Health and Care Bill

Lord Rooker Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Lord Rooker (Lab)]

My Lords, I, too, congratulate the noble Lord, Lord Stevens of Birmingham, particularly on his robust defence of fluoridation in Birmingham. I am going to concentrate on one clause, one schedule and one issue: Clause 144, Schedule 17 and part of the Government’s plan for tackling childhood obesity.

I have lost count of the reports from Select Committees and the National Audit Office on this vital issue, which, irrespective of the damage to health, is on course to bankrupt the National Health Service. I am informed that, since the early 1990s, there have been 14 reports containing 700 recommendations. No Government have done enough. When the coalition came in in 2010, there was a flurry of activity. The outcome, a serious plan, was effectively squashed by Theresa May in 2016 under pressure from the food industry. I was at a meeting of the Parliamentary and Scientific Committee when I heard officials—I shall not name them as I had worked with one of them before—spell out what was planned, but it did not come about.

So, it is better late than never that the Government are acting. There is increased political will to act; this is to be welcomed and actively supported. We have moved on from the “nanny state” arguments nurtured by the food industry. Besides this Bill, though, I would like to know what the Government have been doing since September 2020, when the National Audit Office published HC 726, its report on childhood obesity. Its key findings were worrying, and the five recommendations were a serious plan of action. I have looked but, to be honest, I have not been able to get the detail.

The figures on childhood obesity are startling and on the move. They are not static—we are getting fatter. The National Audit Office’s report pointed out that 20.2% of 10 to 11 year-old children were obese in 2018-19. That figure rose to 26.9% for children in the most deprived areas. The brief from the Obesity Health Alliance gives more up-to-date figures. The last year has shown the fastest increase in child obesity on record. More than 40% of children are obese by the time they leave primary school; for year 6 children, the figure is up from 21% in 2019-20 to 25.5%. It will be really difficult to reverse this trend.

I am about to make my only politically incorrect point. I could not help but notice, in recent years, the astronomical size of some teachers in primary schools. Emerging evidence shows that, besides a 1% year-on-year growth in obesity, the Covid pandemic’s impact is likely to have accelerated the pace of increase in childhood obesity, so there is even more reason to be concerned.

I will support the Government’s action and spur them to do more. They could do a lot worse than adopt the 10-year Healthy Weight Strategy published by the Obesity Health Alliance in September this year. “Healthy weight” is a good way of describing the desired outcome. It does not conjure up too much negativity. I will be watching to ensure that there is no watering down of the modest proposals by the men who made us fat. In this respect, I prefer the evidence from the National Audit Office to that from the food industry on the effects of advertising.

Talking of the men who made us fat, the BBC should show again the 2012 BBC Two documentary “The Men Who Made Us Fat”. The science and methods, both physical and behavioural, that the food industry uses to get us to eat more are eye-watering in their lack of concern for the consequences to public health. I commend the Government and urge them to do more, and I will oppose any watering down.

As an aside, exactly two years ago this week I lost two weeks of my life without warning, with clots, sepsis, pneumonia and a lump. The staff at Hereford County Hospital stopped me going over to the dark side. So far, so good, and I am very pleased to say that I am part of a clinical trial to check the effect of the booster on those who have had leukaemia and lymphoma —a trial called “Prosecco”.

Covid-19: Plan B

Lord Rooker Excerpts

Wednesday 20th October 2021 Lords Chamber

[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.

[Lord Rooker (Lab)]

Would the Minister accept that one of the unfair criticisms, in some ways, over the last 18 months, has been “too little, too late”? That cannot happen again. We need to set good examples. At Prime Minister’s Questions today, there was not a single Conservative MP wearing a mask in a crowded Chamber. What on earth is that as an example to the people on the Tube and everywhere else? Clearly, some small measures now will save the big measures later.

[Lord Kamall (Con)]

I agree with the noble Lord that it is important that we take as many measures as possible to make sure that we do not have to move to plan B. I assure the noble Lord that I do wear my mask to, hopefully, set an example, and I hope others will too—but it is really important that we understand what factors are driving this rise in numbers and the most effective way of tackling it.

Flu Vaccination and Blood Test Cancellations

Lord Rooker Excerpts

Tuesday 14th September 2021 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government what assessment they have made of the level of cancellations of influenza vaccinations and routine blood tests.

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

My Lords, I regret to report that there was a shortfall in the supply of blood tubes of around 13% in the last two weeks of August, which led to some disruption. That has been mitigated through use of government stockpiles, importing tubes and changes in practice. Supply has now returned to normal. It is not true that there is a flu vaccine shortage; the delivery from one supplier was delayed by one or two weeks, but this should have no impact on the flu vaccination programme overall. I am pleased to say that we are in regular contact with doctors, and no issues of cancelled appointments have been raised.

[Lord Rooker (Lab)]

What the Minister just said about blood tests is good news for those who have regular serious blood tests. But on the subject of flu jabs, does he recall telling me earlier this year that the flu jabs were made in the UK? They are not imported. The lorry drivers problem is a UK issue, so this is a home-grown issue. The websites this morning are saying that, up and down the country, GP after GP has been thrown into chaos because they are having to cancel appointments that were made weeks ago. I have personal experience of this, because even in Ludlow we are having appointments cancelled. The idea that this is not a problem is not the case. Why has this been allowed to happen? Everything involved is under our control in the UK.

[Lord Bethell (Con)]

My Lords, it is not my understanding that appointments have been cancelled. If the noble Lord has any anecdotes, reports or evidence of that, I would be very grateful if he could send me that material. Seqirus, the company concerned, brings its vaccines in from overseas.

Covid-19

Lord Rooker Excerpts

Thursday 15th July 2021 Lords Chamber

[Lord Rooker (Lab)]

My Lords, I have listened very carefully to the Minister but I did not quite hear the answer to the questions asked by the noble Baronesses, Lady Tyler and Lady Finlay, about the forthcoming pressures on the NHS. The hospital I was at on Tuesday morning is, I was told, working at full stretch; it is at winter levels in July. Covid is taking up ICU beds and stopping elective surgery now, even before the pressure starts. There are constant references in the Statement about not wanting unsustainable pressures on the NHS, but we are putting such pressures on it by allowing the figures to rip without seeming to have proper back-up services and resources. Can the Minister answer the questions from the two noble Baronesses?

[Lord Bethell (Con)]

My Lords, I thought I had answered the questions put by the two noble Baronesses. I will seek to answer the noble Lord. He is absolutely right: our hospitals are working flat out but this is not mainly because of Covid. As of 11 July, hospital admissions in England were running at 502 a day. As of 13 July, there were 2,970 patients in hospital in England with Covid, of whom 470 were on mechanical ventilation. Catching up on all the backlog—not Covid—is what is consuming the hospitals and making them run so red hot. This is the focus of our healthcare system at the moment, and it will remain so for some time to come. We are under no illusions: there is a massive backlog which includes many people who have not come forward with symptoms of severe disease and will need to be addressed and treated. This is a huge national project that we are undertaking.

Folic Acid

Lord Rooker Excerpts

Tuesday 13th July 2021 Lords Chamber

Asked by

[Lord Rooker]

To ask Her Majesty’s Government, further to the reply by Lord Bethell on 3 September 2020 (HL Deb, cols 444–5), whether they have yet been able to form a conclusion on the outcome of their consultation on the proposal to add folic acid to flour which closed on 9 September 2019.

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

My Lords, I am pleased that substantial progress has been made on this work since I spoke to the House in June, including positive dialogue with all devolved Administrations. It is right that we remain committed to proceeding on a UK-wide basis and I am grateful to colleagues in the devolved Administrations for their energy and support. I assure the House that we are progressing this as a priority, and I look forward to updating the House after the Recess.

[Lord Rooker (Lab) [V]]

Can I assume that the Minister is aware of the statement from the Ministry for Primary Industries in New Zealand on 8 July, five days ago, that as a result of its consultation on folic fortification in 2019 it will fortify all non-organic wheat flour from mid-2023 and therefore join Australia and more than 80 other countries in mandatory fortification? Why are we so far behind New Zealand? The women of New Zealand had the vote 30 years before British women. Can I be assured that British women will not have to wait as long to have safer, healthier pregnancies and fewer babies with a lifelong disability?

[Lord Bethell (Con)]

My Lords, I pay tribute to the Government of New Zealand for focusing on this important issue and to the energy and passion of the noble Lord in his advocacy in this matter. I can give him the reassurance he asked for. This is a priority for the Government. We are taking it through the machinery of the British Government to ensure that it is rolled out safely, extensively and on a nationwide basis.

Medical Devices (Coronavirus Test Device Approvals) (Amendment) Regulations 2021

Lord Rooker Excerpts

Monday 12th July 2021 Grand Committee

[Lord Rooker (Lab) [V]]

My Lords, I do not wish to be at all critical of the figures that the Minister gave in his first few sentences regarding our capacity and what we have been able to do in our laboratories. I suspect, by the way, that he has a new speechwriter, as his speech was slightly different from what I have heard from him before. The reality is that I put my name down for this debate for one simple reason: last week’s reports that the Government intend to charge for devices that are currently free on the NHS. These regulations are about tests for sale.

The eighth report from our Secondary Legislation Scrutiny Committee is a masterclass in drafting. It clearly states that the market is “overwhelmingly dominated” by free NHS tests. Paragraph 3 states that

“the Government want to support a ‘thriving private sector market for COVID-19 detection tests’”.

Paragraph 4 says that these regulations are

“for a time when privately bought tests play a more significant role”.

Well, they certainly will be when the Government start charging for NHS tests. It is a £3 billion market, after all—at least I think so, from the figures I have seen.

In April, when the tests were first brought out, we were told that handing them out—and, indeed, encouraging people to take them—was vital to getting the country back to normal. The Secondary Legislation Scrutiny Committee has been very critical of the failure to supply documentation when the regulations were laid. In at least two paragraphs of its report, the committee makes it clear that free NHS tests must continue.

It is clear that the Government want to charge for the tests. I understand that the promise—and I have made checks—was made to supply them free only until the end of next month, August. There has been no commitment to go beyond that, hence the rush to get these regulations through. Quite clearly, that is what it is all about. It is being pushed through at this last minute, a few days before the Recess, so that the Government can abandon free tests at the end of August. I realise that the Minister has come briefed on the regulations and I am asking about something extra, but let us face it: it was predictable that this would be raised. He has not taken any opportunity to say anything about the maintenance of free tests. I think that is sad because he is going to be asked that repeatedly until the Government are clear about their intentions.

My final point is a question: why do we need to buy the NHS Test and Trace kits for the lateral flow test, the one being given out by local chemists, from one of the Chinese Communist Party-approved companies? How do we know they are not made with slave labour? What kickbacks go to that corrupt political party? What efforts are being made to get them made in the UK—dare I say Europe—or, indeed, Commonwealth countries? We now have the capacity to check the tests in laboratories. Why have we not done something about manufacturing capacity? Why are we reliant—we appear to be reliant—on the fix of the Chinese industrial structure, which is controlled by the Communist Party or it cannot operate? In winding up, the Minister has the chance to be clear. I do not expect him to answer everything, but it would be useful if he would say that the Government intend to pursue free NHS tests for a period beyond the end of August. After all, that is in Recess. We will not have time to query that, as we are not back until 6 September, so that decision would be taken outwith Parliament sitting, and I do not think that would be right.

Women’s Health Outcomes

Lord Rooker Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Rooker (Lab) [V]]

My Lords, as the first male Member of your Lordships’ House to speak in the debate, I welcome very much what the noble Baroness, Lady Jenkin, had to say. Her opening speech was, frankly, awesome—that is how I would describe it.

I do not apologise for returning to the Marmot review, which the Minister has heard me speak about before. Inequalities in life expectancy have increased since 2010, especially for women. Female life expectancy declined in the most deprived 10% of neighbourhoods between 2010-12 and 2016-18. Female life expectancy decreased in every region save for London, the West Midlands and the north-west. Life expectancy in England has stalled since 2010, which has not happened since 1900. When health has stopped improving, it is a sign that society has stopped improving. That is all from the Marmot Review 10 Years On, published in February 2020.

Of course, health is linked to all the other conditions in which people are born, grow, live and work, together with inequalities in power, money and resources. Frankly, the Government have not prioritised health inequalities, despite the concerning trends, and there has been no national health inequality strategy since 2010. This is a national UK issue and cannot be shoved off as a devolved matter.

I have not mentioned Northern Ireland. It has suffered the same as the other three nations but one figure, set out on page 12 of Build Back Fairer: The COVID-19 Marmot Review, is unique in respect of female health. The table is titled: “Relative cumulative age-standardised all cause mortality rates by sex, selected European countries, week ending 3 January to week ending 12 June 2020”. Of the eight countries where the situation got worse—as opposed to the 11 where it got better—the UK’s four nations were in the eight, and in only one of all the countries where it got worse, it got worse for females compared to males. That was Northern Ireland. There is quite clearly something badly wrong in health inequalities between men and women in Northern Ireland for it to stick out like that among all those countries. The recommendations for change are all well known. They are listed in both the Marmot reports I have used.

I note the BMA has highlighted more targeted issues, such as those relating to domestic abuse, pregnancy and maternity services, which male Secretaries of State keep ignoring. However, the first move has to be an acceptance that things have gone really badly since 2010, when the coalition Government imposed swingeing cuts to public expenditure without any analysis of the consequences. One consequence is the stalling of life expectancy, where women have been affected worse than men.

Covid-19 Update

Lord Rooker Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have a prioritisation list for the booster and the third jab. It is my understanding that octogenarians are in category 1, but I am happy to write to my noble friend to confirm that point, in case I have got that wrong. I share my noble friend’s aspiration on care home workers. We are in a consultation; I cannot make the guarantee that he asks for because it is an honest consultation. We have to take people with us: this is not something that we can impose on people against their will. When the consultation has passed, I am hopeful that we will be able to take the steps that he describes.

[Lord Rooker (Lab) [V]]

I congratulate the Minister on his track record of appearances in the House. I will raise two brief subjects with him, both of which have been raised today, neither of which he has addressed. First, are there plans to charge for the lateral flow test? It is now being delivered to people less than 24 hours after they request it, and requests will certainly go down if there is a charge. A clear answer on that would be useful. The second issue is shielding. When the Prime Minister makes a Statement on Monday, in advance of 19 July, it is crucial that something is said about people who were shielding before; they must not be left in limbo and ignored. They could at least be given a warning that they will be given, say, a week or 10 or 14 days before they need to shield, which would remove part of the worry from the large changes due to take place on 19 July. I ask the Minister to respond on lateral flow test charging and shielding, please.

[Lord Bethell (Con)]

My Lords, on lateral flow tests, I said that I did not recognise the press reports that the noble Baroness mentioned, and I still do not. On shielding, I completely agree with noble Lord. Some 1.5 million patients are identified as CEV-equivalent through the new QCovid model, and they have been added to the shielding patient list, with 820,000 who had not previously been invited as part of the JCVI cohorts 1 to 4 given priority access to vaccines. Overall, 3.8 million—I think I said 3.5 million earlier—individuals are on the shielded patient list, and we continue to maintain that through the NHS. We will look at the QCovid model and see if we can apply mix-and-match vaccines, booster shots and third shots to that model, and if we can bring together a new risk assessment for those who are vulnerable. That list could therefore be applied to any future shielding or protection that may be needed.

Covid-19 Update

Lord Rooker Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely understand the noble Earl’s points. On WOMAD, I have a particular interest in that fine festival and I am extremely sad to hear that it has been cancelled, and to have to change my family plans accordingly. I reassure the noble Earl that we have not overlooked the arts at all. They are absolutely paramount in our thoughts. The events research programme is making progress, but it consumes a high number of tests and we simply do not have the capacity, despite the huge investment we have made, for the kinds of figures that would be needed to open up the whole of the arts world at this stage. But I am hopeful that the research we are doing will create the kind of persuasive data necessary to figure out safe ways of reopening the arts, so that we can get back to the life we had as soon as possible.

[Lord Rooker (Lab) [V]]

I welcome the Minister’s openness and transparency about his conduct. I also support what he said about the attacks on Dr Whitty. If there are no arrests before the end of the day, it will just show how useless the Metropolitan Police is under its current leadership. In his Statement, the Secretary of State talked about keeping the NHS safe. What I have not really connected, both from the previous Question and this Statement, is that keeping the NHS safe cannot be done in isolation. The issue of social care and its reform is inexorably linked to keeping the NHS safe, and that point does not seem to be used by Ministers as a serious connection. Finally, without abuse, if this country starts boosters or third jabs later this year when people in countries such as Nepal are still going without vaccinations, it will be a thundering international disgrace.

[Lord Bethell (Con)]

My Lords, I have failed in my mission, because I have sought to convey to the Chamber that we completely understand that the NHS, social care and public health—the three sectors of our healthcare system—are inextricably linked. That is why we are bringing to the House the health and social care Bill that we are. That is why we have already brought about a large number of reforms, including ICSs and the integration of various diagnostic elements, and have sought to bring more parity for social care workers and those in public health. The noble Lord absolutely hits the nail on the head. I completely agree with his point, and that is our guiding star for the future.

Social Care and the Role of Carers

Lord Rooker Excerpts

Thursday 24th June 2021 Lords Chamber

[Lord Rooker (Lab) [V]]

My Lords, we know what the problem is. We have just heard that the Lords Economic Affairs Committee spelled it out in detail in July 2019, and the House debated it in May this year. In the meantime, of course, the Prime Minister has more than once told us that he has a plan—famous for social care plans is our Prime Minister. I will use just one speech, made in Dudley, on 30 June last year, as an example, when the Prime Minister said

“we won’t wait to fix the problem of social care that every government has flunked for the last 30 years … We are finalising our plans and we will build a cross-party consensus”.

There is another chance today to hear from a Minister the excuses for no action being taken on the plans that the Prime Minister has more than once said were finalised.

The Lords Economic Affairs Committee said that an injection of £8 billion was needed—of course, that was two years ago—just to restore the level that the coalition Government of Tories and Lib Dems inherited from the Labour Government in 2009-10. The Mencap brief for today’s debate gives one example of a £180 million gap in local authorities for people of all ages with a learning disability to be able to live a decent life.

The question is: how do we get the cash? Not from people selling their homes, as the Prime Minister is against that—but it is happening every week. It has to be a national effort, shared as we share the funding for the NHS. The Government want to be consistent with their manifesto, so here is my solution. Yes, it will involve more tax, but it will save money and misery in the end. My bid is simple: the over-40s pay an extra 2% on income tax as a social care supplement. As for national insurance, why on earth does it cease at the age of 65? I was on a salary until I was 72, and paid no national insurance after the age of 65. Today, I am an 80 year-old, 40% taxpayer, yet I pay no national insurance. You could keep the rate the same, or tweak it after 65, and stay in line with the Tory manifesto, and you could get this social care supplement from employers as well. The extras for pensioners, such as winter fuel and bus passes, are all great and convenient, but we should make them taxable. As the Minister who introduced the 75p pension increase in 2000, while ensuring that the poorest pensioners got £3, I say we need only the double lock introduced by Labour; the triple lock cannot be justified any longer.