Covid-19: Antiviral Pills

Lord Ashton of Hyde Excerpts

Monday 31st January 2022 Lords Chamber

[Lord Geddes (Con)]

My Lords—

[Lord Ashton of Hyde (Con)]

My Lords, there is plenty of time. I think one side could give way to the other.

[Lord Boateng (Lab)]

My Lords, the Government have long said that the problem with vaccines globally has been not supply but distribution. What proposals will the Government bring forward to illustrate how the antivirals will be distributed and supplied globally?

Health and Care Bill

Lord Ashton of Hyde Excerpts

Lords Hansard - Part 2 & Committee stage
Monday 31st January 2022 Lords Chamber

[Lord Ashton of Hyde (Con)]

My Lords, before we resume the debate, perhaps I may point out that we went very quickly last Wednesday—many thanks for that excellent performance. The last group also went quickly. May I respectfully point out that we need to do nine and a half groups this evening? Once again, I ask noble Lords to acknowledge how much we still have to do on this Bill and adjust their contributions accordingly if at all possible.

[Baroness Bennett of Manor Castle (GP)]

My Lords, debate on this group was somewhat interrupted and I will remind everyone that we are talking about dental health. I will speak first to Amendment 224 in the name of the noble Lord, Lord Hunt and others, to which I attached my name. It calls for a statement from the Secretary of State on access to dental care at regular intervals.

This comes back to a point I have made again and again about the Secretary of State taking responsibility and being forced to come before Parliament to take that responsibility. The noble Lord, Lord Hunt, introduced the amendment clearly and I agree pretty well with everything he said. However, I will now start to disagree with him. I note that I am addressing a number of amendments on fluoridation that were signed by my noble friend Lady Jones of Moulsecoomb. Those who were paying attention before will note that her name was on the Annunciator as being in the other Committee Room when we started this group, so I am speaking on her behalf.

There is an interesting progression here because, if I had been asked to do that a few years ago, I would have been quite uncomfortable. Had I been asked a few years ago which Green Party policy I disagreed with, the one I would have questioned was our opposition to mass fluoridation. But I have been on a political and scientific journey since then and I have come to realise that fluoridation is one of those health measures and medical practices that came to be adopted because it seemed like a good idea, well before we did proper trials, work and consideration. As the noble Lord, Lord Reay, said, there is now increasing scientific questioning.

I do not want to go over the same ground as the noble Lord, Lord Reay, but will think about where we are and apply systems thinking to this. The fact is that, according to the Drinking Water Inspectorate, the number of people now willing to drink water from the taps in the UK has dropped from 90% in 1978 to 73% in 1998. To put it another way, one in four people now mistrust the water coming out of their taps and will not drink it.

We can see the impact of that if we happen to go into a supermarket. We see a great many people lugging large, often plastic, bottles of water. They are often people who are struggling to pay for that water, yet they are buying it because of their lack of trust in the water supply that is actually far healthier than what is in the bottles. I would urge them all to drink the tap water, which is the healthy option.

We have a real problem of trust—something we have seen in other contexts. This potential mass fluoridation imposed from the centre above is something that potentially could have a real impact on reducing tap water. The noble Lord, Lord Reay, said, “Well, people can’t afford it, so it’s the poorest who’ll be forced to drink the water”. But the evidence shows that many people who cannot afford it now—from more disadvantaged and BAME backgrounds and who suffer from many disadvantages—who are reluctant to drink that water. We have also seen these issues of trust around the Covid-19 vaccine. These issues could see real risks to dental health.

We also want to apply some real systems thinking. The noble Lord, Lord Reay, referred to the fact that Scotland has brought in some good, targeted programmes on dental health that help children learn to brush their teeth and address diet and the consumption of sugary foods that has so many other health issues. We know what happens in politics. We have a problem with tooth decay and the Government say, “Right, we’re doing fluoridation”. Where are we going to see the money, focus and attention on those targeted programmes that would reach the children who need it most?

Health and Care Bill

Lord Ashton of Hyde Excerpts

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Flight (Con)]

My Lords, I support the amendment of the noble Lord, Lord Forsyth, but was asked at short notice by my noble friend Lord Suri to present his contribution. He makes the point that we humans look after animals and other living creatures with the highest levels of care—

[Lord Ashton of Hyde (Con)]

The normal convention in this House is that if a Member is not present at the beginning and end of a debate, they should not speak. It is not right to read out someone else’s speech.

[The Lord Bishop of Carlisle]

My Lords, I recognise and respect the integrity and passion that underlie Amendment 297. However, I rise to agree wholeheartedly and briefly with those noble Lords and noble and learned Lords who have already expressed their significant reservations about it.

There are two problems in particular with that amendment. The first has to do with the many contentious arguments for and against any legislation permitting assisted dying, some of which have already been mentioned. Tempting though it is to rehearse some more of those, I am conscious not only of the time but of the fact that they have already been presented recently and at length, as we have been reminded by the noble and learned Lord, Lord Mackay, at Second Reading of the Assisted Dying Bill here in your Lordships’ House. The ongoing process of that Bill, however slow it may be, should not be undermined. We have also been assured that this is not primarily what Amendment 297 is all about. I might add that the terminology of that amendment is unhelpfully vague. “Vague” is a word that has already been used more than once in the debate today. For instance, we might ask exactly what is meant by “terminally ill” or “medical assistance”.

The second problem, which has already been persuasively argued, concerns the attempted use of this Health and Care Bill potentially, if not directly, to change the law on assisted dying. The proper place for any amendment of this kind should be Committee on the Assisted Dying Bill, not Committee on this Bill, which would be subverted were this amendment to be accepted.

With regard to Amendment 203 in this group, whether or not it is deliberately linked, it is evidently concerned to address the holistic needs of those approaching the end of their lives, and that includes, of course, talking about death. That is something that we would all wish to encourage. However, there is again an issue of vagueness in the amendment, as in Amendment 297. For example,

“wishes and preferences for the end of their life”

could include almost anything, from repeated albeit futile chemotherapy, through bucket list wishes, to assisted suicide. Who decides, and how, that someone lacks capacity for engaging in a conversation about their holistic needs? Who is a “relevant person”, as we have just been reminded by the noble Baroness, Lady Finlay? Then, in proposed new paragraph (c), what does

“having regard to the needs and preferences recorded in such conversations”

actually entail?

Most of what is proposed in the amendment is already covered in End of Life Care for Adults: Service Delivery, NICE guideline NG142, which was published on 16 October 2019. Perhaps it would be simpler just to require healthcare professionals to meet the requirements of that guideline, which would address the heart of the amendment’s stated, and laudable, objective.

--- Later in debate ---

[Baroness Smith of Newnham (LD)]

My Lords, perhaps the Minister, in replying, can tell the Committee whether he will talk to the usual channels, especially since I note that the Chief Whip and the Deputy Leader are both in their places, about whether time could be made available for further discussion of the Bill that is extant. Because whatever the merits or demerits of assisted dying, this is not the Bill for such an amendment.

[Lord Ashton of Hyde (Con)]

My Lords, the noble Baroness, Lady Grey-Thompson, has been trying to get in for a while.

--- Later in debate ---

Clause 70 agreed.

[Lord Ashton of Hyde (Con)]

My Lords, I have got up twice today to ask people to be succinct. Front Benches and Back Benches have been very good at that, so I want to say thank you very much. I am very grateful.

House resumed.

Hospital Beds and Social Care

Lord Ashton of Hyde Excerpts

Thursday 6th January 2022 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for raising this issue previously with me in private, and for looking into it. One issue that is very clear to us is that effective use of the NHS estates is a top priority for the Government. We have not yet considered the benefits of using vacant hospital land or unused buildings, but we are committed to utilising the estates to their maximum capacity. Rehabilitation is a critical element of the health and care system, and there are a number of areas that we are looking into, including some of the suggestions made by the noble Baroness—but also best practice from other parts of the world.

[Lord Ashton of Hyde (Con)]

My Lords, I think it is the turn of the Liberal Democrats. The noble Lord, Lord Jones of Cheltenham, wishes to speak virtually, so I think that this is a convenient moment to call him.

[Lord Jones of Cheltenham (LD) [V]]

According to the Alzheimer’s Society, nearly two-thirds of all hospital admissions for people living with dementia are unnecessary and could be prevented with high-quality personalised social care. Does the Minister agree that providing such care will reduce pressure on our NHS? If so, can he outline the steps that the Government are taking to deliver high-quality personalised care to people with dementia?

--- Later in debate ---

[Lord Kamall (Con)]

The noble Baroness makes an important point. The task force, working with all the various partners, is looking at the different pathways. Most patients can be discharged from hospital to their own home, but a number are held back because they should be discharged from hospital to their own homes but with a new additional or restarted package, which may take time. Patients might be discharged to residential care within the independent and community sector, but one issue is that a number of our care homes are owned privately and are not necessarily as joined up in the system. Patients may also have been discharged to a care home, but sometimes the family may not appreciate or approve of the first venue given and may push back and ask for another one. There are a number of issues that we are looking at; it is very complicated, which I am sure all noble Lords understand. We are trying to really push and get to the bottom of this. Another thing is to make sure that there is education across health and social care staff so that they really understand the needs of particular patients.

[Lord Ashton of Hyde (Con)]

My Lords, the noble Baroness, Lady Masham, wishes to speak virtually, so I think this is a convenient point to call her.

[Baroness Masham of Ilton (CB) [V]]

My Lords, as president of the Spinal Injuries Association, I ask the Minister whether he realises that there are many people who are severely paralysed, some of whom need two or three carers each day living in their own homes. Is he aware that the skilled labour market of carers from Europe has dried up since Brexit, leaving many people in a state of fear and anxiety of being at risk? The Government can help. Will they?

Health Security (EU Exit) Regulations 2021

Lord Ashton of Hyde Excerpts

Monday 12th July 2021 Lords Chamber

[Lord Bethell]

That the draft Regulations laid before the House on 21 April and 7 June be approved.

Relevant documents: 1st and 6th Reports from the Secondary Legislation Scrutiny Committee. Considered in Grand Committee on 5 July.

[Lord Ashton of Hyde (Con)]

My Lords, on behalf of my noble friend the Minister, I beg to move the Motions standing in his name on the Order Paper.

Motions agreed.

NHS Digital: Primary Care Medical Records

Lord Ashton of Hyde Excerpts

Tuesday 8th June 2021 Lords Chamber

[Baroness Cumberlege (Con) [V]]

My Lords, I am very grateful for the Minister’s reply, especially hearing that this is all to be put back until 1 September. That is a very good decision, because we have heard that patients have not been able to get their GP to accept the information on the form for them to opt out of the proposed system. The system is not working at the moment, and we are very concerned. There was a thought that the system would be anonymised, but that is not what is proposed. It is pseudo-anonymisation, with NHS Digital having the capacity to identify individuals. There is no capacity for people to unanonymise. It needs a really thorough rethink. I very much congratulate—

[Lord Ashton of Hyde (Con)]

Could I ask the noble Baroness to ask her question?

[Lord Bethell (Con)]

I am enormously grateful for the noble Baroness’s endorsement of our decision to delay the rollout. As the absolute epitome of the patient safety cause, she knows more than anyone the importance of data to that cause. I completely endorse the points she made.

Social Care: Person-centred Dementia Care

Lord Ashton of Hyde Excerpts

Monday 17th May 2021 Lords Chamber

[Lord Ashton of Hyde (Con)]

The noble Baroness is muted; she needs to unmute.

[The Lord Speaker (Lord McFall of Alcluith)]

I think we will have to move on. I call the noble Lord, Lord Curry of Kirkharle.

Covid-19: Dental Services

Lord Ashton of Hyde Excerpts

Tuesday 10th November 2020 Lords Chamber

[Lord Flight (Con) [V]]

My Lords, there are three big factors that are causing these problems. First, there is the potential patient’s caution and the worry of contracting Covid-19, which leads them to put off treatment and save the money until normal times return. Secondly, dental sessions are taking much longer, partly because of the fall in the number of patients per session and lower throughput. The principal barrier to resuming services is the issue of the fallow time required following aerosol-generating procedures. The solution is greater ventilation. The key need is to increase the patient throughput and to reduce—

[Lord Ashton of Hyde (Con)]

Could the noble Lord put the question please?

[Lord Flight (Con) [V]]

Will the Government be willing to put up any funding to deal with the issue of fallow time between treatments?