Lord Chris Rennard's Recent House of Lords Appearances

From https://www.theyworkforyou.com/peer/13277/lord_rennard

  • Oct 31, 2018:
    • Health: Diabetes - Question for Short Debate | Lords debates

      My Lords, I refer to my interests in the register. I congratulate the noble and learned Lord, Lord Morris of Aberavon, on securing this debate and on his personal tenacity in pursuing the important issue of helping people with type 1 diabetes to secure access to new technologies that might help them to manage their condition better. My own interest in diabetes is long term and personal. My father was one of the first people to benefit from the development of insulin in the 1920s; he developed diabetes probably as a result of the shock he experienced having a leg amputated following injuries to it during the First World War. Because of insulin he was able to live quite a long life for someone born in 1889. I was born in 1960, when he was 71. His survival for so long was testament to the effectiveness of insulin in saving lives and helping people to live with a condition that, until then, had been known to have fatal effects for thousands of years.

      I was diagnosed with type 2 diabetes at the relatively young age of 34, almost 25 years ago. My lifestyle, related to my work in politics, was extremely poor for a long period. By the time that I was 45, I was on insulin as well as tablets. In my late 40s, I was warned that even the maximum levels of every form of medication available would not sustain me into my 50s unless I changed that lifestyle fundamentally.

      However, changes to lifestyle are not so relevant to people with type 1 diabetes, and not always achievable for those of us with type 2 diabetes. The consequences of poor diabetic control are the same for people with either type 1 or type 2 diabetes. My own poor diabetic control some years ago is probably responsible for the fact that both my feet now suffer from a condition called foot drop. This means that I need to wear ankle foot orthoses, known as AFOs, and, like all other diabetics, I have to take great care of my feet.

      I have been fortunate to receive great support from the diabetic team at St Thomas' Hospital. I was there yesterday and was pleased to be told that my long-term control, as measured by my HbA1c blood glucose level, remains very good at present. It has been helped by changes in lifestyle, including those that have resulted from a GP referral for some physical fitness training-which I certainly needed-the acquisition of my Fitbit monitor and recognition that I needed to eat more healthily and consume fewer products filled with sugar, which for many people is a very addictive ingredient.

      I know from friends with type 1 diabetes how much harder it is for them to maintain good control, whatever they do. They have to test their blood with finger-prick tests eight or more times per day and can observe their blood sugar levels increasing rapidly or falling dramatically, sometimes without any apparent explanation. The emergency services all too often have to pick up someone who has collapsed, with many people thinking that they are perhaps drunk when in fact they are suffering from a "hypo". I experience hypos rarely, but type 1 diabetics are much more vulnerable to them.

      The problems associated with both types of diabetes have grown rapidly in prevalence and are likely to do so even more in future. Diabetes UK said on Monday that some 500 people with diabetes die prematurely each week. I regularly read distressing accounts of how more than 6,000 foot amputations per year result from diabetic-related conditions, many of which are preventable. If not managed effectively, poor diabetic control results in loss of sight, kidney disease and a much greater prevalence of strokes and heart disease.

      The most recent NHS National Diabetes Audit report on complications and mortality shows that men and women between the ages of 35 and 64 living with type 1 diabetes are three to four times more likely to die prematurely than those without the condition. Men and women in the same age range who have type 2 diabetes are up to twice as likely to die prematurely.

      What can be done? Control is of course the key, and I have no doubt that wider use of FreeStyle Libre, a flash glucose monitoring system, is assisting a number of people, particularly those with type 1 diabetes, to improve their control. I have looked at the Medtech innovation briefing from NICE and the devices appear immediately cost effective compared with, let us say, the costs of 10 finger-prick tests per day. The evidence of benefit to long-term blood sugar control is not yet so clear, but I know from my own experience that behaviour is changed in a positive direction when you are regularly alerted to your blood sugar levels. This is, in my view, much more likely to be the case with such a flash monitoring device than with the more traditional blood glucose meter.

      There was very strong evidence in the report suggesting that users of a flash glucose monitoring device suffered far fewer hypos, experiences that can be very unpleasant and quite dangerous. The fact that such devices can now potentially be prescribed as a result of their inclusion in Part IX of the England and Wales drug tariff a year ago is very welcome but, as the noble and learned Lord, Lord Morris of Aberavon, said, there is still far too much variation between CCGs in their provision, and the guidelines from NICE are very restrictive. In the recent Question that he referred to, he suggested that around 30% of CCGs are not yet considering prescribing these devices.

      I know that the aim of reducing variation in the management and care of people with diabetes by 2020 is included in the NHS England mandate, but can the Minister tell us a little more this evening about exactly how this will be achieved? There are implementation plans to facilitate the wider provision of flash glucose monitoring systems; how are these progressing? We all know that we need to rely on NICE conducting some sort of cost/benefit analysis for any such product, but is the Minister satisfied that its processes for analysing the costs and benefits of new technologies aimed at improving diabetic control are sufficiently long term? Does he accept that any such analysis for public policy should factor in all the long-term costs to the NHS and the welfare system of poor diabetic control, as well as the wider benefits to the economy and to society of helping people to achieve good control?

      Flash glucose monitoring, real-time continuous glucose monitoring and insulin pumps may all provide technological solutions to help people with type 1 diabetes live healthier and happier lives for very much longer. There is, for example, a much greater provision of insulin pumps in the United States than in this country, and this is not simply because the US has a greater love of technology than we do. Overall, the US healthcare system is known to be massively inefficient and ineffective compared to our own NHS but, with an insurance-based model, you know that the insurance companies evaluate the long-term costs to their businesses of dealing with the complications that arise from poor diabetic control. These insurance companies appear to have decided, on sound business grounds, that much greater provision of insulin pumps saves them money in the long run, to say nothing of the wider benefits to patients and everyone else.

      I look forward to the Minister's comments on these issues and what he has to say about how technological innovation may help some of the problems associated with diabetes.

  • Oct 25, 2018:
    • Elections | Cabinet Office | Written Answers

      To ask Her Majesty's Government, following the incorrect election result declarations in three wards of the London Borough of Newham in May, what assessment they have made of the requirement to list election candidates on ballot papers in alphabetical order of commonly used surnames whilst requiring the results to be declared in order of legal surnames.

    • Elections | Cabinet Office | Written Answers

      To ask Her Majesty's Government what assessment they have made of the operation of the arrangements under section 46 of the Electoral Administration Act 2006 for Returning Officers to correct mistakes made in the counting process after a result has been declared; and how many instances there have been of such corrections being made by Returning Officers since the Act came into force.

  • Oct 9, 2018:
    • NHS: Diabetes - Question | Lords debates

      My Lords, does the Minister accept that funding for the kind of structured educational programmes that are necessary to support people with diabetes is actually threatened by the reductions in provision for public health, and that a survey by GPonline showed that 30% of practices are reducing provision for weight management courses? Is this not counterproductive to a strategy that should be based on prevention?

  • Sep 7, 2018:
    • House of Lords (Hereditary Peers) (Abolition of By-Elections) Bill [HL] - Committee (2nd Day) | Lords debates

      My Lords, to save the time of the House, and perhaps to protect its reputation, can the noble Lord confirm that, if his argument on this amendment has merit, he will seek to test the opinion of the House and put in Tellers so that we can show our opinion? If, on the other hand, he is not going to test of the opinion of the House, or not put in Tellers and waste our time, surely he is accepting that his argument does not have real merit and he is simply trying to filibuster and defeat the Bill.

    • House of Lords (Hereditary Peers) (Abolition of By-Elections) Bill [HL] - Committee (2nd Day) | Lords debates

      My Lords, the Bill of the noble Lord, Lord Grocott, has full support from these Benches. The principle is entirely right. It is very important that we improve the reputation of this House by ending what is considered to be a farcical process of continuing to conduct hereditary by-elections. The Burns report has been referred to several times already. The Bill would actually assist the process of bringing forward Burns, which will face some problems if we do not bring an end to the hereditary by-elections because of the issue that has been raised about having a higher proportion of hereditary Peers in the House, unless we do something to stop them.

      There is nothing with which I disagree in the regret Motion of the noble Lord, Lord Trefgarne. I recall that in 2010 the then Labour Government, in their Constitutional Reform and Governance Bill, brought forward the abolition of hereditary by-elections and received majority support in the House of Commons. One reason why the Bill of the noble Lord, Lord Grocott, should be approved is to allow the Commons to vote on the issue; if we do not approve it, the Commons will not have that say. That being said, in my view the regret Motion of the noble Lord, Lord Trefgarne, adds nothing to the debate. There is nothing with which I disagree but it takes up precious time and encourages the perception that there is a filibuster trying to prevent the Bill being approved. The filibuster itself brings the House into disrepute. That is enough said; I urge Members of the House to say no more than necessary in order to move on with the business, approve the Bill and discard what I consider to be irrelevant regret Motions.

  • Sep 4, 2018:
    • Elections: Personation - Question | Lords debates

      My Lords, the Minister declined my invitation to the Government to assess the level of personation by contacting returning officers to see how many tendered ballot papers had been issued. So I asked the Electoral Reform Society to do the job. Using freedom of information requests, it received responses from 239 returning officers, showing that in the general election last year the total number of alternative ballot papers across those 239 council areas that had to be issued when someone turned up at a polling station and found that their name had been used to claim a vote, or perhaps that their vote had been given in error and the wrong name crossed off, was a mere 49. So what justification could there be for rolling out compulsory voter ID at all polling stations?

    • Elections: Personation - Question | Lords debates

      To ask Her Majesty's Government what is their assessment of the level of personation at elections in Great Britain.

  • Jul 23, 2018:
    • Subversion: Russia | Cabinet Office | Written Answers

      To ask Her Majesty's Government what steps they are taking to work with other countries to prevent Russian influence from undermining democratic principles including by (1) providing funding to influence electoral outcomes significantly, (2) establishing social media accounts which disguise their real origin, and (3) promoting fake news, including relating to the attempted murder of their opponents on British soil.

  • Jul 19, 2018: