Bread and Flour Regulations 1998

Lord Kamall Excerpts
Wednesday 11th September 2024

(4 weeks, 1 day ago)

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Baroness Merron Portrait Baroness Merron (Lab)
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The noble Lord raises an extremely good point. Before we speak about the groups to which the noble Lord referred, I want to point out that fortification will not be enough in any case. We need to continue our encouragement for women to take daily folic acid supplements before conception and in the first 12 weeks of pregnancy, because doing so can prevent up to seven out of 10 cases of neural tube defects—I want to emphasise that. I will take on board the noble Lord’s very important point and ensure that it is part of our considerations.

Lord Kamall Portrait Lord Kamall (Con)
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My Lords, I start by paying tribute to the noble Lord, Lord Rooker, for his persistence in this matter. When I was a Minister, I found it rather frustrating to be told that the consultation process could not be speeded up, so I pay tribute to the Minister for the progress she has made. However, I want to ask about a possible unintended consequence. The NHS website says that folic acid is not suitable for some people: those who are allergic to folic acid, obviously; those who have low vitamin B12 levels; those who have cancer, unless they have folate deficiency anaemia; and to those who are having a course of haemodialysis or who have a stent in their heart. Given these warnings on the NHS website, can the Minister assure the House that she is confident that those who suffer from those conditions will not be harmed unintentionally by increasing the volume of folic acid in our bread and flour?

Baroness Merron Portrait Baroness Merron (Lab)
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I thank the noble Lord for his support in this area; I know that he also worked hard to make progress in it. I can give the assurance he asked for, and I would say to people that if they are concerned, they should seek expert advice about their own personal circumstances. All of the expert advice and relevant committees are content that this is the right way forward.

HIV Care: Access

Lord Kamall Excerpts
Wednesday 11th September 2024

(4 weeks, 1 day ago)

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Baroness Merron Portrait Baroness Merron (Lab)
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Yes, and I thank the noble Baroness for making those points, which I certainly agree with. The challenge for us now is to reduce the number of people who live with undiagnosed HIV, but also to reduce the number not seeking care and treatment. For the first time, the latter has exceeded the former, which suggests that we have a challenge we must focus on in the new plan, and we will do so.

Lord Kamall Portrait Lord Kamall (Con)
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My Lords, I pay tribute to my noble friend Lord Black for his consistent campaigning on this issue, and especially for helping those with HIV. What has been learned from previous initiatives? We know that in recent years, the NHS and the previous Government looked at ways to address issues such as vaccine hesitancy, and the reluctance of some to seek tests and treatment at any time. What lessons have been learned from these previous initiatives for the HIV action plan—for example, by working with local communities and the charities that a number of noble Lords have mentioned to encourage more patients with HIV to seek treatment, especially in communities such as black and Asian communities, where there may also be a stigma, as the noble Lord, Lord Fowler, mentioned, around admitting that they have HIV?

Baroness Merron Portrait Baroness Merron (Lab)
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There is what I call a three-pronged approach to interventions to reduce the number of people not being seen for care, which is so important, as I know the noble Lord is aware: identifying people who have not been seen for care; contacting them and re-engaging them; and addressing the barriers to engagement, which a number of noble Lords have referred to. This means sustaining engagement with care in the long term and supporting people with HIV.

We will review what lessons we are learning from the HIV action plan for England, which runs to 2025, and that means we will be able properly to inform the development of the new plan. I look forward to updating your Lordships’ House on this.

Pharmacies: Rural Areas

Lord Kamall Excerpts
Tuesday 10th September 2024

(1 month ago)

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Baroness Merron Portrait Baroness Merron (Lab)
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On the point that the noble Lord correctly raises, it is worth reflecting that there has already been a reduction in the number of pharmacies since 2017. There are now some 1,200 fewer pharmacies than we had in 2017 and 600 fewer than there were two years ago. This is a trajectory that we would rather was not the case. Support is available—for example, through the Pharmacy Access Scheme, which provides financial support to pharmacies in areas where there are fewer pharmacies. I can say that we are monitoring access to pharmacies. While it is the case that four in five people live within a 20-minute walk from a community pharmacy, we absolutely recognise that the experiences of patients differ. If we are to see pharmacies as key to future plans for the health services, we will have to address that.

Lord Kamall Portrait Lord Kamall (Con)
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My Lords, we recognise that the current access to healthcare is based on an outdated model, where far too many patients are unable to book GP appointments online or by telephone in advance. They have to join the 8 am lottery to try to get an appointment by phone, only to be referred later to a pharmacist or hospital. The Pharmacy First reforms introduced by the last Government attempt to unblock the GP surgery bottleneck by allowing patients to access treatment for common health conditions without the need for a GP appointment. To ensure that patients in rural communities equally benefit from the Pharmacy First initiative, is the Minister able to give the House a firm commitment that the Government will continue the Pharmacy First approach and look at how this could be accessed by more patients in rural areas?

Baroness Merron Portrait Baroness Merron (Lab)
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I am pleased to say that, as I am sure the noble Lord is aware, prescribing pilots are going on in NHS England. These will look at what more pharmacies could do in this regard, in particular asking whether more minor illnesses could be dealt with, and whether the long-term management of conditions could be better managed through pharmacies. We will be very interested in what those pilots come up with. They are across the entire country, so will of course include rural areas. This is something that we will want to ensure is available in rural and urban environments.

Government Policy on Health

Lord Kamall Excerpts
Tuesday 10th September 2024

(1 month ago)

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Lord Kamall Portrait Lord Kamall (Con)
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My Lords, the Minister will know that there have been concerns over Labour’s appointment of donors and party apparatchiks with little or no experience to senior Civil Service positions, which have led the Civil Service regulator to launch a review into Labour appointments.

I accept that this case is different. We understand that the Secretary of State is new to the role and inexperienced. We also know that Alan Milburn brings a huge wealth of experience in healthcare both in government and from personal consultancy, advising one of the largest providers of residential care for older people. I have also seen reports that he is a senior adviser on health for a major consultancy firm. I want to be clear, this is valuable experience and I applaud the Government for seeking such experience in the same way that noble Lords welcomed the appointment of the noble Lord, Lord Robertson, to review defence capabilities.

However, I am sure the Minister will also recognise the issue of real or perceived conflicts of interest—something that Labour Peers rightly questioned Ministers on when we were in government. So, in that spirit, I will ask the Minister a few questions about how the Government can look at potential perceived conflicts of interest and how they will be managed. Given Mr Milburn’s consultancy interests, can the Minister tell us what his formal role is? Is it a paid role and, if so, how much does he earn? Which meetings does he attend? Does he attend meetings without Ministers being present? Are notes taken for these meetings? How do the department and the Government ensure that he does not have access to commercially sensitive documents that could be of interest to his clients?

If the Minister cannot answer all these questions, I ask her to write to me and other noble Lords with answers and place a copy in the Library. Let me be clear, I completely understand why the Secretary of State appointed Mr Milburn—due to his experience in government and the private sector. It is valuable experience, from which a new Government could learn. I hope the Minister will accept my questions in the spirit of ensuring that the conflicts of interest are managed and there is real accountability, so that the Government can get the best out of Mr Milburn in his new role.

Lord Kennedy of Southwark Portrait Lord Kennedy of Southwark (Lab Co-op)
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Before the Minister responds, I make it clear that these should be questions, not speeches.

NHS Blood and Transplant Service: Blood Stocks

Lord Kamall Excerpts
Tuesday 30th July 2024

(2 months, 1 week ago)

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Baroness Merron Portrait Baroness Merron (Lab)
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I assure the noble Lord that it is indeed a temporary problem. However, it is likely the alert will go on for a little while yet, not least because, as I mentioned, we can benefit from keeping it in place. I absolutely associate myself with the assessment that it is so much better to be self-sufficient within the United Kingdom, and that will be of great benefit. It is important to realise that this is a situation that we must live with but not be at the mercy of. I also assure the noble Lord and the House that this is because of external factors and not internal factors to do with the service, as was the case in 2022.

Lord Kamall Portrait Lord Kamall (Con)
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I thank the noble Lord, Lord Rooker, for raising this important issue and for his supplementary question. I also thank the Minister for her answers so far. Can she tell your Lordships whether the department has found an obvious reason why these stocks were low, and whether it was a confluence of factors or an unusual occurrence? I was speaking to a noble Lord who is an existing blood donor; he told me that when he read about the shortage he had not yet been contacted. What have the Government and the NHS learned from this experience about what does and does not work, both in the UK and in other countries, when it comes to encouraging the public to come forward to donate blood to avoid future shortages?

Black, Asian and Minority-Ethnic Women: Maternal Mortality Rates

Lord Kamall Excerpts
Monday 29th July 2024

(2 months, 1 week ago)

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Baroness Merron Portrait Baroness Merron (Lab)
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I will indeed be very pleased to report back to your Lordships’ House on this matter. It is something that greatly concerns me, because it cannot be acceptable that women go into childbirth, which should be a happy and safe occasion, and perhaps come away with trauma, and in some cases families experience death as well. We cannot have a situation like that. I have been very moved by the stories I have heard and will commit to working to put improvements in place, and to sharing that with noble Lords.

Lord Kamall Portrait Lord Kamall (Con)
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My Lords, I welcome the Minister to her place. I look forward to working constructively with her as we did when our roles were reversed. Has she read the report by Sands, the baby loss charity? It gave examples of Asian parents being dismissed as either being too anxious or exaggerating their claims, while black parents were stereotyped as feisty or dramatic by some NHS staff. When I was a Minister, a young female civil servant told me about her friend, a young Afro-Caribbean lady whose baby died during birth. When she tried to get the records for what happened that evening, she was told that they had somehow magically disappeared. She was being gaslighted. We know that the majority of NHS staff are highly dedicated but, when we hear stories such as this, what does the Minister believe should be done to tackle the culture of cover-up and gaslighting by that small minority of NHS staff?

Baroness Merron Portrait Baroness Merron (Lab)
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I thank the noble Lord for his kind remarks; I am very pleased to see him again across the Dispatch Box. The duty of candour is extremely important in all this. Racism in this area is not just towards mothers and families; as the noble Lord said, it is also towards staff. Clearly, we need to tackle this for both patients and staff. The patient’s voice is key. Even at this early stage, it is quite clear to me that women, and people of black, Asian and minority-ethnic heritage, are not being listened to. We will bring forward plans to put this right. As part of the report to which I referred earlier, I will be glad to update the House in this regard.