NHS: Hospital Visiting

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 15th September 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, of course I understand the reason for very great care in relation to infection control in our hospitals, but it is notable that a press release by NHS England in July, at the time of the announcement of a reduction in restrictions by the Government, said that hospital visiting guidance is set to remain in place for all staff and visitors. The concern is that the health service will never change this guidance. Surely there should be some review of the general guidance, given what is happening in society as a whole and the autumn and winter plan that the Government announced yesterday.

[Lord Bethell (Con)]

My Lords, we brought in harsh guidance at the early stage of the pandemic. That was lifted quickly, for exactly the reasons the noble Lord gave, and we keep the current restrictions under review all the time. But it is up to local trusts to put the right infection control measures in place. Although we have some guidance in place, it encourages visiting, for the reasons the noble Lord points out, and we leave it to trusts to make the ultimate decisions.

Flu Vaccination and Blood Test Cancellations

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 14th September 2021 Lords Chamber

[Lord Bethell (Con)]

I would be absolutely delighted to put the letter into the Library as requested by the noble Baroness, but please do not think for a moment that I am in any way seeking to pass responsibility. I am pointing out the very clear fact that GPs are responsible for implementing the flu vaccination programme. It is something that they do brilliantly. No other country has a flu vaccination programme with the impact that ours has. GPs are taking on more responsibilities this year with secondary school children being vaccinated. The rate I am expecting for this year will be higher than we have ever seen before.

[Lord Hunt of Kings Heath (Lab)]

My Lords, any delay in blood tests or flu vaccination must have some impact on patient safety. What monitoring are the Government doing to try to measure the impact? Will the Minister ask the Healthcare Safety Investigation Branch to conduct a review?

[Lord Bethell (Con)]

My Lords, my understanding is that patient safety has not been at stake, but the noble Lord makes an extremely good point. I am not sure it is my role to instruct HSIB on this, but I will look into whether investigation is necessary. I reassure him that these shortages have not had a profound impact. We have marshalled the use of the tubes extremely carefully and have pushed back some routine blood-taking. That will have a small impact but we have put in place provision for a catch-up.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) Regulations 2021

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 14th September 2021 Grand Committee

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

My Lords, over the past few months, the Government have made a concerted effort to bring forth a sense of normality across the country with the easing of restrictions, while maintaining caution with regard to this deadly virus, which clearly has a long way to run. These regulations are a key part of this dual-track effort, significantly reducing the burden of self-isolation while protecting society from the threat of contagion. The main focus of the regs is the isolation protocols, so I begin by reflecting on the crucial role that contact tracing and self-isolation play in fighting the virus.

Since it was established in May 2020, NHS Test and Trace has contacted more than 15 million people who have tested positive for Covid-19 or who have been in contact with a positive case. Tracing—the bedrock of any public health intervention—has improved substantially over the last several months. In October 2020, 60% of close contacts were being reached. In comparison, over the period from 26 August to 1 September, 87.3% of positive cases transferred to NHS Test and Trace were reached, as have 89.5% of their contacts where usable contact details were provided. That is a remarkable achievement.

The public realise the importance of isolation. July’s ONS statistics that show 79% of positive cases reported complying with the self-isolation guidance, alongside 89% of close contacts. That is a terrific response from the public and it has proven a vital weapon in our arsenal against the virus.

What is the impact of this massive financial and societal investment? A recent study from PHE, published today and called the Canna model after the idyllic Scottish western isle, which some noble Lords may have visited, shows that from August last year to this April, test, trace and self-isolation activity reduced the transmission of the virus by between 10% and 28%. The PHE research demonstrates that self-isolation helped to bring R below one at crucial times, reducing the duration and impact of lockdown. Over the full period of the study, the Canna model estimates that isolation due to test, trace and isolate policies prevented between 1.2 million and 2 million secondary cases. The NHS Test and Trace service has also enabled us to identify peaks and troughs in case rates, supporting decisions on when restrictions should be tightened or could be eased.

We recognise that none of this has been easy. The requirement to isolate creates enormous challenges for individuals and their families across the country. A study in March 2021 by the BMJ concluded that offering financial and practical support to individuals who needed to self-isolate would likely improve compliance. We support that view. Since September last year, we have provided councils with £280 million to issue support payments to those who may face financial hardships because of self-isolation. We have also made up to £100 million available between March and September this year for councils to offer practical and emotional support to some of the most vulnerable in our communities, covering over 200,000 people. It is right, though, that we sought to reduce the burden of self-isolation at the earliest opportunity.

The amendments to the self-isolation regulations we are debating balance these factors and provide a significant easing of burden from self-isolation requirements while maintaining vital measures to reduce the spread of the virus. These amendments came into effect on 16 August and allow those who are fully vaccinated to be exempt from self-isolation if they are the close contact of a positive case. Based on the data, we know that the vaccines reduce overall symptoms by between 80% and 90%, hospitalisations by between 90% and 95%, and deaths by around 95%. Therefore, we have adapted our approach to self-isolation to reflect this and ensure we balance the need to slow down the transmission of the disease with the need to get back to normal.

As well as fully vaccinated adults, several other groups have also been exempted from the requirement to self-isolate. The amendment provides an exemption to self-isolation for the close contacts who have taken or are taking part in an MHRA-approved trial for a Covid vaccine. This will ensure that they are not disadvantaged as a result of their personal sacrifice. We recognise also that some groups cannot be fully vaccinated on medical grounds. The amendment therefore includes an exemption for those close contacts who can evidence that they are unable to be vaccinated for medical reasons.

Finally, we have carefully considered the impact on those under the age of 18. There are unqualified harms to children’s educational, emotional and social outcomes as a consequence of self-isolation, as well as of the infection itself. The risk of hospitalisation and intensive care admission in children due to Covid is very low—approximately eight per 100,000 population aged under 18 are admitted to hospital. The incidence of mortality in children as a result of Covid is also extremely low. By balancing these factors, the SI provides an exemption for those close contacts under the age of 18 from self-isolation.

Those who are exempt will be advised to take a PCR test as soon as possible to check whether they have the virus. Though not required to self-isolate, they will be advised to consider other precautions, such as wearing a face covering in enclosed spaces, as well as limiting contact with others, particularly those who are clinically extremely vulnerable. However, it remains the case that if any of these groups develop symptoms they should self-isolate immediately and take a PCR test. Anyone, whether fully vaccinated or not, who goes on to test positive will remain under a legal duty to self-isolate.

Although I sympathise with the burden and the challenges that self-isolation creates, it will continue to play an indispensable role in containing the virus. The Secretary of State said more on this in his Statement earlier on the winter strategy for tackling the virus. While restrictions are easing, we must all continue to adhere to the self-isolation regulations and the guidance if we are to continue protecting our friends, families and communities. I commend these regulations to the Committee.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I very much agree with what the Minister said about the importance of self-isolation. I note that emphasis is given in the winter plan to the importance of isolation in relation to breaking transmissions. The issue I have is that there is a proportion of the population who find self-isolation very difficult, and there are legitimate reasons for that. I have been studying TUC research, which shows that 24% of low-paid workers say they cannot afford to take time off for sickness, as opposed to 6% of high-paid workers. It reckons that only 35% of low-paid workers get full sick pay, as opposed to 80% of high-paid workers, defined as those earning more than £50,000 per annum. Statutory sick pay is only £96.35, less than any other OECD country. It is reckoned that 72% of low-paid workers cannot work from home, compared with 20% of high-paid workers.

Social Care: Family Carers

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 13th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do recognise the problem: 23% of carers—1.3 million—provide care for 50 hours or more a week. That is an absolutely astonishing figure, and I pay tribute to the contribution they make. The overall contribution by carers is around £56 billion a year. We cannot undervalue that contribution in either emotional, care or financial terms. The precise allocation of funding for this new financial package is not yet confirmed. When it is, I will make sure that the reasonable points the noble Baroness made are heard clearly in the department.

[Lord Hunt of Kings Heath (Lab)]

My Lords, in his first Answer, the Minister mentioned the Health and Care Bill and a more general duty to promote the interests of underpaid carers. Can he tell me why, at the same time, the Government are getting rid of the current provision in law of a carer’s right to an assessment when they take on a new caring role and the right to be consulted on whether they are willing and able to care? It is a crucial right of carers to have a proper assessment. Why is it being taken away?

[Lord Bethell (Con)]

My Lords, I completely agree that the carer’s assessment is the building block of our system. It is incredibly important; we do a lot of work to encourage more carers to get it. I do not know specifically about the point that the noble Lord makes on this additional component, but I would be glad to enter into correspondence with him on it. The broad principle of the importance of the carer’s assessment is one with which I wholeheartedly agree.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 9th September 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend has had an interest in this very important area for some time, and I completely applaud his diligence on it. It is an area that I share an absolute fascination with. We know so much about the vaccines but so little about the body’s immune system. It is incredibly frustrating but it is, I am afraid to say, just one aspect of this pandemic.

To answer the specific question of how many people have had the disease, it is difficult to be precise. Unfortunately, a lot of people have had the disease and never known that they had it. The fact that they have now gone on to have a vaccine means that it is extremely difficult for us to trace whether they have had the disease, because we do it mainly through the counting of antibodies. My noble friend can look on the ONS website, which I am sure he probably has, and he will see that the Venn diagram makes it almost impossible to figure out exactly how many people have had the disease. I can, through correspondence, share with him the various modelling that we have done, but there is not a definitive answer to that question.

I wish it were true that having had the disease and the vaccine together creates some kind of super-immunity, but I am afraid that there is a subset of people who have had both the vaccine and the disease who then go on to have the disease again. I have met a few of those people; they are extremely frustrated, as you can imagine. I am afraid that it does not bode well for thinking that the vaccine presents a concrete and immutable guard against the disease. I am afraid we will be living with the thought of boosters and improvements on the vaccine for some time to come. That is emerging as something we are working on. We are doing a tremendous amount of research on this. I had a meeting earlier with the antibody team, and I reassure my noble friend that we are doing everything we can to understand it better.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I come back to the advice from the JCVI relating to 12 to 15 year-old children who do not suffer the underlying conditions it has set out. I worry about the implications of that being overruled through the process that the Ministers have set up, seeking the advice of the four Chief Medical Officers. The Minister will know that they concluded that some young people, although it would be extremely rare, could suffer from myocarditis with lifelong consequences.

I must ask about the ethical considerations here as to some young people who will be damaged as a result of that decision because 6 million adults are too stupid or ignorant to have the vaccination. That surely is where our focus should be. Could he say something about what the Government are doing? Does he agree that the integrity of the whole vaccine process, not just in relation to Covid, is at stake here? I think that the JCVI should be listened to.

Residential Social Care: Staff

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 6th September 2021 Lords Chamber

[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.

[Lord Hunt of Kings Heath (Lab)]

My Lords, a disproportionate part of the proposed rise in national insurance will fall on low-paid workers, including those in the care sector. When this announcement is made, I hope that the Minister will come forward with plans to ensure that staff in the sector get a decent living wage.

[Lord Bethell (Con)]

My Lords, the noble Lord is right that taxes have to be spread across the whole country, but I remind him that the national living wage has risen by 2.2% in the last year, which benefits everyone across the population.

NHS Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 22nd July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

As my noble friend will know, I know Dr Jackson extremely well from the old days and heard her story with great regret. I took the story back to the department and played it into the system, as I told him I would do. A report is being drafted and I can reassure my noble friend that it is being taken seriously. The clarification of guidelines has been sent to all wards and there has been additional training for staff put in the position of needing to consider and engage with loved ones on this issue. However, may I push back against my noble friend? It is not right to try to generalise about staff on this point. I have the highest regard for NHS staff. In the very large majority of cases, they have worked extremely well in difficult circumstances in these situations and they are owed our respect for that.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the Minister made that point very well. I declare an interest as a member of the board of the GMC because I want to ask him about workforce strategy. Clause 33 of the Health and Care Bill sets out a duty on the Secretary of State to publish

“at least once every five years … a report describing the system in place for assessing and meeting the workforce needs of the health service”.

The Minister will be aware that a number of NHS organisations say that this is not going far enough and that what is needed is the development of regular, public, annually updated long-term workforce projections so that the health service can meet the undoubted challenges that lie ahead. Is the Minister prepared to consider this?

[Lord Bethell (Con) [V]]

My Lords, I have heard the noble Lord on this point two or three times and he makes the argument extremely well and persuasively. As he knows, a huge budget of the NHS goes on the workforce; essentially, the NHS is a mobilised healthcare workforce. It is intrinsic to the success of the NHS that we manage our workforce correctly. There are substantial workforce transformation programmes in place at the moment, including the People Plan, and a huge recruitment drive is going on, including the creation of a much clearer employer brand, which has landed very well among the workforce generally. However, I take the noble Lord’s point. I am not the workforce Minister but I will take it back to my colleague Helen Whateley in the department and ask her for her consideration.

Covid-19

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 21st July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

I completely agree that the post-lockdown wave is a well-known phenomenon, and we are living through the pain of it right now. I do not agree that test, trace and isolate is a shambles, and if the noble Baroness really still feels that way, I would be glad to arrange a briefing for her. As for what more we can do, we are investing heavily in the system and we will continue to improve things, as we have done already.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, on 28 June, the Secretary of State said that the lifting of restrictions in July would be “irreversible”, but the Minister will know that the SAGE meeting of 7 July said that all modelled scenarios show a period of extremely high prevalence of infection, lasting at least until the end of August. It identified four risks associated with high infection, including an increase in hospitalisations and deaths. If there is a risk of the NHS being overwhelmed, surely the Government will have to consider some more lockdown restrictions.

[Lord Bethell (Con) [V]]

My Lords, the noble Lord, who is so wise in these matters, has answered his own question. If necessary, we will do what it takes, but the aspiration is clear: we are seeking to get the vaccination level to such a high rate that R is below 1 and no further lockdowns are necessary. That is an honourable, reasonable and epidemiologically sound objective.

Folic Acid

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 13th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the Government of New Zealand for focusing on this important issue and to the energy and passion of the noble Lord in his advocacy in this matter. I can give him the reassurance he asked for. This is a priority for the Government. We are taking it through the machinery of the British Government to ensure that it is rolled out safely, extensively and on a nationwide basis.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, assuming that the Minister is able to come back to the House after the Recess and give the green light, can he say when we could implement this policy? Does he agree that the recent report of the Health Select Committee on maternity services underlined the importance of making this decision soon?

[Lord Bethell (Con)]

My Lords, it is not only its importance for maternity services that is on my mind. It is also the recently announced office for health promotion, which will lead the national effort to improve and level up the health of the nation in the round by tackling obesity, improving mental health and promoting physical activity. This important initiative should be seen in the context of that important strategy. I completely endorse the ambition expressed by the noble Lord.

Hospital Waiting Lists

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, waiting lists are published throughout the NHS and I would be very happy to write to my noble friend with details of the web locations for that data. We are working on the forecasts at the moment. It is not possible to forecast precisely when we can back to where we were, but I reassure my noble friend that a huge amount of work is going on to get there as quickly as possible, including 1.8 million diagnostic tests and treatment for 1.1 million patients since April 2021.

[Lord Hunt of Kings Heath (Lab) [V]]

Even if we get back to where we were in March last year, it will be a status quo in which all the key targets have been missed. When will the Government get back to meeting the targets that they inherited in 2010 with the Liberal Democrats? They have presided over a gradual but disastrous deterioration in overall performance.

[Lord Bethell (Con)]

My Lords, there has been an enormous pandemic, which has, of course, had a huge impact on the healthcare system. During the pandemic, the financial support for the NHS—as well as the system support—has been huge and had a huge impact. We are looking at a backlog and working hard to get through it, but noble Lords should be in no doubt that we are thoroughly committed to getting back to full operational capacity.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, what a perceptive question from the noble and right reverend Lord—he absolutely hits the nail on the head. The honest truth is that we do not have the precise figures on this but the indications are that he is right: the vaccine does not stop you being infected or transmitting it, but it reduces the chances of both those things dramatically. That is one of the reasons why we have kept our foreign travel arrangements under review. It is possible that the effect that he describes may mean that we can look very thoroughly at foreign travel—I think all noble Lords would welcome that.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I have no doubt about the Minister’s personal integrity but he will recognise that he is part of a Government who are not exactly renowned for their probity or truthfulness. I want to ask him about lateral flow tests. There have been reports that the accuracy of this test, which has been less than 100% in any case, is less still when it comes to the delta variant. Can he say a little more about that, and what discussions are taking place with UK companies, who appear to have developed better models which may be more accurate?

[Lord Bethell (Con)]

My Lords, the noble Lord is entirely right that the Porton Down verification team has looked extremely closely at all lateral flow tests and their sensitivity to the delta variant in particular. There is suggestion and some indication that for very low viral loads, the LFTs are not quite as sensitive, or if they are sensitive, the band is less easy to read. However, for higher viral loads—in other words, the kind of viral loads that the body needs to carry to be infectious—there is no change of sensitivity. Therefore, from that point of view the LFTs continue to perform their original purpose very effectively but we need to keep a very close eye on sensitivity with the new variants.

I pay tribute to all UK companies which are coming forward with LFT, PCR or genomic sequencing tests. I am extremely proud of the progress that the UK diagnostics industry has made. We have extremely high standards and extremely high validation and authorisation protocols through Porton Down. Those standards are very difficult to achieve but we are working extremely closely with UK companies to try to get them over the line so that they can play an important role in our response to the pandemic.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

I am enormously grateful for the question from the noble Baroness. She gives me an opportunity to lift my head for a moment and think about a brighter future, because she is entirely right. One of the possible benefits from this awful virus is a different approach to public health that is much more effective in fighting contagious diseases, where we have much more effective tests for everything from flu to RSV to things like Covid as well, and where we can get therapeutic drugs to people the moment they test positive so that they do not fall sick. We can use this investment in public health to help level up some of the health inequalities that have beset this country so heavily.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is there not a problem in looking for a different approach in the future? The precedent set by the Government’s attitude to Parliament fills one with a great deal of concern about the way our parliamentary democracy is going to work. Can he simply tell me why the Prime Minister did not make a Statement to the Commons last night?

[Lord Bethell (Con)]

My Lords, the Secretary of State was there. I thought he presented the steps regulations extremely clearly and did a great job.

Covid-19: Vaccines and Pregnancy

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 14th June 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, would it not be a good idea if the Chief Nursing Officer and the Chief Midwifery Officer gave a conference from Downing Street to reinforce the message that the Minister has given today about the safety of the vaccine? Can he tell me what the Government are doing specifically about the conspiracy theories going round in relation to safety risks to mothers and babies?

[Lord Bethell (Con)]

My Lords, when it comes to conspiracy theories, we have found that the best people to communicate on that are those who women and mothers trust and are dealing with during their pregnancy, typically their nurses and doctors. We have ensured that all the right materials are there, so that difficult questions can be answered in a collaborative dialogue. That is the most effective way of dealing with this.

NHS Digital: Primary Care Medical Records

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 8th June 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful for the question. I will look into that date and share whatever materials are available.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am fully behind the sharing of information, for the reasons that the Minister explained. But does he agree that to ensure public confidence, the Government have to do something about the current clunky opt-out approach that they have taken and make it easier, and publish the names of the companies to whom this information will be given and what they are paying for it? The Government must not hide behind commercial confidentiality. We as patients have an absolute right to know this.

[Lord Bethell (Con)]

My Lords, I agree with the noble Lord that the opt-out system deserves to be looked at. We are undertaking a review of the opt-out system to streamline it along the lines that he described. However, he peddles a slightly false impression. There are extremely detailed considerations in the IGARD minutes, available online—39 pages from the last meeting—which go into great detail on the arrangements for the sharing of each piece of data. On payment for the data, I remind him that—as I am sure he already knows—these are payments for costs and not payments for any kind of charge. All data is shared for very strict reasons to do with research and planning. There are no other reasons for sharing the data.

Covid-19: Variant B.1.617.2

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 26th May 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right, and I am grateful that he has looked at the dashboard as carefully as he clearly has done and drunk deeply from the rich array of data that we have available there. On a more serious point, there are some significant outbreaks—they are listed very clearly on the PHE dashboard—where we have put in place significant outbreak management procedures, including surge vaccination, surge testing and additional communication with the community. But the noble Lord is right that the Indian variant is proving to be extremely competitive with the Kent variant, and we should expect that to start to spread around the country.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, can the noble Lord update the House on the potential vaccination of secondary school children?

[Lord Bethell (Con)]

I am afraid I do not have a specific update for the noble Lord. It is an area that we will be extremely interested in looking at, but there are regulatory processes to be gone through at the MHRA and vaccine policy procedures to be gone through at the JCVI. They will both be looking at that. At the moment, our focus is on getting the vaccine into as many arms as we possibly can, particularly among the high priority groups, but we will turn to that at some point in the future.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 18th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Tedros principle of us being safe only when we are all safe remains the most profound insight. The noble Baroness is entirely right: we must do more to try to help those in the developing world. The frustrating truth is that the world simply does not have enough capacity for the manufacture of these very complex and tricky substances. We are straining every sinew to try to deliver the 9 billion vaccines we need to deliver worldwide vaccination, but the rate of manufacturing is not as high as any of us would like. I take my hat off in particular to AstraZeneca, which has provided licences for the vaccine worldwide on a no-profit basis, but I also pay tribute to the other vaccine companies, which, despite what one might read in the press, are trying all they can to set up manufacturing sites all around the world. Progress is being made.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I too salute AstraZeneca for its noble efforts. However, I would like to take the Minister back to the SAGE meeting of 13 May, when the Government were warned:

“In the areas where numbers of infections are increasing rapidly … an even faster increase can be expected if measures are relaxed”.


The Government went ahead with relaxing the measures yesterday. I know that Mr Dominic Cummings can perhaps not be regarded as the most reliable of commentators, but was he not right to say that fast, hard and effective action is the best policy for the economy, as opposed to always delaying taking decisive action? When it comes to the next stage, can we be reassured that the decision will not be taken until the evidence in June is fully assessed and evaluated?

[Lord Bethell (Con)]

My Lords, I am a big supporter of the “fast and hard” principle. In our response in Bolton, Bedford, London and elsewhere, we have demonstrated that principle in our handling of the Indian variant. I point out that the use of testing and social distancing measures in schools has been enormously effective. One of the remarkable aspects of the infection rate so far is that transmission levels among school-aged children have not increased in the way that SAGE and others, including myself, once feared. We should take a “glass half-full” moment to applaud that fact. I reassure the noble Lord that we will absolutely make these decisions on the data. Space has been put in between the steps for exactly that reason, and we are not going to rush it.

Crohn’s Disease and Ulcerative Colitis

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 15th April 2021 Lords Chamber

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

My Lords, on the basis of the IBD audit, NHSEI is working closely with front-line clinical experts, patient representative groups and leading charities, including Crohn’s & Colitis UK, to develop evidence-based improvement tools to address possible variations in service. This work includes an important new inflammatory bowel disease right-care scenario, setting out what high-quality, joined-up care looks like at every stage of the patient journey.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I am grateful to the Minister. He will know that over 500,000 people are living with inflammatory bowel disease, often with debilitating long-term symptoms and complications. Given the current huge variation in standards of care to which the noble Lord referred, will the Government appoint a national clinical director for IBD, solely to concentrate on spearheading a drive to implement the national IBD standards, which are backed by 17 healthcare professional and patient organisations?

[Lord Bethell (Con)]

We are doing a huge amount in this area, as the noble Lord rightly points out. In particular, we are working with Crohn’s & Colitis UK on the scenario work I mentioned. That is on top of working on diagnostic waiting times, formal personalised care, access to specialist treatment and formal, structured education. I will look into the possibility of having a formal leader to oversee all these strands, but my impression is that, at present, the work is best done by the individual workstreams I mentioned.

Folic Acid

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 23rd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to both the stamina and the passion with which the noble Lord puts his case. He puts it extremely persuasively. We have worked hard to engage with policymakers on this, meeting mill owners, including artisanal mill owners, and those who are engaged in the supply of food. The supply of food has been a difficult area in the last year. It is difficult to lay this extra burden on the trade. It is extremely open to the option and we remain optimistic that this is a route we can walk down. There has simply not been an opportunity to make that commitment as yet, but I will update the House as soon as I possibly can.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, yesterday, the Minister said that the health of the nation had to change emphatically. The recent NHS White Paper, to which my noble friend Lord Rooker referred, actually promised a more direct government role in improving people’s health. For instance, as president of the British Fluoridation Society, I was delighted that the Government are now committed to fluoridating water supplies. Given that, would it not be a very important indicator if the Government were to announce very shortly that they are going to go ahead with this?

[Lord Bethell (Con)]

My Lords, the noble Lord blows my own words in my face very effectively indeed. He is entirely right—we are committed to preventive medicine in the round. Fluoridation is one graphic example of that and the use of folic acid to address neural tube defects is another good example. That is why we did the consultation in 2019 and are considering the responses, and it is why I have made the commitment to return to the House once we are able to give an update.

Health and Social Care Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right to emphasise this incredibly important aspect of our toolkit to manage infection rates down. The workplace is an area of infection threat and asymptomatic testing is a way to keep workplaces safe. We have put in place until the summer the free provision of lateral flow tests for those who wish to do workplace testing, and we are looking at ways in which we could potentially extend that, particularly in circumstances where the infection rate crept up again. We are working very closely with BEIS colleagues to look at the kind of regime that would be necessary. I pay tribute to DfT colleagues who have trail-blazed this area with the test to release programme, which uses private testing capacity for that important transport corridor, and to colleagues at UKAS who have put in place the accreditation necessary to create an independent, private ecology of the kind that the noble Lord refers to.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I come back to the point raised by the noble Lord, Lord Cormack: the SPI-M-O consensus statement of 24 February showed that while 95% of care home residents had had the vaccine, only 70% of staff had. We really must do better on this; does the Minister agree?

[Lord Bethell (Con)]

My Lords, I could not agree more heartedly; the vaccination of staff is a massive priority. Those figures give us cause for some reflection on how we can increase them. The adoption rate of vaccines by all healthcare workers has been much more impressive than on previous vaccine rollouts, so we are encouraged overall, but we are determined to hammer out all the last rock pools where people have not been persuaded. As I alluded to my noble friend Lord Cormack, we are looking at all methods to make sure that we get there in the end.

NHS: Pay

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 9th March 2021 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government, further to the assumption set out in the NHS Long Term Plan Implementation Framework, published in June 2019, of a 2.1 per cent pay rise for National Health Service staff in the 2021/22 financial year, what plans they have to review their submission to the NHS Pay Review Body.

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

My Lords, our written evidence to the independent pay review body set out what is affordable. We have increased the size of the NHS workforce over the last decade and have committed a record-setting additional £33.9 billion by 2024-5 for the NHS to meet the rising demand for services. With strides being made in recruitment and retention, an enormous effort is under way to make the NHS a more inclusive and enjoyable place to work, with excellent well-being support for all staff.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the Government say that they cannot afford to give nurses a decent pay rise, yet they have managed to squander billions of pounds on management consultants, fly-by-night companies and friends of Ministers. The long-term plan built in a 2.1% pay rise for NHS staff next year; it was factored into the funding settlement and enshrined in legislation. It is one thing for the PM to be filmed applauding his appreciation for NHS staff, but no amount of clapping will help pay for rising living costs. Does the Minister agree that the Government should reverse this evidence and give staff in the NHS the increase they deserve?

Independent Medicines and Medical Devices Safety Review: Sodium Valproate

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to those who have put together the valproate registry scheme that became live on 11 February. My noble friend is entirely right. There are 22,095 people on the registry; 462 of them had 490 conceptions, and 180 women were prescribed in a month when they were pregnant. A redress scheme is not necessarily the correct solution to this problem. We are considering it extremely carefully, and when we publish our overall response to the Cumberlege review we will include our considered response to the redress suggestion

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the noble Baroness, Lady Cumberlege, concluded in her report that the system still did not know how to minimise the risk of future babies being damaged, despite 27,000 women of childbearing age currently taking valproate in the United Kingdom. In view of that, does it not make the case for a redress scheme absolutely persuasive?

[Lord Bethell (Con)]

My Lords, I will leave it to the response to the Cumberlege review to make the decision on the redress scheme. In the meantime, our focus is on a regime ensuring that those who take this important drug have the right advice to prevent them becoming pregnant. I emphasise that specialists review the treatment and ensure that an annual risk acknowledgment form is signed by the prescriber and the patient. This is an important measure ensuring that all those who take this potentially life-changing drug acknowledge and understand the implications of becoming pregnant.

Covid-19: Brazilian Variant

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right, which is why the Prime Minister struck such a cautious tone when he unveiled the road map. We are not through this yet. A substantial proportion of the country is vaccinated, but we have to protect the vaccine. For those who have not been vaccinated, there are risks, and that is why we still have in force a “do not travel” alert and why we are maintaining marketing and communications at every level on the restrictions that are still in place.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, to come back to my noble friend Lady Thornton’s Question, the Minister will know that, at the SAGE meeting on 21 January, there were warnings that geographically targeted bans cannot be relied upon to stop the importation of new variants, partly because of indirect travel. He has just said that he does not want a backdoor entrance through Ireland. But what are the Government going to do about indirect travel, which is a clear route into this country to avoid the current quarantine rules?

[Lord Bethell (Con)]

Those who travel to the UK must fill in a passenger locator form. On the PLF they have to state whether they have been in a red list country. We also share an enormous amount of information with the aviation industry to cover people’s previous travel, and therefore it is not as easy as the noble Lord might think to take a hop and a skip into Britain through a third country, as has been proved by those who have travelled from Brazil and been caught by the red list. However, his point is well made, which is I why I reinforce what I said earlier: we keep the red list under review and, if it proves necessary to extend the countries on that list, we shall do so to protect the vaccine.

Covid-19

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

The virus mutates all the time and minute variations have happened from the very beginning. However, this virus has been unusual in not having profound mutations; it had not changed its seriousness, its transmissibility or its escapology in a meaningful way until the end of last year. Those were not—how shall I put it?—completely unexpected, but they had not been identified before. When they were identified, we changed our tactics, our strategy and our approach. Our determination to keep out variants of concern is manifested in these proposals, and we have moved extremely swiftly to enforce border control as the threat has mounted.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I want to follow up on that question. The SAGE minutes of 21 January make clear that

“reactive, geographically targeted travel bans cannot be relied upon to stop importation of new variants … due to the time lag between the emergence and identification of variants of concern, and the potential for indirect travel via a third country”.

By confining the quarantine measures to travel from red-list countries, are the Government not ignoring the SAGE warning about indirect travel?

[Lord Bethell (Con)]

My Lords, SAGE is entirely right that we have to be careful about indirect travel. That is why we have introduced a passenger form that requires people to detail all their recent travels. It is why we have attributed to the filling-in of the form very serious enforcement measures, including the potential for a large custodial sentence if it is filled in incorrectly. It is why we are using all the benefits of technology and of airline databases in order to track people’s travel and ensure that they are not in any way misleading us or skipping around borders to get here. The noble Lord is right that this is a very serious matter. This is a 21st-century pandemic and we are determined to use the techniques of the 21st century to keep out variants of concern. Countries such as Taiwan, Iceland, Australia, New Zealand and Singapore have demonstrated that if you use thoughtful 21st-century methods then you can make a big impact on transmission, and that is what we are determined to do.

Hotel Quarantine for Travellers

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 3rd February 2021 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what plans they have to implement a mandatory hotel quarantine for all travellers arriving in the United Kingdom.

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

My Lords, these new measures at the border are a necessary step to protect the public and our world-class vaccination programme. Every layer of protection we have put in place will help reduce the risk of transmission of the virus and prevent any potential new strain entering the UK. All measures will be kept under review and, if required, further action will be taken to add another layer of protection against transmission.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, given the good news on vaccines, should we not be ever more vigilant on our borders? The 22 December meeting of SAGE identified the rapid spread of a variant in South Africa, and the NERVTAG meeting of 13 January warned of the rapid growth of variant B1351 in South Africa and called for enhanced border measures. Since then, how many people have entered the UK from South Africa? Why, as Yvette Cooper said yesterday, is it still possible for people to return home to the UK from South Africa and go straight into the community with no tests on arrival, no quarantine hotels and no quarantine taxis? Scotland has announced extensive new quarantine rules today. When will the Government get a grip and bring in the much tougher quarantine measures they should have introduced weeks ago?

[Lord Bethell (Con)]

My Lords, I entirely agree with the noble Lord. He is right that additional vigilance is required. The advent of new variants that could have higher transmissibility or escape the vaccine is a complete game-changer, and that is why we have changed our approach to border management. We have upgraded our border control measures, and there will be further government announcements on that. We have introduced red lists of countries where there are variants of concern, and we have implemented Project Eagle, the tracing project to track down those who have tested positive in genomic sequencing for variants of concern.

Health: Brain Tumours

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 19th January 2021 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what steps they are taking to encourage research into (1) the causes, and (2) the treatment, of brain tumours.

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

My Lords, I am hugely grateful to noble Lords for bringing this challenge to my attention. It is House of Lords advocacy at its best. We have met interested parties and I am pleased to say that we have a plan. Workshops are being booked, more research is being funded and we are encouraging more researchers to become involved. I am hopeful that this will mean progress and I am watchful to ensure that it delivers.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I am very grateful to the Minister for that positive response. Can he assure me that, in addition to seeking ways of being able to spend up to the £40 million research money made available, he will comment on the report of the chair of the all-party group on brain tumours, which says that there is greater need because there are no researchers able to undertake much of this research? Can he consider steps to address this imbalance and attract the brightest of medical and scientific minds into this uniquely complex area?

Medicines and Medical Devices Bill

Debate between Lord Bethell and Lord Hunt of Kings Heath

Report stage & Report: 2nd sitting (Hansard) & Report: 2nd sitting (Hansard): House of Lords
Thursday 14th January 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab) [V]]

I very much agree with the noble Baroness, Lady Jolly, that this afternoon we have given a powerful signal to the Government. Certainly, from these Benches, we very much support her amendment and her efforts to get redress for people who were grievously damaged by procedures undertaken in the National Health Service.

The noble Lord, Lord O’Shaughnessy, talked about one woman’s experience of the impact of surgical mesh, and the huge pain and damage inflicted. I was very grateful to him when I had a Question on surgical mesh, which he answered, as watching it from the Gallery were a group of women from Sling the Mesh, who I had brought in. He gave a lot of time to them afterwards; perhaps it paved the way to the inquiry established under the chairmanship of the noble Baroness, Lady Cumberlege. Like him, meeting those women and talking to them about what they had suffered made me absolutely determined to do anything I could to raise the issue.

We were very fortunate that the noble Baroness, Lady Cumberlege, accepted the chairmanship of this inquiry, given the quality of her team and the extraordinary lengths to which she went to produce its very fine report. Anyone who has met the people involved and listened to the suffering that they have undertaken is left with a feeling that it is awful. Something must be done for them and I very much hope that the Minister will be sympathetic.

[Lord Bethell (Con)]

My Lords, what a moving and heartrending set of speeches on a very important amendment, which I take extremely seriously. It raises the issue of establishing a specific redress scheme for those medicines and medical devices considered by the review: sodium valproate, the use of pelvic mesh and hormone pregnancy tests. The stories in the review, which have been told here this afternoon, are extremely moving on every single level. I cannot but pay testimony to those who have conducted the campaign and given evidence about their own personal suffering—and who, quite reasonably, look for some form of redress.

I completely understand why my noble friend Lady Cumberlege has raised this issue and why she and other noble Lords have asked for progress on her review. I also completely understand the importance that she and her team attach to this recommendation. They rightly spent considerable time drawing on a wide range of complex evidence before reaching their recommendations. The Government feel it is only right that we also give that incredibly helpful report our full consideration before responding to its recommendations. I remind noble Lords about the timeline for a response to these kinds of reviews, which we have gone over before. I think we are well within the normal response time for such reviews, Covid notwithstanding.

In order to determine whether redress schemes should be established, the Government have a duty to ensure that the final decision is fair for patients and for citizens more generally—not just the patients and citizens affected by the three treatments that my noble friend Lady Cumberlege alluded to, but all citizens and patients; you cannot favour someone over another. This requires extremely careful consideration of any proposed scheme but also the precedent that any decision sets for future policy-making. We spoke in the previous debate about the £83 billion problem. That kind of financial impact has a profound bearing on this kind of discussion.

My noble friend Lady Cumberlege asked when the Government will respond to her review. The Written Ministerial Statement of 11 January sets out the Government’s interim response. I emphasise to anyone who may be confused that it is just an interim response to the report of the IMMDS review. We currently plan to respond to the report later this year; that is a commitment made by my honourable friend Nadine Dorries, the Minister in the other place. The report took over two years to compile and we therefore consider it absolutely vital for the sake of patients, especially those who have suffered greatly, to give this recommendation the full consideration it deserves.

The noble Baroness, Lady Bennett, asked why the Government have established redress schemes in the past but are unwilling to commit to the schemes proposed in this amendment. I think that one is too early to call. It is right and proper for the Government to carefully consider proposals for redress schemes on their own merits to ensure a fair outcome for patients, and citizens more generally.

The noble Lord, Lord Hunt, asked why it is taking so long to consider the recommendations. The report took over two years to compile, so we need to consider it very carefully. I do not want to use the Covid pandemic as a catch-all excuse, but the reality is that our hospitals are overwhelmed; the Department of Health has doubled in size in the last six months and even with that it is overworked and overstretched. The resources and capacity to respond to this kind of report are, I am afraid, distracted on other matters of national health crisis. However, I reassure the noble Baroness, Lady Cumberlege, and other noble Lords who have spoken that work is under way and we will set out the Government’s response to this report later this year.

I could not help but be enormously moved by the testimony of the noble Lord, Lord O’Shaughnessy. In essence, he asked why the Government do not recognise that the patients highlighted in the report of the medicines and medical devices review suffered unavoidable harm, particularly those who took hormone pregnancy tests. The Government absolutely do regard their suffering most seriously indeed and are considering the contents of the report. I am restricted in what I can see regarding hormone pregnancy tests in particular, given the live litigation, but I want to make clear the Government’s position regarding a causal association between HPTs and adverse outcomes in pregnancy. The scientific evidence has been reviewed on a number of occasions, most notably by the Commission on Human Medicines expert working group on HPTs, which, as noble Lords will know, reporting its findings in November 2017. The EWG concluded that the scientific evidence did not support a causal association and that remains the Government’s position.

Just as Covid-19 impacted the publication of the report, it has also had an impact on the timing of our response. I know, and recognise, that that is enormously frustrating. The Government are committed to responding and I assure the noble Baroness, Lady Cumberlege, that work is under way. Our upcoming full response will address recommendation number four. We are moved by the stories; I am totally and utterly sympathetic to the situation that the patients affected by these conditions find themselves in on a day-to-day basis. They are still living through it today. I would like to regard myself as a compassionate person, but it is not appropriate to make policy on this kind of matter through primary legislation. For that reason, I ask my noble friend to withdraw her amendment and await the Government’s full response to her report.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

I thank my noble friend for providing this opportunity to scotch that unhelpful rumour. I confirm that there are absolutely no animal components in the vaccine. That point has been endorsed by the British Islamic Medical Association, members of which issued a fatwa earlier this year confirming that the vaccine was halal. My noble friend is right that there are stories on social media that are extremely distracting. We engage with sympathy with those who are concerned about the vaccine, but these stories are completely wrong, and I would like to put them to bed.

[Lord Hunt of Kings Heath (Lab) [V]]

May I continue on the theme of vaccines? Has the Minister seen the very recent survey by King’s College and Ipsos MORI, which found that 46% of all 16 to 34 year-olds say that they have seen or heard messages discouraging the public from getting the vaccine? Alarmingly, 27% of them believe that the real purpose of a mass vaccine programme against coronavirus is to track and control the population. Social media is playing such an important role in vaccine disinformation. Is the Minister really satisfied that all is being done to combat it?

[Lord Bethell (Con) [V]]

My Lords, the noble Lord, Lord Hunt, is right to be concerned. Some of the data we have on public attitudes is of extreme concern and the statistics he has referred to show exactly why we have focused on this area as much as we have. We have worked extremely closely with social media platforms to try to minimise the availability of this material, and we have a large communications programme to engage with those concerned about taking the vaccine. I reassure him that our experience to date has been that when those who are considering taking the vaccine reach the moment of decision, their confidence increases, and I am hopeful that that will continue.

Ockenden Review

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 14th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

On behalf of the Chamber, I thank my noble friend for his touching testimony. He is entirely right; there are two CCGs in the local area: the Telford and Wrekin CCG and the Shropshire CCG. They did exactly what they should have done in 2013, launching an investigation into the levels of service at the Shrewsbury and Telford Hospital NHS Trust. It is not clear why the findings of that report turned out as they did; nor is it clear why other interventions, or potential interventions, by the CQC and other regulators did not get to the bottom of the problem. Those questions will be addressed in the second of Donna Ockenden’s reports, in 2021; there has not been time for them all to be addressed in the interim report, but there is much more to go into, and this is undoubtedly one of the important points she will need to address.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I declare an interest as a member of the GMC board. Nothing can excuse the repeated failures and the lack of compassion and kindness exposed by the review. What is so striking is the paragraph in the report that refers to the eight chief executives working in the trust over a period of 10 years and 10 chairs over 20 years —no wonder there is a leadership and governance issue in the trust. I ask the Minister: what on earth have NHS England, NHS Improvement and the CQC been doing? It seems that their interventions, which I suspect have been punitive in nature, have not provided the kind of support that is needed.

Does the Minister agree that we need a wholly new approach to this trust, which gives it high-level attention and provides stability in leadership—not a constant turnover because of an intervention by one or other of the many regulators that can do this—and above all, support from neighbouring services that can provide help? I suspect that this trust needs an awful lot of help to get out of this terrible situation.

[Lord Bethell (Con) [V]]

My Lords, I completely take on board the noble Lord’s observations. It is true that Donna Ockenden’s report alludes to the failure by senior leadership to monitor and intervene where clearly there were problems. However, let us not confuse correlation with causation. This was not caused by a failure of senior leadership, but by a breakdown in the basic management systems and culture of the maternity services within the trust. That should have been addressed by the senior leadership, but it was not necessarily caused by them. I completely endorse the observation of the noble Lord that neighbouring trusts have an important role to play in checking in and benchmarking behaviours. That is a point made very clearly in the Ockenden report, and one that I hope they will step up to.

Coronavirus Vaccine

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 3rd December 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is right about the NHS volunteers. We would very much like to work with those who stepped forward. Their move was extremely welcome and kindly meant. However, the deployment of the vaccine is a precise affair. We are relying on people having to put in long hours—often not at their own discretion or convenience. Volunteers may well play a role, but the backbone and functional aspect of the deployment will rely on professional staff.

I appreciate her conundrum about the military. It is a delicate dilemma. I do not want to live in the kind of country where we turn our back on the military because some people might feel uncomfortable at the sight of uniforms on the streets. We need to build trust with communities. I want to use this moment of the vaccine to build a bridge of trust between those whom the noble Baroness reasonably described and the military. We must not make the mistake of disrespecting the military by turning them away from this important task.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, as the Minister who established the MHRA, I strongly endorse the Minister’s congratulations. I pay particular tribute to the outstanding leadership of Dr June Raine. I note what the Minister said about unpaid carers and the justification for not giving them priority but would the Government be prepared at least to discuss this with Carers UK? On care homes and visitor testing, which are mentioned in the Statement, is the Minister aware of calculations by Care England that the infection control fund will not cover the cost of implementing the new testing regime, let alone all the other areas for which the fund is intended? Will the Government consider increasing the fund?

[Lord Bethell (Con)]

My Lords, the support we are giving to social care throughout this period is incredibly important. I should be happy to meet with Care UK to discuss this. I cannot duck the issue. The JCVI has made its prioritisation clear. It is based on thoughtful science, infection rates and the calculation of how best to save life. While I feel compassion for carers, including some in this Chamber, we have to live with this tough decision. I cannot pretend I am going to try to change it. The inspection control fund is generous; we have put a large amount of money into it. If it proves not to be enough, we will be happy to revisit it. Protecting social care through these final few months is a big priority. I should be happy to discuss how we can do this better with the noble Lord at his convenience.

Department of Health and Social Care: Unpaid Advisers

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 17th November 2020 Lords Chamber

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, yesterday former Conservative Attorney-General Dominic Grieve described the Johnson Government as presiding over

“the disappearance of any standards of conduct at the heart of government”,

and said that the cronyism of administrative decisions had communicated to young people in particular a sense of government as corrupt. Given that, can the Minister be surprised that there was concern over the conduct of Mr Pascoe-Watson after he had ceased to be an adviser?

[Lord Bethell (Con)]

I always take the words and advice of former Attorney-General Dominic Grieve extremely seriously, and I value his opinion greatly.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 12th November 2020 Lords Chamber

[Lord Bethell (Con)]

My noble friend is right that the advice to business is extremely important, and we are ambitious to try to unlock the economy to enable people to return to as normal a life as they possibly can and to prepare the country for Christmas. However, it is too early to tell exactly what the state of the pandemic will be on 2 December. There is a review of the tiering system, and we will learn the lessons of the last round. The Prime Minister has made it very clear that he is committed to returning to a regional tiering system, but the exact dimensions and specifications of that system are under review, and communication to business of how, and to which regions, it will apply will be forthcoming once the analysis of the contagion has been completed.

[Lord Hunt of Kings Heath (Lab) [V]]

I declare my interest as a member of the GMC board. I return to the Statement made by the Secretary of State, in which he said, referring to NHS staff:

“The deployment of the vaccine will involve working long days and weekends, and that comes on top of all the NHS has already done”.—[Official Report, Commons, 10/11/20; cols. 746.]


The noble Lord will be aware that the GMC granted temporary registration to around 27,000 doctors in order to help out with the pandemic crisis. My question is: has the department considered using these doctors, not many of whom have actually been used by the NHS so far, for the vaccine programme? Will he look into that?

[Lord Bethell (Con)]

My Lords, the noble Lord raises a very good point. We pay tribute to all those who stepped forward, whether they were young doctors at the end of their training or older doctors who were returning to the profession. It was a really important and touching moment when those doctors stepped forward. He is right that not all of them were needed or used during the pandemic. My understanding, from the deployment team, is that they are looking at all avenues to have the largest army of people possible in order to use the vaccine. I am not exactly sure of the exact status of the 27,000 doctors he alluded to, but I would be glad to write to him with details.

Covid-19: Dental Services

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the concern about children is particularly acute. We are especially keen to encourage parents, to ensure that they are still bringing children forward. That is why we have the Help Us to Help You campaign to encourage public access to NHS services. She is entirely right that acute situations—involving, for instance, some form of anaesthetic—provide a particular challenge. We have a prioritisation process in place, and I understand that that is working well to ensure that those who have the greatest need are put at the front of the queue. However, as I said to the noble Baroness, Lady Uddin, I would welcome any feedback from those who think that the system is not working well enough.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I declare my interest as president of the British Fluoridation Society. Just on that last point, in a number of parts of the country, no elective surgeries, except for those that might be totally prioritised, are being done at the moment. The prospect is of a few more months with a virtual lockdown of elective surgery. As far as children are concerned, will the Minister look into this matter urgently? Will the Government prioritise preventive schemes as we come out of the pandemic, such as fluoridation, supervised tooth-brushing programmes in schools and public service ads?

[Lord Bethell (Con)]

My Lords, I completely agree with the noble Lord that prevention is the key. In our document on the matter, Advancing Our Health: Prevention in the 2020s, we have committed to the consulting on and rolling out of supervised tooth-brushing schemes in more preschool and primary school settings in England. We have also set out our support for expanding water fluoridation, and we intend to announce further details of our water fluoridation plans shortly.

Covid-19: Intensive Care Treatment

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 29th October 2020 Lords Chamber

[Lord Bethell (Con)]

My noble friend is entirely right to chase me in this matter. I remember the commitment very well and I will endeavour to find out from my colleagues at the department how they are doing in getting those important papers into the Library.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the Minister was very forthright today in rejecting the Sunday Times story. A month ago, he was very forthright in an answer to the noble Lord, Lord Balfe, about blanket DNR notices. Picking up on the question today from the noble Lord, Lord Balfe, does he think that there might be an issue of communication where staff are working on the front line, where impressions are given that are not in accord with official government policy? In the light of all this, has he given some thought to the way in which communications with NHS staff might be improved in order to deal with these very troubling issues?

[Lord Bethell (Con)]

I am not sure that I agree with the implication of the noble Lord’s question—that somehow there is a prejudice on the front line against older people and that staff take it into their own hands to make decisions that are in themselves inherently unfair. That is not my experience. Where the noble Lord absolutely has a point is that people are extremely sensitive about these kinds of issues, and, quite rightly, are deeply concerned that they are going to get the treatment and care that they deserve and will not be subject to any form of unfairness. It is imperative that the NHS builds trusts and conveys a strong communication on these issues. To push back against the noble Lord, it is not my impression that the staff at the NHS have lost sight of this important principle.

Covid-19: Charitably Funded Hospices

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 28th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right. Some £1.54 billion is spent on hospices each year. Of that, £1.2 billion is charitable; I pay tribute to those from the hospice movement who were recognised in the recent Birthday Honours List for supporting that fundraising. Let me assure the noble Lord that the challenge he describes is recognised in the department. The Minister responsible will meet key hospice stakeholders, including from Marie Curie, Sue Ryder, Hospice UK and Together for Short Lives, on 4 November when the challenge that he describes will be discussed.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I am a long-standing supporter of Birmingham St Mary’s Hospice. If the current restrictions stay the same as now, the hospice estimates that, by the year’s end, fundraising and retail income will be down by more £1.5 million—and by more if we have a more severe lockdown rule. This is a massive amount for a small charity to make up. The Minister has referred to the support received from the Government via Hospice UK. That was hugely welcome, but the hospice movement needs an immediate second injection of funding, and it needs to know when that will happen. Hospices cannot wait much longer.

[Lord Bethell (Con)]

My Lords, I completely recognise the note of urgency in the noble Lord’s comments. I also recognise that, as we go into a Covid winter, the hospice movement, which has contributed so much to our response to Covid and brought valuable capacity to the care of the elderly and the vulnerable during the first wave, needs answers. I recognise the funding gap that he describes, in particular the collapse in retail income that many depend on, but I assure the noble Lord that the meeting on 4 November will have these issues on the agenda. The movement should look forward to that meeting as an opportunity to discuss the issues he describes.

Medicines and Medical Devices Bill

Debate between Lord Bethell and Lord Hunt of Kings Heath

Committee stage & Committee: 2nd sitting (Hansard) & Committee: 2nd sitting (Hansard): House of Lords
Monday 26th October 2020 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister for his response. Could he say a little more about the Government’s overall patient safety strategy? He is saying essentially that the Bill is confined to medicines and medical devices regulation, yet underlying the concerns of the noble Baroness, Lady Cumberlege, is the fact that patient safety has not been gripped. In a sense, he has given a technical response. We will come to more specific amendments relating to, say, a patient safety commissioner, but at some point it would be interesting to get an insight into government thinking about patient safety more generally.

[Lord Bethell (Con)]

I will be candid with the noble Lord. The Cumberlege report has put patient safety absolutely at the top of the agenda. If it was not for Covid, it would be the primary issue of today in health matters and would lead all our thinking for the year ahead. The report is incredibly important and it has made its mark in a big way. However, it was delivered at the end of July and, if you take out August, that is only six or seven weeks ago. It takes a bit of time to respond to these reports. I know that the noble Baroness is chafing at the bit and wants a response—of course she does—but it has not been very long in report terms.

I cannot avoid the obvious, which is that we are in the middle of an epidemic. The Department of Health is completely overrun. We have nearly doubled in size in the past four weeks, but even so the capacity for response, in ministerial time and official time, simply is not there. I completely understand the keenness of noble Lords in this Room to get a clear response, but the sequencing is that this is a Bill on medicines and medical devices. We seek to take on board the lessons of the Cumberlege report and, where possible, specific items, but the Bill is not designed to be a vehicle for the implementation of the report recommendations. We will acknowledge and, where possible, accommodate the report’s insight, but the report needs a formal response from the Minister for Patient Safety and I am not that Minister and there has not been time for that response to arrive yet.

Covid-19: South Yorkshire

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 22nd October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is right that the situation at airports is distressing and has caused huge damage to travel, the airline business and hotels. However, foreign travel represents a massive threat in forward transmission of the virus. Testing at airports catches only a tiny proportion of those infected, and quarantine arrangements are not wholly reliable. For that reason, we are running a pilot in the UK to see what can be done but we will tread cautiously.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the Minister has said that he will not publish the criteria under which a local area can move in and out of a tier. Does he agree that publishing some indication would give local people a clearer understanding of what needs to happen to move out of a tier? Perhaps I may refer to the proceedings of the Secondary Legislation Scrutiny Committee earlier today, which, looking at the tiered approach, said, “For public trust to be maintained, the Government have to be much more transparent in explaining the basis of their decision-making, including setting out how they balance the competing health, social and economic interests and the data to support the decision.” Will the Minister look at this?

[Lord Bethell (Con)]

My Lords, I hear the point loud and clear from both the noble Lord and others who have raised it. The question of the exit strategy is a priority and it is inevitable that people will be asking exactly that. We have sought hard over recent months to make the regulations clearer, simpler and more understandable for the public; the rule of six, the tier strategy and other measures are efforts to do that. However, his point about exit strategies is extremely well made and I would be glad to take it back to the department and to push as hard as I can on it.

Covid-19: Information Sharing with Police Forces

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 20th October 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what is the legal basis for their Memorandum of Understanding with the National Police Chiefs’ Council which allows police forces to access information that tells such forces if a specific individual has been told to self-isolate due to the COVID-19 pandemic.

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

My Lords, the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020 authorised the police, local authorities and NHS Test and Trace to share information where necessary for the purposes of enforcement. The Department of Health and Social Care and the National Police Chiefs’ Council have agreed a memorandum of understanding so that, when given a report that someone is failing to self-isolate, the police can check with NHS Test and Trace whether the person in question has been formally notified to self-isolate.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am grateful to the Minister but does he agree that sharing what is essentially health information with the police is a highly sensitive matter? This should not have been sneaked out on a Friday night without any parliamentary reference whatsoever. Was NHS experts’ advice taken regarding the impact this might have on people prepared to take the test? Is the Minister aware of the advice given by the BMA and other health service organisations, particularly in relation to harder-to-reach communities, that this may dampen down the numbers of people coming forward for tests? Was that taken into account?

Covid-19

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is right to raise questions about the way in which the disease is transmitted. We have put a huge amount of effort into studying it. I pay tribute to the epidemiologists who have crafted sophisticated models and have sought to test them in practical ways in order to establish, for good, the really important questions of how one person’s conversation, breathing and spoken word might transmit the disease to another person either through the air or on surfaces. Understanding that is absolutely essential in order for us to put in place the right kinds of Covid safety measures. However, at this stage it is an imprecise science. For instance, there is some evidence that transmission from hygiene and surfaces can play a very important role, perhaps meaning that we have to invest more thought and commitment in cleaning measures. The guidelines we have for workplace and school testing reflect the very best provable standards according to scientific evidence. We continue to invest in these important epidemiological insights, and I welcome very much the contribution of the scientists on SAGE and all those who continue to try to gain a better understanding of this issue.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, in the first Statement that we are debating, the Secretary of State spoke about the strategy being to suppress the virus and support the economy and the NHS. He did not specifically mention the vaccine programme, although clearly it is an important part of our approach. Although the Government have secured early access to, I think, over 300 million doses, there will not be enough for the entire population to receive them immediately. The Joint Committee on Vaccination and Immunisation has published interim advice on a prioritisation programme. Will the Government follow that advice, and can the Minister say more about what work is being undertaken to encourage a high uptake?

[Lord Bethell (Con)]

I thank the noble Lord for his interest. The JCVI is, as he described, the agency responsible for giving advice on the prioritisation plan. Our policy is to follow that advice, and I pay tribute to those on the panel for the hard work they are putting into that. The interim advice is extremely thoughtful and follows the best values and standards of this country. We are putting a lot of work into trying to raise adoption rates of the vaccine. We face a challenge from those who would like to query the science or have some form of national or commercial vested interest in undermining confidence in the vaccine. We are putting a lot of work into mitigating that risk. That is not work that I would like to discuss at the Dispatch Box but I would be very glad to share some of it privately at a later date.

Covid-19: Local Restrictions

Debate between Lord Bethell and Lord Hunt of Kings Heath

Friday 9th October 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what plans they have to seek Parliamentary approval for new local COVID-19 restrictions before they come into force.

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

My Lords, as the Secretary of State for Health and Social Care told the other place last week, for significant national measures with effect on the whole of England or UK-wide, the Government will consult the House of Commons wherever possible and hold votes before such regulations come into force. The arrangement of business and scheduling of debates in this House is a matter for discussion through the usual channels. Noble Lords will know that in this House the Government do not schedule debates without consulting the usual channels first.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, that is a very disappointing Answer. Last week, Mr Speaker criticised the Government for treating the Commons with contempt in the way that Covid regulations were dealt with and called for the most significant to be debated and decided on at the earliest point. The Government now propose to introduce a new tiered level of restrictions for local lockdowns. They are of national significance; whatever their justification, they involve a serious restriction of people’s personal liberties and will put many businesses in jeopardy. Does the Minister accept that Parliament should be asked to approve them before they come into force? Can he tell me what discussions have taken place to ensure that this happens?

[Lord Bethell (Con)]

My Lords, any new regulations will be scrutinised by both Houses in line with the requirements set out by Parliament in the relevant parent Act. The procedures for approving affirmative instruments are set out in your Lordships’ Standing Orders, and it is not in my gift to amend, suspend or ignore these. The local measures need to be enforced quickly if they are to be effective.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 6th October 2020 Lords Chamber

[Lord Bethell (Con)]

I completely endorse the views of Sir Paul Nurse on this and on all matters, wherever I can. The noble Lord is entirely right: speed is critical, which is why we have put major laboratories in regions up and down the country. There are nearly a dozen of them now; they are paired with the pathology networks of the NHS, and our tracking and tracing system works closely with local government. When the large call centre-based tracking and tracing has gaps or when local teams can supplement, augment or complement the work done by the major teams, we seek those opportunities wherever we can.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I remind the House that I am president of the Health Care Supply Association. I come back to procurement and contracting. Will the Minister respond to the question of my noble friend Lady Thornton about a break clause in the contract with the private suppliers of test and trace? Will he confirm that Public Health England is fully a part of his department, that its staff are officials of his department and that the Secretary of State is fully accountable for its performance?

[Lord Bethell (Con)]

My Lords, I cannot give a detailed analysis of the thousands of contracts that the test and trace system have gone into, but I reassure the noble Baroness, Lady Thornton, and the noble Lord, Lord Hunt, that these contracts are pragmatic, commercial and thoughtful. The interests of the taxpayers are paramount, and a substantial team of commercial professionals and lawyers from the Department for Health, the NHS and the Cabinet Office is focused on making sure that we get value for money.

The noble Lord, Lord Hunt, is right: PHE is entirely accountable to the Department for Health. I do not know the precise status of the contracts for staff, but they are an important and valued part of the Department for Health’s family, and we work extremely closely together.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 23rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, it is with sadness that I note that the infection rate in Sweden is inching up, and with regret that I note that Stockholm is bringing in many lockdown measures similar to those in the UK. The noble Lord is right that Sweden has had a distinctive approach, but it is not as distinctive as would appear. Many of the same regulations that we have had here have been applied in Sweden. One area where Sweden has shown leadership is in compliance among the public. When regulations have been brought in, there have been extremely high levels of compliance, and therefore the optics are different from the reality. This Government have never supported a herd immunity strategy.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I remind the House of my presidency of the Health Care Supply Association. I want to ask the Minister about testing. He will be aware that the medicine supply chain rose to the huge challenge presented partly because, early on, pharmaceutical wholesale staff were classified as key workers. That gave them access to priority testing, but on Monday the Government issued a revised list that excludes those pharmaceutical wholesale staff. The Healthcare Distribution Association has reported to me that there are already delays in staff accessing these tests. It is very concerned that, if this continues, it will have a very detrimental effect on the supply of medicines to hospitals and pharmacies. Would the Minister be prepared to take this away, look at it and see whether they could be added back to the priority list?

[Lord Bethell (Con)]

The noble Lord makes an extremely good point. I am grateful to him for alerting me to this question in advance. We take the contribution of pharmacists to the battle against Covid extremely seriously. I am not sure, right now, why pharmacists have been taken off the list and I would be glad to look into the matter and respond to him shortly.

Health Care: Guidance

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 21st September 2020 Lords Chamber

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the distinction between different patient groups has particularly affected care home residents through the blanket use of “do not resuscitate” orders without explanation to patients and families. Will the Minister make clear his abhorrence of this practice, and can he say how he will ensure that the recent winter guidance in relation to this for adult social care will be followed in full?

[Lord Bethell (Con)]

My Lords, there are no blanket DNR notices. These are completely abhorrent and against the NHS constitution. We are not supporting them at all. The noble Lord is entirely right that families should be consulted before any such measures are put in place. The social care plan published earlier this month makes that absolutely clear.

Covid-19: NHS Long-term Plan

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 15th September 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government, in the light of the Covid-19 pandemic, what plans they have for changes to the NHS long-term plan.

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

My Lords, I pay tribute to the NHS for its remarkable achievements in response to Covid-19, from freeing up an additional 33,000 beds for Covid patients, to maintaining access to primary care by ensuring that 93% of GP surgeries offer video consultations, and swiftly mobilising an additional 65,000 former clinicians to help fight the virus. Learning from the Covid response will naturally inform future service priorities. However, at present, the Government’s focus remains on supporting system recovery and any amendments that may be needed to the NHS long-term plan will be considered in due course.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister and echo his tribute to the magnificent efforts of health service staff. I remind the House of my membership of the GMC board. He will know that the NHS entered this crisis underpeopled and under-resourced, and that a huge backlog of work has built up. There have been estimates that as many as 10 million people will be waiting for treatment at the end of the year. There is an issue with cancer patients waiting for tests and treatment. Can he give an indication of the work being done, despite the pandemic, to get the NHS back on track? Surely he agrees that the NHS five-year plan will have to be recalibrated to take account of this.

[Lord Bethell (Con)]

I thank the noble Lord for his generous comments towards the NHS. Undoubtedly it is true that, after a massive epidemic such as the one we are living through, we will have to rethink some of our priorities and learn from Covid, but I will add a few comments about the restart. The focus on getting patients back into hospital is having a huge impact on cancer waiting lists. Attendance at GP surgeries is increasing all the time, and waiting lists are coming down dramatically. I pay tribute to NHS staff for their hard work on this matter.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have embraced the “test, test, test” recommendation in a very big way, and the noble Earl is entirely right to aspire to using testing to enable a return to the economy, theatreland and all sorts of public gatherings. We are looking energetically at this, working with suppliers, academia and the NHS to figure out ways of using the new testing technologies in the way he describes.

However, we are at a relatively early stage and I am not able to make announcements on this here today. We have funded—to the tune of £500 million—a huge amount of investment in these technologies and, when they are right, we will roll them out in the theatres and airports of Britain.

[Lord Hunt of Kings Heath (Lab)]

My Lords, we have heard a lot from the Minister today about the importance of obeying the law, yet a Bill has been introduced in the other place today that essentially sees the Government seeking to break the law. I refer him to what Geoffrey Cox, the former Attorney-General, said this morning:

“When the Queen’s minister gives his word, on her behalf, it should be axiomatic that he will keep it, even if the consequences are unpalatable. By doing so he pledges the faith, honour and credit of this nation and it diminishes the standing and reputation of Britain in the world if it should be seen to be otherwise.”


He went on to say:

“It is unconscionable that this country, justly famous for its regard for the rule of law around the world, should act in such a way”.


Does the Minister think this a good example to the public, and does he not fear that the appeal to the rule of law regarding the rule of six might just fall on rather stony ground?

[Lord Bethell (Con)]

My Lords, I am here to support the regulations before the House, not to comment on the issues about which the noble Lord asks.

Covid-19 Update

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 10th September 2020 Lords Chamber

[Lord Bethell (Con)]

I reassure the noble Baroness, Lady Meacher, that saliva testing is a massive priority for the Government. I reassure her and Professor Spiegelhalter that the positive error rate in the saliva test trials in Southampton has been incredibly low—virtually zero. From that, we take great reassurance that this will be an effective vector for testing.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, will the Minister accept that the reason for scepticism about the Moonshot gimmick is that the Government have a consistent record of overpromising and underdelivering? The Minister will know that the latest test and trace stats are not good: they show that 69.2% of close contacts of people who have tested positive with Covid-19 in England were reached—that is the lowest percentage since the scheme was launched. What would he say to Bridget Phillipson, the MP for Houghton and Sunderland South? Because Sunderland has a rising number of cases, she checked online this morning the availability of tests: no home tests were available and no drive-through tests could be found. Later in the morning, the only test offered was a two-hour drive away in Scotland. Why should anyone believe the ideas that the Government float from week to week?

[Lord Bethell (Con)]

My Lords, I completely and utterly reject the noble Lord’s suggestions. I remember well the nay-sayers, the sofa epidemiologists and the sceptics who, when we had testing at the level of 5,000, poured cold water on the idea we would get to 100,000. We hit that target. We have made amazing progress since and we will continue to push for more testing.

Covid-19: Response

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, the relationship with local authorities is extremely good, and I recommend that noble Lords do not believe everything they read on this subject. I completely commend those who work closely with PHE, the test and trace programme, the joint biosecurity team and all the sectoral parts of government that reach out to local authorities, DPHs and local infection teams. A very strong bond is forming, and we have a very large number of outbreaks up and down the country that you never read or hear about, and which are not celebrated either for being good or bad because that partnership works well. The intelligence and data are put into the hands of the people who need them, and the teams move quickly and effectively to deal with the outbreak. I am extremely grateful for this; a huge amount of progress has already been made, and we continue to invest in those relationships.

[Lord Hunt of Kings Heath (Lab) V]

My Lords, it is clearly good to hear that the relationship with local government is on a good level, as the Minister has said. However, why is it that directors of public health have been complaining for weeks about the lack of information? The Minister says that they are getting all the information they need, but this has occurred only in the last few weeks. If it is a question of data protection legislation, why was emergency legislation not put through in the spring to enable local authorities to have all the information they clearly need?

[Lord Bethell [V]]

My Lords, it is put to me week in, week out that our relationship with directors of public health is in some way troubled. I reassure noble Lords that, every single day of the week, we are in contact with dozens of directors of public health in amicable, constructive dialogues that lead to concrete action, local interventions and sharing of data. These conversations happen in a cordial and friendly fashion. The message may have got through to some noble Lords that there is some huge acrimony and difficulty between us, but that is not the perspective that I have. The data has got through. It is a hell of a thing to have put up a huge track and trace system in a few months. That we can get such detailed data to a large number of people within the envelope of reasonable data security legislation is nothing short of a miracle. I am extremely proud and pay tribute to those involved.

Covid-19: Test and Trace App

Debate between Lord Bethell and Lord Hunt of Kings Heath

Monday 22nd June 2020 Lords Chamber

[Lord Bethell]

My Lords, the decision to change strategy was taken ultimately on operational grounds. The regulatory environment was not necessarily relevant for that. We cannot avoid the fact that there have been technical issues with both the Apple and the NHS apps. We are still some way from resolving those issues, but we hope to overcome them, in partnership with Apple, and the House will be updated when we do.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, the SAGE minutes of 1 May indicate that 80% of contacts should be isolated within 48 hours of the original case becoming ill. The SAGE meeting on 19 May included the summary point that a test, trace and isolate system would be necessary, though not sufficient on its own, to allow changes to distancing measures without pushing R above 1. Given the failure of the Government’s app, and their intention to reduce the two-metre social distancing rule, has SAGE now changed its mind?

[Lord Bethell]

My Lords, the Government have the two-metre rule under review, but no decision has been made on it. Enormous progress has been made on reducing the turnaround times of tests. A large proportion of them now take place within 24 hours and we remain focused on this important index.

Exercise Cygnus

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 9th June 2020 Lords Chamber

[Lord Hunt of Kings Heath]

To ask Her Majesty’s Government what action they took following Exercise Cygnus to prepare the United Kingdom for responding to a major pandemic.

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

My Lords, Exercise Cygnus addressed the greatest risk in the National Risk Register of Civil Emergencies: a flu pandemic. All the recommendations from Exercise Cygnus were accepted and taken on board. Many of these proved invaluable for informing the response to Covid, including plans for legislation that would assist in response measures, for bringing back retired clinical staff, for flexing systems beyond normal capacity and for establishing a group of expert advisers on moral, ethical and spiritual issues.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, if the Minister is so confident that the lessons from Exercise Cygnus informed the UK’s preparedness, why was the care sector so neglected? To deal with the surge of NHS patients expected in the event of a pandemic, the exercise identified that extra capacity would be required in care homes. Why was that not heeded and why, as Martin Green, chief executive of Care England, put it, was PPE redirected away from care homes and the NHS given a clear instruction in March to send people to care homes despite no testing for infection being available?

Dental Care

Debate between Lord Bethell and Lord Hunt of Kings Heath

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

The noble Lord is entirely right that poor dental care is extremely damaging to individual health. The current situation is one that we massively regret, but the safety of patients and dental professionals is paramount. The aerosols generated by dental drilling and other dental practices leave the threat of germs in the air in a dental practice for hours to come, which could be caught by staff or future patients. It is for that reason that we have focused the infection protocols in 500 special units that have the right kit, the right training and the right arrangements.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I declare my interest as president of the British Fluoridation Society. I recognise the work done in setting up urgent treatment centres, but they are patchy in England and many provide only for pain relief and tooth extraction. Many high street dentists are in danger of bankruptcy, because the Chancellor’s schemes to help businesses have not been applied to them. Will the Minister consider setting up a programme of work with the BDA and the Chief Dental Officer to establish a national plan to get dentistry back on track and save the profession from ruin?

[Lord Bethell]

My Lords, I completely understand the points that the noble Lord has made. He refers to a situation that we are fully aware of, and I completely agree with his analysis. The truth is that tooth extraction avoids some of the risks that I described, but treatment in the centres is not limited to extraction and other protocols are arranged. The Chief Dental Officer is working on a dental plan, and we are liaising with colleagues in the Treasury to see what more can be done to help dental practices.

Covid-19: Personal Protective Equipment

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

I am not sure that I agree with the analysis of the noble Lord. No one could have anticipated the huge demand for PPE not just in the NHS and care homes but in other workplaces. This is a global phenomenon. The chase for PPE is difficult in all countries around the world. Britain is not alone in struggling with this. I do not think now is the time for apologies; now is the time for delivering PPE, and that is what this Government are focused on doing.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I declare an interest as president of the Health Care Supply Association and thank the Minister for his tribute to procurement professionals in the NHS and the supply chain, SCCL. I return to the issue raised by the noble Baroness, Lady Smith, and the noble Lord, Lord Patel, about cross-government working. It is clear that this is a concern of not just the department of health. It certainly involves the Cabinet Office as well. Is there someone in the Government who has the authority to make the final decisions? It is not clear at the moment.

[Lord Bethell]

The noble Lord asked for clarity; let me be clear. The NHS is the client. The department of health pays the bills. Other departments are doing their bit to help. We are very grateful to the Cabinet Office in particular for providing contract and procurement staff, and we are thankful to all other departments that have lent us their staff or their logistical skills in delivering our PPE commitments.

Covid-19

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

I would like to recruit my noble friend to our testing organisation, because she has exactly the right ideas, and the programme she described is exactly what we are doing. The Army is putting together 50 transit vans with tents and cones to be able to travel to places such as care homes to conduct testing, particularly at times of epidemic. Amazon is putting together home testing kits, which means that no one need drive anywhere to have a test, and we are working with care homes so that care workers can take the swabs and then drop off bags of them at a reasonable place so that they can be processed by our laboratories. Drive-in testing was an early but limited programme, and we have a lot more going on than that.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister; he has had a lot of work to do in the Lords today. He commented on ONS figures and the analysis it has done on the number of people who have so sadly died. The figure he gave in the Statement was, I think, around 18,000. I assume that these are deaths from the virus of people in hospital. I suspect he will have seen a piece in the Financial Times earlier this week which did some analysis of the ONS figures. It suggested that the figure of deaths caused by the pandemic was as much as 41,000. Have his officials looked into this and can he comment on its veracity?

[Lord Bethell]

I have not seen the piece in the FT, so cannot comment on the noble Lord’s remarks. All I would remind him, as I have said in previous answers to similar questions, is that false reporting of a death is an offence. Doctors are required to make a clear report of a death. If it is associated with Covid in any way, the word “Covid” will be in the death certificate. If it is in the death certificate, it will make its way through the CQC to the ONS figures. There should be no ambiguity about this at all.

Health: Lesbian, Bisexual and Trans Women

Debate between Lord Bethell and Lord Hunt of Kings Heath

Thursday 5th March 2020 Lords Chamber

[Lord Bethell]

I assure the noble Baroness that there is full recognition and awareness of and concern about this issue. The impact of Dr Michael Brady, whom I spoke to yesterday, is profound. He has a very high profile within the department, and the work he has done is valued and will make an impact.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is this not an illustration of the problems with the NHS’s current structure? Ministers can proclaim anything they like from the Dispatch Box, but at the moment, they do not control what is happening in the NHS. It is time for Ministers to restore their power of direction over the NHS.

[Lord Bethell]

The noble Lord makes an interesting point, but it is simply not true that Ministers do not drive change or have an impact on reforms in the NHS. We have a profound and energetic reform agenda, and it is being driven through with energy and determination.

Influenza: People with Learning Disabilities

Debate between Lord Bethell and Lord Hunt of Kings Heath

Tuesday 1st October 2019 Lords Chamber

[Lord Bethell]

The noble Lord makes an excellent point, and this is an area of concern, but I should like to reassure him that these are not delays; they are in fact phasing. What we learned from last year is that the identification of which particular flu strain is likely to hit the northern hemisphere is not always clear at the beginning of the season, so we have learned to phase the delivery of the vaccines in case the strain of the influenza virus changes or is not as anticipated. This is interpreted by some pharmacologists as a delay, but in fact it is a pragmatic decision made at the very highest levels.

[Lord Hunt of Kings Heath (Lab)]

My Lords, one of the difficulties of encouraging flu vaccination among vulnerable people is that the rates among NHS staff themselves is disappointingly low. What action are the Government taking this coming winter to encourage NHS staff to take up the vaccine?

[Lord Bethell]

My Lords, it is entirely correct that the struggle to get NHS staff vaccinated is one that concerns the Government greatly. There is an in-depth education programme, and the offer of eligibility for NHS staff has been rolled out to a considerable degree already. Uptake is not as high as we would like it to be, and it remains an area of focus.