Inflammatory Bowel Disease

Baroness Redfern Excerpts

Monday 20th May 2024 Lords Chamber

[Lord Markham (Con)]

The long-term workforce plan sets this out. We are getting a good response in terms of filling up the places. We have about 98% or 99% of the training places filled. The challenge is that this service, more than anything else, suffers from the highest burnout. That is the area where we are struggling to fill the places. Therefore, we are trying to ensure that this scarce resource is used by people and that this early screening test is used so that people can see who they really need to see.

[Baroness Redfern (Con)]

My Lords, I welcome the Government’s commitment to appoint a senior official to take responsibility for home care medicine services as a way forward to address awareness of coeliac disease and Crohn’ disease. Will there be a periodic update of data on how home care medicine services are functioning and a date for commencement of that data?

[Lord Markham (Con)]

We had a very good debate on this a couple of weeks ago. All noble Lords accepted that it was a bit of a Cinderella service at the moment, but vitally important to a lot of people’s everyday well-being, so I am happy to do that.

Integration of Primary and Community Care (Committee Report)

Baroness Redfern Excerpts

Thursday 9th May 2024 Lords Chamber

[Baroness Redfern (Con)]

My Lords, it is a pleasure to follow my noble friend Lord Jamieson’s excellent maiden speech. I have enjoyed our mentoring discussions since he entered the House. Having served a successful term as chairman of the LGA, he noted in his leaving remarks:

“When we can speak with one voice, and with coherent arguments, we have real strength”.


That is crucial to the LGA’s ongoing success, now and into the future.

My noble friend also held the position of leader of Central Bedfordshire Council. His further interests are, in particular, sustainability, improving the health service, and the levelling-up agenda. I know he is committed to all councils playing their part in improving the health of their residents, meeting their housing needs and providing green spaces, which we all agree are vital to improving well-being and tackling social isolation. Yes, my noble friend certainly has much to contribute to the House and we look forward to his future interventions in the coming months. Finally, I am told that his immediate plan on leaving the LGA was to see Bruce Springsteen, but I do not know whether he managed to do it. He says that he did, so there we go.

It is indeed a privilege to speak in this important debate. I thank the Government for their response on this area of primary and community care. I thank our chair, the noble Baroness, Lady Pitkeathley, for her excellent chairing throughout our meetings, when we had the opportunity to hear from the many witnesses who gave up their valuable time to attend. I also thank our much-valued secretariat.

The value of collocation and multidisciplinary working in primary and community care is unquestionable, but having said that, care will continue to vary, whether in urban, rural or, indeed, coastal communities. It is valuable to pool additional funding into the BCF where that need is greater. I agree with the importance of all local authorities keeping boundaries under review, with support from all affected partner local authorities.

The overwhelming issue is the major barriers arising from the variability of our IT systems. Much work is needed in all areas to bring those systems together so that they are compatible, and to make real and lasting improvements by promoting interoperability between IT systems. That would not only make it easier for people to track information but allow for quicker decision-making, acknowledge patient privacy and, above all, cut bureaucracy. In essence, data sharing must improve so that we can say that data is just one click away, sweeping away the many fragmented systems that ask patients over and over again to supply the same medical information and engulf them in bureaucracy.

I am pleased to note that the Government have emphasised how important it is to provide additional clarity where necessary to support further integrated working practices. They have also acknowledged that the digital transformation of health and social care is a top priority for the DHSC by enforcing these standards through compliance notices, together with financial penalties, in parallel with an accreditation scheme. The framework accreditation programme will simplify procurement and speed up the adoption of innovation through frameworks, so I welcome NHS England changing the NHS standard contract by requiring trusts and foundation trusts to use only accredited frameworks from April 2024.

I turn to the estate. In essence, in many instances the answer to overcrowded hospitals is not building more hospitals but linking with intertwined primary care and social care services, as infrastructure is simply too important and costly to get wrong. If this does not happen, more expensive hospitals will need to be built to manage acute needs that could have been prevented or better managed.

For most people, being treated at or as close as possible to home is best for their health and is how they want to be cared for, rather than leaving their health needs until they require hospital treatment. That is best, and cost-effective for the NHS, but there is a cycle of invisibility of primary and community health and care services, which are hard to quantify and easy to overlook because less data is available.

Equipping our valued staff with improved training, creating opportunities through built-in shift flexibility for health workers, and giving greater responsibility for good career progression will no doubt improve morale and retention. For those reasons, that will attract and interest new employees, making the NHS a serious, attractive proposition now and for their future progression. As ICSs become more involved in education, training and planning, a plus point must be extending the provision of placements across primary, community and social care, in particular the independent and voluntary sectors, so that students can gain valuable experience of care outside hospitals, thereby introducing them to wider career opportunities.

Delivering primary care with the premises and tools needed to keep patients healthier for longer has to be a win-win: reversing the predicted rise in demand for high-cost, reactive, hospital-based care; supporting people in taking care of their health and well-being; and intervening early, keeping people healthy at home for as long as possible, and enabling them to retain their confidence, particularly when they live on their own.

This is against the background of an expected increase of 25% in the number people in the UK aged over 65 by 2050. That is certainly a massive challenge for any Government. I welcome the expansion of community pharmacies, which are showing good signs of integration and co-operation and take significant time away from GPs. The Government are consulting on extending prescribing rights to dental therapists and hygienists; this is hopefully to be concluded soon, ensuring a faster service. Therefore, patients must be given more powers, via the NHS app, to control their own health and NHS services, and to facilitate self-care in collaboration with professionals. Unfortunately, we have low levels of digital literacy among some staff, patients and service users; that is a barrier that must be worked upon and overcome.

Yes, much has to be done. Much more needs to be done if we are to see patients at the very heart of their health journey.

Children’s Health: Ultra-processed Foods

Baroness Redfern Excerpts

Wednesday 25th October 2023 Lords Chamber

[Baroness Redfern (Con)]

My Lords, I thank noble Lords for allowing me to speak in the gap—and my thanks to the noble Baroness, Lady Jenkin, for introducing this debate, which raises challenging issues. The importance attached is that the focus should be on trying to eliminate at the earliest opportunity addictive products that create poor outcomes for our young people and to designate clear information, particularly on labelling on snacky and on-the-go foods that are high in fat, sugar and salt. Good advice labelling, with a typeface large enough to be read, can be really good for families, helping them to make informed choices—and not with a tiny typeface so that it is hidden. This poses a question that needs an answer, of whether there is a case for revisiting our food labelling laws.

The facts are stark, when one in three children leaving primary school is obese. The statistics are truly shocking, particularly when it is noted that evidence found that 64% of school lunches with high calorific value come from ultra-processed foods. There is an opportunity for change—an open door beckons for our young pupils—for schools and public settings to create a ripple effect for new alternative healthy and attractive choices.

The Government have reaffirmed their priority of continued action to reduce the consumption of these highly calorific foods, with their advertising proposals of a watershed of 9 pm on television and UK on-demand programmes. Those restrictions were originally due to come into force in January 2023, but they are now not due for a further two years. Delays are not something that we should be contemplating. Online advertising of unhealthy food and drink products is a further outlet attracting a younger audience.

As we have heard, there are many arenas in which change for good can be made in helping to reduce the number of obese children and reduce sugar content for better oral health, better to minimise the number of teeth extractions that have to be carried out in hospital settings, which can be very upsetting.

If industry does not change, government must dig deep to intervene sooner, as time is ticking on our obesity figures, which are alarming, and the cost for the NHS speaks for itself.

NHS Dentistry

Baroness Redfern Excerpts

Monday 31st January 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for that suggestion, which I will take back. The BDA, the NHS and the Department of Health and Social Care are well aware that we need to tackle a raft of health inequalities in this country, including in dental care. The Covid pandemic has highlighted some of those inequalities, and so we can focus on them.

[Baroness Redfern (Con)]

My Lords, I welcome the Government’s much-needed boost and the extra £50 million. I particularly welcome the allocation to my area, the north-east and Yorkshire, of over £9 million. One of the six aims of the national contract reform is regarding dentists. With the current contract, how will the Government set a date for the end of the UDA framework? When might it be rolled out to help with recruitment and retention of NHS dentists, as there is urgent need for reform?

Health and Care Bill

Baroness Redfern Excerpts

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

[Baroness Walmsley (LD)]

My Lords, a very compelling and, indeed, conclusive case has been made by the noble Lord, Lord Blencathra, and other speakers in favour of this amendment, and I hope the Government will accept it. I particularly commend the suggestion made by the noble Lord, Lord Rooker, that the answer is there for us in science. I have only one question, because I have no intention of repeating all the excellent comments that have been made. This morning, I went into the Bishops’ Bar and picked up a box of lateral flow tests. On the box was written, “Made in China”. Can the Minister explain what efforts have been made to ensure that noble Lords, in their attempt to protect others and themselves, are not unwittingly supporting forced labour and slavery?

[Baroness Redfern (Con)]

My Lords, I rise briefly to support this amendment, and I apologise for not attending Second Reading.

This amendment requires the Government to perform a risk assessment on whether there is a “serious risk of genocide” in a region from which it is sourcing—not to make a genocide determination. It is the UK’s obligation under international law, as a signatory to the genocide convention, to perform such a risk assessment. We have heard many harrowing stories, which we find so difficult even to believe. Uighur identity is being erased: future generations are lost through forced birth-prevention measures, and millions have been detained, tortured and violated in concentration camps.

The incorporation of this amendment would send a clear signal to both the Chinese authorities and the international community that the UK is committed to ridding its supply chains of forced labour, fulfilling its obligations under international law and protecting Uighur people from genocide. The amendment is an opportunity to offer the Uighur community accountability for genocide and crimes against humanity, and I support it.

[Lord Collins of Highbury (Lab)]

My Lords, like the noble Baroness, Lady Sugg, I apologise to the House for not participating on Second Reading. This is one of those rare opportunities for me to be at one with the noble Lord, Lord Blencathra. These opportunities do not arise very often, but today is one of them. Of course we were at one in the debate on the then Trade Bill, and I very much welcome the continued focus on this issue, particularly by the noble Lord, Lord Alton. On the Trade Bill, we—I with my amendment—attempted to ensure that we were not simply trapped by this very strict legal definition of genocide and that we focused on broader human rights issues, particularly when it comes to trade. We find the reason for that when we ask—I pick up the point made by the noble Lord, Lord Polak—“When does genocide start?” How does it start? It often starts by the use and harassment of words; it starts with words.

In quite a few debates I have given books a plug. I am currently reading “Chips” Channon’s diaries, which I would recommend. Reading his discussions during the 1938 crisis, I was struck by how anti-Semitism was just common talk, and how people were portraying Hitler as not that bad, as well as some of the incidents: Kristallnacht was “unfortunate”. It is those sorts of things that we really do need to focus on, and I hope that the Minister will be able to do that.

This debate is about probing government action; it is not simply saying, “This is our amendment: take it.” This is Committee stage, and I hope we can use it properly to probe the Government because, sadly, I often think—today of all days—that we do not have joined-up government and there is too often a gap between what the Government say and what they do. As the noble Lord, Lord Alton, said, only 12 months ago the Foreign Secretary, now Deputy Prime Minister—who knows what he will be tomorrow—announced business measures regarding human rights abuses in Xinjiang.

I have read the BMA’s briefing, which focused on ethically sourced procurement. That is what this debate is about. It is not just about the definition of genocide. The National Health Service, is, I think, the biggest single procurer of medical products in the world. It has huge opportunities to influence trade and price. We have debates about price and my noble friend Lord Hunt focuses on that a lot. With that leverage, the NHS has the opportunity to influence change. This debate is not about punishing China or the Chinese people but about influencing change and hoping that the Chinese Communist Party and the Chinese Government will think twice about some of the actions they are taking. I hope today we will have an opportunity to probe what the Government are doing, look at what they have said and see what they have done.

Following his announcement in January 2021, Domonic Raab went to the Human Rights Council. There he said:

“The UK will live up to our responsibilities.”


He referred to

“measures aimed at ensuring that no company profiting from forced labour in Xinjiang can do business in the UK, and that no UK businesses are involved in their supply chains.”

That is absolutely right. The promised measures he outlined included

“a Minister led campaign of business engagement to reinforce the need for UK businesses to take action to address the risk.”

Have we seen that? Where is the evidence? I am not sure that I have seen it, even though I have asked numerous questions on the Modern Slavery Act about that.

Dominic Raab then referred to

“a review of export controls as they apply to Xinjiang to ensure the Government is doing all it can to prevent the exports of goods that may contribute to human rights abuses in the region.”

Here, I pick up the point mentioned by my noble friend Lord Hunt: this equipment could be used to do the very things he highlighted regarding organ transplants. I want to hear from the Minister: what are we doing on that commitment made 12 months ago? What are we doing at the WHO on investigating this abhorrent practice?

Dominic Raab also referred to

“the introduction of financial penalties for organisations who fail to meet their statutory obligations to publish annual modern slavery statements, under the Modern Slavery Act.”

I have repeatedly asked Ministers when and how that is happening, but, 12 months later, I have seen no evidence. As we heard in this debate, it is not as if that obligation is particularly hard to meet. It is not as if it says, “You won’t do this” and “You will do that”. It simply records what they are doing.

Sugar

Baroness Redfern Excerpts

Monday 24th January 2022 Lords Chamber

[Lord Kamall (Con)]

We are looking at a number of different measures in terms of what works and what does not work, and we are very clear that it must be based on evidence. The Government keep all taxes under regular review, and decisions about the future development of taxes are made by the Chancellor, in line with the Government’s tax policy-making framework.

[Baroness Redfern (Con)]

My Lords, overconsumption of sugar causes both dental decay and obesity, but it is dental disease which, unfortunately, is in many cases largely irreversible. Does the Minister agree that action to tackle diet-related disease such as tooth decay must be formally recognised as an integral part of ongoing work to confront obesity?

Calorie Labelling (Out of Home Sector) (England) Regulations 2021

Baroness Redfern Excerpts

Thursday 22nd July 2021 Lords Chamber

[Baroness Redfern (Con) [V]]

My Lords, I am pleased to have this opportunity to speak in support of the draft Calorie Labelling (Out of Home Sector) (England) Regulations 2021, noting the requirement for labels to be displayed by April 2022. This is another step forward in addressing obesity, which, as we know, is one of our biggest public health challenges, as our food environment continues ever to change. It is targeted not only at the eating-out sector, but also at the consumption of on-the-go snacks. More than a quarter of adults and one-fifth of children eat food from out-of-home outlets at least once a week. The regulations include bakeries, caterers, supermarkets and entertainment venues, so this is an important tool in guiding customers and making informed choices much easier for everyone.

I welcome the response to the consultation about concerns expressed by individuals living with eating disorders. It is important to note that appropriate provision is being made in the regulations to allow businesses to provide an alternative menu without calorie information, if the customer so wishes. That also endorses the Government’s commitment to playing their part in engaging with eating disorder charities in offering continued support and guidance, with a commitment to timely reviews of the impact of these regulations, not only on obesity but also on eating disorders.

Calorie labelling in the out-of-home sector applies to English businesses with more than 250 employees operating outlet foods that are prepared for immediate consumption. Smaller businesses are exempt, but I hope that many more outlets will come forward to offer their support and contribute meaningfully in the coming months so that they, too, can inform their customers and show that they want to be part of this drive to encourage even more people to make healthier food choices.

Feedback has shown overwhelming public support for calorie labelling on menus. Unfortunately, childhood obesity continues to be one of the major health problems faced by this country. Nearly one-quarter of children in England are overweight or obese when they commence primary school. Statistics also show that three out of five children are overweight when they leave primary school. Obese children are more likely to become obese adults, adding to their vulnerability. This further impacts on their life outcomes, in developing the increased likelihood of heart disease and cancer. Significantly, we are seeing more people at the relatively young age of 40 suffering from type 2 diabetes, with numbers almost reaching a staggering 5 million. All this can have a negative impact on mental health as well.

In conclusion, putting calorie labelling on menus and offering information for families will assist them in making better-informed, healthier choices when eating out. It will be another step towards complementing the Government’s healthy weight strategy, which was published last year. I support these draft regulations.

Body Mass Index

Baroness Redfern Excerpts

Thursday 22nd April 2021 Grand Committee

[Baroness Redfern (Con) [V]]

I thank the noble Lord, Lord Addington, for introducing this short debate on the effectiveness of the body mass index. I am pleased to have the opportunity to contribute.

My focus will be to highlight the effect of childhood obesity, which we know is significantly increasing. This is where the Government urgently require further action in tackling significant inequalities in physical and mental health outcomes. It also represents a major challenge for the Government’s levelling-up agenda with regard to opportunities and outcomes for our young people.

The effects of weight bias and obesity stigma can be particularly severe for children. They can experience a greater chance of being bullied, leading to low self-esteem and poorer academic performance, which can severely affect their life chances. It is tragic, too, that many children growing up will also have associated health risks, such as type 2 diabetes, cancer and heart disease.

When used appropriately, body mass index can provide valuable information for care focused on individuals that does not discriminate against anyone. It is important that healthcare professionals take a person-centred approach to discussing weight and health, use appropriate language and consider the use of BMI based on individual circumstances.

There are also clear opportunities for highlighting the contents of food. Retail outlets also must step up and support a move towards much clearer food labelling, particularly with additional nutritional and calorific labelling on the front of packaging in our supermarkets, cafés, restaurants and takeaways. Let us not forget all those highly calorific soft drinks, which must be addressed. We need stricter guidelines regarding rules on advertising. Evidence shows that children who are already classed as obese or overweight eat more in response to advertising.

Weight loss has been shown to bring undeniable health benefits, so does the Minister agree that, in any new plans, front-line services should provide obesity support in all the right cases?

Finally, I support BMI measurements in the context of them being used for informed, holistic and person-centred care where appropriate and where they can provide valuable information for care.

Covid-19: Government’s Publication of Contracts

Baroness Redfern Excerpts

Thursday 11th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord’s imaginative reach is to be applauded. I will be absolutely categorical about what I said on 1 March. I never said that the ends justified the means or that I thought that Ministers were above the law. I always said that this Government champion transparency and that we would try to be within the law wherever we could be. I do not wish to make this point too many times: the public expect us to deliver safety for front-line workers, and that meant securing PPE. If we were a few days late on the publication of some contracts, then I think the public would definitely take our side in that decision.

[Baroness Redfern (Con) [V]]

My Lords, during the Covid-19 pandemic, the fundamental aim of government has been to save lives and to do whatever is necessary to continue saving them. At the beginning of the pandemic, only 1% of PPE was produced here, whereas nearly 70% is produced here now. Will the Minister assure the House that the Government will do all they can to support this newly acquired manufacturing base for PPE and not return to relying totally on imports?

[Lord Bethell (Con)]

The noble Baroness is right: it has been the most amazing turnaround—an achievement that has surprised me. This has absolutely turned on its head some of the assumptions about what Britain’s manufacturing base can achieve in terms of affordability, technical ability and return on investment. I am enormously proud of that achievement, and I can reassure the noble Baroness that we are absolutely doubling down on it. It has made us rethink our entire manufacturing strategy for medicinal, pharmaceutical and health products and medical devices.

ONS: UK Life Expectancy

Baroness Redfern Excerpts

Thursday 17th December 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord makes his point extremely well: smoking rates in this country are far too high. The huge amount of Covid advertising at the moment has squeezed out a lot of our public health messages, and I reassure him that we will return to them—including the smoking campaign—when normal business resumes.

[Baroness Redfern (Con) [V]]

My Lords, there have been life expectancy improvements in the UK, which I welcome. My concern regards paediatric obesity, which brings associated increased risks of morbidity, disability and premature mortality in adulthood. The Government have set a national ambition to halve childhood obesity rates by 2030. As they have taken a strong lead with the soft drinks industry levy, what proposals are being looked at to extend its mandatory approach beyond soft drinks to wider product ranges?

[Lord Bethell (Con)]

The noble Baroness is entirely right: 15% of children aged two to 15 are obese. That is a shocking figure, and extremely disappointing. We have already done a lot to bring in the taxes on sugary drinks, and we are ploughing the money from them into sport in schools. But she is right that the taxes on sugary drinks provide an interesting template, which could be used in other areas where industry fails to step up to its responsibility and to reduce the harm of fatty or other destructive foods.