Arts: Energy Cost Support

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Thursday 20th October 2022 Lords Chamber

[Lord Kamall (Con)]

Ah, it was my noble friend; I thank noble Lords. Next time I will bring my rear-view mirror. One of things we have to be very careful about are those organisations that are commercial but also receive taxpayer or lottery funding. It is important that we understand which sectors needs support. We are constantly in conversation with individual venues, and the umbrella organisations of different sectors. We want to understand how the plan that we have put in place works and where it might not work, so we can look at the plans beyond March next year.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I can assure the Minister that the entire sector needs support at the moment. Of course he is right that choices have to be made. We are well aware that some of those choices may be very uncomfortable and will be threatening to a number of sectors. Could he reassure the House that the DCMS will fight the corner of the cultural sector when these challenges come forward? It can look very successful from in front, because it is a very successful aspect of our economy, but behind the scenes it is really struggling and it will need all the support it can get from the department.

[Lord Kamall (Con)]

The noble Baroness makes a very important point about the importance of our cultural sector to our economy, but also to the social life and well-being of so many people across the country. Sometimes that cannot be measured in simple econometric terms. I remember, from my time as Health Minister, how much social prescribing was helpful. Cultural organisations and individuals play a role in well-being, and help people get through difficult situations. I assure her that I am so excited to have this job because I am now the Minister for Civil Society—my dream job. I want to work right across the sector, with the heritage sector, the museum sector and others, to champion them, not only to the outside world but also within government.

Youth Sport Trust Report

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Tuesday 11th October 2022 Lords Chamber

[Lord Kamall (Con)]

The Government are refreshing the sport strategy at the moment. Noble Lords who took part in debates on the Health and Care Bill will remember that we talked about the cross-government approach to sport and physical activity. We are looking at a number of initiatives for improving it. We welcome reports such as this, as they highlight the areas that we need to focus our efforts on as we work out what has worked in the past and what we need to improve. We hope to fill those gaps where they exist.

[Baroness McIntosh of Hudnall (Lab)]

The Minister referred earlier to part of the Government’s strategy being to engage schools to try to get them to open for longer. This is a noble aspiration. However, he will be aware that school budgets were under pressure long before the energy crisis hit. They are now under much greater pressure from that and from other initiatives that the Government are requiring them to undertake. Can he give us an assurance that, if this thinking is taken forward, it is not simply added to the other burdens on schools without any additional resource to support it?

[Lord Kamall (Con)]

We are working across government on this. With DfE, we are looking at opening up existing sports and leisure facilities, including schools. We have to work with schools to work out what works for them and how we share the cost, to make sure they do not have an unfair burden on them. We are now working on the third phase of the opening school facilities programme to meet those needs. This phase will look at consistency in the school system and how to connect schools to national and local sporting activities and providers, as well as making sure that children get access to extra-curricular activities, whether at school or local sports clubs.

London Olympic and Paralympic Games 2012: Legacy

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Monday 10th October 2022 Lords Chamber

[Lord Kamall (Con)]

Yes, when I was being briefed for this Question, one of our discussions was about whether the Government would think about bidding for future events—not just athletics or major games but others. For example, one of the things we learned from previous events such as the Rugby League World Cup was that we could have concurrent rugby league world cups—the men’s Rugby League World Cup, the Women’s Rugby League World Cup and the Wheelchair Rugby League World Cup, around which they announced that they also organised a learning disabilities day. We want to learn as much as possible about whether it is always feasible to integrate these different tournaments rather than keeping them separate, and make sure that any buildings we use can be used by the local community afterwards so that it does not remain purely in the interests of elite sportspeople.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, to take the Minister back to the question from the noble Baroness, Lady Bull, and extend it into his wider brief, is he aware that many arts organisations—particularly small local museums and galleries—are acutely dependent on volunteers? The shortage of volunteers is not just an inconvenience to them but an existential threat. Can he expand a little more on what he expects government policy to do to help that?

[Lord Kamall (Con)]

One of the things I was very reassured by when I came into the department was how seriously it takes volunteering and what it wants to do for it. As I said earlier, we are looking at different ideas around how we can encourage volunteers in their communities—maybe putting their postcodes somewhere and linking them to their local community foundation, which can then signpost them to volunteering opportunities—and at people who want to set up a project when they have seen a problem in their community and want their hands held to set it up. We are looking at the full range of volunteering, from helping existing projects to creating new ones.

Mental Health: Advertising and Body Image

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Thursday 30th June 2022 Lords Chamber

[Lord Kamall (Con)]

My noble friend has asked me a very concise question, which will require a less concise answer. Clearly, there is a link between obesity and type 2 diabetes, for example, but one of the difficult things in this area, as with much in healthcare, is getting the right balance. The more emphasis we put on tackling obesity, the more unintended consequences there will be for people with eating disorders. There is now calorie labelling in restaurants and other out-of-home places, but some charities working with people with eating disorders are concerned that this may have a negative impact on them. It is always a difficult balance, but we must try to achieve it.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister and other noble Lords have raised the issue of social media. What assessment has he made—or is he aware of—of the influence of social influencers, particularly in cases where they are supported by commercial deals that pay them in part to promote certain kinds of advertising?

[Lord Kamall (Con)]

The noble Baroness makes a really important point about a contributing factor to people having poor body image. We know that there are influencers who promote certain products, and that they often alter their own image so that it is almost an idealistic image—whatever that means. Young people then feel inadequate when looking at those images. We also must recognise that this issue affects not just young people but a range of people—even older people. For them, it might be as a gentle a thing as a comb-over, but if that makes them feel better, great. We must look at this issue in its entirety, and it has been looked at as part of the online advertising programme.

Draft Mental Health Bill

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Tuesday 28th June 2022 Lords Chamber

[Lord Kamall (Con)]

I am sure the noble Lord is aware that one of the things we found when looking at the shortage of doctors—even though we have more doctors than ever before—was that some people are likely to stay close to where they were trained. That is why, for example, we have opened the new medical schools, and we are bringing more doctors into the system. Clearly, that will not happen overnight, since training to be a doctor takes a very long time.

We are also looking at what else needs to be done at that level. There are other pathways, such as nurses becoming doctors after a certain amount of time. Clearly, international recruitment plays an important role there. Our aim is to have an additional 27,000 mental health professionals in the NHS workforce by 2023-24. We are investing money to achieve that, but again, it is a question of how long it takes for the money to get through. At the same time, we must ensure that by having this additional workforce in the NHS, we are not squeezing out the voluntary sector but ensuring that we are working in partnership with it.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I am sure the Minister will agree that if we get to point of having to apply the Mental Health Act to a particular individual, the system has failed because that person is, by definition, in crisis. I entirely accept that this Bill is necessary because the current legislation is no longer fit for purpose—Simon Wessely’s review is a very salutary read in that respect—but it is none the less the case that what we really need is to better equip our preventive services to deal with incipient mental health problems as they emerge, trying to prevent them becoming critical. That has been alluded to, in various ways, during this discussion.

Can the Minister tell the House where the £900 million —I think that is what he said—that is being committed immediately to the improvement of mental health services is to be spent? The real crisis is in the availability of human resource to deliver the service. There simply is not enough of it, as many people in this House, and certainly beyond, know from personal experience.

[Lord Kamall (Con)]

As noble Lords discussed during the Health and Care Bill, prevention is crucial. One thing I became aware of when I became a Minister was, when talking to the NHS and others, how they want to move away from purely curing to prevention. In response to the noble Baroness’s specific question, I commit to write to her on the exact allocation of that, but there is one area that plays an incredibly important role. We know, for example, looking back on the crisis, that when we did not know how long it would last, that created a lot of uncertainty. Uncertainty is very unbalancing for people, and it is a huge factor in them having mental health issues. Clearly, one of the issues that came up during the Bill was the use of civil society organisations, social prescribing, music and art therapy, but also conversations—people being able to talk to someone about the issue they are facing and feeling they are not alone. Clearly, that is something we have looked at, in terms of prevention, but in response to the specific question I commit to write to the noble Baroness.

Long Covid

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

My noble friend is absolutely right that we must take this seriously. This is why, first, we have tried to map it to the three medical conditions I mentioned earlier: acute Covid-19, ongoing symptomatic Covid-19 and post-Covid-19 syndrome. We are also looking at the WHO definition, which defines post-Covid-19 condition as the condition that

“occurs in people who have a history of probable or confirmed SARS-CoV-2 infection; usually within three months from the onset of COVID-19, with symptoms … that last for at least two months”

and which

“cannot be explained by an alternative diagnosis.”

In my meetings with other Health Ministers from across the world, they want to learn from us what we are doing on long Covid and how we can co-operate better.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister has stressed the fact that the diagnosis of long Covid is quite tricky and variable, according to the period of time over which people have suffered from it. Can he tell the House what support the NHS is able to provide for GPs to understand how to look at people who are presenting with an unspecified collection of symptoms which might be long Covid? Can he also say what is being done to help employers to understand this?

[Lord Kamall (Con)]

The noble Baroness makes an important point because there have been some reports that patients feel that GPs have not taken their concerns seriously. In response, NHS England has worked with the Royal College of General Practitioners to provide advice for GPs on the identification and management of long Covid. They have also worked with Health Education England to produce e-learning modules on Covid-19 recovery and rehabilitation. Rather than take up too much time, I commit to writing to the noble Baroness on her second question.

Eating Disorders

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Tuesday 1st March 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord is absolutely right; it is not just about understanding the issue but resolving it. Before the pandemic, we were meeting the targets of ensuring that people with disorders were seeing a specialist. Sadly, as a result of the pandemic, we have fallen behind. One of the reasons we are investing extra money in community health for adults and children now is to ensure that we catch up and make sure that people who are suffering with eating disorders are seen by clinicians who understand the issues and the differences between types of eating disorders, so that they are not misdiagnosed or given inappropriate information.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister will know that, although we routinely associate eating disorders with adolescents in particular, they may have roots in adolescence but sometimes emerge very powerfully in later years. They are consequently a lot more difficult to diagnose and manage. The noble Baroness, Lady Parminter, used the word “manage” in talking about how these illnesses should be treated. It is a matter of concern that GPs in particular and hospital services are extremely overstretched. The long-term management of remitting and recurring eating disorders is very hard to sustain. Can the Minister tell us what the Government are doing about that?

Eating Disorders

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Monday 17th January 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness raises a very important point about how we identify children and young people who are suffering from these disorders or may be a few steps away from it. We know that there are programmes from the Department for Education and our department to tackle mental health issues in schools, identifying pupils and encouraging them to come forward, to talk to a counsellor in the school, and making sure that there is signposting in the right place to ensure that we can tackle their issues.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, the Minister mentioned that eating disorders do not always present in the same way. He will be aware that some fluctuate, moving from chronic to acute over a period and back again. When people seek treatment for eating disorders, at the moment those who can afford it are not even able to access treatment in the private sector. If they were able to, however, would they then be able to access NHS treatments at a later date, for example, should they not be able to afford to continue with private treatment?

[Lord Kamall (Con)]

The noble Baroness raises a really important point. It is an issue that was raised over the weekend, in an individual case. I know that we are always advised as Ministers not to get involved in individual clinical decisions, but in this this case a child had not yet got a bed and the parents wanted to take them out for private treatment until a bed became available. They were told that if they went to use the private sector they would be put at the back of the list. I am trying to get more details on this but it seems a lack of common sense. I want to understand why it is happening, but I have not had an answer yet.

Breast Screening

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Tuesday 14th December 2021 Lords Chamber

[Lord Kamall (Con)]

I have previously announced government investment in retention programmes and looking at getting back those who have retired and increasing training places in medical schools and elsewhere.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, going back to the question from the noble Baroness, Lady Fookes, could the Minister remind the House exactly what is the rationale for not including women over 70 in the screening programme, given that, as he has conceded, vulnerability to breast cancer increases with age?

[Lord Kamall (Con)]

The Marmot review found that screening women outside the ages of 50 to 70 could lead to overdiagnosis and to referring women for unnecessary tests and overtreatment. But women in other categories with a very high risk of breast cancer—those with a family history, for example—are often screened earlier and more frequently. Women are not automatically invited for breast cancer screening if over 71, but they can request screening themselves.

Covid-19 Update

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Wednesday 8th December 2021 Lords Chamber

[Lord Kamall (Con)]

Yes. Given the advice on testing, especially if you are pinged and have to test, clearly we will make sure that there are sufficient tests available.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, can the noble Lord say a word about enforcement? In my observation of the use of face masks on London transport, for example, compliance has increased significantly in the past week, so there is a disposition on the part of many people travelling to comply. But there are still a significant minority—and that minority is important—who do not comply and do not appear to carry or exhibit any evidence of exemption. Will people whose job it is to ensure that people on public transport or elsewhere are wearing masks get the help and guidance they need to understand where the limits of their powers might be?

[Lord Kamall (Con)]

Enforcement has been a constant concern throughout, and workers have been concerned about having to enforce. The police and certain transport operators may issue fixed penalty notices to those who refuse to wear a face covering when required to do so and are not exempt or do not have a reasonable excuse. This will be used only as a last resort. The fines will start at £200, which will be halved if paid within 14 days. For repeat offenders, the second offence will be £400, the third £800, the fourth £1,600, the fifth £3,200, and the sixth and subsequent offences £6,400. The price mechanism will be used as a deterrent, but I am sure that the authorities will exercise discretion, so they may give an informal warning first, as has happened. They can also take measures if members of the public do not comply with this law without a valid exemption. They can deny access to public transport services, and direct someone to wear a face covering or leave a service if they are not wearing one without a legitimate reason.

HIV and AIDS

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Wednesday 1st December 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness makes a very important point of which we should all be aware. It is great that we are all living longer and, as I am sure noble Lords agree, that we are being sexually active for longer. The HIV plan sets out how we look at different—for want of a better word—segments or parts of different communities where there are issues, and how we target messaging there. That is the most important thing, rather than trying to have a one size fits all that others could ignore.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, there has been a huge amount of progress in the last 30 years since—I think I may say my noble friend—my noble friend Lord Fowler did his good work. But there is still work to do in this country. I noted that the Minister proudly referred to there being perhaps less stigma in this country than elsewhere. It is true that we have no room for complacency in this regard and that this is still one of the main reasons why people who should be tested are not being tested. Can the Minister tell the House the Government’s current assessment of the infected but untested rate of HIV/AIDS in this country?

[Lord Kamall (Con)]

I am afraid I do not have a specific figure for the noble Baroness, but the action plan sets out how we are going to increase access to and scale up HIV testing, by focusing on populations and settings where testing rates have not been high to ensure that we tackle them, that new infections are identified rapidly and that people receive the necessary treatment faster to prevent complications. We will operate the annual HIV Testing Week between 7 and 11 February 2022, and the campaign will be called “It starts with me”. During that week we will open self-sampling HIV testing services for all residents of England, and we want to make sure that lots of different programmes are raising awareness. I know that a number of noble Lords across the House take this issue seriously and I would welcome their advice.

Covid-19 Update

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Wednesday 10th November 2021 Lords Chamber

[Lord Kamall (Con)]

I start by thanking the noble Baroness, not only for her question but for the conversations that we have had to help my understanding of the subject and the consequences of some of these actions. I welcome the expertise from across the House when it comes to a number of health-related issues.

The consultation quite clearly said that many felt that vaccines remain our best defence against Covid-19 and that the vaccination programme has prevented thousands of hospitalisations and deaths in the UK. The more staff who are vaccinated against Covid-19, the more likely it will be that vulnerable people in their care, and other colleagues, are protected. Several studies have provided evidence that vaccines are effective at preventing infection and transmission—and beyond preventing infection have an additional benefit of reduced transmission by those individuals who become infected despite vaccination because of a reduced duration or level of viral shedding.

On the specific question, I am sure that the noble Baroness recognises—as I know from when we discussed these issues—how complex this issue is. There are ethical and health issues, and the concerns of patients and their families, who feel much more comfortable about being treated by staff who are vaccinated.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, I think that there are probably very few people, apart from hardened anti-vaxxers, who do not accept that vaccination is good and that it has done a huge amount to reduce the impact of the pandemic, which has had such devastating effects. However, following on from the question from the noble Baroness, Lady Watkins, it would appear likely that there will be not unintended but predictable and intended consequences as a result of this policy, which is that some NHS staff, and, more immediately, some social care staff, will simply give up doing what they do. In those circumstances, what advice is the Minister or his Government offering, particularly to private sector care homes, as to what they should do if faced with staff losses other than simply to reduce their capacity to take in new patients?

I noticed that the Minister did not pick up the question from the noble Baroness, Lady Brinton, about the example that people in public life—I name nobody in particular—can set by wearing their masks, appropriately, on all occasions when it is sensible to do so. What encouragement can he offer to the rest of us about further examples being set on that front?

[Lord Kamall (Con)]

There clearly are concerns. These were expressed in the stakeholder engagement that occurred with both the social care sector and other sectors that will need to bring this in from March next year—we are bringing it in now but with a grace period until next March. A lot of this engagement and consultation discussed how we can support staff who are unwilling to be vaccinated as well as understanding their concerns and whether employers see these as legitimate.

Thinking back to the beginning of the crisis, one of the reasons this was called for in care homes as quickly as possible was the data from the early part of the pandemic, when there were a disproportionate number of deaths in care homes. A number of people, including patient groups and families of patients, were quite adamant that if their relatives were in a care home, they wanted to make sure that they were being looked after by staff who had been vaccinated.

There is another vaccine that is a condition of deployment, that for hepatitis B. I have asked medical staff whether they are concerned about this and a number have said no, because they are already compelled to have the vaccine for hepatitis B. That is a condition of deployment and staff see this vaccine as just as essential. That assuaged some of the concerns I had over compulsion. These are difficult, unprecedented times. We would not ordinarily want to go with compulsion, but the health of the nation is at risk and many people want to feel much more reassured that they, or their family members who are receiving care, are looked after by people who have been vaccinated.

--- Later in debate ---

[Lord Kamall (Con)]

I thank the noble Lord for pressing on that point, as a number of others have. I am assured that the Prime Minister and his team followed all the rules that they were required to follow in that hospital, whether about face masks or otherwise. This is what I have been informed and it is all I can report.

[Baroness McIntosh of Hudnall (Lab)]

Since we have a little time left, could I ask the Minister to go back to the question of the support that care homes, hospitals and other healthcare settings may need in the not unlikely event that they will lose staff as a result of this policy? I completely understand that vaccination is highly desirable and that the intention is to encourage people to be vaccinated. However, it is pretty clear that some will not be and that will have an impact. What support will be on offer in healthcare settings to people who are having to cope with the impact of losing staff as a result of this policy?

[Lord Kamall (Con)]

In consultation with the social care sector and the wider NHS, including trusts, discussions have looked at the impact and what would happen, but also how to make the message more positive, how to encourage staff to take up vaccines and how to listen to their concerns. In some cases, employers have said that they do not feel that staff have given a legitimate reason for not taking up the vaccine, but they are also under pressure from patients’ families to make sure that they employ care staff who have been vaccinated. They are trying all the different areas of persuasion, including targeted campaigns and one-to-one conversations in some cases, to encourage them as much as possible. At the end of the day, even before the introduction of vaccinations as a condition of deployment, many care homes were already trying to push their staff to take vaccinations because they are concerned about their patients.

Covid-19: Plan B

Debate between Baroness McIntosh of Hudnall and Lord Kamall

Wednesday 20th October 2021 Lords Chamber

[Lord Kamall (Con)]

I am sure the noble Baroness will appreciate that all these issues are not necessarily binary, and that there are often a number of trade-offs, not only between economic and health factors but also within the health community itself. For example, there have been warnings that if we go down the route of more restrictive measures, we will see an increase both in patients who are unable to have the surgery that they had planned and in mental health cases.

[Baroness McIntosh of Hudnall (Lab)]

My Lords, taking the Minister back to the answer he gave to my noble friend Lord Rooker, on the issue of mask wearing, the evidence seems to be that wearing a mask does have an impact on whether viruses are transmitted, and in this case there is efficacy in respect not only of Covid-19 but of other viruses which could be circulating at this time of year and themselves putting pressure on the NHS. What is it that the Government cannot bear about asking people to wear masks? It has no economic cost, costs very little in terms of inconvenience and has a very significant impact.

[Lord Kamall (Con)]

I assure the noble Baroness that plan B does involve legally mandating face coverings in certain settings, such as public transport and shops. I am sure many noble Lords will have recognised, when they are travelling in by public transport, the number of people wearing masks on public transport, even though advice by the transport companies has dropped.