Folic Acid

Baroness Kennedy of Cradley Excerpts

Wednesday 23rd June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I entirely agree with the noble Lord that we are committed to following the science and are totally persuaded by it. However, I cannot avoid the fact that there were elections in devolved nations, which have meant that politicians and Secretaries of State in some of those countries were not available to engage with. I am pleased to report to the House that we have made a lot of progress in engaging with the devolved nations. We could not possibly do this policy without their support, buy-in and alignment. Progress is continuing at great pace, and I look forward to returning to the House and updating it at a future date.

[Baroness Kennedy of Cradley (Non-Afl) [V]]

My Lords, in March this year, the noble Lord said that the Government were taking time to create a

“solution that is endorsed by mill owners, paediatricians and all the relevant stakeholders.”—[Official Report, 23/3/21; col. 720.]

Given that the position of UK flour millers is acceptance if the Government decide to introduce mandatory fortification, and given that there is overwhelming support from the medical community, why are the Government dragging their feet and not introducing this measure, when it is proven to reduce neural tube defects in babies? Next month is the 30-year anniversary of when this link was proven. Why are we taking so long to put this measure in place?

[Lord Bethell (Con)]

My Lords, the noble Baroness is entirely right: medical opinion on this matter has absolutely consolidated around support for it, and the consultation in September 2019 was extremely positive indeed. I am extremely grateful to mill owners, both the large industrial ones, which make a lot of the white flour, and the artisanal mill owners, which had complexities of their own. The engagement with them has been enormously positive, and I cannot see any obstacle on that front. However, there is a machinery of government point that needs to be addressed: we have to work it through the devolved nations and other arm’s-length bodies, and we are doing that at pace.

Covid-19: Tracking

Baroness Kennedy of Cradley Excerpts

Wednesday 30th September 2020 Lords Chamber

[Baroness Kennedy of Cradley (Non-Afl) [V]]

Have the Government set a target for the number of people who need to download the NHS Covid app for it to be an effective solution for suppressing the virus? If so, what is the target and what are they doing to reach it, should it exist? More generally, what are they doing to increase the number of people using the app?

[Lord Bethell (Con)]

My Lords, there is no particular target where the app becomes relevant or non-relevant. Some 14 million downloads to date is a remarkable number and the app is already proving effective, with a substantial number of people having received notifications from the proximity device and who are now abiding by isolation measures. We have a massive marketing campaign that has been seen by 97% of the population and ongoing activity, particularly among hard-to-reach communities and the young, to support the downloading and use of the app.

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

Baroness Kennedy of Cradley Excerpts

Friday 24th July 2020 Lords Chamber

[Baroness Kennedy of Cradley (Non-Afl) [V]]

My Lords, I thank the noble Lord, Lord Bethell, for his explanation of these regulations. I will ask a few questions in the short time I have. Has the regime of fines already put in place by the Government been effective? How many fines have been issued to date? What amount has been collected and where does the money go? Does the Minister think it fair to fine an individual £100 for not wearing a face mask when the Government’s advice on this issue has been so confusing? Finally, what is the Government’s advice for shop workers, who are confused and worried about their role in enforcing these fines?

Covid-19: Masks

Baroness Kennedy of Cradley Excerpts

Thursday 11th June 2020 Lords Chamber

[Baroness Kennedy of Cradley (Lab) [V]]

My Lords, there is strong scientific evidence to support the obligatory use of face masks as part of a strategy to fight Covid-19. To name a few examples, as mentioned by my noble friend Lord Campbell-Savours, there is the modelling survey published yesterday by the Universities of Greenwich and Cambridge; the compelling evidence from Japan, Hong Kong, South Korea and Germany; and evidence that shows that droplets can linger in the air for tens of minutes, which potentially rides roughshod over the effectiveness of measures for queueing in shops. With shops reopening on Monday, social distancing will become harder. The government advice is to wear a face covering where social distancing is not possible, especially indoors, but when we decide to go to a shop, we will have no idea how empty or busy the streets or shops will be. Rather than the government advice remaining vague and weak, should the advice not now be strong and clear: wear a mask to protect others and their mask will protect you?

Covid-19: Cancelled Medical Operations

Baroness Kennedy of Cradley Excerpts

Wednesday 10th June 2020 Lords Chamber

Asked by

[Baroness Kennedy of Cradley]

To ask Her Majesty’s Government what assessment they have made of the impact of cancelled medical operations due to the COVID-19 pandemic.

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

My Lords, NHS trusts were rightly asked to postpone elective activity to free up capacity to support the response to Covid-19. The latest data shows that there was a 30% reduction in the number of completed admitted patient pathways in March 2020 compared to the same month last year. Data for April is due to be published by NHS England tomorrow. The NHS is safely restoring urgent non-Covid services, catching up on the backlog, and ensuring that surge capacity can be stood up again should it be needed.

[Baroness Kennedy of Cradley (Lab) [V]]

My Lords, thousands of patients with non-Covid conditions are not getting the treatment they need, and thousands more with life-threatening diseases such as cancer are going undiagnosed every day. Yet we see reports that private facilities, which the Government are paying for, are either empty or hosting only a trickle of NHS patients. Can the noble Lord say how many private beds paid for by the Government are being used by the NHS, and what is the Government’s plan to stop waiting lists hitting 10 million by Christmas?

[Lord Bethell [V]]

My Lords, I do not have the precise figures which the noble Baroness asked for. However, I reassure the Chamber that the NHS is working hard to ensure that those who need urgent surgery, such as cancer patients, have it, and we have committed a substantial amount to the Help Us, Help You media campaign, which is having an impact in restoring confidence in returning to hospitals.

General Practitioners

Baroness Kennedy of Cradley Excerpts

Wednesday 17th October 2018 Lords Chamber

Asked by

[Baroness Kennedy of Cradley]

To ask Her Majesty’s Government what progress they are making in increasing the number of general practitioners in England.

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

My Lords, the Government still intend to increase the number of doctors in general practice by 5,000, but we recognise that this will take longer than hoped. Last year we recruited the highest number of doctors into GP speciality training. There is also a broad offer for GPs to stay in the NHS, including a £10 million retention fund. Furthermore, since 2015, more than 3,000 other clinical staff are working in general practice.

[Baroness Kennedy of Cradley (Lab)]

My Lords, properly resourced, general practice is key to keeping people well and relieving wider pressures on the NHS, yet the Government’s target of 5,000 more GPs by 2020—or whatever date they are now going to set—is in tatters. Workload pressures, oversubscribed patient lists and funding shortfalls are driving down GP numbers. Statistics published this month show that the number of GPs has fallen by 6% since 2015, with the June 2018 figure 1,400 below the target set. Is there a plan to adjust the recruitment target to account for the year-on-year loss? Can the Minister confirm the actual delivery date for the target?

[Lord O'Shaughnessy]

The noble Baroness is correct, unfortunately: she is using accurate figures. We have not achieved the GPs numbers that we wanted but we still intend and need to recruit those other 5,000 GPs. It is worth pointing out that the funding for general practice will have increased by around £2.5 billion over the five years between 2015 and 2020, so I do not accept her point about funding shortfalls. The money is there, but we need to recruit more GPs and keep them in the service.

Dental Care

Baroness Kennedy of Cradley Excerpts

Thursday 1st February 2018 Lords Chamber

Asked by

[Baroness Kennedy of Cradley]

To ask Her Majesty's Government what action they are taking to improve dental care in England.

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

My Lords, the Government are committed to increasing access to dentistry and improving oral health outcomes, particularly for disadvantaged children. Across England, access to NHS dentistry is improving. We are also reforming the current dental contract to increase dentists’ focus on preventing, as well as treating, disease and oral ill health. Alongside this, NHS England’s Starting Well scheme will help children in high-need areas to access appropriate dental care.

[Baroness Kennedy of Cradley (Lab)]

I thank the Minister for that reply, but dental care in England is in crisis. Charities now provide emergency dental care. A quarter of all five year-olds have tooth decay. More than half of dentists plan to leave the NHS within five years and government spending on NHS dentistry has fallen by £170 million since 2010, meaning that patients pay more and more. The NHS dental contract that the Minister mentioned needs urgent reform—something that Labour recognised back in 2009. Why, despite running pilots since 2011, are the Government now saying that they need more time—a couple of years, perhaps—before wider rollout can even be considered? By what date, therefore, do the Government expect to deliver reform to these urgently needed NHS dental contracts?

[Lord O'Shaughnessy]

I am afraid I do not recognise the picture that the noble Baroness paints. She is quite right that 25% of five year-olds are not decay-free; obviously, that is not good enough, but that figure has been increasing over the past 10 years. I should also point out that there are more dentists practising in NHS dentistry than ever.

The noble Baroness is quite right that a pilot has been going on in 75 dentists’ surgeries. An evaluation report will be produced by the deputy Chief Dental Officer in the next few months. That will set out the path toward the full reform of the dental contract.

Health: Obstetrics and Gynaecology

Baroness Kennedy of Cradley Excerpts

Monday 17th July 2017 Lords Chamber

Asked by

[Baroness Kennedy of Cradley]

To ask Her Majesty’s Government what action they are taking to address the issues raised by the Royal College of Obstetricians and Gynaecologists programme Each Baby Counts.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, the Government and NHS England are supporting NHS maternity and neonatal services to address the Each Baby Counts recommendations on clinical care, human factors and reviewing cases with poor outcomes. Key initiatives include the Saving Babies’ Lives care bundle, an £8 million maternity safety training fund, which includes multidisciplinary training on team working and communication, a maternal and neonatal health safety collaborative programme, and a national standardised perinatal mortality review tool.

[Baroness Kennedy of Cradley (Lab)]

I thank the noble Lord. This report by the royal college, which I believe is the first of its kind, creates a national measurement and a national picture, and shows that over 500 babies who died or suffered brain injuries during birth could have had different health outcomes if they had received different care—the human cost of a maternity service which is thousands of midwives short, underresourced and under increasing pressure and demand. How are the Government addressing the chronic shortage of midwives in the NHS, when new figures out last week, I believe, showed that more midwives are leaving the service and fewer midwives are joining it? Will he meet me and representatives of the royal college to discuss how training can match the implementation of the recommendations in the report and how best those recommendations can be continued in the work of midwives?

[Lord O'Shaughnessy]

The noble Baroness is quite right to highlight the appalling tragedies involved. As she said, over 500 families could have had different outcomes if the care they had received had been different. That is worth dwelling on because every one of these incidents is a human tragedy. She highlights midwives. There are over 2,000 more midwives in the National Health Service and 6,500 in training. There has been a big increase in the number of births in recent years, so the number has had to rise. Of course, I would be delighted to meet her to discuss the training and to make sure that it is the very best available so as to avoid and, as the Secretary of State has said, to reduce the number of maternity incidences in future years.

National Health Service: Nursing Staff

Baroness Kennedy of Cradley Excerpts

Monday 16th June 2014 Lords Chamber

Asked by

[Baroness Kennedy of Cradley]

To ask Her Majesty’s Government why there has been a reduction in the number of senior nurses in the National Health Service since 2010.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, local NHS organisations are best placed to determine the skill mix of their workforce and must have the freedom to deploy staff in ways appropriate for their locality. Some organisations have reviewed their nursing staff structures to ensure that they are delivering quality of care for patients. This has resulted in a decrease of some senior posts. However, there has been an overall increase in nursing numbers, with over 3,300 more nurses, midwives and health visitors since 2010.

[Baroness Kennedy of Cradley (Lab)]

I thank the Minister for that reply, but since 2010 there has been a decrease of 4,000 senior nursing posts—modern matrons, ward sisters and specialist nurses, which we all recognise, as indeed do the Government, as being universally critical to patient care. Are the Government not worried about the fact that, on the one hand, trusts are saving money by decreasing these senior nursing posts yet, on the other hand, they are spending money by increasing the pay of executive directors by 6%? What are they going to do about reversing this worrying trend, and how are they going to tackle this dangerous loss of experience and skill in our NHS?

[Earl Howe]

My Lords, the figure that I have is in fact a decrease of just over 3,000 nurses in senior positions at bands 7 and 8, but that is more than made up for by the increase of over 7,500 nurses at bands 5 and 6 on the front line. On the noble Baroness’s second point, the figures that I saw emanating from the Royal College of Nursing should be looked at with some caution; the RCN has included exit packages for executive directors but not for nurses. In fact, the latest independent evidence shows that for the third year running there was no increase in median executive board pay. It is important to compare like with like there, and the figure of 6.1% as a rise for executive directors is not one that we recognise.

National Health Service: Nursing Staff

Baroness Kennedy of Cradley Excerpts

Monday 12th May 2014 Lords Chamber

Asked by

[Baroness Kennedy of Cradley]

To ask Her Majesty’s Government what steps are being taken to ensure adequate levels of nursing staff in the National Health Service.

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, patient safety is paramount. Patient safety experts agree that safe staffing levels should be set locally. Local NHS organisations are best placed to determine the skill mix of their workforce and must have freedom to deploy staff in ways appropriate for their locality. We have commissioned NICE to develop guidance on setting safe staffing levels and to endorse safe staffing tools. If hospitals do not have sufficient nurses, the Chief Inspector of Hospitals will take action.

[Baroness Kennedy of Cradley (Lab)]

As today is International Nurses Day, will the noble Earl join me and many others in this House in paying tribute to the hard work of our NHS nurses? Further, can he explain why, since 2010, the actual number of qualified nurses has fallen and nearly 4,000 senior nursing posts have been lost? What are the Government going to do about that worrying reduction in experience and skill in nursing in our NHS?

[Earl Howe]

My Lords, I readily join the noble Baroness in paying tribute to our nursing workforce, whether in acute settings, in the community or, indeed, in any other setting. In fact, if the noble Baroness consults the official statistics, she will see that there are more nursing, midwifery and health visiting staff at present than there ever have been in the history of the NHS. Since the election, more than 5,100 more nurses are working on our wards, there are more than 1,700 more midwives and more than 2,000 more health visitors. We have been able to fund these increased numbers by a reduction in administrative staff—today there are more than 19,600 fewer administrative staff. I would be interested to hear where the noble Baroness gets her figures from but, as she will have gathered, mine are completely in the other direction.