Terminally Ill Adults (End of Life) Bill

Lord Harries of Pentregarth Excerpts

Committee stage
Friday 12th December 2025 Lords Chamber

[Lord Falconer of Thoroton (Lab)]

The noble Lord puts it accurately. Some countries have taken one view and other countries have taken another. It is clear from the choice that I am supporting that we take the view that pregnancy should not be a bar to it, though inevitably, as the noble Baroness, Lady Grey-Thompson, said, there should be questions in relation to appropriate people, whether they are pregnant or not, which may have an effect on the result. On the more detailed questions, based on what I am saying, they would not arise in the Bill.

Going on to the third category, homeless people, again with six months to live or less, will very frequently, as my noble friend Lady Gray said, have complex needs and complex lives. I am very strongly against that right to an assisted death being taken away from them, but the safeguards will apply, to be sure that it is their clear and settled view and not the product of coercion.

Finally, the noble Baroness, Lady Berridge, raised the education, health and care plan. The range of people with an EHCP is very wide, as everybody knows. I am again very against excluding everybody from the significant provisions of the Bill, because the protections are there. They can go up to the age of 25 and, as I indicated last Friday, for people aged 25 and under we should think of whether there should be enhanced protection. That would include everybody up to the age of 25, including those under an education, health and care plan. In the light of those indications, I hope—

[Lord Harries of Pentregarth (CB)]

My Lords, I spoke at Second Reading but have not yet intervened in Committee. I have the greatest respect for the noble and learned Lord. However, would he not agree that there is a special vulnerability about all the categories that we have been discussing this afternoon? Are there any provisions that he can build into the Bill to address this? If you took a homeless person who only had six months to live and said, “Come and live in a five-star hotel and have good palliative care”, would they then still choose an assisted death? If you took somebody out of prison who had only six months to live and said, “We’re giving you early release, you can live in a five-star hotel with good palliative care”, would they still choose an assisted death? There is a particular vulnerability about these people. It is no good simply talking about their rights. They do have their rights, but they are vulnerable. I hope that the noble and learned Lord might be able to build something into the Bill to protect these categories of people.

[Lord Falconer of Thoroton (Lab)]

I completely accept that there are vulnerabilities in these groups. The question is whether we should exclude everybody within those groups from this right. Should we exclude every single homeless person or prisoner? We can disagree on this, but I am saying that I do not think that is right because the protections are sufficient.

Finally, the noble Lord, Lord Carter of Haslemere, asked how we deliver our Article 2 duty to protect people from death when they are in prison and we are offering them an assisted death. We are protecting them through the detailed safeguards there are before the individual prisoner is entitled to have an assisted death. In my view, that will be an adequate protection and give adequate effect to Article 2. In light of my remarks, I hope the noble Baroness will feel able to withdraw her amendment.

Wheelchair and Community Equipment Strategy

Lord Harries of Pentregarth Excerpts

Thursday 11th December 2025 Lords Chamber

[Lord Harries of Pentregarth (CB)]

My Lords, I thank the noble Lord, Lord Hunt, for introducing this debate, which is of great importance. I am the main carer for my wife, who is severely disabled, and I have calculated that we probably need at least nine pieces of equipment to lead any kind of reasonable life. She has a hospital bed to stop her having sores, a hoist to get her out of bed, a commode wheelchair to wheel her to the stairlift, a turner to get her on to the stairlift to take her downstairs, another turner to get her onto the commode lift and a commode lift to take her into the bathroom, in addition to a lifting armchair. In addition, there are special adaptations in the bathroom, with rails and so on, and there are both powered and hand wheelchairs, because we can get into the GP only with a small hand wheelchair. There are at least three ramps to get her out of the house.

We are very fortunate; this is a good story. We have what we want to lead a decent life. It is partly provided and partly purchased by us. However, it brings to my mind the total nightmare of those who do not have that equipment, or if equipment breaks down and they are not able to get emergency help to mend it. As we have heard from the noble Lord, Lord Hunt, and others, there is widespread dissatisfaction among those who need equipment because of frustrations, delays and bureaucracy, and I will not repeat those figures. I was particularly moved, as others were, by the story of Rhys Porter, who has cerebral palsy and was without essential equipment, including a hoist and home adaptations, for two years. Apparently, during this time, his parents had to help him use a commode seat in his bedroom and drag him into the family bathroom on a towel once a week, putting them all at risk of injury. When he needed surgery, there was no immediate help to have a hoist to get him out of bed. Such equipment, for Rhys and countless others, is critical, not only to support day-to-day activities but to ensure that essential medical treatment can take place, avoiding further complications.

Such delays are not just occasional. The crisis impacting community equipment, causing months—sometimes years—of delay for assessment and medical kit, is systemic rather than down to individual actors. The main reason, as we have already heard but it is worth repeating, is that there is a lack of national oversight. Statutory responsibilities are left to local authorities and ICBs, which creates inconsistent and patchy provision, and confusion over who ultimately is responsible for this essential service. Moreover, the situation is likely to get worse; with an ageing population and the rise of chronic health conditions, the demand for mobility aids of various kinds is going to increase. It is vital that the Government act now before the situation deteriorates even further.

In the light of the APPG for Access to Disability Equipment’s finding that there is no national strategy, no coherent commissioning framework and no single accountable Minister for community equipment, will the Government now commit to developing a national strategy for both community equipment and wheelchair services, overseen by a named Minister with clear responsibility for delivery?

Cancer Research UK Report

Lord Harries of Pentregarth Excerpts

Tuesday 5th December 2023 Lords Chamber

[Lord Markham (Con)]

No, I do not believe that is why people are being referred; it is to give them peace of mind. People know their own bodies and, if they are concerned about having cancer, they know that we want to put their minds at risk. I am familiar with that statistic. I had heard that 95% of people who go to these referrals, thankfully, do not end up with cancer but, boy, do they have peace of mind since we are able to give them that assurance.

[Lord Harries of Pentregarth (CB)]

I declare an interest, as I have a son who is an oncologist. As the Minister knows, one of the most serious forms of cancer—and growing at this time—is melanoma. The melanoma charities are campaigning to reduce the VAT on sun cream in order to reduce the incidence of this terrible cancer. Have the Government come to a view on this reduction of VAT?

[Lord Markham (Con)]

I do not think that the Government have come to a view but I understand the point. I will take that back to the department and the Treasury.

Care Homes: Energy Costs

Lord Harries of Pentregarth Excerpts

Thursday 8th September 2022 Lords Chamber

Asked by

[Lord Harries of Pentregarth]

To ask Her Majesty’s Government what assessment they have made of the likely impact of increased energy costs on care homes; and what extra support they intend to provide in response.

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

The Government are committed to working with local authorities to help manage the pressures of inflation, for various reasons, on adult social care. We acknowledge the impact that challenges such as energy price rises will have on residential care providers and right across the system. As noble Lords will be aware, the Prime Minister has stated that a package of support for energy costs is her priority. Sadly, in terms of timing, we expect announcements shortly and will see how that feeds into the social care sector.

[Lord Harries of Pentregarth (CB)]

I thank the Minister for his reply. As he well knows, care homes are already under great financial pressure. In the six years up to 2020, more than 1,600 had to close—many of them rated good or very good—and the rise in energy costs is already absolutely staggering, from something like £660 per bed per year to over £5,000 per bed per year. Of course, some help will be offered this afternoon, but is the Minister confident that the Government have really taken on board the sheer scale and seriousness of this situation for care homes?

[Lord Kamall (Con)]

The noble and right reverend Lord makes a really important point about this issue and the impact on social care. What we are seeing right across government is the impact of this energy crisis: that is why the Prime Minister is making this announcement. We will then have to look into the details of how that affects the different sectors. We have heard from the social care sector, we have heard from care homes and we have heard from patients themselves about their concerns about the cost. I am afraid I cannot give more details at the moment. The Government are working very closely at the moment with local authorities and are in constant conversation about how we can help reduce the burden. Once we have more details of the package, we can look at that in more detail.

Health and Care Bill

Lord Harries of Pentregarth Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Harries of Pentregarth (CB)]

My Lords, I too thank the noble and national “treasure”—the noble Lord, Lord Stevens—and welcome him to the House. I wish to focus on three areas: care homes, care workers and carers.

Last night, “Panorama” examined the financial structure behind two big care home chains. It discovered that the ultimate owner was a private equity company based in a tax haven, and that between that owner and the home there might be more than 100 other shell companies. Furthermore, the equity companies owning the chain changed frequently, each time taking more money and loading the debt on care homes.

The result was that at least 20% of the money that should have gone to support the resident was used to pay interest on the debt and dividends to shareholders, leading in some cases to poor care. Moreover, in a number of cases, the debt became unsustainable, so the home had to go into receivership, with the residents left in great uncertainty about their future. Is the Minister content that the present Bill will be able to ensure that the financial structure behind care homes in the future will not be of this type, able to load debt on to homes in a way that harms residents?

That having been said, the vast majority of care homes provide dedicated service. This was very much shown in the first phase of the pandemic when, for example, care workers actually lived in some homes to safeguard the residents from infection. However, there are now 170,000 vacancies in care homes and almost every home in the country has been hit by staff shortages, as underpaid and exhausted care workers leave. This raises the whole question of their pay, conditions and status.

There is a totally unacceptable turnover rate of care workers, as the noble Lady, Baroness Altmann, emphasised, while their average pay compares very unfavourably with that of a shop worker. Of course, this applies not just to those working in care homes but to the vast number now working in the community, trying to care for people in such a way as to keep them in their homes. We are still in a position where far too many hospital beds are being occupied by those who should be cared for in the community. That depends on care workers actually being available.

I believe in and greatly value the business sector of our society, not least innovators and genuine entrepreneurs. The whole country depends on their success but no less should we value the care sector and recognise this in the status that it is given, which should be reflected in how its workers are paid and treated. At a time when we will soon have 1 million people suffering from dementia and with the prediction that by 2050 that figure will be 2 million, we are no less dependent on the care workforce than we are on those working in business.

I welcome the Government’s recent statement that they are spending a least £500 million so that the social care workforce has the right training and qualifications and feels recognised and valued for its skills and commitment; they are also prioritising workforce well-being and support, including better access to occupational health services. The second question I ask the Minister is this: is he satisfied that this Bill, as set out at the moment, will ensure that this very excellent aim will be properly checked and monitored?

I now turn to carers—that is, those caring for a relative or friend on a voluntary basis. The support provided by people caring for a family member or friend who is older, disabled or has a long-term condition is vast. Prior to the pandemic it was estimated to be worth £132 billion per annum and during the pandemic, in one year, at about £193 billion. With an ageing population we are likely to continue to see a rise in the number of people providing care in this way. Carers’ health is often impacted by caring. Those who care for people in their house for more than 50 hours a week are twice as likely to be in bad health than non-carers. Carers UK has suggested some interesting amendments to this Bill to ensure that this element of the care sector is properly recognised and taken into account.

Finally, the word “care” is a precious one. The categories of “care worker” and “carer” are fundamental to our society. They need to be recognised accordingly, both in our attitudes and in the law, the latter so often being powerful in shaping those attitudes. I hope that as a House we will be considering amendments which ensure that that is indeed the case.

Covid-19 Update

Lord Harries of Pentregarth Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, SIREN is one of the most thought-provoking and interesting of all the many studies that we have done. It is a sad fact that we do not understand many of the aspects of the body’s immune system, and that is why we are so committed to that study. It suggests that once you have had the virus, your body’s immune system is extremely strong. The proportion of people who catch it a second time round is incredibly small. That is good news for those who have caught it and for those who have had the vaccine, because if the immune system works well after catching the virus, it probably works well after the vaccine. However, we continue to publish from the SIREN study. On the health impacts of wearing face masks, I am not fully across that, but I will be glad to write to my noble friend with any details that I may have.

[Lord Harries of Pentregarth (CB) [V]]

The Government have been concerned for some time that even though someone is symptom-free and has had both vaccine jabs, there is still some risk that they might pass it on to others. But surely the risk must be minuscule. Have the Government ascertained how minscule the risk is compared with other much more major kinds of risk, and has there been a danger of the Government overcompensating here, particularly with respect to those in that position wanting to enter this country?

[Lord Bethell (Con)]

My Lords, what a perceptive question from the noble and right reverend Lord—he absolutely hits the nail on the head. The honest truth is that we do not have the precise figures on this but the indications are that he is right: the vaccine does not stop you being infected or transmitting it, but it reduces the chances of both those things dramatically. That is one of the reasons why we have kept our foreign travel arrangements under review. It is possible that the effect that he describes may mean that we can look very thoroughly at foreign travel—I think all noble Lords would welcome that.

Social Care

Lord Harries of Pentregarth Excerpts

Wednesday 28th October 2020 Lords Chamber

[Lord Bethell (Con)]

My noble friend is entirely right. One of the experiences of Covid has been the mobilisation of technology to help those in social care. That has ranged from very basic implementation, such as sending iPads to people in social care so that they can message and video their loved ones when in some form of lockdown, to the work done with broadband providers to ensure that those without it can have access to it, all the way through to the use of the most complex artificial intelligence and big data, to help with diagnosis in social care, and the management of care itself. That commitment to technology will continue and will form an important part of improving the commitment to social care as part of the new regime.

[Lord Harries of Pentregarth (CB) [V]]

The Royal Commission on long-term social care, chaired by the late lamented Lord Sutherland of Houndwood, reported in 1999. Only two years later, the Scottish Government adopted its main proposal of state support for personal and/or nursing care. How is it that, some 20 years later, successive Governments in the UK have failed to address the issue properly, in the way that the Scottish Government appear to be able to do?

[Lord Bethell (Con)]

The noble and right reverend Lord is entirely right. There has been a large number of reports on social care, but they have not in themselves brought us closer to a new deal. That is why the Government’s commitment is not necessarily to launch new reviews but to engage in consensus building across the political parties. That consensus building has been lacking in the past and has continually proved to be the stumbling block to reform. The commitment of both the Government and other Benches to those talks is the essential building block of any major reform. I completely pay tribute to the Leader of the Opposition and the Prime Minister for their commitment to those talks.

Covid-19: Rise of Positive Tests

Lord Harries of Pentregarth Excerpts

Wednesday 9th September 2020 Lords Chamber

[The Deputy Speaker (Lord Faulkner of Worcester) (Lab)]

Lord Desai? Lord Harries of Pentregarth.

[Lord Harries of Pentregarth (CB) [V]]

Moving on from the question asked by the noble Baroness, Lady Jolly, about care homes, and the Minister’s response, are the Government publishing the number of cases and deaths due to Covid in care homes? If not, why not?

[Lord Bethell (Con)]

I advise the noble and right reverend Lord that those figures are published on the PHE website. I would be glad to send him an email with the link.

Suicide

Lord Harries of Pentregarth Excerpts

Tuesday 8th September 2020 Lords Chamber

Asked by

[Lord Harries of Pentregarth]

To ask Her Majesty’s Government what steps they are taking in response to the reported rise in the number of people committing suicide.

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

My Lords, one suicide is too many suicides. That is why we published a cross-government suicide prevention workplan in 2019, are investing £57 million in suicide prevention in the NHS, are rolling out suicide prevention plans across the country and are committed to working with charities such as the Samaritans and the Zero Suicide Alliance.

[Lord Harries of Pentregarth (CB) [V]]

I thank the Minister for his reply and what the Government are doing. Unfortunately, male suicides are the worst they have been for two decades. There is particular concern among men between the ages of 45 and 49, and suicide is the highest form of death for those under 50. It is a particular concern in areas of Yorkshire and Humber. In his latest book, Professor Michael Sandel argues that this is part of a wider malaise in society. In a highly competitive society such as ours, there are those left behind without any sense of value, dignity or self-esteem. Will the Minister encourage the suicide strategy advisory group to look at what Michael Sandel has said and its implications for government policy?

Childhood Obesity

Lord Harries of Pentregarth Excerpts

Wednesday 2nd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the report from Professor Sally Davies has not been lost; the July obesity strategy leans extremely heavily on the insight and advice of Sally Davies, who continues to have a strong presence in the department and informs all our decisions, as does the public health team at PHE. Professor John Newton had an extremely high profile during the launch of the obesity strategy in July and continues to have an important voice at all levels of the department.

[Lord Harries of Pentregarth (CB) [V]]

In her 2019 report, the Chief Medical Officer pointed out that, when we leave the European Union, it will be open to the Government to alter VAT rates. She recommended that healthy foods should remain without VAT, as they are at the moment, but that there should be a tiered approach to unhealthy foods and drinks as far as VAT is concerned. What is the Government’s response to this recommendation?

[Lord Bethell (Con)]

My Lords, the Government are not planning a review of VAT at present.