(3 years, 5 months ago)
Lords ChamberMy Lords, I refer to my interests in the register. It sounds as though what you really need is a secure card that proves your identity and has important information uploaded to it, such as your vaccination status—something my noble friend was introducing, only to have it scrapped by an incoming Conservative Government. We have had 10 wasted years. If there is to be a vaccination app or some other certification, can we be assured that it will not contain data that purports to show that holders are safe to travel because they have had a negative test under the absurd test and trace scheme? The BMJ has reported that the level of false negatives is of the order of 30%. Such negative tests have no probative value, despite the Government, according to the Public Accounts Committee, wasting £37 billion on them.
My Lords, that is not our approach. Our approach is to try to use whatever technologies work in order to open up our borders. The idea that 30% of tests are not correct is an unhelpful suggestion by the noble Lord. We will be using testing in the validation app.
(3 years, 6 months ago)
Lords ChamberMy Lords, we have provisions for tackling obesity in the health and social care Bill, as the noble Lord knows, but the focus of the cross-ministerial board on health will be to bring together government efforts on not just obesity, but health inequality in the round. The board’s remit has not yet been published, nor has its membership or chairmanship, but I reassure noble Lords that that is coming reasonably soon.
So we have to wait for a cross-ministerial board; that will really make a difference. Overall, the Government’s record has been appalling. Improvements in life expectancy, which had been rising steadily since the 1950s, stalled in 2010 when the Conservatives were elected and throughout the subsequent decade. What is more, according to the King’s Fund, real government spending on public health has fallen by 15% in the last six years. That is not new, so why do we have to wait for the so-called levelling-up White Paper and this cross-ministerial thingy? Why can the noble Lord’s department not get on with boosting public health locally, rather than reshuffling the deckchairs nationally by abolishing Public Health England and diluting that focus?
I feel inspired by the noble Lord’s passion for the subject, but it is not fair or reasonable to suggest that death rates in the country are driven by the electoral cycle. Far from it—this Government have been extremely committed to the obesity strategy, not least because of the personal story of the Prime Minister. We have not abolished Public Health England; we have redefined it as two organisations, UKHSA and the OHP. The impact of those will be profound.
(3 years, 8 months ago)
Lords ChamberI completely and utterly reject the suggestion that priority was given to people who had connections in the right place. Priority was given to those who had plausible products that they were able to sell to us. I take this opportunity to thank in particular Ian McKee, the noble Lords, Lord Evans and Lord Hunt, and Richard Baker for their recommendations, which were picked up by the procurement team, put into the high-priority lane and made a valuable contribution to our efforts to get PPE.
The noble Lord told the House on 1 March that he was content to be in legal breach, as the ends justified the means. That is a very slippery slope for a Government. Was it acceptable for Sitel to ignore GDPR by instructing staff to put patients’ personal details on their private emails because their computer systems could not cope? If that was not justified, the implication is that it is only Ministers who are above the law. But if it was okay, does he accept that it gives a green light to every dodgy or crony contractor to enrich themselves by breaking or bending the law?
My Lords, the noble Lord’s imaginative reach is to be applauded. I will be absolutely categorical about what I said on 1 March. I never said that the ends justified the means or that I thought that Ministers were above the law. I always said that this Government champion transparency and that we would try to be within the law wherever we could be. I do not wish to make this point too many times: the public expect us to deliver safety for front-line workers, and that meant securing PPE. If we were a few days late on the publication of some contracts, then I think the public would definitely take our side in that decision.
(3 years, 8 months ago)
Lords ChamberMy Lords, the test and trace system is part of an essential response to a virus pandemic that has shaken the world, and the costs of that pandemic are enormous. I regret them very much and wish with all my heart that we did not have to spend this money on our pandemic response, but there is no other way of cutting the chains of transmission and responding effectively to this awful disease. The ongoing pay arrangements for nurses and doctors are commitments that we will live with for years to come, and there is a difference between the two.
My Lords, I should declare that my wife works in the NHS. Does the Minister agree with his ministerial colleague Nadine Dorries that the 1% settlement is generous because it is better than a pay freeze? Nurses get maybe 70p a day while billions are wasted on crony contracts and £200,000 is being spent on titivating a Downing Street living room, replacing decorations that are barely three years old. Does the Minister—or the Chancellor, for that matter—have any idea what living on £25,000 a year is really like?
My Lords, I cannot hide from the noble Lord the fact that across the public sector there is a pay freeze. The only area that that does not apply to is the NHS, a point that I think my colleague made very thoughtfully. I remind the noble Lord that many in the private sector have lost their jobs and prospects altogether and that there is a massive economic challenge on the horizon. We fool ourselves if we close our eyes to that and regard the public sector as somehow sacrosanct and immune to the larger economic challenge.
(3 years, 8 months ago)
Lords ChamberAs the noble Lord knows, I cannot comment on some of those cases specifically because they are subject to legal action at the moment. However, in broad strokes, I say that there were a lot of people who stepped forward to help us in our time of need; I do not condemn them. Some of them came not from the PPE industry but from others. I am extremely grateful to all those who stepped forward to help us when we needed it.
The Minister is on very thin ice. He is following Machiavelli’s teachings that the ends justify the means. He should be careful— this is the same argument that led to French aristocrats being guillotined after the revolution, to Stalin’s terror and to the blackshirts of Kristallnacht. Does he accept that the Government and Ministers have to obey the law? If he thinks that this case was trivial, where does he draw the line? Contracts to cronies? Clearly not—not until No. 10 spads have been “sighted”. Proroguing Parliament illegally? Clearly not. Interning vaccine refusers? Where is the line?
I am enormously grateful for the colourful character of that question. However, the noble Lord makes a serious point. We do respect the law, which is why we have published the contracts. The case found that we had published them 17 days late. Any reasonable person faced with a huge pandemic would think that a 17-day delay is a perfectly reasonable price to pay for saving lives. The noble Lord asked me about the price we are willing to pay and the reasons for standing out on this: saving lives is what this delay was about.
(3 years, 9 months ago)
Lords ChamberMy Lords, I completely agree with the noble Baroness. As I said earlier, we are not safe until we are all safe. That is an absolute axiom. It will soon become a cheesy remark but that does not make it any less true. Britain is totally committed to the principle of global distribution of the vaccine. We are extremely proud of AstraZeneca, which has a profit-free approach to the intellectual property around the vaccine. It is quite possible that as a cheap, easily administered and portable vaccine, it may become the common global standard for vaccination. It is my hope that it will be rolled out globally, and that it is updated as necessary, as mutations and variants of concern begin to affect it. Britain is very committed to CEPI, Gavi and ACT. These are the major financial commitments that the world has joined in to get the vaccine to the developing world, and we are using our chairmanship of the G7 to champion that agenda.
The variants of concern are already here, so self-isolation is vital for those who test positive in the community, yet many fail to do so because they will lose wages. Four million people in the UK have had Covid. The NAO says that the Government have spent over £270 billion on the pandemic so far. That is the equivalent of £67,500 per person infected. If that is the cost of each person who is infected by those who do not self-isolate, how low would the R number have to be for it not to be cost effective to pay at least £1,000 to everyone who tests positive, to ensure that they self-isolate?
I am grateful for the noble Lord’s fascinating mathematics, but there are other principles at stake here and I am not quite sure that his arithmetic can be leaned upon. One of those principles is personal responsibility. We cannot pay the entire nation a huge wage to stay at home for the entire epidemic; we have neither the cash resources nor the value base to do that. We must look to people to do the right thing. If we do not, we will end up with a country that is dependent on the Exchequer for its money and has the wrong values for the kind of enterprise economy that we need to build to get out of this epidemic.
(3 years, 11 months ago)
Lords ChamberI draw attention to my interests in the register and beg leave to ask the Question standing in my name.
My Lords, more than 137,000 people in the UK have received the first dose of the Pfizer/BioNTech Covid-19 vaccine in the first week of the largest vaccination programme in British history, and I thank all those involved. It will take at least until spring for all high-risk groups—an estimated 25 million people in England—to be offered a Covid vaccine. We remain committed to the principle of offering everyone in Britain a vaccine.
The Government have form on overpromising and underdelivering, so I am interested in the figure that the noble Lord has given. Assuming that he is going to achieve 25 million vaccinations, that means in excess of 1 million people a week being vaccinated between now and then. With 200 vaccination centres, that means something like 7,500 vaccinations per week and, if centres work 14 hours a day for seven days, that will be something like 75 per day. Does the noble Lord not think that he is in danger —again—of overpromising and—again—of fuelling the widespread belief that the crisis is over, which is leading to the behaviour that we all know is likely to fuel the number of cases in the next few weeks?
My Lords, the mathematics done by the noble Lord are interesting but not quite a reflection of the strategy. It is undoubtedly true that the NHS is, wisely, taking the start of the deployment with great care. This is an extremely complex vaccine to deliver, but hospital hubs, local vaccination services and vaccination centres will be rolled out around the country. The kind of ambition that the noble Lord describes—quite rightly—is exactly what we seek to deliver; we will update the House as that deployment plan rolls out.
(4 years ago)
Lords ChamberMy Lords, I thank my noble friend for his comments and reassure him that the Government are absolutely focused on the restart programme. The chief executive of the NHS has written to GPs, emphasising the absolute and primary importance of face-to-face appointments, for exactly the reasons that my noble friend knows full well. I also emphasise the enormous response that we have had from the public, and that we are meeting exacting targets for those face-to-face meetings. I also emphasise that new technologies and techniques have been very much welcomed by the public. Telemedicine, and telephone and video consultations, have proved to be extremely popular and helped to increase the number of appointments last month compared with this time last year.
My Lords, nearly three-quarters of GP consultations at the peak of the pandemic were conducted by telephone or video call. A BMA survey in June found that nine in 10 GPs want to continue to deliver consultations remotely, once the pandemic has ended. Many people are reluctant to discuss their symptoms in this way, or cannot access the necessary technology, and often diagnoses are not possible without a physical examination. Is the Minister happy with such a change? What guidance does the department intend to give on this, and will the GP contract be reviewed to reflect what is happening?
The noble Lord is entirely right. Without doubt, there are very many circumstances in which a face-to-face appointment is absolutely necessary, whether that is for a physical analysis, for the comfort of the patient or to check out other symptoms that may not be apparent from a telephone call. However, there are other people for whom telephone appointments are helpful. The Royal College of Physicians found that 20% of patients over 65 felt worse after an in-person appointment because of the stress involved. But the noble Lord is entirely right that guidelines do need to be evolved in order to reflect the changes, and there may be a moment when the GP contract needs to be revisited.
(4 years ago)
Lords ChamberMy Lords, we are enormously grateful for the very many people who stepped forward to offer help during this time. When the Prime Minister made his public call for help, 16,500 people contacted us with various offers. It was, of course, necessary to triage and prioritise that huge list. In that list there were a great many people who had extensive experience in their area; there were people who were new to the game; there were have-a-go heroes; there were multinational companies. There were also those whose intentions were not as pure as one would hope. We approached each and every one on their merit, and there were official guidelines to guide the procurement processes. We have stuck to those guidelines every step of the way.
Yesterday the Minister said that he had personally made 300 calls to potential suppliers of PPE earlier this year. Not surprisingly, given the report from the National Audit Office today, which the Daily Mail described as devastating, he did not tell us how the lucky recipients of all his calls were chosen. Could the Minister tell us whether one of those calls was to the jewellery designer Michael Saiger, based in Miami, who received more £200 million in contracts from the Minister’s department, paying £21 million to a Spanish fixer? How did Mr Saiger and his jewellery come to the attention of the department? Why were major British companies with well-established global supply chains, which offered to help, ignored?
My Lords, I am grateful to the noble Lord for referring to my calls. I would have made a lot more than 300 calls then, because those were extremely difficult times. I would remind him that the NAO report says that we found Ministers had properly declared their interests, and we found no evidence of their involvement in procurement decisions or contract management. Ministers were not involved in procurement decisions; they facilitated the introduction of potential suppliers at a time when there was a massive global crisis. Supplies to this country were being abducted by other countries, supply chains had broken down, the channel tunnel was constrained and the Indian transport system had ground to a halt. Presidents were literally diverting planes in the air with supplies meant for one country and grabbing them for their own. In those circumstances, Ministers and their advisers intervened to get the right supplies to the front line to help those seeking PPE. Those were extremely energetic efforts. I am extremely proud of that work. Procurement decisions were left to civil servants.
(4 years ago)
Lords ChamberTo ask Her Majesty's Government how many contracts they have placed for the purchase of (1) personal protective equipment, and (2) the mass Covid-19 testing programme, (a) with suppliers identified as “VIPs”, and (b) using fast-track procurement procedures since 1 March; what is the total value of any such contracts; and what steps they are taking to demonstrate that such contracts (a) represented value for money, and (b) involved no favouritism.
My Lords, 289 contracts with an estimated value of £6.1 billion have been awarded by the DHSC to private sector suppliers to support test and trace, and 370 contracts worth an estimated £8.3 billion for the delivery of PPE. These figures are currently being validated with the National Audit Office. A direct award of a contract—an option available under the procurement regulations in cases of extreme urgency—has been used in the great majority of these cases. I reassure noble Lords that suppliers are evaluated by departmental officials and awarded contracts in line with the DHSC’s standard contract terms and conditions.
My Lords, the noble Lord must realise that he is in danger of appearing complicit in the stench surrounding these procurements. On 6 April, he met with Meller Designs, which provides beauty products. It is owned by a man who was the finance chief of Michael Gove’s leadership campaign and a donor to the Conservative Party, while the noble Lord, Lord Feldman, who also sat in on that meeting, was chairman of the party. A few weeks later, the company was awarded a series of contracts amounting to £155 million for face masks and hand sanitisers. Those did not go through the normal procurement processes. What was discussed on 6 April? Will the Minister publish all documentation relating to every one of these VIP and fast-track procurements, including emails or messages suggesting specific contractors, and show how decisions were based on value for money rather than favouritism?
My Lords, the noble Lord will remember that at the beginning of this year the global supply of PPE, in particular, and other medical supplies completely collapsed. There was a global drought in the supply of key materials necessary for the protection of doctors, nurses and front-line healthcare staff. In those circumstances, we relied on a very large network of contacts and formal and informal arrangements in order, under extremely difficult circumstances, to reach the people who could manufacture these supplies, often moving their manufacturing from one product to another.
(4 years, 2 months ago)
Lords ChamberMy Lords, I am not sure that I have a precise answer to the noble Baroness’s question on easement powers. It was my impression that they had not been used in the vast majority of areas—only in a few areas—and that, where they had been applied, their use had been of a mainly administrative rather than practical nature. However, I am happy to look into the question that she asks and to reply to her by letter.
My Lords, the noble Lord has responded rather testily to a number of your Lordships in providing answers. In particular, he failed to answer the substantive question from my noble friend Lord Hunt of Kings Heath about why people were being sent, or being told to go, such extraordinary distances when they wanted and needed a test. He says that he does not want to have the blame game, but that is blamed on people who did not need a test going for one. First, can he tell us what those figures are and, secondly, can he reassure us that the messages he is now giving out will not lead to people who should be tested feeling that they should not bother the system? That would be just as big a danger.
I shall be extremely careful about how I reply to that question because I would not want to come across as testy. The noble Lord is right: it is a challenge to strike the right balance between guiding towards testing those who truly need tests because they have symptoms and trying to get those with less of a priority away from testing. I reassure him that, even under current circumstances, 90% of those who apply for a test get one within 20 miles and the average distance to travel is six and a half miles. Therefore, even though some of the anecdotes about being recommended to travel long distances might seem extraordinary, the lived reality of most people who go for tests is that they are quick, near, accurate and effective.
(4 years, 4 months ago)
Lords ChamberThe noble Baroness is right about culture change, but we are aware that having a big, clunking fist of financial threat hanging over individuals who are considering the admission of mistakes is not the right combination to create a culture of self-awareness and acknowledgement. We have to move extremely delicately to encourage people and make them feel safe enough to acknowledge the mistakes that might have happened and to embrace the kind of dialogue with patients that is necessary to deal with these results. That delicate balance is one of the most important things to get right in our reaction to this report.
We have heard some of this before. Thirty-four years ago, I submitted to the then Secretary of State—now our Lord Speaker—a patients’ charter prepared by the association of CHCs, which talked about listening to patients, putting them at the centre of every decision, and having a proper system of redress. Since then, every White Paper published by every successive Secretary of State has paid lip service to those principles, as the Minister has today. But the noble Baroness, Lady Cumberlege, has shown how shallow the commitment has been. The Minister talked about a patchwork quilt of safety mechanisms; can he convince us that this time it will be different? When will the Government say not only that they accept her recommendations in full, but what robust arrangements there will be to make sure that action and culture change actually follow?
Let me reassure the noble Lord that this report is taken seriously. But I acknowledge the fact that some of these issues are extremely complex, and when dealing with issues such as sexism, bullying, racism and a failure to engage with patients, there are not single-shot solutions like patients’ charters that will somehow transform the ecosphere. We have to look at it in the round, and that is why there will be major interventions like the HSIB, the people plan and the focus on fairness in the workplace that will ultimately make a big difference.
(4 years, 5 months ago)
Lords ChamberMy Lords, the progress on testing in social care is dramatic. The rollout of testing to all care homes is complete, and tests have been offered to all those who are symptomatic. The focus is very much on staff who travel between more than one home, and asymptomatic testing. As for the economy, all those who show symptoms can have a test, but we are talking to business about how businesses can also contribute to their own testing regimes, and we look forward to developing those plans.
My Lords, knowing who has and who has not had the virus is clearly essential in knowing who should be isolating themselves. The Minister has failed to answer my questions on what proportion of the self-testing kits are being returned, and on the estimated number of false negatives as a result of people not swabbing themselves properly or because of inherent weaknesses in the test itself. However, at the moment, NHS staff are being given antibody tests and many who have palpably had the virus and been exposed to it are showing as negative. What is the department’s working estimate of what proportion of false negatives there will be in those antibody tests?
My Lords, the noble Lord makes an important point. How it is that some people have palpably had the virus, as he rightly says, but do not show a positive antibody test, is a mystery that we do not fully understand. It seems that the tighter—more minimal—the amount of antibody left in the bloodstream, the less likely it is to register in the test. We are undertaking a massive antibody testing programme through the health service to understand this phenomenon more closely, and we look forward to publishing those results as a priority.
(4 years, 7 months ago)
Lords ChamberMy Lords, I share the noble Baroness’s endorsement of the tremendous response from British manufacturing. Some 176 firms have applied to the scheme and we are processing their suggestions. My noble friend Lord Deighton is a powerful advocate for the Make programme. I thank in particular Don & Low, Ineos and Survitec, which have already made a considerable contribution to production.
My Lords, NHS Providers warned last night of a very real risk that front-line staff’s confidence and trust in national leaders could be significantly undermined unless trust leaders and staff are confident that they are receiving adequate supplies of the right equipment at the right time. On Saturday, Robert Jenrick promised that a very large consignment of PPE would arrive from Turkey on Sunday. In fact, it was not until yesterday that half of the promised 84 tonnes arrived. Trying to grab headlines with a dubious promise is hardly likely to help staff confidence. Is it true that Turkey was asked to facilitate this shipment only the day after the Minister’s promise? Could the Minister tell us what is the daily requirement for PPE in the NHS and how it compares with the Turkish shipment?
My Lords, it is not correct that Turkey was asked to intervene only at the last minute. We have been in constant, daily and regular contact with the Turkish Government. We are grateful to the Turkish Government for their help and involvement and we continue to work with Turkish companies on this order. On the NHS’s requirement, this virus undoubtedly requires much more protection than any other disease that we have encountered. The demand for PPE will continue to rise. We will meet that need through our Make programme and continued strong relationships with foreign providers.
(4 years, 8 months ago)
Lords ChamberI thank my noble friend for his question on deep cleaning. I reassure him that no one is suggesting that the best efforts of any employer to protect the welfare of their staff is in any way irrelevant or undervalued. Cleaning is an important response to this virus and those who decide to put resources into cleaning their premises are entirely to be lauded. There is clear guidance on the PHE website. I have put that guidance in the Library and would be happy to arrange for it to be emailed.
Let me try to explain the nub of the question. The CMO has not put the daily deep cleaning of offices or any work premises at the top of his priorities. The reason for that is that it takes only one person to touch a doorknob at 7 am for that doorknob to be contagious for the rest of the day, whereas a pair of hands can be cleaned many times a day. If you do the arithmetic of how the virus is spread—as the modelling professionals do at SAGE—constant handwashing, which we bang on and on about, is the most effective way of preventing the virus spreading. When that no longer proves an effective measure, the CMO will undoubtedly change the guidance and publish that guidance widely.
My Lords, I am slightly surprised by that answer. I was not going to ask about this but, none the less, I will. Surely, what the noble Lord, Lord Forsyth, is asking is: if an employer wants to go above and beyond the current minimum level of requirement, where can they get guidance? That seems quite important. The question I would like to ask the Minister is this: obviously, we wish Nadine Dorries all the best for her recovery, but is the line by which she acquired the virus yet clear? If it is not possible to answer that, of those people who have been confirmed to have the virus, in how many cases is the route by which they acquired it known? If that route is not known, clearly this is much more endemic than has previously been said.
My Lords, not wishing to return to question of deep cleaning too many times, I just reassure the noble Lord that the published guidance is very clear. It says that this virus can be cleaned with conventional soaps and conventional detergents, of the kind already freely available and used by cleaning companies. There is nothing technically challenging about the cleaning of offices, homes or hands in the case of this virus. It is just about thoroughness. That guidance exists. If it would be helpful, I would be happy to share it with noble Lords in this Chamber.
It is not possible to discuss Nadine Dorries’s case in detail. On community contagion, which is the nub of the question, we have reached the stage where the origin of every positive case is not known. In other words, there are people who have picked up the virus for whom no simple explanation can be given for where they got it. Therefore, the CMO has stated clearly, including in briefings to noble Lords, that his opinion is that the virus is present in the community but, as I explained, that the levels of positive testing suggest that it is not very prevalent. The CMO in his briefing estimated that between 5,000 and 10,000 people had the virus earlier this week. Those are the kinds of proportions we are talking about at this time.
(4 years, 10 months ago)
Lords ChamberMy noble friend is right, and police collaboration after Brexit is one of the big priorities of this Government. That is why in the implementation period, we will be discussing this with the EU and our partners. The political declaration envisages a relationship spanning operational and judicial co-operation, data-driven law enforcement and multilateral co-operation through EU agencies. Those three important silos will be the basis of our ongoing negotiations.
My Lords, we all appreciate that the Home Office must be a difficult government department for Ministers to supervise and control. I can think of a former Home Secretary who felt obliged to offer his resignation over these sorts of matters, and my noble friend Lady Hughes resigned because of failures within the department. The former Home Secretary, Amber Rudd, also had to resign because she had inadvertently misled the House of Commons as a result of poor information. Can the Minister tell us—in answer to the question of the noble Baroness, Lady Hamwee, which was not answered—precisely when Ministers were notified that this failure had occurred, and who took the decision that it should not be made public on the basis of reputational damage? Are any Ministers contemplating their positions?
The paper trail is extremely complex, and I am not in a position to give the kind of blow-by-blow account that the House would like. I sympathise with the question, and I would like to be able to give the noble Lord more detail. I am afraid that these issues are a necessary part of upgrading our technical and data arrangements. This is a complex and ongoing project, and while this mistake is extremely regrettable, at no point has there been any suggestion that those involved have not behaved with best intentions.