Elderly Social Care (Insurance) Bill [HL]

Lord McFall of Alcluith Excerpts

3rd reading
Friday 4th March 2022 Lords Chamber

[Baroness Penn (Con)]

My Lords, noble Lords may wish to have a short debate before we pass the Bill.

[The Lord Speaker (Lord McFall of Alcluith)]

Actually, I hesitated very slightly there, but nobody seemed to be standing up. If somebody wishes to stand up, the Floor is theirs.

[Baroness Merron (Lab)]

The Lord Speaker is most kind: I will be quicker in future.

I thank the noble Lord, Lord Lilley, who is not able to be in his place today, for his considerable consideration and work during this Bill’s passage. I am grateful to him for having given your Lordships’ House the opportunity to discuss such important issues, which are particularly timely considering the passage of the Health and Care Bill. As noble Lords will be aware, while discussion on the Bill was welcome, it has unfortunately not found favour across the House. I certainly look forward to the Bill being an encouragement to the Minister to come forward with ways to support the sector properly. I look forward to a real and sustainable plan for fixing the issue that faces us. So, I extend my thanks to all Members of your Lordships’ House for their contributions during the passage of the Bill, and to the noble Lord, Lord Lilley, and I look forward to hearing from the Minister.

Health and Care Bill

Lord McFall of Alcluith Excerpts

Lords Hansard - Part 1 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Sharkey (LD)]

My Lords, Amendment 106 is in my name and those of my noble friend Lady Walmsley and the noble Baroness, Lady Thornton. I am very grateful for their support.

Two months ago, two of our Select Committees, the DPRRC and the SLSC, published simultaneous and collaborative reports. The DPRRC report is entitled Democracy Denied? The urgent need to rebalance power between Parliament and the Executive, and the SLSC report is called Government by Diktat: A call to return power to Parliament. It would be very hard to exaggerate the importance of these reports, and I congratulate both committees on a very timely and disturbing reminder of the Government’s habit of trying to bypass Parliament and avoid effective scrutiny, as they do again in this Bill.

Both the reports focused on the long-standing abuse of the use of delegated powers legislation, and the DPRRC concluded:

“The abuse of delegated powers is in effect an abuse of Parliament and an abuse of democracy, and this report will, we hope, be a prompt to strengthen Parliament in the coming years.”


We can make a start on that hope with this Bill.

The DPRRC noted in its report of 15 December that the Bill contains 155 substantive provisions and 156 delegated powers. It concluded:

“The Health and Care Bill is a clear and disturbing illustration of how much disguised legislation a Bill can contain and offends against the democratic principles of parliamentary scrutiny.”


The report examines some of the Bill’s clauses in some detail, including the insertion via Clause 20 of a new Section 14Z48 into the National Health Service Act 2006. Essentially, the new section gives a Minister the power to make law by simply publishing “a document”. The department tries to justify the lack of any parliamentary procedure associated with the publication of a document on the grounds that the power is concerned with operational and administrative matters. However, the DPRRC goes on to say:

“Such a power is very unusual. If used in a context other than one involving public sector health bodies, it might give grave cause for concern and set an extraordinary precedent. Statutory liabilities should be imposed transparently, subject to clear legal conditions and parliamentary scrutiny.”


I should point out here the force of the word “unusual” in the committee’s comments. This is the highest form of disapprobation used by committees, and for good reason. This proposed new section is a blatant, transparent and disgraceful attempt to avoid any parliamentary scrutiny whatever.

The DPRRC’s conclusion is damning. It says:

“The power to impose a legal liability by merely publishing a document, without any parliamentary scrutiny, is a striking example of disguised legislation. We regard it as an inappropriate delegation of power, which should be removed from the Bill.”


In its report on the Bill of 7 January, the Constitution Committee agreed with the DPRRC’s recommendation to remove the new section from the Bill. I agree strongly, and that is what our amendment would do. I suggest to the Minister that if he wants to retain the powers set out in proposed new Section 14Z48, he rework them between now and Report so that they at least involve scrutiny by the affirmative procedure. If not, he can certainly expect us to return to this serious abuse of delegated powers on Report. I beg to move.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely and I invite her to speak.

Health and Care Bill

Lord McFall of Alcluith Excerpts

Lords Hansard - Part 1 & Committee stage
Tuesday 18th January 2022 Lords Chamber

[Baroness Meacher (CB)]

My Lords, I will also speak to Amendment 177. Amendment 20 requires the Secretary of State to ensure that the better care fund, an important and successful initiative, is used to support service integration for children as well as adults. As the Bill stands, the better care fund will continue to be focused exclusively on adults. This is one of a number of amendments that we will debate over the coming weeks which together ensure the children are given equal treatment with adults in the Bill. I assume at the outset that the Minister agrees in principle with us that children and adults should be treated equally in the Bill. Can he give the House an assurance that this is the case—I cannot believe it is not—and if it is not, can he give us the reasons why?

We understand that the fund has focused on adults until now but surely it is time to extend it to children’s services. When the better care fund is all about integration of health and social care, it is hard to understand why children’s services should be excluded. Integrated multiagency support for children and families is key to delivering on the Government’s policy agenda, including for disabled children, those with special educational needs, children supported by the social care system and children during the first 1,000 days of life. Extending the scope of the better care fund to children would greatly accelerate this process of integration and support the Government’s ambitions for children.

I recognise that the funding streams and systems involved in services for children are complicated and it would involve work to extend the better care fund to incorporate those systems. However, this complexity is precisely why good and integrated services for children are so hard to achieve and why the better care fund could be so beneficial.

To illustrate the point, I will quote from a letter I received last week from Julian Wooster, the Somerset director of children’s services. He welcomes this amendment and explains that

“unfortunately we currently have a perfect storm of issues nationally in relation to placements of teenagers with complex needs, which is having a detrimental impact on their well-being.”

Apparently, the Association of Directors of Children’s Services has made a number of submissions, including the following commentary to the review of children’s social care which is under way:

“Despite long standing and ongoing discussions about the needs of children across the children’s social care, mental health and youth custody secure estate, the three systems continue to be separately commissioned, operate under separate legislative frameworks and are the responsibility of different government departments, each with different priorities. This can present practical barriers to local innovations and change. Locally in Somerset the council and NHS colleagues have worked well together on a joint initiative, which is receiving national interest. If the country is to benefit, Wooster claims, there needs to be a joint framework which the better care fund could provide.”


I am aware that officials from the department have been having positive conversations with colleagues from the Children and Young People’s Health Policy Influencing Group and the National Children’s Bureau, and I hope these will continue. But what I hope today is that the Minister will clarify to the House is that he has no objections to the principle of extending the remit of the better care fund to children, and that he is happy to explore how that might be achieved.

I turn briefly to Amendment 177, which seeks to ensure that the needs of those aged nought to 25 are adequately met under the integrated care systems. The amendment would require the Secretary of State to publish guidance on how ICSs should meet their obligations and with which ICS bodies would be required—that is a very important word—to comply. I do not think that I really need to persuade the Government that meeting the health needs of children from birth to adulthood is perhaps the most important investment in the health of the nation. Obviously, good health in childhood is likely to lead to good health in adulthood, to the benefit of every single one of us and to our NHS and taxpayers. We know that integrated care systems will have to cater for all ages in the context of the historically large backlog of appointments and treatments. It will be all too easy for particular groups to be left behind, unless there are specific provisions in the legislation to make sure that they are not.

As this Bill passed through the House of Commons, I was really pleased to hear that the Minister for Health had recognised the importance of meeting the needs of babies, children and young people. In particular, I warmly welcomed his commitment in Committee to ask his officials to develop bespoke guidance spelling out how ICSs should meet their needs. I understand that officials from the Department of Health and Social Care are currently engaged in discussion with the Children and Young People’s Health Policy Influencing Group on the development of that guidance, which is really encouraging.

I hope the Minister understands the reason for this amendment. Given that the Minister in the other place has shown his commitment to the principle of issuing guidance, our purpose here is to ensure that the guidance is published and will have statutory force to ensure compliance with it. I shall not go into the details of the amendment, but those are its objectives. I hope the Minister will be able to agree to this amendment, as it does nothing more than ensure that his colleague’s commitment in the other place is honoured by the new system. I beg to move.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely, and I invite her to speak.

[Baroness Masham of Ilton (CB) [V]]

My Lords, I have my name to Amendment 98. I am very pleased to support the noble Baroness, Lady Tyler of Enfield, in this amendment, so that the safeguarding of children has an important place in this Bill.

Vulnerable children’s needs must be highlighted. It is not long ago that six year-old Arthur and the little girl called Star were cruelly murdered, and the chances of saving them were missed. Over the years, there have been many other shocking cases where children were tortured and killed. It is vital that all the safeguarding people involved in the many tragic cases of vulnerable children work together. It should not be left to one junior social worker, who may be frightened of facing difficult, devious and cunning parents. I hope that the Government agree on the need to upgrade safeguarding children’s needs and will help to see that it is in the Bill. The needs of children should not be passed over and neglected.

I also support many other amendments in this group.

Vaccination Strategy

Lord McFall of Alcluith Excerpts

Thursday 13th January 2022 Lords Chamber

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

I thank the noble Baroness for raising these issues. The first issue, that of anti-vaxxers, is really important. In a free society we always have to get the balance right between freedom of speech, making sure that people are free to go about their daily work, and making sure that those who want the vaccine get it as soon as possible. The Government are aware of this and are looking at it, but it is really important that we get the right balance. Whatever we think of the anti-vaxxers’ message, they have a right to say it, but we have to make sure that it does not impinge on the liberty of others to get their vaccine, especially since we are encouraging as many people as possible to get vaccinated.

I join the noble Baroness in paying tribute to the Chief Medical Officer, Jonathan Van-Tam. He appears on our daily omicron calls and I have had a number of conversations with him, and I know that there is incredible respect for JVT across the country. Indeed, I know that a number of people tuned in to his Christmas lectures on the virus; as the noble Baroness says, they were an excellent explanation of the virus and how to tackle it.

As for how we reach local communities, particularly those communities that have not come forward, I have had a number of conversations with noble Lords and Baronesses with their own experience of working with local communities in a bottom-up way. We have seen a number of local activities; indeed, my local masjid, or mosque, has a walk-in vaccination centre, and we have seen that in other faith places. A number of faith-based and interfaith networks have worked closely with the local community, because often some communities do not have the trust in authority that they have in priests, vicars, bishops—if I may say so—imams, et cetera. That is really important. We have also recorded promotional films in a number of languages, including Punjabi and Urdu in Birmingham, and got some celebrities to come up. I know I have gone on too long but I am very excited about what we are doing.

[The Lord Speaker (Lord McFall of Alcluith)]

The noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, I too echo the gratitude that this House and this country shows to Jonathan Van-Tam. Four months on, there are still severely clinically extremely vulnerable people eligible for a third primary dose and then a booster who cannot book their booster because the data system still cannot record this. Many CEV young children with underlying conditions are still waiting for their vaccines, as well as for guidance on how they, their families and their schools can keep them safe from Covid. This is important because there are now more children in hospital with Covid in the last three weeks than in the nine months of the first wave. Please can the Minister say how these people, who the Government say need the vaccines right now to keep them safe, can get them?

[Lord Kamall (Con)]

I thank the noble Baroness for making me aware of the issues. She will recall that we had a meeting on how we can address the concerns of the clinically extremely vulnerable, and I had hoped that a number of action points had flowed from that. If those have not been acted upon, I hope she will write to me and I can chase up the department and the NHS. I had assumed that that meeting, where we gave them some action points, was effective. I am sure she remembers that we requested a letter with action points, but if those have not been followed up, I will endeavour to chase that up.

[The Lord Speaker (Lord McFall of Alcluith)]

The noble Baroness, Lady Masham of Ilton, is taking part remotely. I invite the noble Baroness to speak.

Ambulance Response Times

Lord McFall of Alcluith Excerpts

Wednesday 1st December 2021 Lords Chamber

[Lord Kamall (Con)]

All noble Lords have raised important points about the pressures on different parts of the system. In taking a systemic overall view, the Secretary of State is holding regular “pressure” meetings and looking at the key metrics in getting those pressures down. He is also looking at how we can tackle things systemically from within, including discharge issues. We are looking at how to improve on discharges to make sure that there is enough space, thereby continuing to ensure not only that elderly patients are back in their homes as quickly as possible, but that we reduce the length of time that others have to wait for ambulances.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, that concludes Oral Questions for today.

NHS: Primary Care Surgeries

Lord McFall of Alcluith Excerpts

Wednesday 24th November 2021 Lords Chamber

[Lord Kamall (Con)]

The Government recognise that it is important that people can see GPs and, as much as possible, invest in making sure that there are more full-time equivalent GPs. We have done that and we will continue to do so.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the time allowed for this Question has elapsed.

Dementia: Art and Music-based Interventions

Lord McFall of Alcluith Excerpts

Monday 22nd November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for that suggestion. We are looking, across the health sector, at how we can think outside the box and train students in other disciplines to help in healthcare. Clearly, music can potentially play a role. In terms of the music studio offer, can I just say “Wait until you’ve heard me”?

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, all supplementary questions have been asked. We now move to the next question.

Covid-19: UK Arrivals

Lord McFall of Alcluith Excerpts

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

As someone whose family comes from outside the EU, who has taught in universities and who recognises the great asset that there is and the great advantages that there are in being open to the world, and global Britain, I share the noble Baroness’s frustration. Yes, we have left the EU, which is very much a project of white privilege, and moved to a more global outlook. It is really important that we now focus on the world generally. The issue is quite technical at the moment. One of the things needed for the test and trace system to work is that you need access to the underlying data and verification. We are looking at a number of different options for how to achieve that.

[The Lord Speaker (Lord McFall of Alcluith)]

The noble Lord, Lord Flight, is not present so I call the noble Baroness, Lady Hayter of Kentish Town.

[Baroness Hayter of Kentish Town (Lab)]

As the Minister has said, our universities have long been a welcoming and inspiring academic hub for international students but stories such as the ones that we have heard—along with, I am afraid, the attack on freedom of speech at the LSE and the shameful treatment of Professor Stock, which we will come to shortly—added to Covid and online teaching, to say nothing of the Brexit fallout, which means that EU schools can no longer use group passports, all question our ability to attract youngsters from across the globe. What are the Government doing to re-establish our reputation in this sector?

Clinical Negligence Claims

Lord McFall of Alcluith Excerpts

Wednesday 10th November 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness raises an important point that spending more on compensation means less money for the care of patients. That is why we are committed to looking at various ways of reducing this and are working with the Ministry of Justice. Issues include the role the royal colleges play and the training they give to their medical staff, while needing to instil a culture of more openness when things go wrong. When things go right, we are ready to praise but when things go wrong, they have to stop hiding, delaying and denying, and be open.

[The Lord Speaker (Lord McFall of Alcluith)]

I call the noble Lord, Lord Walney. He is not present. I call—

[Lord Walney (CB)]

Yes I am.

[The Lord Speaker (Lord McFall of Alcluith)]

I am sorry.

[Lord Walney (CB)]

Thank you. I accept entirely what the Minister says about learning from experience but was this not supposed to have been baked into the NHS after numerous reports in recent years? Does he accept that we need to look again at the way in which the NHS trusts are often slow in learning from their mistakes, rather than allowing this culture to continue?

Health Care and Adult Social Care

Lord McFall of Alcluith Excerpts

Wednesday 27th October 2021 Lords Chamber

[Lord Kamall (Con)]

I think that all noble Lords will agree with the point made by the noble Lord about the importance of unpaid carers and also paid carers. In relation to unpaid carers, we hope that as the social care reforms, in particular, come through, patients will be able to take advantage of social care. That will remove some of the burden from unpaid carers and free up their time. We are, however, looking closely at the implications and consequences of some of the proposed reforms.

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, that concludes Oral Questions for today.