Midwives: Bullying

Lord Lucas Excerpts

Tuesday 16th April 2024 Lords Chamber

[Lord Markham (Con)]

We have the highest level of staffing ever in midwifery, 5% up on last year and 21% up on 2010, against a background of static births. I want to address that point on staffing; staffing levels are high. However, as the noble Baroness says, there are issues around culture. On the national inquiry, again, every one of those 150 trusts was visited by the CQC in the last year or so and action plans made on how to address this. We know what we need to do; we just need to get on and implement it.

[Lord Lucas (Con)]

My Lords, I am grateful to my noble friend for his replies. I am much more grateful to the many midwives who have helped my family over the years. They give an extraordinary service. If we are not to have an inquiry, will my noble friend make sure that his ears and doors continue to be open when things are not going as well as they should? The NHS has a habit of closing doors on things and making it difficult to interact with it. Bullying is not the only problem. There is a succession of problems which need bringing out into the air, such as overmedicalisation, the failure to implement the better births policy, and the regulatory culture overseen by the NMC. The Minister could help with that.

[Lord Markham (Con)]

I agree with my noble friend. Over the last 18 months, I have appreciated the power of this House and of these Questions. Each time I get one, it sets off a process. In this case, I undertook to meet the Chief Midwifery Officer to make sure that feet are being held to the fire. I know that Minister Caulfield is doing this. It is to the credit of the House that it has this scrutiny role.

Nursing Courses: Reduction in Applications

Lord Lucas Excerpts

Tuesday 19th September 2023 Lords Chamber

[Lord Markham (Con)]

As I just mentioned, the whole point around nursing associates is to try to attract those more mature recruits as well. As I was trying to show with the example of my mother, there are lots of people who have a lot of value that they can give later on in their life. That is definitely the sense of direction that we are trying to achieve. I repeat that, while people are talking as if numbers are going down, across the field of graduates, apprenticeships and associates we are looking at a 20% increase since pre-pandemic levels.

[Lord Lucas (Con)]

My Lords, would my noble friend consider making it much easier for young people to get work experience in the NHS, so that they can see what a wonderful career it is, rather than having to rely on the chance of someone they know working in that industry?

[Lord Markham (Con)]

Absolutely. We are trying to adopt a modular approach so that you can have units that can build towards getting in there. For people who go into social care, for instance, there is a modular unit that can add towards going into nursing later on. That is a means of attracting people to nursing by having more routes in and making a career such as social care attractive in terms of career progression.

Health and Care Bill

Lord Lucas Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

[Baroness Blower (Lab)]

My Lords, this is a key opportunity to do something really significant for the health of the nation, from the youngest to the oldest, and for all the groups we refer to as “excluded.” This is a key moment. If the Minister can respond positively to the questions put to him by the noble Lord, Lord Moynihan, he will be doing a very good job for the nation.

[Lord Lucas (Con)]

My Lords, I entirely support my noble friend Lord Moynihan when he asks for proper accountability. That is what drives the few examples of successful cross-departmental co-operation. One of the recent missed opportunities is Defra not picking up on aspects of the Glover report that deal with people getting out into the landscape. To make a difference to that, Defra has to care and it has to be brought to account, but there also has to be a good enough mechanism to ensure that if Defra does propose to do something, someone is going to fund it. That would certainly apply too to schools’ collaboration with local sports clubs. Parents up and down the land want that to happen. But how is that going to be afforded? How is that going to be made to happen? Who is holding the systems accountable? There has to be some system whereby accountability and interest flow through—as my noble friend said, ideally, to Parliament—to make that happen.

I have written to the Minister on perioperative care, which is another example. How does the NHS collaborate with all the other people who might provide the support required for effective perioperative care? They are not in the NHS; it does not work that way. You can have a system that just involves spending the money and ticking the box because that money has been spent; or you can have one with real accountability, in which people care whether you get the results and are measuring that, and who feed that through to someone with a central interest in things. So I am really going to listen to the Minister with great interest on this.

[Baroness Merron (Lab)]

My Lords, I want to thank the noble Lord, Lord Moynihan—along with the noble Baronesses, Lady Morris and Lady Grey-Thompson, and the noble Lord, Lord Addington—for bringing forward this important amendment. It does strike me as strange that the UK does not already have a national plan in place to promote sport, health and well-being. If we are to tackle the acute obesity crisis in this country, a joined-up, forward-looking strategy at a national level is necessary. From these Benches, we support this amendment wholeheartedly. It offers huge potential to tackle obesity, poor mental health and a sedentary lifestyle in a joined-up way that sees people as whole people with different pressures and needs, but with the intention of focusing on prevention. So, I hope the Minister will be able to respond positively tonight.

Health and Care Bill

Lord Lucas Excerpts

Committee stage
Wednesday 9th February 2022 Lords Chamber

[Lord Berkeley of Knighton (CB)]

My Lords, I always enjoy listening to the noble Lord, Lord Blencathra, because he has an absolutist way of delivering his ideas. But his ideas here have prompted other noble Lords to a very sensible suggestion that we need to look further at this.

We have to look at this question with great compassion —compassion for women who feel uncomfortable and compassion for women who are trans. We all know that, sometimes, people are born with mixed chromosomes. It is not black and white. It is a very complex issue. The suggestion of the noble Lord, Lord Hunt of Kings Heath—I see the noble Lord, Lord Blencathra, nodding —must be the right way forward. It needs to be looked at with great care and in great detail, by people who know what they are talking about.

[Lord Lucas (Con)]

My Lords, I very much agree with the noble Lord, Lord Hunt, and others. I was here for 20 years during the struggle for single-sex wards, and it was a notable achievement of the Benches opposite that they got there. I remember, in those long debates, getting a real understanding of the distress that women felt at being made to suffer in mixed-sex wards. I do not think it is right to destroy all that just in the cause of a small group of patients.

The rights of women need to be considered alongside those of trans people. Both matter, both are important, and we should not, as Stonewall has sought to do, bend the law to impossible interpretations and impose that covertly on the National Health Service. We should try openly to discuss this difficult issue and arrive at a compassionate solution that does our very best for all patients. I have faith that if the Minister promises that, we will get that.

[Baroness Barker (LD)]

My Lords, the noble Lord, Lord Hunt, used the important word “contention”—a contention that there is a tension between the rights of women and those of trans women. He and I disagree about that because I believe that they both deserve to be treated properly and respectfully. I believe that the Equality Act enables that to happen.

It is that Act which enables there to be single-sex provision. It is precisely because there are occasions and times when it is important for that to happen that we have to embody it in law, otherwise it could not exist. That is why under the Equality Act there is a specific statement that there should be safeguards in place, that there are special circumstances where treatment needs to be sex-specific, and that where it is assessed that a trans person should be put in an otherwise gendered ward, such departures are allowed but they need to be proportionate to achieving “a legitimate aim”. Like my noble friend Lady Brinton, I do not believe that making assumptions about a person because of the way they look is a legitimate aim.

I have listened carefully to all the speeches that have been made, and they have contained some very powerful contentions and assertions. What they have not contained is any evidence at all that this is a significant problem in the NHS. The amendments would cause a significant problem in the NHS—for all patients, not just trans patients, if one thinks through the implications of what has been written in them.

Day to day, NHS staff routinely have to deal with patients of all sorts, with all sorts of difficult problems, and as professionals they make judgments day in, day out about what is appropriate care. Unless and until there is significant evidence that backs up the assertions and contentions of the noble Baroness, Lady Nicholson, and the noble Lord, Lord Blencathra, I believe we should leave them with the guidance that has worked perfectly well up till now.

Women’s Health Strategy

Lord Lucas Excerpts

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

Yes, I can reassure the noble Lord that the call for evidence is open to everyone aged 16 and over, which, of course, includes people with disabilities and learning disabilities. The online survey within the call for evidence specifically mentions disabilities throughout, and I reassure the noble Lord that the evidence that we gather with regard to disabilities and learning disabilities will be considered extremely carefully to inform the priorities, content and actions of the strategy.

[Lord Lucas (Con) [V]]

My Lords, should we be looking at leveraging the great success that we have had in developing online medicine during the pandemic to provide women with unmediated, immediate and direct access to specialist services on chronic issues such as menstruation, menopause problems and so on? After all, this is a structure that we have used successfully for many decades for eyes and teeth, and it is one that might also suit the trans community.

[Lord Bethell (Con)]

My Lords, as Minister for Innovation I favour using technology and the latest techniques wherever possible to provide options and choices for all patients, including women, to address their conditions. With women, the delicate question of their bodies, and the different functioning of their bodies to men’s, is one that the health system has to reconcile itself to. I do not regard technology as a panacea to that central challenge; in fact, I think that many of the issues that women face will require face-to-face consultations, and we remain committed to ensuring that that is an option for everyone.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020

Lord Lucas Excerpts

Wednesday 30th December 2020 Lords Chamber

[Lord Lucas (Con) [V]]

My Lords, I offer my unreserved congratulations to the Government, their scientists and the National Health Service on the signal success of getting to the point where the Oxford vaccine is available to us. We are entering the last phase of this struggle. I in no way share the gripes of those of my colleagues who have expressed them. The best that can be said for them is that if they had been in charge, they might possibly have made different mistakes. I think the Government’s record has been one that we will look back on, if not with pleasure then at least with confidence that they have done as well as anyone might expect under the circumstances.

When it comes to the vaccine rollout, I join the noble Lord, Lord Bilimoria, and my noble friends Lady McIntosh of Pickering and Lady Altmann in being concerned that there are some signs that the rollout is being held up by an insistence on good practice, which is appropriate in normal times but not now. We really must not let the best be the enemy of the good. Every day’s delay is another day’s deaths.

I cannot see what the difficulties are in, say, chucking the vaccine out to pharmacies. There are 65,000 pharmacies in this country and they are all used to administering flu vaccines; if they were administering 15 Covid vaccines a day, we would be doing 1 million a day in total. It is well within our capacity to get this out while accepting a few imperfections in the cause of a much-reduced tally of deaths.

Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020

Lord Lucas Excerpts

Wednesday 14th October 2020 Lords Chamber

[Lord Lucas (Con) [V]]

My Lords, I am grateful to the Government for their efforts to reduce the spread of coronavirus and I am pleased to have avoided it myself so far. It has had a pretty severe effect on some of my friends and relations.

Picking up on a point made by the noble Lord, Lord Greaves. I would be interested to know what the Government make of the Japanese approach to the pandemic. It focuses on cluster-busting, which is a conviction that the disease runs in clusters so that many people who get the disease do not spread it, but some will spread it excessively. The way to find the most cases most quickly is by backward tracing. In that way, a cluster can be found quickly, which is where most of the spreading takes place. I understand that there may be some reluctance to apply this technique in areas where there is a high incidence of the disease, but I would have thought that, in those areas which are mercifully relatively free of it, it should be the principal technique employed in order to keep us free of it. I ask this because it has worked so signally well in Japan.

There has to be quite aggressive backward tracing and a need to go at it hard. But it is possible to use cheap, low-sensitivity tests to uncover the cluster. You do not need the slower but more accurate tests that we seem to be using at the moment. I hope very much that the Government are picking up on this idea and will be able to give the noble Lord, Lord Greaves, and me an encouraging answer.

Covid-19 Update

Lord Lucas Excerpts

Thursday 10th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the regulations are not in place at the moment to test the millions of teachers and other important workers who are returning to the workplace on a regular basis. We have neither the science nor the capacity to do so, but we are reviewing this and looking at ways of using testing to restore confidence and enable a return to workplaces or other situations where social distancing is more challenging.

[Lord Lucas (Con) [V]]

My Lords, I encourage the Government to be completely open with the data and research regarding this epidemic and to put it all on the GOV.UK website. When we opened up the data on BSE, the problem was solved within two weeks by researchers who were outside of government. When Ofqual refused to open up on its algorithm, it resulted in our recent troubles and disasters. Being open with data results in much more criticism, but that criticism is much better directed. And it makes it much easier for people like me to accurately defend government policy.

[Lord Bethell (Con)]

I completely agree with the sentiments shared by my noble friend. Transparency has the effect of sunlight, putting a spotlight on information. It helps those who wish to contribute to make their efforts felt. We have embraced transparency: I cite the example of SAGE, where the minutes of its meetings and the data it works on are routinely published. I completely endorse my noble friend’s comments.

Covid-19

Lord Lucas Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

The noble Lord, Lord Patel, will be interested to read the details of our ONS serology tests that have begun earlier this week, which will be published in mid-May. These are surveillance tests and will provide us with the information that we need to understand how the epidemic is developing. At the right time we will also bring in mass serology testing. However, as the noble Lord will be aware, when prevalence rates are around 3%, 4% or 5%, as they seem likely to be, serology tests for managing the epidemic are not relevant yet.

[Lord Lucas (Con)]

I am delighted that the Government are taking resilience seriously. Will my noble friend confirm that the Government will have a permanent stake in the facilities and the intellectual property that they are creating, to ensure that it stays here and is well maintained? Will he also extend the interest in resilience to pharmaceutical intermediates and generics, where we are also seeing problems developing which were also problems when we were contemplating no deal? There seems to be a strong argument for having a better set of arrangements in place in this country to ensure supply in difficult times.

[Lord Bethell]

My noble friend Lord Lucas is quite right about IP, although I bear testimony to the private companies and major corporations which have reacted incredibly generously and enthusiastically by supporting the Government during this crisis. Our supply chains absolutely need to be reviewed. Resilience is clearly more important now than it has ever been. When we look at the way in which our medical, pharmaceutical and device supply chains are put together, they will look quite different in years to come.

Covid-19: Medically Vulnerable People

Lord Lucas Excerpts

Wednesday 22nd April 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right. Letters should have been sent to all those who should be shielding. I am aware, as she rightly points out, that this process happened extremely quickly and there was a very fast turnaround. I have accounts of people who were sent a letter who should not have had one and I have accounts of people who should have had a letter who did not get one. We are working hard to fill the gap, but 1.3 million letters were sent out and, on the whole, I believe that this exercise has delivered clear recommendations to those involved.

[Lord Lucas (Con)]

To follow on from my noble friend Lord Lamont’s question, can we please ensure that vulnerable people have agency, that those who want to act as the unvulnerable are allowed to, that grandparents who wish to see their children are allowed to, and, at the same time, that those who are young and vulnerable are protected in their decision to continue to isolate and are not discriminated against because of it?

[Lord Bethell]

My noble friend Lord Lucas makes a completely reasonable plea. On a personal level I completely understand where he is coming from. I have elderly relations who I would like to see, hold, touch and socialise with. But, as I said, I cannot hide from the House that this virus is an extremely predatory killer that has in its sights particular demographic groups, including the elderly and in particular those with conditions. It would be wrong of me to mislead the House by pretending that there was an easy way out of this epidemic for those who the disease seeks to attack.