Data Protection and Digital Information Bill

Debate between Lord Davies of Brixton and Lord Kamall

Committee stage
Wednesday 20th March 2024 Grand Committee

[Lord Kamall (Con)]

My Lords, I rise to speak in favour of Amendments 1 and 5 in this group and with sympathy towards Amendment 4. The noble Lord, Lord Clement-Jones, will remember when I was briefly Minister for Health. We had lots of conversations about health data. One of the things we looked at was a digitised NHS. It was essential if we were to solve many problems of the future and have a world-class NHS, but the problem was that we had to make sure that patients were comfortable with the use of their data and the contexts in which it could be used.

When we were looking to train AI, it was important that we made sure that the data was as anonymous as possible. For example, we looked at things such as synthetic and pseudonymised data. There is another point: having done the analysis and looked at the dataset, if you see an identifiable group of people who may well be at risk, how can you reverse-engineer that data perhaps to notify those patients that they should be contacted for further medical interventions?

I know that that makes it far too complicated; I just wanted to rise briefly to support the noble Lord, Lord Clement-Jones, on this issue, before the new rules come in next week. It is essential that the users, the patients—in other spheres as well—have absolute confidence that their data is theirs and are given the opportunity to give permission or opt out as much as possible.

One of the things that I said when I was briefed as a Health Minister was that we can have the best digital health system in the world, but it is no good if people choose to opt out or do not have confidence. We need to make sure that the Bill gives those patients that confidence where their data is used in other areas. We need to toughen this bit up. That is why I support Amendments 1 and 5 in the name of the noble Lord, Lord Clement-Jones.

[Lord Davies of Brixton (Lab)]

My Lords, anonymisation of data is crucially important in this debate. I want to see, through the Bill, a requirement for personal data, particularly medical data, to be held within trusted research environments. This is a well-developed technique and Britain is the leader. It should be a legal requirement. I am not quite sure that we have got that far in the Bill; maybe we will need to return to the issue on Report.

The extent to which pseudonymisation—I cannot say it—is possible is vastly overrated. There is a sport among data scientists of being able to spot people within generally available datasets. For example, the data available to TfL through people’s use of Oyster cards and so on tells you an immense amount of information about individuals. Medical data is particularly susceptible to this, although it is not restricted to medical data. I will cite a simple example from publicly available data.

Draft Mental Health Bill

Debate between Lord Davies of Brixton and Lord Kamall

Tuesday 28th June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble and learned Lord makes an important point. I am very much aware of today’s earlier discussion, when I was smiling, perhaps over-smugly, thinking, “At least we’ve got pre-legislative scrutiny.” However, I accept the noble and learned Lord’s point that it has to be proper pre-legislative scrutiny. I hope he will forgive my lack of experience on this. I am not yet aware of the difference between good and thorough pre-legislative scrutiny and brief pre-legislative scrutiny, so I will have to take this back to the department and will write to him and others.

[Lord Davies of Brixton (Lab)]

We thank the Minister for the draft Bill. Although it is on the law of mental health, it has clear financial implications and so a specific commitment to provide the resources to implement the changes in the law would be valued. In addition, however, given the agreement that there is about what will be in the Bill, what steps are the Government taking to get it implemented straightaway? There are so many proposals in Sir Simon Wessely’s report that could be implemented immediately, so I hope the department is pursuing that proactively.

It is important to understand a bit of the context here. We are heading into financially difficult times. We know that there is a close connection between people’s personal financial problems and mental health and that there will be an increasing level of indebtedness, which automatically means greater need for services. Maybe the Minister can reassure us that the resources will be there to carry out what is in the proposals.

[Lord Kamall (Con)]

The noble Lord makes an incredibly important point. We have seen the impact that the pandemic has had on mental health across all age groups. During the Health and Care Bill, the noble Lord and many others raised the issue of parity between mental health and physical health, and I thank him for that. That brought home that the current legislation is out of date, which is why we really need to update it. I also thank noble Lords who have spoken so far for agreeing that this is not a party-political issue at all. We all want to address this issue, and maybe the issue of funding will come up. The Government remain committed to achieving parity between mental and physical health services to reduce inequalities. We are making good progress; investment in NHS mental health services continues to increase each year, from almost £11 billion in 2015-16 to £14.3 billion in 2020-21. We expect all current CCGs—and ICBs once operational —to continue to meet the mental health standard, and we have made a number of amendments. We are investing more than £400 million over the next four years to eradicate mental health dormitories. Clearly, as we go through the Bill, there will be financial implications, which will be considered as we debate it. I cannot give a clear pledge on which measures will be implemented until we have seen the Bill. Clearly, however, we understand that a lot of this is long overdue, so the quicker we can get this done and come to an agreement satisfactory to all sides of the House, the sooner we can get on with implementing it.

Integration White Paper

Debate between Lord Davies of Brixton and Lord Kamall

Thursday 10th February 2022 Lords Chamber

[Lord Davies of Brixton (Lab)]

My Lords, the one thing I admire about the document is the way in which the meaningless term “levelling up” has been shoehorned into the text. I want to raise the bundle of issues which have been grouped under the heading of parity of esteem between physical and mental health. It is not an issue we need just to have in the back of our minds; it needs always to be front and centre in the development of policy. More could be covered than is in the White Paper. One of the examples given in the White Paper is of Mandeep. It is well chosen. It is a case of someone with mental health problems and diabetes where there is a success to point to: where joined-up working has reduced the differential in suffering from diabetes experienced by people with and without mental health problems. That is a good example of what can be achieved. I hope that parity of esteem will be central in what the Minister is doing.

[Lord Kamall (Con)]

I thank the noble Lord for raising the issue of mental health and parity of esteem, not only here but in our debates on the Health and Care Bill, and for our continuing conversations. We hope that we will be able to find a solution to make sure that mental health has parity of esteem. In previous Bills, health has meant physical and mental health, but I recognise the mood of the House when noble Lords ask for it to be stated explicitly somewhere, even in the triple aim. We are looking at solutions for that. He is absolutely right that it is not just about physical health; it is about mental health, about well-being, about tackling inequalities and about disparities. However, we cannot do that from here. We have to make sure that the place-based organisations, working in partnership with integrated care systems, really understand what is happening locally and are best placed to do that.

Covid-19: Lockdowns

Debate between Lord Davies of Brixton and Lord Kamall

Wednesday 9th February 2022 Lords Chamber

[Lord Kamall (Con)]

Had I still been in academia and was asked to referee this paper for a journal, I would have pointed out a number of issues, including the focus and bias on one particular study, for example, and the studies that were excluded without justifying why.

[Lord Davies of Brixton (Lab)]

My Lords, I understand that the rules on replying to Questions mean that there is not enough time for the Minister to explain everything which is wrong with this particular paper. Does he agree that it would be useful to draw your Lordships’ attention to the work of the Science Media Centre, which has provided a comprehensive explanation of its deficiencies?

[Lord Kamall (Con)]

If the noble Lord would like to write to me with details of that paper, I would be happy to share it with other noble Lords.

Health and Care Bill

Debate between Lord Davies of Brixton and Lord Kamall

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

[Lord Davies of Brixton (Lab)]

My Lords, I just want to contribute to this debate. I fully support the remarks of my noble friend Lady Thornton. I was particularly struck by her dissection of this Government’s totally preposterous claim to have a plan for social care. They do not have a plan. All they have is a regressive tax and a broken promise.

I am tempted by the remarks of my noble friend Lord Lipsey to enter into a broader debate on these issues. Clearly, this issue is not going to go away. This is not the end and the issues that were raised will come back again and again until we move towards something fairer and more comprehensive. I cannot resist saying that I am unconvinced that deferred annuities will have any part in any sort of mass market provision of care. As a product, they are fatally flawed, in my view.

My noble friend’s remarks also made me think of the extent to which this debate is taking place while ignoring the key factor in these issues, which is housing or, rather, property management. That is really what we are talking about, but we do not mention it in the context of these debates, which is unfortunate. I am glad my noble friend raised these issues. However, I think the substantive point this evening is the imperative of sending this clause back to the Commons where they can reassess it with greater time than they were allowed initially.

Finally, I just want to highlight the revealing and outrageous statement by the Minister in the Commons, Mr Argar. He said the Government

“have always intended for the cap to apply to what people personally contribute, rather than on the combination of their personal contribution and that of the state.”—[Official Report, Commons, 22/11/21; col. 110.]

I do not believe that means-tested benefits are any more money being given by the state than my pension that I get from the national insurance scheme. It is outrageous to cast people as, in a sense, recipients of charity. It is their rights as citizens to have this money, and it is their money; it is not the state’s money. It reveals the Poor Law mindset of this Government.

[Lord Kamall (Con)]

My Lords, I understand the concerns about the lack of debate in the other place on this issue. The Government are putting in place a package of reforms to be implemented in 2023. The introduction of the £86,000 cap on costs is part of a package through which we hope that no one will lose out when compared to the current system. I will get the source that the noble Baroness, Lady Thornton, asked me for. I think that is a reasonable question.

The Government believe that having the cap in place allows people to balance their personal responsibility of planning for later years and puts in place a system where we hope that no one faces unpredictable care costs. Without Clause 140, two people with the same level of wealth, contributing the same amount towards the cost of their care, could reach the cap at very different times, driven not by how much they are spending on their care but how much the local authority is. We wanted to address that perceived unfairness.

Instead, the Government made the decision to offer the same cap for everyone. However, the cost for people with more modest means will be reduced in two important ways: first, through means-tested support, including for those living in their home. This kicks in as soon as someone’s assets fall below £100,000, potentially right from the start of their care journey. We chose to offer the same threshold for means-tested support, no matter where somebody draws on care, because we want to support and encourage people to be able to stay in their own homes whenever they can. That was an ambition set out in our White Paper, People at the Heart of Care.

Covid-19 Update

Debate between Lord Davies of Brixton and Lord Kamall

Monday 29th November 2021 Lords Chamber

[Lord Kamall (Con)]

My noble friend will be aware of the constant debate that there has been in the public sphere about the effectiveness of masks, when they are effective and who is affected. Therefore, we have always followed scientific advice on the wearing of masks and where would be most appropriate. We know that many noble Lords and others have called on us literally not to let the masks slip, as it were, and to make sure that people continue to wear masks. There have been others, however, asking why people still need to wear masks. We have always been vigilant, and the fact that we now have this new variant means we are taking a precautionary approach. We will continue to review it and it could well be that, in three weeks’ time, we will see how dangerous it has been and how effective mask wearing has been in the places that we have specified.

[Lord Davies of Brixton (Lab)]

My Lords, it is now recognised widely that none of us is safe until we are all safe, leading to the conclusion that we need a worldwide vaccination programme. However, there is mounting evidence that populations that are immunocompromised, especially people living with HIV, provide a particularly ideal environment for the mutation of the virus. Does the Minister accept that we must therefore contemplate the possibility of having a global programme of antiretroviral medicine as part of our response to Covid?

[Lord Kamall (Con)]

I thank the noble Lord for the point he just made. If he will allow me, I will take that back and try to get an answer for him.

Health: Type 2 Diabetes

Debate between Lord Davies of Brixton and Lord Kamall

Tuesday 12th October 2021 Lords Chamber

[Lord Kamall (Con)]

I first thank the noble Lord very much for his warm welcome and his modest appraisal of my performance thus far. I am told that, coming from him, that is high praise indeed; he may disagree afterwards. As he knows, the Government are committed to this, but one thing we always have to look at in introducing new laws, bans or taxes is unintended consequences. Before I came to this role, I read some research which said that there were unintended consequences of some of the sugar taxes; for example, did they force people from poorer families or poorer communities to buy alternative, cheaper brands of the same drinks with the same sugar content, or did they just take the hit to their pockets and pay more? Were the outcomes any better? When looking at some of the programmes being put in place to tackle type 2 diabetes and the taxes proposed, it is important that we make sure it is all evidence-based and work out whether there are unintended consequences. If there are, we must find other ways to make sure we tackle obesity and some of the other issues that lead to type 2 diabetes.

[Lord Davies of Brixton (Lab)]

My Lords, the figures in the report are shocking, so I hope the Minister understands that with diabetes, as much as or more than other conditions, there is a need for close and consistent monitoring, not just for the patient’s sake but to avoid greater subsequent demand on the NHS. Is he therefore concerned by reports that in too many areas the essential regular reviews of patients’ conditions are simply not happening because of pressure on clinics or even a shortage of the equipment required to undertake the necessary tests?

[Lord Kamall (Con)]

I take a personal interest in diabetes; I have two very close family members with diabetes, one type 1 and one type 2. I noticed during the Covid lockdown the different approaches in meeting their clinicians—telephone calls rather than meeting in person, and reviewing their charts and sugar graphs over time, which is regularly done at these reviews. I agree completely that it is really important that we now try to address this backlog as much as possible. I know that the Secretary of State is committed to making sure that, with the uplift, we try to tackle as much of the backlog as possible, including for patients with type 2 and type 1 diabetes.