Smoking

Baroness Blackstone Excerpts

Thursday 25th January 2024 Lords Chamber

[Lord Patel (CB)]

My Lords—

[Baroness Blackstone (Lab)]

My Lords, I refer to my interests as set out in the register. Would the Minister agree that smoking in pregnancy has enormously damaging effects, leading to much poorer birth outcomes than for mothers who do not smoke? Would he also agree that incentives to pregnant women not to smoke have been very effective? In the light of this, could he give a guarantee that the existing scheme, which comes to an end this year, will be continued with adequate resources, so that it is not in any way disrupted?

[Lord Markham (Con)]

I totally agree with the noble Baroness on the importance of stopping smoking—always, but especially during pregnancy. In fact, we have a maternity debate coming straight after this, where this will be one of the things that we discuss. I hope, from showing that we are putting all this spend in place, that we are backing everything that works. As long as the anti-smoking in pregnancy measure continues to work, that will be one of the major features to make sure that we are continuing to stop all activity, but especially in pregnant ladies.

Osteoporosis: Early Detection

Baroness Blackstone Excerpts

Thursday 19th January 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord refers to the fracture liaison services. It is the responsibility of all ICBs to roll out those services or their equivalent. Regarding the numbers that he cited, I should say that 51% of ICBs have a fracture liaison service in that shape or form and the others have different versions of it, and they are all responsible for rolling those out. At the same time, they are also responsible for musculoskeletal services, to make sure that we have nationwide provision for it.

[Baroness Blackstone (Lab)]

My Lords, the Minister said that prevention is better than cure. That is obviously the case, yet we have severely failed to prevent the horrible development of this crippling disease, which mainly affects women, as has been said. He has talked about a 95% target. What is he going to do, as the Minister with some responsibility in this area, to ensure that the target is met, given the failures in the past? Will he find a way of reporting back to the House on progress in reaching that target?

[Lord Markham (Con)]

One of the many things for which I am responsible is NHS performance, as I think the House is aware, and these are exactly the sorts of issues that I am interested in, so I am happy to undertake to give an update on that. We all know that effective spend, which we need to make sure is always put to best use, involves identifying where these problems are, and 3 million people are affected every year. As I said earlier, a fractured femur is the second biggest reason for intake into hospitals, in terms of beds. That is something that I am happy to be measured by and report back on.

Maternity and Neonatal Services

Baroness Blackstone Excerpts

Tuesday 25th October 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. I agree. This was captured in recommendation 1 by Dr Kirkup about having early warning indicators in place. That is what we have set up in the maternity quality surveillance framework, which has the oversight in this area and can escalate concerns and effectively report to the national maternity safety surveillance and concerns group, which can then put the trust into special measures.

[Baroness Blackstone (Lab)]

My Lords, I declare an interest as the chair of the trustees of the Royal College of Obstetricians and Gynaecologists. I am aware that the Government have allocated an extra £200 million for maternity services over the last couple of years, but according to the Health and Social Care Select Committee this is not nearly enough. It recommends up to £350 million for staffing alone. Do the Government accept that, above all, more funding is needed now for multi-professional training and to support programmes to improve clinical practice? If so, can the Minister say how much funding the Government are prepared to allocate and when?

[Lord Markham (Con)]

I agree. We are putting the money into the training programmes. We have actually put £95 million on top of the £127 million investment into this area. As ever though, what is most important is outcomes not investment. Alongside the tragic instances we have seen, we have seen a reduction in stillbirth of 19% since 2010, a reduction in neonatal mortality over 24 weeks of 36%, and a reduction in maternal mortality of 17%. Alongside these tragic findings of individual trusts, we have an improving picture of maternity care overall.

Medical Abortion Pills

Baroness Blackstone Excerpts

Thursday 10th February 2022 Lords Chamber

[Lord Kamall (Con)]

One of the reasons, as my noble friend would acknowledge, is that we had lockdown and then we were let out, and then we had more restrictions. We did not want to announce something and then have to go back on it. All I would say is that it was always intended to be a temporary measure. We have looked at the responses to the consultation in order to reach a decision, and we will be issuing our considerations later.

[Baroness Blackstone (Ind Lab)]

My Lords, I wish to declare my interest as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. Following up on the question from the noble Baroness, Lady Sugg, I find it very strange that the Government are taking so long to make this decision. The temporary service that was provided for early medical abortions comes to an end at the end of next month. The evidence is clear. According to a survey of 50,000 women published in a leading medical journal, telemedical abortion is

“effective, safe, acceptable and improves access to care.”

In these circumstances, what is holding up the Government’s decision? It seems obvious that it would be welcomed by doctors involved in the treatment of such women, and by the women who need this care.

[Lord Kamall (Con)]

As I am sure noble Lords will acknowledge, this is a very sensitive area. Initially, it was meant to be a temporary-only service. If we do decide to respect its temporariness, an extension will probably be made to ensure that the clinics and other medical services have time to adapt before returning to the position before the pandemic.

Vaccination Strategy

Baroness Blackstone Excerpts

Thursday 13th January 2022 Lords Chamber

[Lord Kamall (Con)]

One of the wonderful things about your Lordships’ House is its range of expertise. I thank the noble Lord for enlightening us on the earlier question. However, as I committed to the noble Baroness, I will check the department’s reply and hope it corresponds with the noble Lord’s response; otherwise, I am sure we will have more discussions.

On young women, the noble Lord is absolutely right that we should be encouraging as many people as possible to take the vaccine, even—I know this is being broadcast publicly—those who have not had their first or second vaccine. It is not too late. We urge everyone to have their first and second vaccine, but also to have the booster. It is the best protection, even for those who have previously had Covid. We know that almost all pregnant women who are hospitalised or admitted to intensive care with Covid-19 are unvaccinated. The latest data from the UK Health Security Agency shows that Covid-19 vaccinations provide strong protection for pregnant women against the virus. It shows that the vaccines are safe for pregnant women, with similar birth outcomes for those who have had the vaccine and those who have not. We have launched a new campaign that urges pregnant women not to wait to take the vaccine; it highlights the risks of Covid-19 to mother and baby and the benefits of vaccination.

[Baroness Blackstone (Ind Lab)]

My Lords, I declare my interests as set out in the register. Following on from the question of the noble Lord, Lord Patel, I want to pick up the issue of pregnant women. The Government have belatedly—very belatedly—announced a campaign to persuade pregnant women to get vaccinated. Had they done it earlier, some deaths would have been avoided. Is the Minister aware of the particularly low levels of vaccination among pregnant women from ethnic minorities? What are the Government doing to reach out to them in particular, to persuade them to get vaccinated and save their own lives and those of their unborn children?

[Lord Kamall (Con)]

The noble Baroness makes an incredibly important point that I am sure we all agree with. This is a combination of two issues. One is reaching those communities that generally, pregnant or otherwise, are not being vaccinated. The other is making sure that pregnant women are receiving the message that it is safe to have the vaccine. We are doing this through a number of channels, including through medical staff and the NHS, but we also have a number of targeted campaigns, looking at those communities to make sure we build trust, break those gaps down and give them the confidence to come forward and be vaccinated.

Covid-19: Vaccines and Pregnancy

Baroness Blackstone Excerpts

Monday 14th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, my noble friend made a clear case for the importance of improving the way in which patient data is collected and analysed in this country. It is something that we are working on at the moment. She highlights a very difficult situation. A third of women do not know that they are pregnant, of course, and, when they are pregnant, their data is first caught at the hospital where they decide to have their birth. Those databases are not easily linked. We do not have a countersignal for pregnancy at the moment; it is therefore not an acute priority. However, I take my noble friend’s point and will look into it further.

[Baroness Blackstone (Ind Lab)]

My Lords, I declare an interest as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. The RCOG survey found that more than half of those who declined the vaccine did so because they were waiting for more information about the safety of the Covid-19 vaccination during pregnancy. Will the Government, as a matter of urgency, issue guidance to all pregnant mothers explaining that the vaccination will not harm their unborn babies? Will they also provide facilities for pregnant women to be vaccinated at antenatal clinics as a mechanism to increase the take-up of vaccinations by pregnant women?

[Lord Bethell (Con)]

I am extremely grateful for those constructive suggestions from the noble Baroness. We have a very large amount of materials specifically for pregnant women, including guidance for pregnant women and a guide for women who are of childbearing age, pregnant or breastfeeding; those are widely distributed by GPs. However, as I said, a lot of pregnant women do not know that they are pregnant, so it is not possible to reach all of them all the time. At the moment, our priority is to ensure that those aged over 50 take their second jab. We will sweep up other demographics, and we will make that a priority when we reach it.

Women’s Health Strategy

Baroness Blackstone Excerpts

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, my noble friend touches on two very important points. He is entirely right that mental health has previously been underrepresented in the strategies of our healthcare. I hear loud and clear noble Lords who repeatedly make the case for a greater focus on mental health, and I take that message back to the department as much as I can. I reassure him that mental health will be very much a priority in this area. The two facts—that it is often women who are connected with mental health issues and that it is women who are often overlooked—are probably connected. It is extremely challenging for us to get women from ethnic minorities, for instance those from a Gypsy or Roma background—that is such a good example—fully engaged in our healthcare strategy. If the noble Lord has any suggestions or recommendations for how we can better engage with them, I invite him to submit evidence to the consultation.

[Baroness Blackstone (Ind Lab)]

My Lords, I draw attention to my interests as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. I warmly welcome this Statement, but we know that women’s healthcare is too often fragmented and unco-ordinated. So how will the Government ensure that their different strands of work on women’s health—this strategy, the sexual health strategy and the violence against women and girls strategy—are all properly aligned and based on a life course approach to women’s health, avoiding the creation of even more fragmentation for women?

[Lord Bethell (Con)]

My Lords, the question of fragmentation does not affect women alone; it is a problem across the healthcare system. However, the noble Baroness is entirely right: some of the conditions that afflict women in particular are not properly prioritised, and, therefore, the pathways connected with them are not as developed as they should be. That is the kind of challenge that we wish to address. However, the overall macro point is this question of listening: have we really listened to women—their symptoms, needs and health priorities—or are we behind the curve on that? I suspect that, too often, the health priorities that women would like to see emphasised simply have not been heard by the system.

Ockenden Review

Baroness Blackstone Excerpts

Monday 14th December 2020 Lords Chamber

[The Deputy Speaker (Baroness Fookes) (Con)]

I do not see the noble Baroness, Lady Altmann, in her place, so I call the noble Baroness, Lady Blackstone.

[Baroness Blackstone (Ind Lab)]

My Lords, I declare an interest, as set out in the register, as the chair of the trustees of the Royal College of Obstetricians and Gynaecologists. As the Minister has admitted, this report makes shocking reading, so what steps will the Government take to monitor the improvements they are pledging for maternity services right across the country to avoid the tragedies that are revealed by this review? Will the Government commit to publishing the findings of any future evaluation and, in particular, data on the avoidable deaths and long-term disabilities that result from failures in the care of women during childbirth?

[Lord Bethell (Con) [V]]

My Lords, policy officials at the DHSC are working with both the CQC and NHS England on improving our surveillance and the publication of data, as the noble Baroness rightly points out. A key development in this area is the work by HSIB to investigate each and every death and major incident in maternity suites. That provides an absolutely invaluable resource to understand where and when things go wrong. We will continue to publish those reports as they happen and will learn lessons from their insights.

Covid-19 Vaccine Rollout

Baroness Blackstone Excerpts

Wednesday 9th December 2020 Lords Chamber

[Lord Bethell (Con)]

I am enormously grateful to the noble Lord for his clear and heartfelt offer of help, and I completely endorse his comments. The collaboration between the NHS, the Government and business has been at the heart of our entire response to the pandemic. This collaboration has been termed the “triple helix”—a phrase that I like very much indeed. It is going to be at the heart of our building back of the healthcare system in the years ahead. On the noble Lord’s kind offer, I remind him that when someone takes any medical treatment, including a vaccine, they have to have the space to take stock and recover from the excitement of the vaccine, and they have to be supervised in that space by someone with some kind of clinical experience. So, while his offer is kind, it is likely that vaccine distribution will be in locations where we can put clinical supervision.

[Baroness Blackstone (Ind Lab)]

My Lords, do the Government intend to create some kind of vaccination passport, which will allow people to attend events across the UK and to travel to and from the UK without quarantine, if they have been vaccinated?

[Lord Bethell (Con)]

My Lords, the noble Baroness raises an extremely intriguing prospect. If it is indeed the case that those who have been vaccinated are not themselves contagious and cannot transmit the disease, there is the possibility that the vaccination will enable them to do things that might not be open to other members of the public. However, it is too early to call that one. We do not have the scientific evidence to demonstrate that the vaccine stops any infectiousness. We are working hard to try to understand that better. If it can be proved, we will look at an enable strategy.

Covid-19: South Yorkshire

Baroness Blackstone Excerpts

Thursday 22nd October 2020 Lords Chamber

[Baroness Blackstone (Ind Lab)]

My Lords, what steps are the Government taking to increase NHS lab capacity for testing in areas suffering from new restrictions? What advice has been given to care homes in those areas to alleviate the appallingly inhumane denial of access of families to their elderly relatives? For example, will regular testing be made available to those visiting their desperately lonely and sometimes confused relatives in care homes?

[Lord Bethell (Con)]

I pay tribute to NHS colleagues who have done an enormous amount to increase NHS lab capacity, and would be happy to share the numbers with the noble Baroness. We have written to care homes to emphasise the critical importance of the pastoral visits to which she refers. There is no question of a care home shutting out visitors if it can be avoided and we are putting regular testing in place to protect care homes. We are looking at providing regular testing for visitors and hope to make progress on it.