Mental Health: Advertising and Body Image
Debate between Lord Robathan and Lord Kamall(2 years, 4 months ago)
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Lord Kamall (Con)
A range of issues were looked at in the online advertising programme, including advertising on social media, where people get messages from in the first place, and what the most effective method is. What do we ban? What do we give advice on? What do we give warnings to? It is an incredibly complicated issue, but we are looking through lots of evidence that came in as a result of the consultation.
Lord Robathan (Con)
My Lords, what assessment have Her Majesty’s Government made of the link between body image, obesity, childhood obesity, diabetes, cancer and early death?
Lord Kamall (Con)
My noble friend has asked me a very concise question, which will require a less concise answer. Clearly, there is a link between obesity and type 2 diabetes, for example, but one of the difficult things in this area, as with much in healthcare, is getting the right balance. The more emphasis we put on tackling obesity, the more unintended consequences there will be for people with eating disorders. There is now calorie labelling in restaurants and other out-of-home places, but some charities working with people with eating disorders are concerned that this may have a negative impact on them. It is always a difficult balance, but we must try to achieve it.
Covid-19: Lockdowns
Debate between Lord Robathan and Lord Kamall(2 years, 9 months ago)
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Lord Robathan
To ask Her Majesty’s Government what assessment they have made of the paper A Literature Review and Meta-Analysis of the Effects of Lockdowns on COVID-19 Mortality, published in January; and in particular, the conclusions that (1) lockdown measures during the pandemic reduced COVID-19 mortality by 0.2 per cent on average, and (2) the public health benefits of such measures were outweighed by their economic and social costs.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
The paper has yet to be peer-reviewed and there are important methodological issues that we would expect the reviewers to address. For example, the figure of 0.2% reduction in Covid-19 mortality from lockdown comes mainly from one of the 34 studies reviewed, while other studies report a reduction in mortality of up to 35%. To examine the trade-off between the public health benefits of lockdown and the economic and social costs requires a wider examination of the evidence.
Lord Robathan (Con)
My Lords, I am grateful to my noble friend for that reasoned Answer. I have absolutely no idea whether these conclusions are correct, but does my noble friend think that the formulation of government medical policy should be influenced by a wider range of scientific advice, such as that from the authors of this paper, rather than by the narrow focus of SAGE? This is epitomised by the discredited Neil Ferguson. Is he an ex-member? I cannot quite remember. He is still dragged out by the BBC to spread inaccurate gloom and doom. Can my noble friend also confirm that the Chief Medical Officer, at the Cabinet meeting on 8 December, predicted that without further lockdown by new year London would be like Lombardy was in March 2020?
Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021
Debate between Lord Robathan and Lord Kamall(2 years, 11 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
My Lords, I beg to move that the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021 be approved and shall also be moving the Health Protection (Coronavirus, Wearing of Face Coverings) (England) (Amendment) Regulations 2021 and the Health Protection (Coronavirus, Restrictions) (Entry to Venues and Events) (England) Regulations 2021.
Despite our progress so far and our investment in treatments, the omicron variant has been designated a variant of concern and so we must act now, as quickly as possible, to slow its spread. The UK Health Security Agency predicts that omicron will become the dominant strain within one to two weeks across the whole country. In response, the UK’s four Chief Medical Officers have raised the Covid alert level to 4, its second-highest level.
Although we do not yet have a complete picture of omicron’s severity, it has become increasingly clear that omicron is growing much faster than the previous delta variant and is spreading rapidly all around the world, so its higher transmissibility means it still threatens to overwhelm the NHS. We are seeing increased transmission rates reflected currently in case rates, and the current doubling time for omicron cases is now between two and three days. We need to act now to help slow the spread of the variant and reduce the chances of the NHS coming under unsustainable pressure, while buying time to deliver more boosters.
On 8 December, the Government announced that it was now necessary to implement plan B measures in England in response to the risks of the omicron variant. This includes: extending regulations on face coverings to make them mandatory in most indoor public settings from 10 December; asking those who can work from home to do so from 13 December; and making vaccine or test certification mandatory for entry to certain venues and events from this morning.
Today, we are debating the regulations that bring about the legal requirements for face coverings and certification. These regulations are sunsetted or due to expire on 26 January 2022, but they will be reviewed by the Government in early January. We are also debating regulations that bring important changes to self-isolation requirements to enable fully vaccinated contacts to take part in daily contact testing.
From 10 December, face coverings have been mandatory in most indoor public spaces in England. However, they are not required in hospitality settings such as cafés, restaurants and pubs, or in nightclubs. Exemptions apply—including for children aged under 11 and for those unable to wear a face covering for health or disability reasons. Evidence from the UK Health Security Agency respiratory evidence panel suggests that all types of face covering are, to some extent, effective in reducing transmission.
From today, showing the NHS Covid pass is mandatory as a condition of entry to certain settings in England. This is not a vaccination passport, and people will have different ways to show that they are eligible. Negative test results provide some assurance that an individual is not infectious when the test is taken and for a short time afterwards.
There is evidence to suggest that vaccination reduces the likelihood of infection or transmission to a small degree with delta, which continues to circulate. Early evidence suggests that vaccine effectiveness against symptomatic infection after two doses is significantly lower against omicron than against delta. Nevertheless, a moderate to high vaccine effectiveness is seen in the early period after a booster dose. Vaccine effectiveness is also likely to be higher in preventing severe, rather than mild, disease, and it continues to be vital in response to the high levels of delta cases that continue to circulate.
Covid status can also be shown through proof of a negative test taken in the previous 48 hours, which demonstrates that you are less likely to be infectious, as well as proof of medical exemption or evidence of participation in a clinical trial.
Certification will apply in a limited number of settings, including venues acting like nightclubs; indoor events with 500 or more attendees likely to stand and move around; outdoor events with 4,000 or more attendees likely to stand and move around; and all events with more than 10,000 attendees. Vaccine or test certification will not eliminate the possibility of infectious people attending or transmitting the virus in these settings, but it will help to reduce the risks.
The test, trace and self-isolate system continues to be one of the key ways to control the virus and to protect our nation. Yesterday, the Government introduced a policy of daily testing for all fully vaccinated contacts of people who have tested positive for Covid-19. This will identify—or help to identify—the virus quickly and help to break chains of transmission without requiring large numbers of people to self-isolate. To support this, we have removed the requirement in the self-isolation regulations for all close contacts of suspected or confirmed omicron cases to self-isolate, regardless of their age or vaccination status. This was introduced as a temporary measure on 30 November. Unvaccinated adult contacts will continue to be legally required to self-isolate, unless they are participating in an approved workplace daily contact testing scheme. We will constantly monitor and review the data.
Lastly, let us all urge everyone who can have the vaccine to get boosted now. More than 24 million booster or third doses have already been administered across the UK. Our target is to offer this to every eligible adult in England by the end of December.
I thank everyone involved in the vaccination programme for their continued efforts to maintain this tremendous progress over the important weeks ahead. I understand that there are concerns among noble Lords across the House about these regulations. It is always a difficult balance and we hope we have got the balance right. I look forward to continued scrutiny by noble Lords and to their valuable contributions to this debate.
Lord Robathan (Con)
My Lords, I will start with a quote:
“It always suits Governments … to scarify the population.”
This was specifically about the ID cards Bill in 2005, when
“only a handful of principled Tories stuck up for liberty, and they were duly overwhelmed by the Government.”
The same person promised to “eat” his ID card if asked to show it to an official—so I expect that noble Lords will recognise the author of the quotes, who was then the Member of Parliament for Henley and editor of the Spectator.
Roosevelt famously said in his 1933 inaugural speech during the Depression—others had said it before—that
“the only thing we have to fear is fear itself”.
So what is going on? Why are the Government scarifying the population and stoking fear?
Medical Schools: Training Places
Debate between Lord Robathan and Lord Kamall(2 years, 11 months ago)
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Lord Robathan
To ask Her Majesty’s Government how many training places for new doctors there were in medical schools and other institutions in (1) 2000–01, and (2) 2021–22; and what plans they have, if any, to increase the number of places for 2022–23.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
In the 2000-01 academic year in England, there were 4,300 government-funded medical school places. Initial data shows that, in 2021-22, 8,460 places have been taken up, including additional places for students who completed A-levels in 2021 and had an offer from a university in England to study medicine subject to their grades. The Government continue to monitor the number of medical school places that they fund to ensure that it is in line with NHS workforce requirements.
Lord Robathan (Con)
My Lords, the Answer is quite encouraging, but doctors and other medical staff are working flat out on our behalf, and we are told that there are not enough doctors. That is because we are not training enough. Some 21 years ago, Gordon Brown confected a row over a girl called Laura Spence, who was well qualified but was not able to get into Oxford to read medicine because there were not enough training places. We have had all three major parties in government in those 21 years, and there are still not enough training places. Rather than taking doctors from the poorest countries in the world, where they are needed, and bringing them here, does not my noble friend think that it is time to make sure that we train enough doctors in this country and that there are enough training places for them so we can actually service our own needs?
Lord Kamall (Con)
I thank my noble friend for the question, but there are record numbers of medical students in training. There are currently more than 35,000 doctors in undergraduate training and 60,000 doctors in foundation and speciality postgraduate medical training. On the international market, we follow strict ethical guidelines, in line with the World Health Organization guidelines.
Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021
Debate between Lord Robathan and Lord Kamall(2 years, 11 months ago)
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Lord Kamall (Con)
I apologise to noble Lords— I was looking forward to so many more contributions. I hope noble Lords will forgive me for enjoying the debate rather too much. I apologise to my noble friend Lord Greenhalgh, who has been waiting for ages, and to my noble friend behind me who says he has to go to the theatre. I hope he will wear his mask when he goes to the theatre.
I thank all noble Lords for their contributions to today’s debate. What is really important and what it shows is that we are still debating issues and contesting the science. Clearly there is a range of views across the House on the issues raised. There is no consensus on this. That is really interesting in the way it shows that we can debate these issues and question the statistics. I will turn to some of the points noble Lords made, particularly about some of the statistics but also on the regulations.
I hope noble Lords will forgive me if I do not answer every single question and refer to every single noble Lord who asked them—unless noble Lords want to stay here a bit longer and my noble friend Lord Greenhalgh can go and have another teacake or something while he is waiting.
Lord Kamall (Con)
Sorry, was that offensive? I apologise for any offence caused to my noble friend. I just assumed that because I like teacakes, my noble friend also does.
I will start with some of the questions. On the question of how many people have been helped by some of these financial services, as of 17 November 2021, local authorities have reported 362,573 successful claims since the start of the scheme, totalling £181 million in test and trace support systems.
Despite the easing of the restrictions at step 4 of the road map, the Government have continued to recommend that face coverings are worn in crowded and enclosed spaces. We accept that there is wide support for reintroducing mandatory face coverings, but we have always tried to balance these issues. As I said in previous debates, we look at a number of factors, not only medical but economic and social. Also, within health itself, many mental health experts are very concerned that we might go for more lockdowns and about some of the measures that a number of noble Lords have mentioned.
As we saw in the debate, there are noble Lords who believe that we have gone too far and noble Lords who feel that we have not gone far enough unless we effectively enter a second lockdown. That shows the range of views here and the difficulty, as my noble friend, Lady Altmann, said, that the Government are damned if they do, damned if they do not, but we accept that.
So, do face masks actually work? This is where there is still a debate. I thank my noble friend Lady Noakes for pointing out the article by Professor Simon Wood, who is professor of statistics at the University of Edinburgh, in which he analysed the BMJ paper. It is in effect a meta-analysis. A number of newspapers have taken a line saying that wearing a mask cuts Covid by 53%. I encourage noble Lords to read the article, in which he takes apart the statistics as a statistician and looks at, as those who have done statistics will understand, whether we have a significant number of samples to make it statistically sound. In addition, Professor Naismith of Oxford University has been quoted as saying that
“the Scottish and English approach to masking, although formally different since July, has made no meaningful difference to delta.”
Once again we see that there is a whole range of views, but we have listened to those views. Because we do not yet know enough about this variant, we will continue to review the data. For example, some say that it is very mild in South Africa so we should not be overly concerned about it, but we also have to remember that South Africa has a different demographic in terms of younger people. We know that when the virus first struck it disproportionately affected older people—as my noble friend Lord Robathan said, people aged over 85. On the balance of the data at the moment, we believe that wearing face masks works but we have always been very careful to make sure that it is proportionate where we do it.
On the expiry of some of these measures, as the Prime Minister said on Saturday, all the provisions that have been voted on will be reviewed in three weeks. They are necessary and proportionate while we learn more. I refer to the economics Nobel laureate Friedrich Hayek, who talked about humans having limited knowledge. He talked about the conceit of knowledge. The way to understand a lot of complex problems is to allow the discovery process to take hold and to look at what we can learn from that process. We should be very careful not to imagine that we have total knowledge. What we have to do is assess it proportionately.
It is our hope that these regulations will no longer be necessary in three weeks’ time and that we can return to the system that we lived under last week, but in the event that we need more time to understand the effect of the variant, or that the data shows that we need to take a different approach that requires new regulations, the House will return to Parliament ahead of the Christmas Recess for a debate and vote on the regulations ahead of their coming into force.
On regulations expiring, the international travel regulations will expire at the end of 16 May 2022. The face covering regulations will expire, unless extended, at the end of 20 December 2021. The self-isolation regulations at the moment expire at the end of 24 March 2022, but we will continue to review the data. Almost daily the data is being reviewed and conversations are going on. We will also continue to review the data on the new variant and we hope to update Parliament on the review in the week commencing 13 December.
A number of noble Lords asked about facilities. We are told that setting up dedicated testing facilities at border entry points such as airports is logistically difficult at the moment, and risks delays to passenger journeys and operations. Given the turnaround for a PCR test, passengers would still have to travel to their home or the place they are staying and isolate there before receiving a result. The Government are taking a measured and proportionate response. We want to try to protect the UK from omicron while allowing continued safe travel.
A number of references were made to points made by Dr Jenny Harries. As the Prime Minster said, the guidance remains the same as the measures that were in place to fight delta. We have now brought in tougher measures, but we continue to take advice from a number of experts. Individual experts are free to give their viewpoint but we look at the balance—some of it medical, some of it clinical, but also economic and social factors—and getting that proportionate.
Covid-19 Update
Debate between Lord Robathan and Lord Kamall(2 years, 11 months ago)
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Lord Kamall (Con)
The important thing for us is to make sure that PCR tests are available and that there is sufficient supply and capacity to deliver them. Frankly, as much as we want to make sure there are enough PCR tests, we want to make sure that supplies come to the market. But, as the noble Baroness will be aware, my right honourable friend the Secretary of State has raised concerns about the cost of some of the PCR tests and has been quite public about that.
Lord Robathan (Con)
My Lords, first, did the Minister see the interview with Dr Coetzee, the South African doctor who first identified the omicron variant, on “The Andrew Marr Show” yesterday? She said that the British Government were overreacting and, when asked, specifically agreed that they were panicking. Secondly, could he identify and publish for the benefit of everyone the studies that have shown that wearing these flimsy, non-surgical face masks is effective in preventing transmission? I refer to the excellent research which my noble friend Lord Ridley detailed in the Grand Committee on 26 October, which is in column 123 of Hansard. So far, no proper study has shown that wearing a face mask is effective.
Lord Kamall (Con)
I thank my noble friend for those points. On the comments made by the South African expert, I raised these issues with officials and experts today; one of the points made was that there are different demographics of who has been affected. We want to make sure that we are being cautious and proportionate. Therefore, we have taken these measures as a precaution. On the efficacy of face masks, the point my noble friend makes shows that there is a debate, but we have decided to err on the side of caution to make sure that we are prepared.
Cancer Drugs: Licensing and Approval
Debate between Lord Robathan and Lord Kamall(3 years ago)
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Lord Kamall (Con)
Both NICE and MHRA are aware of the concerns, particularly regarding the delay between approval and licensing. That is why they are having conversations with NHS England and NHS Improvement to make sure, as far as possible, that they can discuss co-operation to ensure the speedy approval of drugs.
Lord Robathan (Con)
My Lords, regarding the efficacy of cancer treatment, so far this year, six friends of mine have died from cancer; all were under 80 and three were younger than me. I know of many more who have terminal cancer, regrettably. I also knew one person who died from coronavirus aged 55. She had leukaemia, or blood cancer, which destroyed her immune system, and she caught the virus while she was being treated in hospital. To put cancer in perspective, how many people under the age of 80 have died this year from cancer and how many people under the age of 80 have died in this terrible pandemic, which has shut down society, damaged our children’s education and mortgaged their future for decades to come?
Lord Kamall (Con)
I thank my noble friend for his question. The focus was on fighting Covid and making sure that people were vaccinated as quickly as possible. As noble Lords know, economics is about the allocation of scarce resources and there are always trade-offs. Sometimes there are unintended consequences of focusing on one condition rather than another. I will write to my noble friend with an answer to his specific question.
COVID-19: Type 2 Diabetes
Debate between Lord Robathan and Lord Kamall(3 years, 1 month ago)
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Lord Kamall (Con)
In response to the increases in weight due to Covid-19, but also before, which led to more type 2 diabetes, the Government, the DHSC and the NHS have been looking in detail at how to respond. Further details will be made available.
Lord Robathan (Con)
My Lords, I am glad that the Government recognise that this is a huge problem, and the dangers that being overweight brings, especially during Covid. However, does my noble friend not recognise that the strategy, good as it may be, is not working? Is it not time to revert to the situation when I was young, when it was not socially acceptable to be grossly overweight, and to push individual responsibility? Government policy should tell people that they must not eat so much.
Lord Kamall (Con)
I am beginning to wish I had eaten a full breakfast. With any strategy or programme, we always have to be careful about unintended consequences. As we focus more on obesity and make more people aware of healthy living and healthy eating, it is important to have the right balance and to be aware of the impact this can have, so that we are not creating more problems, concerns and anxieties for those who suffer from eating disorders.
Covid-19: Plan B
Debate between Lord Robathan and Lord Kamall(3 years, 1 month ago)
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Lord Kamall (Con)
I thank the noble Baroness for her question and, while I have the opportunity, for all her advice, as a new boy in the role. We will continue to look at a number of different factors, including both economic and health indicators, before we judge whether it is necessary to move to plan B. Plan B does not actually involve complete lockdown. It involves introducing mandatory vaccine-only Covid status certification in certain riskier settings; legally mandating face coverings in certain settings, such as public transport; and communicating clearly and urgently to the public if the risk level increases.
Lord Robathan (Con)
My Lords, could my noble friend tell us, following the amazing success of the vaccine rollout, what proportion of hospital beds are occupied by Covid patients? Because it seems to me that some people—some doomsayers—are trying to create panic where there is no need for it.
Lord Kamall (Con)
I thank my noble friend for his question. I do not have the detailed data and I will write to him. But in terms of the link between cases, hospitalisations and deaths, it is quite clear that the vaccine has been working to break the link between the number of cases, hospitalisations and deaths.