Office for Health Promotion

Debate between Lord Fowler and Lord Bethell

Thursday 29th April 2021 Lords Chamber

[Lord Bethell (Con)]

I completely take the point of the noble Baroness. We are extremely conscious of the challenge presented by social media in particular to identity and sense of body image. I know that there is much liaison between Public Health England and obesity and anorexia charities about its marketing to ensure that it hits the right note. We are investing in digital technology to try to get people moving and change their lifestyles; I pay tribute to the team behind Couch to 5K, who have used apps and digital engagement to encourage millions of people to take important steps towards a more active lifestyle.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the fourth Oral Question.

Folic Acid

Debate between Lord Fowler and Lord Bethell

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I take on board the point that it is time to act. That is why we are working hard on the matter. As I said, I hope to return to the House on this soon.

[The Lord Speaker (Lord Fowler)]

My Lords, all supplementary questions have been asked; congratulations to the Minister. We now move to the third Oral Question.

Care Homes: Guidance

Debate between Lord Fowler and Lord Bethell

Wednesday 21st April 2021 Lords Chamber

[Lord Bethell (Con)]

I completely sympathise with the noble Baroness’s point. She is right: this puts huge pressure on residents and their families. I am heartfelt when I say that I completely agree with her that this has an impact on the mental health and well-being of residents. However, their health, their safety and their actual lives take priority, I am afraid. We are at a moment where, even with the rollout of the vaccine, there is still a high infection rate in the country. If the virus gets into a home it has a potentially devasting effect, spreading very quickly within the confined spaces of the home among people who, typically, are highly vulnerable. That is why we have to put in place these serious protocols. This is done with huge regret and we review it constantly. It is my sincere hope that we can lift these protocols as soon as we possibly can, but until the day when the evidence is conclusive, we have to have them in place in order to protect lives.

[The Lord Speaker (Lord Fowler)]

My Lords, all supplementary questions have been asked and that brings Question Time to an end.

Covid-19: Obesity

Debate between Lord Fowler and Lord Bethell

Wednesday 21st April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I defer to the noble Lord’s expertise and authority in speaking on behalf of those who live in deprivation. He is a valued spokesman for people in such conditions. However, on his analysis, I do not think that poor people cannot lead healthy and fit lives. I do not believe that they cannot make the right decisions for their futures. I have the utmost respect for those who live in poverty; it is for us to give them the inspiration and knowledge that they need to make the right decisions.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now move to the fourth Oral Question.

Folic Acid

Debate between Lord Fowler and Lord Bethell

Tuesday 23rd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I accept the challenge from my noble friend, who articulates his point extremely well. I can see in front of me the timeline on this issue. I can only say that we are trying to approach this in a way that creates a durable, long-lasting solution that is endorsed by mill owners, paediatricians and all the relevant stakeholders. It takes time to build that sort of consensus but we totally recognise the importance of this issue—1,000 NTD deaths a year is far too many. I undertake to put pressure on the department to ensure that this issue makes progress as soon as possible.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed.

Covid-19: Vaccination Programme

Debate between Lord Fowler and Lord Bethell

Wednesday 24th February 2021 Lords Chamber

[Lord Bethell (Con)]

I do not have the precise figure to hand. Those in group 4 will include those with Down’s syndrome and other CEVs; those with severe or profound learning disabilities will be in group 6. As we know, group 4 has had an extremely high conversion rate and, although I do not think it is exactly 100%, it will be an astonishingly high amount and, if those figures are available, I should be glad to write to the noble Baroness with them.

[The Lord Speaker (Lord Fowler)]

My Lords, sadly, the time allowed for this Question has elapsed.

Food-related Crime

Debate between Lord Fowler and Lord Bethell

Monday 22nd February 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord undoubtedly knows that, since January 2021, the FSA has been running a 12-month pilot of the new model of working with local authorities on trading standards in order to improve the work between the FSA and trading standards to address any gaps there may be in that collaboration. On the noble Lord’s question about honey fraud, I completely endorse his shock and outrage that the honey that we buy in the supermarket may be adulterated. It is sometimes said that there is 10 times the amount of manuka honey on sale than could ever be possibly made by the bees of New Zealand. There are challenges on nuclear magnetic resonance spectroscopy allocations, as the noble Lord undoubtedly knows. We are working extremely hard with both Defra and the Laboratory of the Government Chemist to put pressure on international authorities to align the data needed in order to investigate honey more closely.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. That brings Question Time to an end.

Dentists: Covid-19

Debate between Lord Fowler and Lord Bethell

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am grateful for that account of the Northern Ireland statistics, which tell a very similar story to those in other parts of the United Kingdom. The noble Lord is entirely right that those statistics tell a story of the massive challenge dentists face in order to increase the number of appointments per day. We are looking at a number of measures to try to improve that, including ventilation, which was referred to earlier by the noble Baroness. Testing is another option we are looking at. We are trying to put in place the kind of pre-appointment and point-of-care testing that can protect both the employees of dental practices and their patients. I hope that will help accelerate improvement in this area.

[The Lord Speaker (Lord Fowler)]

My Lords, I regret that the time allowed for this Question has elapsed. We now come to the third Oral Question.

Osteoporosis: Treatment

Debate between Lord Fowler and Lord Bethell

Tuesday 9th February 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend is prescient to raise this issue on a day like today, which is slippy and dangerous for those who may take a fall. He is entirely right that the early diagnosis and treatment of osteoporosis are critical for those suffering bone fractures as well as for the system as a whole. The fracture liaison service can play a key role in reducing the risk of fractures in patients and to this end it has been promoted and recognised as best practice by NHS England. As part of the falls and fragility fracture audit programme the fracture liaison service database measures participation and standards in fracture liaison services.

[The Lord Speaker (Lord Fowler)]

Baroness Chisholm of Owlpen. No? I call the noble Baroness, Lady Bull.

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[Lord Bethell (Con)]

My Lords, last year we launched a massive campaign, the Better Health campaign, to encourage healthier living with respect to both eating habits and fitness—I can report to the House that I have committed myself to that campaign and it is bearing some good fruit. We are spending hundreds of millions on marketing, we have engaged dieting services for those who wish to be involved in them, and we have mobilised a huge number of exercise regimes, including the park runs. These are bearing up well, but I encourage all those who wish to have a healthier life to do more.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the third Oral Question.

Covid-19: Over-75s

Debate between Lord Fowler and Lord Bethell

Tuesday 9th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, that is slightly beyond the reach of the Department of Health and Social Care, but I appreciate the noble Lord’s point.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed and we now come to the second Oral Question.

Covid-19: Vaccination

Debate between Lord Fowler and Lord Bethell

Wednesday 20th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am enormously grateful for the testimony of the noble Lord, but I would probably put it slightly differently. Listen, we are in Act I, and I do not think it is quite the right moment to take curtain calls and bows just yet. The NHS has stepped up to this challenge absolutely magnificently, but there is still a huge amount to do and to get through. In addition to the praise that the noble Lord rightly gave the NHS, I also pay tribute to other parts of government, and particularly to the Army, local authorities and the private sector, which contributed the vaccine in the first place, all of which have worked together in a great spirit of collaboration. It is only through that spirit of collaboration that we have been able to deliver what we have.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed, and we now go back to the third Oral Question.

Covid-19: Variant

Debate between Lord Fowler and Lord Bethell

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

The exchange of information between the scientific community has worked extremely well during this pandemic and epidemic, and I pay tribute to it for the open-hearted and transparent way in which it has exchanged data across political, cultural and national boundaries. In terms of transmission, the noble Viscount alludes to something that is very difficult to pin down. It is not clear what proportion of the disease is transmitted through the air and what proportion by touch and manual transmissibility. That is a very frustrating conundrum. The CMO guides us to believe that there is more transmissibility through the air than by touch, but it is absolutely essential that people keep their distance and wash their hands.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the third Oral Question.

Obesity

Debate between Lord Fowler and Lord Bethell

Tuesday 5th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness makes her point very fulsomely. We are doing a huge amount on advertising, promotions, front-of-pack nutritional labelling, out-of-home calorie labelling, alcohol calorie labelling and a whole range of stuff. The noble Baroness may well shake her head, but the truth is that this Government are doing more than any previous Government in this matter.

[The Lord Speaker (Lord Fowler)]

Could we have short supplementaries, please? I call the noble Lord, Lord Brooke of Alverthorpe.

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[Lord Bethell (Con)]

The noble Lord makes an incredibly important point, and he makes it very delicately. I am extremely grateful to him for bringing this to the Chamber. It is true that many people from rural communities in the subcontinent bring with them eating habits that are simply not appropriate for modern life. We have seen that in Covid, where some of the most challenging incidences of Covid ITU have been in communities with a high level of people from the subcontinent, whose eating habits have, frankly, left them in no good state to fight this horrible disease. Tackling that issue is extremely complex, and I am extremely grateful to the Sikh community for setting this good example.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the third Oral Question.

Care Quality Commission Report

Debate between Lord Fowler and Lord Bethell

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

I am very grateful for the reminder from the noble Baroness, and I would be glad to take her recommendation back to the department and write to her on whether there are any measures that we need to put in place to ensure that we are fulfilling our commitments under the Autism Act. It was an important Act, and I suspect that we are well within the measures that it has enacted.

[The Lord Speaker (Lord Fowler)]

Can we speed up a little, please? I call the noble Baroness, Lady Jolly.

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[The Lord Speaker (Lord Fowler)]

Did the Minister hear that in his babysitting duties?

[Lord Bethell (Con) [V]]

My Lords, my noble friend makes an extremely important point. The role of families and communities in the social care provided to those with autism and learning difficulties is extremely important and will be at the centre of every recommendation that we make in response to this report.

HIV: Pre-exposure Prophylaxis

Debate between Lord Fowler and Lord Bethell

Tuesday 1st December 2020 Lords Chamber

[Lord Bethell (Con)]

I am afraid that I was not a Minister in the period that the noble Lord is talking about, so I cannot account for that. However, I agree with him that, on the point he raised about access to PrEP among women and the black community, we have a case to answer. I completely acknowledge that, particularly among the black community, this is one of the most difficult areas that we have to tackle in order to hit our objective of zero transmissions by 2030. We are working extremely hard to try to reassure those who are hesitant about taking on such therapies that they are safe, accessible, private and relevant. We need to win that battle in order to hit our target.

[The Lord Speaker (Lord Fowler)]

All supplementary questions have now been asked and we will therefore move on to the next Question.

HIV: Ending Transmissions

Debate between Lord Fowler and Lord Bethell

Tuesday 1st December 2020 Lords Chamber

[Lord Bethell (Con)]

The Covid epidemic has disrupted things, but I reassure the noble Baroness that in the spending review 2020 we have confirmed that the public health grant will be maintained into next year, enabling local authorities to meet pressures and continue to deliver important public services. DHSC will confirm final allocations in the coming week, including the position on HIV PrEP. I reassure the noble Baroness that PrEP has proved to be an enormously valuable contribution to our fight against transmissions, and we continue to back it.

[The Lord Speaker (Lord Fowler)]

My Lords, I fear the time allowed for that Question has elapsed.

DHSC Answers to Written Questions

Debate between Lord Fowler and Lord Bethell

Wednesday 25th November 2020 Lords Chamber

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

My Lords, the very large number of questions which have been put to the Department of Health is completely unprecedented. We had 577 in the whole of 2019. So far in 2020 we have had 1,783, of which 799 have been answered on time and the rest are late. I apologise for that; it is a matter of huge regret. I ask for the forbearance of the House, as the pandemic has put enormous pressure on the department.

The noble Baroness, Lady Thornton, quite correctly alluded to one aspect of the answering of questions: the questions themselves often address novel challenges. Traditionally, we get questions about things that the department has been doing for years and years, where it is easy to pluck out an answer from the database or from the encyclopaedia of answers. The noble Baroness gave a good example of a question where it is difficult to elicit an answer. I know the exact question she referred to, because I have sought really hard to provide an answer to the noble Lord, Lord Bassam. The question of how many swabs have not been returned by post is much more complicated than it might look. There are different types of swabs; different schemes—ONS, REACT, clinical trials—send in the swabs. Inconveniently, they do not pool all the answers. Also, some swabs may sit on a bench or in a cupboard at a house for a long time and it is not possible to know when they are, or are not, sent back.

I cite that as an example of the kind of challenge that we have faced in answering questions from noble Lords. I am not trying to detract from the inconvenience of questions not being answered on time, but I assure the House that we have put in considerably more resources. We have upgraded the quality of the people who are answering the questions and have an absolute commitment to trying to answer them on time.

[The Lord Speaker (Lord Fowler)]

My Lords, I remind Ministers that the instruction to be brief applies to their answers, as well as to questions from other Members.

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[Lord Bethell (Con)]

My Lords, before the pandemic the parliamentary affairs team was made up of nine people; it has grown to 15. The ministerial correspondence and public inquiries team has grown from 51 people to 111. I think the noble Lord would agree that, at a time when we are trying to deal with test and trace along with programmes on therapeutics, restart, seasonal flu, PPE and vaccines, having 111 people working on correspondence seems the outer limit of what would be proportionate.

[The Lord Speaker (Lord Fowler)]

My Lords, all questions in this section have now been asked. We will come to the next in a moment.

Covid-19: Vaccination Prioritisation

Debate between Lord Fowler and Lord Bethell

Wednesday 25th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord tempts me to commit to schedules that I am simply not in a position to commit to, I am afraid to say. The performance of the various vaccines is extremely complex: each one of them needs a different delivery plan. In collaboration with the NHS, we are putting in place an extremely energetic and thoughtful deployment programme. Those in charge have been instructed to have that ready to start from 1 December, but I will not hide it from the House that it may well be after the new year that the very large numbers begin. I reassure the House that we are super-focused on this deployment plan, and, as soon as the vaccines become available, we will be trying to get them to the public as soon as we can.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed, and that brings us to the end of Question Time.

Covid-19: Vaccines and Medical Equipment

Debate between Lord Fowler and Lord Bethell

Wednesday 25th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the question of vaccine intellectual property is a delicate one because, as was mentioned earlier, we rely on the private sector for a lot of funding and research, and for supplying the research. So, we are respectful of intellectual property as a principle. None the less, we are also grateful to vaccine manufacturers that have taken an open-source approach to vaccine intellectual property and have made local manufacturing available, so that there can be an extremely wide distribution of vaccines, including to those in the developing world who would otherwise struggle.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed.

Covid-19: Dental Services

Debate between Lord Fowler and Lord Bethell

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I agree with the noble Lord’s analysis, but it is too early to make commitments on funding.

[The Lord Speaker (Lord Fowler)]

I make the point that I say at the beginning of every Question Time that two points are the maximum that should be made.

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[Lord Bethell (Con)]

My Lords, the bottleneck around the training of new dentists, an incredibly important priority for the nation’s teeth, is one that the CDO is extremely concerned about. The question of simulation machines is not one that I was aware of but I will be happy to look into it and reply to the noble Baroness on how we can make progress.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has now elapsed.

Covid-19: Contracts and Mass Testing Programme

Debate between Lord Fowler and Lord Bethell

Wednesday 4th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, please.

[The Lord Speaker (Lord Fowler)]

Would noble Lords please not interrupt the Minister.

[Lord Bethell (Con)]

We have published 80% of the contracts to date and are working on publishing the rest. I hope that that will meet noble Lords’ expectations.

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[Lord Bethell (Con)]

My Lords, I do not want to give the impression that absolutely everything is perfect. Those were desperate days and we had to do extraordinary things to protect our healthcare staff. I remind noble Lords that other countries were flying in their representatives with bags of cash on private jets in order to seal contracts and some of our supplies were literally taken from under our noses on the runway at Hong Kong airport. They were extremely difficult times and I do not pretend for a moment that everything was absolutely perfect, but I reassure noble Lords that the right procedures were put in place by officials, and I reassure the noble Lord that these figures are currently being validated with the National Audit Office.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed and it brings Question Time to an end.

Covid-19: Intensive Care Treatment

Debate between Lord Fowler and Lord Bethell

Thursday 29th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I share my sympathies with the noble Baroness for the loss of her friend, for which we are all very sad. However, I take exception to her implication of a fiasco in the use of algorithms. I do not accept the implication that it is regular practice for clinicians somehow to give up on patients who stand a chance simply because their reading of an algorithm says that they should move on to someone else. That is not how we run the NHS; it is not how we had to run it during the first wave and it is not how we intend to run it during the second.

[The Lord Speaker (Lord Fowler)]

My Lords, all supplementary questions have been asked and both Private Notice Questions have finished.

Covid-19: Charitably Funded Hospices

Debate between Lord Fowler and Lord Bethell

Wednesday 28th October 2020 Lords Chamber

[Lord Bethell (Con)]

The issue raised by the noble Baroness is one that I am aware of. Who can think of a more moving cause than hospices for children? This will be definitely be on the agenda for 4 November and I will raise the issue with my honourable friend the Minister for Social Care.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed, which brings Question Time to an end.

Social Care

Debate between Lord Fowler and Lord Bethell

Wednesday 28th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we all acknowledge the power and intellectual insight of the Economic Affairs Committee report, which was welcomed on the Floor of the House and speaks for itself in terms of its authority and insight. But my noble friend is, I am afraid, not being reasonable when he says that Covid is not an excuse for inaction. There is an enormous focus on the front line and by the management of the NHS and the DHSC on preparing the winter plan, which is ambitious but also extremely stretching. There simply is not the management or political capacity to take on a major generational reform of the entire industry in the midst of this massive epidemic.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed and we now come to the fourth Oral Question.

Covid-19: Test Results

Debate between Lord Fowler and Lord Bethell

Tuesday 27th October 2020 Lords Chamber

[Lord Bethell (Con)]

I am extremely grateful to the noble Lord—I am never embarrassed—for giving me the opportunity to say a massive thanks to those tens of thousands involved. They take a huge amount of heat from the criticism targeted at test and trace, but many of them are working through the night to hit our targets, because people often take their tests during the morning or the afternoon. A lot of them work at the weekend and during holidays, when people often want their test results. It is arduous, tough, technical work and we are enormously grateful to those concerned. On local testing, we have in place 100 local test partnerships between local authorities and the national test and trace system which are proving extremely valuable, particularly in targeting hard-to-reach communities. We are putting an enormous amount of resources into them and they are proving extremely successful.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. That brings Question Time to an end.

Covid-19: Information Sharing with Police Forces

Debate between Lord Fowler and Lord Bethell

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

I am grateful for that important question. At no point would I ever wish to cast any aspersions or slur at the noble Lord, Lord Hunt, who I count as a close colleague and someone whose opinion I respect enormously. However, I was replying in response to his question about BAME communities. We are deeply involved in talking to a large number of those communities, which have traditionally been hard to reach. We are engaged with them on many levels to talk to them about how we can address the marketing challenge of getting our messages to them, how we can shape our messages so that they are fully understood, and how we can address any concerns they may have about the test and trace programme.

I can report to the noble Baroness that we have been extremely pleased by the very encouraging responses that we have had from those communities, which is why I do not think it is reasonable to assume that any particular community would be more or less suspicious of this programme than another.

[The Lord Speaker (Lord Fowler)]

My Lords, all supplementary questions have been asked, and that brings the Private Notice Question to an end.

Cancer Task Force

Debate between Lord Fowler and Lord Bethell

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

I thank the noble and learned Lord for sharing that moving testimony. The broad point that he makes is entirely right—that Covid has an impact on our healthcare system that goes way beyond those who have Covid. It has an impact on the care and outcomes of all sorts of people who need important places in the healthcare system. That is why this Government are committed to the suppression of the virus and to protecting the NHS, and it is why, on behalf of everyone, we wish both the noble and learned Lord and his grandson well.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed.

Covid-19: Great Barrington Declaration

Debate between Lord Fowler and Lord Bethell

Tuesday 13th October 2020 Lords Chamber

[The Lord Speaker (Lord Fowler)]

My Lords, I remind noble Lords to keep supplementary questions brief.

[Lord Bethell (Con)]

My Lords, I note that the 16,000 scientists supporting the Great Barrington declaration include “Dr Brian Blessed; doctor in winged flight, Z-cars and booming laughter”, “Dr Johnny Fartpants” and “Dr Johnny Bananas”. The serious point, however, is that the idea of “focused protection” is both unethical and impractical. Even if it was not, growing evidence of the impact of long Covid on the fit and young is mounting every day. On herd immunity, we currently have 8% sero-positivity, but we would need 70% for herd immunity, and it is completely improper to ask the young of Britain to suffer the risk of long Covid in order to achieve that. Winter is coming, and cold temperatures and more inside activity will raise prevalence. The great protection is simply not a conscionable option.

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[Lord Bethell (Con)]

The noble Lord is entirely right in his analysis. The briefings from the Vaccine Taskforce to the Prime Minister are encouraging. One of the striking things about the updates is not only the promising nature of the Oxford vaccine, which is progressing very well, but the substantial pipeline of a dozen or more other vaccines that are coming through. Six of those have already been contracted by the Vaccine Taskforce on four different vaccine platforms. I am afraid that I cannot provide a firm schedule as such things are not in the gift of Ministers, but I am informed that progress is substantial.

[The Lord Speaker (Lord Fowler)]

I call the noble Lord, Lord Faulkner, who I forgot to call before.

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[Lord Bethell (Con)]

The noble Lord is entirely right: the impact on the economy of a full national lockdown has been learned already. We know what that looks like. It is a very tough decision and it is my hope and expectation that the British public and the health system will respond to the challenge they face and will step up. I would like to guide the noble and gallant Lord to the publication by the Government Actuary’s Department, the Office for National Statistics and the Department for Health and Social Care Direct and Indirect Impacts of COVID-19 on Excess Deaths and Morbidity. It spells out in very clear terms the economic and mortality effects of letting the disease rip. Those costs are simply unconscionable.

[The Lord Speaker (Lord Fowler)]

My Lords, the time has elapsed for this Question.

Food Hygiene Rating Displays

Debate between Lord Fowler and Lord Bethell

Wednesday 7th October 2020 Lords Chamber

[Lord Bethell (Con)]

Well, the noble Baroness makes a strong case. I think a lot of consumers would like to see the kind of rating that she describes. I am not sure whether it is rightly the responsibility of food inspectors to provide that complex service, but we are working very closely with the hospitality sector on both tracing and the implementation of Covid-friendly measures. The response from the sector has been extremely strong, but we are maintaining a close analysis of progress.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the fourth Oral Question.

Social Care Workers

Debate between Lord Fowler and Lord Bethell

Wednesday 7th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness makes her point extremely well. We want social care to be a profession that people seek out, where they seek professional development and where they can find a fulfilling lifetime career. That will not be true for everyone, but we need a backbone of people who are committed to social care. That is why we have massively increased the funding to local authorities so that they can address the challenge of social care, and why we have published the adult social care coronavirus winter plan in order to provide short-term support for local authorities to achieve exactly what the noble Baroness has spelled out.

[The Lord Speaker (Lord Fowler)]

Short supplementaries, please.

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[Lord Bethell (Con)]

My Lords, I am extremely grateful for the noble Lord’s recommendation. The project that he describes is incredibly interesting. I am not aware of it today, but I will definitely seek it out and try to find out more. I emphasise the broader point that the noble Lord is making: fresh thinking, digital innovation and the work of entrepreneurs to try to create new ways of working—to pool, for instance, the efforts of teams of people and to use platforms like the one that he describes—can make a massive difference in the area of social care. We are very supportive of digital entrepreneurs bringing fresh thinking to this important area of work.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has now elapsed. ‘

Covid-19: People with Learning Difficulties and Autism

Debate between Lord Fowler and Lord Bethell

Monday 5th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, let me clarify with an update on the numbers. As of 25 September 2020, 690 deaths from Covid of people with learning disabilities have been reported to the leader programme since 16 March. We have commissioned Public Health England to carry out additional analysis of the existing data, which will be published as soon as it is completed. We are not trying to hide from this issue. Covid has raised very serious questions about the impact of a pandemic on those with learning difficulties, who are often more susceptible to disease and mortality than others. We absolutely accept the challenge of figuring out how to protect the most vulnerable in our society. Therefore, we will embrace the opportunity to take these learnings and put them into a disability report at some point in the future.

[The Lord Speaker (Lord Fowler)]

My Lords, I regret that the time allowed for this Question has elapsed.

Covid-19: Adult Social Care Complaints

Debate between Lord Fowler and Lord Bethell

Monday 5th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right. There are very good arguments for combining the two ombudsmen and that is recognised by both of them. However, the framework and structure for that kind of reform is best conducted when there is an overall reform of social care. The Government made it crystal clear during the election that they are committed to a major and significant overhaul of the social care system. That has been reiterated by the Prime Minister and the Secretary of State for Health and Social Care. When it happens, we will review the combination of those two ombudsmen, as the noble Baroness described.

[The Lord Speaker (Lord Fowler)]

Baroness Warsi? We will move on to the noble Baroness, Lady Thornton.

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[Lord Bethell (Con)]

My Lords, I recognise that the ombudsman’s recent report on adult social care did call for a statutory requirement for signposting. We have worked substantially with the sector to improve signposting of the ombudsman and other routes of complaint. The commitment by CQC and Healthwatch to the “Because we all care” campaign is an important and effective measure to fill the gap and raise awareness of the complaints procedure. It is right to wait until we see the results of that campaign. We acknowledge the possibility of mandatory signposting but would like to see a voluntary and more effective marketing campaign work if it possibly can.

[The Lord Speaker (Lord Fowler)]

My Lords, all supplementary questions have been asked. We now move to the second Oral Question.

Covid-19: NHS Application

Debate between Lord Fowler and Lord Bethell

Thursday 1st October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, version 1 does not have an international component to it, but that is something that we would seek to develop. I emphasise that the app in its current form is very much focused on providing a huge amount of personal privacy and is therefore not an appropriate vehicle for putting in place any form of surveillance or quarantine management. That would be in breach of our arrangements with our technical partners, Apple and Google. Therefore, although I cannot give my noble friend Lady McIntosh a complete answer, I would like to hint that perhaps this will not be the vehicle for accelerating airport testing.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed.

Hospitals and Nursing Homes: Do Not Resuscitate Notices

Debate between Lord Fowler and Lord Bethell

Thursday 1st October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I welcome the testimony of the noble Baroness. We often keep track of Wales’s use of innovative health measures and, while I am not aware of this concept in particular, I will be glad to take the advice back to the department, recommend it and return to the noble Baroness with a response on how we are going to take it forward.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed—my apologies to the noble Lord, Lord Foulkes.

Covid-19: Tracking

Debate between Lord Fowler and Lord Bethell

Wednesday 30th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the point of the app is to support our tracing efforts and provide security among those who are in areas that are not socially distanced in order to alert them when they have been near someone who has recently had a test. The test results are not, as the noble Lord described, typically available after seven days. The figure is much lower and we have already found enormous support for the use of the app.

[The Lord Speaker (Lord Fowler)]

My Lords, all supplementary questions have been asked and we now come to the third Oral Question.

Mental Health Services: Young People

Debate between Lord Fowler and Lord Bethell

Thursday 24th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are rolling out our response to the Green Paper on mental health for young people. That has included the implementation of mental health support teams, which will make a big impact. In addition, and in response to recent circumstances, on 8 September we launched a mental health well-being campaign specifically for children and young people through the PHE website. It encourages a personal mind plan and the use of a quick and easy interactive tool, and 2.5 million mind plans have been completed since its launch.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this question has elapsed. We now come to the fourth Oral Question.

Covid-19: NHS Long-term Plan

Debate between Lord Fowler and Lord Bethell

Tuesday 15th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Chancellor has made it clear that catch-up support for the NHS to recover from the impact of Covid is an important part of his financial projections. However, I remind the noble and gallant Lord that we are investing in 40 new hospitals. It is a massive capital investment and the impact on our healthcare service should not be underestimated.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now move to the next Question, which is from the noble Lord, Lord Storey.

Covid-19: Self-isolation Payment Scheme

Debate between Lord Fowler and Lord Bethell

Wednesday 2nd September 2020 Lords Chamber

[Lord Bethell (Con)]

The evidence base and criteria were our discussions with local authorities and community leaders on what an effective amount would be that would tip the balance in a personal decision to isolate. As I said earlier, those personal decisions are extremely tough. It was agreed with local infection teams and authorities that this was the kind of sum that would make a difference.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed, and that concludes Question Time.

Childhood Obesity

Debate between Lord Fowler and Lord Bethell

Wednesday 2nd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Government are not planning a review of VAT at present.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed.

Smoking

Debate between Lord Fowler and Lord Bethell

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, I completely hear the views of retailers. No one wants to put a retailer in an awkward position and I completely understand why they would support the introduction of licensing. However, that is not currently our plan and we believe that we can get to a smoke-free 2030 without introducing onerous and expensive new regulations of the kind that the noble Viscount describes.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the fourth Question.

Pharmacies

Debate between Lord Fowler and Lord Bethell

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

We are fully engaged with the sector. The National Pharmacy Association and the other stakeholder groups are in close communication with the department to ensure that they have the PPE, medicines and finances to keep going during the epidemic. The voice of the DPHs is involved in that stakeholder engagement.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed.

Nurses: Recruitment

Debate between Lord Fowler and Lord Bethell

Thursday 18th June 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness raises a very concerning point. I take the Chief Nurse’s advice and observations at face level. I express my profound thanks to all those nurses who have been redeployed to the front line and have performed an important task but who are now feeling a sense of either anti-climax or uncertainty. I reassure them that there is an enormous number of job opportunities in the NHS, that there is a role for them in the NHS of the future, and that we will be investing massively in the role of nurses in the years ahead, as exemplified by our commitment to recruit.

[The Lord Speaker (Lord Fowler)]

My Lords, I regret that the time allowed for this Question has elapsed. It would be very helpful if colleagues would keep their supplementary questions short so that we can get everyone on the list to ask their question. The third Oral Question is from the noble Lord, Lord Arbuthnot of Edrom.

Covid-19: Track and Trace System

Debate between Lord Fowler and Lord Bethell

Thursday 18th June 2020 Lords Chamber

[Lord Bethell [V]]

I do not agree with that analysis. I am afraid that areas such as care homes are where the app is least effective, because the residents are static and therefore the app is not really the facility for identifying infections. This is where the manual “test and trace” process is the most effective. That is why we are super-focused on getting it right. We are working very closely with the social care community to ensure that the “test and trace” systems are working well. We are flooding social care with tests and ensuring that our tracing agents are well trained to handle local outbreaks in care homes and to deal with care home staff.

[The Lord Speaker (Lord Fowler)]

My Lords, I regret that the time allowed for this Question has elapsed, so we come to the second Oral Question. I call Lord Clark of Windermere.

Exercise Cygnus

Debate between Lord Fowler and Lord Bethell

Tuesday 9th June 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, the Association of Directors of Adult Social Services had strong input into operation Cygnus and its recommendations were taken on board. It was however a trial run for a flu pandemic, not of the kind that Covid produced, and the demands on PPE, the health sector and the care sector were more profound than the flu pandemic trials prepared us for.

[The Lord Speaker (Lord Fowler)]

Lord Lansley. No?

--- Later in debate ---

[Lord Bethell [V]]

The noble Baroness will not be at all surprised to learn that I do not agree with her analysis in any way. Operation Cygnus demonstrates that we did have robust systems in a great many areas and I am grateful to it for identifying some areas that we went on to improve. As for working with the private sector, I bear testimony to its enormous contribution to our Covid response. I do not agree with her characterisation of the profit motive.

[The Lord Speaker]

Lord Naseby. No?

--- Later in debate ---

[Lord Bethell [V]]

The noble Baroness conflates two separate matters. The National Risk Register of Civil Emergencies is updated regularly and assesses civil emergency risks with a five-year horizon. The ongoing monitoring of risks in overseas countries is done in a different manner. I was trying to convey to the House that operation Cygnus was a rehearsal for a flu pandemic, not for the kind of virus that Covid proved to be.

[The Lord Speaker]

My Lords, the time allowed for this Question has elapsed. We will now move to the second Question, in the name of the noble Baroness, Lady Quin.

Hospitals: Patient Safety

Debate between Lord Fowler and Lord Bethell

Thursday 21st May 2020 Lords Chamber

[Lord Bethell]

The noble Lord speaks of a fear that I recognise. It is a sad feature of our times that patients who should be in hospital are anxious about attending because of possible infection with Covid. Different trusts approach this in different ways. Some sites have been deemed Covid-free and are used for, for instance, cancer treatment, whereas larger sites manage differently, perhaps by allocating certain buildings to be Covid-free and others not. We have tried our hardest to reassure the public that they can proceed in the NHS with safety.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. We now come to the second Oral Question, from the noble Lord, Lord Teverson.

Dental Care

Debate between Lord Fowler and Lord Bethell

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right. I confess to having a profound biscuit habit through the Covid epidemic which I am wrestling to get over. On a serious note, the Covid epidemic has put a spotlight on the health of the nation. There seems to be some evidence that we have suffered badly from the epidemic partly because of obesity. The Prime Minister has commented personally on this issue. It will be a priority of the Government to address this point once the epidemic is over to restore the health of the nation and to tackle obesity.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has now elapsed. I thank all who put questions and the Ministers who answered. That concludes the Virtual Proceedings on Oral Questions. The Virtual Proceedings will resume at a convenient point after 12 noon for the Private Notice Question on scientific evidence relating to the reopening of schools.

Covid-19: BAME NHS Staff

Debate between Lord Fowler and Lord Bethell

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right. We owe a huge debt of gratitude to those BAME staff, whether black Afro-Caribbean or Filipino, who have put their lives at risk on the front line. It is a wake-up call; we should always be thinking about how we can accelerate opportunities for all members of staff. Those who start at the lower ranks should be given whatever opportunities are available to progress to a higher rank. The noble Baroness is entirely right that this puts a spotlight on our commitment to those groups. I completely endorse her point.

[The Lord Speaker (Lord Fowler)]

My Lords, unfortunately the time allowed for this Question has elapsed.

Covid-19: NHS Contact Tracing App

Debate between Lord Fowler and Lord Bethell

Monday 18th May 2020 Lords Chamber

[Lord Bethell]

My Lords, we are in discussions with many other Governments—those in the east, which have a tradition of these apps, and fellow travellers like ourselves. It is a highly technical and difficult area; Britain is leading the way in many ways and we have learned an enormous amount. I have personally spoken to the Taiwanese Government, who have taught me an enormous amount, and those conversations continue regularly.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has elapsed. It is worth noting that, in the whole Proceeding, we excluded only two possible questioners, so apologies to them. I thank your Lordships. That concludes the Virtual Proceedings on Oral Questions. Virtual Proceedings will resume at 3.30 pm for a Private Notice Question on post-Brexit customs arrangements in Northern Ireland.

Covid-19: Vulnerable Populations

Debate between Lord Fowler and Lord Bethell

Tuesday 12th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is right to raise concern for the homeless—surely one of the groups suffering the most in the current epidemic. We are putting in place facilities for testing, housing and mental health support for the homeless. We envisage that these will continue for the length of the epidemic.

[The Lord Speaker (Lord Fowler)]

My Lords, I fear that the time allowed for this Question has elapsed.

Covid-19: Contact-tracing App

Debate between Lord Fowler and Lord Bethell

Wednesday 6th May 2020 Lords Chamber

[Lord Bethell]

I reassure the noble Lord, Lord Wallace, that sunset arrangements will form part of the conditions of the app and that they will be published shortly.

[The Lord Speaker (Lord Fowler)]

My Lords, the time allowed for this Question has now elapsed.

Covid-19: Personal Protective Equipment

Debate between Lord Fowler and Lord Bethell

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is right to champion this point. The Cleveland Clinic is known to us. I will ensure that it is played into the task force that is working on both the regulations and practicalities of reuse.

[The Lord Speaker]

My Lords, that concludes the Virtual Proceedings on Oral Questions. Thank you very much, questioners and Ministers. The Virtual Proceedings will resume at 12.15 pm for the Private Notice Question in the name of the noble Baroness, Lady Smith of Basildon.

Covid-19: Extent of Infection

Debate between Lord Fowler and Lord Bethell

Wednesday 22nd April 2020 Lords Chamber

[Lord Bethell]

My noble friend Lord Dobbs is entirely right to put his finger on this important matter. The CMO was clear from the very beginning that Britain’s mortality rate came as much from Covid as from non-Covid deaths. We review this situation regularly and thoroughly, and we will be glad to update the House at a future date. We are very conscious of the threat of which my noble friend speaks.

[The Lord Speaker (Lord Fowler)]

Supplementary question: the noble Lord, Lord Krebs. Lord Krebs? No? In that case, I call the noble Lord, Lord Hain.

--- Later in debate ---

[Lord Bethell]

The noble Lord raises a completely valid point on the accessibility of drive-in centres. They suit some people but not all, as he rightly points out. That is why we have brought in at-home testing arrangements, delivered mainly by Amazon. They started on Monday, and we are very ambitious for both their scale and their scope, particularly for the demographics of which he speaks.

[The Lord Speaker]

Supplementary question: the noble Baroness, Lady Lawrence of Clarendon. Lady Lawrence? No? I call the noble Lord, Lord Moynihan, for his supplementary question.

--- Later in debate ---

[Lord Bethell]

Serology tests provide important data on the behaviours of the virus. We still do not fully understand what kind of immunity and antibody response will be long-lasting in the body. There are mysteries to this virus that are yet to be solved; serology tests are vital to that and they can play a part in the back-to-work strategy. However, I would remind him that it is a tiny proportion of the population—probably around 5%— who have antibodies. We cannot put the economy back on its feet with just 5% of the population.

[The Lord Speaker]

My Lords, I am afraid that the time allowed for this Question has elapsed. Two noble Lords were not called; I am sure that this will be taken into account in future lists.

Covid-19: Medically Vulnerable People

Debate between Lord Fowler and Lord Bethell

Wednesday 22nd April 2020 Lords Chamber

[Lord Bethell]

The noble Lord makes a very reasonable request. I have sought clarification from the department on this point, because his suggestion seems eminently reasonable, and as soon as I have a reply I will write to him and share the contents with the Library.

[The Lord Speaker (Lord Fowler)]

My Lords, I regret that the time allowed for this Question has elapsed. I apologise to the few people at the end of the list who have not managed to get in. We will seek to deal with that in the allocation for future Questions.

Covid-19: Removal of Restrictions

Debate between Lord Fowler and Lord Bethell

Tuesday 21st April 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right. Tracking and tracing will be absolutely essential for keeping down R0, the transmission rate, when it comes to the implementation of our medium-term strategy. We are working extremely hard to dramatically increase our testing capacity. I assure the House that that capacity is growing enormously, at scale and exponentially. It is our expectation that it will easily meet the requirements of tracking and tracing. That tracking and tracing will be implemented by several work streams. The app already unveiled will be an important part of that, as will the PHE manual contact-tracing resources and the use of any other technological advances and innovations developed as part of this response to the epidemic.

[The Lord Speaker (Lord Fowler)]

Lord Mackay of Clashfern. No? Okay, we will go on. Lord Patel.

--- Later in debate ---

[Lord Bethell]

The noble Lord is entirely right. I commend the colleagues from all the nations with whom I have been working over the last month. One of the most singular and impressive aspects of the response to Covid-19 has been the way in which the four nations have worked together. I am enormously grateful to my colleagues for the consistent, collaborative and helpful approach that has characterised this response. Geographical difference is the kind of subject that the CMO will give us advice on. This is, naturally, a huge concern to those who feel that they might be left behind, but the CMO will provide the best advice and we will follow the science.

[The Lord Speaker]

My Lords, I afraid that the time allowed for Questions has now elapsed. I thank all noble Lords who have contributed to the first Oral Questions session by way of a Virtual Proceeding. As the noble Lord, Lord Baker, said, it shows that we can hold the Government to account in different ways. We will, doubtless, get better at it as the weeks go by, but this was a very important beginning and the information that came out was valuable. I thank all noble Lords and apologise to those who did not get to speak. That brings the Virtual Proceeding to an end.