NHS: Allocation of Financial Resources

Lord Campbell-Savours Excerpts

Thursday 11th May 2023 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

The noble Lord, Lord Campbell-Savours, is taking part remotely.

[Lord Campbell-Savours (Lab) [V]]

My Lords, is it not possible that the great British public just might be prepared to see a far greater proportion of their taxes diverted from ill-thought-out and often totally unnecessary tax concessions to the better off, which invariably fail any incentive testing anyhow, in favour of a properly funded National Health Service that slashes waiting times, properly funds health professionals and meets the health requirements of the British people? That is what the public want. Just ask them and look at the polling data.

[Lord Markham (Con)]

We are putting in record investment. Right now, we are spending about 12% of our GDP on health services; a few years ago, the figure was more like 7% or 8%, so there is record investment. I think the whole House would agree that how we use that investment is the most important thing. We have seen that certain hospitals have a 13% lower cost per patient treatment than others because of effective use of technology. That is where I want to see investment take place.

Streptococcus A: Antibiotics

Lord Campbell-Savours Excerpts

Thursday 15th December 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the noble Lord, Lord Campbell-Savours, is participating remotely.

[Lord Campbell-Savours (Lab) [V]]

My Lords, as someone on a six-day lockdown and on intermittent antibiotics to deal with a lung condition following surgery, can I suggest, on these shortages, that guidance on antibiotics such as amoxicillin should be updated to allow for greater flexibility of expiry dates? There is too much wastage, and with careful prescription advice and labelling, antibiotics can have a far longer shelf life before deteriorating. Rigid advice on packaging should be relaxed in favour of more flexible expiry dates, as current advice only serves the manufacturers, who sell more.

[Lord Markham (Con)]

I thank the noble Lord and I agree. We are looking at every sensible measure we can to ensure we have the greatest flexibility of supply. Expiry dates are clearly one thing we can look at, and I will take that back to the department. I wish the noble Lord well and hope that he feels better soon.

Health and Care Bill

Lord Campbell-Savours Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

[The Deputy Speaker (Lord Lexden) (Con)]

I now invite the noble Lord, Lord Campbell-Savours, who is taking part remotely, to speak.

[Lord Campbell-Savours (Lab) [V]]

My Lords, this is an important amendment. To me, it is the most important in the Bill. It concerns preservation of life in conditions of general pandemics. If you leave worldwide vaccine manufacturing programmes to the free market, you will never fully deliver. Profit will always trump the public good, unless the state intervenes in some regulatory form or another. This is basically why I am a Labour person.

With that in mind, it is clear that the more we are told that the current arrangements for licensing and manufacturing are necessary for reasons of quality control, the more I am convinced that this is not the only consideration in mind. There are other considerations—primarily the need to maximise profit. There is nothing wrong with profit if the justification is reasonable. It drives initiative and entrepreneurship. However, when there are wider issues involved, as in the case of a global pandemic which threatens the well-being of nations and the international economy, there must be a consideration of the wider public good and benefit. I am not convinced that, apart from the case of the AstraZeneca project, public benefit has been the driver.

In Committee, I set out in some detail a case wider than this amendment for worldwide licensing arrangements based on the original amendment of my noble friend Lady Chakrabarti. I remain confused by the Government’s position, which seems ever reliant on research and limited production at home, with volume production overseas. I would have thought that there are lessons to be learned about supply volatility from the case of oil from Russia. Equally, with both China and India leading the world in vaccine supply—at the same time as both countries remain reluctant to support us over certain areas of dispute and crisis in foreign policy—alarm bells should be ringing. I remain of the view that we in the United Kingdom should lead the world in this area of research, development, manufacturing, licensing and supply.

We are moving into an era of further pandemics as research-spawned accidental releases inevitably will reoccur, or perhaps they will not even be accidental in origin. There are huge foreign policy benefits to be gained arising out of being the world’s primary producer and licensee of these vaccines. When you help people, they remain indebted. That is the approach China is taking in many areas of its foreign policy.

I will give an example. The French Government funded my higher education in France 60 years ago. To this day, I remain indebted to France, with a lifetime feeling of obligation. This is often the case for foreign students. I believe that if we had been suppliers and licensees to the world over the recent period, in particular Africa and the third world, the payback would have been immeasurable, with huge implications for foreign policy.

I will exaggerate to make my case: suppose we had been supplier and licensee to China. Can noble Lords imagine what influence such beneficence would have had on Chinese public opinion and, perhaps ultimately, on Chinese foreign policy? A friend in need is a friend indeed—we should never forget that.

I appeal to the Government, even at this late stage in the current pandemic, to think long term, and create the vaccine supply, manufacturing and licensing programme that my noble friend Lady Chakrabarti is advocating. Her amendment seeks at least a temporary, time-agreed waiver. It is a start. I am using her amendment to argue a wider case, a new vision. Her excellent amendment puts in place a building block on which a longer-term strategy should be constructed. We should lead by helping others to help themselves. The rewards are inestimable.

[Lord Russell of Liverpool (CB)]

My Lords, I was happy to add my name to this amendment to give it a bit of cross-House balance. Like the noble Baroness, Lady Brinton, I am an officer of the all-party parliamentary group on coronavirus. In the last two years, we have had a bellyful of coronavirus; we have heard ad nauseum about the problems and the tragedies that it has created and encompassed, and that is partly what leads to this amendment.

It is self-evident that the United Kingdom, and most of the rest of the world, was unprepared. Countries that had experienced SARS, particularly in south-east Asia, had a better idea of what they were getting into. Frankly, however, for most of us in the West, it was the blind leading the blind. Looking in the mirror today—and accepting our failings, and the unease that we in the developed world should surely feel for largely having prioritised looking after our own—is for me, certainly, distinctly uncomfortable.

The aim of Amendment 174 is very simple: equitable access to affordable health technologies for all. One of the biggest challenges is how to deal with the exclusive intellectual property rights that exist in the healthcare sector. Only 7% of people in low-income countries have been double vaccinated. Only an additional 14% have had one dose.

Noble Lords should remember where the variants have come from. The exception, of course, is alpha, for which global Britain is responsible, so that is something that we can be proud of. Beta came from South Africa, gamma from Brazil, delta from India, and omicron is truly global because it started in about 10 countries simultaneously. The two countries that went it alone, rather proudly, in developing their own vaccines—China and Russia—have produced manifestly inferior vaccines, which have not been subject to proper, clinical peer scrutiny.

I give two examples of the problem we face. First, Pfizer’s new antiviral treatment excludes most Latin American countries, and generic versions—unless Pfizer does something about relaxing its intellectual property—may not be available in those countries until after 2041. Secondly, Tocilizumab, an antiviral manufactured by Roche, which is based on UK government-funded research, is unable to be manufactured in countries with established production capacity because Roche is enforcing its patents in these countries. There is a global shortage of this particular treatment.

Tackling the complex world of healthcare intellectual property is not easy. In my past career as a headhunter, I worked with clients that were large, complex, well-funded, international pharmaceutical companies, so I know full well the level of intellect and resource that they put into their intellectual property defences. We must apply ourselves in a disciplined and determined way at an international level; this is a chance for Great Britain to prove that it is indeed global. As an aside, during Oral Questions this morning, some of us on the Cross Benches were playing a game where, every time somebody from the Government Front Bench mentioned global Britain, another notional £10 clinked into the pockets of the Cross-Bench Christmas drinks fund; this afternoon, we had a particularly fruitful Oral Questions. As a mantra, it is meaningless unless it has real content behind it.

We need to develop a rapid response plan for the next pandemic. We will demonstrate that we have intellectual and moral myopia if we fail to do it. In a nod to Amendment 170, which we debated earlier, we should not show that we are content to let the less-developed world suffer from what I would describe as unassisted dying. That is unacceptable.

Health and Care Bill

Lord Campbell-Savours Excerpts

Lords Hansard - Part 1 & Committee stage
Wednesday 9th February 2022 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I am a former trustee of UNICEF UK and, before that, Christian Blind Mission, a global disability charity. I have seen first hand the two-tier system of access to global vaccines and medications. It is a pleasure to hear the noble Baroness, Lady Chakrabarti, set out how, through her Amendment 292, the UK can fulfil its global public health responsibilities for investment in research into vaccines and other health technologies and how, in an emergency, companies developing these goods would also be required to help. She has introduced it in her usual effective and persuasive way. I suspect I am not alone in valuing her contributions to your Lordships’ House.

Throughout this pandemic, the Government have rightly congratulated themselves on their investment in research on the range of vaccines developed in rapid time and also the extensive, rapid clinical trials assuring their safety prior to approval. However, less satisfactory has been the UK Government’s view about their international moral responsibilities as a member of the OECD and one of the high-income countries with access to much-respected vaccination and pharmaceutical research. The World Health Organization has said right from the start of the pandemic that no country is safe until all are safe, but low and middle-income countries have not just not had the advantage we have; we have reneged on our promises to them over the last two years.

The UK Government repeatedly tell us that they have donated cash to Gavi and COVAX, but the reality is that we need to help those countries now to become able to manufacture their own medicines and vaccines in the light of emergencies such as future pandemics. The old adage of “Give a child a fish, feed them for a day. Teach a child to fish, feed him for ever” is so true. Here, the fishing rod is the skills to manufacture and sell medications in a future pandemic.

The TRIPS waiver, or intellectual property waiver, is supported by the World Health Organization and many large charities and countries, including the USA and others. However, as we have heard, the EU, the UK and Switzerland are not in that bracket. Its intention is to increase vaccine production in developing countries by sharing intellectual property for vaccines publicly for the period of that pandemic. It is needed because the data for November 2021, nearly a year from the first vaccine being delivered, showed that just 4.2% of people in low-income countries had received their first Covid vaccine. Across Africa, 6.3% are now fully vaccinated. COVAX has shipped just one-third of what it had expected would be available by the end of October—those expectations were based on promises from high-income countries. Export bans, manufacturing delays and bets on vaccines that have not received regulatory approval have also held up deliveries. Worse, we know that in this country we have thrown away vaccines rather than redirect them if we chose not to use them at a particular time.

It is time that the UK took a leading role in fulfilling the World Health Organization’s call. Now is the time to make all countries safe, not just for Covid but in preparation for whatever future pandemics may occur, and make sure every country is safe in the future.

[Lord Campbell-Savours (Lab) [V]]

My Lords, I want to speak narrowly to subsection (5) of Amendment 292, where it refers to the waiving of intellectual property rights and the protection of undisclosed information, and also where it refers to the waiving of agreements, all in an effort to assist global manufacturing. It provides a peg for me on which to hang the holy question of inadequate vaccine supply arrangements for third-world countries and, in particular, the need for greater manufacturing capacity, which would be assisted under a system of global waivers.

Two weeks ago, there was an interesting contribution from the noble Lord, Lord Grimstone of Boscobel, where, in reply to my noble friend Lady Chakrabarti, he said,

“there is no evidence that waiving intellectual property protections would advance these objectives,”

those objectives being

“help with vaccine production and distribution.”—[Official Report, 24/1/22; col. 8.]

I simply do not understand the Minister’s logic. As I see it, it is perfectly possible to manage such manufacturing requirements under directly monitored, subcontracted, licensee production arrangements.

In the same exchange, my noble friend and I went on to call for the 100 potential manufacturers in Africa—indeed, my noble friend has done it again today—identified by a number of charitable organisations to be encouraged to produce a Covid vaccine in approved plants under the subcontracting arrangements I have referred to. The Minister in reply, quite rightly, appeared preoccupied by ensuring companies were able to continue with “innovation.” I totally agree on that. That is a laudable objective that we all support. However, what evidence is there to suggest that in an entrepreneurial world, production under the carefully constructed management arrangements I have suggested deters innovation?

My suggestion in my original contribution was that it is perfectly possible to produce a vaccine and its subsequent product variants in dedicated production areas in approved plants and specialist facilities under the quality control of personnel seconded from advanced-nation producers. That is what I am asking for in the questions I have been asking repeatedly. What is the problem? How can that possibly destroy innovation as Ministers are suggesting? On the contrary, it raises greater challenges. It is a spur to increased innovation and, additionally, profit-taking, which I recognise is an important factor in funding research and development.

With less than 10% of the population in the world’s poorest countries being vaccinated under current vaccination production arrangements, we are prolonging the pandemic by leaving the door open to new variants. New variants will inevitably appear in under-vaccinated populations or, more specifically, in under-vaccinated ethnic groups which, often through a lack of available, detailed knowledge and under peer pressure, remain unconvinced of the need for vaccination.

I simply cannot understand the commercial, political or moral logic behind a failure to sponsor vaccination production under the arrangements I have outlined. We in the UK could be leading the world through this crisis if my suggestion was followed. We have spent billions on support schemes, much of it, sadly, wasted and lost in fraud. We could have spent much of that on vaccine initiatives. I think we are missing a trick, but it is not too late, as these pandemics are here to stay in one form or another. I appeal to the Minister to free up the market and pursue the strategy that I, and others far more significant than I, have been suggesting in this debate.

Covid-19 Update

Lord Campbell-Savours Excerpts

Wednesday 10th November 2021 Lords Chamber

[Lord Campbell-Savours (Lab)]

My Lords, if, after Friday, without the knowledge of management as to vaccination, an unvaccinated person working in a care home knowingly or unknowingly transmits the virus to a care home resident, does not the act of transmission constitute a criminal act under a legal definition of assault? Would not an action, whether civil or criminal, be against the care home worker personally and not the care home itself, which would be an innocent party? This is an important issue and, if the Minister feels unable to answer me today, perhaps he could write to me.

--- Later in debate ---

[Lord Kamall (Con)]

Whenever I have visited hospitals during the lockdowns or restrictions, we have sought advice from the staff around us. We have asked what measures are appropriate and whether we should keep face coverings on at all times. There have been times when they have said that, in particular areas, you can take your mask off. I was not at the visit yesterday, as I am sure the noble Lord will acknowledge—in fact, I was here answering questions—so I cannot go into detail. However, having visited hospitals myself, I am aware that you go in wearing a mask by default, but there are times when staff say, “In this area, you can take it off”.

[Lord Campbell-Savours (Lab)]

Is not the answer to the question asked by my noble friend that the Prime Minister was acting irresponsibly and was wrong?

[Lord Kamall (Con)]

I am afraid that I was not there, so I do not know what advice he had been given at that moment by that particular trust. Noble Lords can do trial by TV as much as they like, but while you go in with a mask on by default, when you are there with workers from the NHS who are often giving advice, they may say at times, “In this part, it’s fine. You do not need to do that.” That may well have been the case, but I am afraid that I do not know the details.

Covid-19 Vaccinations

Lord Campbell-Savours Excerpts

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Lord for that question. I have been made aware of this by more than one noble Lord today. I contacted NHSX; it said that it is looking into it and trying to work on a fix as soon as possible. If the noble Lord is aware in a couple of days that that has not been fixed, I hope he will remind me so that I can prompt NHSX.

[Lord Campbell-Savours (Lab) [V]]

My Lords—[Inaudible]—very closely to the wise words of Gordon Brown on the need to distribute surplus vaccines internationally. Vaccine expiry is inexcusable. Gordon has made it his life’s work to defend, promote and support the interests of those in need. The third world is in need; if we fail to meet the challenge then not only it but we will lose out. I urge the Minister to listen to him and take this call back to the department for action.

[Lord Kamall (Con)]

I thank the noble Lord for that point. I think noble Lords agree that it is really important that we make sure that we vaccinate as much of the world as possible. There is no point in us being vaccinated if we then travel to areas in the rest of the world where people are exposed. We are co-operating on a number of international programmes, including COVAX and others. One of my portfolio roles in the department is on international agreements and liaison. I have been speaking to a number of Health Ministers from a number of different countries about how we can help more. I have also been talking to some of the suppliers of the vaccines about how we can make sure that, where we do not order domestically, we can redirect some of those orders for international help. I completely agree with the sentiment of the question from the noble Lord that it is really important that we play our part in helping the international community.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021

Lord Campbell-Savours Excerpts

Tuesday 20th July 2021 Lords Chamber

[Lord Campbell-Savours (Lab) [V]]

My Lords, I greatly welcome this debate and the tabling by my noble friend of her very relevant amendment. According to the Explanatory Note, the regulations provide that for,

“the purposes of preventing, detecting and controlling the spread of infection, registered persons … must secure that a person … does not enter the premises used by A unless B meets specific requirements”,

which are then set out. However, the list of requirements excludes the crucial requirement that is now the subject of a national debate: the wearing of masks. The regulations appear to put in place a non-statutory framework governing mask use, thereby relying on a voluntary approach under guidance notes. Guidance notes will not work. They will be widely ignored, perhaps even in care homes to some extent.

In anticipation of liberation day, there already has been widespread non-compliance in wider society. We are ignoring at our peril the experience of countries worldwide where the real benefit of mandatory masking under properly enforced regimes has been at the heart of policy, not only in care homes but in wider social interactions. Masking crucially helps to alert the public to the real dangers of the virus.

If, as I suspect, and for reasons that I understand, the Government remain torn, they should put the wider question of masking in its broader application to the House of Commons. Let MPs take that decision this week before the House rises. Let them face up to their responsibilities. They will have to listen to a divided public while arguing their case. The whole issue could then be decided on a free vote. It is not unprecedented. An informed decision on masking cannot be ducked and if the Government themselves are uneasy over the decision, Parliament, where I believe there is majority support, must take it.

Mandatory masking is absolutely crucial in the building of public confidence in the Government’s wider Covid relaxation strategy. I am convinced that the alternative is increased Covid hospitalisation as a more liberalised regime leads inevitably to disease spread, cancelled operations in the NHS, a lack of confidence in public protection leading to increased workplace absences, further damage to the high street with the possibility of renewed restrictions, public anger over government vacillation, further deterioration in the public finances and a prolonged epidemic.

The mask is a signal, an alarm bell and constant reminder. It acts as an amber light and is the only way in which one can signal to the public the danger of infection and the scale of personal risk—the risk from onward transmission to colleagues and friends, and the need to be constantly on the alert. The moment that one drops the requirement for a mask, the public will act defensively by withdrawing from public engagement, whether at the place of work or socially, or they will mistakenly conclude that the problem is past and life is returning to normal, which it is not. That is my fear.

Liberation day is potentially opening the door on a disaster and I cannot understand why those who oppose lockdown but who are calling for an early return to normality cannot support mandatory masking. It helps their case and would facilitate the early return for which they yearn. It secures a wider form of individual freedom. I say to the Government that they need to get real and take the lead. The public are looking to the Government to show the way. Either take a big decision to maintain masking or let the Commons take it on a free vote.

Do not get bogged down in misinterpretation of what constitutes liberty. Your liberty should not be at the cost of my liberty that dropping the guard in care homes will soon expose. If, as an individual citizen, I have to lock myself away and lose my freedom as a consequence of you securing your freedom, we then need arbitration. Care homes, offices, shops, public transport and, indeed, all public places are similarly at risk and threatened by this new approach. I plead with the Government, even at this late stage, for sanity in the policy that they are pursuing. Please do not make this grave mistake.

Covid-19 Update

Lord Campbell-Savours Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Bethell (Con)]

I am afraid we cannot have in place laws on the intimate practicalities of people’s lives for the long term. We do not have a law on sneezing. I would not think of sneezing in the presence of noble Lords, but I do not accept that I should be given a fine for doing so.

[Lord Campbell-Savours (Lab) [V]]

My Lords, following calls from the BMA, the RCM and Cambridge University Hospitals, can we have an assurance that in every setting where health workers are caring for patients with suspected or confirmed coronavirus, the health worker will be wearing at least a close-fitting FFP3 mask, thereby maximising personal protection? Can we be assured that the wearing of regular masks in such conditions will not be permitted? Mask specification is critical in healthcare settings.

[Lord Bethell (Con)]

My Lords, the noble Lord’s expertise on mask specification is well known in the Chamber and I bow to his greater knowledge on this. Of course, healthcare workers, social care workers and anyone exposed to those known to be carrying coronavirus should have entirely appropriate and significant protection. I do not know the precise mask numbers, but I would be glad to write to the noble Lord to confirm the current guidelines.

Covid-19 Update

Lord Campbell-Savours Excerpts

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am not aware of all the details of the latest Statement. It is my understanding that there is substance there; I gather that there will be change and I look forward to reading about that.

The noble Lord gives me an opportunity to reflect widely, and I hope he does not mind if I do so. There have been lots of uncomfortable inconsistencies and moments of disproportionality where noble Lords have rightly challenged the Government as to whether they have got every dotted “i” and crossed “t” absolutely right. The singing issue is probably the most graphic and certainly the most discussed example. I will personally be hugely relieved if we can move on from the current situation.

[Lord Campbell-Savours (Lab) [V]]

My Lords, is it not obvious that if you reduce mask wearing on public transport and in public places, those who believe they are more exposed to the virus will then reduce their use of public transport and avoid public places? People who are fearful of more liberated environments will avoid them, leading to a slowdown in the return to work that the Government want. Indeed, it is the reverse of what the Government want. Why remove those restrictions that offer the only way of securing public confidence in the new regime that is being proposed?

[Lord Bethell (Con)]

I applaud the noble Lord for his advocacy of mask wearing, but of course this issue cuts both ways. He is right that we need to build back trust in sharing space with one another, but I am not sure that mandatory mask wearing either builds trust or erodes it. If we give people the impression that wearing masks is somehow a panacea that protects everyone on a tube train or in a lift, that is a false impression. Masks are not a panacea. In fact, for some people, they can be a source of grave concern and be enough to send them back home to seek safety. I take the noble Lord’s point that we have to be clear about this, but I am not sure that mandatory mask wearing, or even ubiquitous mask wearing, is either a universal antidote to the spread of the disease or necessarily builds trust in the manner he describes.

Health Protection (Coronavirus, Restrictions) (Steps and Other Provisions) (England) (Amendment) (No. 2) Regulations 2021

Lord Campbell-Savours Excerpts

Wednesday 16th June 2021 Lords Chamber

[Lord Campbell-Savours (Lab) [V]]

My Lords, yesterday, in a perhaps intemperate intervention, I expressed frustration over the Government’s vaccine manufacturing strategy. However, the Minister’s response—characteristically frank and generous—left me both alarmed and even more concerned. The noble Lord, Lord Bethell, said that

“we make hardly any vaccine at all. It is not for us as a nation to manufacture the vaccine. Where we have contributed is, first, through the science—particularly the AstraZeneca vaccine—and, secondly, through global leadership.”—[Official Report, 15/6/21; col. 1785.]

I profoundly disagree with this strategy.

In February last year I challenged the policy on mask supply, and I now challenge the strategy on vaccine supply. I am using this SI as a peg on which to hang my case. WHO stats indicate vaccination rates of less than 5% across much of the globe. The world is becoming increasingly reliant on China, with its hugely expanding export programme, for vaccine supplies.

India, with a vaccination rate of perhaps 6%, is struggling to deal with its own Covid crisis. Covishield, under licence from AstraZeneca, Covaxin, under licence from Bharat Biotech, and potentially Sputnik are all needed to deal with the Indian crisis—there are a third of a million deaths already, and Indian vaccines are now subject to an indefinite export ban.

Therein lies the problem. Diverse vaccine ingredient supply arrangements cannot be relied on at a time when world demand is soaring. We need to ramp up our own ingredient and wider vaccine production capacity. The current vaccine shortages are an alarm call. A policy based on fortress Britain scouring the world in the future for precious ingredient supplies has huge implications for foreign policy, stability both at home and abroad, and the third world.

The answer is for the UK to change course and follow a more adventurous strategy. We should lead the world in vaccine supply with a manifold, substantial increase in full-spectrum-of-ingredients vaccine production capacity, here at home. We would win the respect of the world if we were to follow that course.

We need to listen to Gordon Brown when he stated last weekend:

“At least 11bn vaccine doses are needed to guarantee all countries the same levels of anti-Covid protection as the west. Without that … the disease will continue to spread, mutate”.


I hope we are all listening to those very wise words.