Covid-19: Intensive Care Treatment

Lord Balfe Excerpts

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My Lords, I do not know whether that specific instruction has been withdrawn; I will be glad to write to the noble Lord on that.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.

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.

Cancer Task Force

Lord Balfe Excerpts

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?

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.

Folic Acid

Lord Balfe Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay testimony to the good work of my noble friend Lord Rooker on the campaign for mandatory fortification of flour with folic acid. He introduced a Private Member’s Bill and his work has been earnest. My personal experience is that my cousin James was born with an NTD; he survived two weeks and, sadly, passed away. Therefore, this is a matter that has my personal commitment. However, I am not in a position to give him the date he wishes, but we will come back to the House and answer his Question in due time.

[Lord Balfe (Con)]

I welcome the Minister to his three and a half hours at the Dispatch Box. I first raised this matter as president of the British Dietetic Association, the trade union that represents dieticians. There is overwhelming evidence in support of adding folic acid. As long ago as 1 March 2018, I was promised that the Government would be looking at a date for this to be done. I join the noble Lord, Lord Rooker, in being very disappointed about this. I ask the Minister to get on with this, please. As long ago as March 2018, we were being promised a date and we still have not got one. Please take some action.

[Lord Bethell (Con)]

My Lords, I completely accept the urging of my noble friend Lord Balfe on this matter. He is entirely right. There is very strong scientific evidence in this area; the Government accept that, and this is why they have launched a consultation, which was due to be published earlier this year. However, Covid has blown us away and that is why the announcement has been delayed. The Government have listened to the scientific evidence, which is very persuasive, and the decision will be made when the time is right.

Covid-19

Lord Balfe Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is completely talking my game here. I wish I could be 100% specific about the timeframes, but we are still going through the validation process. Personally, I am hugely optimistic. The noble Baroness, Lady Thornton, mentioned the work in this area of Yale University, which really changed our perceptions of the role that saliva testing could play. It can be used in the big PCR machines, it may be used in point-of-care machines and there is even a possibility that it could be used in the small plastic lateral-flow machines much loved by the husband of the noble Baroness, Lady Neville-Rolfe. I hope very much indeed to be able to update the House soon and to lay out a framework, but I afraid that at present the validation results have not come through and it would be premature of me to try.

[Lord Balfe (Con)]

Although the Minister mentioned the need to get back to face-to-face visits, it is not mentioned in the Statement. In our local hospital, Addenbrooke’s, the instruction has been that no people are to be seen unless it is absolutely necessary. Indeed, one consultant told me they had been forbidden to see a patient unless they needed to. Our local GP service provides no face-to-face meetings other than after you have been triaged and jumped through some hoops. It even had a tent outside for a time. Can the Minister assure us that some pressure will be put on local hospitals and GPs to get back to normal and start seeing people? As letters in the Times have proved, the fact that you do not see people means you miss serious diagnoses.

[Lord Bethell (Con)]

My Lords, massive pressure is on the NHS from every level to get back to normal. Attendance rates are increasing dramatically in every area of the NHS. I pay tribute to those who have gone through enormous hoops to create safe and protected protocols to have people back in the system, but I cannot hide from my noble friend the fact that the health system will not be the same, going forward. We will have to change our approach to infection control and hygiene and have face-to-face contact in a completely different way. It makes no sense for lots of ill people to congregate in a GP surgery and to spread their disease among one another. We have to rethink the way we did our healthcare in the past in order to protect healthcare workers and patients from each other’s infections and to afford a sustainable healthcare system that can afford to look after everyone.

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.

Medicines and Medical Devices Bill

Lord Balfe Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020 Lords Chamber

[Lord Balfe (Con)]

My Lords, I too extend my congratulations to the Minister on introducing the Bill. I suspect it will be a somewhat different Bill by the time we have finished with it.

This exposes the whole nonsense of “taking back control”. We are 3% of the world drugs market; the European Medicines Agency is 25%. The way for us to gain control is to work with our colleagues in large organisations where we can have considerable impact, not to start setting up our own organisations. The impact of moving away from the European Medicines Agency is going to be a considerable extension of a centralised process of regulation and it is also going to add to the unaccountable powers of Ministers, because the EMA does have a certain amount of accountability attached to it, which I do not think will happen. Indeed, it will not be the Ministers who will be making these decisions; it will be civil servants some way down the pecking order—and many of them will in the end have to take account of what the medicines agency has to say.

One danger we face is what the British Medical Association has called the butterfly effect: we have a slight derogation from a slight position of an EMA rule, then it multiplies, because one leads to another and then to another. You have to ask yourself whether this divergence can be kept under constant evaluation, because it needs to be. I put it to the Minister—he may not like it—that in the end we are going to have to negotiate a formal agreement for continued participation in EMA assessments, because we need a common assessment. We face otherwise the danger of delay—that manufacturers will say, “Let’s be logical: 22% of the market is in Europe, 3% is in Britain, so let’s get the European agreement first, because that’s where things are based.”

As a side-effect, we will then need an agreement with Euratom for isotopes, which has not yet been mentioned but is crucial to the health service, and that will have to be a separate agreement. We will also need to maintain access to EU funding programmes; we need these joint programmes to develop to do the best job for the citizens of this country—and, of course, we need alignment with the clinical trials regulations. We cannot have a different clinical trial regulation in Britain from what is in practice in the rest of Europe. We need all those things, and we need a professional structure in Britain for advising the Minister and drawing on the advice available.

I support the idea of a commissioner for patient safety. I hope that the Minister will go away and work out how it is to be done before he gets defeated on the Floor of the House. I also believe that the proposal on the harvesting of organs will not get through this House, and there will be an amendment on that. I say to the Minister: please do your homework and bring us something that we can agree with. Otherwise, the Government are going to get defeated.