Smoking

Debate between Lord Naseby and Lord Markham

Thursday 25th January 2024 Lords Chamber

[Lord Markham (Con)]

The honest answer is that we do not know yet, and that is a problem. As we know, a number of these things take time to play through. That is why we want to make sure we take a precautionary approach. In this legislation, we aim to really stop anything that is targeted at young people in terms of vaping. We see vaping as an important tool to help people quit smoking, but we are equally sure that we never want anyone to start vaping. That is why we will also look at banning anything that targets young people, such as flavouring and packaging. We want to stop anything targeted at youth vaping.

[Lord Naseby (Con)]

My Lords, why are His Majesty’s Government ignoring the experience of New Zealand? That country has found the idea behind this Bill—it had a similar one—to be totally unworkable. Secondly, why are we undermining the existing scheme that has done so well, with under 2% of young people even bothering to take a taste of smoking? Does my noble friend not recognise that there are other, far more important health dimensions that need the resources that are to be wasted on this useless Bill?

[Lord Markham (Con)]

First, my understanding about New Zealand is that one of the biggest bones of contention was that it was looking to reduce the number of smoking retailers from 6,000 to 600; that is where their Bill came into difficulty. I am afraid I must disagree with my noble friend on the importance of this. It costs the economy about £17 billion a year and causes about 80,000 deaths, and 80% of people who have taken up smoking wish that they had never started. I think those are very strong reasons which I know the majority of this House is behind, and that is why I am delighted to be introducing that legislation shortly.

NHS: Drug Shortages

Debate between Lord Naseby and Lord Markham

Wednesday 17th January 2024 Lords Chamber

[Lord Markham (Con)]

I assure the noble Lord that a specific team, the medical supply team, works to manages this across the piece. It is a complex area, as we have said. There are 1,000 notifications a year about supply shortages—that has been consistent over the last so many years—that the team works to resolve. I am sure that, as this debate progresses, we will talk about some of the issues, including getting the MHRA to expedite regulatory approval, working with alternative suppliers, buying internationally where needed—we did that very well last year on strep A—and, where really necessary, introducing serious shortage protocols. It is an issue that we take very seriously, and we are managing it.

[Lord Naseby (Con)]

My Lords, “may” is the wrong word; there is a shortage at this point in time, certainly from the inquiries I have made. Is it not time that we had another look at the existing procedures on recompensing drug manufacturing and maybe producing a new version of the PPRS, which worked extremely well in its time?

[Lord Markham (Con)]

Actually, we recently reached a new agreement with the drug suppliers on this. I think we were all pleased to do that, and it will ensure we continue to get continuity of supply. I have quizzed the team at length on this and asked it to sit down with the British Generic Manufacturers Association, which produced these figures, specifically to understand where there are differences, because I must be honest: the team does not recognise those numbers. We did not see an increase over the last few years. Where there are specific instances, such as ADHD, which I worked with the noble Baroness, Lady McIntosh of Hudnall, on recently, remedial actions are in place to ensure we can manage through the supply issues.

Food: Two-For-One Offers

Debate between Lord Naseby and Lord Markham

Wednesday 19th July 2023 Lords Chamber

[Lord Naseby (Con)]

My Lords, if a product is marketed legally in the United Kingdom, why should His Majesty’s Government feel they have to interfere at all with the marketing of that product? I understand the point about education and totally accept it, but is it not wrong for His Majesty’s Government to restrict what is a legally marketed product?

[Lord Markham (Con)]

We are trying to educate, inform and nudge. The best example of all is encouraging the industry to reformulate its foods to be healthier. At this point, I am glad to say that, since we introduced these restrictions, Mars, Galaxy, Bounty and Snickers have reformulated, and even Mr Kipling’s Deliciously Good cakes are compliant.

NHS: Doctors’ Strikes

Debate between Lord Naseby and Lord Markham

Wednesday 5th July 2023 Lords Chamber

[Lord Markham (Con)]

As we have seen, it is having an impact, regrettably. We saw that from 14 to 17 June: almost 100,000 appointments were lost during that strike. We are now looking to cover that up. That is why we are firm in our conviction that we want to resolve this situation. These sorts of things are not good for anyone. We have a formula that worked; we have managed to do this with nurses and the Agenda for Change unions, which make up the vast majority of the health service. Our hope is that we can sit down and have sensible conversations and do the same with doctors and consultants.

[Lord Naseby (Con)]

My Lords, I thank my noble friend for his ingenuity and the work he has put in since taking over this role. All we hear of pay rises is that they should be 12%, 19%, 39% or whatever. Has the time not come for a slightly different approach? We should calculate the capital cost of whatever sections of the health service claim they have lost, pay them that cost and then revert to the normal process of review bodies.

[Lord Markham (Con)]

I thank my noble friend for his kind words. We are willing to look at all solutions. We have to balance the salary wishes of doctors with making sure that we keep the money in front-line services. Everyone is aware that pay rises of 35% would eat heavily into what we can do and afford on the front line. We need to get that balance right.

General Practitioners: Recruitment and Retention

Debate between Lord Naseby and Lord Markham

Monday 12th June 2023 Lords Chamber

[Lord Markham (Con)]

All the things that the noble Lord points towards are covered in our plan for recruitment and retention. The things that we have announced, particularly on pensions—a key reason why people were leaving—were welcomed by the sector and the fact that we have record numbers in training is also a step in the right direction. But, as we freely admit—this is what the primary care plan is all about—a lot more work needs to be done and is being done.

[Lord Naseby (Con)]

As my noble friend knows, we have an Armed Forces scheme for young doctors to train and they have to commit to five years in the Armed Forces. Is he also aware, as I am sure he is, that Singapore’s health service has a scheme whereby young medics who qualify have to work in the Singapore national health service? At a time when we see an increasing number of our qualifying young doctors going abroad, is it not time that we looked at both these schemes and modified them to the UK situation?

[Lord Markham (Con)]

My noble friend makes a good point: if we are investing eight years in training, in the case of a GP, to ensure that they are at the top of their profession, so to speak, it is reasonable to expect them to work for a number of years in the UK so as to make good on that investment.

Covid Pandemic: Testing of Care Home Residents

Debate between Lord Naseby and Lord Markham

Monday 6th March 2023 Lords Chamber

[Lord Markham (Con)]

We all agree that visiting should be allowed as much as possible. I know that the policy is that people can receive at least one visitor, but I know that there are also examples where that is not happening enough. It is very clear, from our side, that it is a priority that everyone should have visitation rights, because they are vital. Can we say that that will always be the case in every circumstance in the future? Well, clearly no one foresaw the pandemic, so this is one of those situations where we can never say so definitively, but we all firmly agree that visitation is a key part of people’s care and well-being.

[Lord Naseby (Con)]

Is my noble friend aware that I should declare an interest, in that my wife is a retired GP? In the period February-March 2020, it was very clear to those of us who were in contact with the medical services that things were not right in care homes. On 21 April 2020, I put down a Question—and I have a copy for my noble friend—which read:

“To ask Her Majesty’s Government what has been the COVID-19 testing policy for hospital patients that have been discharged to nursing and care homes over the last four weeks.”


That took us back to 23 March 2020. I got an Answer some three weeks later, which read:

“As outlined in the Adult Social Care Plan, published on 15 April 2020, any patient who moves from the National Health Service to social care will be discharged in line with the current NHS COVID-19 Discharge Requirements. NHS England and NHS Improvement published a letter on 16 April addressed to all accountable officers of all hospitals (public and private sector) working for the NHS and discharge teams outlining the new requirement to test patients being discharged from hospital to a care home.”


This did not answer the Question that I had asked about what had happened between the latter end of March and early April.

I recognise that my noble friend has only recently joined the Front Bench but, as far as I am concerned—I have taken a detailed interest in this—it is fundamental that we are honest. If things went wrong, as I am sure they did, they must come out in the public inquiry. I am happy to give a copy of my Question to the opposition parties, so that they do not have to scratch around to find it.

[Lord Markham (Con)]

Yes, it is vital that we understand exactly what happened when and that we learn lessons. I am sure we will see that some mistakes were made, and we need to learn from those. From our side, that was the whole point of setting up the Covid inquiry. We will ensure full co-operation.

Tobacco Control Plan

Debate between Lord Naseby and Lord Markham

Wednesday 23rd November 2022 Lords Chamber

[Lord Markham (Con)]

I will need to write to the noble Lord on that. I am aware that different methods exist, but I think we are all united on the need to do everything we can to prevent any circumvention.

[Lord Naseby (Con)]

Is not any plan meaningless when at least a third of the market is supplied by illegal imports? His Majesty’s Government appear not to have done anything to stop this, and it is the young people in our country who are smoking the cheap, illegally imported cigarettes.

[Lord Markham (Con)]

We are working very hard with HMRC on this. I think we can all agree that one thing that Brexit was good on was restricting the number of cigarettes that people can bring in legally from other parts of Europe.

Social Care Sector: Staff Shortages

Debate between Lord Naseby and Lord Markham

Monday 21st November 2022 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness. In the past few days, local authorities have been notified of the £500 million discharge fund. That funding will go out in December and January, so it is very much going out there. It is very much designed to address the issues of discharge, creating new places and helping to recruit.

[Lord Naseby (Con)]

My Lords, is there not a case for formally involving the Commonwealth in this aspect? There is already a trial going on with Sri Lanka for nursing. I suggest to my noble friend the Minister that there are other Commonwealth countries that would be more than willing to have a two-way flow and help reduce the huge shortage that we have.

[Lord Markham (Con)]

I agree with my noble friend. Overseas and Commonwealth recruitment is a key area here, which is why I am delighted that we have addressed the visa restrictions and entered social care on an essential workers list. We have already seen 15,000 people come in this space, and that figure is increasing month on month. My noble friend is correct that this is a critical area for recruitment for us.

NHS: Discharge to Assess Policy

Debate between Lord Naseby and Lord Markham

Tuesday 8th November 2022 Lords Chamber

[Lord Markham (Con)]

As mentioned, the Carers UK report and its findings made for sobering reading. It clearly shows why it was right to delay the guidance until we had that input; again, that will be followed up at the conference on Thursday. I think we all agree on the premise that we want to discharge people into their home quickly because that is the best place they can be, provided that they are medically able to be there. It is then in their home that the assessment takes place. Clearly, that must happen in a timely fashion and with the carer’s involvement but, again, the survey showed that that is not being done quickly enough in many cases. I accept that there are many things we need to learn from this but I think we can all agree on the direction: it is right to discharge people quickly provided that back-up and support are there to ensure that they have what is needed.

[Lord Naseby (Con)]

My Lords, as one who has been a carer in the recent past, I ask my noble friend the Minister to double-check that, before any patient leaves any form of NHS care, they have had a thorough checklist of every conceivable thing, including medicines, vaccination or any other procedure that has been undertaken on that patient.

[Lord Markham (Con)]

My noble friend makes the point well. I agree. It is my understanding that such a checklist exists but I will check that and come back to him.