Vaccination: Condition of Deployment

Lord Farmer Excerpts

Thursday 3rd February 2022 Lords Chamber

[Lord Kamall (Con)]

I agree with the sentiments expressed by the noble Viscount. Sometimes it takes the worst of times to bring out the best in people. It was an incredible response. It was also a very sad, emotional response. People lost loved ones, friends and relatives, and we were unable to contact people. I still have not seen my mother since January 2019 and my father died in September 2020, and I have not seen his grave. We have all been through incredibly emotional times and lost loved ones. On the fourth jab, we are continuing to review this—for example, we know that Israel has gone for a fourth jab. The briefings I get say that it is too early to tell whether there will be a fourth jab. It depends on whether immunity wanes, and whether the immunity that people now have responds to new variants, for example. In the longer term, if we have to live with this virus, will it almost be like the flu, with people having to take annual jabs? It is too early to give a definitive answer on that, but as soon as the evidence suggests one way or the other, we will notify noble Lords.

[Lord Farmer (Con)]

My Lords, may I come at this matter from another angle? Dr Steve James, the King’s College Hospital intensive care doctor who defended the principle of bodily autonomy to the Health Secretary, said natural immunity should be taken into account. Healthcare workers like him, especially those who have had Covid, keep topping up their natural immunity with micro exposures. In the omicron rethink, are the Government considering allowing vaccine-hesitant people to use readily available antibody test kit results instead of vaccine status?

[Lord Kamall (Con)]

First, I thank my noble friend for giving advance notice of the question, enabling me to try to get an answer. While we do intend to revoke the VCOD, subject to consultation in these sectors, we believe that staff still have an important professional responsibility to be vaccinated. The Secretary of State has written to regulators to review their guidance on vaccination for social care providers and the importance of vaccination in supporting the provision of safe care. We believe that vaccination remains important. In conversations I have had—on the daily calls with the UKHSA, for example—I have been told that even if people believe they have natural immunity, vaccination increases immunity by a further percentage. We believe it is worthwhile encouraging people to take vaccines.

Health and Care Bill

Lord Farmer Excerpts

Lords Hansard - Part 1 & Committee stage
Wednesday 26th January 2022 Lords Chamber

Moved by

[Lord Farmer]

154: Clause 21, page 30, line 1, leave out “may” and insert “must”
Member’s explanatory statement
This amendment and others to Clause 21 and Schedule 4 in the name of Lord Farmer would specify that integrated care partnerships consider how to integrate family help services into the provision of health and social care services, as relationships are recognised by research as a 'health asset'. ‘Family help’ is defined in accordance with the Independent Care Review’s starting definition. ‘Family hubs’ are named as key potential sites for delivering integrated paediatric health and family help.

[Lord Farmer (Con)]

My Lords, I will speak to all four amendments in this group in my name. I remind the Committee that I have already declared my interests, especially as regards integrated care and family hubs.

In Committee in the other place, the Minister, my honourable friend Edward Argar, recognised

“that the system has been calling for two different and important types of integration: integration within and across the NHS to deliver healthcare services within a defined locality, and integration between the NHS and local government and wider partners.”

He went on to say:

“The ICP is intended to bring together health, social care and public health to develop a strategy to address the needs of the area also covered by the integrated care board. If”—


I emphasise “if”—

“the ICP wants to go further, it can also involve representatives from the wider system, where appropriate, such as voluntary and community groups, and social care or housing providers. That will be up to the ICP, and we will welcome locally driven innovation to reflect local circumstances.”—[Official Report, Commons, Health and Care Bill Committee, 16/9/21; col. 332.]

I, too, welcome locally driven innovation to reflect local circumstances, as I will emphasise shortly. However, I am genuinely mystified as to why integration between the NHS and local government and wider partners is voluntaristic in the Bill. My Amendment 154 would exchange “may” for “must” and require integrated care partnerships to include in their strategy a statement of how health-related services could be more closely integrated with health and social care.

--- Later in debate ---

[Lord Kamall (Con)]

I thank my noble friend Lord Farmer and all noble Lords who spoke about their experiences. The creation of integrated care boards represents a huge opportunity to support and improve the planning and provision of services to make sure that they are more joined up and better meet the needs of infants, children and young people.

Before I go into the specific amendments, I make it quite clear, as my noble friend said, that the Government set out in their manifesto a commitment to championing family hubs. We want to see them across the country, but at the same time we must give democratically elected councils the choice to shape how services are delivered, bearing in mind some of the points made by the noble Lords, Lord Mawson and Lord Warner, whom I thank for their experience on this.

The Government agree that it is vital to ensure that ICPs work closely with a range of organisations and services to consider the whole needs of a family when providing health and care support. In preparing the integrated care strategy, the integrated care partnership must involve local Healthwatch and the people who live or work in the area. We are working with NHS England and NHS Improvement on bespoke draft guidance, which will set out the measures that ICBs and ICPs should take to ensure they deliver for babies, children and young people. This will cover services that my noble friend considers part of family help.

In addition, the independent review of children’s social care is still considering its definition of “family help”, and the definition published in The Case for Change may well be further refined as a result of ongoing consultation. It would be inappropriate to define the term in legislation at this stage, pre-empting the full findings of the review and the Government’s response to it. Also, it is important that there should be a degree of local determination as to what should be included in the strategies of ICBs and ICPs. In order for them to deliver for their local populations, a permissive approach is critical.

On Amendment 167, we agree that family hubs are a wonderful innovation in service organisation and delivery for families. The great thing about them is how they emerged organically from local councils over the last decade. I pay tribute to my noble friend for the key role he has played in advocating family hubs and bringing this innovation to the heart of government. The Government strongly support and champion the move but we are clear that they have to be effective and successful—they need to be able to adapt to local needs and circumstances. They also need to be able to operate affordably, making use of a diverse range of local and central funding streams.

In both these regards, local democratically elected councils should hold the ultimate decision-making power over whether to adopt a family hub model and how it should function. As such, I regret that we cannot support the amendment, which would place too much prescription on the decisions and actions of local authorities and risk imposing significant new financial burdens. For this reason, I ask my noble friend to consider withdrawing his amendment.

[Lord Farmer (Con)]

My Lords, I thank the Minister for his rather disappointing reply and those who supported these amendments, particularly the noble Baroness, Lady Tyler, and my noble friend Lady Wyld, for giving such clear definition to the services and the advantages of family hubs. I take to heart the advice from the noble Lord, Lord Mawson, about unintended consequences. I would quite happily talk to him about this. I also take the point from the noble Lord, Lord Warner, that it is nought to 19, not nought to five. Families have so many problems with teenagers, as we see on the streets today, and family hubs can be a non-stigmatising place where help can be got.

I agree with the noble Baroness, Lady Merron, about Sure Start. In a way, I have always said that family hubs are building on Labour’s Sure Start centres. However, it is not nought to five but nought to 19—in fact, nought to 25 for children who come out of the care system, et cetera, with special needs.

There might be concern that my amendments attempt inappropriately to set in concrete the policy of family hubs when it is constantly progressing. However, the changes I have described are not just about bringing the latest policy idea into the Bill. Absent of these references to places where families know that they can access help and be connected to the full gamut of local services and support, the Bill will not reflect the overarching direction of travel. Their inclusion requires health to be fully on board, which has not happened in the past, to the detriment of the success of previous policies.

Health and Care Bill

Lord Farmer Excerpts

Committee stage
Thursday 20th January 2022 Lords Chamber

[Lord Farmer (Con)]

My Lords, my Amendment 57, which the noble Baroness, Lady Masham, has mentioned, is also supported by the noble Baroness, Lady Walmsley. I declare my interest as a director and controlling shareholder of the Family Hubs Network Ltd, which advocates for family hubs and advises local authorities on how to establish them. I am also a vice-president of the LGA.

In speaking to my Amendment 57, I would point out that in Chinese medicine you traditionally saw the doctor when in health. They were paid a retainer to keep you that way and, if you became sick, they would not be paid until health was regained. This speaks volumes about alternative health paradigms to our own. Even if we never go that far, the prevention of disease and the maintenance of health should be an overriding priority for the health service.

In placing the duty to prevent the development of poor physical and mental health directly under the duty to promote the NHS constitution, it is my intention to make it a similarly fundamental duty. Prevention is always better than cure. Yes, prevention is already mentioned in the Bill, for example in Clauses 5 and 16, and elsewhere in Clauses 20 and 59. However I do not consider that it is given sufficient weight, particularly given concerns shared with me by members of the Family Hubs Network.

Family Hubs Network members work with existing integrated care systems and note that the main issue faced by these ICSs is the management and throughput of the frail, elderly population to address bed-blocking and the onward delays to elective surgery. Hence they can lean towards an acute hospital reactive care model. Family Hubs Network members are already seeing the consequence of this with, for example, few if any ICS strategies focusing on population health through prevention and early help, especially for children and families.

Indeed, more and more ICSs are seeing community-based contracts swallowed up by the acute hospital conglomerates. They rarely, if ever, hold the necessary cultural understanding of community care, prevention and early help, and their interests do not lie in these. Children’s health services, which would ideally be delivered in the community, can be drawn into acute hospital structures which are more reactive than preventive in nature. Yet in some cases these very same services, such as continence, speech and language, allergies and others, are being delivered in community settings, close to families, through integrated family service hubs. Given that many of these health needs are also psychosocial and practical, accessing them from such settings enables families also to receive local authority-commissioned early help. This surely is integration in action.

My amendment also specifies that health services should be available in the community where possible, to improve access and help prevent conditions from worsening. A local-by-default approach would cut down the number of patients required to make prohibitively long journeys when a service could instead be delivered in a primary care or local authority setting. We need a reverse Beeching for healthcare, where we reopen community hospitals. Out-of-area specialist mental health hospitals, which remove people from the social networks which help them get better more quickly, were in the news again this week. Local units have closed and there is a lack of care in the community, even though this is a far less expensive option and the setting in which many prefer to be treated.

Returning to the issue of our ageing population, a reactive care model is completely unsustainable. Unless we focus on preventing big-ticket items such as diabetes, depression, anxiety and dementia—the list is endless—the cost of providing healthcare will keep going up year on year, by even more than it already does. A preventive paradigm would ensure greater ruthlessness about educating parents and healthcare workers about the psychotic effects of high-strength cannabis, for instance.

The eminent professor, Sir Robin Murray, recently said:

“I think we’re now 100 per cent sure that cannabis is one of the causes of a schizophrenia-like psychosis. If we could abolish the consumption of skunk we would have 30 per cent less patients”—


this was in south London—

“and we might make a better job of looking after the patients we have.”

In 2019, Murray’s research team reported in the Lancet Psychiatry their finding that south London had the highest incidence of psychosis in Europe and singled out cannabis as the largest contributing factor. He expressed concern that some liberal-minded parents would rather see their children smoking pot than drinking, without appreciating the potential associated dangers and the social and economic costs. These multiply with skunk, which is several times more potent than the drug they might have been used to in their day.

It is not just parents who need educating, including about higher-strength forms: experts say that cannabis addiction is treated by health professionals as a low-risk soft drug, yet, since 2005, there has been a 777% increase in the number of those aged 55 and over who need treatment for it. When cigarettes’ contribution to the development of lung cancer was firmly established, action to prevent smoking was taken despite it being fashionable and popular—more than 60% of adult males smoked; now that number is approaching 15%.

When there is incontrovertible evidence that something harms mental or physical health, a duty to prevent would mean that such damaging ignorance was no longer allowed to prevail. Ditto foot-dragging on access: mental health care in the community has been talked about since we began to close asylums in the early 1960s, yet it is still in the NHS long-term plan. I am keen to hear from my noble friend the Minister why prevention should not be given prominence as a duty in the Bill.

[Baroness Hollins (CB)]

My Lords, it is a pleasure to follow the noble Lord, Lord Farmer. I really appreciate his remarks about Professor Murray’s work and his interpretation of it.

This is a Bill about integration, but how much integration will it actually achieve? We have spoken many times about wanting health and social care to work better together, but there is a difference between collaboration and integration. The former achieves two separate systems that, while better aligned in, for example, their information sharing, still operate without particular reference to the other. Those who use both systems continue to straddle a divide between the two and, too often, fall between those gaps.

Integration, on the other hand, speaks of synergy and of systems that enable one another and close the divide between the two, so that people can move between them without the terrifying leap of faith that currently exists. This is what will truly make a difference for those who use these services.

Unfortunately, the Bill in its current form will struggle to bring about this true integration. It requires the production of only a health outcomes framework, which will simply entrench the divide between health and social care, as both will continue to pull in different directions with different objectives, which are often conflicting.

Currently, health and social care sectors work towards two different sets of aims: social care is led by the well-being objectives of the Care Act 2014, whereas the NHS is led by various objectives set out in documents such as the NHS constitution, the NHS Oversight Framework and the NHS Long Term Plan.

An integrated service would mark a major shift in how the two systems view their role in supporting those who use their services. For example, it could see the NHS adopting an approach that was informed by ensuring the independence of its patients in a similar way to the principles that lead the provision of care and support. The greatest problems have been caused when health and social care start to gatekeep their domains: I have had to speak too often about the abhorrent placement of people with complex needs in in-patient units far from home, as a result of catastrophically poor alignment of health and social care support to meet their needs locally. I declare an interest as chair of the Department of Health and Social Care-appointed panel to oversee the discharge of people with learning disabilities and autistic people who are detained in long-term segregation.

I want to thank Mencap and Skills for Care for briefings on my amendments in this group. My Amendments 85 and 88 would place greater emphasis on the provision and quality of social care services and on the integration of health and social care services. I also declare an interest as president of the Royal College of Occupational Therapists. This is relevant because occupational therapy is a health profession that is equally at home in the NHS and in social care, and because occupational therapists have a role in tackling long-standing health inequalities through community rehabilitation and in prevention.

The history of health and care integration is littered with a natural reflex towards health and the pressing political priorities of the day. The ICB is primarily NHS focused and will hold responsibility for strategic planning and monitoring of services against the needs of an ICS population, but the answers cannot all come from health alone. We are in danger of missing an opportunity.

A duty to promote integration must include adequate provision for both health and care by taking a holistic approach. The outcomes from one will impact significantly on the other. Viewing the duty to promote integration through a health lens alone limits our understanding of what social care has to offer—think back to the debate on my noble friend Lord Mawson’s amendment on Tuesday. In some areas, integrated care system planning seems to focus mostly on integration within healthcare and not on integration between and across health-led provision and social care. At present, provider alliances are largely acute trust led.

Let us take discharge co-ordination as an example. It is currently suboptimal, with too few care co-ordinators, a lack of social care representation and feedback in assessment decisions, and a neglect of the resources and expertise of voluntary and independent providers.

The staffing context is complex. According to Skills for Care, there are 17,700 organisations providing or organising care, delivered through 39,000 establishments. Some 41% of those are residential, 59% are non- residential and 68% are CQC regulated. More than 6,000 organisations have fewer than four employees. That is a very broad church of employers. Not only does it make it much more difficult to communicate but social care lacks the infrastructure of the NHS to disseminate and co-ordinate.

My amendments propose strengthened provisions for ICBs to consider how integration benefits and can benefit from social care. My Amendment 89 would require ICBs to develop and publish a health and social care outcomes framework at least every two years to ensure that health and social care services are properly integrated.

ICSs present an opportunity to co-ordinate services, improve population health and plan on a system-wide basis to attract and retain staff with the right mix of skills. The ICS role should therefore ensure that the right staff skill mix is available to deliver this singular vision, a vision of person-centred and outcome-based care through multidisciplinary teams operating with and around each individual. Integrated care would mean that people would only have to tell their story once to receive high-quality, joined-up and seamless care. The approach each system takes to workforce planning will rightly vary to meet local needs and requirements, but that does not mean that their workforce plans cannot be measured against a joint outcomes framework. In collaboration with partners, Skills for Care has developed principles of workforce integration which address the above points.

The aim of this amendment is to ensure that health and social care do not pursue two different sets of objectives but work to a common aim to underpin transformation. I ask the Minister to reassure the Committee on these points. I believe these amendments will be helpful.

Health and Care Bill

Lord Farmer Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Farmer (Con)]

My Lords, I join with all noble Lords to welcome the noble Lord, Lord Stevens of Birmingham. I really enjoyed his constructive and funny maiden speech.

If integration is the aim of the Health and Care Bill, it fails in one extremely important respect, brought into stark relief by the tragedy of Arthur Labinjo-Hughes. I say this not to appropriate a hard case, but because the two reviews led by the noble Lord, Lord Laming, following similarly horrifying child deaths, both stressed the need to integrate all the services that should keep children safe. Although prevention and early intervention in the form of family help have been missing for too long from the pipeline that led to children’s social care, this lack is now finally being rectified by the Government’s focus on rolling out family hubs. Yet this important new infrastructure, which also integrates paediatric health, goes unmentioned in the Bill.

Family help needs to include an emphasis on the prevention of family breakdown, the elephant in the room of children’s social care policy. As I said yesterday after the repeat of the Statement about Arthur,

“Evidence shows that children on the at-risk register are eight times more likely to be living with a natural parent and their current partner”—[Official Report, 6/12/21; col. 1677.]


than the national distribution for similar social classes. Children living in households with unrelated adults are nearly 50 times as likely to die of inflicted injuries than children living with two biological parents. When both mother and father feel kin altruism towards a child, this can make a significant and decisive difference to that child’s health. Good family and other relationships are health assets, so the Bill should treat family-based interventions as part of the overall health approach and recognise the need to integrate them with physical and mental health provision.

Even absent this monstrous case, the Health and Care Bill should be reinforcing and integrating other cross-departmental work in government, such as the commitment to champion family hubs for families with children aged nought to 19—or up to 25, if there are special educational needs. Family hubs build on the work of children’s centres but go far beyond it and are central to the implementation of the Start4Life workstream, based in the Department of Health and Social Care. In fairness to the Government, this agenda has gathered considerable momentum since the Bill was published, and family hubs are now a big-ticket spending item in the £500 million spending-review commitment to support families.

They can also work preventively to meet children’s health needs, in relation to childhood obesity for example, as close to home as possible. In Essex, family hubs deliver midwifery and immunisation services and prevent unnecessary attendances in GP practices and A&E. They also deploy community-based clinical expertise for conditions such as allergies, continence, perinatal mental health, speech and language services and neuro- developmental conditions such as autism. This means that busy parents, who often have several children to look after, are spared lengthy and expensive hospital visits. When getting to that visit proves too difficult for the family, the ill child goes without treatment, and hospital- based services have yet another wasted appointment.

A preventive community asset-building approach requires out-of-hospital care to be protected and enhanced, possibly by ring-fencing funding for community-based provision. Yet the importance of preventive health support and treatment has not been adequately covered in the Bill. It is simply listed as one of several commissioning requirements of ICBs, with no broad mention of children’s health. Only young children are mentioned in the context of maternity services. Finally, the desired short and long-term health and well-being outcomes for children and families need to be determined, achieved and measured.

In summary, children’s community health provision must begin with a preventive community asset-building approach and be aligned and integrated with public health and local authority-funded early-help provision. As Dame Rachel de Souza, the Children’s Commissioner, said about Arthur, the life of a child is of “inestimable value”. The omission of school-age children, young people and family support was always puzzling, given the integrating imperative of the Bill. It makes even less sense in the wake of this tragedy.

Men’s Health Strategy

Lord Farmer Excerpts

Monday 25th October 2021 Lords Chamber

Asked by

[Lord Farmer]

To ask Her Majesty’s Government what plans they have to introduce a men’s health strategy.

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

Average male life expectancy is below female life expectancy in the UK, although women spend a greater proportion of their lives in ill health and disability. We are committed to taking action on the range of specific conditions that affect men particularly, including heart disease, liver disease and cancer. Tackling mental health, including suicide, and smoking—both of which are more prevalent in men—are also an important focus.

[Lord Farmer (Con)]

I thank my noble friend for that fairly comprehensive reply and I take this opportunity to welcome him to the Front Bench and give him every wish for good health during his tenure. The latest ONS estimates show that male life expectancy is falling. What analysis have the Government made of the social determinants of health that contribute to this decline, particularly many men’s lack of close relationships? How will they address the fact that, although loneliness is putting significant pressure on GPs, men are less likely than women to come forward?

[Lord Kamall (Con)]

I thank my noble friend for his warm welcome and hope that this continues for some time. To answer his question, the Government regularly consider the social determinants of health, especially how they contribute to our life and healthy life expectancy. We have seen growth in life expectancy slow in line with many countries, which is a challenge that has been exacerbated by the Covid-19 pandemic. We have not yet made a specific assessment of how social determinants drive male life expectancy. On the point about men’s loneliness, since the beginning of the pandemic we have invested £34 million in organisations supporting people who experience loneliness, including men.

NHS: Hospital Visiting

Lord Farmer Excerpts

Wednesday 15th September 2021 Lords Chamber

Asked by

[Lord Farmer]

To ask Her Majesty’s Government what steps they are taking to ensure visiting arrangements in all NHS hospitals resume as soon as possible.

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

My Lords, we absolutely recognise the importance of people’s ability to visit their loved ones. Over the pandemic, NHS guidance advised all NHS hospitals to welcome visiting in a Covid-secure way. Now that we are not in a national lockdown, visiting arrangements are set out locally by NHS trusts and other NHS bodies. The health, safety and well-being of patients, staff and communities remains the priority, but careful visiting policies remain appropriate to ensure safe hospital visits.

[Lord Farmer (Con)]

My Lords, I thank the Minister for his Answer. Do the Government collect statistics on the number of in-patients whose mental well-being deteriorates during their stay in hospital? Also, what assessment, if any, has been made of the impact of visits on patients’ mental well-being and recovery?

[Lord Bethell (Con)]

My noble friend raises an important question. Mental well-being is affected by visiting. We know that particularly from social care, where this has been a particularly onerous problem for those in care and their loved ones. I am not aware of any statistics being assessed but I will look into it and write to him. He makes an extremely important point. We do, however, take statistics on nosocomial infection. I am afraid that is a massive issue, which we must balance at the same time.

Covid-19 Update

Lord Farmer Excerpts

Thursday 9th September 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful to the noble Lord for raising the point again, and my apologies to the noble Baroness, Lady Brinton, for not addressing her point the first time around. I will just say that, from 19 July, it has been voluntary for organisations to use and implement the Covid pass under step 4. There are some essential settings where certification should not be used, and we have made that plain.

However, the Government are encouraging and supporting businesses and large events to use the Covid pass. The Government intend to make full vaccination a condition of entry to nightclubs and other venues where large crowds gather from the end of September. Work is under way to find a solution for Northern Ireland citizens who have been vaccinated in England but are registered with a GP in Northern Ireland. We are also very close to establishing data flows with the Isle of Man.

To the noble Lord’s point about those who have had their vaccinations overseas, in countries such as Norway, he is entirely right. We are working extremely hard on those processes. I have met with NHSX and NHSD to talk about this matter and I assure him that we are putting every effort into dealing with it. I wish that we had dealt with it by now. It is an extremely complex matter. The validation and verification of vaccines requires an enormous amount of bilateral and multilateral co-ordination, and the approval of different vaccines taken by different people in different locations and the record keeping by overseas countries are things that we have to consider and manage. He is right: when the Covid pass system is brought in, those who have had a vaccine overseas will need special consideration. I reassure him that we are working as hard as we can to resolve that issue.

[Lord Farmer (Con)]

My Lords, perhaps I might bring up the subject of antibodies. All the statements seem to be focused completely on vaccinations, yet there is growing evidence that those people who have had Covid and have had vaccinations are indeed almost super-immune even to variants. There was an article in today’s Telegraph about that. So my first question is, do the Government have any idea how many people have in fact had Covid? There are an awful lot of people who have not had symptoms, have been at home, have had it and have recovered, and the Government have not really been informed about it. Is there knowledge in the Government about this area and, if so, is research being done on the strength of the antibodies of those who have had Covid and is that being taken into account in policy?

[Lord Bethell (Con)]

My noble friend has had an interest in this very important area for some time, and I completely applaud his diligence on it. It is an area that I share an absolute fascination with. We know so much about the vaccines but so little about the body’s immune system. It is incredibly frustrating but it is, I am afraid to say, just one aspect of this pandemic.

To answer the specific question of how many people have had the disease, it is difficult to be precise. Unfortunately, a lot of people have had the disease and never known that they had it. The fact that they have now gone on to have a vaccine means that it is extremely difficult for us to trace whether they have had the disease, because we do it mainly through the counting of antibodies. My noble friend can look on the ONS website, which I am sure he probably has, and he will see that the Venn diagram makes it almost impossible to figure out exactly how many people have had the disease. I can, through correspondence, share with him the various modelling that we have done, but there is not a definitive answer to that question.

I wish it were true that having had the disease and the vaccine together creates some kind of super-immunity, but I am afraid that there is a subset of people who have had both the vaccine and the disease who then go on to have the disease again. I have met a few of those people; they are extremely frustrated, as you can imagine. I am afraid that it does not bode well for thinking that the vaccine presents a concrete and immutable guard against the disease. I am afraid we will be living with the thought of boosters and improvements on the vaccine for some time to come. That is emerging as something we are working on. We are doing a tremendous amount of research on this. I had a meeting earlier with the antibody team, and I reassure my noble friend that we are doing everything we can to understand it better.

Covid-19 Update

Lord Farmer Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I suspect that I have corresponded with the noble Lord from my personal email address; I am deeply hurt that he does not want to receive any of my emails again, but not entirely surprised. The waiting at test and trace has moved dramatically, as I think the noble Lord knows, from the central supply of testing and tracing services to a much more local model, and that does not always manifest itself in the corporate accounts of the organisation. It manifests itself in both the management and the delivery, and I pay huge tribute to those who are involved in the local implementation. As I said earlier, the way in which the delta virus infection rates, which were skyrocketing at one point, have been turned around in places such as Hounslow, Blackburn with Darwen and other areas of the north-west is phenomenally impressive and is a tribute to the impact of test and trace.

[Lord Farmer (Con)]

My Lords, what has the SIREN study most recently established about the effectiveness of infection-induced antibodies over time? Furthermore, as per my Written Question, answered by the Minister on 2 June 2021, why has not Public Health England or another government-backed health body conducted a review of research on the long-term effects of face mask wearing when clinicians such as Antonio Lazzarino from UCL’s Institute of Epidemiology and Health Care cite deleterious health effects?

[Lord Bethell (Con)]

My Lords, SIREN is one of the most thought-provoking and interesting of all the many studies that we have done. It is a sad fact that we do not understand many of the aspects of the body’s immune system, and that is why we are so committed to that study. It suggests that once you have had the virus, your body’s immune system is extremely strong. The proportion of people who catch it a second time round is incredibly small. That is good news for those who have caught it and for those who have had the vaccine, because if the immune system works well after catching the virus, it probably works well after the vaccine. However, we continue to publish from the SIREN study. On the health impacts of wearing face masks, I am not fully across that, but I will be glad to write to my noble friend with any details that I may have.

Covid-19: One Year Report

Lord Farmer Excerpts

Thursday 25th March 2021 Lords Chamber

[Lord Farmer (Con) [V]]

My Lords, the Coronavirus Act one-year report, published earlier this week, states:

“Since the start of the pandemic, we have dramatically improved our understanding of the virus: the physiological impact it causes, how it transmits, and most importantly, the measures we can take to reduce infection.”


What it tellingly neglects to say is that we have also, dramatically and painfully, improved our understanding of the mental and physical health impacts of those measures—tellingly, because our draconian restrictions have produced a new social order that has infection reduction as the one overriding priority, regardless of how low infections are.

A public health-determined yardstick of risk is firmly in the ascendant and seems likely to remain so for the foreseeable future. Polling showing public support for restrictions cannot be the sole occupant of the driving seat in this House. We are here to scrutinise the likely effects of legislation. We know enough about the effects of lockdowns to give us pause before we renew the regulations being debated.

For the sake of time, I will focus on brain and mind. The monotony of lockdown depletes our memories and makes us sluggish, and screen overload cramps our ability to concentrate. Isolation causes brains to shrink. Lonely people’s brain volumes reduce in the region affecting decision-making and social behaviour. Prolonged isolation affects regions associated with learning, memory and the processing of emotion. Basically, the processing capacity of a brain not constantly challenged through social interaction begins to decline. Loneliness releases stress hormones affecting neuro- transmitters such as dopamine, serotonin and adrenaline, which profoundly influence brain function and mood. It also sharply increases the rate of Alzheimer’s disease among the elderly.

Finally, uncertainty drowns creativity—the elixir of progress and the main natural resource for our island race. We were told that the road map would bring certainty, but instead its rate-determining steps inherently mean constantly changing goalposts. For example, if risk assessment is fundamentally changed by new variants of concern, does that mean, as some fear, that our borders will remain indefinitely closed?

Fear is an important factor, which the Government and their spokespeople in the scientific community seem to have no interest in dissipating, possibly because they see it as a vital tool of social control to force people to abide by our particularly extreme restrictions. Their effect has been to penalise the many, due to fear of the misbehaviour of the few. Holidays always seem one more unattainable metric away.

Many parallels have been drawn with the Second World War and the need to keep morale high over that long campaign. I am not a historian of that period, but I seem to recall that the population were regularly inspired to keep going. The diet of public pronouncements we have been living on cannot be so described. Deaths—key to another of the four criteria—are now even lower than in non-Covid times, but this is hardly mentioned. Fear can now be retired and inspiration can take its place.

Finally, if SAGE meeting attendance is determined by the Chief Scientific Adviser and the Chief Medical Officer, surely the likely emphasis will be the low level of risk acceptable to public health, leaving little oxygen for mental health and other considerations, such as the need to boost morale, resuscitate the economy and get those who have been laid off working again. My question for the Minister is: at what daily rate of infections, hospitalisations and deaths will we unlock?

At the risk of sounding dramatic, many are concluding that a world run according to a level of risk acceptable to public health is one that might be hardly worth living in. It is absolutely clear that, when the day of reckoning comes as to their handling of the pandemic, the Government will be held to account not just for how well they held down infections but for how they balanced this against these other harms that have emerged over this torrid year.

Women’s Health Strategy

Lord Farmer Excerpts

Tuesday 9th March 2021 Lords Chamber

[The Deputy Speaker (Lord Duncan of Springbank) (Con)]

My Lords, we now come to the 20 minutes allocated for Back-Bench questions. There are 13 questioners and only 20 minutes, so pith is the order of the day.

[Lord Farmer (Con)]

My Lords, I have constantly argued against the lack of emphasis on prevention in the Domestic Abuse Bill and have been assured that the domestic abuse strategy and guidance will fill that gap. Domestic abuse disproportionately affects women’s mental and physical ill health, so will the new women’s health strategy prioritise its primary prevention, rather than, as usual, simply addressing its terrible harms?

[Lord Bethell (Con)]

I pay tribute to my noble friend for his campaigning on this important cause. It is not the specific focus of the health strategy but it will play a part in it, and I encourage my noble friend to submit the characteristically detailed evidence, for which he is so well known, to this important evidence-gathering process.