Covid-19: Masks

Lord Naseby Excerpts

Thursday 11th June 2020 Lords Chamber

[Lord Naseby (Con) [V]]

Back in March, we were told by the Health Secretary, Matt Hancock, that the science behind the general population wearing masks was “extremely weak”. At the same time, the WHO said to wear masks, and Germany and the others followed. Two months later, based, presumably, on new evidence that no one has seen—if, in fact, there is any evidence at all—we have advice on transport and hospitals; I am not sure about advice for care homes, or whether they have been forgotten again. The WHO continues to advise 1-metre distancing, and that is immediately followed by France, Italy and the others. Meantime, we poor souls have to stick with 2 metres, and a whole host of queries around why the WHO advice is yet again being ignored. Frankly, this is not acceptable.

Draft Human Tissue (Permitted Material: Exceptions) (England) Regulations 2020

Lord Naseby Excerpts

Monday 18th May 2020 Lords Chamber

[Lord Naseby (Con)]

Good afternoon, my Lords. I am sorry that I am only on audio today; I have had some technical problems.

I want to focus on communication; I have spent a lifetime in that world. The starting point seems to be the statement from the Department of Health and Social Care on 25 February that, although 80% of people would be happy to donate organs and tissues on death, only 37% are currently registered. As the Minister said, demand has increased since the original briefing: the figure then was 5,100; it is now 5,200. I understand that deemed consent is likely to produce an additional 700 a year. That means that, if demand remains constant, it will take at least another seven years to work off.

On 25 April 2019, NHS Blood and Transplant launched a campaign called “Pass it on”, which aimed to communicate the change in the law and the choices available. Was any audit made of people who had ever heard of this campaign or were able to communicate back what it was about?

In the commercial world, it is normal with something as important as this for a whole structure of market research to be set up following some initial trials. My first question is on that. However, instead of just asking questions, I want to put forward a few thoughts on how we could communicate better. I went to my local surgery this morning to renew a prescription. I walked round; I could not see anything obvious about donations. A large number of people as NHS patients go to clinics. I am not conscious of anything in the publicity at the few that I have been to about what we are talking about.

I am waiting for an appointment for glaucoma at Bedford Hospital. I did not see anything last time I went in; I will check again. Each of us has to renew our driving licence after a period of time. Why do we not have a campaign attached to that renewal about the need for donations? We all of us have dental appointments. Would it not be a good idea if a leaflet or something was available when we went to the dentist? Above all, there are all the specialist medical charities—my goodness, they do a really good job. They are brilliant communicators. I first took out my donor card in 1981 because I had a particular interest in kidneys at the time. I have it in front of me. I was hoping to show it, but it is looking a bit moth-eaten as I flick it over now. Perhaps we could get all those medical charities on board. They would need financial assistance to do it, but they are like terriers and we need people like that to communicate this very important category of future life.

Then there are people coming to our country—the naturalisation permissions, the immigration approvals and, for UK people, passport renewals. There again is an opportunity to communicate.

Finally, there have recently been some really good, in-depth TV programmes on the challenge of the virus. Let us ask each of the channels to do a separate programme on this issue, so that we can get the 37% up to way over 50%, thereby giving us at least a chance of meeting the demand that is out there. It needs to be addressed. I wish everybody well in that. I thank the noble Lord, Lord Hunt, who rightly calls for —[Inaudible.]

Coronavirus Bill

Lord Naseby Excerpts

2nd reading & 2nd reading (Hansard - continued) & 2nd reading (Hansard - continued): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Lord Naseby (Con)]

My Lords, before I say anything else I would like to pay tribute to the Prime Minister and his team of two advisers who communicate almost daily with the British people. In my experience of 46 years across two Houses, that is unique. I pay tribute to that team and to all Ministers at every level, particularly my noble friend on the Front Bench, who was my excellent Whip until he was promoted.

I am here—as someone who is 83 I am not supposed to be here—because the Bill is very intrusive, but I recognise that the situation is so serious that it is appropriate. I see my role as one to ask questions. I have spent most of my 46 years here asking questions: on the Public Accounts Committee for 12 years; as Deputy Speaker; and then in this House.

I come from a medical community: my wife, to whom I have been married for 59 years now, is a full-time GP while my son is a doctor. Necessarily, as I and my wife have worked in the UK, India, Sri Lanka and other parts of south and south-east Asia, we understand the medical world at some length. I recognise that south Asia and south-east Asia had the SARS catastrophe, and as a result of that they are used to dealing with the great problem that we now face. They were prepared for pandemics, which the West was not and is not.

I have a question about the aims of the Bill. The summary of impacts says:

“The purpose of the Bill is to provide powers needed to respond to the current coronavirus epidemic. Powers are for use only if needed, judged on the basis of the clinical and scientific advice”—


or, as the Prime Minister says, action to save the NHS and to save lives. Is that the limit? Frankly, I do not think it is. I believe that there is another criterion. Are we to follow totally slavishly those two conditions, regardless of any impact on the economy? I venture to suggest that we should not.

A section of the NHS which I looked at closely over the weekend is the dental community. I had a telephone call on Sunday from a dental practitioner in Bedford, because Bedfordshire and Northamptonshire are where I know best. He raised with me the key point issued by the British Dental Association, and that is uncertainty. The BDA recommends that

“no aerosol generating procedures are undertaken on any patient without appropriately fitting FFP3 masks, other required protection equipment and protocols”.

That is pretty clear. It is backed up by this individual consultant, who then said to me in an email: “The situation is that the front-line ITU staff do not have FFP3 masks. We will not treat cancer cases until equipped. We will need to run some emergency clinics, but where are they to be?” Since nobody else has raised dental matters, I say to my noble friend on the Front Bench that I hope this can be looked into.

Secondly, I thought we were communicating with all the trade associations, but two days ago I read in the Telegraph that the CEO of the UK Chamber of Shipping in London makes the point that shipping is an absolutely vital industry. It has made contact with Her Majesty’s Government—that has been raised with the Transport Secretary—but has heard nothing. That is a problem, is it not?

What can be done? Since the Prime Minister is a great believer in Churchill, I suggest that he might think about having the equivalent of Lord Beaverbrook. On the television news last night or the night before, there was a shedload of these masks—a warehouse full —at Amazon. Why are those in the warehouse? They should be out with the front-line people waiting for them. It needs someone to get behind this and get those masks out and into the field. I suggest that this must be happening in many other areas as well.

I finish by saying a huge thank you again to the front-line NHS staff. I have lived with that community for years. It is doing more now than it has ever had to. I re-emphasise that we have to learn from what Korea and others did. The key word is “testing”. We need large-scale, readily available testing, combined with case isolation and contact tracing.

My last question to my noble friend is: where are we on testing? The WHO recommends: trace the contacts to trace infection; isolate to stop the spread; then test, test, test. If we do all that, we ought to, and might hopefully, get through the incredible challenge we face at the moment. I wish all those involved all possible success in their attempt to do so.

NHS Pensions: Taxation

Lord Naseby Excerpts

Tuesday 9th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness knows that I cannot answer for the Chief Secretary to the Treasury, although I know that this issue has been raised with the candidates as part of the leadership campaign and that they see it as a priority. As I said in my Answer to the noble Baroness, Lady Finlay, we recognise that the 50:50 flexibility option does not provide unlimited flexibility for clinicians to target their own personalised level of pension growth. Other options, such as additional pension accruals to purchase individual units alongside a pension, may be considered as part of the consultation. The message going out to the sector is that we want as much flexibility as possible to try to find the right solution to meet the complex needs of the system.

[Lord Naseby (Con)]

My Lords, is my noble friend aware that this issue was raised on the Floor of the House? I was one of those who contributed; I hastily declare an interest as a trustee of the Parliamentary Contributory Pension Fund. Against the background of what was raised some three weeks ago and the evidence that was already in the field, I do not blame any particular Minister, but is there not a pensions section in Her Majesty’s Treasury that must know what options are available to Her Majesty’s Government in coming to a decision that will ensure that the consultants affected will not be forced to retire when they reach 60? That evidence must be there by now; surely, we can have some fast decisions on this major issue.

[Baroness Blackwood of North Oxford]

I absolutely share my noble friend’s desire for a speedy response. He is right that the evidence has come forward and that the issue is affecting front-line services, which is why we are keen to bring the consultation forward as quickly as possible and resolve it. He is also right that those in the Treasury will have seen the evidence and it is right for them to consider it. It is important to understand that the consultation is about the implementation of tax policy, not changing it. That would be a separate question for the Treasury team.

NHS: Waiting Times

Lord Naseby Excerpts

Tuesday 18th December 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Lord well knows that we live in a society which has a mixture of public and private provision. That is true of every public service in most countries of the developed world. The critical point is that we need to invest in our National Health Service, and that is something the Prime Minister is determined to do.

[Lord Naseby (Con)]

Has the time not come for a further review of the previous policy when the right honourable Member for Rushcliffe, as Secretary of State, allowed for a tax reduction or costs to be set against tax for those who take themselves off the NHS list for a particular ailment, thereby freeing up the NHS to carry on the work it should be doing and does so well?

[Lord O'Shaughnessy]

I am grateful to my noble friend for the suggestion. I do not think that now is the time for such a use of public resources, but it is notable that over three-quarters of subscriptions for private medical insurance are paid for by companies as a benefit that they provide to their staff. That is an enlightened approach to looking after the welfare of staff that we want to encourage.

Health: Flu Vaccines

Lord Naseby Excerpts

Tuesday 23rd October 2018 Lords Chamber

Asked by

[Lord Naseby]

To ask Her Majesty’s Government whether there is any shortage of flu vaccines; and if so, what steps they are taking to rectify this.

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

My Lords, there is no overall shortage of flu vaccines. The Joint Committee on Vaccination and Immunisation recommended that the newly available adjuvanted trivalent inactivated influenza vaccine, or aTIV, is the most effective vaccine for the over-65s. To enable the vaccine to be available this year, it has been necessary for the manufacturer to stagger deliveries between September and November. Everybody who wants to be vaccinated should be able to do so before December.

[Lord Naseby (Con)]

I thank my noble friend for that Answer, but how is it, given the statement from NHS England that last year was the worst for deaths for seven years at 15,000, that here we are with a new vaccine geared to those most at risk—I happen to be one and I declare an interest—yet I go into my GP, a brilliant practice in Potton, Greensands, and there are no vaccines available and no notice of exactly when those vaccines will come? Can my noble friend tell me and other patients whether those vaccines are actually going to be available in sufficient time for all patients at risk to be vaccinated before 1 December? Unless that is done, they will be useless to us in the older age group.

[Lord O’Shaughnessy]

I take my noble friend’s point very seriously. It is worth stating that the reason for moving to this new vaccine is precisely because it is more effective. Unfortunately, the response rates for the vaccine that was used in the over-65s last year were not as high as hoped. Indeed, there were quite a number of admissions to intensive care units of that age group. That is the reason for moving to the vaccine, but because it is the first year it has been available, it has been necessary, because of global demand, to stagger the delivery, as I said. GPs and pharmacies were informed of this staggering of deliveries at the beginning of the year. I can tell my noble friend that 8.2 million doses have already been ordered for this age group, of which 4.9 million have already been delivered, against around 7.6 million used last year. So there is adequate supply, and it will be delivered to all GPs and pharmacies as necessary to meet the demand by the end of November, so that by the beginning of December anybody who wants that vaccination should be able to access it.

The NHS

Lord Naseby Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord Naseby (Con)]

My Lords, it is an honour for all of us in this place to speak in this debate on the 70th year of the NHS. We owe a great thanks to the noble Lord, Lord Darzi, for showing the initiative. We also owe him a thank you for when he was the Minister on the Benches for the Government, over a number of years, because he certainly got a grip of things when he was there. I also pay tribute to my noble friend sitting on the Front Bench, as it is a long time since we have had a Conservative Member sitting there who has tried really hard to get a grip of the issue.

I am a marketing man by profession and I am looking at the things on which we need action on a practical basis. I start with the GPs; I am married to a retired one. It is not working at GP level today, on the whole. I exempt the GP practice where I am a patient at Greensands in Potton, which is pretty good, but it is not working because there are not enough GPs. There are also not enough district nurses. Those are the two key areas. Just look at the figures for district nurses. The graph has gone down for the last X number of years, certainly the last 10 years. We have to double the number of district nurses, because they are the people who visit patients at home and keep them out of hospital and the GPs’ surgeries. That is point number one.

Secondly, my wife was a full-time GP and she looked after me and three children in our constituency, and all the rest. Initially, she had a small practice and she built up to a very large practice in Bedfordshire. There were night calls and weekend calls. One of the doctors did minor surgery and it worked well. None of that happens today. Why do we not have minor surgery from our GPs? That would relieve our hospitals a little. Why do we not have more GP hub units like the one in Biggleswade today, which works at weekends? It is looked after not by doctors who are running their normal practices, but other doctors do the work and that unit works well.

Thirdly, we need to look at the number of doctors. We have about 50% of what we need. I hope nobody thinks that I am biased, but there is something wrong with the gender balance. Nearly 60% of the medical school intake is female now. The net result, as ladies across the medical profession will know, is that 5% never work, 80% work half-time and about 15% work full-time. Against that background we need two women for every man, so that is a challenge. Moreover, my son works as an Army doctor and he had it in his contract to work for five years. In Singapore, if you take a medical degree you have to work full-time for five years. Not surprisingly, if you leave early you have to pay back the money that has been spent on you.

As a further point, in Bedfordshire there is the Luton and Dunstable Hospital. It has a unit where, when you arrive, they assess you and you go either to its GP unit or to A&E. Seventy per cent go to the GP unit. That is the situation.

Finally, on payments, I am fed up with looking in my surgery at the number of people who do not turn up. Somehow, we have to find an answer to that. Personally, I think we should trial a £10 fee for those who fail to turn up.

NHS Winter Crisis

Lord Naseby Excerpts

Monday 8th January 2018 Lords Chamber

[Lord O’Shaughnessy]

I thank the noble Baroness for her good wishes, and I wish her and all noble Lords a happy new year. She asked several questions, and I will try to deal with them all. Her first question was about being well prepared. Those were the words of Sir Bruce Keogh from NHS England, not mine. I should also point out that Keith Willett, the director for acute care for NHS England, said that the service is better prepared than ever. Of course, that does not mean that there are not challenges. We know that this happens every year.

One of the ways that we see challenges happen is that there are cancelled elective procedures. I have been looking back over the data for the past 20 years. In quarter 4 of each year—January to March—those cancellations do happen. In fact, I was looking back at 2000-01 and there were 24,000 cancelled or postponed operations that year, which is actually one of the highest over that period. These things do happen during winter, and that is one of the ways of coping. The Prime Minister has apologised for that, and I endorse that. Of course, it is not a state of affairs that we want to happen, but it is necessary to make sure that the most urgent cases are treated. It should be pointed out that the direction about elective procedures made it clear that time-critical procedures around cancer operations and others can go ahead. We will see over time what the impact of that was.

I will mention one other thing about preparedness. The noble Baroness talked about bed occupancy. Of course, we know that high levels of bed occupancy are a concern. Bed occupancy was below the target of 85% going into this period—on Christmas Eve it was 84.2%, I believe—so that was put in place. We know it is going to be challenging. We know that flu is going to continue to have an impact over the next few weeks, and we will see what we can do, but we know that the NHS has put in unprecedented levels of preparation to make sure that we can get through what is always a difficult period.

[Lord Naseby (Con)]

My Lords, is it not encouraging that at least this year there was preparation for winter? The fact that it was not an enormous success everywhere is a lesson that I hope Her Majesty’s Government will take on board. Against that background, will my noble friend be preparing a report on the experience this winter? Will he confirm that next year there will be a plan which takes on board the experience of this year? I can quote only from local experience but is it not a fact that Luton and Dunstable University Hospital, which has had a special A&E unit for some years, did not have difficulty, whereas other hospitals that were not prepared to that extent appear to have had difficulty? If that is the case, is it not time we brought the other hospitals up to a better standard—the sort of standard that Luton and Dunstable University Hospital gives to its community?

[Lord O’Shaughnessy]

I thank my noble friend. He is right to point out that there is variation across the country. He mentions Luton and Dunstable University Hospital. It has been a pioneer of how to make sure that people coming into A&E are properly dealt with. Indeed, the £100 million that was invested in A&E services to support better triaging was based on the Luton and Dunstable model. Obviously, we need to make sure that those high standards are replicated across the country.

I will give one further example of an area where that planning has taken place. We know that there has been pressure on ambulance services and that there has been a variability of performance there. There is now a national ambulance control centre which is keeping real-time data and looking at how to manage that performance so that we can get a proper national grip on this picture.

NHS: EEA Doctors

Lord Naseby Excerpts

Tuesday 12th December 2017 Lords Chamber

[Lord O'Shaughnessy]

I think I may have detected a qualified welcome from the noble Baroness for the achievements of last year in providing that reassurance. Clearly, we want to make sure that there is the best possible working environment for our medical staff, wherever they come from, and that involves, as the Prime Minister has set out, having world-leading employment rights.

[Lord Naseby (Con)]

My Lords, is the Minister as concerned as I am that this Question refers to the EEA as well as the EU? I am mystified about why any Norwegian or Icelandic doctor should be concerned about Brexit. In addition to that, is my noble friend not absolutely correct? I went to Bedford Hospital a week ago on a Sunday with an EU doctor. That doctor made it quite clear to me that the reassurance that had been given by Her Majesty’s Government was sufficient for her—and, I believe, her husband—to continue to work in the NHS.

[Lord O'Shaughnessy]

I thank my noble friend for pointing that out. It is extremely reassuring to know that the message is getting through. We as a department and as a Government have a job to do in making sure that everybody hears that message of reassurance, because we want those EU workers to stay and contribute to our NHS.

Nurses and Midwives: Numbers

Lord Naseby Excerpts

Monday 4th December 2017 Lords Chamber

[Lord O'Shaughnessy]

My Lords, the rules as they are apply, so those who are eligible to apply for a right to remain can do so. We are talking about providing a path for those who are not yet at that point, now or in the future, to achieve settled status to provide the kind of certainty that we know. I understand that this causes some people to pause for thought about whether they should stay.

[Lord Naseby (Con)]

Will my noble friend ensure that the answer he has just given is publicised in every NHS hospital in the United Kingdom? There is not that depth of understanding in the average medical practitioner, nurse or administrator in our hospitals that he has so clearly communicated. Will he also reconfirm that the number of training nurses is going up, as I think he said, and is considerably higher than it has been during the previous decade? If that is the situation, it is surely to be greatly welcomed.