Health and Care Bill

Baroness Smith of Newnham Excerpts

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Carlile of Berriew (CB)]

The noble Lord is trespassing on the old Social Democratic Party by using words like disingenuous. I will give him an example: some years ago, I chaired a Joint Select Committee of both Houses of Parliament dealing with the draft Mental Health Bill. That particular Bill was never enacted after our year of meetings and the report that we produced, but there was not a single person or NGO—including some that have been mentioned today—that did not believe that it was a parliamentary Bill. A Bill is a Bill is a Bill. In this Parliament we have draft Bills but not half Bills. That is my answer to the noble Lord.

I do not want to take up more time. I finish by saying that I think this is a completely misconceived proposal, both procedurally and, were we to come to it, on the merits.

[Baroness Smith of Newnham (LD)]

My Lords, I shall speak to both amendments but I shall speak first to Amendment 203, which, on the face of it, I am minded to support.

My reason for that—I hope this is not seen as a Second Reading speech—is that two years ago, just before Christmas, my mother contacted me and said she thought she had terminal cancer. She was taken to hospital two weeks before Christmas and died on Boxing Day, not of terminal cancer but of end-of-life COPD. I had no idea that she had end-of-life COPD, although I knew she had COPD. On Christmas morning, I was summoned to the hospital, and a junior doctor asked me what I wanted to do: “Your mother’s been a bit unconscious. What do you want us to do? Do you want us to wake her up? Do you want us to do anything?” That is not really the best conversation to have. The next morning, Boxing Day, I had almost exactly the same telephone call: “Please come to the hospital, your mother is very ill.” I said that I had had the same conversation yesterday. However, on this occasion I was summoned in and met a doctor who spoke to me with compassion. My father and I agreed that my mother should not be resuscitated. I had never had that conversation with her, but, when I went through her things, I discovered that she had completed a form that said: “End-of-life COPD. When in doubt, do not resuscitate.”

So, in many ways the amendment in the name of the noble Baroness, Lady Meacher, is very attractive because it is surely right that, towards the end of their lives, people talk about what is appropriate.

--- Later in debate ---

[Baroness Meacher (CB)]

It might help the Committee if I make clear that, as I understand it, all our Fridays are taken up, because people are talking so long on all these Bills that we are having to use Fridays for government business, and also there are lots of Private Members’ Bills with Second Readings to come. So my understanding is that we have done what we can do with my Bill.

[Baroness Smith of Newnham (LD)]

My Lords, perhaps the Minister, in replying, can tell the Committee whether he will talk to the usual channels, especially since I note that the Chief Whip and the Deputy Leader are both in their places, about whether time could be made available for further discussion of the Bill that is extant. Because whatever the merits or demerits of assisted dying, this is not the Bill for such an amendment.

[Lord Ashton of Hyde (Con)]

My Lords, the noble Baroness, Lady Grey-Thompson, has been trying to get in for a while.

Covid-19: UK Arrivals

Baroness Smith of Newnham Excerpts

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

I welcome questions from noble Lords, particularly on getting the booster on the app, because when I am talking to officials in the department and the NHS it shows how important it is that we do this as quickly as possible. One of the tasks is to be accountable and to push the NHS and others to make sure that we are doing this. Sadly, when I ask what the problem is on test and trace, I am told that it is unable to validate the vaccination status of people whose vaccines are not recorded on a national immunisation management system. I have asked about passenger locator forms and whether we could use a similar technology. At the moment that is done on trust, but you face a very high fine if you are misleading; maybe that could be a solution. I assure noble Lords that I really am pushing.

[Baroness Smith of Newnham (LD)]

My Lords, I refer to my registered interests. I have printed off the advice given by my university, Cambridge, to international students and what it means to be fully vaccinated. To come into the country, if they are fully vaccinated, they do not have to isolate when they arrive, as the noble Baroness, Lady Royall, pointed out. If the system can understand when they arrive in the country that they are fully vaccinated, why can the NHS app not understand that they are fully vaccinated when they get pinged by test and trace?

[Lord Kamall (Con)]

I share the frustration of the noble Baroness and others. This is not great for our international, global outlook, or for the fact that we want to attract the best students from around the world, not just Europe. We are a global country and we have to address this. I am pushing the NHS on this because it is really important. The problem is the national immunisation management system, to use the technical term, and the inability to validate the data of overseas visitors.

GPs: In-person Appointments

Baroness Smith of Newnham Excerpts

Tuesday 19th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for his warm welcome to me in my new role. As other noble Lords have expressed, it is really important to make sure that the relationship between patient and doctor or GP is respected. That will not always mean being seen face to face, but when a patient asks for this there has to be a good medical reason if the appointment is not. Speaking from personal experience, I have found online consultations as good as, if not sometimes better than, face-to-face appointments.

[Baroness Smith of Newnham (LD)]

My Lords, I declare an interest. Last November, my father turned yellow. He rang to get a doctor’s appointment and was given a telephone consultation. He does not have a smartphone. The GP said, “It’s jaundice, but it might be pancreatic cancer.” No other suggestion was made and there was no suggestion that he could go in to see the GP. He did not know that he had a choice. He is still with us 11 months later; it clearly was not pancreatic cancer. The idea that people have choice does not work if they are not strong and vocal enough to be able to tell the GP practice, “I need a face-to-face appointment.” What will the Minister do to make patients aware that this is possible?

[Lord Kamall (Con)]

I sympathise with the case that the noble Baroness communicated. It is important that GPs and patients work that relationship out between themselves. If a patient asks for a face-to-face appointment and the GP refuses to give one, the GP has to have a good medical reason.

Covid-19: Conflicts of Interest

Baroness Smith of Newnham Excerpts

Wednesday 18th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the very large number of advisers, both paid and unpaid, were all processed by the department and their paperwork was then handed on to the Cabinet Office for approval. George Pascoe-Watson, as others, was sent both a declaration of interest form, which he filled in and is on record, and a volunteer agreement, which has the Official Secrets Act built into it. His work was covered by that.

[Baroness Smith of Newnham (LD) [V]]

My Lords, could the Minister tell the House whether the Government’s anti-corruption champion, John Penrose MP, has been involved in looking at any conflicts of interest or whether he is in danger of having a conflict of interest himself?

[Lord Bethell (Con)]

I am not aware of him being involved in the work to which the noble Baroness refers.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Baroness Smith of Newnham Excerpts

Wednesday 4th November 2020 Lords Chamber

[Baroness Smith of Newnham (LD)]

My Lords, I, like many noble Lords who have spoken this evening, find that it is with a very heavy heart that I support the regulations for a further period of lockdown. I very much regret that. I have a series of questions for the Minister because I have concerns about the Government’s approach to scrutiny, parliamentary democracy and the use of evidence. I am not a scientist and will not try to second-guess any of the scientific evidence, unlike some noble Lords who have put down amendments or moved a fatal Motion, as the noble Lord, Lord Robathan, has.

Back in September, the Government appeared to have evidence that a second lockdown or circuit-breaker would be necessary. Why did it become so urgent that it had to be announced only last Saturday, and the Prime Minister had to announce what he planned, not in front of the House of Commons but at an emergency press conference, allegedly because of a leak? Are this Government fit for purpose? Are they able to produce the necessary legislation in a timely manner? If the information that the Government had last week was dramatically different from that in September, it would be useful to know, but it is not clear that it was. There were calls from the Official Opposition and the Liberal Democrats for a circuit-breaker much earlier. Why do the Government use the evidence only when they choose to then claim that it is urgent, making sure that there is little time for parliamentary scrutiny?

Like several of the noble Lords who have tabled amendments, I have concerns about the economy and mental health. I declare an interest as a resident fellow of a Cambridge college; I will be locked down, as will the students. I live in a flat; they will live in small rooms for a month. Have the Government done an assessment of the impact on mental health? On 16 March, I asked the Minister what assessments had been done, before the lockdown proposed then. On that occasion, he told me that I was

“entirely right to be concerned about the holistic challenge we face”

and that the announcement on 16 March

“focused on the clinical response”,

but that the Minister would

“be glad to answer any questions on specific subjects as they arise.”—[Official Report, 16/3/20; col. 1362.]

Eight and a half months later, can he give us some answers?

Health Protection (Coronavirus, Local COVID-19 Alert Level) (Very High) (England) Regulations 2020

Baroness Smith of Newnham Excerpts

Wednesday 14th October 2020 Lords Chamber

[Baroness Smith of Newnham (LD)]

My Lords, I very much regret the statutory instrument that we are debating this afternoon. Like other Members of your Lordships’ House, I am acutely aware of the need to be able to deal effectively with Covid-19.

I declare my interest. I might go by the title of Baroness Smith of Newnham, which is in Cambridge, but I am of Crosby in the county of Merseyside, which I believe Her Majesty’s Government have now renamed Liverpool City Region. I am from Sefton. On Friday, I was planning to travel to visit my father, as well as my optician. That might of course be seen as simply “doing a Dominic Cummings” but I had anticipated doing so. I have talked to my family and asked what they think about the tier system and, in particular, the question of visits by members of the family who no longer live in the city region. Officially, we can visit but we cannot stay—or maybe we can, although it is advised not to.

I have looked at the three statutory instruments that we are dealing with today—unlike the noble Baroness, Lady Noakes, I propose to speak to only one of them—but it is not clear how people are expected to engage between the three tiers. It is not necessarily clear to people in Sefton and others parts of Merseyside why they should be in the “very high” tier, when infection rates are lower than in Manchester, Nottingham or Newcastle-upon-Tyne. If it is because of the capacity of the local hospitals being reached, that needs to be made much clearer.

Given that I am from Crosby, I should be most grateful to be told whether outdoor locations where people are permitted to meet include a beach. To me, that is outdoors and possibly a place where I am allowed to meet my father. However, in terms of trust and understanding the Government, can the Minister explain why this approach is being taken now rather than their having proposed something clearer and more self-explanatory three weeks ago, when SAGE put forward its suggestion for a circuit break?

Covid-19: Response

Baroness Smith of Newnham Excerpts

Monday 27th July 2020 Lords Chamber

[Baroness Smith of Newnham (LD) [V]]

My Lords, the noble Baroness, Lady Falkner of Margravine, raised the issue of the procurement of PPE. Can I press the Minister on the procurement of vaccines? According to the Statement, the Government appear to have secured 190 million doses of vaccine—if they succeed. Could he tell us what procedures have been undertaken to procure the vaccines and reassure the House that the country will not lose money if the vaccines do not, in fact, succeed?

[Lord Bethell [V]]

I am not quite sure of the 190 million number. I think that is possibly an aggregate number of different vaccines. However, the practicalities of vaccine research are extremely expensive, and there are eight, nine or 10 potential runners and riders in the global vaccine market. It is the practice for countries to contribute to those research costs up front in order to have access to the vaccine should it be successful. That is the practice for medical research of many kinds, and these are the practical costs of trying to break the difficult mystery of the disease and providing security for ourselves and for our children.

Covid-19 Update

Baroness Smith of Newnham Excerpts

Monday 16th March 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right. As a trustee of Sadler’s Wells, I understand completely the implications of what she is saying, her point about insurance, and the confusion there might be about what the current status is. I simply cannot answer the question right now. I am not trying to avoid a difficult question; I simply do not have the information. When I do, I will be very happy to write to her and to others who have asked about this.

[Baroness Smith of Newnham (LD)]

My Lords, the Minister has told us several times that the key government priority is to deal with the health crisis of Covid-19. But what work are the Government doing to ensure that the other issues that have been raised, for the self-employed and for small businesses, do not lead to such severe crises that we see an outbreak of suicide because people simply cannot cope and think they do not have a future? It is not only the virus: there needs to be a whole series of decisions around questions that have been raised this evening, to which we have not yet had any answers.

Hospitals: Listeria

Baroness Smith of Newnham Excerpts

Monday 17th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Lord, Lord Tunnicliffe, for his question. The purpose of the review is to build on previous work and to implement standards for higher-quality food for NHS patients. It will take a root-and-branch approach and will follow the evidence where it can make improvements. The terms of reference are to work with the NHS and stakeholders; they are currently under development, but will be shared with Parliament as soon as they are set in place.

I can also reassure the noble Lord on the question he raised about the products. While GFC manufactures a range of products, in the consumption data gathered from case records only sandwiches were identified as having been consumed. It is therefore anticipated that the review targeted at the NHS is the right approach.

[Baroness Smith of Newnham (LD)]

My Lords, like the noble Lord, Lord Tunnicliffe, my thoughts and prayers are with the families of those who died. It is clearly right, as the Secretary of State said in his Statement, that people expect to be safe and looked after in hospitals. Yet the Answer to the Urgent Question seems to spend rather a time talking about healthy food and other wider issues. This is an urgent issue. What will happen urgently to ensure that similar situations cannot happen again? Getting rid of sugar may be important, but ensuring that listeria is not present is vital. What necessary steps will be taken to restore trust urgently? I am sure that we all welcome the Secretary of State back to his full-time job now that he has stopped trying to be leader of his party.

National Living Wage: Social Care

Baroness Smith of Newnham Excerpts

Thursday 5th May 2016 Lords Chamber

[Lord Prior of Brampton]

The noble Baroness is absolutely right. Our whole focus must be on the residents of these homes rather than the owners. There are a number of very highly leveraged providers in this sector, which have high levels of debt—often very expensive debt—for historical reasons. The CQC is keeping a very close watch on them. When there are early-warning signs of difficulties, the CQC and the local authorities will put in place alternative plans.

[Baroness Smith of Newnham (LD)]

My Lords, talking to a charity recently I was told that some care homes have already raised fees by £100 a week since the introduction of the national living wage in April this year. What plans do the Government have to look at the relationship between the cost of care homes and the cost to the individual of the economic viability of care homes, in light of the fact that the target for 2020 is to have a national living wage of £9? We need social care and care homes to be economically affordable.

[Lord Prior of Brampton]

The living wage will go up over this period of time. The better care fund and the social care precept will of course go up, too, over this period. Clearly there will be some fee increases. Local authorities have an obligation under the Care Act to have a sustainable and diverse market in their area. There will be fee increases to private providers but the main squeeze—the main concern which we in this House should have—is over local authority-funded care.