Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021
Baroness Bennett of Manor Castle Excerpts(2 years, 11 months ago)
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Baroness Walmsley (LD)
My Lords, before I follow up my noble friend Lady Tyler’s comments, I want to say how much I agree with the noble Lord, Lord Cormack. The way in which this has been done—I agree also with the noble Lord, Lord Hunt—is absolutely shocking; it is a contempt of Parliament. I was horrified when I read the report of the Secondary Legislation Scrutiny Committee about how bad it was and how late the sort of impact assessment—I call it a sort of impact assessment —has been produced.
Of course, we do not need an impact assessment to know what the problem at the heart of this is, apart from the compulsion element, which I understand: it is the fact that so many people are hesitant and mistrusting about having a vaccination. We also know from the work of Healthwatch, mentioned by my noble friend, that the most effective way of addressing the problems that people have with the vaccination is to have a one-to-one discussion with them so that they can say what their problems are and have them addressed. It needs to be done with a person whom they trust—somebody who they believe has some knowledge and understanding of the issues.
The difficulty with doing this at the moment is that all those people are very busy. We have the winter problems coming up; we have the omicron variant of Covid-19 increasing day by day and our NHS is on the edge of falling over. So I have a little suggestion for the Minister. There are plenty of doctors and nurses relatively recently retired who for one reason or another are reluctant to come back into the front line at the moment. However, they retain the respect of the health community. I understand from the executive summary that the total cost of replacing members of staff who are likely to leave because, whatever happens, they do not want to have a vaccine is £270 million. Could not some of that money be used to get those doctors and nurses with the knowledge and the trust of their recent fellows to have those conversations, without interrupting the staffing of hospitals, where it is bad enough at the moment, as we have lots of vacancies? We know that we cannot take all those people out to have those conversations, because it takes time and it has to be done with sensitivity and consideration. Could not some of that money be used to bring back some of those very experienced people to have those conversations and, hopefully, to reduce the number of those who absolutely will not be vaccinated and, sadly, will leave the profession?
I shall ask the Minister one more question. A few weeks ago, I asked him whether patients had the right to request that they should be treated by vaccinated staff only. Whatever the Government do, it will not all be done until April, which is months away. So there will be lots of patients treated between now and then by people who are not vaccinated. I asked the Minister whether patients had a right to request to be treated by vaccinated people only. He very kindly wrote to me, but I am afraid he was not able to give me a definitive answer. Now all the work has been done on this statutory instrument, I wonder whether things have become any clearer on that issue.
Baroness Bennett of Manor Castle (GP)
My Lords, a great deal of concern about procedure has been expressed from all sides of your Lordships’ House. I have nothing to add on that, except to say that I share those concerns.
I have two specific questions for the Minister. The first builds on the comments of the right reverend Prelate the Bishop of St Albans, who talked about how we have to win the argument on vaccination and the concern about unintended consequences and potentially discriminatory outcomes. When I look at the impact assessment, it is focused entirely on the care and health sectors. For example, paragraph 126 refers to
“the possibility of negative behaviour change resulting from the policy. For example, a German experiment found that vaccination requirements increased anger among individuals with existing negative vaccination attitudes and led to a decrease in uptake”.
As far as I can see, there does not appear to be in this impact assessment any consideration of impacts outside the health and care sectors. If we are creating this process, it will have impacts right across society, not just in the health and care sectors. We are talking about systems thinking here: not just what making a decision in the health and care sectors means for the health and care sectors, but what it means across the whole of society. What are the negative impacts of people in general deciding not to get vaccinated because of this?
The second point I draw from a very useful briefing from the Homecare Association. I do not think anyone else has asked this question, and I feel I should ask it for the Homecare Association. It said that it is extremely concerned about the intention to legislate rather than persuade. It is asking about a contingency plan if, indeed, the results are towards the worst end of the impact assessment. What are the Government doing to plan for this situation, when we have already had 1.5 million hours of commissioned care not delivered between August and October because of lack of availability? If this gets much worse, what plans do the Government have to fill the gaps?
The Deputy Speaker (Lord Duncan of Springbank) (Con)
My Lords, there will be one winder taking part remotely, the noble Baroness, Lady Brinton. I hope we can go to her now.
Health and Care Bill
Baroness Bennett of Manor Castle ExcerptsTuesday 7th December 2021
(2 years, 11 months ago)
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Baroness Bennett of Manor Castle (GP)
My Lords, I am going to structure this speech untraditionally, beginning with a short list of some of the issues that I expect to pick up in Committee and adding to the list already laid out by my noble friend Lady Jones of Moulsecoomb as her agenda. The British Association of Social Workers is concerned about the dilution of local authority responsibilities. The Institute of Alcohol Studies points out the failure to address the harm done by advertising for alcoholic products. The Venice Commission concludes that it undermines trust in the Parliamentary and Health Service Ombudsman. Unpaid carers are deeply concerned about Clause 80, as the noble Baroness, Lady Pitkeathley, outlined, and, of course, multiple organisations and Peers are gravely concerned about the lack of workforce planning.
I want to spend most of my time looking at the big structural changes introduced by this Bill—astonishingly, as many noble Lords have noted, at a time of tremendous pressure and struggle for our health service. The warning from the British Medical Association that the Bill will
“do more harm than good”
in this context must be noted. I want to engage particularly with two speeches, starting with that from the noble Lord, Lord Lansley. He raised the way the kind of structures created by the Bill reflect those that
“JP Morgan and Rockefeller used when creating vast monopolies.”
Those noble Lords, among them the noble Lord, Lord Stevens of Birmingham, insisting very vigorously that the Bill is not about privatisation—really, really it is not—might like to reflect on that analogy.
The noble Lords, Lord Lansley and Lord Adebowale, noted that integrated care systems have been around in one form or another for six years already. They were brought in de facto into the NHS, without parliamentary oversight, and now we are being asked to approve that model. Somehow, that makes me think of the Henry VIII powers that, rightly, so exercise many of the legal experts in your Lordships’ House. I do not believe anyone disagrees with the idea of integration. Regarding each individual engaged with the system as a person needing a mixture of medical and other care, not as a set of conditions, is obviously essential and all too rare. But the big question is, how? There is an important question to ask about models: what are their origins?
The origins of so much thinking about healthcare systems in the UK come from the United States—as do many of the personnel, who come from giant American healthcare companies. I am talking, of course, about the top of management. That is astonishing, when you think that the world’s richest country can reasonably be classed as having the world’s worst health system. It is a system that absorbs enormous resources—financial, physical and human—to produce astonishingly bad outcomes, whether measured by mortality, morbidity, the actual volume of care provided or inequality. Yet we seem to draw most of our thinking, and many of our senior personnel, from the US.
Maybe I am wrong that this is a failure; maybe the issue is the purpose of the system. If you acknowledge that the purpose of the US healthcare system is to be a cash cow, not a care provider, then on that measure it is a raging success—one that is already consuming about 8% of England’s NHS spending and providing a quarter of our mental health in-patient beds.
It has not always been so. Think back to 2015, when Hinchingbrooke Hospital was briefly in the hands of the healthcare company Circle. Soon, care was rated “inadequate”; the company complained that it was not making any money and handed it back to the Government. Multinationals have found it hard to make money from operating some elements of our current health system but now, potentially, they will have a new way of taking over.
The integrated care board model is closely based on health maintenance organisations, also known as managed care organisations. These are responsible for providing only limited free services to an identified group of people. In the US, they are like customers, but very constrained ones. The sad reality of where we are now in the UK is that, with our level of spending on health significantly below that of nations of comparable wealth, we are already heading towards this. A survey by openDemocracy found that one in five people had had a doctor or other health professional suggest that they needed to go private to get the care that they needed. Nine out of 10 patient-facing staff said that they had been unable to give a patient treatment or a procedure that they would benefit from. With a block of patients and a fixed budget, how much further might this Bill take us down that road?
Lest noble Lords think I am going out on a limb here, I point out that the BMA has noted that the Bill
“risks making it easier for private companies to win NHS contracts without proper scrutiny.”
We have already seen this in action in our social care system over decades under successive Governments. The Bill does nothing to tackle the predatory financing that has consumed our care homes sector, with 84% of beds provided by for-profit companies, and one-sixth of the fee for a bed in financialised homes going towards interest payments.
If this brief outline has left noble Lords wondering or puzzled about the apparent lack of resistance from the Front Bench on this side to the basic structural changes here, where should they go? I suggest they read the work of Professor Allyson Pollock, Peter Roderick and Caroline Molloy on openDemocracy and, on social care in particular, the work of the APPG on Limits to Growth.
Health and Social Care
Baroness Bennett of Manor Castle Excerpts(2 years, 11 months ago)
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Lord Kamall (Con)
I thank the noble Baroness for the points she makes. We are doing what we can to support the dedicated NHS staff in healthcare services. This year alone, we have invested over £15 billion on top of the existing NHS annual budget, and that includes funding to help get patients out of hospital, freeing up beds and supporting hospitals to manage Covid-19. In addition, we are looking at how we can tackle capacity issues on NHS 111 and A&E. We are giving NHS 111 £98 million to boost capacity, help people avoid unnecessary ambulance trips to A&E and take pressure off hospitals. We realise that NHS 111 is often the first port of call to provide urgent medical advice quickly and book time slots for people at their local A&E or appointments at alternative services. We are also delivering the largest ever seasonal flu vaccination programme, so we hope to tackle it on that basis. A number of CCGs and others are having conversations about how we can tackle the pressures on A&E.
The noble Baroness makes the point about staff who, during Covid, went way beyond the call of duty, and we managed temporarily to address those concerns. We are very grateful to staff who had retired and returned, and we are looking at whether that can be a long-term solution. We need to make sure that no one who is willing to come back is disincentivised. I do not have the details at the moment but I commit to write to her.
Baroness Bennett of Manor Castle (GP)
My Lords, the first paragraph of this Statement says that it outlines
“the preparations we are making so that health and social care services remain resilient … and available to patients”.
How does that square with the fate of the residents of Berkeley House in Kent, which was home to adults with severe learning difficulties and autism, who were told at 7.30 in the morning that they would have to leave by 5 that evening? Among them was one resident who had to be sedated to ensure he could safely be moved. Berkeley House is owned by Achieve Together, one of a chain of companies registered through the tax haven of Jersey that ultimately appears to be owned by AMP Capital, a global investment firm based in Australia. How does providing a “resilient … and available” social care system line up with homes such as this being run for profit, not for the public or the residents’ good?
Lord Kamall (Con)
We have to recognise that if we look at the social care system, there are an awful lot of private providers. Quite often, when we look at private providers, it is private patients who subsidise their ability to provide places for state-funded patients. In our health system overall, there will always be a mixed economy, including state provision. Lots of our GPs, for example, are partnerships—they are not state-run, some of them are co-operatives, some are even for profit. When we look at the overall health system, there will be a general balance. I am not aware of the particular case, so I thank the noble Baroness for raising it, but one of the things we are committed to is making sure that we improve services, whether they are state-funded or private, as part of the overall system of healthcare that we have in this country. Clearly, where providers are not providing a service, there will be CQC and other assessments to see whether they are fit.
Lord Kamall (Con)
When you look at our health and social care sector, you see that one of the issues is a lack of joined-up thinking over the years. We have seen report after report about the future of adult social care gathering dust on the shelves—not forgetting that lots of people who are not older are also in the social care system. The White Paper we published last week was a first attempt to try to tackle the problem long term. We recognise that you have to look at the long-term issue—which, frankly, successive Governments have kicked down the road for years, and not really tackled—and we have made an attempt to do that with the 10-year vision we published last week. But we have also committed to the first three years of funding, to realise that vision. We now have a framework against which to judge future progress in adult social care, so that, overall, it is no longer seen as a poor relation of the rest of the health system and is properly joined up on a number of different levels—not only career paths but also the data that can be shared, so that you do not have the drop-off that happens when someone leaves hospital and enters a social care home and you have to find all that data again; the home is prepared to accommodate that patient with all their specific needs at the beginning.
In the longer term, with increases in technology, we hope that, instead of patients leaving hospital to go to a residential home, they will be able to return to their own home with the help of technology. All that will take time, but we have laid out that vision.
In the short term, we have laid out the winter plan, which includes looking at how we tackle some of these social care issues and how we recruit more social workers via the £162.5 million. The Made with Care plan will make sure that social care seems more attractive. For a long time, no one has really “sold” social care as a career. We want to ensure that it is seen to be just as valid a career as any other and offers a real career path. We also want to see a professionalisation of the industry, so that people feel valued.
Baroness Bennett of Manor Castle (GP)
My Lords, in responding to my last question, the Minister referred to the mixed economy of ownership of healthcare provision. I am sure that he is aware that 84% of care home beds are provided by for-profit providers. Tonight, the “Panorama” programme is looking at HC-One, which is the biggest care home chain provider, with 321 care homes, formed in 2001 from the collapse of Southern Cross. I will not ask the Minister to watch the programme, since I know that he is a very busy person, but will he undertake to look at a summary of it, particularly the fact of the funding of HC-One, which appears to include a £540 million interest-only loan from a New York-listed property company? A great deal of this has been uncovered by the Centre for International Corporate Tax Accountability & Research.
Lord Kamall (Con)
I thank the noble Baroness for sharing all that data with me. The point remains that our system of healthcare will, through CCGs at the moment and integrated care services in the future, continue to commission some from the state and some privately; that is the way it is. What is really important is not who provides it but the care that the patient receives at the end of the day, and the fact that taxpayers are getting value for money. We should judge outcomes, not inputs.
HIV and AIDS
Baroness Bennett of Manor Castle Excerpts(2 years, 11 months ago)
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Lord Kamall (Con)
One of the best ways to help to vaccinate people across the world is through multilateral, bilateral and plurilateral partnerships. We will have donated 100 million coronavirus vaccine doses by next June. We are committed to working internationally. This issue comes up at the G7 where, once again, we are seen as leaders on the COVAX programme and other such programmes. It is important that we focus on what is effective and how we can get vaccines to those who really need them.
Baroness Bennett of Manor Castle (GP)
My Lords, following on from the noble Baroness’s question, the UK Government played a leading role in establishing the Medicines Patent Pool, which is a means of simplifying and accelerating the generic production of HIV medicines by sharing patents. Does the Minister agree that a global pooling mechanism for Covid-19 would support countries’ ability to access the vaccine and the drugs required to control Covid-19 infections? Will the Government give their full support to the Covid-19 Technology Access Pool and encourage UK pharmaceutical companies to license through it?
Lord Kamall (Con)
In tackling coronavirus and helping those who cannot access even a first dose of the vaccine while people in this country are now going for their third—even fourth—injection, it is really important that we act internationally. This issue comes up at international meetings. We are seen to be leaders in co-ordinating; we are doing much of that via the international COVAX programme and by talking to pharmaceutical companies about what more they can do.
Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021
Baroness Bennett of Manor Castle Excerpts(2 years, 11 months ago)
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Baroness Bennett of Manor Castle (GP)
My Lords, the noble Baroness, Lady Thornton, importantly said that the pandemic is not over. I think sometimes, listening to your Lordships’ House, that some people have not accepted that. Your Lordships’ House, based on its loudest voices, also appeared to have decided to act as though it has not in the procedural decision we made earlier.
On the mask-wearing regulations, I go back to Monday’s repeated Statement on Covid. At the time, on Twitter the hashtag “COVIDisAirborne” was trending. As far as I could trace through the mysteries of Twitter, one of its origins was Dr Kimberly Prather, chair of atmospheric chemistry at the National Academy of Sciences in the US. I would like an assurance from the Minister that the Government understand that fact, as expressed by that hashtag. A number of contributors to these debates have indicated this, particularly the noble Baroness, Lady Blower, and others addressing ventilation in schools, and both Front-Bench speakers.
Why does the mask mandate not cover cinemas and theatres? In his response on Monday’s Statement, the Minister said that it does not apply in hospitality venues, restaurants and pubs because people eat and drink there, so they are taking their masks on and off. That surely does not apply to cinemas and theatres. I still do not believe we have heard from the Minister the reason why it does not apply to those two places, with their obvious general lack of ventilation and the fact that people sit together for hours. Maybe they are spaced out; I have heard Members of your Lordships’ House make the point that, “It’s all right, I am sitting away from people”. Covid is airborne. It circulates in the air. I would love the Minister to clearly acknowledge that fact, because I do not think the Government are acting as if they do.
Also on these regulations, why do we not have a “work from home if possible” ruling in the current state of considerable uncertainty? Many have been doing it over many months; they are set up for it; it is perfectly possible; it reduces the risk and danger at a point when we really do not know how great it might be.
Finally, there have been many points in this debate I might have liked to respond to, but I will pick up just one. I ask the Minister to acknowledge how much we now rely on medical and social science experts, many of whom have worked for many hours and months above and beyond the call of duty. Will he join me in regretting that Members of your Lordships’ House should choose to attack individual experts who choose to contribute to public life and exercise their right to engage in political debate, and acknowledge that that is not an appropriate way to treat people contributing to public life?
Noble Lords
Covid-19 Update
Baroness Bennett of Manor Castle Excerpts(2 years, 11 months ago)
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Lord Kamall (Con)
As my noble friend will be aware, vaccination as a condition of deployment has been brought in for the social care sector. It will be brought in for the wider NHS, but there is a grace period in certain cases. Management are being encouraged to meet with staff to encourage them, particularly staff who are vaccine-hesitant. There is a grace period to see us through the winter period; it runs up to April next year. However, we are encouraging as many members of NHS staff as possible to get vaccinated and we have a high rate of vaccination so far.
Baroness Bennett of Manor Castle (GP)
My Lords, the Minister referred to a thriving diagnostic market in PCR tests. When these were previously commonly required, there were huge problems with misleading advertising about costs and people being misled about the services and timings on offer. Have the Government solved these problems and are they looking at how much money these companies are making out of this thriving market?
Lord Kamall (Con)
The important thing for us is to make sure that PCR tests are available and that there is sufficient supply and capacity to deliver them. Frankly, as much as we want to make sure there are enough PCR tests, we want to make sure that supplies come to the market. But, as the noble Baroness will be aware, my right honourable friend the Secretary of State has raised concerns about the cost of some of the PCR tests and has been quite public about that.
Covid-19
Baroness Bennett of Manor Castle Excerpts(3 years ago)
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Lord Kamall (Con)
The noble Lord raises a really important point on staff, doctors, nurses and other healthcare workers in our health system. The Government have a zero-tolerance approach to abuse and harassment; we are investing in better security at GP surgeries and are committed to working with the NHS to make sure our primary care workers feel properly supported. We are also constantly having conversations with trusts and the NHS generally about making sure that staff feel safe to work and how we can make sure that that happens. Anyone who has visited a hospital recently will have seen the signs about zero tolerance.
We are constantly talking to NHS England about workforce pressures. We are looking at specific campaigns—for example, we have announced social care recruitment—and other campaigns to attract more workers to the NHS.
Baroness Bennett of Manor Castle (GP)
My Lords, on the Minister’s comment about masks on public transport, my understanding is that that is only in London and is not the case in the rest of England. I draw to your Lordships’ attention my experience in Edinburgh Waverley station yesterday evening. Scotland of course does have a mask mandate, and it was very clearly announced at extremely regular intervals. Additionally, it came with a message that said, “That means that you are not allowed to eat anything in the station”, which I have never heard in England.
The Statement says that
“we must stay focused on the threat that is in front of us and seize every opportunity to bolster our vital defences”.
As most of the Front-Bench questions pointed out, this Statement entirely focuses on vaccines. We have been very aware of the issue of aerosol transmission for a very long time now. The last figures that I have been able to find—from a week ago—show that fewer than the promised 300,000 carbon dioxide monitors for schools have actually been delivered. They were promised by the end of the autumn term. Of course, all those CO monitors do is identify the problem—the lack of air circulation. They do not actually deal with it. Will that target be met, and will schools get their carbon dioxide monitors? More than that, are the Government providing adequate support for schools and indeed other organisations that identify a problem with ventilation?
I notice that the UK Health Security Agency is funding a trial of air purifiers of different sorts in 30 Bradford primary schools. This is two years after the pandemic started, and we have known for a long time about aerosol transmission and the problem of unventilated rooms. Not all school rooms or rooms in general—including in your Lordships’ House—can be ventilated. Are the Government really paying the attention that they should be to dealing with aerosol transmission, ventilation and air purification?
Lord Kamall (Con)
A lot of investment has gone into making sure that there is ventilation in schools. I will talk to my counterpart in the Department for Education to see what more can be done, but I know that the department is very aware of this issue and is looking more into it.
On the noble Baroness’s first question, we want to be clear and not confuse the message: vaccinations work and are our best line of defence. We do not want people to get a false hope that there are other ways to protect themselves. Not all people who do not take the vaccine are anti-vaxxers: some of them think that just wearing a mask may well protect them.
We want to focus on this message: get vaccinated; if you have been, get your booster; and if you have had your first vaccine, get your second one. There is nothing to fear from getting vaccinated. We are not only sending that message out but actively looking at different campaigns to reach those difficult-to-reach individuals in many communities.
Social Care Funding: Intergenerational Impact
Baroness Bennett of Manor Castle Excerpts(3 years, 2 months ago)
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Baroness Bennett of Manor Castle (GP)
My Lords, I thank the noble Baroness, Lady Greengross, for securing this debate.
First, a minute of history. In 1987 the NHS had more than 127,000 acute hospital beds and more than 52,000 geriatric beds. Some 20 years later, geriatric bed numbers had been cut by over 60% and acute beds by 20%. In 2010 the category of “geriatric beds” disappeared altogether. That followed a 1981 White Paper, Growing Older, and a DHSS consultation paper in the same year, Care in the Community, which both planned for transferring patients from hospital settings into the community. That meant handing over the frail elderly to be units of profit for the financial sector. For all the wonderful compassion of horribly underpaid, highly skilled care workers, that is their real status. Many care homes are loaded with unsustainable debt, owned by private equity and reliant on risky financial structures. A 12% return is expected, yet this should be, without the debt, an extremely low-risk financial sector, where a 5% rate of return is considered reasonable.
I look forward to the speech of the noble Lord, Lord Sikka, who I believe will be setting out further detail on this, but I want to look at the question posed by the noble Baroness, Lady Greengross. Where is the intergenerational problem here? We have a system problem: the exploitation of each generation in turn by the financial sector, and the exploitation of the workers whose caring humanity leads them to labour for utterly inadequate wages in poor conditions. The elderly today are being treated as cash cows, and the young are being expected, through national insurance, to pay in, before in their turn being forced into the same dysfunctional, exploitative system.
I saw some debate that insurance might fill this gap, but why do we not insure all generations, and all of our futures, as we do with a still inadequate and inequitable but basic state pension, by providing free social care to all who need it, funded—in another term, insured—by all of us through general, fair, progressive taxation; far more progressive taxation than we have now? That is society taking responsibility for all its members, sharing the responsibility for all who need care.
The Green Party calls for national insurance to be replaced with a single, unified income tax to reduce loopholes and raise £24 billion to fund social care. All income, including rental and investment income, would be taxed at the same rate, and this, of course, would remove the unjust loophole whereby earnings above £50,000 are charged only at the 2% national insurance rate. As with medicine, so with care: there should be no place for the profit motive in its provision.
Calorie Labelling (Out of Home Sector) (England) Regulations 2021
Baroness Bennett of Manor Castle Excerpts(3 years, 4 months ago)
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Baroness Bennett of Manor Castle (GP) [V]
My Lords, I am in favour of both regret amendments and commend the noble Baroness, Lady Bull, and the noble Lord, Lord Brooke of Alverthorpe, for tabling them. I recognise that at first glance, backing both these amendments might appear contradictory. One regrets the regulations while the other seeks to expand them, but what we are talking about here are two different sets of products. Eating is something we all have to do and need to do collectively in a far healthier manner than we do now. I hardly need to rehearse our place as world-leading in obesity and subsequent morbidities and mortality. It is one league table we certainly do not want to be high-ranking in.
Eating out, eating in the community with friends and family, can and should be healthy, happy occasions but we know, as the noble Baroness, Lady Bull, has powerfully outlined, that for those with eating disorders—between 1.25 million and 3.4 million people in the UK—they can easily be fraught, difficult and immensely stressful. There is strong evidence that calorie labelling will only add to that. There is little evidence of the effectiveness of calorie labelling in tackling our obesity crisis, as the noble Baroness, Lady Parminter, outlined.
The science tells us that counting calories in food consumption is a far from exact or useful approach. We need a nutrient-rich, calorie-appropriate national diet based on vegetables, fruit, and wholegrains, giving us a range of important nutrients, as the noble Lord, Lord Moynihan, just outlined. A calorie label tells us nothing about that. All calories are not equal and the values of two servings of food with identical calorie counts could be at opposite ends of the health scale. An artificially sweetened, flavoured and coloured dessert may be very low calorie but it also has virtually no nutritional value, and increasingly we understand that artificial sweeteners, as well as raising serious questions about their safety, contribute to increased risk of metabolic conditions such as type 2 diabetes and heart disease, even if the mechanism for that is as yet poorly understood.
We also increasingly understand that the thermic effect of food depends on a whole range of consumption factors, such as the size of the meal, the pace of eating and the time of day. Relying on counting calories is a simplistic—potentially dangerously simplistic— approach to achieving a healthy diet. There is also the issue of our microbiome—damaged and reduced by our national diet of ultra-processed pap that is 68% of the calories that we consume—that we are increasingly understanding has a significant impact on appetite and consumption. We need a joined-up public health approach to tackling our obesity issue, as the noble Baroness, Lady Bull, said.
I was very tempted to use this debate to deplore the Government’s immediate, negative, knee-jerk, populist reaction to Henry Dimbleby’s excellent and important proposed national food strategy which proposes such an approach while also taking account of the disastrous environmental impacts of our broken food system. However, I decided that there was not really the proper space to do that, but I must note a question that I asked during the passage of the Agriculture Bill debates: what constitutional place does Mr Dimbleby occupy? We kept being told throughout that debate when issues of food and public health came up to “wait for Dimbleby”. How can Ministers say that about something they are signalling that they plan to ignore, essentially?
On the simple proposition that if we have calorie labels on food, they should also be on alcohol, even if we did not, alcohol is of limited nutritional value; however, most drinkers do not understand how it might contribute to obesity, as the noble Baroness, Lady Finlay of Llandaff, outlined. I declare an interest, as I do drink alcohol. I try to drink in moderation and take account of the energy intake from it. What the Government are regulating here is inconsistent between alcohol and food. We know that the alcohol sector has a large amount of lobbying muscle, as seen in its resistance to advertising restrictions. Unfortunately, we are seeing this effect further here.
Covid-19
Baroness Bennett of Manor Castle Excerpts(3 years, 4 months ago)
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Lord Bethell (Con) [V]
I am grateful for my noble friend’s kind remarks. Her question is extremely complex, and difficult to answer briefly but I will rest on one particular answer. As I said before, this is a question of getting the disease transmission to a point where R is below one. If that can be done on a national basis, we have contained the disease. We can then turn to local outbreak management. That is when test and trace resources will come into their own and local deployment will make a big difference. That is when we can consider the virus to have been beaten. We are not quite there yet, but vaccination rates are incredibly impressive and I am hopeful that we are near to that point.
Baroness Bennett of Manor Castle (GP) [V]
My Lords, the Statement given in the other place said that
“our wall of protection must be more than just vaccines alone”.—[Official Report, Commons, 19/7/21; col. 688.]
Yet it made no mention of ventilation despite its obvious importance, given that I am hearing, as I am sure many others are, about double-vaccinated people becoming infected every day, and about the widespread transmission of Covid-19 in schools among children of all ages. The noble Baroness, Lady Thornton, asked, without answer, whether air filtration was being installed over the holidays in every school. I add—this could be done rather more cheaply—can schools be given help over the summer to do a ventilation plan for every classroom? Strategic placement of fans, and the choice and manner of window-opening, could be crucial. I see from media reports that the Government plan to replace the “hands, face, space” slogan with the slogan “keep life moving”. If it is not too late, may I suggest that “keep air moving” would be far more useful?
Lord Bethell (Con) [V]
I am grateful to the noble Baroness for giving me an opportunity to address this issue, and I hope the noble Baroness, Lady Thornton, will forgive me for overlooking it in my opening answers. The noble Baroness, Lady Bennett, is entirely right: ventilation is critical—but it is also challenging. On air filters, we have to understand better the science of whether filtration really makes an impact on the spread of the virus. I would not want investment in a large amount of ventilation infrastructure that did not actually have an impact. I agree that we have a lot to learn from the Victorians, who understood these matters very well. We must understand how modern buildings, which are often airtight to achieve environmental qualifications, may need to be adapted to get fresh air within them. We may also need to change our lifestyles, so that more socialising, eating and drinking is done outside—something that I, as an outdoorsy person, would very much welcome.