Healthcare (International Arrangements) Bill

Debate between Baroness Chisholm of Owlpen and Baroness Jolly

Report stage (Hansard): House of Lords
Tuesday 12th March 2019 Lords Chamber

[Baroness Jolly (LD)]

My Lords, I too support the amendments in the names of the noble Baroness, Lady Thornton, and my noble friend Lord Marks. I repeat the view that he and the noble and learned Lord, Lord Judge, expressed: we should be producing only legislation resulting from the decision to leave the EU. I thank the Minister very much for meeting us and for the government amendments—particularly to those Henry VIII clauses, which have absolutely no part in modern legislation.

I agree with previous noble Lords, but any Bill dealing with healthcare agreements outside the EU is different. I would be happy to look at these issues in another Bill at another time. As has just been said, the expansion in scope of the Bill looks opportunistic and is completely inappropriate at the moment.

[Baroness Chisholm of Owlpen (Con)]

My Lords, I cannot agree with these amendments. As we pointed out during the progression of the Bill, we live in a global world, with more people travelling internationally for all kinds of reasons. There is obviously a huge demand for healthcare systems between countries, giving the traveller peace of mind that the foreign country they are in can respond to healthcare needs.

As was also mentioned, we already have simple reciprocal agreements with non-EU countries. The domestic implications are limited, and our current powers to charge domestic overseas visitors, and the regulations under such powers, provide for domestic implementation. Importantly—

Health: Folate

Debate between Baroness Chisholm of Owlpen and Baroness Jolly

Thursday 1st March 2018 Lords Chamber

[Baroness Chisholm of Owlpen]

Well, I cannot. I am sure that he would be willing to meet, but I cannot answer for him. The noble Baroness is completely right. One reason that there has not been movement on this until now may be because of problems with the upper level, which this report says is not a problem. If the upper level is no longer needed, that will provide reassurance on the safety of mandatory fortification and we will be able to proceed.

[Baroness Jolly (LD)]

My Lords, much of the first world, and indeed parts of the rest of the world, are heeding the advice of British scientists, and I am delighted that we are here now getting a bit nearer to putting folic acid in flour. The Minister said that several departments would need to be involved in this. Will she tell us which departments?

[Baroness Chisholm of Owlpen]

Yes, Defra and the Department of Health.

Human Fertilisation and Embryology (Amendment) Regulations 2018

Debate between Baroness Chisholm of Owlpen and Baroness Jolly

Tuesday 27th February 2018 Grand Committee

[Baroness Jolly]

I did not mean to mislead the Minister, I just anticipated that many more regs would need a similar sort of exercise to that we have done today—in the NHS health sphere and in general. The question was really about workload: how many more do we expect to come down the track, when do we expect them to come and are we anticipating that they will be finished by Brexit date? Is there any indication that they are being done on a slightly ad hoc basis or are some being prioritised over others? I am sorry if the Minister is unable to answer that now, but if she wants to write to me, that will be fine.

[Baroness Chisholm of Owlpen]

I cannot give a timing on that now so I will have to write. These regulations needed to be dealt with anyway and they are slightly late, partly due to a general election, so we have to put them in place now. It actually has nothing to do with Brexit. We have to put them in place now, otherwise we would have heavy fines. In a way, that slightly answers the question from my noble friend Lord Deben about why we are doing it. We are making sure that our standards are as high as those of other EU countries, so this is actually transposing existing regulations and making us consistent with the EU; we are not adding anything new.

Pregnancy: Folic Acid

Debate between Baroness Chisholm of Owlpen and Baroness Jolly

Tuesday 23rd January 2018 Lords Chamber

[Baroness Chisholm of Owlpen]

No, it is not mulish obduracy. The Secretary of State is minded to look at this again and has asked officials to draw up a plan because we are listening to what everybody says. Your Lordships will just need to wait to see what the Secretary of State comes out with.

[Baroness Jolly (LD)]

My Lords, could the Minister tell the House when the Government last ran a campaign to remind women to take folic acid before they became pregnant and how many women were targeted? Do the Government foresee any future efforts to increase the number targeted, and if not, what responsibility do the Government have towards babies born with neural tube defects?

[Baroness Chisholm of Owlpen]

As I think was mentioned earlier, 50% of all pregnancies are unplanned, so the health education messages are provided in a range of settings, targeting women of child-bearing age. There is the Healthy Start programme, through which free vitamin vouchers are offered to pregnant women on low incomes, who will receive certain benefits. The NHS Choices website provides healthy lifestyle advice during pregnancy, including on the importance of folic acid supplementation, and there is the NHS Start4Life information service. Early in pregnancy, a midwife will provide information about nutrition and diet, including supplements such as folic acid and vitamin D, as well as lifestyle advice.

Pharmacy (Preparation and Dispensing Errors—Registered Pharmacies) Order 2018

Debate between Baroness Chisholm of Owlpen and Baroness Jolly

Wednesday 6th December 2017 Grand Committee

[Baroness Jolly]

Indeed, yes.

My noble friend Lord Clement-Jones has given the Committee the detail. I, too, champion local community pharmacies and pharmacists. This SI covers some of the content of his original amendment and will have a considerable impact on the profession. We are all human; we make mistakes. In the previous debate, I outlined a mistake which happened within my own circle at home and caused a large high-street pharmacy to change the way in which it dispensed and stored medicines. The measure will have an impact in that some pharmacists and pharmacy assistants will feel more confident in owning up to making mistakes. We are encouraging people within the health and social care service to do this because we will then learn and share good practice. It is good legislation: mistakes are confessed to and rectified, and lessons are learned.

We heard from the Minister at the outset of this debate that more legislation will be coming down the track to look at other things. When that legislation comes before us for debate, I hope that all the areas that have been exposed today as being in need of tidying will be tidied up.

[Baroness Chisholm of Owlpen]

I hate it when notes come over one’s right shoulder just as one is about to stand up, because one never has time to read them.

I thank all noble Lords for their points. The noble Baronesses, Lady Thornton and Lady Jolly, and the noble Lord, Lord Clement-Jones, all said that the measure was a long time coming. I certainly agree; six years is clearly far too long. I say in mitigation that we were hoping to bring it forward in 2015, but several things happened which I am sure noble Lords will remember: an election, followed in 2016 by a referendum, which rather held things up. Even so, 2009 to 2015 was quite a long time, but we must welcome it now.

The noble Baroness, Lady Thornton, referred to there being no formal requirement to report. We want to encourage pharmacists to feel that they can come forward and report. We do not want to put strong legislation in place for that; we want there to be a feeling of openness, that they can come forward without feeling that that they are likely to be prosecuted. With the champions and the guidance in place, that should happen, and they should get used to this just being part of what they do without fear of further prosecution.

The noble Baroness, Lady Thornton, mentioned pharmacy owners. We want pharmacy owners to have systems in place whereby anyone who discovers an error makes sure that the patient is notified. If this needs doing, the legislation deliberately incentivises candour on the part of all responsible people at the pharmacy. The noble Baroness asked also whether there should be a mandate for reporting errors. As I said earlier, the defences have been drafted to incentivise the reporting of errors not just by the error maker; in addition, all pharmacy professionals are already subject to professional standards set out by the pharmacy regulators, the General Pharmaceutical Council and the Pharmaceutical Society of Northern Ireland. These standards include duty of candour, which includes an obligation to be open and honest.

The noble Lord, Lord Clement-Jones, mentioned pharmacy technicians in Northern Ireland. They are not registered in Northern Ireland as they are here, so they cannot come under these defences. The criminal offences are still there, so this measure makes the right balance. If there is gross negligence or serious errors are made, there is still legislation in place whereby pharmacists can be prosecuted.

I do not have the date for this to go forward for care and hospital settings, but come this summer they will be starting to look into how to bring that forward. It will be interesting to learn how this works in the pharmacy setting and then to bring that forward. We are keen that that happens.

I certainly hear what the noble Lord, Lord Clement-Jones, said about appreciating pharmacies. We do indeed, and we realise what a very important role they have to play not only for supplying medicines but for giving advice. The noble Baroness, Lady Jolly, mentioned one of the errors we hope will be picked up in the new form—coloured boxes. I remember so well as a nurse the danger if you have different medicines in the same coloured boxes when you grab them quickly. Luckily you always had two people checking the medicines in nursing so errors rarely occurred, but that is exactly what we hope this will pick up.

I hope I have answered all the questions raised, in which case I finish by saying that we feel the order will add further impetus to the work already under way to reduce medical errors across the health service and provide much-needed assurance that pharmacy professionals can discuss inadvertent dispensing errors without fear of prosecution. It is important that the pharmacy professions build on this, help to underpin a learning culture that puts the patient first, and ensure that patients receive excellent care and service from registered pharmacies.