Defence Spending
Lord Stirrup Excerpts(1 year, 1 month ago)
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Baroness Penn (Con)
My Lords, I agree with the noble Lord about the need to increase our spending on defence and start that now. That is why defence received its settlement a year earlier than other departments in the spending review 2020. It is why, alongside the integrated review refresh, we have included an uplift beyond that, including £4.95 billion for defence over the next two years to improve readiness and resilience of the Armed Forces, including bolstering our conventional stockpiles, enabling an early investment for the AUKUS submarine alliance and modernising our nuclear enterprise.
Lord Stirrup (CB)
My Lords, does the Minister recall that as recently as 2010, we were spending 2.6% of GDP on defence? Given the accounting changes that have occurred since then, that probably equates to something more like 2.8% in today’s terms. So the recent announcements putting us on a trajectory to 2.5% really cannot be seen as scaling some new peak, but rather as clawing us a little further out of the hole into which we have sunk. Does she accept that not only is there more to be done but that it needs to be done with urgency, and that saying we aspire to 2.5% when fiscal conditions permit is about the same as Government Front-Bench spokesmen saying they will bring something to this House “in due course”? It is pretty much meaningless.
Baroness Penn (Con)
I would like to reassure noble Lords that there is more money now going into defence. It is the largest sustained increase in defence spending since the end of the Cold War and, in recognition of the changing picture globally, we announced at the Budget money on top of that investment: £4.95 billion over the next two years and an extra £11 billion over the next five years to improve the country’s resilience and readiness.
Wagner Group: Sanctions Regime
Lord Stirrup Excerpts(1 year, 3 months ago)
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Baroness Penn (Con)
My Lords, it is worth clarifying a number of points. In this case, we are talking about a designated person and the derogations under the sanctions regime allow for legal fees. That is clearly provided for within the sanctions regime. I understand that the Wagner Group is subject to sanctions under the Russia sanctions. On the question of proscription, I will have to write to the noble Lord.
Lord Stirrup (CB)
My Lords, Russia’s war in Ukraine is being spearheaded by a mercenary organisation which has terror, torture, murder, rape and all other forms of brutality at the heart of its activities. Does the Minister agree that, quite aside from the illegality of Russia’s actions in Ukraine, we should be doing all we can to ensure that such a group is unable to operate anywhere in what we would refer to as our civilised world and that we have made a less than glorious start in this regard?
Baroness Penn (Con)
I join the noble and gallant Lord in completely condemning the actions of this group. I know we have had the basis to sanction the group under the Russian sanction regime. I am sure we are looking at all the tools we have available to us to take further action. Proscription was one avenue raised by the noble Lord, Lord Purvis, and I will write to noble Lords to set out the Government’s position on that.
Defence: Budget
Lord Stirrup Excerpts(9 years, 5 months ago)
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Lord Newby
My Lords, that is an interesting idea. However, the key thing is the content of the review, rather than the procedure.
Lord Stirrup (CB)
My Lords, the Minister referred to the fact this country is still the second largest contributor to NATO. Sadly, that is not a terribly high bar to clear these days. At the recent NATO summit in Wales, the Prime Minister stressed the importance of alliance members contributing at least 2% of their GDP to defence. While no one can commit the next Government, does the Minister not think that, were the current Prime Minister to form the next Government, it would be utterly bizarre if he and his party were not to adhere to this principle which he so strongly espoused so recently?
Lord Newby
My Lords, I really cannot comment about what the leader of the Conservative Party might think after the next election.
Assisted Dying Bill [HL]
Lord Stirrup Excerpts(9 years, 5 months ago)
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Lord Stirrup (CB)
My Lords, I will speak very briefly. I intended to preserve my first intervention for an amendment to which I have attached my name in the second group, but a couple of things have been said in this excellent debate that we should reflect on and that need a little clarification. It has been said that the Bill is not about doctors or lawyers, but about patients and patients choosing to die. That is not the case. The Bill is about others being permitted to contribute to a patient’s death. This is not the dying Bill, but the Assisted Dying Bill. It is imperative that we focus our attention on the rules and safeguards that would be applied to those who will contribute to a particular patient’s death.
In his very moving speech, the noble Lord, Lord Campbell-Savours, said that people simply want out. I understand that entirely and I absolutely respect it. Some people will of course have religious objections to that. I do not. I get that, I understand it and I do not believe that anyone should stand in their way. However, this is not just about people wanting out, but about people wanting others to help them through the exit. That raises fundamental issues of ethos in a number of professions. As the noble Lord, Lord Ribeiro, has said, this is a significant issue for the medical profession. I am not a member of it, but I have family connections and have spoken to many doctors—some of them relatives—on this issue. There is huge concern about it. I will expand on those issues in a later amendment. However, we should not concern ourselves with who in this House feels compassion; we all do. I am sure that we are all very sympathetic to the motives behind the Bill. As I said at Second Reading, I have the profoundest respect for the people who have brought the Bill forward and for their motives. However, I also have the profoundest reservations that, in attempting to do something good, we may in the process do something that will be much more harmful in the long run.
Baroness Cumberlege (Con)
My Lords, I totally agree with what the noble and gallant Lord has just said. I come from a medical family. I am not a doctor, but I was made a fellow of the Royal College of Physicians, which asked me whether I would chair a working party to look at medical professionalism. That comes very much into these amendments.
We spent a very long time thinking about this extremely difficult issue. Do people care about professionalism? Where is it? How is it defined? What is it all about? We had a very interesting scribe—the editor of the Lancet, Richard Horton—who devised an extremely good definition, which was very long. I said to my working party that I would not remember that great paragraph if somebody said to me, “Lady Cumberlege, what do you mean by ‘medical professionalism’?”. We put our heads together and thought very strongly. We decided that medical professionalism is signified by the values, behaviours and relationships that underpin the trust the public has in doctors.
I very much support my noble friend Lord Carlile’s amendment. I fear that if we do not adopt something like this, which he described as a complete court-based model, trust in the medical professional will be eroded. That is surely the last thing that any of us wants. The noble and right reverend Lord, Lord Harries of Pentregarth, made a very interesting speech and I very much support what he said. However, I take issue with one thing. He talked only about doctors; we have heard only about doctors. Reference is made in the Bill to clinicians and to nurses. The noble Lord, Lord MacKenzie, and I have tabled a number of amendments, which we will come to later, on the role of nurses in this. They are mentioned as clinicians. I met with the Royal College of Nursing yesterday—I am also a fellow of its college—and we had a long discussion on this. There are one or two wrinkles on prescribing, but the same issues of professionalism are shared by nurses.
My noble friend Lady Wheatcroft dismissed very quickly the idea that there was a lot of abuse. We have already been urged to think about the patients. On 14 May, I initiated a debate in your Lordships’ House on elder abuse, in which 12 noble Lords took part. I had to research that topic. It was very interesting. If you look at things such as the Care Quality Commission and recent reports into Mid Staffordshire and all the rest, we know that a certain amount of abuse is taking place, certainly in residential homes, nursing homes, hospitals and prisons, but also in people’s own homes. The Department of Health estimates that just under 500,000 elderly people are subject to abuse in the community. That is why we want a differently shaped Bill and why we want to take the National Health Service—healthcare—out of making the final decisions. As my noble friend Lord Tebbit said, it is very hard to discover where the abuse is taking place, especially in people’s homes. That is why it is essential that we accept the amendment tabled by my noble friend Lord Carlile.
Lord Carlile of Berriew
The intention is to reduce the period. That does appear in other amendments.
Lord Stirrup
My Lords, my name is attached to Amendment 67. At Second Reading I made it clear that my principal concern with the Bill was the way in which it affected the medical profession. The medical profession is essentially about saving, protecting and enhancing life. It is true that doctors can make decisions to withhold or withdraw artificial support for life. It is also clear, as has been said today, that they make decisions that will result in death; for example, choosing between a mother and child on occasion, or between Siamese twins. However, the intent—the driving purpose—is always to save and protect life.
In the Bill, the medical profession will be called on to cross a distinct line. It is invited to participate in the active termination of someone’s life—to participate in killing them. That is a very serious line to cross. Once it is crossed, as I said at Second Reading, there is no easily defensible position behind it. No one knows when the retreat will end.
This amendment does not allay that concern; indeed, I am not sure that any possible amendment to the Bill would address that concern completely. However, it does at least ease it to a degree. The crucial point is to remove the medical profession from the decision-making part of the process. Of course it has to be involved, and of course you need medical opinion. However, doctors are called on in the Bill to decide things that are, frankly, not even within their competence. Whether they are in the competence of anybody, including lawyers, is a matter for debate, but it is better that they should be removed from the medical profession.
The medical profession is of course called on to make a prognosis. My son is a cardiologist and has made it clear to me that, although he is called upon to make prognoses and does so, they are guesses. They are educated guesses—I have to say that they are very expensively educated guesses—but they are nevertheless guesses. They turn out to be right sometimes; they turn out to be wrong quite often—far more often than the medical profession would wish. It is an entirely different matter for a doctor to say to a High Court judge, “In my opinion, the most likely outcome in this case is X, but of course it could be Y or Z”, and for the court, on the basis of that expert opinion and all the other evidence that it has sought and assembled, to reach a comprehensive judgment. However, to ask doctors to do that is to put too great a burden on the shoulders of those who are already heavily burdened.
One of the concerns about this whole process is getting doctors to be involved in it in the first place. We know that a great many people in the medical profession are very concerned about the Bill, and would be unwilling to participate in the process. It might just be that if we are able to come up with some better decision-making process such as the one that has been outlined in the various amendments put forward by the noble Lord, Lord Carlile, we might get more of the medical profession engaged than would otherwise be the case. Surely, for those who are proposing the Bill that would be a good thing. Therefore, for those reasons, I support the amendment in the name of the noble Lord, Lord Carlile, including Amendment 67, to which I have put my name.
Lord Tebbit
My Lords, as I have listened, my mind has turned to the practice of those who may be seriously ill or handicapped in some way or another signing DNR—do not resuscitate—forms. Are they affected by these restrictions? Should we indeed be allowing DNR forms to exist? We do not ask whether the person who signs it is mentally competent to do so, nor do we involve the High Court or anybody else. Are doctors obliged to respect a DNR form? I am not quite sure—is anybody else here?
Lord Stirrup
Will the noble Lord accept—perhaps he will not—the proposition that there is a distinct difference between a doctor failing to resuscitate or withholding artificial support to life and actually participating in the taking of a life? That is why there is such a focus in this debate on the roles and responsibilities of those people. There is a difference of very great magnitude between that and the DNR case. Does he agree?
Lord Tebbit
My Lords, I entirely agree with the noble and gallant Lord. I think there is a distinct difference but I do not think that we should just go on, forgetting the existence of those forms or forgetting the role of the doctor in deciding whether or not to respect them. It is not an easy question to answer, always, is it?