Folic Acid
Baroness Jolly Excerpts(3 years ago)
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Lord Bethell (Con)
My noble friend is right: with half of pregnancies unplanned or unexpected, it is entirely right that we should seek to raise issues such as folic acid. The Government are committed to the preventive agenda, and folic acid is just one among many examples where we hope to mobilise public interest in looking after their own health to avoid these kinds of conditions. Her point is extremely well made.
Baroness Jolly (LD) [V]
My Lords, the department’s website states:
“More than 60 countries worldwide now add folic acid to their flour, including Australia, Canada and the US.”
It goes on to say:
“In Australia, neural tube defects fell 14%”.
This would save 400 babies a year in the UK. The department has spent the last year making Covid-related decisions in our best interests. Given the Minister’s comments, can we expect an announcement by the end of June?
Lord Bethell (Con)
The noble Baroness puts the statistics persuasively. The numbers I have are slightly different, but her gist is right. I hope to return after purdah to revisit this important subject.
Alcohol Harm Commission: Report 2020
Baroness Jolly Excerpts(3 years ago)
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Baroness Jolly (LD) [V]
My Lords, for such an excellent report, two minutes will not do it justice. The commission report that we are debating does not pull its punches and I would have been disappointed if it did. “It’s everywhere”—walk through any town or city centre in the UK from midday onward and it is difficult to miss those sitting on benches, amiable but often addicted to alcohol, drinking their cheap booze, which is often cider. At just over £1 for a litre of a supermarket’s own brand, that is a cheap way to get drunk. For the most part, they make no trouble early on; later, they can become rowdy and, after closing, violent. Local authorities license outlets—pubs, corner shops and supermarkets. Is it really necessary to have five outlets within a three-minute walk for a town with a population of just over 9,000?
This all comes at a cost, but, for many, after time, there will be an impact on their friends and families. Addicts are not easy to live with and relationships suffer. Health suffers too. Service providers need to be aware that primary services for those dependent on alcohol need to be fairly close to places of work or home for those who need them. Funding for services for addicts is from local authorities. Can the Minister guarantee that local authority public health services will still be funded through the future health and social care Bill? To move addiction services to the NHS would be a retrograde step.
There is also a woeful lack of psychiatrists training in addiction psychiatry in England. Can the Minister confirm that there is a nationwide drive to attract trainees?
I realise that there is no instant fix, but how successful are the Government in encouraging young health professionals to train in these areas?
Care Homes: Guidance
Baroness Jolly Excerpts(3 years ago)
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Baroness Jolly
To ask Her Majesty’s Government what assessment they have made of the impact of their guidance Visits out of care homes, last updated on 7 April, and in particular the requirement that residents making a visit out of a care home should isolate for 14 days on their return.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the Government do not underestimate the heavy burden of infection protocols on those who live in social care and on their loved ones. However, the public health advice is clear: once an infection enters a closed environment such as a social care home, it spreads far and fast, as we found out last year. We hope that the vaccines will change this and we keep the policy under review but, until the evidence is conclusive, the safety of residents remains our priority.
Baroness Jolly (LD) [V]
My Lords, care home residents have been cooped up for more than a year. Most of them have received two doses of the vaccine and many are becoming depressed at not being allowed to go for a walk with a family member, or even to vote in person at the polls. At a recent sitting of the Joint Committee on Human Rights, the pressure group Rights for Residents told the committee that
“the Government’s guidance on visiting out of care homes … is blatant human rights abuse”.
As the situation is easing somewhat, when do the Government expect to reassess that guidance?
Lord Bethell (Con)
My Lords, the noble Baroness puts the case extremely well. I do not deny her suggestion that this is a huge burden on those involved. However, data from the ONS makes it clear that, across care homes, when one case of coronavirus is reported, an estimated 20% of residents typically subsequently test positive for Covid—even under the current state of the vaccine rollout. We remember Holmesley care home in Sidford, Devon, where there were 11 deaths because of a major outbreak. We are still in the middle of the pandemic. The vaccine is making progress, but we have to take things one step at a time.
Covid-19: One Year Report
Baroness Jolly Excerpts(3 years, 1 month ago)
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Baroness Jolly (LD) [V]
My Lords, I too support the regret Motion in the name of my noble friend Lady Brinton, and I am sure that the noble Lord, Lord Cormack, speaks for many of us.
Many of my noble friends have covered the legislative points that I would have made. Trusting in their liberalism, I will look at this from a practical viewpoint. As things stand, overseas travel for pleasure is illegal. From 15 February, all arrivals at English, Scottish and Welsh airports and seaports are required to undertake two mandatory Covid-19 tests: one on day 2 and another on day 8 of their 10-day quarantine. All passengers, no matter which country they have travelled from, are already required to provide proof of a negative Covid-19 test, taken no more than three days before departure, and must self-isolate on arrival. A passenger locator form must also be completed, with fines ranging from £5,000 to £10,000 for failing to quarantine in a government-approved hotel or at home. Can the Minister tell us whether local government are leading on this work? How many quarantining arrivals slip the net? How many people are required to pay those eye-watering fines?
This system is not peculiar to travellers arriving in the UK. My son, who holds dual British and Australian nationality, has just quarantined in a Sydney hotel, at his own expense, prior to starting a job. After leaving the plane, he and all the other passengers were marched to a bus and delivered to the hotel. I understand that the plane was nearly empty of passengers. Can the Minister tell us what overseas examples were examined when our quarantine and test and trace systems were being set up? There are plenty of examples to look at, yet we ended up with a botched app which failed to work. Not once was I sent a warning notification via the app, yet I cannot believe that I never came close to a Covid risk.
We did not need to start from square one with this. There were plenty of good examples from across Europe and beyond, and I am sure that many noble Lords saw the “Panorama” programme broadcast last Monday. Several south Asian countries are acknowledged as good examples in dealing with Covid. The state of Kerala in India gave local, non-clinical community support to those extended families who were self-isolating, and the population at large were given out umbrellas that doubled as parasols but which, more importantly, were also automatic self-distancing devices.
The approach by South Korea was impressive. President Moon Jae-in spoke of the need for trust and calm. I am not sure how much trust and calm were around in the Department of Health and Social Care during the last year. The South Korean approach to Covid-19 was helped by experience in 2015 of MERS, another coronavirus, which claimed 38 lives. There was no lockdown, no businesses closed, and no hospitals were overwhelmed. Their track and trace systems were ready to go, but so were the regulations introduced for small and medium pharmaceutical companies to produce test kits very quickly. This measure meant that 120,000 tests could be carried out daily almost straight away, whereas the UK struggled to hit its initial target of 10,000.
Countries that have implemented successful test, trace and isolate systems have seen fewer cases and far fewer deaths and have built the trust needed to encourage a culture of voluntary compliance with the rules. It might be worth looking at this as, despite their best efforts, many think that a third wave is inevitable. An isolation policy will only work with an effective long-term local test and trace system, which will need to be in place to handle any outbreaks, whether small or large.
I echo the noble Baroness, Lady Quin, in congratulating the hundreds of volunteers who have delivered vaccines on their days off to countless older and vulnerable people. Those of us who have received our first vaccine know the sense of relief, which was almost instant; it is the first real step out of this bad dream. In light of the new truce, is the Minister confident that we can get our second AstraZeneca jab in early May? There is much concern in the community of older people. What is the department’s plan B? I hope that we will be back to business as usual next year, but I would not place a bet on it.
Covid-19: Resuscitation Orders
Baroness Jolly Excerpts(3 years, 1 month ago)
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Lord Bethell (Con)
The noble Baroness makes a very fair point; such care needs to be in the work plan particularly of those with learning difficulties, but of all those in care. We absolutely endorse the approach taken by the Resuscitation Council, which has extremely good guidance in this area.
Baroness Jolly (LD) [V]
My Lords, no one doubts the events described by the right reverend Prelate and noble Lords. By when can we be confident that the same could not happen again?
Lord Bethell (Con)
My Lords, we could not be moving more quickly. We got the report out before the end of the pandemic; we have acknowledged the issue and written numerous letters into the system, as I have mentioned; and we are putting in place the resources needed to support the necessary training and interactions. We are taking this extremely seriously and we are moving as quickly as we possibly can.
Folic Acid
Baroness Jolly Excerpts(3 years, 1 month ago)
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Lord Bethell (Con)
My noble friend makes the case extremely well. I reassure him that, in February 2020, officials from the DHSC and Defra met representatives from the Society for the Protection of Ancient Buildings’ Mills Section and the Traditional Cornmillers Guild and visited windmills and watermills to understand at first hand the practicalities around fortification for those premises. The commitments made on those visits will, I think, build a policy that takes into account the very special needs of those important artisanal trades.
Baroness Jolly (LD) [V]
My Lords, I commend the noble Lord, Lord Rooker, for his tenacity on this issue, and fail to understand why successive Governments have not recommended the addition of folic acid to flour, as well as fluoride to water, following many western Governments. For those who live on junk food, folate deficiency can turn into a serious disorder and, if left unchecked, can be fatal. In addition, the possible damaging effects to the foetus during pregnancy make this a no-brainer. The consultation closed 18 months ago, so when will the Minister bring the update to the House?
Lord Bethell (Con)
The noble Baroness puts the case well. It is an issue that I feel personally committed to; a cousin of mine was born with a neural tube defect many years ago, and the effects of that hit my family extremely hard. I recognise the problem of unplanned pregnancies and the need to find a way to get folic acid to people who were perhaps not intending to have a pregnancy. We take this matter extremely seriously, and I commit to returning to the House when we have an update on it.
Health and Social Care Update
Baroness Jolly Excerpts(3 years, 1 month ago)
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Lord Bethell (Con)
I am extremely impressed by the noble Lord’s perseverance on this issue. I know that he feels very strongly about the need for members of the public to be involved in policing the wearing of masks. However, that is simply not the way in which the British administration of guidelines is handled in this country; it is for those who are put in positions of badged authority to implement them. I simply cannot advocate that members of the public should intervene on one another to insist on, or apply any form of retribution regarding, the wearing of masks.
Baroness Jolly (LD) [V]
My Lords, I welcome the Statement and the Government’s ambition. At the end of the Statement, there is a commitment to building 40 new hospitals, hiring 50,000 more nurses and backing the NHS and social care. Can the Minister outline what sort of backing the social care sector can expect, and by when?
Lord Bethell (Con)
My Lords, I am grateful for the broad and large hook that the noble Baroness has provided me with. I reassure her that not only do we have a massive amount of support already in place for social care to help it through the current pandemic and the huge amount of pressure that has been put on its staff, residents and supply chain; we also have put in place an enormous amount of financial support for local authorities to ensure that they can provide the kind of improvements to social care that are needed. One area in which we have made enormous advances is care tech—that is, digital and technologically driven support. It has taken a huge step forward in the last year and impacted enormously on the lives of those in social care of all kinds.
NHS: Pay
Baroness Jolly Excerpts(3 years, 2 months ago)
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Lord Bethell (Con)
My Lords, the noble Baroness makes some vivid comparisons on completely incomparable pay differentials. The values that we have are absolutely aligned with public service values. We are determined to create a workplace that is just, fair and equitable. We are committed to giving people a fair reward for the work that they do and to giving people decent job prospects within that role. Those are the values that people go to work for and are motivated by. We need to put together a package that works across the piece and is not narrowly focused on one particular material point, such as pay. I stand by what I said previously: the package of measures that was put in our evidence to the pay review body sees all those values in the round.
Baroness Jolly (LD) [V]
My Lords, for the last 10 years NHS pay has lagged behind inflation. Year on year, health professionals have had less to spend than they had the previous year, and the 1% pay rise does not help as inflation removes any increase. Apart from the moral case put by noble Lords, this is not good economics. If people are paid more, they spend more by putting cash back into the economy. Will the Minister ask the Chancellor to look at this again?
Lord Bethell (Con)
My Lords, I am at a slight disadvantage because I am not quite sure that I can substantiate the noble Baroness’s view that pay has lagged behind inflation. Her economics lesson is extremely interesting but not one that the Chancellor is necessarily persuaded by. Where she is entirely right is that pay is an important aspect of any recruitment campaign by the NHS, and that is why we have put recruitment at the heart of our commitment to it. That is why we are recruiting 50,000 nurses and making a very large number of GP appointments. We are seeing huge gains in achieving those targets, which reflects the fact that there is not a massive or structural misalignment in our pay arrangements.
Women’s Health Strategy
Baroness Jolly Excerpts(3 years, 2 months ago)
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Lord Bethell (Con)
I reassure the noble Baroness that we are committed to getting this right. The Minister of State and Secretary of State are both very committed to this agenda, and the whole healthcare system has tuned in to the importance of getting this right. I pay tribute to some of the fantastic women whom I have worked with during the pandemic at the highest levels of the healthcare system. I will not do a rolling name check now, but I reassure the noble Baroness that there are some phenomenal female leaders at the top of the NHS, social care and science, who will, I am sure, personally drive this agenda forward.
Baroness Jolly (LD) [V]
My Lords, the Statement yesterday addressed “taboos and stigmas” around areas of women’s health, and the greatest of these must be FGM, which was not mentioned yesterday. In the year to March 2020, there were over 6,500 women and girls in whom FGM was identified: that is over 15 women a day that we know about. How do these girls and women fit into the national strategy?
Lord Bethell (Con)
My Lords, we are of course drafting the national strategy, and we are collecting evidence on what its priorities should be. Undoubtedly, FGM should be in there; it is the most horrific crime, and it still touches far too many girls’ and women’s lives. I would like to see this country rid of it forever as soon as possible, and I encourage the noble Baroness to submit evidence on that point so that we can move clearly on it.
NHS: Staff Numbers after Covid-19
Baroness Jolly Excerpts(3 years, 2 months ago)
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Baroness Jolly (LD) [V]
My Lords, the NHS is critically short of staff so it is a credit to all that over the pandemic the amount of care given increased by one-third with the total workforce short by 84,000. The scale and complexity of care have risen considerably over the last few years, and I trust that the NHS pay review body will take all this into consideration.
Our Chief Nursing Officer has £28 million to recruit internationally nurses and midwives who are keen to join the NHS front line. The global market has widened for the ethical recruitment of health and care staff by aligning with the WHO code of practice. How many overseas nurses does the CNO hope to recruit? The forthcoming health and care Bill, which I hope is innovative, puts a duty on the Secretary of State to report on workforce planning responsibilities, which would be an ideal opportunity for parliamentary scrutiny. Maybe then we can revisit the issue.