NHS: Drug Shortages

Lord Cunningham of Felling Excerpts

Wednesday 17th January 2024 Lords Chamber

[Lord Markham (Con)]

Actually, we recently reached a new agreement with the drug suppliers on this. I think we were all pleased to do that, and it will ensure we continue to get continuity of supply. I have quizzed the team at length on this and asked it to sit down with the British Generic Manufacturers Association, which produced these figures, specifically to understand where there are differences, because I must be honest: the team does not recognise those numbers. We did not see an increase over the last few years. Where there are specific instances, such as ADHD, which I worked with the noble Baroness, Lady McIntosh of Hudnall, on recently, remedial actions are in place to ensure we can manage through the supply issues.

[Lord Cunningham of Felling (Lab)]

My Lords, will the noble Earl please focus—

[Noble Lords]

Oh!

[Lord Cunningham of Felling (Lab)]

I am sorry; will the noble Lord please focus on pancreatic cancer and say whether he is satisfied with the performance of the National Health Service and others in respect of research into and finding solutions to what in many respects is apparently becoming a notifiable disease and a sentence of death?

[Lord Markham (Con)]

I thank the noble Lord for my proposed promotion. My noble friend Lord Moylan has also raised pancreatic cancer a number of times. To be absolutely honest, this is one of those cases where we are on a journey. I think we have got on top of certain areas, such as prostate cancer, about which we have increased awareness to ensure we get detection early on, but we do not detect pancreatic cancer early enough and, unfortunately, it is then often too late. We are working on something to try to correct that. The noble Lord is quite right to bring it up, and I am happy to write to him to tell him exactly what we are doing.

Bread and Flour Regulations 1988

Lord Cunningham of Felling Excerpts

Tuesday 7th February 2023 Lords Chamber

[Lord Markham (Con)]

To be clear, I was referring to scientific advice I received today about the potential risk of masking, as I said. It is a concern but, as ever, one of the wonders of this House is the expertise available on tap. I will go back to consult on that and write to the noble Lord.

[Lord Cunningham of Felling (Lab)]

My Lords, between 80 and 90 countries now add folic acid to flour, with no known side-effects. What are the Government waiting for? All the evidence is there, all the science is there and this is all well known. I do not know, speaking for myself, what the delay is about.

[Lord Markham (Con)]

As I say, there is a process involving co-ordination with the devolved Administrations. We have to consult the EU, as mentioned, because of Northern Ireland is part of it all, and then allow the industry to get on board. Again, we are all in favour, without a doubt, but 40% of the respondents were anti. So we need to be careful to do this in the right way. I hope and believe this to be the first step but, as ever, the first step is often the hardest. We are getting there and this will make a difference.

Bread and Flour Regulations: Folic Acid

Lord Cunningham of Felling Excerpts

Wednesday 6th July 2022 Lords Chamber

[Lord Kamall (Con)]

The advice still does not accept Professor Wald’s paper. But we did say in the meeting, if the noble Lord remembers, that we should not let the scientific debate be the enemy of progress. We are progressing, and I am able to share an indicative time- frame. We can debate at appropriate levels after that, but we are progressing where there is consensus.

[Lord Cunningham of Felling (Lab)]

My Lords, why does the Minister refuse to implement the regulations when there is abundant evidence internationally in support of this? Even worse, what does he have to say to those 18 women each week who lose a baby because of the Government’s failure to act?

[Lord Kamall (Con)]

The noble Lord has a couple of questions there, and I will try to answer them as quickly as possible. We are hoping to launch a consultation in August/early September, with a close date 12 weeks after that. There should be a government response on the final position in Q1 2023. After that we have to notify the World Trade Organization and the European Commission, because of the Northern Ireland aspect of this issue. After that, we have a notification period of between two and six months. Assuming that that is all cleared as quickly as possible, we will be ready to lay the provision by Q4 2023. It is glacial, but I assure the noble Lord that we are doing this as quickly as we can.

Folic Acid Fortification

Lord Cunningham of Felling Excerpts

Wednesday 6th April 2022 Lords Chamber

[Lord Kamall (Con)]

I think the noble Lord will be aware that pregnant women are advised to take 400 micrograms of folic acid. That high level cannot be put into other foods because there are some unintended consequences. For example, it disguises some other traits and conditions in the older population. Therefore, one needs to get the right balance and proportion for the wider population.

[Lord Cunningham of Felling (Lab)]

My Lords, why did the Minister not say—or give some indication—as to when this working group will report, first to the Government and secondly to this House? It has had long enough since my noble friend succeeded in moving this policy change. When does the Minister expect the report, and when can we see some action?

[Lord Kamall (Con)]

I understand the complete frustration with the delays. When I asked the departmental officials about them, they said, “Funnily enough, usually we are people who support democracy, but democratic elections have got in the way.” Delays are due, for example, to the 2019 general election, the Scottish and Welsh parliamentary elections and the Northern Ireland elections.

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

Lord Cunningham of Felling Excerpts

Tuesday 14th December 2021 Lords Chamber

[The Lord Bishop of St Albans]

My Lords, I think many of us are grateful for the comments from the noble Baroness, Lady Noakes, about process and impact assessments, and I echo those.

I shall make one or two comments about the substantive issues. Incidentally, we have been thanking the Government and medics for the rollout, but I want to pay tribute to the people who are going to be sitting up half the night: the managers of GP practices—they are the ones who get people there to get the vaccine. Very often they are forgotten, so I want to make that point.

I want to make some points about the very real problems that there are with this way forward. I am very sympathetic and, on balance, I think this is the way forward, but for many decades we have taken very seriously those who have very real concerns about receiving a vaccination. Those are not concerns that I share personally, but there are those, for example, who are concerned about the use of aborted foetal cells or testing on animals. We—both myself and more widely in the Church of England—have always maintained the position that freedom of belief or religion should not be compromised by the introduction of any form of coercion or forced decree. This is difficult, because it is not just about someone’s right but about the effect that they have on someone else. Recently, I heard from someone who was jabbing—giving vaccinations—that someone came in without a mask on. They challenged him and he said, “I don’t get on very well with masks”, to which one of the nurses said, “Well, I hope you get on well with a ventilator.” That is the implication; we know what the medical science is.

The problem is that there is the danger of a subtle form of racial discrimination via the backdoor. Ethnic minorities comprise a much higher percentage of healthcare staff compared with the overall population. We know that they are more likely to be religious than the white British majority, and vaccine hesitancy is much higher among these communities. There is a whole range of complex issues to do with social trust and people’s position in society that I do not want to steamroller over without raising and putting on the record as we move forward with this programme. A worrying confluence of factors could leave those historically discriminated against being forced to choose between violating deeply held principles and unemployment. No one, whether white or from an ethnic-minority background, should be forced into that corner.

This raises the really important issue of how we are addressing vaccination hesitancy. I have been talking to the noble Lord, Lord Sharpe, about how can we help with that more widely across the globe. This is a reminder to those of us who are in touch with—particularly if you are in my line of business—black churches and so on that we need to up our game in addressing the reasons for vaccination hesitancy. We need to do it urgently, because the more that we can win the argument, the more we will save ourselves a lot of unintended consequences of discrimination that may result from these regulations.

[Lord Cunningham of Felling (Lab)]

My Lords, I declare an interest as a member of the Secondary Legislation Scrutiny Committee. Your Lordships will no doubt be delighted to know that, in January, I shall be leaving it—not by choice but because I have been cycled off.

At the heart of this dispute with the Department of Health and Social Care is the requirement, not option, that any department submitting secondary legislation—principally to this House, since it is almost never discussed at the other end of the Corridor in the House of Commons —should include an impact assessment. This is not an optional extra. It is not a take it or leave it. It is a requirement at the heart of the process. The committee is meeting at the moment—it may have concluded—and it has a Conservative chairman, who is very good. There is no predetermined disposition among its members to seek a confrontation with any government department. However, in this case, the Secretary of State and his department have point-blank refused to carry out an impact assessment. It is a challenge to Parliament and to the parliamentary process. That is what is taking place.

I agree with almost everything that the right reverend Prelate said about enforcing vaccination and I realise that there are some very serious problems to be resolved there. But that is not what the argument is about. It is about whether Parliament—in this case, your Lordships’ House—has the right to require any government department to produce an impact assessment about its proposals for legislation. It is quite a simple matter. It is not onerous in most cases. It is necessary for the committee to consider the impact assessment—along with other aspects of the legislation, of course—before reporting to your Lordships’ House. I did not hear in the Minister’s opening remarks a coherent explanation—and I have never received or seen one—of why that is not possible in this case.

As I said, your Lordships require their colleagues on the committee to analyse secondary legislation. That is our role and, if we do not have an impact assessment, we cannot fulfil it. That is the issue. I agree with what the right reverend Prelate said, but this is not about enforcing vaccination. It is about trying to learn to understand the impact, through an impact assessment, of this proposed secondary legislation. If committees are not allowed to take a stand on this, there is little purpose to them, because this is one of the fundamental issues of secondary legislation. That is our job and our responsibility and it is what we have been trying to do.

[Lord Framlingham (Con)]

My Lords, I had not intended to contribute to this debate, but I will say a few words. First, I am completely against any compulsory vaccination of any kind. It goes completely against all that we should believe in and I am totally opposed to it. Secondly, I recently put down two Written Questions to the Minister’s department: one about people who had been vaccinated and one about people who had tested positive with antibodies. I wanted to know the difference between the two; I wanted to know about protection from the disease and about transmission of the disease. The Answers that I got said, “We’re looking at it, but as far as we can tell at the moment, there is no difference”—it was 84% versus 85%. There is no difference between the protection that the vaccine offers and the protection given by antibodies in the normal course of events. Surely we are not going to vaccinate people who have the antibodies. It is absolutely pointless, particularly if they are thousands of schoolchildren. Can we not test people who have the antibodies and tell them that they do not need to be vaccinated? That seems to be common sense.

Brexit: Health Policy

Lord Cunningham of Felling Excerpts

Wednesday 6th December 2017 Lords Chamber

[Lord O’Shaughnessy]

I recognise that there is uncertainty. That is why we have set out our intention of offering a route to settled status for those people working here, and why we want the issues of citizens’ rights to be dealt with as soon as possible in the next phase of talks. The noble Baroness and other noble Lords will be interested to know that, if you compare June 2016 to June 2017, there are more EU workers working in the NHS from one year to the next.

[Lord Cunningham of Felling (Lab)]

My Lords—

[Lord Tebbit (Con)]

My Lords—

Smoking: E-Cigarettes

Lord Cunningham of Felling Excerpts

Tuesday 3rd February 2015 Lords Chamber

[Earl Howe]

My noble friend is absolutely right. I hope that message will come through loud and clear from the measures the Government are taking to ban smoking in private cars when children are present, to introduce standardised tobacco packaging and to prohibit proxy purchasing of tobacco.

[Lord Cunningham of Felling (Lab)]

My Lords, is the noble Earl satisfied that e-cigarettes are tamper-proof and that what they contain cannot be substituted for other more dangerous substances?

[Earl Howe]

The noble Lord makes an extremely important point. It is one that is addressed in the tobacco products directive, which is due to come into force next year. The EU Commission is clear that any e-cigarettes sold need to be tamper-proof, particularly as regards children interfering with the contents.

Public Health

Lord Cunningham of Felling Excerpts

Tuesday 30th November 2010 Lords Chamber

[Lord Cunningham of Felling]

There is much to welcome in the noble Earl’s Statement and I agree with my noble friend Lady Thornton that there are some things to be concerned about. We should be careful that nudge does not become fudge in respect of the implementation of these policies. My question relates to the very substantial reductions in teaching grants to our universities. Has anyone in Government yet done any work on or given any thought to the implications of the reductions in those grants for the training of doctors, dentists and other paramedics in our higher education institutes and other colleges? If they have not, they should do so quickly, because the implications of those cuts could have a very substantial bearing on the number of doctors, dentists and others coming out of our universities in the future.

[Earl Howe]

My Lords, the training of the workforce will be key—I would not disagree with the noble Lord on that question. This is a matter on which we are focusing very closely. I will need to write to the noble Lord on the specifics of his first question because the figures are not in my brief, but we are clear that, without the necessary workforce to deliver the public health programme on the ground at local authority level, we will not be able to see the improvements that we need. That will be a major focus for my department.

Health: Diet

Lord Cunningham of Felling Excerpts

Tuesday 13th July 2010 Lords Chamber

[Earl Howe]

My Lords, I have no doubt that my noble friend is correct. I am sure that she will wish to place the correct representations in the right ear, and I will assist as best I can.

[Lord Cunningham of Felling]

My Lords, one of the principal reasons for the creation of the Food Standards Agency was to remove such decisions from political and ministerial control. This came about because of the loss of trust of the British people in guidance and statements from Ministers following things such as BSE and other terrible food infections across the country. In the light of that, is not what the Government are now considering a completely retrograde step?

[Earl Howe]

My Lords, as I said in answer to the noble Lord, Lord Krebs, we fully recognise the important role that the FSA plays. I identify myself fully with his remarks about the reasons why the FSA was created. I speak as a former junior Minister in the department that he led in such a distinguished way, and I realise fully the force of what he said.