Terminally Ill Adults (End of Life) Bill

Lord Harper Excerpts

2nd reading
Friday 19th September 2025 Lords Chamber

[Lord Harper (Con)]

My Lords, it is a great pleasure to follow the noble Baroness. At the end of her speech, it was very clear that she should have had no concerns about the contribution she would make to the debate—it was a very powerful speech.

We are all the product of our experiences. One of the most profound and shaping that I had in public life was being shadow Minister and then Minister for disabled people. The reason for that was the opportunity I had over the four years or so in those two roles to meet people of all ages who had thrown in front of them, sometimes over the whole of their life and sometimes as a result of circumstances, challenges and difficulties that they faced doing the things that we all take for granted: living an independent life, working, bringing up a family, contributing to society and making the best of what they had in front of them. Many of those people are profoundly concerned by what the Bill will do to society’s view of people who have challenges thrown in front of them.

I know that is not the intention of the promoters of the Bill, but it does say something fundamental about society’s view of life, particularly life lived by people who have profound challenges. That is why the Bill is not supported by a single organisation in this country that represents disabled people—not a single one—and we should listen to their views and take them very seriously.

The second very powerful argument we have heard in this debate, referred to by the noble Baroness, Lady Fox of Buckley, is the one about choice and autonomy. The reason why that argument fails in this case is that you are taking a decision that impacts only upon yourself and has no consequences for others. The problem is that in delivering rights and choices for those who will be the beneficiaries—if that is the right word—of the Bill, you are effectively taking away choices and opportunities from others. There are competing rights, and when we have competing rights, we always have the most difficult decisions to make, and they are always the most charged political conversations we have.

The second reason why that argument fails is that, for choice to mean anything, it has to be a meaningful choice, and we do not have that in this country. We have some excellent palliative care, but it is not universally available to everybody; and in the Government’s 10-year plan for the NHS, there is no plan and no ambition to make it so, not even at the end of that 10-year period. I am afraid that a choice for assisted suicide without access to good quality palliative care is no choice at all.

My final point is about being clear about what we are doing here. As the noble Baroness, Lady Fox, said, and my noble friend Lady May of Maidenhead said last week, this is about assisted suicide. We are amending the Suicide Act to provide a defence for people taking their life. If the promoters of the Bill and those who support it find plain and clear language uncomfortable, rather than attacking those that use that plain and clear language, as they have done with my noble friend Lady May, they should perhaps reflect upon what it is they wish to do.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 1st March 2022 Commons Chamber

[Sajid Javid]

The hon. Lady is right to raise this matter. As she will know, owing to the pressures of the pandemic we have seen significant challenges for ambulance services throughout the country. Just a few days ago I met the head of the West Midlands ambulance service to discuss some of the issues, and also how the extra funding that we provided over the winter—some £55 million of support for ambulance services—is helping.

[Mr Mark Harper (Forest of Dean) (Con)]

May I press the Secretary of State on how the increases in NHS capacity will be maintained over the medium term? His own Department has forecast that waiting lists may hit 9 million or 10 million in the next couple of years. The Government also have a plan to take the extra funding coming from the increase in national insurance and the health and social care levy out of the NHS to fund our long-term social care plans. How are the two to be reconciled?

[Sajid Javid]

As my right hon. Friend will know, when I presented the NHS’s elective recovery plan for the covid-19 backlog in the House a couple of weeks ago, I made it clear that we expect waiting lists to rise before they fall. That is because some 10 million people stayed away during the pandemic, and we want as many as possible of those who want and are able to come forward to do so. At the same time, the NHS will be massively increasing its activity, in new ways and with new funding. It is essential for there to be much greater integration between the NHS and social care, and we set our plans in detail in the White Paper published last week.

Elective Treatment

Lord Harper Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

The hon. Gentleman raises a series of very important points, especially in what he said about cancer and radiotherapy. I believe he already has a meeting in the diary with Health Ministers, and I will look out for the output of that meeting. I agree with what he said about radiotherapy and the importance of investment in that, and there is a lot more investment. I referred earlier to the £6 billion extra capital budget, and a large part of that will be used for new diagnostics. I hope he also agrees with me that, as well as radiotherapy, we need to invest in the very latest cutting-edge technology for cancer care, such as proton beam therapy, which I saw for myself last week in London.

[Mr Mark Harper (Forest of Dean) (Con)]

The Secretary of State will know that many on this side of the House were very reluctant, but did support the increase in resources for the NHS through the increase to national insurance and then the health and social care levy. When we are making that argument to our constituents, they will expect that money to deliver results, so may I make one observation and ask one question? The observation is that, while the plan is welcome, only getting to 99% of patients waiting less than a year by March 2024 is not ambitious enough, so will he perhaps be more ambitious? Will he also say a word about how the resources raised through national insurance will be removed from the NHS and flow into social care? From October 2023, we will have to fund social care with the same money. He did not talk about that, and social care is as important as the NHS, so will he say a word about that?

[Sajid Javid]

My right hon. Friend is absolutely right about the importance of making sure that every penny spent in the NHS, or social care for that matter, is spent wisely and in the very best interests of taxpayers. I absolutely agree with him on that, and that also has to translate into the ambition. My right hon. Friend, like other hon. Members, will not have had time yet to look at the plan. I am happy to discuss it with him afterwards if he wishes. I hope he agrees that it is full of ambition. Indeed, if the NHS can go much further than the targets I set out earlier, that is what we all want. As I said in my statement, it does depend on how many people come back to the NHS, and that is very hard to estimate, but I want as many people as possible to come back.

My right hon. Friend is right to raise the importance of social care and the need for much better integration between healthcare and social care. We will set out more detailed plans on just that very shortly.

Covid-19 Update

Lord Harper Excerpts

Thursday 13th January 2022 Commons Chamber

[Sajid Javid]

As I have mentioned, JVT’s move is the country’s loss, but Nottingham’s gain, and I am glad that the hon. Lady is delighted. On investment in the NHS, she will know that, even before covid-19, the Government had already set out, in the long-term plan for investment in the NHS, the extra £30 billion going into the NHS by the end of that period, with huge investment in areas such as cancer care, mental health care and electives. Then during the crisis, which has of course been very challenging for our health and care services, as it has been across the world, we have set out over £40 billion of extra investment, including this year, to help us get through this crisis.

[Mr Mark Harper (Forest of Dean) (Con)]

I welcome the change in the self-isolation rules that the Secretary of State set out. It is a good indication that the Government can be flexible on policy, so let me have another go on the subject I raised yesterday. My right hon. Friend heard the exchange I had with the Vaccines Minister. She agreed with me from the Dispatch Box that persuasion was the best and right way to get health and social care workers to be vaccinated. However, telling a health and social care worker that they will be sacked if they do not get vaccinated is not persuasion, but coercion. Will my right hon. Friend reflect on whether it is sensible on 1 April to continue to try to implement a policy that, according to the Government’s estimates, will mean 73,000 NHS staff and 38,000 domiciliary care workers losing their jobs? When a policy is not working, it is right to ditch it, isn’t it?

[Sajid Javid]

First, I commend my right hon. Friend for the scrutiny that he has constantly provided of the Government’s covid policy. He did that long before I was Secretary of State and I am pleased that he has continued to provide that scrutiny, which is very valuable. It is most valuable to me when he supports the policy, as he did on self-isolation today, but it is still valuable when he challenges the Government to think again about policy. That is very important. I addressed the policy he raised of the vaccine as a condition of deployment in the health and social care sector a bit in my statement. He will have heard that we are committed to it, but that is because it is right that, in those settings where there are people who are more vulnerable than others, they are put first. We know that vaccines limit transmission and that as a result it is safer for patients if the individuals who provide that care—the health and care workers—are vaccinated. The policy is about putting patients first, was voted for by the House with an overwhelming majority, and the Government intend to implement it.

Vaccination Strategy

Lord Harper Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

I do not recognise the data given by the right hon. Gentleman. We have already invested £465 million in a recruitment and retention programme for care home staff. It is important to recognise that caring is a worthwhile career. The carers I have met are really dedicated and get a lot from it. I come back to the fact that it is important to keep the most vulnerable in our society safe, whether they are care home residents or patients who are acutely ill in hospital.

[Mr Mark Harper (Forest of Dean) (Con)]

My sources in the NHS tell me that last week they received either from the Department or from NHS England instructions effectively on how to go about firing people from the NHS in April if they have not been vaccinated. That caused them considerable concern. The Government’s own analysis, prepared by the Minister’s own Department, is not of the position now; it is of the expectation of where we will be in April. Analysis from her own Department, signed off by her, thinks that 73,000 NHS staff and 38,000 domiciliary care workers will leave.

I want people to be vaccinated, but we know that the protection against infection wanes quite quickly from 10 weeks onwards, which means that we are not protecting others. I want people to be vaccinated, but I—and public health professionals—think that the best way is to persuade them, not threaten them with the sack. If people have not had their first jab by 3 February they will be unable to be fully vaccinated by April, so may I urge her, even at this stage, to come back to the House and reflect on whether threatening people with the sack if they do not get vaccinated is the right policy?

[Maggie Throup]

I completely agree with my right hon. Friend that persuasion is the right way to go. That is why the uptake went up tremendously among care home staff and since we implemented the policy for the NHS the uptake among NHS staff has increased tremendously as well, which is really encouraging. We want it to be a positive choice, and we want people to understand that they are protecting not just themselves and their families but the patients they care for, ensuring that they are safe. Those one-on-one conversations are ongoing to ensure that people understand that, from the perspective of patient safety, this is the right choice to make.

Public Health

Lord Harper Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

The covid-19 pandemic has caused upheaval across the world, forcing Governments everywhere to wrestle with how to keep their citizens safe while protecting the liberties that we all hold dear. We have learned a lot from our experience and the experience of others, and of course we are still learning. But we can take huge pride that thanks to the defences that we have built, so much of this year has been a year of recovery. We have enjoyed greater freedom than at any time during the pandemic so far. Thanks to the rapid progress of our vaccination programme, our investment in treatments and our decision to open up during the warmer summer months, we are in a far stronger position than we were last winter.

But even as I stood at this Dispatch Box back in July to announce the major milestone of taking step 4 in our road map, I said that

“we know that the greatest risk to the progress we have made is the possibility of another new variant, especially one that can escape immunity and puncture the protective wall of our vaccination programme”.—[Official Report, 12 July 2021; Vol. 699, c. 22.]

We have always known that variants have the potential to knock us off our course, and we have built the capacity to identify and respond to those that pose a threat.

The vast majority of new variants present no risk whatsoever. Since the summer, there have been hundreds of new variants, but only one of them—omicron—has been designated a variant of concern. For example, just last month, I updated the House from this Dispatch Box on AY.4.2, a new form of the delta variant, which preliminary analysis showed at that time might be more infectious. I said then that we would keep it under review, and that is what we did—and we took no action.

But omicron is a grave threat. We acted early to slow its spread, strengthening our testing regime and placing 11 countries on the travel red list, but despite those swift steps, the data over the past few days has shown more cause for concern. I would like to reinforce to the House today—to all hon. Members—why omicron represents such a risk to the progress that we have all made so far together.

[Mr Mark Harper (Forest of Dean) (Con)]

I am listening carefully to the Secretary of State’s comments and am grateful that he has brought these measures before the House. I asked him yesterday whether he would give a commitment at the Dispatch Box to recall the House if the Government had to bring further measures in other than those being proposed today, so that we could be involved on behalf of our constituents in making that decision. He kindly agreed to take that matter away and discuss it with the Prime Minister. Is he able now, at the Dispatch Box, to commit that if the Government were to take further measures to deal with omicron during the recess, they would recall the House of Commons so that we are able to have all the evidence and participate in taking those decisions on behalf of the constituents we represent?

[Sajid Javid]

I of course understand the importance of my right hon. Friend’s question; as he said, he asked it yesterday and, understandably, has asked it again today. I hope he will understand that I am not able to give that commitment alone; it would not be a decision for me and my Department alone, but I know the Government would consider it together seriously.

--- Later in debate ---

[Mr Mark Harper (Forest of Dean) (Con)]

Let me start with a few words about the big picture. My hon. Friend the Member for Winchester (Steve Brine) put this very well. We know that covid is going to be with us forever, and we know that we are going to have variants forever. The chief scientific adviser has told us that, and I agree with him. There are many people who think that we will just have to wait a bit and it will all be over, but that is not happening. We have to be realistic about what we are facing, and according to Jeremy Farrar, we are facing this challenge as probably the best protected country in the world through vaccination.

This was effectively the first big test for the Government: how do we deal with a variant of concern in a very well vaccinated population? I am disappointed that we have quickly gone into panic and emergency mode, with late Sunday night broadcasts—not in the House of Commons where questions can be asked—scaring people witless. For example, they have been told that two doses give them no protection, which is not true. Two doses provide weakened protection from omicron against infection, but they still provide good protection against serious disease. I am concerned that many people out there who have had two doses and who are perhaps vulnerable now feel that they have no protection. That is simply not correct. If this is the first test, I do not think we are doing very well.

[Aaron Bell]

The data from South Africa that we heard this morning in the Science and Technology Committee showed that we still have good protection against severe disease from two doses of Pfizer, but it has gone down from 93% to 70% for hospitalisation. That is four times the risk of hospitalisation.

[Mr Harper]

I have seen that, and I look forward to the information from the UK. The point I have been making in my constant repetition about the House sitting next week or the week after or being recalled—my right hon. Friend the Member for South West Wiltshire (Dr Murrison) also mentioned this—is that we are learning new information every day, and when we get that information, we might need to make different decisions. The House needs to be involved in those decisions; they should not simply be made by Ministers by decree. I repeat that point, and I do not understand why Ministers will not give us that assurance. It would build a lot of trust and good will among colleagues, and I do not understand why they will not give that commitment.

These decisions have significant economic and social impacts, as well as impacts on the NHS’s ability to deliver non-covid treatments. My hon. Friend the Member for Winchester has already pointed out that the NHS is going to scrap a whole load of elective surgeries and consultations with GPs in order to get boosters delivered. That might be the right decision, but I do not think that a proper balancing is taking place. Goodness knows how long it is going to take us to recover from the creation of this new backlog over the coming months. If the Government’s fears, as set out by the Secretary of State, are confirmed in any way, what is the exit strategy? What approach are they going to take to ensure that we do not face on-and-off seasonal restrictions forever? That is a serious question, and it has been raised by other colleagues. We need an economy that functions, people need to build lives that can function and the NHS needs to be able to function and deliver all the other healthcare we require.

Let me turn briefly to plan B. I am happy to support the measures on self-isolation. I simply note that, two weeks ago when we were asked to vote to restrict them, I voted against that. Two weeks later, the Government have agreed that I was right to do so, because they are effectively revoking those earlier measures. I will leave that thought with colleagues for when they decide whether they wish to listen to the advice of Ministers or others.

On vaccine passports, the Government’s plan B makes it very clear that Ministers’ preference is for vaccine-only passports. The only reason why tests have been incorporated is to buy or secure the support of the Opposition. That is the only reason. Ministers’ preference in writing is for vaccine-only certificates, so we know what they would like to do if they could get away with it.

The Secretary of State also made some commitments about not supporting mandatory vaccination for the entire population. The only reason that needed to be said is that, two weeks ago, the Prime Minister put on the table the whole concept of mandatory vaccination and talked about having a “national conversation” about it. All I say is that, if Ministers wish to build trust and good will, they need to be careful about what they say. They should not fling these very troubling concepts around without thinking about them. Words have consequences, both in terms of what happens in the real world and of the trust that needs to be built with Members of Parliament and the public.

What is proposed for vaccine passports is very limited, but that was the case everywhere they were introduced around the world. Everywhere they have been introduced, they have been extended. In Wales, for example, where Labour is in power, they have been extended in terms of the venues to which they apply, so anyone who thinks that Ministers will stick to what is currently on the Order Paper are, I am afraid, kidding themselves.

The final thing I say to colleagues is this: the vote on vaccine passports is not just about the regulations on the Order Paper; it signals how we wish to treat this House, how we wish to be treated on behalf of our constituents, and the direction of travel and the approach. If my colleagues wish to send the Government a clear signal that they need to rethink their approach, then, certainly on vaccine passports, they should vote against them. Send the Government a clear message that we can do better. There is a better way, and we should send that message today.

Covid-19 Update

Lord Harper Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

That is not a matter for my Department.

[Mr Mark Harper (Forest of Dean) (Con)]

Mr Deputy Speaker, you will be aware that a couple of days ago the Department of Health and Social Care published something on social media that jumped the gun on the decision the House is being asked to take tomorrow. It is welcome that the Secretary of State intervened, saying:

“No law is decided until Parliament votes on it. I’ve asked for this graphic to be deleted”.

Of course that is not entirely true, because most covid laws, including the mask mandate, have come into force before Parliament voted on them.

This morning the Prime Minister refused three times to rule out further restrictions being imposed before Christmas. I will not ask the Secretary of State to contradict the Prime Minister, but if the Government do decide to announce further restrictions before Christmas, or indeed after Christmas, will he assure me from the Dispatch Box that this House will be recalled to debate and vote on the measures? It is not acceptable to keep governing this country by decree; the Government have to involve Members. I agree with what the Secretary of State said about using Members of Parliament; that means involving us in decisions and getting this House to make the laws. He will then find there is much more of a team approach, rather than decrees and late-night television addresses without taking the House seriously.

[Sajid Javid]

I am not aware of any plans for any further restrictions. As I told the House from this Dispatch Box last week, we are focused on the regulations that are coming before the House and will be subject to the will of the House. We will see if they are approved.

My right hon. Friend asked for an assurance, and I will take that back to my right hon. Friend the Prime Minister.

Covid-19 Update

Lord Harper Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

It is important that sick pay begins from day one, but in terms of supporting areas—whether it be Hull or others—the right hon. Lady is right to point to the importance of the vaccination programme. The measures that we are taking, especially to help with the booster programme, including bringing on board more pharmacies, more hospital hubs and help from the military, will all help to increase access.

[Mr Mark Harper (Forest of Dean) (Con)]

Having looked very carefully at the evidence and listened to what the Secretary of State said, I have to say that the initial evidence on omicron does not support the introduction of these measures, because the protection against serious disease remains strong. If the Secretary of State’s fears are confirmed, there is no exit strategy from the measures that he has set out; we will end up having to introduce them permanently. What I am really concerned about is that it is unquestionably the case that, over the past couple of weeks, the Government’s credibility—whether it is on Paterson or on the Christmas parties—has taken a hit. Why should people at home, listening to the Prime Minister and the Secretary of State, do things that people working in No.10 Downing Street are not prepared to do?

[Sajid Javid]

When it comes to the exit strategy—this is a very important question from my right hon. Friend—a number of factors are at play. The one that I would point to that is possibly the most important is the pharmaceutical defences that I referred to earlier, particularly the booster programme. Whatever emerging evidence there is on vaccine efficacy against omicron, it is perfectly reasonable to assume that, at this stage, a booster dose gives significantly more protection, and the more booster doses that we have in arms will certainly help with the exit strategy. As for the comment that my right hon. Friend made about activities that may or may not have taken place in Downing Street, I refer him to the comments that my right hon. Friend the Prime Minister made earlier today.

--- Later in debate ---

[Dame Diana Johnson]

On a point of order, Mr Speaker. In the light of the Health Secretary’s announcement about the guidance that people should work from home wherever possible, are you able to say anything to the House about what will happen to Parliament before we rise on 16 December?

[Mr Mark Harper]

Further to that point of order, Mr Speaker. I think we established when debating these measures before that it was essential for the proper conduct of business and for Ministers to be held to account that we attended Parliament in person to make sure that the right decisions were made for the British people, and I very much hope that will continue.

Covid-19 Update

Lord Harper Excerpts

Monday 6th December 2021 Commons Chamber

[Sajid Javid]

UK citizens who are abroad and wish to return home should comply with the requirements, but the right hon. Gentleman has raised an important issue, which I will take away and look into further.

[Mr Mark Harper (Forest of Dean) (Con)]

Madam Deputy Speaker, I know that you will find it as comforting as I did that the Prime Minister’s official spokesman this morning confirmed that the Government were confident that next week they would have more data than they currently do, and that the Government would update Parliament before the House rises for Christmas; that is very welcome. The Prime Minister’s official spokesman also reserved the right to implement measures, if necessary, during the recess. It is perfectly reasonable that the Government retain that power, but if restrictions are important enough to implement during the recess, the House should be recalled for us to debate and vote on those matters. May I have an assurance from the Secretary of State that that is what will happen?

[Sajid Javid]

My right hon. Friend should be assured that there will be a further update next week, as I have also just committed to. As he says, if—and it is a big if—it were necessary for the Government to take important action during the recess, of course people would expect us to take that action. As for whether Parliament should or should not be recalled, that is something that I will take back to my right hon. Friend the Prime Minister.

Adult Social Care

Lord Harper Excerpts

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

Of course pay is important, but it is not just a question of pay. I joined a group of carers in a domiciliary care round earlier, and I spoke to them about this. They said that the most important thing for them was changing the way in which the profession was perceived, and that they never wanted to hear themselves described as “just a carer”. That struck me as very important, because it was an aspect of professionalising the workforce. Recognition is also valuable. These are private companies, but of course the council is a big buyer of care services as well, and that will feature in the local government spending settlement towards the end of the year.

[Mr Mark Harper (Forest of Dean) (Con)]

As chair of the all-party parliamentary group on learning disability, I welcome what I understand has been extensive engagement with the sector in the production of the White Paper. I know that it has been much appreciated.

As for the issue of resources, many Conservative Members found it hard to vote for a tax increase of £12 billion a year, but what is really important is for the money to be used effectively. May I pick up what was said by my right hon. Friend the Member for Newark (Robert Jenrick), and suggest that when the local government settlement is published, it should show the settlement for not just one year but a number of years? We could then see a big share of those funds moving from the NHS to social care, which would enable local government to plan appropriately and the NHS to accept that it will not keep that money forever once it has dealt with the backlogs. Many of us are quite sceptical about that. I think that the more transparency there is, the easier the Minister’s job will be in getting those resources into the social care sector.

[Gillian Keegan]

My right hon. Friend is absolutely right. More than 250 organisations worked with us to develop this White Paper, and I want to thank them for their input. Of course they welcome the steps that we are taking. I do not know how many Green Papers, White Papers and other papers they have tried to get some change from, but this one is finally starting on the road to deliver and transform the sector. He is right to say that the longer we can have some understanding of the settlement for funding, the better, and I am sure that my colleagues who are working on that will have heard his question.