Covid-19: Vaccines and Pregnancy
Debate between Lord Bethell and Baroness Blackstone(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, my noble friend made a clear case for the importance of improving the way in which patient data is collected and analysed in this country. It is something that we are working on at the moment. She highlights a very difficult situation. A third of women do not know that they are pregnant, of course, and, when they are pregnant, their data is first caught at the hospital where they decide to have their birth. Those databases are not easily linked. We do not have a countersignal for pregnancy at the moment; it is therefore not an acute priority. However, I take my noble friend’s point and will look into it further.
Baroness Blackstone (Ind Lab)
My Lords, I declare an interest as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. The RCOG survey found that more than half of those who declined the vaccine did so because they were waiting for more information about the safety of the Covid-19 vaccination during pregnancy. Will the Government, as a matter of urgency, issue guidance to all pregnant mothers explaining that the vaccination will not harm their unborn babies? Will they also provide facilities for pregnant women to be vaccinated at antenatal clinics as a mechanism to increase the take-up of vaccinations by pregnant women?
Lord Bethell (Con)
I am extremely grateful for those constructive suggestions from the noble Baroness. We have a very large amount of materials specifically for pregnant women, including guidance for pregnant women and a guide for women who are of childbearing age, pregnant or breastfeeding; those are widely distributed by GPs. However, as I said, a lot of pregnant women do not know that they are pregnant, so it is not possible to reach all of them all the time. At the moment, our priority is to ensure that those aged over 50 take their second jab. We will sweep up other demographics, and we will make that a priority when we reach it.
Women’s Health Strategy
Debate between Lord Bethell and Baroness Blackstone(3 years, 8 months ago)
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Lord Bethell (Con)
My Lords, my noble friend touches on two very important points. He is entirely right that mental health has previously been underrepresented in the strategies of our healthcare. I hear loud and clear noble Lords who repeatedly make the case for a greater focus on mental health, and I take that message back to the department as much as I can. I reassure him that mental health will be very much a priority in this area. The two facts—that it is often women who are connected with mental health issues and that it is women who are often overlooked—are probably connected. It is extremely challenging for us to get women from ethnic minorities, for instance those from a Gypsy or Roma background—that is such a good example—fully engaged in our healthcare strategy. If the noble Lord has any suggestions or recommendations for how we can better engage with them, I invite him to submit evidence to the consultation.
Baroness Blackstone (Ind Lab)
My Lords, I draw attention to my interests as chair of the trustees of the Royal College of Obstetricians and Gynaecologists. I warmly welcome this Statement, but we know that women’s healthcare is too often fragmented and unco-ordinated. So how will the Government ensure that their different strands of work on women’s health—this strategy, the sexual health strategy and the violence against women and girls strategy—are all properly aligned and based on a life course approach to women’s health, avoiding the creation of even more fragmentation for women?
Lord Bethell (Con)
My Lords, the question of fragmentation does not affect women alone; it is a problem across the healthcare system. However, the noble Baroness is entirely right: some of the conditions that afflict women in particular are not properly prioritised, and, therefore, the pathways connected with them are not as developed as they should be. That is the kind of challenge that we wish to address. However, the overall macro point is this question of listening: have we really listened to women—their symptoms, needs and health priorities—or are we behind the curve on that? I suspect that, too often, the health priorities that women would like to see emphasised simply have not been heard by the system.
Ockenden Review
Debate between Lord Bethell and Baroness Blackstone(3 years, 11 months ago)
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The Deputy Speaker (Baroness Fookes) (Con)
I do not see the noble Baroness, Lady Altmann, in her place, so I call the noble Baroness, Lady Blackstone.
Baroness Blackstone (Ind Lab)
My Lords, I declare an interest, as set out in the register, as the chair of the trustees of the Royal College of Obstetricians and Gynaecologists. As the Minister has admitted, this report makes shocking reading, so what steps will the Government take to monitor the improvements they are pledging for maternity services right across the country to avoid the tragedies that are revealed by this review? Will the Government commit to publishing the findings of any future evaluation and, in particular, data on the avoidable deaths and long-term disabilities that result from failures in the care of women during childbirth?
Lord Bethell (Con) [V]
My Lords, policy officials at the DHSC are working with both the CQC and NHS England on improving our surveillance and the publication of data, as the noble Baroness rightly points out. A key development in this area is the work by HSIB to investigate each and every death and major incident in maternity suites. That provides an absolutely invaluable resource to understand where and when things go wrong. We will continue to publish those reports as they happen and will learn lessons from their insights.
Covid-19 Vaccine Rollout
Debate between Lord Bethell and Baroness Blackstone(3 years, 11 months ago)
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Lord Bethell (Con)
I am enormously grateful to the noble Lord for his clear and heartfelt offer of help, and I completely endorse his comments. The collaboration between the NHS, the Government and business has been at the heart of our entire response to the pandemic. This collaboration has been termed the “triple helix”—a phrase that I like very much indeed. It is going to be at the heart of our building back of the healthcare system in the years ahead. On the noble Lord’s kind offer, I remind him that when someone takes any medical treatment, including a vaccine, they have to have the space to take stock and recover from the excitement of the vaccine, and they have to be supervised in that space by someone with some kind of clinical experience. So, while his offer is kind, it is likely that vaccine distribution will be in locations where we can put clinical supervision.
Baroness Blackstone (Ind Lab)
My Lords, do the Government intend to create some kind of vaccination passport, which will allow people to attend events across the UK and to travel to and from the UK without quarantine, if they have been vaccinated?
Lord Bethell (Con)
My Lords, the noble Baroness raises an extremely intriguing prospect. If it is indeed the case that those who have been vaccinated are not themselves contagious and cannot transmit the disease, there is the possibility that the vaccination will enable them to do things that might not be open to other members of the public. However, it is too early to call that one. We do not have the scientific evidence to demonstrate that the vaccine stops any infectiousness. We are working hard to try to understand that better. If it can be proved, we will look at an enable strategy.
Covid-19: South Yorkshire
Debate between Lord Bethell and Baroness Blackstone(4 years ago)
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Baroness Blackstone (Ind Lab)
My Lords, what steps are the Government taking to increase NHS lab capacity for testing in areas suffering from new restrictions? What advice has been given to care homes in those areas to alleviate the appallingly inhumane denial of access of families to their elderly relatives? For example, will regular testing be made available to those visiting their desperately lonely and sometimes confused relatives in care homes?
Lord Bethell (Con)
I pay tribute to NHS colleagues who have done an enormous amount to increase NHS lab capacity, and would be happy to share the numbers with the noble Baroness. We have written to care homes to emphasise the critical importance of the pastoral visits to which she refers. There is no question of a care home shutting out visitors if it can be avoided and we are putting regular testing in place to protect care homes. We are looking at providing regular testing for visitors and hope to make progress on it.
Covid-19 Update
Debate between Lord Bethell and Baroness Blackstone(4 years, 2 months ago)
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Lord Bethell (Con)
My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.
Baroness Blackstone (Ind Lab)
My Lords, given the intrusive and damaging effects, especially on family life, of the decision to limit social contacts to six people, can the Minister say why it was decided to apply this both inside and outside, rather than to follow the Welsh Government’s position of applying the new ruling only to meetings inside? Does he agree that medical evidence suggests that the chance of contracting the virus outside is tiny in comparison with inside, and that, with regard to his quest for simplicity, nobody is so simple that they cannot tell the difference between inside and outside.
Lord Bethell (Con)
My Lords, I agree that everyone can tell the difference between inside and outside, but everyone also has eyes, and may have seen, as I have, how people crowd together in the forecourts and beer gardens of Britain. If they were all standing on draughty hillsides with the wind blowing the disease around, that would be one thing, but the simple fact is that our prevalence has gone up—the evidence speaks for itself—and that is why we need to be clearer about this simple measure.
Medical Teaching and Learning: Ethnic Diversity
Debate between Lord Bethell and Baroness Blackstone(4 years, 4 months ago)
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Lord Bethell
The noble Baroness put her point well, although the broadband deficiencies meant that I did not get all of it. I emphasise that this area of policy work is very much the focus of the drafting of the People Plan, which will put a spotlight on a number of the areas of our human resources, including BAME people, and we look forward to the publication of that plan.
Baroness Blackstone (Ind Lab) [V]
My Lords, while the curricula of medical schools are for them to determine, could the Minister tell the House whether any meetings between the Medical Schools Council and Ministers have taken place recently? Will he ensure that a meeting is arranged in the near future to hear from the medical schools what they are doing, first, to improve the representation of Afro-Caribbean staff and students and, secondly, to ensure that teaching and research properly explore those conditions to which the BAME community is especially susceptible? Black lives really do matter.
Lord Bethell
The noble Baroness asks a very specific question; I cannot, I am afraid, answer precisely on what meetings there have been with the medical councils, particularly during the busy Covid period. All I can say is that there is ongoing and regular engagement with the medical schools that focuses very much on the key issues that she describes. Diversity and Inclusion: Our Strategic Framework 2018-2022, from Health Education England, is a very explicit and specific programme of works in which we engage all those in health education. As I mentioned, we are working extremely hard on our recruitment campaigns to ensure that they reach communities otherwise not reached.
Covid-19: Mental Health Services
Debate between Lord Bethell and Baroness Blackstone(4 years, 4 months ago)
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Lord Bethell [V]
My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.
Baroness Blackstone (Ind Lab) [V]
My Lords, there is increasing evidence that the mental health of children and young people has been badly affected by the Covid-19 lockdown. Given that the provision of mental health services to this age group was already inadequate, why has progress in implementing plans in the Green Paper on child mental health been so poor, particularly in the rollout of child mental health teams? What steps will the Government now take to rectify that?
Lord Bethell [V]
The noble Baroness is likely correct that the epidemic has had a particular effect on children and young people. The evidence on this is not crystal clear, but that is the strong instinct of all those in the field. I personally welcome the reopening of schools, which will have a particularly beneficial effect on those children who at present are stuck at home and do not have the support of the school system. Mental health services for young people are part of our long-term plan, with the additional £2.3 billion of spending on mental health. Our ambitions in that area remain enormous.
NHS: Children’s Emergency Beds
Debate between Lord Bethell and Baroness Blackstone
Lord Bethell
The noble Baroness touches on an incredibly important point. Undoubtedly, accident and emergency services are suffering a big spike in attendance by children and young people. I travelled to 20 accident and emergency wards in December and saw for myself the long queues of children. Clearly, something needs to be done to guide children away from accident and emergency. That is why this Government are doing an enormous amount to improve primary care services by investing in the 111 service and treatment-in-a-day services, for example, which can move people from A&E to create space for those in the most need.
Baroness Blackstone (Ind Lab)
My Lords, I pick up on my noble friend’s question about staff shortages, to which the Minister did not reply. For many years now, there has been a serious shortage of paediatric nurses with the specialist skills needed to work in ICU. However many of these units we have around the country, they will not be very effective if we do not have the skilled staff to man them. What are the Government doing to fill these places where there are shortages?
Lord Bethell
The Government are investing in 50,000 new nurses, many of whom will be trained for exactly the kind of services that the noble Baroness described. In particular, mental health investment is a big focus for the Government, with plans to have spent £12.5 billion on mental health care in 2018-19. Our NHS funding Bill, which will receive its Second Reading in the Commons today, will explain exactly how much money will be spent.