General Practitioners: Recruitment and Retention

Lord Singh of Wimbledon Excerpts

Monday 12th June 2023 Lords Chamber

[Lord Markham (Con)]

What we totally accept and believe is that primary care is where a stitch in time saves nine, to take that saying. That is why I believe that the primary care plan is a big step forward. As I said, the fact that we are doing 10% more appointments per day is significant, as is the Pharmacy First initiative that we have announced, which will bring on stream another 10 million appointments a year, allowing people to navigate whether a pharmacy is the best place for them to get treatment, in which case they can go there first. These are all practical plans that are in place and are making a difference.

[Lord Singh of Wimbledon (CB)]

My Lords, I declare an interest as someone who has children and grandchildren in the medical profession. Would the Minister agree that there is something terribly wrong in the recruitment and retention of doctors when newly qualified doctors from Nigeria are paid more than those in this country when doctors find it easier and more profitable to do locums than stay in a fixed career path; and, finally, when doctors are being inundated with attractive requests from Australia and New Zealand to emigrate to those countries, leaving a dearth in this country?

[Lord Markham (Con)]

All the things that the noble Lord points towards are covered in our plan for recruitment and retention. The things that we have announced, particularly on pensions—a key reason why people were leaving—were welcomed by the sector and the fact that we have record numbers in training is also a step in the right direction. But, as we freely admit—this is what the primary care plan is all about—a lot more work needs to be done and is being done.

Covid-19: Update

Lord Singh of Wimbledon Excerpts

Tuesday 20th April 2021 Lords Chamber

[Lord Bethell (Con)]

I am extremely grateful for that perceptive question. We are looking, at this very moment, at our arrangements for the autumn. For the flu vaccine, we hope to double down on our hugely successful efforts from last autumn. We hope to build on the experience of the Covid vaccine to ensure that a much wider range of people have the vaccine, so that we can deal with those who might head towards severe illness, and to stop transmission. When it comes to the Covid vaccine, we are beginning to try to understand whether a booster shot will or will not be necessary to address the threat of VOCs. As I said earlier, we are still at a stage where we do not have the full science at our disposal but, if necessary, we will roll out a vaccine booster programme in the autumn.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, India being placed on the red list will cause real hardship to many UK citizens with close family ties in the subcontinent. Does the Minister agree that, while this has necessitated the cancellation of the Prime Minister’s visit to India, it will also have prevented him bringing back a virulent strain of the virus Modi-us bigotus, which attacks and can seriously harm a country’s entire democratic immune system?

[Lord Bethell (Con)]

My Lords, our thoughts are with the people of India at a time when they are fighting the disease in very difficult circumstances. I acknowledge that, for families in the UK with family and business ties with India, the arrangements under the red list are extremely inconvenient, and we are doing it only because it is absolutely necessary.

Health and Social Care Update

Lord Singh of Wimbledon Excerpts

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I hear my noble friend’s message loud and clear and he has made the case both persuasively and thoughtfully. He is a little ahead of events. It is not possible for us to put in any form of certification or mandation until the vaccine has been offered to absolutely everyone in the country. However, he will know that the Cabinet Office has a review process in place that is looking at exactly the dilemma he has spoken to.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, I congratulate the Government on the success of their vaccination programme. We should also applaud the way that the NHS has responded to the pandemic in reorganising priorities and efficiently facilitating the vaccine rollout. Does the Minister agree that the controversially privatised NHS Supply Chain has done less well in the provision of PPE and that the Government’s track and trace programme has also been found wanting? According to the National Audit Office, some of its consultants have been paid thousands of pounds a day for sitting at home with very little work.

[Lord Bethell (Con)]

My Lords, I am grateful to the noble Lord for his tribute to the NHS, both the front-line staff and those who have organised the vaccine rollout. He is right to say that this has been a huge national achievement. However, I do not accept the characterisation he has made of other aspects of our pandemic response, including the provision of PPE, which, by the way, involved a huge global competition for extremely rare materials and led to a massive increase in domestic production. I also do not agree with his characterisation of the test and trace programme, which has developed into becoming one of the largest testing programmes in the world. It is now extremely effective, with tracing completion rates above 90%.

Covid-19 Update

Lord Singh of Wimbledon Excerpts

Thursday 4th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I disagree completely with the noble Lord’s first point. The vaccine would not have happened without AstraZeneca and the other private companies that have produced, manufactured and delivered it, so I do not know where the public sector would have got its vaccines from. I completely reject that point.

I agree with his second point. I should not have said, “When we are through this pandemic” because we are going to live with its consequences for many years to come, and if it is not this pandemic, there may be others in the future. We have all, I think, taken on board the fact that in the modern world, there is a new, 21st century cost for the kind of global lifestyle that we have got used to, and that is the international spread of viruses. We can, I think, win the battle, but we will have to adapt. Learning how to do that is the challenge of this year.

[Lord Singh of Wimbledon (CB) [V]]

I too would like to offer my congratulations to the Government on the speed and efficiency of the vaccine rollout. Due credit must be given to all our health professionals for their dedication in risking their own health in care homes and when visiting private houses. The sight of an end to the pandemic should not lead to smugness. We were caught ill-prepared when it began and, with environmental and climate change, along with the increasing movement of people, there will always be new threats. Does the Minister agree, as he has already hinted, that we should plan to use this experience to combat these new threats more effectively?

[Lord Bethell (Con)]

My Lords, I am grateful to the noble Lord for teeing up what I hope can be an insight about the future. We will have to work much more closely with our international allies and colleagues on this matter. We must invest in vaccines, therapeutics and antivirals on a prophylactic basis to be ready for when the worst viruses, including coronaviruses, emerge. We will have to bring international flying standards up to a much higher level so that the spread of viruses when pandemics occur is kept under control. We will also have to put the necessary surgical capacity into our healthcare systems to ensure that they are much more resilient than they were in the past. These are just three examples of the kind of changes that are on the horizon. I am hungry to get on with them and I am sure we will have a fantastic impact in our battle against disease.

Independent Medicines and Medical Devices Safety Review: Sodium Valproate

Lord Singh of Wimbledon Excerpts

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful to the noble Lord for raising that study. It is not one that I am aware of, and I am keen to go back to the department to find out whether it has done any analysis of it. I will write to the noble Lord with a response.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, the report First Do No Harm underlines the hurt and devastation that can result from not making patients aware of the possible side-effects of drugs. The harm done by giving sodium valproate during pregnancy cannot be undone, and generous support should be provided. Does the Minister agree that, while the appointment of a patient safety commissioner is a move in the right direction, that in itself underlines the importance of keeping patients fully informed of possible side-effects and listening to their concerns?

[Lord Bethell (Con)]

The noble Lord puts it extremely well and I totally agree with the thrust of his point. For patients to have the right information about the risks of the medicines that they are prescribed is essential. However, if I may stray into a different subject, there is also patient choice. For many patients, sodium valproate provides an incredibly valuable relief from epilepsy and mental illness. It is a drug that continues to be prescribed because some have no choice and there is no valid alternative to the drug. The number of people being newly prescribed the drug—new starters—is down dramatically from previous years, but for some it really is an important part of their therapy. The decisions that they make are personal ones, and we should respect those.

Covid-19 Vaccines Deployment

Lord Singh of Wimbledon Excerpts

Thursday 11th February 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right. We are entering a different phase of the rollout where definitions are not based so clearly on age and where more choices have to be made. Noble Lords have raised special groups and interests for which they have made a good case for them to be prioritised. We are reaching the moment when that communication will be made more clearly. I cannot say for certain what it will be because I do not yet have the information in my gift. However, I reassure the noble Baroness that, when that moment comes, the communication will be done very clearly and all the arguments that have been made in this Chamber will be listened to.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, I have two concerns about a generally impressive vaccine rollout. The first is the advice not to book a summer holiday. Even if it is cancelled later, planning for a break can have an important therapeutic effect on people at a very difficult time. The second is the policy of not allowing visits to relatives in care homes until all staff and residents have been vaccinated. However, I am reliably told that the vaccination take-up among staff in some homes is as low as 20%. Does the Minister agree that a policy which bars vaccinated relatives while giving unvaccinated staff unrestricted access needs to be revisited urgently?

[Lord Bethell (Con)]

My Lords, the noble Lord touches on one very positive subject: summer holidays. I entirely agree with him on the therapeutic effect of planning one’s holiday. I spend far too much time looking at Scottish cottages and the North Coast 500 to inspire me about the months ahead.

The noble Lord touches on the very difficult subject of care homes. I do not avoid the fact that this is one of the most awkward and regretful circumstances of the moment we are in. The bottom line is that care homes have many residents of different ages. A care home epidemic is unbelievably difficult to control and leads to mortality and sickness. I do not recognise the 20% figure that he articulated, but he is right that in many homes it is not the case that 100% of residents have been vaccinated. It is certainly not the case that everybody who would wish to visit one has been vaccinated. We are in a strange lacuna where visits are not possible—at least not indoor visits, only outdoor ones. I hope that we can end this awkward and difficult moment with the swift and emphatic deployment of the vaccine.

Obesity

Lord Singh of Wimbledon Excerpts

Tuesday 5th January 2021 Lords Chamber

[Lord Bethell (Con)]

Yes, I entirely agree with the noble Baroness. There are parts of the Government’s estate where more could and should be done in order to promote healthy foods. I pay tribute to the work of Prue Leith, who has done a lot to champion healthy food in hospitals. Progress has been made; I visited Southampton hospital with her earlier last year and saw her bringing healthy food direct to the patients, and the use of trolleys in order to ensure that warm food is delivered and that food does not have to come out of a plastic bag. More can be done, but I reassure the noble Baroness that we are working hard at it.

[Lord Singh of Wimbledon (CB) [V]]

The Sikh community has for some years run lectures and health checks in gurdwaras to reduce the calorie-rich diet of those from rural communities to one more suitable for the more sedentary occupations in the UK. Would the Minister agree that, with a little support from the Government, our places of worship can be of real help in reducing an above-average incidence of obesity and associated health risks in those from the subcontinent?

[Lord Bethell (Con)]

The noble Lord makes an incredibly important point, and he makes it very delicately. I am extremely grateful to him for bringing this to the Chamber. It is true that many people from rural communities in the subcontinent bring with them eating habits that are simply not appropriate for modern life. We have seen that in Covid, where some of the most challenging incidences of Covid ITU have been in communities with a high level of people from the subcontinent, whose eating habits have, frankly, left them in no good state to fight this horrible disease. Tackling that issue is extremely complex, and I am extremely grateful to the Sikh community for setting this good example.

Covid-19 Update

Lord Singh of Wimbledon Excerpts

Tuesday 15th December 2020 Lords Chamber

[The Deputy Speaker (Baroness Watkins of Tavistock) (CB)]

The noble Lord, Lord Rooker, and the noble Baroness, Lady Fox of Buckley, have withdrawn, so I call the noble Lord, Lord Singh of Wimbledon.

[Lord Singh of Wimbledon (CB) [V]]

My Lords, the Statement rightly emphasises the need for swift and decisive action to control the deadly virus, which is increasingly affecting schoolchildren. Yet, when a few schools in London planned to close a few days before the end of term but to continue with internet classes, they were threatened with legal action. Does the Minister agree that, while children’s education is important, their health and that of their parents and grandparents should also be considered before rushing to legal threats?

[Lord Bethell (Con) [V]]

The noble Lord makes his point well, but I respectfully disagree. One of the great challenges from closing schools is that young people then socialise and spread the disease much further and wider than they would if they stayed at school. This has been demonstrated time and again around the world. Also, to keep our hospitals open and our businesses and education systems going, and to stop deprivation from accelerating, it is desperately important to keep schools open. That is why, today, we announced the rollout of a much greater and enhanced asymptomatic testing regime for schools, in the new year, which will see bubble and teacher testing, so that schools can remain open.

Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020

Lord Singh of Wimbledon Excerpts

Friday 25th September 2020 Lords Chamber

[Lord Singh of Wimbledon (CB) [V]]

My Lords, first, it would be a little irresponsible for a doctor to stop giving medicine to a seriously ill patient at the slightest sign of improvement. Does the Minister agree that that is precisely what the Government did when, despite warnings from local leaders, they eased restrictions in Bolton and Trafford, only to reimpose them after a huge rise in numbers of those affected?

My second concern is the growth of difficult-to-understand language around prevention, with uncertainty over what constitutes a support bubble and whether immediate relatives can be considered part of the same household, et cetera. Does the Minister agree that a much sharper advertising campaign is needed on the dangers of this killer disease not only to the individual but to those they hold near and dear—a need that is even greater in close-knit, newer communities in our northern towns?

Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 2) Regulations 2020

Lord Singh of Wimbledon Excerpts

Friday 18th September 2020 Lords Chamber

[Lord Singh of Wimbledon (CB) [V]]

As we have heard this morning, these regulations are complex and, at times, confusing. I believe that much more should be done to greatly increase public awareness of the dangers of this painful killer disease. I am particularly concerned about the rising incidence in areas with large subcontinental populations, such as Leicester, Sandwell, the north-east and now Lancashire. Here, because of genetic factors, many carry a greater than average risk. Many are not avid listeners to or viewers of the BBC but regularly watch dedicated TV channels catering for them. Will the Minister use these to create greater awareness in this part of our community, which is at greater than average risk?