argyrotsipi/train-dataset huggingface dataset:
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): I want to make it clear to the noble Baroness that I am not talking about bringing these two pieces of legislation together. I know some people have suggested that that should be done, but I am not asking for that. I am simply suggesting that this legislation, which makes a substantial change to what has been the basis of decision-making about best interests on the basis of harm to self, is now going to include harm to others. We were told back in the summer, when the Minister sent us a letter, that the Government were waiting for the outcome of the Mental Health Act review to see what the impact would be. We are now being told, as the noble Baroness, Lady Stedman-Scott, confirmed, that that basis of decision-making is changed by this legislation. It is linked to the necessary and proportionate assessment that people will have to make. I think that is a major change that will perhaps result in the detention of quite a number of people. I do not think it is unreasonable for the Government to wait until Sir Simon Wessely has published his report to ensure that the two pieces of legislation are not drifting further apart.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): I thank all noble Lords for taking part in that debate, which was a useful exchange of views and information. The Minister is in some difficulty, because the two organisations that he cited are on record as saying that they do not support the Bill in its current form. I remain of the view that we run the risk of attempting to deal with an underfunded, under-resourced system by putting in place another underfunded, under-resourced system which dilutes the protection of vulnerable people Ahead of debates on other groupings, I simply ask how many times the Mental Capacity Act and DoLS codes of practice were changed. How many times were they amended? I do not disagree that a code of practice is a good place in which to put examples; I do not think it is a substitute for having well-drafted legislation and regulations—regulations can often be changed I will read Hansard with great care, but I reserve the right and hope, with the assistance of the noble Baroness, Lady Browning, who is not in her place but is equally concerned about these matters, to return to the matter. I beg leave to withdraw the amendment.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-22
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, this is a fascinating discussion which will be familiar to the noble Lords who took part in previous legislation on mental capacity and on mental health. The thing I am most heartened by is the prediction made by the noble Baroness, Lady Murphy, of what Sir Simon Wessely might do in his review of the Mental Health Act. Way back when the law was reviewed in 2005—I think it was then but I am hopeless with dates—I was one of a number of Peers who argued the case that people with fluctuating mental health conditions should be able to say, at a point when they had capacity, "At some future point, if I have an episode, it is likely that I may refuse treatment but, right at the moment, now that I am well, I wish to say that I want you to ignore that". That was resolutely turned down by the small bunch of forensic psychiatrists who were behind that change to legislation. So I am glad that the world of mental health is moving to catch up with other parts of medicine, where greater involvement of patients and exercise of patient choice is something to be encouraged and not dismissed Many of the arguments that the noble Baroness, Lady Finlay, put forward were arguments which were put up against the original proposals of the Mental Capacity Act. I believe that, were this to be in legislation, we should be able to put a lot of safeguards around it. At this stage, I encourage the Minister to take these proposals and put them into the future discussions that will take place on the Bill.
NATO Brussels Summit 2018 — House of Lords, 2018-07-16
Topic: Defense
Menzies Campbell (Liberal Democrats, Centre to centre-left): My Lords, anyone present in Brussels last week would regard the Statement as an inadequate account of the nature of the summit, not least because of President Trump’s divisive, disruptive and dismissive behaviour—particularly towards our Prime Minister. It is of great importance to bear in mind now the complete unpredictability of the person whom I suppose is the nominal and practical leader of the North Atlantic alliance. The Prime Minister says that she welcomes his visit to Helsinki to meet Mr Putin; perhaps we had better wait until we hear what he says about Mr Putin before we extend such a welcome. But there was one matter on which the Statement was right: we must increase our own defence spending, not just to satisfy Mr Trump but—given his unpredictable nature—to allow for the possibility that Europe may have to act on its own.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-09-05
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, I just want to share the thoughts that I had over the summer, when we had a very long time to look at this proposal. I have been wrapping my head in wet towels looking at this legislation, trying to work out what it is all about, and to answer a key question: why this Bill now? I am still not happy that I have the right answer The noble Baroness, Lady Murphy, referred to the Mental Capacity Act as a "monstrous" Act—the DoLS part of it. But let us be fair, when the Select Committee did its review, we found that the Act was held in quite high regard; the problem with it was that it was not properly understood and that had caused problems with its implementation. It is true that we said in the Select Committee report that there needed to be an absolute root and branch review of DoLS, but we prefaced all our recommendations for the review of the Act on one other premise, which has been ignored by the Government. We said that one of the reasons that we saw for the failure of the Act to be properly implemented was that there was no central ownership of the Act and no single body responsible for its implementation. The Government have chosen to ignore that. Instead, they have shoved responsibility for the MCA on to the CQC, where it does not get specialist attention. There is nothing like the attention paid to the Mental Capacity Act that there is to the mental health legislation, and yet if it is not properly implemented, people can be deprived of their liberty.
Civil Liability Bill [HL] — House of Lords, 2018-06-12
Topic: Health
Jonathan Marks (Liberal Democrats, Centre to centre-left): I shall speak very briefly to Amendments 35 and 36, both of which concern medical reports. These and also Amendment 39, to which my noble friend Lord Sharkey spoke, are in my name. The purpose of Amendment 35 is simple. While it is very difficult to prove, there is widespread concern that the quality of medical reports and, sadly, sometimes the quality and genuineness of those who provide them, is low Of course, it is notoriously difficult for clinicians to give reliable evidence of whiplash injuries, both because the symptoms are self-reported—and reported differently by different patients depending on their robustness—and because patients’ accounts are hard to test objectively. Assessment of the likely duration of whiplash injuries, which becomes increasingly important in view of a cliff edge-type tariff, is also very challenging because the course of recovery is extremely difficult to predict and varies from patient to patient, again often dependent on no more than the robustness of the patient concerned. However, some clinicians develop considerable experience of these injuries, and a sensible system of accreditation, with the assistance of MedCo—which is already involved in assisting with the criteria for qualifications to produce medical reports, and quality assurance—ought to be able to encourage some consistency. That is why we seek the incorporation of a reference to MedCo in the legislation Amendment 36 would require the Lord Chancellor, "by regulations make provision for the cost of obtaining appropriate medical evidence … to be recoverable by a claimant who succeeds … unless the court decides that such recovery would be contrary to the interests of justice". This is a topic on which I have sought reassurance from the Minister in previous stages, and I have received some. But the current position is that recoverability is a matter of discretion. With the proposed change in the small claims limit and the proposed new portal, we would like to hear a statement that it is intended that in all cases where a claimant, even one below the small claims limit, succeeds in recovering damages for pain, suffering and loss of amenity under the tariff, the cost of obtaining the medical report, which will be compulsory, will go with it, unless doing so, "would be contrary to the interests of justice".
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-15
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): Following on from the observation made by the noble Baroness, Lady Murphy, one of the most common restrictions of liberty is medication and medication reviews. We often think of it as being physical but it is not. New medicines often come online and create change. I take her point and hope we will be able to work towards a definition.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-15
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, again I preface my remarks by saying that these amendments were drafted when the role of the care home manager was less clear than perhaps it is now. Nevertheless, they take us to the important point about determinations on mental capacity and the requirement to make sure that they are evidence based. In the Bill as it stands, a huge amount of discretion is given to care home managers and people involved in care to determine whether someone has capacity. We do not believe that that is right. Determining whether someone has capacity is difficult to do and something for which a great deal of training and experience is required. We keep coming back to what would be acceptable levels of training and qualifications to exercise that determination Amendment 21 seeks to provide that there should be an evidence base and that those making the capacity assessment should go through it and be ready to justify their decisions accordingly. I will go back to a point and reiterate it, although it must be rather boring: a DoLS assessment is different from a care assessment, and whoever makes and records such assessments should know that they are challengeable in court, which is a big responsibility Amendment 22 again endeavours to make sure that the person carrying out the assessment of capacity should be properly qualified, a point I have made before. I do not think that the Bill as it stands is sufficiently robust about the level of professional training needed and therefore this is a matter to which we should return Amendment 25 in a way follows on from our previous discussion. With this Bill we will move into a new position where the assessment of capacity is not as clearly specific to the situation as it is under the Mental Capacity Act. We are also moving towards a position in which assessments can be rolled over for longer periods. I am not saying that that should not happen and I take absolutely the point that a number of the assessments being required under DoLS are unnecessary. When someone has had a diagnosis of dementia, for example, their capacity to make decisions may not fluctuate or change, but we need to be altogether a lot more precise in the terminology being used in the Bill. It is not just a change in someone’s condition but may also be a change in their circumstances which has led to the deprivation of liberty. We are bringing in a new test to show that things are necessary and proportionate. I do not think that it is that clear or that it will clarify the decisions which are going to have to be made. This is an attempt on our part to move away from what we believe to be a position where the subjective judgment of care providers would have been given too much weight in the determination of capacity. The amendments on that issue are probing in nature and I beg to move.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-10-15
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, I thank all noble Lords who took part in this debate. It has clarified some matters to a certain extent. I very much welcome the Minister’s suggestion that we should meet further. There is agreement on the part of everybody that we want to cut down the number of unnecessary repetitions of assessment, but to do that we need to be quite clear that the assessments are done correctly and by the correct person The Minister talked about qualifications changing and wishing to move towards a competency-based arrangement, but the parallel with Mental Health Act and approved mental health practitioners is a good one. All sorts of people from different disciplines and backgrounds are approved mental health practitioners. As the noble Baroness, Lady Finlay, illuminated, a whole number of people from different professional backgrounds could be AMCPs. The important thing is that they have demonstrable expertise in this legislation. I yet again make the point to him that he talks about using different assessments, but assessments under this legislation are not the same as care assessments. They are particular ones. We have not had the discussion about the implications for the changes to Care Act assessments if this Bill goes through, but we need to because we need consistency between the two Nevertheless, I am heartened by the Minister’s response. We are not quite there yet on this. We need to do a number of different things to make sure there is consistency and clarity across the range of professionals engaged in doing these assessments, and that the people who are being cared for and their families, and care home managers, can have a reasonable expectation that these crucial assessments—it is assessment of someone’s capacity; it is a really important one—are done consistently under the Act. It is when assessments are done badly that these things start to unravel. I very much thank the Minister for his response and at this stage I beg leave to withdraw the amendment.
Defence Fire and Rescue Project: Capita — House of Lords, 2018-06-21
Topic: Defense
Julie Smith (Liberal Democrats, Centre to centre-left): My Lords, what experience does Capita have of running fire and rescue services? What does the Minister think we should be taking from the fact that, as the noble Lord, Lord Tunnicliffe, pointed out, Capita doing recruitment for the Army has not been a notable success? Is value for money—meaning cost-cutting—the only thing that matters to the Government in letting this contract?
Long-term Plan for the NHS — House of Lords, 2018-06-19
Topic: Health
Judith Anne Jolly (Liberal Democrats, Centre to centre-left): My Lords, I too thank the Minister for his Statement. I welcome any increase in funding. Should the Chancellor be wondering how to pay for it, we on these Benches would be quite happy to see a 1% increase on income tax, for starters. The IFS has said that increases of close to 4% are needed for social care, as well as a funding boost for the NHS. Yet the Statement had nothing to say on this vital issue. We all know that the NHS cannot function efficiently unless social care is working well too. Many local authority leaders are indignant that the Green Paper has been moved further down the track, so when the new funding does arrive there is already a sizeable deficit to claw back. They are extremely anxious about the situation with adult social care funding being insufficient for this financial year What conversations have been held with the LGA, local council leaders and the Ministry of Housing, Communities and Local Government in advance of these statements? We are also dismayed about the silence on mental health, public health and community health funding. One in four of us will be affected by mental illness, there is an obesity epidemic among our children, too few health visitors, and we are critically short of psychiatric social workers. Is the Minister confident that these issues can wait until the autumn NHS plan and the Budget?
Long-term Plan for the NHS — House of Lords, 2018-06-19
Topic: Health
George Willis (Liberal Democrats, Centre to centre-left): Will the Minister accept that in terms of productivity, one of the issues that is holding us back in developing things at speed is the overregulation of the whole of the health system? We have two systems regulators and seven professional regulators; we were promised in 2014 that there would be legislation to simplify the regulatory system. Can the noble Lord assure the House that we will have a bonfire of regulations and put the right regulations in place to move this agenda forward?
Long-term Plan for the NHS — House of Lords, 2018-06-19
Topic: Health
Joan Walmsley (Liberal Democrats, Centre to centre-left): My Lords, first, the Statement mentions £1.25 billion cash to cope with specific pension pressures. Is that because so many doctors are retiring early, and therefore drawing their pensions early, because of the pressures of the job? I know three GPs who are retiring far too early because of those pressures, so will the NHS be able to spend some of that money to relieve those pressures? Secondly, the Statement mentions that the Government want to prioritise prevention and that the NHS should get better at managing demand effectively. There are two factors that limit its ability to do that: social care has been mentioned by many noble Lords but I would also mention prevention. Can the Minister assure us that, when we get the spending review, the amount of money that goes to local authorities co-operating with the NHS on the prevention of ill health will not just be enough to make up for the cuts they have suffered over recent years but enough to really go forward and transform prevention measures?
Counter-Terrorism and Border Security Bill — House of Lords, 2018-10-29
Topic: Defense
Brian Paddick (Liberal Democrats, Centre to centre-left): My understanding is that it is an offence to travel to an area to engage as a foreign fighter. I cannot remember what exactly the legislation is, but reference has been made to it by other noble Lords this evening.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-27
Topic: Health
Elizabeth Barker (Liberal Democrats, Centre to centre-left): My Lords, my name is attached to some of the amendments in this group, most notably Amendment 88. I endorse everything that the noble Baroness, Lady Watkins, said in her introduction. It is paramount that those detained under this legislation, and their friends and family who care for them, must know in exact detail that they are being detained under a law that stipulates that their detention should be the least restrictive option for their care and what their rights are In speaking to my amendment, I wish to return to a theme I have spoken to throughout our discussions: the role of a code of practice. As I said in our previous discussions on the right to information—as set out in cols. 335-38 of Hansard on 15 October—there is a fair amount of unease and disquiet among stakeholders about the Government’s understanding of the duty to provide information and its place in legislation. It is important to state again that statutory codes do not exist without a statute, and the majority of laws do not have a code of practice. Codes are there only for when non-legal people are using a law directly. No one expects non-legal people to read or necessarily understand a statute and so a code is provided. Such a code follows what is in statute and sets it out in lay terms and at length. But it would not exist if the obligation in law was not clearly set out We have had some case law about the Mental Capacity Act code of practice. In 2018, in the case of An NHS Trust and others (Respondents) v Y, the Supreme Court said: "Whatever the weight given to the Code by section 42 of the MCA 2005, it does not create an obligation as a matter of law to apply to court in every case" In the Mental Health Act code, which has been in force for a very long time, and to which the original drafters of the Mental Capacity Act looked when drawing up the legislation back in 2005, there is an explicit duty on hospital managers to provide information to a person who is detained and to the relevant interested persons responsible for their welfare No doubt the department will stick to its line that a code of practice is adequate. However, for the reasons I have outlined, which I think are compelling, we do not. I therefore simply wish to indicate that if the noble Baroness, Lady Watkins, is minded to push her amendment to a vote, she will have support from this side of the House.
Mental Capacity (Amendment) Bill [HL] — House of Lords, 2018-11-27
Topic: Health
Judith Anne Jolly (Liberal Democrats, Centre to centre-left): My Lords, I had not fallen asleep. We are nearly there. I put my name to Amendments 140 to 147A because they are important, although I suspect that they will not make it into the Bill. It is important to have these discussions at this stage In Committee, I tabled amendments on the review of the Mental Health Act and the code of practice. I still support them. The request for an equality impact assessment in Amendment 143A in the name of the noble Baroness, Lady Thornton, is the right thing to do. The amendments ask the questions but the issues are still real and important. The amendments also relate to how a future Bill could be handled. Indeed, it helps us to look back to other Bills; I cite the Care Act, for example, where a Committee of both Houses went through the Bill over a prolonged period to ensure that by the time it hit your Lordships’ House, it was worth reviewing The Minister has done a very good job of pulling this all together so far; Third Reading is still to come. I understand full well that he will not put any of these amendments in the Bill, but he should take seriously the concerns that they raise from Members of your Lordships’ House.
NHS: New Junior Doctor Contract — House of Lords, 2016-04-18
Topic: Health
Joan Walmsley (Liberal Democrats, Centre to centre-left): My Lords, this Statement comes at a time when the latest figures for A&E performance are the worst ever—1% lower, we were told last week, than the figure for January, which was the previous worst ever. The staff are very close to exhaustion. Thirty-five per cent of the doctors in this country were born abroad—the highest level in the OECD. With this very long-running dispute, many junior doctors are now saying that they are going to go abroad, and the Government have not told us whether they will increase the number of places for trainee doctors to try to compensate for that. We, and the doctors themselves, really need to know I would also like the BMA to tell us what percentage of its members now want to strike, because I think that it has given us old figures. However, if the Government want a seven-day NHS, this is absolutely the wrong time to target the junior doctors. They need to do some proper negotiation and not hold the sword of Damocles over the heads of some of the most important public servants we have.