Folic Acid

Lord Hunt of Kings Heath Excerpts

Tuesday 13th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the Government of New Zealand for focusing on this important issue and to the energy and passion of the noble Lord in his advocacy in this matter. I can give him the reassurance he asked for. This is a priority for the Government. We are taking it through the machinery of the British Government to ensure that it is rolled out safely, extensively and on a nationwide basis.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, assuming that the Minister is able to come back to the House after the Recess and give the green light, can he say when we could implement this policy? Does he agree that the recent report of the Health Select Committee on maternity services underlined the importance of making this decision soon?

[Lord Bethell (Con)]

My Lords, it is not only its importance for maternity services that is on my mind. It is also the recently announced office for health promotion, which will lead the national effort to improve and level up the health of the nation in the round by tackling obesity, improving mental health and promoting physical activity. This important initiative should be seen in the context of that important strategy. I completely endorse the ambition expressed by the noble Lord.

Women’s Health Outcomes

Lord Hunt of Kings Heath Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I very much welcome this debate and commend the noble Baroness, Lady Jenkin, on her opening speech. One of my main concerns is that, historically, women have been underrepresented in clinical research, as both researchers and the subject of research. The noble Baroness, Lady Jenkin, also referred to that. As a result, many diagnostic tests and treatments have been based on data gathered from men. Women are still not taking part in clinical trials to the same level as men. We need to understand the barriers that prevent women taking part in these trials, and encourage and enable them to take part.

This impacts across medical provision, but I will focus on heart attacks. Research into different treatments for men and women has shown that women are more likely to be treated less aggressively in their initial encounters with the healthcare system, until they have to prove that they are as sick as male patients. Once they are perceived to be as ill as similarly situated males, they are likely—but not always—to be treated similarly. This can be seen with heart attacks, where women having a heart attack delay seeking medical help longer than men because they do not recognise the symptoms and believe it is men who get heart attacks, not women. Some 50% are more likely than a man to receive the wrong initial diagnosis for a heart attack. Many are less likely than men to receive a number of potentially life-saving treatments in a timely way and, following a heart attack, are less likely to be prescribed medications to help prevent a second heart attack.

If there was any complacency about women’s health issues, the recent report from the Health Select Committee on the shocking state of many maternity services should be a great warning to us. This has been known for some time now. There has been an endless number of inquiries, yet we have been waiting for action for far too long.

It is not just about research and treatment of disease, as experienced by women. Ensuring women’s safety, privacy and dignity while they are in hospital is vital. Women often favour single-sex wards for very good reason: rates of sexual assault are far higher in mixed-sex wards. The Health Service Journal reported last year that at least 1,000 sexual assaults were reported by female and male patients on mixed-sex mental health wards between April 2017 and October 2019, yet there are indications that the NHS is moving away from giving enough provision to single-sex wards. Could the Minister look into this and see what can be done to ensure the NHS does what Ministers asked of it over the last years?

Coronavirus Act 2020 (Early Expiry) Regulations 2021

Lord Hunt of Kings Heath Excerpts

Monday 5th July 2021 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister for his explanation of these regulations. Clearly it is a good thing that the provisions are no longer considered necessary.

I want to ask the Minister about the impact where the provisions were in fact used. First, the Church of England measures allowed the postponement of the dissolution of the General Synod to 31 July 2021 and the continuation of members of the synod in office. Would the Minister care to tell me what impact that had on the running of the affairs of the Church of England? As a Minister of the Crown in a country where the Church of England is the established Church and Her Majesty the Queen is its Supreme Governor, I am sure he is on top of this matter.

I also want to ask the Minister about the Care Act provisions, which, as he explained, enabled local authorities to relax some duties on them, enabling them basically to prioritise the most serious and urgent cases by not conducting a full needs assessment or delaying some assessments. Eight local authorities used these powers between April and June 2020 but none did so after then, as the Minister said. Has he made any assessment of the impact of the use of those powers by those eight authorities? Also, have we learned anything? For instance, have we found a way potentially to streamline the assessment process?

Of course, the care sector has been under considerable pressure for some years. The pandemic brought huge challenges with it, and we still await a plan for its long-term sustainability. In joining my noble friend in congratulating the NHS on the hugely deserved award of the GC today, I am sure that we should also acknowledge the tremendous efforts of so many in the care sector in these past 15 months.

Health Security (EU Exit) Regulations 2021

Lord Hunt of Kings Heath Excerpts

Monday 5th July 2021 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister for his full explanation of these regulations. The need for them is self-evident in the post-Brexit situation and I welcome the intent behind them.

Of course, also behind the regulations is the need for the continuation of effective co-ordination between the UK and the EU. The implementation of the health security part of the trade and co-operation agreement is meant to support effective future working and information sharing; it also enables the UK to request early access to the EU Early Warning and Response System in respect of a serious cross-border health threat.

We debate these regulations at a time when the EU has proposed legislation to ensure that it is nimbler in responding to serious cross-border threats to health in future, including the declaration of an EU emergency situation, an enhanced mandate for the European Centre for Disease Prevention and Control, and a reinforced mandate for the European Medicines Agency to enhance its role in crisis preparedness and management for medicinal products and medical devices.

I have no doubt that a more effective EU response to a serious cross-border threat to health that also affects the UK is to be welcomed, but it will work only if we are in full co-operation mode with the EU. The Minister has been reassuring on this but I would like further assurances on our arrangements. He made mention of the UK health protection committee, which is a governance organisation in respect of the UK Government and the devolved Administrations, and the UK Health Security Agency. Can he give some information about when he expects the agency to be up and running? What is happening in the interim?

I also want to ask the Minister about the specific arrangements in place in respect of Northern Ireland. I know that we are to debate regulations on the placing of medicinal products and medical devices on the Northern Ireland market due to the terms of the protocol. Are there any particular implications for Northern Ireland in respect of these regulations?

Finally, I refer to Secondary Legislation Scrutiny Committee’s report on this SI. Although the committee did not report this instrument to the House, it did comment on the Explanatory Memorandum, stating:

“Although the Explanatory Memorandum (EM) provided is full of information on future EU-relations, it does perhaps overestimate the average reader’s knowledge of the UK’s plans”—


well, quite. I understand that the committee asked a number of questions to which the Minister’s department has provided answers. However, the committee made this point:

“Because of the pandemic, coordination of health surveillance is more important than usually, and an EM needs to make it absolutely clear to the House what it is being asked to agree to.”


Can the Minister assure me that his department has taken note of these comments in respect of further regulations?

Covid-19 Update

Lord Hunt of Kings Heath Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, what a perceptive question from the noble and right reverend Lord—he absolutely hits the nail on the head. The honest truth is that we do not have the precise figures on this but the indications are that he is right: the vaccine does not stop you being infected or transmitting it, but it reduces the chances of both those things dramatically. That is one of the reasons why we have kept our foreign travel arrangements under review. It is possible that the effect that he describes may mean that we can look very thoroughly at foreign travel—I think all noble Lords would welcome that.

[Lord Hunt of Kings Heath (Lab) [V]]

My Lords, I have no doubt about the Minister’s personal integrity but he will recognise that he is part of a Government who are not exactly renowned for their probity or truthfulness. I want to ask him about lateral flow tests. There have been reports that the accuracy of this test, which has been less than 100% in any case, is less still when it comes to the delta variant. Can he say a little more about that, and what discussions are taking place with UK companies, who appear to have developed better models which may be more accurate?

[Lord Bethell (Con)]

My Lords, the noble Lord is entirely right that the Porton Down verification team has looked extremely closely at all lateral flow tests and their sensitivity to the delta variant in particular. There is suggestion and some indication that for very low viral loads, the LFTs are not quite as sensitive, or if they are sensitive, the band is less easy to read. However, for higher viral loads—in other words, the kind of viral loads that the body needs to carry to be infectious—there is no change of sensitivity. Therefore, from that point of view the LFTs continue to perform their original purpose very effectively but we need to keep a very close eye on sensitivity with the new variants.

I pay tribute to all UK companies which are coming forward with LFT, PCR or genomic sequencing tests. I am extremely proud of the progress that the UK diagnostics industry has made. We have extremely high standards and extremely high validation and authorisation protocols through Porton Down. Those standards are very difficult to achieve but we are working extremely closely with UK companies to try to get them over the line so that they can play an important role in our response to the pandemic.

Hospital Waiting Lists

Lord Hunt of Kings Heath Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, waiting lists are published throughout the NHS and I would be very happy to write to my noble friend with details of the web locations for that data. We are working on the forecasts at the moment. It is not possible to forecast precisely when we can back to where we were, but I reassure my noble friend that a huge amount of work is going on to get there as quickly as possible, including 1.8 million diagnostic tests and treatment for 1.1 million patients since April 2021.

[Lord Hunt of Kings Heath (Lab) [V]]

Even if we get back to where we were in March last year, it will be a status quo in which all the key targets have been missed. When will the Government get back to meeting the targets that they inherited in 2010 with the Liberal Democrats? They have presided over a gradual but disastrous deterioration in overall performance.

[Lord Bethell (Con)]

My Lords, there has been an enormous pandemic, which has, of course, had a huge impact on the healthcare system. During the pandemic, the financial support for the NHS—as well as the system support—has been huge and had a huge impact. We are looking at a backlog and working hard to get through it, but noble Lords should be in no doubt that we are thoroughly committed to getting back to full operational capacity.

Social Care and the Role of Carers

Lord Hunt of Kings Heath Excerpts

Thursday 24th June 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab) [V]]

We are in a vicious cycle. After decades of reviews and failed reforms, the level of unmet need rises, the pressure on unpaid carers grows, the supply of care providers diminishes and the strain on undervalued care workers ever increases. Yet, far from having an “oven ready” social care deal, the Government are seemingly paralysed and constantly postpone the hard decisions they need to make.

Paid carers make up a 1.5 million workforce, but there are millions more unpaid carers. As a society, we rely on unpaid carers and exploit them while giving them a lack of personal support, respite care or funding. Carers UK has carried out research on the impact of the pandemic on unpaid carers. It shows that 81% of carers provided more care during the pandemic, 64% have not been able to take any break because of a lack of respite care, and 74% feel exhausted and worn out. If we are to support these amazing people, we have to reform social care, starting with implementation of the Dilnot proposals by putting a cap on care costs, but that is not sufficient. As Dilnot himself has said, additionally we need a pay rise for social care staff and extra cash for the current system to increase the numbers eligible for care. It will cost: the Health Foundation says £11 billion a year, but I suspect that is an underestimate. Rather like the experience of the NHS at its formation, there is a huge level of unmet need that will emerge if the current tight eligibility criteria are relaxed, as they must be. It will cost, but if our experience of the last 15 months has taught us anything it is that it is imperative to sort this out.

Why then have the Government postponed a decision time after time? It appears that the latest setback is due to the Prime Minister’s financial illiteracy in refusing to allow any increase in income tax, VAT or national insurance to pay the additional cost. He may think it is smart politics. He may think it is best to waste money on vanity projects such as the ludicrous proposal for a new royal yacht—I wish the noble Baroness, Lady Jolly, much joy in focusing on that and other defence matters in the future—but the Prime Minister’s ultimate legacy will be to be remembered as a man who ducked the most pressing public policy issue of the day.

Covid-19 Update

Lord Hunt of Kings Heath Excerpts

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

I am enormously grateful for the question from the noble Baroness. She gives me an opportunity to lift my head for a moment and think about a brighter future, because she is entirely right. One of the possible benefits from this awful virus is a different approach to public health that is much more effective in fighting contagious diseases, where we have much more effective tests for everything from flu to RSV to things like Covid as well, and where we can get therapeutic drugs to people the moment they test positive so that they do not fall sick. We can use this investment in public health to help level up some of the health inequalities that have beset this country so heavily.

[Lord Hunt of Kings Heath (Lab)]

My Lords, is there not a problem in looking for a different approach in the future? The precedent set by the Government’s attitude to Parliament fills one with a great deal of concern about the way our parliamentary democracy is going to work. Can he simply tell me why the Prime Minister did not make a Statement to the Commons last night?

[Lord Bethell (Con)]

My Lords, the Secretary of State was there. I thought he presented the steps regulations extremely clearly and did a great job.

Covid-19: Vaccines and Pregnancy

Lord Hunt of Kings Heath Excerpts

Monday 14th June 2021 Lords Chamber

[Lord Hunt of Kings Heath (Lab)]

My Lords, would it not be a good idea if the Chief Nursing Officer and the Chief Midwifery Officer gave a conference from Downing Street to reinforce the message that the Minister has given today about the safety of the vaccine? Can he tell me what the Government are doing specifically about the conspiracy theories going round in relation to safety risks to mothers and babies?

[Lord Bethell (Con)]

My Lords, when it comes to conspiracy theories, we have found that the best people to communicate on that are those who women and mothers trust and are dealing with during their pregnancy, typically their nurses and doctors. We have ensured that all the right materials are there, so that difficult questions can be answered in a collaborative dialogue. That is the most effective way of dealing with this.

NHS Digital: Primary Care Medical Records

Lord Hunt of Kings Heath Excerpts

Tuesday 8th June 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful for the question. I will look into that date and share whatever materials are available.

[Lord Hunt of Kings Heath (Lab)]

My Lords, I am fully behind the sharing of information, for the reasons that the Minister explained. But does he agree that to ensure public confidence, the Government have to do something about the current clunky opt-out approach that they have taken and make it easier, and publish the names of the companies to whom this information will be given and what they are paying for it? The Government must not hide behind commercial confidentiality. We as patients have an absolute right to know this.

[Lord Bethell (Con)]

My Lords, I agree with the noble Lord that the opt-out system deserves to be looked at. We are undertaking a review of the opt-out system to streamline it along the lines that he described. However, he peddles a slightly false impression. There are extremely detailed considerations in the IGARD minutes, available online—39 pages from the last meeting—which go into great detail on the arrangements for the sharing of each piece of data. On payment for the data, I remind him that—as I am sure he already knows—these are payments for costs and not payments for any kind of charge. All data is shared for very strict reasons to do with research and planning. There are no other reasons for sharing the data.