Health and Care Bill

Debate between Lord Patel and Lord Lansley

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

[Lord Patel (CB)]

My Lords, I support all the amendments in the name of the noble Baroness, Lady Cumberlege. She introduced them very comprehensively and I agree with what she said. My noble friend Lord Stevens of Birmingham added to it, so much has already been said and I need to be extremely brief.

I concur with my noble friend Lord Stevens of Birmingham that outside bodies, including professional organisations in medicine, oppose these powers and that they will lead to more chaos rather than solving problems. As a clinician, I find the unchecked powers for Secretaries of State over local service reconfigurations that the Bill proposes astounding. Local service reconfigurations should be driven by clinical advice and expert assessment of what services are needed to meet the health needs of a local community with patient safety at the heart, as well as considerations about what resources are available in terms of workforce, infrastructure and the proximity of alternative services.

The powers in the Bill would allow the Secretary of State to initiate service changes without any consultation. How can any Secretary of State feel sufficiently qualified to be making unilateral judgments about what constitutes “safe”? The existing, largely successful, processes, which have already been mentioned, take account of clinical advice and the views of local communities in the final decision have been effective. The noble Baroness gave the example of Kent and Medway stroke services, which were held up by the Secretary of State, not by the consultation. I strongly support these amendments and I hope that the Minister will think about removing the provisions from the Bill.

[Lord Lansley (Con)]

My Lords, I shall be brief. I put my name to Clause 40 stand part, and I think that is the best way to go. I shall add one or two things. First, as Secretary of State, I asked the now noble Lord, Lord Ribeiro, to lead the independent reconfiguration panel, and I never had cause to regret doing so. Secondly, I can say something which other noble Lords cannot, because I am on this side, and I am hoping that we continue to have Conservative Secretaries of State for many years hence. They will be much better off if they do not do this. If the Government take Clause 40 out, they will equally not regret doing so.

Professional Qualifications Bill [HL]

Debate between Lord Patel and Lord Lansley

Committee stage
Monday 14th June 2021 Lords Chamber

[Lord Lansley (Con)]

My Lords, I am very glad to follow the noble Lord, Lord Fox. Like him, I was moved to draft Amendment 56 not least by the report of the Delegated Powers and Regulatory Reform Committee, which at the end of its consideration of Clause 3 said that it

“represents an inappropriate delegation of power and should be removed from the Bill.”

The noble Lord was not proceeding entirely on his own initiative, and I entirely recognise where he is coming from.

I am coming from this as a Member of the International Agreements Committee. We are looking at many of the negotiations taking place between ourselves—now as an independent trading state—and other countries in creating international agreements. I do not personally see the world as divided into trade agreements and other agreements. We are increasingly entering into economic partnership agreements where, to be frank, the issue of services and the mobility of professionals should rightly play an increasing part in the economic partnerships that we forge with other countries. I want to see us enter into frameworks with other countries whereby our professionals can work there, and their professionals can work here. That will be, as trade often is, to the benefit of all parties.

On that basis, I considered whether this may be like the Trade Bill, in which we effectively gave Ministers the regulatory power to amend legislation and bring it in line with the continuity agreements we enter into. The conclusion I reached is that it is not like that; these are new agreements, not continuations of old ones. From our point of view, as a committee charged under CRaG with the scrutiny of new agreements, we are only too aware that this House has no capacity to block such a treaty, and no capacity to amend it.

Where secondary legislation is concerned, the House may have the power to stop statutory instruments, but in this territory, frankly, we would enter very difficult terrain. We would end up with our Government having signed an agreement with another country, intending to be bound by it under international law—indeed, it may have come into force—and, at that point, this House would have to consider its implementation in legislation. It seems to me, therefore, that the remedy of deleting Clause 3—and so requiring that every time Ministers want to implement an international recognition agreement in legislation, they have to do it in new primary legislation—is asking too much. As time goes on, there will clearly be framework international recognition agreements under which Ministers will regularly, or maybe frequently, need to change the secondary legislation affecting a range of professions and regulators.

My thinking was that we should—as we often do—allow Ministers the power to change the statutory instruments and secondary legislation relating to new international recognition agreements, but not the power to change primary legislation. That is why, instead of changing Clause 3 itself, Amendment 56 amends the regulation clause at the end, Clause 13, and would provide that the power in Clause 3 to implement international recognition agreements is a power to modify subordinate legislation but not primary legislation; that would be the effect of Amendment 56. Noble Lords may support the noble Lord, Lord Fox, and others in opposing Clause 3, but—if they share my belief that we will often be in this this territory, with Ministers having to change secondary legislation and much less frequently primary legislation, and that, when they do, they should secure the consent of the House, with our ability, as ever, to insert amendments, conditions and caveats, as well as sunshine clauses and so on—then they should in due course consider an amendment on the lines of Amendment 56 to strike a better balance, giving Ministers power but not a Henry VIII power.

[Lord Patel (CB) [V]]

My Lords, to start, I do not agree with the amendment tabled by the noble Lord, Lord Lansley. I clearly understand the point that he is trying to make; in fact, I have my name down with others to strike Clause 13 from the Bill, but we will come to that.

I will say in a minute why I do not agree with the noble Lord’s proposition but I do agree with that of the noble Lord, Lord Fox, and, absolutely, with his argument. It was clear from the comments of the Delegated Powers Committee that it considered this clause unnecessary. I personally think this is the key clause of the whole Bill; all the other clauses revolve around it.

Professional Qualifications Bill [HL]

Debate between Lord Patel and Lord Lansley

Committee stage
Wednesday 9th June 2021 Lords Chamber

[Lord Lansley (Con)]

My Lords, I am glad to have the opportunity to follow the noble Baroness, Lady Bennett of Manor Castle. She was right to say that we will probably need to think a little further about the subsequent scrutiny arrangements for the operation of this legislation. I fear that the amendments we have at the moment probably do not do it.

Perhaps with the exception of Amendment 54, they all suffer from the difficulty of proposing subsequent scrutiny of the impact of this legislation on issues which will themselves be impacted by a wide range of other legislation, administration and circumstances. It is difficult to isolate the impact of this legislation in particular. When we re-examine it we should, if not legislating, certainly be looking to Ministers to say that we should focus on understanding how it is working after a suitable period. One of the conventional processes would be five-year, post-legislative scrutiny. That would probably be the appropriate route down which to go.

I want to say a word about the issue of consultation, which came up under the previous group. There are a number of amendments in this group, but I am pretty sure that the proposers of Amendments 25 and 29 will recognise that they do not provide appropriate consultation opportunities. If there is a mutual recognition agreement in an international agreement with another country, it will have been subject to its own consultation arrangements. To have another consultation on the regulations to implement it would be inappropriate. It is also inappropriate and unnecessary to consult on regulations simply to get rid of the existing EU directives or retained EU legislation.

Turning to Amendments 14 and 19, in both instances there is a good case for consultation. I am not sure whether it needs to be legislated for in statute, but we too often assume that there is a public law duty to consult when there is not. It may be better to have a statutory duty to consult even if it is framed, pretty much as these provisions are, in broad and general terms, just to ensure that Ministers go through the appropriate processes at the right time. I am quite supportive of Amendments 14 and 19 for these purposes, particularly Amendment 19.

We had a previous discussion about demand. You cannot look at demand for professional services without actually asking consumers, so making sure that consumers are consulted in the process would be a good approach. I hope that Ministers will at least look at whether there is a place for a statutory duty to consult on regulations under Clause 1, and on the question of demand for professional services being met.

[Lord Patel (CB) [V]]

My Lords, I will speak mainly to Amendment 53 in the name of the noble Lord, Lord Fox. I had hoped that he would speak before me, so I could hear his views on the amendment, but I support its intent. I might have some reservations regarding whether a report should be made within 12 months or a longer period, as others have mentioned. I also agree with the noble Lord, Lord Lansley, that it is not a question of the impact on innovations of this Bill alone, but the cumulative impact of other Bills, to which this one might add. That is the issue I wish to explore.

The United Kingdom has a big ambition to be a science superpower, as has been said many times by our Prime Minister. In fact, he is the second Prime Minister, including Harold Wilson, to have mentioned science as a driving force for the United Kingdom and the UK’s leading in science. So, we have a great ambition: we are going to invest 2.4% of GDP by 2027 and, depending on the spending settlement to be announced shortly, it looks as though there will be £22 billion for R&D leading up to 2024. A significant amount of resources is being put in. So, what drives innovation? The drivers of innovation are research infrastructure; funding; importantly, career development opportunities for early-career researchers—I emphasise early-career; and collaboration and knowledge exchange through institutions in different countries working together.