House of Lords Third Reading shows Health and Care Bill Parliamentary consensus on World Economic Forum agenda

Thank you to the thousands of members of the public who have supported the Don’t Blow It! Campaign to scrap the Health and Care Bill – aka the Corporate Takeover Bill, and to the tiny handful of politicians who have responded positively to the campaign, in particular Margaret Greenwood MP and Baroness Natalie Bennett. 

Self congratulatory and cursory House of Lords’ Third Reading of the Health and Care Bill

Apart from Baroness Bennett’s speech, which called on the government to listen to and act on public “cries from the heart” about the need to safeguard the NHS as a universal comprehensive public service, the sparsely attended Third Reading consisted of around 20 minutes of four peers congratulating each other about how they’d “improved” the Bill with a handful of amendments, passed after nine days of Committee and four days of Report. 

A smattering of peers for the Health and Care Bill Third Reading

The peers ignored the fact that at the Committee stage, of the 477 Amendments considered:

  • 64 were withdrawn
  • 18 were disagreed
  • 339 were not moved
  • 56 were agreed (all by Lord Kamall, the Minister responsible for steering the Bill through the House of Lords).

At the Report Stage, as far as we can make out, there were 16 divisions (votes) on amendments. The government seems to have lost 14 and won 2. These amendments are here on the Parliament UK website.

In brief, these were the Report Stage amendments that the House of Lords voted through.

Update 29th March

(Confusingly, the House of Lords amendments have been renumbered in the 29th March document “On Consideration of Lords Amendments to the Health and Care Bill, prepared by the government for the 30th March House of Commons Consideration of the Lords Amendments, and in the List of Lords Amendments to the Health and Care Bill

As far as I’ve been able to it figure out, I’ve added the new numbers in brackets. From the 29th March document, it looks as if the government has pretty much trashed all the House of Lords Report Stage amendments – and where it has not outright rejected them has generally replaced them with weaker versions.

The brief description of the HoL amendments, below, refers first to the amendments as made by the HoL – and then to the government amendments of the HoL amendments that are recorded in the document “On Consideration of the Lords Amendments to the Health and Care Bill)

Update 3 April 2022

Here is the Parliament UK record of COMMONS DISAGREEMENT, AMENDMENTS IN LIEU, AMENDMENT TO A LORDS AMENDMENT AND REASONS

This goes back to the House of Lords on 5th April for consideration of the House of Commons amendments.

Here is info about the House of Lords Amendments which were the basis of the House of Lords 3rd Reading of the Health and Care Bill, and a summary of the government response to them.

Amendment 9 – Conflict of interests ( Amendment 11 in the List of Lords Amendments to the Health and Care Bill )

This ensures that conflict of interest rules that apply to an Integrated Care Board (ICB) also apply to commissioning sub-committees. Specifically, that the Constitution must specify these rules, including the appointment of members so as to avoid the appointment of anyone perceived to have an actual or potential conflict of interest.

The 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 11
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Argar proposes to replace this HoL amendment with a weaker one that says if, hypothetically, the IC Board constitution allows committees or subcommittees to exercise commissioning functions, then responsibility for appointment of members and making sure they don’t have conflicts of interests rests with the IC Board Chair.

Opening the door to cronyism.

Amendment 12 – ICB members (New Amendment number 105 List of Lords Amendments to the Health and Care Bill )

This Amendment ensures that at least one member of a local area’s Integrated Care Board has expertise and knowledge of mental health.

The 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 105
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Argar proposes replacing the HoL amendment with a requirement that the chair must exercise an approval function mentioned elsewhere in the Bill, to ensure that at least one of the ordinary members of the IC Board must have knowledge and experience of mental health services.

Comment: this seems to be about concentrating IC Board power in the hands of the Chair. By specifying that the member with knowledge of mental health services should also be an ordinary member ie not a member of a partner NHS organisation in the ICS, this seems to narrow the possibility in the HoL amendment, that the member could be from any part of mental health services.

Amendment 80 – Workforce assessments ( New Amendment number 29 List of Lords Amendments to the Health and Care Bill )

This requires the government to publish independently verified assessments every two years of current and future workforce numbers required to deliver care in England.

The assessments should take into account the economic projections made by the Office for Budget Responsibility, projected demographic changes, the prevalence of different health conditions and the likely impact of technology.

The 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 29
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Comment: If the NHS is fully staffed it will once again be able to provide a service to everyone as it did before. And once again there would be no room for the private sector to function. So an NHS fully staffed to provide a comprehensive and universal service is absolutely incompatible with a privatisation agenda. 

But the privatisation agenda is rampant. Today (29th March) the Health Service Journal has reported leaked NHSE guidance that pushes NHS hospitals to develop ‘private patient opportunities’:

“Official draft guidance has encouraged trusts to grow their ‘private patient opportunities’, despite facing huge backlogs of NHS work. The NHS England document, leaked to HSJ, includes instructions to local leaders for the new financial year starting in April. It said: “Trusts should continue to actively explore and develop opportunities to grow their external (non-NHS) income… Private patient services continue to be a significant source of material opportunity in the NHS.’ It adds that NHS England and NHS Improvement will work with trusts to ‘identify and scale-up NHS export opportunities and support development of private patient opportunities to generate revenue and provide benefits for NHS staff and local patients and services’. A number of trusts, particularly in London, generate substantial income from privately paying patients, some of whom travel from overseas. The draft guidance, titled Revenue Finance and Contracting Guidance for 2022/23, has been circulated to local trust leaders within the last few months.”

Amendment 84 – Service reconfiguration (New Amendment number 30)

This removes a clause from the bill that enables the government to intervene in the reconfiguration of care services.

The 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 30
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Amendment 108 – Supply chains (New Amendment Number 48)

This ensures that the procurement of all goods and services from overseas for the health service in England is consistent with the UK’s obligations under the Convention on the Prevention and Punishment of the Crime of Genocide.

The 29th March document “On Consideration of Lords Amendments to the Health and Care Bill” records:

Lords Amendment No. 48
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.

The government proposes replacing it with a weaker amendment for the Sec of State to carry out a review into the risk of slavery and human trafficking taking place in relation to people involved in NHS supply chains, and to present a report on the review to Parliament within 18 months.

Amendment 113 – Discharge of patients (new HoL Amendment Number 51)

The HoL amendment retains the duty on a NHS or independent hospital, to ensure a patient must be safe to discharge from hospital and mirrors carers’ rights, which were established in the Community Care (Delayed Discharges, etc) Act 2003.

But the 29th March document “On Consideration of Lords Amendments to the Health and Care Bill” records:

“Lords Amendment No. 51
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Instead, he proposes a much weaker amendment that removes any reference to patients’ rights under the Care Act 2014, the Health and Care Act 2006 and the Children Act 1989.

Amendment 116 – Holding of patient data (New Amendment number 57)

This seeks to keep statutory protections in place in regard to the safe haven for patient data across health and social care, required for national statistics, for commissioning, regulatory and research purposes. It also ensures that NHS England do not take on this responsibility because of a potential conflict of interest in their role.

But the 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 57
Edward Argar
To move, That this House disagrees with the Lords in their Amendment”

Oops!

Amendment 124 – Disclosure of protected material (New Amendment number 109)

This removes the provision allowing coroners to require the disclosure of protected material from the proposed Health Service Safety Investigations Body.

But the 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 109
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Don’t really understand the significance of this rejection on the Amendment. Seems possible that requiring the disclosure of protected material might make people less willing to pass information to the Health Service Safety Investigations Body?

On 1st April, Doctors’ Association UK voiced its strong support for the ruling by MPs to back the amendment that doctors submitting evidence to the Health Safety Investigation Body may not be summoned by Coroners. Here is the Doctors’ Association UK press release:

Amendment 141 – Care cap (New amendment number 80)

This deletes clause 155, regarding the cap on care costs for charging purposes.

But the 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

Lords Amendment No. 80
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.

Instead, he proposes replacing it with an amendment that is too long and complicated for me to follow, but which makes reference to local authority and non-local authority charges for provision of services to meet eligible needs, along with personal budgets and independent personal budgets. Which leads me to wonder if this is about splitting care costs between local authority-provided personal care and NHS Continuing Care for nursing care, and the provision of personal health budgets that may blur the boundary between means tested social are and non-means tested NHS continuing care.

Amendment 144A – Commencment of Care Act 2014 provisions (New amendment number 81)

This amendment inserts a new clause to ensure that all provisions under sections 15 and 16 of the Care Act 2014 have come into force before 1 April 2023.

But the 29th March document “On Consideration of Lords Amendments to the Health and Care Bill records:

“Lords Amendment No. 81
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.”

Government changes agreed

Members also agreed to government changes establishing a licensing regime in connection with non-surgical cosmetic procedures.  (New HoL amendment number 84 in List of Lords Amendments to the Health and Care Bill )

Amendment 158 – Tobacco regulation (New number 85-88 in List of Lords Amendments to the Health and Care Bill )

This requires the government to carry out a consultation for a regulation scheme for the prices and profits of tobacco manufacturers and importers.

Funds raised by the scheme would be used to pay for the cost of tobacco control measures to help deliver the government’s aim to make smoked tobacco obsolete by 2030.

The Government minister Edward Argar has moved that the House disagrees with all the Amendments 85-88.

Amendment 162 Organ trafficking (new Lords Amendment number 89)

This ensures that in relation to organ tourism, there must be informed consent with no coercion or financial gain for the donation of organs.

This would therefore prevent organ tourism which involves either forced organ harvesting or black market organ trafficking.

Lords Amendment No. 89
Edward Argar
To move, That this House disagrees with the Lords in their Amendment.

Edward Argar has moved a replacement Amendment that seems to create an offence that relates to controlled material consisting of or including a human organ.

Amendment 172 -Dispute resolution about child palliative care (New Lords Amendment no 90)

This HoL amendment allows for dispute resolution between doctors and parents of a child in palliative care, by allowing parents access to evidence and opinion on alternative medical treatments.

But the government has rejected the amendment, in advance of the HoC consideration of the HoL amendments on 30th March, and has replaced it with a weaker amendment that the Sec of State will carry out a review into the causes of disputes between doctors and parents over the treatment of critically ill child patients, and must publish the outcome of the review within one year.

Amendment 183 – Termination of pregnancies (New Lords Amendment no 92)

This allows for the medicines used for termination of pregancies to be taken in a pregnant woman’s home, subsequent to a consultation with a registered medical practitioner,
nurse or midwife via video link, telephone conference or other electronic means.

The government has NOT amended this HoL amendment in advance of the HoC consideration of the HoL amendments on 30th March.

At the Third Reading in the House of Lords, these are the “improvements” that Lord Kamall chose to mention:

“banned hymenoplasty; introduced a power to create a licensing regime for non-surgical cosmetic procedures; extended the gamete and embryo storage limits; made important commitments to safeguarding children; …strengthened the NHS’s commitment to net zero [and] included specific references to tackling inequalities.”

https://www.theyworkforyou.com/lords/?id=2022-03-23a.976.9

No longer a Tory Bill but a cross-party Parliamentary consensus on a World Economic Forum agenda

Unlike the second reading in the House of Commons – where the Labour Party put forward (but lost) a reasoned amendment to reject the whole Health and Care Bill, there was no likelihood of Labour Party support for such an amendment at the House of Lords 3rd reading – either by way of an amendment that “the Bill do not pass”,  or for voting in the House on the day against the motion that the “Bill now pass.”

Apart from Baroness Natalie Bennett, a lone voice at the House of Lords Third Reading, it seems clear that this is no longer a Tory Bill but a Parliamentary consensus on an agenda drafted by NHS England (originally from the World Economic Forum).

Baroness Thornton, Shadow Spokesperson (Equalities and Women’s Issues), Shadow Spokesperson (Health) said:

“I agree with the Minister that we have improved the Bill; it is a much-improved Bill that we are sending back to the Commons…”

https://www.theyworkforyou.com/lords/?id=2022-03-23a.978.0

Baroness Walmsley, Co-Deputy Leader of the Liberal Democrat Peers, said:

“My Lords, this Bill is of great significance to the NHS, care services and, in particular, patients and residents in the care system. As the noble Baroness, Lady Thornton, and the Minister have said, it has been improved by your Lordships’ usual scrutiny.

“I am very grateful to the noble Lord, Lord Kamall, and the other two Ministers working on the Bill. By my calculations, the Government have given us either changes or reassurances on 13 different areas in this Bill. 

“This Bill has been a model of how people can work across parties in this House.”

https://www.theyworkforyou.com/lords/?id=2022-03-23a.978.0

Baroness Findlay of Llandaff, Deputy Chairman of Committees, Deputy Speaker (Lords), said:

“[T]his Bill leaves us better. It has been a genuine pleasure to work on it. Some of us have worked on previous Bills, and I have to say that this was a more enjoyable and rewarding experience because the dialogue involved a better interchange at many points.

“We have made some points of great significance, one of which was over palliative care, which has been dear to my heart. Palliative care has come of age.”

https://www.theyworkforyou.com/lords/?id=2022-03-23a.978.0

The Bill is still not in the interests of the public or indeed of the NHS itself as a comprehensive, universal public service

The final speaker, Baroness Natalie Bennett,  was a lone voice in the House of Lord during the 3rd reading, referring to “cries from the heart” from members of the public about the direction of the NHS under the Bill. She said:

This House has improved the Bill, but I feel I need to say that I have received in the last few days a significant number of emails. They are not part of a co-ordinated campaign; they are cries from the heart, many from long-term NHS campaigners who I have known for a long while. I quote just one of these, which says that:

“The Bill is still not in the interests of the public or indeed of the NHS itself as a comprehensive, universal public service”.

“That is an expression of feeling that I am hearing very strongly. I hope that the Minister will listen to that and understand that there are very grave concerns out there among the public about the direction of the NHS.

“The improvements that we have at least delivered, as other noble Lords have said, should stay, but the Government really need to safeguard this universal public service.”

https://www.theyworkforyou.com/lords/?id=2022-03-23a.980.0

Next stage: House of Commons Consideration of Lords Amendments

This will take place on 30th March. The Parliament UK website explains what the process is:

“When a Bill has passed through third reading in both Houses it is returned to the first House (where it started) for any amendments made by the second House to be considered.

“What is ping pong?

“If the Commons makes amendments to the Bill, the Lords must consider them and either agree or disagree to the amendments or make alternative proposals.

“If the Lords disagrees with any Commons amendments, or makes alternative proposals, then the Bill is sent back to the Commons.

“A Bill may go back and forth between each House until both Houses reach agreement on the exact wording of the Bill – this is known as ‘ping pong’

House of Lords consideration of Commons amendments

This is scheduled for 5th April.

“What happens after consideration of amendments?

“When the exact wording has been agreed by the Commons and the Lords, the Bill is ready for Royal Assent. Once a Bill receives Royal Assent it is made an Act of Parliament (the proposals in the Bill become law).

“In exceptional cases, when the two Houses do not reach agreement, the Bill falls. If certain conditions are met, the Commons can use the Parliament Acts to pass the Bill, without the consent of the Lords, in the following session.”

2 comments

  1. Thanks for putting all this work in Jenny.

    On what date is the bill expected to go back to the commons?

    SONIK will be taking action of some sort, possibly an open letter to all Kent MPs outlining the main objections and getting it into the press.

    Carly

    On Thu, 24 Mar 2022 at 21:38, Calderdale and Kirklees 999 Call for the NHS wrote:

    > Green__Jenny posted: ” Thank you to the thousands of members of the public > who have supported the Don’t Blow It! Campaign to scrap the Health and Care > Bill – aka the Corporate Takeover Bill, and to the tiny handful of > politicians who have responded positively to the campaign, ” >

    Like

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