Mental Health Act Reform

Baroness Barker Excerpts

Monday 18th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is 100% right: we can definitely start work on the recommendations of the report. As I said earlier, we have already done so: committing £400 million to end dormitories in 40 trusts. That sort of parallel processing can be done for other elements of the report. The consultation began last week, which shows our determination to get moving. Some recommendations of the report are spellbindingly obvious; we will work on them immediately. The role of police suites in safe refuge, cited by the noble Lord and by the noble Lord, Lord Winston, is exactly such an example.

[Baroness Barker (LD) [V]]

My Lords, this is yet another NHS document which makes not a single mention of the needs of LGBT people. The Statement is in effect an admission that the Mental Health Act 2007 was deeply flawed and, as a result, thousands of people have been subject to wrongful treatment. Will the Government act now to stop the abuse of community treatment orders and other elements of that Act that have led to the position that is so accurately described by Sir Simon Wessely?

[Lord Bethell (Con)]

My Lords, I confess that the noble Baroness has me on the hop there, because I had not noticed that LGBT issues are not mentioned in Sir Simon’s report. I share the noble Baroness’s surprise about that. Let me return to the document and I will address her point in correspondence.

Medicines and Medical Devices Bill

Baroness Barker Excerpts

Report stage & Report: 2nd sitting (Hansard) & Report: 2nd sitting (Hansard): House of Lords
Thursday 14th January 2021 Lords Chamber

Amendment 68 withdrawn.

[The Deputy Speaker (Baroness Barker) (LD)]

My Lords, we now come to the group beginning with Amendment 69. I remind noble Lords that Members other than the mover and the Minister may speak only once and that short questions of elucidation are discouraged. Anyone wishing to press this or anything else in this group to a Division must make that clear in debate.

Amendment 69

Moved by

Covid-19: Variant

Baroness Barker Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord has more medical expertise than me to be able to answer that question, but the briefing that I have is that the significant mutation in the Kent variant is not of a kind that should affect the efficacy of either a single dose or two doses of the vaccine. This comes as a significant relief to the vaccine programme. We remain on the balls of our feet, looking out for any variations that might affect vaccine deployment, but at this stage we have not found anything that poses a significant threat.

[Baroness Barker (LD)]

My Lords, the ONS data in the second week of December showed that the number of cases from all variants of the virus had rocketed. Why did the Government fail to act on that information until late December?

[Lord Bethell (Con)]

The noble Baroness is entirely right that the EpiData showed that the figures shot up in December; that is exactly why we looked extremely carefully at the genomic data from Kent and other places. As she knows, genomic data takes time to process—the tests can take a week to turn around. Looking at all the variants and matching EpiData figures with genomic data is an enormously complicated mathematical task. We moved as swiftly as possible and far faster than in many other countries.

Cannabis Oil

Baroness Barker Excerpts

Tuesday 12th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness is being a little unfair; Health Education England published a medicinal cannabis education package on 8 August 2019. But we cannot force clinicians to make prescriptions. That is not how the health service works. We need to work on clinical trials to put in place the correct authorisations and to give marketing authorisations for these important and promising drugs. That will require collaboration between government, the regulator and industry, and I call on industry to step up to that challenge.

[Baroness Barker (LD)]

My Lords, some people in England and Wales are reliant on hormone therapies produced in the EU 27. Who precisely in the NHS is responsible for ensuring continuity of supply of those therapies to patients?

[Lord Bethell (Con)]

My Lords, procurement decisions in the NHS are done by the NHS. I do not think that a specific or unique group is focused precisely on hormone therapies, but I would be glad to go back to the department and write to the noble Baroness to confirm that.

Puberty-blocker Drugs

Baroness Barker Excerpts

Thursday 10th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

I reassure the noble Baroness that patient-doctor confidentiality remains paramount and is respected. To update her, the Tavistock has immediately suspended new referrals for puberty blockers and cross-sex hormones for under-16s. In future, they will be permitted only where a court specifically authorises it. I reassure the noble Baroness that those already on the programme will continue their medication until the review has been finalised.

[Baroness Barker (LD)]

The legal team that brought the recent case has, over recent years, brought several cases designed to oppose LGBT rights and to restrict the reproductive rights of women and girls. All those actions are consistent with campaigns run by organisations including the Heritage Foundation and the Alliance Defending Freedom—extreme evangelical right-wing American organisations. Will the Minister tell the House which NHS England boards and committees approved the amendment of the gender identity service specification on 1 December, prior to the court requiring them to do so, and in the light of the fact that this judgment can and will be appealed? If he does not have that information now, will he write to me?

[Lord Bethell (Con) [V]]

Well, my Lords, it is not appropriate for me to comment on those who have brought these cases, and outstanding judicial proceedings exist and are in place at the moment, so it is not possible for me to comment from the Dispatch Box in response to the noble Baroness’s remarks. All I can say is that the NHS, NICE and the Tavistock all have the interests of patients at their heart; we are not ideological about that. We are absolutely committed to the best interests of patients, and I would be glad to write to the noble Baroness to answer in any way that I can the questions she asked.

HIV: Ending Transmissions

Baroness Barker Excerpts

Tuesday 1st December 2020 Lords Chamber

Asked by

[Baroness Barker]

To ask Her Majesty’s Government what progress they have made towards ending HIV transmissions by 2030.

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

My Lords, the Government remain fully committed to achieving zero new HIV transmissions in England by 2030. This is why we endorsed the HIV Commission, which was established by the Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation, and we welcome its report, published today. I reassure noble Lords that we will consider all the recommendations carefully, including an interim milestone of an 80% reduction in new HIV transmissions by 2025, and how we can expand testing. We will use the insights of the report to shape our upcoming sexual and reproductive health strategy and HIV plan.

[Baroness Barker (LD)]

I thank the Minister for that reply. I am very proud to a member of the party which, before anybody else, advocated that there be services for people with HIV and AIDS, and we will be there until this report is fully implemented and the fight against AIDS is won. Will the Government move to introduce a system of opt-out testing so that all people, including men and women from black and minority ethnic communities, can know their status, and we can get sooner to the point where they can get treatment and stop transmission?

[Lord Bethell (Con)]

The noble Baroness refers to one of the most interesting of the recommendations of the commission’s report. I took a briefing from the commission yesterday; members made that point very clearly, and their arguments were extremely persuasive. We have learned a lot during the Covid pandemic about opt-out testing; I completely understand the value of it, and I will take that recommendation to the department to look at it very closely.

Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020

Baroness Barker Excerpts

Wednesday 25th November 2020 Grand Committee

[Baroness Barker (LD)]

My Lords, I warmly welcome the noble Lord, Lord Davies of Brixton, to your Lordships’ House and congratulate him on his speech. I was unaware of his professional background, but his explanation has led me to understand why there is such a sense of excitement among those Members of your Lordships’ House who are mere accountants. I look forward to the noble Lord joining the long-standing gang of Members who take a considerable interest in mental health and who often act as a bulwark against Members of the House of Commons who feel unable to take action on mental health legislation because of the grief they get from the popular press.

I declare an interest as a member of a special advisory panel for Rethink Mental Illness; I am indebted to it and to Mind for their briefings. When the Coronavirus Act went through, the mental health provisions were among the most controversial and the most feared, not only by lobby groups and patient groups—there was also a considerable amount of discomfort on the part of mental health professionals about what was being done. Under the Mental Health Act 2007, there is already a lack of patient involvement in decision-making, specifically in mental health. That is a fundamental flaw.

It was, on that basis, wrong to take away the safeguards that are the subject of these statutory instruments, and I am very glad that they have not had to be used. They have not had to be used because of the extraordinary efforts of both staff and indeed patients in the early part of this year. Both Mind and Rethink have done a considerable amount of work talking to people who were in acute services in particular. The surprising finding was the extent to which patients were deeply grateful to staff for continuing to look after them when the staff might well have been putting themselves in danger.

The extent to which patients were comfortable with incarceration during Covid was directly related to two factors: first, their ability to contact friends and family remotely and, secondly—because they are people just like the rest of us—the extent to which they were enabled to get out into the grounds and get fresh air. It is worth noting at this point that, in the recently announced hospital-building programme, only one of the new hospitals will be a mental health hospital. Given that we are likely for some considerable time to be going in and out of periods of physical restrictions because of the virus, we should do well to look at the physical estate of mental health services.

I agree with others that the £3 billion announced is very welcome, but there is a grave danger that it will be stretched way too thinly. A lot of it was earmarked before we entered the current situation. As others have said, and as the studies done by Mind and Rethink have shown, it is evident now that people are coming into community services with a greater degree of severity of mental distress and agitation. This is a clear signal that we will, in the coming months, see a much greater level of more severe illness if we do not put money now into rapidly accessible community services—patients are telling us that they cannot access those services. What efforts will be made to ensure that input of both staff and resources into a greater degree of community services?

In all the Government’s lockdown announcements, I have never seen anything acknowledging that those areas of the country that have been under severe lockdown for several months might have a greater need of mental health services than those that have not. Is that part of the analysis that the Minister’s department is undertaking? This is part of the question that I really wish to put to him. We are sitting waiting for the Government’s response to Sir Simon Wessely’s review. To what extent will the things that been learned during these last six months go into that review? For example, what have we learned about disproportionate levels of mental illness and lack of services among black and minority-ethnic communities, and what are we doing about children and young people? Can he tell us to what extent we have learned the lessons of the last six months and whether they will be in that new legislation?

Covid-19: Vaccine

Baroness Barker Excerpts

Wednesday 11th November 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord makes a persuasive case for those who are most vulnerable, including the itinerant and the homeless. We have seen for ourselves the impact of the disease on those who live in close quarters with each other, have health vulnerabilities or are exposed to the disease due to the nature of their circumstances. Those who are most vulnerable should surely be at the top of the list. I do not know the precise arrangements for the homeless and itinerant, but he makes an extremely good point, and I would be glad to get back to him with details.

[Baroness Barker (LD)]

My Lords, as is the case with the ordering of home testing kits, in order to prove one’s identity and access the vaccine, will UK citizens be required to share their credit rating history with US data-mining companies with which the Government have signed contracts?

[Lord Bethell (Con)]

No, they will not.

Covid-19: Contracts and Mass Testing Programme

Baroness Barker Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the circumstances of the pandemic were exceptional, and I am not sure that any large company had any experience of putting together a national test and trace programme. The firms to which the noble Lord refers have considerable consulting experience and the capacity to support the national rollout of a large organisation such as NHS Test and Trace. They have provided invaluable support to the country at a time of need. All our contracts are scrutinised extremely closely by the finance function in the DHSC, and we are supported in that by the government legal service and finance staff from the MoD and the Cabinet Office, for which we are enormously grateful.

[Baroness Barker (LD)]

My Lords, in July, a company called Topham Guerin was given a £3 million contract, without any tender process, to test public understanding of health messages relating to Covid. It did not have any experience in health messaging; those running the company appeared to be friends of Dominic Cummings and Michael Gove. Will the Government now publish the tender that has subsequently been issued, the research findings and the evaluation relating to this contract? As the country goes into lockdown, it is fair that taxpayers know whether we are paying money for old rope.

[Lord Bethell (Con)]

My Lords, the insight into how the public react to key messages associated with our healthcare and health advice has been absolutely critical. Behavioural change and asking the public to step up to extremely challenging requests from the Government require a huge amount of analysis and study. The support from our own communications team has been supplemented by agency support, which has both the capacity and the expertise to provide the necessary insight. That insight has been critical to the success of our messaging.

Blood Safety and Quality (Amendment) (EU Exit) Regulations 2020

Baroness Barker Excerpts

Monday 2nd November 2020 Grand Committee

[Baroness Barker (LD)]

My Lords, I thank the Minister for introducing these regulations. Indeed, I remember taking part in that debate in January 2019—I am looking at the noble Baroness, Lady Thornton, and clearly she does, too. Although much time has passed, little has changed. We are still facing a situation in which we live under the threat of leaving with no deal and therefore being a third country in terms of EU regulation. These matters are of immense importance. We are, as the noble Lord, Lord Lansley, said, talking about tissues and materials and so on which are in high demand and of which there is not a great surfeit.

It is important now to realise that we are talking in these regulations simply about the circumstances under which we would import such materials from the EU into Northern Ireland and into Great Britain. I will say one thing for Brexit: it has educated the British public in what the United Kingdom is and what Great Britain is and what the differences are between the two. Some of us who were brought up in Scotland have long known the difference.

I understand what the Minister says about these regulations being important in order to enable the current regime, or congruence of regimes, to continue. However, we are still talking about these regulations applying only for a transitional period of six months. The noble Lord, Lord Lansley, is absolutely right that we will face the prospect very shortly of having part of the United Kingdom under a regulatory environment into the terms of which the UK Government have had no input. I happen to think that that is an inevitable part of Brexit, and I am not surprised that that was never put on the side of a bus. None the less, it has important consequences for people in Northern Ireland and for the rest of us in the United Kingdom.

Can the Minister say who will have the responsibility for keeping under review the regulatory burden and costs of operating two different systems within the United Kingdom, and who will be responsible for the long-term monitoring of issues such as the availability of organs and tissues within Great Britain on a long-term basis? My noble friend Lady Walmsley is right: there is a degree of danger here to the supply of these necessary items.

When we debated these regulations in 2019, I did not get a satisfactory answer on inspection of premises and what would be the responsibility of both the British authorities and others to notify serious incidents within 24 hours. Perhaps in his response the Minister might take that up.

I also think that the noble Lord, Lord Lansley, is absolutely right that Clauses 42 and 43 of the United Kingdom Internal Market Bill have no place on our statute book. They certainly have no place in relation to the importation of these materials from the EU.

So politically we are no further on, but perhaps the Minister might be able to enlighten us with a bit more detail than was the case back in January 2019.