Prioritising Early Childhood: Academy of Medical Sciences Report

Lord Rooker Excerpts

Monday 11th March 2024 Lords Chamber

[Lord Markham (Con)]

I totally agree about the importance of research and data. We have spent about £580 million on research in the children and young persons’ space since 2020. As per the earlier question, data is vital to this. I saw a fascinating example just a couple of weeks ago in the Cambridge Research Centre concerning young children. It is using data to construct what it calls “virtual children”, to look at rare diseases, how they progress and different treatments that can be tried. It is truly revolutionary and something I totally support.

[Lord Rooker (Lab)]

My Lords, I distinctly heard my noble friend Lord Hunt describe these children as obese and overweight. The Minister has addressed only obesity. You can be overweight without being obese, but it means you are on the way to obesity. That is the serious problem.

[Lord Markham (Con)]

I think we all agree that it is a very serious problem, so I do not want to diminish that. I was trying to demonstrate that the steps we are taking—there is a lot to do in this space—are having an effect. Noble Lords have heard me say before that our reformulation efforts mean that everything from Mars Bars and Snickers to all sorts of other foods are having the sugar content taken out, so we can make sure they are healthier for people to enjoy.

Strikes (Minimum Service Levels: NHS Ambulance Services and the NHS Patient Transport Service) Regulations 2023

Lord Rooker Excerpts

Wednesday 6th December 2023 Lords Chamber

[Lord Thomas of Cwmgiedd (CB)]

I thank the Minister very much and welcome the fact that, although this legislation extends to Wales and Scotland, it applies to neither of them. This is a welcome change of mind; I hope that it will be carried through in other pieces of legislation or other instruments contemplated that relate to both education and the NHS.

I want to add one further observation, if I may, in support of what the noble Baroness, Lady Merron, said. We can of course pass instruments of this kind after the Government have gone out to consult, and they can say with some force that they have had some views, but doing it that way diminishes the status of our democracy. This is the place where the debate should take place. On a contentious issue—this is very contentious—we ought to have the argument here so that people know that it is open. I very much hope that a means can be found when we get to the more contentious areas of education and staffing levels in the other aspects of the NHS—perhaps on other matters, too—so that we have a mechanism for a meaningful debate in this Chamber for the strength and the health of our democracy, which is under such pressure from some who think that their voices do not count.

[Lord Rooker (Lab)]

My Lords, I came in today to break the habit of a lifetime—I have been in the House for more than 20 years, half of them as a Minister—because I proposed to vote against the first two Motions. I was going to support the first two fatal amendments. I felt deprived that I did not have the opportunity to do that—I am still going to make my points, mind you.

These are steps too far. I do not think that we should pussyfoot around. We know that, earlier in the year, the Government rejected the report on the Bill from the Delegated Powers Committee. There are times when this House should not simply fall into line with this Tory Government; this is one of them. I am reminded in some ways that, very sadly, we are missing today the contribution of the late Lord Judge who, earlier this year—on more than one occasion—made it clear from those Benches that we need to use the powers available to this House when we need to be firm. There were a couple of debates on it. In my view, this is such a time.

In answer to the Lib Dem Benches, we know that the health service bosses are not independent—we know that from the pay review bodies—so it is fairly obvious what will happen. I realise about the so-called conventions but they are between Labour and the Conservatives. There is no rule in the Statutory Instruments Act 1946 about not voting against a statutory instrument in either House; it is just the convention that we do not do it. We fear now that, if we do it to them, they will do it to us. In fact, the Tories have done it more to Labour than Labour have to the Tories so I am not going to take any lectures about conventions from this Government, who have breached, systematically ignored and torn up many of the conventions that rule our constitution. I will not rely on the use of fatal amendments by the noble Lord, Lord Strathclyde, either.

One area will suffice as an example: electoral law. I am in favour of ID cards but the identity system was deliberately designed to reduce voting. Rees-Mogg admitted when he was the Leader of the other place that they had got it wrong: they fully intended to get fewer people in polling stations. The Government have neutered the Electoral Commission as the guardian of free and fair elections and, this past month, they changed the finances of elections, all without any consultation and with no Speaker’s Conference whatever. That is part of the constitution and the conventions on the way we do things. We do not have to follow the conventions: if a thing is bad enough, vote against it.

Paragraph 41 of the Secondary Legislation Scrutiny Committee report on these regulations—this committee reports to this House, having been set up by the House to look at these issues—says:

“The Department of Health and Social Care’s … consultation document acknowledged that, during past strikes, emergency provision has been delivered through voluntary arrangements”.


So why are we doing this? Why are we picking on ambulance workers? It is not needed. If there were any evidence of flagrant abuse and the voluntary system not working, believe you me, your Lordships would know about it. That is the reality. Therefore, on this one, if anybody called the vote—although it has now been denied—I would be happy to vote against the SI.

I cannot quote much from my experience. When you lose the opportunities of the other place to be in contact with constituents and with people’s daily lives, it is different; it is different when you stop representing people simply because you are in this place. However, I will give one example from my personal experience. Four years ago this month, a few days before Christmas, I was carted really late one Saturday night from Hereford County Hospital, which had spent four years stopping me going over to the dark side, to Worcester Royal, to have my first chemotherapy as an in-patient. The weather was atrocious; the main roads were blocked. The driver of the ambulance said to me, “I’d better warn you now: it might be a bit rough—I’ve got to go down some country lanes”. We passed three upturned cars due to the weather. When I got through it all, I wrote to the chief executive and said, “You’d better put a note on the chitties of those two people who looked after me in that ambulance that night”. It was absolutely horrendous.

I now think that people like that who do this job cannot be trusted to deliver emergency services when there is a dispute—disputes deliberately created by the Government anyway for political reasons. The reality is that I am prepared to vote against this SI, above the others—I am not saying anything about the other two. We have evidence from our own committee that it is not needed, and I have my own bit of personal experience. I thought, “Why pick on the ambulance workers?” If there were an opportunity, I would vote against the SI; I may not have the opportunity, therefore I will obviously support the regret amendment. However, I much regret that I may not be able to vote for the fatal amendment.

[Lord Hendy (Lab)]

My Lords—

Folic Acid Fortification

Lord Rooker Excerpts

Tuesday 25th July 2023 Lords Chamber

Asked by

[Lord Rooker]

To ask His Majesty’s Government whether it remains their policy to reduce the number of pregnancies affected by neural tube defects through mandatory folic fortification of bread flour.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

My Lords, the Government remain firmly committed to proceeding with a policy of mandatory fortification of non-wholemeal wheat flour with folic acid to help prevent neural tube defects in foetuses. As I have previously updated noble Lords, this policy is being delivered as part of the wider review of the Bread and Flour Regulations. Having consulted, we are finalising policy decisions; we expect to publish a response this summer and lay new legislation early in 2024, subject to clearances.

[Lord Rooker (Lab)]

I remind the Minister that it is now 35 weeks since the consultation on the Bread and Flour Regulations closed. The last time they were reviewed, in 2013, the Government’s decision was announced within 20 weeks of the closure. It is now four years since the Government consulted on fortification of bread flour with folic acid, and it will be two years this September since they made their seminal decision actually to do it. So, we have just lost another two years, which means another 300 babies born with lifelong illnesses, and 1,600 terminations.

When will we get some action? We have lost two years since the previous decision, when it was announced that we were going forward. The Minister has already indicated—he was clever to do so—in answer to the previous Question that he has a problem with Northern Ireland. It is a pity that the noble Lord, Lord Dodds, is not here, because then we would get the facts on Northern Ireland. If that is the excuse, it will not be good enough.

[Lord Markham (Con)]

I first thank the noble Lord, Lord Rooker, for his tireless and passionate campaigning on this issue, which he is right to do. As I have learned, the situation is complex. We had 369 consultation responses, and more than 13,000 different SKU items—products containing flour—will be affected. We are not just talking about bread; pizza, lasagne, cakes and sauces are all affected, so you have to change the labelling of all those. We are trying to bring them all on board in a sensible manner, and to get this right quickly. We believe that a lot of people will voluntarily take this up much quicker. When you are talking about changing labels on the 22 billion items that are sold each year, you obviously need to look at how to do that practically and within a reasonable timeframe.

Food: Two-For-One Offers

Lord Rooker Excerpts

Wednesday 19th July 2023 Lords Chamber

[Lord Markham (Con)]

First, I thank the noble Baroness for her tireless work in this space. I think we have shown that our restrictions are absolutely placed to inform and educate people so that they can have a healthy diet. I mentioned what we have done on location—the so-called pester power avoidance. It is estimated that these measures will reduce calorific intake by 96%. That is the prize that we are looking at here.

[Lord Rooker (Lab)]

My Lords, can the Minister confirm that the Secretary of State for Health actually believes in public health policy, because his recent speech at the Centre for Policy Studies—I watched all of it—indicates he does not?

[Lord Markham (Con)]

He definitely does. He was very much behind these measures. Just look at what we are doing in the smoking space, through the swapping out of cigarettes for vapes—another example of where we are taking action. As I mentioned, the evidence from Kantar suggests that it is working.

Cancer Referral Targets

Lord Rooker Excerpts

Monday 5th June 2023 Lords Chamber

[Lord Markham (Con)]

That is exactly the example I was giving when I mentioned lung cancer targets, where mobile devices are being used. Interestingly, the most deprived areas have been targeted because they are often areas of high smoking, and these are the areas where they have managed to get screening times down the most. We have the opportunity to put CDCs in the areas of most need. We all agree that there is unprecedented demand and that we have to expand supply; there is no other way to meet that demand but to expand supply.

[Lord Rooker (Lab)]

Having gone through treatment myself in the last few years—successfully so far—I want to ask the Minister whether anybody is measuring the growth of mental illness among people who know that they need treatment but where it is constantly delayed. The pressure on those people and their families is enormous. Is there any measure of extra mental illness caused by this delay?

[Lord Markham (Con)]

The noble Lord is correct. I have a friend who is in that situation. We all understand the stress of waiting and what it can cause. I will come back to the noble Lord on the research into the impact on mental health. I absolutely accept that a lot more needs to be done, but one of the main things is the target of diagnosis within 28 days, which we are now hitting 75% of the time. That gives people peace of mind quickly, particularly as 94% of those people end up being negative—only 6% are positive. Peace of mind is crucial here.

Life Expectancy: Pensions, Health and Insurance

Lord Rooker Excerpts

Wednesday 26th April 2023 Lords Chamber

Asked by

[Lord Rooker]

To ask His Majesty’s Government how changes in life expectancy as measured by the Office for National Statistics have affected planning for pensions, health and insurance.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Government consider a range of metrics when determining our approach to pensions, health and insurance, including life expectancy where relevant. We are committed to improving health life expectancy by five years by 2035 and to reducing the gap between areas where it is highest and lowest by 2030. Our major conditions strategy will focus on health conditions that contribute most to morbidity and mortality.

[Lord Rooker (Lab)]

I thank the Minister, but is he aware that Office for National Statistics figures show that life expectancy, which is a key indicator of national health, has stalled in the UK since 2010 for the first time in 120 years? Is he aware that one consequence of this is that over half of families in England cannot get a funeral in less than three weeks, and 17% cannot get one for over a month? Funeral directors are running out of storage space because of what is happening. There are far too many early deaths under this Government, as shown in the report from the Government Actuary’s Department, placed in the Library last week, which states that before the pandemic the UK had the lowest life expectancy of any major European country.

[Lord Markham (Con)]

I am aware that there has been a similar phenomenon across all the G7 western nations. Life expectancy has been plateauing for the last few years, and the only country to buck that trend is Japan. A lot of this is to do with obesity, which I know noble Lords regard as a very important issue. While we are improving issues such as alcohol intake, the impact of obesity on healthy lifestyles is an important factor that we will need to tackle.

Bread and Flour Regulations 1988

Lord Rooker Excerpts

Tuesday 7th February 2023 Lords Chamber

Asked by

[Lord Rooker]

To ask His Majesty’s Government when they expect to announce a decision following the consultation on the Bread and Flour Regulations 1988 which closed on 23 November 2022.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)]

The Government will publish an interim response within 12 weeks of the consultation closing, on 14 February, with a fuller government response later this summer. We received 369 responses, and UK officials are currently reviewing them in detail with a review to finalising policy decisions. Following that, the Government expect to lay new legislation early in 2024 subject to clearing parliamentary process. Discussions with industry on the practicalities of folic acid fortification of flour are also ongoing.

[Lord Rooker (Lab)]

I have to say that is the first time the Minister has answered one of my Questions on this, and I am very grateful to him. He gave some positive dates, which we can hold him accountable to, and it looks as though there is some progress. I will make just one point. It is already three months since the end of the consultation. That is another 250 neural tube defect pregnancies, 80% of which will be terminated, and close to 50 live births of children who will have lifelong disabilities. It really needs to speed up. I fully accept what the Minister said, and I am very grateful for that—it would be churlish to be otherwise. However, the fact is that time is of the essence on this. We have a cure for 80% of the issue, but we are not using it at the present time.

[Lord Markham (Con)]

I thank the noble Lord, who has been a tireless campaigner on this issue. Again, a benefit of this position is getting to learn new subjects, and this is one of them. I can see why he campaigns so hard on it. I am delighted to say that we are getting there, albeit that it could be argued that maybe it could be quicker. At the same time, industry is seeing that, and the good news is that it is already adjusting. The majority of breakfast cereals are now fortified and a lot of the rest of the industry is responding. We are making a difference, and I thank the noble Lord again for his campaigning.

NHS Industrial Action: Government Preparations

Lord Rooker Excerpts

Tuesday 13th December 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend for his question. He is quite right. As mentioned before, this body was set up in 1984 and extended to other areas of the health service in 2007. Since then, Governments of all colours have followed its recommendations because, after all, it is the expert in this field. We have honoured that in full because it is right that the experts determine it. Working towards making sure that the next settlement in April—which, let us face it, is only three or four months away—covers the latest situation would be a good way ahead.

[Lord Rooker (Lab)]

Is not the total silence of all members of the pay review body since it delivered its report to the Government remarkable? Has anyone asked them, bearing in mind that they delivered their report when inflation was about 3% or 4%, whether they believe the figures in their report are still relevant today? Forget last April or next April—we are talking about today. The pay review body has been loaded up with a responsibility by the Government which in a way is not solely its responsibility. The Government do not have to accept its recommendations, as the Scottish Government have not. Has anybody asked it whether, in the present circumstances and with inflation so high, it still stands by the report it delivered in the middle of last year?

[Lord Markham (Con)]

My understanding, based on the long time that this has been in place, is that this is an annual review. April is now quite close; for that April review, it can take into account all the factors, including what happened to inflation during the year. I expect it will take all that into account, quite rightly, in what it comes up with for that next pay review. It is a long-established principle that it is there to do this. I trust it to get the right answer in time for April.

Childhood Obesity

Lord Rooker Excerpts

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend and totally agree with him. As we have all mentioned, physical activities are a key part of a healthy lifestyle, regarding not just obesity and healthy eating but mental health. There is a lot of evidence to show that sport and a healthy lifestyle are good for everyone. We are working with the DfE and DCMS on this, but I agree that it we will need to keep it central to our agenda.

[Lord Rooker (Lab)]

I say to the Minister that we do not need to reinvent the wheel. A perfectly good practical policy was worked out at the end of the David Cameron period in government; it arrived on the desk of Theresa May, who scrapped it. Why not go back to that?

[Lord Markham (Con)]

I am afraid the noble Lord is testing my memory as to what that was. If he will excuse me, I will find out what it was and write to him.

Bread and Flour Regulations: Folic Acid

Lord Rooker Excerpts

Wednesday 6th July 2022 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government, further to the answer by Lord Kamall on 6 April (HL Deb col 2076), what progress they have made towards amending the Bread and Flour Regulations to include folic acid fortification.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

I am grateful to the noble Lord for continuing to promote this important policy. I hope that, following our meeting in May, the noble Lord is sure that the Government share his commitment to getting folic acid fortification done as part of the Bread and Flour Regulations review. The review continues to progress, we are aiming to launch a consultation shortly and I am able to share an indicative timeline for the process.

[Lord Rooker (Lab)]

I am grateful to the Minister for his Answer and confirmation, but just in case there is any backsliding in his department, may I suggest that he asks them a question? Can anybody name any one of the 85 countries that have made fortified folic acid mandatory, some for over 20 years, that has pulled out; and can the Minister name any one of the 85 that has found a bad side-effect? The answer to both questions is no. Then, he can go and face the 18 women last week, this week, next week and the week after who have terminations after the 20-week scan. The department is sitting on a cure to stop 80% of that distress among our fellow citizens. We are going at a glacial pace— I accept it is in the right direction, but it is glacial.

[Lord Kamall (Con)]

I hope the noble Lord appreciates that there is debate here. He has written to me a number of times about Professor Wald’s paper, which has been put before the advisers in the department. I think what we are seeing is scientific contestation: some people say that the science is settled, but others say that you have to be very aware of the unintended consequences. The NHS website advises people with certain conditions not to take folic acid, the worry being that, for people who do have levels of folic acid, we may end up solving one problem and unintentionally creating another.