General Medical Council: Internal Guidance

Lord Cormack Excerpts

Tuesday 17th October 2023 Lords Chamber

[Lord Markham (Con)]

I absolutely agree. That is why, as I say, we could not be firmer in saying we want to make sure it is very clear in the NHS Constitution that we are referring to women as women—that has to be the absolute primary descriptor—and men as men. We could not be clearer on that, and I am very happy to take that up across government as well.

[Lord Cormack (Con)]

My Lords—

[Lord Sandhurst (Con)]

My Lords—

[Baroness Williams of Trafford (Con)]

My Lords, my noble friends should come to a gentlemen’s agreement on who is going first.

[Lord Cormack (Con)]

My Lords—

[Lord Sandhurst (Con)]

My Lords—

[Noble Lords]

Oh!

[Lord Cormack (Con)]

I am most grateful. Would my noble friend on the Front Bench take the opportunity to pay tribute to the heroism—I use the word deliberately —of JK Rowling and those like her who have spoken out so passionately and so often? What the noble Baroness, Lady Hayter, said, we should all echo to the rafters.

[Lord Markham (Con)]

I completely agree. I believe that, more than anything in society, we have to be tolerant of people and their ability to have free speech and express their views freely. I think we have all seen circumstances where people feel intimidated in expressing what they feel is right, particularly in this circumstance of stating clearly when a woman is a woman and when a man is a man.

Folic Acid Fortification

Lord Cormack Excerpts

Tuesday 25th July 2023 Lords Chamber

[Lord Markham (Con)]

I first thank the noble Lord, Lord Rooker, for his tireless and passionate campaigning on this issue, which he is right to do. As I have learned, the situation is complex. We had 369 consultation responses, and more than 13,000 different SKU items—products containing flour—will be affected. We are not just talking about bread; pizza, lasagne, cakes and sauces are all affected, so you have to change the labelling of all those. We are trying to bring them all on board in a sensible manner, and to get this right quickly. We believe that a lot of people will voluntarily take this up much quicker. When you are talking about changing labels on the 22 billion items that are sold each year, you obviously need to look at how to do that practically and within a reasonable timeframe.

[Lord Cormack (Con)]

My Lords, my noble friend was right to acknowledge the indefatigable campaigning of the noble Lord, Lord Rooker, but will he please not rely upon these government phrases “shortly”, “in due course” and “soon”? Perhaps he could tell us which of those comes first. We feel that we are being fobbed off and that the delay is inordinate. He talked about early 2024, but will it really be early 2024? According to me, January is early 2024.

[Lord Markham (Con)]

I thank my noble friend, and I agree. I hate the words “in due course” because they mean “whenever”. While I freely admit to using words such as “soon” and “imminent”, “in due course” is not a term I use, and I understand the point being made. The consultation will be published late in the summer. It is a complex area, and I have said that I want to get personally involved now; I want to make sure that we get the balance right between the many competing interests. The legislation is planned for early 2024. All I can do on my side is to undertake to push that forward as much as possible.

Invasive Group A Streptococcus and Scarlet Fever

Lord Cormack Excerpts

Monday 5th December 2022 Lords Chamber

[Lord Markham (Con)]

All I can say on that is that, clearly, that is not acceptable and we need a situation where it can, and that is why we should have inspectors. If we are using 111 as a backbone service, as we are in this case, it is vital that people are getting proper advice. By the way, I see a lot of that, and it is something that I am personally involved in now, as well as using it digitally—a lot of these things can be done through the use of the apps and so on—but, clearly, we need to make sure the advice people get is sound.

[Lord Cormack (Con)]

If a parent has not had a response from 111 within an hour, should they not then ring 999?

[Lord Markham (Con)]

I would advise—and again this is personal advice—that, if they have not got a response and they are concerned about their child, it is probably better and quicker for them to drive, if they are able to. Clearly, if there is a 999 ambulance response because they cannot get to the hospital quickly, then that is a fallback, but if they are able to drive with their child and they are concerned in that way, my advice would always be to go for safety first in this. Again, as a parent of a four year-old and seeing the chatter on social media over the weekend, I know this is an area of concern. Clearly, we need to make sure that reassurance is there for everyone.

Coronavirus: New Cases

Lord Cormack Excerpts

Monday 11th July 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord will be aware of the different balances and trade-offs that the Government have to consider. At one stage, I think we spent £2 billion in a short period on testing, and a number of people in the health system said that surely that money would be better spent elsewhere, given the backlog due to lockdown. It is always a difficult trade-off on where you spend the money. At the moment, there are people who are still eligible for free tests: certain social and healthcare workers, and also people visiting and some carers. All this will continue to be monitored. Should the number of cases spiral out of control, clearly we would look to reintroduce free testing at some stage, should that be needed.

[Lord Cormack (Con)]

My Lords, Covid is clearly here to stay. As we will be into autumn within two months or thereabouts, what plans do Her Majesty’s Government have to give a dose of the vaccine to everyone in autumn along with the flu vaccine?

[Lord Kamall (Con)]

My noble friend raises a very important question. We are waiting for advice from the JCVI, coming later this week, on the autumn programme. There have been various reports, but we are waiting for confirmation of whether it will be the existing cohort of 75 and over, 70 and over, or whether it will be given to wider groups. That is being considered and will be announced later this week.

Bread and Flour Regulations: Folic Acid

Lord Cormack Excerpts

Wednesday 6th July 2022 Lords Chamber

[Lord Kamall (Con)]

The reason we have a consultation is so that we are aware of unforeseen circumstances and that, hopefully, we deal with unintended consequences before they occur. It is all very well saying that the science is settled; we have reached a level of consensus where both sides can agree, and that is what we are progressing from. Once it is implemented, we can start reviewing whether it should be a higher level and whether there are unintended consequences. The history of contestation in science goes back a long way; think of the heliocentrism versus geocentrism debate. People thought that the universe revolved around the earth, but Aristarchus of Samos, al-Battani, Islamic philosophers and others challenged that, and Copernicus proved that heliocentrism was right.

[Lord Cormack (Con)]

My Lords, will it take as long for my noble friend to come to this conclusion? If there were a Nobel prize for prevarication, he would win it.

[Lord Kamall (Con)]

I am not sure that I should thank my noble friend for that question. I really do not mind being heckled, as long as I am not being asked to resign, frankly.

Covid-19: Restrictions

Lord Cormack Excerpts

Monday 14th March 2022 Lords Chamber

[Lord Kamall (Con)]

We constantly have meetings with the UKHSA and a number of different scientists join us for the calls when we have them, but we have always balanced things up. I shall give an example of a conversation I was having just before Christmas with some of the modellers. I asked them “What is your advice?”, and they said “Minister, before we give you the advice, you have to bear in mind that we are only considering the variant at the moment. It is for you to consider the wider medical balancing issues, and also the economic and social costs as well, and we recognise that you have to balance all those up.”

[Lord Cormack (Con)]

My Lords, further to the question asked by the noble Lord, Lord Reid, and declaring a similar interest, I ask my noble friend not just to write to the noble Lord, Lord Reid, but to make a general announcement, so that we know when these fourth jabs will be administered.

[Lord Kamall (Con)]

I can see that that may well be a reasonable request, so why do I not discuss what is relevant and perhaps write to all noble Lords?

Covid-19: Lateral Flow Tests

Lord Cormack Excerpts

Thursday 10th February 2022 Lords Chamber

[Lord Kamall (Con)]

Clearly, the noble Baroness raises a number of important considerations for when we come up with a living with Covid strategy. At the moment, we are consulting on it to make sure that we have an appropriate strategy that covers many of the issues she referred to.

[Lord Cormack (Con)]

My Lords, am I right in thinking that my noble friend said that 25% of the testing kits are made in this country? Does it follow from that that the other 75% are made in China, or is there a wider field of manufacture?

[Lord Kamall (Con)]

As far as I am aware, they are from other countries; I do not know the exact figure for China. The suppliers that have been chosen have passed our protocol and meet the requirements of the procurement framework. It is really important that we have a rigorous standard, given that we found that many of the tests did not meet the instructions for use, as they claimed. We want a testing regime that is not only one of the best in the world but also very well trusted, especially if we are looking at using home testing for future diagnostics to identify more diseases and viruses, rather than waiting for people to go into hospital.

Vaccination: Condition of Deployment

Lord Cormack Excerpts

Thursday 3rd February 2022 Lords Chamber

[Lord Cormack (Con)]

My Lords, as my noble friend knows, I have advocated compulsory vaccination since the beginning of last year. I am very disappointed that this decision has been made. Can my noble friend assure me that there will not be another variant breaking out in a few weeks’ time that will be much more dangerous? Of course, he cannot. If he can, we will all be delighted. Would we think of suspending the requirement for a motorist to pass a test and have a licence before driving? A car is a lethal machine. Well, a worker who has this virus can be a lethal instrument within a hospital or care home. Can my noble friend at least give me an absolute assurance that this policy will be under constant review?

[Lord Kamall (Con)]

I thank my noble friend for his question and for his longer-term engagement with me on this issue. I assure him that we are keeping this under constant review. The evidence changes. We are aware that new variants will arise, as is natural with any virus. Given the replication factor, when the virus replicates, there will be some imperfect replications and so there will be variants. That is just part of the virus spreading. As my noble friend acknowledges, we cannot give an absolute guarantee that there will be no new variants, but we are keeping an eye on all the variants and their continued transmission, along with the tools that we are using to protect workers, staff and everyone, to make sure that we are continuing to protect people as best as possible.

Health and Care Bill

Lord Cormack Excerpts

Committee stage & Lords Hansard - Part 1
Tuesday 11th January 2022 Lords Chamber

Therefore, it is up to this Committee of the whole House to demand as much information about the Government’s intentions as we can get through the use of exploratory amendments over the next few weeks. The Minister can be assured that we will do so; I look forward to his response and having time to read the impact assessment.

[Lord Cormack (Con)]

My Lords, in the absence of the noble and learned Lord, Lord Judge, I take it upon myself to echo the trenchant observations of the noble Baroness, Lady Walmsley. What do the Government think Parliament is? What do they think it is for? Again and again, we have these Bills—skeleton Bills, Christmas tree Bills, call them what you like, but one thing is abundantly plain: Henry VIII is sitting firmly on his throne issuing his diktats.

This is no way for a democratic Government to treat Parliament, especially the elected House. However, if the elected House will not fully protect itself, we have a duty to speak up for it. There are many who, because of the circumstance of their election recently in Parliament, perhaps feel a bit diffident, but we have a duty not to be diffident. We in this House have a duty to say, “This is no way to treat Parliament”, because we are in effect creating executive departments with dictatorial powers. That is inimical to a parliamentary democracy. It is plain wrong. I do not know how often I shall intervene in the debate on this Bill, but what I do know is that I do not like what I see.

I have enormous and genuine respect for my noble friend the Minister. He has already, very rightly, earned himself a reputation in this House as somebody who is anxious to learn about parliamentary customs and practices, and to listen and reflect. I beg him, as I look at him now, to please talk to his colleagues in the other place who have greater power within the department and say to them that there is real concern in this House—I am delighted to see my noble friend Lady Cumberlege nodding at this point—which has within it many medical experts, such as my noble friend Lord Ribeiro, the noble Lord, Lord Winston, who does not seem to be here this afternoon, my noble friend Lord Kakkar and many others who know about medicine and how things should be organised and who do not see it as their prime purpose to help a Secretary of State hang his baubles on the Christmas tree.

We have a chance—we have done it before in other Bills—to try to improve on this skeleton, this Christmas tree, and to put Henry VIII back in his box, which is where he should be put. I hope that as this Bill goes through your Lordships’ House it will be probed, scrutinised and improved.

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

I start by thanking the noble Baroness, and indeed all noble Lords who have spoken thus far. I will make a general point in response to my noble friend Lord Cormack. I recognise that I am relatively new to this House and that I have much to learn. I hope to learn much, not only from noble Lords who have more experience of the procedures of this House and of holding the Government to account but from many noble Lords from across the House with medical expertise and management expertise in the health and social care sector.

I also thank the noble Baroness, Lady Thornton, for bringing this debate before the Committee. Amendment 1 would mean that we could not commence the change of legal name from the National Commissioning Board to NHS England until after an impact assessment for each of the clauses in Part 1 of the Bill is published, while Amendment 315 would mean that we could not commence Part 1 until after the publication of an impact assessment for each clause’s impact on the risks, costs and benefits to patients.

I hope I can reassure the noble Baroness that my department has published the impact assessments. She acknowledged this and I accept that they were not published in the most timely way. I will endeavour to do my best to make sure that we publish these assessments with as much notice as possible. They are available for noble Lords to review on GOV.UK. I am very happy for the noble Baroness to take credit for the first impact assessment. We will endeavour to do better. We will also commit to publishing further impact assessments for secondary legislation made under the powers contained in the Bill, where those regulations will have significant impact on the health and care system or private businesses, to provide transparency and clarity to the system.

The amendment would also delay the commencement of Part 1 until at least six months after commencement regulations were laid before your Lordships’ House. This would delay the implementation of the key provisions contained in Part 1.

The NHS put forward its recommendations for legislation in 2019. It is preparing, subject to parliamentary passage, to implement the ICB provisions of the Bill from July 2022. We know that ICBs in effect exist in many areas, in whatever form of development, and it is essential that we put these on a statutory footing as soon as possible. The development of ICBs builds on years of development work in local systems to improve partnership working. Delaying the implementation risks a loss of momentum in establishing statutory integrated care boards and the benefits that they are intended to deliver. For these reasons, I ask the noble Baroness to withdraw her amendment.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Lord Cormack Excerpts

Wednesday 15th December 2021 Lords Chamber

I agree.

[Lord Cormack (Con)]

If nobody else is going to get up, I will. My Lords, some of the things my noble friend said, I entirely agree with. There has been a very real degree of confusion. It is inexplicable to have a situation in which you are told not to go to your place of work, but do go to the office party. This confusion spreads like a cancer through a community—but we are here to debate something slightly different.

Yesterday in the other place, there was a massive majority in favour of the propositions before us. There is a very important constitutional issue here. This House is not the elected House. I believe fervently in it and have made that plain on innumerable occasions, and I believe that we have a real job to do, but when the elected House has given, by a massive majority, approval to certain orders dealing with the most important issue of the day, it would be ill advised for us to vote in a contrary direction.

While I admire my noble friend’s persistence—he certainly has not come new to this subject—I urge him, as the debate takes its course, to consider very carefully before he divides the House. There is clearly no doubt that there is a very real division in the Conservative Party, with the so-called libertarian wing. However, all these things have been oversimplified; the keynote of the debates has been hyperbole, which is not really very good for sensible parliamentary debating and democracy.

The fact that the Conservative Party is divided is common knowledge. I urge those who have not done so yet to read the main leader in today’s Times and a very penetrating article by our colleague, my noble friend Lord Finkelstein, also in the Times. I ask noble Lords please to read those articles and consider carefully what they say. We are at crisis point in this country when a large number, more than a hundred—99 voted and many abstained—of the governing party refuse to support the Government. That is a very serious matter.

However, an MP is an MP, no matter what constituency he or she sits for. Each Member of Parliament has a vote of equal value. Yesterday, as I said at the beginning, a massive majority of Members of the other place decided to support what the Government are proposing—a divided Government, yes, and the division in the Government is not caused, let us be honest, just by this subject. The appalling way in which the Owen Paterson affair was handled is indicative of a Government which have lost their grip.

My noble friend the former Chief Whip—he is an old friend—may be waving his hands at me; Chief Whips are important, but parliamentary democracy is even more important. I believe, as I said, that it would be ill advised for us to vote today against what the Government have proposed. We should not seek to contradict the other place but, with a degree of sadness perhaps, we should endorse it and certainly not divide the House.

[Baroness Walmsley (LD)]

My Lords, the Prime Minister has correctly pointed out that a “tidal wave” of the omicron Covid-19 virus is upon us. Yet the noble Lord, Lord Robathan, wants to do nothing. I do not agree with him. He wants to learn to live with the virus; most people do not want to have to learn to die with it.

There are three sets of regulations before us today. I will first deal with extending the mandatory wearing of face masks. We support it because face masks work. But who is monitoring or enforcing it? To give the Minister one example out of hundreds of thousands, on Monday one of my colleagues was travelling on an LNER train for two hours to come to your Lordships’ House—I must ask why we are here in person today—and only about 60% of the passengers were wearing masks and somebody behind her was coughing and spluttering for the whole two-hour journey. Nobody checked. This must be enforced.

The second set of regulations are on changing isolation rules for contacts of people testing positive. We support them but I have concerns about reported supply issues in self-administered lateral flow tests. People are just “strongly advised” to take tests for seven days after they have had contact. Will there be enough and will there be regular public information to remind people how important it is to take them? Will anyone check that they have done so?