NHS: Nursing Workforce

Lord Dodds of Duncairn Excerpts

Wednesday 8th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, there are vacancies in nursing, as there always are. The vacancies at present are not hugely higher than they are normally and, in fact, we have more nurses today than we did two years ago. What I can report to the noble Baroness is that UCAS data shows 27,720 acceptances to nursing and midwifery courses in England as of 7 September. That is extremely good news; it shows the commitment of our graduates to the nursing profession and our commitment to making sure that more nurses are trained.

[Lord Dodds of Duncairn (DUP)]

My Lords, there are concerns that in some areas there are dangerously low staffing levels as a result of nurses leaving the profession. In the Belfast trust, in the first six months of this year alone, hundreds have left due to the Covid pandemic and for other reasons. Undoubtedly, that will have an impact on tackling long waiting lists. Can the Minister assure me that the money raised under the new health and social care levy and sent to the devolved Administrations, including Northern Ireland and Scotland, will actually be spent by those Administrations for those purposes, including addressing nursing shortages? As things stand at the moment, that money could be used for other purposes.

[Lord Bethell (Con)]

My Lords, there are 303,900 full- time nurses in the NHS trusts and CCGs, an increase of more than 8,900 from June 2020, so the impression that the noble Lord is giving is not, I am afraid, entirely supported by the numbers. In terms of recruitment, 2021 saw a third consecutive year of growth in the number of applicants to nursing and midwifery courses, which again is very good news. As for commitment on devolved Administrations, of course devolved does mean devolved, so I am not sure that I am in the position to make the commitment that he has sought.

Medical Devices (Northern Ireland Protocol) Regulations 2021

Lord Dodds of Duncairn Excerpts

Monday 12th July 2021 Grand Committee

[Lord Dodds of Duncairn (DUP) [V]]

My Lords, I begin by thanking the Minister for his clear explanation of the purposes of this secondary legislation. The statutory instrument is necessary, of course, only because of the Northern Ireland protocol, as the Minister made clear. That protocol means that EU law is applied to Northern Ireland across a wide range of matters without any elected Member of the Stormont Assembly or this Parliament having any vote on the matter.

On Friday, in evidence to the Northern Ireland Assembly, the noble Lord, Lord Frost, said that

“you need to have broad consensus”

to make the protocol work between now and four years’ time,

“and the fact we don’t have it is what worries us so much.”

He has also said previously, in speaking to the Northern Ireland Affairs Select Committee on 16 June, that

“the protocol depends on consent. It is very difficult to operate it if there is not consent and willingness from one segment of Northern Ireland opinion”.

I am sure the Minister will confirm his agreement with his ministerial colleague on this vital issue.

So we have before us this afternoon a situation where the EU regulation on medical devices entered into force in Northern Ireland directly on 26 May, and Northern Ireland is now subject to the EU regulatory system for medical devices and not the UK one. This statutory instrument is necessary to try to meet the challenges and practical applications of the EU directive applying directly to Northern Ireland. Whatever the mitigations, it would be better in every sense if Northern Ireland were simply in the same regime as the rest of the United Kingdom. Most medical devices, and £600 million-worth of medicines, are brought into Northern Ireland every year, 98% of which are from Great Britain. As has been mentioned, there are 300 operators of medical devices in Northern Ireland affected by this SI.

Following up on what the noble Lord, Lord Lansley, referred to, can the Minister confirm that the CE marking will be required indefinitely for devices placed on the Northern Ireland market by manufacturers, unlike in the rest of the United Kingdom? Can he confirm that the somewhat bizarre UK(NI) marking will be needed if a UK-notified body undertakes third-party conformity assessment? Can he also confirm that, to place a device on the Northern Ireland market, Great Britain manufacturers will need to appoint an EU or Northern Ireland-based authorised representative? The complexity and extra bureaucracy of all of this, and the cost to the taxpayer, need to be called out and quantified.

The applicability of the EU regime in this area adds not one jot to the safety or security of the people of Northern Ireland. Having Northern Ireland under the UK regime for medical devices would not harm or endanger the EU single market in any way. The whole basis of this SI is unnecessary and undemocratic.

Finally, the noble Lord, Lord Frost, has indicated that the EU is yet to respond to 12 papers tabled by the UK Government. Can the Minister indicate in his response whether any of them relate to medicines or medical devices?

Folic Acid

Lord Dodds of Duncairn Excerpts

Wednesday 23rd June 2021 Lords Chamber

Asked by

[Lord Dodds of Duncairn]

To ask Her Majesty’s Government what progress they have made with the response to their consultation about the fortification of flour with folic acid.

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

My Lords, the administration of folic acid to the bread of the nation to avoid around 500 neural tube defects a year is exactly the sort of preventative health intervention that we are putting at the heart of our health strategy. I am pleased to say that progress is being made, and I thank the devolved Administrations for their engagement in this measure to ensure that we have alignment between the four nations. I reassure noble Lords that this remains a priority for the Government.

[Lord Dodds of Duncairn (DUP)]

My Lords, surely the Government have run out of time and must now announce that they will follow the science and finally act to help to prevent the entirely avoidable numbers of babies born with neural tube defects? Recommendations were to be announced as soon as the recent elections were over, and if we are serious about preventative medicine and health, surely on this issue, where UK research has led the way to many other countries taking action long before now, there really can be no further delay or excuses.

[Lord Bethell (Con)]

My Lords, I entirely agree with the noble Lord that we are committed to following the science and are totally persuaded by it. However, I cannot avoid the fact that there were elections in devolved nations, which have meant that politicians and Secretaries of State in some of those countries were not available to engage with. I am pleased to report to the House that we have made a lot of progress in engaging with the devolved nations. We could not possibly do this policy without their support, buy-in and alignment. Progress is continuing at great pace, and I look forward to returning to the House and updating it at a future date.

Covid-19 Update

Lord Dodds of Duncairn Excerpts

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

No, I am afraid the noble Lord completely overstates the case; I do not accept the characterisation he has made at all. The challenge is enormous, and he is right to feel that this is one of the most important tasks for humanity in the round—I cannot emphasise that enough. But the practicalities are that, in Britain, we make hardly any vaccine at all. It is not for us as a nation to manufacture the vaccine. Where we have contributed is, first, through the science—particularly the AstraZeneca vaccine—and, secondly, through global leadership. The Prime Minister, through the G7, has sought to use that post as much as he can, in order to promote the vaccine. I do not accept that China and Russia have in any way contributed anything like the West has done; the numbers simply do not support that. We are working extremely closely with the regions of the world—with Africa, South America and beyond—in order to set up the kind of manufacturing that those countries need to provide their people with the safety from the virus that they deserve.

[Lord Dodds of Duncairn (DUP)]

My Lords, urgent decisions on Covid restrictions are needed elsewhere in the United Kingdom as well. Does the Government accept, however, that decisions that are for a devolved Government to make must be that devolved Government’s responsibility, and their responsibility alone? For Westminster to impose its will on the Assembly on devolved matters would be totally unacceptable and would lead inevitably and inexorably to a collapse of confidence in devolved institutions.

[Lord Bethell (Con)]

I am enormously grateful to all the devolved authorities for the work that they have done with the vaccine and in healthcare. Generally, it has been a very close collaboration, and one that I hope continues.

Carers: Support

Lord Dodds of Duncairn Excerpts

Thursday 10th June 2021 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

I call the noble Lord, Lord Pendry. No? In that case, I call the noble Lord, Lord Dodds of Duncairn.

[Lord Dodds of Duncairn (DUP)]

My Lords, I too pay tribute to the millions of unpaid carers across the country; they contribute and sacrifice so much on a daily basis. We recognise the great demands and burdens that have resulted because of the pandemic. I urge the Minister to think what more can be done to provide these people with breaks. They need them to counter social isolation and loneliness and for their mental and physical well-being. I thank the Government for what they are already doing. What more can be done?

Osimertinib Cancer Treatment

Lord Dodds of Duncairn Excerpts

Tuesday 18th May 2021 Lords Chamber

[Lord Dodds of Duncairn (DUP)]

My Lords, Northern Ireland is subject to EU law when it comes to the single market for goods and medicines because there is a grace period until 31 December 2021. After that, say representatives of the pharmaceutical industry, the supply of 98% of medicines from Great Britain to Northern Ireland is at risk of being discontinued. That is a truly outrageous and scandalous situation. The effects are already being felt. Can the Minister confirm that the Government will take whatever steps are necessary in terms of the protocol to guarantee the continued supply of medicines to Northern Ireland from Great Britain without any further regulation being required?

[Lord Bethell (Con)]

My Lords, I have met with industry on this matter for the past 18 months. I am afraid that the message I get from it is not of the alarmist kind that the noble Lord described—quite the opposite. I pay tribute to the industry for its enormously collaborative sense of partnership and I really do not believe that there is any threat of the kind that the noble Lord described.

Northern Ireland: Flight Passengers and Covid-19

Lord Dodds of Duncairn Excerpts

Wednesday 28th April 2021 Lords Chamber

Asked by

[Lord Dodds of Duncairn]

To ask Her Majesty’s Government what steps they will take to ensure that the necessary information about flight passengers who are crossing the border into Northern Ireland from outside the United Kingdom is shared with the Northern Ireland health authorities in order to prevent the spread of COVID-19.

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

My Lords, coronavirus restrictions, including the arrival of international travellers, are led by the Northern Ireland Executive. I am extremely grateful to the Northern Ireland Minister of Health who is working closely with his counterpart in the Irish Government to facilitate the sharing of data for international travellers travelling across the border. The Government continue to support ongoing co-ordination between the UK Government, the Northern Ireland Executive and the Irish Government as part of our collective ambition to drive the virus down.

[Lord Dodds of Duncairn (DUP)]

My Lords, I am grateful to the Minister for his reply. The common travel area is a very positive feature of life between the United Kingdom and the Irish Republic and has been so for many decades, predating our EU membership. Yet there remain serious problems with the Irish Republic carrying out the necessary urgent work needed to allow the sharing of information from Irish passenger locator forms for those transiting to Northern Ireland and to the rest of the United Kingdom. This delay is increasing the risk of the spread of Covid, especially variants coming into Northern Ireland and the UK. The Northern Ireland Health Minister that the noble Lord referred to expressed serious concerns as late as last week, in evidence to the Northern Ireland Assembly, about the dragging of feet. It has been flagged for many months. Will the Minister please raise this at the highest levels of the UK Government and ensure that action is taken to close this problem off?

Folic Acid

Lord Dodds of Duncairn Excerpts

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

I completely endorse the tribute of the noble Baroness to those who have worked on this policy. She is right: the science that has gone into this has been persuasive around the world. I thank those in industry who worked with us on our pilot, which proved extremely successful. We are in good shape when it comes to thinking through the implementation of such a policy. My hands are tied at the moment, because of purdah, but I hope to return and fulfil the noble Baroness’s wishes.

[Lord Dodds of Duncairn (DUP) [V]]

I congratulate the noble Lord, Lord Rooker, and other noble Lords on their tireless work on this issue. As former co-chair of the all-party group on folic acid fortification of flour in the other place, I remember the campaign to bring about the consultation well. As the parent of a son born with a neural tube defect, I am keen to see the Government act as quickly as possible to prevent avoidable births of children with such a condition. For the sake of the unborn and their families, can the Minister give a categoric guarantee that, after 6 May, when the elections are out the way, we will finally get definitive action and definite proposals?

[Lord Bethell (Con)]

My Lords, I join the noble Lord in paying tribute to all those who have worked so hard, particularly the noble Lord, Lord Rooker, who has delivered a playbook campaign on this. Being on the receiving end, I pay tribute to the grace, persuasiveness and energy with which he has conducted that campaign. He is not the only one, and I pay tribute to the personal testimony of the noble Lord, Lord Dodds— what a moving story he has just told. All who have been involved in these sorts of conditions would have been touched by that. I cannot deliver the categoric guarantee that he asks for but, as I said, we are looking at it extremely carefully and I hope to return soon.

Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021

Lord Dodds of Duncairn Excerpts

Monday 22nd March 2021 Lords Chamber

[Lord Dodds of Duncairn (DUP) [V]]

My Lords, I congratulate the noble Baroness, Lady Chapman, on her maiden speech and I wish her well for her future in the House.

I have considerable sympathy with the noble Baroness, Lady Thornton, over the use of the urgent powers procedures in relation to these regulations. However, I want to deal with some substantive issues around the regulations and the common travel area. I would be grateful if the Minister could set out clearly how international visitors from high-risk countries are monitored after crossing from the Irish Republic into Northern Ireland and then into England or other parts of the UK, because at present there is a major loophole.

There has been an ongoing problem with getting the necessary information and data from the Irish Republic authorities. The Northern Ireland Executive and our local Health Minister have been calling for that information to be shared from passenger locator forms in the Irish Republic, with little or no progress so far. It is imperative that the Dublin Government act on this, otherwise there is a massive problem. They should have done so months ago and we were assured that that would happen, but it has not yet occurred.

Passenger locator form information needs to be shared between the Irish Republic and the UK authorities, especially in Northern Ireland. That issue has been raised bilaterally, as I have said, but it needs to be resolved as a matter of urgency. Arguments have been made concerning problems with data sharing and that legislation may be needed, but we cannot afford to waste any more time, given the urgency of the problems concerning the spread of Covid through international travel.

Can we have a collaborative approach? Will the Minister urge information-sharing with the Irish Republic and vice versa? Can he speak to colleagues in government to ensure that support is given to the Northern Ireland Executive in trying to extract this vital information? Information and data are shared fairly regularly on a whole host of issues to do with security and immigration for dealing with the common travel area, and it needs to happen in relation to Covid. It really is a matter of life and death.

Social Care Funding (EAC Report)

Lord Dodds of Duncairn Excerpts

Thursday 28th January 2021 Grand Committee

[Lord Dodds of Duncairn (DUP) [V]]

My Lords, this is one of those issues that many people do not think about until it affects them or a family member. Successive Governments have thought about it a considerable amount but have chosen to do nothing. As a result, it has become —as described by the National Pensioners Convention, among many others—the Cinderella of public services, inadequately funded and not delivering for many people, when they need it most. This debate, therefore, is important although belated. I am grateful to the noble Lord, Lord Forsyth, and for this most comprehensive report and findings, which are relevant not just to England but to other parts of the United Kingdom.

The Covid pandemic has exacerbated many of the problems that we face and accelerates the need for reform. There always seems to be a good reason—not least financial—to put off reform in this area; it keeps being delayed and delayed. It was good that, in his first speech as Prime Minister, Boris Johnson promised to fix the crisis in social care but, as many noble Lords have rightly said, we now need action. I trust that the Government will soon produce proposals to support and sustain a modern social care system, and that these will be implemented as quickly as possible. I would be grateful if the Minister could tell us what his timescale for reform is.

There is a lot of confusion and misunderstanding around what the state can and cannot provide in social care, unlike the care provided by the National Health Service, which is free at the point of need. The United Kingdom faces a growing ageing population, with higher, more complex health needs. The decline of family and community networks increases the demand for public services. The costs of social care are a significant burden and fear for older people and their families. Social care should be treated, like the NHS, as a core public service: people need to be able to access it when they need it, at all times. That means sustainable funding over the long term, not continued short-term fixes, if they can be called that.

Many families are shocked to discover the labyrinthine process that they have to negotiate when they seek help, at a time when there is often a great deal of stress and strain. The do not understand how health needs are fully met by the state and free at the point of need, yet care needs are means-tested. This can lead to terrible shocks when they are faced with massive care costs. We need to move to the position of free personal care for those who need it, at the very least.

A high quality of care is absolutely essential and, for that, as other noble Lords have said, there must be proper training for care workers, which invests in and respects them, in the same way as there is for those who work for our National Health Service. Low pay needs to be urgently addressed, as do ways to improve retention and recruitment of staff. I add my voice to those who have already talked about recognition and support for the millions of unpaid family carers, who do an incredible job delivering a considerable amount of care across this country, in normal circumstances, but who, during the pandemic, have worked heroically to care for and protect their relatives at home. Many of them are elderly, and likely to suffer from poor health themselves and be in the lowest income bracket. There are estimated to be over 1 million people, maybe 1.5 million, aged over 65 with an unmet care need. That is truly shocking in this day and age. The current system is disjointed, piecemeal and underfunded. That must end as soon as possible.