Women’s Health Outcomes

Baroness Bennett of Manor Castle Excerpts

Thursday 8th July 2021 Lords Chamber

[Baroness Bennett of Manor Castle (GP) [V]]

I thank the noble Baroness, Lady Jenkin of Kennington, for securing this debate—a timely update a year on from the brilliant report of the noble Baroness, Lady Cumberlege, as the noble Baroness, Lady Bottomley of Nettlestone, just said.

Today’s debate led me to look back over our debates on the Medicines and Medical Devices Bill, during which the Government conceded, after Scotland led the way, on a patient safety commissioner for England. We were promised then that serious consideration was being given to the report’s other recommendations to support victims of disastrous medical procedures and to prevent future avoidable damage. I follow the noble Baroness, Lady Walmsley, in pointing out that the victims of sodium valproate, pelvic mesh implants and Primodos are still waiting. The First Do No Harm report concluded that thousands of lives were ruined because officials failed to listen to female patients. I hope we might hear some good news on that issue from the Minister.

In three minutes, there are many issues I could cover, but I want to extend the conclusions of the noble Baroness, Lady Cumberlege, to broader issues. I note that women wait longer to be diagnosed for many conditions, including cancer, and that heart disease in women is more likely to be misdiagnosed. Mental health is likely to be the diagnosis for a wide range of conditions that have a clear physical cause, often discovered only after many years of suffering.

I note too that intersectionality is at sometimes deadly and always damaging play here, and that women from BAME backgrounds and the LGBTIQA+ community are more likely to report poor treatment from their GP and receive inadequate support from services.

In the brief time left to me, I thought I would focus on an area still getting far too little attention and, like so many others, that is being exacerbated by the Covid-19 pandemic. That is musculoskeletal disorders. I point the House to the excellent briefing for this debate from the Chartered Society of Physiotherapy, which covers that as well as many other important issues. I should perhaps declare a personal interest here, having relied over many decades on physiotherapists to keep me going and repair damage wrought on the sporting field and in the workplace.

As I read that briefing’s recommendations on preventing musculoskeletal problems through access to occupational health physiotherapy, I thought of some women I met in Sheffield working at picking up baskets for a major supermarket’s home delivery service from midnight to dawn. I heard from them how physically challenging it was and how tough it was in the chiller and freezer sections.

We have to think about the many women who are doing what is often a double shift in the home with child and elder care. They also suffer musculoskeletal damage from that, and would greatly benefit from musculoskeletal first contact physiotherapists in primary care being available to all.

COVID-19 Variant: Travel Guidance for Local Authorities

Baroness Bennett of Manor Castle Excerpts

Wednesday 26th May 2021 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, given the long, arduous months of confinement suffered by the city of Leicester, compounded by the confusion caused by the apparent secret lockdown, and then the recognition that the city of Leicester should not have been included on the list, according to the figures—that arose as a result of a faulty calculation—can the Minister explain how the error came to be made in the case of the city of Leicester and how it will be avoided in future?

[Lord Bethell (Con)]

My Lords, guidance for people in Bolton and Blackburn with Darwen was published on Friday 14 May. It was then extended on 21 May to Bedford, Burnley, Hounslow, Leicester and North Tyneside. That guidance has now been fine-tuned, in response to feedback from the local directors of public health and, as the noble Baroness will know, the website has been updated. The chronology of that is relatively straightforward. It could have been done better—that I have made plain to the noble Baroness, Lady Thornton—and we are with working directors of public health, local authorities and others to ensure that we get smoother systems for that kind of thing.

Covid-19 Internal Review

Baroness Bennett of Manor Castle Excerpts

Thursday 20th May 2021 Lords Chamber

[Lord Bethell (Con)]

I am extremely grateful to my noble friend for his comments. He is entirely right. The battle against anti-vaxxers has been very successful. We have used a spirit of dialogue with people who have very personal and legitimate questions about a vaccine that requires an injection of fluids into their body. People quite reasonably have detailed questions about its impact. I applaud officials and partners of the Government who have been so effective at conveying the message on the safety and efficacy of the vaccine. It really has demonstrated the power of government and NHS communications at their best.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, I join the chorus of welcome to the noble Baroness, Lady Merron, who referred, as have other Peers, to the National Audit Office report on the handling of the pandemic. Commenting on that, Gareth Davies, the head of the NAO, stressed the need to “learn lessons at speed”. The Minister has often expressed how useful and informative he has found the contributions in your Lordships’ House. Would those contributions not be better informed if Members could absorb and reflect on the findings of the internal review as the country and the world continue to deal with what is, certainly on the global level, a raging and deeply dangerous pandemic?

[Lord Bethell (Con)]

I am enormously grateful to the NAO for the powerful report that it has published. It said many complimentary things about the Government’s handling of the pandemic. I am grateful to noble Lords for the counsel and challenge that they have given here in this Chamber. I point out the vast amount of data and information that we have published, which is at the disposal of the public and parliamentarians. However, confidential advice from officials to Ministers on a means-of-working review is not the kind of thing that I think adds to this sort of debate, and for that reason it is most appropriately kept confidential.

Covid-19 Update

Baroness Bennett of Manor Castle Excerpts

Tuesday 18th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I enjoyed the contemporary dance at Sadler’s Wells, which really lifted my heart, but I rather wish I had been at Saracens for that thumping victory and to see my favourite team doing so well after a difficult year. I very clearly hear the concerns of noble Lords about social mixing of amber and red route passengers at airports, and one reads about it in the papers. I reassure noble Lords that the amount of segregation in place in the airports is the focus of both Border Force and the Home Office. We are absolutely doing our best. We are looking at red list terminals, but the practicalities of that when there is a relatively low level of flights are very challenging indeed. I reiterate my point that if you are travelling you are putting yourself at risk, and there is no way we can pretend otherwise. If you are travelling, you should isolate yourself for a substantial amount of time when you touch down in the UK. This question of mingling in airports is, to some extent, a red herring.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, it is clear that the B16172 variant of SARS-CoV-2 is now established in the community, but that only highlights the need to keep out further variants of concern that will inevitably arise around the world as the coronavirus runs rampant. Following the question of the noble Baroness, Lady Watkins of Tavistock, can the Minister reassure me about the security arrangements in quarantine facilities given the number of cases of transmission in New Zealand and Australia, who have long practised quarantine? How often are staff being tested? Are they being paid in ways that mean they do not have to take other jobs, particularly jobs where they may have contact with large numbers of people? Are ventilation systems being checked regularly?

[Lord Bethell (Con)]

My Lords, the noble Baroness is entirely right to cite the examples of Australia and New Zealand and the challenges they have had with staff manning managed quarantine facilities. I am extremely grateful to officials from both Australia and New Zealand for the very thorough briefings we had when we set up our managed quarantine facilities. We totally took on board their profound insight on that area and that was the number one thing they told us to get right. We focused on it, we have invested in it, and that has worked well to date.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Baroness Bennett of Manor Castle Excerpts

2nd reading
Friday 16th April 2021 Lords Chamber

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, I thank the noble Baroness, Lady Wyld, for bringing us the Bill, and offer my group’s full support. We have heard many important contributions already. I associate myself with the comments of the noble Baronesses, Lady Walmsley, Lady Bull and Lady Sugg—particularly the last, on the urgent need for more regulations.

This is a long, obvious and necessary measure. Although it is disappointing that it took so long for it to reach us, at least we are here now. However, it is important to consider why we need this legislation at all. There is little doubt that, while we will soon have this measure on our own soil, once travel restrictions are lifted, at least some who might have sought these practices here will do so overseas where restrictions are, in some cases, less strict or non-existent. There is also the problem of enforcement, of course, as outlined by the noble Baroness, Lady Meyer.

To protect the young people—indeed, all people—of Britain, it is worth thinking about why there should be such demand for these medically unnecessary, expensive and dangerous procedures; indeed, the noble Baroness, Lady Wyld, rightfully and graphically outlined the dangers. Surely this is evidence of the need for much further action. There has been much talk about, and focus on, the technologically new social media, but it is important that we do not underestimate our children’s ability to think critically and clearly about what happens to them and the world they live in—particularly if we provide the educational framework of critical thinking to do so.

It is also important that we do not ignore other, possibly greater, pressures. Your Lordships know about the push that comes from advertising. This includes not just direct advertising for procedures, although we should be looking at considerably tighter controls on that, but broader advertising that depicts airbrushed, perfect features and flawless complexions achieved through art, not life. Look at the sheer level of bombardment with such images to which we are all subjected, whether by choice or not. Less advertising in our public spaces, with more art, poetry and nature instead—there’s a radical idea for your Lordships’ House.

There is also the pull of insecurity, fear and competition in the workplace. There is the gig economy, with management practices that regularly cull the so-called lowest performers in workplaces. There is the weight of student debt and the fear of economic difficulty. All combine with the assumption that, for a wide range of jobs—practically any job—individuals need to market themselves, present themselves well and compete to get to the top of the pile.

The noble Baroness, Lady Wyld, in introducing this Bill, identified her interest in Ofsted. I hope that she will think about how Ofsted, and all those involved in education, can inoculate our young people against the economic, social and commercial pressures, with strong support for their mental health and well-being, and how we can transform our society and our economy to greatly reduce—even end—these workplace pressures. As the noble Baroness, Lady Massey, said, we need a public health approach— a systems-thinking approach.

Covid-19: One Year Report

Baroness Bennett of Manor Castle Excerpts

Thursday 25th March 2021 Lords Chamber

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, it is a pleasure to follow the noble Baroness, Lady Tyler, and to support her tribute to NHS staff and her question about pay.

I begin with a very important question of democracy affecting the operations of your Lordships’ House and the conduct of this debate. I refer to an article published yesterday in the Huffington Post, titled “Consultants Deloitte Paid To Draft Ministers’ Parliamentary Answers On Test And Trace”. It reports on a series of contracts worth £323 million to “support” the Department of Health and Social Care and the national testing programme—contracts held by the consultant Deloitte. The report says that the contracts include

“help provided with PR and communications, with a requirement to ‘draft and respond to parliamentary questions, Freedom of Information requests, media queries and other reactive requests’ and to ‘support lines to take and Q&A’s in anticipation of queries’.”

My question to the Minister is simple: does he consider this appropriate? Should a private contractor be drafting and providing ministerial answers at all? In particular, should a private contractor be drafting ministerial answers on work that it is engaged in, especially when it is marking its own homework—this is Deloitte drafting answers for the Government about the work of Deloitte? Is it achieving results in drafting answers to questions similar to the disastrous outcomes of test and trace? I ask this specifically, given that my honourable friend the Member for Brighton Pavilion is still waiting for an Answer to a Written Question in the other place, numbered 149740, which names Deloitte and which was tabled on 5 February, concerning the work of test and trace in her constituency. Will the Government next be relying on Heathrow Airport to draft answers on aviation, or on the China General Nuclear Power Group to supply answers on energy policy, or on Bayer to give the ministerial view on GMO crops? Today’s debate is not focused on test and trace specifically, but perhaps the Minister could tell how us whether any of the answers that he has in his folder have been drafted by Deloitte consultants.

To be clear, of course I am not saying that civil servants should not consult outside experts. If there is a technical question from your Lordships’ House, a civil servant consulting an expert, including an industry expert, is obviously reasonable. The question is where the direction and guidance are coming from. Has that been privatised, as so much else has? For the information of the Minister, I note that in the other place, this morning, the Minister for Implementation said that she would be looking into the Deloitte contracts, but this is also a specific matter of concern for your Lordships’ House, given that it directly affects our proceedings.

Turning to the Motion to Regret tabled by the noble Baroness, Lady Brinton, I cannot believe that there is a Member of your Lordships’ House who would not support her expression of sorrow for the massive death toll and the swathe that has been cut through communities, particularly more disadvantaged communities. Can anyone really oppose regret for the millions of self-employed people who have been left penniless and scrabbling desperately to survive, or for the continuing, still unresolved failure to provide funds for workers infected with the coronavirus or potentially exposed to it, who are denied the financial support that they need to self-isolate? How can this Motion to Regret not be supported? Were I physically in your Lordships’ House, I would be looking at the Benches around me as I speak.

I note the words in the Motion to Regret that call

“on Her Majesty’s Government to publish a comprehensive plan to manage… the number of cases of Covid-19 and any new variants”.

Compared to the chaotic slew of localised, highly confusing statutory instruments that flooded through your Lordships’ House last autumn, we have got some way towards that at least, finally, with a national road map out of lockdown, rather than a casual “it will all work out” wave of the hand from the Prime Minister. But as the Motion in the name of the noble Baroness, Lady Brinton, indicates, it is still lacking in detail, and is particularly lacking a focus on vital ventilation issues.

I saw in the New York Times a detailed plan for how open windows and fans might be used to manage airflow in a classroom to minimise risk of transmission. I have not seen similar guidance from the Government. Such guidance is urgently needed, now that we know that social distancing, screens and hand washing do not provide a Covid-safe work or social space. Only carefully managed ventilation and air filtration can do that, but I regret that my Written Questions on these issues have received scant answers.

The Green group will be supporting the Motion to Regret in the name of the noble Baroness, Lady Brinton. We are also calling for an immediate inquiry into what has happened thus far. We must understand the many things that have gone wrong, so that we can strengthen resilience and tackle poverty, inequality, overcrowding and poor housing, and set up our society to contain Covid and manage future threats in this age of shocks.

Covid-19: Government’s Publication of Contracts

Baroness Bennett of Manor Castle Excerpts

Thursday 11th March 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is right: it has been the most amazing turnaround—an achievement that has surprised me. This has absolutely turned on its head some of the assumptions about what Britain’s manufacturing base can achieve in terms of affordability, technical ability and return on investment. I am enormously proud of that achievement, and I can reassure the noble Baroness that we are absolutely doubling down on it. It has made us rethink our entire manufacturing strategy for medicinal, pharmaceutical and health products and medical devices.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, given that we are not now in an unpredictable emergency situation but in a long-term continuing pandemic, can the Minister reassure me that all treatments of future contracts will meet the legal reporting requirements and that the Government might even eventually publish the full structure of test and trace?

[Lord Bethell (Con)]

We absolutely endeavour to fulfil the Cabinet Office guidelines on the publication of contracts, and I can provide that reassurance to the noble Baroness. It is my understanding that the structure of test and trace has been published. I will look into finding a link to that and would be glad to send it to her.

Women’s Health Strategy

Baroness Bennett of Manor Castle Excerpts

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, as Minister for Innovation I favour using technology and the latest techniques wherever possible to provide options and choices for all patients, including women, to address their conditions. With women, the delicate question of their bodies, and the different functioning of their bodies to men’s, is one that the health system has to reconcile itself to. I do not regard technology as a panacea to that central challenge; in fact, I think that many of the issues that women face will require face-to-face consultations, and we remain committed to ensuring that that is an option for everyone.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, I will not ask the Minister whether he has read Invisible Women by Caroline Criado Perez—or the medical chapter at least—but, if he has not, I would recommend it. One of the things that it highlights is how many widely and long-used drugs have never been tested for any sex and gender variations in responses. Do the Government have a systematic programme for checking that all drugs have been so appropriately assessed—so that, when the results of this call for evidence are received and acted on, appropriate treatments are available to the newly enlightened medical systems?

[Lord Bethell (Con)]

My Lords, I have previously referred to the challenge of gender-comprehensive clinical trials. There is growing evidence that drug prescriptions should be personalised a great deal more than they are, right across the board—not just on a gender basis but on genomic, ethnic, age and weight bases as well. The noble Baroness makes an extremely good point on this. I cannot guarantee that we will retrospectively conduct gender-specific clinical trials on the full library of medicines in the medicine cabinet, but we are keen to aspire to ensuring a future commitment to gender-specific clinical trials going forwards.

NHS: Staff Numbers after Covid-19

Baroness Bennett of Manor Castle Excerpts

Thursday 4th March 2021 Grand Committee

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, I am indeed here. I have one minute and two points. First, on recruitment and training, the World Health Organization reports that there are 28 million nurses worldwide but a 5.9 million global shortfall in the number of nurses needed. One in every eight nurses practises in a country other than the one where they were born or trained. The UK is a wealthy country and is traditionally a large importer of this scarce and valuable human resource, which other speakers have referred to. Surely we should be training sufficient numbers of nurses for our own needs and more. I note recent figures that UCAS has received 48,830 applications for nursing courses in England, up from 35,960 at the same point last year. In the continuing emergency situation, will the Government ensure that everyone who wants to study nursing gets a place, and will they agree to the Royal College of Physicians’ request to double the number of medical school places?

Secondly, on retention, for which one requirement is surely decent pay, there are many reasons to give the NHS a pay rise that I hardly need to list. However, I note that research by independent analysts London Economics found that 81% of the cost of an NHS pay rise would be recouped by the Government through additional taxes paid by the employee and employer, taxes earned through the greater economic activity that the pay rise would generate, and higher loan repayments by recent graduates. So why not a pay rise?

Covid-19

Baroness Bennett of Manor Castle Excerpts

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, SAGE is entirely right that we have to be careful about indirect travel. That is why we have introduced a passenger form that requires people to detail all their recent travels. It is why we have attributed to the filling-in of the form very serious enforcement measures, including the potential for a large custodial sentence if it is filled in incorrectly. It is why we are using all the benefits of technology and of airline databases in order to track people’s travel and ensure that they are not in any way misleading us or skipping around borders to get here. The noble Lord is right that this is a very serious matter. This is a 21st-century pandemic and we are determined to use the techniques of the 21st century to keep out variants of concern. Countries such as Taiwan, Iceland, Australia, New Zealand and Singapore have demonstrated that if you use thoughtful 21st-century methods then you can make a big impact on transmission, and that is what we are determined to do.

[Baroness Bennett of Manor Castle (GP) [V]]

In his answer to the noble Lord, Lord Patel, the Minister said that

“the crew are, wherever possible, vaccinated.”

It was not clear from context whether the Minister was referring only to plane and train crews or also to bus drivers and quarantine hotel staff. Is this a change in government policy to prioritise the vaccination of key workers, as the Green Party has been calling for?

[Lord Bethell (Con)]

While I acknowledge the Green Party’s views on this matter, the JCVI has been clear about what prioritisation levels 1 to 4 are. As I said earlier, we will be looking at the other prioritisation lists in time. I am in no way signalling a change in government policy, because that, I am afraid to say, is not in my gift.