Health and Care Bill

Lord Ashton of Hyde Excerpts

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Flight (Con)]

My Lords, I support the amendment of the noble Lord, Lord Forsyth, but was asked at short notice by my noble friend Lord Suri to present his contribution. He makes the point that we humans look after animals and other living creatures with the highest levels of care—

[Lord Ashton of Hyde (Con)]

The normal convention in this House is that if a Member is not present at the beginning and end of a debate, they should not speak. It is not right to read out someone else’s speech.

[The Lord Bishop of Carlisle]

My Lords, I recognise and respect the integrity and passion that underlie Amendment 297. However, I rise to agree wholeheartedly and briefly with those noble Lords and noble and learned Lords who have already expressed their significant reservations about it.

There are two problems in particular with that amendment. The first has to do with the many contentious arguments for and against any legislation permitting assisted dying, some of which have already been mentioned. Tempting though it is to rehearse some more of those, I am conscious not only of the time but of the fact that they have already been presented recently and at length, as we have been reminded by the noble and learned Lord, Lord Mackay, at Second Reading of the Assisted Dying Bill here in your Lordships’ House. The ongoing process of that Bill, however slow it may be, should not be undermined. We have also been assured that this is not primarily what Amendment 297 is all about. I might add that the terminology of that amendment is unhelpfully vague. “Vague” is a word that has already been used more than once in the debate today. For instance, we might ask exactly what is meant by “terminally ill” or “medical assistance”.

The second problem, which has already been persuasively argued, concerns the attempted use of this Health and Care Bill potentially, if not directly, to change the law on assisted dying. The proper place for any amendment of this kind should be Committee on the Assisted Dying Bill, not Committee on this Bill, which would be subverted were this amendment to be accepted.

With regard to Amendment 203 in this group, whether or not it is deliberately linked, it is evidently concerned to address the holistic needs of those approaching the end of their lives, and that includes, of course, talking about death. That is something that we would all wish to encourage. However, there is again an issue of vagueness in the amendment, as in Amendment 297. For example,

“wishes and preferences for the end of their life”

could include almost anything, from repeated albeit futile chemotherapy, through bucket list wishes, to assisted suicide. Who decides, and how, that someone lacks capacity for engaging in a conversation about their holistic needs? Who is a “relevant person”, as we have just been reminded by the noble Baroness, Lady Finlay? Then, in proposed new paragraph (c), what does

“having regard to the needs and preferences recorded in such conversations”

actually entail?

Most of what is proposed in the amendment is already covered in End of Life Care for Adults: Service Delivery, NICE guideline NG142, which was published on 16 October 2019. Perhaps it would be simpler just to require healthcare professionals to meet the requirements of that guideline, which would address the heart of the amendment’s stated, and laudable, objective.

--- Later in debate ---

[Baroness Smith of Newnham (LD)]

My Lords, perhaps the Minister, in replying, can tell the Committee whether he will talk to the usual channels, especially since I note that the Chief Whip and the Deputy Leader are both in their places, about whether time could be made available for further discussion of the Bill that is extant. Because whatever the merits or demerits of assisted dying, this is not the Bill for such an amendment.

[Lord Ashton of Hyde (Con)]

My Lords, the noble Baroness, Lady Grey-Thompson, has been trying to get in for a while.

--- Later in debate ---

Clause 70 agreed.

[Lord Ashton of Hyde (Con)]

My Lords, I have got up twice today to ask people to be succinct. Front Benches and Back Benches have been very good at that, so I want to say thank you very much. I am very grateful.

House resumed.

Health and Care Bill

Lord Ashton of Hyde Excerpts

Lords Hansard - Part 2 & Committee stage
Monday 31st January 2022 Lords Chamber

[Lord Ashton of Hyde (Con)]

My Lords, before we resume the debate, perhaps I may point out that we went very quickly last Wednesday—many thanks for that excellent performance. The last group also went quickly. May I respectfully point out that we need to do nine and a half groups this evening? Once again, I ask noble Lords to acknowledge how much we still have to do on this Bill and adjust their contributions accordingly if at all possible.

[Baroness Bennett of Manor Castle (GP)]

My Lords, debate on this group was somewhat interrupted and I will remind everyone that we are talking about dental health. I will speak first to Amendment 224 in the name of the noble Lord, Lord Hunt and others, to which I attached my name. It calls for a statement from the Secretary of State on access to dental care at regular intervals.

This comes back to a point I have made again and again about the Secretary of State taking responsibility and being forced to come before Parliament to take that responsibility. The noble Lord, Lord Hunt, introduced the amendment clearly and I agree pretty well with everything he said. However, I will now start to disagree with him. I note that I am addressing a number of amendments on fluoridation that were signed by my noble friend Lady Jones of Moulsecoomb. Those who were paying attention before will note that her name was on the Annunciator as being in the other Committee Room when we started this group, so I am speaking on her behalf.

There is an interesting progression here because, if I had been asked to do that a few years ago, I would have been quite uncomfortable. Had I been asked a few years ago which Green Party policy I disagreed with, the one I would have questioned was our opposition to mass fluoridation. But I have been on a political and scientific journey since then and I have come to realise that fluoridation is one of those health measures and medical practices that came to be adopted because it seemed like a good idea, well before we did proper trials, work and consideration. As the noble Lord, Lord Reay, said, there is now increasing scientific questioning.

I do not want to go over the same ground as the noble Lord, Lord Reay, but will think about where we are and apply systems thinking to this. The fact is that, according to the Drinking Water Inspectorate, the number of people now willing to drink water from the taps in the UK has dropped from 90% in 1978 to 73% in 1998. To put it another way, one in four people now mistrust the water coming out of their taps and will not drink it.

We can see the impact of that if we happen to go into a supermarket. We see a great many people lugging large, often plastic, bottles of water. They are often people who are struggling to pay for that water, yet they are buying it because of their lack of trust in the water supply that is actually far healthier than what is in the bottles. I would urge them all to drink the tap water, which is the healthy option.

We have a real problem of trust—something we have seen in other contexts. This potential mass fluoridation imposed from the centre above is something that potentially could have a real impact on reducing tap water. The noble Lord, Lord Reay, said, “Well, people can’t afford it, so it’s the poorest who’ll be forced to drink the water”. But the evidence shows that many people who cannot afford it now—from more disadvantaged and BAME backgrounds and who suffer from many disadvantages—who are reluctant to drink that water. We have also seen these issues of trust around the Covid-19 vaccine. These issues could see real risks to dental health.

We also want to apply some real systems thinking. The noble Lord, Lord Reay, referred to the fact that Scotland has brought in some good, targeted programmes on dental health that help children learn to brush their teeth and address diet and the consumption of sugary foods that has so many other health issues. We know what happens in politics. We have a problem with tooth decay and the Government say, “Right, we’re doing fluoridation”. Where are we going to see the money, focus and attention on those targeted programmes that would reach the children who need it most?

Health and Care Bill

Lord Ashton of Hyde Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

Relevant documents: 15th, 16th and 19th Reports from the Delegated Committee, 9th Report from the Constitution Committee

[Lord Ashton of Hyde (Con)]

My Lords, before we commence proceedings on the Bill, I will outline the plan for today. We will shortly begin the eighth day in Committee on the Bill. There is no other business, but we will take a short break around 2 pm. We will sit until 7 pm. At the outset, I thank the staff of the House for supporting this additional lengthy Friday sitting, both those here in the Chamber and those who do the enormous amount of work that goes on behind the scenes to get the House up and running.

I fear that noble Lords know what I will say next. I do not want to deny the House the fullest chance to scrutinise this Bill. As over 40 hours have been devoted to that end, not even my fiercest critics could say that time for debate has been curtailed. However, we still have a lot of amendments to get through. I know, based on the experience of last Wednesday, that good progress can be made. I know that the Front Benches will work to ensure that their contributions are concise and to the point and I hope that all noble Lords will do the same.

We should perhaps bear in mind the late, great Nicholas Parsons and make our speeches without repetition, hesitation or deviation and perhaps for just a minute. This is a self-governing House, so all I can do is ask and implore noble Lords to respect the conventions and courtesies of the House to ensure effective and efficient scrutiny of this legislation.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, before calling the first amendment, I indicate that the noble Baroness, Lady Brinton, will be taking part remotely.

Clause 141: Provision of social care services: financial assistance

Amendment 237

Health and Care Bill

Lord Ashton of Hyde Excerpts

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

[Lord Sentamu (CB)]

Noble Lords might say that it was a long time ago, but it was debated. It is not as if this has never been debated properly. It went through all the processes and unfortunately the Bill was lost. Is this another example of once something is lost, you bring it back again and again? I do not want to be like a particular German Chancellor who lost an election and said, “This is really wrong, we must change the people.” Friends, we are a revising Chamber. We need a bit of humility about our position, and should not think that we can instruct the Secretary of State to bring in a particular Bill because time has been lost.

[Lord Ashton of Hyde (Con)]

My Lords, I detect a sense that the House would like to hear from the Front Benches, but I know that all noble Lords have a right to speak and that the noble Baroness, Lady Grey-Thompson, is very keen to say something. I am sure she will understand that the House wants to hear the Front Benches and that, if my noble friend wants to bring this to a vote, we should get on with it.

[Baroness Grey-Thompson (CB)]

My Lords, I have spoken numerous times about my opposition to assisted suicide for many different reasons. It is not, for me, about the sanctity of life. Not everybody who believes that the law should not be changed has strong faith. However, we are continually being asked to vote through the principle and think about the detail later. The devil is in the detail.

Detailed scrutiny is our role as a revising Chamber. The Commons has so many of its amendments guillotined. However, we have to take an issue such as this, which is about ending people’s lives, very seriously and we have to debate some of the detail. I know that the noble Baroness, Lady Meacher, feels strongly about this and I wish she had pressed much harder and much earlier for a Committee stage for her Bill. In an issue such as this, when we are talking about ending people’s lives, there should be hundreds of amendments, because it has to be debated properly.

I would like to briefly go on the record to thank the hundreds of people who have written in. We are really lucky right now that we live in a democracy and that people are able to freely express their opinions, whether we agree with them or not. Our role in the House of Lords is to deal with those people who write in. Lots of people from both sides have written to me. However, we must also be really careful in our language and not scare people into thinking that assisted suicide is the only option for them.



As a disabled person who sits in this Chamber with a red stripy badge, I have a huge amount of privilege. Many, many thousands—tens of thousands or more—of disabled people do not have privilege in respect of protection. This amendment and what it seeks to do will fundamentally change the political and societal landscape for disabled people. If people have not read it, they should look at the article by the noble Lord, Lord Shinkwin, this weekend about how disabled people are encouraged to think that they would be better off dead than live with an impairment. Even in this Chamber, we hear about things such as incapacity and incontinence and all the things that people fear. I push back on that, and I push back on the view that public opinion is overwhelmingly in support of this. On the Dignity in Dying website, 284,881 people have signed the public petition. On the Commons website, asking for a change in the law, 46,483 people have done so. That is not overwhelming public opinion.

I know the frustration of people who want to change the law. I can feel it; we hear it, and I admire the fact that the noble Lord, Lord Baker, says that we are a democratic Chamber. There are plenty on the outside who would not agree with that in terms of the way that we operate. This, however, is a constitutional matter. For all those arguing in favour of this tonight, I really look forward to them supporting my Private Member’s Bills asking for things such as good education, work, social care and access to trains, which are the things for which disabled people are arguing. This is not it: this is not the right time and not the right place. I do not support this amendment.