NHS: Staff Numbers

Lord Dobbs Excerpts

Tuesday 12th September 2023 Lords Chamber

[Lord Markham (Con)]

The whole House will, I think, recognise that we have extensive plans that are, as I said, backed by £2.4 billion. That is what the long-term workforce plan was all about. There were many requests for us to put it in place and that is what we have delivered. All of this comes in the context of 63,000 more members of staff over the past year—actually, around 280,000 more members of staff since 2010. Those are substantial increases. Do we need to do more? Yes. Is that what the long-term workforce plan is all about? Yes.

[Lord Dobbs (Con)]

My Lords, those within the NHS must be allowed to work safely. Has my noble friend seen the reports today? A third of female surgeons have been sexually assaulted by other doctors within their workplaces, sometimes while they are actually operating on people. It is as unbelievable as it is appalling. What plans does my noble friend have for getting to the bottom of this, finding out the truth of these allegations and holding responsible those who are responsible for the safety of working practices within the NHS? In its recent dealings with him, did the British Medical Association mention this terrible issue—or have its interests been concentrated solely on money?

[Lord Markham (Con)]

I thank my noble friend. Like all of us, I am sure, I was appalled to hear about that study. The most fundamental purpose of any employer is the safety and well-being of their staff, obviously, and I am afraid that the hospitals that allowed that to happen and allowed that culture to take place clearly failed. Clearly, we need to get to the bottom of that. As I often say, it starts with the leadership in each hospital and the culture that is built up within each college. Those are the people who need to be looking at themselves in the mirror and asking whether they have the right culture to make sure that everyone feels safe in the workplace.

Autism: Diagnosis Targets

Lord Dobbs Excerpts

Tuesday 16th May 2023 Lords Chamber

[Lord Markham (Con)]

Clearly, we pull together all the numbers. Typically, about 2.9% of children and young people are diagnosed with autism. I do not know whether that is different among ethnic minorities. I will happily research that and write to the noble Lord.

[Lord Dobbs (Con)]

My Lords, may I ask my noble friend about artificial intelligence—AI? It is going to have a transformational impact on our National Health Service, for good, or possibly for ill. It will transform diagnosis, treatment, outcomes and—who knows?—it may even help us to make appointments more effectively. Of course, it will have an impact on those who work in the National Health Service as well as those who are treated by it. Have the Government started getting to grips with analysing what lies ahead with artificial intelligence? If not, I encourage them to do so very quickly because I believe that the impact of this will come much more rapidly than we might perhaps think at the moment.

[Lord Markham (Con)]

First, I totally agree with my noble friend’s sentiment about the power that AI, when done in the right way, can have in this space. Clearly, the stress is on the words “the right way”. I think it is fair to say that we are all on the nursery slopes as regards what it can do. I have seen how effective it can be in taking doctors’ notes, recording a meeting and drafting action points, which a doctor can then review. I am sure that we would all agree that that is very promising. There are future generations of AI being talked about that may be able to perform diagnosis. In the 10 to 15 years of looking ahead in the long-term workforce plan, these are some of the things that we will have to try to take into account. However, we are in the very early stages.

Long Covid

Lord Dobbs Excerpts

Tuesday 25th April 2023 Lords Chamber

[Lord Allan of Hallam (LD)]

My Lords—

[Lord Dobbs (Con)]

It is this side. Thank you for giving way; I appreciate it. So far, 223,738 people have died from Covid and it has cost this country between £310 billion and £410 billion. Last month, in a Written Question, I asked the Government what they thought were the origins of Covid. The Answer that came back, which was not a reply at all, was that they fully supported the World Health Organization’s study into its origins. But that is an organisation that once speculated that Covid might have come into China on a package of frozen food. The World Health Organization has achieved very little since, and Nature magazine has just revealed that it has “quietly shelved” its second scientific investigation into Covid’s origins. Why do the Government appear so uninterested in the origins of a disease that has cost us so much? Why did it happen, where is it going and how are we going to prevent a second epidemic causing the same sort of chaos that came from Covid?

[Lord Markham (Con)]

We are interested, and the Covid inquiry is all about finding out the origins and learning the lessons. I, among others, am very keen to hear that.

If I am allowed to, I am happy to take the question that was not allowed in. Okay, I am not—I tried.

Excess Deaths in Private Homes

Lord Dobbs Excerpts

Tuesday 10th January 2023 Lords Chamber

[Lord Dobbs (Con)]

My Lords, it is blindingly obvious that lockdown has had a huge impact on the number of excess deaths. Indeed, many people warned of that consequence at the time. I will put it politely: at that time, the Government showed a deep lack of interest in the points being made. We are now talking about excess deaths in the hundreds of thousands, quite apart from the extraordinary impact that it has had on mental health, particularly for young people. Could he please promise that the Government will take every step, and then go a step further, to ensure that the inquiry into this by the noble and learned Baroness, Lady Hallett, deals with what we got wrong as well as the many things that we got right, to make sure that we are properly prepared for a future challenge if it should ever arise?

[Lord Markham (Con)]

I totally agree with my noble friend. We all know that it was an unprecedented time, and we learned lessons all the way through: we were much more resistant to locking down as time went on, for all the good reasons mentioned by my noble friend. Yes, that absolutely needs to be a key feature of the report.

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

Lord Dobbs Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Dobbs (Con)]

My Lords, I shall try to be very brief. First, I want to thank my noble friend the Minister. He arrived in his job at a particularly difficult time. There has been turmoil, but he does his job with great sensitivity. I hope he will excuse me if I in any way ruffle his collar today. He said that we do not yet have a complete picture of the latest variant. That is absolutely the case and I want to press him on it a little. I find it difficult to simply accept that we must follow the science. What is the science? Science is not God and scientists are not messiahs. There are some pretty inadequate scientists, as well as some very gifted ones. Our job is to listen and learn, not simply follow blindly.

I have tried to listen carefully through this debate and many others, but I still do not understand the difference between a passport and a mandatory certificate—I hope the Minister will forgive me. I have been asking for a debate on passports. This is a very difficult issue which you can see from many different sides, but it is central to this policy. I have been asking for that debate ever since the start of the pandemic but we still have not had one. I still do not understand why all these new regulations have come in just days after we abandoned the red list on international travel, but there are many things that do not necessarily fit together easily in these difficult times.

There are many costs associated with any policy, no matter how well intentioned it might be. One cost I think we will be discussing for many years to come is the impact of these policies on the mental health of this nation, particularly the younger population. I wonder whether the Minister has looked at the increase in self- harm among young people or the number of attempted suicides. This is a real issue, yet we do not have impact assessments on any of these things—this is the debate we had yesterday. The Government are not doing enough to keep us informed or to allow us to debate the many issues associated with this pandemic.

I will ask the Minister three brief questions about the tidal wave that we are now experiencing. Of course, we want to be properly prepared for contingencies and cannot wait until we have answers to all the questions before we act. However, could we be told how many deaths have so far occurred from omicron in this country? I would have thought that an important, fundamental building block of any policy. Of those deaths, did the person die from omicron or simply with it? That is a very important distinction. Were those deaths of people who had been vaccinated or were they the unvaccinated? I do not know the answers to these questions and that certainly affects the way I would make up my mind about this policy. We need to know these basic figures.

As we have just heard, Covid has the capacity to ruin lives, but our reaction to it also has that capacity. We must seek a proper balance, rather than simply going blindly down the road of saying “This is the science; we must therefore do this without any debate at all”. I am grateful to my noble friend Lord Robathan for raising these issues today, because we need to debate them. If I were in his position, I suggest that I would not push this to a vote. However, he has done us a service in allowing us to discuss issues which would not otherwise have been properly discussed. We have been in pandemic circumstances for almost two years and too many outstanding questions have still not yet been answered. I hope that, through impact assessments and other means, the Government will make even more effort to answer the questions that we need to have answered.

[Baroness Bennett of Manor Castle (GP)]

My Lords, as an aside, I begin with a reflection on how this debate illustrates how outdated our political frames and the arrangement of our political furniture are, with the idea that we have two sides of politics. That clearly does not reflect the way our politics is operating now. I must respond to the noble Lord, Lord Dobbs, who asked how many deaths there have been from omicron; he appears to have learned nothing from the past two years about the exponential spread of viruses and the delay between infection, hospitalisation and death.

I caught the No. 29 bus down this morning. I saw, as I have seen pretty well throughout the last two years, the public in advance of where the Government thought they might be. The bus was largely empty. Everyone on it was wearing a mask properly. I was seeking to speak after the noble Lord, Lord Thomas of Gresford, because I wanted to say how honoured I would have been to do so and to express my respect for his presence and speech today. It is an utter rebuttal to the claim of the noble Lord, Lord Robathan, that we are all free to make our own decisions. None of us is free to choose whether or not to breathe. We all have to breathe the air in this Chamber and wherever we go.

That brings me to the first of my two points. We could be debating some very different SIs today, ones based on both the science and a response I had from the noble Lord, Lord Bethell, in July, when he was sitting where the Minister is now. The noble Lord said then that

“ventilation is critical—but it is also challenging.”—[Official Report, 21/7/21; col. 335.]

Instead of these SIs, we could be debating SIs that allowed for an emergency scheme for entertainment premises—concert halls and theatres—to have on the door, as restaurants do for food health, a rating for ventilation. People would be able to choose which venues they went into based on the real measure of risk that they presented. We could see another SI that would have an emergency programme, as the National Education Union has for many months been calling for, of installation in schools of not just carbon dioxide meters but ventilation and filtration systems. We are seeing isolated trials popping up, but not those things.

However, we cannot see emergency SIs such as those because such long-term schemes would take many months to implement. But they are long-term schemes that should have been implemented many months ago. I turn to a British Medical Journal editorial from July, which says that

“workplaces, healthcare facilities and education providers”

must

“pay greater attention to the cleanliness of the air”.

This editorial was written by world-leading microbiologists and engineers.

Over the past two years we have seen a public who have done amazing things, shown an amazing grasp of reality and adapted their behaviour accordingly. Sadly, we have seen a Government which have not lived up to their responsibilities and have been totally focused on one prong of defence—vaccination. I absolutely support and agree with the huge drive for vaccination, like many Members of your Lordships’ House; my booster is booked for next Monday. I am holding out for that and hoping to survive until that point.

I turn to the other SI, on vaccine passports. The noble Baroness, Lady Walmsley, and the noble Lord, Lord Scriven, made some very powerful points about the medical faults in this. I will pick up another concern, which I raised yesterday when we were talking about vaccination for deployment in health and care. If we send a message to people that vaccination is something that we have to force them to do, it risks building resistance and being counterproductive. We want to get to a situation where every person for whom it is medically possible is vaccinated, and has chosen to be. That requires a fairly large ask—trust in the Government—but above all it requires a programme of education and outreach, which we have clearly not seen nearly enough of.

In the other place, the Green MP Caroline Lucas, while expressing great reluctance, voted with those opposing the vaccine passport SI before us. I must admit I feel rather torn at the moment, because I think the SI is dangerous and counterproductive, but I feel extremely uncomfortable with people making different arguments grouped in the same space, so I have not quite decided what to do. But I want to see a Government allowing people to keep themselves safe by taking on what the noble Lord, Lord Bethell, accepted was crucial in July, which is ventilation.

I also pick up the point from the noble Baroness, Lady Hayman, on global scale. No one is safe until everyone is safe. The Government are not doing nearly enough to get vaccines around the world, so we will see more risks. In picking up on how people can keep themselves safe, whatever the Government pass, we will see people not going to entertainment venues and rearranging their lives. That means that people and businesses will need public support, on which I agree with the noble Lord, Lord Blencathra. We also need people to be able to keep other people safe, which means proper and full sickness payments when they have to self-isolate, as they should.

Covid-19 Internal Review

Lord Dobbs Excerpts

Thursday 20th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, it is not for me to define exactly what the scope of the inquiry will be but the noble Baroness’s points are extremely well made. I emphasise the importance of women. We are in the midst of consultation on the women’s health strategy. It is proving to be an incredibly impactful process and events are being held almost daily. I encourage all noble Lords to submit evidence to the health strategy on any issues that they feel strongly about. This could be a really impactful turning point in the way in which the health of women in this country is massively improved.

[Lord Dobbs (Con)]

Does my noble friend agree that publishing an internal review right now would do nothing less than risking a dodgy dossier, of the sort we have seen before which shed far more confusion than light? Does he not think that the most important use of time right now would be in getting to grips with the anti-vaxxers who are spreading vicious lies, so that we can get on with vaccinating as many people as possible and bringing this country together as quickly as possible?

[Lord Bethell (Con)]

I am extremely grateful to my noble friend for his comments. He is entirely right. The battle against anti-vaxxers has been very successful. We have used a spirit of dialogue with people who have very personal and legitimate questions about a vaccine that requires an injection of fluids into their body. People quite reasonably have detailed questions about its impact. I applaud officials and partners of the Government who have been so effective at conveying the message on the safety and efficacy of the vaccine. It really has demonstrated the power of government and NHS communications at their best.

Health and Social Care Update

Lord Dobbs Excerpts

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are committed to both our levelling-up agenda and the kind of population health measures to which the noble Lord alludes. That is why we are bringing the NHS and social care Bill before the House later this year. I hope that the noble Lord engages with it to bring his insight to the debate.

[Lord Dobbs (Con) [V]]

My Lords, I assume that my noble friend shares with me a profound sadness at what is going on in the EU. Will he, instead of following their appalling example or indulging in tit for tat, remind the world that Britain after Brexit does things differently? We prefer the rule of law to knee-jerk protectionism, we pursue free and fair trade, and we honour our commercial contracts. Does he agree that this makes Britain one of the most attractive places in the world for pharma, biosciences and anyone to do business with?

[Lord Bethell (Con)]

My noble friend has just made a fantastic pitch for my job. He articulated the case for investing in Britain to pharmaceutical and medical devices companies around the world. Which company cannot be looking at Europe, right now, wondering whether Britain is not, by far, the best destination for their investment and research? I completely agree with my noble friend; my head is in my hands when I look at Europe and what is going on there, but my hope is that good sense will return. In the meantime, if anyone wants to invest any money in life sciences, please give me a ring.

Covid-19 Update

Lord Dobbs Excerpts

Thursday 4th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I thank the noble Baroness, Lady Andrews, for her questions. Perhaps I may tackle the specific question of airport testing, which has been raised a couple of times. The honest truth is that the arrival of families in south Gloucestershire and Aberdeen who had done a pre-flight test and subsequently developed symptoms demonstrates, I am afraid, that pre-flight and airport testing is not as effective as one would hope. If it were, we would not have to impose a 10-day testing regime with tests on the second and eighth days. That is the only rigorous way in which one can do it. It is estimated that airport testing catches perhaps between 10% and 20% of infection, and that is why managed quarantine is so important. The infection rate among those who arrive in the UK is high enough for us to be seriously concerned and to impose the kind of isolation that we have done. Until that infection rate is reduced, I am afraid that we have to look forward to managed quarantine and isolation being a part of the travel experience for some time.

[Lord Dobbs (Con) [V]]

My Lords, I add my congratulations to those offered to all those involved in a remarkable national achievement. It has also been a personal triumph for my noble friend and all his colleagues. However, perhaps I may pursue the question that my noble friend Lord Cormack raised a moment ago. An alarming proportion of Covid infections have been caught by patients in hospital and those inside care homes. Can the Minister elaborate on government plans to require those who work in the NHS and care homes to accept vaccination if they are to continue to work among such vulnerable people? Why are so many of them so reluctant? Does he agree that the trade unions have some nerve in describing any suggestion of that sort as bullying?

[Lord Bethell (Con)]

My Lords, I completely acknowledge the concerns of my noble friends Lord Dobbs and Lord Cormack about nosocomial infection. Undoubtedly, infections caught onsite in Britain last year and this year, and in every epidemic, are not only among the saddest forms of contagion but among the most dangerous. I want to reassure both my noble friends that we are absolutely focused on this point. It is, though, too early to make a call on professional mandatory vaccination. We have got through only the first 20 million people in the highest-risk and, therefore, the oldest age groups, and we have not moved through all the other age groups. The Cabinet Office is looking at this matter and has a review process in place. When that process has coughed up its findings, we will be in a position to debate the matter, and I look forward to that in due course.

Covid-19 Update

Lord Dobbs Excerpts

Thursday 4th February 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right that understanding of the role of aerosols is growing. Frankly, I find it quite terrifying. She is right that we need to look particularly at the way our office spaces are ventilated. The statistics I have seen on the potential cost of rebooting the ventilation of the UK’s workspaces in order to make them Covid-friendly are that it would cost tens of billions of pounds. Our focus is therefore on vaccine deployment, but work is going on to reimagine and envisage how workspaces could be made safer, not just for this pandemic but for the future. I can imagine a world where ventilation is given greater hygienic priority in future.

[Lord Dobbs (Con) [V]]

My Lords, I was rather alarmed at my noble friend describing himself as a neophyte. He rather strikes me as being a battle-hardened veteran by this stage. I shall ask him about convalescent plasma. We had high hopes of it a year ago, yet the recovery trial at Nuffield College has now been ended and the BMJ has concluded that there is no convincing evidence of its effectiveness. And yet the NHS website is still seeking volunteers, and just this morning I heard a radio advertisement pleading for more volunteers to come forward. Will he clear up the apparent confusion there? Is it still a possibility that this might be something we are pursuing, or has it been put to one side?

[Lord Bethell (Con)]

My noble friend is right. The story of convalescent plasma is heartbreaking. I had extremely high hopes that it would be a rather wonderful way in which those who had been hit hard by Covid could be agents in the recovery of those who were newly in hospital. Convalescent plasma has a very successful record throughout history of being a source of therapeutic help, but the science is the science and we have to be respectful of the clinical trials, however heartbreaking the news is. We have massively downgraded our expectations. There is hope that convalescent plasma could be used in primary care in a very early intervention, but there are problems with the delivery of that medicine and primary care is not in great shape at the moment to be plugging blood into people just because they show some symptoms of Covid. We are continuing our collection until the last clinical trials in primary care are finalised, but I am afraid to say that our expectations in that area are much less than they were a few weeks ago.

Puberty-blocker Drugs

Lord Dobbs Excerpts

Thursday 10th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

I am sure that the noble Baroness’s testimony is entirely right, and it concerns me that anyone has any concerns in this matter. I reassure her that the Tavistock is doing absolutely all it can to reassure current patients and those who are on the referral list; its communications have been excellent throughout. The provision of puberty-blocker services to existing patients has continued, and it will remain in close contact with those patients as the review plays out.

[Lord Dobbs (Con) [V]]

My Lords, I hope this is an appropriate moment to reflect on the life of Jan Morris, that glorious writer who died just over two weeks ago. She was born a man, served in the British Army, fathered four children with her beloved wife Elizabeth and then transitioned from male to female in the 1970s—a challenge she bore with extraordinary humour and patience. So perhaps I may recommend that my noble friend reads all her books in his spare time. Would he agree that Jan Morris’s example of seeing the world in glorious colours, rather than narrowly in black and white, and of always showing kindness and tolerance even to those who disagreed with, and perhaps disapproved of, her, is an example that should inspire all sides of this debate and give comfort to those, in particular children and their parents, who find themselves struggling with the same difficult situation she did?

[Lord Bethell (Con) [V]]

[Inaudible]—to be more affected by their warmth and kindness. Jan was an absolute model of warmth and kindness. Having worked in the nightclub industry, I have met, worked with and enjoyed the company of many trans people, which has always proved to be an extremely uplifting experience. I am a massive supporter of the trans movement in the round.