Counsellors of State Bill [HL]

Lord Sentamu Excerpts

Committee stage
Wednesday 23rd November 2022 Lords Chamber

[Lord Wolfson of Tredegar (Con)]

My Lords, I will make a more lawyerly point. I heard the wise intervention of the noble Lord, Lord Pannick, on what is regular and the powers of the Lord Chancellor. I will not comment on either of those points. But I heard the noble Lord say, in moving the amendment, that his wish was to provide some clarity. I respectfully suggest that its wording actually does the precise opposite, because he has used the verb “excluded”—although, when he moved it, he used the word “removed”. In the context of this legislation, verbs are important. A Counsellor of State can be excepted if they are overseas, for example, which means that they cannot act but they do not lose their place in the pecking order. If they are disqualified, they lose their place in the pecking order, and the next person in line takes that place. It is not immediately clear to me whether “excluded” is “excepted” or “disqualified”. With the greatest respect, I suggest that it is this amendment that ought to be excluded.

[Lord Sentamu (CB)]

My Lords, I also apologise for not being here on Monday; I had to handle some serious matters in Berwick. Yes, the constitutional monarch has consulted, and this House considered this at Second Reading and agreed the terms as in the legislation. So there is no question of the supremacy of Parliament not being recognised. The suggestion of the noble Lord, Lord Berkeley, is almost like rubbing it in—it is just one of those words we would not want to use. We should restrict the Bill to what was asked of us. This was considered, and therefore the wording is there.

Another thing is that we can never predict anyone’s future. I could be ill tomorrow, or I could be dead, and that would be the end of me. Anticipating what may or may not happen in legislation is always pretty difficult, so leave it well alone.

[Lord Newby (LD)]

My Lords, I have considerable sympathy with the thoughts behind this amendment, because the debate has shown that there is a certain amount of confusion about which members of the body of Counsellors of State will undertake royal duties, do undertake royal duties or might be asked to do so. In addition to the Duke of Sussex and the Duke of York, Princess Beatrice—although I might be wrong about this—is also not a working royal. That means that three members of this extraordinarily small body will never be asked to perform the function, which just seems strange.

An amendment of this sort would enable matters to be clarified. There are a number of deficiencies in its drafting, some of which were raised by the noble Lord, Lord Pannick. It also raises in my mind the question of what would happen if we were to exclude two or three Counsellors of State. Who would replace them? Would they be replaced and, if so, on what basis? There is ambiguity. In an ideal world, this ambiguity would be dealt with by consideration of these matters.

For example, it is up to the King to decide which members of his family he considers working members of it. He decides who acts as a working member of the Royal Family, so I think we could get round all that. However, as we debated on Monday, once you start down this route, it takes quite a lot of time and effort to deal satisfactorily with all the wrinkles. Given everything else that lies before us, I am not sure it is a priority. However, one idea is that the work could be done on this to the extent that, at some point in the future, there may need to be another Counsellors of State Bill to include an additional person. It would be a good thing if this could be cleared up at the same time.

CHOGM, G7 and NATO Summits

Lord Sentamu Excerpts

Monday 4th July 2022 Lords Chamber

[Lord Ashton of Hyde (Con)]

My Lords, I think that the noble Lord, Lord Browne, knows what I am going to say. I think that it is only right that, when a noble Lord arrives five and a half minutes after the start, he should not really speak. But I do accept that there are not many people here. I think it would be good if the noble Lord allowed people who were here at the beginning of the debate to speak, and if there is time afterwards then he might be allowed to speak.

[Lord Sentamu (CB)]

My Lords, I thank the noble Baroness for the Statement, which has a lot of hope and a lot of challenges in it. I chair the board of Christian Aid, which has been working hard in Ukraine ensuring that incubators are provided, because two hospitals were destroyed, and there have been a lot of miscarriages and premature births taking place. We thank the Government for the disaster aid that has raised a lot of money, and through your offices, again, we have been able to help out.

On defence, during our debate on the humble Address I brought up the issue—as everybody is wanting to look at more lethal weapons—of the whole growth of unregulated, autonomous robots. These are very good at not being controlled by a person but have been set within themselves, and their destruction is unbelievable. What are Her Majesty’s Government doing to create a treaty which will limit the way that these weapons are developed?

[Baroness Evans of Bowes Park (Con)]

I thank the—

Health and Care Bill

Lord Sentamu Excerpts

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

[Baroness Hollins (CB)]

My Lords, I do not understand why it is a conscience vote if it is not about the substance or the subject but somehow about parliamentary process. That does not seem to me to be a matter of conscience.

The point is that people want better care at the end of their life. The amendment to this Bill from the noble Baroness, Lady Finlay, is a game-changer. I wonder how many noble Lords understand that something has changed during the passage of this Bill. For the very first time, people will now be eligible and able to have palliative and hospice care at the end of their lives commissioned by the NHS. It is the responsibility of all integrated care boards to commission proper, good palliative care so that the poor care and poor deaths that people in this House are afraid of will be a thing of the past.

This is the wrong time to talk about introducing lethal drugs as a last resort. We should be looking forward with optimism and hope about how things have changed. This is also relevant to my noble friend Lady Meacher’s Bill. Noble Lords have questioned the motives of Peers who have tried to amend that Bill. It needed to be amended and scrutinised. My amendments were all about palliative care—this was before the game-changer of universal palliative care—being available before people are offered the only option of lethal drugs. If lethal drugs are the answer, why was this not an amendment to introduce lethal drugs to enable people to be assisted in their own suicide? Palliative care will reduce the supposed demand for physician-assisted suicide.

I think the statistics have been misrepresented. Only 10 US states have legalised physician-assisted suicide, despite the supposed success in Oregon. Maybe they have recognised that palliative care decreases rather than increases when lethal drugs are available. Some 200 attempts to introduce physician-assisted suicide in the United States have been defeated.

[Lord Sentamu (CB)]

My Lords, I do not want to detain the House long. The noble Lord, Lord Forsyth, told us that this is not to open the debate in favour of or against assisted dying but, as the debate has gone on, there has been an opening up of that debate. We have to look very carefully at what was given to us by the noble and learned Baroness, Lady Butler-Sloss, on the constitutional question. This amendment is not saying that the Government must find time to debate this matter but instructing the Secretary of State.

This is a revising Chamber. It is made up of unelected people telling the Government in the elected place that they must produce a Bill and it must be given time. That is my worry. My views on assisted dying are very clear. I will debate it whenever the issue comes back again, but the issue for me now is to avoid what was happening towards the end of Theresa May’s Government, when the Back-Benchers were trying to take control of government business. That led us into a mess.

I am not against speaking in favour of any Government of any colour, because I have never been a member of any party, but I want to observe how the liberalisation of homosexuality actually happened. Michael Ramsey, as Archbishop of Canterbury, began a debate in your Lordships’ House because of what had happened to Turing and many other people. He just thought: is it natural justice that consenting adults should actually be prosecuted and have to go through horrendous treatment, some of them facing horrendous stuff? The debate happened here and what was the result? It was the Wolfenden report. That recommended that this should be debated and a Minister of the Government, and Mr Jenkins on behalf of the Labour Party, joined in the debate and what happened? The law was passed. Where did it start? It started in the elected Chamber.

I have a real concern that we, as a revising Chamber, are not even considering a Bill that has actually come from the Government but instructing the Secretary of State to produce a Bill within a year of this coming into being and saying that it must be debated. Does this respect our position and why we are here? This is not revising legislation, at which all your Lordships do a fantastic job. Without your Lordships, the Bills in this country would be horrendous. However, let us not overreach ourselves and think that we can instruct the Secretary of State to bring this in. Who is the Secretary of State in this case? is it the Secretary of State for Health and Social Care?

May I please ask that we get another amendment or another Statement to give the House a Private Member’s Bill that needs to be given sufficient time to be debated properly? Also, other people told your Lordships that on 21 September 2015, there was full a debate in the other place.

[A noble Lord]

A long time ago.

[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.

Health and Care Bill

Lord Sentamu Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, I have been in this House for 22 years and I have been asking for this for at least 20 of them. It really is time that the Government got on with it. At the time, I was told that most wine comes from abroad and we cannot legislate for what is put on the labels, but it cannot be impossible to put information on the shelf labels or online. If people do not know what they are putting inside their bodies, they cannot moderate it.

[Lord Sentamu (CB)]

My Lords, I support this amendment. I will tell a true story of a teetotal preacher who harangued his congregation that nobody should be drinking because it is dangerous, damages our health and damages everything else. “Alcohol should be banned,” he said, “and the best thing to do is go and drown it in the river.” Unwittingly, he then said, “Our final hymn is ‘Shall We Gather at the River?’ The beautiful, the beautiful river.” He did not see the contradiction in what he said. This amendment is full of clarity, clarifying areas that need to be put fairly clearly. The obligation that it puts on the Secretary of State and, incidentally, all of us is very clear. Because of the real danger in what overdrinking does to a lot of people, I say: no, we shall not gather at that river, that beautiful, beautiful river.

[Baroness Merron (Lab)]

My Lords, it is a pleasure to follow the noble and right reverend Lord, who reminds us of our obligations to assist with alcohol-related ill health. I thank the noble Baroness, Lady Finlay, and the noble Lord, Lord Shipley, for putting these amendments before your Lordships’ House today. The first is a probing amendment about the need to report on the consultation on alcohol labelling. It is absolutely right to raise this: consumers have a right to know what is in their drinks, to make informed choices about what and how much they drink. Currently there are no legal requirements for alcohol products to include health warnings, drinking guidelines, calorie information or even ingredients. Research by the Alcohol Health Alliance found that over 70% of products did not include the low-risk drinking guidelines, and only 7% displayed full nutritional information including calories. I certainly add my voice to welcoming the forthcoming consultation on alcohol calorie labelling. When can we expect to see this, and what is the reason for the amount of time that it has taken to bring it forward?

Amendment 296 requires the Secretary of State to make a five-yearly statement on the cost efficacy of alcohol services. As we know, rigorous impact evaluation is absolutely key to good policy-making and improving the lives of those who use alcohol services. At present, the Government cannot say that they are meeting their responsibility to tackle alcohol harm with the requisite financial commitment and in the right places. Perhaps the Minister will tell your Lordships’ House what evaluation measures are already in place.

Of course, the background to all this is that, since 2012, there have been real-terms funding cuts to alcohol services of over £100 million. Pre pandemic, only one in five dependent drinkers was believed to be in treatment, leaving a shocking four out of five without help. The pandemic has only worsened the situation. I hope that the Minister will agree that there is a need to do better to ensure that we know how policies and services help or hinder the treatment of problem drinking, in order that efforts and resources can be targeted to where they work best.

[Earl Howe (Con)]

My Lords, I pay tribute to the noble Baroness, Lady Finlay, for her work as chair of the Commission on Alcohol Harm. I thank her for this opportunity to set out the current state of play on the Government’s alcohol policy. I am the first to acknowledge the seriousness of the harms caused by the consumption of alcohol, which she pointed out.

Effective alcohol labelling is an important part of the Government’s overall work on reducing alcohol harm. I am pleased to tell the noble Baroness that the legal powers available to the Government are already sufficient to enable us to consult and report on alcohol labelling. The kind of power proposed in her probing amendment is highly prescriptive, and, from a purely practical point of view, would not allow for sufficient flexibility in the consultation process, which could make the process less effective.

As she knows, as part of the Government’s Tackling Obesity strategy, published in July 2020, the Government committed to consult on whether mandatory calorie labelling should be introduced on all pre-packed alcohol as well as alcoholic drinks sold in the out-of-home sector. I repeat that commitment today, and, as part of our public consultation, we will also seek views on whether provision of the UK Chief Medical Officers’ Low Risk Drinking Guidelines, which includes a warning on drinking during pregnancy, should be mandatory or continue on a voluntary basis. The noble Baroness, Lady Merron, asked when we might expect that consultation to be forthcoming. I am afraid I can say no more than “in due course” at this stage, which I realise is not wholly enlightening, but it is as far as I can go at the moment.

Turning to Amendment 296, which proposes additional reporting and government statements, we do not think a new reporting requirement is necessary. The Office for Health Improvement and Disparities already publishes annual data on estimated numbers of alcohol-dependent adults within local authorities in England. Health commissioners can use this data to estimate local need and appropriately plan their alcohol treatment services. Outcomes for local authority-funded alcohol treatment services are already published at local and national level via the national drug treatment monitoring system. The Office for Health Improvement and Disparities also provides a number of data tools to enable local areas to compare their performance against other areas and nationally, including the public health outcomes framework, local alcohol profiles for England and the spend and outcomes tool.

On funding, local authorities are currently required to report on their spend on alcohol services annually to the Department for Levelling Up, Housing and Communities. Through the “why invest?” online guidance, the Office for Health Improvement and Disparities already produces data and information on the return on investment for alcohol and drug treatment. The guidance includes cost savings data on treatment interventions in primary and secondary care and on specialist and young people’s treatment services. There is a strong programme under way to address alcohol-related health harms and their impact on life chances, and to reduce the associated inequalities which the noble Baroness emphasised, including an ambitious programme to establish specialist alcohol care teams in hospitals and to support children of alcohol-dependent parents.

Throughout the Covid-19 outbreak, drug and alcohol treatment providers continued to support and treat people misusing drugs and alcohol. OHID supports local authorities in this work by providing advice, guidance and data. OHID is developing comprehensive UK guidelines for the clinical management of harmful drinking and alcohol dependence. These aim to develop a clear consensus on good practice and to improve the quality of service provision. The work is expected to be completed later this year.

Finally, we are currently developing a new commissioning standard for drug and alcohol treatment which aims to increase the transparency and accountability of local authorities on how funding is spent. It will include requirements to commission services—

[Lord Sentamu (CB)]

I am sorry to disturb the Minister in mid-flow. He described this amendment as prescriptive. Seat belts became prescriptive, and most people now wear their seatbelt. There was no question of an in-between. Smoking was another, and the effect has been to improve our public life. Without clarity—and we still will not have options—how will the Government achieve what wearing seatbelts and not smoking have achieved in terms of health? Alcohol needs to have similar treatment.

[Earl Howe (Con)]

The noble and right reverend Lord makes an extremely cogent set of points. I criticised Amendment 259 only on the grounds that it was overprescriptive. Surely, what we want in any consultation is a broad enough question to put to the public and those who have expertise in this area. If we make it too narrow—I said “overprescriptive” rather than “prescriptive”—we are in danger of introducing a lack of flexibility. That was my only point there.

I was just mentioning the development of a new commissioning standard. It will include requirements to commission services to meet a wide range of individual needs, and services will be monitored against these. I hope that information provides the noble Baroness and the Committee with a useful update on where we are with this important agenda and will enable her to feel reasonably comfortable in withdrawing her amendment.

--- Later in debate ---

[Lord Cormack (Con)]

Well, I certainly was going to make my remarks brief, and I am sorry that I was detained for one minute. I just want to give my wholehearted support to these amendments. There is no more despicable trade than the trade in human organs and no more despicable practices than those that are going on in China at the moment, simultaneously with the opening of the shameful Games. I very much hope that my noble friend, who so politely interrupted me, will be able to give us a very supportive statement when he comes to wind up this debate.

[Lord Sentamu (CB)]

My Lords, I also stand to support Amendments 265 and 282. I am grateful to the noble Lords, Lord Hunt, Lord Ribeiro and Lord Alton, and the noble Baronesses, Lady Northover and Lady Finlay.

I declare an interest as, quite a number of years ago now, I was one of those who signed up to say that, at the moment of death, all my organs will be left to the National Health Service for any scientific work that may be required. I carry a card, but it says that my organs should be kept in this country and not exported anywhere else, because I have no trust that they would not be used for purposes for which they were not intended.

When I was doing philosophy in Cambridge, Professor Williams posed a question. He said “Surprising things happen—that they are no longer surprising. Comment.” Noble Lords who have done philosophy will know how complicated that question is.

In Uganda, Idi Amin was known for the people that he feared most. He would cut off their heads, put them in the fridge, and put their organs in another fridge. People did not believe this, and he was overthrown. His treating of the human body like something you simply dispose of was horrific. No wonder a lot of people died under that terrible Government of his when he was in power. What we are being asked is: should the standards in this country also be somehow given over to other countries so that they can learn? But we too have got to be very careful that our standards are as high as the tissue Act says.

We live in a world that is so perilous at times, and where some people may disappear and you never see them. In Uganda, quite a number of leading people disappeared and, up to today, we do not know where they went. The thing is, they would be put in drums of acid and their bodies would be dissolved. Surprising things happen—that they are no longer surprising. May we be so vigilant. These two amendments do the job, so I hope that the Minister when he responds will have heard the urgency in the speeches, but, most of all, in the amendments themselves.

[Baroness Thornton (Lab)]

My Lords, can I say how much I agree with my noble friend Lord Hunt, the noble Baroness, Lady Northover, and the noble Lords, Lord Ribeiro and Lord Alton? They know I have been with them on this journey throughout. I probably would go a bit further than my noble friend Lord Hunt’s Amendment 265, because I believe that this country should follow the example of France and ban the exhibition of plasticised cadavers and human body parts.

In 2019, we had an OQ on this, which many noble Lords here today took part in. I said at that time that there is an

“ethical issue at play here”

and that it seemed that the businesses that had

“the exhibitions which use plasticised cadavers and foetuses for supposedly educational purposes could use modern materials and production to create the same exhibits. That begs the question: why use cadavers and human body parts at all? If the answer is that people want to see such things and will pay to do so, I remind noble Lords that people used to flock … to see public executions until 1868.”

It is an ethical issue. I am afraid that the noble Baroness answering that debate at the time said that

“the ethical position is not one for government.”—[Official Report, 27/2/21; cols. 228-29.]

Well, I would say that this debate shows that the ethical position is absolutely one for government.