Bread and Flour Regulations 1988

Lord Rooker Excerpts

Tuesday 7th February 2023 Lords Chamber

Asked by

[Lord Rooker]

To ask His Majesty’s Government when they expect to announce a decision following the consultation on the Bread and Flour Regulations 1988 which closed on 23 November 2022.

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

The Government will publish an interim response within 12 weeks of the consultation closing, on 14 February, with a fuller government response later this summer. We received 369 responses, and UK officials are currently reviewing them in detail with a review to finalising policy decisions. Following that, the Government expect to lay new legislation early in 2024 subject to clearing parliamentary process. Discussions with industry on the practicalities of folic acid fortification of flour are also ongoing.

[Lord Rooker (Lab)]

I have to say that is the first time the Minister has answered one of my Questions on this, and I am very grateful to him. He gave some positive dates, which we can hold him accountable to, and it looks as though there is some progress. I will make just one point. It is already three months since the end of the consultation. That is another 250 neural tube defect pregnancies, 80% of which will be terminated, and close to 50 live births of children who will have lifelong disabilities. It really needs to speed up. I fully accept what the Minister said, and I am very grateful for that—it would be churlish to be otherwise. However, the fact is that time is of the essence on this. We have a cure for 80% of the issue, but we are not using it at the present time.

[Lord Markham (Con)]

I thank the noble Lord, who has been a tireless campaigner on this issue. Again, a benefit of this position is getting to learn new subjects, and this is one of them. I can see why he campaigns so hard on it. I am delighted to say that we are getting there, albeit that it could be argued that maybe it could be quicker. At the same time, industry is seeing that, and the good news is that it is already adjusting. The majority of breakfast cereals are now fortified and a lot of the rest of the industry is responding. We are making a difference, and I thank the noble Lord again for his campaigning.

NHS Industrial Action: Government Preparations

Lord Rooker Excerpts

Tuesday 13th December 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend for his question. He is quite right. As mentioned before, this body was set up in 1984 and extended to other areas of the health service in 2007. Since then, Governments of all colours have followed its recommendations because, after all, it is the expert in this field. We have honoured that in full because it is right that the experts determine it. Working towards making sure that the next settlement in April—which, let us face it, is only three or four months away—covers the latest situation would be a good way ahead.

[Lord Rooker (Lab)]

Is not the total silence of all members of the pay review body since it delivered its report to the Government remarkable? Has anyone asked them, bearing in mind that they delivered their report when inflation was about 3% or 4%, whether they believe the figures in their report are still relevant today? Forget last April or next April—we are talking about today. The pay review body has been loaded up with a responsibility by the Government which in a way is not solely its responsibility. The Government do not have to accept its recommendations, as the Scottish Government have not. Has anybody asked it whether, in the present circumstances and with inflation so high, it still stands by the report it delivered in the middle of last year?

[Lord Markham (Con)]

My understanding, based on the long time that this has been in place, is that this is an annual review. April is now quite close; for that April review, it can take into account all the factors, including what happened to inflation during the year. I expect it will take all that into account, quite rightly, in what it comes up with for that next pay review. It is a long-established principle that it is there to do this. I trust it to get the right answer in time for April.

Childhood Obesity

Lord Rooker Excerpts

Thursday 17th November 2022 Lords Chamber

[Lord Markham (Con)]

I thank my noble friend and totally agree with him. As we have all mentioned, physical activities are a key part of a healthy lifestyle, regarding not just obesity and healthy eating but mental health. There is a lot of evidence to show that sport and a healthy lifestyle are good for everyone. We are working with the DfE and DCMS on this, but I agree that it we will need to keep it central to our agenda.

[Lord Rooker (Lab)]

I say to the Minister that we do not need to reinvent the wheel. A perfectly good practical policy was worked out at the end of the David Cameron period in government; it arrived on the desk of Theresa May, who scrapped it. Why not go back to that?

[Lord Markham (Con)]

I am afraid the noble Lord is testing my memory as to what that was. If he will excuse me, I will find out what it was and write to him.

Bread and Flour Regulations: Folic Acid

Lord Rooker Excerpts

Wednesday 6th July 2022 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government, further to the answer by Lord Kamall on 6 April (HL Deb col 2076), what progress they have made towards amending the Bread and Flour Regulations to include folic acid fortification.

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

I am grateful to the noble Lord for continuing to promote this important policy. I hope that, following our meeting in May, the noble Lord is sure that the Government share his commitment to getting folic acid fortification done as part of the Bread and Flour Regulations review. The review continues to progress, we are aiming to launch a consultation shortly and I am able to share an indicative timeline for the process.

[Lord Rooker (Lab)]

I am grateful to the Minister for his Answer and confirmation, but just in case there is any backsliding in his department, may I suggest that he asks them a question? Can anybody name any one of the 85 countries that have made fortified folic acid mandatory, some for over 20 years, that has pulled out; and can the Minister name any one of the 85 that has found a bad side-effect? The answer to both questions is no. Then, he can go and face the 18 women last week, this week, next week and the week after who have terminations after the 20-week scan. The department is sitting on a cure to stop 80% of that distress among our fellow citizens. We are going at a glacial pace— I accept it is in the right direction, but it is glacial.

[Lord Kamall (Con)]

I hope the noble Lord appreciates that there is debate here. He has written to me a number of times about Professor Wald’s paper, which has been put before the advisers in the department. I think what we are seeing is scientific contestation: some people say that the science is settled, but others say that you have to be very aware of the unintended consequences. The NHS website advises people with certain conditions not to take folic acid, the worry being that, for people who do have levels of folic acid, we may end up solving one problem and unintentionally creating another.

Folic Acid Fortification

Lord Rooker Excerpts

Wednesday 6th April 2022 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government when they intend to introduce draft legislation to replace the Bread and Flour Regulations, following their decision to implement folic acid fortification announced in September 2021.

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

I pay tribute to the noble Lord for his tireless advocacy of this important policy. Substantial progress has been made since September 2021, including working with the devolved Administrations to establish a cross-industry Bread and Flour Technical Working Group engaging stakeholders to move forward to the regulatory review. Proposed changes are being finalised and impacts assessed by a whole-UK working group for a consultation once the Northern Ireland Assembly elections have concluded.

[Lord Rooker (Lab)]

I thank the Minister. This is taking a long time. I have only one question for him. Given that it is now more than 30 years since the medical research councils connected up the difficulties of neural tube defects and that more than 80 countries have operated the policy, will he commit to using the best possible science? People have spent decades on this, and scientists tell me this can prevent up to 80% of neural tube defects. It has advanced since the original science 30 years ago.

[Lord Kamall (Con)]

The noble Lord is absolutely right: our scientific knowledge increases as scientists challenge each other and come to other conclusions. We have to be aware that there is no off-the-shelf solution. For example, I am sure the noble Lord will be aware that in Australia they can divide the flour and fortify only flour used to make bread. That cannot be done in this country, which is why we are working with stakeholders including heritage millers, for example, to make sure that we have the right solution. It has all been delayed due to a number of elections.

Health and Care Bill

Lord Rooker Excerpts

Consideration of Commons amendments
Tuesday 5th April 2022 Lords Chamber

In a letter today to Peers, the Minister says that we can have a review—a point he made earlier—but we have been offered reviews on countless occasions. The road to hell is paved with reviews and good intentions. The noble Lord, Lord Blencathra, offers us something much better, and I hope that the House will vote for it, as Sir Iain has asked us to do, to give the House of Commons a chance to incorporate a measure that enjoys widespread support across all Benches and across both Houses.

[Lord Rooker (Lab)]

My Lords, in our debate on 31 January, I made the point at some length that it was not possible to trust accreditation of products based on paper and supply chains. I assume that the Minister has been briefed on this. After that debate, on 3 March, he wrote a long letter to me and the noble Lord, Lord Alton, and towards the end of it raised my point about the supply of cotton-based products.

I had explained that it is possible, using the techniques of element analysis, to take a product and find out where the cotton was grown. You do not need paperwork to do that, or trusted supplier chains. The technique and the technology are there. You can find out whether it was grown in Xinjiang, another part of China, or another part of the world. The Minister said in his letter that bidders to the NHS supply chain will have to certify that they are better-cotton-initiative certified. That is the very thing that we need to avoid. You cannot trust paper-based systems of supply. You must use the technology to find out where the cotton is grown.

In the government amendment that has come from the Commons, paragraph 3 specifically refers to cotton-based products—so, given the final paragraph of the Minister’s letter, saying that the NHS supply chain does not have a contract to use the element-analysis services supplied by Oritain, what has happened since? Has there been any contact between the Department of Health and the NHS supply chain with the company that has the technology? I have no interest to declare here. I made it absolutely clear in the debate that this came out of a “long read” in the Guardian way back in September. The technology is there, not just in cotton but in other issues. Here I am just using it for cotton—the uniforms, the mattresses and the products. In subsection (3) of the new clause proposed by Amendment 48A, the Government are going to assess cotton. Have they done anything since our debate in Committee to make arrangements to use the technology, on the basis that you cannot trust paper-based supply chain accreditation? It is a simple question, and I would like an answer.

[Baroness Finlay of Llandaff (CB)]

My Lords, I rise very briefly to support Amendment D1, tabled by the noble Lord, Lord Blencathra. Last night I was part of a BMA web conference mounted by the Ethics Committee, of which I am an elected member, looking at the powerful evidence coming out of Xinjiang province in China. The concern is that, if we are purchasing products from there, we are complicit in the appalling human rights abuses that we were shown evidence of in this webinar. Therefore, I hope the House will support that amendment.

I return to the very important Amendment B1, tabled by the noble Baroness, Lady Cumberlege. This is not just a static situation. It is worsening. All that we have done is not just more of the same; we are actually sliding downhill rapidly. I want to give a little bit of data to the House to support that statement. There are now 1,565 fewer GPs than in 2015, meaning that there is a shortfall of 2,157 against the target that was set by the Government in their manifesto promise, in terms of where we are tracking to date.

The number of fully qualified GPs by headcount has decreased by over 600, so there are now just 0.45 fully qualified GPs per 1,000 patients in England, down from 0.52 in 2015. This means that each GP is responsible for about 300 more patients than previously. In terms of physiotherapy—I declare an interest as president of the Chartered Society of Physiotherapy—the model shows that 500 new physios are needed each year for multiple years to meet demand. There needs to be a trebling of the 6,000 NHS physio support workers. In nursing, the district nursing numbers have dropped from 7,055 in 2009 to 3,900 in 2021, which is a 45% drop. This is all going in the wrong direction. From the data that I could obtain, it looks as if three-quarters of nursing vacancies are filled by temporary staff.

This amendment, tabled by the noble Baroness, Lady Cumberlege, is crucially important. It would be a dereliction of our duty to ignore supporting that amendment, given all that we know and all the work that has gone on. That is not to be critical of the Minister and his team at all, because I am sure that it is not his personal wish that we do not have this in place—but we certainly do need a completely new approach to workforce planning.

Covid-19: Lockdowns

Lord Rooker Excerpts

Wednesday 9th February 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Lord makes important points. If we look at the history of the debate about the world being round, at one time scientists believed that the world was flat. Because of scepticism and contestability in science, we have been able to come to the conclusion that the world is round. That shows the importance of science being contestable and of having an open debate.

[Lord Rooker (Lab)]

On the issue of Covid and mortality, does the Minister have a view about the allegations made in the BBC2 documentary last night that there were hundreds of thousands of excess deaths because of the business and political attacks on the AstraZeneca vaccine in the early days? The fact is that its non-profit system did not suit the drug industry’s business plan. The massive allegation that, because of this failure, hundreds of thousands of extra people died, clearly ought to be investigated.

[Lord Kamall (Con)]

I apologise to the noble Lord. I did not see the programme last night. I was swatting up for the Health and Social Care Bill debate today and for this Question. The noble Lord refers to an important point. We should not forget not only the contribution that the research community made towards those vaccines, but also that AstraZeneca was prepared to supply, commercialise and distribute them on a not-for-profit basis. Sadly, it was attacked for doing so, not just for commercial reasons, but also by other countries that engaged in vaccine nationalism and disparaged the efficacy of the vaccine. Unfortunately, people in other countries have lost out. I hope that we do not see this in future.

Health and Care Bill

Lord Rooker Excerpts

Lords Hansard - Part 1 & Committee stage
Monday 31st January 2022 Lords Chamber

[Baroness Sugg (Con)]

My Lords, I rise to speak briefly in support of this amendment and, in doing so, I apologise that I was not here at the Second Reading, although I have followed the progress of the Bill carefully.

Last Thursday at Oral Questions, in response I think to the noble Lord, Lord Rooker, the Minister spoke of the importance of examining the provenance of health equipment that comes to the UK. He said his department was working

“to ensure that it is not from regions where there is slave labour, or where the Muslim Uighurs are being persecuted by the Chinese Government.”—[Official Report, 27/1/22; col. 439.]

We must of course ensure that the products and equipment in our supply chain are ethically sourced. Last week, my noble friend acknowledged that we need to do more here, and this amendment gives us the opportunity to do just that. Noble Lords speaking before me clearly and comprehensively laid out why we should avoid procurement from such areas.

All UK government departments need to do more to look carefully at their supply chains, but we must start somewhere. The DHSC, with its scale of procurement, and the reports we have seen of the prevalence of Uighur forced labour in PPE and healthcare supply chains during the Covid-19 pandemic, seems to be the right place to start.

The issue of genocide has been subject to lengthy debate in your Lordships’ House, not least during the Trade Bill last year. While a form of compromise was reached, it is limited to countries with which we will be entering free trade agreements. That is not a solution for procurement for many of the countries with which the DHSC does business. Importantly, this amendment would create a process, a mechanism, through which the UK Government could be required to assess regions for “serious risk of genocide”, and indeed publish their assessment. That process is, so far, sadly lacking in this country.

The UK has a responsibility to do all it can to protect against human rights violations and genocide. We also have a responsibility to our NHS workers and those who use the health service to make sure that we give them ethically sourced products. As my noble friend Lord Blencathra said, UK taxpayers do not want to be part of genocide.

We need to see deeds, not words. This amendment will significantly reduce the likelihood that the Government will procure goods or services from regions where there is a serious risk of genocide. It will bring the UK a step closer to developing a comprehensive framework in responding to allegations of genocide, and will meaningfully engage its obligations to prohibit, prevent and punish perpetrators of genocide. It does so in a limited, proportionate, reasonable and modest way.

I hope the Government will properly consider this amendment, I look forward to hearing the Minister’s response, and I know that he will have heard support for it from all sides of your Lordships’ House.

[Lord Rooker (Lab)]

My Lords, the Government should embrace this amendment. I want to concentrate on the traceability argument of goods, and in particular cotton imports. Without good traceability, the genocide convention obligations cannot be met.

To date, I have had two very poor replies on cotton traceability from the noble Lord, Lord Grimstone of Boscobel, at Question Time on 21 October, and a Written Answer on 24 January. Of course, as has already been said, we are miles away from the policies of the United States Government, who have taken a proactive approach to imports from regions of China where we know human rights abuses take place. As has been said, on 23 December, President Biden signed the legislation into law.

It simply cannot be left to commercial companies to satisfy themselves. It is crucial to understand the geographic origins of products and conditions of production. The two things are intertwined and they both need to be dealt with. There has to be a robust methodology that is reliable even when working with partners that may be untrustworthy or unco-operative. The use of middlemen such as commodity traders and the practice of blending fibre from multiple sources create additional difficulty.

Traceability—both what is termed as upstream, starting at the farm, or downstream, to map products back to their origins—is currently used. However, full visibility of the supply chain using these methods is impossible, and especially so in restricted areas such as Xinjiang Uyghur Autonomous Region. It is just impossible to do in the normal way you would look at traceability. If the Minister is in doubt about this, his department should read the report from the Center for Strategic and International Studies of November last year entitled:

“New Approaches to Supply Chain Traceability (implications for Xinjiang and Beyond)”.


My conclusion from that is that paper-based traceability and supplier information is a non-starter for effective due diligence.

In addition, there is abundant evidence that the Chinese Communist Party, which owns China, actually launders Xinjiang cotton, either semi-finished or blended, into international supply chains. This is set out in considerable detail in the November 2021 paper by Laura T. Murphy of Sheffield Hallam University entitled:

“Laundering Cotton: How Xinjiang Cotton is Obscured in International Supply Chains”.


In 2019, it was established that 85% of Chinese cotton was from Xinjiang. That means that cotton from the Uyghur region of China accounts for 22%—a fifth—of cotton worldwide. What was once grown or reared retains details of its origins—in a way, this is the test. However, it takes more than a paper trail to identify as such. It requires forensic work; chemical, isotope and genetic tracing and other methods that I will not list here are all crucial.

I will give a good example. From 1,000 garment samples collected across the world in high-street fashion shops involving nearly 50 brands, Oritain Global Ltd detected that in Vietnam, Cambodia and Bangladesh, the cotton in the garments had a mixture from Xinjiang of between 6.5% and 25%. Chinese cotton was 41% consistent with Xinjiang. Some 10% of samples of products tested in the UK were consistent with Xinjiang cotton. The UK has a high rate of imports from Bangladesh, where 25% of the cotton was from Xinjiang. It is worth pointing out that India has zero consistency with Xinjiang; India has cleared out Chinese cotton fabrication.

As to the practicalities for the health service, in 2019, the UK imported furniture, bedding and mattresses from China to the tune of £2.3 billion and imported apparel and clothing accessories to the tune of £3.7 billion. Has the NHS used beds and mattresses containing cotton from China or from suppliers using connections with China or other countries known to have a mixture of Xinjiang cotton? Where did all the Nightingale equipment appear from so quickly? As I asked last week, without any warning, how much China cotton is involved in NHS uniforms and accessories? Others have mentioned face masks, but as I pointed out last Thursday, more nurses means more uniforms.

Has the NHS supply chain used Oritain’s element analysis to check, or is it just relying on suppliers’ paperwork to check what would be only part of the supply chain? Companies and Governments need a degree of independence in assessing traceability and to not rely on companies doing it themselves. Some of the supply chains are five or six levels removed, so they cannot possibly have faith in each level and know the details from manufacturers, middlemen, traders, and agents. With the best will in the world and good corporate responsibility, checking the paper trail of five, six or seven levels will not work.

As I said earlier, the way to do it is to work on the basis that a product that was once grown or reared holds signs of its origins, and today’s advanced technology can do it. The technology of element analysis used by Oritain claims that it can tell the difference between two tea estates with a dirt road between them—it is so good and effective. For those who want more, I suggest the long read in the Guardian of 16 September 2021, which is where I came across the use of the technology. I have since met with senior reps of Oritain Global Ltd to better brief myself. Modern forensic technologies must be used, as is now required in the USA. The United States is using these technologies. Why are they not being used in the UK? The NHS, as the largest employer in Europe, should have a leading role.

It is not normal for the origin of cotton to be stated on labels. Of those 1,000 products which I mentioned were checked by Oritain last year, only 3% had the information on the label and, as a warning, the higher quality a product which attracts higher prices is more likely to be consistent with Xinjiang than cheaper items, so you must be really careful what you are looking at. Non-disclosure is almost the norm and of those who do disclose there is a high percentage of non-compliance, so labels and paperwork are not the answer.

Technology is the answer, and the ball is in the Government’s court. The old-fashioned gentlemen’s agreements and systems we are used to will not work. Modern technology is thought to be 95% accurate in identifying where an item was grown or reared. Only with that degree of information can the NHS satisfy the convention obligations. Otherwise, it will not work. The Government ought to embrace the amendment and then the new technology.

[Lord Polak (Con)]

My Lords, I pay tribute to my noble friends Lord Blencathra and Lady Hodgson, the noble Lord, Lord Alton, and the noble Baroness, Lady Kennedy of The Shaws, for tabling this important amendment. My noble friend Lady Sugg referred to last Thursday. That was 27 January, when the world came together for Holocaust Memorial Day in memory of the millions murdered under Nazi persecution. Members in the other place stood up and pledged “Never forget, never again”, while we in your Lordships’ Chamber sadly did not find a way to mark the day. Today, I repeat that promise.

Since the start of the pandemic, it seems that millions of pounds-worth of healthcare equipment have been procured from Xinjiang, despite the reports of the appalling treatment of the Uighurs. Will the Minister tell us whether our pandemic response benefited from procured equipment exported from Xinjiang?

NHS: Nurse Recruitment

Lord Rooker Excerpts

Thursday 27th January 2022 Lords Chamber

[Lord Kamall (Con)]

I cannot comment on the exact numbers, but I will find the answer and write to the noble Baroness. I might add that I am the son of people who came from outside the UK or European Union, and I get slightly concerned with the tone when people say, “Let’s not have foreign nurses in our NHS.” It is important. Immigration plays a brilliant role in this country and always has. If you look at the post-war public services of this country, it was people from the Commonwealth who came and saved our public services.

[Lord Rooker (Lab)]

Can I say to the Minister that more nurses means more uniforms and more garments? The NHS boasts about being the largest employer in Europe, so what action does the National Health Service take to ensure that the cotton in any of the garments used for NHS nurses’ uniforms is not grown in Xinjiang in China? The technology is available to do that; paperwork is not required, and people tell lies. The use of technology would guarantee that we could play our part in making sure that slave labour is not part of the production of our nurses’ uniforms.

[Lord Kamall (Con)]

I hope the noble Lord will forgive me if I tell him that I have not examined nurses’ garments in detail. In terms of provenance, it is important at the moment—and we are doing this on lots of equipment that comes to the UK—to ensure that it is not from regions where there is slave labour, or where the Muslim Uighurs are being persecuted by the Chinese Government. We need to do more; indeed, I have had conversations in the department to find out how we can trace the sources of the products and equipment that we buy to make sure that they are ethically sourced.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Lord Rooker Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Fowler (CB)]

My Lords, perhaps I may intervene briefly as the last Secretary of State who had responsibility for a major epidemic, that of AIDS.

It is in no way exceptional that there should be profound differences in view among politicians and others of the way in which an epidemic or pandemic should be handled. In my day, we had chief constables openly attacking the patients and the Government. We had religious leaders, I regret to say, arguing that it was not a public health issue at all, but one of morality. We had Ministers, particularly Scottish Ministers, arguing that giving free needles to drug addicts was condoning crime, although there was absolutely no evidence that crime increased, and the example of our Government was followed worldwide. We had a Treasury which refused to provide extra resources for the pandemic.

Debate, controversy and difficulties on the way forward are absolutely nothing new in debates of this kind. The crucial question is: what advice do we follow? My view now, as then, is that we should follow the advice of the public health experts inside the Department of Health who work on these issues year after year, in particular the Chief Medical Officer. I pay particular tribute to my old CMO, Donald Acheson, and the new CMO, Chris Whitty. Chris Whitty and the Chief Scientific Adviser have done a remarkable job for this country over the last months and deserve full credit for that.

It is said that this is a question of freedom; obviously, I do not discount that argument, but surely the exercise of that freedom should not put others at risk. That seems to be a matter of common sense. It should not lead to infection being spread or hospitals having to prioritise which patients they treat because some have decided to remain unvaccinated and then become dangerously ill.

As is evident, after my spell on the Woolsack, I am now a Cross-Bencher, so I am not an automatic or whipped supporter of the Government—I am not whipped at all. My days as Conservative Party chairman are behind me—noble Lords might be very grateful for that—and no more than noble Lords in the Labour Party do I automatically follow the lead of the Government Front Bench. However, I must say that I think their case is totally overwhelming. The success of the national vaccination programme has moved us ahead in the race to get people vaccinated in this country and worldwide but, with the new omicron variant, we have to work even harder to stay ahead. That is the lesson of the whole thing.

Last week, we learned two things about this variant. The first is that no variant of Covid-19 has spread this fast—if you want a definition of an emergency or a need for action, surely that is not a bad one. We expect the numbers to increase dramatically in the days and weeks ahead. I do not think that is seriously disputed by anybody so, again, this is an argument for action. As the Prime Minister said—for once, his language is not over the top—

“there is a tidal wave of omicron coming”.

That seems to be the view of the public health experts as well. We know that a third or booster dose provides strong protection, with analysis from the UK Health Security Agency showing that a third dose is 70% effective at preventing symptomatic infection. We expect the booster to take effect more quickly than the second dose. Again, I would have thought that this should provide an incentive to us to do what is not just the best thing in terms of public health but the right thing, as I would term it—and action is the right thing.

What I really wished to say to this House in the few minutes that I have spoken is that we should do our utmost as a House and a Parliament to appear united. It seems it is not the best day to make that case or plea, after the rather dismal vote in the House of Commons yesterday, but I hope that the House of Lords will give support to this struggle. Parliament consists of two Houses—a fact that seems to be conveniently forgotten by much of the media and the press—and this House can give a real lead as far as the handling of this pandemic is concerned.

Like the noble Lord, Lord Cormack, whose speech I enjoyed, I hope that the noble Lord who has proposed a series of amendments will not persist with them. The Government have far more support than I think they realise. Far more people outside this confined area of Parliament are signing up to the case that they are putting. Ministers should persist in their case and fight for it as strongly as they can.

[Lord Rooker (Lab)]

My Lords, I make two preliminary points before my main point. First, it would be quite contrary to the way in which this House works and to the conventions under which we operate to throw out secondary legislation. This is just not on. We do not do it, and it would be quite wrong to attempt to do so. Secondly, I follow up on what the noble Baroness, Lady Walmsley, who spoke for the Liberal Democrats said. As many other people have done, I tried to order lateral flow tests this morning. They are not available; you cannot order them. Every week for the past two months, I have succeeded in ordering them and the pack has arrived within a couple of days. The Minister must have an answer to this fundamental issue. Now, you cannot just walk into the chemist and collect them, or order them via a QR code, as you could do months ago—at 8.30 am today, it was not possible.

The Minister said that we are doing all this to protect people—which is true—and also to protect the NHS. I make no apology for asking why is it that we need to protect the NHS? It seems self-evident: we need to protect the NHS because it is incredibly vulnerable compared with how it was. In recent years, we have lost 17,000 beds, systematically and deliberately. Why?

I cite two or three examples from the recent NAO report on NHS backlogs pre pandemic. The OECD is the rich countries—or rather, the richer countries— of the world. In the context of the health systems within the OECD, the UK has fewer resources than many of the other rich countries. The UK has 2.4 hospital beds per 1,000 of the population. France has 5.8 and Belgium 5.5—and they are not the highest. Sweden has 2.1, which is less than the UK but, at 2.4, we are way down the list. With 8.5 nurses per 1,000 of the population, the UK is 11th on that list, whichever way you look at it. Ireland has 12.9; Germany 14; and France 11.1. This is all before the pandemic. The UK has three doctors per 1,000 of the population. Sweden has 4.3 and Spain has 4.4. They are not the highest; the highest is much greater. Finally, in 2019, we did 175 CT, MRI and PET examinations per 1,000 of the population. France did 332; Austria 349, and Belgium 313. In other words, the NHS has been deliberately run down since 2010. The other thing that has happened since 2010 is that life expectancy has stalled—read the Marmot reports. Why has life expectancy stalled since 2010? More people are dying earlier as a result of life expectancy stalling. There is something systematically wrong.

Of course, we need to carry these orders for public health reasons. I have no problem with that. I am 100% with the noble Lord, Lord Fowler. When it comes to protecting the NHS, we have to ask ourselves why it is so vulnerable. It is because we have lost out on doctors and nurses and because of the other issues that I have raised. It has been done systematically. I do not know why—a national policy has never been announced on that. We always talk about protecting the NHS. We need to ask why.

I hope that the noble Lord will not push this to a vote. He would be breaching the conventions of the way in which this House is run. I presume he is only pushing for a vote because he wants to win—you do not push for a vote if you do not want to win. Throwing out the regulations would breach the conventions and the elected House would be after us pretty damn quick—and rightly so.