Abortion (Disability Equality) Bill [HL]

Lord Swinfen Excerpts

Report stage (Hansard): House of Lords
Friday 24th February 2017 Lords Chamber

[Lord Swinfen (Con)]

My Lords, I am a complete layman in these matters. When the noble Lord, Lord Winston, responds, can he tell the Committee what in his view is a “high probability”? What does he mean by that? Also how long is “shortly after” a birth? Would that be hours, days, weeks or years?

[Baroness Stroud (Con)]

My Lords, I thank the noble Lord, Lord Winston, for the time he has given me to understand fully his amendment, and I put on the record my deep admiration and respect for so much of the work he has done.

Of all people, the noble Lord, Lord Winston, will be only too aware of the extraordinary medical progress that is being made in perinatal and neonatal care. In this Bill we should be advocating for the best treatment of children with disabilities. The provision of holistic care, including perinatal and neonatal hospice care at the end of life, can help to ensure that these babies are treated with dignity, care and love. While the life expectancy of these babies may well be brief, they do have a life and are significant family members who will be valued, remembered and treasured.

The Northern Ireland Executive have recently set out a commitment to provide such hospice care in the Department of Health’s 10-year plan on palliative care for children. I hope that we will see such care being provided elsewhere in the UK. Perhaps the Minister can comment on that.

Amendment 1, aside from being antithetical to the spirit of the Bill, is fraught with difficulties, as we have heard in the debate. Taking the amendment in the order of its wording, what would be judged to be a “high probability?”. We have heard that question repeatedly in the debate. Is that more than 90%, more than 50%, or 65%? How would the decision about likely death be made? Would that be with or without treatment, since conditions may be classified as the same but manifest varying symptoms, from those which may be lethal to those which may in fact be treatable or not immediately lethal? In my meeting earlier with the noble Lord, Lord Winston, we discussed cleft palate, which can be very severe or quite minor and correctable. How long would “shortly after” need to be to qualify? Would it be a matter of hours or days or months? What would count as a “serious fetal anomaly”, since that is not even a medical term? Amendment 1 does not bring any certainty; rather, it raises more questions than answers.

These questions demonstrate how the law would treat these children differently from those without disabilities. It would again enshrine the discrimination that my noble friend Lord Shinkwin is seeking to eliminate, and I encourage noble Lords not to support the amendment.

National Institute for Health and Care Excellence

Lord Swinfen Excerpts

Monday 13th July 2015 Lords Chamber

[Lord Prior of Brampton]

The noble Countess makes a very insightful point. Non-productive time—by which I mean the time when nurses are not dealing directly with patients—varies considerably, but the average seems to be about 20% to 25% of their time. The better-organised wards—which takes me back to an earlier point—where there is strong local leadership from the ward sister will be organised in such a way that staff will spend much more time with patients. I agree entirely with the noble Countess’s point.

[Lord Swinfen (Con)]

My Lords, is part of the problem due to the specialisation of nurses? Are far too many of them being trained only as specialists so that they are therefore unable to be moved from one part of a hospital to another? Would more general training be better?

[Lord Prior of Brampton]

I do not think that is a problem. In many ways, in acute hospitals we lack generalists. That is true of consultants as well of nurses. That is actually my noble friend’s point. Possibly there are too many specialists, but on a cardiac ward or a specialist acute ward you need specialist nurses who know how to operate the equipment as well as how to look after the patient. You need a good balance between the two but, if anything, I fear we have, as my noble friend said, become too specialist and insufficiently generalist.

Health: Folic Acid Fortification

Lord Swinfen Excerpts

Wednesday 2nd April 2014 Lords Chamber

[Earl Howe]

That is an issue that we will of course weigh up as we look at the risks and benefits and take a decision, as we will in the next few days.

[Lord Swinfen (Con)]

My Lords, what are the risks of adding folic acid to flour?

[Earl Howe]

My Lords, the scientific committee pointed to several risks. One is that an overdose of folic acid may mask vitamin B12 deficiency, particularly in the over-65s—and this may be an issue in which a number of us wish to declare an interest. The committee also pointed out that although there was no specific evidence of a link to bowel cancer, there are nevertheless experts who believe that the evidence is equivocal in that area, and we need to take the balance of opinion very seriously.

NHS: Private Companies

Lord Swinfen Excerpts

Monday 11th February 2013 Lords Chamber

[Earl Howe]

The noble Lord raises an important point. A great deal of work is currently being done on the way in which the education and training of NHS clinical staff is funded. Changes are being made this year in order to make funding fairer and more transparent generally, and the Government will consider any further recommendations that Monitor may choose to make in this area if they would bring about further benefits to patients.

[Lord Swinfen]

My Lords, how will the quality of the work be evaluated?

[Earl Howe]

My Lords, the system will operate in a way that ensures that non-NHS providers who provide services to the National Health Service pass a quality test with the Care Quality Commission. They will be obliged after that, should they receive the benefit of contracts from the NHS, to demonstrate that they have abided by the terms of the contract.

NHS: Health Tourism

Lord Swinfen Excerpts

Monday 28th May 2012 Lords Chamber

[Earl Howe]

My Lords, were that situation to occur, the issues arising from it would be little different from the issues today in that health is already devolved. However, I cannot speculate on whether there would be a different policy on immigration in Scotland compared to south of the border as we are really not in that territory yet.

[Lord Swinfen]

What checks are actually carried out to ensure that patients are entitled to free National Health Service care?

[Earl Howe]

My Lords, it is incumbent on NHS trusts when a patient presents directly to them to ensure that the person in front of them is entitled to NHS care, and they have various means of doing that. However, primary care in this country—care delivered by GPs—is not subject to any checks of that order.

NHS: General Practitioners

Lord Swinfen Excerpts

Wednesday 23rd May 2012 Lords Chamber

[Earl Howe]

My Lords, the Government have laid down no bar on homeopathic medicine. The prescribing of homeopathic remedies is very much a matter of clinical judgment and we would not wish to fetter that.

[Lord Swinfen]

My Lords, to what extent are general practitioners using telemedicine to cut down the time needed to obtain specialist medical advice for their patients?

[Earl Howe]

My Lords, this is a very exciting area. I have seen some extremely good examples of telemedicine that will deliver not only greater efficiency within the health service, sometimes enabling clinicians to diagnose conditions in patients from a remote standpoint, but also greater safety and effectiveness of care for patients. For example, I saw a demonstration of stroke diagnosis that can be done remotely by laptop. This is an area on which the department is focusing a lot of attention, not least through the 3millionlives initiative, through which we hope over the next few years to ensure that 3 million people benefit from telecare and telemedicine.