Care Home Occupancy Rate

Baroness McIntosh of Pickering Excerpts

Wednesday 28th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have written to local authorities to make it clear what the funding is there for and to make recommendations on the sort of financial support that may be needed to bridge this moment when occupancy levels have been reduced because of concerned families taking their loved ones out of care homes. That funding is in place, and it is up to local authorities to make their decisions on the matter.

[Baroness McIntosh of Pickering (Con)]

My Lords, what has the impact of the pandemic been on those who choose to receive care in their own homes? With the rise of closures of private care homes and fewer public sector beds being available, have we got the balance in provision right?

[Lord Bethell (Con)]

My Lords, there is an important area of support for those who decide to have care at home. During the pandemic, we did an enormous amount to ensure that there were infection-safe procedures and to reduce the use of itinerant care workers in order to provide safety for those who were at home. Support for those who choose to be cared for at home should be increased. I do not recognise the idea that the number of beds in local authority care has reduced so far, but I am happy to look into the matter.

National Health Service (Charges and Pharmaceutical and Local Pharmaceutical Services) (Coronavirus) (Amendment) Regulations 2021

Baroness McIntosh of Pickering Excerpts

Monday 26th April 2021 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

My Lords, I start by declaring my interest with the Dispensing Doctors’ Association, as in the register of Members’ interests.

I welcome the regulations before us this afternoon; the instrument makes a permanent change to broaden the existing arrangements for the supply of prescription items for pandemic disease or in other serious emergencies. As indicated by the Secondary Legislation Scrutiny Committee, there really are no downsides to this. The instrument

“allows specified medicines to be issued free of charge either on prescription or in response to a patient group direction (PGD), a pandemic treatment protocol (PTP) or serious shortage protocol (SSP) authorised by the Department for Health and Social Care.”

I welcome the opportunity to discuss the regulations before us. I also pay tribute to the role that community pharmacies have played in this regard—both generally and particularly during the pandemic. I would link to the role of community pharmacies the particular role that dispensing doctors have played. I once again ask my noble friend the Minister if, in the course of the afternoon, we could focus particularly on delivering medical care and pharmaceuticals in a rural setting, and ensuring that all aspects of rural life, including health policy, are delivered in a way which has clearly been rural-proofed.

I am delighted to join the noble Lord, Lord Hunt, and the noble Baroness, Lady Barker, in paying tribute to the role that community pharmacies play. But I would also like to pause for a moment and set out, as is referred to in the Explanatory Memorandum, the role that dispensing doctors have played. This is something of a lifelong interest for me because my late father was a dispensing doctor and my brother is a retired dispensing doctor. Dispensing doctors exist in rural areas because a pharmacy is not commercially viable. They date back to the time of Lloyd George and the National Insurance Act 1911.

It is important to appreciate that the income from dispensing cross-subsidises the medical service. Dispensing doctors do not have access to EPS—electronic prescription services—for their dispensing patients, over a decade since the system was introduced. That would seem to be a sign that perhaps rural-proofing in England is not working as well as it is in Wales, where they will be included for dispensing patients. Pharmaceutical needs assessment can place a dispensary under threat if a pharmacy application is made, unlike in Wales, where dispensing doctors are a full part of the pharmaceutical service, thanks to the Welsh department listening to the actions requested by the Dispensing Doctors’ Association.

Dispensing doctors are buying drugs in the same marketplace as pharmacies, yet their system of reimbursement and fees are different from community pharmacy. Despite this, as I understand it, NHS England and the department exclude dispensing doctors—in particular the DDA—from discussions on these matters. I ask my noble friend: why is that the case? The noble Lord, Lord Hunt, also mentioned that community pharmacies are excluded from these decisions as well. It strikes me that, immediately, the DDA, representing dispensing doctors and community pharmacies, should be at the table when these matters are discussed.

Most dispensing practices have vaccinated their patients against Covid as there is no scope for large centres in remote and rural communities. It is extremely difficult in areas such as sparsely populated parts of north Yorkshire for patients to access any such urban remote centre. Also, a lack of rural proofing harms rural communities. Primary care networks are being set up yet most dispensing practices are, in effect, their own primary care network given the large practice areas and dispersed populations that they serve.

As I mentioned previously, dispensing doctors are NHS GPs who are permitted to dispense medicines in designated rural areas where a community pharmacy is not economically viable. As I also said previously, dispensing practices use any profits that they make from the purchase of the drugs that they dispense to cross-subsidise the provision of the medical practice. That is often overlooked. There has never been any formal acknowledgement of this in England, although I understand that Scottish officials have done so before the Scottish Parliament.

In making the specific request to have regard the role of dispensing practices as well as community pharmacies in the dispensing of drugs under the regulations before us this afternoon, may I make a more general request to my noble friend that his department practise proper rural proofing? This will ensure that the work of, and reimbursement of, dispensing doctors in dispensing to their patients—often in rural, remote and sparsely populated areas—is properly addressed in the terms I have set out.

In that regard, I shall support the Motion to Regret before us this afternoon if the noble Lord, Lord Hunt, presses it to a vote. I hope that my noble friend the Minister will look sympathetically on the arguments I have made in favour of dispensing doctors specifically and the rural proofing of health policy more generally.

Covid-19: One Year Report

Baroness McIntosh of Pickering Excerpts

Thursday 25th March 2021 Lords Chamber

[Baroness McIntosh of Pickering (Con)]

I thank my noble friend the Minister for presenting the regulations before us. I declare my interest in working for the Dispensing Doctors’ Association. The importance of these regulations is the consistency and clarity of the message, so that the public and others can fully understand what we are being required to do.

I turn first to the regulation requiring the wearing of face coverings, the Explanatory Memorandum for which tells us what the road map outlining the four steps will be. They are:

“The vaccine deployment programme continues successfully; Evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated; Infection rates do not risk a surge in hospitalisations which would put unsustainable pressure on the NHS”


and

“Our assessment of the risks is not fundamentally changed by new Variants of Concern.”


The problem I have is that we have been told to expect a third wave and that we will have to adapt to any serious mutations and variations. We have now seen such a third wave in many continental countries, along with what they call the British variant, which I rather take offence to—I think we call it the Kent or the South African variation here. What are the plans to deal with a third wave, and with more serious variations and mutations? Should these not have been put into the regulations? I am not convinced that we have that information before us today.

I also support the conclusions of the Secondary Legislation Scrutiny Committee. In particular, it highlights that subsequent steps may not be brought into effect if

“local hotspots of infection … delay the lifting of national restrictions.”

I shall press my noble friend the Minister on this. What will the circumstances be under which those restrictions would not proceed?

In its report, the committee also talks about the fact that

“these Regulations impose a ban on all travel from England to a destination outside the UK”,

in which I have an interest because I have family in Denmark. To be honest, I would rather see them while they are alive than have to attend a funeral, which would be too late an event.

We are then told by the scrutiny committee that:

“A fine of £5,000 is imposed on anyone leaving England or being present at an embarkation point for the purpose of travelling outside the UK, without a reasonable excuse or an exemption”


and that

“Changes to these provisions are separate from the Steps and will be linked to reviews by the Global Travel Taskforce which will first report on 12 April”.


Are we going to have further regulations after that review? Since many of these things, as my noble friend Lord Lansley pointed out, are dealt with in the schedules to the steps regulations before us, it would be helpful to know that while we debate them today.

I pay tribute to all those involved in the success of the vaccination programme and congratulate my noble friend for being with us and appearing before us on so many occasions to facilitate our greater understanding of the regulations as they have been rolled out.

I would like to pause for a moment to look at the rural aspect not just of this but of so many parts of health policy and ask whether we can learn from recent experience. I hope that my noble friend will agree that vaccination delivery in rural areas has outstripped that in urban areas, and I think that the main reason for that is because primary care has taken the lead—they have outperformed and we should recognise that. The large, urban vaccination centres, which often cannot be accessed by those most in need, the vulnerable and the elderly, have not been as successful, and I understand that they have had many vaccinations left over at the end of the day.

That leads me to my general final point, which recurs in every aspect of policy but particularly in health policy. We are told that all health policy is rural-proofed, but we have it on record from the Department of Health that, in its view, Defra is responsible for rural-proofing. I ask my noble friend: have the regulations before us been submitted to Defra, or have they been rural-proofed by the department officials themselves? It is extremely important that vaccinations and testing take place as close as possible to where the patients live to enable us to drum down on any further outbreaks or mutations.

Health and Social Care Update

Baroness McIntosh of Pickering Excerpts

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I could not agree more heartedly; the vaccination of staff is a massive priority. Those figures give us cause for some reflection on how we can increase them. The adoption rate of vaccines by all healthcare workers has been much more impressive than on previous vaccine rollouts, so we are encouraged overall, but we are determined to hammer out all the last rock pools where people have not been persuaded. As I alluded to my noble friend Lord Cormack, we are looking at all methods to make sure that we get there in the end.

[Baroness McIntosh of Pickering (Con)]

I welcome the Statement, in particular the reference to the future discharge programme for hospitals. Does my noble friend agree that it is essential to rural-proof this policy? Will the Government look favourably on establishing health hubs in rural towns, to provide treatment and test availability and to allow the potential to avoid hospital visits?

[Lord Bethell (Con)]

My noble friend hits the nail on the head; who could think that a return to the previous regime of turning up at a GP’s surgery or a hospital every time you feel ill could possibly be a wise way of going about your healthcare system? Professor Sir Mike Richards has done an extremely good report on community health hubs, which we are looking at very closely; it has some very wise words that we are minded to follow up.

Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021

Baroness McIntosh of Pickering Excerpts

Monday 1st March 2021 Lords Chamber

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I am delighted to follow my noble friend Lady Wheatcroft. I look forward to the Minister’s answer as to what constitutes a rave.

I congratulate the Minister on bringing forward SI 97. I thank him especially for responding to the two specific points that the Secondary Legislation Scrutiny Committee identified in its report as wanting. The Government are closing these loopholes. They were accused of not sharing data effectively with the authorities to enable them to enforce self-isolation. They are also bringing forward a new fixed-penalty notice in the circumstances set out in the statutory instrument. Even though these measures were introduced six weeks ago in January, I congratulate the Government on the fact that we are now successfully tackling the potential spread. I welcome this instrument, which effectively tackles potential spread in the workplace and at illicit gatherings.

I will focus my attention on what I believe is still wanting and needs to be addressed as a matter of urgency, as other noble Lords have mentioned during this debate. We are failing to secure our borders successfully. It is obviously highly damaging that a potential victim of the Brazil variant of coronavirus is wandering around and has not yet been identified. We are an island, so it is easier for us to control access and entry into the country, whether by plane, boat or Eurostar.

I urge the Minister to go back to what used to happen, and it is a very simple solution. If you were travelling by plane—and this applied also to entry by ship or Eurostar—a white landing card used to be issued, filled in and handed in before landing. Presumably these cards were handed directly to Border Force. I urge my noble friend to have hard copies of passenger locator forms for this purpose on all planes, trains, boats and Eurostar services. That would ensure that any individual entering the country for whatever reason submits details of where they have come from and where they will be staying, so that Border Force and the police can access their whereabouts at the earliest possible stage.

Food-related Crime

Baroness McIntosh of Pickering Excerpts

Monday 22nd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the focus of the unit tends to be on either food that is unfit for human consumption, such as in the horsemeat scandal of 2013, which the noble Baroness will remember, or on the passing off of low-quality food with a higher-quality label. It is not involved in addressing the theft of food. However, I agree with the noble Baroness that getting good-quality food to all the population is a priority, and that is one of the Government’s priorities.

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I applaud the work of the National Food Crime Unit. The main function of the Food Standards Agency is food safety and surveillance. We are currently in the midst of a salmonella outbreak through the import of chicken nuggets from Poland. Does my noble friend share my concern that this raises serious issues about the food safety and surveillance system and why this outbreak was perhaps not detected during the import of this meat into the UK?

[Lord Bethell (Con)]

My Lords, I am across the recent outbreak of chicken nugget salmonella poisoning across the UK. However, I point to the work of the European distribution fraud unit, which is very much focused on this kind of cross-border food crime. I will take back to the department the noble Baroness’s recommendation and will write to her if there is any update that I can provide her with.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021

Baroness McIntosh of Pickering Excerpts

Monday 8th February 2021 Grand Committee

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I draw attention to my interests with dispensing doctors as in the register. I add my congratulations to the Minister, the Government and all those involved with such a successful vaccination programme in which we can all take great pride.

I draw my noble friend’s attention to one aspect of the South African variation which is causing deep concern across the medical community: the fact that the mutation, or the variation, that we are now identifying as coming from South Africa actually arose during South Africa’s summer, but nevertheless spread quite widely and rapidly throughout the community. Does my noble friend share my concern that this shows that this particular variation—and perhaps others to come—is not a seasonal variation but could actually spread throughout the warmer months? Have the Government done any specific research on this, and do they have any plans for how to tackle this particular dimension of this variation?

Looking ahead to the fact that there will be, in all probability, a need for a booster vaccination this autumn and in years to come, what plans have my noble friend and the department made to ensure an equally smooth rollout of booster vaccinations in addition to the annual flu vaccination for the elderly and, as was the case this winter, the over-50s? Will my noble friend give a commitment today that the department will rely specifically on rural GP practices to ensure a smooth rollout of both the flu vaccination, as in previous years, and a booster vaccination this autumn and in successive years? Will he ensure that GPs, being closest to their patients in very outlying areas, will be asked to deliver these as effectively as they have this year? Can he update us about the inclement weather and what delays the department is expecting to occur—albeit in the short term—to the vaccination timetable which has been rolled out?

Through my noble friend, can we pay a heartfelt thanks to all those involved on the front line, particularly in hospitals? As my noble friend mentioned, this has been a very long winter, and those staff in hospitals, ambulance services and paramedics have been stretched to the utmost. We owe them a great debt of gratitude for all the work they are doing and will continue to do for the foreseeable future. It is important that we pay tribute to the department and all on the front line at this time.

Medicines and Medical Devices Bill

Baroness McIntosh of Pickering Excerpts

3rd reading & 3rd reading (Hansard) & 3rd reading (Hansard): House of Lords
Thursday 21st January 2021 Lords Chamber

In a time of war, Beveridge realised the aspirations of people had changed. In the time of Covid, they are changing now, and we have to acknowledge that patients and the public voice must be heard. If private enterprise can bring forward a vaccine in under a year, Ministers, parliamentarians, the department and the healthcare system should rise to the challenge of reform towards a totally patient-oriented service. That is what I believe is essential for the future of our country and our future health and well-being.

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I am delighted to follow my noble friend Lady Cumberlege; I pay fulsome tribute to her and the team that, through her leadership, produced the report, First Do No Harm, from which we see this Bill. I would like to join her and others in paying tribute to my noble friends Lord Bethell, Lady Penn and Lord Howe, who I had the honour to work with, as a humble bag carrier, in the other place.

In recalling my interest with the Dispensing Doctors’ Association, I would like to make one plea to the Minister as this Bill proceeds to the other place. For clinical trials and patient safety, which is the focus of the Bill, which I wholeheartedly support, we need to rely on patients making their data available and giving consent for it to be used for clinical purposes. During the passage of the Bill, I raised what has now been seen in Denmark—a huge reaction against patient data having been abused and used for commercial purposes against the wishes, and without the consent, of patients. Were that to happen here, it would detract from the fundamental good of this Bill and the wider public benefit to the NHS and future patients of sharing the clinical data that permeates this Bill. I urge the Minister, therefore, to look seriously at the practical question that remains of how patient consent will be obtained and confidentiality respected, particularly in meeting the requirements of clinical need. But I am delighted to have played even a small part in the passage of this Bill, and we look forward to its passage through the other place.

[Lord Patel (CB) [V]]

My Lords, I am delighted to have this opportunity to express my thanks to the Minister—the noble Lord, Lord Bethell—the noble Baroness, Lady Penn, and all the other noble Lords who have been taking part in this legislation, in particular those who spoke to and supported my amendments from all sides of the House.

Much has already been said about what we have achieved. I know that time is running short, so I will try and be brief. Of course I congratulate, first and foremost, the noble Baroness, Lady Cumberlege, for achieving what I had tried before—getting patient safety on statute. I did not have her tenacity or clout. So, many congratulations to her and, I believe, the commissioner for patient safety, who will make patient safety stronger in the whole of the health service.

I am very grateful to the Minister, the noble Lord, Lord Bethell, to the noble Baroness, Lady Penn, and to the noble Earl, Lord Howe, for the many meetings they arranged with us to hear our concerns and find solutions. I know it is a privilege for me to speak in person, but I hope all my colleagues on the Cross Benches—more than 12 of them—who took part in the Bill will feel I can speak on their behalf to thank Ministers and all other noble Lords.

I am also grateful to members of the Bill team, who were very helpful at the many meetings that the Minister arranged. And I am grateful to outsiders, in particular the University of Birmingham faculty of law, which worked very hard to produce the details of the legislation. Thank you all.

Medicines and Medical Devices Bill

Baroness McIntosh of Pickering Excerpts

Report stage & Report: 2nd sitting (Hansard) & Report: 2nd sitting (Hansard): House of Lords
Thursday 14th January 2021 Lords Chamber

[Lord Lansley (Con) [V]]

My Lords, I am very glad to follow the noble Lord, Lord Freyberg, who has made some very cogent points, both in that speech and when we discussed these clauses in Grand Committee.

I want to make two points. The first is about the structure of Amendment 18. I am not entirely sure that I understand why pharmacovigilance has been singled out in the amendment as a reason why disclosure should be made, as distinct from, for example, public health co-operation or the pursuit of research. Indeed, the Minister referred to the sharing of information in relation to international clinical trials as a very good example. If one were to legislate in this form, it would be inevitable that the reference to pharmacovigilance would be regarded as having additional weight, and the absence of reference to other purposes for which information would be shared would be regarded as less important. I am not sure that that would be at all helpful to have in statute.

My other point is in relation to Clause 7(5). Government Amendment 22 refers to and introduces a provision that assists in understanding the relationship between this legislation and other enactments concerning the disclosure of information. Clause 7(5) states:

“Nothing in this section authorises a disclosure of information which … contravenes the data protection legislation (but in determining whether a disclosure would do so, take into account the powers conferred by this section)”.


Noble Lords may recall the Trade Bill and, in particular, the debate we had on the Trade (Disclosure of Information) Act just before Christmas and new year. We passed legislation the purpose of which was, among other things, to ensure that we clarified the relationship between that enactment and others that authorise disclosures of information or, in some circumstances, prohibit such disclosures. The particular basis for the structure of that Bill was to clarify a situation where there is a statutory gateway and other enactments that put constraints on the disclosure of information.

In subsection (5) it is clear that if someone is considering a disclosure that might contravene the data protection legislation, that legislation must be considered alongside the powers in this legislation. That enables them to satisfy the test in the Christian Institute and others v The Lord Advocate 2016 Supreme Court decision, as referred to in my noble friend Lord Grimstone’s letter to us about the Trade Bill. In the Trade Bill, though, as is the case in this Bill, we have reference both to the data protection legislation and to the Investigatory Powers Act. In the Trade Bill, amendments were introduced on Report to ensure that the saving reference—that is, when determining whether a disclosure would contravene the legislation, it takes into account the powers in this section—was applied to both the data protection legislation and the Investigatory Powers Act. However, in this legislation—Clause 7(5)(b) —the saving reference is applied to the data protection legislation but not to the Investigatory Powers Act.

My question, which I am sorry I have not had an opportunity to give the Minister notice of, as I have started working through these issues only very recently, is this. Having dealt with this matter on the Trade Bill, I would have thought that both these subsections should have the saving reference that allows the question of the contravention of those Acts to be considered, including reference to the powers in this Bill. I wonder if he would agree.

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I am delighted to follow my noble friend, who speaks with such great authority both as a former Secretary of State for Health and as someone who has followed the Trade Bill and the Trade (Disclosure of Information) Act so closely.

At the risk of dancing on the head of a pin, the amendments in this group are quite close, and the Minister set out every reason why we should support his Amendment 17. He said that information would be shared only in the circumstances where there is perceived to be a public need. The amendments and explanatory statement of the noble Baroness, Lady Thornton, refine that by saying that, in the context of giving effect to an international agreement or arrangement concerning the regulation of human medicines, it should be disclosed only provided that it is in the public interest to do so. A number of noble Lords have spoken with great eloquence and passion on these issues, including the noble Lords, Lord Patel, Lord Clement-Jones and Lord Freyberg, and my noble friend Lord Lansley. I have to say that I personally would draw the line at disclosing information for a commercial need as opposed to a public one.

I have a particular question about Amendment 19, which clearly states that patient information cannot be disclosed where the patient could be identified and that that information cannot be given without their consent. I remember that I was once asked to participate in a study; I signed the form and was delighted to do so, and never heard any more about it. I would just like to know how Amendment 19 would work in practice. At what point, and by whom, would the patient be contacted if that information was about to be disclosed and their consent sought?

I have reservations about this group. I remember the important debate that we had on the Trade Bill in this regard, and I am delighted to see that those issues are being considered in the context of this Bill as well. I have two concerns that I hope can be allayed. The first is that public need should not be deemed to collude with commercial need where it might not be in the interests of the patient. The second is about informed consent: how will the patient be consulted within the provisions of Amendment 19?

[Baroness Cumberlege (Con) [V]]

My Lords, this has been an interesting and well-informed debate, and I am quite reluctant to enter into it. I support government Amendment 19 and particularly Amendment 20 tabled by the noble Lord, Lord Clement-Jones. I hope I have got this right, although I am very happy to be put right if I have not. As I understand it, Amendments 19 to 25 concern consent, relating very specifically to the disclosure of information in accordance with international agreements. This is information that I think a relevant authority such as the MHRA holds in connection with human medicines.

As I listened to the noble Lord, Lord Freyberg, he raised a question in my mind about devices. We know that pharmaceuticals are much more closely regulated than devices have been, so can the Minister tell us a bit more about instances where there is a comparable agreement, and perhaps an amendment, for medical devices? I want to know whether they are on all fours with pharmaceuticals. I suspect not. Having listened to the noble Lord, Lord Freyberg, I think that there is more to hear on this.

--- Later in debate ---

[Baroness Masham of Ilton (CB) [V]]

My Lords, I am pleased to follow the noble Lord, Lord Lansley. I support Amendments 51 to 53 because it is important that the new clause will read “must” instead of “may”, so that the advice on medical devices will be clear and should be followed. “May” means it can be optional and makes the regulations weaker, and people might miss important aspects of care. There is no doubt that clear, correct information is the way to better patient safety. In many ways, communication within the National Health Service should be improved.

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I am delighted to follow the noble Baroness, Lady Masham, and earlier speakers in welcoming this group of amendments. I support government Amendments 50, 64 and 96 and welcome the placing of the advisory committee on a statutory footing, and particularly that the affirmative procedure will be used.

My question goes to the nub of Amendment 50—in which regard, if this is correct, Amendments 51 and others in this group will not be needed. Is it for the Secretary of State to decide what goes in the regulations on which presumably Parliament will be consulted under the affirmative procedure?

I can quite understand that the use of “may” appears to be discretionary, leaving open what should be included. Having got this far, it would be helpful to understand the thinking behind the use of “may” in Amendment 50, which indicates that this may be discretionary, whereas clearly it appears to be the will of the House that this is mandatory.

[Baroness Jolly (LD) [V]]

My Lords, we support these amendments from the Government and from the noble Baroness, Lady Thornton, which relate to the creation of a statutory committee to provide advice to the Secretary of State. Government Amendment 50 would allow the creation of such a committee in relation to medical devices, and the amendments in the name of the noble Baroness, Lady Thornton, in this group would require the Secretary of State to create the committee in Amendment 50, as the Government’s amendment states only that the Government “may” create the committee, not that they must.

No Secretary of State should be above independent advice. Amendment 50 is no bad thing, and of course any advisory committee on a statutory footing should consist of patients as well as experts. I understand that there might be kickback on the amendments in the name of the noble Baroness, Lady Thornton, but a Secretary of State will rarely have expertise in medical devices, so an ad hoc independent committee to inform, advise and warn would be very valuable. A lot of thought will need to be given to working out its terms of reference. We therefore support Amendments 51 to 53. As the noble Lord, Lord Lansley, said, it will also be critical to ensure how this committee will work alongside the MHRA.

--- Later in debate ---

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I am delighted to follow the noble Baroness, Lady Finlay, and speak on this group of amendments. I can see that the noble Lord, Lord Hunt, speaks with passion and some considerable knowledge and experience of NICE. But I am concerned and would just like to understand, as we have established that patient safety absolutely has to be paramount, that patient safety could not be compromised through either of the two amendments—Amendments 46 and 66—in this group.

The noble Baroness, Lady Finlay, set out in the earlier amendment in Committee a two-year licensing procedure and, now that we have obtained an assurance that the approval processes are to be revised, I would imagine that the same procedure as set out under Amendment 66 should be considered as part of that review and revision of the processes. I would also like to further understand how a role for NICE as set out in Amendment 66 actually fits in with the Bill before us today and, in particular, the role as set out, and just agreed, of what the advisory committee should be.

My concern is absolutely that patient safety has to be paramount—first, foremost and bottom line. In my view, what is sought to be set out in these two amendments in this little group should be best done as part of an overall review of the processes to which the Government, as I understand, are already committed.

[Baroness Masham of Ilton (CB) [V]]

My Lords, I am grateful to my noble friend Lady Finlay of Llandaff for alerting me to the fact that government Amendment 45 pre-empted our Amendment 46. They were grouped on different days, but I am pleased that others were thinking on the same wavelength.

I am very happy to support Amendment 66 in the name of the noble Lord, Lord Hunt of King’s Heath. The availability of medicines and medical devices is top of my priority list. In fact, antibiotics have saved my life on several occasions. It is important that NICE adheres to health equality: everyone who needs medicines or medical devices should be treated equally and there should be no delay. Unfortunately, with this devious coronavirus, this has not happened, but we hope for better days.

Having experienced a member of my family dying, I know that sometimes it seems worth trying anything that might help and that is in the research process. There are many really rare diseases which need orphan drugs; they can be a lifeline to the individual. I hope that NICE will consider them without delay and realise their importance and value to these small patient groups. It is so frustrating when patients in Scotland and other European countries can get medicines and medical devices, when those in England cannot; patients here have to wait—unless the public come to their rescue by crowd funding.

Many users of devices also need instruction on their use, and staff and patients need training. Personal medicine is so important and patient safety is absolutely paramount.

Covid-19: Vaccinations

Baroness McIntosh of Pickering Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely hear my noble friend’s encouragement, and her advocacy on behalf of business and a return to normal is heard loud and clear. The deployment is happening literally as quickly as we can possibly make it. I suggest to her that even NHS workers have to sleep, they have families, and it is not possible to run operations through the night on a mass scale. You cannot force people to turn up for a vaccine. I am not sure that the idea that millions of people will turn up at 4 o’clock in the morning for a vaccine is entirely realistic. However, my noble friend’s point about scale and whether we can move faster and turn around the situation more quickly is extremely well made. I reassure her that we are doing everything we possibly can.

[Baroness McIntosh of Pickering (Con) [V]]

Will my noble friend join me in congratulating dispensing GPs in rural areas on hitting the main target group of over 80 year-olds? Can he confirm that the latest spike in care homes may be attributable to the fact that a second dose is not being administered within 21 days? Will he revert to that practice as far as possible and ensure that the same vaccine is given for the second dose?

[Lord Bethell (Con)]

I pay tribute to the role of dispensing GPs, who will play an incredibly important role in the rollout. However, I reject the suggestion that any spike in care homes is in any way related to decisions on the second dose. The new variant has spread throughout society, including care homes, and that is the explanation for the spike.