Covid-19: Dental Services

Baroness Bull Excerpts

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, one area where the Government have made a big commitment to dentists is in PPE. As of Wednesday 4 November, over 5,000 dental and orthodontic providers in England had registered with the PPE portal and over 36 million items of PPE had been delivered. In terms of the commitment to workers, I will have to come back to the noble Baroness.

[Baroness Bull (CB)]

My Lords, I declare my interests as set out in the register. Reduced clinical capacity not only impacts on patients but massively disrupts the education of dental students, who typically treat over 400,000 volunteer patients each year as part of training. Since March, many schools have been unable to provide any patient-facing education at all. Will the Government respond to requests from dental schools and hospitals to invest in high-quality simulation facilities, to mitigate the impact of this reduced clinical experience and ensure that students can graduate and provide the workforce of the future?

Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020

Baroness Bull Excerpts

Friday 25th September 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, the recent rash of debates on health protection regulations is indicative of the speed at which this situation is evolving, and it underlines the importance of effective communication strategies to help people understand the changes and distinguish rumour from truth. Technology and social media are clearly valuable in this effort, but this week the World Health Organization warned that they are also enabling an infodemic that undermines the public health response and jeopardises measures to control the pandemic.

Fake news spreads fast and it has real and life-threatening consequences. By promoting fake products, spreading misleading information and encouraging suspicion of official guidelines, it can increase anti-masks, anti-lockdown and anti-vaccination demonstrations and campaigns that can seriously compromise the attempts to fight Covid-19. Research from King’s College London, in which I declare my interest, has found a clear link between beliefs in conspiracy theories and mistrust of government, authority and science, and the likelihood of rejecting a Covid vaccination when it arrives.

So while clear messaging based on accurate, evidence-based information is vital, it is not in itself enough. We also need effective strategies to combat the spread of misinformation and disinformation. Can the Minister say what the Government’s counter-disinformation unit is doing to tackle this infodemic and does he agree with the Democracy and Digital Technologies Select Committee of this House that the delay to the online harms legislation means that the UK currently lacks the appropriate laws to tackle the spread online of misleading and harmful content related to Covid-19?

As infection rates rise and regulations change, uncertainty and anxiety increase, so there is an urgent need for the Government, media platforms and civil society to work together to combat misinformation and disinformation and mitigate the risks they pose to the efficacy of regulations such as those we are debating today.

Anti-obesity Strategies

Baroness Bull Excerpts

Monday 14th September 2020 Lords Chamber

Asked by

[Baroness Bull]

To ask Her Majesty’s Government what assessment they have made of the impact of anti-obesity strategies on people suffering, or recovering, from eating disorders.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, eating disorders are serious life-threatening conditions, and it is important that people have access to the right mental health support in the right place and at the right time. We carefully consider all views on our measures to reduce obesity. This includes feedback from a wide range of experts in response to our public consultations on specific policy proposals.

[Baroness Bull (CB)]

My Lords, as the Minister says, eating disorders are indeed serious mental health issues, but their relationship with obesity is complex. Many obese people also live with eating disorders, which means treatment is not always as simple as rebalancing calories in and out. Does the Minister accept the expert advice that elements of the new strategy, like food labelling and calorie counting, are dangerous triggers for eating disorders, and that slogans emphasising personal responsibility stigmatise people whose obesity has more complex roots than a failure to get a grip? Will he agree to meet with me and eating disorder specialists to discuss how this important strategy can be more effective for its intended audience and avoid collateral damage for those people for whom “Eat less, exercise more” is a dangerous message?

[Lord Bethell (Con)]

My Lords, I entirely agree with the noble Baroness that serious eating disorders are complex, and we need to resource the medical attention required by people with serious mental health issues. However, I do not completely align with her view that all obesity is not a matter of personal responsibility, nor that the education of people about the content of their food through labelling cannot be an important part of our battle against obesity. Covid has spelt it out clearly to all of us. Some 67% of the country is overweight in some way or another. But this is a policy that we are determined to get right, and I would very much welcome the opportunity to meet with the noble Baroness and her team.

Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020

Baroness Bull Excerpts

Thursday 3rd September 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, the statutory guidance to these regulations is clear that, prior to issuing a direction, local authorities must have due regard to the Equality Act 2010 and should consider carrying out an equalities impact assessment to determine whether the measure might disproportionately affect people with protected characteristics. However, the guidance makes no provision for those with impaired mental and decision-making capacity, which means it is unclear whether and how these regulations apply to people who cannot fully understand them, or what the consequences are of them not following them.

It is therefore not clear whether someone with reduced mental capacity would be subject to criminal sanction for unwittingly breaking local lockdown rules. Nor is it clear what is supposed to happen in a case where this new power is used to remove someone with impaired capacity from a restricted area or a mass gathering. Can the power also be used to return the person to their home, or does it seize as soon as they are outside?

Expanding the statutory guidance would help local authorities to meet their obligations to those people with reduced mental capacity, while clear, unambiguous guidance would help those people and the people who care for them to comply more easily with the regulations. It would also reduce the potential for unintended contravention, avoiding the messy question of whether criminal prosecution could follow. Can the Minister commit to reviewing the statutory guidance to include the need for local authorities to take into consideration reduced mental capacity, in accordance with the Mental Capacity Act, when exercising their power to impose restrictions?

Folic Acid

Baroness Bull Excerpts

Thursday 3rd September 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, the 2006 SACN report Folate and Disease Prevention found that there was insufficient human data to say conclusively whether increased levels of blood folate from fortification might impact on the efficacy of anti-folate medication, which acts in chemotherapy by blocking the action of folic acid. The 2017 update is silent on this issue. Can the Minister clarify whether the absence of a reference to this issue is because there is still insufficient data, or is it because research has ruled out any adverse impact of mandatory fortification on those patients taking anti-folate medication?

[Lord Bethell (Con)]

My Lords, I am not aware of any conclusive scientific evidence that contradicts the benefits of folic acid. As I said, the demographic data would seem to suggest that experiences in other countries have been benign. Longitudinal studies take a very long time to emerge and, therefore, we are not expecting a massive change in that data. However, back at the department, I will ask if any science has emerged and I will write to the noble Baroness if I can put my hands on anything.

Covid-19: Response

Baroness Bull Excerpts

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, it is put to me week in, week out that our relationship with directors of public health is in some way troubled. I reassure noble Lords that, every single day of the week, we are in contact with dozens of directors of public health in amicable, constructive dialogues that lead to concrete action, local interventions and sharing of data. These conversations happen in a cordial and friendly fashion. The message may have got through to some noble Lords that there is some huge acrimony and difficulty between us, but that is not the perspective that I have. The data has got through. It is a hell of a thing to have put up a huge track and trace system in a few months. That we can get such detailed data to a large number of people within the envelope of reasonable data security legislation is nothing short of a miracle. I am extremely proud and pay tribute to those involved.

[Baroness Bull (CB) [V]]

My Lords, I want to follow the noble Lord, Lord Reid of Cardowan, in pointing to ONS data, this time data showing that 60% of all deaths from Covid-19 have been among those living with disabilities. A recent report from Oxford University and the Bonavero Institute of Human Rights found a failure of government to embed social and human rights models of disability in its response to the pandemic, and a failure to support people with disabilities to make the adjustments required to comply with fast-changing regulations and to continue to live flourishing lives. Will the Government commit to an immediate review of the impact on disabled people of legislation passed during the coronavirus crisis, and will they put in place a disability-inclusive Covid-19 response and recovery action plan which involves people with lived experience of disabilities in decisions on economic and social recovery as well as ongoing healthcare guidance?

[Lord Bethell [V]]

My Lords, it is a horrible truth that this disease hits hardest those with vulnerabilities. We have put in place a massive national programme to seek to protect the most vulnerable, and those with disabilities have been very much the focus of our attention. I cannot make the commitments that I know the noble Baroness wants me to make, but I reassure her that those with disabilities are the focus of what we are trying to do.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020

Baroness Bull Excerpts

Friday 24th July 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, I should like to highlight the implications of these regulations for people with disabilities or impaired decision-making capacity and for those who support them. Once again, new regulations have come into effect that offer no clarity on how they should be applied when someone lacks the capacity to understand that they are in contravention of the law, or on the responsibilities of a person using these powers in regard to those with impaired decision-making capacity. The Oxford University Disability, Law and Policy Project at the Bonavero Institute of Human Rights recently reported on the impact of coronavirus-related law, policy and practice on people with disabilities. It found a failure on the part of the Government to implement properly their legal duties with respect to these people’s rights.

Last week, charities called on the Prime Minister to prioritise the national disability strategy and factor the needs of disabled people into every change in regulations going forward. Can the Minister confirm that the Government will respond positively to this plea? If they act now, there may still be time to mitigate the immediate impacts of this crisis and its long-term consequences for people living with disabilities.

Food: Fruit and Vegetables

Baroness Bull Excerpts

Monday 6th July 2020 Lords Chamber

[Lord Bethell]

My noble friend touches on an interesting area. I cannot answer it precisely. I am not sure that we have taken any assessment of the effect of eating vegetables and fruit during the lockdown, but I will find out from the department and write to the noble Lord.

[Baroness Bull (CB) [V]]

Can the Minister clarify where responsibility lies for overseeing the nutritional quality of food delivered to children eligible for free school meals? During Covid, reports have circulated on social media of packages containing crisps, chocolate biscuits and a block of fat marked “for cooking only”. In response to a letter by leading food policy experts, sent to both Defra and Public Health England, each body seemed to indicate that the other should be held responsible. Does the Minister agree that, without clarity on this, the focus on good nutrition is at risk and accountability too easily sidestepped?

[Lord Bethell]

The noble Baroness is right to cast a spotlight on an apparent area of policy confusion. Labelling is normally associated with Defra, and the provision of school meals with the Department for Education. If there is ambiguity about that, I would be happy to chase it down for the noble Baroness.

Covid-19: Response

Baroness Bull Excerpts

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

I am afraid I did not hear the full question from the noble Baroness, but if I understood her correctly, she referred to track and trace. I reassure her that we are putting a huge amount of resources into that surveillance. It is true that surveillance does not currently exist. We do not have the facilities that some Asian countries, such as Taiwan and South Korea, had following SARS, about which we now know so much. We are putting the correct resources in place, and we hope very much to have a detailed local and demographic understanding of where and how the disease is progressing. That information is essential to beating it.

[Baroness Bull (CB)]

My Lords, many people in learning disability care services have very complex care needs that make them vulnerable to Covid-19. Indeed, recent numbers from the CQC showed that the provisional number of deaths reported across all settings where autistic people and/or people with learning disabilities may live was 175% greater than expected over the month from 10 April. When will the welcome extension of testing to all care settings announced today roll out? Can he confirm that regular testing will be available, given the potential of the virus to be spread between care homes by so-called bank staff filling temporary vacancies?

[Lord Bethell]

The noble Baroness is entirely right that the deaths of those with learning difficulties have been one of the most disturbing and sad aspects of this disease. We are focused very much on ensuring that we protect those with learning difficulties, such as those with autism, in whatever way we can. With regard to recurrent testing, the tests that we have are not a limitless resource and we have to prioritise them. Although we have massively increased the number of tests that we have, it is not possible to test millions of people on a very regular basis with hundreds of thousands of tests. However, we are using them intelligently and prioritising areas where there are infection control problems. We believe that that is the most effective way of using our resources.

Covid-19: Vulnerable Populations

Baroness Bull Excerpts

Tuesday 12th May 2020 Lords Chamber

Asked by

[Baroness Bull]

To ask Her Majesty’s Government what assessment they have made of the measures in place to protect vulnerable populations during the COVID-19 pandemic.

The Question was considered in a Virtual Proceeding via video call.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, social distancing and shielding measures are in place to protect vulnerable and clinically extremely vulnerable populations. Those identified as clinically extremely vulnerable are advised to stay at home with no face-to-face contact until at least the end of June. Our approach is under continuous review. The Government’s position on shielding and social distancing reflects the latest SAGE and clinical advice from the Chief Medical Officer.

[Baroness Bull (CB)]

My Lords, every person with a learning disability has the right to be supported to live in their community, but Covid-19 is putting already-delayed in-patient transfers at risk. In March some 1,900 adults and 200 children were still locked away in in-patient units, the majority sectioned under the Mental Health Act and staying for five years in facilities intended to be short-term. Can the Minister share his department’s updated assessment of whether the Mental Health Act easements provided for in the Coronavirus Act will be required, now that the peak in infections has been passed and a plan for lifting restrictions is taking shape? Does he share concerns that these easements, if enacted, would risk the delivery of the care needed to support community living and the achievement of the goals set out in Transforming Care?

[Lord Bethell]

The noble Baroness, Lady Bull, asks a searching question. On whether the Mental Health Act easements of which she speaks have already been enacted, I will have to find out exactly what those arrangements are and write to her. However, I assure the House that the care of the most vulnerable is absolutely the Government’s number one, top priority. It is true that some of those caring and providing important pastoral care for the most vulnerable have been worst hit by Covid—the examples she gives are really good ones—but we are absolutely putting the care of the most vulnerable at the top of our priorities.