HIV: Pre-exposure Prophylaxis

Lord Scriven Excerpts

Tuesday 1st December 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness makes an entirely fair point. Access to PrEP is not as even as it could or should be. It is a very important tool in our fight against the transmission of HIV, and it is a programme that we support wholeheartedly. However, it takes time to roll out a therapeutic such as this through the entire healthcare system. We have focused its supply through sexual health units because they are the most thoughtful and reliable places for the kind of consultation and expertise needed for a delicate new therapeutic like PrEP. However, she raises a good point that perhaps this should be and could be updated.

[Lord Scriven (LD)]

My Lords, since 2017, both Scotland and Wales have supplied uncapped access to PrEP, so will the Minister tell us what is stopping uncapped access to PrEP in England, so that we do not have a postcode lottery for access?

[Lord Bethell (Con)]

The noble Lord will be aware that there is a detailed conversation with local authorities about ensuring that we get exactly the right balance for funding. As the noble Baroness rightly pointed out, we need to make sure that the supply of PrEP is conducted in a way where there is good consultation and where those who are applying for the therapy are given good advice. That is best done with help from local authorities, and we are trying to hammer out a deal to ensure that that is done thoughtfully. That deal has been delayed by Covid, but we are looking forward to announcing a resolution of that before the next funding round finishes.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020

Lord Scriven Excerpts

Tuesday 1st December 2020 Lords Chamber

[Lord Scriven (LD)]

My Lords, when government Ministers have to spend two days explaining when and how you can eat a Scotch egg to help slow down the transmission of a deadly virus, you know the simplicity of the rules and the clarity of the message, so vital to the task, have been lost. It is an indication of the confusion that has been created by constantly changing the rules that both individuals and businesses must adhere to. This is not helped when the former senior adviser to the Prime Minister clearly broke the rules and the full weight of the Prime Minister’s office was used to defend breaking the law.

People want to do the right thing to protect their loved ones, businesses, jobs and the community they live in. However, listening to people, you get a real sense that they do not understand what they are being asked to do anymore. The Government have complicated not only the message but the rules people must abide by. These regulations, 70 pages long, with nuanced rule after nuanced rule depending on which tier you live in, will cause further confusion.

The next four weeks highlight how this is not about creating a sensible, calm, strategic set of rules to slow the transmission of the virus but a bureaucrat’s dream and Ministers trying to control things from a Whitehall office. On 2 December, we are into tiers and a new set of rules; on 16 December, the tiers are reviewed, and we could have a new set of rules to live and work by; on 23 December, we throw the tiers out, and we can have Christmas; on 27 December, we are back to the tier rules of 16 December; on 30 December, the tiers are reviewed again, and we could have to contend with a further set of rules. In all reality, can the Minister say that potentially having to live under five sets of rules within one month is going to create trust, stability and clarity and give people and businesses the platform to be able to plan their everyday lives as well as fully understand what they are being asked to do to slow the transmission of this deadly virus?

The country requires richer, deeper understanding of the triggers that put an area into a set of restrictions and, just as importantly, the trigger points that release them from the most restrictive rules. The analysis that the Government have provided is not a serious attempt to explain. It is a commentary without the clear evidence that is required for people to understand and plan their lives. I asked the Minister: rather than a broad-brush approach, what empirical evidence will the Government bring forward to show how the triggers are adopted for an area going into and out of a tier?

In Sheffield, we are bewildered as to why we are in tier 3. The latest set of figures indicate we had, on 25 November, 185 cases per 100,000 people. Hospitals are moderately busy but in no way full to capacity. The local Nightingale hospital for Yorkshire and the Humber sits empty; our case rates are falling. Meanwhile, some areas with greater hospital activity, less ICU capacity, higher case rates per head and rising cases have been put in tier 2.

It is also worth noting that the department of the director of public health for Sheffield City Council has written to local care homes suggesting that lateral flow tests are not specific enough and that it is seeking government data and assurance. I ask the Minister: are the Government totally confident that lateral flow tests are safe and reliable enough to be used in care homes so people can visit?

The country has had a £20 billion failing national system. The Government highlight the number of tests, not their quality or the speed of the results. There is a very poor record on tracing and almost a laissez-faire isolation system that keeps leading us back to these types of regulations.

Dealing with this virus does not have to be like this, with ream after ream of confusing emergency law. Some of us have been saying since February that, to minimise disruption, a localised test, trace and isolate system is required. It is now time to do things differently. We need to localise the test, trace and isolate system within a national framework that supports local areas with the expertise and resources to deal with real hard tracing and have proper and resourced community teams supporting people who need to isolate. It needs to be underpinned by a government commitment to reward people for doing their civic and national duty of isolating, like they do in Taiwan, by paying people their full income while they isolate. I ask the Minister if and when this could be done.

The Government need to listen and refocus test, trace and isolate. They need to understand the results that local test, trace and isolate can bring, support that and underpin it with an income guarantee for those who isolate. If this is not done, we will be back here, fortnight after fortnight, confusing people, with the Government taking knee-jerk powers that affect businesses and individuals, causing debt, strain and worry.

We are reaching the end of the path of just nodding through emergency regulations; it is time to review the whole strategic approach of how the country deals with slowing the transmission of the virus, taking from international examples, such as South Korea and Taiwan, about how to minimise disruption by getting a proper local test, trace and isolate system. The Government need to understand that they are now on warning to radically change the way they manage this virus, or future regulations will not be nodded through so easily.

Covid-19: Vaccines and Medical Equipment

Lord Scriven Excerpts

Wednesday 25th November 2020 Lords Chamber

[Lord Bethell (Con)]

I entirely endorse the sentiment the noble Lord expresses. I offer my profound thanks to the devolved authorities for the immense spirit of collaboration which has characterised the response to the pandemic. Often, it would seem from the headlines that the nations are at odds with each other; that is not my experience. The Christmas negotiations he cites are a very good example of that, and I hope the vaccination arrangements will be the finest moment.

[Lord Scriven (LD)]

My Lords, on 25 September the JCVI reported the serious risk of disease and mortality from Covid according to deprivation and ethnicity. These issues have to be taken into consideration in the vaccination programme, so why does the present list of priorities for the vaccine ignore those factors completely?

[Lord Bethell (Con)]

My Lords, the noble Lord is entirely right that deprivation and ethnicity are key considerations in the morbidity of Covid; we are all acutely aware of them. The JCVI has looked extremely closely at a variety of different models for prioritising vaccination. Prioritisation based largely on age gives the most accurate and thoughtful prioritisation of the vaccine and is also simple to understand and deliver. That is why it has gone down that route.

Personal Protective Equipment: Procurement

Lord Scriven Excerpts

Thursday 19th November 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord, Lord Triesman, misconstrues the nature of events. The Prime Minister made a number of public calls for help, which resulted in more than 15,000 offers. Of course, those had to be triaged. Not all were credible. Some were helpful and some were well-intentioned but not all were practical. We had to find a way of prioritising the most impactful. Anyone in our position would have done the same. This credible list included senior professional healthcare clinicians; members of former Governments of all parties; leaders of British industry; and all manner of helpful people, some of whom came from completely unexpected places. I should be happy to tell the stories of some of those unexpected offers another time. The noble Lord’s description of the prioritised channel is a misrepresentation. I regret that I cannot proceed as he asks.

[Lord Scriven (LD)]

My Lords, let us be clear. The issue is not that people stood up; it is what the Government then did to procure goods and services. Yesterday’s National Audit Office report states

“we cannot give assurance that government … mitigated the increased risks … or applied appropriate commercial practices”

at all times. That is technical-speak for not being able to rule out fraud or corruption. How can the Minister stand at the Dispatch Box and say with any credibility that all the rules were carried out and there were no conflicts of interest? Which should we believe, a line from the Dispatch Box or a report from the National Audit Office?

[Lord Bethell (Con)]

My Lords, I do not really recognise the noble Lord’s technical-speak interpretation of the NAO report. In fact, the report is crystal clear. Yesterday, I quoted from its references to Ministers and conflicts of interest, and I do not think that I need to repeat it: it was crystal clear. However, perhaps I may reassure the noble Lord. I do not pretend for a moment that every single piece of paperwork got done on time during the pandemic—quite the opposite. We rewrote the guidelines on 18 March and reissued them: there is no way that you can jump through the hoops of a normal tendering process when you are in the middle of a massive global land grab. I am not pretending that; I am saying that there were not conflicts of interest, that Ministers were not involved in the procurement decisions and that the nation should be proud of the way in which we responded to the pandemic.

Covid-19: Conflicts of Interest

Lord Scriven Excerpts

Wednesday 18th November 2020 Lords Chamber

Asked by

[Lord Scriven]

To ask Her Majesty’s Government what assessment they made of conflicts of interest before engaging specialist advisers to inform their response to the COVID-19 pandemic.

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

My Lords, in our nation’s time of need we have been very fortunate to call on the talents of many, including colleagues old and new, some paid and some unpaid. Appointments are considered on merit and, when required, we ask candidates to declare any interests. We assess these on a case-by-case basis, but declaring an interest is not always a barrier to being appointed. There are, however, robust processes in place to manage any conflict. These ensure that no one gains unfairly from advising the Government.

[Lord Scriven (LD)]

My Lords, can the Minister give a logical reason why a company with no history of supplying PPE that is introduced by a special adviser can be passed from a Minister’s office, be fast-tracked and be 10 times more successful in getting a contract to supply PPE—which sometimes cannot be used because it does not meet the standards—than a company with a solid track record of supplying PPE that has no access to a special adviser or Minister?

[Lord Bethell (Con)]

My Lords, we are enormously grateful for the very many people who stepped forward to offer help during this time. When the Prime Minister made his public call for help, 16,500 people contacted us with various offers. It was, of course, necessary to triage and prioritise that huge list. In that list there were a great many people who had extensive experience in their area; there were people who were new to the game; there were have-a-go heroes; there were multinational companies. There were also those whose intentions were not as pure as one would hope. We approached each and every one on their merit, and there were official guidelines to guide the procurement processes. We have stuck to those guidelines every step of the way.

Covid-19 Update

Lord Scriven Excerpts

Thursday 12th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am not sure that I entirely understood the question. In terms of the private beds that we intended to use, that capacity was extremely valuable as a fallback during the first wave, but I am pleased to say that it was not needed. There is some testing in the private sector, but we are not leaning on that at the moment. The testing that is done by the Government is through test and trace, and we are committed to using as much of that capacity as is needed.

[Lord Scriven (LD) [V]]

The Statement says nothing about antibody testing. On 6 October, the noble Lord announced the £75 million single-source purchase of antibody test kits from Abingdon Health. Official correspondence, dated 1 October, reveals that the department had a report by Public Health England that shows that those antibody tests were not accurate enough for their intended use and that the department would delay publication of the report until after the Government announced that they had purchased them. Why was that, Minister?

[Lord Bethell (Con)]

If the noble Lord would not mind, could he repeat the question, because I could not hear the words, I am afraid?

[Lord Scriven (LD) [V]]

The Statement says nothing about antibody testing. On 6 October, the noble Lord announced the £75 million single-source purchase of antibody test kits from Abingdon Health. Official correspondence, dated 1 October, reveals that the department had a report by Public Health England that shows that those antibody tests were not accurate enough for their intended use and that the department would delay publication of the report until after the Government had announced that they had been purchased. Why was that, Minister?

[Lord Bethell (Con)]

I am afraid I am not familiar with the report to which the noble Lord refers. I am glad to undertake to write with an answer to that question.

Covid-19: Vaccine

Lord Scriven Excerpts

Wednesday 11th November 2020 Lords Chamber

[Lord Bethell (Con)]

We are working extremely closely with the Northern Ireland Administration to ensure deployment of the vaccine; as I said earlier, this will be done on a four-nations approach. The Oxford vaccine is going through the final stages of phase 3. We are very much looking forward to hearing how it is going but I am afraid to say that I do not have a precise date for when that will be.

[Lord Scriven (LD) [V]]

My Lords, what specific arrangements have the Government put in place at our borders to ensure that the vaccine can pass speedily, without hindrance, from Belgium after 31 December?

[Lord Bethell (Con)]

My Lords, we have extremely detailed and thorough arrangements for our borders on 31 December. No problems are envisaged with regard to the vaccine.

Covid-19: Contracts and Mass Testing Programme

Lord Scriven Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is right that transparency is key. I take those principles extremely seriously, and that is why we are publishing the contracts. I encourage anyone who is interested in looking at them to look at my Twitter feed, where I published a link to the Contracts Finder service yesterday. I reassure her that, although some connections were made through networks, absolutely every contract had exactly the same technical assurance, exactly the same contract negotiation and exactly the same procurement scrutiny. Those were done by civil servants, and value for money for the taxpayer and the people was guaranteed by that process.

[Lord Scriven (LD)]

My Lords, the Minister seems to say that there is nothing to see here, whereas some of us think that there is a whiff of uncertainty and of some things being not quite right. Therefore, will he agree to appoint an independent forensic auditor to carry out an independent report that can be published publicly to show exactly what has happened with PPE procurement?

[Lord Bethell (Con)]

My Lords, I do not want to give the impression that absolutely everything is perfect. Those were desperate days and we had to do extraordinary things to protect our healthcare staff. I remind noble Lords that other countries were flying in their representatives with bags of cash on private jets in order to seal contracts and some of our supplies were literally taken from under our noses on the runway at Hong Kong airport. They were extremely difficult times and I do not pretend for a moment that everything was absolutely perfect, but I reassure noble Lords that the right procedures were put in place by officials, and I reassure the noble Lord that these figures are currently being validated with the National Audit Office.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Lord Scriven Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Scriven (LD)]

My Lords, in September 500 people were in hospital with Covid-related symptoms. Today, as we speak, the figure is nearly 11,000. If the Government had taken the advice of SAGE at the beginning of September, the number would clearly have been lower.

The effect on the NHS of having 11,000 Covid patients is not just a crisis in critical care for Covid patients; it is a crisis for anybody who has a life-threatening condition. Beds are filling up and, if this rate continues, people with life-threatening conditions will not be able to get the life-saving treatment they need in the NHS. That is why we need to act. I have some sympathy with some of the amendments that have been tabled but, because of that one fact, I cannot support them today. It is beholden on us to act, not just because of those with Covid but because of those who will have strokes, heart attacks and other life-threatening conditions now that we have got to this stage. I blame the Government for getting to this stage by not acting faster, but that one statistic alone makes me feel that we have to act.

We then have four weeks in which the Government have to put in place a national system for sorting out test, trace and isolate. On testing, it is not just a case of putting another two or three noughts on the number of tests carried out; it is about getting to the right people at the right time and getting the test back speedily. That is absolutely vital. The Government need to make sure that they stop talking just about quantity and start talking about quality as well.

Tracing is a national disgrace and is causing the virus to spread faster. We need to localise the tracing system, with local knowledge and shoe-leather epidemiology. We need people who know the streets, back doors and ginnels, and who know where to get to and how to speak to people. The Government need to localise by working with industry, academia and local government. It has to be about not just money but expertise, getting the data in a way that local areas require. That is absolutely vital.

Isolating is about giving people financial security so that they do not have to worry about feeding their children or paying their mortgage or rent. It should be seen as a national and civic duty which the Government support, without more sticks or penalties. Taiwan has shown how this can be done: with Covid teams which go in and support people, not just financially but with psychological help. There is help with childcare and food, and by checking on people’s health.

So, through gritted teeth, I will support these regulations. We, the public, will do our bit. We will stay at home, protect the NHS and save lives, but over the next four weeks the Government have to do their bit—sorting out the test, trace and isolate system.

Blood Safety and Quality (Amendment) (EU Exit) Regulations 2020

Lord Scriven Excerpts

Monday 2nd November 2020 Grand Committee

[Lord Scriven (LD)]

I too thank the Minister for presenting the statutory instruments. I will speak in particular to the blood safety and quality regulations. These are clearly very important and, as we get closer to the date by which a deal was meant to have been arrived at and there is not one, they become even more important, particularly given the shelf life of blood.

I will follow on from what the noble Lord, Lord Hunt, said. Standards in Northern Ireland are linked to the EU and will continue to be linked to the EU under the agreement. For Great Britain, divergence can take place. I note that the Minister said it was a floor and not a ceiling, but sometimes the floor can fall in, even with small changes—for example, on the storage of blood. So how will the Government ensure that divergence does not mean that standards will change before they come before Parliament and are passed into law, which could mean that the supply of blood becomes slower than is operationally required?

I note that 6.5% of plasma is imported from the EU to the UK. Can the Minister confirm what arrangements have been made to ensure that that plasma will continue to be available to those in GB—and speedily? If we go to a no-deal arrangement, what arrangements are there and what discussions have been had with the EU with regard to our position on getting this supply of plasma? Will it change if we are a third country? I seek exactly the same assurances on the supply of blood for patients with rare diseases who require imported blood and blood components. What arrangements have been made to ensure that the supply and standards remain the same over a period of time?

If the EU brings in new technical updates, what processes for Great Britain will be in place and how will they be linked to future EU standards? What proactive work will take place, or will we have to reactively change if the EU changes its standards and is seen to diverge?

It is clear that the arrangements on this seem certain—but only if the GB Government decide not to diverge at any point. I want assurances in particular on that, but also with regard to supply. In the House of Commons debate at the time of the 2019 regulations, the Under-Secretary of State at the Department of Health and Social Care stated very clearly that the fast-tracking of shipments at ports and alternative routes were being prepared. Have those now been prepared and, if they have, what arrangements are in place for the fast-tracking of shipments at ports and alternative routes for the supply of blood into the UK, Northern Ireland and GB?