(4 years, 9 months ago)
Lords ChamberTo ask Her Majesty’s Government what facility they will make available as proof of vaccination for those wishing to travel who do not have a smart phone and access to the verification app.
My Lords, since May, individuals in England who have had two doses of an approved Covid-19 vaccine have been able to demonstrate their vaccine status for international travel. The services can be accessed through digital and non-digital routes, via the NHS app and the NHS website or by calling 111 to request a letter. The devolved Administrations are making available similar letters for use in travelling overseas. Over 63,000 people have requested a letter since the service was launched.
I am very grateful to the Minister for his positive answer. Can he tell the House exactly how long it takes to get a printed letter as opposed to downloading the app, and how this will relate to the new electronic travel authorisation, which hopefully will coincide with lifting restrictions on British travellers here and abroad?
My Lords, 57,000 people have received their letters so far. I am not aware of any delays. Those who wish to can use a pharmacy for the delivery of their letters. It is encouraging news and we have gone to considerable lengths to meet the suggestions of charities which we engaged with on the letters. They are available in different languages and in Braille.
(4 years, 10 months ago)
Lords ChamberMy Lords, the noble Lord is right: this is a 21st-century problem that we may well be living with for the rest of our lives. It is absolutely right that we look at the best and latest technology to try to mitigate risk and reduce the impact on the things that we love doing, including global travel. However, the image that he cited is a little far away at the moment, I am afraid: we are struggling to get accurate tests from a gob of spit, let alone from the air in an airport cabin. However, we are meeting with the firms who are investigating these kinds of technologies; that is done through the innovations and partnerships department of test and trace, and we are hopeful that those technologies will emerge.
My Lords, I draw attention to my interests in the register. It is very welcome that red-list passengers will now be separated, but, the longer the queues, the more likely the infection is to spread. It cannot be right to take 10 minutes per passenger to clear them through the system. Surely we can use the kind of evidence that is being used in other parts of the world, get our act together and, with the help of this excellent Minister and the noble Baroness, Lady Williams, put pressure on the Health Secretary and the Home Secretary to put even more resource in, and, above all, use technology and the experience in the rest of the world to get this right.
The noble Lord is entirely right: this is exactly what we have sought to do—namely, to front-end a huge amount of the administrative burden into the passenger landing form through the CMS computer system so that all the bookings, details and testing are pre-prepared before anyone arrives in the terminal. None the less, travel in the days of a pandemic is a complicated affair. Some people are trying to skip out on their responsibilities, and therefore there is an administrative burden. We hope to roll out e-gates for both the amber and red lists, once the red-list terminals are open. This will take a great pressure off the passenger point.
(5 years ago)
Lords ChamberMy Lords, I am very proud to follow my noble friend and to offer her the warmest possible welcome to this House. I congratulate her not only on an excellent maiden speech but on the ability to get so much into such a short period. The time constraint has not prevented her presenting a picture of what has happened and what must happen in a way that I would have been proud to have delivered myself. I warmly welcome what she said and I hope that she will forgive me—because she spelled out why—for remarking that this is one of those very rare occasions when I can say that I wish that someone was not on our Benches but was instead down the Corridor. But I am very pleased that she is here and that she will make a continuing contribution, as she has described, to Labour taking its full place once again as the Government of our country.
I am diffident about the short time I have available, because my noble friend Lady Thornton was well ahead of me in understanding the extent of the impact of the virus over 12 months ago. I pay tribute to her for that. I agree entirely about process and procedure, but I share the concerns of the noble Baroness, Lady Altmann, about where we are going. As she rightly said, we have those delivering to all of us both essential goods and equipment across the country on a daily basis, and by necessity coming in to deliver what otherwise would not be possible. I simply put this on the table: if the vaccine is safe and successful—I believe that it is—and if the upgraded PCR tests are to be as successful as I know they will be, we will need to find new ways of being able to open our economy, to trade again, to keep people in jobs and to ensure that the economy of the future is secured.
The doom and gloom merchants must be very careful in what they say and how they say it in the months ahead because, quite honestly, enforcement is one thing but compliance is another, and we need the people of this country to feel optimism and hope, because the world is going to have to live with this virus—but live with it safely—for a long time to come.
(5 years, 4 months ago)
Lords ChamberMy Lords, I was going to make an esoteric and wide-ranging speech on the relationship between the protocol, the MHRA and the European Medicines Agency and wow the gathered hundreds of online Peers in order to demonstrate my technical knowledge, but I have abandoned that in favour of saying something very brief on the relationship between these regulations and the Bill to which the Minister has already referred, and on today’s announcement about the purchase of the Pfizer BioNTech vaccine.
I genuinely congratulate the Minister—he must have had nightmares over the last eight months of Questions and Statements on PPE, test and trace, and everything else—on actually managing to find the time to be entirely on top of, and extremely impressive in, the process of taking through the somewhat delayed legislation on medical devices. I also congratulate him on his willingness to be flexible. It is easier to be flexible with one’s own side, but I actually am impressed that he, on behalf of the Government, has been able to respond so effectively to the superb campaign of the noble Baroness, Lady Cumberlege, in relation to the protections that we debated in Grand Committee. I know that my noble friend on the Front Bench has done a sterling job in supporting and working on that.
I want to test out this afternoon—in relation to what we are debating, because it is directly related to it, although it will be the subject of a Statement tomorrow—the extraordinary misunderstandings that appear to exist not just on the twittersphere, which you would expect because the very word “Twitter” brings that to mind, but in social media and the broadcast media as well. These relate to the relationship between the MHRA and the European Medicines Agency, and the relationship between what is possible now and what might change following the final conclusion of whatever deal is done at the end of the transition period in respect of our exit from the European Union at the end of December.
Perhaps the Minister—and this is a kind of run-out for tomorrow, seeing as there are so few of us gathered together—could confirm that the MHRA has powers, and has used them already when we were, and remain in the transition period, members of the European Union, in circumstances where it was appropriate to act swiftly when the European Medicines Agency was taking a longer period of time to come to a judgment on the efficacy of a particular procedure or vaccine. Regulation 137, I think, relates to this. Would it not be nice if we could join the German ambassador in welcoming international collaboration, rather than always having to believe that when we borrow someone else’s horse we should get commended for riding it in in front of the others? I am very supportive of what has been done; I believe that the MHRA has done its job thoroughly and efficaciously. It is excellent that we have been able to move quickly, not least because we might be able to transport the vaccine during December, before whatever chaos exists from 1 January. It is a great move forward; we should all celebrate it, but we should do so within the context of the reality of the situation, the knowledge of what existed already, the relationship of continuity after 1 January and the celebration of international collaboration to tackle the virus which, after all, is a pandemic.
(5 years, 4 months ago)
Grand CommitteeMy Lords, I unequivocally endorse the Minister’s words of appreciation of the work of everyone, at every level, who has maintained a degree of service that has avoided the use of the powers under Schedule 8. It is an unalloyed pleasure not to be giving the Minister a hard time, given that, as far as I can see and looking back in history, no other Minister in the Lords has taken more flak for the Government as a whole for so little reward. It is therefore a pleasure to be able to say that this is a very welcome move.
Noble Lords will remember, because they were either in the Chamber or, more likely, watching, the powerful speech made by the noble Baroness, Lady Grey-Thompson, back on 25 March, when the Minister was putting the Bill through this House. On both disability and mental health, she understandably warned of the danger to the rights of so many people from the measures that were felt at the time to be needed to ensure that functioning services could continue, albeit without the safeguards that all of us would wish. This afternoon we acknowledge that those safeguards are being put back in place—their erosion has not been needed—and, as the Minister said, that is due to so much hard work and ingenuity by so many people. I am sorry that the Welsh Administration feel that they still need the measures as a backstop. I hope that they will not, after their two-week lockdown, feel that they still need to be used.
I just ask the Minister in a friendly way whether he can identify—if not this afternoon, perhaps he can write to me—any service level agreement from the Treasury in relation to the £3 billion announced by the Chancellor of the Exchequer in respect of mental health services? While the withdrawal of the powers under Schedule 8 is entirely welcome, the capacity within the system before the Covid pandemic was under enormous strain, and that has obviously been made worse by the number of people who have experienced mental health and stress issues over the past nine months. Many more will experience these over the winter until we have the vaccine onstream and can get back to some sort of normality.
Capacity will remain a major question for all of us, and I hope that the Minister will be able to confirm that a proportion of the additional resource being allocated to getting the health service back onstream and undertaking the diagnostic and treatment requirements that have so often been delayed will also apply to the capacity of the mental health services. With that, I welcome the regulations very strongly.
(5 years, 4 months ago)
Grand CommitteeMy Lords, it is a pleasure to follow my noble and learned friend Lord Mackay of Clashfern in talking to my noble friend Lady Cumberlege’s important amendment. It is impossible to match the passion and forensic skill with which she introduced her amendment—no one can make the case better and I will not try—but I offer her my deepest support for what she is trying to achieve through it.
The review that my noble friend carried out is quite simply one of the most remarkable of its kind, detailing as it does the extraordinary harm done to patients, mostly women, because of an inadequate safety regime that was too lax on products coming into the market, not capable of fully monitoring the adverse effects of products while they were used in the health system, and unwilling to heed the voices of those crying out in agony because of the harm being done to them and their families.
The First Do No Harm report is full of arresting facts: the 11-year delay between the first statistically significant evidence of the links between hormone pregnancy tests and malformations in babies; the lack of clinical evaluation of the use of mesh—a supposedly inert and harmless device—in the treatment of pelvic organ prolapse in tens of thousands of people; and the 20,000 people exposed in utero to sodium valproate in the UK, around half of whom have been affected physically or mentally, often very severely. But its true power comes from the testimony of those women whose lives were turned upside down by the adverse effects of these tests, pelvic mesh, sodium valproate and other medical scandals.
It was a privilege to hear this testimony at first hand when I was a Minister in the department, and I pay tribute to those brave women who led delegations to bring their message of pain and sorrow, and of being patronised by those who claimed to care for them, to us. Marie Lyon, Kath Sansom, Emma Murphy, Janet Williams—women like them are the reason why Ministers, and ultimately the then Prime Minister, asked my noble friend to carry out her review. It is to tens of thousands of women like them and their families that we owe a duty to implement the findings of that review.
There are many excellent proposals in the report, and it is my sincere wish that my noble friend Lord Bethell and his colleagues at the department will implement its recommendations as soon as possible. However, one recommendation stands out: the proposal for a patient safety commissioner, which is the subject of the amendment. Having served in government, I know that there is often internal resistance when a review proposes a new arm’s-length body or something of that kind, so I will explain why I believe that this one is so important and why there is a strong precedent for a Conservative Government introducing one.
As my right honourable friend Jeremy Hunt said when he first launched the medicine and medical device safety review in February 2018, it is the responsibility of the Government to listen, hear and act with compassion, speed and proportionality when things are going wrong. As the exhaustive findings of my noble friend’s review show, this did not happen, time and again, over many decades—and it must.
Whose responsibility, then, should it be? I, like other noble Lords, have great confidence in the NHS, the MHRA, the DHSC and other bodies, but we must be honest that none of them has consistently lived up to the maxim propounded by the former Secretary of State. More importantly, too many patients have had negative experiences interacting with these organisations when they were seeking help, so confidence in their ability to act in patients’ interests is not robust.
As the review continued, it became clear to me, as it did to my noble friend Lady Cumberlege, that there was a need for an entirely independent body that could act as the patient’s friend on safety in the system, a gateway and a support mechanism where those who were not being listened to could go—if you like, a conscience for the system. This would benefit the health system too, providing aggregated access to new information on safety issues and a potential to spot emerging concerns. Nothing that currently exists could perform both these essential functions in a way that carries the support of patients.
These are precisely the roles that the patient safety commissioner is proposed to play. There are different ways it could be implemented, of course, but it must be independent of the department and the NHS, as other noble Lords have said, and it must be patient-facing in all it does. We already have examples of how this could and should work. Many noble Lords have referred to the excellent work of the Children’s Commissioner. I also point to the Victims’ Commissioner, a role fulfilled until recently with great expertise by my noble friend Lady Newlove, and the new independent office of the Domestic Abuse Commissioner. It is absolutely right that these new positions have come into being, and I am proud that it was a Conservative Government who created them.
So once again I throw my weight behind the proposals of my noble friend Lady Cumberlege. I am sure that my noble friend the Minister is highly sympathetic to this cause. For the sake of all those women—and the men and children who have also been harmed—I hope that we can work together to make it happen.
First, I declare a tangential interest in the sense that I am patron of the Society of Occupational Medicine and, together with the faculty, it obviously has a real interest in this area, as well as its broader remit. I apologise to the noble Baroness, Lady Cumberlege, and the Committee for not being in my place at the beginning of her incredibly powerful speech, and I endorse what people have said already about not only the speech but the incredible work and reflections in the report.
The history that the noble Lord, Lord Patel, gave us, indicates very clearly the challenges that have been faced in this area. I am the first Member to speak who, as a former Member of Parliament, had people at my surgery bewildered, frustrated and not in a position, as they were in America, to go down the litigious route to get any satisfaction. But, of course, down the road and down the line is, as the report of the noble Baroness, Lady Cumberlege, indicates, is too late. Having someone who can intervene to prevent misery, hurt and, for many, terrible trauma for life is really important.
When you have the noble and learned Lord, Lord Mackay, and a former Health Minister, the noble Lord, Lord O’Shaughnessy, on your side, you are on a winner, and I hope that the noble Lord, Lord Bethell, will be able to indicate that he is prepared to go back to what we used to call the Legislative Committee—difficult as that is, because there is enormous resistance in government, as the noble Lord, Lord O’Shaughnessy, will remember and my noble friend Lord Hunt will be painfully aware, to having substantial amendments to Bills and to conceding that measures were not thought of first within the department. But I hope that on this occasion it will be possible to do so.
Reference has been made to other commissioners, and I endorse what the noble Lord, Lord O’Shaughnessy, said about the noble Baroness, Lady Newlove, and the powerful work that she did. I respect her greatly, as I do Anne Longfield, the Children’s Commissioner. I say to my good friend and noble friend Lord Hunt that I like to think that some of us in the political arena played a bit of a part in getting the schools reopened as well as the commissioner, but she did a phenomenal independent job in that area. I hope that the commissioner recommended by the noble Baroness, Lady Cumberlege, would be able to do the same in this sometimes forgotten area.
I am not sure that she will thank me for this, but perhaps the noble Baroness will accept that there may be a connection with the Health and Safety Executive, because the research and testing facilities it has may have a relevance here, and some connection with the commissioner that she has recommended may be sensible. My noble friend Lord Hunt and I shared an interest in this when we were both at the Department for Work and Pensions and the HSE reported to us. We had a number of ideas which, because we had both moved on, did not come to fruition—but here we are, all those years later, with an opportunity to do something that would be of great benefit to many people—mainly, as the noble Lord, Lord O’Shaughnessy, said, women—who have suffered so grievously and did not need to.
The noble Baroness, Lady McIntosh of Pickering, has scratched from this group, so we move on to the noble Baroness, Lady Ritchie of Downpatrick.
(5 years, 5 months ago)
Grand CommitteeMy Lords, although I was the shadow Health Secretary for two years in the 1990s, I speak with some temerity because the three contributors that we have just heard have expertise on this issue that I do not. I rarely say that when I decide to speak in Committee or on the Floor of the House.
I want to make three points. One was made by my noble friend Lord Hunt but reinforces the points made by the noble Lords, Lord Lansley and Lord O’Shaughnessy. It is about innovation and the way in which the acceleration of known therapies—in this case, gene therapy—can make such a difference. My much-missed and much-loved friend, the late Baroness Jowell, pioneered the idea of rapid, speedy throughput of potential new therapies, including gene therapy, and ideas to fruition. As a Minister at the time, the noble Lord, Lord O’Shaughnessy, was extremely helpful and supportive. I will always be grateful to him for attending Tessa’s funeral and being really committed to seeing her ideas go forward. I am glad that he was able to contribute this afternoon. I hope that the Minister will bear in mind the reality of what happens to individuals in practice and not forget the continuing campaign and support of Tessa’s family, particularly her daughter and her son.
I want to touch on two tangential issues. One is the real problem we have with substituting for procedures that are withdrawn because overseas manufacturers decide that they will not sell to us, including how we can initiate alternatives within the research available to us. Eighteen months ago, I had a procedure on my hand. I was told by the consultant that this procedure avoided having to have surgery; your Lordships and those who are taking any notice of this debate will be aware that hands are rather critical to me in a whole range of ways, so it was a very attractive alternative. However, she told me that I was one of the last patients to benefit from it because it had been withdrawn by an American supplier.
The very opposite happened in my old constituency, where Swann-Morton, a mutual that has existed for more than 80 years, produces a large number of cutting-edge facilities, from old-fashioned scalpels to the most modern and up-to-date tools for doing the job. I want to know what we will be able to do post Brexit to protect the likes of Swann-Morton, which is a big employer in the locality—it is a mutual in every sense, including the decisions taken by the employees themselves —from being excluded from markets that they previously had obvious access to, which reduces their competitiveness and ability to proceed. They have also been hit by Covid, of course; the fewer the procedures undertaken through the NHS, the more this hits the budgets of those who rely on a continuing flow of orders.
I could not find another niche in this particular group of amendments to make my point, so I have used my ingenuity. I am grateful for not having been heckled.
My Lords, there is no need for me to speak at length because I agree with much of what has been said. It has been fascinating to listen to how people who were Secretary of State and Minister of Health change, once they are not in that position, in fighting for resources and more innovation to be brought into the NHS quicker. I commend that, but I wish it had happened when they were in charge. I say this tongue in cheek to tease them, of course.
I support the amendments in the names of the noble Lord, Lord Lansley, and Amendment 124 in the name of the noble Lord, Lord Hunt of Kings Heath. What they both said is correct: the NHS is very slow to bring in innovation. Also, when innovations are available that will benefit patients, trying to use them is very difficult as a clinician because they are sometimes quite unique and not routinely used.
I will give noble Lords an example. Standard radiotherapy is used for cancer treatment, but occasionally the cancer does not respond, so the radiotherapist and medical oncologist would on very rare occasions want to use what is known as CyberKnife—focused radiotherapy that deals with the tumour but does not damage the surrounding tissue. I am told that to do this would require a request to be sent through the NHS trust system to the CCGs to get their approval, but this treatment is usually required now—today—not in about three weeks’ time, because the patient is in the advanced stages of cancer.
This is just one example; there are lots of others. What the noble Lord, Lord Hunt, said at the end of his speech was right: while this debate is maybe not directly linked to regulatory issues in medicines and devices, a much wider debate needs to be had on whether we have evolved processes that are counterproductive to bringing in or even developing innovations, as the noble Lord, Lord Lansley, referred to on a previous group of amendments. I am slightly hesitant to say that.
The original concept of NICE was to have an opportunity to bring modern innovations rapidly into the NHS. Yes, there was another side to it: that it should be effective and not increase costs unnecessarily. I know this because I was associated with it at the time of its formulation. I took a different route; I did not continue to be involved with NICE, but I became chairman of a similar organisation that the Scots established, at the time called the Clinical Standards Board for Scotland. I deliberately separated bringing innovations into the clinical area from the area of medicines by having the Scottish Medicines Consortium be quite different. However, the concept was the same in England and Scotland. Unfortunately, we need to get back to finding how we can bring in modern innovations more quickly and how we can use our science and the NHS as the core to make more innovation. However, I commend what the noble Lords, Lord Lansley and Lord Hunt, had to say.
(5 years, 5 months ago)
Lords ChamberThe feedback from the Vaccine Taskforce is very promising. It has six contracts for vaccines on four different platforms. The Oxford vaccine is by far the front runner, but what is really encouraging is the substantial pipeline of other vaccines coming through. I am afraid I cannot commit to the timing on that, but all the news we have is extremely encouraging and we are putting deployment protocols in place to be able to deliver it as quickly as possible. I also flag that the therapeutic drugs and rapid testing also provide strong answers to the threat of coronavirus.
I have a similar declaration to the noble Lord, Lord Scriven, and agree with his comments on tests, where the 24-hour turnaround for tests has now dropped to 15% of the total. Perhaps the Minister could comment on the fact that, given the announcement this morning by the Chancellor, including the £2,000 retrospective contribution per month for those businesses not legally locked down and closed but which are being devastated by what is happening around them, it would have been perfectly reasonable to have reached a settlement with the Mayor of Greater Manchester, and it would be perfectly reasonable to expect the Sheffield City Region now to have its resource topped up from the £30 million that has been allocated to take account of that announcement this morning.
First, I am glad to say that we have struck a financial arrangement with the Mayor of Manchester, and one of the valuable points that I think the noble Lord is alluding to is that that agreement is fair to all the other regions where we have struck agreements. It is not possible to do more generous agreements with one region over another simply because of the hard bargaining of one mayor over another. I pay tribute to those in Sheffield and South Yorkshire for the way in which they have gone about their negotiations and the implementation of the new tiering system in South Yorkshire.
(5 years, 6 months ago)
Lords ChamberMy Lords, I shall do my best to adhere to the stricture about four minutes. I reiterate the accolades placed on the shoulders of the Minister on Friday; he has an impossible task.
On 24 March, I was surprised to find myself in agreement with the noble Lord, Lord Robathan, at Second Reading of the emergency Bill—it was probably as surprising to him as it was to me. For once in my life, I advocated caution and proportionality, and expressed concern not just about the nature of the emergency Bill but about the increasing use of the public health Act of 1984 to which the Minister referred. It is the two Acts together that I want in my short time to deal with, and the use by fiat and diktat of the 1984 Act—which was obviously intended to provide powers to tackle the pandemic and the control of diseases—without recourse to democratic accountability and the ability to hold the Government properly to account. It is not the individual measures that I want to deal with but the overall direction.
We need confidence, clarity and consistency. We are lacking in confidence, which is undermined almost daily, particularly by the broadcast media and some irresponsible people on social media. We have a total lack of clarity about exactly what works, when it works and how it should work, and we have been completely lacking in consistency.
On what the Minister said about the Act, it is commendable that more than 60,000 people were brought back into the health service and many reregistered, but we have a 30% shortfall in the use of capacity in the NHS, because following the decanting of people from beds and the clearing of facilities we have got nowhere near back to normal. As a consequence, diagnoses are delayed, treatment is deferred and people who should not be dying are dying of serious illnesses. Where are the 60,000-odd people to ensure that that can be dealt with, either through primary care or the reopening of wards?
These are crucial questions that need to be answered, but I have one final point to make to the Minister. Can we persuade the Government to reshape and refresh the scientific advisory group on the emergency? Many of them have done a fantastic job, but they are tired. They reinforce one another, and we have silly statements coming from some people who ought to know better about locking down the over-45s. It is time to let students get on with learning and to stop pretending that universities can provide both research and teaching without the money to do so. It is time to ensure that young people can get on with their lives. While the rest of us should take greater measures to protect ourselves, we as a nation need to ensure that we protect our democratic procedures, our legitimacy and consent within government. We have the power to ask the difficult questions that other people would rather not hear.
(5 years, 6 months ago)
Lords ChamberMy Lords, in my two minutes, I want to make it clear that I support carefully targeted local action that is democratically agreed with local authorities and mayors where appropriate, ensuring that we evaluate and monitor how that is working and learn the lessons. Perhaps the Minister would indicate in his response what lessons have been learned from looking at areas that are very close to each other, such as Oldham and Bolton, and the different outcomes from very similar lockdown measures, so that we can target more clearly what needs to be done and learn when it is not working.
Can we also ensure not only that the democratic process works speedily, in the way described by the noble Lord since the beginning of August, but that we sometimes address the elephant in the room? Infection rates rose during August and by the end of the month hospital admissions had started to rise. Was there any correlation with Eat Out to Help Out, which economically was incredibly successful but might have contributed to where we are today?
Will the noble Lord use his power and that of the Government to try to damp down the hype, speculation and fear that keep on emerging? Today it is universities and the fear that students might not be able to go home for Christmas—as though semesters do not end in time for people, if necessary, to be properly tested and allowed to go home. We are seeing hype, including from responsible outlets such as the BBC which ought to know better, which can have an impact on postgraduate taught courses and research qualifications that people have not yet fully taken up as they come into the country, perhaps from across the world.
In other words, can the Minister say how we are learning the lessons since 24 March? I never thought that I would say this in the House, but I agree with Graham Brady, the chairman of the 1922 Committee, that we need to ensure that democracy works in advance of, and not just after, measures have been taken.