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.

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.

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.

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.

Medical Devices (Northern Ireland Protocol) Regulations 2021

Baroness Ritchie of Downpatrick Excerpts

Monday 12th July 2021 Grand Committee

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

My Lords, I thank the Minister for his explanation of these regulations. I accept what the statutory instrument is intended to do. However, I have some questions, as I want to see streamlined processes with no impediments to the supply of medical devices into Northern Ireland or to those that are currently under construction. There are about 500,000 medical devices, ranging from sticking plasters to dental implants to hip replacements, so they have many forms and functions. We are trying to achieve pragmatic solutions under the protocol to ensure that there are no impediments to their supply.

I have several questions for the Minister. Does the existing legislation on medicines and medical devices, which was approved in Parliament last year, have corresponding legislation in Northern Ireland to ensure that people with particular mesh problems will have a resolution and see an improvement to their health?

Furthermore, on the protocol, what discussions are taking place in the joint committee and the specialised committee with the EU on the exportation issues relating to the transfer of medical devices and medicines, to ensure that they will all continue to be supplied post December 2021? For example, the Royal College of Podiatry and the Ethical Medicines Industry Group are seeking mutual recognition agreements for the supply of those medicines and medical devices post 2021 as part of the protocol. What progress has been made in this regard? What evidence is there of working together to arrive at a long-term solution that avoids unnecessary regulatory complexity and duplication?

Given that the risk of medicines leaking into the EU single market from Northern Ireland in an unregulated manner is very slim, an agreement that permits medicines licensed for use in GB to be supplied to Northern Ireland only without additional checks would deliver on both sides’ needs. What steps are being made in this regard by UK and EU negotiators?

Do the common frameworks on blood safety and quality, on organs, tissues and cells, and on public health intersect with the protocol? What pressure can be brought to bear on the Northern Ireland Executive to sign off on these common frameworks, which deal with technical and policy divergence between Whitehall and the devolved Administrations? I look forward to the Minister’s responses to these issues on this important matter for the people of Northern Ireland.

Covid-19 Update

Baroness Ritchie of Downpatrick Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Bethell (Con)]

We have committed to issuing guidelines for the vulnerable and immunosuppressed before 19 July. I cannot share with the noble Baroness at this stage exactly what those guidelines will say, but her points are very well made. We have not made a decision on antibody testing yet, but she raises an important point. We have a number of therapeutics and antivirals that may provide either prophylactic protection or support in the case of infection. Knowing whether somebody has antibodies before they go into the winter is one of the things that should really help to provide reassurance as well as important clinical data on how treatment might pan out. We are looking at the use of antibody tests for that reason.

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

My Lords, the Statement says that there are currently no plans to vaccinate the under-18s. Can the Minister indicate what the possible timeframe could be for reversing that decision and vaccinating that cohort, taking on board that around 0.5% of pregnancies are to girls aged under 18? Will he further elaborate on the fact that the Prime Minister indicated that there will be deaths—quite a large number—when we open up? What level of deaths do the Government consider acceptable?

[Lord Bethell (Con)]

My Lords, the vaccination of children is something that we are looking at; it is with the JCVI at the moment, I understand. I do not have the precise timetable at my fingers. What I will say is that we of course need to vaccinate as many adults as we can and will therefore move to children after that, because they are the ones who least need that protection. My nephew has been vaccinated in another country; I have spoken to him about it and it is very touching to hear him describe how he now feels that he can visit relatives who might be vulnerable or have co-morbidities. He sees it as a contribution to the national well-being. That is exactly the spirit in which we go into this but, as I say, it is up to the clinicians to make their pronouncement. We wait to hear from them before we can make a decision.

Women’s Health Outcomes

Baroness Ritchie of Downpatrick Excerpts

Thursday 8th July 2021 Lords Chamber

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

My Lords, I commend the noble Baroness, Lady Jenkin, for securing this important debate and for depicting the lifecycle of women, with its many challenges. There are life challenges, societal challenges and, above all, gynae- cological challenges, which we have all faced in our lives.

It is quite clear that research has found a gender health gap in the UK, where many women receive poorer healthcare than men. This poses the question: why has this been the case and what measures will be taken to rectify the situation at governmental level, working with communities and the voluntary sector?

Many of the challenges facing women’s healthcare have already been raised in the Paterson Inquiry, and the First Do No Harm report, which found that the healthcare system was

“disjointed, siloed, unresponsive and defensive.”

The Saving Lives, Improving Mothers’ Care report said that, between 2016 and 2018, 217 women, or 9.7 women per 100,000, died during pregnancy or up to six weeks after childbirth

“from causes associated with their pregnancy”.

In academic research, Caroline Criado Perez, to whom the noble Baroness, Lady Jenkin, has already referred, has argued that women have been considered less important in healthcare as far back as ancient Greece. Arguing that the problem still exists due to a patriarchal worldview being prevalent in our healthcare system, she said that women are routinely under- represented in clinical trials and that medical research proposed by women is not allotted the same funding as medical research proposed by men for men. I am not sure about that, as somebody who is on a clinical trial—a double-blind trial for breast cancer.

Research and observations would show that, in many societies, women have provided the caring at the expense of being cared for, thus placing their health needs as secondary to those of men. I look at research from Northern Ireland and a matter that has already been referred to by the noble Lord, Lord Rooker. It shows that women have a 70% chance of providing care, compared with 60% of men. By the time they are 46, half of all women have been a carer—11 years before men. I look forward to the Minister’s response.