Health: Quad-demic

Debate between Baroness Merron and Lord Bethell

Tuesday 10th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I listened carefully to the noble Lord. The JCVI considered that there was less certainty about how well the RSV vaccine works in people aged 80 and over when the programme was introduced in 2023, and that is because, as the noble Lord said, there were insufficient people aged 80 and older in the clinical trials. The JCVI continues to keep this under review, including looking at data from clinical trials and evidence in other countries, and there will shortly be an update to your Lordships’ House in respect of research and clinical trials.

[Lord Bethell (Con)]

The Minister says that we are determined to learn the lessons of Covid. During Covid we had vaccination rates of 90% but, as she said, only 16 million—just 25%—of our citizens have had the flu jab and vaccination rates among children are also deteriorating at a rate. I say this with some personal interest because there was an outbreak of the quad-demic in my own household at 2 am today. There are three times as many people in hospital today with flu than in this week last year. Can the Minister please explain what she is doing to increase vaccination rates, particularly among children?

Online Safety Bill

Debate between Baroness Merron and Lord Bethell

Committee stage
Thursday 11th May 2023 Lords Chamber

[Baroness Merron (Lab)]

My Lords, I shall speak to this group which includes Amendments 52, 99 and 222 in my name. These are complemented by Amendments 223 and 224 in the name of my noble friend Lord Knight. I am grateful to the noble Lords, Lord Clement-Jones and Lord Bethell, and to the noble Baroness, Lady Bennett, for putting their names to the amendments in this group. I am also grateful to the noble Lord, Lord Moylan, for tabling Amendments 59, 107 and 264. I appreciate also the work done by the APPG on Digital Regulation and Responsibility and by Full Fact on this group, as well as on many others in our deliberations.

These amendments would ensure that platforms were required to undertake a health misinformation and disinformation risk assessment. They would also require that they have a clear policy in their terms of service on dealing with harmful, false and misleading health information, and that there are mechanisms to support and monitor this, including through the effective operation of an advisory committee which Ofcom would be required to consult. I appreciate that the Minister may wish to refer to the false communication offence in Clause 160 as a reason why these amendments are not required. In order to pre-empt this suggestion, I put it to him that the provision does not do the job, as it covers only a user sending a knowingly false communication with the intention of causing harm, which does not cover most of the online health misinformation and disinformation about which these amendments are concerned.

Why does all this matter? The stakes are high. False claims about miracle cures, unproven treatments and dangerous remedies can and do spread rapidly, leading people to make the poorest of health decisions, with dire consequences. We do not have to go far back in time to draw on the lessons of our experience. It is therefore disappointing that the Government have not demonstrated, through this Bill, that they have learned the lessons of the Covid-19 pandemic. This is of concern to many health practitioners and representatives, as well as to Members of your Lordships’ House. We all remember the absolute horror of seeing false theories being spread quickly online, threatening to undermine the life-saving vaccine rollout. In recent years, the rising anti-vaccine sentiment has certainly contributed to outbreaks of preventable diseases that had previously been eradicated. This is a step backwards.

In 2020, an estimated 5,800 people globally were admitted to hospital because of false information online relating to Covid-19, with at least 800 people believed to have died because they followed this misinformation or disinformation. In 2021, the Royal College of Obstetricians and Gynaecologists found that only 40% of women offered the vaccine against Covid-19 had accepted it, with many waiting for more evidence that it would be safe. It is shocking to recall that, in October 2021, one in five of the most critically ill Covid patients was an unvaccinated, pregnant woman.

If we look beyond Covid-19, we see misinformation and disinformation affecting many other aspects of health. I will give a few examples. There are false claims about cancer treatment—for example, lemons treat cancer better than chemotherapy; tumours are there to save your life; cannabis oil cures cancer; rubbing hydrogen peroxide on your skin will treat cancer. Just last year, the lack of publicly available information about Mpox fuelled misinformation online. There is an issue about the Government’s responsibility for ensuring that there is publicly available information about health risks. In this respect, the lack of it—the void—led to a varied interpretation and acceptance of the public health information that was available, limited though it was. UNAIDS also expressed concern that public messaging on Mpox used language and imagery that reinforced homophobic and racist stereotypes.

For children, harmful misinformation has linked the nasal flu vaccine to an increase in Strep A infections. In late 2022, nearly half of all parents falsely believed these claims, such that the uptake of the flu vaccine among two and three year-olds dropped by around 11%. It is not just that misinformation and disinformation may bombard us online and affect us; there are also opportunities for large, language-model AIs such as ChatGPT to spread misinformation.

The Government had originally promised to include protections from harmful false health content in their indicative list of harmful content that companies would have been required to address under the now removed adult safety duties, yet we find that the Bill maintains the status quo, whereby platforms are left to their own devices as to how they tackle health misinformation and disinformation, without the appropriate regulatory oversight. It is currently up to them, so they can remove it at scale or leave it completely unchecked, as we recently saw when Twitter stopped enforcing its Covid-19 misinformation policy. This threatens not just people’s health but their freedom of expression and ability to make proper informed decisions. With that in mind, I look forward to amendments relating to media literacy in the next group that the Committee will consider.

I turn to the specific amendments. The new clause proposed in Amendment 52 would place a duty on category 1 platforms to undertake a health misinformation risk assessment and set out a policy on their treatment of health misinformation content. It would also require that the policy and related terms of service are consistently applied and clear and accessible—something that we have previously debated in this Committee. It also defines what is meant by

“harmful health disinformation and misinformation”—

and, again, on that we have discussed the need for clarity and definition.

Amendment 99 would require Ofcom to consult an advisory committee on disinformation and misinformation when preparing draft codes of practice or amendments to such codes. Amendment 222 is a probing amendment and relates to the steps, if any, that Ofcom will be expected to take to avoid the advisory committee being dominated by representatives of regulated services. It is important to look at how the advisory committee is constructed, as that will be key not just to the confidence that it commands but to its effectiveness.

Amendment 223, in the name of my noble friend Lord Knight, addresses the matter of timeliness in respect of the establishment of the advisory committee, which should be within six months of the Bill being passed. Amendment 224, also in the name of my noble friend Lord Knight, would require the advisory committee to consider as part of its first report whether a dedicated Ofcom code of practice in this area would be effective in the public interest. This would check that we have the right building blocks in place. With that in mind, I beg to move.

[Lord Bethell (Con)]

My Lords, it is a great honour to rise after the noble Baroness, Lady Merron, who spoke so clearly about Amendment 52 and the group of amendments connected with health misinformation, some of which stand also in my name.

As the noble Baroness rightly pointed out, we have known for a long time the negative impact of social media, with all its death scrolls, algorithms and rabbit holes on vaccine uptake. In 2018, the University of Southampton did a study of pregnant women and found that those who reported using social media to research antenatal vaccinations were 58% less likely to accept the whooping cough vaccine. Since then, things have only got worse.

--- Later in debate ---

[Baroness Merron (Lab)]

My Lords, I am most grateful to noble Lords across the Committee for their consideration and for their contributions in this important area. As the noble Baroness, Lady Kidron, and the noble Lord, Lord Clement-Jones, both said, this was an area of struggle for the Joint Committee. The debate today shows exactly why that is so, but it is a struggle worth having.

The noble Lord, Lord Bethell, talked about there being a gap in the Bill as it stands. The amendments include the introduction of risk assessments and transparency and, fundamentally, explaining things in a way that people can actually understand. These are all tried and tested methods and can serve only to improve the Bill.

I am grateful to the Minister for his response and consideration of the amendments. I want to take us back to the words of the noble Baroness, Lady Kidron. She explained it beautifully—partly in response to the comments from the noble Baroness, Lady Fox. This is about tackling a system of amplification of misinformation and disinformation that moves the most marginal of views into the mainstream. It deals with restricting the damage that, as I said earlier, can produce the most dire circumstances. Amplification is the consideration that these amendments seek to tackle.

I am grateful to the noble Lord, Lord Moylan, for his comments, as well as for his amendments. I am sure the noble Lord has reflected that some of the previous amendments he brought before the House somewhat put the proverbial cat among the Committee pigeons. On this occasion, I think the noble Lord has nicely aligned the cats and the pigeons. He has managed to rally us all—with the exception of the Minister—behind these amendments.

[Lord Bethell (Con)]

The noble Baroness is entirely right to emphasise amplification. May I put into the mix the very important role of the commercialisation of health misinformation? The more you look at the issue of health misinformation, the more you realise that its adverse element is to do with making money out of people’s fears. I agree with the noble Baroness, Lady Fox, that there should be a really healthy discussion about the efficacy, safety and value for money of modern medicines. That debate is worth having. The Minister rightly pointed out some recent health scandals that should have been chased down much more. The commercialisation of people’s fears bears further scrutiny and is currently a gap in the Bill.

[Baroness Merron (Lab)]

I certainly agree with the noble Lord, Lord Bethell, on that point. It is absolutely right to talk about the danger of commercialisation and how it is such a driver of misinformation and disinformation; I thank him for drawing that to the Committee’s attention. I also thank my noble friend Lady Healy for her remarks, and her reflection that these amendments are not a question of restricting free speech and debate; they are actually about supporting free speech and debate but in a safe and managed way.

Health and Care Bill

Debate between Baroness Merron and Lord Bethell

Lords Hansard - Part 1 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Bethell (Con)]

My Lords, I will briefly say that I am extremely optimistic about family hubs. They answer the challenge to solve the complexity around integration incredibly well. My noble friend Lord Farmer made the point that one cannot think of a better example of what integration looks like than family hubs. The noble Baroness, Lady Tyler, talked clearly and persuasively about the journey they have been on.

My noble friend has made the case for these amendments. Other noble Lords have made the case for updating the legislative framework. I ask the Minister to look carefully at what can be done to bring these laws up to date so that family hubs can thrive, as I believe they will.

[Baroness Merron (Lab)]

My Lords, I am grateful to the noble Lord, Lord Farmer, for introducing this important debate and to other noble Lords who have supported the amendments before us and spoken about how we can improve the support that families will receive through this Bill. As the Family Hubs Network rightly observes,

“prevention is simply listed in the Bill as one of several commissioning requirements of ICBs with no broad mention of children’s health”.

This group of amendments gives us the opportunity to sharpen this.

As we have heard, the issues that families face, in whatever form or shape, do not exist in isolation. In addition to the impact of financial, housing, social and other pressures, the physical and mental health of a child or young person affects the physical and mental health of not just their parents, but their wider family, and vice versa. It makes common sense to facilitate a healthcare system that is designed and resourced to actively take a holistic approach to the many issues that face children and those who care for them.

I cannot help but feel that the points raised today are not new. We have the experience of Sure Start to show us how effective properly integrated family services can be. As the Institute for Fiscal Studies confirmed:

“By bringing together a wide range of early years services for children under 5, Sure Start centres dramatically improved children’s health even through their teenage years.”


Early investment is crucial.

I hope the Minister will be keen to embed change in this Bill to replicate the success that we saw through Sure Start. The first step towards doing this is to make sure that integrated care partnerships are properly required to consider how family help services can be thoroughly integrated into our health and care system, so that family members—no matter what form those families take—are seen as both individuals and groups who have an effect on each other.

Covid-19: Aligning UK and Foreign Entry and Return Requirements

Debate between Baroness Merron and Lord Bethell

Monday 19th July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I do look at the costs and have regular meetings with the team to look at this. I pay tribute both to officials and to the industry for standing up an enormous number of tests. I believe that, between 30 June and 7 July, 182,137 tests of people quarantining at home were registered and processed, and 18,946 by those who manage quarantine. That is an enormous number and pays tribute to the industry. A variety of costs reflects a variety of different services and in itself is not a problem—but we are driving the costs down and the industry is responding accordingly.

[Baroness Merron (Lab)]

My Lords, regrettably, we see the Covid border restrictions descend into further chaos with the last-minute U-turn on self-isolation requirements for fully vaccinated people returning from France. Once again, we see the travel industry and the British people paying the price. Will the Minister agree to publish the full data behind the traffic light system, and could he give his views on the stance of the World Health Organization, which has reaffirmed that it believes that proof of vaccination should not be required for international travel?

[Lord Bethell (Con) [V]]

My Lords, we are working with our partners to try to open up borders. There is a growing consensus that vaccination is an important component in opening up borders, and the Government generally support that. The virus itself chops and changes; we have to adapt in response to the growth of variants. I cannot promise that we will not act promptly and emphatically when the health of the nation is threatened.

Folic Acid

Debate between Baroness Merron and Lord Bethell

Tuesday 13th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I share the sense of urgency expressed by the noble Baroness in her articulation of those statistics. They are both worrying and entirely accurate. We very engaged with the devolved assemblies. Welsh and Scottish Ministers have expressed their support, but with Northern Ireland it is important that we consider all the implications of the Northern Ireland protocol. I am therefore not able to lay out the precise timetable now, but I reassure the noble Baroness that we are moving as quickly as we can.

[Baroness Merron (Lab)]

My noble friend Lord Rooker continues to press to protect newborn babies while, sadly, the Government have over a number of years continued to drag their feet. In preparation for the Minister’s forthcoming update, which he has promised the House today, what assessment have the Government made of the impact of the Covid-19 pandemic on the financial and practical ability of women to access prenatal vitamins, including folic acid? How has the pandemic affected awareness-raising to ensure that women are not missing out on vital nutrients in the early stages of their pregnancy?

[Lord Bethell (Con)]

I am sorry, I cannot answer the noble Baroness’s question directly. I am not sure whether an assessment has been made of the impact of the pandemic on the consumption of folic acid, but it has undoubtedly raised the importance of these kinds of preventive measures. We have never been more acutely aware of the importance of improving the health of the nation, and this is an important step in that direction.

Covid-19: Wuhan Institute of Virology

Debate between Baroness Merron and Lord Bethell

Wednesday 30th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I agree with the noble Lord’s appeal for more data—but, candidly, as I know he knows, it is not just quantity of data that we need; it is the right data. Where we are struggling is in getting genomic sequencing of new mutations from the furthest reaches of the virus’s spread. We need a systematic programme around the world that shares the sequences of new mutations with academics who can study and assess them. Without such a systematic programme we are flying blind. That is why we are working on the new variant assessment platform and other pandemic preparedness projects.

[Baroness Merron (Lab)]

My Lords, scientists are warning that we are in an era of pandemics, and that viruses more deadly, contagious or resistant to antibodies than Covid-19 could emerge. What steps are the Government taking to prepare themselves and the country for the next potential pandemic, and will the Minister commit to ensuring that future pandemic preparedness plans are independently assessed and reported to Parliament?

[Lord Bethell (Con)]

My Lords, I pay tribute to the Chief Scientific Adviser, Sir Patrick Vallance, who is leading the pandemic preparedness work. He is doing an enormous amount both on the international treaties through our G7 chairmanship, and on the internal domestic re-envisaging of our healthcare system. We need to invest more in public health, and we also need the data, the diagnostics and the patient behaviours that support really rigorous tracking down of diseases when they arrive. The noble Baroness is entirely right: pandemics will come, sooner rather than later.

Folic Acid

Debate between Baroness Merron and Lord Bethell

Wednesday 23rd June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, it is my understanding that both the Department of Health and Defra have been engaged with other countries on this matter. I will be glad to write to the noble Baroness with any details that we may have on record.

[Baroness Merron (Lab)]

My Lords, I listened to the Minister’s answer where he referred to delays as a result of the Covid pandemic and the elections in the devolved Administrations. While they may be recent issues, this delay well precedes both those important events. As my noble friend Lord Rooker and others have so eloquently expressed, patience on this is long exhausted and parents-to-be cannot be expected to continue to carry such risk. Can the Minister tell the House exactly when babies will be protected? Is the delay that we have seen over decades due to any change in the Government’s position?

[Lord Bethell (Con)]

I absolutely reassure both the noble Baroness and all noble Lords in the Chamber that there is absolutely no equivocation on behalf of the Government in this matter. It is a huge undertaking to put a substance in the food of the nation. It is therefore something that has to be endorsed by all the relevant bodies, including the four nations and other arm’s-length bodies. We have to ensure that we have all the public health sign off and the industry support that we need, and we need to take the public with us. There will be a moment when we need to sell this to the public, and they will have questions and we will need to have a dialogue. When that happens, I would like to have crossed all the “t”s and dotted all the “i”s so that we are in great shape. That is why we are being as thorough as we can. I reassure all noble Lords that there is no question of us going backwards on this.

Covid-19: Vaccines and Pregnancy

Debate between Baroness Merron and Lord Bethell

Monday 14th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness points to one of the challenges of longitudinal research: the babies have not been born for very long, of course. We need to do long-term studies to understand the effect. There is no evidence at all of a negative outcome but we will need to monitor that; research resources will be dedicated to looking at it.

[Baroness Merron (Lab)]

To tackle the risk of stillbirths and emergency Caesareans among mothers who are giving birth and have contracted Covid-19, as we see the vaccination programme extend further—particularly into the younger age groups—will the Minister look at prioritising pregnant women for vaccinations? I refer particularly to women in the later stages of pregnancy.

[Lord Bethell (Con)]

My Lords, the JCVI has a clear set of prioritisation protocols, which we are sticking to. The fact of being pregnant does not seem to have a direct impact in terms of severe disease or death, so there is no clear evidence at the moment for putting in or changing the prioritisation of pregnant women. However, we constantly review that and we are naturally concerned to protect both the mother and the child.

Covid-19: Government Handling and Preparedness

Debate between Baroness Merron and Lord Bethell

Tuesday 8th June 2021 Lords Chamber

[Baroness Merron (Lab)]

My Lords, research released for Carers Week makes sobering reading. During the pandemic, 72% of carers have had no break whatever and, of those few who have had a break, many used the time for housework or their own medical appointments. With the risk of a third wave still a cause for anxiety, what plans are in place, or indeed in development, to ensure that unpaid carers can have restorative breaks and that their needs are at the heart of the Government’s plan for social care reform?

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

My Lords, I absolutely join the noble Baroness in paying tribute to all carers, particularly unpaid carers, who have shouldered a huge burden in the past 18 months. The role that they have played has been a real example of the sense of service and commitment that characterises the social care community in this country. We have put in place a large amount of resources through local authorities and payments to local authorities to support carers. That has helped in infection control and to reduce the itinerant nature of some social care in order to prevent the spread of the disease. But it is undoubtedly true that the burden on unpaid carers remains immense, and we continue to support, both through local authorities and through charities, the work that they do.

Covid-19: Poverty

Debate between Baroness Merron and Lord Bethell

Thursday 27th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I hear my noble friend’s warning very clearly and he is absolutely right. We must not be confused between statistical correlation and causation. However, one thing that has become clear is that in Covid personal health status, particularly obesity, has been a driver of severe illness and mortality. The environments in which people live and work have been a driver of infection. Those two are probably inescapable conclusions and will be central to our levelling-up agenda.

[Baroness Merron (Lab)]

The pandemic has brutally exposed the health inequalities that ran deep in our society even before Covid-19, and it is certainly welcome that the White Paper acknowledges that. However, even the best efforts of an integrated care system can only go so far in preventing ill health. Forthcoming legislation needs to be underpinned by national policy measures and funding to tackle overarching determinants of health. With that in mind, will the Minister comment on why the Queen’s Speech did not contain improved funding for public health, given the Government’s professed commitment to levelling up and building back better?

[Lord Bethell (Con)]

My Lords, the noble Baroness is entirely right that it cannot be for either the law or the Department of Health to solve a national challenge. That is why the Prime Minister has committed to appointing a cross-ministerial board. It needs the co-ordination and focus of many different departments that handle health, social welfare and the culture of the country to tackle these tricky, long-standing and difficult challenges.

COVID-19 Variant: Travel Guidance for Local Authorities

Debate between Baroness Merron and Lord Bethell

Wednesday 26th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, guidance for people in Bolton and Blackburn with Darwen was published on Friday 14 May. It was then extended on 21 May to Bedford, Burnley, Hounslow, Leicester and North Tyneside. That guidance has now been fine-tuned, in response to feedback from the local directors of public health and, as the noble Baroness will know, the website has been updated. The chronology of that is relatively straightforward. It could have been done better—that I have made plain to the noble Baroness, Lady Thornton—and we are with working directors of public health, local authorities and others to ensure that we get smoother systems for that kind of thing.

[Baroness Merron (Lab)]

My Lords, I share a lot of the concern in the House about the confusion that has been sown. I am somewhat shocked that the Government did not work closely with those who are dealing with Covid in the affected areas, who are at the sharp end: the mayors, public health officials and councils. They are the local experts, and I implore the Minister to work closely with them. Does he accept that what is really needed in the affected areas now is isolation support, enhanced contact tracing and the rollout of vaccine for everybody?

[Lord Bethell (Con)]

My Lords, I completely object to the false premise of the question. I cannot tell you how hard we are working in collaboration with local authorities, directors of public health and the incredible rhythm of regional partnership teams, regional team updates and the huge amount of data and interaction between all parts of government. It is absolutely phenomenal, and the characterisation by the noble Baroness is just not right. Where I completely agree with her is that we are working as hard as we humanly can to get the vaccine out to everyone, we are doing absolutely all we can to spread testing to all areas where there are outbreaks and we are working extremely hard to improve all those systems.

Covid-19 Internal Review

Debate between Baroness Merron and Lord Bethell

Thursday 20th May 2021 Lords Chamber

[Baroness Merron]

To ask Her Majesty’s Government whether they will publish their internal review of the handling of the COVID-19 pandemic.

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

My Lords, I start by welcoming the noble Baroness, Lady Merron, to the Bench; I am very much looking forward to working with her in the months ahead. The Prime Minister confirmed on 12 May that a public inquiry will be established on a statutory basis to consider the Covid-19 pandemic, including the Government’s handling of it. I can confirm that while DHSC officials carried out a routine internal ways-of-working review, this was absolutely for the purpose of providing advice to Ministers only.

[Baroness Merron (Lab)]

My Lords, the National Audit Office report published yesterday both highlighted the need for the Government to learn lessons at speed and advocated greater transparency. Publishing an already completed internal review of the Government’s handling of the Covid-19 crisis would support a plan to contain the threat of new variants, and I urge the Government to do so. I am interested to know whether the Minister can come to agree with me on this. With experts, including SAGE, warning that it is very much in the balance as to whether further restrictions will be lifted in June, given the dramatic rise in Indian Covid-19 variant cases, will the Government learn the lessons and urgently review travel and quarantine arrangements?

[Lord Bethell (Con)]

My Lords, I absolutely agree with the noble Baroness that we are at a pivotal moment in the pandemic; matters are on a knife-edge. There is so much good news about the effect of the vaccine that we should celebrate, but there is enormous jeopardy in the threat posed by variants. That is why we are very much focused on dealing with the pandemic before us. The inquiry promised by the Prime Minister is for spring next year, and until then we will continue to be focused on today’s pandemic.