The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
My Lords, I refer to my entry in the register of interests. I thank the noble Baroness, Lady Thornton, for securing this important debate and all noble Lords across the Chamber for their thoughtful and considered contributions. I will try to do their points justice in my response; where I do not, I promise to follow up in writing.
The pandemic has tested us all in many ways, as I am sure noble Lords agree. Governments and healthcare systems around the world are all facing the same set of challenges in tackling long Covid. Although I am to some extent still “the new guy”, I am under no illusions about how these add to the existing challenges facing the NHS, some of which have already been debated in the Chamber. We have done much already, but I shall not pretend that we have got it all right. We must do more, as was well put by my former colleague, my noble friend Lord Bethell, and many others.
Today’s debate has been wide-ranging, and I will do my best to respond to the issues raised. I will set out what the Government are doing on the serious challenges of long Covid, such as NHS healthcare, research, employment and social support. However, with the presence in this House of so many of the key players in the fight against Covid—my noble friend Lord Bethell and the noble Lords, Lord Darzi and Lord Stevens—it is only right that we first recognise the critical role they all played and the support they gave in the unprecedented global challenge we faced. The country acted decisively and, I think we broadly agree, got the big calls right. We were the first country to administer an approved vaccine and the first to administer a bivalent vaccine for the original strain and omicron, and we had the fastest booster programme across Europe. I pay tribute to my predecessor and all other colleagues for the tireless work they did in that area.
As mentioned by many noble Lords, including my noble friend Lord Bethell, we all agree that prevention is better than cure. It is the best defence. Not only have vaccines been proven to stop serious illness, but—I accept, more anecdotally—they are thought to reduce the risk of long Covid. As we all know, we have administered 139 million vaccine doses, 40 million boosters and a world-class programme. On the point made by the noble Lord, Lord Brooke, rather than being one of the worst in Europe, in terms of excess deaths, which is the internationally recognised definition, we are one of the best. However, I agree with my noble friend Lord Bethell that we need to bring what we have done on Covid prevention into our research on long Covid prevention.
The point was very well made by many noble Lords that it is not just about research into Covid but, as the noble Baronesses, Lady Scott and Lady Meacher, said, linking how long Covid might connect with ME, chronic fatigue syndrome and other similar areas. As we know, it is a complex area. Various speakers, including the noble Baroness, Lady Masham, and the noble Viscount, Lord Stansgate, mentioned how complex this is. We need to make sure that our research digs into all these areas. Some 220 different symptoms are included, I believe. The research we have done, such as the REACT study from Imperial, in which the noble Lord, Lord Darzi, has been so involved, and the UCL research on brain fog, mentioned by the noble Viscount, Lord Stansgate, and to which I am sure the noble Baroness, Lady Neuberger, is connected through her UCH connections, is vital. There are honest debates around this; there is also research into weight management and its impact on long Covid, as brought up by the noble Lord, Lord Brooke. We all agree that there must be an honest debate to really understand the drivers behind it. We need to be clear about that.
I can commit that the £50 million for research is protected. As the noble Baroness, Lady Brinton, said during her excellent history lesson—I will look up Pale Rider—there are many lessons to learn from Spanish flu. I agree that Covid is not over, unfortunately, so she has from me a commitment to that research.
In answer to the point made by the noble Lord, Lord Brooke, about the levels of investment, the £50 million we are investing in research is, I believe, second only to the USA, so we are very much among the leaders. This is in addition to the £108 million spent on Covid research to date. To answer the point made by the noble Baroness, Lady Thornton, we are fully committed to international research, and making sure it is a two-way process in which we share our findings and commit our data.
Regarding data, some excellent points were made by the noble Baroness, Lady Thornton, and the noble Lords, Lord Kakkar and Lord Griffiths. Noble Lords have heard me say before that I am a bit of a data anorak, so I totally understand its value in this space. I will make sure that noble Lords have a detailed answer on this, but it is something I very much support and believe we need to be doing.
I say in response to the noble Baronesses, Lady Scott and Lady Meacher, who spoke about trying to understand how long Covid might interact with, or have similarities to, ME and chronic fatigue, that funding is still available. The right reverend Prelate the Bishop of Exeter spoke about the rural impact, and I would say there is scope there. The noble Lord, Lord Kakkar, asked if we need to do more. Funds are still available within that £50 million, but it is something we believe in, and as we know from short Covid—if that is the right term for it—our research was vital and we remain committed to playing a leading role on the world stage.
We all know that research is only of any use or has any point if it actually creates treatments we can use within the NHS. As many speakers have said, only if these are substituted into services will they really help. The UK was one of the first countries to recognise and respond to long Covid, and we set up the national long covid commission guidance with new care pathways. As part of that, as mentioned by many speakers, including the noble Earl, Lord Clancarty, access to information and education for doctors is key. The Royal College of GPs and the HEE have put out information, but to judge from some of the examples given today, it has clearly not been disseminated widely enough.
I appreciate the tips from the noble Baroness, Lady Taylor, about getting extra funding from the Chancellor. As many of us might have seen, extra funding was announced in the other House earlier, but I appreciate the tips and, believe me, I will be using them. I assure the noble Baroness, Lady Neuberger, that the £224 million we have already invested is a commitment, and it has helped set to up 100 specialist treatment centres, many in rural areas. I had a chance to look up the figures, and I think I counted seven in Devon, but I will confirm that, because it is not just an inner-city issue but a whole-country issue. There is also the question of the impact on young people and children, a point made by the noble Baronesses, Lady Watkins and Lady Masham. Fourteen of those 100 centres specialise in treating children and are therefore helping to deal with this issue.
The point that these measures are only any good if we are making people aware of them all was very well made by the noble Baronesses, Lady Donaghy and Lady Pitkeathley, and the noble Earl, Lord Clancarty. I am proud of what we have managed to achieve on the Your COVID Recovery web app: we have had 12 million visits from people looking at advice on how they can recover. However, I am by no means complacent about the need to make sure that there is advice everywhere.
I will get back to the noble Viscount, Lord Stansgate, on ivermectin, as I need to get some detailed advice on that. However, as the noble Earl, Lord Clancarty, talked about people feeling the need to go to private centres and often try unproven medicines, generally I would caution against that, as I am sure many of us would. While this is a complex area and we are still learning about it, I advise people to stick to the proven methods we are trying to adopt through our own NICE guidelines and our own centres. That is what we are trying to do right now through the NHS, but as the noble Baroness, Lady Brinton, and others mentioned, this is not a one-and-done matter. This is a long-run thing, so these services will need to evolve over time, and we will need to keep up.
As we all know, looking at what we are doing health-wise is only part of the picture. The noble Lord, Lord Bethell, started the discussion on this point very well, and a number of noble Lords contributed to it, speaking about the whole impact on employment, work and schools, and—as was well said by the noble Lord, Lord Griffiths—on a personal basis. The impact of long Covid is much wider than just on health, and I very much recognise its impact on employment and work. As many noble Lords will know, I was the lead NED of the Department for Work and Pensions before I came into this role, so I am very aware of the 2.5 million people out of work due to long-term sickness, towards which we now know that long Covid is contributing. Action in this area to help those people is vital not only to their health but to the health of the economy. I know that this is a priority of colleagues at the DWP, and it is part of the £1.3 billion investment to support the long-term sick into work.
I totally accept the point made by a number of noble Lords, including the noble Baronesses, Lady Donaghy, Lady Watkins, Lady Masham, Lady Neuberger and Lady Brinton, about the impact of long Covid on our own NHS staff. We need to make sure that we are supporting them through this. I have done a bit of research on whether long Covid can be defined as an occupational disease, as was mentioned. This is a complex area, because, as we mentioned before, there are 220 different symptoms connected with it. However, the DWP is being advised by the independent Industrial Injuries Advisory Council on this. It has recently published a paper prescribing five complications following Covid which should be considered in awarding personal independence payments. I am sure this will be an evolving picture, but my DWP colleagues are looking at it.
Of course, this issue is much wider than the NHS; it should be embraced by all employers. I am very pleased that I have an opportunity to speak at the CBI conference shortly about health in the workplace. This is something that I plan to bring up then, because it is important that all our employers recognise that health is everyone’s business, as was said in a consultation document that recently went out, to which we will respond shortly. Clearly, the role of employers is key to all that.
Personally, I would like to see the sort of approach taken in Japan, in which employers take on a big role in the health of their workforce and very much look at prevention. As my noble friend Lord Bethell said, it should not just be our health service looking at prevention methods; we need to be giving people over 50 health MoTs, and looking at cardiovascular impacts as well as how employers can help in that space.
I hope I have answered many of the points raised today. I commit to cover any I have missed in a detailed response. I finish by again thanking the noble Baroness, Lady Thornton, and all the speakers. I found this a very informative debate. We can all say that we have much more to learn about long Covid and that we continue to be guided by the science. But the virus has definitely not gone away and, unfortunately, as many noble Lords mentioned, we will have to live with Covid and long Covid for a long time to come. We must continue to be proactive to prevent through our vaccine programmes, to treat through NHS services, to research to continually improve understanding, and to support people to get back into work. I thank noble Lords.