Medicines and Medical Devices Bill

Lord Balfe Excerpts

Committee stage & Committee: 5th sitting (Hansard) & Committee: 5th sitting (Hansard): House of Lords
Wednesday 11th November 2020 Grand Committee

Further extending prescribing responsibilities could help those people better to support vulnerable groups of patients who need to minimise contact with healthcare professionals, I believe that the arguments for the new clause are overwhelming. Much of the work to achieve its aim has already been undertaken, so there should be no delay. A commitment to bring back a proposal and a timetable for implementation is completely reasonable, so I hope that the Minister will respond favourably to the amendment, which proposes to insert a new clause in the Bill.

[Lord Balfe (Con)]

It is a great pleasure to follow the four noble Lords who tabled this amendment, all of whom are working from exactly the same brief as I am—I can tell that from the quotes. First, I should declare an interest: I have not been present in Committee before, but am here as a former president of the British Dietetic Association, a TUC-affiliated union. The Bill was published during the dying days of my presidency and I undertook to speak in support of the proposed new clause.

I have nothing substantial to add to what has been already been so ably said by colleagues. I will just point out that dieticians are one of the groups seeking to extend this, and people often misunderstand what dieticians are for. The number of times I have been asked whether I am associated with Weight Watchers has rather driven me insane, but dieticians are actually more involved with undernutrition than overnutrition. Although people think of obesity and what are now the more popular things, the biggest challenge facing the average dietician is a person probably over 80 years old, almost certainly living alone and generally not caring for themselves. So the role of a dietician is often to get people to eat a balanced diet. They work in hospitals and in the community, and with other health professionals, particularly in developing clinical management plans. That effort would be reduced if this proposed clause were accepted.

Points about dieticians and others have been extensively made. I understand that

“within three months of this Act being passed”

is a big ask, but also that, unless we ask for something, we will probably not get anything at all. The noble Lord, Lord Bradley, has already quoted the Minister at Second Reading saying that they were

“considering across all non-medical groups … where there is a need to consider undertaking formal consultation on potential amendments to prescribing responsibilities”.—[Official Report, 2/9/20; col. 432.]

I realise that, at the time of Covid, there is a huge number of demands on the Minister’s department and the staff therein but, overall, if this can be made to work, it will benefit and increase the productivity of health professionals. So, in associating myself with the previous speeches, I also encourage the Minister to give as positive a response as he is able to. I am sure that, if we extend prescribing rights, we will be benefiting many patients and the medical profession. We will also be enabling many health workers to play a more effective role in the care of their patients.

[Baroness Jolly (LD) [V]]

My Lords, I support Amendment 49 in the names of the noble Baroness, Lady Thornton, and the noble Lords, Lord Hunt of Kings Heath, Lord Ramsbotham and Lord Bradley. It mandates the Secretary of State to publish proposals and a timetable for additional healthcare professionals to be given appropriately restricted prescribing rights. As other noble Lords have said, for well over 20 years, some appropriately trained nurses have been prescribing from a restricted list. I see no reason why, as the noble Baroness, Lady Thornton, described, appropriately trained allied health professionals and others, working from a list of approved medicines commensurate with their profession, should not do the same.

This is entirely appropriate at the moment, when it is not always easy to access a GP. We have seen how successful giving prescribing rights to both community and practice nurses has proven to be. Patients are becoming more willing to have appointments with AHPs and nurses, rather than GPs, which frees doctors to concentrate on patients requiring more experience, such as those with unusual or complex conditions. This is a win-win amendment and I heartily commend it.

Covid-19: Vaccine

Lord Balfe Excerpts

Wednesday 11th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have extremely detailed and thorough arrangements for our borders on 31 December. No problems are envisaged with regard to the vaccine.

[Lord Balfe (Con)]

My Lords, I draw attention to the bit of the Question that says:

“distribute approved coronavirus vaccines in the UK and internationally”.

There is a great danger in the international distribution that corruption will creep into the system. Can the Minister assure me that the Government will co-ordinate with the EU and like-minded international aid agencies to ensure that corruption is avoided and the vaccine that we donate is delivered for free to vulnerable groups in countries overseas?

[Lord Bethell (Con)]

My noble friend makes a very reasonable point. The marketplace for vaccines is extremely competitive. The British Government have been emphatic in our commitment to CEPI, Gavi and the other vaccine organisations. The COVAX advance market commitment aims to produce 1 billion doses for high-risk populations in 92 developing countries in 2021. We support that initiative enormously and work with other partners to ensure the fair and equitable distribution of vaccines around the world.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

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Wednesday 4th November 2020 Lords Chamber

[Lord Balfe (Con)]

My Lords, this is not the first time I have said in this Chamber that the Government need to fundamentally rethink their position. We are asked to believe that the rate can be pushed down by closing churches, John Lewis, bookshops, gyms and swimming pools but leaving open Tesco, Sainsbury’s, Marks & Spencer and the Co-op. I have very good news for the noble Baroness, Lady Smith. My wife was in the Cambridge branch of M&S yesterday to buy some tights before lockdown; they assured her that they would be packing as many clothes as possible into the grocery section so that it would still be possible to buy tights and so on. Are this Government sponsored by Amazon or by Deliveroo? Which is it, or is it both?

Some 40,000 people have died, and we are now told that another 80,000 are going to die. What have we been doing for the last six months? The Government need to go back to the drawing board and call in people such as Professor Heneghan and other scientists to look more carefully at the numbers.

I recently spent four days in Stockholm. They have the same problem as we do, but they have dealt with it very differently. Stockholm has not locked down its economy; the death rate is lower than ours and it is managing to carry on. A lot of sensible social distancing precautions are in place; most of the museums are closed, but not the economy. As you walk around, you do not get this feeling of dread, with everybody looking like frightened little mice. I ask the Government to look at resetting their strategy.

My final point is this. If there is a vaccine, the consequences will still have to be dealt with. The virus might well mutate. After all, the flu virus mutates—you need a flu jab every year. We seem to be talking about a vaccine as though it will come down from heaven like manna, we will consume it and we will be protected for ever. It will not work that way. The virus will manage to mutate, and we will have this problem with us for a very long time.

At the beginning of this debate, the noble Lord, Lord Robathan, talked about causing national self-harm. I honestly believe that we are talking ourselves into a corner because we are refusing to consider the basis on which we are working. That basis is wrong and it needs to be looked at again.

Covid-19: Intensive Care Treatment

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Thursday 29th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not know whether that specific instruction has been withdrawn; I will be glad to write to the noble Lord on that. I reassure him that, during an epidemic of a highly contagious disease, a hospital might not be the safest place for someone who is ill in a care home; nor would it necessarily be the safest place for someone who has gone to their GP and is sitting in the GP’s surgery. It is therefore absolutely essential that clinical risk management and advice is sought before referral to a hospital. There is no prejudice or unfairness here: it is simply good clinical practice.

[Lord Balfe (Con)]

My Lords, the Sunday Times has form on inaccurate stories, as does the Telegraph. Indeed, I asked the Minister a Question on 21 September about a Telegraph story about age restrictions, and he assured me that there were none. I asked him

“will he agree to place a copy of all the circulars from DHSC in the Library so that we can see what is going out?”

In reply, he said

“I will inquire as to what we can possibly share, so that these decisions are as transparent as my noble friend wishes”.—[Official Report, 21/9/20; col. 1596.]

I think it would help keep the papers on the right track if more was put into the Library. Will the Minister tell me how he is getting on with his endeavours to get this information into the public domain?

[Lord Bethell (Con)]

My noble friend is entirely right to chase me in this matter. I remember the commitment very well and I will endeavour to find out from my colleagues at the department how they are doing in getting those important papers into the Library.

Cancer Task Force

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Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

The concern is serious. However, I reassure the noble Lord that although those waiting longer than 62 days for an urgent GP referral increased to about 21,000 between the end of March and the end of May this year, it now stands at about 8,000, which represents a dramatic decrease in the backlog. We have invested in the “Help Us Help You” campaign, which is directed specifically at those who are most at risk from cancer. It is a massive campaign that we are rolling out shortly, and we will continue to invest in it if that is needed.

[Lord Balfe (Con)]

My Lords, calculations by the charity Action Radiotherapy suggest that the cancer treatment backlog may cost more lives than the coronavirus itself—indeed, it estimates that it could be as high as 100,000. Can the Minister give us details—and if not, can he place them in the Library—of the investment in and expansion of radiotherapy services that is being considered and of the aim to reduce the number of machines that are beyond their 10-year lifespan?

Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 5) Regulations 2020

Lord Balfe Excerpts

Tuesday 20th October 2020 Lords Chamber

[Lord Balfe (Con)]

My Lords, I would like to add a bit of nonsense for the noble Lord, Lord Mann. My noble friends Lord Blencathra and Lord Moylan, if I understood them correctly, said that we would have to learn to live with the virus. That is now the bottom line. The increase in infections is quite different from the increase in deaths and serious infections. The fact that the average age of death is 82.4 and that people have underlying conditions has not been lost on the young, who widely regard themselves as being pretty well exempt—and, if they do get it, it is a bit like a cold; they will sniff it off. I am sorry to say that this may not be lost on the young, but it is also not lost on the old that the health service is in a state of virtual collapse when it comes to treatments for cancer, heart problems, colonoscopies and many other things. We cannot carry on, and I would like the Minister to go back to his department and say, “Look, we really have to rethink this.”

The press and the public, and in particular what I think of as the “thinking classes”, are turning against the Government. You have only to read today’s Times— and I am told that there are similar things in the Daily Mail—to work out that the Government are gradually losing the confidence of the commentariat, because these measures are seen as not working. I would ask for a coherent strategy, because local authorities are not enforcing; I do not think that the police in Cambridge have issued a single penalty notice, and they do not show any sign of wishing to do so. So it is time to reconsider, and maybe Professor Heneghan should be brought in to lead the Government’s analysis of the science.

Covid-19 Update

Lord Balfe Excerpts

Tuesday 6th October 2020 Lords Chamber

[Lord Bethell (Con)]

I am grateful for the noble Lord’s question. My right honourable friend was very clear. The Chief Medical Officer analysed our assessment of the disease and its impact, and assessed that it had not substantially changed as a result of these data. The Statement from my right honourable friend is crystal clear. I will be glad to send the noble Lord a copy of that Statement if he does not have it.

[Lord Balfe (Con)]

My Lords, this afternoon’s release from the Office for National Statistics tells us that:

“There were 215 deaths involving … COVID-19 … in England and Wales in the week ending 25 September”.


This remains far below the numbers seen earlier in the pandemic and accounts for just 2.2% of all deaths in the latest week. Our liberties are being trashed and our freedoms removed. When will the Government get down to putting some hope into things? Most people do not know what the rules are, and if they do they are getting round them. I should like a commitment as to when we can open up surgeries and hospitals, and a promise that by Christmas people will be able to visit their elderly relatives in care homes and those who are unfortunate enough to be in hospital. Can we not have a bit of hope, as opposed to this constant gloom?

[Lord Bethell (Con)]

I hear my noble friend’s frustration, and he is right to call for hope. We all want some hope—we are all feeling exhausted by Covid. But it is ironic that my noble friend mentions the low level of deaths as though that were a bad thing. To me, that number is a source of huge pride, because it shows that we have kept a lid on Covid—our NHS is improving the treatment of people who have Covid and we are winning the battle against Covid. I celebrate that.

Health Care: Guidance

Lord Balfe Excerpts

Monday 21st September 2020 Lords Chamber

Asked by

[Lord Balfe]

To ask Her Majesty’s Government what guidance they have issued since the end of May 2020 to hospitals, General Practitioners and other health care providers about giving appropriate treatment to different patient age groups.

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

My Lords, I make this point very clearly. The NHS provides a comprehensive service available to all, irrespective of gender, race, disability or age. No guidance has been issued on the provision of appropriate treatment based solely on age. The NHS has issued guidance for the restoration of non-Covid-19 health services, working on the principle that the most clinically urgent patients should be seen first, followed by those who have been waiting the longest.

[Lord Balfe (Con) [V]]

I thank the Minister for his reply. He will be aware that there have been letters in the Telegraph and elsewhere, saying an advisory age of 75 is being brought in. First, is any age guidance given in any of the information sent out by his department? Secondly, will he agree to place a copy of all the circulars from the DHSC in the Library so that we can see what is going out?

[Lord Bethell (Con)]

My Lords, I can confirm clearly that reports of any sort of age limit of the kind referred to by my noble friend are completely wrong. On the matter of sharing circulars, there will be certain practical challenges to that, but I will inquire as to what we can possibly share, so that these decisions are as transparent as my noble friend wishes.

Coronavirus

Lord Balfe Excerpts

Wednesday 16th September 2020 Lords Chamber

[Lord Balfe (Con)]

I want to talk about care homes and hospital in-patients, many of whom have been marooned for literally months. One of the problems is the testing regime. Could I ask the Minister, first, to give priority to relatives of people in care, so that they can be tested and go in and see their loved ones? Secondly, there is clearly a problem with a lot of the staff, because they are moved around a lot. Can the Minister undertake that his department will consult UNISON, the main trade union for those staff, and see what it can do to open things up so that people in care homes and hospitals are able to be visited again?

[Lord Bethell (Con)]

My Lords, I note my noble friend’s comments. However, I flatly deny that the social care system and social care homes have been in any way marooned. We have made a profound commitment, particularly in the testing environment, to supporting social care. One hundred thousand tests a day out of our capacity of between 200,000 and 250,000 are ring-fenced for social care and delivered to social care every day. Many of the challenges that we have for walk-in and drive-through testing centres are exactly because we are so committed to the ring-fenced testing for social care. That is a commitment that we are proud of and remain committed to.

I want to clarify with my noble friend that it is not an appropriate use of government test and trace capacity for relatives to use test and trace as a convenient method to find out whether they have the disease before they go to see relatives. That is not an appropriate use and not in the guidance.

As for UNISON, we are very much engaged with the union and are supporting staff in every way we can. However, I very much take on board my noble friend’s notes, and we will maintain that correspondence.

Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020

Lord Balfe Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Balfe (Con)]

My Lords, we are at a tipping point in this matter. Much of the population no longer believes in the measures that are being put forward. On Monday this week, the Times carried a story with the headline:

“Second wave … this winter could kill 85,000 people”—


that is, twice as many people who have already died. In the middle of the article was a little table showing that one person died the day before the story was published.

Many people, particularly the young, think that old people are legislating for them. Many old people feel that middle-aged people are pushing them around and telling them to isolate. Now, we have this legislation, which effectively ends political protest. I carry no brief for Extinction Rebellion, but it could easily be banned under this legislation, and that would be wrong. We will face an inability of the state to get its citizens to behave in the way we wish without coercive measures, and that we cannot do. Therefore, the Government should look, first, at exempting political protests from the regulations and, secondly, at easing up, because if they do not, the population will. The fact is that there is freedom to dissent in this country. There is also a freedom to do foolish things, and people should defend that. That is what this is about.

Finally, people often used to say to me, “Do you know that Jeremy Corbyn? He’s dreadful, isn’t he?” I used to say to them, “You should meet his brother.” I do not think that we were right to fine Piers Corbyn £10,000. He has very quickly raised that sum on the net, and if we carry on with this level of confrontation, we will regret it.