NHS National Health Inequalities Improvement Programme

Lord Mann Excerpts

Thursday 25th May 2023 Lords Chamber

[Lord Markham (Con)]

Yes. It is worth reiterating that the 37.5% free school meal level is an achievement, as is the fact that all infant schoolchildren receive free school meals—higher than ever before. However, the noble Baroness is correct in terms of what happens during holidays. That is why we have the holiday activity fund, which in the summer holidays, for instance, provides meals for four of the weeks, as well as for another week in winter. Clearly, we need to keep that under review to make sure that that is sufficient.

[Lord Mann (Non-Afl)]

My Lords, currently some Jewish children are having to survive due to the funding formula on a bagel every dinnertime. Is that acceptable and, if not, which Minister will sort it out?

[Lord Markham (Con)]

I hope that every child would have something more nutritious and healthier than just a bagel. I will happily discuss that with the noble Lord; I am not familiar with that particular case but it is something I will happily take up.

Recovering Access to Primary Care

Lord Mann Excerpts

Tuesday 9th May 2023 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend. As evidence of the good work that receptionists do under trying circumstances, in a recent survey 91% of patients said that their needs were met. On the target of having 6,000 extra GPs by the end of this Parliament, currently we have increased the number by 2,000 but, in all honesty, I think the feeling is that we will struggle to meet the 6,000 target—I believe that is something that Sajid Javid, as Minister, said before. But there is a 50% increase in the number of graduate trainees since 2014, with more than 4,000 currently in training. So we have made steps in the right direction, albeit not as far as we would hope.

On the supply of antibiotics, the idea behind this is that there will be certain agreed treatments that the pharmacist will be able to give. Clearly, UTIs is an example where you often need antibiotics to clear those up, and in those circumstances there will be agreed treatments that pharmacists can give: provided that, in the pharmacist’s judgment, the symptoms warrant it, the pharmacist will be able to enable the supply of antibiotics. On all those, this is a very positive way forward.

[Lord Mann (Non-Afl)]

The Government’s housing policy is to build, or to have built, 300,000 new houses a year. Has that been factored into this announcement? Is it the Government’s view that these new houses are a problem for primary care provision, or can the Minister assure me that the funding formulas are sufficiently robust that new housing is seen as an opportunity for primary care?

[Lord Markham (Con)]

The noble Lord is quite correct to point out that, where you have a number of new houses in a local community, you need to make sure that there are primary care services to serve them as well. Funnily enough, just today I was having a conversation with Housing Minister Maclean on this very subject, about changing the way that we look at Section 106 payments—or CIL payments, as they are called these days—to make sure that the provision of the primary care estate is one of the key elements that can be funded through that. I know that DLUHC colleagues are very much on board with that, because absolutely fundamental to the point that the noble Lord makes is that we need to make sure that, alongside the new housing, which we all agree is very important, there are sufficient primary care services as well.

New Hospitals

Lord Mann Excerpts

Thursday 18th November 2021 Lords Chamber

[Lord Kamall (Con)]

I assure my noble friend that, in deciding where to build a hospital, among the things that the NHS and others look at are the needs in the community, existing infrastructure and making sure that we can build hospitals that are fit for the future, that are digital, that are transformative, but are led by clinicians as opposed to construction experts.

[Lord Mann (Non-Afl)]

The Minister said, just a moment ago, “whatever you call it”. When David Cameron was Prime Minister, he gave a pledge on district general hospitals and the definition of hospitals became important. Many of us said that, in order to be defined as a hospital, it had to incorporate 24-hour accident and emergency. What is the Minister’s definition of a hospital and is the pledge from David Cameron on district general hospitals current?

[Lord Kamall (Con)]

Each of the building projects will be a new hospital that will deliver brand-new, state-of-the-art facilities. One thing that we must be careful of is that if we say, “Well, you can’t call that a new hospital, even though it is a new facility, because it’s on an existing site”, we do not create perverse incentives, where the local NHS or the local ICS says, “We mustn’t build it there, because we will be accused of not having a new hospital”. Surely what we should be focusing on is outcomes, not inputs, and the fact that we are delivering modern, digital hospitals for the future.

Covid-19 Update

Lord Mann Excerpts

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

I am sympathetic to the noble Lord’s travel arrangements, but I do not philosophically think that harmonisation of all regulations across all the nations of the United Kingdom is necessarily desirable. It is important that people have trust, and sometimes that trust is built on local leadership that takes a different perspective or has different circumstances to try to manage. There has been a large amount of discussion about the differences in the guidance between the nations. My personal experience is that, like DNA, 99% of it is common, with very small differences—although they are inconvenient to handle and manage. I have been travelling up and down the country as well, and, in fact, the consistency has been very large.

[Lord Mann (Non-Afl)]

Until last week, British citizens who were four years old and younger returning to this country were not required to be tested while quarantining. Why was this change made last week, so that four year-olds, three year-olds, two year-olds, one year-olds and newborn babies now require testing in order for fully vaccinated families who have been properly tested and are negative to be able to get out of quarantine? What is the medical evidence that suggests that testing these babies will help?

[Lord Bethell (Con)]

My Lords, I confess that the noble Lord’s question is new to me. I will look into that matter and write to him with an update.

Care Home Occupancy Rate

Lord Mann Excerpts

Wednesday 28th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, there is an important area of support for those who decide to have care at home. During the pandemic, we did an enormous amount to ensure that there were infection-safe procedures and to reduce the use of itinerant care workers in order to provide safety for those who were at home. Support for those who choose to be cared for at home should be increased. I do not recognise the idea that the number of beds in local authority care has reduced so far, but I am happy to look into the matter.

[Lord Mann (Non-Afl)]

NHS England and Public Health England’s contingency planning for pandemics was strengthened after the SARS epidemic. Will the Minister put in the Library the minutes and documents that show what the NHS policy was in January 2020 on the transfer of people between care homes and hospitals and between hospitals and care homes during a pandemic?

[Lord Bethell (Con)]

My Lords, NHS minutes are published as a routine matter, of course. I would be happy to write to the noble Lord with a link to the right minutes.

World Health Organization: Pandemics

Lord Mann Excerpts

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Earl refers to the important role that the WHO plays. Of course, we are all frustrated sometimes with our multilateral organisations, but the noble Earl quite rightly alludes to the dependence that many countries have on the advice, counsel and practical support that organisations such as the WHO provide. That is why we want the WHO to step up to its responsibilities, why we have instituted a major reform programme recommendation, and why we are extremely hopeful that the WHO steps up.

[Lord Mann (Non-Afl)]

Will the WHO have a specific input and a direct voice in the G7 deliberations?

[Lord Bethell (Con)]

My Lords, the WHO is not a sitting member of the G7, but we have a representative attending our health track in Oxford, and we have been in dialogue with them directly with our agenda on the G7.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2021

Lord Mann Excerpts

Monday 8th February 2021 Grand Committee

[Lord Mann (Non-Afl)]

We are a stoic lot in this country, but I cannot go swimming. I cannot watch rugby. My team has been promoted to the Premier League for the first time in 16 years, and none of us can go to watch and cheer them on. I cannot accept the kind offer from the noble Lord, Lord Naseby, to be his guest at Northamptonshire cricket club. I cannot have any weekends away. I cannot go to the theatre with my wife, which is what she loves doing. I cannot climb mountains. In fact, I cannot do anything I want to do. I have no interest in Ocado, Amazon or Netflix—none. And I am in a better position than most people. A teacher on BBC Radio 5 Live this morning said three out of 25 kids in her school were in class today—22 were not there. People are struggling to cope.

The Government are making a fundamental error in what they are saying at the moment. It is the first big error, in my view. Of course, you can criticise various things from the past—whether they were done by the Government, NHS England or Public Health England—and say that they could have been done better with hindsight that we did not have before. But this is an error of the future, and it is a political error. I have heard Ministers in the past day or two say that we are not having a vaccine passport because we are not forcing people to have the vaccine, and that we are not a country that will legislate to force people to have the vaccine. But that entirely misses the point of a vaccine passport.

I can tell the Minister that no one will be allowed in the miners’ welfare clubs if they have not had the vaccination, because we are damned if we have been through everything we have gone through to have some Herbert turn up thinking they are better than the rest of us, choosing not to be vaccinated and causing problems. We are not having it.

A week ago, my tiny grandchildren, who I have not seen for eight months, packed their rucksacks in Budapest in Hungary—we are talking about under-sixes—and announced they were going to get a plane to come to visit us, but they cannot. I am damned if, when I am eventually allowed to go to Hungary, I have to ask my GP for a note and waste their increasingly valuable time to say that I have had the vaccine I need to get into Hungary. That is what will be required. The last time I went there, I had to prove that I had had the tests. I had to wait 24 hours—there was a big red cross on the door until those tests came through. They will require a vaccine card. You cannot get into Tanzania or other parts of Africa without a yellow fever card. That is sensible.

The vaccine card is not about saying you have to do it; it is absolutely about, “Here’s the injections you’ve had.” Idiots like me need it on one piece of card so we can remember what we have had—particularly if we will need to have boosters—just like you do if you go to places such as Africa, to remember that you are up to date. That is what it is about.

I hear what the noble Lord, Lord Blencathra, said. He usually speaks a lot of sense. I am with him in spirit, although not necessarily in the detail, on care homes. We have 308 Peers over the age of 75. I would expect Peers to demonstrate to the staff here that they have had their vaccines. Therefore, the vaccine card would be peer-group pressure to get people vaccinated. It is essential. The Government need to get this right.

Covid-19: Vaccination

Lord Mann Excerpts

Wednesday 20th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not quite agree with the premise of the question, which is the concept of being partially vaccinated. When you get your first vaccination shot, you are vaccinated, your body has been primed, B cells make the antibodies and you learn how to fight the disease. That is categoric. Where the noble Baroness absolutely has a point is that it is an uncomfortable truth that when we lean in to the virus, it will seek to escape and mutate, and that is the moment of absolute highest risk for the country. That is why we are trying to move as quickly as we humanly and possibly can: there is a moment in time, an opportunity to get the vaccine out to as many people as possible to avoid the mutation throwing up variants that escape our vaccine.

[Lord Mann (Non-Afl)]

We heard a few voices last spring and summer suggesting that the National Health Service was not good enough and that a privatised service would have been better in dealing with the pandemic. They are remarkably silent now. Will the Minister join me in the celebrations across this country at the moment of the brilliance of the National Health Service and the fact that people being vaccinated are going in with a smile on their face, being welcomed by people—volunteers and staff—with a smile on their face, all saying how brilliant our National Health Service is?

[Lord Bethell (Con)]

My Lords, I am enormously grateful for the testimony of the noble Lord, but I would probably put it slightly differently. Listen, we are in Act I, and I do not think it is quite the right moment to take curtain calls and bows just yet. The NHS has stepped up to this challenge absolutely magnificently, but there is still a huge amount to do and to get through. In addition to the praise that the noble Lord rightly gave the NHS, I also pay tribute to other parts of government, and particularly to the Army, local authorities and the private sector, which contributed the vaccine in the first place, all of which have worked together in a great spirit of collaboration. It is only through that spirit of collaboration that we have been able to deliver what we have.

Covid-19: Vaccinations

Lord Mann Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, that is a very good reminder. I will be glad to return to the department and check that the bilingual material is as she asks, and I will write to her with the details.

[Lord Mann (Non-Afl) [V]]

My Lords, the NHS has been put in charge of this and is delivering big time, and everyone I speak to is delighted about the way the rollout is going. When we move into the next phase, will workplaces be targeted, so that they are able to do their own logistics and get thousands done at a time, quickly, cheaply and easily?

[Lord Bethell (Con)]

My Lords, that is a decision for the NHS deployment team. I do not know the precise answer but frankly, based on experience I would guess that NHS environments are probably the focus for the deployment—that the focus is on where NHS staff can have safe, hygienic environments, rather than on workplaces. However, I will take the noble Lord’s idea back to the department and write to him to see whether that is being considered.

Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020

Lord Mann Excerpts

Thursday 7th January 2021 Lords Chamber

[Lord Mann (Non-Afl)]

There is huge support out there for the lockdown, although everyone I know is asking, as am I, why our borders are open, because one thing is certain: if Donald Trump is allowed in during the lockdown, there will be a significant problem for the Government with public opinion.

Looking at the pace at which they are vaccinating, what is Israel doing right that we are not? Can I suggest some reasons to the Minister? My own GP service today is vaccinating for flu but is not allowed to vaccinate for Covid because of new Public Health England rules. I suggest that this is the same reason why pharmacies are not being allowed to vaccinate. It is not because they cannot, since they are vaccinating for flu at the moment, but because of Public Health England rules relating to Covid. I know a nurse, retired after 30 years, who has been re-recruited this week as an assistant and is allowed to vaccinate for flu, but despite that 30 years is not allowed to vaccinate for Covid because of Public Health England rules. Who will get on top of Public Health England? It strikes me that people keep attacking the Government, but the problem I have is with some of the actions of Public Health England, and this demonstrates that. This overcautious approach is delaying and will delay further.

I end not by talking about what is rightly going on with the prioritising of the most elderly and vulnerable, because that is appropriate. In the next stage, I predict that Public Health England will not allow workplaces to vaccinate but will allow the employer to take on the costs, the hassle and the administration. In an area such as the district I live in, 10,000 could be done in a day if they were done in the large workplaces. Then we would really be getting on top of the problem. Which Minister will take on and sort out the bureaucracy from Public Health England?

[The Deputy Speaker (Baroness McIntosh of Hudnall) (Lab)]

I call Lord Bhatia. He is not there. I call Lord Bourne of Aberystwyth.