Covid-19: Update

Debate between Lord Bethell and Lord Duncan of Springbank

Tuesday 20th April 2021 Lords Chamber

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

My Lords, I am enormously grateful to both the noble Baronesses, Lady Brinton and Lady Thornton, for such thoughtful questions. I totally and utterly endorse both with regard to their massive thanks to NHS staff, to the vaccinators and, in particular, I echo the words of the noble Baroness, Lady Brinton, who thanked the invisible workers. I am acutely and particularly aware of the lab technicians, many of whom have worked unbelievably hard in difficult circumstances, often located far from their homes, supporting our laboratories up and down the country. There are many other categories of invisible workers in our healthcare system and they deserve our huge thanks.

I am as concerned as the noble Baronesses about the threat of variants of concern. It is an absolutely frustrating and anxiety-making fact, that we simply do not know a huge amount about what the impact of these variants will be on transmissibility, severity and escapology. We are throwing absolutely everything we have got at this to try to understand the features of this disease. However, it is true that while we can study them in a mathematical or computer-generated model, we get only so far with that. We can study them on the workbench and get a little bit further, we can stick them in a tube with some serum from someone who has had a vaccine, and maybe figure out a bit more, but it is only when we have the real-world data of how the vaccines have worked in real life when put up against the virus that we can accurately conclude what the impact will be. Therefore, only the passage of time will give us the critical data we need to go forward.

In the meantime, we are standing up a huge international effort to try to understand the variants that are emerging around the world. The noble Baroness, Lady Thornton, asked me about global co-ordination. Britain is absolutely playing its role; it is using its chairmanship of the G7 to full effect. As noble Lords are, I am sure, fully aware, we have a world-leading facility in genomic sequencing. We have made a massive, open-hearted offer to the world to sequence the genomes of any variants of concern, from any country in the world, through the newly launched New Variant Assessment Platform. We are working to set up hubs to develop expertise in that capacity around the world. We are working extremely closely with multi-laterals such as the WHO, with the relevant major trusts such as the Gates and Rockefeller foundations and the Wellcome Trust, and with individual countries, to provide the insight, the fast-turnaround analysis and the assessment of new variants as they turn up.

Within our own country, it is concerning that variants have made landfall, but I reassure noble Lords that we have put in place remarkably diligent efforts to close down any spread of variants of concern when they have occurred, whether they are from India, Brazil or South Africa. It is a fact that the Operation Eagle process, which is supported by local authorities, DPHs, test and trace and by the JBC, has so far—touch wood—proved to be extremely effective at closing down community spread. We have numbers of the variants in the UK but a very large proportion of them are known to be related to travel and they have not yet created clusters of infection of the kind that might cause concern. The MQS—Managed Quarantine Service—has played an absolutely critical role. I pay tribute to the MQS team, who are at this very moment putting in place arrangements for managed quarantine for flights with travellers from India. They have put in place the necessary pre-testing, the hotels and the assessment.

While I hear, loud and clear, the concerns raised by the noble Baroness, Lady Brinton, about that process, I reassure her that her list of concerns is quite different from the operational notes that I am given every day. The truth is that it has kept a lid on any spread of VOCs in the UK to date. On Wandsworth, I pay tribute to the enormous civic response to our concerns around the cluster there. I recognise the concerns of the relative of the noble Baroness, Lady Brinton, in that area, but there has been an absolutely massive news and community-marketing promotion of the home testing, pharmacy testing, MTUs and ATSs in Wandsworth. Very few people indeed cannot have heard of the arrangements that are in place.

With regard to the OCTAVE clinical trials, that is of grave concern to all those who have immunosuppressed circumstances. We are working extremely hard with Birmingham University, with Professor Paul Moss, to understand more about the response of those with immunity issues. It is a frustrating fact that those with pre-existing immunity issues are likely to be the ones who have the lowest and least response to the vaccine. We are trying to understand as best we can how that can be supplemented. As noble Lords may know, we have already invested considerably in new arrangements for therapeutics and antivirals that we believe will support those with immunosuppressed conditions. I would be glad to write to the noble Baroness about our arrangement for vaccines for the under-12s.

If there are any other questions that I have not had time to answer, I would be glad to write to the noble Baronesses with full answers.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, we now come to the 30 minutes for Back-Bench questions. I ask that noble Lords keep their questions as short as they can.

Hotel Quarantine for Travellers

Debate between Lord Bethell and Lord Duncan of Springbank

Wednesday 3rd February 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend is right that we have to be proportionate and balance risk. I flag that we are aware of the extreme measures some passengers go to in order to avoid boundary controls. Some people go to extraordinary lengths to undertake journeys that, frankly, are dangerous and irresponsible. I would normally consider travel a right of enormous value which I would fight for individuals to have. But in a pandemic, it is different. In a pandemic, travelling is dangerous. You may be taking a variant of significant danger to the country of your destination, and it cannot be regarded as something done easily and lightly, as in normal times.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

The next speaker is the noble Baroness, Lady Masham of Ilton. Is the noble Baroness with us? We will come back to the noble Baroness. Let us go to the noble Lord, Lord Clark of Windermere.

[Lord Clark of Windermere (Lab) [V]]

My Lords, the Minister said that he believed there was a basic right to travel. I put it to him that there is an even greater right to live, yet we have the highest death rate per head of the population of any country in the world. Should we not put the right to live at the top of our agenda?

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[Lord Bethell (Con)]

My Lords, matters are evenly balanced. There are 143 confirmed and probable cases of the variant first identified in South Africa. Most of those have been connected with travel to South Africa, and those involved have been isolated. There are around a dozen in respect of which the chain of transmission is not fully understood. We have put in place a substantial team of dedicated tracing professionals to track down those variants of concern, along with teams in the relevant postcodes, so we are doing both a fire blanket of testing within the community and forensic detective analysis to track down the chain of transmission. It is my belief that that will be enough to keep the spread of the virus under control in this country, but we are watchful and concerned.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

We will return to the noble Baroness, Lady Masham, after the next speaker, who is the noble Lord, Lord Vaizey of Didcot.

[Lord Vaizey of Didcot (Con) [V]]

My Lords, it may seem paradoxical to impose tough restrictions just when a version of the winning post is in sight, thanks to the Minister and his colleagues’ excellent vaccine rollout. It may give us some comfort if he could update us on how effective his experts think the vaccines will be against the new variants.

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[Lord Bethell (Con)]

The thrust of the noble Lord’s question is entirely right. We are now living in different circumstances; the variants of concern could emerge as a real threat to the vaccine. This Government will do whatever we can to protect the vaccine deployment and the reassurance it has given to millions of people, and to protect our hospitals, our NHS and life. We will therefore do whatever it takes. He is right that travel arrangements for people must be subject to mandatory control; it is not possible to hope that people will go home and isolate in cases such as this. Hotels may play an important part in ensuring that that mandate is truly effective. Our plans are being processed at the moment; our monitoring of the variants of concern has been upgraded massively, with huge investment in international surveillance. We will update the House accordingly.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, I am afraid the time allowed for this Question has now elapsed.

Medicines and Medical Devices Bill

Debate between Lord Bethell and Lord Duncan of Springbank

Consideration of Commons amendments & Ping Pong (Hansard) & Ping Pong (Hansard): House of Lords
Tuesday 2nd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not intend to repeat much of what I said at Third Reading. Many thanks to the noble Lords who have contributed to the changing shape of the Bill. From Committee to ping-pong, we have listened, heard proposals for change and brought workable, practicable compromises forward.

I wish to repeat the remarks made by the noble Baroness, Lady Thornton. She congratulated all of us on the effective communication that has made it possible to make considered progress on this Bill, despite all the challenges that Covid-19 has presented us with. This a very fair assessment; I agree with it completely. From the report of my noble friend Lady Cumberlege to the demonstrated expertise of our medicines regulator, the MHRA, we have seen the importance of patient safety, clinical trials, our life sciences sector and effective regulation bear out in our hospitals, clinical trials and patient community.

I look forward to the debates ahead of us on the regulations that will be made under the Bill. They will be important, as we set forward on our course for the best possible regulatory regime for the UK, with the patient at its heart.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

Noble Lords will be pleased to know that no one has requested to speak after the Minister.

Covid-19: Vaccinations

Debate between Lord Bethell and Lord Duncan of Springbank

Wednesday 13th January 2021 Lords Chamber

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

My Lords, I am enormously grateful for the detailed questions from the noble Baronesses. In particular, I endorse the words of the noble Baroness, Lady Thornton: it is indeed a remarkable achievement to have invested in such a broad array of candidates and to have purchased such an enormous quantity of doses—367 million. This is indeed a profoundly important step by the Government and one that we should celebrate and take pride in.

However, I acknowledge the searching questions from the noble Baronesses, so let me try to cover as much ground as I possibly can. The noble Baroness, Lady Thornton, asked about the digital backbone. This is absolutely critical to vaccine delivery. In many ways, injecting it into arms is the simple bit. Capturing the records, getting the invitations out right and the process of establishing identity are absolutely critical; in any project of this scale and complexity, that is where the problems are most likely to happen. That is why I pay tribute to colleagues at NHSX, NHS D, Test and Trace, PHE and elsewhere in the NHS who have done an amazing job of bringing together patient records around the nation to ensure that the invitations are sent out promptly and accurately and that the records are captured correctly. That information will be absolutely essential to both pharmacovigilance and the policy assessment of key issues such as transmissibility and efficacy. It employs the yellow card system to spot adverse incidents, and all data will go straight into the GP record, which is profoundly important when it comes to the research and analysis of the rollout of the vaccine. These may seem like prosaic details, but it is the most enormous digital achievement and one that will have an amazing impact on the health of the nation. I enormously encourage everyone in the country to ensure that they know their GP number, that they are properly registered with their GP and that they respond to any correspondence about the vaccine.

The noble Baroness, Lady Thornton, characterised the vaccine rollout as “traditional”. Can I just push back gently on that suggestion? There is nothing traditional about the sheer scale of this rollout, or about its speed and complexity. Our approach has been to work through the NHS, and from that point of view it might seem traditional, but I reassure noble Lords that not only is the latest technology being used but there is also the complexity of the collaboration between all the different parts of government—the Army, the NHS and PHE. Every single relevant part of government is being employed in this huge task, and it is something we should be enormously proud of.

The noble Baroness, Lady Thornton, asked about the supply figures. I am pleased to tell her that AstraZeneca has confirmed that it will be supplying 2 million vaccines a week. That is an enormous sum and it will mean that we can hit some really ambitious targets. Some 14.5 million people will be vaccinated by mid-February. Those are in categories 1 to 4, which includes care home residents and residential care workers, and they represent 88% of the mortalities in hospital. That will be transformational to the resilience of our healthcare system and to our approach to the pandemic. Some 17 million further people from categories 5 to 9 will be vaccinated by the end of spring, and all adults over 18—52 million of them—will be offered the vaccine by the autumn. That is a massive achievement.

The noble Baroness, Lady Brinton, quite rightly emphasised that this does not change absolutely everything overnight. She asked, quite reasonably, about schools and workplaces. I can confirm that there is still a huge amount to do by the entire nation to ensure that we do not have high infection rates, that we still deploy testing in order to break the chains of transmission and that we understand how to keep infection down—because the tragic thing about this awful virus is that it hits the old and infirm, who can be protected by the vaccine, but it also hits the young. It has become very clear from recent hospital admissions and from our growing understanding of long Covid that this disease hits all parts of society, and although we will have the most afflicted vaccinated by the spring, this is still going to be a societal challenge for months to come.

The noble Baroness, Lady Brinton, mentioned the letters to those shielding, which suggest that people should still remain shielded. That is a really important point and one we have to resolve, because those who are shielded who may go out into the community can themselves still be vectors of transmission. Those very people who we have done so much to protect may themselves be transmissible. Therefore, people are going from being protected to being potentially dangerous to others, and this is going to be a mind shift that we will all have to go through.

The noble Baroness, Lady Brinton, asked about GP surgeries. I acknowledge her point. There have undoubtedly been stories of GP surgeries which have set up queues of people to be vaccinated and then there has not been a delivery of the vaccine. However, I reassure the Chamber that it has been a very small minority. More than 95% of vaccination deliveries have happened on time, and in the grand scheme of things I take the view that if some GP surgeries have stood people up and asked them to come back another time, that is a small price to pay to ensure that the greatest number of people can be vaccinated as fast as possible.

The noble Baroness, Lady Thornton, asked about London. It is true that if we look at the infection rate, London has a relatively small distribution of the vaccine, but we are a young city here in London, so it makes sense that we have a lower proportion of vaccination. There are 2.8 million people who are more than 80 years old in the country. Not many of them are found in London, which is why the London figures look as they do.

On pharmacies, I reassure all noble Lords who have asked me about this that my colleague in the other place, Nadhim Zahawi, is incredibly energetic in engaging pharmacy chains and community pharmacies. It is true that we have a pilot with hundreds of pharmacies already running in it, but it is very much our intention to work closely with pharmacies to deploy the vaccine. As noble Lords know, vaccines come in plates of 1,000. It is much easier to deploy those plates in large centres than in small ones. We are working extremely hard to break those packages down into smaller groups and to get those groups into smaller locations but, quite reasonably, in order to get the vaccine into the most arms possible, we are starting with the big centres.

The noble Baroness, Lady Brinton, asked me about hygiene management in the distribution of the vaccine. She is entirely right: if you have a small room, such as a GP surgery, and you have a large queue of people, it is going to be extremely difficult to keep them all separated. That is why the development of these seven massive distribution centres in such places as the ExCel and Millennium Point in Birmingham is such an important development, because there is the space to be able to move very large numbers of people safely through the process. They will have a huge impact when they are opened next week.

On 24/7 vaccination, I am pleased to say that the Prime Minister has made an announcement on that. I must share with noble Lords that there has not been an overwhelming consumer demand for vaccinations at 4 am, but we are going to try this out as a process, and if there is indeed a big demand for late-night vaccination, then we will step up to the opportunity.

I was asked about rural distribution. Yes, it is incredibly important to get through to rural communities, particularly as many of the elderly and infirm can be found outside the city centres. I reassure noble Lords that, before very long, we will have vaccination centres within 10 miles of all communities. The noble Baroness, Lady Brinton, is entirely right to say that there will be some people for whom we have to take the vaccination to them; we cannot expect them all to drive to a vaccine centre. Provisions are being made through local health authorities in order to ensure that that is delivered.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, we now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can call the maximum number of speakers.

Coronavirus

Debate between Lord Bethell and Lord Duncan of Springbank

Wednesday 16th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I thank colleagues at the DfE for their hard work in providing guidelines to universities and to vice-chancellors for implementing thoughtful arrangements for the return of students. It is very much the ambition of this Government that universities are brought back to life and that education and the impact of their work continues. None the less, it is not just the campus environment that concerns us—it is also the off-campus activities of students. For that, we look to universities to provide pastoral guidance to students to ensure that they are socially distanced and behave responsibly. We are keeping an eye on those behaviours and, should outbreaks or prevalence rise among students, we will have to review those guidelines.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, the time allowed for this Question has now elapsed.

Independent Medicines and Medical Devices Safety Review

Debate between Lord Bethell and Lord Duncan of Springbank

Thursday 9th July 2020 Lords Chamber

[Lord Bethell]

The HSSI Bill is an incredibly important part of our agenda. It is not currently on our schedule, but we hope to bring it back at some date, or incorporate its contents in another vehicle.

[The Deputy Speaker]

I call the noble Lord, Lord Willis of Knaresborough. No? In that case, I call the noble Lord, Lord O’Shaughnessy.

[Lord O’Shaughnessy (Con) [V]]

My Lords, as a former Health Minister I add my apologies to these women on behalf of the Government I served. They were let down over many years and I pay tribute to their courage in coming forward for this review. I also pay tribute to my noble friend Lady Cumberlege and her review team for a superb, landmark piece of work. I want to press my noble friend the Minister on one issue: he mentioned that Aidan Fowler is the national director of patient safety in NHS England. That is quite right and very welcome, but the report recommends that somebody from outside the system—someone whose first loyalty is to patients themselves, not to the NHS—should be the gateway, the representative on behalf of patients. I know my noble friend wants to consider these recommendations carefully, but will he not rule out the idea of a new, patient-focused commissioner simply because there is someone leading on patient safety in NHS England already?

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[Lord Bethell]

My Lords, one cannot read the descriptions of the consequences of some of the surgery around mesh, and the pain and suffering that some of the women endured, without feeling huge anger and shame and instinctively wishing to ban such a thing. However, mesh offers a solution to some women whose prolapse is profound and who have run out of options. There are women for whom mesh has been a great saving and where there has been a successful procedure. Procedures around mesh have improved dramatically. We are reluctant to apply a blanket ban, but we take the recommendations of the report very seriously and will be looking at this procedure extremely closely.

[The Deputy Speaker]

My Lords, the time allowed for this Question has now elapsed.

Food: Fruit and Vegetables

Debate between Lord Bethell and Lord Duncan of Springbank

Monday 6th July 2020 Lords Chamber

[Lord Bethell]

My Lords, I pay testimony to the hard work of the noble Baroness in this important area. The schemes she mentions have been incredibly impactful and this subject is very important. The progress made by the Start4Life, Change4Life and Eatwell programmes has been encouraging, as it has raised awareness of options for children and adults. The battle they face against decisions people make about their diet is extremely tough, but we remain committed to those programmes and will continue to invest in them.

[Lord Duncan of Springbank (Con) [V]]

I ask the Minister what work the department has undertaken to explore the impact of fresh fruit and vegetables on the development of mental health in young people. In particular, what impact has there been from their being deprived of that during this period of home-schooling?

[Lord Bethell]

My noble friend touches on an interesting area. I cannot answer it precisely. I am not sure that we have taken any assessment of the effect of eating vegetables and fruit during the lockdown, but I will find out from the department and write to the noble Lord.

Covid-19: Test and Trace App

Debate between Lord Bethell and Lord Duncan of Springbank

Monday 22nd June 2020 Lords Chamber

[Lord Duncan of Springbank (Con) [V]]

My Lords, I have listened to my noble friend and feel that confidence in the Government has been shaken by this approach. I have one question: how do we anticipate this approach now being rolled out across the four nations of the United Kingdom and how will they interface, one with another?

[Lord Bethell]

My Lords, in all aspects of our battle against Covid, we have sought a four-nations approach. We hope to work together for one solution. I am aware that other nations are looking at their own options, but it is our hope that, in time, they will all come together for one solution.

Covid-19: R Rate and Lockdown Measures

Debate between Lord Bethell and Lord Duncan of Springbank

Tuesday 9th June 2020 Lords Chamber

[Lord Bethell [V]]

I completely agree with the noble Lord that we need to get the economy back, and I very much agree with his last word—safely. The CMO’s advice is very clear that social distancing of two metres makes a very big difference compared with one metre. When the time comes to move from two metres to one metre, we will very clear about that moment, and I, for one, will celebrate the reopening of restaurants and pubs, which are a source of great joy and happiness for the nation.

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, the time allowed for questions has now elapsed.

Dental Care

Debate between Lord Bethell and Lord Duncan of Springbank

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

The noble Lord’s concerns are well understood. Practices that depend on private income are particularly affected, because the NHS has guaranteed the income to NHS practices for their NHS work. We are working on a UK-wide national plan, and it is a massive priority for the Government.

[Lord Duncan of Springbank (Con)]

My Lords, I echo the points made by the previous speaker: £7.8 billion is spent on private dental health care, yet dental practices of this nature are among the only businesses not to receive the full business rate relief. Will the Minister commit to ensuring that they receive adequate provision, as a matter of urgency, to ensure that these practitioners do not disappear from the high street?

[Lord Bethell]

My Lords, I cannot make the commitment that my noble friend seeks at the Dispatch Box, but I promise to convey his thoughts to the discussions taking place between DHSC colleagues and the Treasury.