(3 years, 4 months ago)
Lords ChamberMy 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.
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?
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.
(3 years, 4 months ago)
Lords ChamberWe 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.
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?
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.
(3 years, 5 months ago)
Lords ChamberMy Lords, when it comes to conspiracy theories, we have found that the best people to communicate on that are those who women and mothers trust and are dealing with during their pregnancy, typically their nurses and doctors. We have ensured that all the right materials are there, so that difficult questions can be answered in a collaborative dialogue. That is the most effective way of dealing with this.
My Lords, can the Minister comment on or indicate the extent of the level of co-operation between the UK Government and the devolved Administrations regarding vaccination take-up and pregnant women?
My Lords, the vaccine programme has worked extremely well across all the nations of the UK, and there is a huge amount of collaboration, particularly between the CMOs. Material is routinely shared between all the countries, and I am not aware of any differential outcomes in any particular part of the UK.
(3 years, 5 months ago)
Lords ChamberMy Lords, I pay tribute to my noble friend for his advocacy on behalf of Nepal; we are all extremely moved by the stories from Nepal and the challenge that it has had from Covid. We are extremely supportive of his initiative for both medical supplies and the vaccine but, as I said, there is a sequencing challenge here. Our priority as a Government is the British people. It is important that we see the job through. As the noble Baroness, Lady Brinton, pointed out, there is a threshold to which we need to get the British public to ensure that the R rate remains below one and that the new India variant, or any other variant, does not run amok and drive up hospitalisation in the UK. Until we have reached that point, we must focus on the job at hand. In the meantime, and in parallel, we are doing absolutely everything we can to grow global manufacture of the vaccine and ensure that countries such as Nepal receive secure and reliable supply. My noble friend should be reassured that we are absolutely firm in that commitment.
My Lords, we have often heard it said that we will not all be safe until the whole world is safe. Today, UNICEF, the children’s charity, is lobbying the G7 Ministers, asking for an ongoing distribution of vaccines to poor and developing countries, rather than supplying surplus vaccines at the end of our programme, because they may not be able to use them in the best possible way at that stage. Will the Minister, further to the answers he has already given, go back to his ministerial colleagues and the Prime Minister and urge them to please undertake that global vaccination programme, along with other G7 countries, now? The WHO said yesterday that inequitable vaccination is a threat to all nations.
I completely endorse the sentiments of the noble Baroness and can absolutely reassure her that this is top of the agenda for the G7 leaders’ meeting later this week. The Prime Minister will absolutely be ramming home the message that she put extremely well. Roughly 1 billion vaccinations have been done around the world so far; that leaves another 7 billion or 8 billion to do. We need manufacturing on a scale that the world simply does not have today to see that job through. That is why the UK has contributed so much through the AstraZeneca vaccine, which is a wonderful, portable, cheap and flexible platform for creating vaccines for the world. We are ensuring that that magic source is available to all those who can contribute vaccine manufacturing capacity anywhere in the world. In the meantime, we will ensure that any capacity that we have after we have done the British public is made available, but we have to see the job through here in the UK. It would be utterly counterproductive if the UK, having got so far, tripped over at the last hurdle.
(3 years, 6 months ago)
Lords ChamberI am enormously grateful to the NAO for the powerful report that it has published. It said many complimentary things about the Government’s handling of the pandemic. I am grateful to noble Lords for the counsel and challenge that they have given here in this Chamber. I point out the vast amount of data and information that we have published, which is at the disposal of the public and parliamentarians. However, confidential advice from officials to Ministers on a means-of-working review is not the kind of thing that I think adds to this sort of debate, and for that reason it is most appropriately kept confidential.
My Lords, this morning on BBC News there has been a suggestion that the Indian variant has been due in large part to ineffective track and trace. Would the Minister like to comment on that?
My Lords, I do not think that is correct. The noble Baroness is right to ask the question because we should always challenge our systems, but track and trace has really delivered for the country when it comes to the containment of the variants. We were extremely concerned about the Manaus variant. That was why we instigated Project Eagle, an intense application of testing in communities on a very large scale and forensic tracing, putting huge resources into tracking down the movements of those who tested positive with a VOC. We then had the South African variant, which has been successfully contained. We could not have imagined that an Indian VOC of this kind could make its way into this country with such high transmissibility, and I pay tribute to those working in track and trace who have bought us an enormous amount of time so that we can bring in surge testing and surge vaccination to contain and minimise the spread of this variant.
(3 years, 6 months ago)
Lords ChamberMy Lords, I reject the accusation of complacency. We have worked unbelievably hard with Northern Irish stakeholders, the pharmaceutical industry and EU colleagues to ensure the smooth running of the supply of medicines in Northern Ireland. The facts speak for themselves: so far, they have run extremely smoothly indeed. I reassure the noble Baroness that the UK Government are committed to parity of access to medicines across the UK, including Northern Ireland. Despite different approval routes, we have ensured that all patients have access to medicines at the same time, and we will maintain that commitment.
My Lords, will the Minister commit to meet the pharmaceutical industry, otherwise known as PAGB, which I met several weeks ago and which told me about problems that could ensue from 1 January next year in relation to the availability of over-the-counter medicines in Northern Ireland, due to the requirements of the protocol? Will the Minister undertake to meet this organisation to ensure that there are immediate discussions between the UK and the EU to resolve any ongoing difficulties and impediments?
I note the point made by the noble Baroness. As I mentioned in relation to the point made by the noble Baroness, Lady Jolly, on this issue, it is not one that I am not aware of, but I would be pleased to meet with the party she described in order to understand it better.
(3 years, 6 months ago)
Lords ChamberMy Lords, the noble Baroness puts the case for supported housing social care for those with low levels of dementia extremely well. It is slightly beyond the purview of the Department of Health, but the case she makes is strong. I would be glad to go back to the department and find out if any measures are taking place.
(3 years, 8 months ago)
Lords ChamberMy Lords, the noble Lord puts the situation well. I do not agree with every aspect of his assessment, but his concerns are shared by the Government. We keep the whole situation under review, but the bottom line is that we do not know the impact of the variants of concern on the vaccine and vice versa. We keep the situation very closely monitored. The measures in place are entirely proportionate to the threat we face but, should that escalate, we will not hesitate to take the necessary decisions.
My Lords, in commending the rollout of the vaccination programme, could the Minister indicate whether the Government have made arrangements for its continuation in subsequent years? What discussions have there been and potential arrangements made with the devolved Administrations on this?
My Lords, we very much hope that the vaccination programme being delivered today will lead to an inflection point in the whole country’s approach to vaccinations overall. That is not just for Covid, but for flu, HPV and other prophylactics. We are on the brink of a massive change in our mindset regarding preventive medicine. There is an opportunity here for us to completely change the way in which we do healthcare—from an emphasis on late-stage and acute medicine to preventive early-stage medicine. The stakes are enormous. We are determined to grab this opportunity with both hands and we will take our friends in the devolved authorities with us.
(3 years, 8 months ago)
Lords ChamberMy Lords, participants in clinical trials for breast and ovarian cancer not only take the medication as part of those clinical trials, whether they are double-blind or whatever, but give information about their genomic background and their ongoing assessments. Would it be possible, subject to their permission, to use that information from women as part of the strategy for updating and improving women’s health?
The noble Baroness is way ahead of me on that extremely specific point. I would be very happy to understand it more clearly, and if she could write to me with the details, I would be happy to take it on board.
(3 years, 9 months ago)
Lords ChamberMy Lords, I do not agree with the noble Lord’s analysis. We are sometimes constrained by supply, but I am reassured that we will hit the targets that I articulated. London has a younger demographic, which is why the rollout percentages can seem lower than in other areas.
My Lords, will the Minister outline the Government’s strategy to address those areas and people who are reluctant to take up the vaccine? Those of us who have had it know that it is the passport to our freedom.
My Lords, we have an extremely sophisticated and energetic programme in this regard. Let me flag that the most important influencers in anyone’s decision on whether to take the vaccine are the people whom they know and love. The best way to encourage vaccine uptake is to take the vaccine yourself.
(3 years, 10 months ago)
Lords ChamberMy Lords, based on the scientific and medical evidence, which undoubtedly will be gathered throughout this vaccination process, can the Minister indicate if there will be annual rollouts of the vaccination programme from 2022 onwards?
My Lords, I cannot look into the future with that much clarity, but the noble Baroness raises a possibility that surely must be accounted for. It is possible that this kind of coronavirus may mutate; it may need to be managed, as we do other flus. It is too early to make that call but that is the kind of thinking that goes into the development of the NIHP—the new National Institute for Health Protection.
(4 years ago)
Lords ChamberMy Lords, the memory of Baroness Tessa Jowell has had a huge impact in this area. I remember well her testimony from these Benches and the mood of the House then. It was an extremely moving and impactful occasion and we remember her very fondly indeed.
My noble friend is entirely right that it is extremely frustrating that not more of this money has been spent. You will not catch me saying that very often at the Dispatch Box, but in this case, it is true. Managing the pipeline of research submissions through the process to the NIHR is a challenge. The NIHR has very high standards for the allocation of research grants and to date, it has struggled to find the number and quality of grants to support. That is why we will put a renewed focus on supporting the drafting of better grants, and I would be pleased to meet with the charities recommended by my noble friend in order to discuss the ways we can do that.
My Lords, I have been told that only 5% of national spend on cancer research is devoted to brain tumour research. Let us consider the collaborative work being undertaken on precision medicine by the University of Bristol and Queen’s University Belfast. What additional funding could be dedicated to this area, which provides individualised treatments to ensure better patient outcomes?
The noble Baroness is entirely right that precision medicine offers an enormous and powerful opportunity for us to tackle cancers. Brain cancers are particularly difficult to tackle, especially in adults, and we are daunted by the struggle to make further progress in this area. Since April 2018, we have spent £5.7 million on directly funded brain tumour research, but that is not enough and we would like to spend more. I am open to recommendations on how the money could be spent.
(4 years, 1 month ago)
Lords ChamberThe noble Baroness puts the case very well. I completely acknowledge that the FSA favours extending mandatory display ratings to England and that in June and November last year the National Audit Office and the Public Accounts Committee respectively recommended that the FSA pursues this ambition as soon as possible. We very much take on board the views of all these public bodies and will consider the advice given to Ministers as soon as possible.
My Lords, the Minister has indicated a warmth towards placing this rating on a mandatory footing. For the avoidance of doubt, can he indicate what is stopping the Government from doing it? Is it the legislative timeframe?
My Lords, the immediate concern is, of course, the epidemic, which has slowed things down. It means that management resources that should be dedicated to things such as this are currently distracted. But I reassure the noble Baroness that work is being conducted on the advice being given to Ministers. Updates have been given in the other place on the progress of this policy. I can do nothing more than express warmth at the moment, but there will be decisions and movement on this in the near future.
(4 years, 2 months ago)
Lords ChamberMy Lords, once again I pay tribute to Pendle Borough Council, which is an absolute model of local collaboration in the handling of a local outbreak. I am greatly encouraged that Pendle has stepped forward to do local tracing. I do not know the precise details and will not pretend otherwise, but the story the noble Lord tells illustrates a harsh truth: not everyone wants to be traced. Not everyone participates in the system with the kind of enthusiasm one would like. It sometimes takes persistence and determination to track people who may be recipients of some very difficult news about their isolation and how they are going to spend the next 14 days—news that may either have an economic impact on them or seriously disrupt plans for them and their family. It is tough to track and trace people. That is why we work with local authorities to do it, why I was proud to announce the numbers earlier and why I am grateful to the noble Lord for illustrating the point with his story from Pendle.
My Lords, reference has already been made by the Minister to the quicker saliva tests for Covid-19. For the avoidance of doubt, can he outline to the House the timeframe for these trials and an implementation timeframe if they are successful?
The noble Baroness is completely talking my game here. I wish I could be 100% specific about the timeframes, but we are still going through the validation process. Personally, I am hugely optimistic. The noble Baroness, Lady Thornton, mentioned the work in this area of Yale University, which really changed our perceptions of the role that saliva testing could play. It can be used in the big PCR machines, it may be used in point-of-care machines and there is even a possibility that it could be used in the small plastic lateral-flow machines much loved by the husband of the noble Baroness, Lady Neville-Rolfe. I hope very much indeed to be able to update the House soon and to lay out a framework, but I afraid that at present the validation results have not come through and it would be premature of me to try.
(4 years, 4 months ago)
Lords ChamberMy Lords, the role of pharmacies in the administration of vaccines is critical. Not only will the standard flu vaccine be coming up shortly, but, if today’s news is to be taken on the level, the possibility of a Covid vaccine is at some point on the horizon. That is why we are talking to the sector about the role that community pharmacies can play in the greater administration of vaccines, both of flu and of Covid.
My Lords, will the Minister indicate what further discussions will take place with the National Pharmacy Association to ensure that community pharmacies become the front line for giving out services that would normally have been dealt with by GPs and emergency departments, to ensure that they take the flak and slack off the National Health Service and continue to provide an essential service to the wider community?
As the noble Baroness is probably aware, the Secretary of State for Health and Social Care spoke at the annual conference of the National Pharmacy Association, at which he reiterated his commitment to the sector. The noble Baroness puts it well: pharmacies have something very special and valuable because of their trusted role. We very much want to see an enhanced role for pharmacies in the delivery of healthcare.
(4 years, 4 months ago)
Lords ChamberTo ask Her Majesty’s Government what assessment they have made of the report by the Independent Medicines and Medical Devices Safety Review, First Do No Harm, published on 8 July.
While the NHS is a beacon of brilliant care and safety in the majority of cases, we must do better, as this report demonstrates. I apologise in full on behalf of the healthcare system to all the families affected in this report for the time it has taken to listen and respond to their concerns. I salute their courage and persistence in coming forward to make these concerns known. Much has already changed. We are introducing major advances in legislation, but we will respond further. In the meantime, I pay tribute to patients who bravely shared their experiences to inform this important report.
My Lords, I thank the Minister for his fulsome apology on behalf of the Government to all the victims—all the women and all the families. The first duty of any healthcare system is to do no harm, and the damning report from the noble Baroness, Lady Cumberlege—whom I congratulate—into the use of these medical devices and medicines, including pelvic mesh, reveals shocking failures in this duty of care. What further urgent action will the Minister, along with his colleagues in the department of health, now take to implement the review’s nine recommendations, including a task force and an exhortation to the devolved nations to implement and act on those recommendations?
My Lords, much has already happened, and I point to the appointment of a national patient safety agency, run by Dr Aidan Fowler, whom I know and to whose fine work I bear testimony. Much is due to happen shortly: I emphasise the introduction of a registry amendment to the Medicines and Medical Devices Bill, which is due to be debated in this House shortly. But there is more to be done. The Government must consider the report’s recommendations, on which we will return shortly.
(4 years, 5 months ago)
Lords ChamberThe noble Lord is entirely right that public confidence is important here. I emphasise that huge progress has been made. We have signed contracts for over 2 billion items of PPE with over 20 UK-based manufacturers alone. The progress made on face masks, visors, gowns, aprons and so forth is enormous, and the accounting for that will continue through the usual channels of government procurement publication.
My Lords, to what extent are the Government engaged in the procurement of PPE in a collective effort with the devolved institutions, and what discussions are taking place to ensure that every region is well equipped with adequate PPE and will have long-term infection control in place over the next 90 days and beyond?
My Lords, we have had regular engagement with the devolved Administrations and have discussed how we manage cross-border services. The balancing of stockpiles of PPE around the nation is something that we are very much focused on. We have moved from the supply of PPE to a few NHS trusts to nearly 55,000 individual users of PPE. This is a massive undertaking that has hugely expanded the scope of our PPE supply.
(4 years, 6 months ago)
Lords ChamberMy Lords, I do listen to “More or Less”. I absolutely love it, and it is a shame that I did not hear the episode to which the noble Lord refers because I would have reprimanded them greatly. The 100,000 tests a day are done very clearly. I would be glad to take the noble Lord, Lord Rennard, to visit our Lighthouse Labs to see the remarkable automation and robotics that achieve that remarkable effect. On the care home figures, we work hard in order to create prompt, immediate, daily figures. Those are then verified and put into the official national figures that are curated by the ONS. Having operational figures that are delivered quickly is important for decision-making. Having figures officially verified by the ONS to audit those results is an entirely appropriate way of doing things. It is a system that works, and we currently have no intention to change it.
Is the Minister confident that the public health surveillance system in the UK is able to detect and manage cases and their contacts and identify at-risk cases—that is, test, track and trace?
I am afraid I did not hear the full question from the noble Baroness, but if I understood her correctly, she referred to track and trace. I reassure her that we are putting a huge amount of resources into that surveillance. It is true that surveillance does not currently exist. We do not have the facilities that some Asian countries, such as Taiwan and South Korea, had following SARS, about which we now know so much. We are putting the correct resources in place, and we hope very much to have a detailed local and demographic understanding of where and how the disease is progressing. That information is essential to beating it.
(4 years, 6 months ago)
Lords ChamberMy Lords, I pay tribute to those BME workers on the front line. There is no doubt that their courage and bravery in the face of heightened risk is one of the things that has kept the NHS and our care service working and we owe them a huge debt. That debt will be paid by providing testing for anyone who needs it. To answer the noble Lord’s specific question, we started rolling out asymptomatic testing throughout the NHS and care service last week. The results of that will be published by the NHS shortly.
My Lords, the Minister will be aware that, to be effective, testing in care homes of residents and staff needs to be done continuously. Can he confirm when this testing system will be established and then achieved?
Testing in care homes is absolutely a number one priority. We have massively ramped up testing: we are now running it at 30,000 tests a day. We will test 300,000 care home residents and 500,000 care home staff before mid-June. That will make a massive difference, but we will not stop there. The ongoing and regular testing of both residents and staff will be a core part of our test and trace programme.
(4 years, 6 months ago)
Lords ChamberMy Lords, it is not a go-it-alone app; others are following our lead on this. It is interoperable, and we are working with other countries to make sure it is. Testing with the public has turned out to be extremely positive and we look forward to publishing the audit shortly.
My Lords, the importance of track, trace and isolate is beyond doubt, but what assurances can the Minister give to your Lordships’ House that this data, as part of data-sharing with the NHS, will be anonymised and protected to prevent information being used by others?
(4 years, 7 months ago)
Lords ChamberI have not seen the piece in the FT, so cannot comment on the noble Lord’s remarks. All I would remind him, as I have said in previous answers to similar questions, is that false reporting of a death is an offence. Doctors are required to make a clear report of a death. If it is associated with Covid in any way, the word “Covid” will be in the death certificate. If it is in the death certificate, it will make its way through the CQC to the ONS figures. There should be no ambiguity about this at all.
Will the Minister provide an assurance that there will be rigorous tracking, tracing and isolation of those in care homes, including the staff and residents? Through its European director, the World Health Organization told us today that there were significant deaths across Europe, including in the United Kingdom and Ireland, and that there is a need to address this.
The noble Baroness, Lady Ritchie, addresses a very difficult problem. The programme we are looking at, announced earlier today with the change to our guidelines, is the testing of asymptomatic carers and residents in care homes. It is a natural and growing concern that the disease may be present in an asymptomatic form. We are determined to get the infection out of our care homes and the NHS.
(4 years, 8 months ago)
Lords ChamberMy Lords, will the Minister consider a meeting of the British-Irish Council to deal specifically with the rising level of dementia cases throughout our devolved institutions, as well as England, with special reference to social care and the need for investment in it? It is urgently required.
The noble Baroness is quite right that this issue is not limited to England. The devolved Administrations are very much focused on it. I will look into the relevance and possibility of the kind of meeting she describes.
I reassure the noble Lord that the four CMOs from all parts of Britain have worked extremely closely and that their decision-making has been done on a joint basis. Work on a possible Bill has also been run past the Executives and Assemblies of all the nations; there is extremely close collaboration between all parts of Britain.
My Lords, I thank the Minister for repeating the Statement. Throughout this transitional phase, are the Government still availing themselves of the medical expertise in the respiratory field that is available through the European reference networks?
The noble Baroness is more of an expert on those networks than I am. All I can say is that we are going about this epidemic by focusing on all our strong relationships to make the most of everyone we know. We are throwing ourselves into every opportunity we have with gusto.