Commonwealth Fund Report: NHS Ranking
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 2 months ago)
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Lord Bethell (Con)
My Lords, I pay tribute to Andrea Leadsom for her report and all those who collaborated in drafting it. The noble Baroness is entirely right that those in the first 1,000 days of their lives are the people we should focus on—that is why we commissioned the report in the first place. We have embraced many of the recommendations and we will continue to see through their implementation.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, we will now have a virtual contribution from the noble Baroness, Lady Brinton.
Baroness Brinton (LD) [V]
My Lords, the report points out that, although the UK is fourth overall in the rankings, we are ninth out of 11 on health outcomes. As the noble Baroness, Lady Thornton, outlined, the top three countries are particularly good at investment in preventive services and primary care, but the report also talks about wider social care, including housing, nutrition, transportation and early years services. All these investments tackle inequity and deprivation, as covered in both the Leadsom report and the Marmot report. Given the Chancellor of the Exchequer’s statement that there is no money for anything other than the NHS and social care, what are the Government proposing to do to address investment in these vital areas?
Lord Bethell (Con)
My Lords, I remind my noble friend that the report looks at 10 countries, so although we are at the bottom, it is bottom of a very small list. There is competition within the NHS—the 2012 Act organised that. My experience of working in healthcare, which has only been for one and a half years, is that collaboration, rather than competition, is the key to productivity. Getting diagnosis and the patient journey right requires a huge number of experts to work together and huge expertise, often in many different organisations. We are keen to use technology and modern techniques to make sure that collaboration is at the heart of the way in which the NHS works.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
NHS: Nursing Workforce
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 2 months ago)
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Lord Bethell (Con)
My Lords, I acknowledge my noble friend’s concerns about that point. It is a fact of life of trying to manage complex healthcare systems that you do not know necessarily on a day-to-day basis which staff you will need and exactly where you are going to need them. Therefore, we rely on flexible working arrangements, which suit some nurses who cannot make the kind of time commitments that are needed for a full-time job. There are hourly costs to that additional flexibility, but we leave it to chief executives to balance those benefits and disbenefits to achieve their objectives.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Residential Social Care: Staff
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 2 months ago)
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Lord Bethell (Con)
We are enormously grateful for that report, which has made a huge impact. I am not sure of the specific impact of the measures the noble Baroness describes, but I would be glad to write to her.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Animal Diseases: Future Pandemics
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 4 months ago)
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Lord Bethell (Con) [V]
My Lords, our contributions to “one health” are partly through our collaborations with foreign Governments, but they also include Defra’s work here in the UK and the contribution of British scientists, such as through the Trinity Challenge that I mentioned. The noble Baroness is right that this is not cost free, and we have to explain the value of this work to the taxpayer. That explanation is easier after a pandemic as massive as the one we have had, but we need to look closely at the value-for-money judgments needed before we make the necessary investments in this agenda.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed. We now come to the third Oral Question.
Covid-19: Aligning UK and Foreign Entry and Return Requirements
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 4 months ago)
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Lord Bethell (Con) [V]
The current data suggests that the vaccine certificate is the most emphatic indicator of reduced infection and therefore transmission. That is the basis on which we are currently looking to try to open the borders. The noble Lord makes the good point that in countries that have had high infection rates some form of antibody recognition might be possible—but that is not the route that we are looking at at the moment.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed. We now come to the third Oral Question.
Folic Acid
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 4 months ago)
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Lord Bethell (Con)
My Lords, I do not need to explain to a seasoned veteran such as my noble friend that the British Government have had a lot on their hands in the past 18 months and that getting right important measures such as this, that touch the lives of every single person in the country—at least, all those who have bred—is an extremely delicate matter. That is why we have to do it in a thoughtful, constructive way. There is no cutting corners on a measure such as this. I reassure my noble friend that we are going through it as quickly as we can. I am not able to give him the timetable that he asks for, but I would like to return in the new term with further details.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked.
Health: Dementia
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 4 months ago)
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Lord Bethell (Con)
I completely accept the noble Baroness’s point. It is clear that the benefits of digital do not play out for the elderly and those who face dementia and other similar conditions in the same way as they do for younger people and those accustomed to and familiar with Zoom and other digital services. She is entirely right that the symptoms and features of dementia, Alzheimer’s and Parkinson’s are sometimes picked up only through face-to-face engagement. That is why we are working hard to reopen GP surgeries and to ensure that such appointments can take place.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Covid-19: Wuhan Institute of Virology
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 4 months ago)
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Lord Bethell (Con)
My Lords, specific official engagement with the investigation is done through PHE, and we have a PHE official sitting on the investigation. That is the right way of conducting a scientific dialogue. The DHSC and FCDO also have extremely active interests in this. As for the tone in which the noble Lord talked about how we should approach this challenge, I say that we have to work in partnership with other countries. There is no way in which we can demonise one country or another in this matter. Partnership is the only way ahead. What we can, I hope, bring to the party is a sense of urgency and a sense of focus.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Hospital Waiting Lists
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 4 months ago)
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Lord Bethell (Con)
On the elective recovery fund, I cannot make that commitment at the Dispatch Box but I reassure my noble friend that we are in it for the long haul and we recognise that this will be a major project needing major resources. When it comes to the health of the nation, the obesity strategy is a cross-departmental and energetic programme that tackles the issues that my noble friend is concerned about. He is entirely right that the costs of our healthcare system are predetermined by the overall health of the nation, and that is why we encourage people to eat well and lead healthy lives.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allotted for this Question has elapsed. We now come to the fourth Oral Question.
Folic Acid
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
I absolutely reassure both the noble Baroness and all noble Lords in the Chamber that there is absolutely no equivocation on behalf of the Government in this matter. It is a huge undertaking to put a substance in the food of the nation. It is therefore something that has to be endorsed by all the relevant bodies, including the four nations and other arm’s-length bodies. We have to ensure that we have all the public health sign off and the industry support that we need, and we need to take the public with us. There will be a moment when we need to sell this to the public, and they will have questions and we will need to have a dialogue. When that happens, I would like to have crossed all the “t”s and dotted all the “i”s so that we are in great shape. That is why we are being as thorough as we can. I reassure all noble Lords that there is no question of us going backwards on this.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed, and we now come to the second Oral Question.
Covid-19: Care Homes
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, I am extremely sympathetic to the noble Baroness’s point and conscious of her specific point that we could be in danger of over- reaching or in some way emotionally overcompensating for perceived mistakes in the past. We are conscious of that possibility, but I would like to reassure the noble Baroness that it is not the case. The decisions we have made on infection control and on visiting in care homes are tough—they are hard—but in recent weeks there have been outbreaks in care homes in London and Bolton in which vaccinated residents have caught the disease and had serious symptoms. That is something we are extremely wary of. When the vaccination has reached a higher proportion of the population and R is below 1, we will be in a position to change these policies. We will do so at pace and as quickly as we reasonably can, but until that moment arrives we have to take these tough decisions.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Covid-19: Vaccines and Pregnancy
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, the vaccine programme has worked extremely well across all the nations of the UK, and there is a huge amount of collaboration, particularly between the CMOs. Material is routinely shared between all the countries, and I am not aware of any differential outcomes in any particular part of the UK.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked.
Covid-19: Proof of Vaccination
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, I pay tribute to the England football team, who did extremely well; I am glad that my noble friend was able to attend. He is entirely right: this is an incredibly valuable resource. We have a very strong preventive agenda in our healthcare strategy. The vaccine has demonstrated how we can use modern medical technology to prevent the spread of disease, and it is by using thoughtful technology like this app that we can popularise and make useful a vaccine approach that could reach out to other diseases.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked and we now move to the next Question.
Carers: Support
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
The noble Baroness is undoubtedly right that carers have taken on a hugely bigger burden. More carers have been involved in looking after loved ones and families; those already working have worked longer hours; and the kinds of work they have done has been extended because some local authority provision has not been possible during the lockdown and the pandemic. I recognise that it is taking time to reopen many of those services, but I reassure the noble Baroness that we are working hard, we recognise the issue, and the issue of breaks in particular is one that concerns us. I will be glad to meet anyone she recommends.
The Lord Speaker (Lord McFall of Alcluith)
I call the noble Lord, Lord Pendry. No? In that case, I call the noble Lord, Lord Dodds of Duncairn.
Lord Bethell (Con)
My Lords, I cannot provide a direct answer to the noble Lord’s reasonably broad question, which illustrates the very wide range of care undertaken by Britain’s unpaid carers. As the noble Lord rightly says, some are working 24/7, almost without respite, in incredibly demanding and challenging circumstances, others are dropping in to see a neighbour for an hour or two a day, and there are many permutations in between. It is really important to have local provision so that there is tailor-made support by people who are close and in the community. I am afraid there are not the kind of blanket measures that the noble Lord seeks, which is why we work through charities and local authorities to provide the support that people need.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
NHS Digital: Primary Care Medical Records
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, I contest the premise of that question. I have not had a single complaint from anyone who has had the vaccine or been on any prioritisation list for the vaccine. Tens of millions of people have had it and they embrace the fact that their clinical data was used to roll out the vaccine. I accept the noble and gallant Lord’s point on explaining. We can do more to explain to the public. We want to engage the professions and the public in a story about how they can use their clinical data more emphatically. On the way in which the data is shared, it is already extremely tightly controlled. I would be glad to go through that with the noble and gallant Lord if that would be helpful.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Covid-19: Poverty
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
The noble Lord speaks movingly about this important issue and social mobility is itself a massive issue for the country. It does not fall directly within the remit of the Department of Health, but the NHS itself can be an enlightened employer in this respect. Many families have seen great advances in their personal development there, and I hope that it has a spirit of meritocracy and opportunity. I would be glad to write to the noble Lord to share with him the kinds of initiatives designed to increase social mobility that there are within the NHS.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked.
Covid-19: Variant B.1.617.2
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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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.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Heathrow Airport: Border Control Passenger Safety
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, I pay tribute to the officials, Heathrow and the carriers for the provisions that they have put in place for those who have exceptional needs for travel. It is a truth that many people travel for health needs, and many must travel in order to address difficult circumstances that they may have. Therefore, it is entirely right that we put in place a system of exemptions and support for those who are either elderly or have some form of disability. My noble friend is entirely right that it is an unfortunate consequence of the administrative burden of red and amber processing at our ports that there are serious delays, and they fall most heavily on the vulnerable.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Care Homes: Insurance Indemnity
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, I do not have the precise number at my fingertips, but I can reassure the noble Lord that the proportion that has gone under in the last year is not dramatically higher than in previous years. We monitor the situation extremely closely. I am aware of the concerns of noble Lords about the financial position of the social care industry and we are taking very careful measures to ensure that we are on top of the financial monitoring situation.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked and we now come to the second Oral Question.
Social Care: Person-centred Dementia Care
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 6 months ago)
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Lord Bethell (Con)
The noble Lord hits the nail on the head. Our entire response to the pandemic has taught us that early intervention and diagnostics are absolutely critical, and that is at the very centre of not only the NHS Long Term Plan but the departmental priorities for the years ahead. This can indeed make a huge difference to the treatment of and prognosis for those with dementia, Alzheimer’s and Parkinson’s, and we are very much focused on taking that forward.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked. We now move to the next Question.
Eating Disorder Services: Referrals
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, the eating habits of the nation have changed considerably in recent years. The amount of food that people eat that has been prepared by others has risen dramatically, and many people have no idea what is in the food they are eating. That is why we have moved to bring in calorie labelling on food that is delivered and in restaurants. I am acutely aware of the concerns of the noble Baronesses, Lady Parminter and Lady Bull. We are committed to engaging with eating disorder charities, Beat and other key stakeholders, and to listening very carefully to their concerns on this.
The Lord Speaker (Lord McFall of Alcluith)
My Lords, all supplementary questions have been asked.
Crohn’s Disease and Ulcerative Colitis
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 7 months ago)
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Lord Bethell (Con)
I completely sympathise with all those with IBD and associated conditions. The situation the noble Baroness described is exactly right and it is extremely challenging. I have particular concern for those shielding for a very long period, although I hope many of them will not be waiting long for their second vaccine. Those with all conditions have endured some waits because of Covid, but the NHS is working incredibly hard on the catch-up. Huge progress has already been made and there is a massive focus on diagnosis in particular, to ensure that we catch up with all those presenting with problems who need diagnoses.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Covid-19: Vaccinations
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 11 months ago)
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Lord Bethell (Con)
I completely understand the noble Lord’s impatience to know that. I am afraid that I cannot provide him with a precise date. One reason why is because we do not know the availability of the other vaccines. As he knows, the AstraZeneca vaccine, the Moderna vaccine and three others are all in the pipeline at the moment. If they get authorisation from the MHRA, that will completely change our deployment programme. At the moment, we are putting in place contingency measures for an uplift in our deployment should any of those be authorised; that will lead to a major growth in our deployment plans.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed. Oral Questions have now finished.
ONS: UK Life Expectancy
Debate between Lord Bethell and Lord McFall of Alcluith(3 years, 11 months ago)
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Lord Bethell (Con)
My Lords, I think that healthy living and life expectancy is a strategic marker. We are naturally focused on it and, in particular, the disparities between communities, which have been alluded to by a number of noble Lords. The huge gap between life expectancy in Blackpool and west London is extremely disturbing, and something that the Government are highly focused on. These are complex issues. They involve government policy—as the noble Baroness quite rightly points out—but also personal behaviours, and it will very much form part of the NHS plan going forward and the rebooting of the NHS in a post-Covid world.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Anti-obesity Strategies
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 2 months ago)
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Lord Bethell (Con)
My noble friend makes an incredibly thoughtful, practical point. Of course, it is easier to tell whether someone is abiding by their obesity commitments if you see them face to face. With regard to schools, I remind her about the hundreds of millions of pounds going into school exercise through the sugar tax payment. That is completely transforming exercise in schools and will have a profound effect over many generations.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Suicide
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 2 months ago)
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Lord Bethell (Con)
The noble Baroness is entirely right that self-harm is an alarming, distressing and rising phenomenon among young people. I welcome the report that she describes, and commit to having a good look at it, when it is published.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Covid-19: Local Restrictions
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 2 months ago)
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Lord Bethell (Con)
I apologise to the noble Baroness for disrupting the lives of local officials, but this disease is completely unpredictable. It is prevalent where we least expect it and it travels long distances very quickly. It is a fact of life—one that local authorities will have to get used to—that we cannot always predict where it is going to pop up and that fighting this epidemic is going to require fast action, which is why we have brought about the kinds of regulations that we will debate in this Chamber later this afternoon.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Folic Acid
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 2 months ago)
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Lord Bethell (Con)
The noble Baroness is entirely right to explain and expand on the wider benefits, but the benefits in respect of NTDs are extremely persuasive in themselves and the consultation focuses on them. I understand that it is an analysis of those benefits that will form the basis of our decision-making.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed.
Mental Health Services
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 6 months ago)
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Lord Bethell
One thing that Covid has thrown a light on is that digital communications have been greatly improved; the use of video conferencing in mental health services is one of the things that have helped. Groups that do not have access to video conferencing need to be reached in other ways. We are working on using telephones and community outreach to do that. My noble friend is entirely right that this needs to be a focus of our work.
Lord Ramsbotham
My Lords, does what the Minister has said apply to prisons and probation?
Lord Bethell
I pay tribute to the Prison Service, which in extremely difficult circumstances has managed to provide pastoral care and clinical segregation in our prisons in a way that has completely outperformed expectations. The effect in prisons has been profound and the mental health of prisoners is concerning. The degree of lockdown in prison cells is an awful aspect of this disease, and undoubtedly we will have to work very hard to manage and deal with the mental pressures on prisoners, which are extremely unfortunate.
The Senior Deputy Speaker
My Lords, the time allowed for this Question has elapsed. The Virtual Proceedings will now adjourn until a convenient point after 12.45 pm for the Motion in the name of the noble Baroness, Baroness Stedman-Scott. Proceedings in the Chamber will be taken at a convenient point after 12.30 pm.
Care Homes: Covid-19 Testing
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 6 months ago)
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Lord Bethell
The noble Lord gives powerful personal testimony. I cannot possibly argue with the details of his story, but I reassure him that the data I have is that the turnaround time for tests is, in the vast majority of cases, radically less than what he described. We are on course for hitting the target of 48 hours for a very large number of tests and 24 hours for a lot of tests.
The Senior Deputy Speaker (Lord McFall of Alcluith)
My Lords, the time allowed for this Question has elapsed. The Virtual Proceedings will now adjourn until a convenient point after 1 pm for the Motion in the name of Baroness Boycott. Proceedings in the Chamber will be taken at a convenient point after 12.30 pm.
Covid-19: Personal Protective Equipment
Debate between Lord Bethell and Lord McFall of Alcluith(4 years, 7 months ago)
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Lord Bethell
The noble Baroness raises a good point. I do not know the precise answer and would be glad to write to her with a clear answer.
The Senior Deputy Speaker (Lord McFall of Alcluith)
Lord Hannay of Chiswick. Lord Hannay? We will go on to the noble Baroness, Lady Ramsay of Cartvale.
Baroness Ramsay of Cartvale (Lab)
My Lords, I have been puzzled—not for the first time—on the PPE distribution question. The UK has always had a system and structure of deciding on priorities of threats to the security and well-being of the United Kingdom. Pandemics have been on that list and given very high priority for a number of years. If that system is functioning, as it normally does very well, how can we have this problem of production, procurement and distribution of PPE? Is it working as it used to? If not, is that because there has been a lack of resources into it in recent years?
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.
The Senior Deputy Speaker
My Lords, the time allowed for this Question has elapsed. The Virtual Proceedings will now adjourn until 1 pm for the debate in the name of the noble Baroness, Lady Wheeler.