(3 years, 10 months ago)
Lords ChamberMy Lords, on turbo-charging the vaccine deployment, the two key focuses are: first, on very large centres, which can have a very large throughput of people, as these will make an enormous difference and bring an industrial energy to the process; and, secondly, to extend the reach into the hard-to-reach communities, whether those are rural or where people are not in the mainstream of British life. Regarding the noble Lord’s point on the “war”, while it might seem obvious to him that everyone will step forward for the vaccine that is not, strictly speaking, right. Some people are going to make careful decisions before stepping forward to have it, so we have to think about making it attractive and reasonable to as many people as possible, particularly those who are vulnerable to the disease. I do not think it is right that we cannot have a consumer mentality to this. We have to treat the public with consideration and thoughtfulness, because they will decide whether they are going to step forward or not.
I now call the noble Baroness, Lady Meacher. Lady Meacher?
Sorry, I could not get myself unmuted. My Lords, as a Covid sufferer, which I am, I too applaud the Government’s amazing vaccination programme. I just have a few points of clarification. First, when the Government talk about offering a vaccination to all four top vulnerability groups by mid-February, do they mean all those groups will have a vaccination by mid-February or an invitation for one, which, of course, could be for a vaccination in March or April? Secondly, is there any progress yet on bringing forward the second vaccination—we are talking about the country here—from the 12-week point, bearing in mind the greater risk of mutations while we have this rather long wait between first and second vaccinations? Thirdly, if I may, can the Minister contradict the anti-vax story, which I regard as very dangerous, that the vaccinations contain polyethylene glycol which could be dangerous for allergic people? These stories just have to be crushed, if we can.
My Lords, that is a decision for the NHS deployment team. I do not know the precise answer but frankly, based on experience I would guess that NHS environments are probably the focus for the deployment—that the focus is on where NHS staff can have safe, hygienic environments, rather than on workplaces. However, I will take the noble Lord’s idea back to the department and write to him to see whether that is being considered.
My Lords, all questions have been asked.
(3 years, 11 months ago)
Lords ChamberMy Lords, I am extremely grateful for the clear and thoughtful questioning from the noble Baronesses, Lady Thornton and Lady Jolly. Both of them are right: we are seeing a sharp rise in south Wales, London and parts of the east and south-east of England, which is making us rethink some of our approach to Christmas. We have seen a sharp rise in the virus across London, Kent, parts of Essex and Hertfordshire, and reports of a new variant. We saw the evidence of this starting in the 15 to 19 year-old age group and we have taken swift and decisive action but, unfortunately, more may be necessary. We know that this rise will be mirrored in hospital admissions, and it takes only a few doubling times to put pressure on the NHS. The noble Baroness, Lady Jolly, is absolutely right to question whether we have the resources in place to see such doubling take place over time. This is a trend we are seeing all over Europe, in countries such as Sweden, where nearly all the intensive care in Stockholm is currently in use, and even in Germany, where tougher new restrictions were announced over the weekend.
It is entirely natural that we look very closely at the Christmas relaxation, but I am not in a position to share any update on that this evening. The noble Baroness, Lady Thornton, asked: what is the Secretary of State’s plan to keep us safe? We have plans, and I will be glad to share them with noble Lords. However, may I just say a word about personal responsibility? The noble Baroness, Lady Thornton, put it well: it is up to each and every one of us to decide whether we will take a minimalist or maximalist interpretation of the rules. At the end of the day, it is a personal decision on what kind of risk approach one will take to Christmas. The SAGE advice has been published and it is clear. It does not make very comfortable reading for those of us with elderly relations who have been looking forward to seeing us, but it clearly states that we should be looking to spend time at Christmas with as few people as possible for as short a time as possible and, wherever possible, outside instead of inside. I am afraid to say that that will be what a responsible Christmas looks like for everyone. It is not something that the Secretary of State can ordain; it is, unfortunately, what the spread of the virus requires.
I acknowledge—the noble Baroness, Lady Thornton alluded to this—that the tier 3 regimes, particularly in the north of England, have had a profound impact. The behaviours of people in the tier 3 areas have been considerably amended, and that has seen a sharp reduction in the infection rates in those areas. It demonstrates that restraint works, and I take a moment to applaud all those who have played a role in that achievement.
On the vaccine, I will be very happy to provide an update on the special cases that the noble Baronesses alluded to. Both the case for unpaid carers and the case for the terminally ill are powerful, and we are listening carefully to them as they are made. However, the JCVI has put in its priority decision and that is what we are working to at the moment. Any further complications or refinements to that create profound operational challenges, but we are listening very sensitively to the case being made for the special cases.
I share the tribute of the noble Baroness, Lady Jolly, to the AstraZeneca team. The “Panorama” programme last night was a tonic for the soul during these difficult times, and I would recommend it to everyone.
As to the new variant to which the noble Baroness, Lady Jolly, alluded, the preliminary scientific judgment is that it does not at the moment show any evidence that it will escape either the vaccine or any other therapeutics that are targeted at Covid. That is always the natural concern in these circumstances; we are studying it very carefully indeed and will, of course, update the House if any changes do emerge. However, the new variant, which has been correlated with higher levels of transmissibility in Kent, does remind us that the threat of Covid is undiminished and we must remain committed to the restrictions in place to contain this horrible virus.
My Lords, we now come to the 30 minutes allocated for Back-Bench questions.
(3 years, 11 months ago)
Lords ChamberMy Lords, I thank the noble Baronesses for their thoughtful and searching questions on an important day’s traffic of announcements from the Government. I would like to try to tackle them as comprehensively as I can, but I assure both noble Baronesses that I will write to them on any points I fail to address in these comments.
The noble Baroness, Lady Thornton, started by saying that she felt the endless cycle of lockdowns had not been working. It is undoubtedly true that we all regret the return to a national lockdown earlier this month, but it is not true they do not work. New infections are down by a third, and that is an enormous achievement by the British public, whose discipline and obedience to the restrictions has yielded a massive dividend.
The noble Baroness said that test and trace was not working. It is undoubtedly true that when prevalence levels are so high, when there are more than half a million infections in the country and when new infections are running at five digits, it is extremely challenging for any national testing and tracing system to keep up with that sort of capacity. I beg the noble Baroness to give some ground and acknowledge the achievement of the huge scaling of the number of tests, the vast number of people who have been asked to isolate, thereby breaking the chain of transmission, and the hard work of those who work on the tracing side of the business, which has dramatically increased its performance and will continue to meet target numbers.
The noble Baroness also talked about care homes being stranded. I remind her that we have come a huge distance. I could reel off a dozen achievements in the care homes strategy, but two stand out. First is the regular testing of staff, which has now become a systematic programme that has massively protected those in care homes. There has also been the recent introduction of testing for visitors, which brings welcome relief for those needing to support and visit those in care homes, a much-valued service that needed a huge amount of work to put into place.
The noble Baroness talked about the role of the public. I have alluded to my respect for and thanks to the public. I will be crystal clear: the challenge that we face as a country is not public apathy but the virus itself. There is an absolutely vicious aspect of the virus, which is its high contagiousness. In a room with a few people together, it is quite unlike most contagious diseases in its infectiousness. When we talk about the challenge of social distancing and the need for lockdowns, it is not one another whom we blame: it is the virus itself. I encourage all those who feel frustrated to remember who the enemy is.
The noble Baroness asked whether the tiering allocations would be done in consultation with local authorities. The brief answer to that question is no. We tried that, but it did not prove a successful experiment. The acrimony and large amount of delays created long-standing problems for the implementation of the policy. Therefore, we will be implementing the tiering on a fortnightly basis from the centre. It is a big yes, however, on the approach to community testing and infection control. We absolutely want to work in partnership with local authorities and local DPHs, which have all the powers that they need to decide whom they seek to target and what incentives they would like to provide for those who need to be attracted to testing. I also say yes—absolutely—to transparency, both in terms of the publication of the numbers and our approach to our collaborations. I put on record our massive thanks to local authorities, particularly those that have been working with us over the last fortnight on our community testing programme, the publication of which earlier today is a really important framework of the local-national partnership of which I have spoken at this Dispatch Box many times. It really brings alive that commitment.
The noble Baroness, Lady Jolly, was entirely right that there was an influenza plan, but it envisaged a completely different type of virus. The lessons from the influenza plan, though relevant for the kind of flu envisaged, were not applicable for the coronavirus. A good example of that is the PPE. Had we followed the possibility of preparing a massive stock of PPE for the kind of flu envisaged in the influenza plan, we would have had the wrong kind of PPE. There was nothing that we could have done about that.
The other big learning was on mortality rates. The mortality rates for Covid-19 and the long-standing effects that it has on people are completely unlike those of the kind of flu that we were envisaging earlier. It has been a grave learning curve to have to change our plans to deal with Covid.
In relation to other learnings or things that we have moved on since then, I reiterate a theme that I have mentioned before: our commitment to national and local test and trace. Quite understandably, the noble Baroness challenges me on that point, but I gently remind her that, in February, local authorities did not have any tests; nobody had any tests. We were doing 2,000 tests a day. Therefore, it is all very well saying that we should have left test and trace to local authorities, but there simply were not the resources there to do that. It took a massive national programme and huge national effort to get us up to half a million tests a day, which is something that the local authorities, even in collaboration, could not possibly have done.
The local authorities also did not have scalable tracing capacity. The PHE capacity was designed for ultra-low prevalence rates—for when you are chasing a few dozen carriers of a disease who, perhaps, have recently arrived from overseas. It was not designed for 20,000 infections a day, which is the kind of infection rate we have been looking at recently. It was only by building the data systems, protocols and guidelines, and having tens of thousands of employees, that we have been able to put that tracing capacity in place.
We also did not have the organisational or analytical capacity to do the kind of surveillance that is done through ONS and REACT or the kind of data management that the JBC has done. Now that we have those components in place—the physical, data and diagnostic frameworks—we are in a position to work as a team, both nationally and locally. The noble Baroness is entirely right that that local insight, intelligence, empathy and leadership are absolutely critical for our success, and I encourage her and all those in the Chamber to read our community testing programme, which was published earlier today and which encapsulates the spirit of the local-national partnership of which the noble Baroness has spoken previously in the Chamber.
The noble Baroness challenges me on communications, and I will not deny that it has been one of the great challenges of the pandemic to try to explain, in a fast-changing and confusing climate, the government imperative and recommendations to the public. One of the key things that we have learned is that, sometimes, the desire to share the delicious complexity of the epidemiology stands in the way of simple communication. Sometimes, trying to find the exemptions that are fair to everyone and cater to every single consultative recommendation stands in the way of simplicity, straightforwardness and tractability.
We have learned that, sometimes, it is more important to be simple, clear and straightforward than to try to accommodate every nuance and exception. This is why we have pursued rules like the rule of six, have gone for a simple and easily understood regional tiering process and applied the 10 pm curfew, although we have updated that to an 11 pm curfew, with a drinking-up time of 10 pm. That kind of consistent messaging is what the public, quite reasonably, respond to, which is why we have moved to it.
In response to the noble Baroness’s question about under-12s, I say that there are both the communication and epidemiological reasons that children are vectors of disease. This is an uncomfortable truth because they very infrequently show any symptoms and it is incredibly inconvenient—I say this as someone with four children, three of whom are under 12. However, it would be epidemiologically irresponsible to try to make an exception in that way, and I certainly will be spending quite a lot of Christmas with my family.
In relation to hardship, the noble Baroness makes the point extremely well, and we are totally sympathetic to her point. It is undoubtedly true that the least advantaged will be the hardest hit by this epidemic. It is true because their jobs are hit hardest, particularly those in casual labour, because the virus often hits those who have the most cramped accommodation or low-quality health and because many of those who live on the borderline of life will be the ones nudged into poverty.
The Government have worked hard, with the furlough scheme in particular, to ensure that a financial safety net is put into place, but I have no doubt that there will be a moment when the economic hardship created by the pandemic will be acute, and I have no doubt that the mental health implications of that for the population will be extremely hard. The Government are extremely aware of that and we are trying our hardest to minimise the impact. One reason why we are hitting the virus hard with these tiers is to ensure that we can get the economy back as quickly as we can, mostly to the advantage of those who are hit the hardest.
The noble Baroness asked me about entry and exit points to the tiers, and I have no easy solution for her. There are very clear considerations which we will be looking at when we consider which regions go into which tier: case detection rates, particularly of those over 60; the rate at which cases are falling; the positivity rate; and pressure on the NHS. But this is an incredibly complex matrix of interdependencies. It is not simple to plop it into the kind of easy algorithm that can churn out an answer at the push of a button; nor is it easy to have one simple metric where we can say, “You’ve hit this and therefore you move this way,” or “You’ve failed and you move that way.” If it were so easy we would publish it. The best advice we can get is that we have to consider all those factors when making those decisions. We will do it in a spirit of transparency, but we will have to make tough decisions. I reassure noble Lords that it will happen every two weeks, as the Prime Minister explained, and we will seek to be as fair and thorough as we possibly can.
My Lords, we now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers. I now call the noble Lord, Lord Caine.
My Lords, I am enormously grateful to the noble Lord for his very generous comments. I commend him for his advocacy both in the instance of Covid and for his lifelong commitment to standing up for the homeless. He is right that the homeless are undoubtedly super-vulnerable to a pandemic such as Covid and that there is a finance problem for the charities which look after those who live on the streets. He is right that those who have trouble paying their rent and face eviction are in a particularly difficult position. That is why we have put in place a mortgage relief scheme, continue to support the furlough scheme and keep in mind the plight of those who struggle to pay their household bills.
The noble Lord, Lord Liddle, has scratched, so I now call the noble Lord, Lord Dobbs.
My Lords, I would like to indulge in a little flight of fantasy by bringing two different elements together. The first is the Oxford vaccine, which appears to be much cheaper and easier to distribute than the other vaccines currently on offer. The second is the pressure on our foreign aid budget. Will my noble friend have a word with his Foreign Office colleagues and see whether it is possible to bring the two together, using the aid programme to distribute the Oxford vaccine as soon as any surplus supply becomes available? Distributing it to our aid recipients to help them with their own battles against Covid will show that Britain is a proud world leader in supplying practical humanitarian support.
My noble friend makes a very interesting point. Our priority right now is to vaccinate the British public. He is right that there are many vaccines available and Britain has made a massive investment in vaccines. We are also supporters of the international distribution of vaccines and the fair access of the developing world and those around the world to vaccines. That is why we support COVAX, Gavi and CEPI. He is right that there is an opportunity somewhere, and we are entertaining ways of supporting such a vision.
I call the noble Lord, Lord Dubs.
The noble Lord hits the nail on the head. We have already brought into place a test-to-release programme for foreign visitors and we are looking at ways in which such a principle could be applied elsewhere.
The noble Baroness, Lady Noakes, has withdrawn. We are not sure whether we have the noble Lord, Lord Rooker. We do not. I now call the noble Lord, Lord Forsyth of Drumlean.
My Lords, could my noble friend comment on reports in today’s press that four hospitals only, in the whole of England, are busier than last winter? Could he explain how on Saturday Michael Gove warned that, unless the latest regulations were implemented, every hospital in England risked being overwhelmed by Covid-19 cases? Before our debate tomorrow, could he publish the modelling on which this assertion was based?
I completely endorse the noble Baroness’s points. I know well the very good work that both Birmingham and the entire West Midlands are doing. Recruitment of champions and liaison with faith leaders are exactly the kinds of interventions that local authority leadership can provide. It is absolutely at the heart of our local and national approach. We are providing the kind of support that local authorities need to pursue these plans, which includes military personnel, testing facilities, data and analysis, and financial support, where necessary.
The noble Lord, Lord Balfe, has withdrawn, so I now call the noble Lord, Lord Moynihan.
My Lords, I congratulate my noble friend the Minister on the importance that he attaches to the safe return of fans to designated sports events, the reopening of many gyms and sporting activities across England, and the financial package announced last week for key sports in need of urgent financial assistance. Does he agree that we now need to help all clubs, particularly grass-roots clubs, to fulfil the critical role of ensuring that the population is as active and healthy as possible, to provide a strong counter to the Covid virus? Delivering and funding that objective must remain a key priority for the Government.
(4 years ago)
Lords ChamberI thank the noble Lord for his description of the role. I do not endorse it but am entertained by it. Let me be clear: the people who stepped forward and took ministerial appointments brought a wide range of skills, some of them quite soft in terms of networking, energy, the ability to negotiate and understanding the important skills of communication. Those are the kinds of skills that we value. They were provided for free in the instance to which the noble Lord has referred, and were limited in their timescale, scope and interactions with the department.
The noble Lord, Lord Scriven, has withdrawn.
My Lords, I deeply regret that some noble Lords are dragging this debate down to the issue of unpaid advisers. This is most inappropriate. No one could object to unpaid advisers; I have used them. I have even taken advice from people on the Benches opposite; that is how low I am prepared to sink. It is not about them being unpaid or giving advice; it is about the lack of transparency and accountability. Will the Minister agree that announcements should be made about unpaid advisers so we can know it is happening and guarantee there are no leaks—which there appear to have been so far.
It is a reasonable question and let me be clear. This year, we are seeing a massive change in the behaviours of our entire population—from the big macro challenges such as the rule of six, social distancing and adherence to infection control procedures, through to different uses of NHS and medtech. This morning, I spent my time looking at the marketing for “111 First”—the important new way of using 111 that will give people guidance on using the service before they get to A&E. This has been possible only because of the change in the use of medtech and the changing attitude to telephones and the internet brought about by the pandemic. The noble Baroness is right that there is a big focus on communications right now, but that is because things are changing so quickly and we need to get the message across to the population in clear, persuasive terms, to provide the guidance they need to protect and save themselves.
My Lords, all supplementary questions have been asked.
(4 years, 3 months ago)
Lords ChamberMy Lords, as the management of Covid-19 moves to localised decision-making, good will is going to be more important than ever to ensure that people observe the restrictions placed on them. I use my own circumstances as an example. I am currently living under, and fully complying with, extra restrictions because of the outbreak in the centre of Blackburn, yet I have a Bolton address, a Bolton telephone number and I live in Bolton. For me, as for hundreds of others, a random line drawn on a map places us on the far boundaries of Blackburn with Darwen. This geographical disconnect, which will be replicated across the country, risks undermining co-operation. I would be most grateful if the Minister could assure the House that, should local authorities have to take the difficult decision to impose extra restrictions or lockdown, they will be charged to do everything in their power to make them as narrowly focused as possible to ensure that the necessary element of good will remains.
The noble Baroness is entirely right that these local outbreaks create invidious choices for local authorities, and the fine tuning of the boundaries is an important part of the lockdown process. We saw that in Leicester, where the boundaries of the lockdown were changed for the very reasons that she outlines, both to preserve trust and in order to be effective. However, I remind the noble Baroness that the movements of people within areas mean that the disease can spread. Therefore, the lockdowns do not necessarily apply only to those areas with high prevalence in any one period, and sometimes buffers need to be put around the infection area, which is why these areas can seem to be either unfair or overextended.
(6 years, 4 months ago)
Lords ChamberMy Lords, I am delighted that the noble Lord, Lord Darzi, has not been replaced by a robot, and I thank him for the wonderful way in which he introduced an important debate on an important day. Like many people in our country, I owe a huge debt of gratitude to the NHS. It nursed me back to health when I broke my back in a riding accident at the age of 17, and today the brilliant rheumatology and orthopaedic departments at Guy’s and St Thomas’, along with my exceptional GP Stephen Liversedge, literally hold me together and keep me physically and economically active. I congratulate the noble Lord, Lord Winston, on the birth of his new grandchild. Three weeks ago my daughter gave birth to my grandson at St Thomas’. I cannot praise the community midwives and the staff of St Thomas’ who looked after her highly enough.
It is hard work not being well, especially as you get older or suffer economic hardship alongside being poorly. In the mid-1990s, when I was deputy chairman of the then Salford Royal Hospital NHS Trust, I would regularly pop into the hospital at weekends to speak to visitors, patients and staff when they had a bit more time to talk and were less stressed. Invariably, at the top of their health concerns would be worries about not being able to park, difficulty getting transport to hospital, childcare while they were in hospital or visiting, weariness at constantly having to explain their symptoms and their circumstances, fear of losing their independence and their job and fear of not being able to cope with the financial burden of recuperation or to care for themselves or their relatives when they returned home. Much of this is beyond the control of the NHS, but all of it is an important ingredient in the recovery and well-being of patients and their families. That is why it is crucial that we bring together as many services and patients as possible, taking a holistic view that puts people at the centre of decision-making.
In 2015 the 37 NHS organisations and local authorities in Greater Manchester came together to form the Greater Manchester Health and Social Care Partnership and signed a ground-breaking agreement with the Government to transfer the management of these services to Greater Manchester. The Government’s enabling legislation, the Cities and Local Government Devolution Act 2016, made this a reality. In one of its documents, the partnership said:
“Our health and social care reform is built on the need to reimagine services across our whole care system”.
I am delighted to say that, in my home town of Bolton, which is one of the 10 metropolitan and city councils that make up Greater Manchester, reimagining began on Tuesday with a decision by the council and the NHS to work together to take steps to join up health and care. I wish them well.
This builds on an already established and visionary partnership between the council, the NHS and the University of Bolton, which in 2012 saw the opening of Bolton One, a £31 million health, leisure and research centre. Our universities, with their research facilities and training in new ways of working, are vital in this mix of integrated care—and it is not just universities with medical schools but all universities across the country that are delivering excellent work in health and social care. I hope noble Lords will indulge me if I single out the University of Bolton, where I served as the first chancellor, for being ranked number one in England for teaching quality across its nursing courses in the Times and Sunday Times Good University Guide 2018.
I cannot begin to imagine what the future of the NHS will look like, with new technologies and redesigned services. But the one constant will be the dedication and experience of the people on the ground, doing the job and working so hard to look after us and keep us well. I pay tribute to them and wish the NHS a very happy 70th birthday.
(7 years ago)
Lords ChamberThe NHS has never been better prepared for winter and, indeed, for flu. There are something like 21,000 people eligible for free flu jabs this year, including, for the first time, care workers in the independent and voluntary sector. So that is good progress. Of course, we do not know how exactly it will play out.
On the point about readmission, the head of Healthwatch said that the data raises some big questions—and we would agree with that. Some work needs to be done on the quality of the data, and NHS Digital has been asked to look at it. One issue is having the right care settings for patients to be discharged to, which is why I am sure the noble Baroness will welcome the data published last week showing a £500 million-plus increase in health and social care spending on precisely that kind of provision.
My Lords, a few weeks ago, I read an excellent letter by a doctor in a newspaper which said that, as well as having the flu jab to protect ourselves, we have a responsibility to those around us who are more vulnerable. I was shocked last year, when I went to the excellent drop-in centre that we have every year, to discover that one of the most vulnerable groups to influenza is pregnant women. Would my noble friend agree that that message of responsibility to others is a very powerful one, and one that should make us all stop, think and then be immunised?
My noble friend is absolutely right. I fear that the Westminster flu clinic had run out of jabs when I went, unsuccessfully, to get mine, but I did have one last week. Her point was about super-spreaders and this is one of the reasons why young children aged two to eight—who are most likely to live in families with pregnant women—are now getting the nasal spray at nursery and in school. This is precisely to protect the families of those who are most vulnerable.
(11 years, 1 month ago)
Lords ChamberMy Lords, are Amendments 138A and 138B consequential and therefore to be moved formally?
My Lords, I do not think that the noble Lord, Lord Low, wished to move these amendments. He did of course move his earlier amendment which the House decided upon, but I think that he indicated he was satisfied with my reply on these amendments. I do not want to mislead the House at all, but I believe that that is right.
(14 years, 4 months ago)
Lords ChamberMy Lords, the noble Baroness, Lady Masham, has grown even more in my estimation. At 17, I fractured my spine—and if I had not had regular and large doses of morphine I do not know how I would have coped.
Just over four years ago, for reasons known only to itself, my immune system started to attack my body and I experienced the most excruciating pain in my feet, which spread to my hands, my wrists and then just about every other joint in my body. I could walk only if I wore the clumpiest of trainers, and I will always be grateful to your Lordships for allowing such glamorous footwear to be worn in the Chamber. At times the pain I experienced was so bad that my husband would walk downstairs in the morning to find me with my hands inside the deep freeze, so desperate was I to find relief.
I am not alone in my discomfort, and when I recount my own experiences I know I speak on behalf of around 600,000 people in the UK who suffer from one form or another of inflammatory arthritis. Some 380,000 of these have rheumatoid arthritis, which affects three times more women than men. Therefore, I am most grateful to the noble Lord, Lord Luce, for securing this debate.
According to the Arthritis and Musculoskeletal Alliance, musculoskeletal disorders are the second biggest cause of work-limiting health problems and sickness absence in the UK, with an estimated cost to society of some £7 billion per annum—and that is at 2007 prices.
There is a high divorce rate among women with this disease, probably because there are times when we cannot lift a kettle, cut a loaf of bread, do the washing up or iron a shirt. There are some days when you just cannot do anything. We need understanding and supportive families, and I am blessed with a great family.
I now inject drugs which keep most of my symptoms at manageable levels. I am lucky, if that is the right word to use, that I contracted this horrible disease at a time when medical research is making such tremendous breakthroughs. It has been my experience and, as research shows, the experience of most people, that services are most effective when they are delivered through a well-established multi-disciplinary team. The care I get from the rheumatology department at Bolton, which I will probably receive for the rest of my life, is second to none. As well as having had my drug regime sorted out, I have had physiotherapy, occupational therapy, Pilates lessons, warm hand waxes, podiatry and, best of all, acupuncture, which simply took the pain away and left me feeling beautifully relaxed. If I had wanted it, I could have had counselling or hydrotherapy. You name it; there was something for every need.
The acupuncture was so popular that it was difficult to book sessions, which were available only during the working week. I ask my noble friend the Minister whether there are plans to train more practitioners in acupuncture, and might we ever see weekend clinics for all forms of pain relief? I know that Bolton has been running some sessions to train patients in the self-administration of acupuncture, the results of which would be interesting to look at.
I have had excellent access to care in the NHS but, as the noble Lord, Lord Luce, said, this is unevenly resourced. For anyone suffering from chronic pain it is vital, not only for the well-being of the individual but for their families and society as a whole, that they get quick and consistent access to drugs and pain relief, delivered over a range of disciplines, so that they can lead as normal and economic a life as possible.