Gametes and Embryos: Storage Limit

Baroness Thornton Excerpts

Tuesday 9th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for his work on the subject when he was the responsible Minister to help change the policy so that all people, regardless of medical need, may benefit from greater choice about when to start their family. The 10-year renewal periods will be put in place to give people the opportunity to decide whether they wish to continue with their storage of gametes or embryos. The department is currently working with the Human Fertilisation and Embryology Authority to set out the plans for detailed implementation, including on how the renewal periods should be handled by fertility clinics to ensure that they work.

Fertility clinics will be expected to contact people storing their gametes or embryos a year before a renewal period has ended, so there would be 12 months’ notice. In addition, people will have a six-month grace period following the expiry of any renewal period, in which they can get in touch with clinics to re-engage storage if they wish. I am sorry that I am going on longer than usual, but this is an important issue. It is our view that we would provide an appropriate amount of time for clinics to contact their patients, and for patients to decide what they wish to do with their gametes or embryos in storage.

[Baroness Thornton (Lab)]

My Lords, I return to the question of the noble Baroness, Lady Deech, because we need some clarity here. For some people, months count. They will be having their eggs destroyed now, in the next few months. Therefore, while I congratulate the Government on the regulations that added two years to the 10-year period in recognition of the need to provide an extension during the pandemic, the Minister needs to be absolutely clear because time is fast running out. Are the Government going to provide interim transitional arrangements before the legislation is before the House? From these Benches, we are very keen and across the House there is an enormous amount of support for this to happen. Frankly, if the Minister brings forward the regulations tomorrow, they will go through.

[Lord Kamall (Con)]

I thank the noble Baroness for that very kind offer, but we have already stated that it is the Government’s intention that no one misses out on the opportunity to extend the storage of their eggs, sperm or embryos. As she will be aware, in 2020 in light of the Covid pandemic, we took steps to extend the storage. We are currently considering options to make sure that no one misses out on the benefits of the new policy. Given the detailed consultation we have just been through, we hope to announce details in due course. Of course, if an amendment is laid to the forthcoming Health and Care Bill, we will consider it.

Cancer Drugs: Licensing and Approval

Baroness Thornton Excerpts

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness. It is important that NICE, MHRA and others hear some of the concerns, and the fact that we are being held to account today shows how important this is. Unfortunately, some existing legislation restricts MHRA’s ability to share information with partners, including NICE, which would help them to plan their processes more efficiently. NICE, MHRA, NHS England and NHS Improvement are talking about the concerns raised by noble Lords and generally about delays in the process. They are talking about how they can improve access, including through initiatives such as the Innovative Licensing and Access Pathway launched in January 2021, and sharing as much information as they can upfront. Both MHRA and NICE are aware of the concerns and made that clear when I met them recently after their board-to-board meeting.

[Baroness Thornton (Lab)]

My Lords, I will follow up on questions that noble Lords have already asked. The ongoing NICE methods and processes review missed the opportunity to propose a new process to mirror accelerated regulatory processes. There are concerns that capacity constraints will limit NICE’s ability to publish decisions as close to marketing authorisation as possible, including for oncology drugs, through the new Project Orbis route, as has been the case with the secondary breast cancer drug, Trodelvy. Have the Government assessed whether the system is fit for purpose in achieving the objective which the noble Lord has articulated: to deliver quick patient access to new, clinically effective treatments? What concrete steps have been taken so far to address any concerns?

[Lord Kamall (Con)]

Both NICE and MHRA are aware of the concerns, particularly regarding the delay between approval and licensing. That is why they are having conversations with NHS England and NHS Improvement to make sure, as far as possible, that they can discuss co-operation to ensure the speedy approval of drugs.

Covid-19 Vaccinations

Baroness Thornton Excerpts

Monday 8th November 2021 Lords Chamber

[Baroness Thornton (Lab)]

I start by thanking the Minister for taking the Statement. I very much welcome the new antiviral, molnupiravir—another name we all have to learn—as a significant drug in our armoury in the fight against Covid. I think this might be my and the Minister’s first Covid Statement since he was appointed, though we have done several Questions. I thought it might be useful to remember the last 18 months for a moment, when his predecessor and the House dealt with, on average, two Statements and several Questions about Covid a week.

Let us be quite clear: the NHS and social care services have saved the country, and they continue to do so as we move into winter. I again place on record my gratitude from these Benches to the NHS, social care services and all the staff from the top to the bottom of our health service who have worked so hard to save lives, protect the vulnerable and roll out vaccines. But we should remind ourselves that 142,000 people have died from Covid in the UK so far, and 1,173 died last week. We have the highest, or one of the highest, infection rates in Europe. This is not over by a long way, and we are now moving into the winter. Frankly, one has to question whether the Government have a handle on Covid going into the busiest season for our NHS.

The Government must get a grip on the stalling vaccination programme. The Health Secretary, Sajid Javid, is calling on younger relatives to help their eligible parents and grandparents take up the offer of the booster and the flu vaccine. Older and vulnerable people have been urged to get their Covid-19 booster jabs as part of a “national mission” to help avoid a return to Covid restrictions over Christmas. The Health Secretary said:

“If we all come together and play our part”,


the country can

“avoid a return to restrictions, and enjoy Christmas.”

That is a bit late, and it is absolutely in line with this Government’s handling of the pandemic—about two to three weeks later than they need to be. It is a bit rich for the Secretary of State to line up who is to blame if we do need further restrictions at Christmas because the Government have failed to get everyone vaccinated who needs to be.

I ask the Minister specifically about immuno- compromised patients. In September, the JCVI recommended that severely immunosuppressed patients have a third primary dose prior to having their booster jab to maximise their protection. There has been a lack of clarity about whether and when this would happen, which has caused huge confusion among a very vulnerable group in our communities. It is estimated that between 400,000 and 500,000 people fall into this category and are entitled to both a third primary jab and a booster. These two things are not interchangeable. Can the Minister tell the House how many of this group have received a third primary jab, and how many are going on to have a booster? How many are missing out on potentially life-saving doses of Covid vaccines after confusion about who is eligible for a third dose followed by an additional booster jab?

The blood cancer charity Myeloma UK said its helpline has been inundated with hundreds of inquiries in recent months from patients who are struggling to book their third and fourth doses. To compound this challenge, patients like this cannot turn up at a walk-in or mass vaccination centre. What plans are there to ensure that the immunosuppressed receive the vaccinations they need?

More generally, local residents are contacting their MPs to say that they cannot get the boosters they so desperately want. One lady in her 70s with an underlying health condition went to her pharmacy and called 119, just to be told that she was not eligible for her booster—but she knew she was. She finally has one booked in December, but she had to rely on her daughter to book the appointment because she does not use the internet. The system simply is not working for many of those who need it most, because they do not have access to the internet or the new technology the Government want them to use to get their boosters.

Turning to care home residents and booster vaccinations, 1 November was the Government’s target for getting care home residents their booster jab. Could the Minister tell the House what proportion of care home residents have been vaccinated so far? My honourable friend Dr Allin-Khan said in the Commons on Thursday that only about a quarter of care home residents in Leicester have had their booster. The former Secretary of State is now calling for all NHS staff to be compulsorily vaccinated. Is this government policy? If so, what is the timetable? Is it wise to force this through right now when the NHS has a vacancy rate of 100,000?

Finally, plan B, which contains measures that we on these Benches already support, such as mask wearing and allowing working from home, is simply not enough on its own. Yes, we support it, but we must turbocharge vaccine boosters, fix sick pay, and improve ventilation. Does the Minister agree?

[Baroness Brinton (LD) [V]]

My Lords, from these Benches, we add our thanks to all those involved in the current delivery of vaccinations, whether they are GPs, nurses, healthcare assistants or volunteers at vaccination centres, and we thank more broadly our NHS and care-sector staff who are still working extremely hard to reduce the backlog of cases while coping with over 9,000 patients currently in hospital with Covid.

The Minister knows that the Delta variant and its subvariant, which is thought to be behind the growth of cases in the west country and Wales, remains highly transmissible. Doctors are reporting daily that double-jabbed patients are catching Covid and passing it on. Why have none of the mitigations in plan B been carried out? Many scientists, including some members of SAGE and Independent SAGE, believe that we should be operating them now to reduce the high numbers of cases and not be faced with a second Christmas being cancelled by the Prime Minister at short notice.

From these Benches, we have asked time and again for the wearing of facemasks inside and on public transport, as well as room ventilation in schools and other public venues, to be mandated, and for social distancing to remain. There are now, on average, 35,000 new cases daily, a shockingly high number. Professor Peter Openshaw, the chair of NERVTAG, said today that it was clear that immunity from the vaccines is waning. Yes, and vaccination is vital, but with cases at this level why are the Government not making mask mandates and social distancing formal?

Today, the Prime Minister once again reminded people to get their jab, whether first, second, third or booster, the ONS data showing that the risk of dying from Covid is 32 times greater in unvaccinated people. Can the Minister tell us why last week it was announced that vaccination centres are now closing at 6pm? Surely it should be easy for people to get vaccinated at a time that works for them, when they leave for work or get home from work?

The last time we spoke about Covid, I asked the Minister what the Government were doing to prevent some of the very unpleasant anti-vaxxer interventions at school gates and outside some vaccine centres. Has any action been taken on their disgraceful leaflets, which deliberately look like an NHS document but are full of direct lies and mistruths? It is important, because, by the Minister’s own numbers in this Statement, only 22% of 12 to 15-year olds have had their vaccination so far. I think Ministers now recognise that cases in this age group are driving cases in the older age groups, which is probably why hospital numbers are going up.

The noble Baroness, Lady Thornton, referred to the muddle between booster and third doses. The pandemic is far from over for immunocompromised and immunosuppressed people. I declare my interest as one of the clinically extremely vulnerable, as I have said before. I discovered by chance, reading something online, that I am now in the third-dose category. My GP did not know it and I certainly did not know it either. That is the problem. GPs and vaccination centres have not been told about the distinction. I have read the NHS guidance on the third dose, but many other clinically extremely vulnerable people are saying that their surgery or vaccination centre does not understand which category they fall into.

This is not helped by the problems with the online form which I asked the Minister about last week. Does the online form now specify the third dose, which is for around 800,000 people, according to current estimates, not for 400,000 people, as the noble Baroness, Lady Thornton, said, as distinct from the booster, which is for around 20 million? It is important, because the third-dose patients must have a booster in a further few months. If the system is not even recording the third dose, how will it know to call them back?

With the end of the shielding programme on 17 September, Sajid Javid wrote to all those on the patients’ list to inform them that it had finished, that the Government would no longer be offering specific advice and that we should go to our hospital clinicians. But many of us do not have an appointment in the diary, and there is not likely to be one because our clinicians are catching up with the backlog of cases, and those who are specialists in immune diseases are working on the Covid wards as well. So can the Minister say how on earth the clinically extremely vulnerable are meant to know what to do in the meantime?

Will the Minister ensure that the Government will work with patient organisations, clinicians and employer to produce clear and meaningful guidance that promotes safe working practices for this group and, in particular, let employers know that they have to help employees either to work from home or, if they have to go in, to make sure they do not have to go in by train or bus at peak hours? Please will the Government appoint a dedicated national lead to co-ordinate the support and guidance available to people in this group?

The news in the Statement of the approval of the Merck and Ridgeback antiviral Molnupiravir is also good news. I see that just under half a million courses of doses have been ordered. It was good to hear on Saturday of the success of the Pfizer clinical trials elsewhere, but I gather we are some way off from that being approved, because further trials of people who are clinically vulnerable are needed. Can the Minister tell the House the likely timescales of the actual delivery of both these different antivirals?

Finally, I am aware that I have asked some technical questions. If the Minister cannot answer them today, please will he write to me with the answers?

Smoking Cessation: Prescription of E-cigarettes

Baroness Thornton Excerpts

Tuesday 2nd November 2021 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, the MHRA in 2017 said that it was going to ensure that,

“the route to medicinal regulation for e-cigarette products is fit for purpose, so that a range of safe and effective products can potentially be made available for NHS prescription.”

Over four years later, it has now just updated the guidance; there are still no products for prescription. The new guidance only says that the MHRA will support companies to get medicinal licences, and it could take another two years before we see people able to access e-cigarettes for prescription. That seems a very long time indeed. I hope that the DHSC will chase up the MHRA and facilitate this to happen more quickly than it is at the moment.

My second point concerns other tobacco products, including Snus and heat-not-burn tobacco products. Will the Minister confirm, for the avoidance of doubt, that the MHRA’s guidance refers only to e-cigarettes, and the Government are not considering other options involving tobacco products?

Covid-19: Vaccinations Administered Abroad

Baroness Thornton Excerpts

Wednesday 27th October 2021 Lords Chamber

[Lord Kamall (Con)]

One of the difficult issues we face is pushing international partners to agree that the participants of well-regulated vaccine clinical trials should be treated as fully vaccinated. Only a couple of weeks ago I was on a call with G7 health and transport Ministers, trying to push them to ensure that they recognise those very brave people who came forward for vaccine trials. So far, sadly, we have not had much success. We continue to push them, but, in the meantime, we have found the solution of giving people another vaccine in order for them to be recognised. However, we would prefer international recognition.

[Baroness Thornton (Lab)]

I think the Minister needs to simplify this for the House—it is a very simple issue. If it is possible to register in France that you have been double vaccinated through its systems, why is it not possible to do that in the UK? While the JCVI may be working to fix the issue for UK residents who have been double jabbed abroad, British entry regulations have left foreign visitors in limbo. So, although two doses of Covid vaccine administered by a UK-approved regulator is enough to enter Britain without having to self-isolate, it does not seem to be enough to avoid being pinged by what has now been exposed as our expensive and not very effective test and trace system. Does the Minister agree that this does not make sense, and can he confirm that the JCVI review will also aim to resolve this?

[Lord Kamall (Con)]

As I said, we are looking to resolve as many of these issues as possible. There is no logical reason for this not to happen—it is just that we have to push international acceptance but also make sure that we have gone through the processes, especially for those vaccines not recognised by the MHRA.

NHS England Funding: Announcement to Media

Baroness Thornton Excerpts

Tuesday 26th October 2021 Lords Chamber

[Baroness Thornton (Lab)]

The Minister must by now be aware of the chronic staff shortages in the NHS. He will also be aware of the desperate state of some of our buildings in the NHS, and indeed the inadequate facilities for some of our mental health wards. This announcement mentions diagnostic staff, of which already one in 10 are missing. There is a 55% shortage of consultant oncologists, a shortage of radiologists, a shortage of specialist cancer nurses and, so far, no comprehensive NHS staff plan. Could the Minister tell the House who will run the proposed diagnostic centres? Will it be the NHS? Where will the staff for the diagnostic centres, surgical theatres and to operate the new equipment come from?

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

I thank the noble Baroness for her question. Since 2010, we have increased the clinical radiology workforce by 48%, from 3,239 to 4,797 full-time equivalent posts. Numbers of diagnostics radiographers are up by 33% since 2010 and therapeutic radiographers are up by 44%. We are offering those who want to join the radiographic workforce at least £5,000 as a non-repayable grant for each year of their training to be a radiographer. Since 2016, we have seen a 26% increase in those studying diagnostic radiography and a 10% increase in those studying therapeutic radiography.

Men’s Health Strategy

Baroness Thornton Excerpts

Monday 25th October 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for raising this important topic. I have to admit that I was not aware of this before it was raised. In looking into it further, I know that the noble Baroness was in contact with the previous Parliamentary Under-Secretary of State for Innovation on the issue. As the matter rests with the Department for Levelling Up, Housing and Communities, my predecessor, my noble friend Lord Bethell, had followed up with a letter in May this year, outlining the steps that the department is taking regarding toilet facilities, including looking at certain building regulations. The Department for Levelling Up, Housing and Communities has also launched a call for evidence on the provision of male and female toilets. As soon as we have more information, I will write and update the noble Baroness.

[Baroness Thornton (Lab)]

My Lords, suicide is the biggest killer of men under 50 in the UK. This figure, and the high rate among young men in particular, has not changed for decades. Research by the Samaritans shows that affluent middle-aged men seem particularly vulnerable—stigma and unwillingness to ask for support obviously play a part. What specific measures and investment are the Government building into their mental health strategy to address this serious matter?

[Lord Kamall (Con)]

I thank the noble Baroness for raising this very important issue. We know that men are not a homogenous group, as the noble Lord, Lord Scriven, previously said, but some men are less likely than women to seek help or to talk about suicidal feelings. Others can be reluctant to engage with health and other support services. One of the things we have to do is tackle the stigma associated with this; that has been a key priority for years. That is why we funded the Time to Change campaign to 2020-21; it has played a key role. In addition, we have looked at resources on Every Mind Matters, the mental health hub on the NHS website. We have also issued guidance to local authorities and looked at how we can target the high-risk groups such as men.

Covid-19: Plan B

Baroness Thornton Excerpts

Wednesday 20th October 2021 Lords Chamber

[Lord Kamall (Con)]

In order to judge what the next action should be, the Government have laid out plan A. Plan A is focused, for winter 2021-22, on building defences through vaccines, antivirals and disease-modified therapeutics, identifying and isolating cases of transmission through test and trace, and supporting the NHS and social care, but also advising people on how to protect themselves and offering clear guidance and communications.

[Baroness Thornton (Lab)]

My Lords, it is quite clear that those things are not working. When I saw the Secretary of State for BEIS doing the media rounds this morning denying that plan B was coming down the track, I thought we might open a book on how soon the Government will actually launch plan B. I would like to ask the Minister whether plan B becomes necessary because the Government have made such a mess of plan A, with very late vaccinations for 12 to 15 year-olds and a worryingly low uptake of booster jabs. Is it too late to prevent an NHS winter crisis, with the knock-on effects that will have for our backlog?

[Lord Kamall (Con)]

I thank the noble Baroness for her question and, while I have the opportunity, for all her advice, as a new boy in the role. We will continue to look at a number of different factors, including both economic and health indicators, before we judge whether it is necessary to move to plan B. Plan B does not actually involve complete lockdown. It involves introducing mandatory vaccine-only Covid status certification in certain riskier settings; legally mandating face coverings in certain settings, such as public transport; and communicating clearly and urgently to the public if the risk level increases.

Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report)

Baroness Thornton Excerpts

Wednesday 20th October 2021 Grand Committee

[Baroness Thornton (Lab)]

I do not think you need to be old. I have one of those magic hobs myself.

Almost every noble Lord here today can declare an interest in this debate, because we all—possibly excepting the Minister, who is quite a youngster in this Room—have a direct, personal interest in the recommendations and actions arising from this important report, presented by the noble Lord, Lord Patel. I join in the congratulations and applause directed at the noble Lord, who chaired this investigation, and his committee, many members of which have spoken today. They must have worked hard, in unusual and challenging circumstances, to produce this excellent report. I add my congratulations to all noble Lords who have spoken in the debate, and thank the Library and many other organisations for the briefing provided.

The challenge, of course, is what happens next; it always is. It is ensuring that change and progress results from the committee’s labours and deliberation. The Minister’s job today is of course to convince us that these many excellent recommendations will not be consigned to the long grass or worse, because of the blandness—in the word of the noble Lord, Lord Crisp—of the Government’s response.

I was impressed by two things about this report in particular: first, that it linked the socioeconomic factors with the scientific ones; and, secondly, that its clear recommendations provide a pathway—a route map, as the noble Baroness just mentioned—which, if followed and implemented, would lead to significant improvement in the lives of many of our fellow ageing citizens. Although there is not much to celebrate about the ongoing pandemic, the timeliness of the committee’s deliberations meant, as the noble Lord, Lord Patel, said in his opening remarks, that it became clear that the old, those suffering from multiple morbidities and the socially deprived would pay the highest penalty as a result of Covid-19, compared with the young and healthy.

This links to the Government recognising in November 2017 that ageing was one of the great challenges of their industrial strategy; in 2018, they announced the ageing society grand challenge. Indeed, the NHS’s long-term plan accepts that the NHS has a key role to play in ensuring that the extra years of life are spent in good health, while research into the effects of Covid on older people’s lives recognises, as do organisations such as Age UK, that we have a major challenge. Now, we have the Government’s commitment to levelling up, which of course includes looking at the inequalities in our ageing population and the huge differences in life expectancy in different and sometimes neighbouring communities, to which many noble Lords referred.

A combination of all those things suggests, therefore, that this report and its recommendations provide the Minister and his colleagues with a huge and important agenda. Many noble Lords have made those links; this report does the same. My noble friends Lord Browne and Lord Hanworth, and the noble Baroness, Lady Watkins, all addressed this issue.

The Government have said that addressing health inequalities will be at the core of their levelling-up agenda, and the Prime Minister has acknowledged that healthy life expectancy needs to improve. However, as yet, there is no sign of meaningful action or investment to make this a reality. The current plans appear partial and fragmented, while many deprived areas where people are likely to have the poorest health have not yet been identified as priorities for investment. I suspect that my noble friend Lord Davies could give the Government a hint or two on the methodologies that they might use.

In her excellent book, The Age of Ageing Better? A Manifesto for our Future, Dr Anna Dixon says:

“Few of us think of ourselves as old, whether we’re 60, 70 or 80.”


We are privileged here because age discrimination does not really feature in your Lordships’ House. When we hear of an ageing society, we are not experiencing care homes full of people staring at a TV screen. We are generally not bed-blockers, nor do we generally suffer from the loneliness described by this report. In fact, we think of our fellow Peers with value. We think of them bringing wisdom, enlightenment, humour and commitment to the work that we undertake in this place, even at some very great ages.

Yet we are all ageing, of course. It is a natural biological process. I think about my own background: my aunts and uncles come from a working-class family in Yorkshire, where the heavy load of working in the building trade and factors such as diet, smoking, drinking and pollution weigh heavily. All of my mother’s 10 siblings died before the average age you would have expected them to live to, and all of them died of heart disease, stroke or lung cancer. Among my contemporaries from school in Yorkshire, I am the only one who still has a full-time job; they have all retired, apart from one farmer. I intend to keep working full-time as I contemplate the future. We need to celebrate the long-term lives that we experience.

People in England can now expect to live far longer than ever before, but these extra years of life are not always spent in good health, as described in this excellent report, with people developing conditions that reduce their independence and quality of life, as my noble friend Lady Young said. I read with great interest the science bits of this report, and I particularly enjoyed the briefing I received from the British Society for Immunology about the report itself. It is worth looking at that brief, which states:

“It is well established that the immune system changes as we get older. The balance between immune activation, regulation and resolution can be altered as we age, resulting in inadequate protection against infection, along with a greater risk of inflammatory disease. As with many aspects of the human body, there is no one ‘cut off’ point for this to occur but instead it is a gradual process.”


However, the Covid-19 pandemic highlighted the relationship between ageing and the progression of our immune systems as a part of our natural life. My noble friend Lord Winston talked about the complexity of ageing. I wish him well with the challenge that he is facing.

I particularly liked recommendation 7:

“We recommend that UK Research and Innovation commit to funding further research into the biological processes underlying ageing as a priority, in particular to address gaps in understanding the relevance of ageing hallmarks to humans. Research to identify accurate biomarkers of ageing in humans should also be prioritised, to support studies to improve health span.”


This is the recommendation that the British Society for Immunology focused on. It makes the point, which other noble Lords have made, that the scientific understanding of the way in which many drugs interact with the immune system in older people is lacking, often because of a dearth of this age demographic in clinical trials. I found the Government’s response to that recommendation particularly weedy. They need to think about the teeth that the MHRA and other bodies need to ensure that clinical trials have the right demographics.

There are 20-odd recommendations in this report and that is the one that I have chosen to highlight, but the Government have to implement a concerted and co-ordinated set of national policy responses to support healthy ageing. That has to include regulatory and fiscal measures encouraging people to adopt healthy lifestyles. The Government have to have a plan. The response that we have had so far is not a plan. There needs to be a plan and a timetable. As the noble Lord, Lord Crisp, said, the Government need to show how serious they are about this matter.

GPs: In-person Appointments

Baroness Thornton Excerpts

Tuesday 19th October 2021 Lords Chamber

[Lord Kamall (Con)]

The relationship between the patient and the GP is important, so we have made sure that choice is at its centre. As they develop the relationship, they can decide on the most appropriate way to be consulted and to give advice.

[Baroness Thornton (Lab)]

The Government have consistently promised and failed to increase the number of GPs. Instead of the 5,000 additional ones promised in 2015, this year we have 1,300 fewer GPs. When the Health Secretary announced the £250 million winter access fund to enable GP practices to improve the availability of services to patients, where did he think those GPs would come from? Where is the magic locum tree? It is a seven-year pipeline to produce a GP. Does the Minister agree that rubbishing and attacking GPs is not going to attract medics to take up this profession?

[Lord Kamall (Con)]

I think we all agree that we should appreciate the work that GPs did during Covid; they were often the front line. It is important that we continue to make sure that we recruit more GPs. Some 3,793 doctors—the highest ever number—accepted a place on GP training in 2020, so I do not recognise the criticism.