Covid-19 Internal Review

Debate between Lord Bethell and Lord Dobbs

Thursday 20th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, it is not for me to define exactly what the scope of the inquiry will be but the noble Baroness’s points are extremely well made. I emphasise the importance of women. We are in the midst of consultation on the women’s health strategy. It is proving to be an incredibly impactful process and events are being held almost daily. I encourage all noble Lords to submit evidence to the health strategy on any issues that they feel strongly about. This could be a really impactful turning point in the way in which the health of women in this country is massively improved.

[Lord Dobbs (Con)]

Does my noble friend agree that publishing an internal review right now would do nothing less than risking a dodgy dossier, of the sort we have seen before which shed far more confusion than light? Does he not think that the most important use of time right now would be in getting to grips with the anti-vaxxers who are spreading vicious lies, so that we can get on with vaccinating as many people as possible and bringing this country together as quickly as possible?

[Lord Bethell (Con)]

I am extremely grateful to my noble friend for his comments. He is entirely right. The battle against anti-vaxxers has been very successful. We have used a spirit of dialogue with people who have very personal and legitimate questions about a vaccine that requires an injection of fluids into their body. People quite reasonably have detailed questions about its impact. I applaud officials and partners of the Government who have been so effective at conveying the message on the safety and efficacy of the vaccine. It really has demonstrated the power of government and NHS communications at their best.

Health and Social Care Update

Debate between Lord Bethell and Lord Dobbs

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are committed to both our levelling-up agenda and the kind of population health measures to which the noble Lord alludes. That is why we are bringing the NHS and social care Bill before the House later this year. I hope that the noble Lord engages with it to bring his insight to the debate.

[Lord Dobbs (Con) [V]]

My Lords, I assume that my noble friend shares with me a profound sadness at what is going on in the EU. Will he, instead of following their appalling example or indulging in tit for tat, remind the world that Britain after Brexit does things differently? We prefer the rule of law to knee-jerk protectionism, we pursue free and fair trade, and we honour our commercial contracts. Does he agree that this makes Britain one of the most attractive places in the world for pharma, biosciences and anyone to do business with?

[Lord Bethell (Con)]

My noble friend has just made a fantastic pitch for my job. He articulated the case for investing in Britain to pharmaceutical and medical devices companies around the world. Which company cannot be looking at Europe, right now, wondering whether Britain is not, by far, the best destination for their investment and research? I completely agree with my noble friend; my head is in my hands when I look at Europe and what is going on there, but my hope is that good sense will return. In the meantime, if anyone wants to invest any money in life sciences, please give me a ring.

Covid-19 Update

Debate between Lord Bethell and Lord Dobbs

Thursday 4th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I thank the noble Baroness, Lady Andrews, for her questions. Perhaps I may tackle the specific question of airport testing, which has been raised a couple of times. The honest truth is that the arrival of families in south Gloucestershire and Aberdeen who had done a pre-flight test and subsequently developed symptoms demonstrates, I am afraid, that pre-flight and airport testing is not as effective as one would hope. If it were, we would not have to impose a 10-day testing regime with tests on the second and eighth days. That is the only rigorous way in which one can do it. It is estimated that airport testing catches perhaps between 10% and 20% of infection, and that is why managed quarantine is so important. The infection rate among those who arrive in the UK is high enough for us to be seriously concerned and to impose the kind of isolation that we have done. Until that infection rate is reduced, I am afraid that we have to look forward to managed quarantine and isolation being a part of the travel experience for some time.

[Lord Dobbs (Con) [V]]

My Lords, I add my congratulations to those offered to all those involved in a remarkable national achievement. It has also been a personal triumph for my noble friend and all his colleagues. However, perhaps I may pursue the question that my noble friend Lord Cormack raised a moment ago. An alarming proportion of Covid infections have been caught by patients in hospital and those inside care homes. Can the Minister elaborate on government plans to require those who work in the NHS and care homes to accept vaccination if they are to continue to work among such vulnerable people? Why are so many of them so reluctant? Does he agree that the trade unions have some nerve in describing any suggestion of that sort as bullying?

[Lord Bethell (Con)]

My Lords, I completely acknowledge the concerns of my noble friends Lord Dobbs and Lord Cormack about nosocomial infection. Undoubtedly, infections caught onsite in Britain last year and this year, and in every epidemic, are not only among the saddest forms of contagion but among the most dangerous. I want to reassure both my noble friends that we are absolutely focused on this point. It is, though, too early to make a call on professional mandatory vaccination. We have got through only the first 20 million people in the highest-risk and, therefore, the oldest age groups, and we have not moved through all the other age groups. The Cabinet Office is looking at this matter and has a review process in place. When that process has coughed up its findings, we will be in a position to debate the matter, and I look forward to that in due course.

Covid-19 Update

Debate between Lord Bethell and Lord Dobbs

Thursday 4th February 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right that understanding of the role of aerosols is growing. Frankly, I find it quite terrifying. She is right that we need to look particularly at the way our office spaces are ventilated. The statistics I have seen on the potential cost of rebooting the ventilation of the UK’s workspaces in order to make them Covid-friendly are that it would cost tens of billions of pounds. Our focus is therefore on vaccine deployment, but work is going on to reimagine and envisage how workspaces could be made safer, not just for this pandemic but for the future. I can imagine a world where ventilation is given greater hygienic priority in future.

[Lord Dobbs (Con) [V]]

My Lords, I was rather alarmed at my noble friend describing himself as a neophyte. He rather strikes me as being a battle-hardened veteran by this stage. I shall ask him about convalescent plasma. We had high hopes of it a year ago, yet the recovery trial at Nuffield College has now been ended and the BMJ has concluded that there is no convincing evidence of its effectiveness. And yet the NHS website is still seeking volunteers, and just this morning I heard a radio advertisement pleading for more volunteers to come forward. Will he clear up the apparent confusion there? Is it still a possibility that this might be something we are pursuing, or has it been put to one side?

[Lord Bethell (Con)]

My noble friend is right. The story of convalescent plasma is heartbreaking. I had extremely high hopes that it would be a rather wonderful way in which those who had been hit hard by Covid could be agents in the recovery of those who were newly in hospital. Convalescent plasma has a very successful record throughout history of being a source of therapeutic help, but the science is the science and we have to be respectful of the clinical trials, however heartbreaking the news is. We have massively downgraded our expectations. There is hope that convalescent plasma could be used in primary care in a very early intervention, but there are problems with the delivery of that medicine and primary care is not in great shape at the moment to be plugging blood into people just because they show some symptoms of Covid. We are continuing our collection until the last clinical trials in primary care are finalised, but I am afraid to say that our expectations in that area are much less than they were a few weeks ago.

Puberty-blocker Drugs

Debate between Lord Bethell and Lord Dobbs

Thursday 10th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

I am sure that the noble Baroness’s testimony is entirely right, and it concerns me that anyone has any concerns in this matter. I reassure her that the Tavistock is doing absolutely all it can to reassure current patients and those who are on the referral list; its communications have been excellent throughout. The provision of puberty-blocker services to existing patients has continued, and it will remain in close contact with those patients as the review plays out.

[Lord Dobbs (Con) [V]]

My Lords, I hope this is an appropriate moment to reflect on the life of Jan Morris, that glorious writer who died just over two weeks ago. She was born a man, served in the British Army, fathered four children with her beloved wife Elizabeth and then transitioned from male to female in the 1970s—a challenge she bore with extraordinary humour and patience. So perhaps I may recommend that my noble friend reads all her books in his spare time. Would he agree that Jan Morris’s example of seeing the world in glorious colours, rather than narrowly in black and white, and of always showing kindness and tolerance even to those who disagreed with, and perhaps disapproved of, her, is an example that should inspire all sides of this debate and give comfort to those, in particular children and their parents, who find themselves struggling with the same difficult situation she did?

[Lord Bethell (Con) [V]]

[Inaudible]—to be more affected by their warmth and kindness. Jan was an absolute model of warmth and kindness. Having worked in the nightclub industry, I have met, worked with and enjoyed the company of many trans people, which has always proved to be an extremely uplifting experience. I am a massive supporter of the trans movement in the round.

Coronavirus Vaccine

Debate between Lord Bethell and Lord Dobbs

Thursday 3rd December 2020 Lords Chamber

[Lord Bethell (Con)]

As ever, the noble Lord is extremely wise in his observation. He is entirely right to hold us to account. There is no point in enjoying this fine moment too much when you have the noble Lord, Lord Patel, on your case reminding you about the next big challenge around the corner. He is right that pharmacovigilance is essential. We need to make sure that this and other vaccines work and that we learn from the behaviours of all of them. That is precisely why we put the deployment of this vaccine through the NHS. There was a temptation to set up an alternative agency and focus on the actual injection of the vaccine over all other matters. Instead we have run it through the NHS digital process, which means that all the information around the vaccine is put very firmly into the GP record. That means that we can do population-wide analysis of the results of the vaccine. We have a very large research community in the UK both in the companies such as Pfizer, which, as he knows, are responsible for pharmacovigilance, and in the university sector. We will have all those records available for them to do the follow-up work that he rightly emphasises.

[Lord Dobbs (Con) [V]]

My noble friend will know that I have reservations about some aspects of government policy, but the news about the vaccine is wholly good news. It is a triumph for all concerned and I join in with his praise for them, although my noble friend himself should not be shy about taking his own share of the credit. He mentioned that other vaccines are coming down the road—in the pipeline, I think he said—including the Oxford vaccine. These vaccines have different characteristics and require different handling. How do the Government plan to distribute and discriminate between the different vaccines? Will one get priority over another? While I understand that he cannot be precise, can he offer any further guidance about how soon we can hope that everyone who wants one will have a vaccination available?

[Lord Bethell (Con)]

I thank my noble friend for his kind words. I reassure him that everyone in Britain who wants a vaccine will get one. In fact, we are going to do everything that we can to encourage everyone in Britain to have a vaccine. We believe that prevention is better than cure, and that vaccines such as the ones coming down the pipeline offer the best possible fightback against this horrible disease. With regard to the different properties of the vaccine, his observation is entirely right: it is likely that the different vaccines have different properties, not least that some are much easier to transport than others, but some might work better, for example, with children or with those susceptible to other conditions. We do not have full data on the other vaccines so it is impossible to make those comparisons at this stage, but I assure him that when we have the data we will make sensible decisions along those lines.

Covid-19: Vaccines and Medical Equipment

Debate between Lord Bethell and Lord Dobbs

Wednesday 25th November 2020 Lords Chamber

[Lord Dobbs (Con) [V]]

My Lords, I congratulate AstraZeneca and Oxford University on their triumph in developing this vaccine. I hope that my noble friend agrees that without the exceptional input from the private sector, this game-changing treatment simply could not have been developed. What plans do the Government have to cope with the anti-vaxxers? Some of them will simply be individuals exercising their right to say no, but others will be deliberately spreading lies and misinformation that can only undermine trust in the vaccine. Do the Government have any specific plans to deal with this challenge?

[Lord Bethell (Con)]

My Lords, we have extremely detailed and energetic plans to deal with misinformation, which is based on confusion, and disinformation, which is based on malice. It would not be right for me to go through those plans in detail at the Dispatch Box, but I reassure my noble friend that they are in place and are being characterised by a degree of consideration for those who have concerns about the vaccine. It is a grave undertaking to have an injection such as that. People naturally have searching questions they would like to ask, and we are trying to meet those questions with a degree of thoughtfulness and to answer them in the spirit in which they are asked.

Covid-19 Update

Debate between Lord Bethell and Lord Dobbs

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the phenomenon we had noticed was that large groups of people, sometimes in pubs and sometimes in other congregations, would seemingly be from two households, but that the actual definition of “household” was proving to be extremely flexible in the minds of many people. Therefore, putting an integer into the formula makes it much clearer.

[Lord Dobbs (Con) [V]]

May I return to the issue of political gatherings, which my noble friend and I discussed last Thursday? He mentioned that protests such as those we have seen recently from Extinction Rebellion might not be outlawed quite yet, but it is not really a matter of outlawing political protest—I did not ask for that. However, can he understand how deeply outraged many would feel while spending their Christmases abiding by the very difficult rule of six if, out their window, they were watching political protesters who do not give a monkey’s about the rules? Will he confirm that political protesters are subject right now to precisely the same rules as the rest of us?

[Lord Bethell (Con)]

My Lords, I sympathise with my noble friend’s point, but I remind him that the regulations come into force later today. It is up to the Metropolitan Police to implement crowd dispersal but the sentiments he expresses are ones that I share.

Covid-19 Update

Debate between Lord Bethell and Lord Dobbs

Thursday 10th September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right to emphasise the challenge of itinerant domiciliary care. Such workers were always a vector for potential disease and are putting their own lives on the line. That is why we have radically changed the guidelines. We have put more resources in place to ensure greater support for domiciliary care, PPE is stocked for them to use and there is regular individual testing

[Lord Dobbs (Con) [V]]

My Lords, the new guidelines require political protests to be “organised in compliance with” government rules and

“subject to strict risk assessments”.

Who will undertake these assessments, when and how will they be undertaken—I presume they will have to be undertaken before any protest is mounted—and does this mean that the type of protest we saw the other day by Extinction Rebellion will by definition be unlawful?

[Lord Bethell (Con)]

My Lords, my understanding is that the risk assessment is done by the local police force in conjunction with Public Health England, but I am happy to check that and write to my noble friend. With regard to Extinction Rebellion, I found the protest last week particularly tedious but I am not sure if it will be outlawed quite yet.

Covid-19: Rise of Positive Tests

Debate between Lord Bethell and Lord Dobbs

Wednesday 9th September 2020 Lords Chamber

[Lord Bethell (Con)]

I advise the noble and right reverend Lord that those figures are published on the PHE website. I would be glad to send him an email with the link.

[Lord Dobbs (Con) [V]]

My Lords, what I am about to ask implies no criticism, because this is such a difficult question. The increase in restrictions on social gatherings that have just been announced will be so difficult to enforce. Is there at least a case for us to consider focusing more on mortality rates rather than simply on infection rates, and finding better ways of identifying and protecting the truly vulnerable, while allowing the rest of society to get on sensibly with their lives as best they can in the circumstances, before the costs of trying to protect everyone become both economically and politically unsustainable?

[Lord Bethell (Con)]

My noble friend is entirely right to say that the measures that the Prime Minister will describe will impose a huge burden on the whole country. However, he alludes to a hope that I am afraid cannot be borne out in practice, because we have seen, in country after country, that after prevalence follows hospitalisation and mortality, as night follows day. There is an immediate and strong connection between the rise of mortality and the rate of prevalence in the country as a whole. Children see their parents, and parents see the grandparents, so if we really want to protect all those in society, we have to lean into the disease at every level. In addition, it is emerging that the long-term effects of Covid on young people can be profound. Even those with relatively low or asymptomatic reactions to the disease can be affected by fatigue, loss of memory, breathing difficulties and other long-term effects. It is for those reasons that I ask all young people to ensure that they take every step to avoid catching this disease.

Suicide

Debate between Lord Bethell and Lord Dobbs

Tuesday 8th September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble and right reverend Lord is entirely right that suicide is an awful form of death. Each one is worth regret, but the numbers are more complicated than he suggests, as the definitions of suicides and the coroner’s assignment of the suicide definition has changed in the period he describes. While we are all concerned about society, I am not sure I entirely agree with his sombre analysis of society’s values. I have a more optimistic outlook than he perhaps does. The Government’s suicide prevention programme entirely addresses the concerns of individuals and is, I believe, having a powerful effect.

[Lord Dobbs (Con)]

Recently published figures show an alarming, significant increase in suicides among young people, even boys and girls aged 10. Those were pre-Covid statistics. Those statistics are heartbreaking and, I think we all agree, inexcusable. Does my noble friend believe that the social media companies are really owning up to their responsibilities in combating abuse and bullying online? Are we owning up to our responsibilities in schools to educate children about the safe use of social media and to pass on to them the wisdom and support they need?

[Lord Bethell (Con)]

My noble friend is entirely right to raise concerns about the role of social media in rising suicide rates among young people. We are doing an enormous amount to protect young people, incentivising every school to identify a senior lead for mental health, creating new mental health support teams and piloting a four-week waiting time to allow swifter access to specialist NHS care. We are also taking on the social media companies and demanding that they step up to their responsibilities.

Covid-19: Response

Debate between Lord Bethell and Lord Dobbs

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, we can undoubtedly do better in the area of hygiene. The guidance is very clear on what types of detergents work and how they should best be administered. I pay tribute to the cleaning staff in the NHS, who have worked incredibly hard during the epidemic, putting themselves at risk; they have done a very good job. None the less, our view is that the greatest challenge is to change the behaviours of the British public. Work still needs to be done to persuade all of us to wash our hands more and to maintain cleaner personal hygiene. Transmission of the disease happens most often through manual contact—touching the face and shaking hands. That can only be challenged by washing hands.

[Lord Dobbs (Con) [V]]

My Lords, Public Health England has been including in its death totals those who once had Covid, recovered, but have since died from other causes. So, if you once had the virus but no longer have it, and get hit by a bus, you still get listed as a Covid casualty. How can Ministers and others reach sensible policy decisions when the basic statistics provided to them seem so flawed? Has this bizarre practice now stopped? Have Public Health England offered any justification for it?

[Lord Bethell [V]]

The Secretary of State has asked Public Health England to review the logging of death statistics; we await the review’s results.

Covid-19: Personal Protective Equipment

Debate between Lord Bethell and Lord Dobbs

Thursday 16th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, it is a reality that the cost of PPE has gone through the roof. There is nothing that I or the Government can do about that. It is something we are going to have to live with and budget for: it is part of the new reality. As to the procurement of PPE, as the noble Baroness knows, within the care sector it was previously the arrangement that local providers would source their own PPE. The Government have stepped in to bring resilience and confidence to that supply chain and to offer alternative sources of supply to local care homes. We have moved emphatically and sought to bring both affordability and resilience to the supply chain.

[Lord Dobbs (Con) [V]]

My Lords, I was going to ask my noble friend about private sector provision of PPE, but I shall move on to something which may be even more significant—the hopeful news of developments in Oxford scientists identifying a vaccine against Covid. Is my noble friend able to offer any update on that news? Can he set out what role the private sector has in the development and, we hope, eventual manufacture of any such vaccine?

Personal Protective Equipment

Debate between Lord Bethell and Lord Dobbs

Wednesday 24th June 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness is entirely right to emphasise the importance of getting home care workers adequate supplies. The expectation is that the majority of social care providers, including home care providers, would continue to access PPE via their normal wholesale suppliers, but we are rapidly overhauling the way in which PPE is delivered to care homes and domestic care supplies, including through emergency dispatches via the pilot e-portal and the national supply disruption response.

[Lord Dobbs (Con)]

My Lords, it is not simply stockpiling but the ability to supply PPE as and when needed that is so important. Will my noble friend join me in welcoming and congratulating the private sector—firms up and down the country, big and small—which provided such tremendous support in meeting our recent PPE demands, demands not always recognised by Public Health England at the time? Can he assure us that we have learned the lessons and that we can rely on the experience, initiative and abilities of the private sector? Is he able to tell us that in future he expects, if he cannot guarantee, that all future PPE demands will be available from firms in Britain, rather than relying on sources from other, perhaps less reliable, countries?

[Lord Bethell [V]]

My noble friend Lord Dobbs is entirely right: British companies have done an amazing job of stepping up to this challenge. I pay testament to Survitec, Bollé, Jaguar Land Rover, Don & Low and Burberry, which have all made huge contributions, and to the 350 firms we are currently negotiating with to create a new domestic supply. Nearly 2 billion items of PPE have been supplied through UK-based manufacturers. The moment when we are exclusively and entirely dependent on UK supply is some way off, but this provides a critical cushion and helps to build resilience for these important products.

Covid-19

Debate between Lord Bethell and Lord Dobbs

Thursday 23rd April 2020 Lords Chamber

[The Deputy Speaker]

Lord Woolf. No? Lord Dobbs.

[Lord Dobbs (Con)]

Minister, are prisoners in our prison system participating in the manufacture of PPE? Does the crisis not represent an opportunity for many prisoners to not only contribute but move towards some rehabilitation?

[Lord Bethell]

My noble friend Lord Dobbs is right that there seems to be an opportunity, but I have to be candid with him. Our need for PPE runs into hundreds of millions of items. We have delivered more than 1 billion pieces of PPE since Covid began. I am afraid to say that the manufacturing abilities of Her Majesty’s prisons do not reach to that kind of level.

Covid-19: Extent of Infection

Debate between Lord Bethell and Lord Dobbs

Wednesday 22nd April 2020 Lords Chamber

[Lord Bethell]

I thank the noble Baroness, Lady Sheehan, for a very clear Question. I can reassure her on three points. First, front-line staff in the NHS and in care homes are eligible for test on request and we will be opening lines so that they can phone and book their own testing shortly. Secondly, I commend and thank those private research labs already contributing enormously to our testing regime. Thirdly, mass testing is one of the options that we are looking at: the Cabinet Office is devising plans for the medium term and will be publishing them shortly.

[Lord Dobbs (Con)]

First, I very sincerely thank my noble friend for his tireless work during this crisis. Did he by any chance see the BBC report yesterday under the headline “Deaths at 20-year high”? Digging into that needlessly sensationalist headline, intriguingly it reported that the apparent increase was one-third linked to the virus but two-thirds linked to non-virus cases. We all understand that there is an inevitable impact on others while we direct our focus towards the coronavirus, but have the Government undertaken any study of the estimated increase in the number of deaths of non-virus patients during the economic lockdown, and, if so, will they publish its conclusions?

[Lord Bethell]

My noble friend Lord Dobbs is entirely right to put his finger on this important matter. The CMO was clear from the very beginning that Britain’s mortality rate came as much from Covid as from non-Covid deaths. We review this situation regularly and thoroughly, and we will be glad to update the House at a future date. We are very conscious of the threat of which my noble friend speaks.