Coronavirus: UK Deaths

Baroness Merron Excerpts

Monday 29th July 2024 Lords Chamber

[Lord Robathan]

To ask His Majesty’s Government what initial assessment they have made of the number of deaths in the United Kingdom from coronavirus compared to other countries, and of whether the policy of lockdowns in 2020 was effective.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, estimates of excess mortality from the Office for National Statistics show that, between January 2020 and July 2022, the UK’s cumulative overall mortality rate was 3.1% higher than expected. Using this measure of excess mortality, the UK was ranked 15th highest out of 29 European nations examined by the ONS. Research funded through the National Institute for Health and Care Research estimates that national lockdowns saved more than 470,000 lives in the UK in the first few months of the pandemic.

[Lord Robathan (Con)]

I welcome the noble Baroness to her position. She may not remember, but I did ask the same question of the last Government. I am sorry that the noble Lord, Lord Vallance, is not answering the question, because he has an encyclopaedic personal knowledge of this—and I would like to welcome him to his position as well. I will pick up the noble Baroness on what she has just said, because it appears that the Swedish model had a lower death rate than the UK model. We know the impact on the economy, on mental health and particularly on children’s education that the lockdowns had, and the important thing, as the noble Baroness will know, is to not make the same mistakes again. So could she please examine this more carefully and come forward with an initial assessment on whether lockdowns, on a cost-benefit analysis, were worth having?

[Baroness Merron (Lab)]

I thank the noble Lord for his kind welcome and I hear his disappointment that it is not my noble friend Lord Vallance—who will be extremely flattered—answering. On the matter of lockdowns, I start by paying tribute to the British public; it was they who rallied to ensure that lockdowns could save lives. Before Oral Questions, I met with the Chief Medical Officer to discuss the very point that the noble Lord has raised. I say to the House that, when looking at other countries, it is very important to consider the complexity of comparison; it is just not possible to draw direct comparisons. But what I can say is that we are of course waiting for the Covid inquiry, which will shine a light on a number of the matters that the noble Lord has raised.

[Lord Patel (CB)]

My Lords, on a previous occasion when the noble Lord asked the same Question and cited the Swedish mortality rates, I cited a study carried out in Scandinavia comparing the Swedish model with Scandinavian countries that implemented lockdowns. It clearly showed that the death rates were lower in those Scandinavian countries that implemented lockdowns. To satisfy the noble Lord today, I asked ChatGPT to compile all the evidence. It said:

“In summary, while lockdowns during COVID-19 were effective in reducing death rates from the virus itself, they also had complex and varied impacts on overall public health. The net effect on mortality rates includes both the direct benefits of reduced transmission and the indirect consequences of restricted mobility and access to healthcare”.


Will the Minister agree that there is now some evidence that lockdowns were effective in reducing mortality?

[Baroness Merron (Lab)]

I thank the noble Lord for his informed observations. It is true to say that every Government were making decisions based on balance and that, with that, as the noble Lord said, not locking down would have meant that more lives would have been lost. It is important to put on record that the clear majority of professional opinion in this country was that lockdowns absolutely had their place. Even though there was a balance in terms of difficulties with mental health, access to services and the impact on the economy, in Opposition we supported the then Government, as we would in any national emergency.

[Baroness Neville-Rolfe (Con)]

I too welcome the noble Baroness to her role. On a less complex point, lockdown is a very expensive policy and should be used in very limited circumstances. So does the Minister agree in particular that damaging lockdowns in schools—this is about the education of our children—always need to be avoided if at all possible?

[Baroness Merron (Lab)]

I thank the noble Baroness for her kind welcome. Of course, this was a decision taken by the last Government, supported by the Official Opposition. I would say that these kinds of factors were complex rather than “less complex”. Nobody wants to have to lock down a country, but there are rare occasions when we have to consider that. Of course, circumstances changed under lockdown: the fantastic work of the vaccination programme and the vaccine allowed us to unlock. So it is always a moving feast—but I take note of the noble Baroness’s point about the impact on young people.

[Lord Scriven (LD)]

My Lords, the last Government decided to stop various methods for testing Covid-19 last year, other than for those in hospital. Other countries, including the USA, still collect data and the World Health Organization publishes it. So could I ask the Minister to help with public health screening and planning? Will the Government potentially look at this kind of testing being done again and the results published?

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[Baroness Merron (Lab)]

I will look into the noble Lord’s point and come back to him in greater detail. But, fortunately, we can observe at least that Covid-19 is now a relatively mild disease for the vast majority of people. That allows us to put in place a more targeted programme aimed at those who are at higher risk of developing serious Covid-19. It is important that we take technical and expert advice about where we put our efforts.

[The Earl of Clancarty (CB)]

My Lords, following on from the last question, will the Government ensure that the large number of long Covid sufferers do not become victims of the Government’s drive to get the unemployed back to work when what they need primarily is the right medical care and, if necessary, financial support while they get well again? The clue is in the name of the condition; this could be a long process for many, as the Minister will appreciate.

[Baroness Merron (Lab)]

I certainly do appreciate the point made by the noble Lord and certainly, as of April this year, there were some 90 adult post-Covid services introduced across England, along with an additional 10 for children and young people in the manner of hubs. I hope that will be a great support. Long Covid remains something of a new challenge, but these services are offering integrated assessment, medical treatment, rehabilitation and direct access to diagnostics and I can assure the noble Lord that we will not take our eye off the ball.

[Lord Sikka (Lab)]

My Lords, a report by the Institution of Health Equity earlier this year stated that, between 2011 and 2019, over 1 million people died prematurely from a combination of Covid, austerity and poverty, which is a shameful record for the last Government. Can the Minister assure the House that this Government will not neglect the poor and will protect and enhance the real value of wages and benefits?

[Baroness Merron (Lab)]

I can certainly assure my noble friend that we will be working across government to join up our approach because, as I have mentioned in a previous question, the complexity of all this is not to be ignored. Indeed, it is the case that people’s incomes, where they live, the lives that they are managing and how their health is—whether they are, for example, obese or smokers—all impact on health and affect excess deaths. It is our duty to find ways of reducing avoidable deaths and we will do so.

[Lord Lilley (Con)]

My Lords—

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[Baroness Bennett of Manor Castle (GP)]

I thank noble Lords. Following on from the question from the noble Earl, Lord Clancarty, about long Covid, and of course continuing new cases are arising even from apparently initially mild infections, we also face the threat that I hope the Government are watching closely of H5N1 in terms of other respiratory diseases, and we know it is only a matter of time before another respiratory pandemic faces us. What steps are the Government taking to look at air filtration and ventilation systems to provide a better public health system that is more resistant to future diseases in schools and other public buildings and perhaps to provide ways for people to assess in premises they visit how good the ventilation and filtration is for them to be able to go into those environments?

[Baroness Merron (Lab)]

The noble Baroness offers some helpful suggestions as to areas that we can be looking at, but this for me all comes under the headline of resilience and certainly we are monitoring potential emergencies, including the one that the noble Baroness refers to. I can assure her also that preparedness will not just focus on respiratory means of passing on disease but will now look at all of the five routes of transmission, and I feel that will make us a much more resilient country.

Black, Asian and Minority-Ethnic Women: Maternal Mortality Rates

Baroness Merron Excerpts

Monday 29th July 2024 Lords Chamber

[Baroness Gohir (CB)]

My Lords, I beg leave to ask the Question standing in my name on the Order Paper, and declare my interests as set out in the register.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I first pay tribute to the noble Baroness for her work with the Muslim Women’s Network, and for her excellent campaigning to end appalling inequities in women’s experiences across the country. Interventions such as enforced continuity of care for the most deprived and initiatives to tackle racism are key. However, further, urgent action is required. This Government are committed to closing the black and Asian mortality gaps and to ensuring safe and compassionate care for mothers and babies alike.

[Baroness Gohir (CB)]

I thank the Minister for her comments. A number of maternity reports tell us exactly what is contributing to the poor outcomes for minority-ethnic women and their babies. Will the Government bring the recommendations in those reports together to ensure that hospital trusts and medical professional bodies follow them? Will the Minister consider appointing a maternity commissioner, because it would save lives?

[Baroness Merron (Lab)]

I certainly agree with the noble Baroness that the maternity landscape is extremely crowded; there have been a number of reports and inquiries, along with investigations. I shall look very closely with officials at the recommendations from those reports as well as those that are forthcoming. With regard to an independent commissioner, I feel that there is general agreement about what the issues are, and the most important priority is to take action. Of course, in reviewing what is going on, as I am now in this post, I will consider all suggestions, and that includes the one from the noble Baroness.

[Baroness Uddin (Non-Afl)]

My Lords, I also thank my noble friend Lady Gohir for her continuous campaign. I declare an interest having been involved in these matters in Tower Hamlets for some 40 years. I congratulate the Minister on her ministerial role. When she seeks to consolidate these matters and take the best course of action, will she ensure that she looks at the reports that have been on the shelves at the Royal London Hospital trust for the best part of 40 years?

[Baroness Merron (Lab)]

I thank the noble Baroness for her kind remarks and good wishes. Certainly, all reports will be considered because we will look for what works.

[Baroness Benjamin (LD)]

My Lords, sickle cell disorder affects mainly people whose heritage is from Africa, the Caribbean and Asia, and the Sickle Cell Society’s report, No One’s Listening, shows that people with sickle cell experience discrimination when they engage with the NHS. We know that black and Asian women are four times more likely to die in childbirth. Can the Minister assure the House that NHS maternity units have the right level of training, staffing and systems to support safe care for expectant mothers living with sickle cell? I declare an interest as a patron of the Sickle Cell Society.

[Baroness Merron (Lab)]

The noble Baroness is quite right to draw the House’s attention to the important matter of sickle cell. We look to specialist midwives to assist us in this. I have been asked for a particular assurance and it is correct that the noble Baroness seeks that. I shall be pleased to look into it to be able to come back to her in much greater detail.

[Baroness Sugg (Con)]

My Lords, the previous Government introduced the first ever UK women’s health ambassador, who can help to co-ordinate the complex changes that are needed to reduce the mortality rate for black, Asian and minority-ethnic women and their babies. Can the Minister commit to continuing to support the ambassador’s work?

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[Baroness Merron (Lab)]

I pay tribute to the noble Baroness for her work promoting good health for women and girls, and I look forward to working with her and with other noble Lords across the House. One of the first calls that I made was to the women’s health ambassador and I will certainly look to her to drive forward the change and improvements in patient safety and patient experience that we desperately need.

[Baroness Prashar (CB)]

My Lords, while I welcome the Minister’s commitment to look at all the recommendations that have been around for a pretty long time, and it is frustrating that action has not been taken, can she give a commitment that once she has considered those recommendations, and if there is a plan of action, she will report to the House on what that plan is likely to be?

[Baroness Merron (Lab)]

I will indeed be very pleased to report back to your Lordships’ House on this matter. It is something that greatly concerns me, because it cannot be acceptable that women go into childbirth, which should be a happy and safe occasion, and perhaps come away with trauma, and in some cases families experience death as well. We cannot have a situation like that. I have been very moved by the stories I have heard and will commit to working to put improvements in place, and to sharing that with noble Lords.

[Lord Kamall (Con)]

My Lords, I welcome the Minister to her place. I look forward to working constructively with her as we did when our roles were reversed. Has she read the report by Sands, the baby loss charity? It gave examples of Asian parents being dismissed as either being too anxious or exaggerating their claims, while black parents were stereotyped as feisty or dramatic by some NHS staff. When I was a Minister, a young female civil servant told me about her friend, a young Afro-Caribbean lady whose baby died during birth. When she tried to get the records for what happened that evening, she was told that they had somehow magically disappeared. She was being gaslighted. We know that the majority of NHS staff are highly dedicated but, when we hear stories such as this, what does the Minister believe should be done to tackle the culture of cover-up and gaslighting by that small minority of NHS staff?

[Baroness Merron (Lab)]

I thank the noble Lord for his kind remarks; I am very pleased to see him again across the Dispatch Box. The duty of candour is extremely important in all this. Racism in this area is not just towards mothers and families; as the noble Lord said, it is also towards staff. Clearly, we need to tackle this for both patients and staff. The patient’s voice is key. Even at this early stage, it is quite clear to me that women, and people of black, Asian and minority-ethnic heritage, are not being listened to. We will bring forward plans to put this right. As part of the report to which I referred earlier, I will be glad to update the House in this regard.

[Baroness Blackstone (Lab)]

My Lords, I declare my interest as set out in the register. Given the complexity of the causes of these unacceptable mortality rates, what is the Minister’s department doing to ensure that there is a cross-government approach to ending the maternal mortality gap?

[Baroness Merron (Lab)]

My noble friend is quite right: this is a cross-government matter. There are complex reasons why black, Asian or minority-ethnic people are suffering far worse than those who are white. They include socio-economic factors such as deprivation and health inequalities being felt across the whole range. It is not going to be possible to solve this without cross-government co-operation. I look forward to working with my ministerial colleagues to put it right.

[Baroness Hussein-Ece (LD)]

My Lords, I too welcome the Minister’s commitment to addressing this very serious issue. As other noble Lords have mentioned, there have been numerous reports over the years from different trusts highlighting the crisis in maternity services. Training will help, but we hear constantly that a shortage of maternity nurses in many trusts is leading to such situations. The noble Baroness also mentioned that women are simply not being listened to. This has come out in many reports. Will she ensure that women’s voices are heard when they are in labour and giving birth, as they are the experts about their own bodies?

[Baroness Merron (Lab)]

I can say yes to the noble Baroness on the second point, because if we do not listen to patients, we will not get it right. The Government are committed to training more midwives and health visitors and to incentivising continuity of care, as well as to making sure that the National Health Service is focused on tackling inequalities that can be described only as shocking. I absolutely agree about training, but we also need leadership and a determination from the top to put this right, as well as practical plans.

Northern Ireland Dentists: Amalgam Fillings

Baroness Merron Excerpts

Monday 22nd July 2024 Lords Chamber

[Baroness Hoey]

To ask His Majesty’s Government what plans they have to ensure that dentists in Northern Ireland will still be able to use amalgam fillings when the EU ban their use from January 2025.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, on 19 July, as a result of constructive work between the UK Government and the EU, the EU published a notice that recognises the unique circumstances of Northern Ireland and the representations that have been made by the UK Government. It set specific arrangements in place for Northern Ireland, providing an additional 10 years to still use amalgam fillings, or until an earlier time is agreed by the Minamata convention, to which the UK is party.

[Baroness Hoey (Non-Afl)]

My Lords, I thank the Minister for that Answer, which will be very much welcomed by dentists in Northern Ireland, but does she understand that there is a fundamental issue here? There are many more health and other regulations that will need that kind of begging of the EU to make a difference, because Northern Ireland is still under the Windsor Framework and the protocol. Will she commit to working to ensure that Northern Ireland’s place in the United Kingdom, as a fully integrated part of the United Kingdom, is restored, and that this Government will do what they can to make that happen as soon as possible?

[Baroness Merron (Lab)]

As the noble Baroness is more than aware, the Windsor Framework is exactly about safeguarding Northern Ireland’s integral position in the union and the UK internal market. I can assure your Lordships’ House that the Government are committed to implementing the Windsor Framework in good faith. This is a particular set of circumstances and the first opportunity to secure such arrangements, so it is important to see it in this light. I am glad that the noble Baroness welcomes this action by the Government; it is certainly intended to serve the good people of Northern Ireland, and I am glad to be able to present that today.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I refer to my entry in the Register of Lords’ Interests. I welcome the derogation on amalgam fillings, because that issue has been persisting for some time. It proves that a Labour Government are working to find solutions to the outstanding matters relating to the Windsor Framework. In that respect, will the Minister and her colleagues undertake to provide us with details of the resetting of the relationship between the UK and the EU? There are several outstanding matters relating to veterinary medicines and the EU’s carbon floor.

[Baroness Merron (Lab)]

I am glad that my noble friend welcomes today’s announcement. I am sure the House will appreciate the particular set of circumstances surrounding amalgam, which are extremely complex. This has required considerable collaboration between several departments, as well as the devolved Administrations. I hope it will be regarded as something very positive, but I can assure my noble friend and your Lordships’ House that I will discuss with my ministerial colleagues the points being raised about the Windsor Framework and the relationships that that entails.

[Lord Lexden (Con)]

Do the Government accept that there is indeed a considerable amount of further work to be done to ensure that the Windsor Framework provides fully for the free movement of all goods within our precious single market?

[Baroness Merron (Lab)]

Certainly, the Windsor Framework, under which some EU rules apply in Northern Ireland, is intended to help the EU and the UK work together constructively and to ensure the smooth flow of trade within the UK internal market. I am sure that my colleagues in the Northern Ireland Office will continue to keep that under review. I know that the Northern Ireland Secretary has been very involved in the amalgam issue.

[Lord Foulkes of Cumnock (Lab Co-op)]

My Lords, will the Minister confirm that the noble Baroness, Lady Hoey, is one of the people who got us into this mess in the first place?

[Baroness Merron (Lab)]

I thank my noble friend for his opinion; that is noted. The Question from the noble Baroness, Lady Hoey, was extremely welcome.

[Lord Caine (Con)]

My Lords, I congratulate the noble Baroness on her appointment. Clearly, we strongly support the derogation for Northern Ireland, on which we were working tirelessly prior to the election. While agreement is always to be preferred, the Stormont brake remains a crucial democratic safeguard for Northern Ireland in order to prevent the imposition of new EU laws and regulations that, in this case, could have had a devastating impact on dentistry and public health. In the event of that brake ever being activated, will the new Government commit to standing by all its provisions, including the exercise of a veto where necessary?

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[Baroness Merron (Lab)]

I thank the noble Lord for his kind words of welcome and can assure the House that I will certainly do my best in my new role. On the important issue of what next, which I believe the question raises, this will now be a matter for the Democratic Scrutiny Committee in Stormont. It will look closely at what this new arrangement potentially means and will decide the next step, so I suggest that it is in the right place. Of course, we will continue to work closely with our colleagues in Northern Ireland. I believe there will be next steps after we have had the opportunity to hear what the committee says.

[Lord Harris of Haringey (Lab)]

My Lords, I refer to my interest, as listed in the register, as chair of the General Dental Council. Can the Minister express a view, on behalf of His Majesty’s Government, on the safety of amalgam fillings?

[Baroness Merron (Lab)]

Yes, I can confirm that amalgam is safe. The reason for this phase-down of the use of mercury, which is in amalgam fillings, is related to the environment. When mercury is released into the environment—for example, through emissions from crematoria—it can get into the food chain, where it accumulates mainly in fish such as shark and tuna. That can affect those who have a fish-rich diet, in countries such as Greenland, Brazil, Japan and China. However, there is no evidence whatsoever that amalgam is unsafe, and it is with that in mind that we have sought this arrangement for Northern Ireland.

[Lord Forsyth of Drumlean (Con)]

Further to the noble Lord’s rather ungracious question, can the Minister confirm that if we had not left the EU, it would not have been possible to continue with the use of amalgam?

[Baroness Merron (Lab)]

I am sure that there are many opinions in your Lordships’ House about what would have happened if we had not left the EU, and I think it is probably appropriate that I leave it there.

[Lord Scriven (LD)]

Does the Minister agree that it is the policy of the British Dental Association eventually to remove amalgam, so this is about not whether it is removed but the timing of its removal, in a way that helps to ensure continual dental services?

[Baroness Merron (Lab)]

It is indeed, and I thank the noble Lord for his observation, which is absolutely correct. We are very grateful to the British Dental Association for working closely with us not just on this issue but on how we are going to restore NHS dental services across the country, because that is a real task we are going to have to battle with.