International Healthcare Outcomes

Baroness Ritchie of Downpatrick Excerpts

Thursday 19th May 2022 Lords Chamber

[Lord Kamall (Con)]

I had a meeting only a few days ago with the person responsible for primary care—a doctor herself. One of the issues we discussed is how we make more effective use of different levels of primary care. What is interesting here is that primary care has, over time, taken on some of the services that used to be provided by secondary care. At the same time, some of those primary care services are now being contracted out or delegated out to, say, pharmacists or physiotherapists, et cetera. We are looking at a solution-focused way of tackling these issues, rather than focusing on who provides the care.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, as part of a solution-focused diagnosis, NICE has recently made a recommendation to reduce the waiting list for breast cancer diagnosis by suggesting the use of magnetic diagnosis. What acceptance will the department give to this proposal from NICE?

[Lord Kamall (Con)]

I regularly read recommendations from NICE, as do the relevant policy officials. Yesterday, for example, I was asked to the review the NICE business plan for the next few years, so the department will review the NICE recommendations. However, if the noble Baroness will allow me, I will have to write to her on the exact details.

Respiratory Viruses

Baroness Ritchie of Downpatrick Excerpts

Tuesday 11th January 2022 Lords Chamber

Asked by

[Baroness Ritchie of Downpatrick]

To ask Her Majesty’s Government what assessment they have made of the risks posed by respiratory viruses this winter to (1) children, (2) young people, and (3) the elderly; and what further medical protection measures they will put in place to tackle (a) respiratory syncytial virus, and (b) influenza.

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

Influenza remains a health threat, which is why the Government are offering flu vaccinations to more people this winter, including older people and, for the first time, all schoolchildren up to year 11. Reduced transmission of respiratory syncytial virus, or RSV, last winter led to a summer surge, particularly in child cases—there were few among elderly adults—which is now diminishing. Seasonal RSV preventive monoclonal antibodies for highly vulnerable children were authorised from June 2021.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, measures taken to combat Covid-19 over the last year have resulted in the epidemiology of seasonal viruses being out of sync with usual patterns. Last year, Public Health England reported concerns about rising rates of RSV infections in infants following the Covid-19 lockdowns, and reduced immunity levels combined with an already stretched health service. Given the continued pressures on the NHS, can the Minister outline what evaluation the Government have made of the NHS’s capacity to handle a potentially extended RSV season, and will they work with the devolved Administrations in that regard?

[Lord Kamall (Con)]

There was an unseasonal surge in RSV activity during the summer of 2021, which peaked in late July at about 15.7% swab positivity and a hospital admission rate of 2.5%. But, following the summer surge, RSV activity declined and positivity currently sits below seasonally expected levels. As a consequence, the RSV hospitalisation rate has declined since the summer surge.

Public Health: Night-time Working

Baroness Ritchie of Downpatrick Excerpts

Thursday 6th January 2022 Lords Chamber

[Lord Kamall (Con)]

This is why I was so looking forward to coming back here today. The noble Lord makes an incredibly important point about the effects of night-time working on noble Lords. It is really important that we push the Government to understand the impact it is having on our health.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, many of those who work at night are nurses, doctors and care workers because their jobs demand and require it. Their situation has been exacerbated during the Covid pandemic. Can the Minister indicate what work the Government are doing to look into ways of ameliorating and mitigating their situation, so that they can continue to carry out their work unhindered and unencumbered, as they are exposed daily and nightly to the ravages of Covid and other diseases?

[Lord Kamall (Con)]

I think all your Lordships would agree on the incredible dedication of our medical and health and social care staff, before and particularly during the pandemic. We have to remember that a lot of these conditions are governed by the Health and Safety Executive guidance on managing health and safety risks, which includes guidance on shift work and fatigue, to make sure employees are treated with as much dignity and respect as possible.

Breast Screening

Baroness Ritchie of Downpatrick Excerpts

Tuesday 14th December 2021 Lords Chamber

[Lord Kamall (Con)]

The plan will be published in due course. When we look at the backlog for the breast screening programme, we see that all 77 NHS breast screening providers are now operational and screening women. Some have caught up, and others are not predicted to recover by the end of March 2022. That is why NHS England and NHS Improvement have comprehensive plans, including spending and investment.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, as I can testify, breast cancer screening is vital. Allied to this is the need for funding for secondary breast cancer. I know that an audit has been launched here in England, but there are no such audits for secondary breast cancer in Northern Ireland and Scotland. Will the Minister use his good offices with those appropriate Ministers to ensure that such audits are established and that this House can be furnished with ongoing reports of the audit here in England, and the results thereof, to ensure that funding can be deployed into oncology, nursing and care support?

[Lord Kamall (Con)]

I thank the noble Baroness for raising the importance of co-ordination and sharing information across the devolved Administrations. I have meetings scheduled with health Ministers from the devolved Administrations, and I will make sure that my office puts this on the agenda.

Medical Schools: Training Places

Baroness Ritchie of Downpatrick Excerpts

Monday 13th December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for that suggestion. I will look into it and get back to him.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, will the Minister indicate what research has been carried out into the training opportunities for specialist doctors post-graduation who wish to pursue careers as consultant orthopaedic surgeons? At the moment, because of Covid investment resources, there are no training opportunities for them in Northern Ireland. Will the Minister raise this issue and indicate what efforts will be made to address it?

[Lord Kamall (Con)]

I thank the noble Baroness for sharing the experience of Northern Ireland. It is really important that we ensure that we have more training places and that we address the types of training that we do. As the noble Baroness will be aware, it is no longer a simple question of nurses and doctors: we are training a number of physicians’ assistants and specialists, and we will continue to do so.

Covid-19 Update

Baroness Ritchie of Downpatrick Excerpts

Monday 29th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for giving me notice of the question; I appreciate it. The answer that I have been given in response is that we have built a thriving private diagnostic market to meet the demand of the international travellers and day 2 PCR testing for travellers is provided by these private providers. Based on forecast modelling, we are confident that the market has sufficient capacity to meet the rise in demand that omicron may pose.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I thank the Minister for his Statement, in which he indicated that he was chairing a meeting of G7 members to deal with this specific issue. Will that meeting deal with the rollout of excess vaccines to the rest of the world, particularly those countries in southern Africa? I can only think of what my right honourable friend the former Prime Minister Gordon Brown said at the weekend, which was also reaffirmed in the leader column in yesterday’s Sunday Times: that nobody is safe in this world until everybody is safe. So is there a strategic plan to deal with excess vaccines to ensure that they are all used up, and particularly that they are used in those countries in the developing world that need them most?

[Lord Kamall (Con)]

I believe all noble Lords will agree with the points made by the noble Baroness on making sure that as many people in the world as possible have access to the vaccines. Someone said to me today that we are talking about third and fourth doses in the UK, but there are people in many parts of the world who have not yet had their first dose. I am sure noble Lords are aware of that. There is an analogy with when you are on an aircraft and the oxygen masks fall; do you protect yourself before you protect others? There is clearly a debate on this.

The UK remains committed to donating 100 million doses by the middle of 2022. We will have donated more than 30 million vaccines by the end of 2021 and have announced plans for 70 million doses in total so far. We will continue to ensure that any vaccines that the UK does not need are reallocated to other nations which require them wherever possible. Having sat in one of those G7 meetings with Health Ministers and joint G7 meetings with Health and Transports Ministers, I can assure noble Lords that one of the issues that comes up constantly is how we can help the rest of the world, particularly those countries which have not had access to even first doses of the vaccine.

Covid-19: UK Arrivals

Baroness Ritchie of Downpatrick Excerpts

Tuesday 16th November 2021 Lords Chamber

[Lord Kamall (Con)]

I assure the noble Baroness that when I was pressing this issue yesterday with officials in preparation for this Question, I stressed the importance of flexibility and creativity. We need to think outside the box on many issues. One issue we are looking at is: if passenger locator forms can do this, why can the NHS Test and Trace system not? I am told that is because it is based on self-certification. I am pushing the NHS to address and analyse the different options as soon as possible. It is really important we send a message to the rest of the world that we are open to the brightest and the best from across the world.

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, in Queen’s University Belfast, the current position is determined by the Public Health Agency in Northern Ireland and is based on your vaccination status and age, rather than on whether you have home or overseas status. Would the Minister engage with the devolved Administrations, particularly the Northern Ireland Executive, who seem to have best practice in relation to this issue?

[Lord Kamall (Con)]

One of the advantages of having devolved Administrations and different practices is that we can learn from best practice, so I will take the noble Baroness’s advice.

Dementia: Fuelling the Moonshot

Baroness Ritchie of Downpatrick Excerpts

Tuesday 16th November 2021 Lords Chamber

[Baroness Ritchie of Downpatrick (Lab)]

My Lords, I congratulate the noble Baroness, Lady Greengross, on securing this important debate and on all the work that she does as one of the co-chairs of the All-Party Parliamentary Group on Dementia.

I welcome the APPG’s report into the current state of dementia research in the UK, in which evidence was taken from world-leading researchers and academics, research institutions, charities, participants in research and people affected by dementia. In fact, the noble Baroness, Lady Greengross, has this evening characterised the main features of the report and the main recommendations, on which all Members right across this House demand action from the Government.

As the noble Baroness has said, at the 2019 general election the Conservative Party set out its plan to implement a “dementia moonshot” that would double government funding for dementia research by over £800 million, increasing annual funding from £83 million to £166 million a year over the next decade. Sadly and unfortunately, that funding has not yet been realised. When will that funding be provided?

I come from Northern Ireland, where the situation is much worse. In fact, we require assistance, funding and staff resources for the actual diagnosis of dementia. I reside in a health and social services trust area where the figures for dementia, for the actual diagnosis and those waiting a diagnosis, are much greater than in other parts of Northern Ireland. That trust resides 23 miles south of Belfast.

I am only too well aware of the personal impact of dementia on people’s lives. I had two political colleagues who passed away last year with dementia. Up until the onset of their illness, they lived full and active lives, serving their constituents and making a contribution to society, underpinned by the principles of social justice. Sadly, they were unable to enjoy the fruits of retirement because they began to suffer from memory loss, from body depletion and many other physical issues.

I learnt through the news last week that a young lady from Derry, in her mid-50s, who has dementia but could be cared for at home is unable to come home because of the problems of insufficient care packages and funding for them. This is exacerbated by the Covid pandemic. Insufficient care packages, insufficient funding dedicated to them, combined with all the problems of Covid has led to a very serious situation for dementia sufferers.

In that respect, the report from the noble Baroness, Lady Greengross, is very apt at this particular time and needs to be acted upon by the Government. The need for the investment of money and medical nursing staff in the Covid pandemic has delayed the deployment of resources in evidence-based research for dementia care. The APPG’s report Fuelling the Moonshot sets out the current issues facing the dementia research sector in the UK. It highlights examples of where the UK is leading the way in research, and highlights the areas where the promised funding could best be used to cement its place as a world leader in dementia research. The report also refers to the many areas that have experienced difficulties because of the pandemic, including early career researchers, and recommends how they could be supported. I am very pleased to say that Fuelling the Moonshot makes several other recommendations on how biomedical care and prevention research can be supported by the moonshot funding, and sets out how participation in research can be encouraged.

Tonight, along with the noble Baroness, Lady Greengross, and your Lordships’ House, I would urge the Minister and the Government to bring forward that important funding as quickly as possible, with a timeframe for how the funding will be realised, for how it will be implemented and the schemes and programmes in which it will be implemented. When will that happen? Could the Minister outline the specifics in terms of dates for the provision of funding and staff for care, treatment and research? Clarity needs to be provided on how the funding will benefit those living with dementia and the dementia research community.

There are various areas of research where work is required, such as prevention research, biomedical research, early detection and diagnosis, and care research and technology. It is also important for the Government, along with the NHS and the voluntary organisations, to promote the value and benefit of participation in research.

In that respect, I agree with the recommendation that the National Institute for Health Research, the Government and the NHS should work together to drive up participation in dementia research by making JDR—Join Dementia Research—an opt-out service for new dementia patients. I know from the work of Dementia NI that they have four main aims: to challenge the stigma of having a diagnosis by raising awareness about dementia; to promote the right for people living with dementia to be involved in decisions that affect their lives; to provide training, education and awareness to organisations and the public on how to best support people living with dementia; and to support people living with dementia to raise awareness of dementia in their own right. Many of those aims chime with the report just published and—shall we say?—unveiled tonight by the noble Baroness, Lady Greengross.

It is not sufficient to congratulate the noble Baroness; the Government should recognise and acknowledge that action will be taken in this important area. Obviously, there are difficulties, compounded by Covid and the need for essential care packages, but let us hope that there is a resolution in sight. I look forward to the Minister’s response and hope that he and his ministerial colleagues can find the resources to fulfil these recommendations and their own manifesto commitments.

Health: Chronic Fatigue Syndrome

Baroness Ritchie of Downpatrick Excerpts

Tuesday 12th October 2021 Lords Chamber

[Lord Kamall (Con)]

It is always important to recognise the unintended consequences and the costs of any delay. I can understand the frustration of many who have ME/CFS at the delay to the publication of the guidelines. It is important that we try to get as much consensus as possible. If noble Lords feel that there are further delays, I hope they will write to and put pressure on me and wider stakeholders, so that we can put pressure on NICE, but it is important that we try to achieve as much consensus as possible.

[Baroness Ritchie of Downpatrick (Non-Afl)]

My Lords, what issues were raised during the pre-publication period for the final guidelines which merited a pause in publication?

[Lord Kamall (Con)]

I thank the noble Baroness for her question. The issues related to some of the guidelines concerning GET. There was a concern that these would be deleted. Some groups and stakeholders expressed the concern that, while some patients clearly found these damaging, others might find them helpful, or partly helpful—not as a cure in themselves but as part of their treatment. That is why NICE convened this roundtable to ensure that it hears a wide range of views. Hopefully, this can achieve some sort of consensus and help stakeholders to understand where others are coming from, so that some sort of agreement can be reached.

Covid-19

Baroness Ritchie of Downpatrick Excerpts

Thursday 15th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, winter is a challenging time for the NHS, and, during an average winter, seasonal respiratory conditions drive an increased demand for hospital beds, as my noble friend knows. That will add to the already intense pressure that the NHS is under. Plans are being put in place. The circumstances are changeable. If there are any plans whatever that can be published, I will ensure that they are sent to the noble Lord and placed in the Library, as requested.

[Baroness Ritchie of Downpatrick (Non-Afl) [V]]

My Lords, the Statement from the Minister says that the Government will

“expand … capacity for genomic sequencing”,

which would help in the detection of any new variants. Could the Minister define how and when that expansion will take place?

[Lord Bethell (Con)]

Enormous expansion has already taken place: we have brought together the existing dispersed genomic sequencing capacity of the country and brought it to bear, both at the PHE headquarters in Colindale and in Cambridge, where a huge array of sequencing is going on. We have also brought sequencing into Leamington Spa, where, as the noble Baroness may know, we have a large industrialised diagnostics centre, so that sequencing can be done as soon as we have turned around the PCR testing. We are running at around 30,000 or 40,000 sequences a week, which is a dramatic increase on the past, but we continue to invest in this capacity.