Coronavirus Act 2020: Temporary Provisions

Lord Lansley Excerpts

Monday 28th September 2020 Lords Chamber

[Lord Lansley (Con)]

My Lords, it is a pleasure to follow the noble and learned Lord, Lord Judge, although in this instance I have to disagree with him that we must face up to a conflict of interest between national wealth and national health in any simple sense. The relationship between the measures that we take in response to this crisis and the impact on our economy is very complex, and it may well be that we can find our way to reconcile the two. I point out that back in August Ministers were encouraging people to go back to work. In my experience, many people who had been so encouraged chose not to do so but stayed and worked at home. As it happens, it took only three weeks for Ministers then to agree with them. What that demonstrates is that we are beginning collectively, not just as a Government but as a people, to understand the nature of this virus and how we need to respond to it.

I am looking forward to all three maiden speeches, not least that of my noble and learned friend Lord Clarke of Nottingham, whose presence here brings another joy to me, which is that it has restored to eight the number of my former bosses in this House.

I cannot agree with my noble friend Lord Robathan in his Motion of Regret. I think we need these powers and the speed of response necessary is such that it would be inappropriate for us to require parliamentary approval before the exercise of such powers. However, I share with the noble and learned Lord, Lord Judge, the view that we ought to be debating more frequently. That is something which, if in no other way, the usual channels might be able to engineer.

One of the main reasons I support the Act’s provisions is not only the ability to bring people who have recently retired into the NHS and return them to practice; I also hope that, in the time available, we will think that this is not simply a temporary provision but may need to be something that we have in place for some considerable time. I have said before and will say again that we may need something similar to the Reserve Forces for the benefit of the NHS, if we are to recover in the next few years the position that we have lost over the many treatments that have not been able to be undertaken these last six months. We are going to need a lot of help to make that happen.

I want to say three things about further restrictions. First, it is time for those who have been shielded—the vulnerable groups—to have renewed and updated guidance. I was somebody the NHS regarded as shielding because of my past cancer treatment, but I have had no communication about the resources that might be available to those who have shielded since early July, even if I can work it out for myself.

Secondly, my noble friend on the Front Bench knows that I did not think the rule of six was scientific, and he more or less confirmed that. It is rather absurd when you have Ministers debating whether it should be a rule of six or a rule of eight; I wonder why they did not decide on a rule of seven. The point is that it is not rational, as such, but simple. What is rational, and a necessary adjunct to it, is to avoid the mixing of households in circumstances where the most vulnerable people are present in those households.

My third and final point is one I made to my noble friend weeks ago. Universities should be in a position to test students before they return home from university. That will mean a lot of additional testing being available in December.

Coronavirus

Lord Lansley Excerpts

Wednesday 16th September 2020 Lords Chamber

[Lord Bethell (Con)]

That list is already published. I would be glad to send the noble Lord a link.

[Lord Lansley (Con) [V]]

My Lords, one of the big risks this autumn is from students going to university and, perhaps more particularly, returning from university in the run-up to Christmas. How has the guidance been prepared with universities to try to mitigate that risk? I know that Cambridge University is looking even at the possibility of testing all its students on a weekly basis.

[Lord Bethell (Con)]

My Lords, I thank colleagues at the DfE for their hard work in providing guidelines to universities and to vice-chancellors for implementing thoughtful arrangements for the return of students. It is very much the ambition of this Government that universities are brought back to life and that education and the impact of their work continues. None the less, it is not just the campus environment that concerns us—it is also the off-campus activities of students. For that, we look to universities to provide pastoral guidance to students to ensure that they are socially distanced and behave responsibly. We are keeping an eye on those behaviours and, should outbreaks or prevalence rise among students, we will have to review those guidelines.

Covid-19 Update

Lord Lansley Excerpts

Thursday 10th September 2020 Lords Chamber

[Lord Lansley (Con) [V]]

My Lords, the consistency of messaging over time is immensely important to secure public support and adherence. Over the last six months, we have consistently explained that indoor and outdoor gatherings are significantly different, and that the scientific evidence has clearly shown much greater risk for indoor gatherings. Can my noble friend the Minister explain to the House why the Government appear to have abandoned this important distinction in their current guidance?

[Lord Bethell (Con)]

My noble friend is right to point out this important change. The truth is this: from the feedback we had from the public, and from our own analysis of the facts, we see that our guidance was growing increasingly complicated and was confusing the public. While the science may suggest all sorts of clever differences between one situation and another, and between inside and outside, the guidance is effective only if it is clear, understood and obeyed. At the end of the day, what we have done is to clarify some of the more complex areas of our guidance to make it more effective.

Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020

Lord Lansley Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Lansley (Con) [V]]

My Lords, I am grateful to my noble friend for his very clear introduction to and explanation of these regulations. I will make two points. I was very pleased to hear my noble friend make it clear that Regulation 3, on the powers of the Secretary of State, has not been used. It would effectively be a failure were that to happen, so it is very good news that the collaborative work to which my noble friend referred is continuing.

As my noble friend will recall and noble Lords may remember, one of the central arguments I have made from the beginning is that the public health infrastructure established from 2013 onwards was intended to rely substantially on the work of local authorities, to which public health functions and capacities were returned. However, that capacity was not supported with the funding required in subsequent spending reviews. The public health infrastructure should have had increasing resources, at least at the pace of increase provided to the NHS as a whole.

My two points to my noble friend are, first, will he undertake that the Government will continue to work with local authorities so that the powers in these regulations continue to be used collaboratively, with local authorities working with central government rather than by way of Secretary of State directions, which should be avoided wherever possible? Secondly, we must rebuild the capacity in local authorities, not simply for the Covid crisis, but for public health infrastructure more generally.

Medicines and Medical Devices Bill

Lord Lansley Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020 Lords Chamber

[Lord Lansley (Con)]

My Lords, I welcome the Bill. As my noble friend rightly said in a very positive opening speech, it is not only a necessary Bill but one which presents us with opportunities. I hope that, during the passage of the Bill, we will look to realise those opportunities, and I want to refer to one or two.

My noble friend talked about the Delegated Powers Committee’s remarks, which made the very compelling point that, in reproducing the regulation-making powers, we are moving from the power to make regulations to meet EU legal requirements to the ability of Ministers to set down their own legal requirements; these are very different things. What we need to do in the latter case is not to move from where we are now, as my noble friend might have suggested, to something that sets out in primary legislation the detail of these regulations—nobody is intending that—but to something that moves us from a skeleton Bill to a framework Bill. What is the difference? The difference, in my mind, is a very straightforward one. The framework Bill is purposive. It sets out why regulations are being made and gives an ability to look at the primary legislation and ask, “Do these secondary instruments fulfil the purposes of the primary legislation?” During the passage of the Bill, we must look very carefully to meet that test.

I want to make three quick points. First, I think we are already among the best places in the world for medicines innovation. We may be 3% of the pharmaceuticals market but we are 10% of medicines innovation. I want to continue that. One thing the industry has told us, including me, over past years is that it wants to see our NHS take up new medicines and make them available to patients—a point that my noble friend reiterated. There is a commitment in our manifesto that says:

“We will extend the successful Cancer Drugs Fund into an Innovative Medicines Fund”.


I think the time has come for that and I hope that the Bill will make provision for that to happen.

Secondly, the MHRA is a world leader—for example, in the assessment of medical devices—but we have a problem, as the noble Lord, Lord Hunt of Kings Heath, said. We will be accepting CE markings through to 2023. I am pretty sure, unless somebody tells me otherwise, that the EU is not going to accept UK conformity assessments any time soon. So we are in an asymmetric relationship, and we have to think very hard about how we can sustain the MHRA. In the course of that, what the noble Baroness, Lady Barker, said is absolutely right: we must not be pulled between American FDA standards and EMA standards. We should be trying to move everybody to international standards, and that is something we will have to look at hard.

As we put more registries in place, I hope that they will include patient-reported outcomes: that is important. For medical devices, I hope that we will show how we are going to take them up in the NHS as well. On the consultation that ended last year on the medtech funding mandate, the time has come to do it. Ministers have not said that it will be brought into place this year or next. I think that the Bill should bring forward the medtech funding mandate, as the medicines mandate is in place. Finally, on clinical trials, the EU has not implemented its clinical trials information system and is not at present expected to do so until the end of 2021. We need to be in it. The legislation says “corresponding or similar to” but I do not know what “or similar to” means. We are either in it or not in it, and I hope we will be in it.

Covid-19: Response

Lord Lansley Excerpts

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, I pay tribute to my colleague Helen Whately, the Minister for Social Care. She has worked incredibly hard and tirelessly on this area, which is her ultimate responsibility. There is a social care team which handles those negotiations, and I thank all those in the social care industry who are engaged. The social care industry is highly fragmented so engaging with the entire industry is a massive challenge. That is why we have put in place new structures, new dialogues, new guidelines and new ways of working to ensure that we are match-fit for the winter.

[Lord Lansley (Con) [V]]

My Lords, a number of countries, including Hong Kong and Austria, undertake testing at ports of entry. Under certain circumstances, that can limit the time that people have to spend in quarantine. Will the Government offer such testing at UK ports and airports?

[Lord Bethell [V]]

My Lords, that is not in the current guidelines. The noble Lord is entirely right that it is incredibly time-consuming and not currently practicable. For the reasons I outlined in answer to an earlier question, a test today does not guarantee that someone will not be infectious either tomorrow or the next day. That is why we have not focused on testing at ports, but we remain open to suggestions. We assess a large number of options and, as evidence and trials emerge that may demonstrate the efficacy of different policies, we will of course consider them and remain open-minded.

Independent Medicines and Medical Devices Safety Review

Lord Lansley Excerpts

Wednesday 15th July 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is right that regulation is important, but so is culture. I emphasise the importance placed by the Cumberlege report on a change in attitude in the healthcare service as much as on a change in regulation. I cannot guarantee that the EMA and the MHRA will be aligned on regulation in all matters, but I can guarantee that the MHRA will be given the resources it needs to do the job properly.

[Lord Lansley (Con) [V]]

My Lords, as a former Secretary of State for Health, perhaps I may say that I and all my colleagues who have taken responsibility for the NHS over decades should join in expressing our deep regret at the systemic failures laid bare in the report of the noble Baroness, Lady Cumberlege. Will my noble friend reiterate the point about cultural change? It is not just about implementing the recommendations, important as that is, but about achieving cultural change. I direct that point in particular to patient involvement. By that I mean not just consultation, not just a patient voice, not just decision aids but patient-reported outcomes being a central part of the measurement of the performance of our health service and its accountability.

[Lord Bethell]

I completely endorse the comments of my noble friend. To embellish his point, it has been very interesting to see through Covid how patients have had to track their own symptoms, take advice on 111 for themselves and, in millions of cases, look after themselves at home, possibly with telemedicine to support them. This may an inflection point in the attitude of many people to their health. I certainly welcome a revolution of patient power and putting patients first in our healthcare system.

Covid-19 Update

Lord Lansley Excerpts

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

The noble Lord is entirely right. I have four children, all of whom have returned to school this week, and they are all attending smaller classes for smaller amounts of time on different days of the week. As a parenting challenge this is considerable, but it has meant that they have returned to both the social and disciplinary aspects of school. I embrace this development and entirely agree with the noble Lord’s prioritising of this important subject.

[Lord Lansley (Con) [V]]

My Lords, will my noble friend the Minister commit the Government to maintaining their financial support for the Covid-19 volunteer testing network? He will know the important work that it is doing.

[Lord Bethell]

My noble friend is right to raise this important subject. I know the volunteer testing network; I value it enormously and am extremely grateful for its support. I am currently looking into its funding, and I would be glad to write to my noble friend to provide a clearer answer on that.

Covid-19: Deep Cleaning

Lord Lansley Excerpts

Wednesday 11th March 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right to emphasise the importance of personal hygiene. The Government are working hard to drive these messages home. Ultimately, it is up to the public to embrace the messages. A substantial public awareness campaign was launched 10 days ago. From the polling that we have done so far, it appears to have been extremely effective. Based on that polling, we will be launching a further campaign to ensure that everyone is aware of the hygiene protocols the noble Baroness describes.

[Lord Lansley (Con)]

My Lords, the Minister made a good point about timing. Sometimes certain measures require preparation by public authorities and the public before they can be initiated. Does he agree that we may be not too far off a point when we ask those who are elderly and have underlying health conditions not to leave home, and that many public authorities—parish councils, town councils, local government, the NHS and Age UK—might soon want to undertake preparations?

[Lord Bethell]

My noble friend is quite right that measures require preparation. This Government are determined not to be caught on the hoof. In his public statements on Monday the CMO was clear that there are three areas where the modelling suggests there might be a major difference to the delay processes that the House has heard about and understands. My noble friend is also right that the safeguarding of older and vulnerable people would be a likely candidate for that. A substantial amount of time is required though, maybe 10 to 12 weeks or more. It is important that social acceptance of that kind of measure is in place before it is initiated. We are also looking at modelling the kinds of changes which would mean that those who display any symptoms might seek to socially distance themselves or that those who have been tested think about ways of putting space between themselves and their families. These are the kinds of illustrative examples that the CMO has already discussed publicly, and the Government are preparing for those kinds of scenarios at the moment.

Wuhan Coronavirus

Lord Lansley Excerpts

Tuesday 11th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness is quite right. We are aware that there are British nationals on board the “Diamond Princess” in Japan and that six more people have tested positive for coronavirus, none of whom is a British national. We have offered consular assistance to those British nationals—we have been in touch with the “Diamond Princess”—including one who is in hospital. We obviously pay tribute to the work being done in trying to contain the situation there. I identify myself with the thanks and tribute paid to the work of the CMOs, who are doing an extraordinary job right now to make sure that the UK is prepared.

We are one of the first countries in the world to have an effective test; it is working well. Now that the protocols have been sent to the devolved Administrations, testing centres in Glasgow, Edinburgh, Cardiff and Belfast have started testing already. Labs in Cambridge, Bristol and Manchester have started testing today and Birmingham, Newcastle and Southampton will come online shortly. I hope that reassures the House about the capability already available within the NHS.

[Lord Lansley (Con)]

My noble friend’s appreciation of what is being done in contact tracing and the urgency that has been invested in that and other aspects of containment of the disease is welcome. I share the appreciation that there is across the House for that.

I am sure my noble friend agrees that the effort put in now to try to contain the virus is not disproportionate, even if it includes the powers under the new regulation, because it buys us time. She referred to buying time for research into a potential vaccine. I have not seen any reference to other antiviral treatments that might be identified and be of use. For example, if a new flu-like virus was circulating we could use our stockpiles of Tamiflu. Have any viral treatments been explored for this particular virus?

[Baroness Blackwood of North Oxford]

As ever, my noble friend is astute on this issue. Contact tracing has been hugely effective, particularly for the 1,466 passengers and 95 staff who arrived in the UK on direct flights from Wuhan between 10 and 24 January. All those have now passed through the incubation period and none of them was a confirmed case. Of the remaining cases that we have found, a number are linked to contact tracing. We should be very proud of the effectiveness of our system.

On the question of antivirals, work and research is ongoing in regard to a particular HIV retroviral which has been used in this measure. That is being considered. There are three projects which aim to advance the vaccine candidates into clinical testing as quickly as possible. We are also looking at some correspondence from both diagnostic kit manufacturers and potential end users, and we are considering whether we can also improve the diagnostic kit.