Covid-19 Update

Lord Naseby Excerpts

Wednesday 8th December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank the noble Baroness for that question. As far as I am aware, the places administering the booster should be able to give that advice. For example, when I walked in for my booster, they asked which vaccines I had previously had and said that the half-dose I had was sufficient. When I asked about my children, they told me which vaccine was more appropriate for that age group, depending on which vaccine they had. If that advice is not available at the place of vaccination, please let me know. I was not aware of that and I promise that I can look into it.

While I am here, I realise that I did not answer the question from the noble Baroness, Lady Thornton, about the R number. It is currently at 0.9 to 1.1; the latest growth rate range for England is minus 1% to plus 1% per day. As the omicron data comes in, that may well increase, but we have looked at all these measures and are being as precautious as we can in balancing everything up.

In response to the earlier question about the pass—I apologise for the long answer—I have just been told that the NHS has tweeted:

“We are aware of an issue affecting access to the NHS COVID Pass on the NHS App and website. We are investigating this as a priority and will update as soon as we can”.


Clearly, the NHS has been listening to this debate and discussion, and I thank the noble Baroness for raising that. I am sure that noble Lords will agree that that tweet shows the effectiveness of having this debate, so that we can share as much information with the public as possible. I repeat this request: if any noble Lords are aware of any particular problems with the rollout, information et cetera, please let me know and I will investigate as quickly as I can.

[Lord Naseby (Con)]

Last evening, I mentioned to my noble friend the predicament of the 300,000 people who are housebound and cannot go and get a vaccination. I appealed to the Minister, saying that every GP practice knows who these housebound people are and where they live. Will my noble friend now commit himself and the NHS to making sure that every GP practice is asked to go out and give vaccinations to the 300,000 mainly elderly people who are awaiting vaccination?

[Lord Kamall (Con)]

I thank my noble friend for that question. As far as I am aware it has always been the advice that, if people are housebound, they should be able to receive their vaccination in their home. If my noble friend knows of any incidents where that has not happened, please let me know and I will chase them up.

Health and Care Bill

Lord Naseby Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Naseby (Con)]

My Lords, this is a watershed Bill at a watershed time for the National Health Service. I shall touch on a few issues but many more will come up in Committee. Before I do anything else, I offer my congratulations to Her Majesty’s Government on two dimensions. First, for the first time in my experience, Her Majesty’s Government, the NHS and the pharmaceutical industry have got together, worked endlessly and furiously—spending money, yes—and succeeded in producing vaccines that no other country has done at the same pace. That is a huge achievement. Secondly, I thank the NHS front-line staff and our new noble friend, who led them so well.

Of course there are problems. I declare an interest. My wife was phoned while at a party conference and asked to take over a practice because the doctor had disappeared. There were only about 600 or 800 patients. We scrubbed down the old butcher’s shop in Biggleswade and started up, and she built up as a full-time doctor the largest practice in east Bedfordshire. My son served in the Armed Forces as an Army doctor, so I know a little bit about that world.

The greatest thing for me as a marketing man is that, if you are going to solve the problem, you have to look at what is going wrong. I shall highlight a few areas. Frankly, the GP system today is not working. It is poor. The problem arose in 2014 when—I do not say anything party political here—GPs were absolved from looking after patients 24 hours a day, 365 days a year. They were given the opportunity to opt out. Some 90% did so. We went on to this new system and so it has developed. It is not a good system. The worst bit of it is that, when we hit a real crisis, as we have done, we see where it has all gone wrong.

I know it is wonderful to have all these magical technical things but triage is not working. You cannot get through to a doctor. How many people have told me that as a politician? You get through to a receptionist only after you have started at number 15 or 16 in the queue. There are no home visits. My dear wife got really bad Covid. Yes, 111 came out three times, but not once did we see our GP, although we had a couple of phone calls. She is recovered and well. Did we get a home visit afterwards? No. Does anyone who is elderly get a home visit? No, hardly anyone does. Even worse, yesterday’s newspaper said that 300,000 of our citizens are housebound. Every one of those is on a GP’s list, so I hope that every GP who covers those 300,000 people will be out next week ensuring that every one of them gets a jab.

Secondly, I have gone on about medical schools. I asked a Question about them in this Chamber on 26 October 2016. The point was made that medical school places were going to go up by 25%, with an additional 1,500 of them. Yes, that happened, but it was not enough. The crunch, as I said in my supplementary question to my noble friend Lord Prior of Brampton, the then Parliamentary Under-Secretary, was this:

“Today, 56% of the intake of medical students is female.”


That was five years ago; it is worse than that now. I have nothing against that—I am quite happy with 50/50—but, as I said then,

“70% of female GPs today work part-time, and a recent survey by the King’s Fund says that 90% of all medical students in training want to work part-time.”—[Official Report, 26/10/16; col. 197.]

Given the cost of £200,000-plus to train a GP, I proposed at that point that we have a situation, as in Singapore, where you have to sign on for four or five years to work in the NHS, which has paid for your career. I was told that that was perfectly “reasonable” and that the Government would consult on four years. Nothing has happened. If Singapore can work this, why on earth can we not? Our young people, male and female, after they have been given a superb education, should give back to society for four or five years. My son in the Armed Forces had to do that, so the precedent has been set.

One area that will need to be looked at is obesity. The Government are working with the industry, which has worked with the Government before. We need to have a situation where we look closely with industry, and not at the proposals that are currently in the Bill.

Cigarette Stick Health Warnings Bill [HL]

Lord Naseby Excerpts

2nd reading
Friday 3rd December 2021 Lords Chamber

[Lord Naseby (Con)]

My Lords, I declare an interest; I have never smoked in my life, but I hold a modest amount of stock in British American Tobacco. More importantly, in the late 1960s, I was a director of a substantial advertising agency handling the Gallaher brand’s advertising, and I have therefore taken a particular interest in this market ever since.

I remind the House that we are talking about a legally marketed product, not one that is illegal on the market. There are, as noble Lords will know, significant health warnings on the packaging. That was introduced not so very long ago. I was in the communications industry; there is no evidence that those warnings are now useless or diminishing in effect. If you go into any CTN or tobacconist’s today, the cigarettes are not on display; they are behind the shutters, and that is all well controlled.

In my judgment, the Government should focus on investing in public information campaigns, which they have been doing. That is a much more effective way to raise awareness of the impact of smoking and highlight the widespread availability of alternative smoke-free nicotine products such as e-cigarettes, nicotine patches and heated tobacco products.

In addition, the regulations are already clear that tobacco products with a clearly noticeable taste or smell other than that of tobacco are prohibited. We do not need any new regulation. When one looks also at the purported health benefits of implementing a ban on using flavours as ingredients, it is entirely speculative. The ingredients do not encourage smoking or prevent smokers quitting.

On the question of age, I remember that when I was flying for national service in Canada at the age of 18, there was a ban on young men going into pubs if they were under the age of 21. All we did was make sure we found someone who was 21 and he bought the alcohol. Exactly the same would happen here. At the age of 18, adults are well aware of the risks associated with smoking and should be free to access a legal product if they so wish, as they do with alcohol. Raising the age to 21 will not change the demand for the product. Instead, it will result in 18 to 21 year-olds shifting from legal, tax-paid products to unregulated and untaxed products from illegal channels.

On a practical level, the age at which people can access restricted projects such as alcohol, tobacco, vaping, betting and the National Lottery has thankfully been standardised by Her Majesty’s Government, and it would be an absolute waste of time and confusing to the consumer if this bit of another market was done at different age.

Then there is a call for stricter control of retail licensing of selling tobacco products. But the tobacco traceability and security features system, known as the track and trace system, already provides a de facto retail registration scheme. An important point is that retailers cannot legally sell tobacco products unless they are registered through this system. Alongside that are regular, unnoticed, unnotifiable checks on all retailers. That is the most effective way to ensure that they comply with that. The most effective way to protect legitimate businesses and government revenues, as I point out to my noble friend on the Front Bench, is through the tobacco traceability and security features system registration and the enforcement measures associated with it. That is key to the whole thing, really.

The tobacco industry itself supports a significant increase in penalty thresholds, reflecting the quantity of illicit tobacco that has been seized, and whether it is a first or second offence that has been committed. As I understand it, the tobacco industry currently adopts and advocates a wide range of measures to prevent young people taking up smoking. For instance, as we all know, there is the CitizenCard—although perhaps we do not all know, judging by one or two of the comments made this afternoon. That card is recognised by the PASS proof of age scheme and supported by the Home Office, the Chartered Trading Standards Institute, the Security Industry Authority and the National Police Chiefs’ Council. In conjunction with the proof of age card, the CitizenCard runs a wide UK campaign, and that creates a good barrier to prevent underage people buying tobacco products. If any retailers do not do it properly, they are reported to trading standards for follow-up and possible enforcement.

Finally, looking at the industry levy itself, following a public consultation by Her Majesty’s Treasury in 2015 into the design of a levy on tobacco manufacturers’ profits, the Government concluded that it would be unworkable and so decided not to introduce it. Nothing has changed since then, and the reasons for rejecting this approach remain valid. On 16 June Her Majesty’s Government restated their position on the tobacco levy:

“We do not believe a levy is an effective way to raise revenue or protect public health.”—[Official Report, 16/6/20; col. 189.]


I will finish on the question of whether there should be a profit cap on individual manufacturers and importers. At this time and in this country, we do not want to put a message out to the world that we, as a Government, are interfering in a legitimate business, and wish to ensure that it is difficult for that to go forward. This Bill is totally misguided. Its promoters are ignoring the extensive controls that there are already. It interferes with individual liberty to choose, and above all it sends out a message that the UK is hostile to business, which is not a message that I wish to see.

--- Later in debate ---

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

My Lords, I add my congratulations to my noble friend on progressing his Private Member’s Bill to this stage and on securing this important debate.

Over the past two decades the UK has introduced a range of public health interventions and a strong regulatory framework to help smokers quit, and to protect future generations from using tobacco. Thanks to these, smoking rates in England are down to a record low of 13.9%, from 19.8% in 2011. If we go back even further, we see that the smoking rate was at 45% in the 1970s. As the noble Baroness, Lady Merron, has said, these reductions have been cross-party; Governments of all colours have tried to tackle this issue.

Those reductions are something we should be very proud of but not complacent about. While we celebrate this success, we recognise that there are still 6 million smokers in England, with smoking remaining one of the biggest causes of preventable mortality and, as a number of noble Lords have acknowledged, one of the largest drivers of health disparities. One of the reasons why I am very pleased that we now have the Office for Health Improvement and Disparities is that there will be a laser-like approach in the attempt to tackle these disparities.

Smoking rates still range from 23.4% in Blackpool to 8% in Richmond upon Thames. In addition, smoking rates vary significantly among certain groups. Nearly one in 10 pregnant women still smoke, increasing the risk of health problems for their babies. The Government are determined to reduce smoking rates in groups that smoke disproportionately, as well as across the board—so, work is going on not just in respect of pregnant women but elsewhere. For example, we know that 23% of routine and manual workers smoke, while the rate among people with long-term mental health conditions is nearly 26%. That is why there is so much to do. We have to make sure that we understand those parts of communities where we can, laser-like, focus our action. That is why the Government have set the bold ambition for England to be smoke free by 2030.

The Government recognise the good intentions behind the Bill. I pay tribute to my noble friend Lord Young of Cookham not only for the Bill but for his long-standing commitment to encouraging smokers to quit. My noble friend himself has told me about his work in the 1970s but also as a Health Minister in the 1980s. Let no one be in any doubt that the Government are clear that we strongly support measures to stop people smoking but also to educate current smokers of its dangers. We have already introduced a number of measures, such as graphic health warnings on tobacco packaging and information on packs giving further advice on how to quit.

While we sympathise with the aims of the Bill, we believe that policy should be evidence-led. It is therefore vital that we conduct further research to build up a strong evidence base to support measures before bringing them forward. To date, sadly, no country has introduced such a measure so there is very little evidence so far on its impact in supporting smokers to quit, compared with other measures we are looking at. Several other measures have been tried in other countries—for example, warnings inside the pack as well as outside—and there are a number of other issues we are examining.

The Government are in the process of developing a new tobacco control plan that will include an even sharper focus on tackling health disparities and will support the Government’s levelling-up agenda. We want to explore a broad range of new regulatory measures to support our ambition to be smoke free by 2030. So, I reassure noble Lords that we will be reviewing this proposal as part of that work.

I turn to some of the specific questions that were asked. A number of noble Lords asked about the tobacco control plan. Rather than implementing blanket measures that may not always reach some of the communities that need to be reached, we want to ensure that the plan has an even sharper focus on disparities and that it supports the Government’s levelling-up agenda. We need bold but impactful proposals. With the establishment of the Office for Health Improvement and Disparities, we are going to draw on its advice on how to address the high levels of smoking among some of these groups, and harness that advice to develop robust and effective proposals that will ensure that our plan delivers the smoke-free 2030 that this country deserves.

We are developing policy for the tobacco control plan and intend to publish it next year. There is a current tobacco control plan, which runs until 2022. We hope to include a number of measures that focus on health disparities and groups where smoking rates are not falling fast enough. I have already mentioned pregnant smokers and smokers with mental health conditions, but that also includes smokers in many deprived parts of the country.

We were asked about the amendments to the Health and Care Bill. We were grateful for the suggested amendments, which show support for strong tobacco control, but once again we need to see the evidence and make sure that such measures are targeted at groups we want to encourage, as well as more generally. At this stage we do not believe we should accept the amendments but, as I have said, next year we will be publishing our new tobacco control plan, since the current one runs until 2022.

Some of these examples include stop smoking services, which we have found produce high quit rates of 59% after four weeks. Since 2000, they have helped nearly 5 million people to quit. We have also protected a public health grant over the course of the spending review to ensure that local authorities can continue to invest in stop smoking services, because they have been seen to be successful. As long as they are successful, they will continue to be part of our armoury.

The noble Lord, Lord Moylan, asked about evidence. The Office for Health Improvement and Disparities continues to monitor developments in tobacco control across the world. We share our knowledge with international partners and draw on their evidence-led experiences to make sure that we are introducing effective measures, rather than just introducing measures we feel might work without evidence.

The noble Lord, Lord Rennard, talked about youth smoking. He is absolutely right, but youth smoking rates continue to decline, and they are currently at their lowest rate on record. In 2018, 5% of 15-year olds were regular smokers, 2% of 11 to 15 year-olds were regular smokers, and 16% had never smoked. While the youth rates are declining, we should not be complacent. We know that smoking remains an addiction largely taken up in childhood, with the majority of smokers starting as teenagers and then becoming addicted. We want to build on that recent success and protect young people from harmful tobacco, and we have an area of focus targeted at that.

My noble friend Lord Naseby talked about the tobacco levy. We recognise that the tobacco industry is already required to make a contribution to the public finances through tobacco duty, VAT and corporation tax—in many ways, it pays our wages. The department will continue to work with HMT regarding tobacco taxation and revenue funding. This includes reviewing options such as the future levy, but we want to make sure that it is an effective way to raise additional funds to support stop smoking services.

The noble Baroness, Lady Uddin, was very honest in her appraisal of her ability to stop smoking in her family. But she made some interesting points, not only about having failed to prevent her family smoking but about whether young people will read the warnings on the cigarettes. I think that is a point we have to look at. Will they be dismissed, just as the effectiveness of the warnings on the outside has waned over time? Will the same thing happen here?

[Lord Naseby (Con)]

As I mentioned, I spent 20-odd years in advertising. The Bill says that the warning has to be in red on blank white paper—quite frankly, that will be very difficult to read. If my noble friend is serious about this, I suggest he takes advice from those who know a little more about printing.

[Lord Kamall (Con)]

I thank my noble friend Lord Naseby for that intervention; I will take account of his advice. In fact, I want to thank him for his advice, given the number of years he spent in the advertising industry. Something we are looking at generally in the public health approach in this country are those experts from the advertising industry who have looked at behavioural studies and behavioural economics to encourage people to buy their products or to smoke, and to attract a number of them—as poachers turned gamekeepers—to help us understand the skills they use to attract smokers and people eating high-fat food, and to turn that around to discourage people from taking up smoking and eating food that might cause obesity.

The noble Baroness, Lady Uddin, also talked about smoking in pregnancy, and we recognise this problem. It is sad that 10% of pregnant women still smoke, and they are not falling in line with other groups. Therefore, we are looking at how we address that at prenatal and neonatal clinics, but also during that whole experience. How do we reach those mothers, and would that really be effective?

One of the questions asked was about a number of different ideas that came up. Basically, we want to follow the evidence. That is really important. There is a tobacco plan already in progress, which will end in 2022. Next year, in 2022, we will publish the new tobacco plan, and we are looking at evidence from around the world and at what works. But we also want to see how we can work across government. For example, we are working closely with the Department for Education to ensure that the harms of smoking are in the curriculum, but many of us will remember being at school and receiving education on a number of different issues related to lifestyle. A number of my friends would say, “I’m never going to smoke or drink”, and two years later, I would see them at parties, smoking and drinking.

Therefore, we have to understand how effective these messages are, how long they work for, and how we can make sure that they continue to work. We understand and accept that we need to continue to take action; we must not be complacent. We want to look at the evidence: some 64,000 people still die each year from smoking; two-thirds of long-term smokers will die from it; it is one of the greatest drivers of health disparities and, as many noble Lords have said, it causes a great, heavy financial burden. In fact, each year smoking costs society £12.5 billion, with a cost to the NHS of around £2.5 billion. We believe that making smoking obsolete would free up £15 billion per year, benefiting especially the most disadvantaged families and the most deprived communities.

Given the lack of evidence and the other measures being considered, the Government do not feel that the Bill is appropriate at this point in time. However, the Bill’s requirements will be considered as part of the wider range of regulatory proposals to support our smoke-free 2030 ambition. We want to see evidence-based, targeted proposals and to make sure that they are effective.

I once again thank my noble friend Lord Young of Cookham for this important debate and encourage him to continue pressing the Government. I also thank noble Lords for their insightful contributions.

[Lord Young of Cookham (Con)]

My Lords, I thank everyone who has taken part in this debate, starting with the noble Lord, Lord Rennard, whose long-standing commitment to the campaign to reduce the harm done by smoking is well known; he also underlined the all-party commitment. He trailed the broader package of a suite of measures as part of the APPG manifesto published earlier this year, of which this is one component. We look forward to taking that agenda forward on the forthcoming Bill.

My noble friend Lord Naseby and I have been on opposite sides of this debate ever since we both joined the House of Commons on the same day in 1974. I was reading last night a contribution that he made in May 1980, much of which he repeated today, showing consistency. I say to my noble friend that much of his speech was not about the Bill but about raising the age limit, the licensing regime, a potential levy and a tax on profits. I understand that. He described the promoters of the Bill as misguided. I wonder whether he would like to reflect on that, given the wide range of health organisations that I mentioned—for example, the Royal College of Physicians and Cancer Research UK—and whether he also believes that they are misguided in supporting the Bill.

[Lord Naseby (Con)]

The misguided bit is that the promoters of the Bill have not taken any advice on communication. It is quite clear to me, as one who has been a professional in that world, that to place a communication, as my noble friend suggested, on a narrow cigarette that is burning away, in red on a white background, is not good communication.

[Lord Young of Cookham (Con)]

I will come to that specific point, but he described the promoters of the Bill as misguided and I was making the point that he includes among those misguided people a very wide range of serious health opinion. As I said, I will come to his point.

The noble Baroness, Lady Uddin, put the Bill in personal terms. I am grateful for her contribution. She made the point that we need to move on from the health information on packs, which is now taken for granted, to a new means. On my noble friend’s point, he raised the question of whether it would be easy to read. A cigarette is right under your nose so it is probably easier to read what is on the cigarette than what is on the pack. Also, the pack is not seen by other people, whereas, if you put a message on the cigarette, those in the company of the smokers will also see it. I see that as an added advantage of this move.

I listened with some disbelief to my noble friend Lord Moylan. He started off by saying that he was surprised that I had introduced this Bill in the middle of a pandemic, implying that I should wait until the pandemic is over before introducing what I think would be a very useful health measure. Astonishingly, he described the message that I want to put on the cigarettes—“Smoking kills”—as propaganda. Even the tobacco manufacturers now admit that smoking is bad for your health. I just wonder whether my noble friend has ever read the 1962 report of the Royal College of Physicians—the whole weight of evidence. The health warning that smoking kills, and damages your health, is not propaganda but accepted health fact. He should move on.

My noble friend then described the 2030 target for a smoke-free England as ASH’s target, but it is not; it is a government target to which the Government have committed—I look to my noble friend on the Front Bench. Finally, my noble friend Lord Moylan described what I am doing as patronising. There is the libertarian wing within my party, of which he is clearly a member. I have listened to these arguments about things being patronising for the last 30 or 40 years. When there was a proposal to introduce compulsory crash helmets for motorcyclists, that was described as patronising. Parliament legislated and I do not think there is any question of repealing that. I heard exactly the same argument about seatbelts for drivers and then passengers; people said that was patronising legislation. I heard it about banning sponsorship for sporting events and banning smoking on public transport and then in public places. I am sure I will hear it again during the passage of the Health and Care Bill, which has a provision for adding fluoride to water.

Every single one of those measures has been adopted by Parliament, and I do not think anybody would seriously suggest that any of them should be repealed. In due course, measures such as the one I am promoting today will be accepted as conventional wisdom. I hope that, in a few years’ time, my noble friend will accept that this is the direction in which public opinion is moving. As I pointed out, this is a popular measure; it is popular within my party. I am glad I have got that off my chest.

I am very grateful to the noble Baroness, Lady Merron, for her support and her predicted support for the other measures that I and other noble Lords will introduce as amendments to the Health and Care Bill, which gets its Second Reading on Tuesday. That is much appreciated, as is her own record as a Minister in the Labour Government.

Finally, I am grateful to my noble friend the Minister, whose personal commitment to reducing the damage done by smoking shone through his speech. He put the Bill in the slightly broader context of government policy and recognised the imperative to drive down smoking. He said he had strong support for measures to stop people smoking. I will pick up one or two points from his speech for which I am very grateful. He said that the tobacco control plan would be published next year. “Next year” spans several months, so I wonder whether he could at some point be a little more specific about the timing of this plan, for which we have been waiting for some time, rather than referring just to 2022. He made the point that everyone is waiting for robust evidence. If everybody waits for robust evidence, no one will provide it, so at some point a country has to go first. I was grateful that he said that while he was unable to support this measure at the moment, he would consider it as part of the suite of measures to be looked at as part of the tobacco control plan. I accept what he says. That about sums up everything.

Covid-19 Update

Lord Naseby Excerpts

Monday 29th November 2021 Lords Chamber

[Lord Kamall (Con)]

All I can do is thank the noble Baroness for her question. I will have to double-check; as she will imagine, I do not have all the answers at the moment. Throughout the day, as I was preparing for this, the advice was changing constantly, and things were being swapped in. Advisers from the Department of Health and Social Care were saying, “This is the latest advice”, but it was changing literally hourly. I will try to get the latest advice and share this with noble Lords.

[Lord Naseby (Con)]

In light of the overall success of the vaccination programme, is it now a condition of employment that every new recruit to the NHS, at every level, must be vaccinated against Covid and agree to accept any future recommendations on protection against it?

[Lord Kamall (Con)]

As my noble friend will be aware, vaccination as a condition of deployment has been brought in for the social care sector. It will be brought in for the wider NHS, but there is a grace period in certain cases. Management are being encouraged to meet with staff to encourage them, particularly staff who are vaccine-hesitant. There is a grace period to see us through the winter period; it runs up to April next year. However, we are encouraging as many members of NHS staff as possible to get vaccinated and we have a high rate of vaccination so far.

Smoking Cessation: Prescription of E-cigarettes

Lord Naseby Excerpts

Tuesday 2nd November 2021 Lords Chamber

[Lord Kamall (Con)]

As the noble Lord will know, some of the issues are related to leaving the EU, but it is interesting to learn from conversations with the MHRA that it is hugely excited about its ability to be more global in its outlook and to be a centre of expertise that many people across the world will want to learn from. With respect to international engagement, as well as making sure that it updates its guidelines to take account of medical technology there will be ongoing reorganisation and changes, and it hopes to be fit for purpose for many years to come.

[Lord Naseby (Con)]

My Lords, is the Minister aware that, as I understand it, there is a problem with the MHRA budget? This is important work. Furthermore, is it not a fact that the industry itself is supporting this work?

[Lord Kamall (Con)]

It is very important that we get the MHRA to approve these e-cigarette products. The MHRA is seen as a jewel, to which many experts from other countries look. One of my roles is international health diplomacy, and many people I talk to from other countries are very impressed with the work of both NICE and the MHRA. We can use that in our international health diplomacy.

Coronavirus Act 2020

Lord Naseby Excerpts

Tuesday 26th October 2021 Grand Committee

[Lord Hunt of Kings Heath (Lab)]

My Lords, I thank the Minister for his comprehensive introduction to the debate and the statutory instrument. Of course, Covid has brought unequalled challenge to us—a challenge that we have not seen for decades. It has disrupted our lives and many people have died as a result. Of course, the powers that the Government have taken to themselves have been quite exceptional. I do not agree with everything that Big Brother Watch says, but I think it is right to point to the draconian nature of some of those powers. I was very glad the Minister said what he said in relation to Schedules 21 and 22. My understanding is that every single charge made under those schedules was found to be unlawful. As he read out the powers, I shall not repeat them—but they are draconian. They may have been justified, but they were misused. The Minister said that they will be withdrawn. Can he clarify whether they will be withdrawn through a statutory instrument?

The second area I wanted to raise is parliamentary scrutiny. The noble Lord, Lord Cormack, raised during the Urgent Question repeat in the Chamber the point that the Government now seem to announce everything in the media before coming to Parliament. The way in which Parliament has been dealt with over Covid has been very unsatisfactory. We have had more than 500 pieces of secondary legislation; most were rushed out and considered by Parliament retrospectively. The Justice Select Committee reported on this and stated:

“Parliament plays an important role in making sure that the law and any new criminal offences are so far as is possible intelligible, clear and predictable. It is not satisfactory … that Parliament was not … able to fulfil its function when Members were required to consider statutory instruments already superseded”—


this has happened on a number of occasions.

Although it falls to the Commons to vote on the renewal of powers, while we have simply a Take Note approach, the powers are substantial and I must say that I do not think that they should be debated in Grand Committee; they are important enough to be debated in the Chamber and I find it very disappointing that we are here, having to do it in this way.

It is notable that, since we came back in September, there have been hardly any debates on Covid. Again, I find this very worrying, and I would like the Minister to tell me why there have been no Statements. I think the Statement last week was the first one we have had on Covid since we came back. This really is not satisfactory and hardly counts as parliamentary scrutiny.

I also ask the Minister what has happened to SAGE. There has apparently been a downscaling of SAGE’s role. It seems that it now meets only once a month. Can the Minister confirm that and tell me why it is? A government source has been quoted as saying that there is now a lessened demand for scientific advice. Well, I do question whether that is accurate. We are still in a difficult situation: Covid infections are rising and there is a real risk that the booster jab and school vaccinations are behind where they ought to be—hence the Minister’s comments at the end of his introductory speech. My concern is that the Government’s mistakes and, frankly, dubious exceptionalism at the beginning of Covid look like being repeated time and again.

There was another very good joint Select Committee report, from the Health and Social Care and Science and Technology Committees, which was published on 12 October and looked at what has happened over the past 18 months. The report pointed out that the UK was not alone in having suffered badly because of Covid, but we did significantly worse in terms of deaths than many countries, particularly when compared to those in east Asia, even though they were much closer geographically to where the virus first appeared. The report said the UK’s pandemic planning was too narrow and effectively based on a flu model, which failed to learn the lessons from SARS, MERS and Ebola.

Particularly telling was the report’s comment that the Government’s desire to avoid a lockdown because of the harm to the economy that it would entail had a big impact. In the absence of other strategies such as rigorous case isolation, a meaningful test and trace operation and robust border controls, a full lockdown was inevitable and should have come sooner. We saw history repeat itself last autumn, when the Government’s decision not to have a circuit breaker did not follow the scientific advice and Ministers were clearly optimistic in their assumption that the worst was behind us during those summer months.

The question before us today is whether history is repeating itself. We know that our weekly death rate stands at three times the level of other major European nations. We know hospitalisations are rising, and they are certainly at a higher level than in many countries on the continent. The decision to end compulsory mask wearing and to pause plans for vaccine passports in England has made the Government an outlier in their management of the pandemic. By contrast, western European countries such as France, Italy, and in particular Spain, have brought down infection rates to their lowest level since the summer of 2020.

The Government have not been short of advice. When the latest October minutes from SAGE came out, they pointed to current population behaviours being estimated as being closer to pre-pandemic norms than at any point since March 2020—which I think means that people are not wearing masks very much and are not distancing themselves socially. SAGE pointed to early interventions that may reduce the need for more stringent, disruptive and longer-lasting measures to avoid an unacceptable level of hospitalisations.

We have also heard the NHS Confederation calling for not just plan B to be implemented but plan B-plus: calling on the public to mobilise around the NHS and do whatever they can to support front-line services this winter. On the other hand, it has been reported that modelling by the London School of Hygiene & Tropical Medicine has suggested that cases will peak soon and fall away steeply in the winter months. So I ask the Minister to set out current ministerial thinking. I see the temptation to wait and see, in the light of the London School’s modelling. On the other hand, every time the Government have waited and seen, they have turned out to be wrong, so I think at the very least we ought to know today the hard thinking behind the Government’s position in relation to plan B.

[Lord Naseby (Con)]

My Lords, I declare an interest in that I am married to a doctor, a former GP who ran a big practice in Biggleswade.

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

I am sorry, there is a speakers’ list. The noble Lord, Lord Scriven, is next.

--- Later in debate ---

[Lord Naseby (Con)]

I am most grateful. I will make three points about communication. Last Saturday, I queued up at Chicksands centre—two hours’ queueing, with no appointment. Fine—I make no criticism of what was done there. But I then found out that Biggleswade, a town of 30,000-plus which previously did jabs, has no provision. So my advice to my noble friend is to double-check in all the substantial towns to make sure that there is jabbing going on.

Secondly, I mentioned my wife earlier. I declare an interest in that she is a doctor. She was very ill with Covid; she came out six months ago. There was no GP contact and nothing from the hospital. We will monitor it and make sure she is all right, but we are waiting to see whether she gets any communication from anybody—for a woman aged 83.

Thirdly and finally, I was in charge of the communication for the three-day week for an advertising agency. I met daily with the department involved, and the Minister, and we ensured that we had mass communication. Frankly, I see very little in the nationals or in the local papers. I see nothing in the ethnic newspapers and I do not see anything on television. If you want to get this hard core to have vaccinations, you have to swamp the media. I was a professional advertising man before; you do tell them once, you do not tell them twice—you tell them 10 times and then they might hear. I thank noble Lords again for allowing me to take part in the gap.

Covid-19: One Year Report

Lord Naseby Excerpts

Thursday 25th March 2021 Lords Chamber

[Lord Naseby (Con) [V]]

I would like to mention the wearing of face coverings. I have one general question, to which I do not know the answer, and I suspect that the Minister does not, but we need to think about it. At what point do we stop using masks? Will it be when the level of infection is low enough—similar perhaps to the level that we achieve with flu, or whatever? It would be helpful from a medicinal point of view to have some knowledge of when we think it might happen.

My main comments are on the facilitating of elections. The key element in this SI is about voting. Indeed, a few days ago we had a good session on proxy voting, and I welcomed that and commented on it. With this SI we are making provision for the local elections on 6 May and, of course, there is at least one by-election outstanding. Frankly, for once I would just like to say “Well done” to the Minister and his colleagues. The local elections of 6 May are important, and the objectives in Regulation 2(2) are to ensure that voting in polls is held in accordance with the Act and that supporting activities in the weeks preceding the poll, such as campaigning and nomination, take place in a way that minimises transmission risk while still allowing a meaningful campaign. Somebody has thought about that, and I say, “Thank you very much”. There will be hundreds of campaigners out there knowing that, for once, they have a clear steer on what they can and cannot do. Furthermore, someone has had the bright idea that somebody will have forgotten their mask or ignored the fact that they should be wearing one and, as I understand it from the SI, face-covering material will be made available at every polling station.

It is also good to see that candidates and agents will, I assume, be guaranteed access to the counts. That is implied, but I think it needs to be spelled out. Additionally, I am not sure whether my noble friend has done much standing as a candidate—let us assume for a moment that he has not. It is not just the people doing the counting who are important but those who are verifying and checking it from across the table. There is usually a wide span there, so I would have thought that they must be nearly two metres apart. That is very important in marginal seats.

I note also, on the extent of territorial application, that this applies only to England and Wales. All I ask is whether it is similar to what is happening in Scotland and Northern Ireland? I confess that I do not actually know whether they are having local elections there or not—and I should have checked that out, so I apologise.

As a side comment, I am pleased about the clarification for students on their movements between university and home. My noble friend will remember that there was great excitement last year, when it was not at all clear—but it is now quite clear, and that is good. The regulations refer to the facilitation of campaigning in pursuit of electoral success—people being allowed to leave home, and so on. That is good. Again, it will be achieved by allowing people to leave home and gather where necessary to undertake campaigning activities in relation to elections and local referendums. So thank you for that, Minister, and well done to all those who were involved.

I will make a couple of general comments and highlight two issues. I hope that somebody is now preparing a review as we move along of what has gone well and what has not gone well—and care homes did not go well. I took an interest right from the beginning because I always felt, as a Member of Parliament, that they were a key part of my constituency. I used to make sure that I visited them roughly speaking at least three times a year. They were handled pretty shabbily right at the beginning and put at great risk, having to receive patients without testing having been done by the hospitals—and there were other problems. However, to be fair, the Government have listened on that front and action has been taken.

Secondly, the military is a wonderful resource for this nation and for every other nation that has suffered the pandemic. Some nations have recognised—

Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021

Lord Naseby Excerpts

Monday 22nd March 2021 Lords Chamber

[Lord Naseby (Con) [V]]

My Lords, I thank my noble friend on the Front Bench—my goodness, he has broad shoulders—and I warmly support the action he is taking and this SI. I have a couple of questions and concerns.

The first is about the designated entry points. It is obviously easy to do this with flights that come in direct but what about other routes? I have in mind Scotland; I am not sure what is happening there. It is pretty easy to fly into Edinburgh or Glasgow and get across the border. My noble friend from Northern Ireland raised the point that there is not really a border between north and south there. The noble Baroness, Lady Meacher, raised a question about Europe, particularly the areas that are entering the third version of the pandemic. Are they on the red list or not? Secondly, why is it taking quite so long to process people at London airports? The traffic levels are about 25% of normal, yet I was told by somebody last week that it is taking five to seven hours to be processed. There is much talk that they are understaffed.

On paragraph 6.2 of the Explanatory Memorandum, is the passenger locator form working smoothly now? I am not clear about UK nationals coming back from the red zone. Can they isolate at home? I congratulate my noble friend: having had to isolate and caught Covid, I was checked up on by the trace people and by the local authority.

I see that the expiry date for these provisions in 8 June. If they have to be renewed, when will that be?

Finally, I have a question about asylum seekers coming through the red zone. They will not have the resources to pay for a hotel if they are put in one, so how will they be handled? Absolutely finally, the vaccine passport is vital.

Future of Health and Care

Lord Naseby Excerpts

Tuesday 23rd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are putting considerable resources into hospital rebuilding, with 40 hospitals being built over the course of the Parliament; that is a major investment programme. The investment in population health comes out of different budgets. We are looking at how we will use ICSs to bring population health and responsibility for the outcomes of popular age and health metrics much more closely to GPs and hospitals. This oversight needs to be corrected, and it is one of the primary objectives of this Bill.

[Lord Naseby (Con) [V]]

My Lords, speaking as the husband of a former full-time GP, I ask whether the Minister is aware that neither general practice nor community care are meeting patients’ needs today and they require a total review. Also, is it fully understood by government that there is insufficient capacity in our current hospitals and that we need to build more? Having said that, I say that the vaccination programme is brilliant—and I place on record my sincere thanks, from the bottom of my heart, to the NHS staff at Bedford Hospital for saving my wife’s life.

[Lord Bethell (Con)]

I will indeed share my noble friend’s tribute to the vaccination programme and to Bedford Hospital for saving Lady Naseby’s life, for which we are all enormously grateful. However, I would probably leave his company on his remarks on GPs; they are extremely effective in the service they provide to their local communities. The patient satisfaction surveys do not support his contention that there is a massive gap there.

We are committing to building new hospitals in order to expand our capacity, but the essence of the measures in this Bill is more about prevention, population health and supporting better outcomes for the kind of public health measures around things such as obesity that ensure that people do not have to spend their time in hospital when they feel ill and, instead, have an early-stage intervention.

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

Lord Naseby Excerpts

Monday 8th February 2021 Grand Committee

[Lord Naseby (Con) [V]]

My Lords, my wife and I tested positive at the beginning of January. We isolated. Half way through the isolation, my wife was taken seriously ill and taken into Bedford Hospital. Thankfully, she is now at home. I pay a major tribute to the efficiency of the testing at Bedford town car park, and particularly to the care and attention in Bedford Hospital.

On Saturday, I had my coronavirus jab. The whole thing took 10 minutes. It was brilliantly organised. I spent some time talking to the volunteers, and we owe a huge tribute to them. In that context, I hope that some plans are being made for the Prime Minister to write a letter to all the volunteers who have come forward and taken part.

I have three pleas to my noble friend on the Front Bench. One comes from me as a marketing man. The tiers have worked, but one thing you learn about marketing is that you need to refine down areas, particularly if you are test-marketing new products. We are not test-marketing new products; we are test-marketing something which we cannot totally get a grip on. I wonder whether it would not be more sensible, instead of thinking about district council areas, to hone down to major towns and have a close look at them. That way, we would begin to really get a grip on it.

Secondly, on timing, any organisation—whether it be a business, a school, or whatever—needs time to plan ahead. I hope that when the Statement is made on 22 February, the Government will be planning for approximately three weeks’ notice of any substantial change.

Thirdly, I again make a plea for sport. I declare an interest as president of Northamptonshire County Cricket Club. There was virtually no cricket at all last year. The new season starts, if my noble friend would like to note it, on 8 April with county games across the country. All the 18 major counties have Covid-secure grounds. A huge amount of energy, money and resources have been put into those 18 grounds. The staff are well briefed and organised; the players are the same. Can we please try really hard to start off this season—perhaps confining it to one member and one guest at the grounds? I hope that when the Twenty20 comes round, which will not be until the beginning of June, we will be in a position to open up to the public.

Finally, I make a plea for Wimbledon and declare an interest as a member. Wimbledon’s championship is the leading tennis championship in the world. A great deal of work has gone into ensuring that we can, if at all possible, hold a championship this year in the first two weeks of July. There would be no finer advertisement for UK Ltd, and for the great British public, than to see Wimbledon happening with spectators in those weeks. I wish my noble friend all success in the way he is handling these things, and to the teams working for him, I say: thank you—you have done a superb job.

[Lord Clark of Windermere (Lab) [V]]

My Lords, I thank the Minister for all the work he has done in fighting this terrible pandemic. I wish him well with all his efforts in future, but perhaps I can be a little critical of details today, because underpinning this SI are the basic nuts and bolts which make the system work—and they are creaking in places.

We sometimes do not realise that there is a difference between guidelines, which are what Ministers would like us to do but do not have the force of law, and regulations, which do have that force. As we have gone through the tiers created by the Government over the past year, some of the issues have been about guidelines and some about regulations. Let me give a couple of simple examples.

Colleagues will recollect that at the beginning of the year, two women were handed fixed penalty notices by Derbyshire police for reportedly travelling five miles for exercise. The police force subsequently stated that it was reviewing the action based on new national guidelines, but the issuance of the notice was still supported by the Health Secretary, although it did not have the force of law. Then of course we had a similar case—I am not making this as a political point—when the Prime Minister was cycling 18 kilometres to ride around a park in London. I have no trouble at all with that, but the issue is that it causes problems on a wider scale, and with tragic results.

I live in a national park. As I look out of the window, the snow is falling—the hills are covered in snow. Although people have guidelines that the Government’s wish is that they should not drive to the Lake District, but they do. Every weekend, they are still driving regularly from Manchester, Newcastle, Liverpool, Kent and London. That is not illegal, but they are not allowed to spend the night. How do you trap people who are sometimes spending the night?

We had a tragic incident this last weekend involving the mountain rescue, which has been called out several times, when two young men went camping on the mountains above Kirkstone Pass. One of them got chest pains and called the mountain rescue in the middle of the night—it was two in the morning. One member of the mountain rescue slipped and fell; he has very serious injuries.

However, the police cannot stop people driving in to camp. Once they have camped, they can be issued with penalty notices because that is in a regulation: you cannot stay overnight in an area such as this. I am arguing that there needs to be some consistency in the regulations and guidelines so that we know where we stand, and that the police also know what they can and cannot do.

[Lord Naseby (Con) [V]]

I just pushed on the button that said unmute—

[The Deputy Chairman of Committees (Lord Caine) (Con)]

I call the next speaker, the noble Baroness, Lady Warsi. Could the noble Lord, Lord Naseby, please mute himself?