Health and Care Bill

Lord Moylan Excerpts

Lords Hansard _ Part 1 & Report stage
Wednesday 16th March 2022 Lords Chamber

Moved by

[Lord Moylan]

166: After Clause 164, insert the following new Clause—
“Guidance on Pancreatic Enzyme Replacement Therapy
(1) The Secretary of State must, within six months of this Act being passed, publish national guidance making the appropriate prescription of Pancreatic Enzyme Replacement Therapy a priority within pancreatic cancer care in the NHS through the implementation of national targets.(2) The Secretary of State must, within a year of this Act being passed and every year thereafter, publish data on the prescription of Pancreatic Enzyme Replacement Therapy for pancreatic cancer patients.”

[Lord Moylan (Con)]

My Lords, pancreatic cancer is a terrible disease, as noble Lords know: 10,500 people in the UK a year are diagnosed with it, 9,000 people a year die from it and five-year survival rates in the UK rank us 29th out of 33 countries with comparable data. The Government recognise that this is not good enough, so they are commissioning an audit of existing services as a first step to improvement. That is wholly welcome but it is turning out to be a very slow business, with the first data expected in 2023 and no timetable for action to follow.

Amendment 167 in my name is intended to add a sense of urgency to that. I am grateful for the support it has received from the noble Lords, Lord Aberdare and Lord Patel, and the noble Baroness, Lady Hayman of Ullock. However, I turn my attention this evening principally to Amendment 166 in my name, which is also supported by the noble Baroness, Lady Finlay of Llandaff. It relates to improving the treatment of those diagnosed with pancreatic cancer and can be delivered immediately.

The end-of-life experience of pancreatic cancer sufferers includes huge difficulties in eating and digesting food, because of the lack of an enzyme normally produced by a healthy pancreas. Pancreatic enzyme replacement therapy, or PERT, is a simple tablet costing only £7 a day. It is fully approved by NICE and allows sufferers to eat, but it reaches only about 50% of pancreatic cancer sufferers. Why is that? The truth is that we do not know exactly and, pending the audit, may not be able to say exactly. But a likely reason is that diagnosis of pancreatic cancer occurs so late because the symptoms present so late that a prompt decision has to be made about those who might be saved by surgery and those for whom nothing can be done. The former go to specialists, who tend to be aware of PERT and prescribe it. The latter, on the whole, move into more general palliative settings, where it seems that knowledge and understanding of PERT is less widespread.

Amendment 166 obliges the Government to make increasing prescription rates for PERT a national priority, without waiting for the outcome of the current audit. It was tabled in Committee and got a somewhat dusty answer from the Government Front Bench, hence its return today. To say that emphasising PERT should await the outcome of the audit would be to condemn literally tens of thousands of people to unnecessary suffering at end of life so I think these amendments, especially Amendment 166, will find general support across the House. Happily, I understand that my noble friend the Minister will be able to offer certain assurances when he speaks that would make any such Division unnecessary.

Before I conclude, there is one extra step that the Government could make early progress on that would be welcome. It is in disaggregating the data about the prescription of PERT, which can be prescribed for conditions other than pancreatic cancer. While the Government and the National Health Service are able to point to figures showing slowly increasing PERT prescription rates, what they cannot do at the moment is to say whether it is being prescribed for pancreatic cancer or some other condition. Disaggregating that data will be an important job for the Government to do, even to make progress with their own audit. Some comments on that today would also be welcome so, for the moment, I beg to move.

[Lord Aberdare (CB)]

My Lords, I am pleased to speak in support of Amendments 166 and 167 in the name of the noble Lord, Lord Moylan, addressing pancreatic cancer, to which I have added my name. I shall be brief as he has already made the case for these amendments so strongly. Both amendments include deadlines: for guidance on pancreatic enzyme replacement therapy to be published within six months; for data on PERT prescription to be published within a year, and yearly thereafter; and for a report on the audit of pancreatic cancer services to be laid before Parliament within six months and updated six-monthly. The reason for these deadlines comes down to a single word: urgency.

On average, pancreatic cancer sufferers live for only six months following diagnosis and more than half of the 10,000 a year will die within three months. That is hardly enough time for them to say proper goodbyes to their family and close friends, let alone to put their financial and other affairs in order, so the usual government timescales of “in due course” or even “shortly” are nowhere near fast enough for action to improve their treatment. I hope we may hear something more encouraging from the Minister.

Some such improvements may help extend their lives, even if only by a matter of months, but others equally important, such as PERT, may make a significant difference to the quality of the time remaining to them, however short. PERT enables pancreatic sufferers to digest their food; in some cases, it may even help them to gain the strength needed to undergo life-saving surgery. It is recommended by NICE and widely available. It costs just £7 a day per patient. I find it shocking that, as the noble Lord told us, half of patients who need PERT are not being prescribed it, mainly because of lack of awareness among non-specialist staff. Surely the Government can and should investigate and address this with urgency, as required by Amendment 166.

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[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

I thank noble Lords for bringing forward this further debate on the subject of pancreatic cancer services. I begin by confirming that the pancreatic cancer audit is included in the national cancer audit collaborating centre tender, which is currently live. Reporting timelines are included in the specification for this audit, developed in partnership with NHS England and NHS Improvement. However, I hope noble Lords will understand that, during a live tender, the document is commercially sensitive and cannot be shared beyond the commissioning team, as this would risk jeopardising the procurement process. While I recognise that it may be disappointing that I am unable to confirm the timeline for the pancreatic cancer audit until the procurement process is completed, I can say that the future contract to follow the procurement process in relation to the clinical audits is anticipated to start this autumn.

The normal process for a new national audit is a year of development and set-up, followed by data collection and analysis. The publication of the data would then follow. However, on a more positive note—and I hope my noble friend Lord Moylan considers this response less dusty—I can confirm that, alongside the audit of cancer services, important actions are being taken to ensure that clinicians are able to take informed decisions. NHS England and NHS Improvement have ensured that guidance on pancreatic enzyme replacement therapy is shared with cancer alliances to disseminate to clinical teams in their area. NHS England and NHS Improvement will also continue to work with Pancreatic Cancer UK to raise awareness among the clinical community about the value of PERT for many patients with pancreatic cancer.

Noble Lords will be aware that NICE has a clinical guideline, NG85, recommending that PERT should be offered to patients with inoperable pancreatic cancer, and that NICE has also included PERT in its quality standard on pancreatic cancer. NICE clinical guidelines are developed by experts based on a thorough assessment of the available evidence, but they do not replace the judgment of healthcare professionals. They are not mandatory, but they represent best practice. The NHS is expected to take them fully into account in ensuring that services meet the needs of patients. Ultimately, the use of PERT in individual cases is for clinical decision-making, following a discussion between doctor and patient. As such, national targets would not be appropriate.

My noble friend asked another question on data. PERT prescription data is already published online through the English prescribing dataset. This shows that levels of prescription have been rising. The data does not currently differentiate between prescription for pancreatic cancer patients and for people with other conditions. However, NHS England and NHS Improvement will consider PERT prescription data during the scoping of the pancreatic cancer audit.

I end by thanking my noble friend Lord Moylan for his constructive engagement and for pushing the Government on this. But I hope that the reassurances I have given are sufficient to persuade him to withdraw his amendment.

[Lord Moylan (Con)]

My Lords, I am very grateful to noble Lords who have spoken, particularly the noble Lord, Lord Aberdare, and the noble Baronesses, Lady Finlay of Llandaff, Lady Walmsley and Lady Thornton. I know that support for the principle behind these amendments is widespread throughout the House. The Minister has also taken that on board, and I am grateful to him not only for his engagement before this short debate but for the words he uttered from the Dispatch Box. He will be in no doubt that noble Lords will be paying attention to these prescribing rates in the future, carefully following what is happening, monitoring and asking questions to ensure that the information is getting to clinicians and that the medicines are getting to the patients who will benefit from them.

Before I sit down, I want to say a word of thanks to the excellent charity Pancreatic Cancer UK, with which I have worked on this and which I know also works with officials at the department to improve treatment for pancreatic cancer patients. I will test my licence a little further by saying that it is not only pancreatic cancer; there are also conditions such as bile duct cancer, which are just as devastating and which we, as a nation and a National Health Service, need to bring to the fore so that people get better treatment, better care and early diagnosis. We really can do this.

With that, I express gratitude to my noble friend the Minister and the other noble Lords who have spoken. I beg leave to withdraw the amendment.

Amendment 166 withdrawn.

Health and Care Bill

Lord Moylan Excerpts

Lords Hansard - Part 2 & Report stage
Monday 7th March 2022 Lords Chamber

Moved by

[Lord Moylan]

148: Schedule 18, page 254, line 34, after “State” insert “which may not include products containing more than 20% of their calorific value by way of protein and not more than 5 grams of sugar per 100 grams in their composition”
Member’s explanatory statement
This amendment, along with others to Schedule 18, ensures that foods that can be advertised as “low sugar” and “high protein” under Regulation (EC) No 1924/2006 of the European Parliament and of the Council of 20 December 2006 on nutrition and health claims made on foods are exempt from the restrictions on advertising proposed in that Schedule.

[Lord Moylan (Con)]

My Lords, in moving Amendment 148, I will also speak to Amendments 150 and 152 in my name. There are a number of interesting amendments in this group but I intend to stick to my last, broadly, and speak only to the ones in my name.

I had a number of amendments to this schedule—it has been renumbered; it was Schedule 17 but is now Schedule 18—in Committee, but I have decided to stick with just these three. I apologise that there are three; there is only really one, of course, but the schedule is drafted in such a way that everything has to be said three times. This amendment effectively relates to high-protein, low-sugar bars. Noble Lords may wonder why I have developed an interest in such bars; to answer that, I will tell them a story. That is all I am going to do. I will tell noble Lords a story about a real business; I will then ask my noble friend the Minister a question.

--- Later in debate ---

Therefore, I hope that my noble friend can withdraw his amendment, and that other noble Lords will not move theirs when they are reached.

[Lord Moylan (Con)]

My Lords, especially at this time of night, it is very taxing to try to summarise what is a complex debate raging across a number of issues, and in particular to thank everyone who has spoken. If I fail to thank everybody by name, I hope I will be forgiven in the interests of brevity, but I thank my noble friend the Minister again, not only for her remarks but for the attention, care and hard work she has put into addressing all these issues with me and many other noble Lords who have spoken on the various topics we are addressing.

I have to thank one or two other noble Lords. In particular, I express my gratitude to the noble Lord, Lord Krebs, who went out, no doubt at considerable personal risk and with some arduousness, to purchase an example of the Grenade Carb Killa. I had never seen one in captivity or in nature until he produced it in the Chamber today. That in itself is something I am very grateful for. He chose the one that I think is called “white chocolate” or something like that.

Here the noble Lord, Lord Krebs, has been helpful to me. I believe there are 14 different flavours of Grenade Carb Killa. It is the view of the confectioner that manufactures them that some will comply with the profiling model while others will not. Perhaps next time the noble Lord could try a different flavour and have it tested in Liverpool, I think it was, and that would generally help to advance things. The difficulty for the company, though, is that this is not a game. It needs to know which of these products has to be reformulated and how for it to remain compliant and stay in business. This was a very helpful illustration of the difficulties.

One other noble Lord I will mention is my noble friend Lord Bethell, who referred to the tobacco advertising ban as if it were some sort of comparison. There is no comparison. Nobody had to carry out a profiling exercise to decide whether something was a cigarette: it was a cigarette or it was not. There was no question of putting it through a model to discover it was a cigarette. Nobody in the cigarette manufacturing business had to reformulate their product and market test it to make it compliant with regulations. What you can do with a tobacco ban very quickly is simply irrelevant to the hurdles the Government are setting in front of businesses.

Apart from that, the many noble Lords who spoke on other aspects of the Bill, some with great knowledge and experience, have illustrated something that I hope everyone in the House can agree on, with the possible exception of my noble friends on the Front Bench: it really is a crying shame that issues of such importance and complexity should be rammed into a major Bill in a schedule when in fact it must be clear to us all now that this schedule should really have been a Bill in its own right, and should have received the attention and scrutiny these complex commercial and nutritional issues deserve. With that, I beg leave to withdraw my amendment.

Amendment 148 withdrawn.

Health and Care Bill

Lord Moylan Excerpts

Committee stage
Friday 4th February 2022 Lords Chamber

I felt strongly about this issue for many years, because I have seen it slowly trundle down the track—the train leaving the station. I want to reach out a hand and say I have enormous admiration for some very close friends who campaign vigorously on obesity, and who sent me some very rude emails last night after reading the editorial in the Grocer. I understand why they are passionate about the ban as a great signal that progress is being made on obesity. But since 1997, successive Governments have come up with a total of 640 obesity strategies and none of them has been implemented or worked. This is an excuse for an obesity strategy. If noble Lords support my amendments, we can force the Government to go back and to come up with something that will actually work—which, in my opinion, is education for children and great nutrition in schools.

[Lord Moylan (Con)]

My Lords, it is a great pleasure to follow my noble friend Lord Vaizey of Didcot. Might I say, before I get into my stride, that certain noble Lords may have received an email that emanated a week or so ago from what I call the “cold dip” wing of the Conservative Party. Essentially, the message was, “Those rotters Vaizey and Moylan are out to spoil our whizzo scheme”. This is not true, in my case. Unlike other speakers, I declare that I have no interests to declare. I am not aligned with the food industry, the advertising industry, the broadcasting industry or any of the charities that wish to restrict, ban or control various foods and drinks. That seemed to cause a little upset to the noble Baroness, Lady Boycott, who seemed to think that because I could speak in a disinterested fashion I was somehow precluded from taking part in the debate, but I hope noble Lords will not agree that is the case.

I have put my name to a number of amendments in the name of the noble Lord, Lord Vaizey. The ones I have signed up to are essentially to do with giving enough time to implement the ban, if it is brought into effect, and I hope that they are accepted. I note that the Government have brought forward amendments of a similar character; they improve the Bill, but they do not go as far as they should. But it is a good sign, and it shows that what we are engaged in here is improving the Bill, not trying to destroy it.

I will add a particular word in support of my noble friend’s Amendment 247A, which seeks to make the identification of HFSS food a matter that would be subject to parliamentary scrutiny. In effect, what the Government are seeking through this schedule is a power to make binding law—with all the apparatus of fines and other enforcement—by way of mandatory guidance that will not be subject to parliamentary scrutiny. Instead, business planning and investment will always be at the whim of civil servants with no recourse to Parliament. That is not a situation that, in other circumstances, your Lordships’ House would feel comfortable with. We should apply the same standards here and insist that, with Amendment 247A, parliamentary approval is required before these punitive measures can be amended.

The other amendments in this group in my name cover a wide range of issues, but all of them are aimed at helping business plan for and implement the bans that the Government contemplate. That said, I noted last Friday that “Red Box” in the Times was reporting a change of heart by the Prime Minister on the whole policy of introducing the advertising and promotions ban. If this is true, we can happily move on and ignore Schedule 17, since all the evidence—including the Government’s own impact assessment—shows that the policy will, as my noble friend said, have a minuscule effect. The Government’s own assessment suggests that there will be a reduction of fewer than three calories a day. I ask my noble friend the Minister to confirm, when he wraps up, whether or not this planned change of policy is in hand.

Amendments 247, 250A and 253A in my name deal with the question of whether the ban applies to brand advertising and sponsorship—already mentioned by the noble Baroness, Lady Boycott, and my noble friend Lord Vaizey. This concerns advertising when no product of an unhealthy character is included in the advertisement or sponsorship statement. Putting the brand advertising exemption into the Bill is important for business—businesses which are looking for certainty as they are already planning advertising campaigns which will run after 2023.

The exemption for brand advertising was confirmed in Committee in the other place when the Minister there said:

“Products are deemed identifiable if a person could reasonably be expected to identify the advertisements as being for that product. This means that brand advertising is not in scope of the restrictions, as the purpose of the restrictions is to prohibit identifiable products.”—[Official Report, Commons, Health and Care Bill Committee, 26/10/21; col. 676.]


He made similar remarks on Report. This is helpful but putting the exemption into the Bill—alongside the other exemptions—would mean, should the Government wish to revisit this exemption in the future, that they would be obliged to return to Parliament to set out their reasons for doing so and seek the consent of both Houses.

The noble Baroness, Lady Boycott, commenting on this, seemed to say “Why do we need all this paraphernalia? Let’s just trust the Government and go with what they say”. I almost fell off my Bench when I heard her say that. So often in this House we are saying quite the reverse; we are saying let us not trust the Government and insist that, if we want something to happen, it should be on the face of the Bill. That is all I am saying. I believe the Government of course, and in my own small way I trust the Government—but Governments change. If we believe in this, let us see the Government put it on the face of the Bill. This has been called for by the Delegated Powers and Regulatory Reform Committee and the Constitution Committee, which have signalled their dissatisfaction with this way of proceeding.

I turn to Amendments 249A, 252A and 257A in my name, which concern how the Government will assess the effectiveness of the ban. I am assuming, perhaps optimistically, that all noble Lords will agree that the restriction on freedom of expression involved in the Government’s policy should be continued only if it is seen to be effective in its purpose of reducing calorific intake. Indeed, that is the Government’s view, because the Bill contains a five-year review of the effectiveness of the restrictions, in line with better regulation principles, but it is not clear how “effectiveness” will be judged.

The purpose of my amendments is to seek some clarity on the issue now, as we adopt the new rules, so that the effectiveness criteria are not shaped retrospectively in five years’ time. This needs to be done now, in the interests of transparency and to enable the collection of data. It also needs to be done if the industry is to respond by changing its product mix—something which the noble Baroness, Lady Boycott, said she hoped for and looked forward to, and said there was evidence of its having done so in advance. But unless it understands in advance the criteria by which the ban will be judged effective, how can it possibly begin the process of changing the product mix to meet those criteria? The lack of impact of the ban is clear, but the criteria judging how it will be assessed effectively need to be addressed right at the outset.

There is also the question of what the Government will take into account in assessing those criteria. Their impact assessment envisages that the policy will likely reduce calorie consumption by around three calories a day, which is roughly equivalent to half a gram of butter, or one-five-hundredth of a standard pack of butter. This is so small as to be insignificant in terms of health benefits, yet the policy will undoubtedly have wider economic benefits, including on competition, innovation, prices, media revenues, advertising and the wider creative industries. Are the Government going to assess this wider picture?

--- Later in debate ---

[Lord Rennard (LD)]

My Lords, for decades, all the various weak arguments associated with the tobacco industry, opposing tobacco regulation, have been comprehensively and completely disproved by the effectiveness of that regulation at reducing the prevalence of smoking rates. Tonight, we will argue why we need to go further with measures of tobacco regulation to further reduce the prevalence of tobacco smoking. I will speak briefly on Amendments 276, 277 and 278.

It is topical that, this week, mission seven of the Government’s Levelling Up White Paper committed

“to narrowing the gap in Healthy Life Expectancy … between local areas where it is highest and lowest by 2030”.

As Ministers regularly acknowledge, half of that gap is down to smoking, so real commitment to levelling up means that immediate action must be taken on these issues.

The tobacco-related amendments in this group will assist the Government in their stated aim to reduce the prevalence of tobacco smoking to below 5% by 2030. Amendment 276 requires the Secretary of State to introduce health warnings on cigarette sticks and rolling papers, in addition to the existing pack warnings. The claim that there is not yet sufficient evidence to justify the policy is a very weak excuse for inaction, and similar claims were made before the introduction of health warnings on cigarette packs. That is why the tobacco industry opposed them so strongly. These warnings on the packs are proven to be effective in reducing the prevalence of smoking tobacco, saving the lives of some of the people who were addicted to tobacco.

What is effective on the pack must be effective on the product, and 29 different studies have concluded that this would be the case. Other countries are considering this measure, and there is no reason why this country should not again lead the way.

Amendment 277 requires the Secretary of State to mandate pack inserts advising smokers about how to quit, and we know that very many smokers do want to quit. When the Government announced their smoke-free ambition in 2019, they said they believed that there was a “positive role” for such inserts, which they would consider as part of their review of regulations on exiting the EU. But the Government have inexcusably held back so far, making the lame excuse that

“further research”

is supposedly required to

“establish the public health benefit”—[Official Report, Commons, Health and Care Bill Committee, 28/10/21; col. 813.]

before proceeding.

The best research would be to introduce the inserts—at worst a harmless policy and something the tobacco companies could easily pay for from the huge profits they make from shortening the lives of half their customers. As the noble Baroness, Lady Masham, said, pack inserts have been mandatory in Canada for two decades. They have been shown to enhance motivation to quit, increase quit attempts and sustain quitting tobacco.

Amendment 278 would close a loophole in current legislation. In May 2020, it was rightly recognised that menthol can hide the harsh taste of tobacco and make cigarettes easier to smoke and more appealing to children; that is why it was banned. However, a massive loophole allowed flavouring to continue. The Government’s response on this issue in the other place was that

“it is not clear how a ban on flavours would be enforced in practice, as it would include a ban on flavours that do not give a noticeable flavour to the product.”––[Official Report, Commons, Health and Care Bill Committee, 28/10/21; col. 815.]

However, this has not been a problem in either the Canadian provinces or our European neighbours, such as Germany and Finland, which have successfully implemented a complete ban on flavourings.

In the year after the ban on menthol cigarettes came into force, Japan Tobacco made more than £90 million in profits from selling 100 million packs of its so-called “menthol reimagined” brands, which, it argued, were entirely legal. The loophole must be closed. I hope that the Minister will confirm that the Government plan urgently to step up a gear on tobacco regulation and support the tobacco-related amendments in this group.

[Lord Moylan (Con)]

My Lords, I am aware that, in your Lordships’ House, any lack of zeal for persecuting smokers marks one out as an aberration, but some realism has to be brought to this debate. It is my understanding that the Government will rightly resist these amendments so, in the interest of brevity, I will leave it to my noble friend the Minister to give a detailed rebuttal of each of them. However, I have a few things to say.

Unless smoking tobacco is made illegal, which would only bring with it all the organised-crime consequences associated with illegal drugs, the UK will not be smoke-free by 2030 or any other foreseeable date. There is likely to be an irreducible demand for smoking among both a small core of regular smokers and a wider population of people who enjoy the occasional cigarette. A sensible policy would recognise this and seek to accommodate it. There are widely understood risks to health associated with smoking, of course, but, as we have heard in this Committee, so there are with fat, salt, sugar and even fluoride. Despite all that, we have the constant efforts of well-funded zealots to bully and humiliate smokers and place burdens in the path of businesses engaged in the manufacture and distribution of this lawful leisure product.

Each of these amendments falls into one of those categories in one way or another, despite the smoothly expressed words of those who tabled them about increasing public information and the like. The public are already better informed about the risks of smoking than about almost any other topic. The UK is already highly regarded globally for its success in reducing the number of smokers. Those who wish to give up smoking deserve some modest help from public authorities, I agree, but they can be helped in other ways—for example, by diverting into products with much lower health risks. However, the campaigners against smoking cigarettes have been almost as determined to kill vaping as an alternative—although, as was indicated by the speech of the noble Baroness, Lady Northover, even public health officials are now beginning to question whether the initial blanket opposition to vaping is preventing some people making the transition from smoking cigarettes.

A similar question arises now as non-combustible tobacco products increasingly come on to the market. These contain tobacco but it is not heated to the point of combustion, although they still deliver nicotine to the user. Most of the harmful effects of smoking come not from the nicotine as such but from the smoke. Non-combustible tobacco products do not give rise to any smoke. The Government should be able to say, and make clear in their tobacco control policy, whether there should not be distinct regulations covering, separately, combustible and non-combustible tobacco products. I hope that my noble friend the Minister will be able to assure me that this will be so on sound public health grounds.

Covid-19: Road Map

Lord Moylan Excerpts

Tuesday 23rd February 2021 Lords Chamber

[Baroness Evans of Bowes Park (Con)]

My noble friend is right, but we should recognise that hospitals and staff have gone to extraordinary lengths to deliver non-Covid care and treatment, from online consultations to chemo buses and Covid-free surgical hubs. We have seen the benefit of these, with, for instance, almost 390,000 people being treated for cancer between March and November last year. But he is right: waiting times have increased. We have allocated £1 billion to help the NHS recover elective care backlogs. This will be enough funding to enable hospitals to carry out up to 1 million extra checks, scans and additional operations and procedures. We are well aware of the issue he raises. I thank everyone in the NHS for all the work they are doing, but we understand that more work needs to be done.

[Lord Moylan (Con)]

My Lords, as various noble Lords have said, the Government’s plan accepts that Covid is going to remain endemic in the population for many years to come. In fact, the Prime Minister stated in emphatic and, in my view, realistic terms that there is no credible path to a zero-Covid Britain. In that light, does my noble friend agree that the right response is for the UK to redouble its already world-beating efforts to develop and discover new and effective cures and treatments for serious Covid cases?

[Baroness Evans of Bowes Park (Con)]

I entirely agree with my noble friend. That is absolutely right and we have been at the forefront of that. He may be interested to know that we have also established a new partnership with vaccine manufacturer CureVac, which means that we are ready to build on our world-leading genomics expertise to develop new vaccines quickly if new variants appear. We have already placed an initial order for 50 million CureVac doses, in addition to the portfolio of more than 400 million doses that we have already secured. We believe that this will help ensure the ability rapidly to develop and deploy vaccines against any new variant or similar new diseases in the future.