Wuhan Coronavirus

Debate between Lord Patel and Baroness Blackwood of North Oxford

Tuesday 11th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

As ever, my noble friend is astute on this issue. Contact tracing has been hugely effective, particularly for the 1,466 passengers and 95 staff who arrived in the UK on direct flights from Wuhan between 10 and 24 January. All those have now passed through the incubation period and none of them was a confirmed case. Of the remaining cases that we have found, a number are linked to contact tracing. We should be very proud of the effectiveness of our system.

On the question of antivirals, work and research is ongoing in regard to a particular HIV retroviral which has been used in this measure. That is being considered. There are three projects which aim to advance the vaccine candidates into clinical testing as quickly as possible. We are also looking at some correspondence from both diagnostic kit manufacturers and potential end users, and we are considering whether we can also improve the diagnostic kit.

[Lord Patel (CB)]

My Lords, it is always a pleasure to correct the former Secretary of State for Health. This virus is RNA in its genetic makeup. H1N1—the previous pandemic that we were worried about when we stockpiled the antivirals—had a DNA genetic make-up. Some antivirals work better with DNA than RNA, although the Minister was correct to say that there are several antivirals currently being tested to see whether they will work against the coronavirus. As far as a vaccine is concerned, it takes a long time to develop a vaccine; when you develop one, it takes even longer to see whether it is effective.

Last time we discussed this, I said that the Government were taking a proportionate action to contain the virus in the United Kingdom. I believe that to be so even today. However, we might be on the knife edge of a pandemic. If a pandemic is declared, the whole attitude to how we contain this changes. It becomes much more draconian, to stop the movement of people, isolate the index cases and identify the contacts. Currently, asking the Members of this House to wear masks would only make the public panic and ask why we are protecting ourselves when they are not being protected. It can be a good measure, but we have to wait to see how things develop. I would like to hear reassurance from the Minister that there are plans in place, so that if this becomes pandemic, the Government will take the draconian action that is required.

We are fortunate that, apart from the Chief Medical Officer Chris Whitty, who is a first-rate epidemiologist, we have Professor Piot, who discovered the Ebola virus, and Jeremy Farrar, chief executive of the Wellcome Trust. They have better knowledge on containing pandemics than anyone else in the world; I hope the Government will use their expertise.

[Baroness Blackwood of North Oxford]

The noble Lord has demonstrated, far more eloquently than me, why we have more expertise in public health, and in particular in infectious diseases, than many other nations; we of course share our expertise through the WHO with Professor Piot, Professor Jeremy Farrar and our own Chief Medical Officer Chris Whitty. We operate using the best scientific evidence and advice from SAGE, which is currently advising the risk level of moderate. We keep that under constant review and are not complacent in any way. Through the preparations that we are putting through the NHS and all other parts of the system, we will be prepared for whatever situations might emerge should there be more sustained transmission in the UK. We will take the measures necessary to protect public health. The steps that we have taken so far have been proportionate and appropriate; they also demonstrate that the Government will act as necessary to make sure that we protect public health.

Coronavirus

Debate between Lord Patel and Baroness Blackwood of North Oxford

Monday 3rd February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness has rightly raised this issue with me before. She is quite right that flu can and should be managed much more effectively in the community and by individuals. I think we have had an effective flu campaign this year. The flu vaccine has been offered to 25 million people. We have also extended the flu programme this year to children in year 6 to improve herd immunity and drive up its impact. We are seeing the number of those with flu declining, so we are starting to see some improvement. However, I completely recognise the noble Baroness’s point about public health lessons and improving public education on the management of infectious conditions, which we live with every winter, not just when we have an infectious situation such as this. I thank the noble Baroness for an important question.

[Lord Patel (CB)]

My Lords, in my view the measures the Government have taken are balanced so as not to cause a panic and unnecessary alarm. The important thing, though, is that the Government remain on top of developments. If the virus mutates and spreads rapidly from human to human, it will require much more draconian measures to be taken.

It has been reported that the virus transmits from human to human and to people who have not been in China, although the numbers are small. An index or measure of human-to-human transfer is known as R0. It currently stands at about 1 to 2. If it increases, that means the virus is spreading faster. Sequencing of all the known cases so far suggests that the virus has not mutated. It remains 99.98% the same sequence, including in the two patients known in the United Kingdom. I hope the Government have a strategy in place to keep on top of developments and that they will take the steps required to stop the spread.

[Baroness Blackwood of North Oxford]

I thank the noble Lord. He is right that there is a global effort to keep on top of the sequencing of the virus to track any evolution of it. As he said, the indications are that the virus has not evolved in the past month, which is encouraging. The rate of transmission is as reported. That means that the infection control measures in place, which are based on clinical evidence and the data, are proportionate and appropriate. Combined with the public health advice that has come out and the contributions each of us can make as individuals to manage the spread of infection, we believe that this is the responsible and appropriate route. However, as the noble Lord said, we will keep the developing situation under a close eye so that we can respond quickly and nimbly as the situation goes forward.

Wuhan Novel Coronavirus: Threat to UK Citizens

Debate between Lord Patel and Baroness Blackwood of North Oxford

Wednesday 22nd January 2020 Lords Chamber

[Lord Patel]

To ask Her Majesty’s Government what is their strategy for protecting UK citizens from the threat posed by the spread of Wuhan novel coronavirus (WN-CoV).

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, we are monitoring closely the development of this virus. Advice from Public Health England and the Chief Medical Officer is that the risk to the UK is currently low. The UK is well prepared for the emergence of novel viruses. As part of our preparedness, we have introduced enhanced monitoring of direct flights from Wuhan to the UK and updated our travel advice for Wuhan. We continue to update health workers on how to identify, treat and contain any possible cases.

[Lord Patel (CB)]

My Lords, I thank the noble Baroness for her reply and commend the Government for publishing tomorrow initial measures for controlling the spread of this virus, if it comes to the United Kingdom. This is a newly identified virus, which probably originated in animals, particularly in the seafood markets in Wuhan. None the less, it is 80% genetically identical to the SARS virus, which killed a significant number of people. We now understand that, although the Chinese have sequenced the genome of the virus, it has mutated and can now spread directly from human to human, which raises the likelihood that it will spread more widely. The initial illness can vary and is sometimes very mild, hence the case in the United States where the diagnosis was not made on arrival at the airport in Seattle by the authorities, even though they had procedures in place. Will the Government keep a watch out and update the advice depending on how the virus develops? Secondly, will there be procedures for quarantine and follow-up contact if a case is identified, particularly if the virus mutates and becomes highly virulent?

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his important and timely Question. I am happy to update the House that, from today, enhanced monitoring is in place for all direct flights from Wuhan to the UK. Public health officials will meet every direct flight from Wuhan to the UK and will be on hand to provide information about symptoms. Mandarin and Cantonese speakers will be on hand and leaflets will be available in several languages. We will also roll out enhanced monitoring of all flights arriving in the UK from China. Leaflets and information will be available across all UK airports, advising travellers from China on what to do if they feel unwell. The enhanced monitoring of direct flights will obviously be kept under continuous review and expanded if necessary. The risk to the public is low and the NHS is well prepared but, to answer the noble Lord, any patients assessed for this new disease would be isolated under standard procedures if necessary. There are a number of infectious disease units around the country that would be able to respond appropriately.

Health: Sepsis

Debate between Lord Patel and Baroness Blackwood of North Oxford

Wednesday 22nd January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend for this Question and I pay tribute to his work on it, and the work of the UK Sepsis Trust. I am aware of the calls for a national sepsis registry for patients. It is important that we understand the data; we are confident that it provides an accurate indication. We think that UK data is as good as it can be at the moment but that there is a clear need for better data on sepsis. The problem with the registry as proposed is that it would use retrospective data collection. We want to go beyond this with the UK’s five-year national action plan for AMR, which includes a commitment to develop the real-time patient-level data of individual patients for infection, treatment and resistance history. Work is already under way by NHS England and NHS Improvement. I hope that is the kind of answer my noble friend was looking for.

[Lord Patel (CB)]

My Lords, as a country our record for the number of deaths due to sepsis is pretty abysmal, as stated already. Most of that is due to late diagnosis of sepsis. One-third of patients die and for every hour that a diagnosis is delayed, the death rate rises by 8%. Last year, on a visit to a biotechnical company in Northern Ireland, the Secretary of State commended the development of a quick diagnostic test, which will give a result within two hours so as to start appropriate antibiotics. Will the Government make a commitment that when this molecular test is available, which is likely to be soon, it will be immediately available to the whole of the NHS?

[Baroness Blackwood of North Oxford]

The noble Lord, as always, speaks with great expertise in this area. I emphasise the work that has been ongoing to improve the picture on sepsis. Since 2015, screening for sepsis in emergency departments has improved from 52% to 89% and timely treatment for sepsis from 49% to 76%, but the noble Lord is absolutely right that we need to improve the outcomes. Early and accurate diagnosis is at the heart of this. I shall keep an eye on innovations in diagnostics. The noble Lord knows that innovation in this area is right at the heart of what I do, and I think that his proposal is very sensible.

National Health Service: Pensions Tax

Debate between Lord Patel and Baroness Blackwood of North Oxford

Wednesday 30th October 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend for that very direct question. Our estimate is slightly different—that around one-third of GPs and consultants have earnings high enough to potentially be affected by the tapering of the annual allowance for tax-free pension savings. Not all clinicians are affected—it depends on the personal circumstances—but we accept that there is a need for urgent action in this area. That is why NHS employers have published guidance for short-term approaches that could have a mitigating effect on pension tax for the workforce this year and throughout the winter. We have also opened our consultation, which will close this Friday. We have already had 750 responses to it, and stakeholders are broadly supportive of the additional flexibility that has been proposed. We intend that flexibility to be available by April.

[Lord Patel (CB)]

My Lords, I apologise for asking another direct question. The results of a recent survey carried out by the Royal College of Surgeons of nearly 1,900 surgeons were that 68% of consultant surgeons are considering early retirement because of the pension tax situation, 64% have been advised to work fewer hours in the NHS and 69% have reduced the amount of time they spend working in the NHS. What effect does the Minister think that might have on surgical care?

[Baroness Blackwood of North Oxford]

The noble Lord is exactly right to raise this issue and we have taken it very seriously. I have met the president of the Royal College of Surgeons to take on board his concerns. It is exactly why we have brought forward this consultation as a matter of urgency and why the department is making strenuous representations to the Treasury, which is reviewing the operation of the annual tapered allowance, and it is why we will continue to make those representations. However, it is also why we are taking other actions around elective surgery so as to reduce the pressure on surgeons up and down the country.

National Health Service: Healthcare Advice

Debate between Lord Patel and Baroness Blackwood of North Oxford

Tuesday 16th July 2019 Lords Chamber

[Lord Patel]

To ask Her Majesty's Government what analysis they have conducted of the impact of the National Health Service introducing the use of devices such as Amazon’s Alexa for health care advice.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, digital technology will play a key role in making the NHS sustainable. The Secretary of State’s technology vision sets the foundation for a new generation of digital services focused on user need, privacy and security, interoperability and inclusion. The collaboration with Amazon simply connects people to medical information and is already freely available through the NHS website. This service does not provide advice or any form of diagnosis. More modes to access medically verified NHS information can only give UK citizens a better understanding of different medical conditions. The agreement with Amazon is convenient for those who rely on voice-activated technology, in particular blind and visually impaired people.

[Lord Patel (CB)]

My Lords, I thank the Minister for her response and might I say it was a good defence? While I have absolute confidence that Matthew Gould—our previous ambassador to Israel who leads on the project—will get it right, voice-recognition technology has its problems. It must recognise the correct phrase, word and accent. It might be interesting to hear the answers that the Opposition Chief Whip were to get if he asked a question with his accent. I asked five questions at the weekend; all health-related. One I repeated twice and got two different pieces of advice: one was to call 999 and the other was to go to bed and rest.

I know that it is not a diagnostic technology, but it runs the risk of a diagnosis being made, so the key questions are what trials are being carried out, what data protection do we have against Amazon collecting vast amounts of data, and what is the risk of misdiagnosis?

[Baroness Blackwood of North Oxford]

The noble Lord makes very important points. It is important to understand that this is not a technology to offer advice or diagnosis. NHS Digital and NHSX have built an interface to connect the NHS website so that other organisations can make NHS information available on their own sites. That is so that a greater number of people can access NHS information. It has already been made available through a number of other examples such as NHS Go, which is designed to inform young people, accuRx and eConsult. No health data is collected by Amazon. No money is exchanged via this route and all data protection laws, such as GDPR and the NHS data protection rules, still apply. Data protection is still required to protect data through this system.

NHS Pensions: Taxation

Debate between Lord Patel and Baroness Blackwood of North Oxford

Tuesday 9th July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness is right that this is an important aspect of the recruitment and retention of GPs in particular, which is why we are bringing forward the consultation. As I said, we have been working closely with representative bodies, including the BMA and others. When we brought forward the five-year contract for general practice, announced in January, part of that was to provide greater certainty for GPs to plan ahead. Part of the work we have done is looking at other aspects that will ensure recruitment and retention. This includes, as we have discussed before, funding towards 20,000 extra staff working in practices, remaining committed to recruiting an extra 5,000 GPs and looking at targeted enhanced recruitment schemes, which include a £20,000 salary supplement to attract doctors into GP specialty training. The noble Baroness will understand that it takes a little time for these policy changes to be reflected in the data, but she can have no doubt that this is a policy area in respect of which the Government are absolutely determined.

[Lord Patel (CB)]

My Lords, there is currently a disparity in pension arrangements between clinical academics and NHS consultants. Can the Minister confirm that any discussions the Department of Health and the Treasury have will include the university sector? Otherwise, a disparity between pension arrangements will be created, which might affect the recruitment of clinical academics.

Hospitals: Listeria

Debate between Lord Patel and Baroness Blackwood of North Oxford

Monday 17th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I am sure that the noble Baroness would like to hear exactly how effectively Public Health England and others responded in this case. Obviously, these cases should not have occurred in the first place, but the first case occurred on 26 April. There were two cases in one hospital. The second case in a different hospital did not occur until 16 May. It took one week for Public Health England to ascertain that this was a national issue and that the cases were indeed linked. Thereafter, products were withdrawn. Very swift action was taken by Public Health England and the Food Standards Authority and a clear and concerted investigation is now under way. It will be made clear that this sort of thing cannot happen again and that there will be severe consequences for any companies that do not take careful consideration of the consequences if they do.

[Lord Patel (CB)]

My Lords, several important points come out of this tragic incident of five people dying from listeria infections. The first is how quickly we can get a diagnosis of listeria in the food products that are contaminated. Older tests take several days but there are other tests, so I ask the Minister whether rapid diagnosis tests are available. Secondly, if people are infected with listeria monocytogenes it is quite dangerous, so the death of the people concerned may be related to that infection. It is important that the food in the supply chain is tested. Some countries adopt a regulation that requires regular testing of food in the environment where food such as sandwiches is packaged. In the review that will be conducted, will we look at the possibility of such regulation?

[Baroness Blackwood of North Oxford]

I thank the noble Lord, Lord Patel. He is absolutely right that one reason why such fast action was able to be taken was that it was possible to confirm by whole genome sequencing that cases at Manchester and Liverpool were linked by an identical strain in a week. Previously, that would have taken an awful lot longer, so we can be pleased that action was taken much quicker.

In terms of lessons learned, the noble Lord is right that we need to look at how to ensure that local authorities undertake inspections and audits of sites that are approved and that we also collect samples every six months and take action on any results of concern. We must make sure that the NHS follows food safety advice from Public Health England and the Food Standards Authority. Public Health England has confirmed that serving sandwiches in hospitals—I apologise. I am going to faint.

Unpaid Carers: Support

Debate between Lord Patel and Baroness Blackwood of North Oxford

Thursday 13th June 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank my noble friend for this important question. The Carers Action Plan was a real step in the right direction. It has 64 action points and good progress has been made. There will be a progress report in July. Some key steps in it are promoting best practice for local authorities, clinical commissioning groups and other providers in order to give carers much-needed breaks and respite care, which can be the difference between coping and not coping; and providing carer-confident benchmarks for employers who can identify carers within their systems and give them the support they need. Of course, there is also the work I have already mentioned: the £5 million carers innovation fund to find more creative and innovative ways to support carers, who are so crucial to our health and care system.

[Lord Patel (CB)]

My Lords, does the Minister agree that any future proposals for the funding of social care need to be sustainable? Any proposal that requires the burden to fall on those who need social care or their families will not be sustainable and will therefore require contributions from wider society.

[Baroness Blackwood of North Oxford]

I completely agree with the noble Lord, Lord Patel, who is absolutely right that we must ensure that we sustainably fund social care. The Government have provided £3.9 billion more in dedicated social care funding, but we recognise that there is a need for a sustainable financial footing for social care as a whole, which is what we are working towards with the spending review. Nevertheless, carers will continue to play an important part in our healthcare system, as they do within our society. Many people consider that they are making a rewarding and important contribution within their family and community, and we must be grateful to them for that.

Tobacco Harm Reduction

Debate between Lord Patel and Baroness Blackwood of North Oxford

Tuesday 2nd April 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

Smoking remains the biggest cause of death in this country. Strict rules are in place to prevent tobacco companies promoting their products, including through sponsorship. We take the unlawful promotion of tobacco products extremely seriously and expect any organisation found to be flouting the rules to be investigated.

[Lord Patel (CB)]

My Lords, although snus contains both nicotine and tobacco—that is why the Swedes use it—the lung cancer rate in Sweden has reduced, whether that is to do with the use of snus or other reasons. That is the main thing that we should be talking about. What strategies do we have to reduce our lung cancer deaths, which run at about 35,000 a year? Tobacco is a key cause—80% of them are related to tobacco. Does the Minister agree that we should think about a strategy for harm reduction, whether it is snus, e-cigarettes or any other product?

[Baroness Blackwood of North Oxford]

I thank the noble Lord, who has expertise in this area, for his intervention. He is absolutely right that we need to target a reduction in lung cancer rates. Cancer Research UK states that smoking tobacco is the biggest cause of lung cancer in the UK, with seven out of 10 lung cancers caused by smoking. The NHS Long Term Plan has a very heavy emphasis on prevention, including smoking cessation services. One of the first interventions from that plan to be rolled out is the innovative targeted lung health check, which will provide an easy-access gateway to lung health and smoking cessation services. I hope that he is reassured by that answer.

Human Fertilisation and Embryology: Frozen Eggs Storage

Debate between Lord Patel and Baroness Blackwood of North Oxford

Wednesday 20th February 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness is absolutely right that it is important that we continue to support the Bill. I was trying to clarify that I did not think it appropriate to bring forward a change of this nature under regulations. If we were to introduce a change that had a broad effect, it would be appropriate to do so in primary legislation with appropriate parliamentary scrutiny, consultation and clinical support.

[Lord Patel (CB)]

My Lords, if I may, in the absence of the noble Lord, Lord Winston, I will take his perch—as long as nobody tells him that. The question of the science has been referred to. As far as we know, 26 years is the longest that an embryo that was subsequently born managed to survive. However, nobody really knows—we know only of the ones that have been reported. As for how long an embryo might survive, a study that measured the cumulative index of background radiation in mice suggested that when the mice embryos were subjected to increasing levels of cumulative radiation, they survived up to the equivalent of 2,000 years. Therefore, a 10-year limit has no scientific basis. Does the Minister agree?

[Baroness Blackwood of North Oxford]

I would never argue with the noble Lord, Lord Patel, on any scientific matter. My information is that there was no scientific or biological basis for the 10-year limit. It was based on debate and discussion of societal, ethical and cultural considerations, and on the concern that without a maximum limit, there would be questions about storage banks. Vitrification techniques are far more effective now than the slow-freezing techniques, so it is appropriate that these scientific questions are taken into account as this remains under review in the department.

Brexit: Counterfeit Medicines

Debate between Lord Patel and Baroness Blackwood of North Oxford

Thursday 7th February 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Lord for his question. We are committed to meeting the 9 February deadline for the launch of FMD safety measures. We expect all stakeholders in the UK’s supply chain to be aiming to comply with the requirements. We know that much of the supply chain is already prepared, but it is a complex chain, setting up medicine supply across the EU. The main challenges concern error messages; several member states—including Denmark, Portugal, the Netherlands and Ireland—have noted, unrelated to Brexit, that there will be challenges in implementation. The MHRA has notified the supply chain that we will be taking a pragmatic approach to implementation. This is appropriate, to ensure patient safety and a continuation of dispensing.

[Lord Patel (CB)]

My Lords, does the Minister agree that, with the implementation of the falsification of medicines regulation, which also goes with the European register for the verification of medicines, it would be rather unusual if the UK—even in a no-deal Brexit—did not have access to the European medicines register? That would mean it would not be possible for the decommissioning of any medicine to go on the register; any medicine that is dispensed in this country has to be decommissioned. I hope the Minister agrees that the MHRA will have to work with the European Medicines Agency to achieve this.

[Baroness Blackwood of North Oxford]

I thank the noble Lord, Lord Patel, for his question; obviously he has great expertise in this area. The Government have been clear that life sciences is a key sector for the United Kingdom, and have stated in the political declaration that we want to have close alignment with the European Union, and to continue close collaboration between the EMA and the MHRA going forward. This will be subject to negotiation, depending on the outcome of the exit. However, the MHRA is a world-leading organisation. We can be proud of its expertise in licensing, devices, inspections, batch release and pharmacovigilance. It is globally recognised and respected, and we want to ensure that shared experiences continue, for the benefit of both UK and EU patients.