Covid-19: Obesity
Lord Lilley Excerpts(3 years ago)
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Lord Bethell (Con)
My Lords, the Government take the advertising of unhealthy foods seriously, which is why we have commissioned this consultation. It has not finished yet so it is not possible for me to pronounce on its findings, but I assure the noble Baroness that we are looking at this issue extremely carefully indeed.
Lord Lilley (Con)
Does my noble friend agree that the determination of the opposition parties and much of the media to pin the blame for the high level of deaths in this country from Covid on the Government has obscured the fact that the major reason why we suffer from a high mortality rate, compared with other countries, is that we are fatter than other countries? Nearly two-thirds of adults in this country are overweight, and the number of obese people in this country is six times the proportion of obese people in Japan. Can we give those facts to people? They can then make their own decision on whether to take this risk or not.
Lord Bethell (Con)
I thank my noble friend for his question. It is for others in the post-mortem process to pronounce on the exact cause of deaths during Covid, but it is an unavoidable fact that, of the 2.5 million Covid deaths reported by the end of February, 2.2 million were in countries where more than half of the population is classified as overweight; that includes Britain. This is a stark fact that, as my noble friend rightly points out, is sinking in among the British public. We want to use this fact as an inflection point—it is an opportunity —to give people the inspiration they need to take the necessary steps towards healthy and fit living.
Covid-19: Restrictions
Lord Lilley Excerpts(3 years, 4 months ago)
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Lord Bethell (Con)
The noble Baroness quite rightly pays tribute to the work of the NHS. An enormous amount has been done on the marginal expansion of ICUs. My local hospital, University College Hospital, has increased the number of beds from 19 to 52 by expanding the scope of the wards and the oxygen supply. We have put a huge amount of work into A&E units, often building out the front of the units to create more space. Those marginal differences are being extremely effective, and that is our first line of defence. The Nightingale hospitals are there as back-up and, if they are needed, we will bring them into play.
Lord Lilley (Con)
My Lords, perhaps I may break with convention and the advice I was given when I first entered Parliament and ask a question to which I do not already know the answer. Every week, the Government submit figures to EuroMOMO for deaths from all causes. During the spring, the figures showed a huge level of excess deaths over the normal, but currently, and in recent weeks right up to the end of last year, they show almost no excess over the normal level of deaths in this country. That conflicts with all the evidence we are seeing from hospitals and elsewhere. Can my noble friend reconcile the figures and the facts?
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.
Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020
Lord Lilley Excerpts(3 years, 5 months ago)
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Lord Lilley (Con)
My Lords, it is a pleasure to follow my noble friends Lord Howard of Rising and Lady Neville-Rolfe, whose regret Motion I am minded to support.
The Prime Minister has an unenviable task—that of balancing not just health and economic impacts, but conflicting evidence and views, the majority of which, I suspect, are opposed, within Cabinet and among his advisers, to his own instincts. He has been criticised for not imposing those well-known libertarian views on the majority in Cabinet. Prime Ministers are not, however, dictators. I remember Mrs Thatcher, after spelling out her support for a proposal, asking her Cabinet Ministers for their views, all of whom dissented, turning to Nigel Lawson and saying, “Am I alone in supporting this policy?”. To which he replied: “Yes, Prime Minister, but you are not without influence”. I am glad that some of the Prime Minister’s influence has been brought to bear, otherwise these regulations would be even worse.
But there are reasons we should be sceptical about these latest proposals. First, the Government claim to be “following the science”, but there is no such thing as “the science”—there are scientists, who have opinions, and there is the scientific method. That was explained by the great scientist Richard Feynman, who said: “You make predictions on the basis of your theory or model, you compare them with the facts; it doesn’t matter how beautiful your model is, or it doesn’t matter how smart you are, if the model doesn’t agree with the facts, it’s wrong”.
We know that the original assumption that coronavirus would behave like flu was wrong. We know that the Imperial model predictions of half a million deaths here and 85,000 deaths in Sweden were wrong. We know that Sir Patrick Vallance’s prediction of 50,000 cases by the end of October was wrong. We know that on the chart used to frighten us into lockdown on 5 November, every single forecast of deaths over the coming months—not just that of 4,000 a day—has proved wrong. We know that half the graphs used during that extraordinary press conference ahead of the second lockdown turned out to be mistaken or used outdated forecasts, which had subsequently been revised down—which was wrong. We know that the chart leaked to Laura Kuenssberg, showing hospital capacity being overwhelmed, was never issued and has proved wrong. It is reasonable to be sceptical about the projections of what will happen if we do not adopt the measures before us today.
Of course, we all make mistakes, but the second reason for being sceptical is that these mistakes have not been random errors. There have not been some too low, some too high, some too alarmist, some too complacent. All of them have been in the same direction: exaggerating the risks and dangers. I am sure that has not been deliberate, but when errors all point in one direction, it is a sure and certain sign of groupthink. Groupthink is a mindset which can grip any of us, especially if we are convinced that we are in the right and others are in the wrong. Those in the grip of groupthink tend to accept without questioning too closely any evidence which supports their beliefs and discount anything which casts doubt on them, and they tend to ignore the costs of their actions and exaggerate the benefits.
That brings me to the third reason for scepticism, which is that these proposals were not based on any systematic, quantitative analysis of their impact—positive or negative—nor of their costs and benefits. It is not just that the document the Government rushed out yesterday is, to put it mildly, less than convincing; it is because the Government did not even have such an analysis themselves when they reached their decision.
There is an underlying problem which lies behind the Government’s explanations. They seem to believe that R is a constant, and that consequently infections will double every X days—after X days there will be twice as many, after 2X days there will be four times as many, after 3X days there will be eight times as many, and so on. They seem to believe that infections, deaths and the numbers of people in hospital will slow down or decline only as a result of government restrictions, hence the official claim that national and regional peaks occurred after the new measures were introduced. It is simply not true: the peak occurred before these measures were introduced, and there are only two possible reasons for that. One is that R declines as the virus spreads, because the natural spreaders get it and cease to spread it thereafter, and because there is more natural immunity in the population than anything like herd immunity was expected to be. The second reason is that people began voluntarily to restrict their social interactions before they were compelled to.
Whichever of these reasons—and I expect both are the case—they are reasons for not relying on the Government’s projections, not relying on the restrictions being introduced in these measures and asking the Government to think again, which is why I am minded to support the amendment to the Motion in the name of the noble Baroness, Lady Neville-Rolfe.
Covid-19: Transparency and Accuracy of Statistics
Lord Lilley Excerpts(3 years, 6 months ago)
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Lord Lilley
To ask Her Majesty’s Government, further to the statement by the Office for Statistics Regulation on the transparency of data related to COVID-19, published on 5 November, and reports that charts on projected daily deaths from COVID-19 have been reissued, what assessment they have made of such reports; and what steps they are taking to review (1) the transparency and accuracy of statistics relating to COVID-19, and (2) the decisions that are based on such statistics.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the Office for Statistics Regulation is 100% right: the best use of data and statistics is critical in this unprecedented time. All slides and data from press conferences are published on GOV.UK, normally at the time of the press conference. The Government are committed to transparency to build public trust throughout the pandemic; that is why we publish data, the modelling used and any revisions as part of this process.
Lord Lilley (Con)
I thank my noble friend. Does he realise that this rebuke from the statistics regulator is unprecedented, as is the unparalleled series of errors, dubious charts, outdated data and failed projections? It would be bad enough if those errors were random, but they all point in the same direction: alarmism justifying a lockdown. It is invariably a symptom of groupthink when sincere people—I have been there myself—become so wedded to a prediction or policy that they uncritically accept evidence that supports it and ignore facts that challenge it. Will he heed the warning of the great Professor Feynman: when you convert even the finest scientists into policy advocates, you risk ending up with what he called cargo cult science? Should we not leave advocacy to politicians and ask scientists for balanced advice?
Lord Bethell (Con)
My Lords, we are grateful to the Office for Statistics Regulation for its challenge; its points were perfectly reasonable and we take them on board completely. However, I reject the characterisation made by my noble friend and his suggestion that the modelling is either political or erroneous in some way. I remind him that, in January, the modelling showed that the epidemic in China was considerably larger than anything reported at the time. In February and March, we used data from the “Diamond Princess” and elsewhere to show how the threat of Covid was much larger than had previously been understood. In March, we showed that the epidemic in the UK was doubling every three to four days, allowing us to make the difficult decision to lock down. Throughout the spring, the modelling demonstrated that half the UK had not been infected, as previously thought.
In mid-September, the modelling showed that we were at the start of a second wave, despite those who said that there was no evidence of it. It also showed that the uptick in cases involving younger people would spread to older adults and, as a result, into healthcare. Most recently, the six-week projections of SPI-M that were produced throughout October, based on contemporary trends, have been remarkably accurate at assessing the trajectory of hospital admissions and deaths.
Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020
Lord Lilley Excerpts(3 years, 6 months ago)
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Lord Lilley (Con)
My Lords, these measures involve grave restrictions on the economy and our liberties. They may be necessary, but we should take them only on the basis of sound law and solid data. Unfortunately, they are based on dubious law and dodgy data. So, I have tabled a Motion that
“this House regrets that the Regulations have been laid under the Public Health (Control of Disease) Act 1984, which does not give specific powers to Her Majesty’s Government to impose restrictions on uninfected persons, and not the Civil Contingencies Act 2004, which does.”
I am not a lawyer, but I know a man who is: Lord Sumption. He has spelled out that the Public Health (Control of Disease) Act 1984 empowers Governments only to confine infected persons, not to confine the population as a whole, the vast majority of whom are not infected, and still less to close down large swathes of the economy. None the less, the Government could lawfully do all they seek to do in these and other regulations if they invoke the Civil Contingencies Act 2004. In that case, however, they would be subject to much closer parliamentary scrutiny than has been the case. In my own ministerial experience, parliamentary scrutiny invariably led to better decision-making, if only because officials had to work to satisfy all conceivable criticisms, not just those that their Minister could envisage.
The noble Lord, Lord Anderson, contacted me to say that he, too, considers it regrettable from the point of view of parliamentary scrutiny and arguably unlawful that the Public Health Act 1984 was selected in preference to the Civil Contingencies Act, though he took the view that the courts might find a plausible legal argument for upholding regulations made on this basis. Will the Minister either provide a convincing rebuttal of Lord Sumption’s critique, or use the Civil Contingencies Act in future?
I may not be a lawyer, but I did take the Institute of Statisticians’ exams half a century ago and I have been allergic ever since to statistical jiggery-pokery. Noble Lords may recall the gang in Oxford Street which I used to watch fleecing gullible passers by using the three-card trick. They were eventually exposed when a covertly taken film, played back in slow motion, revealed how the trick was done. Ed Conway of Sky News has performed a similar public service by showing, slowly and methodically, how official sleight of hand has misused the figures to justify this lockdown by creating a scarier illusion than they warrant. I urge every noble Lord to google: “Ed Conway: Why doesn’t the Government give us all the information” to see how this trick has been performed.
In brief, we were told at the weekend that the Government’s case for the lockdown rests on the fact that the virus is now spreading even faster than the Government’s reasonable worst-case scenario. Most of us assumed that that referred to the scary projection by Sir Patrick Vallance in mid-September showing reported cases doubling every seven days, to reach 49,000 a day by the end of last month. Far from spreading faster, reported cases are growing less than half as fast—just 20,000 per day. Sir Jeremy Farrar, of SAGE, rushed to Patrick Vallance’s rescue, claiming that his projection has been met, citing the Office for National Statistics’ figures that new infections are running at about 50,000 a day. However, to compare new infections with reported cases is comparing oranges with pumpkins. New infections include non-symptomatic cases and are typically two and a half times as numerous as reported cases, which Patrick Vallance was using.
The Government then claimed that Vallance’s projection was not the realistic worst case. It was certainly never realistic, and it has proved far worse than reality, but the Government refused their actual realistic worst case. Fortunately, the Spectator got hold of an official realistic worst-case scenario for projected deaths. It assumed that the second wave would not begin until mid-November, apparently unaware that students return, the weather gets colder and evenings darker, well before then. Stark data apart, the curve of deaths that have actually happened during the real second wave has followed closely the curve of the projected one. It does not overshoot the scenario for which the NHS has been planning. In short, instead of evidence-based policy, we have seen policy-based evidence.
I am not claiming that a second wave is not serious; it is. I am not suggesting that no action is required; it may be. But using a weak legal base and playing fast and loose with the statistics can only undermine trust in what is proposed in these regulations.
Lord Lilley
At end insert “but that this House regrets that the Regulations have been laid under the Public Health (Control of Disease) Act 1984, which does not give specific powers to Her Majesty’s Government to impose restrictions on uninfected persons, and not the Civil Contingencies Act 2004, which does.”
Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020
Lord Lilley Excerpts(3 years, 7 months ago)
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Lord Lilley (Con)
My Lords, I congratulate the Prime Minister on resisting the pressure for a renewed lockdown. Fewer than 1% of those dying from Covid have been of working age with no comorbidities, so our main aim is to protect the elderly and the frail.
There are two possible strategies. One is to help the elderly and frail avoid succumbing to the infection and the second is to limit the spread of the infection, primarily among those of working age who are unlikely to succumb themselves, but who may infect the elderly and frail. These strategies are not mutually exclusive. Unfortunately, in the regulations we are debating, the Government have put the bulk of their effort into the second strategy. But focusing on the economically and socially active all too often reduces economic activity, destroying livelihoods. I urge Ministers to try to avoid measures that disproportionately harm economic activity, with little likely effect on the rate of infection. The most obvious example of this is the 10 o’clock rule.
At the same time, the Government should put more emphasis on enabling the elderly and frail to avoid infection. In Germany, elderly people in multigenerational households are enabled to live separately in otherwise unused hotel space. Why not also give much more prominent advice to everyone, especially the elderly, to take vitamin C and zinc supplements and to lose weight, all of which will help them be less vulnerable to not only Covid but other ailments?
Testing should be the best the best way to help to protect the elderly and to minimise the adverse impacts of these regulations on the economy. On 14 September, I tabled a Question for Written Answer to try to clarify the Government’s position on this. I referred to the claim by the Secretary of State for Transport that testing could not be used to minimise quarantine for travellers because
“even using highly accurate tests, the capture rate of those carrying Covid-19 may actually be as low as 7%.”—[Official Report, 9/9/20; col. 775.]
What scientific evidence is there for this capture rate? What period after infection did it refer to, and if tests were not identifying infectious visitors to this country, why are we relying on the same tests for the staff and visitors to old people’s homes?
The Question was due to be answered on 28 September, but officials are clearly struggling to find one. I would be grateful if the Minister could either give the answer himself or tell me when I will receive an answer. Whatever it is, it may well have a bearing on the sort of regulations and strategy that we should be following.
Covid-19: Mental Health
Lord Lilley Excerpts(3 years, 11 months ago)
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Lord Bethell [V]
The noble Baroness, Lady Brinton, is entirely right to raise the issue of attendance. One of the greatest concerns during the epidemic is the declining attendance at mental health services, at primary care level and in hospitals. We are working hard on that. Last week, we launched the first aid kit for psychological first-aiders. Public Health England has launched this important resource, and it is indicative of the kinds of measures we are putting in place to address the inequalities of which the noble Baroness speaks.
Lord Lilley (Con) [V]
My Lords, although it is strange to describe people who are, not surprisingly, worried about the current situation as suffering mental health problems, we should be concerned that so many young people are worried and stressed at present. Will my noble friend reassure any young people who have exaggerated fears of Covid-19 that they are more likely to be killed by lightning? I expect that many more young people have justified worries about the threat to their education and future job prospects. Will he abandon the physical distancing rule in schools and colleges, where it is unnecessary, and cut it to one metre elsewhere to enable the economy to recover?
Lord Bethell [V]
My noble friend is entirely right that the fears described as mental health issues are about not only Covid itself but the economic and social consequences. The impact on mental health of the financial crisis 10 years ago was profound, and largely driven by fears of economic hardship. That is paramount. Reducing the distancing is not currently government policy, but we have that under review and news is expected.
Defending Public Services
Lord Lilley Excerpts(7 years, 12 months ago)
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Mr Peter Lilley (Hitchin and Harpenden) (Con)
It is a great pleasure to follow the right hon. Member for Leicester East (Keith Vaz), who, as always, spoke very thoughtfully on a range of subjects, and with great passion in favour of curry and against sugar. However, I was rather surprised that he implicitly endorsed the fundamentally racist immigration policy we currently have in this country whereby any number of white Europeans can come and settle here, with or without jobs, whereas a curry chef from Bangladesh related to people in this country, with an offer of a job, cannot. That is implicit, inevitable and unavoidable for as long as we remain members of the European Union, and that is why so many members of the ethnic minority community in my seat and elsewhere will be voting to leave on 23 June.
I hope, Madam Deputy Speaker, that it is in order for me to speak to the amendment in the names of 54 right hon. and hon. Members, including me, which says that we
“respectfully regret that a Bill to protect the National Health Service from the Transatlantic Trade and Investment Partnership was not included in the Gracious Speech.”
I believe in free trade—I always have and always will. I think I am the only surviving Member of this House who has negotiated a trade treaty—the Uruguay round in the 1990s when I was Secretary of State for Trade and Industry. Therefore, when the Transatlantic Trade and Investment Partnership treaty was presented, my instinct was to support it, but the more closely I looked at it, the more parts of it came to worry me. TTIP is not primarily about free trade. The average tariff imposed by the United States of America on goods from the European Union is 2.5%, and that of the European Union on goods from America somewhat higher. Getting rid of them would be worth while, but it is not a big deal.
However, other aspects of the treaty are worrying. My main concerns relate to the investor-state dispute settlement system. That creates a system of tribunals—special courts—in which foreign multinationals can sue Governments, including the British Government, but the British Government cannot sue them, nor can British companies use those courts should they wish to.
These companies can sue the British Government if they feel that Government policies are harming their investments. For example, US companies could sue a British Government who wanted to take back into the public sector privately provided services in the NHS or education, or to open fewer such services to private provision. The British and EU Governments have denied that such suing is possible, but a cogent counsel’s opinion argues that, because these tribunals can award unlimited fines, and have different evidence criteria from British courts, they could, at the very least, exert “a chilling effect” on Government decision making.
Up until now, most of the concern about this has been expressed by people who have opposition in principle to any private provision in the health service. I do not have opposition in principle, although I have always believed that the scope for it is limited in practice.
I found an example in my own constituency that illustrates the problem that could arise if TTIP were in force. A surgicentre, privately owned, set up by Tony Blair and working alongside the NHS Lister hospital in Stevenage, which serves my constituents, ran into terrible problems. The whole system under which surgicentres were set up was daft; it did not work. So I lobbied against it, as did my right hon. and hon. Friends from Stevenage and north Herts—all of us Conservatives. We lobbied that it should be brought back into the NHS, and we were successful.
However, had TTIP been in force and the company fallen into the hands of an American health company—most private hospitals in this country are now American-owned—the company could have sued the local NHS for taking back that service. At the very least, it might have won massive damages. It might even have been able to prevent that from happening entirely. Even if it had lost, the case would have cost the local health service a massive sum, because the average cost of these cases is $8 million. It seems to me that Members should be very cautious about signing up to a treaty that might have such a consequence.
These tribunals were originally invented to encourage investment by American and other companies in developing countries that had poor systems of government. Their courts were, frankly, unreliable and sometimes corrupt, so a parallel system of courts was set up with the agreement of the local Government. Such Governments were prepared to suffer the indignity of having courts that could overrule their own judiciary and laws in return for encouraging investors to invest in their country, in the knowledge that, should those investors be expropriated, either directly or as the result of Government policies, they could get fair compensation. That was fine, but such courts are not necessary to encourage investment in the UK. America invests more in the UK than in any other country in the world. American companies, like those of many other countries, choose to have cases heard in British courts because they trust our courts system. We do not need a parallel system of courts to encourage and promote investment in this country.
The Government say, “This is impossible. It won’t happen.” If it is impossible, does it really matter if they make such an assurance doubly sure by exempting the NHS from TITP, as amendment (c) suggests, just as the French have exempted their motion picture industry and artistic endeavours from the scope of the treaty? The very fact that the Government are not willing to do so, or have not been so up till now, raises some doubts, at least in my mind, about how secure we will be.
However, the Government have now accepted the amendment, although it is true that they did not have much choice, given the wide support for it in the House. That means the Government are now committed to bringing forward a Bill, and it is very important that they do so speedily, so that we can see whether it will achieve what we want to achieve and so that Members with wider concerns than mine—indeed, I have some further concerns about whether environment or health standards should be taken entirely out of the purview of Parliaments in the ways envisaged—can amend and adapt the Bill accordingly. If the Government do not bring in such a Bill or delay it until after the referendum, we will realise that something fishy is afoot.
John Redwood
Is the TTIP draft treaty not just another example of what I was trying to say, which is that more and more things are no longer under the control of British law makers and electors, but under the control of unelected people in Brussels, and that such things are not amendable once they have been agreed?
Mr Lilley
My right hon. Friend is absolutely right. If we let TTIP through, it will be a further transfer of law-making power away from this country to international bureaucrats and multinational companies.
There is a referendum dimension to the TTIP treaty issue. First, the only absolutely certain way of preventing it is of course not to be part of it—by leaving the EU on 23 June. We might be able to exempt ourselves or to prevent the treaty from going ahead if we remain in, but that is far from certain. Secondly, as my right hon. Friend has said, there is a certain similarity between such courts of a supranational nature—run by bureaucrats to enforce laws negotiated by bureaucrats, which have never been endorsed by this House and are not open to rejection by it—and it is natural that those courts should sympathise with each other and carry the treaty forward. If we were outside, we could negotiate our own deal with the United States, which I hope would not need any such system of courts. Why should America need such courts to invest in this country or for us to invest in the United States? That deal would require a stripped-down and far simpler Bill, and it would be far quicker and easier to negotiate.
Some people have said, “But President Obama has said we won’t be allowed to negotiate a deal and we’ll have to go to the back of the queue”, but the House of Commons Library has revealed that there is no queue. After the negotiation of TTIP, there are no countries with outstanding negotiations with the US. Not only was President Obama trying to bully us, but he was doing it on the basis of a bluff. We will be not at the end of the queue but at the front of it, and we will no doubt be able to negotiate with his successor.
I hope that hon. Members will consider the EU dimensions of TTIP seriously. I accept that people who are very optimistic about what we can achieve within the EU, and about what the EU might be able to achieve in negotiating TTIP with the Americans, might want to take the risk. It is not a risk that I want to take. It is not a risk that those who give high priority to the NHS, or those who are worried about environmental standards, health protection standards and potential threats to our education and other public services, will want to take. In the light of the topic of today’s debate, I hope that we will give priority to protecting public services rather than going along with something that none of us has ever seen—we are not allowed to see it, and it is being negotiated in secret—and that has aspects that most of us ought to find offensive to the House and dangerous to the people of this country.
Nick Herbert (Arundel and South Downs) (Con)
I congratulate the hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss) on her maiden speech. It always takes courage for an hon. Member to make a maiden speech in this daunting Chamber, but it must especially have been so when she paid tribute to her predecessor—her late husband—whose untimely death robbed this Chamber of a promising new Member who spoke with equal passion for his constituents in her city of birth, Sheffield. She will clearly be a great champion for her constituents, and will speak with the bluntness that she declared. I am sure she will be a much respected Member.
I did not intend to address the issue of the European Union, but will respond to the points made by my right hon. Friends the Members for Hitchin and Harpenden (Mr Lilley) and for Wokingham (John Redwood), to whom I listened with great interest. I listened with care to the concerns of my right hon. Friend the Member for Hitchin and Harpenden about the Transatlantic Trade and Investment Partnership. It is surprising that those who have been campaigning to leave the EU, and who for so long have criticised the EU for not completing enough trade deals despite the fact that the EU has more trade deals than any other country—it has far more than the United States—find themselves in the position of criticising trade deals. In my judgment, the benefits of TTIP include a £10 billion a year trade boost to our economy, which would enable us to invest more in public services.
Nick Herbert
My point is that the EU has trade deals with more than 50 other countries, whereas the US has only 14. I thought the narrative was that we want the EU to have more trade deals.
The issue is this: any modern international trade deal will involve some kind of binding arbitration mechanism. My right hon. Friend is clear that he opposes the Canadian free trade deal, but that has been championed by my hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson), who leads the leave campaign, as a model that our country should adopt if we leave the EU. It is also true that the Trans-Pacific Partnership, the North American Free Trade Agreement and even the World Trade Organisation all involve some kind of arbitration panel that takes decisions out of the hands of elected Chambers. If we are to take the position that any trade deal of that kind should be resisted if decisions can no longer be taken by elected Members, none will be acceptable. We would then be in the position of trading without any such arrangements, at potentially enormous cost to our country.
My right hon. Friend the Member for Wokingham spoke with characteristic passion about parliamentary democracy and described this place as a puppet Parliament. I note that none of the Bills in the Gracious Speech that are of interest to me and my constituents are restricted or affected by our membership of the EU. That goes to a central point: we can vote on and discuss much of our legislation and domestic affairs without the encumbrance of the EU. I therefore find it difficult to accept that the 650 Members of the House of Commons are puppets, and that our views and votes on those matters are entirely irrelevant simply because of our membership of the EU. That strikes me as an exaggeration, legitimate though the concern about parliamentary sovereignty might be.
I welcome the proposed prisons and courts reform Bill, having been the author of “Prisons with a Purpose” before the 2010 general election. The document urged the rehabilitation revolution and a transformation of the way in which we run our prisons. The radical reforms proposed by the Government are welcome in respect of reducing reoffending.
A number of measures are of special interest to my constituency of Arundel and South Downs in West Sussex. The neighbourhood planning and infrastructure Bill will address a problem that I spoke about in the House recently. The welcome reform of neighbourhood planning introduced under the Localism Act 2011 empowers local communities to make plans that benefit their local area, but they must not be undermined by speculative developments that call into question the legitimacy of plans that have been voted on democratically in referendums. It would be very welcome if the neighbourhood planning and infrastructure Bill addressed those problems and prevented those speculative development applications. We should remind ourselves that neighbourhood plans have had the effect of producing more and not less housing than was originally intended. Therefore, the proposal will not reduce house building, but will properly empower local communities.
The digital economy Bill is welcome—I am delighted to see my hon. Friend the Minister for Culture and the Digital Economy on the Front Bench. He will know of the concern that many in rural areas have to close the emerging digital divide. We want to ensure that the Government’s welcome proposal to extend superfast broadband throughout the country reaches those in hard-to-find rural areas—they, too, are entitled to fast broadband speeds. That is important for rural employment, but it is also important on the ground of fairness. It will take new means, and I hope the Bill sets out measures that will future-proof broadband provision to ensure that the speeds obtained in those areas meet tomorrow’s as well as today’s needs. Many areas in my constituency currently cannot get broadband at all.
I welcome the education for all Bill and its promise to meet the Conservative party manifesto commitment to a fair funding formula for our schools. West Sussex schools are unfairly disadvantaged in that respect.
I also welcome the modern transport Bill. I should like to refer to two crucial infrastructure issues that affect my constituency. First, on the A27 upgrade, I am delighted that the Government have announced that that major route will be upgraded to include the Arundel bypass and that funding has been provided. I hope the plans continue to timetable, so that work on the bypass begins by the end of the Parliament, as has been set out.
Secondly, the rail service to my constituency is a concern to a large number of hon. Members on both sides of the House. The performance of the Govia Thameslink Railway franchise has simply been unacceptable over the past year, hugely inconveniencing passengers. It must be said that 60% of the delays are the responsibility of Network Rail and result from infrastructure failure. It should also be acknowledged that the Government are embarking on major infrastructure investment, including the £6 billion London Bridge upgrade, which will improve services. Nevertheless, GTR is not meeting the self-set targets in its performance improvement plan. Those targets were low in ambition, but the company is falling below its original performance thresholds set one year ago to improve performance for customers. That failure is exacerbated by the entirely misconceived industrial action of the RMT on driver control of doors. It cannot be a safety issue when drivers rather than guards already control the doors on 40% of Southern services. Industrial action has exacerbated existing problems with the service, meaning a very serious level of disruption for passengers over the past few weeks. This is now causing real anger among my commuting constituents and many others in the area covered by the franchise.
First, there is no justification for the industrial action and it should not continue, and nor should the unofficial industrial action caused by drivers and guards who seem to be suffering from an unusual level of sickness. Secondly, the management of the GTR franchise must recognise that, while the proposed measures to reform how it runs the trains may be justified, its management of the franchise as a whole has been absolutely lamentable. It has brought the Government’s rail policy into disrepute. It is essential that the company and Network Rail are held to account for their poor performance and that they meet their own self-set performance improvement standards.
NHS Bursaries
Lord Lilley Excerpts(8 years ago)
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Mr Peter Lilley (Hitchin and Harpenden) (Con)
It is a pleasure to follow on from the hon. Member for Ilford North (Wes Streeting), who made a thoughtful speech and highlighted an important point about the different study load of those training to be nurses, compared with some of us when we were at university. I do not think that that invalidates the Government’s proposals, but it is an important point to take into account.
Like the hon. Gentleman, I congratulate the Opposition spokesman on calling the debate, which has been an important one, and I congratulate the Minister on a characteristically thoughtful, reasonable and lucid response to it. I cannot help observing that the debate demonstrates the value of having people in this House who come from genuine professions, rather than having reached here purely as a result of being political professionals. There has been considerable input from those who have studied, worked or been in the national health service.
Although it is an Opposition debate, there are some points that we can all agree on. First, we should agree that we need to recruit, train and retain enough nurses to staff our health service to meet the needs of the British people. Secondly, we can agree that it is wrong—morally wrong—to rely on recruiting nurses from poor countries, who have had to bear the cost of their training, to meet our failure to train enough nurses ourselves. Thirdly, we should not be turning away British people who want to train as nurses when we need more nurses. Surely all of us can agree on those three points. We can debate how best we finance the recruitment, retention and motivation of sufficient nurses in this country, but we should all agree that that is the objective.
My initial interest in this topic came a couple of decades ago and resulted from my first career as a development economist working in Africa and Asia. I discovered while I was in the House that we were denuding Africa of nurses. We had recruited more than one in eight of all the nurses in sub-Saharan Africa and brought them to this country. That could not be right. I lobbied against it and the then Prime Minister promised that there would be no active recruitment from Africa, but seven years later I discovered that we had recruited another 60,000 nurses. We were continuing to recruit at several thousand a year, but we were promised that that would cease.
What I blame myself for is that it took me so long to realise that the problem did not lie so much in recruiting from Africa and other poor parts of the world as in our failure in this country to train enough nurses of our own. I did not ask why we were not doing so until I was talking to people in my local NHS, who told me that they were recruiting abroad, mainly in southern Europe but also in Asia, and they were doing so despite the fact that they would have preferred to recruit and employ nurses from the University of Hertfordshire, whom they described as excellent, well trained and in every way desirable. I asked why they did not recruit more, but they said that they could not recruit enough. Even if they recruited the next several years’ worth of output, that would not meet the needs of Hertfordshire’s health service, which is why they were recruiting abroad.
Dr Lisa Cameron
Does the right hon. Gentleman agree that it is ironic that through our international aid programmes we are assisting developing countries to pay for trainee placements in clinical establishments such as hospitals abroad, yet we do not afford the same rights to our NHS trainees here?
Mr Lilley
It is certainly bizarre that we pay African countries to train nurses and promptly recruit them to come here, so we are getting them cheaply trained abroad. I do not mind particularly the manner in which their training is financed.
The problem faced by my local NHS was that it could not get enough nurses from the University of Hertfordshire. I spoke to the University of Hertfordshire, which said that there was no lack of applicants—it turned away three quarters of applicants to its highly regarded nursing courses—but it was not allowed to expand. It had taken me decades in this House to realise that we had a system that limited the number of people we were recruiting. I duly lobbied the Government, and it may be because of my lobbying that we now have this proposal for bursaries, though I suspect the Government reached the decision on their own evidence.
The sad truth is that successive Ministers of all parties—we should recognise that—have bucked the question of how we train enough people in this country. Ministers tend to have a time horizon of roughly the time it takes to train a nurse, so why put up with diverting resources into training when the output of extra nurses will come after they have ceased to be Health Ministers? I am glad that this Secretary of State for Health and his fellow Ministers have addressed the question. However, we should recognise that it is symptomatic of a wider problem across British business in both the private and the public sector that we have a culture that does not put enough emphasis on training. It is particularly bizarre that we allow unlimited numbers of people in universities to study art history and media studies—very valuable subjects—but restrict the numbers who can train to be nurses, when we know we have a crying and desperate need for more.
I am agnostic about the best way to finance the training of more nursing recruits. Clearly, if nurses bear the extra cost, that will have to be reflected in some way in their remuneration. The Minister told us that they will actually be no worse off, so I suppose the assumption is that they will not have to repay much of their loans. It is a somewhat artificial feature of the public finance rules, but it is a feature of them, that perhaps the only way of not borrowing the money from the public ourselves is for the nurses to borrow it and for us then to write off their loans. However, whatever the financial system—the end of bursaries and their replacement with loans is probably the only option—we have to pay nurses enough in the long run to recruit, retain and motivate them.
There is one other issue we should look at before we close the debate. There are 200,000 trained nurses who maintain themselves on the register at their own expense, but who are not currently working in the NHS or elsewhere—they may be taking time off to raise a family, and they may be thinking about coming back some time. We must be much more flexible and creative about providing patterns of work that meet the family needs of those trained, valuable, caring and experienced people if we are to bring them back into the health service. That, too, will help to meet the needs of the health service, as the Government are trying to, sensibly and wisely, in the measures they have brought before us to replace bursaries with loans.