Covid-19: Aligning UK and Foreign Entry and Return Requirements

Debate between Lord McColl of Dulwich and Lord Bethell

Monday 19th July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

[Inaudible]—are engaging with a range of international partners, including the EU and the US, on mutual recognition. Ministers have agreed to begin the formal process of reaching a technical agreement with the EU on mutual recognition of vaccine certificates. This would allow the digital verification of vaccine certificates between the UK and the EU. We believe that this process could be complete within a month, pending the Commission’s acceptance of our application.

[Lord McColl of Dulwich (Con) [V]]

My Lords, have the discussions with these countries involved the question of herd immunity, bearing in mind that countries with low levels of vaccination which have closed their borders will have fewer Covid infections? That could result in less herd immunity in the long term in countries such as New Zealand and Australia, which have closed their borders.

Folic Acid

Debate between Lord McColl of Dulwich and Lord Bethell

Tuesday 13th July 2021 Lords Chamber

[Lord McColl of Dulwich (Con) [V]]

My Lords, one of the first to indicate that folic acid could prevent spina bifida was Professor Richard Smithells in 1980. That was accepted 11 years later, which is nothing compared with the present delay. Spina bifida is one of the commonest congenital defects and is easily prevented by adding folic acid to flour, which is what the Americans did 23 years ago, thus preventing 1,300 babies having that tragic condition every year. We keep hearing about consultations and meetings, which some of us regard more as group psychotherapy than as achieving anything. When will action be taken?

[Lord Bethell (Con)]

My Lords, I completely understand and appreciate the sense of frustration and urgency that my noble friend expressed, but I emphasise that this is a massive national measure. It has to be conducted in a way that takes the nations with us, that people feel confident that the right processes have been adhered to and that there is no doubt about the safety of the measure. This is not a question of foot dragging, quite the opposite. We are doing this in a thorough way that reflects the practicalities and realities of the machinery of the United Kingdom Government.

Health: Dementia

Debate between Lord McColl of Dulwich and Lord Bethell

Monday 5th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the role of carers in the kinds of situations the noble Baroness describes. We are doing an enormous amount to supply training for carers in all facets of their delivery, including support in caring for those with dementia. I am not sure that I can make the guarantee that she seeks right now, but I reassure her that this is one area of our investment in carers that we take extremely seriously.

[Lord McColl of Dulwich (Con) [V]]

My Lords, while these patients are waiting for appointments, could some way be found to encourage relatives and close friends to help those with early dementia by having frequent conversations with them and helping them learn by heart poems they used to be able to recite in earlier years? That might also prove helpful to those relatives and friends, because loss of memory tends to affect us all as we grow older.

[Lord Bethell (Con)]

My noble friend makes a very touching and constructive point, because social engagement and involvement in the community keep older people sharp and their brains engaged and help stave off the ravages of age and the diminution of mental faculties. We all have a role to play in supporting the elderly and those with mental challenges. My noble friend is entirely right to call on the entire community to step up to that role.

Hospital Waiting Lists

Debate between Lord McColl of Dulwich and Lord Bethell

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

I completely take on board the noble Baroness’s advice. When it comes to recruitment, it is right that local engagement with local education has to be the way forward. I can report that the recruitment efforts and marketing campaign that we have put in place to recruit 50,000 new nurses, more GPs and more staff across the healthcare system are working extremely well. There is a renewed interest in careers in health—that is one good dividend of this awful pandemic.

[Lord McColl of Dulwich (Con) [V]]

My Lords, the Government’s £1 billion elective recovery fund is most welcome. Will the Minister support this sum being made available every year until we see light at the end of the tunnel? Can he encourage health authorities to redouble their efforts to get the 40 million people in the UK who are overweight to return to a normal weight and thereby begin to release resources to treat more urgent cases, such as cancer patients?

[Lord Bethell (Con)]

On the elective recovery fund, I cannot make that commitment at the Dispatch Box but I reassure my noble friend that we are in it for the long haul and we recognise that this will be a major project needing major resources. When it comes to the health of the nation, the obesity strategy is a cross-departmental and energetic programme that tackles the issues that my noble friend is concerned about. He is entirely right that the costs of our healthcare system are predetermined by the overall health of the nation, and that is why we encourage people to eat well and lead healthy lives.

Folic Acid

Debate between Lord McColl of Dulwich and Lord Bethell

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I understand that considerable efforts have gone into ensuring that folic acid is put into flours of all kinds, and I pay tribute to the industry for trying to deliver a comprehensive service. I am happy to write to the noble Baroness to confirm that.

[Lord McColl of Dulwich (Con)]

My Lords, as fluoride has been added to drinking water to reduce dental caries, surely the Minister agrees that preventing spina bifida is more important, as a former colleague of mine, Professor Richard Smithells, pointed out nearly 60 years ago. Is it not time to act?

[Lord Bethell (Con)]

My Lords, I take on board the point that it is time to act. That is why we are working hard on the matter. As I said, I hope to return to the House on this soon.

Covid-19: Update

Debate between Lord McColl of Dulwich and Lord Bethell

Tuesday 20th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely recognise my noble friend’s concerns, but I reassure him that surgeries simply are not closed, and if he has any examples of those he thinks are closed, I would be grateful if he would write to me. Hospitals are not closed and if he has any examples, I would be grateful if he would write to me. In fact, the NHS has for months done a huge amount not only to be wide, wide open, but to grow in its capacity quite dramatically. It is an inevitable, predictable, sad but frustrating fact that the impact of the coronavirus pandemic, like every other pandemic, is the hit or the follow-on effect on all the other procedures that are needed from a healthcare system. We have diverted a huge amount of capacity from Covid to ordinary, business-as-usual care; we are doing a huge amount to address the backlog and we will continue to move the resources accordingly, but we have to keep provision in place for those who, I am afraid to say, are still in hospital with Covid, and we are aware that the threat remains on the horizon.

[Lord McColl of Dulwich (Con) [V]]

My Lords, in addition to the great success of the vaccination campaign, at last it is now accepted that the high mortality from Covid in the UK, and in many other countries, is due to the high prevalence of obesity. The high Covid mortality is not the fault of politicians, civil servants or scientists. Does the Minister agree that what we now need is for everyone to unite to support the Prime Minister’s campaign to reduce obesity in order to promote a healthier nation and reduce the mortality from any future pandemics?

[Lord Bethell (Con)]

My Lords, the post-mortem is not fully written. When it is, the causes of our relatively high mortality rate will undoubtedly be complex and a number of factors will have played a role, but the noble Lord is right that obesity will definitely be on the list. This country is too heavy in comparison even to our European partners. We are one of the heaviest countries in the whole of Europe and if you are overweight, I am afraid to say that the brutal truth is that your heart is having to work too hard, your lungs are having to work too hard, your immune system is run down and the ability of your organs to fight disease is greatly reduced. That is one of the reasons why a very large number of people have really struggled in hospital to fight this disease. If you are carrying an obesity-related illness, such as diabetes or some other major affliction, you really are in no shape to fight off one of the major diseases.

The resilience of this country depends on it getting fitter. That is why we have focused on the obesity strategy that we have, and we will be building on it further. The noble Lord is entirely right that this challenge is well recognised by the Prime Minister from the top, from his own personal experience and his acknowledged fight with the disease last year. It is recognised by the whole of government and by the NHS and our healthcare system.

Crohn’s Disease and Ulcerative Colitis

Debate between Lord McColl of Dulwich and Lord Bethell

Thursday 15th April 2021 Lords Chamber

[Lord Bethell (Con)]

I am extremely grateful for the testimony of the noble Baroness. She speaks very movingly about the challenge faced by those with IBD—a challenge that we all sympathise with. We are working extremely hard with both Crohn’s & Colitis UK and IBD patient groups on this scenario. There has been disruption in the last year, but I reassure the noble Baroness that we are working extremely hard to get the scenario out as soon as possible.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, even for very experienced clinicians, diagnosis and treatment of these conditions can be very difficult indeed—as my experience over the years has taught me? Patients may present in bizarre ways—for instance, with a disease of the skin, eyes or joints. Furthermore, a patient with ulcerative colitis can almost imperceptibly become dangerously ill, requiring drastic emergency surgery. Clinicians are always trying to do better, and they need encouragement and thanks, particularly over this very difficult pandemic.

[Lord Bethell (Con)]

My noble friend is entirely right that diagnosis is key to the accurate and prompt treatment of IBD and associated conditions. That is why we have put diagnosis at the heart of our research programme. Between 2015 and 2020, we funded 20 research projects, many of them on diagnosis, with over £17 million committed. That includes a study into the overlap of IBD and magnetic resonance enterology to image Crohn’s disease patients. This approach is extremely promising.

World Health Organization: Pandemics

Debate between Lord McColl of Dulwich and Lord Bethell

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Government are extremely committed to pandemic preparedness. We support the principle of a pandemic preparedness treaty, and we have laid out at UNGA a very clear programme for enhancing global pandemic preparedness. We look forward to the publication of the Independent Panel for Pandemic Preparedness and Response report shortly, and I reassure the noble Lord that this is top of the agenda at our G7.

[Lord McColl of Dulwich (Con) [V]]

Does the Minister agree that the WHO could support the management of future pandemics now by organising a worldwide vaccine passport? People are very keen to travel, and this would help the travel industry and could act as an incentive to those who are reluctant to take the vaccine.

[Lord Bethell (Con)]

My Lords, I share the noble Lord’s passion for international travel. Like him, I cannot wait for global travel to restart. I also see the connection between the promise of a vaccine certificate of some kind and taking up the vaccine itself. Plans for vaccine certificates for global travel are emerging as we speak. We have a Cabinet Office programme which is co-ordinating across government initiatives on vaccine certification, and a review is in progress which will pronounce shortly.

Dentists: Covid-19

Debate between Lord McColl of Dulwich and Lord Bethell

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I would like to reassure the noble Baroness that officials are working extremely closely with the dental profession on the arrangements for the new practice. It will not be a complete renegotiation of the full contract, but we are looking at what arrangements should be in place for 2021-22. And as I said before, I pay tribute to the hard work of dentists. Activity targets are a useful way of getting a focus on increasing the throughput of dentistry. We have a big backlog, and that is one way we can try to increase the velocity of dental appointments.

[Lord McColl of Dulwich (Con) [V]]

My Lords, in order to deal with this backlog, should we not rely on the good sense of dentists to prioritise their patients—for instance, to treat those with pain and infection with antibiotics, then deal with the less urgent problems? Would the Minister consider the fairer solution adopted by Scotland and Northern Ireland, where new activity targets are half those of England?

[Lord Bethell (Con)]

My Lords, the Chief Dental Officer has looked at the activity targets and done extensive modelling to ensure that they are fair and safe. The noble Lord is entirely right that some dental support can be done in absence through things such as antibiotics. But it is important that face-to-face appointments are increased, otherwise, we will have a generation of people whose teeth are not in great shape, which will cost the country dearly.

Cancer Task Force

Debate between Lord McColl of Dulwich and Lord Bethell

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness puts her case extremely well. We have a massive investment in the NHS that spans physical infrastructure and staff, hospitals and investment in nurses. This will have a big impact on the diagnosis of cancer, which we are committed to getting as early as possible, as well as on treatment for cancer. Treatment with radiotherapy will form an important part of that.

[Lord McColl of Dulwich (Con) [V]]

As there has been much more exposure to the sun this summer, there will be a greater incidence of melanoma. Does the Minister agree that screening is essential to detect melanomas before they spread rapidly and are fatal? If they are detected while they are less than 0.6 millimetres deep, they can be cured by a simple removal under local anaesthetic. Does he agree that this ought to be a priority for the task force?

[Lord Bethell (Con)]

My Lords, I completely and utterly agree with my noble friend.

Folic Acid

Debate between Lord McColl of Dulwich and Lord Bethell

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness did, in part, answer her own question. Work to improve the diet of pregnant mothers has progressed impressively, particularly among at-risk groups. However, it is those mothers who do not know that they are pregnant that this measure particularly targets, and that is where its inherent value is. This is why we have conducted a consultation and are looking to make a decision on it in the near future.

[Lord McColl of Dulwich (Con) [V]]

May I congratulate the noble Lord, Lord Rooker, on his importunity in promoting the addition of folic acid to flour? Folic acid is essential to prevent spina bifida and anencephaly, which occur in utero before the lady knows that she is pregnant; hence the importance of putting it into flour, as they have done in the United States for years without any problems. There really can be no possible excuse for delaying the implementation any longer. Preventing this distressing condition is so essential and costs so little. Therefore, can we have a date for when it will be put into practice?

[Lord Bethell (Con)]

My Lords, I entirely endorse the insight of my noble friend Lord McColl. The United States, Canada and Chile were the first three countries to introduce mandatory fortification, and I note that studies demonstrate a decline in NTDs of between 20% and 25%. These are encouraging statistics and the Government recognise them.

Covid-19: Response

Debate between Lord McColl of Dulwich and Lord Bethell

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My 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.

[Lord McColl of Dulwich (Con) [V]]

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?

[Lord Bethell [V]]

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.

Independent Medicines and Medical Devices Safety Review

Debate between Lord McColl of Dulwich and Lord Bethell

Wednesday 15th July 2020 Lords Chamber

[Lord McColl of Dulwich (Con) [V]]

My 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?

[Lord Bethell]

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.

Medical Teaching and Learning: Ethnic Diversity

Debate between Lord McColl of Dulwich and Lord Bethell

Tuesday 14th July 2020 Lords Chamber

[Lord Bethell]

The 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.

[Lord McColl of Dulwich (Con) [V]]

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.

[Lord Bethell]

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.

Covid-19

Debate between Lord McColl of Dulwich and Lord Bethell

Wednesday 8th July 2020 Lords Chamber

[Lord Bethell]

On 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.

[Lord McColl of Dulwich (Con) [V]]

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”.

[Lord Bethell]

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.

Covid-19 Update

Debate between Lord McColl of Dulwich and Lord Bethell

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

My 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.

[Lord McColl of Dulwich (Con) [V]]

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.

[Lord Bethell]

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.

Coronavirus

Debate between Lord McColl of Dulwich and Lord Bethell

Monday 22nd June 2020 Lords Chamber

[Lord Bethell]

The 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.

[Lord McColl of Dulwich (Con) [V]]

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.

[Lord Bethell]

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.