Covid-19 Update

Lord Balfe Excerpts

Tuesday 8th June 2021 Lords Chamber

[Lord Balfe (Con)]

My Lords, could the Government try to get back the initiative so that we are talking about a health service and not constantly talking about Covid? I have some numbers: 114 people are in hospital with the delta variant. Of those, 83 are unvaccinated, 28 have had one dose and just three have had two doses—114 in total. This morning, the cancer support unit released some new figures: referrals are down by 350,000 over the year, there is a backlog of 40,000 new patients, and the survival rate is back to 2010 levels. We have this completely out of kilter, and it is largely because the Opposition are obsessed with it. I ask the Minister to go back to the department and try to reclaim the huge tragedy of unmet need in the National Health Service that has built up because we have done nothing but prosecute Covid. We have to learn to live with it.

[Lord Bethell (Con)]

My Lords, I completely understand my noble friend’s concerns, but I do not accept that we have done nothing. It is quite wrong to suggest that the NHS has done nothing but Covid. In fact, I am incredibly impressed by how well services have been maintained during an extremely difficult period. Were he to join clinicians in the NHS or the department, he would know that there is a laser-like focus on catching up. I remind him that there were 1.86 million urgent referrals and over 470,000 people receiving cancer treatment between March 2020 and January 2021—that is not doing nothing. An extra £1 billion is being used to boost diagnosis and treatment across all areas of elective care. On 25 March, NHS England published its 2021-22 priorities and operational planning guidance, and there is a Minister-led group under Minister Ed Argar, which is absolutely focused on the restart in cancer care in particular. I reassure my noble friend that there is a focus on this, and we are doing everything we can to get through the incredibly important backlog of work that needs to be done.

Covid-19: Poverty

Lord Balfe Excerpts

Thursday 27th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the vaccine race is being contested right across the country, and I take my hats off to all those who are delivering the programme so effectively. We are not too proud to learn from each other. In fact, I pay tribute to, for instance, those in Scotland who have programmes around alcohol and drug use, which are pioneering on a worldwide level. We have to work on this all together, and we will absolutely use the best case studies to apply the best programmes on a countrywide basis.

[Lord Balfe (Con)]

My Lords, I draw attention to my position as a fellow of the Royal Statistical Society. There is an old adage that correlation does not necessarily indicate causation. While it is easy to talk about levels of poverty, there are other factors such as lifestyle and ethnicity, and there will be a need for some multiple regression when studying the consequences. When the committees are inevitably set up to look at the causes and how to deal with those matters, will the Minister make it a priority that a good, well-qualified statistician is included among the members of any committee that is set up?

[Lord Bethell (Con)]

My Lords, I hear my noble friend’s warning very clearly and he is absolutely right. We must not be confused between statistical correlation and causation. However, one thing that has become clear is that in Covid personal health status, particularly obesity, has been a driver of severe illness and mortality. The environments in which people live and work have been a driver of infection. Those two are probably inescapable conclusions and will be central to our levelling-up agenda.

COVID-19 Variant: Travel Guidance for Local Authorities

Lord Balfe Excerpts

Wednesday 26th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am conscious of having been asked questions about the vaccine, testing and lockdowns in Bedford before. However, I absolutely reassure the noble Baroness that we approach all areas on an absolutely equitable basis, and in fact I pay tribute to the people of Bedford and the local authorities there for their energetic response to this pandemic. We are working extremely hard with all local authorities to give them the effective powers and resources to deal with the pandemic on a local basis. That means that national co-ordination comes second to local implementation and that these communications are sometimes extremely complex. We should not be surprised if sometimes there are differences between how different areas implement those communications.

[Lord Balfe (Con)]

My Lords, is it not time for the department to stop formulating rules that are neither enforced nor obeyed? Instead, if it wants to publish lists, could it not consider publishing a list of the growing waiting lists for treatments for cancer, heart problems and the many other things which are growing out of all proportion to the amount of effort put into constantly talking about Covid?

[Lord Bethell (Con)]

My Lords, my noble friend makes an extremely pertinent point but the two things are inextricably linked. We can get back and address the backlog of operations to which he quite rightly alludes only if we are not fighting the pandemic and if our wards are not full of Covid victims. Only through the right kind of guidance, testing, the vaccine and the behaviours of the public can we contain this virulent virus, a new strain of which has arrived on our shores, and if we do not, our hospitals will be overwhelmed and we will not be able to address the backlog.

Covid-19 Internal Review

Lord Balfe Excerpts

Thursday 20th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, as I said before, there was an internal ways-of-working review into the department’s early response to the pandemic, way before the threat of variants was on the horizon. None the less, it is our commitment to focus on the pandemic and the threat presented to us by its future evolution. That is why we are focused on today’s measures. We will leave reflection on the past to the inquiry.

[Lord Balfe (Con)]

Does the Minister see that we will keep on having variants of this virus and, to an extent, will have to learn to live with it? I am sure people would be much happier if we were to downscale the amount of advice that we get from a variety of often dubious sources. The sooner we can publish an inquiry into it, the better. We must recognise that the Government faced an enormous challenge. Overall, they have come out of it pretty well, and we should not carp.

Covid-19: Update

Lord Balfe Excerpts

Tuesday 20th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I hear the message from my noble friend loud and clear. Vaccination rates among care home workers in some communities are just not high enough. The Government have acknowledged that point, and that is why we have launched the consultation. We must be fair to the social care workers who work so hard, looking after those we love and care about. We have put this consultation in place to understand the most thoughtful, fair and meaningful way to go about this knotty problem. The consultation is moving as quickly as it can, and I assure my noble friend that everything is being done to expedite this matter.

[Lord Balfe (Con)]

My Lords, as the Minister will know, I have been a little doubtful about the amount of effort that has gone into this particular exercise. NHS waiting lists have gone through the roof in the last year, and the amount of care being given has dropped substantially. There is now a huge backlog. What plans do the Government have to get the NHS open again? Surgeries are still closed; hospitals are still closed; doctors are still seeing people only on videos. There is no reason now why surgeries should not start to be opened, and no reason why hospitals, apart from looking after their own convenience, should not start to cut the waiting lists back. I ask the Minister whether one of the very able people who are looking after the Covid programme could be diverted to getting the NHS back into action.

[Lord Bethell (Con)]

My Lords, I completely recognise my noble friend’s concerns, but I reassure him that surgeries simply are not closed, and if he has any examples of those he thinks are closed, I would be grateful if he would write to me. Hospitals are not closed and if he has any examples, I would be grateful if he would write to me. In fact, the NHS has for months done a huge amount not only to be wide, wide open, but to grow in its capacity quite dramatically. It is an inevitable, predictable, sad but frustrating fact that the impact of the coronavirus pandemic, like every other pandemic, is the hit or the follow-on effect on all the other procedures that are needed from a healthcare system. We have diverted a huge amount of capacity from Covid to ordinary, business-as-usual care; we are doing a huge amount to address the backlog and we will continue to move the resources accordingly, but we have to keep provision in place for those who, I am afraid to say, are still in hospital with Covid, and we are aware that the threat remains on the horizon.

Crohn’s Disease and Ulcerative Colitis

Lord Balfe Excerpts

Thursday 15th April 2021 Lords Chamber

[Lord Bethell (Con)]

We are doing a huge amount in this area, as the noble Lord rightly points out. In particular, we are working with Crohn’s & Colitis UK on the scenario work I mentioned. That is on top of working on diagnostic waiting times, formal personalised care, access to specialist treatment and formal, structured education. I will look into the possibility of having a formal leader to oversee all these strands, but my impression is that, at present, the work is best done by the individual workstreams I mentioned.

[Lord Balfe (Con)]

My Lords, what assessment have HMG made of how many treatments and admissions for inflammatory bowel disease have been impacted by Covid-19?

[Lord Bethell (Con)]

My Lords, Covid-19 has hit all services in the NHS. I pay tribute to those involved in the IBD area who have moved extremely fast to anticipate these problems. Rapid guidelines for gastrointestinal and liver conditions treated with drugs have been made available over telephone, email and text messaging services. NICE issued new guidance in August 2020 to advise healthcare professionals on gastrointestinal and liver conditions.

Folic Acid

Lord Balfe Excerpts

Tuesday 23rd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I accept the passion with which the noble Baroness has made her case, but it is not fair to say that we have done nothing. The consultation is in place, policy-making is being undertaken and the engagement with mill owners is well progressed. I am hopeful that we can make progress in this area.

[Lord Balfe (Con)]

My Lords, since I entered this House at the end of October 2013, there have been 14 Oral Questions on this subject. I had four years as the president of the British Dietetic Association, which came and went with us pressing for government action. On 3 September last year, the Minister said that

“I am not in a position to give him”—

that is, the noble Lord, Lord Rooker—

“the date he wishes, but we will come back to the House and answer his Question in due time.”—[Official Report, 3/9/20; col. 445.]

When on earth is “due time” going to arrive?

[Lord Bethell (Con)]

My Lords, I accept the challenge from my noble friend, who articulates his point extremely well. I can see in front of me the timeline on this issue. I can only say that we are trying to approach this in a way that creates a durable, long-lasting solution that is endorsed by mill owners, paediatricians and all the relevant stakeholders. It takes time to build that sort of consensus but we totally recognise the importance of this issue—1,000 NTD deaths a year is far too many. I undertake to put pressure on the department to ensure that this issue makes progress as soon as possible.

NHS: Pay

Lord Balfe Excerpts

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am not sure that retention is necessarily the challenge that the noble Baroness suggests. There has in fact been a 26% increase in acceptances to nursing and midwifery courses when compared to last year, and 1,290 more applications were made in 2020 compared to 2019. The truth is that nursing is a challenging job but one that many people want to take up. There is a long queue of people who want these positions because they are rewarding in many different ways. We appreciate the contribution made by nurses and the whole healthcare sector, but there is no disguising the fact that these are attractive jobs, which many people wish to take up.

[Lord Balfe (Con)]

Does the Minister accept that it was not a 2.1% increase but a 2.1% addition to the bill, which included a number of emoluments that are added each year? It was not 2.1% for everybody; it was a whole package. The Government need to get their case across a bit better, particularly with what the Minister just said about recruitment. I suggest that the Government pay attention to getting their case across. As the Minister said, nursing, with its lifetime pension, is a very attractive proposition at the moment.

[Lord Bethell (Con)]

My Lords, the percentages are unbelievably complicated. It is difficult to stand by one single number to represent pay that goes to hundreds of thousands of different nurses under different circumstances. However, I agree completely with my noble friend. What is at stake here is not just one pay rise in one year but the entire package of circumstances in which nurses do their job. We are determined to ensure that that workplace package is as good as it can possibly be. We acknowledge that there are cultural challenges of working in the NHS, which we are fighting hard to improve. We recognise that training opportunities for nurses should be better and we are working hard to improve those. We recognise that nurses have little capacity for holidays, which is why we are recruiting a very large number of new nurses. It is the entire package that we are focused on, which is why we have put forward the affordability argument as we have.

Covid-19: Brazilian Variant

Lord Balfe Excerpts

Tuesday 2nd March 2021 Lords Chamber

[Lord Balfe (Con)]

My Lords, we seem to be devoting a huge amount of state resources to chasing one person with a mutating virus at a time when the National Health Service is on the point of collapse. Waiting lists are going up and we are in a terrible mess. Will the Government accept that viruses mutate and that we need a strategy to deal with that? Constantly locking people up and extending the list of countries so that you can put more and more people into hotels is a self-defeating policy.

[Lord Bethell (Con)]

The vaccine is absolutely central to our strategy. It is an approach that has proved enormously popular, and I think I speak for a large number of people when I say that defending the vaccine has to be our number one priority. If there were a highly transmissible vaccine-escaping mutation, it would take us back to the beginning of this whole pandemic. That is why we have put in place red list countries and managed quarantine. That is why we are committed to Operation Eagle and the efforts to track down those bringing variants of concern into this country.

Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021

Lord Balfe Excerpts

Monday 1st March 2021 Lords Chamber

[Lord Balfe (Con)]

My Lords, I want to take up the point made by the noble Lord, Lord Scriven, and ask the Minister when we will see the MoU. On 17 February, the Minister wrote that it

“is currently being updated to reflect amendments to the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020 on 29 January and feedback from the Information Commissioner’s Office.”

He added that the MoU would be published

“as soon as practically possible.”

That was two weeks ago. Where is it? When will we see it?

I will make some general observations. This has become very much a middle-class debate. A lot of people in this country are not paying much attention to these regulations. Many of them do not understand what they are for—although they understand that they want to get round them. They see an increasingly authoritarian Government increasing the penalties but the police not implementing the law. There is not a single sign of the law being aggressively implemented in the city of Cambridge, where I live. I do not think the police would like to invade the middle-class enclave and I am not sure they would feel that confident going on to the council estates.

So we can keep on giving the police powers to fine and so on, but we need to understand that what is perceived as a hostile environment, backed up by an authoritarian Government, is not working. Threatening people with a criminal conviction that could stop them being employed for ever is an incentive to get around the law as much as it is to obey it, and we have not really followed that up. People will say, “Why should I take the test? I might be found to be infected. Then I would lose my income. I would have to stay at home.” It is a directive incentive not to take a test, and we do not seem to be able to face up to that.

This was made very clear by the noble Baroness, Lady Finlay, when she said:

“Crippling fines and a police record will only disincentivise people to seek testing and disclose their contacts.”—[Official Report, 22/10/20; col. 1668.]


That is absolutely true.

My final point is that I have been abroad fairly regularly during this, because I have a job that takes me to Brussels. I have regularly handed in my test and trace form. It has always been accepted but has not on a single occasion been checked.