Terminally Ill Adults (End of Life) Bill

Baroness Falkner of Margravine Excerpts

Committee stage
Friday 30th January 2026 Lords Chamber

[Lord Sandhurst (Con)]

My Lords, I can be truly short here and it is further to a point made by the noble Baroness, Lady Grey-Thompson. Many of us are concerned about subtle pressure and coercion. It will not appear in all cases, but it will in some and these are legitimate concerns. If this is online, doctors are unlikely to know whether there is someone else present in the room or whether the door is open for someone to listen, nod and encourage the applicant—if I can call the person that—to make their request. If at least one of the panel is present in the room, they would be able to see and counter that. It is really important that there is at least one of those people, preferably the panel, in order to prevent that. That is an important safeguard and, if it is done online, such things could be missed. My recollection is that, in Canada, there have been instances where people, including coroners, have raised legitimate questions afterwards.

[Baroness Falkner of Margravine (CB)]

My Lords, I want to pick up on two points made in this debate. First, if I heard the noble Baroness, Lady Gerada, correctly, when she advocated online meetings, she said that there is no distinction between whether the person requesting permission is in Torbay or Tenerife. That is a profoundly important legal point, which I hope the noble and learned Lord will cover in his summing up. If a person was in an online meeting in a foreign jurisdiction and it subsequently transpired that there was coercion—noble Lords have given several examples of how that could happen—from a foreign citizen, assuming the patient returned to the UK to carry out their wish to be assisted to die, what would be the legal position in the criminal law?

My second point relates to what the noble Baroness, Lady Berger, said about home assessments. I do not have the impact assessment to hand, but I recall that the number of people likely to seek assisted dying is not enormously large, running, say, to many thousands per year. Therefore, if only 10% of people were unable to have face-to-face consultations, surely the impact assessment should cover that small minority of people and the costs and practicalities of them requiring home assessments.

[Lord Polak (Con)]

My Lords, I support the amendments in this group, especially the one from my noble friend Lord Evans. I was not going to speak but I was moved by what the noble Baroness, Lady Smith, said about her father.

I am not a Luddite. My mother passed away in July 2023 from brain cancer, and this debate has reminded me of the Zoom call we had to look at the next stage of her treatment. I was here in London; my sister was with my mother in Liverpool, where she was lying in bed unable to speak. The nurse who was looking at the next stage of treatment for her was in Margate, had never met my mother, and was asking questions for over an hour to which mother could not reply. I have listened to this whole debate, and if we cannot put face-to-face consultation in the Bill, we are doing a great injustice to many people.

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[Lord Harries of Pentregarth (CB)]

My Lords, like the noble Baroness, Lady Hayman, I will respond to the noble Baroness, Lady Blackstone. She seemed to express a kind of common-sense view that of course we all agree that it is much better to have face-to-face interviews, and we have heard all sorts of evidence today from the medical profession and the legal profession about how that is much better. The noble Baroness thinks there should be a code of practice. I agree, but surely that code of practice should be about where there are exceptions. It would be much safer to have a Bill in which it is specified that interviews should be face to face, except for certain exceptions laid out in a code of practice. Surely it should be that way around in order that we have as safe a Bill as possible.

[Baroness Falkner of Margravine (CB)]

My Lords, the noble and right reverend Lord makes a really valid point about codes of practice. Codes of practice sometimes are not statutory, so it would need to be a statutory code. Apart from all that, we also know that codes of practice become outdated. In another area of my expertise, a statutory code of practice was agreed in 2011. Although it is unlawful today, it has still not been withdrawn by the Government.

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[Baroness Andrews (Lab)]

My Lords, I think it is right, as my noble friend Lord Rooker said, that this clause stand part debate is an opportunity for a reset and a rethink about how we are approaching the Bill and the way we are prioritising the arguments. Where I slightly take issue with my noble friend is that I do not think it is helpful to apportion blame. We are where we are with this Bill now, and we are all under the clear impression and instruction that, if the Committee wants to change the Bill, whether those who oppose it or those who support it, we have to get it to Report so that we can do that and then send it back to the Commons improved and amended.

On the question of delegation, I worked with my noble friend Lord Blencathra—I will call him that—on the reports on delegated legislation, and they were extremely important. What we have discovered in this Bill, as the amendments have been put forward, is that there is a difficult balance to be achieved between what goes into the Bill on the principle and the design—our task in this House is to make every Bill workable—and what has been left to delegation. As a result of the nature of the Bill, the behavioural issues that are raised by it, and the extraordinary personal and exceptional circumstances when we are dealing with people in the last months of their life—which we should never lose sight of, no matter what we are debating and how technical and process-driven it is—we have to think about the balance between what is workable because it is in the Bill and will stand in law and what has to be left to delegation going forward and therefore can be amended as circumstances change. That is the situation the Australians find themselves in. We have a lot to learn, as we have already learned, from Australian medics who have told us how they are managing the Bill and what an extraordinary benefit it has been. That is on the public record.

All I would say, before my noble friend Lord Blencathra possibly opposes me, although I hope not, is that this is an opportunity to look at the amendments that are coming forward and the priorities we are attaching to them and whether we can triage them in some way. My noble friend Lord Rooker is right that a lot of these early amendments can fall away, because we have addressed the principle. Can we focus on what it will now take to agree to improve the Bill, so that we can have shared trust across the Committee that this is about improving the Bill and not delaying it to the point that it will never become law?

[Baroness Falkner of Margravine (CB)]

My Lords, I have a point related to the point made by the noble Lord, Lord Harper, about impact assessments. Noble Lords will be aware that I am a former chair of the Equality and Human Rights Commission. I gave evidence on this Bill when it was being examined in the other place. Once it was introduced in your Lordships’ House, I recused myself from the EHRC’s involvement on the Bill, as I anticipated participating on the basis of being a Member of this House. That is the background, should anyone detect any conflict of interest on my part. A senior EHRC commissioner, Alasdair Henderson, who is a barrister, has since represented the EHRC on this Bill.

On 22 January, nearly 60 Members, including me, wrote to the Minister calling on the Government to update their equality impact assessment. This was to pick up the argument from the EHRC—which was put nearly three months ago, so the Government have had a substantial amount of time to think about it—that the current EIA contains several gaps and focuses primarily on access to an assisted death rather than on safeguarding risks and the potential for coercion. That letter has been circulated to the whole House. Yesterday, I received a reply from the Minister declining the request. Parliament will receive an updated impact assessment and equality impact assessment only

“should the Bill receive Royal Assent”,

and

“once detailed implementation work has been completed”.

In other words, the Committee is being told that it must legislate blind.

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[Baroness Thornton (Lab)]

I am slightly puzzled. I have of course read the Minister’s letters, but I am not quite sure why the noble Baroness is speaking about these in the middle of a discussion about clause 1 standing part. Is she supporting the clause standing part or not? Surely that is the debate we are supposed to be having.

[Baroness Falkner of Margravine (CB)]

My Lords, perhaps reference to the Companion will help reduce the noble Baroness’s confusion about my speech. The Companion says that, once the Chair has put the Question,

“a general debate on the clause may take place”.

I am highlighting problems with the clause. Clause 1 is the substance of the Bill and an equality impact assessment is fundamental to our understanding of whether it should stand part.

To come back to the letter, it refers to the possibility of generating comparative evidence on the wider matters, but that would not have produced sufficiently robust conclusions. The matter raised was that the EIA did not deal with any detail of all those certain protected characteristics because it focused on access to assisted dying. Access to assisted dying is not relevant to the safeguarding risks that we have all spent some eight days in Committee debating. The letter says:

“We intend to update both the Impact Assessment and the Equality Impact Assessment should the Bill receive Royal Assent, once detailed implementation work has been completed”.


That will be too little too late. It is of no assistance to Parliament in considering the Bill and its potential consequences. Indeed, the whole point of an EIA is that it is done before or at the time a decision is taken. I refer again to the Cabinet Office guide to making legislation. A failure to undertake a comprehensive EIA means a failure to comply with a public sector equality duty, as post hoc analysis cannot generally cure a failure to have due regard to equality implications at the time a decision is being made.

That is what the courts consistently emphasise. R (Blundell) v Secretary of State for Work and Pensions 2021 noted that post-decision equality analysis is not sufficient to fulfil the duty, as it is supposed to be a real, open-minded consideration of the equality implications, conducted with substance and rigour, not a rearguard box-ticking exercise.

In concluding, I say to the Government that an accurate assessment of how the Bill impacts people who share each of the nine protected characteristics does not betray that position of neutrality. In fact, it is the converse: withholding information is not an act of neutrality but the opposite of that.

The Constitution Committee published a report on the Bill on 11 September, lamenting that supporting documents, including the EIA, “were issued late” or were not available. In the other place, Ministers gave the excuse that the Bill was “highly dynamic” and likely to undergo significant changes during scrutiny, so it was important to wait until the committee concluded its work so that

“we know what it is that we are assessing the impact of”.—[Official Report, Commons, Terminally Ill Adults (End of Life) Bill Committee 30/1/25; col. 282.]

Now we are told that there is insufficient evidence to produce conclusions that are sufficiently robust. I suggest that the Minister review what both the EHRC and the letter submitted by 59 Members of this House have asked her to do and come back with some more positive news at an earlier date.

[Lord Jackson of Peterborough (Con)]

My Lords, I beg the indulgence of the Committee to raise what I think is an important point; I hope the Committee does not think it pedantic. I had not intended to speak but was prompted to by the excellent speech of the noble Baroness, Lady Falkner, and by my noble friend Lady Coffey’s reference to the lack of insight provided by the Government—I will not criticise the sponsor, the noble and learned Lord, Lord Falconer of Thoroton. This—our deliberations, scrutiny and oversight of the Bill—is a moveable feast, so we need information in real time.

My specific point is not just about freedom of information but about Written Questions that the Government have received and not answered. On 1 December 2025 my noble friend Lord Kempsell asked His Majesty’s Government a very reasonable Question. He asked, with regard to the Bill and its impact assessment,

“what assessment they have made of the effectiveness of judicial approval as a safeguard in countries with assisted suicide regimes, including the proportion of applications refused in those countries and the reasons for refusal”.

Two months on, that Question has not been answered. That is unacceptable, because scrutiny and oversight require us to have all the information in our hands, including comparative legal, regulatory and medical regimes.

By comparison, the very sensible Question from the noble Viscount, Lord Stansgate—I do not want to embarrass him because he is in the Chair—about the use of the Parliament Act was asked on 26 January and answered promptly on 29 January. The point is that there should be equality and a level playing field on Questions asked, irrespective of the position on the Bill of the noble Lord asking it.

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[Lord Falconer of Thoroton (Lab)]

The noble Lord notified me of that beforehand; I thank him greatly for his courtesy.

May I briefly refer to the contents of the debate? First, the noble Baroness mentioned devolution. I have nothing to add in relation to devolution, but it felt like she was aiming more at the Government than at me. I am very supportive of the Government in this respect, but I had to say something in relation to that.

I will focus primarily on what my noble friend Lord Rooker said. I do not say this without thinking about it. I have the greatest respect for my noble friend, having been in government—though not as long as him, because I was sacked three years before he was sacked, and he was sacked only because the electorate replaced the Labour Government with a Conservative Government. He survived throughout the whole thing.

My noble friend is, in broad outline, right when he says that Clause 1 contains the spine—the trunk—of the Bill. I believe that this moment very much represents an opportunity for us as a House to see whether there is a way to get through this in time to send the Bill back. I completely accept what my noble friend said about my responsibility for bringing forward, as quickly and as well as possible, the areas where he was kind enough to say that I had been clear about my amendments. So I welcome the door that my noble friend has opened. I am more than willing, in relation to each of the areas where I have identified that I am willing to move, to sit down and try to agree, as much as possible, what those movements should be. I am absolutely sure that we will not agree on everything, but we can determine the things on which we do not agree on Report. So I welcome enthusiastically what my noble friend said about the way forward.

May I deal briefly with what the noble Baroness, Lady Falkner, said? Obviously, I am not responsible for either the impact assessment or the equality impact assessment. I must say, having read the points made by the commissioner of the EHRC, I think that the Government are right: it does not justify either a new impact assessment or a new equality assessment. The Government have been absolutely clear on why they think that, in principle, the Bill does not offend against the convention or the Human Rights Act. They have also been incredibly helpful, through Ministers, in saying where they think amendments might give rise to problems. It is perfectly legitimate for the Government to say, “We’re worried about amendments” but not to introduce a whole new assessment in relation to them.

[Baroness Falkner of Margravine (CB)]

Does the noble and learned Lord agree that, when courts in the United Kingdom rule that the public sector equality duty cannot be an afterthought—that it has to be complied with throughout and that Parliament needs to be aware of changes in circumstances or new issues that come up—it needs to be abided by? I am sorry; I cannot remember the title of the court case I referenced, but I am sure the noble and learned Lord will be able to find it in Hansard.

[Lord Falconer of Thoroton (Lab)]

I am well aware of the court case. It does not justify a new equality assessment in this case.

[Baroness Falkner of Margravine (CB)]

I was talking about the applicability of the public sector equality duty.

[Lord Falconer of Thoroton (Lab)]

I do not think that it justifies a new equality assessment. The thing about equality assessments is that lawyers can constantly write to clients and say, “You haven’t considered this and you haven’t considered that”. Having read in detail the equality assessment, I say that it deals properly and adequately with the issues.

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[Lord Pannick (CB)]

The noble Baroness makes an important point, because this Bill is concerned with providing choice. Of course there is no mandatory obligation, but, if you are given this information, you should have the right—it is your life—to decide whether you wish to take advantage of these provisions. In many cases, if it were me or my family, I would argue strongly that there are other options and other things should be done. But it is a choice, and people should have that choice. That is the philosophy and what has guided so many jurisdictions around the world. Many noble Lords do not agree with that, which is their right, but that is what this Bill is all about.

[Baroness Falkner of Margravine (CB)]

My Lords, the noble Lord rightly emphasises that choice is an essential element of this. But in so emphasising, he appears to cast “choice” in a very black and white manner as if it can suggest, not perhaps 100%, but 99% certainty, one way or another. I am sure the noble Lord is very grateful that he has never been in the situation of the patient sitting in that chair, having a conversation with a doctor, as I have, unfortunately. I can tell him that it is not a conversation with one doctor; it is a conversation across a multiple range of people, because doctors want you to have second opinions and speak to others to see if they might think of how you might ameliorate your illness, particularly in the case of cancer.

Puberty Suppressants Trial

Baroness Falkner of Margravine Excerpts

Thursday 18th December 2025 Lords Chamber

[Baroness Merron (Lab)]

I do agree with that point. We are seeking to protect the safety and interests of children and young people through evidence, and it is right and proper that we get on with that. As the noble Baroness has said, this is a trial; it is being led by King’s College London and the South London and Maudsley NHS Foundation Trust. It has been carefully checked by independent scientists who advise the NIHR and by the MHRA and it has also received approval from a research ethics committee. I would say that we are treading cautiously and correctly in this area, because all that matters is the safety of children.

[Baroness Falkner of Margravine (CB)]

My Lords—

[Lord Paddick (Non-Afl)]

My Lords—

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[Lord Paddick (Non-Afl)]

My Lords—

[Baroness Falkner of Margravine (CB)]

My Lords—

[Lord in Waiting/Government Whip (Lord Leong) (Lab)]

My Lords, it is the turn of the Cross Benches.

[Baroness Falkner of Margravine (CB)]

My Lords, in the case that children cannot consent, which is widely acknowledged, given the age of the children, we know that single-parent consent will be permissible for the PATHWAYS trial. We also know from litigation to date on these vexed matters that parents are going to court to ascertain whether a single parent can consent to this. Will the Government review single-parent consent and insist that both parents must give consent to these potentially irreversible changes, where children’s consent is not possible?

[Baroness Merron (Lab)]

As the noble Baroness rightly says, children, by definition, cannot consent to being on the trial, so places will require parental consent as well as the assent of young people. I can assure your Lordships’ House that, as I have already mentioned, there are strict eligibility criteria to join the PATHWAYS clinical trial. Part of the assessment by the professionals making the decision about engagement involves the role of parents, including whether there has been any undue pressure and a whole range of considerations. I urge the noble Baroness to refer to the details of how young people will be accepted on to this trial. I must emphasise that no person will be guided towards it who should not be. We are seeking young people; there is no requirement.

Terminally Ill Adults (End of Life) Bill

Baroness Falkner of Margravine Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Baroness Gerada (CB)]

My Lords, if a patient is at the end of their life in any practice in the NHS, that patient will be discussed at a multidisciplinary team meeting. The patient will be put on an end-of-life pathway and will have a named clinician within the practice to do their care. This would include assisted dying. There is absolutely no way that a patient, unless in an extraordinary situation—and I take the point about Wales, which has a desperate problem with GPs—would not be cared for in that way. That is how our contract is; that is how we want to care for our patients. We would code it on the notes so that every single person consulting with that patient would know that this patient was an assisted dying choice, and they would get the care that I have just described.

With respect to the arbitrary 12 months or 24 months, many patients choose to move at the end of their life. They choose to move to the place where their loved ones are. Many choose to do something such as go abroad to the countries that they may have come from and come back right towards the end of their life. To put in an arbitrary barrier of 12 or 24 months is not putting the patient first; it is putting an arbitrary time limit first.

[Baroness Falkner of Margravine (CB)]

My Lords, I wonder whether the Minister in winding up could advise us what the Companion says about Peers making speeches on the same amendment over several points of the passage of that amendment.

It is a pleasure to follow the noble Lord, Lord Deben, speaking to the amendment from the noble Lord, Lord Rook. There is a lacuna in Clause 1(1)(d), which, by requiring registration with a GP, does not cover the practical point of what happens to people who have lost contact with their GP. They may have lost contact for no other reason than being so ill, perhaps with cancer as that is the main illness that people who might be seeking assisted dying have, that they have been taken into private care—those who are lucky enough.

An increasing proportion of the population of the United Kingdom now uses private care, not least because employers provide it as part of a package. So, coming to continuity of care, if we must have the light-touch amendment of the noble Lord, Lord Rook, in the Bill, to clarify and strengthen Clause 1(1)(d), I will share with the Committee very briefly a practical experience of what it means to have advanced cancer and the interaction with the GP. My GP practice, having failed to diagnose me over six months, as I mentioned in my Second Reading speech, slipped away the moment I engaged with private care, although every single consultation with a private practitioner is sent to the GP. Nevertheless, between 30 August 2024, when I was first diagnosed, and late this September, I had no contact whatever with my GP practice. I was finally invited to come in and was told I had fallen between the cracks—it must have been a pretty large crack to have lasted 14 months.

I noticed in the equality impact assessment that 66% of the people who sought assisted dying in the two jurisdictions quoted were people who had cancer. My question to the noble and learned Lord when he winds up on this debate is therefore, what consideration has been given, in having Clause 1(1)(d) in the Bill, as to the relationship of the private oncologist who is treating that patient with the local GP, given that terminally ill people in significant enough numbers that we need to be conscious about them in the Bill may well have been—shall I say—passed on from the GP?

As a final point, once I had the diagnosis, I had the experience of requesting treatment at my local—within a walkable distance—leading cancer teaching hospital in the United Kingdom. When I rang about that after the diagnosis, I was told by my GP, “They won’t take you, because now you’ve gone private”. I leave that for noble Lords to reflect on.

[Lord Blencathra (Con)]

Before we move to the rest of the debate, could we please give way to those noble Lords who have tabled amendments? I would like to hear what they have to say.

Junior Doctors’ Strikes

Baroness Falkner of Margravine Excerpts

Monday 17th April 2023 Lords Chamber

[Lord Markham (Con)]

I am afraid I cannot provide a lot more information to the noble Lord, except that complications now include the purdah for local government elections, so I am trying to find out more details on this very subject as to when a date could be set. I am afraid to say I cannot give much more of an update than to say it will be released shortly. What I will say is that, among all this, we are still seeing increases in staff. I was delighted to see that we now have 5,100 more doctors in place than last year, and we have had an increase over the last few years of 30,000 nurses. So, there are movements in the right direction, but clearly more needs to be done.

[Baroness Falkner of Margravine (CB)]

My Lords, we still call it the National Health Service, but the Minister will be aware of the alarming figures for people who have no choice but to move to private provision of care. The numbers registering even for GP services privately must give cause for alarm, because we have got to be in this together to retain the national character of the National Health Service. I appreciate the Government’s concern about higher inflation due to very large settlements, but perhaps the answer is to sit down through ACAS, as the noble Baroness said, and think about slightly more generous one-off payments, because that will not bake in the inflation or increase costs in the longer term.

[Lord Markham (Con)]

I thank the noble Baroness. As I mentioned, we felt we had put a fair offer on the table—something that was recommended by the trade union leaders themselves. I think we need to see the overall verdict come out across the board on all this. I note that less than a third of the membership of the RCN actually turned it down in the end, so we have to see what the overall outcome is. There is an absolute commitment on our side to continue meeting constructively with the RCN and to use all means possible to get to a solution.

Social Care Reform

Baroness Falkner of Margravine Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord makes an entirely fair point. The needs of those who reside in Northern Ireland are paramount in our minds. I would be very glad to meet the noble Lord and discuss how their views and needs can be best incorporated in the policies we are developing.

[Baroness Falkner of Margravine (CB) [V]]

My Lords, does the Minister accept that public opinion has shifted, and that the public are now prepared to pay more to ensure that the elderly and vulnerable are properly looked after? Will the Government look at other countries’ attempts to deal with this tricky problem in terms of financial commitment? Japan has a surcharge for people over a certain age—I believe it is between 40 and 45 —and Germany has long had a solidarity tax to pay for particular hypothecated items. Will they at least look at this before the autumn spending review?

[Lord Bethell (Con)]

My Lords, I reassure the noble Baroness that we are looking at foreign parallels. The examples she gives are extremely instructive and thoughtful. I cannot speak for certain on where the public are on this, but I share her sentiments; I think the pandemic has demonstrated that the public are more connected with and thinking more about those in care than ever before in our nation’s history. It is exactly the right moment in terms of public sentiment to address some of these issues. The generosity of spirit towards the elderly living in care could not have been higher than it was during the pandemic. In that matter, I completely agree with the noble Baroness.

Covid-19: Restrictions

Baroness Falkner of Margravine Excerpts

Thursday 7th January 2021 Lords Chamber

[Lord Bethell (Con)]

The CMO has given some guidance on this matter. He has made the observation that deaths from other flus are down, partly because of the social-distancing that is part of the lockdown. He has also pointed out the very sad, but I am afraid inevitable, possibility that the large amount of infection that has grown up in the last few weeks will in time lead to further deaths. This is an uncomfortable piece of speculation but, as sure as night follows day, I am afraid that infections and hospitalisations will lead to further deaths. We are running at nearly 1,000 a day at the moment and that number is set to increase.

[Baroness Falkner of Margravine (CB)]

My Lords, I refer to my interests as set out in the register and point out that my remarks are personal. Compliance and transmission are interlinked, and transmission rates are hugely dependent on public compliance. So I echo the point made by the noble Lord, Lord Herbert, that, although senior libertarian individuals and leaders point to the fact that individuals can make their own assessments of risk, that is not the case. Does the Minister agree that complying with the rules is a public duty that we owe one another and not a matter of choice?

[Lord Bethell (Con)]

The noble Baroness makes the point well. My observation is that the British public are extremely supportive of both the lockdown and the measures involved. Of course, we all see highly visible exceptions in our travels and when we work, but by and large the British public have massively complied with the measures without any severe form of compulsion, and for that I pay an enormous amount of tribute. In the first lockdown, we had to behave as though the person we saw near us might have the disease; the suggestion now is that we should behave as though we have the disease. It is that discipline that we all need to apply.

Covid-19: Intensive Care Treatment

Baroness Falkner of Margravine Excerpts

Thursday 29th October 2020 Lords Chamber

Asked by

[Baroness Falkner of Margravine]

To ask Her Majesty’s Government whether any part of the NHS has operated under policy guidelines described as a “triage tool” which determine intensive care treatment for patients with Covid-19, and whether such guidelines will be used in the future.

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

My Lords, claims that frail and elderly patients were denied care in wave one of the coronavirus pandemic, in part because of the triage tool developed by the NHS in case it was overwhelmed, are categorically untrue. The Government are ultimately responsible for national policy on public access to NHS services. However, decisions on who will benefit from care are made as part of normal clinical decision-making by clinicians. Guidance to help clinicians make rational evidence-based decisions in the event of ICUs being overwhelmed was commissioned but was halted when it became clear that the NHS would not be overwhelmed.

[Baroness Falkner of Margravine (CB)]

My Lords, I think that the whole House will be grateful to the Minister for his unequivocal rebuttal of that extremely concerning story. Let me be clear that this Question is not intended to criticise the NHS, for which we all have the highest regard. However, according to that Sunday Times story, under conditions of extreme stress, consideration was given to guidance that could have amounted to age discrimination. Does he agree that there is a need for the NHS to uphold its public sector equality duty? Will he provide reassurance that these triage tools should not be used to prioritise patients on any basis other than clinical need either this winter or going forward as routine?

[Lord Bethell (Con)]

My Lords, I am grateful for the opportunity offered by the noble Baroness to reinforce the point. Age discrimination is absolutely forbidden by the NHS constitution. The CMO wrote to NHS trusts on three occasions to reiterate that point. I quote a letter published on 7 April:

“The key principle is that each person is an individual whose needs and preferences must be taken account of individually. By contrast blanket policies are inappropriate whether due to medical condition, disability, or age.”

Covid-19: Response

Baroness Falkner of Margravine Excerpts

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

It may appear from the outside that there are differences between the devolved nations and England, but my experience is that the four-nations approach to combating Covid has been extremely united and effective, and that we have worked extremely well together. It is true that we move at a different pace on some subjects, but we are generally moving to the same destination and in the same direction, and for that I pay tribute to my colleagues in the devolved nations.

[Baroness Falkner of Margravine (Non-Afl) [V]]

My Lords, the United Kingdom has spent 30% more than any other EU country on PPE. Of the UK’s PPE contracts, 73% went through without any competition at all, compared with 61% in Europe. The Department of Health had 137 contracts totalling more than £1.9 billion, none of which was subject to competition, according to Spend Network. The Department of Health has told today’s Financial Times:

“We have a robust process in place to ensure that orders are of a high standard and meet commercial due diligence.”


Which of those two statements is correct—that from Spend Network, or that from the Department of Health?

[Lord Bethell [V]]

Anyone who has stood at the Dispatch Box to answer questions on PPE, as I have done, will feel extremely proud of the fact that we have managed to purchase a very large amount of it under very difficult circumstances. We have also responded well to the challenge of a global collapse in the PPE supply chain. Despite appearances, we have substantial stockpiles of both near-term seven-day and further-term 90-day PPE resources; by that, I am very pleased. Competition does not necessarily guarantee either quality or delivery. I pay tribute to colleagues in the NHS, in the Cabinet Office and at DH who have, under extremely difficult circumstances, thoroughly checked out the delivery and bona fides of the contracts we have signed while working closely with the NSA to avoid fraud. We continue to work closely with both domestic and overseas suppliers, which I would argue has delivered a valuable result for the country.

Medical Teaching and Learning: Ethnic Diversity

Baroness Falkner of Margravine Excerpts

Tuesday 14th July 2020 Lords Chamber

[Lord Bethell]

I am not satisfied; the statistics are not good enough. Twenty-nine per cent of BAME staff experienced harassment. That is not good enough; we must work harder.

[Baroness Falkner of Margravine (Non-Afl) [V]]

Perhaps I might take the Minister upstream a little to the choices made by different communities about entering medical school. What work is being done at 15 and 16 year-old level in schools? Has his department had any conversations with Ofsted about the career choices that kids from diverse communities are making? Many realise that they want to go into medicine when it is too late and they have missed the appropriate A-level subjects so to do.

Independent Residential Care

Baroness Falkner of Margravine Excerpts

Tuesday 7th July 2020 Lords Chamber

[Lord Bethell [V]]

The noble and right reverend Lord is entirely right: the value and contribution of care home workers to society and to the communities that they work in go way beyond the actual monetary value of their salary. We completely respect and pay tribute to the contribution that they have made, particularly during this epidemic. We have sought during the epidemic to run recruitment campaigns to bring in new workers and to help plug any skills gaps, but this is the kind of issue that needs to be addressed in a long-term plan. We have already started work on that plan and look forward to bringing it to Parliament when the kind of cross-party support that is needed is in place.

[Baroness Falkner of Margravine (Non-Afl) [V]]

My Lords, I welcome the initiation of cross-party talks. The Minister will know now that more than two-thirds of the public want to fund health and social care through higher taxation. Will he now accept that as a principle if that is the result of the cross-party talks, instead of his Government ruling out tax increases?

[Lord Bethell [V]]

The noble Baroness makes her case well. There are a large number of considerations in this matter—my noble friend Lord Forsyth has already made a strong case for the recommendations of the Economic Affairs Committee—and we need to look at all of them. It is an extremely complicated area. We need to get buy-in from cross-party support and from a wide number of stakeholders and the businesses involved. Once we are in that position, we will be able to make a plan that delivers a long-term solution to this knotty problem.