National Immunisation Programme
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
I thank my noble friend for the question and her kind words, and I will let the Minister, my noble friend Lord Markham, know. My noble friend raises a good point. Over £405 million was invested by the Vaccine Taskforce to secure and scale up the UK’s vaccine manufacturing capabilities to ensure a robust response to Covid-19 and potential future health emergencies. This includes support for the chemical producer Croda to increase the UK manufacturing capacity of speciality lipids, funding for CPI to develop and equip the RNA Centre of Excellence in Darlington, support for skills development through the Advanced Therapies Skills Training Network, and funding for the Cell and Gene Therapy Catapult. The Government have learned from Covid and are investing heavily in our home-based manufacturing.
Lord Allan of Hallam (LD)
My Lords, while the politicians may be distracted over the next few months, there is nothing to stop technical teams continuing to work on important tools such as easy online access to immunisation records for adults and children. Before he shuts his office up, can the noble Lord provide us with a written update on progress on online access to immunisation records? To him and his noble friend Lord Markham I say so long, and thanks for all the letters.
Lord Evans of Rainow (Con)
I will pass on that message from the noble Lord, who has consistently asked excellent questions about the modernisation behind the scenes of the NHS and of business practices, and on moving from paper to digitising. He is absolutely right and I will take his question back to the department. Moving forward, it is very important that we, and our children and our children’s children, can pick up the app and see what vaccinations we have had. It is very simple and straightforward. I have to say that, in recent years, the Government have made very significant progress on the NHS app, but there is more to do.
Whooping Cough
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The noble Lord, as always, makes a very powerful point and he is exactly right. Whooping cough is cyclical. The last time this country experienced an outbreak was 2016 and we were due to have another outbreak in 2021. As noble Lords will know, we suffered from Covid lockdown and because of the isolation, it went down. So we were due one in 2020-21, and the reason that this outbreak is more powerful is because of social distancing during Covid—and the outbreak is the most severe, as the noble Baroness said, in a long time. That is the explanation—it is cyclical, we had lockdown and we are now in the middle of the severe outbreak.
As for the noble Lord comparing our health service to others throughout Europe, he is exactly right. The UK has the most extensive immunisation programme in the world but, as he rightly points out, we have to communicate that to all the population. NHS England works with UKHSA and the regions to continuously review opportunities to improve uptake and coverage of all NHS routine immunisation programmes, sharing and spreading best practice in what has worked. But we can always learn from other countries to make the NHS even better.
Lord Allan of Hallam (LD)
My Lords, Education Ministers have been very active recently telling parents to send their children to school with coughs and colds, yet the NHS tells us that the early signs of whooping cough are very similar to those of a cold, and we advise people with this condition to stay home and isolate. Does the Minister recognise the risk of confusion for parents in this messaging? Will he talk to his colleagues at the Department for Education, for example, to tweak that messaging, so it is different where children are unvaccinated or where there are local outbreaks?
Lord Evans of Rainow (Con)
The noble Lord is exactly right: communication is critical and, as he well knows, if the message is confusing, it is very unhelpful. But the message is clear that parents and carers have an obligation to immunise their children, not just for whooping cough but for other childhood diseases. Particularly for pregnant mothers, the message is clear: get immunised.
Folic Acid Fortification
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The noble Baroness raises an important point. I do not have the details of the figures that she has asked for, but I will certainly write to her on that very good point.
Lord Allan of Hallam (LD)
My Lords, it is good to hear that the legislation will be coming forward in July. I am sure that it will have a fair wind, given the cross-party and cross-nation support. One of the questions that the Government consulted on was the implementation period. Passing the regulations is one thing; getting the folic acid into the flour is another. Can the Minister give us any indication as to how long that implementation period will be once the regulations have passed?
Lord Evans of Rainow (Con)
The noble Lord, as always, asks a very good question. The proposed transition period for industry to implement changes in the Bread and Flour Regulations review is 24 months. The provisions on folic acid fortification of flour will therefore become mandatory as of 1 October 2026, but there is nothing to stop earlier fortification, should industry wish to do so. I used to work in a bakery and I know that it is a very simple process to put the folic acid in. In my view, 24 months is a very reasonable time. There is nothing preventing the industry fortifying bread now.
Health Data: Research and Analysis
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My noble friend raises a very important point, and I reassure her and the House that only authorised users will be granted access to data for approved purposes. These include NHS staff and those supporting them, such as administrators, bed managers or care co-ordinators, as well staff in social care supporting the move from hospital care. The FDP suppliers can use NHS data only to support NHS services directed by NHS bodies. The suppliers will not control the data on the platform, nor will they be permitted to access, use or share it for their own purposes.
Lord Allan of Hallam (LD)
My Lords, the Government deserve credit for supporting the development of secure data environments such as OpenSAFELY, but a lot of health research data is still moving around using older and less secure environments, and those who are seeking unauthorised access are becoming ever more sophisticated and dangerous. Will the Minister go back to his department and get it to prioritise, with urgency, moving health research from these older and less secure systems to the newer and more secure ones? This is a race against time, and a major data breach would set research back by years.
Lord Evans of Rainow (Con)
The noble Lord raises an important point, backing up the concerns of the noble Lord, Lord Davies. He is exactly right: the Government are moving at pace. I reassure him that I will take his request back to the department.
Medical Student Places
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
I thank my noble friend for that question. She is right to point out that certain GPs in their 50s retire, but the Government are committed to increasing the number of GPs. As I indicated in my Answer, there is a substantial number of younger new GPs in the pipeline.
Lord Allan of Hallam (LD)
My Lords, I associate these Benches with the condolences to the families of the noble Baronesses, Lady Gardner and Lady Massey. The Government, in their response to a Guardian article that queried the student numbers, said that numbers will be increasing “exponentially until 2031”. Exponentially is an impressive adverb that is sometimes used to mean something that is fast and getting faster. It also has a more precise meaning, and there is a formula. Will the Minister share the formula being used between now and 2031, so that we can see how many places will be allocated each year?
Lord Evans of Rainow (Con)
I thank the noble Lord for that question. I do not have a formula in my briefing pack, but I will ask that question and refer the answer back to the noble Lord. I would also point out not to believe everything that you read in the Guardian.
Human Medicines (Amendments Relating to Coronavirus and Influenza) (England and Wales and Scotland) Regulations 2024
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My Lords, these important regulations were laid before the House on 10 January 2024 and I am grateful to be leading the debate on them.
In autumn 2020, in response to the Covid-19 pandemic and following a public consultation, the Government introduced several temporary amendments to the Human Medicines Regulations 2012 to support the deployment of Covid-19 and flu vaccinations. The instrument we are debating today seeks to amend the temporary provisions in the Human Medicines Regulations—Regulations 3A, 19 and 247A—in order to maintain these provisions and support the ongoing delivery of Covid-19 and influenza vaccinations.
I will briefly set out what each of these regulations does. Regulation 3A enables trained healthcare professionals or staff under the supervision of healthcare professionals to conduct the final stage of assembly, preparation and labelling of Covid-19 vaccines, without requiring additional marketing authorisations or manufacturers’ licences, provided that vaccines are supplied under NHS arrangements or by suppliers of medical services to His Majesty’s Armed Forces. The measure also allows for the reformulation and reassembly of authorised Covid-19 vaccines without the need for additional marketing authorisations.
Regulation 19 has enabled Covid-19 and flu vaccines to be moved safely between premises by providers operating under NHS arrangements or suppliers of medical services to His Majesty’s Armed Forces without the need for a wholesale dealer’s licence. Regulation 247A provides a mechanism to expand the workforce who are legally and safely able to administer a Covid-19 or flu vaccine without the input of a prescriber, using an approved protocol. Regulations 3A and 19 have sunset provisions, which mean that they will cease to have effect on 1 April 2024 unless they are extended. Regulation 247A is permitted for use only during a pandemic.
These regulations play a vital role in both the Covid-19 and the flu vaccination programmes. The measures have helped enable Covid-19 and flu vaccines to be safely deployed at speed and scale. They have also ensured that there is sufficient workforce available to administer vaccines.
The Government are committed to protecting people who are most at risk of Covid-19. We are guided by the independent Joint Committee on Vaccination and Immunisation in our approach. While for most people Covid-19 is thankfully a much less serious risk than it was when these regulations were first enacted, vaccines remain the most effective line of defence for those at greatest risk from the Covid-19 virus. In the latest autumn vaccination campaign, more than 11.8 million Covid-19 vaccines were administered by NHS England in the period after national bookings opened on 11 September last year. In addition, over 18 million flu vaccinations were administered in England during the latest autumn campaign, with over 4.5 million people receiving their flu and Covid-19 vaccinations at the same appointment.
Given the continuing importance of these vaccination programmes in protecting public health, the Government have engaged widely to determine whether to retain the provisions in the Human Medicines Regulations beyond their current period. Following initial engagement with key stakeholders, including NHS England, the Government ran a public consultation, from 7 August to 18 September 2023, on proposals to temporarily extend these regulations until 1 April 2026 while a permanent solution is developed. For Regulation 247A, this also involves removing condition A from the regulation, which requires there to be a pandemic. This proposal was based on feedback, including from NHS England, that without these regulations the Covid-19 and flu vaccination services would be negatively impacted and could not continue to be delivered at the scale required. Overall, from the 220 respondents to the consultation, a high level of support was shown for these proposals across all nations.
For Regulation 3A, 89% of respondents agreed that the regulation should be extended. The flexibility provided by this provision continues to play an important role in the Covid-19 vaccination programme due to the supply chain arrangements and the way in which the vaccinations are packaged. Covid-19 vaccinations are not available as a pre-filled syringe and so each vaccine administered continues to require final-stage preparation before administration to patients. The consultation found that the flexibilities have allowed for the safe assembly and preparation at the pace and scale required within the programme. It also found that Regulation 3A improves the operational delivery of Covid-19 vaccines through a safe and effective framework, increases efficiency within the system and allows for delivery at scale, in turn helping to improve access and more effectively using the workforce.
There was also a high level of support in the consultation response for the proposal to extend Regulation 19, with 91% agreeing that this regulation should be extended. Many respondents had commented that, due to vaccines being more easily moved between sites, vaccine wastage had been reduced, helping to reduce the environmental impact of our vaccination programmes—something that we are obviously keen to encourage. At the same time, these regulations were found to have brought about a more efficient use of resources and improved patient access to vaccines, including through co-administration. As I mentioned, 4.5 million people had both their Covid-19 and flu vaccinations at the same time during the last autumn campaign.
For Regulation 247A, a similarly high level of support was seen in the consultation responses: 82% agreed with the proposal to remove condition A from the regulation, which requires there to be a pandemic to be used, and 82% also agreed that this should be time- limited to April 2026. Many respondents cited that Regulation 247A provided a safe and effective mechanism to improve the delivery of Covid-19 and flu vaccines during the pandemic. The measures were also found to have played an important role in reducing workforce pressures, facilitating an increase in the capacity to deliver hundreds of millions of Covid-19 and flu vaccinations and releasing qualified healthcare professionals to deliver other care across the system.
The temporary amendments to the Human Medicines Regulations have been and continue to be vital to the successful delivery of the Covid-19 vaccination programme. To not extend these provisions would have a significant impact on the delivery of current vaccination programmes. Without these provisions, some NHS vaccination activities would need to cease, which would likely have a negative impact on the uptake of these vaccinations.
Therefore, the Government propose to temporarily extend the provisions provided by these regulations to 1 April 2026, while a more permanent solution is developed. In the case of Regulation 247A, the Government also propose to remove the requirement that there should be a pandemic or imminent pandemic when the medicine is supplied. I beg to move.
Lord Allan of Hallam (LD)
My Lords, the instrument seems entirely sensible and I suspect that many of us who have come here to debate it will join in a chorus of approval. I had anticipated that some people might have been here to talk about the evils of emergency regulation, which we are, in a sense, extending today, or even the evils of vaccination programmes—we would have had a lively debate around that. However, it seems that we are only going to be talking about the specific matters before us in the regulations, which is helpful.
It begs the question, which the Minister opened up in his introduction, of what the Government’s plans are for the longer term. The Government essentially face a choice: they can decide to have a single-tier system for the regulation of vaccination programmes, or a two-tier system, of which there are two variants.
The single tier would be that the additional flexibility that has been introduced should apply to all vaccines all the time. I can see that there might be a case for that. The Minister has explained why the Government feel confident that lifting some of the requirements on preparation and licensing for warehousing et cetera has been beneficial. That begs the question: if it is beneficial here, could that be safely changed for all vaccines all the time? Those are the first two parts of it—Regulations 3A and 19(4)(a) to (4)(c).
The second regulation the Minister referred to was Regulation 247A on who can deliver vaccines and making the most of the workforce. I can see that there may be a case for one of the following variants of the two-tier system. The first would be to have a set of criteria to decide when an epidemic is sufficiently serious that we are willing to introduce the extra flexibility. That would be a pandemic-targeted measure. If the Government are thinking in those terms, I hope that we can get on with it rather than waiting until we have a pandemic and going back to having emergency legislation.
If we have a choice between pre-planned legislation and emergency legislation, I think we in this House would always prefer pre-planned. We have a known unknown; we do not know what the new pandemic might look like, but we know that we are likely to get something that requires a mass vaccination programme. If there are criteria for when that programme would kick in in an emergency epidemic situation, it would be helpful if the Minister could give some indication of the Government’s thinking on that.
The second model would simply be that, when a vaccination programme is too big, we have an expanded workforce. The inclusion of influenza takes us into that territory. The influenza vaccine is not in response to a pandemic; influenza is an annual epidemic. Essentially I hear the Minister to be saying that we could not deliver all the flu vaccines we want to deliver without the relaxed model that the pandemic opened up for us in relation to the personnel who can deliver vaccines. If that is the case, it would make sense to get on with it and say that the criteria are that, once we need to deliver more than X million vaccines, we will move to the regime where a larger range of vaccinators can deliver them. It would make sense to do that in a planned way rather than as a reactive measure.
I want to raise another point with the Minister, which I hope he might be able to help us to think about. Do the Government have research under way into the different approaches? Whenever we are thinking of vaccination programmes—I am firmly in the pro-vax camp, if there is such a thing—overriding all this is that patient safety remains critical. If you support vaccination, you are very strongly motivated to make sure that the evidence is there to prove that it is safe.
Through the pandemic we were all part of a wonderful experiment. This is probably the single best-recorded health event in human history, which enables people to study all the different variations. I was jabbed by a soldier in uniform, by my GP, and by a pharmacist. We have had an incredible array of different models for delivering vaccination, not just in the UK but in lots of other countries. My assumption is that clever academics and epidemiologists are studying the cost benefits of all those different models and that that information can be used to inform which future models we want. I hope that the long-term successor regime we will have after 2026 will be informed by that. Does the Minister have any insights into that, and can he give us any pointers, or at least assure us that this kind of research is taking place, so that when we finally settle on a post-2026 regime it will be informed by the evidence?
I am thinking of the debate yesterday and looking across at the noble Baroness, Lady Merron. When I am talking about post 2026, perhaps I ought to direct some of my questions to the Labour Front Bench as well. This year, I might get into the habit of saying, “The Minister and the noble Baroness, Lady Merron”. If they have any thinking on the post-2026 vaccination regimes, it would be helpful to hear that.
Those are my points. Can the Minister give us any insights into the Government’s thinking about whether they are tending towards a single-tier regime with more flexibility for all vaccinations, or a two-tier regime based on the criteria of emergency or simply of scale, so that vaccination programmes larger than X are delivered in a different way from smaller vaccination programmes?
There is also that question about the research. I would like some assurance that we are trying to get some kind of silver lining from the cloud of Covid by taking all the wonderful data we have collected and ensuring that the future efforts we have to make are informed by our experience of the efforts of those incredible teams of vaccinators of all sorts who have been working busily on these programmes over the last three years or so.
Lung Cancer Medicines
Debate between Lord Evans of Rainow and Lord Allan of Hallam(9 months, 2 weeks ago)
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Lord Evans of Rainow (Con)
I am most grateful to the noble Lord for his lifelong service to the community and to this House. He raises a very good point. On the one hand, NICE is clear that there are alternatives to this drug, but it will still be available to current patients. I take on board what the noble Lord says, and I will report it back to the department.
Lord Allan of Hallam (LD)
My Lords, following on from the previous question, and given the importance of speed of access to treatment for cancer sufferers, can the Minister explain what the Government are doing to speed up the process for NICE approvals for new cancer drugs and how that process is being tied into the MHRA licensing process, so that they can run in parallel, rather than one having to wait for the other?
Lord Evans of Rainow (Con)
The noble Lord raises a good point, and I agree with it. Since 2016, the cancer drugs fund, worth £340 million per year, has delivered faster access for tens of thousands of NHS patients to some of the most promising new cancer medicines—in some cases, up to eight months faster, including for Pembrolizumab and Selpercatinib. These are two very important drugs, and the hope is that they will be successful moving forward. Only time will tell, but the Government are committed to introducing life-saving drugs.
Child Obesity
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
I am not sure I can make that commitment to the noble Baroness. The school food standards ensure that children have healthy food and drink options across the school day and restrict foods high in fat, sugar and salt, including high-sugar foods and confectionery. The Department for Education continues to keep the SFS under review. It is right and proper that families that cannot afford school meals should be helped by the taxpayer, but we cannot commit to providing for all schoolchildren.
Lord Allan of Hallam (LD)
My Lords, the data is devastating: 11 year-olds in the poorest areas of our country are twice as likely to become obese as those in the wealthiest, and that gap is growing. I ask the Minister to take a brief holiday from painting a rosy picture of the Government’s plans—I know it is his job to do that—and acknowledge just how badly we are failing children in poor areas, who are acquiring conditions that will leave them less healthy than their wealthier neighbours for the rest of their lives. This requires big, bold steps and urgency, something that the Government can show in other areas of policy but not here, where it really matters.
Lord Evans of Rainow (Con)
I am not aware that I am painting a rosy picture. There are serious issues with childhood obesity in this country, as there are in other countries around the world. Nearly one in 10 children, 9.2%, start primary school living with obesity, and approximately one in five children, 22%, leave primary school living with obesity. Children living in the most deprived areas are more than twice as likely to be living with obesity as those living in the least deprived areas. Obesity costs the country an estimated £58 billion. The Government are doing all we can to help reduce that from an early age.
NHS: Hospital Waiting Times
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My Lords, my noble friend makes a good point. Waiting list management and data collection are held locally by individual trusts and integrated care boards. As such, the department does not centrally collect or hold data on deaths or causes of death on the waiting list. Instead, the Department of Health and Social Care and NHS England measure elective performance using a number of existing robust data collections. The DHSC and NHS England both have statutory duties to promote an effective and comprehensive health service. Within that, NHS England is responsible for holding NHS providers and ICBs to account for their performance. However, my noble friend makes a good point and I will take it back to the department and the Secretary of State.
Lord Allan of Hallam (LD)
My Lords, long wait times for cancer diagnosis and treatment can be a matter of life and death for some people. However, we are still some way off meeting the Government’s faster diagnosis standard of 75% of people receiving a definitive yes or no to whether they have cancer within 28 days of an urgent referral. How confident is the Minister that the Government will meet this target by March 2024, as they promised they would?
Measles Cases
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
From 1 January 2023 to 30 November 2023 there were 209 laboratory-confirmed measles cases in England. Over three-quarters of those cases are from the West Midlands, predominantly Birmingham and Coventry. In the West Midlands, an NHS integrated care board system partnership group has been establishing and co-ordinating a regional response. Extensive local communications and engagement have been undertaken in the West Midlands alongside the immediate response to support the uptake of the measles, mumps and rubella vaccine. Nationally, the UK Health Security Agency has established an incident management team to oversee the public health response to the outbreak. The noble Baroness is exactly right: this country had a proud record on vaccination prior to Covid-19 but there has been a decline in recent years since the pandemic, and we have to do more to get back our status.
Lord Allan of Hallam (LD)
My Lords, a large group of adults in this country have not been vaccinated against measles for a variety of reasons. Can the Minister confirm that any adult who believes that they have not had the MMR vaccine can receive it free of charge on demand from their GP? Is he confident that there is enough capacity in the system for the routine childhood immunisations, as well as for making sure that when adults do the right thing and protect themselves with vaccination they can receive one quickly?
Lord Evans of Rainow (Con)
The noble Lord raises a very good point; about 25 years ago there were rumours and misinformation about the MMR vaccine, so there is a cohort of those in the younger generation—mid-20s or so—who should contact their GP today and ask for an appointment, which can be confirmed. I believe that there is capacity for all those who wish to have vaccinations at their GP surgeries.
Deaths: Younger Age Cohorts
Debate between Lord Evans of Rainow and Lord Allan of Hallam(10 months, 2 weeks ago)
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Lord Evans of Rainow (Con)
I am grateful to the noble Lord for his question and I completely agree with him.
Lord Allan of Hallam (LD)
My Lords, I think it is fair to claim that the pandemic was the most comprehensively documented public health event in human history. How much are the Government spending on teams of crack medical data scientists to analyse the wealth of pandemic-related data from the UK and comparable countries? This is outside the inquiry, which I think is about blame to a certain extent, and decision-making in politics. It is about the science. I suggest to the Minister that, if the Government are able to recover money from dodgy PPE suppliers, investing in this research would be a good use of those funds.
Lord Evans of Rainow (Con)
The noble Lord raises a very important point. Of course, it is very important that we learn from the data. The NHS has very good data scientists, many of whom have helped me with today’s Question Time. Regarding the noble Lord’s other comment, he will not be surprised that I cannot comment on that. But your Lordships’ House can rest assured that the Government and the NHS have learned from the Covid pandemic and that it is very important to learn from examining the data.
Vector-borne Diseases
Debate between Lord Evans of Rainow and Lord Allan of Hallam(11 months, 2 weeks ago)
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Lord Evans of Rainow (Con)
My Lords, I am not aware of the bluetongue outbreak, but the Government do a significant amount of research and checking at ports in the United Kingdom when we import livestock and other things. We monitor that, but I do not know about the specific case of bluetongue and I will write to the noble Lord.
Lord Allan of Hallam (LD)
My Lords, the Health Security Agency report warns that London may already be suitable for the survival of the kinds of mosquitoes that spread diseases. This is very worrying for anyone who lives here and experiences—with alarming regularity—the widespread areas of standing water that are caused by the poor drainage system. Given this health risk, will the Minister join the effort to improve the performance of Thames Water, a company that seems more interested in financial engineering than hydraulic engineering? It seems that our future health depends on the willingness of this Government to “kick water butt”.
Noble Lords
NHS: General Medical Practitioners
Debate between Lord Evans of Rainow and Lord Allan of Hallam(1 year ago)
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Lord Evans of Rainow (Con)
I absolutely agree with the noble Lord. If he is inviting me to do something with that, I will certainly take it back to the department based on his question.
Lord Allan of Hallam (LD)
My Lords, among the fastest-growing groups on the doctors register are so-called specialty and associate specialist doctors and locally employed doctors. These doctors are not currently able to work in primary care, although they are very skilled, and the long-term workforce plan says the Government will look into that. What progress have the Government made in talking to the relevant professional bodies about opening up general practice so that more sessions are available?
Lord Evans of Rainow (Con)
I do not have an answer in my pack to that specific question, but the noble Lord raises a very good point. It is very important that we bring more specialist skills into primary care, and GP practices are exactly the right place, but I will come back to the noble Lord on that specific point.
Respiratory Syncytial Virus: Immunisation Programme
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My noble friend makes a very good point, and the noble Lord, Lord Hallam, often refers to this issue. The latest figures confirm that 95% of parents have confidence in the efficiency of the vaccine and immunisation programme. The Government are committed to tackling vaccine misinformation, which includes ongoing monitoring by the UKHSA of vaccine uptake and attitudes to vaccines.
I refer to my original point—it is very important that we get this right. If we act prematurely and get it wrong, misinformation and conspiracy theories grow from not doing it properly in the first place.
Lord Allan of Hallam (LD)
My Lords, I shall not disappoint the Minister by failing to follow up on this question of vaccine hesitancy, which certainly came to the fore during the Covid pandemic. Like many other noble Lords, I have been to get my flu and Covid booster, and it was interesting that the person giving the vaccination said that they were seeing quite a low uptake. I am interested in understanding whether the Government will carry out a serious study into the extent and causes of vaccine hesitancy during this year’s flu and Covid booster programmes so we can learn from that for future programmes, such as the one for RSV.
Lord Evans of Rainow (Con)
The noble Lord makes a very good point. He is an expert on this matter, and I can assure him and the whole House that NHS England has been proactive in this matter. He is ahead of the game: I have yet to have my vaccines done, but the local GP practices in my neck of the woods, I notice, are doing it digitally, online and via text. They are very good at that.
NHS England is preparing earlier than ever before for what is expected to be another challenging winter. More than 7.7 million people have already received their flu jabs since the start of the autumn campaign on 11 September, so we are making good progress. But that is not to say that some areas could not do better.
NHS Waiting Times: Long-Term Sickness Absence
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My noble friend says, “Not enough”, but wherever we can utilise other sectors, such as the private sector, we do so—but there is clearly more to be done.
Lord Allan of Hallam (LD)
My Lords, the most common conditions that lead to economic inactivity are mental health conditions such as depression and acute anxiety. What are the Government doing to get on top of wait times for therapies that will help people with these kinds of mental health conditions? In particular, what are they doing to address the significant inequalities across the country, which mean that people in some places can get talking therapies quickly, while in other places they are left waiting for many months?
Lord Evans of Rainow (Con)
The noble Lord asks a good question; however, it is not just mental health but also other things, such as musculoskeletal and cardiovascular disease, so the whole thing has to be done at the same time. But, on the disparity of the service, the noble Lord raised a good point, and I have said before from this Dispatch Box that more has to be done to share best practice across NHS England.
Dementia Diagnosis
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The noble Lord raises a very important point. He is right that there is substantial variation across integrated care boards in dementia diagnosis rates. NHS England has commissioned a dementia intelligence network to develop a resource to investigate that very issue. It is important that we learn from the very best so that we can put in place an industry-standard best practice to make sure that we get the very best across the country.
Lord Allan of Hallam (LD)
My Lords, is the Minister concerned that there may be misdiagnosis of Alzheimer’s in people who do not speak English as their first language because of the use of verbal cognitive function tests? What are the Government doing to ensure that appropriate tests are available for people from all the different linguistic groups that have a significant presence in the United Kingdom?
Health: Cardiac Arrest
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The noble Lord is very knowledgeable about the West Midlands. I will certainly take that specific point back to the department.
Lord Allan of Hallam (LD)
My Lords, building on the comments made by the noble Baroness, Lady Finlay, about the importance of defibrillators, the Minister may be aware of a database called the Circuit, which has been set up by the British Heart Foundation and its partners so that people can register the defibrillators they have on their premises. The project is far from complete. What might the Government do to encourage registration of defibrillators with that service and encourage the use of the associated consumer service, www.defibfinder.uk?
Lord Evans of Rainow (Con)
I am most grateful to the noble Lord; as always, he asks searching questions on such matters. I have taken the time and trouble to look into the exact app. As for what the Government can do, he has already mentioned the British Heart Foundation, and we are working closely with it. Noble Lords can download the defib app to locate the nearest defib registration on the Circuit; the defibrillators will appear on it. I encourage all organisations—sports clubs, community churches, and so on and so forth—to register to be on the app. That is key. Having the defib is one thing; having it on that app is another.
Blood Donation
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The number of regular donors of black heritage reached an all-time high of almost 20,000 in the year to April 2023. In addition, 7,427 people of black heritage gave blood for the first time between April 2022 and 2023. This year, the NHS needs 12,000 new black heritage donors, and we are working to that. The latest plan launched in National Blood Week focused on black heritage recruitment. We are making extremely good progress in England, but there is still a lot to do.
Lord Allan of Hallam (LD)
My Lords, is the Minister concerned that people may find it difficult to navigate the complex criteria for deciding whether they are eligible to give blood? Are the Government taking any steps to improve the information flow so that no one who can safely give blood is put off because they find the sign-up flow to be a barrier?
Lord Evans of Rainow (Con)
The noble Lord raises an important point. The barrier is not just to the black community but to us all as a nation. For example, there is a myth that, if you have an ear piercing or a tattoo, you can never give blood again. I remember that, when I came back from jet-setting around the world on business, I was asked where I had been, and Canada and certain states in America were not accepted for some reason. The noble Lord is absolutely right about those barriers. If you have a piercing or a tattoo you can still give blood, albeit after a few months.
Primary Care: Inequality
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Allan of Hallam (LD)
My Lords, as well as the Westminster pilot, studies by organisations such as Imperial College have shown the potential for significant benefits to come from the community health worker model, yet the Minister said in his first response that the department had carried out no formal assessment of the model. Given the potential to improve health outcomes and make savings in acute services, does he agree that such a formal assessment would make sense? Is it something the department would like to do but has just not got round to yet?
Lord Evans of Rainow (Con)
The noble Lord raises a good point. He is right that it is still relatively early days: we have to give it an opportunity to embed. I mentioned Churchill Gardens, but it is also happening in rural areas such as Cornwall, west Yorkshire and other parts of the country. We want to see how the scheme works out, because there will be similar results but with a different flavour depending on whether the area is rural, city, metropolitan or coastal.
Drugs: Supply and Availability
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The Government recognise the valuable role that medicines manufacturing plays in the UK economy. It enables us to capitalise on our world-class research and development, create jobs and, significantly, create growth. Life science pharmaceutical manufacturing was responsible for more than £20 billion of exports in 2021. Our Life Sciences Vision set out the Government’s ambition to create a globally competitive environment for manufacturing investment. Last March, we launched the £60 million life sciences innovative manufacturing fund to encourage manufacturing investment in the UK. We will announce the fund’s winners later this year.
Lord Allan of Hallam (LD)
My Lords, for people to be able to access the drugs they need it is essential that there is a well-staffed network of local community pharmacies. Can the Minister confirm that there will be increased training of pharmacists in the Government’s long-awaited NHS workforce plan? When can we expect to see it?
Lord Evans of Rainow (Con)
I thank the noble Lord for that question. I assure him that, earlier this morning, before I came to this Dispatch Box, I asked for an update on the workforce plan. It is going to be released shortly—
Health: Economic Inactivity
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The noble Baroness asks a difficult question that I cannot answer in full. But the Government are supporting disabled people and have done for over a decade now. It is important that people who can work should do so, including disabled people. But I cannot give a fulsome response to the noble Baroness’s question, so I will write to her.
Lord Allan of Hallam (LD)
My Lords, the data shows that there has been a significant and worrying increase in the number of people leaving work because of long-term illness and disability, and it is in everyone’s interest that everything possible is done to keep people in work as their conditions develop. In that respect, and following the previous question on occupational health, what are the Government doing to ensure that sufficient occupational health professionals are available to support all of the businesses that need them? Will this profession be part of the long-awaited workforce development plan that we are looking for from the Government?
Lord Evans of Rainow (Con)
The noble Lord is absolutely right to talk about data and how we can learn from it. It is currently difficult to quantity the direct effects of this, but it is indeed a factor. Data on employment rates suggests that those awaiting treatment were often already inactive before Covid, and it is therefore possible that longer waiting lists may be exacerbating this. But the noble Lord raised a good point, and I agree with him: that is what the Government will be doing, because it is important to take each patient on a case-by-case basis, rather than a one-size-fits-all approach.
Brain Tumours
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
I thank the noble Baroness for her question; she shows her expertise in such matters. The UK departments for cancer research are jointly funding a network of 17 experimental cancer medical centres across the UK, plus a network for children which is dedicated to early-phase research into childhood cancers; we invested a total of £36 million between 2017 and 2022.
Lord Allan of Hallam (LD)
My Lords, can the Minister assure the House that the Government are committed to supporting research into brain tumours affecting children—in particular DIPG, which affects up to 40 children a year and for which, sadly, there is still no effective treatment?
Lord Evans of Rainow (Con)
The Government are committed to trying to solve the problem of childhood cancers. I am not aware of that specific case, but I can assure the noble Lord that, as I said in my previous answer, government research into childhood cancers will continue. However, there is still a lot of work to do; as the noble Lord well knows, this is a complicated and difficult subject to follow. There is a small medical community looking into this complicated disease, but the Government are doing all that they can.
Medical Devices and Equipment
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My Lords, the People’s Republic of China is not part of the Question and remit I have here, but I will certainly pass the noble Lord’s question on to my noble friend Lord Markham.
Lord Allan of Hallam (LD)
My Lords, the Minister may be aware of research that we have carried out showing that many hospitals are using outdated equipment, including X-ray machines that are more than 20 years old. What are the Government doing to ensure that NHS England’s advice to replace equipment such as scanners and X-ray machines every 10 years is being followed? What are they doing to make sure that cost pressures do not become another reason to delay further the replacement of this essential equipment?
Lord Evans of Rainow (Con)
I am grateful for the noble Lord’s question. As somebody who used to deal in such equipment, I totally agree with him that you should always have the latest, most up-to-date equipment. Twenty years sounds like an awfully long time in technological development terms, so I take on board exactly what the noble Lord says.
HIV Transmission
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
I thank my noble friend for that question. The Prime Minister is also concerned about reports that inappropriate materials are being used to teach sex and relationship education to young people. As the Prime Minister has set out, we are clear that the materials used must be factual and age appropriate. We have brought forward a review of the statutory guidance and will conduct a consultation on it later this year, as planned and in line with the usual process. The review will look at whether we should place clearer limits on the content being taught to children, depending on their age.
Lord Allan of Hallam (LD)
My Lords, there has been a significant and welcome increase in the number of people ordering HIV tests online, but when they go to the freetesting.hiv website they find that tests are available in only a limited number of local authority areas. Will the Minister look at the potential benefits of making this free testing service available in more parts of the country?
Lord Evans of Rainow (Con)
I thank the noble Lord for that question. I was unaware that it was not universally available to all health authorities in the UK, but I shall certainly pass that question on.
Eating Disorder Services: Men
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
The noble Lord raises a very good point. I apologise to the noble Baroness; I cannot give a specific answer as to why it is 2,000 calories rather than 2,500, but I will ask and come back to her.
Lord Allan of Hallam (LD)
My Lords, my noble friend’s Question brought back a memory from my teenage years of being told by a nurse that she would say that I had anorexia but that could not be the case because I was a boy. Fortunately, our understanding has moved on since then and we now recognise that eating disorders can affect everyone, irrespective of gender or age. Does the Minister agree that public health services have a vital role to play in broadening that understanding among the general population? What resources will the Government provide to them for that essential educational work?
Lord Evans of Rainow (Con)
The noble Lord raises a very good point. When he and I were young boys, there was not the internet. He shows that this issue did occur before the internet. Under the NHS long-term plan for 2023-24, we will invest almost £1 billion extra funding in community mental health care for adults with severe mental illness, including dietary issues.
Immunisation: Winter 2023-24
Debate between Lord Evans of Rainow and Lord Allan of Hallam(1 year, 9 months ago)
Lords ChamberRead Full debate Read Hansard Text
Lord Evans of Rainow (Con)
Everyone aged over 50 and at-risk groups were offered a Covid-19 booster and flu jab to increase protection against viruses this winter. We intend to improve on that for the forthcoming winter, in 2023-24.
Lord Allan of Hallam (LD)
My Lords, the Government’s regular flu and Covid-19 surveillance reports tell us that vaccination rates continue to vary widely between different demographic groups. Will the Minister share with the House the Government’s latest thinking on how they are going to improve vaccination take-up in those harder-to-reach groups so that everyone can benefit from that protection?
Lord Evans of Rainow (Con)
The noble Lord has mentioned digital connectivity several times in this place, and that is a very important part of how we can appeal to young people, along with working with education, schools and colleges. As I said in a reply a moment ago, when you visit a GP practice, you will be offered these treatments.
Cancer Therapies Access
Debate between Lord Evans of Rainow and Lord Allan of Hallam
Lord Evans of Rainow (Con)
My Lords, I pay tribute to the noble Lord and the work that he has done on the All-Party Parliamentary Group on Minimally Invasive Cancer Therapies. In 2022-23, Health Education England is continuing to take forward priorities identified in the cancer workforce plan phase 1 and is investing an additional £50 million in 2022-23 to further expand the cancer and diagnosis workforce. Spending plans for individual budgets in 2023-24 to 2024-25 inclusive are subject to a detailed financial planning exercise and will be finalised in due course.
Lord Allan of Hallam (LD)
My Lords, as the noble Lord, Lord Aberdare, has already pointed out, interventional radiologists are essential to being able to provide minimally invasive cancer therapies. What is the Minister’s response to the Royal College of Radiologists’ 2021 census report, which painted a picture of growing concerns about the availability of interventional radiologists, as supply is not keeping up with demand? Will this particular shortage also be covered in the workforce plan? We will keep going on about the plan until we see it.
Lord Evans of Rainow (Con)
My Lords, NHS England commissions selective internal radiation therapy as a treatment of choice for patients with unresectable advanced hepatocellular carcinoma in accordance with technology appraisals and metastatic colorectal cancer in accordance with the NHS England clinical commissioning policy. It should be noted that the market engagement and prior information notice process permitted any NHS trust that hosts a specialist liver service and multidisciplinary team to put themselves forward, either independently or in partnership with other NHS trusts.