Covid-19: Vaccines and Pregnancy

Baroness Blackstone Excerpts
Monday 14th June 2021

(4 months ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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 Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

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 Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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

(7 months, 1 week ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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 Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

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 Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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

(10 months, 1 week ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Baroness Fookes Portrait The Deputy Speaker (Baroness Fookes) (Con)
- Hansard - - - Excerpts

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

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

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 Portrait Lord Bethell (Con) [V]
- Hansard - - - Excerpts

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

(10 months, 1 week ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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 Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

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 Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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

(12 months ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Lexden Portrait The Deputy Speaker (Lord Lexden)(Con)
- Hansard - - - Excerpts

The noble Baroness, Lady Pidding, who is next on the list, has withdrawn , so I call the noble Baroness, Lady Blackstone

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

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 Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

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.

Covid-19 Update

Baroness Blackstone Excerpts
Monday 14th September 2020

(1 year, 1 month ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Bethell Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

My Lords, given the intrusive and damaging effects, especially on family life, of the decision to limit social contacts to six people, can the Minister say why it was decided to apply this both inside and outside, rather than to follow the Welsh Government’s position of applying the new ruling only to meetings inside? Does he agree that medical evidence suggests that the chance of contracting the virus outside is tiny in comparison with inside, and that, with regard to his quest for simplicity, nobody is so simple that they cannot tell the difference between inside and outside.

Lord Bethell Portrait Lord Bethell (Con)
- Hansard - - - Excerpts

My Lords, I agree that everyone can tell the difference between inside and outside, but everyone also has eyes, and may have seen, as I have, how people crowd together in the forecourts and beer gardens of Britain. If they were all standing on draughty hillsides with the wind blowing the disease around, that would be one thing, but the simple fact is that our prevalence has gone up—the evidence speaks for itself—and that is why we need to be clearer about this simple measure.

Medical Teaching and Learning: Ethnic Diversity

Baroness Blackstone Excerpts
Tuesday 14th July 2020

(1 year, 3 months ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Bethell Portrait Lord Bethell
- Hansard - - - Excerpts

The noble Baroness put her point well, although the broadband deficiencies meant that I did not get all of it. I emphasise that this area of policy work is very much the focus of the drafting of the People Plan, which will put a spotlight on a number of the areas of our human resources, including BAME people, and we look forward to the publication of that plan.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab) [V]
- Hansard - -

My Lords, while the curricula of medical schools are for them to determine, could the Minister tell the House whether any meetings between the Medical Schools Council and Ministers have taken place recently? Will he ensure that a meeting is arranged in the near future to hear from the medical schools what they are doing, first, to improve the representation of Afro-Caribbean staff and students and, secondly, to ensure that teaching and research properly explore those conditions to which the BAME community is especially susceptible? Black lives really do matter.

Lord Bethell Portrait Lord Bethell
- Hansard - - - Excerpts

The noble Baroness asks a very specific question; I cannot, I am afraid, answer precisely on what meetings there have been with the medical councils, particularly during the busy Covid period. All I can say is that there is ongoing and regular engagement with the medical schools that focuses very much on the key issues that she describes. Diversity and Inclusion: Our Strategic Framework 2018-2022, from Health Education England, is a very explicit and specific programme of works in which we engage all those in health education. As I mentioned, we are working extremely hard on our recruitment campaigns to ensure that they reach communities otherwise not reached.

Covid-19: Mental Health Services

Baroness Blackstone Excerpts
Thursday 2nd July 2020

(1 year, 3 months ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Bethell Portrait Lord Bethell [V]
- Hansard - - - Excerpts

My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab) [V]
- Hansard - -

My Lords, there is increasing evidence that the mental health of children and young people has been badly affected by the Covid-19 lockdown. Given that the provision of mental health services to this age group was already inadequate, why has progress in implementing plans in the Green Paper on child mental health been so poor, particularly in the rollout of child mental health teams? What steps will the Government now take to rectify that?

Lord Bethell Portrait Lord Bethell [V]
- Hansard - - - Excerpts

The noble Baroness is likely correct that the epidemic has had a particular effect on children and young people. The evidence on this is not crystal clear, but that is the strong instinct of all those in the field. I personally welcome the reopening of schools, which will have a particularly beneficial effect on those children who at present are stuck at home and do not have the support of the school system. Mental health services for young people are part of our long-term plan, with the additional £2.3 billion of spending on mental health. Our ambitions in that area remain enormous.

Coronavirus Bill

(2nd reading (Hansard))
Baroness Blackstone Excerpts
Tuesday 24th March 2020

(1 year, 6 months ago)

Lords Chamber

Read Full debate Read Hansard Text
Department of Health and Social Care
Baroness Harding of Winscombe Portrait Baroness Harding of Winscombe (Con)
- Hansard - - - Excerpts

My Lords, I begin by declaring my interest as chair of NHS Improvement. At my pre-appointment hearing two and a half years ago, I said I would be very cautious about speaking on health matters while in this role, but I hope noble Lords will forgive me for doing so as I feel in these extraordinary times it would be wrong not to speak.

First, I express my deepest sympathy for those who have already lost loved ones because of Covid-19 and I send my very best wishes to those currently in hospital or with relatives in hospital or at home fighting the disease. I shall speak today about why this Bill matters so much, why it matters to our NHS people and why it matters to all of us. I shall start by reading a statement from my noble friend and sort of job-share partner at NHS England and NHS Improvement, my noble friend Lord Prior, who is not in his place today as he and I are endeavouring not to be in the same room at all and are working shifts. My noble friend says: “In its extraordinary history of over 70 years, the NHS has never faced such a momentous challenge. Our country has never depended so heavily on its most loved and respected institution. I”—in fact, we—“know that the remarkable people who work for and with the NHS will more than do their duty; they will do their absolute best. It is a privilege and an honour for me”—us—“to work with them.”

As my noble friend says, our NHS people will do everything in their power to look after us and care for us: our consultants, paramedics, healthcare assistants, junior doctors, nurses, midwives, porters, cleaners, scientists, physios, engineers technologists and procurement teams. There are so many professions, I cannot list them all, as I mean everyone working in our health and care system. There are those directly employed in the NHS, but those working in social care, volunteers, the voluntary sector and, yes, even the independent healthcare sector They are all our National Health Service right now, and my goodness they are working hard and fast to face up to this challenge. They need us to help them. They need us all in this country to play our part, as the Prime Minister said last night. They need us to play our part personally in abiding by the rules the Government have set out, and they need us to play our part practically in sourcing personal protective equipment, making ventilators, expanding testing capacity and coming to work with them, if we have the skills. They need us to care for them, to make sure that they can eat at the end of a long and challenging shift, that they can get to and from work and that their loved ones are okay while they are at work, and they need us to support and cherish them when things go wrong.

They need all of this, and they also need us in this House to play our part constitutionally by passing this Bill to give the Government the powers they need to guide us through this immensely challenging time and to provide our NHS people with the support they need so they can save lives. There are powers in this Bill that many noble Lords have said that in normal times all of us in this House would wish to question, challenge and test, but this is not a normal time. Our NHS people need us to act now. Time is not on our side, and they need all of us to join in this fight with them because right now, this is the ultimate national effort from our NHS, that most cherished British institution. Right now, we, all of us, are the National Health Service in one united effort from everyone in the country, with healthcare professionals in the front line backed up and supported by the whole country, as a genuine united National Health Service.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab)
- Hansard - -

My Lords, like many others in this debate, I pay tribute to the many thousands of people who are working immensely hard to counter the effects of the coronavirus.

This huge Bill gives unprecedented power to the Government. Whether all these powers will be needed is uncertain. There are still questions about the severity of the disease and its future trajectory. The CMO has assessed a death rate of 1%. New research from the University of Oxford suggests 0.7%. In Germany, where far more testing has been done, it is 0.3%. We know that in the UK the average age of death from the virus is 78.5 years, and it is a fair assumption that, very regrettably, of those who succumb, quite large numbers would have died anyway. The measures in the Bill and those already taken, exacerbated by last night’s announcement, are leading to massive fear and anxiety in much of the population. More must be done to explain the demographics, reduce unnecessary fear and protect mental health. We in this House might need to worry about our survival but, fortunately, most of the population does not.

The other general point I want to make concerns the economy. A global recession will lead to the death of many children in poor countries, and it is undisputed that the supply of goods and services will be greatly reduced: first, by closing down production with large lay-offs; and, secondly, by restrictions imposed to keep a large part of the workforce at home. At the same time, in the UK, huge amounts of money are being pumped into the economy for understandable reasons. Are the Government assessing the serious implications for high inflation in the medium term? Will they be considering price controls at a later date?

I turn now to my main focus: how we sustain our education system and protect our children and young people from long-term damage as a result of school closures and the cancellation of public exams. History will judge whether or not the wider measures that have been taken to combat the coronavirus were proportionate. My view is that the decision to cancel GCSEs and A-levels was disproportionate and made without sufficient preparation and the requisite advice on what would be put in place instead. While recognising, as I really do, how difficult it is for the Government in these circumstances, answers are desperately sought by teachers, parents and pupils. Many pupils have said that they feel “gutted”; having spent the past two years working hard to reach their potential and get good grades, they feel cheated that they have been denied the opportunity to do so.

The Government have said that alternative assessments will be just and fair. Teachers will have to draw on many sources, including predicted grades, class work and mock exams results. I am sure that they will do their best. Nevertheless, there are bound to be large variations in the judgments they make. Some will be generous, and others tougher, so it will not always be just and fair. Moreover, universities will face difficult decisions about who to admit; at least a collapse in international student numbers could allow them to admit more home students and veer towards a generous admissions policy. But, given that all secondary schools will be open to allow the children of key workers to be looked after, I think it is a pity that 16 to 19 year-olds cannot work at home until the exams begin, and then come to school to take them. I believe that that is what should have happened.

The other concern about many children being forced to remain at home is the likely outcome of increased social inequality. Schools do not just educate children; they also provide them with a safe haven, a structure to their day and a chance to be creative and to learn about sharing. Schools are a leveller, in that they provide a similar environment for all their pupils, in contrast to the huge inequality in their homes. I am not sure how head teachers will define vulnerable children—presumably it will include those with disabilities, those who have been abused and those who are in children’s homes—but it is doubtful that they will be able to embrace the 4 million children who live in poverty and the many children who live in appalling accommodation, with overcrowding and limited resources.

When the schools reopen, will the Government provide extra resources to schools with many disadvantaged pupils, to allow them to give additional help, particularly to those who have suffered most from possibly many months of being unable to go to school? Will PGCE students be able to complete their courses this summer, to ensure an adequate supply of new teachers?

To conclude, ways must be found to ensure that the drastic decision to close our schools indefinitely does not have life-changing consequences for children and young people, such as increasing their vulnerability to gang violence and crime, as well as to mental illness and anxiety, while trashing our hopes for more social mobility.

Baroness Ludford Portrait Baroness Ludford (LD)
- Hansard - - - Excerpts

My Lords, the only bright spot in this crisis is that experts are being listened to; long may that continue.

Obviously, the overarching concern is that the powers in the Bill should last no longer than is strictly necessary, should not overreach and should not set unwelcome precedents—one thinks, for example, of the reduction to one doctor for the exercise of Mental Health Act powers and the problems around care assessments. Moreover, the powers should not impact unfairly on disadvantaged minorities or marginalised groups, and should not go further than can be truly justified. It is not entirely clear why the Civil Contingencies Act or the Public Health Acts were insufficient in various areas.

In Schedule 21, there is a test of necessity and proportionality which is strangely absent from Schedule 20—the one that affects directions to people. From these Benches, we will therefore table an amendment to require that all the powers in the Bill should be exercised in accordance with the principle of necessity, proportionality and non-discrimination, respecting the European Convention on Human Rights and other human rights instruments. We also want the Government to keep the powers under frequent review and to publish reasons and explanations for any measures introduced under the Bill.

Although the right to life—Article 2 of the ECHR—underpins the response to this pandemic, human rights issues under several articles of the convention are engaged: Article 5 on the right to liberty; Article 8 on the right to family life, as relating to isolation, quarantining and restriction of family visits; Article 11 on freedom of assembly and association, relating to the prohibition of public meetings and gatherings. These are just some of the examples. I am glad that the Joint Committee on Human Rights, chaired by the right honourable Harriet Harman—I declare an interest as a member—is conducting an inquiry into the human rights implications of the response to Covid-19.

There have been shocking cases of victimisation and blaming of certain people due to their perceived ethnic or national origin, particularly those of Chinese and other east Asian appearance. The power for local authorities not to meet some assessed care needs and to avoid the duty to conduct a care needs assessment will impact on the vulnerable. The Government should, at a minimum, notify the Council of Europe and the United Nations, as stewards of the ECHR and international human rights instruments respectively, that the UK is enduring a national emergency, and of the measures being taken. Do they in fact need to formally derogate? Perhaps the Minister could tell us.

People need to be able to assess, scrutinise and, if necessary, question and challenge the Government. It is not helpful to have a Minister on Twitter call someone by a rather vulgar term because they had the temerity to raise questions about the Government’s approach, as happened yesterday. Apparently, there have been no advertisements on social media. I am on only Twitter so I do not see Facebook, Instagram or any of the others but, considering that a lot of money was spent on Brexit no-deal ads on social media, this omission seems anomalous.

Assessing Schedules 20 and 21 is a bit difficult, as we do not yet know how the Government will give effect to the measures heralded in the Prime Minister’s announcement last night. I imagine that is still being worked through. Schedule 20 does raise a lot of concerns. Where are people to be directed or detained? Is a police station envisaged or just home? What screening is to take place, especially given the lack of current testing capacity? Will there be any judicial authorisation of detention or any provision for appeals? What about people who, for one reason or another, do not have a home to go to—the street homeless, sofa surfers, victims of domestic abuse, some immigrants and refugees, who get little or no support? Surely imposing isolation and quarantining restrictions on people living in abusive or dangerous environments would place them in an impossible situation. As concerns Schedule 21, are the closure of premises regulations issued just last Saturday under the public health Act—they were mentioned by my noble friend Lord Newby—to be revoked in the same way as the February regulations on direction and detention of persons are repealed by this Act in Schedule 20?

I want briefly to mention one or two other things. I entirely agree with the noble Lord, Lord Falconer, and the right reverend Prelate the Bishop of Rochester, who raised issues about funerals and religious beliefs as concerns the need for burial and not cremation. As someone who organised my late husband’s funeral just five months ago, and a memorial service four months ago, this is very important to me. I will perhaps have more chance tomorrow to raise concerns about immigration powers as they affect people in immigration detention as well as in prison. Also, the fear of data sharing with the Home Office could deter people from seeking health treatment. Will the Home Office undertake to suspend that data sharing?

There are also some concerns about video hearings in court. Much as one accepts that they are necessary in the circumstances, various safeguards would be required. There are also concerns about changes to the Investigatory Powers Act and the extension to 12 days for a warrant. From experience, we know that there is a ratchet effect of expansion of state powers, as terrorism legislation has shown. We will need to be vigilant to prevent spillover.