Ambulance Response Times

Lord Rogan Excerpts

Wednesday 1st December 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness makes a very important point. We are all aware of the difficulties in different parts of the system. We have invested £450 million to upgrade A&E facilities in more than 120 separate NHS hospitals ahead of last winter, and this is being used to boost the physical capacity of A&E through expanded waiting areas, increasing the number of treatment cubicles, reducing overcrowding, et cetera. This is alongside an additional £1.8 million to place more hospital ambulance liaison officers at the most challenging acute trusts to help address the long delays, to reduce ambulance queueing and to get crews back on the road quickly.

[Lord Rogan (UUP)]

My Lords, the Northern Ireland Ambulance Service and its personnel hold a special place in the hearts of the people there because of their bravery, selflessness and professionalism during 30 years of terrorist violence. With Northern Ireland currently registering the highest Covid infection rate in the UK, the ambulance service is now facing a new challenge, with waiting times trebling and some patients having to wait for up to six hours outside emergency departments to be admitted to hospital. What assurance can the Minister offer the people of Northern Ireland that Her Majesty’s Government are aware of this problem and will offer all possible support to local Ministers to help solve it?

NHS: Primary Care Surgeries

Lord Rogan Excerpts

Wednesday 24th November 2021 Lords Chamber

[Lord Kamall (Con)]

I pay tribute to the noble Lord on his contributions to the Blair-Brown documentary, which I am sure a number of noble Lords enjoyed watching and learning from. It is important that we learn the right lessons from whichever political party, so when Tony Blair, a former Labour Prime Minister, says that we should encourage the private sector to be more involved in partnership with the public sector, we will take that advice.

[Lord Rogan (UUP)]

My Lords, I have great respect for GPs, but with general practices paid for the number of patients registered with the practice, profit-driven services might carry the risk of some GPs choosing to register younger and fitter patients, who will need to be seen less often than older patients. Would the Minister really be comfortable if that situation played out?

[Lord Kamall (Con)]

I am sure that noble Lords agree that it is appropriate that GPs register as many patients as they are able to see, and that their patients, whatever their needs, can access our great system of healthcare in this country. I would indeed be concerned if there were barriers to accessing GP services.

Social Care Reform

Lord Rogan Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Rogan (UUP) [V]]

My Lords, as well as declaring that he had a clear plan to fix the crisis in social care, Mr Johnson stressed in his infamous Downing Street speech of July 2019 that he was the Prime Minister of the whole United Kingdom. When the social care plan is finally brought forward, what guarantees can the Minister give to demonstrate that Mr Johnson’s Government value the social care needs of the people of Northern Ireland every bit as highly as those of patients residing in England?

[Lord Bethell (Con)]

My Lords, the noble Lord makes an entirely fair point. The needs of those who reside in Northern Ireland are paramount in our minds. I would be very glad to meet the noble Lord and discuss how their views and needs can be best incorporated in the policies we are developing.

Heathrow Airport: Border Control Passenger Safety

Lord Rogan Excerpts

Tuesday 25th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I also saw the images circulating last week of queues at Heathrow Airport, and I agree with the noble Baroness that we do not want to see a repeat of those kinds of scenes. However, I do not agree with her analysis. The Managed Quarantine Service has worked extremely well, and I pay tribute to Border Force for its contribution—we have more Border Force staff working today than we did during the 2012 Olympics. It does, unavoidably, take between five and 10 minutes for Border Force personnel to process each passenger; that is an unavoidable bureaucratic burden, but we have taken the necessary steps to ensure safe travel and minimise the circulation of mixed passengers within the terminals.

[Lord Rogan (UUP)]

My Lords, widespread concerns have been raised by travellers arriving at Heathrow, but clearly there are many other border control points in this country. That being the case, can the Minister give a commitment to urgently share the lessons that are being learned at Heathrow with airport authorities in Belfast and Londonderry? As we begin to welcome family, friends and tourists back to Northern Ireland, after the most testing of periods for the Province’s travel and tourism sectors, there is real concern that our relatively low infection rates could take a turn for the worse if common sense and procedures are not followed in all terminals. As the United Kingdom, we simply cannot afford to get this wrong.

[Lord Bethell (Con)]

My Lords, I completely and utterly acknowledge the concerns expressed by the noble Lord and by communities who live proximately to regional airports. As we look to the opening up of more airports, we are enthusiastically and energetically engaged with those communities. I reassure the noble Lord that the systems that we have in place around both red and amber quarantine have extremely tight restrictions on them, and there is no evidence of leakage into the local communities. We are doing our best to communicate that fact to those who are concerned.

Osimertinib Cancer Treatment

Lord Rogan Excerpts

Tuesday 18th May 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend is, as ever, all over the detail. It is my understanding that the gap is a matter of weeks rather than there being any clinical divergence in assessment of the evidence. However, I am afraid to say that I would have to leave it to the EMA to think for itself on that.

[Lord Rogan (UUP)]

My Lords, the noble Baroness, Lady Thornton, rightly mentioned waiting lists. According to the most recent statistics, 9% of the population in England are on hospital waiting lists—the highest figure since records began in 2007. In Northern Ireland, the figure is 23% of the population, by far the highest proportion in the four home nations. The drug that we are discussing has been widely used in Northern Ireland to treat mid and late-stage lung cancer until now. Cancer patients in Northern Ireland now feel that they are being placed at greater risk than cancer patients elsewhere in the United Kingdom. Will the Minister confirm that the supply problems that Northern Ireland is facing would not exist if the United Kingdom Government had not agreed to the European Medicines Agency having jurisdiction in Northern Ireland?

[Lord Bethell (Con)]

My Lords, I do not agree with either the basis or detail of the noble Lord’s assertion. There is absolutely no delay or problem of access for this drug. He is entirely right to say that Tagrisso is currently offered to patients across the UK, including Northern Ireland, for mid and late-stage disease and it will now be offered to patients across the UK, including Northern Ireland, on exactly the same terms for early-stage disease.

Dentists: Covid-19

Lord Rogan Excerpts

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, as I said earlier, 88% of NHS dentists are open. I was at an NHS dentist earlier today, and I pay tribute to all those dentists that are open. I do not know the specific situation in north and east Cornwall, but those in acute pain have access to the 695 urgent dental care centres, which are around England. I have enormous sympathy for those who have painful teeth, and I urge them to hunt down an appointment at one of those centres, where the service is excellent.

[Lord Rogan (UUP) [V]]

My Lords, official statistics show that the number of patients seen by general dental service dentists in Northern Ireland fell from 163,537 last February to just 8,825 in June, but rose again to 49,059 in September. With many of the current Covid restrictions having been put back in place since then, what discussions have UK Ministers had with their counterparts in Northern Ireland and the other devolved regions to encourage people to visit their dentist rather than suffer pain at home?

[Lord Bethell (Con)]

My Lords, I am grateful for that account of the Northern Ireland statistics, which tell a very similar story to those in other parts of the United Kingdom. The noble Lord is entirely right that those statistics tell a story of the massive challenge dentists face in order to increase the number of appointments per day. We are looking at a number of measures to try to improve that, including ventilation, which was referred to earlier by the noble Baroness. Testing is another option we are looking at. We are trying to put in place the kind of pre-appointment and point-of-care testing that can protect both the employees of dental practices and their patients. I hope that will help accelerate improvement in this area.

Covid-19: Vaccines

Lord Rogan Excerpts

Monday 1st February 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend is entirely right: from March, we will have considerably more work both to deploy the second dosage and to supply it. We have those plans absolutely in place: the supply of the vaccine has been put in place to ensure that we have a sufficient number of doses, and the workforce and locations are in place to ensure that we can deliver them.

[Lord Rogan (UUP) [V]]

My Lords, among Northern Ireland Health Minister Robin Swann’s many achievements since the start of the pandemic, he has overseen the establishment of seven regional centres across the Province where the Pfizer Covid-19 vaccine is now administered. I understand that a further significant consignment of the AstraZeneca vaccine is due in Northern Ireland this week for distribution to general practitioners. Can the Minister assure me that the Province’s stocks of the Pfizer vaccine are also being replenished to allow the regional centres to continue their excellent work at the fastest possible pace, including the delivery of a second dose?

[Lord Bethell (Con)]

I join the noble Lord in paying tribute to the good work of the Northern Ireland Health Minister, Robin Swann, whom I commend for his collaborative approach during this entire pandemic. I reassure the noble Lord that we are allocating doses on the business-as-usual, Barnett formula split, with 2.85% going to Northern Ireland. I pay tribute to the NHS there, where 214,601 people have had their first dose. A further 24,323 have had their second dose, and I reassure the noble Lord that we will maintain that velocity of delivery in the weeks to come.

Covid-19 Update

Lord Rogan Excerpts

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness is correct inasmuch as the statistics published for the original app would suggest. However, new statistics about the new app will be published after its launch on Thursday. I reassure her that the circumstances between then and now have changed considerably. The impact of an app that is widely downloaded and implemented across the country can be profound. We are extremely optimistic about its impact.

[Lord Rogan (UUP) [V]]

My Lords, it was announced in Stormont this afternoon that Covid-19 restrictions are to be extended across all Northern Ireland from 6 pm tomorrow. However, given that the Prime Minister is to make his own set of announcements tomorrow, can the Minister offer some clarity on whether the changes in Northern Ireland could be overwritten by Mr Johnson? Can he also offer some insight into what work is going on to try to achieve more consistency of messaging across all four nations of the United Kingdom? It is obvious that the differences are causing profound confusion among the public and putting more lives at risk.

[Lord Bethell (Con)]

My Lords, I note the move by Northern Ireland, which has taken a sincere and thoughtful approach. It is true that there have been some small differences between the different countries, but the vast majority of guidelines, restrictions and lockdown arrangements are shared by all the countries of the United Kingdom. I commend the huge amount of collaboration between all the DAs in working together to fight this horrible disease.

Covid-19 Update

Lord Rogan Excerpts

Thursday 10th September 2020 Lords Chamber

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

My Lords, I am enormously grateful for the thoughtful and informed questions from the Front Bench, and I echo the comments about teachers made by the noble Baroness, Lady Thornton. The return to school is a fundamental priority of the Government. It is a massive challenge for those involved, for governors, teachers, parents and school kids. I endorse the thanks the noble Baroness gave to teachers, who are performing incredibly well. The high return rates—percentages in the mid to high 90s—is remarkable and shows enormous confidence in the system among schoolchildren and their parents.

I also echo the noble Baroness’s thanks to NHS and social care staff who are preparing for winter. Enormous amounts of preparation are going into that. In response to the point made by the noble Baroness, Lady Barker, I reassure the Chamber that engagement with social care, local charities and local councils is incredibly intense and we are working extremely hard with local partners in all areas.

The noble Baroness, Lady Thornton, asked when the new regulations will be delivered. I am afraid that I cannot confirm the precise date, but I can reassure her that this Government are committed to being accountable to Parliament for those regulations and I look forward to that debate.

The noble Baroness also asked about the sequence of announcements. I reassure her that the Prime Minister brought his Statement to Parliament in good faith to update Parliament first. We cannot prevent leaks from happening, and leaks that get on to social media and then into the papers are something that we did not design or deliberately create. They are something that we regret. It would have been massively our preference for the Prime Minister to put Parliament first in his announcement.

The noble Baroness also asked about the testing system. The capacity of the testing system has never been higher: it has increased by 10,000 per day for the last two weeks and continues to increase dramatically. But demand has never been higher either, and there are good, laudable reasons why that demand is going up. The number of tests for supporting the vaccine programme has gone up. The number of tests to support our therapeutics programme has gone up. The surveillance of local prevalence has gone up, and the marketing around the use of tests by those who show symptoms has proved to be much more effective and the take-up among those who have Covid-19 symptoms has gone up. For those reasons we are extremely pleased by that effect.

However, there has also been a significant rise in the use of tests by asymptomatic individuals, largely tied to children returning to school. That is why we have been clarifying the guidance on the use of tests—that they should be used by those who have symptoms and not by those who are asymptomatic. One day, when the capacity is there and the system can bear it, I hope that we will move towards a system where anyone can have a test whenever they like, however they feel, but right now we must live within the system that we have. We are doing hundreds of thousands of tests per day and clarifying with teachers and parents that tests should be used by those who show symptoms and not by those who are seeking some other form of guidance.

Regarding the questions asked by the noble Baroness about the moonshot, I am a little confused. “If we cannot do millions of tests today, how can we expect to be able to do millions of tests tomorrow?” seems to be the question. I will answer it very clearly. The innovation around testing has moved much quicker than anyone could have expected in terms of scale, cost, accuracy and speed. The industry and the professionals in the NHS, academia and private business have come together in a triple helix to collaborate in a massive revolution in testing, which has changed considerably in this country from the days when we were struggling to do 2,000 or 3,000 tests per day to when we had the capacity to do 200,000 or 300,000 tests per day.

We have a clear view of how we can dramatically increase the tests. That clear view has two components: those tests that use existing technology that is purchasable in today’s world, and a clear idea of where innovation will take us in the very near future. This Government are committed to grabbing the opportunity of that innovation in order to dramatically increase the number of tests. There will be nay-sayers who will question whether that innovation will deliver, and undoubtedly there will be set-backs. Not everything will deliver as promised. However, I am extremely optimistic that we will be able to harness the power of science and innovation to invest in the backbone of our data and our delivery mechanisms, and to engage with the British public to deliver a testing system that enables us to return to the life that we love.

The noble Baroness, Lady Thornton, questioned whether the testing system could be relied on to deliver results. Let me explain: the people of Luton and Leicester have used testing and contact tracing, and infection rates are dramatically lower—less than half what they were in late July. Those are two excellent case studies of how our system of testing and contact tracing has turned around difficult situations and pushed back the spread of Covid by breaking the chain of infection. The noble Baroness also asked what we will do to improve the system as it stands. There are three areas of improvement: first, technology; secondly, infrastructure, by which I mean the data and the presence on the ground; and thirdly, engagement with the public so that they understand how to engage and we understand better how to interact with the public.

The noble Baroness, Lady Barker, asked about the contact system and gave some statistics. I reassure her that since 28 May we have rung 272,000 people who have been reached by the test and trace system. Where communication details have been provided, the service has reached 88.6% of close contacts, and 78.4% of people who have tested positive have been reached. Within the bounds of epidemiological effectiveness, these are extremely impressive statistics. Compared with those from other countries, they range among some of the highest. It is an incredibly impressive set of results for a system that was stood up in relatively recent history. Local public systems are complementing the central contact tracing hub, and I pay thanks to all those local authorities that either work with their full-time employees, or, as is often the case, have employed local businesses, to support it.

We have hit our target on care homes—the noble Baroness, Lady Barker, might like to take a moment to celebrate that. We are also trying to work with a degree of transparency in our operations. I do not regret for a moment the fact that the operational senior leadership in the track and trace team has been on the level about the present supply constraints, with social care and the general public. I reassure the noble Baroness, Lady Barker, that care homes absolutely remain top of our priorities. Many of the frustrations the public face, such as longer distances to travel, are exactly because we have put care homes first and have therefore had to dial down some of the availability of tests to the public. We sit down with care homes to discuss winter preparations. An indication of that is the 31 billion items of PPE that we have contracted to buy for this winter—an astonishing figure. That pays great tribute to the work of the noble Lord, Lord Deighton, and the PPE team, who have built up a fantastic stock.

Finally, I would like to express a small amount of confusion about the remarks from the noble Baroness, Lady Barker. On the one hand, she attacked the involvement of major private companies and central control of our track and trace system, but on the other hand, she attacked civic engagement, the volunteering of members of the public to support our track and trace system, and local initiatives whereby NHS trusts have brought back retired staff. The combination of these two themes is the heart of our success, and I celebrate both.

[The Deputy Speaker (Lord Rogan) (UUP)]

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can maximise the number of speakers.

Dental Care

Lord Rogan Excerpts

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

My Lords, I completely understand the points that the noble Lord has made. He refers to a situation that we are fully aware of, and I completely agree with his analysis. The truth is that tooth extraction avoids some of the risks that I described, but treatment in the centres is not limited to extraction and other protocols are arranged. The Chief Dental Officer is working on a dental plan, and we are liaising with colleagues in the Treasury to see what more can be done to help dental practices.

[Lord Rogan (UUP)]

My Lords, United Kingdom dentists, too, are heroes and heroines of this pandemic. In Northern Ireland 100 dentists were sought to run emergency clinics, but more than 400 stepped forward, and dozens more have volunteered to work in care homes. A recent BDA survey warned that three-quarters of Northern Ireland’s dental practices could collapse by the summer because of Covid-19. Like the noble Lord, Lord Hunt, I ask the Minister urgently to consider adopting a UK-wide approach to saving our dental sector from disaster.

[Lord Bethell]

The noble Lord’s concerns are well understood. Practices that depend on private income are particularly affected, because the NHS has guaranteed the income to NHS practices for their NHS work. We are working on a UK-wide national plan, and it is a massive priority for the Government.