(1 year ago)
Lords ChamberThe noble Lord is correct: about 50% of all cases are of chlamydia, and it is undetectable in a lot of people. That is why we have started screening programmes of chlamydia in women, so that it can be picked up when it has been undetected, which we know can be done. As the noble Lord mentioned, we have a programme of chlamydia vaccinations for both females and males. From memory, I think the rate of boys vaccinated is about 30%, but I will come back in writing with the exact numbers.
My Lords, the biggest single cause of death of people with AIDS globally is tuberculosis. Coinfection is a real issue. Although this problem is not nearly as serious at home, there are still thousands of cases a year and they have started going up again. Will my noble friend confirm that, post Covid, the Government will look again at what more needs to be done to eliminate tuberculosis—an entirely treatable disease—from our shores?
Yes, absolutely, as we are in all cases. I want to be clear on this. My noble friend mentioned AIDS: the UN targets are 95%, 95% and 95% for diagnosis, treatment and viral load detection, and we are at 95%, 98% and 98%. We are beating the targets and leading the world on this.
(2 years, 5 months ago)
Lords ChamberMy Lords, the World Health Organization pronounced Europe free of polio 20 years ago, but that was clearly not the case globally. Its emergence here is surely a reminder that a highly infectious disease anywhere can become a highly infectious disease everywhere. Is it not also a reminder of the need therefore for vigilance against such infectious diseases, which are not beaten until they are fully beaten globally? There are other diseases such as TB where there is not even a vaccine. Will my noble friend consider the importance therefore of renewing the UK’s commitment to the Global Polio Eradication Initiative to ensure that, once and for all, this beatable disease is beaten?
My noble friend makes a very important point. Even though a number of countries have been declared polio-free, including the UK because of our high level of polio vaccination, we should be clear that it has been detected and it has derived from someone having had a polio vaccine, probably an oral vaccine—the sugar cube that many of us will remember from our youth, rather than the injection that a person receives now as part of their 6-in-1. That has the potential to spread, and it is why the UKHSA is monitoring it. The important message is to remind everyone: check your red book, check your medical records, check your vaccination record. If you have not been vaccinated against polio or have not had the booster, go to your GP and get it as quickly as possible.
(2 years, 6 months ago)
Lords ChamberThe noble Baroness raises an important point about how we raise awareness, and that goes right across not only the population but patients themselves. NHS England and NHS Improvement are developing plans for future phases of their Help Us Help You campaign to raise awareness of key cancer symptoms. To date, the campaign has contributed to the record high levels of urgent cancer referrals that the NHS has seen since March 2021.
Perhaps I may take the opportunity to address the question from the noble and gallant Lord. Covid clearly affected the backlog. One of the things about the waiting list is that now 80% of people on it are waiting for diagnosis. One of the issues we are looking at is how you push out more community diagnosis centres around the country, not only in hospitals but in shopping centres and sports arenas, so that effectively we go to the patient and detect as early as possible. We hope that all that, in conjunction with things such as blood testing and genomic sequencing, will lead to earlier diagnosis.
My Lords, brain tumours are the single biggest cause of death among children and adults under the age of 40 of any cancer. The Government made a generous commitment to increase funding, which is absolutely essential for brain tumour cancer research, but, so far, they have not met the target that they themselves set. Will my noble friend undertake to review this situation, given the seriousness of the position?
One of the things about answering a question like that is that we are now aware of so many different types of cancer. For example, a blood test that has been trialled identifies 50 different types of cancer. Sadly, my mother-in-law died of a brain tumour, and I have asked questions about that in the department. If my noble friend will allow me, rather than read out a short answer I will write to him in more detail.
(3 years, 5 months ago)
Lords ChamberMy Lords, I have complete sympathy with the noble Baroness about the fast-changing nature of our response to this pandemic. However, as I have said from these Benches before, it is the virus that chops and changes and delivers us surprises. Who would have expected two or three months ago that the delta variant would have hit us as hard as it did?
We are trying to be agile and to adapt to changing circumstances. The guidelines on nightclubs and pubs will be published and when they are published, they will, I hope, be clear. The arrangements for September are being arranged right now. On mandatory vaccination in the NHS—which I think is what the noble Baroness inquired about—we have signalled our intention to consult on mandatory vaccination across the healthcare service. I hope that I will be able to share further details on that with the House at a future date.
In terms of an inquiry, of course I hear Sir Jeremy Farrar. However, I and many others are already working all the hours that God gives us on responding to this pandemic. There is no extra bandwidth for dealing with an inquiry. We are doing our best and we will look back and learn the lessons when the moment is right.
My Lords, given the growing number of people now being pinged and required to isolate, would it not make sense now to extend the sensible and welcome provision for critical workers so that those who have been doubled jabbed and then taken negative PCR tests need not isolate? I appreciate my noble friend’s point about breaking the chain of transmission but there is a danger that people will quite reasonably not see isolation as a proportionate requirement when they have been double vaccinated and tested. As well as the growing impact on businesses and public sector organisations of losing staff for up to 10 days, is there not also a need to maintain public confidence in the NHS Covid app? That is clearly now a serious concern.
I hear loud and clear the concerns that members of industry and critical services have about isolation of the workforce and the impact that is having on supply chains and the provision of services. However, I cannot hide from my noble friend that the infection rates are higher. It is important that people who have been close to someone who is infected isolate themselves. If they do not, infection rates will go higher still, and if we have sufficiently high numbers of infections, although the vaccines are incredibly effective, that will roll into hospitalisations, severe disease and worse. This is a moment for holding steady and keeping the line. I am hopeful that this moment of acute discomfort for industry and services will pass soon.
(3 years, 10 months ago)
Lords ChamberMy Lords, the challenges for effective testing, border security and the development of effective vaccines have obviously all increased hugely with the emergence of new variants, which continues and is causing great public concern. Can my noble friend say what the Government are doing to use the expertise that we have in the UK in genomic testing, which has enabled us to identify these variants, to help other countries do the same? In the end, it is not only the right thing to do morally, but it helps us too.
My noble friend is entirely right. We can only be safe here in the UK if we understand what variants of concern are developing elsewhere in the world, if the countries where those variants are emerging are testing and are identifying those variants, and if measures are put in place to tackle them. That is why we have put together an international platform where we will accept samples of new variants from anywhere in the world and use Britain’s substantial genomic testing capacity to help countries process them. We are sending machines from the UK and providing expertise for all those who need to supplement their genomic testing using the considerable resources of Public Health England, the Sanger Institute and our genomic testing capabilities.
(3 years, 11 months ago)
Lords ChamberMy Lords, I pay tribute to the advocacy of the noble Baroness and her colleagues on this important point. I acknowledge the financial pressures on those of limited means who are required to isolate. We have put in provisions for statutory sick pay and the £500 Covid bonus to help to support those people, and there are local authority funds and provisions to provide additional support. The point that she makes is made well and we completely acknowledge the challenge.
My Lords, does my noble friend share my incredulity that those who are opposed to lockdowns continue to make their arguments, in spite of the fact that cases are obviously rising very fast, in spite of the advent of the new variant, which is more infectious, and in spite of the current very serious pressure that our hospitals are seeing? Is it not the case that, in the end, their arguments boil down to the callous suggestion that somehow elderly people who have pre-existing conditions but might nevertheless expect to live for many more years are expendable, when they are clearly not?
My noble friend puts it well. I always welcome the challenge of noble Lords on any subject whatever, but I agree that underlying many of the objections to lockdown appears to be an assumption that some lives matter less than others. Whether you are asthmatic, diabetic, infirm or just old, I think that your life is worth just as much as everybody else’s. That is why I am extremely proud of the national effort to work together to protect those who are less advantaged and to protect our health service.
(4 years ago)
Lords ChamberThe noble Baroness refers to one of the most interesting of the recommendations of the commission’s report. I took a briefing from the commission yesterday; members made that point very clearly, and their arguments were extremely persuasive. We have learned a lot during the Covid pandemic about opt-out testing; I completely understand the value of it, and I will take that recommendation to the department to look at it very closely.
My Lords, I pay tribute to the long-standing work of the Lord Speaker on HIV and AIDS. I have campaigned beside him in South Africa and have seen the passion with which he devoted himself to this role over many years.
Does my noble friend the Minister agree that the HIV Commission’s recommendation for a plan that the Government should commit themselves to is a wise one which they should adopt? After all, it is D minus 10 now—10 years before AIDS should be beaten, according to the SDG. We have the tools, now we need to implement them.
I reiterate the tribute of my noble friend to the Lord Speaker. Over three decades, he has campaigned tirelessly on these issues, and was instrumental as Secretary of State for Health and Social Security in launching the ground-breaking “Don’t Die of Ignorance” campaign, which made an indelible mark—its impact is remembered today. The tenacity that he has shown in making evidence-based decisions in the fight against HIV is a model for us today.
My noble friend makes a very valid point on the need for a plan. We will issue a sexual health and an AIDS plan in short order; they have been delayed by Covid. He reminds us that it is D minus 10, a goal that we take extremely seriously.
(4 years, 2 months ago)
Lords ChamberThe right reverend Prelate makes a very touching appeal, and I reassure him that both the representatives and the people of Manchester are massively valued. I do not want to cite all the details, but many people in this Government, including me, have spent a vast amount of time in Manchester, value the city, love the people and are greatly distressed at the thought that anyone thinks otherwise. The practicalities of this epidemic have been very regrettable on travel. As a Minister, I regret massively the fact that I have not been able to travel up and down the country. It is not possible to visit cities for face-to-face negotiations in the middle of an epidemic. That would strike the wrong note. It is a contagious threat and that is not possible, but I reassure the right reverend Prelate that everything is being done to value the opinions of the representatives of Manchester, and it will continue to be so.
My Lords, I agree with the Minister’s main point, which is that local lockdowns are really the only choice available to us at the moment if we wish to avoid a national lockdown—which will penalise those areas that do not have the relevant levels of Covid and cause further economic hardship—and are to reject those voices which, through things such as the Great Barrington declaration, suggest that there should be no restrictions at all other than shielding the vulnerable, which would exact a tremendous humanitarian toll. That being the choice, surely local lockdowns, backed by the relevant economic assistance, must be the current policy. If people are looking for bigger solutions, those ought to lie in the advance of either rapid testing or a vaccine. Can my noble friend update us on the potential timetable and likelihood of a vaccine and how prioritisation will be organised to ensure that it is available to those who most need it first?
The feedback from the Vaccine Taskforce is very promising. It has six contracts for vaccines on four different platforms. The Oxford vaccine is by far the front runner, but what is really encouraging is the substantial pipeline of other vaccines coming through. I am afraid I cannot commit to the timing on that, but all the news we have is extremely encouraging and we are putting deployment protocols in place to be able to deliver it as quickly as possible. I also flag that the therapeutic drugs and rapid testing also provide strong answers to the threat of coronavirus.
(7 years, 9 months ago)
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My hon. Friend makes an excellent point. The key element of the fight against antimicrobial resistance is its global nature. We absolutely must not isolate ourselves from the rest of the world—we must collaborate—but we must take national action, too, and I will come on to that shortly.
That figure is of course a prediction—it could be lower, but it could also be higher. Predictions have been made about other contagions, such Ebola, Zika, HIV and Creutzfeldt-Jakob disease, and our scientists, academics and clinicians thankfully have managed to mitigate the worst effects and worst predictions for those diseases. But there are three reasons for us to be more alarmed this time: first, antimicrobial resistance is already happening; secondly, the problem is spreading rapidly and by all available means; and thirdly, research is not being carried out on anything like the scale required.
A quarter of all the deaths that are predicted to happen as a result of drug resistance will be caused by tuberculosis, a disease that already kills 1.8 million people a year. Does my hon. Friend agree that research and development is essential if we are to develop a vaccine to prevent tuberculosis? No epidemic has ever been fully beaten without a vaccine.
I absolutely agree. The difficulty is that due to the reward mechanisms in the system, such research and development is not happening. I will turn to that shortly.
This is not an apocalyptic prophecy. Antimicrobial resistance causes some 700,000 deaths globally and an estimated 12,000 deaths in the UK every year—similar to the number of people who lose their lives from breast cancer. Quite simply, if the bacteria that cause infections become resistant to antibiotics, people die. This issue is listed in the national risk register of civil emergencies, a five-year Government register, which states that an
“increasingly serious issue is the development and spread of”
antimicrobial resistance and points out that much of modern medicine will become unsafe. Minor surgery such as organ transplants, bowel surgery, cancer treatments and caesarean sections will become high risk—there will be more illness and more deaths.
Dame Sally Davies, our chief medical officer, pointed out that antibiotics have extended life by an average of 20 years—20 years of our lives may therefore be lost—and 40% of our population could die prematurely if this situation is not resolved. Operations would become unsafe due to the risk of infection during surgery or chemotherapy. Influenza pandemics would become much more serious. The national risk register states:
“The numbers of infections complicated by AMR are expected to increase markedly over the next 20 years. If a widespread outbreak were to occur, we could expect around 200,000 people to be affected by a bacterial blood infection that could not be treated effectively with existing drugs”.
(8 years, 6 months ago)
Commons ChamberI congratulate the hon. Member for Sheffield, Brightside and Hillsborough (Gill Furniss) on her maiden speech. It always takes courage for an hon. Member to make a maiden speech in this daunting Chamber, but it must especially have been so when she paid tribute to her predecessor—her late husband—whose untimely death robbed this Chamber of a promising new Member who spoke with equal passion for his constituents in her city of birth, Sheffield. She will clearly be a great champion for her constituents, and will speak with the bluntness that she declared. I am sure she will be a much respected Member.
I did not intend to address the issue of the European Union, but will respond to the points made by my right hon. Friends the Members for Hitchin and Harpenden (Mr Lilley) and for Wokingham (John Redwood), to whom I listened with great interest. I listened with care to the concerns of my right hon. Friend the Member for Hitchin and Harpenden about the Transatlantic Trade and Investment Partnership. It is surprising that those who have been campaigning to leave the EU, and who for so long have criticised the EU for not completing enough trade deals despite the fact that the EU has more trade deals than any other country—it has far more than the United States—find themselves in the position of criticising trade deals. In my judgment, the benefits of TTIP include a £10 billion a year trade boost to our economy, which would enable us to invest more in public services.
First, may I clarify to my right hon. Friend that I have long campaigned against TTIP? Secondly, Switzerland has more deals than the EU, including deals with China, Australia and India. The only countries with which the EU has deals that China does not are very minor states.
My point is that the EU has trade deals with more than 50 other countries, whereas the US has only 14. I thought the narrative was that we want the EU to have more trade deals.
The issue is this: any modern international trade deal will involve some kind of binding arbitration mechanism. My right hon. Friend is clear that he opposes the Canadian free trade deal, but that has been championed by my hon. Friend the Member for Uxbridge and South Ruislip (Boris Johnson), who leads the leave campaign, as a model that our country should adopt if we leave the EU. It is also true that the Trans-Pacific Partnership, the North American Free Trade Agreement and even the World Trade Organisation all involve some kind of arbitration panel that takes decisions out of the hands of elected Chambers. If we are to take the position that any trade deal of that kind should be resisted if decisions can no longer be taken by elected Members, none will be acceptable. We would then be in the position of trading without any such arrangements, at potentially enormous cost to our country.
My right hon. Friend the Member for Wokingham spoke with characteristic passion about parliamentary democracy and described this place as a puppet Parliament. I note that none of the Bills in the Gracious Speech that are of interest to me and my constituents are restricted or affected by our membership of the EU. That goes to a central point: we can vote on and discuss much of our legislation and domestic affairs without the encumbrance of the EU. I therefore find it difficult to accept that the 650 Members of the House of Commons are puppets, and that our views and votes on those matters are entirely irrelevant simply because of our membership of the EU. That strikes me as an exaggeration, legitimate though the concern about parliamentary sovereignty might be.
I welcome the proposed prisons and courts reform Bill, having been the author of “Prisons with a Purpose” before the 2010 general election. The document urged the rehabilitation revolution and a transformation of the way in which we run our prisons. The radical reforms proposed by the Government are welcome in respect of reducing reoffending.
A number of measures are of special interest to my constituency of Arundel and South Downs in West Sussex. The neighbourhood planning and infrastructure Bill will address a problem that I spoke about in the House recently. The welcome reform of neighbourhood planning introduced under the Localism Act 2011 empowers local communities to make plans that benefit their local area, but they must not be undermined by speculative developments that call into question the legitimacy of plans that have been voted on democratically in referendums. It would be very welcome if the neighbourhood planning and infrastructure Bill addressed those problems and prevented those speculative development applications. We should remind ourselves that neighbourhood plans have had the effect of producing more and not less housing than was originally intended. Therefore, the proposal will not reduce house building, but will properly empower local communities.
The digital economy Bill is welcome—I am delighted to see my hon. Friend the Minister for Culture and the Digital Economy on the Front Bench. He will know of the concern that many in rural areas have to close the emerging digital divide. We want to ensure that the Government’s welcome proposal to extend superfast broadband throughout the country reaches those in hard-to-find rural areas—they, too, are entitled to fast broadband speeds. That is important for rural employment, but it is also important on the ground of fairness. It will take new means, and I hope the Bill sets out measures that will future-proof broadband provision to ensure that the speeds obtained in those areas meet tomorrow’s as well as today’s needs. Many areas in my constituency currently cannot get broadband at all.
I welcome the education for all Bill and its promise to meet the Conservative party manifesto commitment to a fair funding formula for our schools. West Sussex schools are unfairly disadvantaged in that respect.
I also welcome the modern transport Bill. I should like to refer to two crucial infrastructure issues that affect my constituency. First, on the A27 upgrade, I am delighted that the Government have announced that that major route will be upgraded to include the Arundel bypass and that funding has been provided. I hope the plans continue to timetable, so that work on the bypass begins by the end of the Parliament, as has been set out.
Secondly, the rail service to my constituency is a concern to a large number of hon. Members on both sides of the House. The performance of the Govia Thameslink Railway franchise has simply been unacceptable over the past year, hugely inconveniencing passengers. It must be said that 60% of the delays are the responsibility of Network Rail and result from infrastructure failure. It should also be acknowledged that the Government are embarking on major infrastructure investment, including the £6 billion London Bridge upgrade, which will improve services. Nevertheless, GTR is not meeting the self-set targets in its performance improvement plan. Those targets were low in ambition, but the company is falling below its original performance thresholds set one year ago to improve performance for customers. That failure is exacerbated by the entirely misconceived industrial action of the RMT on driver control of doors. It cannot be a safety issue when drivers rather than guards already control the doors on 40% of Southern services. Industrial action has exacerbated existing problems with the service, meaning a very serious level of disruption for passengers over the past few weeks. This is now causing real anger among my commuting constituents and many others in the area covered by the franchise.
First, there is no justification for the industrial action and it should not continue, and nor should the unofficial industrial action caused by drivers and guards who seem to be suffering from an unusual level of sickness. Secondly, the management of the GTR franchise must recognise that, while the proposed measures to reform how it runs the trains may be justified, its management of the franchise as a whole has been absolutely lamentable. It has brought the Government’s rail policy into disrepute. It is essential that the company and Network Rail are held to account for their poor performance and that they meet their own self-set performance improvement standards.
Does my right hon. Friend think that the licence to operate this service should be taken away and a new supplier found to ensure it is delivered properly and in line with what he would expect?
My hon. Friend raises a fair point. The ultimate sanction available to the Government for the failure of a franchise to perform effectively is to withdraw it. Indeed, that has been suggested by the Prime Minister. The franchise has only just been awarded. One problem is that the company failed to plan for enough drivers, so for the past year there has been a driver shortage. There has literally been an inadequate number of drivers available for the trains and there is a very long training period. The company assures the Government that it can improve its performance. The Government are reluctant to withdraw the franchise and find themselves in the position of running the railway, but unless the position improves more radical measures will have to be taken to deal with the underperformance of this service. Frankly, it has been simply appalling. It is unacceptable for the rail-travelling public in this area. It is time that both Network Rail and Southern recognise that it is no longer acceptable to deliver a low-standard performance of this kind.