Breast Screening
Baroness Bryan of Partick Excerpts(3 years ago)
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Lord Kamall (Con)
The method for booking screenings has now changed, so people can book online on demand, rather than waiting for a referral.
Baroness Bryan of Partick (Lab)
Does the Minister agree that it is beyond doubt now that screening is beneficial? Can he assure us that no credence is given to those arguing that screening leads to overtreatment? Can we say that that is scotched?
Lord Kamall (Con)
The Government completely agree with the sentiments expressed by the noble Baroness.
Virginity Testing
Baroness Bryan of Partick Excerpts(3 years, 2 months ago)
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Lord Kamall (Con)
I thank my noble friend for her warm welcome. In answer to her specific question, the Government absolutely agree with the World Health Organization’s view that virginity testing is a violation of the victim’s human rights and is associated with immediate and long-term consequences that are detrimental to physical, psychological and social well-being—as well as, in simple terms, being demeaning.
On my noble friend’s specific question about what we are doing with the World Health Organization, I shall write to her with more details.
Baroness Bryan of Partick (Lab)
My Lords, virginity testing is an abuse of women and a denial of their rights over their own body. The same private clinics can offer virginity testing and, once they have decided that a woman or a girl is not a virgin, they can then offer hymen repair procedure. Does the Minister agree that this should be illegal and that it is a total abuse of that clinic’s profession? Having listened, as I can hear he has, to campaigners and professionals, will he give a stronger assurance that something will be done in the Health and Care Bill?
Lord Kamall (Con)
The noble Baroness makes a valid point; I do not think anyone in this House would disagree with what she said. Virginity testing is demeaning and hymenoplasty is not only demeaning but damaging to women’s and girls’ health and we want it to be banned as soon as possible. I give a pledge that I will push for this to be introduced as soon as possible. Whenever noble Lords are told that the Government will find parliamentary time to do something, I understand why there might be some scepticism about that, but I will push to make sure that we can introduce it as soon as possible.
Animal Diseases: Future Pandemics
Baroness Bryan of Partick Excerpts(3 years, 5 months ago)
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Lord Bethell (Con) [V]
The noble Lord identifies the threat extremely well indeed. The Department of Health works extremely closely with Defra on this exact point. I pay tribute to both the farming community here in the UK and officials at Defra for their work to encourage farmers to stand back from prophylactic use of antibiotics.
Baroness Bryan of Partick (Lab) [V]
My Lords, one of the most important lessons about “one health” from Covid-19 is that we must share more than just surplus vaccines; we must share the capacity to make vaccine. Can the Minister explain why the Government are resisting even a temporary TRIPS waiver when so many world leaders support it?
Lord Bethell (Con) [V]
My Lords, the noble Baroness is right that we need to massively increase international capacity for vaccine production. The Government are working on a vaccine strategy that will include ideas for doing that. A TRIPS waiver is something we have looked carefully at. It is our strong view that this Government support intellectual property, because it is only through our commitment to intellectual property that we can encourage the kind of massive investment by the private sector necessary to develop vaccines in the first place. For that reason, we remain hesitant about supporting a TRIPS waiver policy.
Elderly Social Care (Insurance) Bill [HL]
Baroness Bryan of Partick ExcerptsFriday 16th July 2021
(3 years, 5 months ago)
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Baroness Bryan of Partick (Lab) [V]
My Lords, earlier this week, I was disappointed to hear a noble Lord asking a supplementary question refer to pensions as a burden. He further suggested that older people are unfairly benefiting at the expense of younger people. His words reflect a view that, when older people have ceased to be productive, they become a drain on resources.
The phrase “We are all living longer”—generally attached to a warning about how much this will cost the taxpayer—was never that accurate and is already out of date. Life expectancy is declining; so too is healthy life expectancy, which will inevitably result in a greater need for social care. Younger family members, some retired themselves, struggle to support older relatives in poor health and ensure that they are well cared for, whether in their own home or in residential care. This Bill does not address their main concerns about the falling standards of care resulting from cuts in funding.
The whole thinking behind this Bill is a hangover from the discredited creed that home ownership is a moral good. Its starting point is less about social care and more about the ability to pass on wealth. As such, it will fail to reach two groups: first, the increasing percentage of people who do not own their home and, secondly, the people wealthy enough not to worry. The Bill is aimed at those in between. They will be asked to gamble a substantial sum of money on eventually needing residential care—not even care in their own homes. I would argue that this is a gamble most would choose not to take. Polling shows that the majority of people want to see social care fully funded through taxation. I note from today’s Times that some Cabinet Members believe that this would require a wealth tax; that is very perceptive of them.
It seems likely that this Bill will disappear without trace. It is irrelevant to the serious debate on how we as a society provide all types of social care in many different settings at a standard we would hope to receive ourselves.
Women’s Health Outcomes
Baroness Bryan of Partick Excerpts(3 years, 5 months ago)
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Baroness Bryan of Partick (Lab) [V]
My Lords, I too thank the noble Baroness, Lady Jenkin, for enabling this important debate. Unlike other health comparisons, the gap between men’s and women’s health is wider in some developed countries than in some less-developed ones. The UK ranks 87th in the world for men’s health, while it ranks 125th for women’s health—38 places lower. This gap puts it 12th in the international list of women’s health inequality. How can this be?
One of the reasons appears to be the misdiagnosis of women’s symptoms, which I will come to later. A second reason is that women are more likely to live in poverty than men. Whether as single parents, unemployed, on low pay, disabled or as pensioners, women are likely to be poorer than their male counterparts.
Not all inequalities in health relate to gender. Better-off women can expect 20 additional years of healthy life than those who are worse off. Even before the pandemic, progress on healthy life expectancy had stalled and begun to go backwards. The latest figures show that less than a third of women are still in work by the time they reach retirement age. For many, this is not through choice but because they cannot find work or are actually too ill to work. We are condemning many of these women to spend the remainder of their lives in poverty.
As we have heard from several speakers, women have to shout louder to get their concerns listened to. Some of the women who have had to shout the loudest are those affected by mesh implants. The independent review chaired by the noble Baroness, Lady Cumberlege, produced its report First Do No Harm one year ago today. It found that women describing their excruciating chronic pain were dismissed as imagining it or told it was their “time of life”. The report argued that anything and everything that women suffer is perceived as a natural precursor to, part of or a post-symptomatic phase of the menopause. What do the Government intend to do to prevent so many women spending their later years in ill health and poverty? When can we expect the establishment of a redress agency, as proposed in First Do No Harm?
Independent Medicines and Medical Devices Safety Review
Baroness Bryan of Partick Excerpts(4 years, 5 months ago)
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Lord Bethell
The noble Baroness is entirely right that transparency is essential in order to have a fair and equitable healthcare system. The GMC has already considered these areas and has moved a long way. The world has changed considerably since many of these horrific events took place, but I am sure there is more to be done and this recommendation, like others, will be considered seriously by the Government.
Baroness Bryan of Partick (Lab) [V]
My Lords, there is so much to be said about this excellent report, but I shall quote one devastating sentence on mesh implants, where it raises the question
“whether the modification of a device so that it required less skill to insert should have been the preferred option rather than improving the surgical skill base.”
Does the Minister agree that there is an urgent need for a robust surgical training programme for inserting mesh devices and, just as importantly, for their removal? Will resources be put in place for such a programme?
Lord Bethell
The noble Baroness is right to emphasise the dangers of the insertion of mesh. It is a procedure that is still taking place within the NHS. We are looking at bids for specialist units in relevant trusts to build up the kind of specialist skills necessary to deal with the problems that have emerged from mesh procedures that have gone wrong.
Independent Medicines and Medical Devices Safety Review
Baroness Bryan of Partick Excerpts(4 years, 5 months ago)
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Lord Bethell
My Lords, no one who reads the report can help feeling anger and shame; the noble Lord puts it well. I completely endorse his feelings and the Government will be looking at these recommendations closely and acting on them in the spirit he describes.
Baroness Bryan of Partick (Lab) [V]
My Lords, I ask this question on behalf of some of the women campaigners. The report states:
“The removal of transobturator tape is technical and complex surgery and there are very few surgeons in the UK capable of undertaking this”.
While this remains the case, will the Minister consider banning these mesh tapes until women can be sure that any post-operative problems can be fully and safely treated?
Lord Bethell
My Lords, one cannot read the descriptions of the consequences of some of the surgery around mesh, and the pain and suffering that some of the women endured, without feeling huge anger and shame and instinctively wishing to ban such a thing. However, mesh offers a solution to some women whose prolapse is profound and who have run out of options. There are women for whom mesh has been a great saving and where there has been a successful procedure. Procedures around mesh have improved dramatically. We are reluctant to apply a blanket ban, but we take the recommendations of the report very seriously and will be looking at this procedure extremely closely.
Queen’s Speech
Baroness Bryan of Partick Excerpts(5 years, 2 months ago)
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Baroness Bryan of Partick (Lab)
My Lords, I join my noble friend Lord McKenzie of Luton in welcoming some aspects of the Pension Schemes Bill, particularly easier access to information through the pensions dashboard and greater protection from misleading information.
Unfortunately, the Government’s understanding of their legal and moral responsibilities relating to misleading information was exposed recently when their QC in the “Back to 60” court case stated:
“It’s clear from case law that the enactment of primary legislation carries with it no duty of fairness to the public”.
Rather than acknowledge that a lack of fairness from government was unacceptable, as it would be from a private pension company, it was used to justify leaving many thousands of older women in poverty. Even the judges in the case said they were saddened by the women’s situation.
This proposed Bill on pensions again fails to take account of the differences in working lives of men and women and, as a result, will continue to treat women unfairly. The gender pay gap remains significant, even when comparing women and men in full-time employment. Women earn considerably less than men through their working lives, and the gap is at its widest for women over the age of 60. It is estimated that women starting work today can expect to receive £225,000 less over their working lives than men.
The pay gap is a disadvantage to women throughout their working years and goes on to make a substantial difference to their pension entitlement should they enrol and stay in an occupational pension scheme, but, not surprisingly, women of all ages are less likely to join workplace pension schemes than men. Nearly 10% of women opt out of auto-enrolment compared with 7% of men. For older women, this increases to 33% opting out.
The reasons are clear. Women are more likely to be in part-time, temporary or unskilled jobs. They are also more likely to be single parents and carry the responsibility of caring for elderly or disabled family members. It is often their money that is vital for immediate household needs such as food and clothes, and they often meet childcare costs from their salary. When every penny is needed for the here and now, it is hard to balance that against a distant future, particularly when that future seems further away than ever.
The treatment of the WASPI women is likely to make all women sceptical about pensions. Rules change and goalposts shift, but never to the benefit of women paying in. Is there any possibility that the Government will make an act of good faith to the women who were misled over their pension entitlement? After all, the Prime Minister agreed that he felt that the answer he got back from the Treasury on behalf of his own constituents was “not yet satisfactory”, and said that, if he was lucky enough to become Prime Minister, he would undertake to return to this issue with fresh vigour and new eyes to see what he could do to sort it out. That being the case, can we expect to see fresh action on this issue soon?
Finally, can the Minister comment on how workers who invest their future in pension schemes can be represented in decisions about how those funds are invested? The money is, after all, their deferred wages.
Safety of Medicines and Medical Devices
Baroness Bryan of Partick Excerpts(5 years, 10 months ago)
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Baroness Bryan of Partick (Lab)
My Lords, I thank the noble Lord, Lord O’Shaughnessy, for tabling this debate and for his continuing interest in the issue. As a relatively new Member, I welcome the noble Lord, Lord Carrington, and congratulate him on his maiden speech.
To confirm how important this debate is, I note that the Medicines and Healthcare products Regulatory Agency has issued three medical device alerts during February—for a pacemaker, an ophthalmic implant and an orthopaedic implant. This has to give us cause for concern. The helpful briefing paper from the Royal College of Surgeons points out:
“The vast majority of medical devices are manufactured and used to high standards”.
However, it goes on:
“Gaps within the current regulatory process … could be putting patients at risk of serious complications and harm”.
One of the examples the royal college gives is of transvaginal mesh implants. I am pleased that, over the past few years, this issue has been taken more seriously. There was a debate in the other place recently, and Members there reported the harrowing experiences of their constituents. Most importantly, the review of the noble Baroness, Lady Cumberlege, will include this issue and I am pleased to see that she will make a return visit to Glasgow later this year. Her comments today were both moving and reassuring for the future.
Last year in Scotland, a woman who died of multiple organ failure was reported to be the first Scottish woman to have had a mesh implant listed as an antecedent cause of death. For a long time, Scottish women who were experiencing debilitating symptoms following mesh implants felt they were not being listened to or even, in some cases, believed. Women made multiple visits to their GPs, taking time off work or giving up work altogether. Many were becoming more disabled and some needed wheelchairs. Women felt that the lack of treatment, continual pain and, for some, the attitude of doctors caused stress and anxiety, which often led to depression.
These women set up a campaign in Scotland, Hear Our Voice, and took the issue to the petitions committee of the Scottish Parliament. From that, a Scottish independent review was established. The review’s final report was, however, not without controversy. Two of the women who had experienced mesh implant surgery resigned before it was published, because they felt it had been watered down from the draft version. It was a real pity that women who had brought the issue to public, media and political notice then felt let down by the final publication.
The Scottish review made the following recommendations: mesh should not be offered routinely to women with prolapse; reporting of all procedures and adverse events should be mandatory; extra steps should ensure that patients have access to clear, understandable advice to help them make informed choices; all appropriate treatment should be available, subject to informed choice and assessment; there should be improved training for clinical teams; and there should be improved research into the safety and effectiveness of the products. How often do patients have to campaign, sometimes for years, to have their concerns addressed? In the meantime, they are often dismissed by so-called experts as overreacting.
We must be able to have confidence in the independence of research. Just this year, a senior medical consultant and researcher acknowledged that he failed to declare £100,000 received from the manufacturer of a type of vaginal mesh implant that he assessed. There is no evidence that his study was influenced by the support he received but it has added to concerns about the lack of transparency from the manufacturing companies.
Obviously, mesh implants are not the only area of concern; breast implants and hip replacements have also had their problems. The Royal College of Surgeons makes the point that, in contrast to drugs, many surgical innovations are introduced without clinical trials or centrally held data. This has resulted in a lack of information and often a considerable time delay in giving a diagnosis, leaving women experiencing chronic pain and sometimes inappropriate treatment.
Women were not given clear information about the risks involved, so they could not have given adequately informed consent. How could the surgeons have provided that information when they did not have the details of clinical trials? Can the Minister assure us that, for the future, will there be more effective clinical trials and faster and more effective action when adverse reactions are reported, and that the people affected will be given sufficient financial compensation, along the lines mentioned by my noble friend Lord Brennan, so as to take at least one worry off their shoulders?