Health and Social Care Update

Debate between Baroness Sheehan and Lord Bethell

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I endorse completely the noble Baroness’s remarks that we depend on the generosity, public spirit and kindness of family carers who provide an enormous amount of support for their loved ones. Without them, the system could not possibly exist and the world would be a much graver place. I recognise that many carers have been pushed very hard by the pandemic. We have put a huge amount of resource into local authorities, which are responsible for providing support for those families, and that includes the kind of respite support that the noble Baroness has rightly pointed to. I am sure that more could be done and I would welcome any correspondence on this by way of follow-up that she would like to send my way.

[Baroness Sheehan (LD)]

My Lords, the Serum Institute of India is producing a billion doses of the Oxford/AstraZeneca vaccine this year. However, we hear that the rate of production may be compromised because of delays in the supply chain of essential items from the US. What dialogue have our Government had with their US counterparts at all levels about how these delays might be overcome?

[Lord Bethell (Con)]

My Lords, the noble Baroness is right to say that the Serum Institute of India is the world’s biggest vaccine manufacturer by far and we are enormously grateful for the strong relationship that this country has with the institute and the contribution that it is making to our vaccine rollout. The supply chains for the world’s vaccine production are unbelievably complicated, with ingredients and individual supply items coming from many different countries for each and every vaccine. It is not possible to provide a running commentary on the progress of each one; nor would it be wise to have a bilateral conversation with the country of origin of every vaccine ingredient. Our relations with India, America and the EU will, I am sure, return to the spirit of partnership and the respect of contract law that have characterised those relationships in the past.

Covid-19 Update

Debate between Baroness Sheehan and Lord Bethell

Thursday 4th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I thank the noble Lord for his grim prognosis and I agree with his analysis. If there is one place in the world where a mutant variation is likely to happen, it will be in an area where you have high infection rates and a large amount of suppression of the virus by either a lockdown or a vaccine programme. If you look around the world, that country is most likely to be Britain. We must be on the balls of our feet to be prepared for unhelpful news on that front.

Can I reassure the noble Lord on the borders? The number of people travelling in and out of the UK has reduced dramatically and the traffic through our airports and seaports is down tremendously. The application of the red list programme is extremely effective and the use of quarantine hotels has been extremely rigorously enforced. The isolation, along with amber routes, has also had enormous resources and is much more effective than it once was. We are prepared to go further. We review the red list constantly and, should the threats mount up to being serious enough, we will extend the red list as far as necessary.

[Baroness Sheehan (LD) [V]]

My Lords, vaccines are key to getting us to a position where we can live with the virus, but we really must listen to scientists telling us that we must control the virus everywhere. While our support for the COVAX initiative is to be applauded, it cannot work effectively without reliable supplies of the vaccine. The Covid-19 Technology Access Pool is designed to do just that. Are we fully engaged in C-TAP?

[Lord Bethell (Con)]

My Lords, we are taking a leadership role in COVAX, CEPI, ACT, Gavi and all the international, multilateral initiatives to roll out vaccine around the world. We are looking at what to do with our own stock of vaccines, and the Foreign Secretary has made it very clear that distribution of the vaccines we have bought is very much on the agenda. The AstraZeneca vaccine is being used as probably the default vaccine of choice around the world, as it is low- cost and easily distributed. Through our G7 chairmanship, we entirely support the agenda of preventing further pandemic by ensuring that vaccines are fairly and widely distributed around the world.

Covid-19

Debate between Baroness Sheehan and Lord Bethell

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is right to cite the example of Israel. It is indeed extremely worrying. I touched upon this point when replying to my noble friend Lord Hamilton on the previous Statement. Undoubtedly the fear is that you vaccinate a large proportion of your most vulnerable population but those who have not been vaccinated—mainly the young—feel a licence to go out and socialise and create an enormous problem by spreading the disease on a large scale among the wider population. As I alluded to in my earlier answer, we currently have an infection rate of between 1% and 2%, It is not impossible that it could rise to 10% or 20%. Should that happen with the kind of proportions of people who then end up being hospitalised whatever their age, or suffering from long-term impacts of the disease, we would have a very big problem on our hands. That is why the Government are moving cautiously. I strike an optimistic tone in my answers, but I am extremely cautious and considered in my approach to policy, as are the Government.

[Baroness Sheehan (LD) [V]]

My Lords, hotel quarantine measures, albeit late and incomplete, are nevertheless welcome—better late than never. However, as things stand, mankind cannot outpace the mutating virus without a global vaccine plan in place. When do the Government think that the time will be right to call for a leader’s summit to develop a global collaborative effort to deal with this pandemic?

[Lord Bethell (Con)]

My Lords, I completely agree with the noble Baroness. As I said earlier, we are not safe until we are all safe. That is an absolute axiom. It will soon become a cheesy remark but that does not make it any less true. Britain is totally committed to the principle of global distribution of the vaccine. We are extremely proud of AstraZeneca, which has a profit-free approach to the intellectual property around the vaccine. It is quite possible that as a cheap, easily administered and portable vaccine, it may become the common global standard for vaccination. It is my hope that it will be rolled out globally, and that it is updated as necessary, as mutations and variants of concern begin to affect it. Britain is very committed to CEPI, Gavi and ACT. These are the major financial commitments that the world has joined in to get the vaccine to the developing world, and we are using our chairmanship of the G7 to champion that agenda.

Covid-19: Vaccination

Debate between Baroness Sheehan and Lord Bethell

Wednesday 20th January 2021 Lords Chamber

[Baroness Sheehan (LD) [V]]

My Lords, can the Minister say how concerned the Government are that diminishing efficacy in partially immunised people among a population with high prevalence of the disease, as we have in the UK, will foster ideal conditions for the virus to mutate into vaccine-resistant forms?

[Lord Bethell (Con)]

My Lords, I do not quite agree with the premise of the question, which is the concept of being partially vaccinated. When you get your first vaccination shot, you are vaccinated, your body has been primed, B cells make the antibodies and you learn how to fight the disease. That is categoric. Where the noble Baroness absolutely has a point is that it is an uncomfortable truth that when we lean in to the virus, it will seek to escape and mutate, and that is the moment of absolute highest risk for the country. That is why we are trying to move as quickly as we humanly and possibly can: there is a moment in time, an opportunity to get the vaccine out to as many people as possible to avoid the mutation throwing up variants that escape our vaccine.

Mental Health Act Reform

Debate between Baroness Sheehan and Lord Bethell

Monday 18th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is right; the numbers are inappropriate. Fifty-one thousand detentions under the Act in 2019-20 seems far too many. Detentions under the Act rose by 40% in the 10 years to 2015, and we thought of this Act to try to address that injustice. The £2.3 billion is new money, and it will make a huge impact on the mental health trusts he describes.

[Baroness Sheehan (LD) [V]]

My Lords, sadly, I have personal experience of having to invoke the Mental Health Act. It is a dreadful process. It concerns me that one of the reforms proposed is to tighten the criteria for civil patients’ detention by raising the threshold for risk of harm. Does the Minister agree that this reform risks increasing harm to the person who is ill and their family?

[Lord Bethell (Con)]

My Lords, that is not the intention of the report, and I confess to struggling to understand how that would be the case. I would welcome correspondence from the noble Baroness to detail her concerns so that they can be taken on board.

Covid-19: Vaccinations

Debate between Baroness Sheehan and Lord Bethell

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord makes the point extremely well, and I agree.

[Baroness Sheehan (LD) [V]]

My Lords, no one is safe until everyone is safe. Does the Minister agree? If so, what thought have the Government given to supporting the temporary TRIPS waiver proposal by South Africa and India, given that it will help the WHO’s efforts to co-ordinate the local supply of vaccines through its C-TAP initiative?

[Lord Bethell (Con)]

My Lords, I would put the truism slightly differently: the vaccine makes you pretty safe, but it does not mean you are not dangerous to other people. I think we all have to get used to that. Regarding the South African variant and the other variants popping up in Brazil and elsewhere, this is a manifestly different disease that is growing up around the world. It has a huge implication for international travel. We are working with the WHO and other groups to try to understand this, but it is certainly of grave concern to the country.

HIV: Ending Transmissions

Debate between Baroness Sheehan and Lord Bethell

Tuesday 1st December 2020 Lords Chamber

[Baroness Sheehan (LD)]

The Global Fund to Fight AIDS, Tuberculosis and Malaria warns that additional support is badly needed to prevent a reversal in “hard-won gains”. Will we, as a lead funder, join Germany, Italy, Canada and South Africa to increase our contribution to the fund as a matter of urgency? A Written Answer will suffice if that is not in the Minister’s briefing notes.

[Lord Bethell (Con)]

The noble Baroness makes a very good point. The UK Government will continue to be a world leader in our HIV response through our considerable investment in the Global Fund to Fight AIDS, Tuberculosis and Malaria as well as through supporting the Robert Carr Fund to advocate for the rights and needs of the most marginalised groups, such as LGBTQ people and sex workers. In relation to reassurance on the point she asks about, I cannot provide that from the Dispatch Box, but I reassure her that our commitment to these international causes remains robust.

Covid-19: Vaccines and Medical Equipment

Debate between Baroness Sheehan and Lord Bethell

Wednesday 25th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, our forthcoming chairmanship of the G7, at the beginning of next year, is giving us a good opportunity to engage with our partners, including the United States, on issues such as the vaccine. We are grateful to Gavi, which is doing a terrific job at buying the vaccine; it is being characterised by what I would term commercial savviness. The spending review implications for ODA have yet to be published fully, but I reassure the noble Lord that funding the global response to the pandemic and the equitable distribution of vaccines, in particular, remains a massive commitment for the Government.

[Baroness Sheehan (LD)]

My Lords, notwithstanding the good use of UK aid via the WHO’s COVAX initiative, evidence shows that treatment providers and Governments have had to grapple with intellectual property barriers to essential products such as therapeutics, respirators and reagents for test kits. Do the Government maintain the position they held at the WTO TRIPS council meeting of 16 October that IP barriers to the Covid-19 response are hypothetical and will not stand in the way of scaling up vaccine manufacture?

[Lord Bethell (Con)]

My Lords, the question of vaccine intellectual property is a delicate one because, as was mentioned earlier, we rely on the private sector for a lot of funding and research, and for supplying the research. So, we are respectful of intellectual property as a principle. None the less, we are also grateful to vaccine manufacturers that have taken an open-source approach to vaccine intellectual property and have made local manufacturing available, so that there can be an extremely wide distribution of vaccines, including to those in the developing world who would otherwise struggle.

Medicines and Medical Devices Bill

Debate between Baroness Sheehan and Lord Bethell

Committee stage & Committee: 3rd sitting (Hansard) & Committee: 3rd sitting (Hansard): House of Lords
Wednesday 28th October 2020 Grand Committee

[Lord Bethell (Con)]

I thank the noble Lord, Lord Alton, for his questions. On remdesivir, I will be glad to find out whether any UK funds were used in its development and will write to him. I will also be glad to write to him about Crown use licences.

[Baroness Sheehan (LD) [V]]

My Lords, this has been a quite passionate debate and I am profoundly grateful to all noble Lords who have taken part in it. The debate goes to the heart of how we see ourselves. We are a kind, caring compassionate country that also abides by the rule of law, whether that is national or international law. That is why I thought it was right to include our ratification of the ICESCR—the International Covenant on Economic, Social and Cultural Rights. The noble Lords, Lord Crisp and Lord Stunell, both invoked that treaty as being an important and fundamental part of Britain’s reputation abroad. The amendment reminds us quite forcefully that a ratified international treaty is national law. That is quite a topical point as we debate this Bill in step with United Kingdom Internal Market Bill.

I am grateful to the noble Lord, Lord Alton, for his contribution, which was a real tour de force. It was informed by many years as a human rights activist and by his membership of the International Relations and Defence Committee, chaired by the noble Baroness, Lady Anelay. He reminded us that the African continent imports 94% of its pharmaceutical requirements. That figure struck me quite profoundly because the next figure that the noble Lord quoted was 96%. That was the finding of the YouGov poll of the proportion of the country that supports what we are trying to achieve here—equitable and fair access across the world for essential medicines. That is a very important reference point for the Government to bear in mind.

At all costs, we must avoid the unseemly debacle that we saw across the world in the early days of Covid-19 as countries scrabbled to get hold of scarce PPE. We must think ahead, put logistics planning in place and up front and support the global effort that seeks to do that.

The noble Lord, Lord Crisp, and my noble friend Lady Walmsley reminded us that public health safeguards were built into the TRIPS agreement because, as my noble friend Lady Barker noted, countries in the least developed parts of the world are right at the back of the queue when it comes to the development of medicines that are desperately needed.

My noble friend Lady Walmsley also highlighted that the insertion of the amendment in Clause 1(2) would mean that the Government would need to have regard to the provisions of the amendment. That is an important point. In his reply, the noble Lord, Lord Bethell, said that we have such a right already—of course we do—but the issue is that existing price control mechanisms are not used effectively enough at the moment; otherwise, we would not see the recurring incidence, which many noble Lords referred to, where the NHS is regularly held to ransom in trying to negotiate prices. While those negotiations go on, with all the delay involved, patients suffer and some patients die.

I thank the noble Lord, Lord Patel, who from his deep health expertise spoke passionately about the ways in which pharmaceutical companies bend the rules and how patients suffer as a consequence. I repeat the request made by the noble Lord, Lord Alton, and by my noble friend Lord Stunell. Why is it that Gilead can get away with charging £2,350 per dose, when the Liverpool University work shows that £9 per dose would reap sufficient profit?

I also thank the noble Baroness, Lady Thornton, for her support. I agree that we ought to listen to Professor Mazzucato on how to approach global challenges, because she understands global economics and can explain it in a way that I find very compelling. My noble friend Lord Sharkey gave a superb summary of the issues at stake. He highlighted, yet again, the moral imperative: it is so true that no one is safe until everyone is safe and, if nothing else, enlightened self-interest must compel us to act more collaboratively on the global stage.

On the issue of C-TAP, the waiver requested by South Africa and India at the TRIPS council meeting speaks to the need to have some way of overcoming the issues in respect of sharing IP rights, data, know-how and the expertise that is lacking at the moment. They would not be asking for that and would not be pushing for it unless it was necessary. Without that, we will not immediately be able to ramp up manufacture of the vaccine when we need it, which will be immediately.

In conclusion, this is a reputational issue for Britain, because it speaks to who we are as a country. I am with the 96%. If we truly want global Britain to be seen as a force for good, we must take this opportunity to join others, to lead from the front and to throw our heft—our quite considerable heft—and expertise behind the global collaborative effort to keep control of Covid-19. And when we are good, we are very, very good.

Covid-19: Test Results

Debate between Baroness Sheehan and Lord Bethell

Tuesday 27th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, on the app, the noble Baroness alludes to two separate issues. The first is the exposure notices, which are not sent by the NHS app but by the Apple telephone device. We have put in the new version of the NHS app a way of mitigating those exposure notices. She is entirely right that the app has no idea of your geography; that is the genius of the app and its commitment to privacy. It means that we cannot tell you where you were exposed, but also that your location and privacy are protected. On social care, we are investing in a large number of trials to try to speed up mass social care testing, including bulk testing and the use of wastewater, which we discussed earlier.

[Baroness Sheehan (LD) [V]]

My Lords, on 25 September, NHS England gave guidance specifically to implement pool testing to speed up testing times. Since then, what increase in pool testing has taken place?

[Lord Bethell (Con)]

My Lords, pool testing offers a huge opportunity to cover a large amount of ground very quickly, and there are some workplace testing champions for it, including Amazon. However, it has some restrictions, in particular not knowing the identity of the person who might have tested positive. That is why we are running a large number of pilots at the moment and investing heavily in trying to figure out this exciting but challenging technology. We will deploy it the moment we can find a model that works.

Covid-19 Update

Debate between Baroness Sheehan and Lord Bethell

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

The noble Lord is right that the R figure is important, but in many ways, at this stage of the epidemic, the prevalence figure—the total number of people who carry the disease—is more meaningful. A higher R on a smaller prevalence is less worrying than a smaller R on a higher prevalence. As to having regional Rs, the data to date has not been strong enough for that to be a reliable figure. However, we are working towards that situation and I can envisage a moment when it would happen.

[Baroness Sheehan (LD) [V]]

Can the Minister say categorically that there will be enough properly equipped staff and support staff across all departments in local hospitals in Leicester to cope with the upcoming spike in admissions? What are the plans if local hospital capacity is breached? Will the Minister categorically assure the House that there will be no transfers from hospitals into care homes as a consequence of the projected spike in admissions?

[Lord Bethell]

I pay tribute to the NHS in the Leicester area, which has done magnificently. I understand that the facilities there are extremely resilient. In Leicester, as in many other places, a major source of concern is the spread of the disease among younger, working-age people, particularly those in their 20s and 30s, many of whom are not showing symptoms—are not touched negatively by the disease and may be socialising—but become infectious to their parents and grandparents. That is the cycle that we have seen in places such as Texas where, after the Easter break, young people led to a large outbreak of the disease. At this stage, hospitals are not facing the pressure, but we are leaning into the disease to prevent the cycle from heading that way.

Covid-19: Extent of Infection

Debate between Baroness Sheehan and Lord Bethell

Wednesday 22nd April 2020 Lords Chamber

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

As of 21 April, 129,044 people have tested positive for Covid-19. This represents less than 0.02% of the population. When the evidence demonstrates that it is safe to do so, we will adjust the lockdown arrangements. We have set out the five conditions that need to be met before lockdown measures are adjusted. These include having reliable data from SAGE showing that the rate of infections is decreasing to manageable levels across the board.

[Baroness Sheehan (LD)]

My Lords, it is very clear that testing is the way out of this. First, there is the immediate urgency of testing front-line health and care workers exposed to high viral loads through lack of proper PPE, and we could do this now if the Government would give the go-ahead to local private research labs with the necessary level-2 clearance, which would not take resources from Public Health England’s needs. Secondly, there is the urgent need for mass testing. Why are the Government forgoing the first in favour of a gold-standard testing regime that they can control from the centre to deliver the second? Can they not do both?

[Lord Bethell]

I thank the noble Baroness, Lady Sheehan, for a very clear Question. I can reassure her on three points. First, front-line staff in the NHS and in care homes are eligible for test on request and we will be opening lines so that they can phone and book their own testing shortly. Secondly, I commend and thank those private research labs already contributing enormously to our testing regime. Thirdly, mass testing is one of the options that we are looking at: the Cabinet Office is devising plans for the medium term and will be publishing them shortly.