Queen’s Speech

Lord Ribeiro Excerpts

Thursday 29th June 2017 Lords Chamber

[Lord Ribeiro (Con)]

My Lords, the election was announced two weeks after the publication of the Select Committee report on The Long-term Sustainability of the NHS and Adult Social Care, thus denying the House the opportunity for an early debate on the report. It became clear during the evidence taking that social care was impacting on the performance of the NHS. The ageing population presents the greatest challenge to the nation and, between 2015 and 2035, the number aged over 75 is projected to increase by 70%.

The gracious Speech identifies the need to improve the social care system and to put it on a more secure financial footing. The committee considered the funding options for social care and looked for examples around the world. In Japan, citizens aged 40 and over pay income-related premiums along with public health insurance premiums. Germany has a similar system, where the principle is that the costs are shared between the employer and the employee, similar to the workplace pension scheme in the UK. We should encourage those who can afford it to make provision for their long-term care and, in particular, social care, and not continue with a system that looks to the state to always pick up the tab. The Minister may wish to say something in relation to the consultation. As recommendation 23 of our report says:

“The Government should also implement as quickly as practicable, and no later than the first session of the next Parliament, new mechanisms which will make it easier for people to save and pay for their own care. The Government should, in the development of its forthcoming green paper on the future of social care, give serious consideration to the introduction of an insurance-based scheme which would start in middle age to cover care costs”.


These are important questions that need to be dealt with and answers provided.

Public health and prevention gets little press in the world of high-tech medicine, but a recent analysis by the Faculty of Dental Surgery at the Royal College of Surgeons should give cause for concern. It shows that there has been a 24% rise in the number of tooth extractions performed on children under the age of four in hospitals in England during the last decade. This is the first time such a long-term study has been done for children under four. Professor Nigel Hunt, the dean of the dental faculty, appealed to parents and the Government to take stronger action over the effects of sugar on our children’s teeth. He noted that the average five year-old eats his or her own weight in sugar in a year. The sugar tax, much derided by the food industry as a nanny-state tax, was introduced in the Budget this year to combat childhood obesity and tooth decay. The Chancellor described it as one tax which will actually reduce revenue. It seems that the threat of the tax and the Government’s legislation on the soft drinks industry levy, due for implementation in April 2018, has already altered behaviour and the food industry is reformulating its products and reducing the sugar content. I hope that the Minister will say more about this and what plans they have to restrict sugar and promote the use of fluoridation nationally to reverse dental caries and prevent obesity and type 2 diabetes.

On health, the only planned piece of legislation that I came across in the gracious Speech is the draft patient safety Bill, mentioned by the Minister in his opening speech. In July 2015, the Secretary of State for Health, Jeremy Hunt, announced the creation of the Healthcare Safety Investigation Branch, or HSIB, modelled on the successful Air Accident Investigation Branch used by the airline industry. The no-blame culture which that has cultivated has encouraged and led to a learning culture which has significantly reduced air accidents. The Secretary of State hoped that the HSIB would do the same for health but, despite starting in April this year, it lacks legal powers. In order to encourage staff to share information more freely with HSIB, it needs a safe space which prohibits the disclosure of information. People have challenged this, but if we want NHS staff to speak freely, we need to give them that opportunity to do so without the risk of litigation.

The current ministerial directions for HSIB do not make provision to override existing legislation, which would allow organisations such as the police, coroners and other professional regulators a power to compel disclosure of information. The HSIB’s chief investigator, Keith Conradi, recently came here to the House to give a briefing on what it is doing and has asked for primary legislation to secure HSIB’s independence. I know that my noble friend the Minister was at the meeting when that presentation was given. Can he say what the timeline is likely to be for the draft patient safety Bill, mindful that we now have a two-year Parliament? When can we expect the HSIB to have the same legal powers as the police and coroners?

Finally, I have a word about the Private Member’s Bill on cosmetic surgery standards, to be introduced in July by my noble friend Lord Lansley. It would equip the GMC with the power to show on the specialist register which practitioners have the credentials to undertake cosmetic surgery and other procedures. In January 2017, the Royal College of Surgeons launched a new system of cosmetic surgery certification to help patients identify surgeons with the appropriate training and experience to perform specific procedures. The recommendations of the Keogh review on the regulation of cosmetic intervention in 2013, following the breast implant scandal, is long overdue. Can the Minister say when it can be implemented?