NHS Dental Services

Debate between Baroness Barker and Lord Kamall

Tuesday 24th May 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord makes an incredibly important point about how we must look at this holistically and not just try to solve one problem or plug one gap while ignoring others. The important thing is what NHS England is doing in conversations about the new contracts. It is looking at how we incentivise dentists to offer services in those areas which are so-called dental deserts. It is also looking at how all the roles have changed over the years. We have certainly seen primary medical care taking on more secondary care. We have also seen pharmacies and others taking on more, so we are looking at different roles around dentists and whether they can take on more of that.

[Baroness Barker (LD)]

My Lords, the Government announced £50 million in extra support for dental practices earlier this year. How many of the practices which received some of that money are in rural areas, which are particularly hit and facing a crisis where about 20% of their dentists are due to retire?

[Lord Kamall (Con)]

The noble Baroness highlights one of the issues that must be addressed: those areas, particularly low-population areas, but also coastal and some rural areas which are so-called dental deserts. It should also be noted that a person is not necessarily permanently registered with a dental practice. You only have to register for as long as your treatment lasts, and if you cannot get treatment at one practice, you should be able to try other practices. You can try 111. I have heard various reports. Some people have told me that 111 is incredibly effective, while others have told me that there are still dental deserts in their local area.

Government Contracts: Randox Laboratories

Debate between Baroness Barker and Lord Kamall

Monday 21st February 2022 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

I start by thanking the noble Baroness for those questions. On her first point, we should remember the stage that the Government were at at the beginning of the crisis. People were dying every day and there were panics; they were not sure what was out there. Clearly, they were going out looking for suppliers for testing and other equipment. There were a number of approaches and different meetings, but one thing that has been quite clear is that all contracts were awarded according to the Public Contracts Regulations 2015. I have been reassured about this by officials. Authorities are permitted to procure goods, services and works via direct award, using Regulation 32 of the Public Contracts Regulations 2015, in exceptional circumstances, such as extreme urgency, without competing or advertising the requirement. I contend that the beginning of the Covid crisis was such an emergency, and that is one reason it was awarded without competition. There are clear procedures, we are committed to openness and transparency and details of the contracts are available online.

The decision on whether to procure a product from a supplier ultimately sits with departmental officials once the offer has cleared assurance steps. These include clinical acceptability and financial due diligence. I often get emails from people who have sat next to me somewhere who say, “I have this fantastic product”, but I have to reply to them and say, “I’m very sorry—I will copy officials into this but I can take no further part”.

I shall try to answer on the emergency procurement procedures, but I want to make sure I have the right note. Clearly, there are unforeseeable circumstances such as, for example, the rapid onset of omicron at the end of 2021. That also required UKHSA to act with extreme urgency. We used Regulation 32 in some cases at the end of last year to supply LFTs over the Christmas and new year period due to increased demand. The use of Regulation 32 was necessary because our DPS 2 procurement had reached its limit of extension and there was no time to run additional procurement. I am sure the noble Baroness and others will remember the end of last year, when people just could not get hold of testing equipment and we were trying to buy as much as we could on the world market.

[Baroness Barker (LD)]

My Lords, since the start of 2020, Randox has secured almost £620 million of government contracts and the firm has been shown repeatedly to produce goods which are faulty or do not work. It got those contracts using personal contacts. Will the Minister undertake that there will be an independent investigation of those contracts and recovery of any public money spent on faulty goods?

[Lord Kamall (Con)]

At the time of the award of the original contract in March 2020, almost no UK supply was available and Randox was able to provide an end-to-end testing service. The department then engaged with a number of suppliers in its effort rapidly to build from scratch the largest testing industry in UK history. That has played an important role in stopping the spread of Covid-19 and saving lives. The service that Randox provided was a very important part of that.

A number of Randox home testing kits were recalled in the summer of 2020 after tests found that swabs were not sterilised. A Public Health England investigation did not find any instances of swabs causing ill health. Randox agreed to provide new Covid-19 self-test kits. The contract was necessary to meet the increase in testing needed. An independent assessment in June 2020 had placed Randox ahead of other laboratories, and Randox was meeting its delivery targets by September 2020. Without Randox, we would not have been able to meet the volume of testing needed over the winter period.

Medical Abortion Pills

Debate between Baroness Barker and Lord Kamall

Thursday 10th February 2022 Lords Chamber

[Lord Kamall (Con)]

I am grateful to the noble Baroness for giving the other side of the debate; it shows what a difficult subject this is. Sometimes people dig up the wider debate, but I think we have to be very careful and focus on the issue. This was a service offered to women, and the initial consultation was in person, but we made temporary provision, rightly, during the pandemic to ensure that women were treated with dignity, while appreciating that it had to be done at distance. We have looked at whether this should continue to be temporary or become permanent, and we are still weighing up this difficult decision. I think the debate today shows that there are a number of views, and it is not as simple as either side proposes.

[Baroness Barker (LD)]

My Lords, the telemedical abortion service has been evaluated separately in England, Wales and Scotland and it has proven to be world leading. The US Food and Drug Administration has recently approved telemedical abortion care in America on the basis of the UK studies. Does the Minister agree that women’s access to safe, high-quality abortion care in the UK should be non-negotiable?

Elective Care Recovery

Debate between Baroness Barker and Lord Kamall

Monday 7th February 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for not speculating. All I can say about the elective recovery plan is that there have been active discussions between my department and the Treasury, and we expect to publish it very soon. On waiting lists, we are looking at how we can best target the backlog. We know that about 75% of patients do not require surgical treatment but require diagnostics. About 80% of patients requiring surgical treatment can be treated without an overnight stay in hospital. Around 20% of patients are waiting for either ophthalmology or orthopaedic services. We are quite clear about what the issue is, and we hope to publish the elective recovery plan very soon.

[Baroness Barker (LD)]

My Lords, the Government have set out in some detail the scale of the waiting list for elective surgery in secondary care, but are absolutely silent on the backlog in primary care. Is that because there is no plan to deal with the backlog in primary care, which has an inevitable knock-on effect on hospital care?

[Lord Kamall (Con)]

We are looking at elective recovery all the way through; some of that will be in secondary care but, clearly, some of that will be in primary care. One of the issues that we want to be sure of is that we have more and more diagnoses, which is why we have rolled out many community diagnostic centres. We are looking to tackle the complete backlog, which is why we have committed an additional £2 billion this year and £8 billion over the next three years and why we will publish the elective recovery plan very soon.

Personal Protective Equipment: Accounting

Debate between Baroness Barker and Lord Kamall

Wednesday 2nd February 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness raises a very important point about storage costs, and we are looking at how we can reduce them. We have managed to reduce weekly storage costs at the moment, but one of the things we are looking at is how we can pass on, donate or sell some of the equipment that is in storage. We have certain standards, other countries have other standards, and we are making sure that we are selling stuff that meets WHO standards.

[Baroness Barker (LD)]

My Lords, in December 2021, Edward Argar reported that the Government were paying £4.5 million a week for storage costs for PPE. Are those storage costs for stuff which is now unusable?

[Lord Kamall (Con)]

As I said earlier, a very small percentage was unusable, but we are looking at some of the things that are supposedly past their use-by and sell-by dates—rather similar to food; people know about the debate around food wastage. We have put out a tender for scientists to look at the equipment to see whether its life can be extended or it can be used in a useful way.

HIV and AIDS

Debate between Baroness Barker and Lord Kamall

Wednesday 1st December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for his question and pay tribute to his work during our many years together in the European Parliament, where he was probably one of the strongest champions for LGBTQ+ issues, and AIDS and HIV awareness. My only regret is that I was not able to champion as strongly as I wanted to on ethnic diversity and the lack of it in the EU. Of course, we remain committed to the Global Fund and to other partners, including UNAIDS and the global financing facility. It is important that we all work together on this issue, not only in our own countries but particularly in countries where the situation is difficult and people have challenging health systems, and in countries where, unfortunately, gay people or those suffering from HIV are discriminated against or even stigmatised. One of the things that we can be proud of in the UK is that we stand up for those people.

[Baroness Barker (LD)]

My Lords, over the past 40 years, this country has led the international efforts to overcome HIV and AIDS. We have done so by leveraging our contributions to international funds. Unfortunately, in 2021, those were significantly cut, jeopardising world-leading research at a point when we were very close to some game-changing treatments and diagnostics. Will the FCDO review look, as a matter of urgency, at restoring the funding for UNAIDS and Unitaid?

[Lord Kamall (Con)]

I am sure that noble Lords understand the reasons for some of those cuts in terms of the pandemic and needing to redirect resources, but we are committed to continuing with funding and working at an international level. In fact, this issue has come up at a number of G7 international health meetings attended by UK representatives. The UK is seen on the diplomatic circuit as one of the leaders standing up for the rights of both gay people and people with HIV/AIDS.

Gametes and Embryos: Storage Limit

Debate between Baroness Barker and Lord Kamall

Tuesday 9th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for that very kind offer, but we have already stated that it is the Government’s intention that no one misses out on the opportunity to extend the storage of their eggs, sperm or embryos. As she will be aware, in 2020 in light of the Covid pandemic, we took steps to extend the storage. We are currently considering options to make sure that no one misses out on the benefits of the new policy. Given the detailed consultation we have just been through, we hope to announce details in due course. Of course, if an amendment is laid to the forthcoming Health and Care Bill, we will consider it.

[Baroness Barker (LD)]

My Lords, the Minister will have seen in the press today the case of Megan and Whitney Bacon-Evans, a lesbian couple required to undergo 12 cycles of treatment before they can access NHS-funded fertility treatment. In effect, that makes it impossible for them to access safe, well-regulated healthcare in this country. That is contrary to the aims of the Act under which lesbians were enabled to access fertility treatment, so will the Government move to stop it?

[Lord Kamall (Con)]

The noble Baroness raises a very important point about same-sex couples’ access to insemination services. In England, details of the local fertility services are determined by the clinical commissioning groups, which take account of the NICE fertility guidelines. These were updated in 2013 to include provision for female same-sex couples who have demonstrated a clinical infertility. The criteria in the guidelines were developed as a way of achieving equivalence between opposite-sex and male or female same-sex couples. However, it is clear that the NICE guidelines are now outdated, and the department has therefore agreed with NICE to start a review of these fertility guidelines. We want the same thing as the noble Baroness: equality.

NHS England Funding: Announcement to Media

Debate between Baroness Barker and Lord Kamall

Tuesday 26th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for the very important point he has raised. A friend of mine with completely different politics from me—probably closer to that of noble Lords on the Benches opposite—once said to me, “The thing about working in the NHS is that we always want more money and we are always looking at how to balance that when we get more money”. I think it is important for the public, but also for workers, staff and patients, that we remember value for money and ensure that we spend as productively as possible.

[Baroness Barker (LD)]

My Lords, every NHS provider and professional group is telling the Government that the key shortage in the NHS is staff—and staff who are not exhausted. Can the Minister share with the House the evidence that led the Government to conclude that what the NHS needs above all else for the next three years is kit?

[Lord Kamall (Con)]

The noble Baroness makes a valuable point. We appreciate the hard work that the NHS workforce—doctors, nurses and other healthcare professionals—has put in. This announcement lays out how we will be spending on more kit but also how productivity will help take some of the pressures off the NHS workforce.