Health and Care Bill

Debate between Lord Kamall and Lord Scriven
Thursday 20th January 2022

(4 days, 5 hours ago)

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Lord Scriven Portrait Lord Scriven (LD)
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I do not think that the Minister really understands. Yes, there may be a duty on local authorities. The amendment tabled by the noble Baroness is basically a duty to promote integration. At the moment, the Bill says that:

“Each integrated care board must exercise its functions with a view to securing that”


health services are provided in an integrated way. The amendment says “and social care”. It then justifies at what point that integration must be done. Why does the Minister feel that not putting this in the Bill somehow strengthens the main aim of the Bill, which is to look at the integration of health and social care for individuals who are going through a health and social care episode?

Lord Kamall Portrait Lord Kamall (Con)
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The Bill complements these existing duties by placing an equivalent duty on ICBs to integrate the provision of health services with the provision of health-related services and social care services, where this will lead to improvements in quality or reductions in inequalities. Taken together with the wider introduction of integrated care boards and integrated care partnerships, this gives the NHS and local authorities the best platform on which to build new ways of working. New provisions in the Bill will also complement and reinvigorate existing place-based structures for integration between the NHS and social care, such as health and well-being boards, the better care fund and pooled budget arrangements. We will, of course, be listening throughout the passage of this Bill to other ways in which we can facilitate the NHS, local authorities and others to work together to deliver integrated care for patients and the public.

Lord Scriven Portrait Lord Scriven (LD)
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I am sorry and will not delay the House much longer, but this is a really important point: the heart of the Bill.

As the Bill is written at the moment, the only integration that the integrated care board is responsible for is to ensure that health services are integrated. That means integrating primary, mental health and acute. It does not say that it is for the integration of social care. That is exactly what the noble Baroness is trying to achieve. As this is written, is it not the case that the duty in the Bill is for the ICB to secure that only health services are integrated?

Lord Kamall Portrait Lord Kamall (Con)
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One of the reasons for the introduction of integrated care boards and integrated care partnerships is to give local systems, both NHS and local authorities, a platform on which to build new ways of working. That includes social care. If the noble Lord feels that this duty is not explicit enough or that we should bring it out, we should have further conversations.

Ambulance Queues: Health Outcomes

Debate between Lord Kamall and Lord Scriven
Thursday 13th January 2022

(1 week, 4 days ago)

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Lord Scriven Portrait Lord Scriven (LD)
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My Lords, I beg leave to ask the Question standing in my name and draw the House’s attention to my interests in the register.

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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We recognise that waiting times can impact outcomes, so patients in queues remain under constant clinical supervision and care and are prioritised according to need. Delays tend to be concentrated in a small number of hospitals, with 29 acute trusts across 35 sites responsible for 57% of the 60-minute handover delays nationally so far this winter. These trusts are receiving intensive support to improve, including through placement of hospital ambulance liaison officers and the safe cohorting of patients.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, half a million acute bed days each year are lost due to delays in discharge directly attributable to non-availability of social care, which leads to bottlenecks in emergency departments and ambulances being unable to unload patients. Does the Minister agree that the split of money raised by the health and social care levy over the next three years therefore needs to be more generous to social care, so people stop having to wait up to seven hours in the back of ambulances?

Lord Kamall Portrait Lord Kamall (Con)
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As the noble Lord will be aware, when the charge was initially announced it was intended to help with social care, which has been neglected for a number of years under successive Governments. Given the pressures of the backlog, the NHS has decided to divert some of those resources to help tackle it. We have invested money in social care in the short-term winter plan, and in the longer term we have announced extra investment to ensure that social care is an attractive career and offers real prospects.

Care Workers: Professional Register

Debate between Lord Kamall and Lord Scriven
Monday 10th January 2022

(2 weeks ago)

Lords Chamber
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Lord Scriven Portrait Lord Scriven (LD)
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When providing care for some of the most vulnerable in our communities, staff such as art therapists and occupational therapists have to have mandatory registration to practise. What is so different for social care staff who provide professional care as part of a multi-disciplinary team to such vulnerable people?

Lord Kamall Portrait Lord Kamall (Con)
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Only last week we opened a consultation on whether or not to make registration mandatory and to move towards it. When I spoke to people in the department about why it is currently voluntary and not mandatory, they said it was because they did not want to inadvertently put people off registering. They were worried that some people might leave the sector if registration was mandatory now. The noble Lord can shake his head, but this is a very real concern. We want to make sure it is voluntary first and we are consulting on the steps towards mandatory registration.

Public Health: Night-time Working

Debate between Lord Kamall and Lord Scriven
Thursday 6th January 2022

(2 weeks, 4 days ago)

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Lord Kamall Portrait Lord Kamall (Con)
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I start by thanking the noble Baroness for the article that she sent a link to, which addressed some of the issues around her Question. The sleep review is looking at all these issues. As she rightly says, there are some links between fatigue and certain ailments and diseases. On some of them, the academics are still challenging each other, but that is all part of the review.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, a wide body of research has revealed that a number of health conditions are related to night-shift working. In the Netherlands, breast cancer is now recognised as an industrial disease for female night-shift workers. What policies are the Government undertaking to deal with this body of research that points to health for night-shift workers being unequal?

Lord Kamall Portrait Lord Kamall (Con)
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The Government commissioned a review of sleep and health from the former Public Health England for 2020-21. That reported just before Christmas and is now being considered by Ministers and other officials. We are hoping that the Office for Health Improvement and Disparities will publish the findings in 2022. The review looked at a number of different things, including trends over time, optimal levels of sleep, links between mental and physical health, the economic impact and factors that hinder interventions to promote sleep. As the noble Lord rightly says, there is research out there about how workers can experience gastrointestinal disturbance and sleeping disorders and the possible association with breast cancer, cardiovascular disease and diabetes. All that will come out in the review, I hope.

Medical Schools: Training Places

Debate between Lord Kamall and Lord Scriven
Monday 13th December 2021

(1 month, 1 week ago)

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Lord Kamall Portrait Lord Kamall (Con)
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The Government follow strict ethical guidelines on international recruitment, in line with WHO guidance, which says we should not be taking nurses and doctors from countries and depriving their health services. But where countries have a surplus—a number of developing countries around the world actually train more people than they have a use for in the local system—they see it as a valuable source of income.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, it is not just a question of the total number of doctors but the number in certain specialisms where there is already a dearth of professionals. What are the Government doing to ensure that, as more doctors come on, they are particularly geared to specialisms where there is already a dire dearth of doctors?

Lord Kamall Portrait Lord Kamall (Con)
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When it comes to workforce plans, particularly in local areas where there is understaffing, we are very much focused on specialisms that are understaffed.

Covid-19: PCR and Lateral Flow Test Providers

Debate between Lord Kamall and Lord Scriven
Monday 13th December 2021

(1 month, 1 week ago)

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Lord Scriven Portrait Lord Scriven
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To ask Her Majesty’s Government what due diligence they carry out on companies listed on GOV.UK, that offer travel PCR and lateral flow tests for COVID-19.

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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The private sector has stepped up extremely rapidly, and most of the tens of thousands of travellers have had an excellent and professional service. However, we do not tolerate any providers taking advantage of customers. All providers in the PCR international travel market are required to meet robust minimum standards, and we remove those we identify as having fallen short of them. Since we launched the travel service, we have removed over 100 providers.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, for many people that is just not their lived experience. The approved supply list for the two-day PCR test on GOV.UK is fundamentally flawed. Many thousands of people either do not receive the test results within the two-day timeline or at all. Despite many people reporting these companies to NHS Test and Trace, they remain on the list as of today, making tens of thousands of pounds while undermining the public health effort. What will the Minister do to ensure that this kind of procedure stops?

Lord Kamall Portrait Lord Kamall (Con)
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It is important to distinguish between PCR tests if you are contacted by NHS Test and Trace and PCR tests for travel purposes. If you are contacted by test and trace, you are sent a PCR test for free. But when it comes to travel, the view is that the traveller should bear that cost rather than the taxpayer. After I saw this Question, I went on to one of these websites and tested it out for myself. As the noble Lord says, the price quoted is often not the first price. I have had a conversation with those that provide it, and they are looking at a number of different solutions.

Covid-19 Update

Debate between Lord Kamall and Lord Scriven
Wednesday 8th December 2021

(1 month, 2 weeks ago)

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Lord Kamall Portrait Lord Kamall (Con)
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I attended a meeting this afternoon with leading epidemiologists, showing the data and separating the omicron variant, the delta variant and the original coronavirus. They have the data, and one of the reasons we have made this announcement is because we are able to distinguish between them. We are constantly reviewing the data for the original coronavirus and the variants but, if the noble Lord has any more scientific or medical questions, he should let me know or attend the briefing with Jenny Harries on Friday.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, the Statement says that the Government are looking to introduce daily tests for contacts instead of self-isolation. I have a couple of questions. My noble friend Lady Brinton asked what the false negative rate is for lateral flow tests at the moment. Secondly, what will be the legal obligation for a person to take this test and then to upload the result so that people know that contacts are taking the lateral flow test?

Lord Kamall Portrait Lord Kamall (Con)
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I am not quite sure about the latest data, because clearly more people have been taking them, but accuracy was in the very high 90s. However, I will commit to write to the noble Lord. On his second question, I will make sure that we get that information out as quickly as possible.

Covid-19 Update

Debate between Lord Kamall and Lord Scriven
Wednesday 10th November 2021

(2 months, 2 weeks ago)

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Lord Kamall Portrait Lord Kamall (Con)
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There clearly are concerns. These were expressed in the stakeholder engagement that occurred with both the social care sector and other sectors that will need to bring this in from March next year—we are bringing it in now but with a grace period until next March. A lot of this engagement and consultation discussed how we can support staff who are unwilling to be vaccinated as well as understanding their concerns and whether employers see these as legitimate.

Thinking back to the beginning of the crisis, one of the reasons this was called for in care homes as quickly as possible was the data from the early part of the pandemic, when there were a disproportionate number of deaths in care homes. A number of people, including patient groups and families of patients, were quite adamant that if their relatives were in a care home, they wanted to make sure that they were being looked after by staff who had been vaccinated.

There is another vaccine that is a condition of deployment, that for hepatitis B. I have asked medical staff whether they are concerned about this and a number have said no, because they are already compelled to have the vaccine for hepatitis B. That is a condition of deployment and staff see this vaccine as just as essential. That assuaged some of the concerns I had over compulsion. These are difficult, unprecedented times. We would not ordinarily want to go with compulsion, but the health of the nation is at risk and many people want to feel much more reassured that they, or their family members who are receiving care, are looked after by people who have been vaccinated.

Lord Scriven Portrait Lord Scriven (LD)
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Evidence-based policy is really important on this. Statistics from the Nuffield Trust show that, with the mitigations that healthcare and hospitals are putting in place, hospital-acquired Covid rates have been coming down since the middle of the year, while rates in the community have been rising. The reason for that is that the mitigation includes face-covering measures which, as the NHS Chief Nursing Officer, Ruth May, said in July,

“will remain in place across healthcare settings so that the most vulnerable people can continue to safely attend hospital”.

If that is the case, why was the Prime Minister not wearing a face covering when in a hospital this week?

Lord Kamall Portrait Lord Kamall (Con)
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I thank the noble Lord for that question and other noble Lords for their questions. I am not the Prime Minister’s keeper; it is as simple as that. We all decide for ourselves. I wear a mask whenever I can and when I talk to different people, I make sure that we are seen to be wearing masks. I thank noble Lords across the House who are leading by example by wearing a mask.

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Lord Kamall Portrait Lord Kamall (Con)
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In consultation with the social care sector and the wider NHS, including trusts, discussions have looked at the impact and what would happen, but also how to make the message more positive, how to encourage staff to take up vaccines and how to listen to their concerns. In some cases, employers have said that they do not feel that staff have given a legitimate reason for not taking up the vaccine, but they are also under pressure from patients’ families to make sure that they employ care staff who have been vaccinated. They are trying all the different areas of persuasion, including targeted campaigns and one-to-one conversations in some cases, to encourage them as much as possible. At the end of the day, even before the introduction of vaccinations as a condition of deployment, many care homes were already trying to push their staff to take vaccinations because they are concerned about their patients.

Lord Scriven Portrait Lord Scriven (LD)
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As we have time, the Minister has just said from the Dispatch Box that the Prime Minister was following the rules of the trust he visited. That trust says on its website that you must

“wear a face covering when you enter the hospital until you leave”,

and adds:

“You must ensure that you wear your covering or mask throughout your visit and you must not remove your face covering/mask or kiss your loved one.”


By not wearing a mask, in either a clinical or non-clinical area, how was the Prime Minister carrying out the policy of that trust to try to save vulnerable people from being contaminated with Covid-19?

Lord Kamall Portrait Lord Kamall (Con)
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Whenever I have visited hospitals during the lockdowns or restrictions, we have sought advice from the staff around us. We have asked what measures are appropriate and whether we should keep face coverings on at all times. There have been times when they have said that, in particular areas, you can take your mask off. I was not at the visit yesterday, as I am sure the noble Lord will acknowledge—in fact, I was here answering questions—so I cannot go into detail. However, having visited hospitals myself, I am aware that you go in wearing a mask by default, but there are times when staff say, “In this area, you can take it off”.

Covid-19 Vaccinations

Debate between Lord Kamall and Lord Scriven
Monday 8th November 2021

(2 months, 2 weeks ago)

Lords Chamber
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Lord Scriven Portrait Lord Scriven (LD)
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I do; you went on for two minutes.

Lord Kamall Portrait Lord Kamall (Con)
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I thank the noble Baroness for her question, I think. To be fair, she has made a number of points, especially about disparities and inequalities. It is quite sad that there is low uptake of the vaccine in a number of communities. I know that the noble Baroness has done a lot of good work in the past in Tower Hamlets and other areas with minority communities.

The most important way we can tackle this issue is to encourage people to be vaccinated. We want to roll out the booster as quickly as possible and, sadly, too many people have still not taken their first and second vaccines yet. I know that noble Lords across the House have many contacts in many communities, so it is important, please, to come to me with suggestions and ideas. I have spoken to a number of noble Lords across the House about how to tackle this and how best to reach people who are hesitant and who may not trust authority, and encourage them to take the vaccine. I thank the noble Baroness for her question.

Public Health Grant to Local Authorities

Debate between Lord Kamall and Lord Scriven
Tuesday 2nd November 2021

(2 months, 3 weeks ago)

Lords Chamber
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Lord Scriven Portrait Lord Scriven (LD)
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My Lords, in begging leave to ask the Question standing in my name on the Order Paper, I declare my interest as a vice-president of the Local Government Association.

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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Since 2016, the local authority public health grant has decreased by 2% in cash terms, but we increased the grant in 2020-21, and in 2021-22, and it now stands at over £3.3 billion. We are maintaining the grant in real terms over the next three years to enable local authorities to deliver preventive and front-line health services which will improve the health and well-being of their communities.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, even with the recent cash increases, the public health grant has been cut in money terms since 2016 by £1 billion, curtailing services such as smoking cessation, healthy families, and sexual health clinics. If the Government really are committed to preventing poor health, why did the Chancellor not restore in the Budget the £1 billion to improve public heath, rather than prioritising giving banks a £4 billion tax break?

Health Incentives Scheme

Debate between Lord Kamall and Lord Scriven
Thursday 28th October 2021

(2 months, 4 weeks ago)

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Lord Scriven Portrait Lord Scriven (LD)
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My Lords, from these Benches I thank the Minister for coming to answer questions on the Statement. These Benches welcome anything, including innovation, that targets the poor health and loss of life years that obesity brings. However, this is really the emperor’s new clothes, because it has to be set in the wider context of the detriment of poor health, public health budgets and poverty. Public health budgets have been decimated, so that many issues connected to the determinants of health cannot be dealt with. Low pay has become the norm for so many in our country. School budgets for extra activities, such as physical activity, and timetabling have caused problems, and food and drinks industry standards also have to be addressed. Tackling obesity is about tackling the lack of opportunity and tackling poverty. Innovation with a wristband is like asking somebody to learn the Green Cross Code they have a motorway to get across. It is not going to be successful.

As a country, we have to start early: we have the second-largest child obesity problem in the whole of Europe. So what are the Government doing to ensure that daily sport as an activity is available in every state school, so that every child has some daily activity? What is the Government’s response to the report by the Association for Physical Education with regard to children’s health and, in particular, with regard to swimming?

Diet at home and in school is important. The Jamie Oliver Foundation Bite Back report basically found that healthy options in schools were more expensive. What are the Government doing to ensure that fresh, healthy food is available at an affordable price in every school in the country? How are the pilots being chosen? The correct areas are the areas of deprivation, because that is where the highest incidences of obesity are. What are the criteria? How are they being selected? How are areas being offered the chance to become part of the pilot? This must be seen as a healthy eating and exercise approach, and not a weight-loss problem. There are far too many citizens in our country who suffer with eating disorder issues. So what are the Government doing to ensure that it is this framework of healthy eating and healthy lifestyles, rather than being seen purely as weight loss?

With regard to the wristband and the data, who will have access to the data? Where will it be stored? What precisely will the data be used for? Will any private sector organisation have access to the data and its interpretation, and, if so, what conditions are in place to ensure that we do not have the problem that we had with DeepMind, where it was used for purposes over and above what was anticipated?

Finally, talking of the private sector, HeadUp Systems is noted in the Statement. This is a company that has a £30,000 turnover and made an £11,000 loss last year. So how, and on what criteria, was HeadUp Systems chosen? What role will it have? Which other private sector organisations were asked to provide the support that HeadUp Systems is doing? What Ministers or officials did members of HeadUp Systems approach or have access to? If there is a contract, what is its value and on what basis was it given to HeadUp Systems?

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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My Lords, I start by thanking the noble Baroness and the noble Lord for their questions. This is a good story in terms of how we tackle health in the modern day. The noble Baroness mentioned the IPPR. I am not sure how well the name “Tony Blair” goes down on the Benches opposite these days—

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Lord Kamall Portrait Lord Kamall (Con)
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I thank my noble friend for those important questions, which are exactly those that I would have asked—and, in fact, did ask the briefing team when I was getting more details on this matter.

Of course, one of the most obvious things that we have to ask is: how do people game the system? Often, when one analyses a scheme, sometimes there are unintended consequences whereby people are able to game it. Someone asked me—I think and hope that it was in jest—“If I ate 75 cream cakes and blamed my metabolism, would I be able to get on to the scheme?” We have to make sure that our data is robust. The pilot will include robust anti-fraud measures in relation to users’ activity and access to incentives.

What is interesting about the scheme is that it is voluntary, but it will also make sure that the users input the data. There has been a lot of research around that, because it has seemed to be a potential weakness, if users were inputting the data, regarding whether they can game the system. We have been assured that measures have been put in place to avoid that sort of gaming but, once again, the evidence will tell. That is why the system is not national but is a pilot to test all these questions to the limit.

The noble Lord mentioned weight loss and obesity, which I shall come to. One of the things that we want to make clear is that the health incentives scheme is not a weight-loss programme; it is a programme for healthy living. It uses an innovative approach to rewards and incentives to help participants to adopt healthier behaviours for physical activity and diet. Of course, it will help those who are overweight. I have been on two diets in my life—no, really I have. What is interesting about this is that, when one looks at these issues, it is not just a question of consuming less but about burning off calories. That is why we want to encourage healthy living as opposed to purely tackling obesity. That is very important.

The other day, I met a young lady who was very slim. She said, “Why do you keep going on about obesity and type-2 diabetes? I am slim and I have type-2 diabetes”. So sometimes we have to make sure that we are clear about these connections.

Lord Scriven Portrait Lord Scriven (LD)
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The Minister has been going for about two minutes now.

Lord Kamall Portrait Lord Kamall (Con)
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Oh I see. I bow to the superior expertise in this House of the noble Lord, Lord Scriven, and I will sit down.

Health Care and Adult Social Care

Debate between Lord Kamall and Lord Scriven
Wednesday 27th October 2021

(2 months, 4 weeks ago)

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Lord Kamall Portrait Lord Kamall (Con)
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The noble Baroness raises an important point but before I answer that specifically, I reassure her that I am a Liverpool fan, as well as an Enfield Town fan. It so happens that my middle name is Salah. I think that I can wear that name on the back of my shirt with pride. I assure noble Lords that I did not line that question up. One reason why the Office for Health Improvement and Disparities was set up in the first place was to look at disparities across a wide range of issues, not only in social care but in relation to gender inequalities, ethnic minority inequalities and some of the other inequalities and disparities between various areas. As the noble Baroness rightly says, sometimes one can find some of the poorest communities right next to the some of the wealthiest. We are hoping to address those issues through the work of the Office for Health Improvement and Disparities, by first identifying where disparities are and then addressing them.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, with more than 105,000 vacancies in social care, we have a bit of a crisis. Which job would the Minister advise a low-paid worker to take when offered one of these three full-time jobs, all advertised today: a delivery driver at £11 an hour, a supermarket shelf stacker at £10 an hour or a senior care assistant at £9.25 an hour?

Lord Kamall Portrait Lord Kamall (Con)
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I do not see myself as someone who is able to offer jobs advice or careers advice. But the points made by the noble Lord help to explain in many ways some of the pressures that care home providers are facing when recruiting in a competitive market. The Government have looked at funding and how we can work with care providers, particularly as many are in the private sector, as I said earlier. They are not directly controlled by the Government and we can therefore work with local authorities and care providers on how to make sure that they pay a competitive salary to attract care workers to work in the social care system, as opposed to some of the more competitive sectors that the noble Lord mentioned.

NHS England Funding: Announcement to Media

Debate between Lord Kamall and Lord Scriven
Tuesday 26th October 2021

(3 months ago)

Lords Chamber
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Lord Kamall Portrait Lord Kamall (Con)
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My noble friend makes a valuable point. It is important that we are accountable to Parliament, and we will continue to be so. I hope that the fact I am here today shows a willingness to be accountable to Parliament.

Lord Scriven Portrait Lord Scriven (LD)
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The Minister has just said in a previous answer that, to deal with the social care crisis, a Bill will be coming forward. The crisis is now. Care homes are not able to take people and are turning them away because of the lack of staff. You will not clear hospitals while social care cannot hope. What will the Government do now to deal with the social care crisis in this country?

Lord Kamall Portrait Lord Kamall (Con)
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The money that has been announced is for April 2022 onwards, for three years. In dealing with the specific issue now, believe me, we are having conversations within the department and elsewhere about how we address some of the issues that people are raising with us.

Coronavirus Act 2020

Debate between Lord Kamall and Lord Scriven
Tuesday 26th October 2021

(3 months ago)

Grand Committee
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Lord Kamall Portrait Lord Kamall (Con)
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I can only repeat what I have said previously but I will look at this in more detail and respond to the noble Lord if he is not satisfied with my response. I will try to make sure that I send a satisfactory response.

A number of noble Lords talked about the evidence around face coverings. Some noble Lords said that they definitely work. Others said, “No, there is no evidence that they work”. Others said, “Actually, they are useful as part of an overall package of other measures”. If the data suggests that the NHS is likely to come under unsustainable pressure, the Government will implement their prepared plan B. That is why we have explained it in advance: so that we cannot be accused of doing things at the last minute. Plan B would include legally mandating face coverings in certain settings, but we are not yet at that stage. The continued efforts of the public in practising safe behaviours and getting fully vaccinated will be critical to ensuring that the NHS does not come under unsustainable pressure.

Lord Scriven Portrait Lord Scriven (LD)
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This is an important issue that goes back to what the noble Lord, Lord Hunt, said. We keep hearing the phrase “when the time is right, we will implement plan B, if required”. Who will the Government take that advice from? Will it be SAGE, which, until now, has given the Government clear scientific advice that the Government have acted on—sometimes belatedly but they have done so? What are the criteria and who will give the advice on determining when the time is right within normal government business, if SAGE is no longer seen as having the primary role in advising, since its remit is during times of emergency?

Lord Kamall Portrait Lord Kamall (Con)
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Before I answer that in more detail, perhaps I may say that we are not putting SAGE into a subordinate role. It is independent and we rely on its advice. However, as I mentioned, we also rely on the Chief Scientific Adviser, the Chief Medical Officer, the UK Health Security Agency, the NHS and others, and balance up views within the scientific and medical professions. I hope I have also laid out the range of data that is examined. The decisions are data-led. We look at immunity, the ratio of cases to hospitalisations, proportional admissions and so on to see whether the data suggests that the NHS will be overwhelmed. That is what leads to the difficult decision-making and balancing up whether the time is right.

One noble Lord—I think my noble friend Lord Ridley —and many others referred to the research of the London School of Hygiene & Tropical Medicine showing the range of views. Some scientists are saying that the virus will grow while others are saying that if we keep doing what we are doing and rely on the booster vaccines, the numbers will drop off. As one can imagine, there is a range of views but I reassure the noble Lord, Lord Hunt, that we have not relegated SAGE. It is independent and we listen to its advice, as we listen to the advice of others.

On face coverings, the point made by my noble friend Lord Robathan was interesting regarding people who say they are in favour of face coverings but, as he sees when he travels on public transport, a smaller percentage wear them. That shows some of the difficulties in polling, whereby there are stated preferences but also revealed preferences. Although many people say that they will do things, one should judge them by their behaviour. I note that my noble friends Lady Foster and Lord Ridley also raised concerns about the efficacy of wearing face masks.

SAGE evidence states that face coverings, if they are worn correctly and of suitable quality, are likely to be most effective, at least in the short to medium term, in reducing transmission indoors where social distancing is not feasible. Reviews by the UK Health Security Agency in June 2020 and January 2021 found evidence that the use of face coverings in the community helped to reduce transmission. Once again, we have a range of views on the efficacy of face masks.

My noble friend Lord Robathan talked about schools, universities and transmission. In universities, there have been low case numbers among students since the end of the 2020-21 academic year, although there have been slight increases in recent weeks.

My noble friends Lady Foster and Lord Ridley asked why the Act was not being repealed. Correct me if I am wrong, but I believe the noble Baroness, Lady Fox, also asked that. Throughout the pandemic, the Government have been clear that the measures will not be in place any longer than absolutely necessary. That is why we are expiring a number of powers in the Act and intend to expire even more when, we hope, there will be a significant landmark in our progress. The two-year lifespan of the temporary provisions of the Act was chosen to ensure that powers remain available for an appropriate length of time and can be extended by the relevant national authority.

My noble friend Lord Balfe asked about test and trace, and the cost. We have released £280 million in funding thus far, which is broken down as follows: £114 million to cover the costs of the main test and trace support system, £116 million for discretionary payments, and £50 million for administrative costs.

My noble friend Lord Naseby asked about minority vaccine uptake. He asked what the Government were doing to drive uptake among ethnic minority communities. We are well aware of this issue and a lot of work is being done with a number of local community associations to work out the best way to reach them. Only yesterday, I asked the noble Baroness, Lady Benjamin, about how we could tackle particular demographics and got some very valuable advice from her on how we could focus. I fed that into the department, so hopefully that will be part of our strategy. What we have seen is pop-up temporary vaccination sites at many places of worship and community locations. One of the things we have been advised is to go to where the unvaccinated are and to see how we can pursue a targeted campaign.

The noble Baroness, Lady Brinton, asked whether there would be a charge for lateral flow tests. Anyone in England can continue to order free lateral flow tests. I am afraid that I am going to run out of time, so I will write to noble Lords.

Men’s Health Strategy

Debate between Lord Kamall and Lord Scriven
Monday 25th October 2021

(3 months ago)

Lords Chamber
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Lord Kamall Portrait Lord Kamall (Con)
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I thank the noble Lord for the advice that he has given me to date on many issues relating to this portfolio. In terms of a specific men’s health strategy, it was quite clear that we needed a women’s health strategy because for many years women’s health had not been given the consideration that it needed, including on a whole range of issues such as clinical trials and data, for example. On male life expectancy, the issues that men face are quite disparate, so we target particular issues such as systemic heart disease, cancers, particularly prostate cancer, the fact that more men than women die from suicide, alcohol-related deaths, drug-poisoning, smoking and obesity. We look at those and target them specifically, rather than putting them into an overall men’s strategy.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, we should not look at men as one homogenous blob. There is more than a nine-year life expectancy difference between men in the top income bracket and those in the bottom 10, which is more than the life expectancy difference between men and women in those brackets. What will the Government do to ensure equity and fairness to tackle this deep-rooted health inequality for some men?

Lord Kamall Portrait Lord Kamall (Con)
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The Government have launched the Office for Health Improvement and Disparities and part of its remit is to make sure that we look at inequalities within the health system, particularly gender inequalities or those to do with income strata, and at how people in different income brackets are affected differently. That is why the word “disparity” is in the name of the office.

Covid-19: Plan B

Debate between Lord Kamall and Lord Scriven
Wednesday 20th October 2021

(3 months ago)

Lords Chamber
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Lord Scriven Portrait Lord Scriven
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To ask Her Majesty’s Government, further to the rising number of Covid-19 cases and comments made by the NHS Confederation regarding the reintroduction of certain restrictions, what criteria they have put in place as the triggers to implement their Covid-19 “Plan B”.

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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I thank the noble Lord for the very important Question. As set out in the Government’s comprehensive Covid-19 Response: Autumn and Winter Plan 2021, if the data suggests that the NHS is likely to come under unsustainable pressure, the Government have prepared plan B contingency measures. We monitor a wide range of Covid-19 data closely, so we can act if there is a substantial likelihood of this happening. We also track the economic and societal impacts of coronavirus to ensure that any response takes into account those wider effects in a balanced way.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, Professor Stephen Reicher, a member of SAGE’s sub-committee, said yesterday:

“I don’t want lockdown … The danger is if you do nothing … in terms of infections, in terms of long Covid, in terms of hospitalisations … they will be left with no alternative.”


Based on what the Minister has just said, what evidence do the Government have of why scientists such as Professor Reicher are wrong in seeking mitigation measures now to deal with the worrying number of viral transmissions as a way of stopping future lockdowns?

HIV Action Plan

Debate between Lord Kamall and Lord Scriven
Monday 18th October 2021

(3 months, 1 week ago)

Lords Chamber
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Lord Kamall Portrait Lord Kamall (Con)
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I thank my noble friend for his question. The four features he referred to are aligned with the independent HIV Commission’s recommendations. The Government have welcomed the HIV Commission’s report and are currently considering its recommendations to inform the development of the forthcoming HIV action plan. Our specific decisions regarding resources for the HIV action plan are being taken as part of the ongoing comprehensive spending review.

Lord Scriven Portrait Lord Scriven (LD)
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My Lords, over a year and a half ago, Jo Churchill, the previous Parliamentary Under-Secretary of State for Health, said that the Government were seriously considering access to pre-exposure prophylaxis for HIV in community pharmacies and GP practices. Will the Minister say when this will happen, and, if he cannot, what is holding this up?

Lord Kamall Portrait Lord Kamall (Con)
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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.