Healthcare (International Arrangements) Bill

Baroness Humphreys Excerpts

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

[Baroness Wheeler (Lab)]

My Lords, I support this important amendment, to which I have added my name on behalf of these Benches, and I thank the Minister for the proposed new clause.

Our original amendment proposing a duty to consult the devolved Administrations before making regulations under Clause 2 highlighted a glaring omission from the original Bill which has now thankfully been remedied by this amendment. Although we were very grateful for the assurances the Government gave that there was active involvement and discussion on the Bill with the devolved Administrations on matters affecting them, the requirement as a statutory duty was crucial, as many noble Lords stressed in Committee. We underlined that a statutory commitment to consult and seek the views of the devolved Administrations on matters affecting them would enable future discussions on reciprocal healthcare arrangements to take place on a collaborative and constructive basis.

I thank the Minister for updating us on Scotland and Northern Ireland, as also happened in Committee. I note too that a supplementary legislative consent Motion with regard to the Welsh Assembly is being discussed today. I was going to ask the Minister for further news, but obviously she has not had any, and I am sure that she will let us know as soon as there is some.

As the Minister also mentioned, in addition to the requirements contained in the amendment, the memorandum of understanding that has been developed between the devolved Administrations and the UK Government to underpin the amendment provides for devolved Administrations to be consulted on: the negotiation of new healthcare agreements; the development and drafting of regulations under the Bill to implement such agreements; and agreements which apply to or have implications for devolved Administrations, and on regulations giving effect to those agreements. We very much welcome that.

Finally, I ask the Minister for a formal response to the question I raised in Committee on the Constitution Committee’s report on the Bill in February in respect of the devolved Administrations. Paragraph 15 stressed the need for the Government to set out how they intend to manage the overlapping competencies in relation to the Bill and other policy areas. The committee pointed out that the potential for overlapping competencies will increase as all powers are repatriated from the EU, as does the scope for disagreement about such issues, and this will need to be managed. If the Minister prefers to write to me on this matter, that would be acceptable and much appreciated.

[Baroness Humphreys (LD)]

My Lords, I am grateful to the noble Baroness for introducing the amendment and for the implicit acceptance that the recognition of the powers of the devolved Administrations was a serious omission from the Bill. I must admit that I find the ineptitude—I think that is the right word—of Ministers and officials who produce Bills such as this without “devolution proofing” them deeply frustrating. Surely it would have been possible someone to take a few seconds at the early stages of the Bill’s production to ask, “Does this Bill have an impact on the powers of the devolved Administrations?” That would have saved so much time, and prevented my blood pressure skyrocketing.

While I am pleased that the amendment calls on the Secretary of State to consult with devolved Administrations on matters that are within their devolved competence, may I press the Minister to explain the implications—and perhaps the limitations—of the word “consult”? My amendment in Committee called for an assurance that the Bill would not allow the Secretary of State to amend, repeal or revoke Welsh primary legislation—which is rather different from mere consultation. I would therefore be grateful if the Minister could clarify this for me so that we have on record a full recognition of the powers of the devolved Administrations.

[Lord Wallace of Tankerness (LD)]

My Lords, I signed the amendment in the name of the noble Baroness, Lady Thornton, in Committee. Indeed, as I indicated in the speech I made then, when evidence was given to the Scottish Parliament committee that was looking at the legislative consent Motion memorandum issue, there was an expectation that there would be a consent provision in the Bill. The noble Baroness, Lady Blackwood of North Oxford, clearly indicated an intention to do so when she replied to the debate; I put on record an appreciation of the fact that we now have this delivered in letter and in spirit.

Healthcare (International Arrangements) Bill

Baroness Humphreys Excerpts

Committee: 2nd sitting (Hansard): House of Lords
Thursday 21st February 2019 Lords Chamber

Moved by

[Baroness Humphreys]

30A: Clause 5, page 3, line 42, at end insert—
“( ) Regulations under this Act may not however repeal or revoke primary legislation in the case of—(a) an Act of the Scottish Parliament,(b) a Measure or Act of the National Assembly for Wales, or(c) Northern Ireland legislation,without the consent of the relevant devolved legislature.”

[Baroness Humphreys (LD)]

My Lords, I apologise for not being able to take part on Second Reading.

This group contains two amendments in my name and that of my noble friend Lady Jolly and a further amendment in the names of the noble Baroness, Lady Thornton, and my noble and learned friend Lord Wallace of Tankerness, which I also support.

Amendment 30A seeks to ensure that the Government may not by regulation repeal or revoke primary legislation made by the devolved legislatures without their consent. Amendment 30B seeks to ensure that the Acts passed in this Parliament giving powers to the devolved legislatures may not be modified without their consent. It could be argued that this is what the Bill tries to do.

I am grateful to the Minister for her response to a question posed by the noble Baroness, Lady Finlay, in Committee on Thursday. However, I would like to use my two amendments to open further discussion around the issue of legislative consent by the devolved Administrations and how this is impacted by the Bill. In the light of the Minister’s response on Tuesday, which was made after my amendments were tabled, I shall keep my contribution relatively short at this stage.

Many noble Lords have already spoken about the wide-ranging powers conferred on the Secretary of State by Clause 2(1)—powers which the Delegated Powers Committee described as “inappropriately wide” and as having “breath-taking scope”. As that committee pointed out in its report of 14 February, its conclusions were supported by the Constitutional and Legislative Affairs Committee of the National Assembly of Wales on the Welsh Government’s legislative consent memorandum on this Bill, where these inappropriately wide powers can be seen to have an impact on the devolved legislatures.

This House’s Constitution Committee records the decision of the Scottish Parliament to agree to an LCM in these “exceptional circumstances”. However, it also records that the Welsh Government have so far declined to give their legislative consent. It describes the Welsh Minister for Health and Social Services, Vaughan Gething AM, as expressing particular concern about Clause 2 because it,

“doesn’t require consultation or consent from Ministers in devolved administrations”.

The Welsh Government would expect to be consulted and their consent sought on this issue because powers over the health service have been devolved to Wales by this Parliament. However, Clause 2 is silent on this and, as such, it is an important omission from the Bill.

The Welsh Government acknowledge, of course, that an LCM will be required by the UK Government because provisions in the Bill modify or fall within the Assembly’s legislative competence. However, they also note that,

“any healthcare agreement entered into on behalf of the UK will affect the NHS in Wales and this legislation will therefore have a significant impact on a devolved policy area”—

and, one might add, potentially a significant impact on their finances too if they are expected to implement a UK policy that they have not budgeted for.

Rightly, the Welsh Government seek assurances from the UK Government to ensure that the Welsh Government are involved in matters that affect devolved areas in Wales and that this is recognised in the Bill.

The Minister said on the first day in Committee that she is in advanced discussions with the Welsh Government and that she hoped to be able to report back on this in more detail on Report, so I will not detain the Committee any further today on this issue. I merely wished to outline my concerns and draw your Lordships’ attention to them at this stage. I look forward to that further debate that she promised. I beg to move.

[Lord Wallace of Tankerness (LD)]

My Lords, I apologise that I was not able to speak at Second Reading. I shall speak in support of Amendment 42, which was tabled by the noble Baroness, Lady Thornton, and to which I have added my name. It is about a duty to consult the devolved Administrations before making regulations under this Act.

My noble friend Lady Humphreys has already given a flavour of the important constitutional and devolution issues which arise as a result of these provisions. As she indicated, unlike the Welsh Assembly, the Scottish Parliament has passed a legislative consent Motion in respect of the Bill—quite exceptionally, because the position of the Scottish Government is generally to withhold consent to legislation in respect of EU withdrawal, but they took the view that they would give consent if there were exceptional circumstances. In this case they believe there are exceptional circumstances. That view was supported by the relevant parliamentary committee in the Scottish Parliament, and last month by the Scottish Parliament as a whole.

This is a relatively modest amendment requiring consultation. The Explanatory Memorandum that accompanies this Bill makes clear in annexe A that there are areas, specifically in Clauses 1, 2 and 4, where a legislative consent Motion is required. It is very obvious, because here we have a situation where international agreements are made by a member state, in this case the United Kingdom, with other countries in respect of a subject matter that is devolved.

I am sure the Minister will be very familiar with Section 2CB of the National Health Service (Scotland) Act 1978, which refers to the functions of health boards outside Scotland. It states:

“Where it is the function of a Health Board to provide or to secure the provision of a service, the Health Board may secure the provision of that service outside Scotland … For the purposes of securing the provision of any service referred to in subsection (1), a Health Board may make such arrangements for the provision of the service as they think fit (and may in particular make contractual arrangements with any person) … Anything done by a Health Board in pursuance of subsection (1) or (2) is to be regarded as done in exercise of functions of the Scottish Ministers conferred on the Health Board by an order under section 2(1)(a)”.


The annotations on the very helpful legislative website indicate that these sections originate in EEA treatment costs regulations. Clearly this impinges on responsibilities devolved to Scottish Ministers. As I said, the legislative consent Motion was passed by the Scottish Parliament.

My noble friend Lady Humphreys mentioned the Constitution Committee. Paragraph 13 of its report on the Bill states:

“We recommend that the Government sets out how it intends to manage overlapping competences in relation to this Bill and other policy areas”.


When the Minister replies, it would be very useful if she could give us some indication of how the UK Government intend to do that. Obviously there are areas—for example, a regulation specifying or describing evidential or administrative requirements or processes—that could have an impact on administrative processes within the responsibility of the Scottish Government or health boards in Scotland.

It is instructive that, when the Health and Sports Committee of the Scottish Parliament took evidence in relation to the legislative consent Motion from Mr Paul Gray, who was the director-general for health and social care and chief executive of NHS Scotland until he stood down this month, he said:

“The Scottish ministers and the UK Government agree that the bill impacts on the devolved function of health. As a result, it requires the consent of the Scottish Parliament. UK Government officials have indicated that the bill will be amended to recognise the responsibility of the devolved Administrations. The proposal is to introduce a requirement to consult the devolved Administrations and to agree a memorandum of understanding with them before regulations can be introduced that impact on devolved matters”.


Subsequently, in answer to questions, Mr Gray went on to say:

“As I said in my opening statement, UK Government officials have indicated that the bill will be amended to recognise the responsibility of the devolved Administrations. The particular point to which I would draw the committee’s attention is the requirement to consult devolved Administrations and agree a memorandum of understanding before regulations can be introduced that impact on devolved matters. The distance that I can go, based on what we have—and bearing in mind that these are proposals—is to say that the current proposal is that there is a requirement to consult the devolved Administrations before regulations can be introduced”.


That was evidence given by the then chief executive of the health service in Scotland to a Scottish parliamentary committee, undoubtedly based on good faith from discussions he had had with officials at UK government level. This amendment seeks to give some substance to what would appear to have been agreed at official level, and I hope that the Minister feels able to accept it.

--- Later in debate ---

[Baroness Blackwood of North Oxford]

We need to bring forward the clause which we have agreed with the devolved Administrations. It is appropriate to do that but I thank the noble and learned Lord for his intervention and, on that basis, I hope that the noble Baroness will feel free to withdraw her amendment.

[Baroness Humphreys]

I thank the Minister for her clarification and the excellent news that the memorandum of understanding has been signed. I seek assurance from her that this matter will be reported on, or an amendment put forward on Report, so that we can hear exactly whether the Welsh Government have completed the LCM process. I thank her very much and I beg to withdraw the amendment.

Amendment 30A withdrawn.

NHS: 111 Service

Baroness Humphreys Excerpts

Monday 21st March 2016 Lords Chamber

[Lord Prior of Brampton]

My Lords, the noble Lord will be aware of the very severe problems at South East Coast Ambulance Service. The chairman has resigned. The chief executive is, I think, on gardening leave at the moment. NHS Improvement is very clear that it needs to sort out the management structure in that ambulance service.

[Baroness Humphreys (LD)]

Will the Minister explain how the 111 service will be improved to ensure that ambulances for life-threatening conditions arrive in a timely fashion and are not delayed or cancelled by 111 call handlers?

[Lord Prior of Brampton]

My Lords, the 999 service runs in parallel with the 111 service. If you have an emergency, you should ring 999; if you have an urgent request you should ring 111 and a decision will be made then on whether to call an ambulance. Interestingly, of the 27% of people who ring 111 who would otherwise have gone to A&E, only 8% are actually referred to A&E.