(3 years, 7 months ago)
Lords ChamberI am hearing July for the time by which everyone will have had the chance to be vaccinated. If you take a district such as Bassetlaw, with 120,000 adults, why can it not be done within a four-week period? Logistically, it is possible but the barriers are those I saw previously when working closely on public health with the primary care trusts and the GPs. The financial model for GPs does not lend itself to volunteers; neither does the primary care model. They would see 50 volunteers as incredible. I could get 500 volunteers within a week—competent volunteers, trained up with ease. They will be thinking of the venues that they use, rather than venues that are difficult to get hold of because that is not what they do. Most critically, employing new people on short-term contracts has been, and is, a big barrier to scaling up.
Indemnity has been raised before. The Government need to get in and facilitate that. It is precisely what we did in Bassetlaw when we managed, within four weeks, to get the vast majority of heroin addicts into medical treatment. Within four weeks, we had that majority. Why? Because we thought outside the normal bounds and got that financial indemnity, using money to ensure that there was no risk to those doing the treatment. I know of nurses, ex-nurses and other health professionals who would love to be involved now but are not getting the opportunity. That must happen.
Finally, on the anti-vaxxers, this place and the Commons should be vaccinated. The anti-vaxxers are far stronger than we imagine, beneath the surface and online. It is crucial that religious leaders should be vaccinated—and seen to be vaccinated—in the next few weeks.
(3 years, 8 months ago)
Lords ChamberThe noble Lord makes the point well. He is right that there are undoubtedly communities that conventional NHS outreach has not got to; we have learned that fact during Covid. Our immediate priority is to reach the over-80s and ensure that the deployment programme works for those groups that are most at risk. We will be turning our attention to the groups that he describes, but I cannot avoid the fact that, if you are going to get a medical service, you need to be registered with a GP. That is something that some people are going to have to make part of their life.
The registered GP services where I live are banging on the door for this vaccine at the moment. What is the latest date for a universal rollout to every primary care area in the country, making the vaccine available to those who are vulnerable?
I completely understand the noble Lord’s impatience to know that. I am afraid that I cannot provide him with a precise date. One reason why is because we do not know the availability of the other vaccines. As he knows, the AstraZeneca vaccine, the Moderna vaccine and three others are all in the pipeline at the moment. If they get authorisation from the MHRA, that will completely change our deployment programme. At the moment, we are putting in place contingency measures for an uplift in our deployment should any of those be authorised; that will lead to a major growth in our deployment plans.
(3 years, 9 months ago)
Lords ChamberThe noble Lord is entirely right. Without doubt, there are very many circumstances in which a face-to-face appointment is absolutely necessary, whether that is for a physical analysis, for the comfort of the patient or to check out other symptoms that may not be apparent from a telephone call. However, there are other people for whom telephone appointments are helpful. The Royal College of Physicians found that 20% of patients over 65 felt worse after an in-person appointment because of the stress involved. But the noble Lord is entirely right that guidelines do need to be evolved in order to reflect the changes, and there may be a moment when the GP contract needs to be revisited.
Iceland has better survival rates for strokes by using telemedicine for decisions in acute care on thrombolysis. Will the Government not take this opportunity to move primary care far more into the modern era by encouraging a far greater use of telemedicine, and not simply hark back to the past as we learn from the experiences of Covid?
The noble Lord makes an incredibly interesting parallel with Iceland. It is not one that I knew, but I will take care to look into it, because it is instructive and informative. He is right to say that Covid has demonstrated the power of telemedicine, and we are keen to learn that lesson. We do not want the elastic band of old practice to snap back to where it was before. To reflect the words of a noble Lord who spoke previously, there will be occasions when tele- medicine is right. The key is getting the blend correct and ensuring that the right format is used in the right circumstances.
(3 years, 10 months ago)
Lords ChamberMy Lords, the data collected by PHE for the test and trace service is held, as I said, by the Contract Tracing and Advisory Service database—the CTAS database—and it will be provided to the police on request. It is not a question of a wholesale sharing of all data. The data that can be shared with the police are the recorded name and contact details of an individual who has been instructed to self-isolate, the date on which they were told to self-isolate and the date on which the period of self-isolation ends. No testing data or health data are shared with the police at all.
Do we have a defined national police strategy on the policing of breaches of self-isolation, or will we see a patchwork of implementation by different chief constables across the country?
I thank the noble Lord for his question. The intention of this legislation is threefold: first, to increase public understanding of the importance of self-isolation; secondly, to help to support people to comply with self-isolation by making sure that they understand the consequences of breaking those rules; and, thirdly, to introduce fixed penalty notices for those who do not follow the rules. Our intention is not to enforce a surveillance culture around this; it is instead to leave it to members of the public to take it into their own hands as to whether they would like to share instances of breaches with the police, and to give the police an opportunity to follow up those reports in a timely, accurate and efficient fashion.
(3 years, 10 months ago)
Lords ChamberWell, I hope that the noble Baroness, Lady Jolly, puts this to the vote, so that I and, I hope, a large majority, can vote against her. The government proposals are sensible, measured and thought through. Where I live they will work, and where I stay in London they are working. I am hearing some nonsense in terms of the evidential base against it, and some statistical nonsense about how Covid spreads. Of course Covid spreads most within the house, as it might do in any other institution including, worst of all, a care home. But how it gets in is the question, and where it comes from. By definition there will be more inside the house, because people are living together within a household. The question for government and, therefore, for us, is how it gets in.
I have minor disagreements with government strategy, and I shall repeat them quickly again. It is a nonsense that a coachload of pensioners can jolly around this and every weekend as if there were no problem in doing so. That should be restricted. It is a nonsense that, successfully, league 7 and below football teams can have crowds—so in my area we can have crowds, because we have rather less successful football teams—but we are not doing what the Germans have done to allow in a safe way limited numbers of fans into the outdoors. It is also a nonsense that we are not using GP practices for the primary healthcare related to this; it needs to be the case when it comes to vaccinations that we use GP practices.
Other than that, I think that the Government are getting it generally right, and we should be backing government in this, because the people certainly do.
(3 years, 10 months ago)
Lords ChamberMy Lords, I pay tribute to the council in Pendle which, as those in the Chamber know, has done an enormous amount to fight Covid infection and has been exemplary in its approach to containment. However, it is a sad truth that the infection is spreading, particularly among the young, and making its way through the generations. You have only to look at the hospitalisation rates today to see that we will have a serious problem as the lag is complete; in a few weeks’ time, those rates will go up. The Government are taking prompt action, which is tough and unpleasant for those involved. I deeply regret the possibility that Pendle may be hit by harder restrictions, but this is a reasonable approach and it is done to save lives.
My Lords, will people be healthier this winter locked up on Zoom, playing computer games and watching Netflix, or out in the fresh air, on the rock, hills and footpaths of England in a socially distanced manner?
The noble Lord is entirely right to champion the role of fitness, exercise and fresh air, and this Government are doing an enormous amount to try to keep sports going during current arrangements. He is entirely right that for families, young people and those used to the outdoors, the prospect of being locked up presents a huge challenge. No one is under any illusion: the prospect of a long winter under restrictions is deeply challenging and unpleasant. However, I celebrate and totally endorse his advocacy of fresh air and exercise.
(3 years, 11 months ago)
Lords ChamberMy Lords, I shall vote against the proposal from the noble Lord, Lord Robathan, if it is put. It is not for this place to vote on this before the Commons has done so; there is a principle at stake. I welcome the noble Baroness, Lady Clark of Kilwinning—who is doubtless as surprised and perplexed to have ended up here as I was—and the noble and learned Lord, Lord Clarke of Nottingham, who is probably less surprised. When we move to York, he and I will both be commuters and I will offer him a car share to save on costs and expenses.
I put to the Minister a question that I have put twice before—I have no axe to grind but I have not had an answer yet. Why is Sweden doing so well, considering strategy? That is a very important question, which Ministers need to be able to answer.
I commend the noble Lord, Lord Addington, for his excellent remarks; I would add the example of the great outdoors. In dealing with this crisis, the Minister might like to be more like a Yorkshireman and walk the Dales. When we do this, we do not hug or shake hands, and we do not kiss strangers; indeed, we give strangers a good berth. If we see acquaintances, we do not spiel out any hot air, we merely nod and carry on. But we do like to be out in the fresh air. If that is withdrawn, I fear that more people will catch influenzas of different kinds. The fresh air in winter is an antidote to that; I hope there will be no restrictions on it.
Similarly, at Christmas, we invite in elderly relatives and neighbours who are on their own; I hope there will be room at the inn in terms of government policy for those who are abiding by the rules, with flexibility at Christmas. Why is there no flu jab being provided in this place, when the catchment group is absolutely one that requires it, in very large percentage numbers? It seems to me that that would be a good exemplar to other areas and walks of life, where similar age profiles are meeting together. The flu jab should be made available here and organised; perhaps the Minister would like to take that up with the appropriate authorities.
I turn now to the subject of sport—in particular, spectator sport and football. I see that football is now joining the demands for more government aid and money. I look and think to myself, “Well, hang on a minute. What about Wembley stadium and the large number of lower-league football clubs in and around London?” Based on the same percentages and ratios that this House and the Commons use, I calculate that about one in nine people take their place. If one in nine seats were taken at Wembley, that would be 10,000. If Wembley was Covid-proofed—it would cost a bit of money but it is doable—having up to 10,000 spectators for Leyton Orient, Brentford, Charlton Athletic, Barnet or Watford would allow them to make good money. Indeed, for a club such as Leyton Orient, that would be an increase in the supporter base, not a decrease. It would be practical, pragmatic and doable. Why are we not using these kinds of opportunities to allow people—safely, in small numbers—to be outside? Being out in the fresh air, not stuck indoors, seems to me crucial as we get to the darker nights of this winter, if we are going to see this crisis through, both mentally and physically.
(3 years, 11 months ago)
Lords ChamberMy Lords, I do not envy the Government the range of advice they get minute by minute from experts everywhere. It must be difficult to reach conclusions from that.
I want to raise an issue that does not seem to have been discussed much in the last three or four months: how different Sweden’s policy is. Have the Government used the UK model to examine what the rate of infection and mortality in Sweden ought to be by now? The presumption is that it would be much higher than in this country, and in other European countries which have followed a similar approach. However, my own rough calculations suggest that it is actually lower in Sweden. That begs a big question about the approach taken in Sweden, where all the over-70s have been advised—pressured—to self-isolate but the rest of society has tended to operate in a much more normal way than in the rest of Europe. There are things we could learn from that. We certainly need to able to answer that question.
A second pressing issue arises from what may well happen in Sweden, where it gets darker much earlier. Our lockdowns and the big wave of the virus happened as we came into warm weather in the spring, when every day was getting longer. The public mood was much easier then than it will be going into winter, when every day it gets darker earlier. The effect on children, in particular, will be quite different when people do not want to use gardens or open spaces, even if they are allowed to, because of the darkness and the weather. I hope the Government will look at this issue.
(4 years, 1 month ago)
Lords ChamberThe noble Lord is entirely right to emphasise the importance of flu vaccination. We are very focused on getting the right amount of flu vaccination stocks and encouraging take-up once the WHO has nominated the right vaccination and we have stocks of it in this country.
Small sports clubs are particularly vulnerable to the lack of people paying to go in. When will the Government come forward with plans to allow small numbers of people to pay to be spectators at sports such as football or rugby league, socially distancing in the same way as is now allowed in cinemas, pubs and restaurants?
(4 years, 2 months ago)
Lords ChamberMy Lords, I do not think anyone needs to apologise for their efforts. I have already paid tribute to the teams at NHSX and NHS Digital for the incredibly hard work they have put in. I cannot disguise how complex and challenging are the issues we face in this area. Some of the best Governments in the world are wrestling with them and they have not been overcome in many territories. I am extremely proud of our achievements to date and look forward to more in the future.
What about the pensioners? Half of Germans say they are not going to use the new app and the German system is underpinned by local health boards ringing up people to trace and test. Why are we not doing the same thing at the local level?
The noble Lord, Lord Mann, is entirely right. One of our learnings—and a point made by many noble Lords—is that, ultimately, the most effective response is the local one. We are at a moment in the epidemic when local outbreaks are what we fear most. The way to handle those is through local contact and tracing. That is currently done by a large tracing team, putting in telephone calls which prove extremely effective. The uptake of the isolation protocol has been extremely high.