest, but I live in the village of Lambourn so, even if I did not want to be, I am very aware of things to do with equestrian sport and particularly races. Anything to do with horses is intrinsically dangerous; indeed, we have a rehabilitation centre for neck and back injuries in Lambourn. When it comes to racing, as my wife has often pointed out to me, there are not many events when an ambulance follows you down the course as you are taking part—so there are structures there. If something that organised is raising concerns—it is not because they want it to be there but because it has to be there—there might well be something worth listening to. We must make sure, when we deliver this, that we do not throw the baby out with the bathwater and that good intentions are erased out. We should go through all those things.

The Government need to start doing something to get better information out there about exactly what they are doing, where the barriers are and what will happen. A series of meetings might help—possibly with parliamentarians and certainly with larger groups—and they should get the information out quickly. It will dramatically help to let the information out in dribs and drabs—as and when they see fit as they go forward—setting out their intentions, and we will bring in stuff behind it. That way, if there is a real fault-line here, as opposed to a fear of one, we will find out. Then we can start to do something about it.

Can the Government give us something that reassures us on our worries about the extra bureaucratic burden, given that people are terrified? They are one newspaper report and a few tweets away from people having a panic about everybody being sued every time anybody gets cuts in an amateur football game. What are they doing? Where are the structures going? That is what is required here.

We all want the big events to be safer, but they will have got it wrong if they apply this to an open mic night at a pub and a Sunday league football game at the same time. We must make sure that people know where those fault-lines are. The exemption for people taking part in sports events is a no-brainer. Can we make sure that this happens and that people know about it? It is clear that they do not, at the moment, and that is a fundamental flaw in the Government’s approach.

[Lord Kamall (Con)]

My Lords, as other noble Lords were declaring their interests, I thought, “Oh, that’s good; I have no relevant interests”. But, the last time I thought that, a number of people tweeted at me for not declaring my interests, so I will bore all noble Lords with them. I am a professor of politics and international relations at St Mary’s University, Twickenham. I teach an MBA module on healthcare policy and strategy. I also work with the medical school that it is starting and have started co-operating with colleagues in the Faculty of Sport, Technology and Health Sciences. I also teach at the University of Buckingham, but I have no contact with its medical school. I just wanted to touch all the bases.

I thank the Minister for setting out these draft regulations in her usual clear manner. Obviously, they arise from the tragic events of the Manchester Arena attack and the subsequent inquiry. Like other noble Lords, my heart goes out to those who were affected; we offer our condolences to the victims and their families, some of whom are probably still in a state of bereavement. Clearly, that inquiry called for a review of healthcare provision at events, as well as clearer standards for public safety, which I think everyone who has spoken is in favour of.

Most of the people who have contacted us said that they support the principle that those attending sporting and cultural events should have access to safe, high-quality medical care—there is no disagreement there—but the question before your Lordships is one not of principle but of implementation and delivery. It is right, therefore, that the detail be scrutinised carefully.

In removing the previous exemption and requiring providers of event healthcare to register with the CQC, the SI clearly extends the CQC’s regulatory remit to a sector that is complex and, in many cases, heavily reliant on volunteers and small providers. You cannot just transplant knowledge from the hospital or mental health sectors into sports events; noble Lords have referred to the range of events that would be covered. This removal, while understandable, has given rise a number of concerns—I am sure that the Minister has heard them—among, but not limited to, small organisations and volunteer-run sports clubs. Like the noble Lord, Lord Addington, I share the concerns of the noble Lords on different Benches who have spoken. There is no disagreement here.

The department’s own impact assessment acknowledges the increased costs associated with registration and ongoing compliance, but one of my concerns arose when I saw the estimate for the registration fee. It said that, for newly regulated providers, it will be between—

Learning Disabilities: Health and Social Care Access

Lord Addington Excerpts

Thursday 26th March 2026 Grand Committee

[Lord Addington (LD)]

My Lords, the most depressing thing about this debate is that it has been decades since I first spoke in a debate that pointed out that anybody with a learning disability or autism will have very bad health results and die early. That is an established fact. My noble friend said that you cannot change the past, but let us at least learn from it. We have been doing this for a long time with various Governments.

It turns out that our medical system is based on somebody telling a medical professional what the matter with them is by responding to certain, usually verbal, stimuli. Any group that has not been able to do that has always suffered badly. For example, it is an established fact that people using sign language have suffered badly. If we are going to do something about that, we will have to make some reasonable adjustments—that is the expression we are using here. If we do not do that, we will continue to get bad results because the medical profession will get involved only when something becomes obvious. We have all been told, again and again, “You should have seen a medical practitioner sooner”. We are guaranteeing that that will happen here if we do not find a way to assess those needs and get in earlier.

For anybody who has a communication problem or is communicating through one person that is going to be worse still. An example is the fear of an individual, usually a parent, who thinks, “What happens to my child with a disability when I’m not around?” The emphasis on that has been made very clear. It might be another relative who is doing the caring or somebody else. According to everything that we have heard today, they are quite right to be frightened when they are going through that.

We also have a system that has a series of flags coming up. As my noble friend pointed out to me, it is great having a flag, but what do we do when we see it? Until we get that ingrained in the training and structure—indeed, until somebody’s life is made more than a little unpleasant if they are not doing it—we will not get change. Every time we have a system that works in a certain way and we want to deviate slightly, what is required is to play the system and get around it.

I will repeat another bit of black humour. It is often said that the first thing a disabled child who wants to do well should do is to choose their parents carefully in order to give them that advantage. I am afraid that that still applies. What are we doing to make sure that when we have a system in place, action is taken? Then, if we have a system in place, are medical professionals told—even if they are not trained to do it themselves—how to communicate with somebody with autism who takes things very literally? How do we get that information out to them? If the patient has certain types of learning difficulties, how do they get in touch with somebody to receive health checks? Those checks normally depend on tick boxes, so how do we avoid that? How do medical professionals extract information from that person, given that we depend on their assessment of their health? If they cannot do it, a prolonged examination will be needed. All of that is clear. If you follow it through, there is an iron logic to it, and it has not changed. It is an accepted system.

I will ask the Minister a few questions. On the flagging system, what is the process to make sure that people react to flags? Where would a medical professional go to get help interpreting and extracting information from a person who has certain types of communication or perceptual difficulties? That is particularly the case if the parent or carer is not readily available. Is there a process? If not, there should be because we are guaranteeing more failure if we do not have one.

These are the things that we have come back to over and over again for years. They have been said with more eloquence and knowledge than I can manage today. Unless the Government can start to address this, we will come back to this subject again in a new form because nothing will have fundamentally changed. I hope this Government will at least move this project on because, let us face it, it is well overdue and needs to be given a good hard push, or even a kick.

Learning Disabilities Mortality Review Reports

Lord Addington Excerpts

Thursday 13th November 2025 Lords Chamber

[Baroness Merron (Lab)]

I understand the point that the noble Baroness makes—it is quite right. We will continue to take account of and work to support parents and those they care for in the way that she describes. Certainly, I will also discuss with the Minister continuing the work with the organisation to which she refers.

[Lord Addington (LD)]

My Lords, to slightly widen the Question, would the Minister look at the fact that anybody who has a communication problem has historically had very bad results, compared with the rest of the population, when dealing with the National Health Service? Those with a hearing impairment would be a classic example. Will the Government have a good look across the whole spectrum of those who have some form of communication difficulty and try to get those medical professionals briefed in different forms of communication for that very important interview?

[Baroness Merron (Lab)]

Again, I certainly accept the important points that the noble Lord is making. It is unacceptable that there are health inequalities and poorer life outcomes. Indeed, action could be taken. That is why our 10-year health plan recognises these inequalities and identifies particularly those with disabilities as a priority group for more of that holistic, ongoing support. Key to that will be the development of neighbourhood services, where such groups will be prioritised.

Support for Infants and Parents etc (Information) Bill [HL]

Lord Addington Excerpts

2nd reading
Friday 6th September 2024 Lords Chamber

[Lord Addington (LD)]

My Lords, sometimes, when you deal with a certain piece of legislation, you get the feel that it is very close to a finished and polished article, and that is what I get here. Thought has clearly gone into it. It is not trying to reinvent the wheel. Although all politicians have that Christmas tree urge to ask, “What can we stick on this?”, I encourage noble Lords to resist on this occasion; the decorations are fine. We must make sure that we can get this through. If the Government are willing to accept this, which I hope they will be, they will be doing a good thing, and they are not doing something that costs a lot. The Bill is merely bringing together everything the Government are doing and letting those who should access them know.

As has already been mentioned, there are different groups of people. Those who most need to know what support is there are those least likely to look for it or to understand it. I am afraid that that is a circle we have not yet squared, but it is true. However, if you have it in one place, you stand an infinitely better chance of doing it, or allowing those who are trying to support them to do it. This is something that this Bill addresses, so that people have a chance of finding the support that is out there.

The noble Lord, Lord Meston, added necessary cold water in saying that there is a group of people who have persistent problems. The noble Lord, Lord Bird, used the word “concatenation”; I had no idea it existed, so it has expanded my knowledge. Everything he said was right. He described this as a brick in the wall to build something better. Although I would have said that it is a bit of the foundations, I agree that it is a good thing.

I could go on at considerable length on this, but I will resist that temptation. Anything that has guidance coming out to deliver it and the Secretary of State reporting back afterwards in order to make an asset to be used in all these things has to be positive. I think that anybody who has been involved in any part of politics or government knows that we have bits of government going off at tangents and not talking to each other.

I hope that the Government will give a positive response to this and tell us the timetable so that we can all cheer it on the way through, because it is good. It will not solve all the problems of the world, but it might be that little bit of foundation of doing things a bit better. I wish the Bill well and look forward to the Government’s response and to the assurance that they will make sure that it becomes law.