Folic Acid

Baroness Hayman Excerpts

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

I reassure the noble Lord and others who have pressed this point that it is a departmental priority. There has of course been a pandemic and that has slowed things down. I cannot avoid that fact, but we are very much returning to the prevention agenda in the round and the issue of folic acid in particular.

[Baroness Hayman (CB) [V]]

My Lords, the Minister will understand the frustration in the House at the repeated delays in implementing a policy that has the opportunity substantially to reduce the scale of suffering that goes on, because of our failure to implement the implications of research that, I remember and as has been said, showed the benefits of fortification in the 1980s. It is desperately dispiriting to know that that research has been taken up by other countries, but not the UK. I press the Minister and suggest that it would be extremely helpful if the meetings that he has said need to take place with the devolved Administrations could be arranged now. Perhaps he could write to the noble Lord, Lord Rooker, copying the letter to other noble Lords, to tell us exactly when the meetings that he has described are scheduled.

[Lord Bethell (Con)]

I hear the frustration loud and clear and reassure the noble Baroness that we are working on this at pace.

Health and Social Care Update

Baroness Hayman Excerpts

Monday 22nd March 2021 Lords Chamber

[Baroness Hayman (CB) [V]]

My Lords, a descent into a tit-for-tat vaccine war would obviously be disastrous, given the global nature of both vaccine supply chains and the pandemic itself. Given the worrying developments that we have seen in this area, what research has been done and consideration given to the possibility of mixing and matching second doses with a different vaccine—something which was talked about originally and might become necessary in the light of particular difficulties in supply chains?

[Lord Bethell (Con)]

My Lords, I completely agree with the noble Baroness that a descent into some type of vaccine war would be extremely regrettable, and the British Government are doing everything they can to continue in a spirit of partnership with overseas Governments. We have not reached the possibility of taking on a mixing and matching approach. We believe that the supply chain we have in place is ample to achieve the targets we have already published. However, to answer her question directly, there is some evidence that mixing and matching may prove to be even better than having two of the same vaccine—that it may stimulate the immune system in ways that give you a more developed response to the virus. Therefore, we continue to look carefully at this possibility.

Covid-19 Vaccines Deployment

Baroness Hayman Excerpts

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am afraid that is not the view of the scientists at the moment. I am extremely glad about all those who have had their first jab, but the very strong recommendation is that everyone has to abide by the lockdown rules at the moment. The transmissibility is still there: a person who has had the jab can still, and often may well, be infected by the disease, carry it and communicate it to someone who has not had the jab. They remain a danger to the community and, until a very large number of the population have had the jabs, those protocols will remain in place.

[Baroness Hayman (CB) [V]]

My Lords, I will first follow up on an earlier question. I am not sure that the Minister managed to reply on the issue of when and if we are expecting evidence on the interval levels between doses on the Pfizer, rather than the AstraZeneca, vaccine?

My main question is about how, given the impressive and successful vaccine programme, we have to recognise that it has mobilised enormous effort and resources. There is growing evidence that Covid will be with us long-term, so it is not a one-off exercise. Can the Minister share government thinking on the sustainability of the programme—for example, the potential for future programmes to be combined with the annual flu vaccination drive or for a single bivalent vaccine against both diseases?

[Lord Bethell (Con)]

My Lords, I reassure the noble Baroness that the interval protocols for the Pfizer vaccine have been completely endorsed by the JCVI, the CMO and the MHRA. They are extremely clearly endorsed by the British authorities, and she should feel enormous confidence in our approach to that.

However, the noble Baroness is right: I do not know, and cannot say for certain, what the long-term prognosis is. We do not know what the transmissibility of the disease will be with the current vaccine. We are working on new versions of it that should address the South African variant, but we do not know for sure whether that will prove dominant in the UK. It is the view of the CMO, Jon Van-Tam, that it will not beat either Covid classic or Covid Kent—but it is not certain whether that is the case right now.

We do not know whether there will be a rolling programme of mutations that roll on to the shore and require us to update the vaccine regularly—or whether we will have to hold our borders as they are now until we have the kind of vaccine development programme that can turn around refreshed vaccines within, say, 100 days. Those are all possibilities; we are putting in place the necessary plans in case that should be required, but it is my confident hope that the current vaccine will have a massive impact on Covid and that we can return to something that approaches normal in the very near future.

Vaccine Rollout

Baroness Hayman Excerpts

Monday 25th January 2021 Lords Chamber

[Lord Bethell (Con)]

It is not a question of one place taking precedence over another. I take a moment to applaud and pay tribute to GPs in Sheffield, and to all those who have proceeded at pace and got through their allocation as quickly as they could. That is absolutely the right priority and the right approach, and it is how we are going to get through the population very quickly. However, some people will get through their list more quickly than others, and it would be a mistake then to start asking them to move down the list when there are still those with very high priority who need to be vaccinated. Although I understand that it may be frustrating for a GP to stand idle, those are the practicalities of what we are doing. The mass vaccination centres are essential to deal with the very large numbers of people that we plan to vaccinate over the next few months. That is why the Sheffield vaccination centre is such good news.

[Baroness Hayman (CB) [V]]

My Lords, I support the Government’s utilitarian public health approach to the spacing of vaccine doses, but does the Minister accept that the argument is dependent on an understanding of the full implications of different dosage regimes, and that a lack of specific data on this particular point in relation to the Pfizer vaccine is fuelling concerns? Will the Government now undertake research on this specific point as part of a vaccine rollout programme, to underpin robust and well-supported policy implementation, both here and in many other countries that could benefit from this data?

Covid-19: Vaccine

Baroness Hayman Excerpts

Tuesday 12th January 2021 Lords Chamber

[Lord Bethell (Con)]

I congratulate my noble friend and Lady Eccles on their double vaccinations. It is one of the most heartening experiences of a pretty dreadful year to witness the rollout of this vaccination and the joy and reassurance it brings to those who have been vaccinated. I reassure my noble friend that the NHS is absolutely putting the resources in place not only to roll out the single and second vaccinations to everyone over 18 who will step up for those but also for the pharmacovigilance to ensure that any adverse effects are recorded through the Yellow Card scheme and that those records are analysed and acted upon so that any changes or tweaks, as sometimes happen, are enacted by the NHS to get the best possible outcome for as many people as possible.

[Baroness Hayman (CB) [V]]

My Lords, may I ask the Minister another question about evidence? When do the Government expect to have clear advice on the possible transmission risk from those who have been vaccinated? Everyone I know who has received the vaccine—they have been delighted to do so and impressed by the efficiency of the NHS—is now talking about meeting their Pfizered friends, seeing grandchildren and returning to volunteering or to your Lordships’ House. Does the Minister acknowledge that there will need to be cogent and clearly communicated advice for those who have been vaccinated, many of whom have been in virtual isolation for nearly a year?

[Lord Bethell (Con)]

The noble Baroness delivers tough news to her friends and to the Chamber, and I completely agree with her analysis. The frustrating truth is that, while the efficacy of the vaccine has been tested on hundreds of thousands in clinical trials, and we can lean on that data extremely well, the transmissibility of those who are immune is not yet clear. We have put in place trials and testing regimes to understand and get to the bottom of this point. But she is entirely right: it is possible, although not proven at the moment, that those who are themselves immune are not sterile but vectors of infection. Were they, for instance, to return to this Chamber, they would potentially infect those of us such as my noble friend Lord Parkinson, who is extremely young and does not qualify for the vaccine any time soon, and who could catch the virus off an octogenarian noble Lord in an instant.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020

Baroness Hayman Excerpts

Tuesday 1st December 2020 Lords Chamber

[Baroness Hayman (CB) [V]]

My Lords, first, I apologise to the Minister because IT problems meant that I could not hear some of his introductory speech. What I did hear, earlier this afternoon, was some of the debate in another place on these regulations. No one listening could be left in doubt about the divisiveness of the proposals before us today, especially in relation to boundaries for the new tiers. These have created a deep sense of injustice and division between regions, areas and communities within regions.

For a variety of understandable reasons, the Government abandoned the clarity and sense of the whole nation being subject to the same constraints that we have had since early November. However, they have patently failed to convince people that the variants in restrictions are properly tailored and appropriate to the situations in the communities in which they live and with which they identify. A lack of respect for local leadership, knowledge and capacity has, I fear, been a recurring feature of the response to Covid, particularly in relation to test, trace and isolate. We must not make the same mistakes when it comes to the rollout of vaccinations.

When the tiers are reviewed on 16 December, I would urge a review of the basis of the boundaries so that they are seen to be more justifiable and fairer, which would engender better compliance. Data is available at the district and borough level on incidents, hospital admissions and all the issues that the Government say they will take into account. This data should be used to produce boundaries based much more on social geography and local conditions than on administrative areas. I recognise that, even if there is greater granularity and that reduces the sense of injustice, it will not eliminate it. The Government need fundamentally to improve the information and communication that they present.

For example, as others have said, the impact statement for today’s debate hardly engenders confidence in the very difficult, nuanced judgments the Minister and his colleagues are making, although I have huge sympathy for them. They can afford to be honest with the population. At the beginning of this pandemic, maybe there were many people who thought there would be an answer—that if they followed “The Science”, we would know what to do. We know that is not the case. We know that we must weigh up a number of factors and balance a number of different harms to try to find the least bad solutions to working our way through this. It is a complex and contested field, and the public are grown up enough to understand that.

I urge that in assessing what boundaries we use and the immediate effects on health—the dangers of Covid and how we protect people from it, as against the longer-term and indirect effects on health and well-being from unemployment and lack of access to normal health services—we respect individuals in our society enough to be frank about how those judgments are made and assessed.

Before I finish, I will say two things. First, most people want to do the right thing; they want to protect themselves and those they love. The Government need to help us do that. They need to empower us with access to testing, by ensuring that the test, trace and isolate systems are effective and working, and by making sure that people do not suffer from being good citizens and obeying what they are asked to do if they have been in contact with others.

Lastly, I was struck by what Dame Sally Davies said yesterday. We ask ourselves all the time why we have seen so many deaths and so much difficulty in coping with this as a country. She pinpointed the underlying public health issues this country faces: deprivation, obesity, dependence on alcohol and the issues that lead to social disadvantage and all that bundle of disadvantages that create ill health and vulnerability. When we review what has happened, I hope we will recognise social injustice as an underlying cause. [Inaudible.] This is not just about PPE but about reversing some of the social injustices in our society.

[Baroness Penn (Con)]

My Lords, now is a good moment to remind speakers of the time limit for this debate, which is six minutes for Back-Bench contributions.

Covid-19 Regulations: Assisted Deaths Abroad

Baroness Hayman Excerpts

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely correct; the Director of Public Prosecutions’ policy for prosecutors in respect of cases of encouraging or assisting suicide sets out factors which prosecutors in England and Wales will consider, in addition to those already outlined in the code for Crown Prosecutors when deciding whether it is in the public interest to prosecute in cases of encouraging or assisting suicide. Among the public interest factors tending against prosecution are that the victim had reached a voluntary, clear, settled and informed decision to commit suicide and that the suspect was “wholly motivated by compassion”. I completely take on board the noble Lord’s encouragement of this review. There is no review planned, but we all acknowledge the changing tone of this debate and I will take his suggestion back to the department. On the point about Scotland and data, I acknowledge different circumstances in Scotland and the remarks on the importance of collecting data from my noble friend in the other place. That is indeed our intention.

[Baroness Hayman (CB) [V]]

My Lords, the Minister’s response to the second question today was more reassuring than his response to the first. I am sure he would agree that these are desperately difficult situations for families, and to have the uncertainty about whether someone would have to undertake alone a journey that should never be undertaken alone because of a wish to protect their relatives from prosecution is frankly unthinkable. On the wider point, could he assure the House that some urgency will be given to this issue of collecting data and seeing in the round the problems that are being caused? We have had piecemeal changes such as the changes from the DPP, but we need to understand more comprehensively the exact implications of what is going on.

[Lord Bethell (Con)]

The noble Baroness is entirely right; Covid has, in a very sad way, thrown a spotlight on the circumstances of those dying alone. That is one of the harshest and most heart-breaking dimensions of this awful pandemic. It throws a spotlight in particular on the way in which the law is applied in this country. The collection of data is a very important component of our review of this important area and I will definitely ensure that the indication given by my right honourable friend in the other place is picked up back at the department.

Covid-19: Local Restrictions

Baroness Hayman Excerpts

Friday 9th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, where the department has used secondary legislation to put in place measures to tackle the coronavirus pandemic, these regulations stipulate that a review of the measures will take place within 28 days. In making a decision on how to proceed, we comply with our legal duties, and all the relevant Acts—the Equality Act, Public Health Act, National Health Act and the family test. We keep the situation under continuous review to consider whether the measures contained in the regulations are still a necessary component of our effective response.

[Baroness Hayman (CB) [V]]

My Lords, Covid is not a one-off, short-term emergency. There will be difficult judgments and hard decisions to be made for many months ahead. Does the Minister accept that it is imperative that we find a way to ensure legitimacy for those decisions by gaining parliamentary assent before, not after, they are taken, and that parliamentary assent before should be the rule, not the exception? Does he further accept, as I believe, that those decisions would actually be improved and better accepted by the population because of the challenge they would receive in public, in Parliament?

[Lord Bethell (Con)]

Well, my Lords, our rule—if there is a rule—is that we are clear that our measures should be locally led. We work with local leaders first and communities to take swift action to prevent and manage outbreaks, ensuring that our responses work for them, supported by a national service which they plug into. It is for that reason that we are considering local tiers. Local alert levels or tiers are designed to standardise the interventions in place in local areas across England to make it easier to communicate what restrictions apply, and in what areas, to the public.

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

Baroness Hayman Excerpts

Friday 18th September 2020 Lords Chamber

[Baroness Hayman (CB)]

My Lords, like others, I find playing the game of legislative scrutiny catch-up unsatisfying and less than we should be doing as parliamentarians. I address my remarks to the rule of six, which was mentioned at the end of the Minister’s speech, and to one specific provision: the decision, in England, to include primary school-aged children in the total of people allowed in the gathering of six.

The other countries of the UK have taken a very different position on this issue. It is clear that young children are not at serious risk themselves. Equally, the evidence suggests that they do not pose a substantial risk of transmitting the virus to others. In any case, the children who will be caught by these regulations are already, in almost every case, members of families that are included in the total of six. So if I am no longer able to meet my son, daughter-in-law and their three children together, I can exclude one of the twins, perhaps, from that gathering to comply with the law. However, if I and my husband meet my four individual sons, themselves heads of households, that will not be illegal, but the risk of that is infinitely greater than the risk of including children.

I understand that this has been done in the interests of simplicity and clarity, but we have also to act in the interests of logic and common sense. I hope that the Minister will assure me that we will monitor the effects in the other countries of the UK and change if necessary.

[The Deputy Speaker (Lord Lexden) (Con)]

My Lords, I call the next speaker, the noble Lord, Lord McCrea of Magherafelt and Cookstown. No? I call the next speaker, the noble Lord, Lord Cormack.

Health: HIV

Baroness Hayman Excerpts

Monday 25th March 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

Knowledge about safer sex and sexual health is essential for young people. They must be equipped to understand and to make safe, informed and healthy choices. That is why we have brought in compulsory SRE for the first time, which all schools should be required to teach.

[Baroness Hayman (CB)]

My Lords, as well as the very welcome national strategy that the Minister described, will she accept that this is a global problem? In other parts of the world, progress has not been as great as it has been here. We need to see that progress. In that respect, does she recognise the work that the Global Fund to Fight AIDS, Tuberculosis and Malaria has had on reducing incidence worldwide of these killer diseases? Will she commit for the Government to be active in their leadership in the replenishment of the Global Fund this year?

[Baroness Blackwood of North Oxford]

We can be incredibly proud that the UK is a world leader in efforts to end the AIDS epidemic, including through our huge investment in the Global Fund, which has provided 17.5 million people with treatment since 2017, and of course through DfID’s research on HIV prevention. That is exactly why DfID has committed to continuing its focus on HIV prevention technologies and I am happy to share that commitment with the noble Baroness.