Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021

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Tuesday 14th December 2021

(2 years, 11 months ago)

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Lord Rooker Portrait Lord Rooker (Lab)
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My Lords, I did not intend to contribute, but I just want to thank the noble Baroness, Lady Noakes, for that speech. I shall get Hansard tomorrow, make my little checklist and wait for what is coming from the other place—the borders Bill; the human rights Bill; the electoral reform Bill—and I will check off her claims about parliamentary scrutiny and believing in the House to see how sincere that speech really was.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, I would not doubt for half a second that my noble friend was entirely sincere. I also believe that she made some extremely powerful points which apply right across the legislative pattern, and which apply equally to both Houses. I hate to say this of a Conservative Government, but they behave as if they treat Parliament with contempt. Whether one is talking about Christmas tree Bills, Henry VIII clauses or the lack of impact assessments—a point made so very powerfully by my noble friend—the Government are found wanting. If we were marking in Greek letters the performance of the Government, I would, as an old schoolmaster, give them “gamma double-minus.”

It really is sad that we have a Government who are treating Parliament in this manner. I sincerely hope that, when he comes to reply, my noble friend the Minister will give a firm undertaking to draw the attention of his parliamentary masters in government to this debate and to the speech of the noble Baroness, Lady Noakes, in particular. They should read, mark, learn and inwardly digest it—to quote the collect for the second Sunday in Advent.

When it comes to the substance, I always deplore anything that smacks of retrospective legislation, because that again is treating Parliament with studied contempt. I know how difficult it has been during these last 18 months or more. We all know that—and we all know that mistakes have been made, sometimes with the very best of intentions. But it is deeply disturbing that there has not been a recognition that retrospective legislation is the very antithesis of democratic parliamentary government.

I have suggested many times, including very recently, that there should be a continuing committee of both Houses looking at Covid legislation and being able to pronounce on it quickly. I made this point only recently to my noble friend. He completely, I am afraid, misunderstood it and told me quite inaccurately that this was a matter for the Lord Speaker—but anybody who knows what the Lord Speaker is able to do and not able to do knows that that is fundamentally wrong.

I know that he is new to Parliament and is serving his apprenticeship with great distinction—we all appreciate that—but it is important that the powers that be realise that in an unprecedented situation unprecedented measures are sometimes needed. They have shown that by issuing diktats; they have not shown it by creating a vehicle for continuous parliamentary monitoring—and they should.

On the subject of compulsory vaccination, my noble friend Lord Bethell knows very well that I have been on about this almost from the very beginning, urging that care home workers should receive compulsory vaccination, and I believe that it is entirely logical to extend that to those who work, because people who come into close proximity to patients at their most fragile and their most vulnerable should not themselves be a potential risk to those patients. We know that in some care homes during the early months—I appreciate that it is much better now—you could find that 30%, 40% or even 50% of care home workers, looking after the most fragile and physically feeble of people, themselves not vaccinated.

How do you solve this? It is, of course, a combination of persuasion and cajoling, but at the end there has to be a point where you say that we cannot allow this to continue indefinitely. Therefore, I think on that point the Government are right and I am grateful for it.

However, we are a Parliament and therefore I come back, as I began, to the admirable speech from my noble friend Lady Noakes. She pointed out—as many others have over the past two or three years, particularly the noble and learned Lord, Lord Judge, who I think must go to bed with an image of Henry VIII by his bedside—how cavalier has been the treatment of both Houses of Parliament by the Government. We are approaching a new year. Let it be a resolution of the Prime Minister and all his Ministers that they are accountable to Parliament; they are not the masters of Parliament.

Baroness Tyler of Enfield Portrait Baroness Tyler of Enfield (LD)
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My Lords, I wish to make some comments about the actual substance of this statutory instrument, although I will start by saying that I have a lot of sympathy with what has already been said about the lack of proper parliamentary scrutiny and indeed the lack of an impact assessment, which is extremely regrettable.

As I have said in your Lordships’ House before, I am very sympathetic to the overall principle that both front-line health and care workers should be vaccinated. However, as I have always said, it must be handled in the right way, particularly given the absolutely acute pressures that both health and social care are under and will be over the winter months. It is absolutely critical that the right amount of help and support is made available to health and care workers who are genuinely vaccine hesitant—and that means things such as one-to-one conversations during work time in which they can express what their concerns are and, I hope, get additional information.

I know very well from personal experience that care homes that, for example, have brought GPs in to have one-to-one conversations, taken the concerns that care workers have expressed seriously and tried to explain why it would be a good idea to have the vaccine, have had an awful lot of success, and I am concerned that there is not enough focus at the moment on that help and support. It was very regrettable—this point was raised by the Secondary Legislation Scrutiny Committee —that the draft Explanatory Memorandum made no reference to any lessons learned from the rollout of the earlier care home regulations, as well as being silent on what contingency plans the department had to cope with the expected staff losses when the regulations take effect. I know that those staffing issues will be particularly acute in London, where I live.

I recently had a helpful meeting with Healthwatch, which shared with me some very good research. It commissioned an organisation called Traverse to undertake in-depth conversations with a range of people, mainly of African, Bangladeshi, Caribbean and Pakistani ethnicity, to understand the reasons for their vaccine hesitancy and what can be done about it. Although the research was carried out with the groups I have specified, I suspect that the conclusions drawn in the report have more widespread application.

I found it interesting that the attitudes expressed were incredibly personal to the individual. One of the lessons learned is that you cannot lump all this together and say, “This is the issue for this group”; you have to think very carefully about individual concerns. There was most clearly, as we know, a lack of trust, which featured strongly in terms of the vaccine, and there was very strong distrust of those who had any possibility of standing to gain commercially from the rollout, which I thought was an important point. Probably most notable of all, people said that they trusted most of all front-line healthcare workers to talk about Covid and the vaccine and had less trust in very senior people in the NHS or Public Health England, who were perceived to have less tangible experience. That interesting document ends with very seven practical tips: ways to try to encourage health and social care workers to become less vaccine hesitant.

I end by asking the Minister whether he is aware of this document—if he is not, I am very happy to send it to him—but, more generally, what steps the Government and NHS England have taken to promulgate this sort of important and practical good practice and advice?

Covid-19: PCR and Lateral Flow Test Providers

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Monday 13th December 2021

(2 years, 11 months ago)

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Lord Kamall Portrait Lord Kamall (Con)
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I suggest that if the noble Lord would like to take a PCR test before he travels, he goes through a number of price comparison websites and chooses the one he feels is more suitable for him.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, there are rumours circulating—more than rumours, I think—that we are running out of testing kits. Is that true? Can my noble friend give us some reassurance on that front?

Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021

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Wednesday 1st December 2021

(2 years, 11 months ago)

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Baroness Tyler of Enfield Portrait Baroness Tyler of Enfield (LD)
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My Lords, I would like to make a few comments about the mask-wearing regulations, which I strongly support while feeling that wearing masks should never have been abandoned in England. It is with great sadness that I have to tell the noble Lord, Lord Robathan, that at exactly this time last year I attended the funeral of a friend of mine, the exact same age as me, who died from Covid. I wonder what the families of the over 1,000 people dying from Covid each week would think if they were listening to our debate now.

The questions I would like to ask the Minister are primarily about compliance and enforcement. When I got on the Tube yesterday, it was clear to me that the message had not got across to quite a few people. I was concerned that there was no one standing at the Tube station to point out to people that it was now a legal requirement and that there were no notices making it clear that that was so, rather than a condition of passage. Those things are different. Can the Minister please explain the responsibilities for enforcement, particularly on public transport, as between, for example, Transport for London staff and the police or transport police?

It is going to be hard to get the messaging back on track after people have been told that they did not need to wear masks; now they are being told they need to again. There is a good reason for it but the bit I have not heard so far in the debate today is that mask-wearing is primarily about protecting other people. Yes, I believe scientific evidence says that it confers a degree of protection on the wearer but it is primarily about protecting others—and we do not know the medical vulnerabilities and risks of the people we sit next to, be it in this Chamber or on public transport. That is the main reason I feel mask-wearing should never have been abandoned.

I also want to ask the Minister about people who genuinely have medical exemptions. Clearly, there are people who do. Yesterday on the Tube, I was standing next to a lady who was wearing a green lanyard and a badge; personally, I found that very helpful. She was making it clear that she was exempt. To help with the compliance issue at the moment, what plans might the Government have to encourage people who are genuinely medically exempt to have badges, lanyards or exemption cards, or something like that? However, it was clear to me that a number of people not wearing masks on the Tube, yesterday and today, were certainly not genuinely exempt.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, I will intervene briefly. I do not like retrospective legislation, and even though these regulations have been introduced much more quickly than some previous ones, we should have brought them in a couple of days ago. Parliament should approve regulations before they are issued. I do not take exactly the same line as my noble friend Lady Altmann, although I generally find myself in great sympathy and agreement with her, because I think we are all tackling the unknown. Nobody knows just how severe this new variant is or how effective the vaccines—I am triple-jabbed—will be. We must bear that in mind.

I make a suggestion which I made a year or more ago, which I think has some merit. Your Lordships’ House and the other place have found our agenda dominated to a large degree by Covid and the various regulations that have been brought in to try to deal with it. I suggested then, and repeat now, that we must accept that we will be living with Covid for a very long time. I have accepted it by coming to your Lordships’ House in person almost throughout the whole pandemic, partly because I hate dealing with Zoom and Microsoft Teams, but also because I like the human contact here. I also believe that, if we are Members, we have a certain duty to be here.

It would help enormously if we could have a Joint Committee of both Houses sitting in almost continuous session, where we could discuss proposals, assess evidence and not disrupt the ordinary and important business of the House. There is a parallel, in a way, with how waiting lists have been added to in the National Health Service and people have been put under enormous strain because of Covid. We would be well advised to try to have continuous parliamentary supervision and monitoring of what the Government propose in the light of all developments. I put that suggestion forward once again.

I have another specific question which I would be grateful if my noble friend would answer. I was contacted a few days ago by someone living in south-west London who is unable to have a vaccine for medical reasons. There are such people. He went to inquire of his general practitioner about the medicine that is now being developed—I am terribly sorry; I am having a senior moment and its name escapes me as I stand before your Lordships. My noble friend referred to it and will know what I am talking about. The general practitioner in question had no knowledge of it, or of where my friend could get it.

I would like an assurance from my noble friend that there is a proper dissemination of information so that doctors who are approached by those who cannot have the vaccine for genuine medical reasons can be informed. I mean genuine medical reasons, as I was one of those, as the noble Baroness, Lady Thornton, knows, who called time and again for compulsory vaccination of those working in care homes. She is kindly nodding approval. I felt the same about those working in the National Health Service. Those who are in contact with the most vulnerable should be obliged to have protection.

Covid-19

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Monday 15th November 2021

(3 years ago)

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Lord Kamall Portrait Lord Kamall (Con)
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The noble Lord’s first point repeats what other noble Lords have said, but for a good reason. I hope that our mentioning this more than once this evening stresses to the NHS and NHSX that it must be sorted out as soon as possible. As I said, I had hoped to have a date to announce this evening, and I am as frustrated as everyone else. We all want to travel and, importantly, there are countries that require proof of the booster.

In terms of children travelling, a solution has been developed to allow fully vaccinated children aged 12 and over to demonstrate their vaccination status. Up to now, some countries have required no proof from children aged 12 and over, but I am being told that a solution is being developed. I will try to push for that date as well, but I definitely want to get a date for when the booster will appear on the NHS app. All I can do is apologise that we have not done this yet.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, as we are clearly going to have to live with this vaccine for several years to come, could we have quite soon a programme for annual jabs worked out? It is clear that that is going to be necessary, and we ought to advance-plan. On the subject of masks: where one is in close proximity with others, they really should be obligatory. I came up on the train this morning, and at least half the people in the carriage were not wearing them. I am on my own on these Benches tonight, but I always wear one when others are around me, and I think that it is very important indeed that we take this elementary step so that it is compulsory on public transport, in shops and other places where people are in close proximity.

Lord Kamall Portrait Lord Kamall (Con)
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On future vaccinations, my noble friend raises an important point, and many will have seen in the media and elsewhere all the discussion about living with this vaccine. At the moment, we have boosters at six months; as the technology and the understanding get better, it seems likely that we will move to annual vaccinations, as we do flu jabs. I cannot say that for definite, but the trend is going that way, given the development of the virus, the variants and the waning immunity over time. The effectiveness of each vaccine at the moment is six months, but one can see the longer term. However, please do not take that as a given—if that is incorrect, I will update the House.

On public transport: I went to a funeral today, and as I was travelling back on the underground, it said, quite clearly, that you must wear a mask, so that is being encouraged. It is part of plan B if we have to move to plan B, but all that data is being analysed and constantly updated with different factors. There is no one trigger for moving to plan B. In previous appearances at the Dispatch Box, I have read out the list of all the factors that are considered. At the moment, the main message is: the vaccine works. We want to encourage people to get the vaccine and especially try to reach those communities that have not even had their first or second vaccine yet.

Public Health England (Dissolution) (Consequential Amendments) Regulations 2021

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Tuesday 9th November 2021

(3 years ago)

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Lord Howarth of Newport Portrait Lord Howarth of Newport (Lab) [V]
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My Lords, I want to take the opportunity of this debate, arising from the dissolution of Public Health England, to pay tribute to PHE and its chief executive, Duncan Selbie. I also want to ask the Minister to tell us more about the Government’s intentions regarding public health, a matter that certainly deserves consultation, as my noble friend Lady Merron has insisted, and more than the perfunctory scrutiny—or non-scrutiny—normally given to a statutory instrument.

With other parliamentary colleagues—including a good number from your Lordships’ House—in the All-Party Parliamentary Group on Arts, Health and Wellbeing, I worked for some years with Mr Selbie and others in his team at PHE. At a time when the Department of Health, NHS England and clinical orthodoxy were far from recognising the significance of the well-being agenda, social prescribing and the potential of the arts to support health and well-being, PHE was positive and far-sighted. During the three-year period of the inquiry which led to the publication of the APPG’s report, Creative Health, in 2017, PHE worked constructively and thoughtfully with us.

The three key messages in Creative Health, underpinned by evidence, were that the arts can help keep us well, aid our recovery and support longer lives better lived; help to meet major challenges facing health and social care, including ageing, long-term conditions, loneliness and mental health; and help to save money in the health service and social care. Duncan was one of a number of distinguished people, including Professor Sir Michael Marmot, who publicly endorsed the findings of Creative Health. He said:

“This is an impressive collection of evidence and practice for culture and health”.


The publication of Creative Health was, I think it is fair to say, a turning point in the recognition by the health establishment of the importance of social prescribing and the engagement of individual creativity in promoting health and well-being.

In a speech at the King’s Fund in November 2018, the then Health Secretary, the right honourable Matt Hancock, explicitly acknowledging the significance of the Creative Health report, said that from now on prevention must be fundamental to NHS strategy and social prescribing must be fundamental to prevention. He stressed the value of the arts and culture in social prescribing, and the NHS Long Term Plan of 2019 reaffirmed the centrality of prevention. Mr Hancock established the National Academy for Social Prescribing later in 2019.

Much has happened since then. While I can well understand that the new Secretary of State is preoccupied with Covid-19, the clinical backlog that Covid has so much worsened and the pressures on the NHS workforce, I would ask the Minister to reaffirm that the Government’s commitment to their prevention strategy is not diminished and that they continue to recognise the importance of personalised health and of the arts and culture in contributing to health and well-being.

I hope the Minister will also pay tribute to Duncan Selbie and PHE. When it was announced that PHE was to be abolished, I was shocked. It was hard not to believe that PHE institutionally and Duncan Selbie personally were being scapegoated for the Government’s own failures in the early stages of the pandemic. Of course, I wish the successor institutions well and look forward to working with them through the APPG and the National Centre for Creative Health. It is a shame, however, that Mr Selbie was cast aside.

I am concerned that the “build back better” plan envisages shifting the NHS towards prevention only as a long-term priority. However, integrated care systems surely offer an early opportunity for the NHS to work better with local authorities and the voluntary and community sector, including arts providers, on prevention. Will the Office for Health Improvement and Disparities be working with other government departments responsible for education, housing and employment in addressing the social determinants of health?

I hope we can be reassured this evening that the Government recognise their error in having reduced the public health grant by no less than 24% per head over the last six years, with terribly damaging consequences, and that the restructuring that has now occurred is intended to provide more, rather than less, support for public health.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, it is a very great pleasure to follow my friend, the noble Lord, Lord Howarth of Newport. I very much look forward to the day when he will be able to rejoin us here on the Floor of the House. He has made an immense contribution during his parliamentary life, both in the other place and here, and I associate myself with and endorse all his comments about the arts and health. But I wanted to make another, more parliamentary point.

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Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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My Lords, I thank the noble Baroness for securing this important debate on secondary legislation in relation to the Government’s public health reforms, and also for this opportunity to explain why they were made, and the context.

Since the outbreak of the coronavirus pandemic, the country has faced its greatest health and economic challenge for decades. The pandemic has highlighted the immense economic, societal and personal costs that ill health can bring, particularly to the most vulnerable. It has also identified weaknesses in our public health system. That is why, in August 2020, the Secretary of State for Health and Social Care announced the Government’s intention to reform the public health system in England. Since that announcement, we have worked to transform our national health protection capabilities to put prevention of ill health and the tackling of health inequalities at the heart of government and to more deeply embed prevention and health improvement expertise across local and national government and the National Health Service. These reforms are driven by lessons learned from the pandemic and by the need to make sure that we have a public health system fit for the future.

From 1 October this year, a new public health landscape was established, and Public Health England was closed. The health protection capabilities of Public Health England, the at-scale operational capacity of NHS Test and Trace, and the analytical capability of the Joint Biosecurity Centre have been brought together into the new UK Health Security Agency to lead the response to Covid so that we now have an organisation dedicated solely to identifying, preventing and managing threats to health. As some noble Lords have acknowledged, the new Office for Health Improvement and Disparities has been created in the Department of Health and Social Care, and the OHID will help our health system to go further in promoting good health and tackling the top preventable risk factors for poor health and disparities.

One noble Lord raised the issue of prevention and cure. One of the conversations I have had with many health experts in my short time in this job has been about how we make sure that we save more money and lives and achieve better health by focusing on prevention rather than, necessarily, cure. I know that noble Lords will remember the debate we had the other day on obesity and what is being done by the OHID there. Now, working with a new cross-government Cabinet committee for health promotion, we will drive and support the whole of government to go further in improving health and tackling health disparities. Alongside this, we have strengthened NHS England’s focus on prevention and population health, transferring to it important national capabilities that will help drive and support improved health as a priority for the whole NHS. Important national disease registries have also moved to NHS Digital.

On the recently laid secondary legislation and the question of ensuring that there is consultation and scrutiny, the amendments themselves do not give effect to the establishment of the UK Health Security Agency, or OHID, or the dissolution of PHE. Public Health England and the UK Health Security Agency are executive agencies of the Department of Health and Social Care, and NHS Test and Trace was part of the department. The restructuring of public health functions in England was therefore an administrative process. The regulations in question were made and laid in accordance with the negative resolution procedure. They make minor consequential amendments to existing legislation, to ensure that the statute book accurately reflects the administrative changes that have taken place. They are not the vehicle for implementing the substance of our public health reforms. There will be further regulations containing references to Public Health England, which need to be updated. I assure noble Lords that they will be amended in accordance with the affirmative resolution procedure and will be debated in Parliament.

I turn now to some of the individual points made. On engagement with stakeholders, since the reforms were announced, a senior stakeholder advisory group was established to advise the Department of Health and Social Care on the best arrangements for national prevention and health improvement functions. I thank the noble Lord, Lord Hunt, for pointing out that praise for Public Health England was not universal. Many will have read articles from health experts, probably the most damning of which was You Had One Job. Questions had to be asked, but we looked at the stakeholder advisory group—its membership and terms of reference are published—and the group included public health, the third sector, think tanks, the health service, local government and other expertise. It worked quickly and we are grateful to all who contributed. Throughout the reform programme, we actively supported and welcomed views from key stakeholders across the spectrum of public health.

We have engaged quite widely, commensurate with the need to make quick progress and not foster a lingering uncertainty for staff, delivery partners and stakeholders. A Written Ministerial Statement was made in March, when we formally established the UK Health Security Agency from 1 April. We also published our evolved proposals in March, including the establishment of what is now OHID, and we invited views on a number of questions to support the successful implementation of the reforms.

Going forward, there is a new cross-government Cabinet committee for health promotion. This means that, across government, we will drive forward action on the wider determinants of health, ensuring that health is a shared outcome and priority. We will make sure that we work across government in a joined-up way.

Also, the creation of OHID—with the “D” for disparities—makes sure that, right at the centre of public health, we are looking at inequalities in the system. Far too often across this country, public health has been seen as the preserve of the privileged white middle class, as opposed to poorer communities. It is important that we make sure that this is no longer the preserve of the privileged white middle class, but of the working class, other people and immigrant communities, who understand some of these disparities in their communities.

Our reforms are explicitly designed to ensure that the different dimensions of public health have the dedicated national attention that each threat faces. The UK Health Security Agency focuses on health security; the Office for Health Improvement and Disparities, on better health and tackling these health disparities; NHS England, on delivery of NHS services to protect and improve health; and NHS Digital, on securing our gold-standard disease registers.

This year, we increased the local authority public health grant and allocated over £100 million of additional funding to local authorities. We are also investing £500 million over the spending review period to improve the Start4Life offer, and we have confirmed additional investment of £300 million to help people to achieve and maintain a healthy weight. Rather than proposing a one size fits all, we are also looking at pilot projects. We look at this as a process of discovery; we all have to admit that we do not have infinite knowledge and sometimes do not always foresee unintended consequences. By piloting projects and allowing the discovery process to take place, we can learn more.

In terms of the pandemic and future pandemics, the UK Health Security Agency’s sole purpose is to ensure the UK is protected from all future health threats, including pandemics, and to make sure we continuously assess our preparedness plans for infectious disease outbreaks. In future, critics can no longer say, “You had one job; why didn’t you do it?” We are focusing on health security.

We are hoping that the Office for Health Improvement and Disparities will work on prevention across all parts of government, given the cross-cutting nature of public health, making health improvement and disparities a focus of government. We are looking at a number of projects and key Covid programmes, making sure that we build back better and that we learn from the issues.

The noble Lord, Lord Hunt, asked about independence and accountability. The public health system in government needs a trusted source of independent scientific advice on health improvement to support evidence-led national decision-making and a focus on health inequalities. The Office for Health Improvement and Disparities will continue to make available and publish public health advice, research, evidence and data analysis, as Public Health England did previously, through a newly recruited Deputy Chief Medical Officer. The Chief Medical Officer will provide professional leadership for the Office for Health Improvement and Disparities, while Ministers will remain in charge of and responsible for policy decisions in that direction.

We hope that these reforms to the public health system that have been explained today will do that, and keep us safe and healthy into better times ahead. Vigilance, prevention and reform are the key words to keep us all safer and, I hope, improve the health of the nation, not only in certain communities but to tackle those disparities where they may have felt ignored in the past.

Lord Cormack Portrait Lord Cormack (Con)
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Does my noble friend accept that scrutiny by Parliament is essential?

Smoking Cessation: Prescription of E-cigarettes

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Tuesday 2nd November 2021

(3 years ago)

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Lord Kamall Portrait Lord Kamall (Con)
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The MHRA has been quite clear that it wants to be in a position to license a product as soon as possible—it says 18 to 24 months. Noble Lords may well want to push the MHRA on that, and that is part of your Lordships’ role. But it is important that we make sure that, when we license a product, both consumers and public health experts can have faith in it.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, I understand from my noble friend Lord Patel that some of the devices and products to which he referred do not bear health warnings on their packaging. Why is that so? Surely that at least should be on all of them.

Lord Kamall Portrait Lord Kamall (Con)
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I thank my noble friend for pointing that out, and I will investigate. Not being a user of e-cigarettes or cigarettes, or of any sort of narcotics or alcohol, I am afraid that I am not really an expert myself. I will look into that and write to my noble friend.

NHS England Funding: Announcement to Media

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Tuesday 26th October 2021

(3 years, 1 month ago)

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Lord Kamall Portrait Lord Kamall (Con)
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The noble Lord makes a valid point on workforce shortages. The Chancellor will confirm wider health budgets at the spending review, which is in only a few more days. We have already increased training places this year and will feed through into the available workforce. Ensuring that we have the workforce necessary to support this expansion will be driven by a combination of things, such as enforced workforce productivity, including from the spending review digital diagnostic investments, which are expected to deliver a 10% to 15% workforce productivity uplift. We are also looking at existing Health Education England funding, which will provide a pipeline for growth in training numbers.

Lord Cormack Portrait Lord Cormack (Con)
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I congratulate my noble friend on an auspicious beginning to his ministerial career. But I also draw his attention to the wording of this Urgent Question, which mentioned an “announcement to the media”. I give strong support to Speaker Sir Lindsay Hoyle in the other place for rebuking the Government for time and again bypassing Parliament. The Government are answerable to Parliament—that is fundamental to our constitution. It is an absolute disgrace that, time after time, Ministers blab to the press before making Statements in either House.

Lord Kamall Portrait Lord Kamall (Con)
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My noble friend makes a valuable point. It is important that we are accountable to Parliament, and we will continue to be so. I hope that the fact I am here today shows a willingness to be accountable to Parliament.

Covid-19: Plan B

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Wednesday 20th October 2021

(3 years, 1 month ago)

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Lord Kamall Portrait Lord Kamall (Con)
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I thank the right reverend Prelate for his question. It is important. Personally, I do believe that many people should be wearing masks and that there is evidence for this. But the fact is, we have to look at a number of indicators and balance those up.

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, could my noble friend tell us how many of us who are eligible for the third jab have had it? I have had mine. Could he also tell us what forward planning we have? Is this going to be an annual event? Are the resources available to ensure that it can be continued indefinitely?

Lord Kamall Portrait Lord Kamall (Con)
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I thank my noble friend for that very important question. Some of the data suggests that there has been a slower uptake for the booster. I do not have the exact information and data available on the uptake of the booster, but I will make sure I write to my noble friend.

NHS Update

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Thursday 22nd July 2021

(3 years, 4 months ago)

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

Lord Cormack Portrait Lord Cormack (Con)
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My Lords, I hope that my noble friend, who deserves a real holiday, will accept that it would have been far better and more honest had the pay award been made in an Oral rather than a Written Statement. We all send our warm wishes to the noble Lord, Lord Brooke of Alverthorpe, for a speedy recovery. However, does not his story underline the need for clarity in Oral Statements? I put to my noble friend last week the idea of statements in all the newspapers which would be clear, cohesive and coherent. Is that idea still being followed up, as he promised it would be?

Lord Bethell Portrait Lord Bethell (Con) [V]
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My Lords, I have followed it up. We have invested a huge amount in our statements. This takes up a large bandwidth for our broadcasters and of the advertising budget of the Cabinet Office and the department—we could not have spent any more money on advertising than we have done to try to get our messages across. However, some of these messages are difficult to understand and sometimes difficult to accept. We all wish that the vaccine was as clear-cut and emphatic as are the vaccines for polio or the other blockbuster vaccines. However, as the noble Lord, Lord Brooke, just described, and as poor old Sajid Javid is currently feeling, two jabs do not guarantee that you will not be infected and infectious. However, neither of them is in hospital and neither of them is suffering from severe disease. The message is nuanced: the vaccines work, will reduce transmission and will help us to get this country out of the disease, but people will still have to proceed with caution, isolate when they are in contact with those with the disease and protect themselves from transmission with masks and social distancing.

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

Lord Cormack Excerpts
Tuesday 20th July 2021

(3 years, 4 months ago)

Lords Chamber
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Lord Cormack Portrait Lord Cormack (Con)
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My Lords, I have been calling for the vaccination of care home workers for months and months. I believe that, when we have had to have so many restrictions imposed upon us—on the number of people we could have in our own homes, where we could go and what we could do—it is entirely reasonable to say that those who care for the most vulnerable members of society should be obliged to be vaccinated. I think that that is reasonable. The noble Baroness, Lady Tyler, indicated that that was the line that she took.

However, I have been doing this for month after month after month, going back to the very beginning of this year, if not before. I regret infinitely the way in which there has been prevarication. It seems to me so obvious that, if this had been said at the beginning of the year, proper legislation could have been produced.

My noble friend Lady Noakes talked about the contempt with which Parliament has been treated. I do not think that anyone since Cromwell has treated Parliament with greater contempt, over a whole range of issues. We are a parliamentary democracy, and the Government are answerable and accountable to Parliament. We have been through an extraordinary series of emergencies, when it has been understandable that certain measures had to be taken, but there has been far too much retrospective legislation, far too much secondary legislation and far too many Henry VIII clauses. I beg the Government and my noble friend Lord Bethell—I am sorry that he is not here; he cannot be with us because he is in isolation. He has not treated your Lordships’ House with contempt—far from it—but there has been an arrogance that has not been attractive.

It is right that we proceed, but it would have been very much better to have primary rather than secondary legislation. Lessons should be learned. We have to come back—the noble Baroness, Lady Tyler, made this point in her speech—to the fact that a very large percentage of those who perished from Covid were in care homes. There were all sorts of factors such as the release of people from hospital to care homes. But the plain, blunt fact is that over one-third—probably 40%—of those who make up the frightening statistic of those who have died were in care homes. Those in care homes are, by very definition, not very mobile, particularly the elderly in care homes. They are fixed.

I first brought this to the attention of the House and Ministers because of a great friend of ours who had a mother who has since died. She was 99 when she died and she had a long life and a good life, until towards the end. Our friend used to say to us, “I have to dress up in all manner of accoutrements, I cannot hold my mother’s hand”—and she could not until just a week or two before she died—“and I cannot communicate with my deaf mother properly.” And yet, in the care home in which she was being well looked after, something like one-third of those looking after her most intimate needs were refusing to be vaccinated. That cannot be right.

Of course, I do not believe in compulsory vaccination regardless, but I do believe it is entirely reasonable to say that those in certain positions have an obligation to their vocation and those they are looking after to do so as safely as possible. We know the efficacy of vaccination; it is not perfect, but it gives a high degree of protection. It is therefore entirely reasonable that we ask those fulfilling those tasks to be vaccinated. But it could have been done in a much better way. The policy could and should have been announced at the beginning of the year because the facts have not changed. There would have been ample time then for primary legislation.

I will not, of course, support the amendment to the Motion moved very eloquently by the noble Baroness, Lady Wheeler, although I respect her very much. I shall vote for the Government; I will be voting with relief but, at the same time, with a heavy heart.