Covid-19 Inquiry

Baroness Neville-Rolfe Excerpts

Tuesday 3rd September 2024 Lords Chamber

[Baroness Neville-Rolfe (Con)]

My Lords, I thank the Minister, the noble Baroness, Lady Merron, and all who have spoken. It has been a timely and extremely interesting debate. I think we all feel for the grief of those who lost family and friends during Covid, for those who are still suffering from long Covid, for those who lost loved ones from other diseases because the health system could not cope, and for children and students who missed out on a proper education.

The wonderful Covid wall on the other side of the Thames is, to me, a regular reminder of that dreadful time and today’s debate has rightly been touched with emotion. I was particularly struck by the speech from my noble friend Lady Fraser of Craigmaddie on the appalling experience of those with cerebral palsy. There is a lot to learn from such examples.

However, I would emphasise the point my noble friend Lord Evans of Rainow made in his opening remarks that most countries and the World Health Organization itself were ill-prepared for the devastation of Covid-19. I know that is something that my noble friend Lord Kamall would have said had he not been absent—assailed, I have to tell the House, by the prickles of a vicious sea urchin in the Indian Ocean, which means that he is not with us today for this important debate.

I will try to focus on the report but, first, I was sorry that in her critical introduction the noble Baroness, Lady Tyler of Enfield, did not give any credit for what the Government did right; for example, the success of the Vaccine Taskforce, which was mentioned by the noble Lord, Lord Bilimoria. The Government also delivered £400 billion of support—more than almost any other country—which protected jobs, businesses, livelihoods and our cultural and sports institutions. The legacy of this expenditure has been an economic challenge for Governments ever since and we need to learn lessons from that for the future.

I think we need to be open to challenging ourselves. I think that has been the spirit of this debate from all quarters, including from my noble friend Lord Hannan about Sweden and its positive comparative mortality figures and the need to be proportionate.

I am therefore glad that the report stresses the importance of learning lessons from experience and suggests, rightly, that government and the Civil Service do not always do this well. I was struck by the failure to follow through on the Korean and Taiwanese experience of MERS—that is in paragraph 5.27—following Exercise Alice in 2016. Their work on border restrictions, contact tracing and quarantining might have prepared us better. My noble friend Lord Lansley made a similar point and the noble Baroness, Lady Brinton, also referred, rightly, to that useful experience.

A chord was also struck with me by the inquiry’s comments on the deleterious effect of the Civil Service’s bureaucracy—that is in chapter 5, page 129. I very much recognise this problem of bureaucracy from my own experience as a Minister.

However, I want to demur from one term used in the inquiry’s summary. It states in terms on page 2 of the report:

“The UK prepared for the wrong pandemic”.


That statement gives an unfortunate and misleading impression, because readers will assume that the efforts made to prepare for an influenza epidemic were mistaken. Nothing could be further from the truth. As the experience of 1919 showed, influenza can be a terrible disease which leads to a substantial number of deaths, including among young people—unlike Covid—so let me offer a maxim: deaths of young people are even more devastating than those of old people. Hence preparing for an influenza epidemic was not wrong, as the inquiry suggests. It was right and it was supported by government and most of the scientists. However, it was not sufficient, as the inquiry reasonably goes on to suggest. More should have been done to prepare for different diseases by building, I would argue, on what had been done in Asia.

I was also concerned by some of the omissions in the report. In particular, there is very little on cost-benefit and its role in making the right choices in emergencies. Some of us on these Benches suggested during the epidemic that much more could and should have been done to make proper use of economic tools to determine policy, and to involve economists in the many expert groups. I was therefore impressed by the thoughtful speech of my noble friend Lord Frost, with the benefit of his inside view as a Minister at the centre of government. I hope that it will be studied by the inquiry. I particularly share the concern he expressed that we might not get a proper report on the cost and benefits of all the measures that were taken during the crisis. I hope that the new Government will think about that and respond positively.

There is also less than I expected in the report on the local aspects. I agree with the Minister in her admiration for the many volunteers who put communities ahead of themselves. This was my own experience in my home village of Chilmark. There were many heroes and a terrific role was played by local people, volunteers and local and health authorities of various kinds. Faith groups, mentioned by the right reverend Prelate the Bishop of London, were also important, although personally I was very saddened by the closure of churches during the first lockdown. The noble Baroness, Lady Tyler, also made some useful points about the importance of such different bodies, both in a responsive and preventive capacity, in preparing for future pandemics. My conclusion from reading the report, and from that discussion, is that the inquiry model proposed for the future is too centralised.

This feeds on to some messages for the inquiry as it moves forward with at least eight—yes, eight—more modules. Let us take its new approach: while I agree with the need for better use of experts, feeding back to them properly on the use of their advice and having less groupthink, it is wrong to try to construct a system with so little ministerial input. The inquiry appears to have a degree of distaste for the political process. My own experience is that Ministers—and spads, who are barely mentioned in the report—must work closely with experts. Ministers have to make trade-offs; you cannot expect them easily to accept what are possibly very costly recommendations from an independent statutory body, as proposed by the inquiry. This is especially the case since all experience shows that it is Ministers who bear the brunt of any criticisms. Ministers must be accountable and in control. I also agree with those who have underlined the importance of accountability to Parliament, including the noble Baroness, Lady Thornton, the noble Lord, Lord Reid, and others. In my own experience as a Back-Bencher during Covid, it was very difficult to get Parliamentary Answers and replies out of our Ministers, so I obviously need to take some lessons from the noble Lord, Lord Winston.

On devolution, I agree that there should be a unified system for dealing with serious emergencies, but the UK Government have to take the lead. I am afraid that the inquiry is rather naive here; it assumes that relations between the four Governments ought to and can proceed smoothly, with no indication of how such a happy state of affairs might be brought about. In particular, it ignores the political grandstanding that was evident during Covid in certain parts of our country. I hope that the inquiry and the Government will pick up what has been said in the debate today in this important area.

The inquiry also needs to be more aware of the cost it has run up. The Library’s best estimate is £162 million so far, with £108 million of that by the inquiry itself. There is also the opportunity cost of the top civil servants involved. This needs tackling—budgets need to be spent on solutions. I suspect that the noble Lord, Lord Harris of Haringey, might agree with that.

I was pleased to see the readiness of the Chancellor of the Duchy of Lancaster to build on what has already been done by the previous Government. We did many things right if you compare our management of Covid-19 with that of some other countries. I think this is because of the strategic decision taken by Ministers to press ahead aggressively with the investment in and the rollout of vaccines—and, indeed, to bring lockdown to an end, in the teeth of opposition from the party opposite.

Since then, as a Government we developed the 2022 resilience framework and the 2023 UK Biological Security Strategy, both of which were widely welcomed. In the wake of Covid we made improvements to data handling and cyber risk in research, and to our assessment of pharma and non-pharma interventions. We established a national situation centre in the Cabinet Office, and strengthened our resilience directorate and training operations. We undertook emergency exercises involving all the key players, learning from the military and business. The noble Lord, Lord Whitty, made a good point about detailed preparation on kit, testing and so on. The lead department approach is vital in answering that important question.

It is vital that all of this is carried forward. Is that the Government’s intention, or does the review of our national resilience that the CDL has announced presage a completely different approach? That is my first question to the Minister this evening. Secondly, what does the Minister think about the inquiry’s proposal for a statutory independent body for whole-system civil emergency preparedness and resilience? I am, frankly, wary of this, because it could undermine essential ministerial accountability.

The report brings out well the sheer complexity of the multilateral system of providing advice to government on health, science, resilience and preparedness for emergencies. It contrasts with large international companies of the kind I have worked in. It is wasteful and inefficient, and it reduces the productivity of the public sector—a concern which I look forward to debating in the House next month. The report rightly calls the institutions and structures responsible for emergency planning “labyrinthine” in their complexity. This carries huge risks. Thirdly, then, what is the Government’s plan to tackle this spaghetti junction of complexity—so well-illustrated in the report’s complicated government department maps?

If the Minister is not able to answer my three questions, I hope she will agree either to write or to a meeting. She will know from discussions we have had before that I am keen to get things right for the future before the next pandemic arrives. Like the noble Lord, Lord Whitty, I have dealt with several, both in the agricultural area and in the medical human area, in my business career. It is really important to learn and implement the lessons of the past so that the future is better. Those who have lost loved ones deserve resolution and to know that we have learned lessons for the future from this devastating pandemic. We need to be challenging and open-minded with ourselves. This report and this debate today have made a very useful start.

Coronavirus: UK Deaths

Baroness Neville-Rolfe Excerpts

Monday 29th July 2024 Lords Chamber

[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.

Care Homes: Evicted Residents

Baroness Neville-Rolfe Excerpts

Thursday 10th March 2022 Lords Chamber

[Lord Kamall (Con)]

One thing that has clearly upset a lot of people is that they are unable to visit. This means not just relatives but, as the noble Baroness rightly said, people who enter care homes to offer healthcare, stimulation and other services to residents. These issues were brought up, I understand, in a meeting with my colleague, the Minister for Care and Mental Health, when she met residents’ associations. It is very important that we recognise all the problems and that we tackle this in a holistic way to make sure that, as we improve the quality of our social care system, and make it more joined-up and integrated with the health system, we are aware of all these problems so that the patient experience is far better all the way through.

[Baroness Neville-Rolfe (Con)]

My Lords, I agree with my noble friend the Minister and noble Lords opposite that it is very important that people can visit their family and their friends in care homes. My husband has had a copy of Wisden from last year for a friend who has been in a care home, and he has not been able to deliver it.

I want to make a wider point about the importance of focusing on social care, despite other preoccupations of the Government. How many care homes do we have now in this country? Is provision going up, or do we have a serious problem?

[Lord Kamall (Con)]

I am afraid I do not have the detailed answers to my noble friend’s questions, but I will write to her. On the overall sentiment behind that question, it is clear that people now recognise—as we have an ageing population and people are living longer—that we should not see social care as a sort of bolt-on or a Cinderella service. It should be properly integrated, which is why we published the paper on health and social care integration and why we want to make sure that people and patients, all the way through their lives, have access to good-quality care, whether in the current health system or in the care system, at whatever stage of their lives they need it.

Covid-19 Update

Baroness Neville-Rolfe Excerpts

Wednesday 8th December 2021 Lords Chamber

[Lord Kamall (Con)]

I am pleased to hear that someone’s Covid app has not crashed. I am not sure if it is due to Scotland or if that is a coincidence; some of the people in the devolved Administrations may want to raise that with me. The guidance is that you should work from home if you can, but clearly there are some issues. I know that there were mental health and other issues before, but that is the guidance. On the medical question, I hope that the noble Lord will join the all-Peers meeting with Dr Jenny Harries on Friday, when he will be able to put that question to her. If not, he should write to me and I will put that question to her.

[Baroness Neville-Rolfe (Con)]

I thank my noble friend the Minister for making a timely Statement, for the boost to the booster programme and for progress on Covid drug treatments. All are very important to our families and friends, and to the country. Against that reassuring background, I think that some of this evening’s comments were a bit over the top and, I have to say, my NHS log-in leapt into life as the Minister was speaking, so it looks as though it is back on track. I have two questions for him. The first is for an update on cancer cases, especially the outstanding number of cancer operations and hospital treatments, and the impact of plan B on their throughput. My second concern is the economic impact of these new measures until the sunset date of 26 January. We have working from home, vaccine passports and enforcement of masks, which will hit travel, entertainment, business, hospitality and so on. What is this wider economic hit? The Government will not publish impact assessments, as they should, despite my efforts to persuade them, but can the Minister expand on the economic aspects and the impact on growth, employment and productivity? The country is indebted as a result of Covid—and the hit has been 10% over the last year—and businesses have been hit by this. We have to look at the economic side as well as the disease control side, which he dealt with so well.

[Lord Kamall (Con)]

I thank my noble friend for making those two important points. As we know from what happened previously, as a consequence of lockdown, many people were unable to have operations or even diagnoses. In fact, much of the waiting list—80%—is for diagnosis. It is too early to tell what the impact will be, but I will find out and write to her. It is quite clear that there will be a negative economic impact. I do not think one has to be the former head of research for an economic think tank to say that, but it depends on how long this lasts and what economic activity continues in the meantime. I will look at that.

Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021

Baroness Neville-Rolfe Excerpts

Wednesday 1st December 2021 Lords Chamber

Everything is set for three weeks’ time. Christmas is coming towards us. I am really concerned that the tone from Ministers in the last 24 hours is that everything is going to be lifted again for Christmas, when we need to wait for the scientific advice. So can the Minister please send the message back that we should be cautious until we actually know and understand what omicron does and how dangerous it is?

[Baroness Neville-Rolfe (Con)]

My Lords, it is a pleasure and a surprise, as we are discussing an SI, to follow the noble Baronesses, Lady Thornton and Lady Brinton. Although I do not agree with much, I do agree that it is very helpful that we are discussing these SIs so quickly, so I thank my noble friend the Minister. I also agree that we must not put retail workers at risk, as we are in the process of discussing in our debates on the police Bill, and that air filtration systems can be valuable in many settings.

The background to this debate is that we have taken major steps to limit the impact of Covid-19, with 115 million vaccine doses now injected in arms across the country. The more vulnerable and elderly have received boosters now totalling over 18 million, and the race is on to double this quickly. This has been well done and we must all be grateful.

We now face the challenge of the omicron—I am told that is stressed like omega, if you studied Greek, which I did not—and I rise to offer modest support for, but also some concerns about, the new regulations on masks. In particular, I agree that it is right to limit their compulsory scope to transport, shops and services such as hairdressers and banks. I am less happy with the regulation on self-isolation, which is potentially much more onerous and lasts, as we have heard, not for three weeks but until 24 March. I have some questions for my noble friend the Minister.

First, how will all this end? What virulence criteria in relation to omicron will lead to the removal of the restrictions? Can this be done at speed like their imposition or, as we have seen before, will such regulations linger on?

Second—and I have a family interest here—can there be an opt-out from travel quarantine testing for those who have recently recovered from Covid and registered as such? This is very important for children at school, where the virus continues to spread fast. I know that the travel PCR requirements are not covered in these regulations, but I hope that the Minister will answer anyway and make sure that further regulations are clear. There is so much confusion.

I would like to record my belief that both sets of regulatory proposals have a serious defect: we do not have the benefit of an impact assessment or anything like it. It may be technically true that there is an exemption for rules lasting less than a year, but it is a highly unsatisfactory state of affairs. An assessment of the cost and economic impact of such measures is essential to good government and the future well-being of our country, and should inform all decisions such as these. Take the first instrument on masks; the analysis in Paragraph 12 of the Explanatory Memorandum is embarrassingly inadequate and does not even mention small business. What studies have the Government conducted into children wearing masks, the negative and the positive? What is the evidence that they will help with the infectious omicron variant?

Let us consider the second set of regulations. The new self-isolation controls will have a huge impact on work, schools, health, social care and other services, as case numbers rise and the “pingdemic” of last summer returns. They also deal a body blow to the already struggling transport industry, with billions wiped off its value since last week. Do the Government prepare proper assessments to inform their actions? I hope they do; they should summarise or publish them for debates such as these. Doing so would serve to limit overreaction. The last couple of days have been full of rumours of possible overreactions, such as masks being required in theatres and restaurants, and school plays and Christmas parties cancelled. Government spokesmen should be calming matters, not encouraging people to close things down.

We have been partly saved by vaccination, but we have encountered needless damage across the economy and society over the last two years, because of our lack of attention to economics. Saturday’s BBC coverage helped me to understand why. At his press conference, the Prime Minister was sensible and serious, but the lead commentary afterwards came from a member of one of the SAGE committees, Susan Michie. She is a professor of health psychology at UCL and a well-known communist, and she wanted to go much further. Why are there a number of psychologists on SAGE and not economists—although I think there is a leading statistician? Indeed, you might ask why communists are involved at all.

On my final point, perhaps my noble friend could say whether he and the Secretary of State, both of whom are more aware than their predecessors of the importance of growth and economics to the well-being of everyone in the country, might look at the composition of SAGE and add an economist or two, now it looks as though, sadly, Covid is continuing to be more extensive than we all hoped.

[Baroness Noakes (Con)]

My Lords, I first support what my noble friend Lady Neville-Rolfe said about impact assessments. In fact, I have tabled a Motion on a later coronavirus order regretting the lack of impact statements, which I look forward to debating with the Minister in due course.

I start by recording what Reuters reported today from a World Health Organization official. He said that, to date, most omicron cases have been “mild” and that there is no evidence yet of reduced vaccine effectiveness. On that basis, we may find that these orders have been overhasty and that we do not see an extension of them.

I will concentrate my remarks on the mask-wearing order, because I continue to believe that there is insufficient scientific evidence on which to base requirements for people to wear masks. Much attention was paid, a week or so ago, to a meta-analysis that was published in the British Medical Journal. Its headline was that masks showed a 53% cut in the transmission of infection. When one looks at the detail of that meta-analysis, the case falls apart. Of the large number of studies included, only six related to mask wearing, of which two had a critical and four had a moderate element of bias. Of those four, only one was a properly randomised trial and its results were inconclusive. There is no evidence that scientifically supports the wearing of masks.

I will not oppose this order and I hope it runs out in a few weeks’ time, but I hope that the Minister ensures that the right messaging is put out. I have heard that the noble Baronesses, Lady Thornton and Lady Brinton, want it extended, including to theatres. They may like to know that this is already happening. I reveal one of my hobbies by saying that, yesterday, I received emails from both the English National Opera and the Royal Opera House telling me that, as of yesterday, they were mandating masks. I have to put up with a mask for the sake of listening to Wagner, this weekend, but the messaging that this order relates only to shops, transport and the close personal services that were referred to earlier is not out there.

In addition, when I got back to my apartment block last night, the management company had splattered the place with “Masks now required”. I challenged that today and of course there is no legal basis for that prohibition, so I have asked it to remove or alter the messaging. Unless the Government give clear messages to the public at large that this is a very limited measure for very good reason, and there is no need for it to be extended further, it will carry on spreading like some kind of virus throughout all social activity. We must not let that happen.

--- Later in debate ---

[Lord Kamall (Con)]

I apologise to the noble Baroness if I came across as sarcastic.

In terms of hospitality settings, quite rightly, as a number of noble Lords have said, even though we have mandated it in certain settings, it is being left to settings to decide. This is in line with property rights, but also something that people have been asking for—a number of noble Lords have asked “Why not just let the establishments themselves decide, so people can make a decision whether they go to somewhere where masks are mandated or somewhere where they are not mandated?” We are looking really hard at this and we want to make sure that we are proportionate. It could be that we find out that omicron is not that dangerous, but we have to make sure that we have the data and that we sequence it all. It could be that it affects us more in the UK that it would in South Africa because of the change in demographics. That is a really important point.

In terms of who is responsible for enforcement, the police and Transport for London officers have powers to issue fixed penalty notices for non-compliance with the regulations. They are using the four E’s in a proportionate way: engaging, explaining and encouraging before enforcement, just to remind people, if they can, to make sure that they wear a face mask.

The Health Secretary has also asked the JCVI to consider giving boosters to as wide a range of people as possible. If you are boosted, your response is likely to be stronger, so it is more vital than ever that we get our jabs.

On helping the rest of the world, the UK remains committed to donating 100 million doses by mid-2022. We are also extremely grateful to the South African Government; we have been talking to a number of partners, including South Africa directly, to make sure that we do not disincentivise other countries for doing the right thing by reporting the outbreak in the first place. We are doing all that we can.

I am trying to make sure that I answer all the questions; I apologise if I am not able to. My noble friend Lady Neville-Rolfe asked about exemptions for children under the age of 11 and those unable to wear a face covering due to health, age, equality or disability reasons. In terms of the impact to the economy, we do not know the extent to which the variant escapes the vaccine, but as soon as we do, we will be able to make a better measure. We do not at the moment expect there to be significant economic disruption. We have said that we believe face coverings are effective at reducing transmission indoors. The recent UKHSA study suggests that all types of face coverings are, to some extent, effective, but we also welcome challenges to that data. The advice remains the same: we believe that, on balance, it is better to wear a face mask. Many noble Lords have agreed and disagreed with that, but we have to balance these things.

Proportionate measures remain in place in schools. Face coverings should now be worn in communal areas by older students and teachers. The Department for Education is looking at how we make sure that there are clear guidelines on that. We advise staff, visitors and pupils to wear face coverings in communal areas.

I turn to the point from the noble Baroness, Lady Tyler, and that very personal case; it highlights—this should sober us up—those very powerful words that this is not over. We have said that consistently. It is not over. If we believed it was over, we would have removed all restrictions. It is highly likely, but not definite, that we may have to continue to get boosters. Just as we have an annual flu vaccine, we may in the future end up with an annual Covid vaccine, including looking at other strains.

We have said who is responsible. In answer to a point made by my noble friend Lord Cormack, may I suggest that he takes his point about continuous committees up with the Lord Speaker? That is not really in my remit as Minister for Health. My initial reaction is that it seems a good idea, but let us see what the Lord Speaker says.

I again thank all noble Lords for their contributions and for continuing to challenge. That is really important. I can assure my noble friend Lord Cormack that today I asked my department for a list of potential or forthcoming regulations so that we can lay them as early as possible, as my noble friend and other noble Lords suggested. I am grateful for the acknowledgement that we laid these regulations as quickly as we could, and I pledge that we will try to improve that as much as we can, I too, believe very strongly in procedure and the Government and the Executive being held to account. It is really important.

[Baroness Neville-Rolfe (Con)]

Before my noble friend sits down, I thank him for mentioning the economy. His assessment is that the impact on the economy should not be great, but of course there has already been an impact on the economy from this new strain. I think I mentioned in particular the transport industry, which has been affected. Would he be able to come back to me on this business of economic assessment—in fact, not only economic, as I am also worried about the impact of the measures being taken on things like cancer deaths. There is no time to discuss that now, but I would really like to have a further discussion, perhaps bilaterally. We will of course have my noble friend Lady’s Noakes’s regret amendment in due course, but that may be months away. It really is very important to understand the implications of what we are doing. We are doing it for the right reason, but it has a wider impact.

[Lord Kamall (Con)]

My noble friend raises an important point. We also have to clear about unintended consequences and the costs of what we have been doing. I read an interesting article from the leading behavioural economist Paul Ormerod, who asked where have all the economists been when it came to this debate, as economics is about considering trade-offs.

I again thank the Government of South Africa for their rapid identification of the variant and their transparency in alerting the global community. I commend our scientific and public health experts who continue to monitor the situation closely alongside our scientific and public health partnership organisations across the world. We are continuing to collaborate in order to understand the virus, including the data and the different demographics that our countries have and whether a study in one place is relevant to a study in another place.

I also thank the House for its valuable scrutiny today. The Government hope that the temporary and precautionary measures laid in these regulations will enable us to slow down the spread of the omicron variant while we gather more information on how best to deal with it and how infectious it is. The Secretary of State assured Members in the other place that if it emerges that the omicron variant is no more dangerous than the delta variant, we will not keep these measures in place for a day longer than is necessary. I hope that that is the case, but we must take precautions and act decisively until we have a fuller understanding of the omicron variant. I commend these regulations to the House.

Food (Promotion and Placement) (England) Regulations 2021

Baroness Neville-Rolfe Excerpts

Tuesday 23rd November 2021 Grand Committee

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the Minister and the Government for the initiative, which I would describe as making tentative moves to try to reduce the growth of obesity. I declare an interest as vice-chair of the All-Party Parliamentary Group on Obesity, and I am grateful to the Obesity Health Alliance, which has recently produced a very wide-ranging and thorough examination of the problem. I am grateful to it for the briefing.

It is worth remembering that the last serious attempt to tackle this was after the coalition Government came into power in 2010-11, when an alcohol strategy was drawn up and there was an engagement between government and the private sector, and the many representatives of the health business, if I can describe it like that, who were anxious to see changes effected. We had the creation of the responsibility deal, which ran from 2011 through to 2015, when it collapsed. The health officials were unhappy about the way in which the agenda was being run, and in 2013 many of them withdrew because they felt that the private sector—the manufacturers and retailers—were controlling the agenda and that public health was rather lower down the line than profits. So it went in 2015, and since then we have had very little change, apart from a growth in obesity.

On the alcohol front, on which we have spoken from time to time, apart from with youngsters there continues to be a problem there, with more and more people going into hospital and more and more people dying from liver problems. The real concern here has been with the growth in obesity among youngsters. We have been at this since 2006, when the Labour Government first kicked it off with the national measurement scheme. Initially, the idea was that we would engage over a very wide area, but because of the continuing cuts that have taken place in public expenditure at local level, it has not really made a great deal of headway. We have had a fallow period, with many of us complaining over the years, but it would be churlish not to say that I welcome this move, although that is not to say that I am going overboard over what the Government are proposing.

I have a number of questions. It has taken us six years—seven years, really, since it will be 2022 by the time we finish the consultation with the parties involved and this is put into effect—but the document talks about waiting another five years to do a review. Unless I have misunderstood, it will be five years before it is fully reviewed again. Could you correct me if I am wrong or, if I am right, explain why we have to wait another five years, which means that we will have run from 2010 to 2027 before we really look at some of the serious proposals made by the Government?

Secondly, I would like to know who is covered by the square footage provision. Obviously, hypermarkets and supermarkets are covered, but I would like to know whether convenience stores are also covered. I live in Battersea, near the bridge, and next to us we have a local co-op that does extraordinarily good business. Would it qualify to be covered by the changes that are proposed? I cannot remember the figure, but it may be 1,200 square feet. I would be grateful if the Minister could say whether convenience stores fall into it, because they are major retailers in this context as they sell nearly half as much as the supermarkets do. If they are not covered, it will be a major omission and something that we would want to return to.

Thirdly, I listen carefully to everything the Minister says as he finds his way with his new brief. At his first Questions, he talked about unintended consequences and said that it is very important when we are making changes that we try to foresee them. I am particularly interested in seeing how retailers effectively drive a coach and horses through so many areas of legislation with their ability to place their goods in a position which sells them best for them but on the other hand brings them to the attention of children, in particular.

Again, I mention my local Co-op. No longer can people see cigarettes. They are hidden. It took years to get that changed, but it is a worthy development that was put through by the Government. When I go in, I am now surrounded by alcohol. We have all this about advertising, thresholds and the rest of it, yet when children stand in the queue to buy their Mars bars in the Co-op, they are surrounded by alcohol and, on the other side, by doughnuts and a host of sweeties which are attractive to them and which, as we know, are at the heart of the growth of obesity. I wonder whether the Government have thought through what will go in place of the movement of some of these articles which are presently being sold, which have been identified as being very risky from a health point of view. If they do not cover it, I suspect we will find, for example, that alcohol goes there, which is what has happened previously. I know that is not about child obesity, but none the less it relates to obesity, as 10% of all obesity comes from the sugar in alcohol. So we are continuing with the same problem, especially given that we still do not have any indication on alcohol. You queue there, and there is no indication of the sugar content or the calorific effects in the drinks. Perhaps the Minister might say what the Government are intending to do about that. I know it is not in this document, but it is all interrelated with obesity, and we cannot separate it too much.

In another initiative, trying to be as positive as I can be with the Committee, Sir Keith Mills, who was responsible for Air Miles and Nectar points, has been doing a special piece of work for the Prime Minister and has come up with a number of trials. Is there a correlation between the work that will be put in place in this document and what he is endeavouring to do in incentivisation? I may sound negative, but I believe in incentives to encourage people to eat and drink better and I believe in trying to find incentives in which the private sector, particularly retailers, will not to try to take advantage but will work together so that we will see positive incentives offered to them to effect changes in the formulation of food and the way in which they present drink and food in retailing terms. Is there a link between the activities he is undertaking?

Finally, can we see more experimentation? I am very pleased that Sir Keith Mills is doing that. Wherever we can try to engage with those who are interested in the private sector, we should try to get joint working taking place where, if the Government see it works yet the private sector does not want it, they will do what they are doing today. I hope they will stick to their guns, legislate and make the changes stick rather than change their mind and run away under pressure from the industry.

[Baroness Neville-Rolfe (Con)]

My Lords, I congratulate the Minister on his clear and succinct explanation of these regulations and of the risks of obesity, which we have witnessed a great deal during the Covid crisis. The noble Lord, Lord Brooke of Alverthorpe, then spoke about the APPG’s work on obesity.

I probably should register an interest. Although I no longer have direct food sector interests, I have shares in Tesco. In fact, I recall that it moved early in banning sweets from checkouts, but obviously it will incur costs from these regulations. I also have shares in Amazon, which, I suspect, could benefit from a shift online as a result of the regulations, which probably bear less heavily on online.

Forgive me for a brief diversion, but I was absolutely delighted to see that the regulations were made under the Food Safety Act. The passage of that Act was one of my proudest achievements as a civil servant. In fact, I supported the late Baroness Trumpington, whom I miss so much; she even gave me a toy pig for my baby, which has now been passed on to the next generation.

--- Later in debate ---

I thank my noble friend Lady Neville-Rolfe for forwarding to me the list of 25 priority questions compiled by the Food and Drink Federation, the British Retail Consortium and the Association of Convenience Stores. It is a priority to finalise the guidance for businesses as soon as possible and make sure that it supports industry as far as possible to get the right balance. Officials are concentrating on completing the exercise and, as part of this, are considering the feedback that the authors of these questions have offered. Our intention is to provide a point of clarification to industry in the final published guidance, which we are working to publish as soon as possible after these parliamentary debates. So, watch this space and do challenge me if it does not happen imminently.

[Baroness Neville-Rolfe (Con)]

It would be very helpful if, in responding to those questions and proposing the guidance, my noble friend the Minister could make a copy available, perhaps in the Library, to those of us who are interested in understanding because I do not think that this is the end of the era on this issue; I think we will revisit it again and again in various different ways.

[Lord Kamall (Con)]

My noble friend makes a very reasonable demand that is difficult for me to refuse. Let me put it this way: I hope that I have not caused any shock waves, as it were.

There has been an impact assessment, which shows that the location restrictions over the 25-year appraisal period are expected to bring health benefits of more than £57 billion and provide NHS savings of more than £4 billion. The volume price restrictions are expected to accrue health benefits of more than £2 billion and provide NHS savings of £180 million. We recognise that there will be costs to businesses; once again, this is all part of that difficult balance and debate. A phrase I have often heard is, “Do not let perfection be the enemy of progress”. We want to try as hard as possible to get this right. From the consultation that has been going on, we are very aware that this will have an impact on a number of businesses but, at the same time, there is lots of pressure, as noble Lords will have heard today, just to get on with it.

[Baroness Neville-Rolfe (Con)]

I am sorry to interrupt again, but £57 billion is a much bigger figure than I have seen anywhere; £3 billion, perhaps separately, I could understand. It is really helpful to have the impact assessment but it is difficult to understand what the benefits and costs are, which we need to understand to give my noble friend the Minister the full support that he requires.

[Lord Kamall (Con)]

Once again, I thank my noble friend for making that request. I always make it clear that it is important that we publish as much evidence as possible and let it be challenged; that is part of a healthy debate. If things do not work as intended, we should see what works and what does not. I am always very sensitive when someone says, “the evidence suggests”. We need to have that challenge but also make sure that we know what works. At the end of the day, we all want to see less obesity across our country, so surely it is important that we make sure that the evidence is there. Where something does not work, we will just have to try other ways.

On compliance, it is for local authorities to decide how best to enforce the requirements. Where an enforcement officer suspects that HFSS food or drinks may be inappropriately promoted, they should request further information to verify. If the product is in scope and has been promoted contrary to the law, an enforcement officer will consider what action should be taken.

Public Health Grant to Local Authorities

Baroness Neville-Rolfe Excerpts

Tuesday 2nd November 2021 Lords Chamber

[Lord Kamall (Con)]

The Government have allocated more money for local authorities but we think that it is best left to local authorities to decide how to spend that portion of their grant, for they are closer to the people in the communities that they serve.

[Baroness Neville-Rolfe (Con)]

Does my noble friend agree that a public health capability in local authorities is very important? I was very impressed by the work the head of the public health office did in my home town of Salisbury during the poisonings of the Skripals. I have heard reports that some of the duties of the office or its funding might be transferred to the NHS, which has enough on its plate. Is there any truth in this report?

[Lord Kamall (Con)]

It is true that some of the allocation for the National Health Service is being used for public health spending, but we want to make sure that across the health system the NHS not only focuses on prevention and therapeutics but works in partnership with the public health authorities.

Commonwealth Fund Report: NHS Ranking

Baroness Neville-Rolfe Excerpts

Tuesday 14th September 2021 Lords Chamber

[Baroness Neville-Rolfe (Con)]

I hope my noble friend has seen recent reports from NHS doctors in the Daily Mail and elsewhere about the slowness of the NHS to embrace obvious change. Does he think that there are sufficient resources such as GPs, hospital doctors, nurses and medical equipment, to allow the new money being made available announced last week—for which, thank you—to be spent effectively, thereby lowering waiting times? I worry that it will just boost pay cheques, as we saw under a previous Administration.

[Lord Bethell (Con)]

My Lords, I take my noble friend’s point: there are hot spots of innovation and change in the NHS, of which we should be proud, but she is right that the NHS is a large organisation and change can be challenging. In particular, I pay tribute to the Office for Life Sciences, the Accelerated Access Collaborative and NHSX—three organisations within the NHS that are driving change. I also pay tribute to the People Plan, which is putting innovation at the centre of the culture within the NHS. I agree with my noble friend that more can be done in this area.

NHS Update

Baroness Neville-Rolfe Excerpts

Thursday 22nd July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, we will be accountable for the use of DNR and it is right that the noble Baroness’s specific question should be asked: were any groups disproportionately at the wrong end of this? She is right to ask the question. I cannot give her a precise date for the inquiry, but I have given absolutely cast-iron reassurances that it will happen. I am very tired, as is everyone else, and the thought of starting an inquiry today while preparing for the winter is not one that will help our productivity or help to save lives in the difficult time that we have ahead. The right time for the inquiry is probably when the pandemic is truly behind us.

[Baroness Neville-Rolfe (Con)]

My Lords, the NHS is highly regarded by most people because it is available to all for free. But, as the Statement rightly recognises, despite record investment, it faces major challenges. In particular, survival rates for many cancers trail those in comparable countries. How do we secure the necessary improvements in the NHS, especially at a time when it faces record waiting times?

[Lord Bethell (Con) [V]]

My noble friend gives me an opportunity to raise one of my main ambitions for the health service, which is clearly outlined in the life sciences vision. She is right: we catch too much cancer at stage 3 or 4, when there is sometimes not much that we can do, and anything that we do will be very expensive and make only marginal differences. That is not the same in all countries and it is not good enough in this country. That is why we need to invest in diagnostics and preventive medicine. We need to reweight our health system away from clinical interventions on lumps and bumps at a very late stage. We need to interact with patients at a much earlier stage of their disease. Only in that way will we be able to afford the healthcare system that this country deserves and to give people longer, better lives.

Elderly Social Care (Insurance) Bill [HL]

Baroness Neville-Rolfe Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Baroness Neville-Rolfe (Con)]

My Lords, the Bill deals, although at one remove, with one of the greatest and most welcome developments of the last two centuries. I refer of course to the extraordinary increase in average human lifespan that has occurred over this period. The separation of clean and foul water, advances in medicine and the development of vaccines, the discovery and invention of antibiotics and the recognition of the importance of safety in industrial processes, taken together with a realisation of the effects of smoking and diet on health and other factors, mean we have seen a rise in the average lifespan from well under 60 to around 80. This is a wonderful achievement but, like all advances, has thrown up problems. The greatest of these is the increased and increasing need of many elderly people for care, especially residential care, and its financing. The present arrangements are creaking.

As a society, we have taken a long time to grasp this nettle and, while Governments of every colour have dallied, the situation has deteriorated. Meanwhile, the financial position of local authorities, at least in England, has become much more challenging for various reasons, one of the most important of which was the cutbacks following the financial crisis of 2008. Some allowance has recently been made for local authorities to raise extra funds for social care, but the sector needs a significant injection of cash if standards are to be maintained, staff are to be rewarded properly and operators are to find it worthwhile to remain in the system.

What are the problems other than the need for money? One is uncertainty. None of us knows, early in life, how much care we will need over our lifetime. We might need none or we might need decades of care. Most of us will fall somewhere between these two extremes, but the financial difference between them is enormous, running into hundreds of thousands of pounds. Accordingly, another problem is fear—fear that we might be faced in old age with vast financial claims that will eliminate our lifetime savings.

All this seems to point to the need for an insurance-based solution, since in many areas of life that is how we cope with risk, with the advantages of pooling risk that it provides, but as my noble friend Lord Lilley has so eloquently explained, this is an area where private insurance cannot operate, mainly because of the fear that calculations will be upset by changes in government policy. My noble friend proposes to solve this dilemma in a typically brilliant way by harnessing the value of people’s houses after death in the way he has outlined as a component of what amounts to a voluntary, but state-guaranteed, insurance system which will operate at minor cost to taxpayers. It has been welcomed today as a workable solution by my noble and learned friend Lord Mackay of Clashfern, and the noble Lord, Lord Wigley, in a powerful speech, said it could play a part. This Bill represents a responsible and timely way forward. We need to act now. There is no sign that the Government will be able to do so quickly, so we should enthusiastically support this Bill which would make a contribution, large or small, to one of the greatest problems of our time.