(3 years, 11 months ago)
Lords ChamberMy Lords, I welcome these regulations, because the trouble with the present local arrangements is that they are far too bureaucratic. Sometimes, they even require the participation of the law. It really is so difficult to get things done. Effective local decision-making is what is required, and we should have much more of it, rather than central control.
Perhaps the local authorities could also point out to all and sundry that politicians and the media, with their enormous power, spend so much time in destructive criticism of the Government, which demoralises the public. Blaming the Government for the high mortality rate of Covid-19 is false. The high mortality rate is due to the fact that over 70% of the people in this country are obese. Obesity and Covid-19 is a potentially fatal combination. If politicians and the all-powerful media really want to help the British people, they should support the Prime Minister in his campaign to combat the obesity epidemic.
(3 years, 11 months ago)
Lords ChamberMy Lords, I congratulate my noble friend Lady Cumberlege and her committee on producing such a thorough and important report.
I draw attention to a practice that many of us clinicians used for years. It detected clinical problems in treatment, equipment and management early on. We had weekly meetings for an hour or so to discuss any complications that had occurred in the previous week. It was attended by consultants, junior staff, medical students, nurses and a manager or two. It was always an interesting and very instructive meeting, and it brought problems to light early on. People were very honest about their mistakes; it became rather like the general confession. Of course, it was essential to have as a chairman of these meetings somebody who was friendly and encouraged people to adopt the attitude of “There but for the grace of God go I”. It was a very inexpensive and successful kind of quality assurance.
I have a few questions to put to the Minister. First, do the Government plan to mandate the tracking of all medical devices used in the UK and not just those selected at random? Secondly, will the use of medical device registries be extended to patient outcomes? Thirdly, will the Government go ahead and establish the post of a patient safety commissioner, as strongly recommended by my noble friend Lady Cumberlege and many of your Lordships? Some years ago, I used to carry out transplant operations and became very familiar with the problems involved.
I emphasise that in Committee I shall fully support the amendments in the names of the noble Lord, Lord Hunt of Kings Heath, and the noble Baroness, Lady Finlay of Llandaff, dealing with forced organ harvesting. As mentioned before, Sir Geoffrey Nice QC stated in his report that forced organ harvesting has been committed for years throughout China. [Inaudible.]
I am afraid that we can no longer hear my noble friend. If he would make his concluding point, that would be wonderful.
Perhaps those who spend so much time attacking the Government about this and that might like to turn their attacks on the Chinese Government, whose morally corrupt behaviour demonstrates to the world what is going on in China.
Finally, I again congratulate my noble friend on her outstanding report.
(4 years, 1 month ago)
Lords ChamberMy Lords, the obesity package that the Prime Minister announced today is one of the most ambitious, impactful and thoughtful of any Government in recent history. We will see how it plays out and consider new measures when the time is right.
Covid-19 and obesity are so often a fatal combination, and it explains the high mortality in the UK, with its dense population and the fact that two-thirds of people are either overweight or obese. Is it not therefore time for those strangers to the truth in the media and in politics to stop demoralising the public with their repeated false news, including blaming the Government for the high death rate? Should we not expect the media and politicians to use their power to support the country and the Prime Minister’s campaign to reduce obesity and its complications, in order to minimise the number of deaths from the next pandemic?
My Lords, it is not the feeling in the Government that we should duck hard questions about performance, and we embrace those who ask difficult questions about how things have gone. None the less, the noble Lord is entirely right that the country has a difficult challenge that it needs to face up to: that of obesity. It has had a profound effect on the health of the nation for a generation and we have been caught out by Covid, as obesity has undoubtedly had an impact on our total death rate. It is a point that the Prime Minister made powerfully in his video earlier today. That is why we have put together the package that we have, and we look to all civic leaders and the media to support us.
(4 years, 1 month ago)
Lords ChamberMy Lords, I first thank the noble Baroness, Lady Cumberlege, for such a wonderful and constructive report, and all the members of the committee, especially Professor Sir Cyril Chantler, whom I have known for many years.
I have just two questions. Will the report encourage clinicians to consult the appropriate royal college before designing a new treatment? Secondly, after introducing a new treatment or a new operation, should the clinician be encouraged to wait for an appropriate interval to ensure that no complications occur?
I thank the noble Lord for his searching questions. The role of the MHRA on both medical devices and medicines has been massively upgraded, and the review process for new medical devices has been improved. However, medical devices have different criteria from medicines.
One of the most important things that we have sought to do is to include a registry of the medical devices themselves and a registry of the medical devices inserted into individuals. Compliance with both procedures are the most important steps for clinicians embarking on new products.
(4 years, 1 month ago)
Lords ChamberThe noble Baroness is right; the representation of BAME communities at the higher echelons of the medical establishment is not good enough. In too many areas, the representation is not fair and does not reflect the much higher proportion of BME workers at other levels of the health service. We are working hard on a variety of agendas: the People Plan, which I have already mentioned, and the NHS workforce race equality standard. These measures are taken seriously and we are working hard to change the balance of representation.
Does the Minister agree that, in considering this important subject, there is certainly no room for complacency? However, we do need to know accurately the extent of the problem. Certainly, in all my years in medicine, I have always had this subject very much in mind in selecting and teaching students, selecting doctors and management generally.
Incidentally, I have been very close to members of ethnic minorities who have done much better in life than I have: fellows of the Royal Society, members of the Order of Merit, knights of the Order of the Thistle, presidents of royal colleges and even one who became a king.
My Lords, I completely agree with the noble Lord, Lord McColl, that complacency is our enemy. I recommend to him the NHS workforce race equality standard publication, which is very detailed in its analysis of the problem and is a guide to the challenge we face and a measure of how far we have come. I completely commend the achievements of those in the BAME community who often far outperform those of us who were born in Britain.
(4 years, 1 month ago)
Lords ChamberOn PPE, I pay tribute to my noble friend Lord Deighton, who has performed an amazing task in providing an enormous supply of PPE. There is sufficient PPE in the NHS, social care and other parts of the healthcare system for all those who need it. There is a PPE hotline for those who would like to order it directly and, at this stage, stockpiles are being created to get us through the winter months. On tests, a testing portal is available to all of social care. It can be accessed either by social care employers or, if employees or residents want a test, they can order one themselves through the public testing portal. It is my understanding that posted tests are no longer counted in the same way: they are counted not on dispatch but when they are processed. The “test and trace” programme initiated this change in the recent change of data, which I think was 10 days ago.
My Lords, last week I understated the figures on the deadly combination of Covid-19 and obesity. House of Commons Library figures show that 72% of UK people are either obese or overweight. What is even more tragic, 33% of 10 year- old children are overweight or obese. These appalling figures may help explain the high mortality from the coronavirus in the United Kingdom, so will the Minister endorse the urgent need to persuade people to lose weight? To save lives, we should follow the advice of the Prime Minister himself, who said, “Don’t be a fatty in your fifties”.
I think my noble friend and I need to have a chat about statistics, because the statistics I have differ from his. Mine suggest that 28% of the public are either obese or overweight, and it does defy common sense that 72% the public are obese or overweight. Maybe he and I can have a chat about that offline: I would be glad to clear it up. However, my noble friend makes a really important point that I and the Government completely endorse: the Covid epidemic has been a wake-up call for the country—in that, he is right. There is an urgent need to address the obesity epidemic and the Government are looking at ways to do so. The Prime Minister is personally vested in it and my noble friend’s points are extremely well made and supported on these Benches.
(4 years, 1 month ago)
Lords ChamberMy Lords, it is beyond my reach to instruct the House on its debates, but I would entirely agree with the noble Baroness that one of the saddest and most challenging aspects of Covid is that it hits society where it is weakest. It has undoubtedly hit those with health issues the hardest and has exacerbated health inequalities. It is my sincere hope that this Covid epidemic will be an inflection point, when this country embraces a strong public health agenda and addresses those health inequalities with energy.
Does the Minister agree that the reason why so many people in the United Kingdom and the United States have suffered from Covid-19 is that the majority of people in both countries are obese? Covid-19 and obesity is a lethal combination. We urgently need a nationwide campaign to reduce the obesity epidemic—to persuade people to put fewer calories into their mouth before the next pandemic arrives to affect even more people.
The noble Lord overstates his case a bit—it is 28% of Britons who are obese—but his point is very well made. We have undoubtedly been challenged as a nation because too many of us are overweight, and I say this with a degree of personal humility. As I said in my previous answer, there is a significant opportunity for this country to regard Covid as a massive warning shot and a potential inflection point where we address overeating and, as a nation, embrace the opportunity to get fit and lose some weight.
(4 years, 2 months ago)
Lords ChamberThe noble Baroness, Lady Brinton, is right that the creation of a seamless network between the centre and local authorities is challenging. A huge amount of work has gone into refining the accuracy and speed of the exchange of data, and the joint biosecurity centre is investing a huge amount of effort in getting this right. The responses to Kirklees, Leicester and Cardiff show the progress that has been made, but also some of the shortcomings. We are fully aware of the challenge and difficulty of getting this right; we are very much focused on it and it is our top priority.
As obesity makes one more likely to suffer with Covid-19, and as more than half of people in the UK are obese, will the Government launch an all-out campaign this summer to reduce obesity by persuading people to put fewer calories into their mouth before the next pandemic arrives to kill even more people? Exercise is good for general health but will reduce weight only in grams, whereas eating puts on weight in kilos.
My noble friend makes a tough but serious set of points. It is undoubtedly true that this country has been hit hard by Covid because of the prevalence of obesity, and it is a truth long explained by Public Health England that there is a direct correlation between calorie intake and weight—there is no getting away from that. The Government are looking at how to address this issue, public health remains a massive priority for us and, when the time is right, we will look at ways of using marketing to communicate the message on this.
(5 years, 1 month ago)
Grand CommitteeMy Lords, I shall describe how I tried to enhance the co-operation and understanding between academia and hospitals by having all the trainees in a third of the south-east region spend a year or two on the academic side. In 1971, as professor of surgery at Guy’s Hospital, I started a comprehensive training programme that lasted until the trainees were appointed to a consultant post.
Several years were spent in district general hospitals and several years at Guy’s. The trainees experienced a wide range of surgical disciplines, including anaesthetics and intensive care. They also spent a year or two on the research side, including a year at Harvard. This gave them an involvement in research that they carried with them into their consultant work in the NHS. In addition, many of them became professors of surgery. The Guy’s Hospital training programme gave junior staff not only more comprehensive training but more security and a more stable family life. It also shared out the junior staff more fairly with the district general hospitals in a third of the south-east region. Most important of all, it encouraged young trainees to embrace academia early on in their career.
(5 years, 6 months ago)
Lords ChamberI thank the noble Lord for giving way. While access to treatment is vital, I hope the Minister will agree that it is equally important to address modifiable risk factors for eating disorders. There is good evidence that weight-related bullying, teasing and criticism increase the risk of eating disorders, and young people studying physical subjects such as dance or sport are particularly vulnerable to inappropriate comments from teachers and coaches. The Minister will be aware that size is not a protected characteristic under the Equality Act 2010. Given this, can she confirm that guidance is available to support teachers who are dealing with young people in using language that avoids triggering long-term issues around eating and body image?
The noble Baroness is absolutely right. It is very important we send the right messages to young people at exactly the right time. That is why we are implementing the children and young people’s Green Paper on the basis that early intervention and prevention are the priority in mental health. In December 2018, we announced 25 trailblazer sites that will provide school and college-based services to help children and young people with mild to moderate mental health issues, staffed by a new workforce. Twelve of these trailblazer areas will pilot a new waiting time standard for children and young people’s mental health services. This is to address exactly the issue that the noble Baroness raised.
My Lords, does the Minister agree that, when we talk about eating disorders, the most serious eating disorder by far is the obesity epidemic, which is now impinging on the Armed Forces? Ejector seats in fighter planes are having to be modified because of obesity, and no doubt the noble Lord, Lord West, will be interested, because we may have to enlarge the escape hatches of submarines.
I thank my noble friend for that question. I do not feel able to comment on ejector seats or submarine hatches—I may have to look to the noble Lord, Lord West, for advice on that matter—but I believe that obesity is a serious issue, and that is exactly why we introduced the children’s obesity plan.