Covid-19

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 15th September 2021 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, I join other noble Lords in congratulating the Government on the last two Statements and the decision to encourage vaccination in 12 to 16 year-olds. However, some teachers who have been very involved in assisting pupils with swabbing are concerned that there might be an expectation that they do inoculations. Can the Minister confirm that that will not be expected of teaching staff? I think he implied that it will not be in his discussion of nurses.

Will the Government seriously consider alternatives to quarantining in hotels by giving individuals the choice to be tagged and remain in one centre if they travel back to the UK? This is particularly important for British citizens working abroad who have been doubly vaccinated.

[Lord Bethell (Con)]

My Lords, I absolutely reassure the noble Baroness that teachers will not be involved in the vaccination programme. I pay tribute to the work that teachers have done in organising pupils and, on occasion, administering the swabs themselves. It has been an impactful programme and we are enormously grateful. There is an established vaccination programme that, as I mentioned, makes use of professional nurses. That is the route we will take in this instance.

When it comes to the MQS programme, the bottom line is that hotel quarantine is extremely effective. It really does stop the spread of the disease as it comes into the country. That is absolutely relevant when we have the threat of variants of concern. We keep the question of tagging in sight. It is a very intrusive measure and we are not convinced that it will necessarily be, in current terms, as effective as hotels, but I take the point the noble Baroness made and will continue to look into it further.

NHS: Nursing Workforce

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 8th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely acknowledge the phenomenon of burnout that the noble Lord rightly points out; the NHS people recovery taskforce, appointed to tackle exactly that problem, is very much focused on it. It works in conjunction with the NHS retention scheme and has led to the appointment of new well-being guardians, which have made a huge impact. The statistics suggest that the leaving ratio, previously at 10.3%, has now been reduced to 8.3%. That is an encouraging sign, but we have a number of other measures in place to ensure that retention remains upward at a time when, as he pointed out, nurses are under huge pressure.

[Baroness Watkins of Tavistock (CB)]

My Lords, a group of Nightingale scholars has informed me that nurses are experiencing greater levels of abuse verbally, on social media and physically, together with racism; they attribute this in part to the long waiting lists and their duties in encouraging Covid vaccinations and mask wearing. Will the Government commit to furthering zero tolerance against violence and racism towards NHS staff, which the scholars argue would aid retention significantly?

[Lord Bethell (Con)]

My Lords, the noble Baroness raises a really important point. We addressed it nearly 18 months ago, before the pandemic, when we had a crackdown on racism and abuse from patients. I would be very grateful if she could send me the details of her correspondence, and I shall look into whether we need to do more on that immediately.

Residential Social Care: Staff

Debate between Lord Bethell and Baroness Watkins of Tavistock

Monday 6th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not completely recognise all of the noble Baroness’s figures, but I acknowledge that recruitment in many sectors of the economy is tough at the moment, and that is why we are putting in the measures that I mentioned to the noble Baroness, Lady Brinton. I add that we are doing an enormous amount to fund: we have put £1 billion of additional funding into social care for 2021-22, on top of the significant support provided to the sector during Covid-19 over the last year. This is money directly to address the issues that she is concerned about.

[Baroness Watkins of Tavistock (CB)]

My Lords, Plymouth’s university trust had to shut to new admissions, except for emergencies, partly because 100 beds had people in them who would have been better off at home or in residential care. This was only last week. Does the Minister agree that any CCG or local authority contracts let to provide social care in residential settings should include allowances for the cost of staff, their training, PPE, sickness and annual leave, and be funded at least at the equivalent of the local living wage, so that we can get back to a normal NHS care situation?

[Lord Bethell (Con)]

My Lords, I take on board the anecdote that the noble Baroness has just mentioned—I will look into that. I did not know about the arrangements at the Plymouth trust. On the whole, the arrangements for discharge have moved on a long way during the pandemic, and the financial arrangements for discharge have improved dramatically, so I am disturbed to hear the story that she tells, and I will definitely look into it.

Covid-19 Update

Debate between Lord Bethell and Baroness Watkins of Tavistock

Tuesday 18th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am extremely grateful to my noble friend for her insight. She is entirely right; this awful pandemic does have a silver lining, which is that it can be an inflection point for a complete transformation in our public health messaging. The work we are doing on communicating the threat of the variants is one example of that. The next front line will be the flu jab rollout in the autumn, where take-up rates have been okay but not great. I hope that, when the flu jab campaign begins this autumn, a completely different generation and spread of people will step up to that opportunity. We are working extremely hard to use the public mood and sentiment behind preventive medicine to full effect to ensure that the flu jab works, that therefore a much smaller proportion of the population will transmit flu, and that deaths and severe disease from flu will be reduced. That can be the legacy of this awful pandemic.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I welcome the vigilant focus described in this Statement that has been adopted by the Government, and that the response is being co-ordinated through the UK Health Security Agency. Could the Minister explain how England is working with the other three countries in the UK to ensure that a proactive approach is taken to the new virus variant, that the uptake of vaccines increases, that the monitoring of transmission continues, and to enable early intervention should the number of cases increase? In particular, what data are the Government collecting on the number of people in quarantine hotels testing positive for coronavirus and how many people have absconded from quarantine? Would the Government consider adopting a process similar to the electronic tagging undertaken in South Korea, to more accurately monitor the movement of people in and out of the country at its borders?

[Lord Bethell (Con)]

I am enormously grateful to the noble Baroness for that creative and thoughtful question. The good news is that the number of absconding residents from managed quarantine is minimal; it can be counted on one hand and many of them have been retrieved. The bad news is that the positivity rate in managed quarantine is far too high. I do not have the precise number in front of me and do not want to guess at it, but it is clearly true that far too many people are getting on planes when they are infected and far too many people are catching the disease on their travels. When we think of how to manage any vaccine-evading and highly transmissible variants, we have to look to the red list for secure protection for this country. She asked another question I cannot remember, but I will be glad to write to her about it.

Social Care: Person-centred Dementia Care

Debate between Lord Bethell and Baroness Watkins of Tavistock

Monday 17th May 2021 Lords Chamber

[Lord Bethell (Con)]

I pay tribute to those who deliver person-centred care. The noble Lord referred to hospices, and I am extraordinarily touched and impressed by the way in which they delivered on an enormously difficult task during the pandemic. We debated earlier the financial arrangements around hospices and the delicate state of their finances. We continue to be in touch with the industry and will take whatever measures necessary to ensure its financial stability.

[Baroness Watkins of Tavistock (CB)]

My Lords, will the Minister explain what plans the Government have to invest in socially rented supported housing for people with early dementia? It is very clear that this would reduce short-term admissions to acute hospital beds, which will be necessary in order for us to meet the challenges that the NHS faces with current waiting lists. If the Government have no plans for considering this kind of supported housing, which many people who can afford it purchase for themselves, can the Minister assure us that he will ask the Government to consider this issue?

[Lord Bethell (Con)]

My Lords, the noble Baroness puts the case for supported housing social care for those with low levels of dementia extremely well. It is slightly beyond the purview of the Department of Health, but the case she makes is strong. I would be glad to go back to the department and find out if any measures are taking place.

Office for Health Promotion

Debate between Lord Bethell and Baroness Watkins of Tavistock

Thursday 29th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, as my noble friend knows, the publication of the consultation on advertising is due soon, and I look to it very much. She is entirely right that obesity, seriousness of illness and death from Covid are clearly related; this has been a wake-up call and we are stepping up to the challenge as of now.

[Baroness Watkins of Tavistock (CB)]

My Lords, the Royal College of Nursing has called for a substantial increase in the number of school nurses to ensure the monitoring and promotion of healthy lifestyles for pupils, so that they are better prepared for learning after substantial absences associated with Covid-19 lockdowns. Can the Minister outline how the Office for Health Promotion will work with the Department for Education to co-ordinate and lead improvements in children’s health, including in school nursing reform?

[Lord Bethell (Con)]

My Lords, I am grateful to the Royal College of Nursing and the noble Baroness for that extremely constructive and thoughtful suggestion. That is exactly the kind of cross-government, inter- departmental suggestion that the OHP will focus on. I will be glad to take that to the OHP and make it clearly.

Care Home Occupancy Rate

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 28th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I absolutely join my noble friend in commending the incredible contribution of care home staff, domiciliary staff, unpaid care workers and all those who support loved ones, neighbours and residents. The Covid pandemic has shone a light on the selfless contribution of those people. The service continuity and care market review keeps a careful eye on the financial stability of the market. We are in constant contact with some of the biggest providers. The scene we see at the moment is not one that causes a huge amount of concern, but we keep close to the market.

[Baroness Watkins of Tavistock (CB)]

My Lords, I declare my interests as outlined in the register in relation to the Outcomes First Group quality committee. Can the Minister explain how he will ensure that the Government work with the Care Quality Commission to see how we can deliver a strategy that promotes care home financial stability so that there are sufficient beds available this winter to enable the NHS to deliver suitable care for those on waiting lists, without older people having to go into hospital unnecessarily?

[Lord Bethell (Con)]

The noble Baroness makes a good point. There is always a tension in having enough beds in care so that those who need somewhere to be supported are not sent to hospital, thereby occupying valuable beds that should be used for elective surgery or other more complex and important procedures. We are working closely with the CQC to ensure that the right strategies are in place to deal with that.

Covid-19: Resuscitation Orders

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 24th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the report is crystal clear that we accept that more training is needed. Front-line care support workers need to be given more support in their interactions, and we will be putting that in place.

[Baroness Watkins of Tavistock (CB)]

My Lords, I draw attention to my interests in the register, in particular the fact that I am a nurse involved with the Outcomes First Group, which supports people with learning disabilities. In order to increase the population’s awareness of care planning in relation to living and dying well, will the Government, in addition to training, consider incentivising healthcare workers to ensure that they have sufficient time to undertake proper assessment of individuals with cognitive impairment and learning difficulties as part of their routine care planning, which should be recorded and reviewed at least biannually?

[Lord Bethell (Con)]

The noble Baroness makes a very fair point; such care needs to be in the work plan particularly of those with learning difficulties, but of all those in care. We absolutely endorse the approach taken by the Resuscitation Council, which has extremely good guidance in this area.

Future of Health and Care

Debate between Lord Bethell and Baroness Watkins of Tavistock

Tuesday 23rd February 2021 Lords Chamber

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I declare my interests as outlined in the register and broadly welcome this paper. I particularly applaud the removal of the need for competitive tendering and the introduction of the discharge to assess model, which I and many other professionals have long advocated. However, could the Minister explain why such extensive powers are planned for the Secretary of State prior to the reforms of social care coming before Parliament? Why can they not come concurrently? He has partly just explained that, but it would be much better if we waited and did the two things together. Section 5.153 of the White Paper is designed to widen the scope of Section 60 of the Health Act 1999 to provide further powers enabling the Secretary of State to

“make a large number of changes to the professional regulatory landscape through secondary legislation.”

I seek assurance that there will be ample opportunity to debate this latter issue during the passage of the Bill.

[Lord Bethell (Con)]

I am extremely grateful to the noble Baroness, Lady Watkins, for her generous remarks on competitive tendering and discharge to assess. These are examples of where we have listened to stakeholders and those in the NHS who have called for changes. In terms of the powers given to the Secretary of State and the link with social care, it is worth remembering that this Bill is a stepping stone towards other changes. Changes to social care funding can take place largely without any legislative change; they can be introduced by secondary legislation. Changes to the funding model in social care are a matter for a very large engagement process that will include other parties, as the Prime Minister has outlined, and will include very considerable engagement with stakeholders.

In the meantime, we are seeking to correct an overreach in the seclusion and mandation of the NHS to give the Secretary of State the kinds of powers that are reasonable in a parliamentary democracy in the governance of such a large and important national institution. Those powers are to be used with restraint and a degree of circumscription, but they rebalance the political geography of the NHS to give it full accountability. As such, they give the kind of authority the Secretary of State needs to institute the kinds of social care reforms I know the noble Baroness, Lady Watkins, is interested in.

Covid-19 Update

Debate between Lord Bethell and Baroness Watkins of Tavistock

Thursday 4th February 2021 Lords Chamber

[The Deputy Speaker (Lord Russell of Liverpool) (CB)]

Since the noble Baroness, Lady Jolly, has withdrawn her name, I call the noble Baroness, Lady Watkins of Tavistock.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I ask the Minister about British citizens working overseas. I declare an interest in that my son is in this category. We have done such a fantastic job here on the vaccines to date, but there are many British citizens working abroad in a volunteer, business or diplomatic role. They recognise the need for quarantine and the need for vaccinations to enable them to work between their UK base and their overseas commitments. How best can the Government include those UK citizens in our vaccination programme—clearly, not giving them priority but to ensure that we protect their health, as well as that of people living in Britain at the moment?

[Lord Bethell (Con)]

My Lords, the Government take very seriously their commitments and obligations to those British citizens who live overseas. It is a matter of considerable concern that they be included in the vaccination deployment. However, there are certain practical challenges with this, so we invite those who want the vaccination to return to British shores so that they can be part of the vaccination process, and to ensure that they are registered with their GPs so that they are included in the list. The Prime Minister has made it very clear that we are putting border measures in place that will ensure that we are protected against mutations and variants. Once again, therefore, I invite all those living overseas who want the vaccination to ensure that they have thought-through arrangements in place to return to this country to get their vaccinations.

Covid-19 Update

Debate between Lord Bethell and Baroness Watkins of Tavistock

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, the restrictions in England have never been based on a two-week circuit breaker. It was not a policy that the DHSC supported.

[The Deputy Speaker (Baroness Watkins of Tavistock) (CB)]

The noble Baroness, Lady Blower, has withdrawn, so I call the noble and gallant Lord, Lord Craig of Radley.

[Lord Craig of Radley (CB) [V]]

My Lords, the Statement refers to a new variant of the virus. Is this the only variant, or are others being found overseas? Porton Down is working to discover whether the current vaccines will remain effective. When does it hope to report? I declare an interest: I was vaccinated in the Fakenham medical centre in Norfolk this morning—a very efficient and reassuring experience—which had 365 planned for today.

--- Later in debate ---

[Lord Bethell (Con) [V]]

My Lords, the noble Baroness is entirely right: the whole purpose of the isolation payments and the idea behind them is the recognition that people who are being asked to self-isolate, particularly if they come from a low-income household, to which the isolation payment is targeted, need financial support to fulfil their civic obligations. That is why we put the scheme in place. It is true that it has been tremendously successful in some areas. We continue to review whether that fund needs to be topped up.

[The Deputy Speaker (Baroness Watkins of Tavistock) (CB)]

The noble Lord, Lord Rooker, and the noble Baroness, Lady Fox of Buckley, have withdrawn, so I call the noble Lord, Lord Singh of Wimbledon.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, the Statement rightly emphasises the need for swift and decisive action to control the deadly virus, which is increasingly affecting schoolchildren. Yet, when a few schools in London planned to close a few days before the end of term but to continue with internet classes, they were threatened with legal action. Does the Minister agree that, while children’s education is important, their health and that of their parents and grandparents should also be considered before rushing to legal threats?

--- Later in debate ---

[Lord Bethell (Con) [V]]

I completely accept the point made by the noble Baroness. It is incredibly frustrating that the exact communities which have often seen some of the highest mortality rates are also those which are sceptical about the vaccine. This is one of our biggest challenges; it has been for months and will continue to be so. I pay tribute to colleagues at the Department of Health and the Cabinet Office who have done a huge amount in working with specialist media—radio, magazines and online forums—to target exactly these communities. They have used advertising and direct engagement with the presenters to put the message across, often in local languages, and this has proved increasingly effective.

[The Deputy Speaker (Baroness Watkins of Tavistock) (CB)]

My Lords, all speakers have been called.

Social Care Workers

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 7th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the recruitment of nurses is extremely encouraging. We have had an enormous response, with more than 10,000 nurses already recruited and recruitment rates to universities for nursing qualifications also up. We have an enormous marketing campaign supported by broadcast and social media. However, more needs to be done and we are very focused on this area. The use of agencies provides some surge capacity for hospitals—it has a role—but I completely acknowledge my noble friend’s point that agency support needs to be used in a considered, thoughtful and commercially intelligent way.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, the introduction of living allowances for nursing students has improved recruitment this autumn. Stable funding for social care purchasers and providers in both care homes and domiciliary-based service is necessary to ensure dignity in care for the vulnerable in our society. It is essential that careers in social care are attractive and that staff are supported to deliver high-quality personalised care to clients. What plans do Her Majesty’s Government have to support local authorities, further education colleges and social care providers to train and retrain social care staff? Central funding is necessary. Incentives are needed to demonstrate that those joining the social care workforce are as valued by government and society as those working in the NHS.

[Lord Bethell (Con)]

The noble Baroness makes her point extremely well. We want social care to be a profession that people seek out, where they seek professional development and where they can find a fulfilling lifetime career. That will not be true for everyone, but we need a backbone of people who are committed to social care. That is why we have massively increased the funding to local authorities so that they can address the challenge of social care, and why we have published the adult social care coronavirus winter plan in order to provide short-term support for local authorities to achieve exactly what the noble Baroness has spelled out.

Covid-19 Update

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 23rd September 2020 Lords Chamber

[Baroness Watkins of Tavistock (CB)]

My Lords, I thank the Minister for coming to take questions on this Statement. I will ask about two issues. If he cannot answer me now, could he kindly write with information? My main concern is people who are still going to work and caring for people who are Covid positive. Based on the highest prediction of need, how many days’ worth of PPE stock does the UK currently have in store for the NHS and voluntary and independent-sector providers of health and social care, including care homes and domiciliary services? How rapidly can stocks be replenished? What proportion is produced and manufactured in the UK? Have we tested the distribution systems and are they satisfactory?

My second question is in relation to vaccination. Vaccination will obviously be really important, but what are we doing now to support the Prime Minister’s approach, declared in August 2019, that we will increase MMR vaccination rates, among other needs, so that all people are protected as far as possible against other infections during the rise of Covid?

[Lord Bethell (Con)]

My Lords, the noble Baroness asked about PPE, which is naturally a concern as we go into winter. I assure her that the NHS has 15-day, 45-day and 90-day plans for the supply of PPE to the NHS and the independent sector. Roughly half of that comes from British sources. The distribution mechanisms have been radically overhauled and tested, and have proved to be utterly modernised.

We are working extremely hard on the deployment of a Covid vaccination. She rightly mentions other vaccinations. I assure her that we have 30 million doses of the flu vaccination. As she rightly points out, there appears to be a strong link between having flu today, Covid tomorrow and problems with a combination of both at a later date.

Childhood Obesity

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 2nd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the noble Baroness, Lady Chisholm, for her expertise in this matter. She is entirely right that decisions made by families together are more powerful than those made by individuals. The obesity campaign launched in July seeks to achieve exactly that by having a campaign on better health targeted at the whole population. I also emphasise the Healthy Start vouchers, a scheme to provide a nutritional safety net to hundreds of thousands of pregnant women and families with children aged under four, which is one way of bringing families together around healthy food.

[Baroness Watkins of Tavistock (CB)]

School nurses play important roles in dietary education for new parents and school pupils. With the anticipated changes to Public Health England, how will the Government ensure, without structured plans, that these services are strengthened to promote healthy eating and exercise to prevent early childhood obesity?

[Lord Bethell (Con)]

The noble Baroness is entirely right that these nurses play an absolutely pivotal role. The reorganisation around PHE is due to start in April. We are seeking the best possible advice on where that work could be best sited. The National Institute for Health Protection is one potential home, but I reassure the Chamber that a safe and important home for those nurses is a priority for the Government.

Covid-19: Response

Debate between Lord Bethell and Baroness Watkins of Tavistock

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, that is not in the current guidelines. The noble Lord is entirely right that it is incredibly time-consuming and not currently practicable. For the reasons I outlined in answer to an earlier question, a test today does not guarantee that someone will not be infectious either tomorrow or the next day. That is why we have not focused on testing at ports, but we remain open to suggestions. We assess a large number of options and, as evidence and trials emerge that may demonstrate the efficacy of different policies, we will of course consider them and remain open-minded.

[Baroness Watkins of Tavistock (CB)]

My Lords, the Statement is clear that the intention is to mass-vaccinate the population once we have a vaccine that is safe and effective. Can the Minister inform us of Her Majesty’s Government’s plans to achieve this, in the light of concerns among general practitioners that they will be overwhelmed, and given that as many as one in six people in a recent survey said that they would not take up the vaccine if it was available? Do the Government intend, for example, to deploy the many nurses and doctors who volunteered to assist earlier this year to deliver vaccinations for both flu and Covid-19? Will they engage faith leaders in encouraging the uptake of vaccinations through proper explanation of the benefits to individuals and to society as a whole of so doing?

[Lord Bethell [V]]

The noble Baroness raises an incredibly important issue and I pay tribute to Kate Bingham, who is running the Vaccine Taskforce. She is tackling exactly the issue that the noble Baroness raised. GPs are right to be concerned about capacity, which is why we are looking at ways of massively increasing the capacity to deliver such a vaccine. We will definitely look at resources such as returnees, pharmacists and other sources of people power to deliver the vaccine into the arms of the nation. On the anti-vaxxer groups, the fake news and wrong stories around vaccines are an area of deep concern. We are working with faith groups and other civic leaders to put right the arguments for a vaccine because, at the end of the day, any vaccine requires the participation of a large proportion of the country in order for it to be truly effective. It will cause huge disruption and personal suffering if trust is not maintained in the efficacy of such a vaccine.

Independent Medicines and Medical Devices Safety Review

Debate between Lord Bethell and Baroness Watkins of Tavistock

Thursday 9th July 2020 Lords Chamber

[Lord Bethell]

My noble friend Lady Cumberlege has put it incredibly well and I endorse her testimony about the courage and expertise of the patient groups who informed this report. I am only sad that they cannot be here to share this important moment. I pay tribute to the work of my noble friend and her team working on this. Patient safety is uppermost now in the mind of health carers. She is absolutely cutting with the groove. The words of Jeremy Hunt are very well made, and we are utterly committed to looking seriously at these recommendations.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I add my apologies to the patients and their families and acknowledge the superb work done by the noble Baroness, Lady Cumberlege, and her team. The report makes very salutary reading. Are we going to make sure that we keep central records relating to any type of implant in future, including mesh used in hernias, so that we can follow up individual cases as appropriate? Will the Government consider returning to the Health Service Safety Investigations Bill, which was delayed and abandoned as a result of the recent general election?

[Lord Bethell]

Health records are absolutely key—that is why we have tabled an amendment on them. That amendment enjoys the support of the Government and of me personally.

Social Care

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 8th July 2020 Lords Chamber

[Lord Bethell]

My noble friend is entirely right: there is a massive potential liability. We are acutely aware of the intergenerational implications of social care reform. It is only right that we treat both those in social care and future generations fairly. Those considerations will be uppermost in our minds.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, can the Minister assure the House that any reform of the social care system will be accompanied by a comprehensive workforce strategy and fundamental improvements to employment conditions by moving away from zero-hours contracts, perhaps to an annualised hours system, to guarantee social care workers regular incomes?

Medicinal Cannabis

Debate between Lord Bethell and Baroness Watkins of Tavistock

Monday 6th July 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is very specific in her questions, and I am afraid I am not able to answer them specifically because they are subject to restrictions and confidentiality. Where I agree with the thrust of her question is that we have been in a bit of a cul-de-sac in this area, but the department is working hard to unblock the problems that have existed. Despite Covid, we appear to be making some progress on this.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, two cannabis medicines have MHRA approval. One of them, Sativex—prescribed within the NHS for multiple sclerosis—has a high level of the active cannabinoid THC, so we know cannabis has medical value. There is no doubt that many more cannabis medicines will be licensed in the coming years. Does the Minister therefore agree that while we are reviewing our current trials, we should evaluate whether it is justified to regard cannabis, in a medical way, as a controlled drug in the long term?

[Lord Bethell]

The noble Baroness will not be surprised to learn that I have just spent three and a half months looking at drugs that might make a difference to Covid, only to find that many of them are not helpful and often quite dangerous, so I do not share the optimism bias that many have towards unlicensed drugs. We remain conservative in our approach to clinical trials. I agree with the noble Baroness and others who have suggested that progress on this should be quicker, and I am leaning into the subject to try to bring that about as soon as we can.

Covid-19 Update

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

My noble friend points to the crux of the matter, which is that the correct response to such a local outbreak requires careful collaboration between PHE, with its expertise, insight and data, and local leaders, who have local insight, regulatory muscle and influence. Her account of talking to the mayor and raising these issues is very important and interesting. All I can say is that we are now focused on making sure that PHE and the local authorities in Leicester work together very closely. We have learned lessons in this area. Certainly, outbreaks in some other towns and cities have been handled with a higher degree of collaboration at an early stage.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I declare my interests as outlined in the register. The Statement makes no mention of day centres, many of which are lifelines for carers who have had little or no respite during the UK-wide lockdown. They support people with long-term conditions, including learning disabilities, dementia and severe, enduring mental illness. In the event of local restrictions associated with Covid-19 hotspots, how will such centres be affected? With the increasing stigma associated with working in areas with high Covid-19 rates, many agency staff are refusing to work in certain care homes. Can the Minister explain what safeguards around care and treatments, including access to higher levels of healthcare and specialist services, are being planned to ensure that care home residents will not be adversely affected by further restrictions associated with high localised infection rates?

[Lord Bethell]

It is my understanding that many day centres will be reopened, although they will have to undergo a very careful risk assessment and, depending on the physical layout, may not be able to open at full capacity. However, I am happy to check that point and reply to the noble Baroness in detail. The issue of agency staff is a big problem, particularly where the staff are itinerant, but I remind her that we are embarked on a massive recruitment programme for the social care sector, including a large recruitment marketing campaign. That is bearing fruit and we are filling spaces very quickly.

Covid-19: Mental Health

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

The area of antenatal and natal services has developed a huge amount of concern and, as my noble friend may remember, we adjusted the guidelines to give parents greater access to mother and child at an early stage. This area does concern us. However, it is a relief that, generally speaking, the disease has not hit pregnant women and early born children in the way that it has hit elderly people, and for that we are grateful.

[Baroness Watkins of Tavistock (CB) [V]]

My Lords, I refer to my interests in the register. As acknowledged by the Minister, the impact of nursing people with Covid-19 on the mental health of nurses is estimated to be considerable. A recent brief report from the University of Manchester into suicide by nurses identified a higher prevalence in female nurses than in women from other professions. It is vital that there is a dedicated support offer for the mental health and well-being of the NHS and social care workforce. Will the Minister ask Her Majesty’s Government to consider extending the current England-wide practitioner mental health service commissioned for doctors and dentists to include all nurses employed in the NHS, community and social care settings?

[Lord Bethell]

My Lords, the confidential helpline for the health and well-being of NHS staff was launched on 8 April. That remains in place and has delivered important mental health support for NHS staff. I will take away the noble Baroness’s recommendation to extend it to a wider community.

Personal Protective Equipment

Debate between Lord Bethell and Baroness Watkins of Tavistock

Wednesday 24th June 2020 Lords Chamber

[Baroness Watkins of Tavistock]

To ask Her Majesty’s Government what contingencies they have put in place to ensure adequate stocks of personal protective equipment for (1) a potential second wave of Covid-19, and (2) sustainable long-term infection control management in the United Kingdom.

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

My Lords, thanks to the efforts of my noble friend Lord Deighton and to brilliant British manufacturers such as Polystar, we have now massively expanded our national effort to buy PPE from around the world, to produce more PPE in the UK and to deliver PPE to the front line, where it is needed most. Despite the global challenge around PPE, we are now confident that we can meet the needs of health and social care over both the next seven and 90 days.

[Baroness Watkins of Tavistock (CB)]

I thank the Minister for his reply. Could he be more specific? Based on the analysis of the maximum use of PPE in the NHS and social care community recently, how many days’ worth of PPE supplies do Her Majesty’s Government plan to hold permanently as a contingency for a potential second wave in the long term? Is it the Government’s intention to work with the devolved Administrations to adopt a four-country approach to supply and distribution according to need?

[Lord Bethell [V]]

My Lords, we have contacted over 175 new suppliers and recently secured a further 3.7 billion gloves alone to meet demand. This approach will massively increase our stockpiling as we prepare the resources that we need for the winter ahead. We would like to have line of sight for 90 days’ worth of PPE supply, and that is what we are working against at the moment.

Nurses: Recruitment

Debate between Lord Bethell and Baroness Watkins of Tavistock

Thursday 18th June 2020 Lords Chamber

[Lord Bethell [V]]

My noble friend makes an incredibly interesting suggestion on a combined course. I am prepared to look into that and write to her about whether work has been done on such a measure.

[Baroness Watkins of Tavistock (CB)]

My Lords, I declare my interests as outlined in the register. Not only do we need to recruit new students this year, but we must retain those entering their second and third years of study and ensure that those in their final year, who are currently helping the NHS in a working capacity, complete their training. It is vital that we introduce universal cost of living maintenance grants that reflect students’ needs. I understand that the Prime Minister said that he will look into that further following a meeting of the Education Select Committee. Will the Minister confirm that in addition to the £5,000 maintenance grants there will be an additional £1,000 for mental health and learning disability nurses this year? Is he willing to meet me and other interested Peers to look at the long-term support for nursing students?

[Lord Bethell [V]]

The noble Baroness is entirely right about retention: we are battling the leakage of skills and experience from the NHS. In September 2019, the Government announced a £210 million boost for front-line NHS staff, which includes, as she referred to, funding for a £1,000 personal development budget for every nurse, midwife and allied health professional working in the NHS. I would be glad to meet her and her colleagues to discuss what more can be done.

Covid-19: Obese and Overweight People

Debate between Lord Bethell and Baroness Watkins of Tavistock

Thursday 4th June 2020 Lords Chamber

[Lord Bethell]

My noble friend is right that personal responsibility and the leadership of those in areas of responsibility are incredibly important. Shame is not a policy that the Government particularly endorse, but I will confess to personally having a sense that I need to lose a stone in order to be match fit for the winter. I commit to my noble friend to undertake this arduous and difficult task over the next three months and will account to him on what progress I have made.

[Baroness Watkins of Tavistock (CB)]

My Lords, global scientific data is clear: obesity weakens immune systems, resulting in increased susceptibility to a range of diseases. Covid-19 has shone a light on the effects of being overweight, and I welcome the Government’s concern and intervention for the future. What plans do they have to work with survivors of Covid-19 who are overweight? There is a real risk that many will suffer post-viral fatigue, which will further exacerbate unhealthy lifestyles and could well result in a significant number of subsequent deaths that are in fact associated with the recovery—or non-recovery—period following Covid-19. Will the Government deliver clear and transparent guidance on healthy lifestyles and provide support to overweight people who have survived Covid-19?

[Lord Bethell]

The noble Baroness is entirely right: there is nothing new to the impact of Covid on those with a high BMI; it is entirely consistent with the impact of other diseases. She is also right that one of the nasty aspects of Covid is its long-term effects, which are not fully understood yet. Evidence suggests that these may be extremely damaging, and it is true that the Prime Minister has spoken about the impact of Covid on him. I have had pneumonia; I know the long-term damage of these kinds of diseases on people. We are looking very hard at offering the kind of support that she describes to those who have been hard hit by Covid.

Covid-19: Critical Care Capacity

Debate between Lord Bethell and Baroness Watkins of Tavistock

Monday 23rd March 2020 Lords Chamber

[Lord Bethell]

My Lords, we are greatly relying on an influx of staff such as freelance locums in order to increase the numbers at the front line in dealing with Covid-19. Arrangements for the pension scheme are included in the Bill that we will bring to the House tomorrow. On supplies to GPs and pharmacies, a huge procurement programme is going on at the moment, and we are taking stocks out of our no-deal preparations in order to ensure that both GPs and pharmacies are well stocked.

[Baroness Watkins of Tavistock (CB)]

My Lords, many healthcare workers are concerned about their own health, particularly with regard to carrying the virus from their work into their homes and infecting their families. The Financial Times reported this morning that the Government have approached Amazon to deliver coronavirus tests urgently to front-line health and social care workers. This of course would provide some reassurance to staff and enable them to know whether they are infected, and therefore whether they should stay at work. Can the Minister offer an estimate as to when such a scheme could be rolled out?

[Lord Bethell]

My Lords, the bravery and commitment of our front-line staff are to be commended. I think I speak for all of us when I pay tribute to everyone who has put their safety and health on the line. There is no doubt that those in the NHS who are working with those affected with Covid-19 are taking a huge risk, and it is our commitment to support them where we can. Hotel rooms are being booked for NHS staff who are reluctant to return home and who would quite wisely prefer to seek alternative accommodation. Tests are absolutely essential in order to get not only front-line clinical and ancillary staff but the whole country back to work. The Government are committed to finding a way to roll out a testing programme that gives British people confidence that we can beat this virus.

Covid-19: Helplines

Debate between Lord Bethell and Baroness Watkins of Tavistock

Thursday 19th March 2020 Lords Chamber

[Baroness Watkins of Tavistock]

To ask Her Majesty’s Government what plans they have to establish a COVID-19 specific helpline in addition to NHS 111; and whether any such helpline could be staffed by retired medical and nursing professionals.

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

My Lords, as part of its coronavirus response, NHS 111 has already trained an additional 1,000 call-handlers. NHS England has been clear that investment will increase as demand continues to rise. As part of the health system’s wider response to the coronavirus, the GMC, the NMC and other professional regulators have written to professionals who have left their registers within the past three years to ask them to return to support the coronavirus response.

--- Later in debate ---

[Baroness Watkins of Tavistock (CB)]

My Lords, I first acknowledge the Lord Speaker’s demonstrable leadership in deciding to work from home. We need to remember that we are televised and we need to model the behaviour we are asking of the rest of the country. I thank the Minister for his response, but draw his attention to the fact that there are many retired professional health workers who wish to contribute to the NHS and social care needs of our population in all four countries of the UK but who have their own health concerns. Many, like myself, are fit enough to return to clinical practice and are of course willing to do so. However, utilising others by quickly teaching them a specific algorithm for the Covid-19 virus could relieve anxiety and provide advice to our population and, in particular, relieve NHS 111 to deal with other concerns. We are very worried that, even in the short term, people with perhaps severe problems who should be ringing 999, but do not know that until they have rung 111, will have to wait a disproportionately long time. I wonder whether we could see how quickly we could get a specific line using the expertise of the people I referred to.

[Lord Bethell]

The noble Baroness, Lady Watkins, reflects the feeling of all the House in her comments on the Lord Speaker, and I entirely endorse her comment that we must all respect the guidance and advice given to us by the Government. I pay tribute to the Lord Speaker for his comments on that subject.

In terms of 111, she is entirely right that the NHS is under acute pressure, which is particularly felt on the front line in the interaction with concerned people who are understandably phoning 111. The 111 system is recruiting a large number of new handlers. In addition, we have put a letter through the GMC, NMC and other professional bodies and there will be a registration page on the front page of those bodies’ websites—it will be going up very shortly, either tomorrow or very soon afterwards, I believe—for recently retired professionals to register their interest in rejoining their local NHS health authorities in some way. Those applications will then be passed on to the local authorities and triaged, and the applicants will be allocated suitable responsibilities. I pay tribute to all those who are thinking of returning or have returned to active service, often putting themselves in danger and taking risks in the service of the NHS to look after patients. The skills of the recently retired may range from those who are younger and active and can be on the wards through to older people who may have desk-based tasks, but it is up to the local authorities to decide where best they can conduct their services.