Thyroid Patients: Liothyronine

Debate between Lord Kamall and Baroness Masham of Ilton

Wednesday 6th July 2022 Lords Chamber

[Lord Kamall (Con)]

I have had prior notice from other noble Lords about this issue and have organised meetings with my officials in the past on this—I am always happy to do so. Given the concerns about the lack of commissioning for people who have tried the first-line treatment and now want the second-line treatment, NHS England intends to revise its guidelines. It is sorry about the process, but it must consult before it can change those guidelines.

[Baroness Masham of Ilton (CB)]

My Lords, is this not a case of discrimination against those patients who need the drug?

[Lord Kamall (Con)]

The current advice is for them to try the first-line treatment and only if that does not work should they go for the second-line treatment which noble Lords are asking for. In some cases, there may be patients in the other direction, who could go on to the first-line treatment. NHS England clearly understands the problem and the concerns that many noble Lords have raised, and it is consulting on the guidelines.

Polio

Debate between Lord Kamall and Baroness Masham of Ilton

Thursday 23rd June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord makes a really important about the future of the NHS and our health services. Last week, the Government published the Data Saves Lives strategy, which is what it says on the cover. One of the first issues we must tackle is digitising the NHS as much as possible. Digitisation is one of my three priorities, alongside sharing data. First, this will ensure that we can identify population health issues and patterns in conjunction with AI; secondly, giving appropriate access to researchers allows us to continue to be world-beating in identifying such issues. In future, it may well be that we can get a sample, use a bit of AI—thanks to other data sets—and locate more accurately. At the moment, we are really at the cutting edge of this. What will be vital to it is the digitisation, sharing of and access to data across the system.

[Baroness Masham of Ilton (CB)]

My Lords, is it known how many countries are using the live vaccine, which is different from the vaccine we are using?

[Lord Kamall (Con)]

I am aware that there are still some countries that use the oral polio vaccine, as opposed to the IPV we use in this country. I do not have the exact numbers with me. If the noble Baroness with allow me, I will go back to the department, see if that information is available and then write to her.

Health and Social Care Leadership Review

Debate between Lord Kamall and Baroness Masham of Ilton

Thursday 9th June 2022 Lords Chamber

[Baroness Masham of Ilton (CB)]

It is tragic that so many babies and mothers have died when they should have been safe in hospital. What happened to the standards of care which were required? Fresh young enthusiastic people joining the NHS and those in care should be safe from bullying, harassment and discrimination. If something goes wrong with patients’ treatment and care, should there not be a duty of candour, with openness and honesty? Surely this should be incorporated in leadership education. I hope that it will be.

[Lord Kamall (Con)]

The noble Baroness is absolutely right that there should be a duty of candour. Noble Lords will remember that during the Health and Care Bill debates there was the debate around the openness of HSIB process. Here we have a difficult balance. On one hand, if someone has acted inappropriately or caused damage, you would want them to be brought to justice but, on the other hand, we know that the NHS has a culture of cover-up when things go wrong. It is great that we praise the NHS when things go well but I have heard too many stories of when things go wrong and clinicians close ranks and cover up.

Sometimes, they gaslight. I was talking about this the other day to a young official in the department and she told me about her friend, a young Afro-Caribbean female, whose baby died during birth. When she complained, the papers suddenly, magically disappeared. How can that happen? We have to make sure that there is real justice, but we have to get the right balance. HSIB makes sure that there is a safe space so people can feel free to come forward, so that we learn from that. Sometimes there may not be justice for the individual, but we can make sure that we avoid a repeat of these incidents. The Ockenden report clearly showed the role that the culture of the organisation played. We must be careful: there should not always be a focus just on numbers; we do not want to train people within the wrong culture and do more damage. We have to tackle all these issues at the same time.

GP Access

Debate between Lord Kamall and Baroness Masham of Ilton

Tuesday 7th June 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, we have a virtual contribution from the noble Baroness, Lady Masham of Ilton.

[Baroness Masham of Ilton (CB) [V]]

My Lords, is the Minister aware that many GPs’ surgeries made it clear during Covid-19 that they did not want patients who might have coronavirus coming to them? Does the Minister realise that many early diagnoses of seriously ill patients, including those with cancer, have been missed, putting extra pressure on everyone involved at present?

[Lord Kamall (Con)]

The noble Baroness makes an important point. Because of the focus on Covid and making sure we were keeping everyone safe, especially before we had a vaccine, precautions clearly had to be put in place. Of course, at the time it seemed eminently sensible to make sure that doctors and patients were protected. As the noble Baroness rightly highlights, the unintended consequence of this has been a backlog in seeing other patients. One of the things we are doing is making sure that, as we roll out these community diagnostic centres and modernise primary care, we can see patients in a more timely way. The GP does not necessarily have to be the first point of contact.

North East Ambulance Service

Debate between Lord Kamall and Baroness Masham of Ilton

Monday 23rd May 2022 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, will the Government do their best to stop cover-ups, which there have been over this matter, so that this does not happen in future?

[Lord Kamall (Con)]

Absolutely. It is really important that we have a duty of candour and that people can be open. We saw this during the passage of the Health and Care Act, with HSSIB. Although there might be an initial reaction to find the culprit, or whatever the issue is, it is really important that we learn from mistakes made. It is a difficult balance, but we have to make sure that we have an open environment and culture so that people feel safe to come forward and explain what happened, and to make sure that these services learn from what went wrong. We have been absolutely clear that there is a cultural issue that has to be addressed, but also that NDAs have no place in the NHS.

Vaccination Strategy

Debate between Lord Kamall and Baroness Masham of Ilton

Thursday 13th January 2022 Lords Chamber

[Baroness Masham of Ilton (CB) [V]]

My Lords, how much research is being done on persons who may have developed Guillain Barré syndrome after the coronavirus vaccine booster? Is the noble Lord aware that there have been several cases of this serious condition recently?

[Lord Kamall (Con)]

I thank the noble Baroness for the question. I will have to write to her with the answer.

Hospital Beds and Social Care

Debate between Lord Kamall and Baroness Masham of Ilton

Thursday 6th January 2022 Lords Chamber

[Lord Ashton of Hyde (Con)]

My Lords, the noble Baroness, Lady Masham, wishes to speak virtually, so I think this is a convenient point to call her.

[Baroness Masham of Ilton (CB) [V]]

My Lords, as president of the Spinal Injuries Association, I ask the Minister whether he realises that there are many people who are severely paralysed, some of whom need two or three carers each day living in their own homes. Is he aware that the skilled labour market of carers from Europe has dried up since Brexit, leaving many people in a state of fear and anxiety of being at risk? The Government can help. Will they?

[Lord Kamall (Con)]

The noble Baroness makes a very important point. One thing that the Government announced before Christmas was on visas and encouraging more care workers to come to this country. Where she and I might disagree is that we are going to approach the best in the world, not just Europe—we want the best staff possible.

Breast Screening

Debate between Lord Kamall and Baroness Masham of Ilton

Tuesday 14th December 2021 Lords Chamber

[The Lord Privy Seal (Baroness Evans of Bowes Park) (Con)]

My Lords, the noble Baroness, Lady Masham of Ilton, wishes to speak virtually, and I think this is a convenient point for me to call her.

[Baroness Masham of Ilton (CB) [V]]

My Lords, as GPs are having to work in vaccination centres, would it be possible for people who think they have or may have cancer—breast cancer or other cancers—to go straight to secondary care for investigations? GPs cannot do everything at the same time. Does the Minister agree with me that it is important to have a speedy diagnosis for cancer?

[Lord Kamall (Con)]

I think all noble Lords would agree with the noble Baroness that it is important we have speedy diagnosis. On the specific question, I will check and get back to her.

Covid-19 Update

Debate between Lord Kamall and Baroness Masham of Ilton

Wednesday 8th December 2021 Lords Chamber

[Baroness Masham of Ilton (CB) [V]]

My Lords, I thank the Minister for repeating this very important Statement. Many people are concerned about taking the booster because they do not know what the result will be of mixing vaccines such as Pfizer and AstraZeneca. Nobody seems able to give advice. It is very worrying. GP surgeries just do not want to know. What can the Minister do about this? Some of these people are elderly, but there are also young people. How can one advise them? They want to speak to a human being, not just a repeated voice which does not answer their questions. Some of these people are pregnant. The ones I talk to are in a rural area; I do my best to tell them how important it is to have a vaccine, but they just want an official voice. I hope the Minister can give some advice.

[Lord Kamall (Con)]

I thank the noble Baroness for that question. As far as I am aware, the places administering the booster should be able to give that advice. For example, when I walked in for my booster, they asked which vaccines I had previously had and said that the half-dose I had was sufficient. When I asked about my children, they told me which vaccine was more appropriate for that age group, depending on which vaccine they had. If that advice is not available at the place of vaccination, please let me know. I was not aware of that and I promise that I can look into it.

While I am here, I realise that I did not answer the question from the noble Baroness, Lady Thornton, about the R number. It is currently at 0.9 to 1.1; the latest growth rate range for England is minus 1% to plus 1% per day. As the omicron data comes in, that may well increase, but we have looked at all these measures and are being as precautious as we can in balancing everything up.

In response to the earlier question about the pass—I apologise for the long answer—I have just been told that the NHS has tweeted:

“We are aware of an issue affecting access to the NHS COVID Pass on the NHS App and website. We are investigating this as a priority and will update as soon as we can”.


Clearly, the NHS has been listening to this debate and discussion, and I thank the noble Baroness for raising that. I am sure that noble Lords will agree that that tweet shows the effectiveness of having this debate, so that we can share as much information with the public as possible. I repeat this request: if any noble Lords are aware of any particular problems with the rollout, information et cetera, please let me know and I will investigate as quickly as I can.

Covid-19 Update

Debate between Lord Kamall and Baroness Masham of Ilton

Monday 29th November 2021 Lords Chamber

[Baroness Masham of Ilton (CB) [V]]

My Lords, it is very difficult to find out why many people are hesitant about having a booster jab having had two vaccinations. Does the Minister think that, if something went wrong and left a person seriously disabled from the vaccine, but if they knew they would have adequate compensation, they might be more willing to have the booster?

[Lord Kamall (Con)]

I thank the noble Baroness for raising that important point. We have made the point that it is not over, but one thing that we have seen, sadly, with the uptake of the booster vaccine is that a number of people felt that because they had had the first and second doses, they could almost return to normal. Maybe we could have been stronger with the message that it is not over, but we continue to say that we should be ever vigilant. The important point is that, if you have not had the booster, we ask you to come forward, just as we ask all those who have not had their first or second vaccine to come forward. We are trying to work with all those in different communities to make sure that they come forward. We are, for example, working with interfaith communities and local groups.

Covid-19 Vaccinations

Debate between Lord Kamall and Baroness Masham of Ilton

Monday 8th November 2021 Lords Chamber

[The Deputy Speaker (Baroness Henig) (Lab)]

My Lords, the noble Baroness, Lady Masham of Ilton, is taking part remotely and I invite her to speak.

[Baroness Masham of Ilton (CB) [V]]

My Lords, what is the situation with vaccination against coronavirus for inmates and staff in UK prisons? Prisoners often get transferred to other prisons and they move in and out when released and recalled. Many live chaotic lives, but it is important that they all get vaccinated. Is there a system to see that this process is safeguarded, so that jabs are fully completed? Prison health must not be forgotten.

[Lord Kamall (Con)]

The noble Baroness raises a very important point. As far I am aware—I will confirm this—the population of prisons is being treated the same as the wider population in terms of encouragement to take the vaccines and the booster. I will double-check and write to the noble Baroness.

NHS: Fracture Liaison Services

Debate between Lord Kamall and Baroness Masham of Ilton

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

My noble friend raises an important point. We accept this estimate; we are working hard to remedy it and to provide the healthcare that people need. The NHS has established the Best MSK Health national improvement programme, which is focused on improving the whole pathway for those with MSK conditions. That programme will include identifying and tackling variations in access, outcomes and experiences. I am also encouraged to see that the NHS is keeping FLS as a priority in its recovery plan, which includes plans to deliver more of these services across the country. On top of that, the Office for Health Improvement and Disparities is looking specifically at the issue of disparities, not only for MSK conditions but for others.

[Baroness Masham of Ilton (CB) [V]]

Can the Minister ensure that people living in rural areas who are at risk of osteoporosis will be able to be diagnosed by a DEXA scan? Is he aware that this opportunity has been turned down for the local hospital at Northallerton, despite the wishes of the consultant and the Friends of the hospital who raised the money to buy one? What can be done about that?

[Lord Kamall (Con)]

I am not sure about the specific case that the noble Baroness raises, but I will write to her. However, generally, there is an investment of £2.3 billion to increase the volume of diagnostic activity and to roll out at least 100 community diagnostic centres, to make sure that we are taking diagnosis closer to patients in their communities.

Cancer Drugs: Licensing and Approval

Debate between Lord Kamall and Baroness Masham of Ilton

Monday 8th November 2021 Lords Chamber

[Lord Kamall (Con)]

It is important that we learn the best lessons from abroad on incredibly important issues such as this. Where NICE and MHRA are allowed to talk to each other and co-operate—there are some restrictions, as I am sure many noble Lords are aware—both clearly recognise that there are great concerns and distress on the part of the many patients who want access to these drugs, and they are trying to work out how they can speed up the process as much as possible.

[Baroness Masham of Ilton (CB) [V]]

My Lords, how can we speed up the process once new, innovative medicines have been approved by NICE so that patients get their benefit? Is the Minister aware that other countries, especially Germany and France, are leading the way with cancer drugs while England is near the bottom of the list? That is not good enough, is it?

[Lord Kamall (Con)]

I thank the noble Baroness. It is important that NICE, MHRA and others hear some of the concerns, and the fact that we are being held to account today shows how important this is. Unfortunately, some existing legislation restricts MHRA’s ability to share information with partners, including NICE, which would help them to plan their processes more efficiently. NICE, MHRA, NHS England and NHS Improvement are talking about the concerns raised by noble Lords and generally about delays in the process. They are talking about how they can improve access, including through initiatives such as the Innovative Licensing and Access Pathway launched in January 2021, and sharing as much information as they can upfront. Both MHRA and NICE are aware of the concerns and made that clear when I met them recently after their board-to-board meeting.

HIV Action Plan

Debate between Lord Kamall and Baroness Masham of Ilton

Monday 18th October 2021 Lords Chamber

[Lord Kamall (Con)]

As the noble Lord says, in March 2020 the Government announced that the HIV prevention drug PrEP would be routinely available across England in 2020-21. It is now routinely available in specialist sexual services throughout the country. The settings in which PrEP could be made available outside these health services, such as pharmacies, will be considered as part of the ongoing work on the development of the sexual and reproductive health strategy and the HIV action plan. We plan to publish the HIV action plan later this year to coincide with World AIDS Day on 1 December, and the sexual and reproductive health strategy shortly thereafter.

[Baroness Masham of Ilton (CB) [V]]

My Lords, I welcome the Minister to the fight against HIV/AIDS. Will he agree with me that NHS England, public health, local authorities and voluntary organisations should work together to fight against HIV infection so that it does not become fragmented? Because of the coronavirus infection, many people think that HIV/AIDS has gone away: it has not.

[Lord Kamall (Con)]

I thank the noble Baroness for reminding us that HIV has not gone away. This is why the Government have an action plan. All noble Lords will agree on how important it is to tackle HIV and to raise awareness. The Government hope, in their plan and strategy, to be able to do this as soon as possible, and we remain committed to the goals previously set out.