Health and Social Care Act (Northern Ireland) 2022 (Consequential Amendments) Order 2022

Baroness Ritchie of Downpatrick Excerpts

Monday 5th September 2022 Grand Committee

[Baroness Brinton (LD)]

My Lords, I will intervene from the Liberal Democrat Front Bench on this one. I could see the alarm in the Minister’s eyes that a Westminster health and care spokesperson might try to intervene on an order to do with Northern Ireland health and care. I assure him that it is as technical as his contribution at the beginning. We have no problem at all with the statutory instrument in front of us today.

I want to make one point, which I hope the Minister will take back. The noble Lord, Lord Murphy, may be aware that the Health and Care Act is the first real attempt by a Government in this country to combine health and social care, so Westminster, on behalf of England, is finally getting its act together and combining the two—which, whatever opposition we had to elements of it, we certainly welcomed. In March, during its passage through your Lordships’ House, a number of amendments were ruled out of order because they referred to some of the UK-wide legislation that the Minister referred to in his opening. We were told that an agreement had been struck by the Government with all three devolved nations, which had already taken their legislation through, and therefore that amendments we wished to lay could not be laid.

They were very minor and technical, so I will not go into them here. However, if we are going to talk about the importance of devolved responsibilities and try to mend some of the complex technical issues around legislation that crosses into UK-wide legislation, those working on Bills, certainly in your Lordships’ House, need to know at a much earlier stage where those discussions need to be had. It would have helped the transition of the Health and Care Bill, which was enacted on 28 April—some two months after the Act we are discussing was enacted—because there were things we would have liked to change and would have raised much earlier, had we been aware that there were issues.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I support this very technical order. Like the noble Lord, Lord Murphy, I make a plea yet again for negotiation between all parties and both Governments to get the institutions up and working to look at the areas where there are problems or impediments, including in the protocol, and any other issues.

The most important thing that the people of Northern Ireland require is a functional Government who are delivering for all of us on health and social care, the economy, infrastructure and job creation. In relation to this, I agree with the noble Lord, Lord Murphy. There are chronic waiting lists in Northern Ireland for specific disciplines. There are also waiting lists to get on to waiting lists, which can cause such consternation for individuals who are ill. That has been the situation for quite some time.

I do not disagree with the assimilation of the Health and Social Care Board into the Department of Health and the five health trusts. As a former MP I had experience of dealing with the Health and Social Care Board and the health trusts. I could never fully understand or appreciate the difference in their workload, because the health and social care board commissioned the services and acted as the prescriber of what services were required. Notwithstanding that, that is a job better done by the Department of Health.

In relation to that, maybe the Minister would have talked to the current caretaker Minister, Minister Swann, who served as Health Minister for the last nearly three years, about what savings are projected from the assimilation of the Health and Social Care Board into the department and trusts. Will those savings be ploughed back into the delivery arm of the trusts so that people can access services in the medical and clinical areas to which they are entitled?

[Lord Lexden (Con)]

When my noble friend comes to reply, could he give the Committee an impression of whether the problems with the health service in Northern Ireland, although very considerable, have deepened yet further during this unfortunate period, which strengthens the reasons why we want devolution back?

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[Lord Caine (Con)]

The noble Lord is absolutely correct to point that out. It is 24 weeks; I said 28 because the current deadline is 28 October. Although Ministers can stay in place, they are very limited as to what they can do—they cannot take decisions that would require executive agreement because there is no functioning Executive and they cannot take decisions that would be cross-cutting with other departments—but it is a preferable situation to the one we had when the Assembly was last down, when just civil servants were running the show. I am all too well aware of the limitations. For that reason, noble Lords are absolutely right to set out once again the urgency of restoring a properly functioning Executive and Assembly in which Ministers are fully accountable to the Assembly and, through the Assembly, to their respective electorates within Northern Ireland.

The noble Baroness, Lady Ritchie, again underlined with her questions on certain aspects of the legislation the importance of getting the Assembly back. Although her questions were directed at me they really should be directed by MLAs to the Health Minister. I am very happy to look into the matter for her, but it is essentially a devolved one on which further elucidation would be gained through Health Minister’s Questions in the Assembly rather than in a House of Lords Grand Committee.

[Baroness Ritchie of Downpatrick (Lab)]

I asked the question because we as a House of Lords are being asked to approve an order that would enable a change in in English, Welsh and Scottish legislation to reflect the dissolution of the Health and Social Care Board. In view of that, would the question not be quite prescient? I also thank him for going to ask the current Minister for that information on the projected savings and whether they will be ploughed back into the service.

[Lord Caine (Con)]

As I said to the noble Baroness, I am perfectly happy to do so. I appreciate that no MLA is able to stand up in the Assembly and ask those questions at the moment, so I am happy to look into the matter and come back to her.

I welcome the noble Baroness, Lady Brinton, to her place. She correctly identified my look of alarm at the fact that a Westminster health spokeswoman had come into a debate on Northern Ireland matters. She will be aware that I played no role whatever in the passing of the health and social care Act, so I must confess to a certain degree of ignorance of some of the matters she raised. Again, I am happy to look into them for her.