Vaccinations

Lord Suri Excerpts

Wednesday 15th June 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness raises a very important point. We have to recognise that the UK has one of the most comprehensive childhood and adolescent immunisation programmes in the world. We have seven national childhood immunisation programmes, three adolescent programmes and two elderly programmes. Vaccine uptake in the UK remains high overall, but there has been some decline in routine childhood vaccines—so we have been looking at school-based immunisation programmes, some of which were clearly interrupted due to Covid. At the same time, from October to December 2021, the coverage of childhood vaccination programmes actually increased.

[Lord Suri (Con)]

My Lords, it is vital that primary carers help increase the delivery of a structured mass vaccination programme to deal with conditions such as shingles and influenza. Are the Government going to act promptly, given that the fundamentals are in place since Covid-19 has been dealt with?

[Lord Kamall (Con)]

I thank my noble friend for that question. There is a lot of innovation in vaccines. Over the years, we have seen combined vaccinations, and some places have moved away from vaccinations to orals or to not necessarily needing vaccinations at all. I am aware of that, and I would be very happy to write to my noble friend with more details.

Sugar Reduction Programme: Bread

Lord Suri Excerpts

Wednesday 25th May 2022 Lords Chamber

[Lord Kamall (Con)]

On the direct question that the noble Baroness asked, I will have to go back to find out more and will write to her. The Government are very keen on some campaigns that she will be aware of, such as the Better Health campaign, launched in July 2020. In January 2022 it took over from Change4Life. We now have the NHS Food Scanner app; with a quick scan of a barcode, families can see how much sugar, saturated fat and salt is in their everyday food and drink. There is also a campaign on on-demand video, as well as on YouTube, and we encourage people to download the app from the App Store or Google Play. More campaign resources are available, and I am sure that noble Lords would like to help promote them.

[Lord Suri (Con)]

My Lords, the staple food of many people’s day is bread. The sugar content in the average slice of processed bread varies but can be up to 3 grams. Sugar is formed naturally in the baking process, but it is often added into it. The benefits of adding sugar are favourable for the bread-making process but not for the people consuming it. Bread can be baked without adding sugar and, yes, that will indeed alter its texture, taste, freshness and the speed of its rise. If we look at the ancient history of bread, we see that making it uses grain and wheat flour; chapatis, naans and numerous Middle Eastern flatbreads usually do not have sugar added. These recipes are healthy and are still being consumed today. Health is wealth; take care of it.

[Lord Kamall (Con)]

Right. I begin by thanking my noble friend for that very comprehensive question. As I said earlier, some sugar is needed in the process, but he makes an important point about how we reduce the unneeded additional sugar that is added. I have already given the reasons why there is some sugar, and no doubt the chemical processes will be improved over time: as mankind’s innovation and ingenuity increase, we will see more substitutes for sugar. I was also interested in the point made by the noble Lord about chapatis; next time I go to a restaurant I will ask about their sugar content.

Long Covid

Lord Suri Excerpts

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

The NHS is working with the wider scientific community to better understand both Covid-19 and its long-term health impacts. The £50 million in research is to understand, first, the actual condition—and, as I said earlier, it is not necessarily a medical condition—and how we map and treat it. In addition, we have had 22 research studies to examine the cause of long Covid, to diagnose the condition and to optimise the design of healthcare systems. A lot of this has been done by the National Institute for Health and Care Research, which continues to welcome applications for further research.

[Lord Suri (Con)]

My Lords, long Covid must be taken seriously, as it is a sickness that has different degrees of symptoms for everyone recovering from coronavirus. Although most people recover quickly, there are those who have symptoms which last weeks or months after the infection has gone. There is also a burden on the people who must look after, and take care of, those suffering from long Covid, as it impacts people across all age groups. I request that Her Majesty’s Government take the necessary steps for research into long Covid so that people do not continue to suffer for such lengthy periods following the infection stage.

[Lord Kamall (Con)]

My noble friend is absolutely right that we must take this seriously. This is why, first, we have tried to map it to the three medical conditions I mentioned earlier: acute Covid-19, ongoing symptomatic Covid-19 and post-Covid-19 syndrome. We are also looking at the WHO definition, which defines post-Covid-19 condition as the condition that

“occurs in people who have a history of probable or confirmed SARS-CoV-2 infection; usually within three months from the onset of COVID-19, with symptoms … that last for at least two months”

and which

“cannot be explained by an alternative diagnosis.”

In my meetings with other Health Ministers from across the world, they want to learn from us what we are doing on long Covid and how we can co-operate better.

St George’s Hospital: Patient Deaths

Lord Suri Excerpts

Wednesday 18th May 2022 Lords Chamber

[Lord Kamall (Con)]

The noble Baroness clearly draws on her own experience of this. First, we have to wait for all the coroners’ inquests to finish; I think 36 have been completed at the moment. There will then be reviews, to which there is a statutory guideline on when they have to be responded to. However, it is also important to recognise the differences between the coroners’ inquests and the work of the independent mortality review, which was not undertaken to determine the cause of death in individual cases or attribute blame to individual clinicians—it was looking at a number of procedures.

[Lord Suri (Con)]

My Lords, it is nice of the noble Lord, Lord Hunt, to put this Question to the House. It is a very serious matter that patient deaths at St George’s Hospital were unnecessary. Having digested the comments, we must take the appropriate steps so that such negligence is not repeated. Hospitals are meant to save the lives of patients, not end them. Human life is very important.

[Lord Kamall (Con)]

My noble friend makes very important points which I am sure many noble Lords will agree with. It is about understanding what went wrong in places and learning from that. NHS England and Improvement is committed to improving the standard of patient safety investigations. It set up a new patient safety investigations team; as many noble Lords will know, HSSIB and a number of other panels and investigations are also looking to learn. In addition, NHS England and Improvement will have to respond to the coroners’ reports.

NHS: Targets

Lord Suri Excerpts

Thursday 6th February 2020 Lords Chamber

[Lord Suri (Con)]

My Lords, I am grateful for this opportunity to consider opportunities to improve the NHS and get waiting times down. I thank the noble Lord, Lord Hunt, for securing the time for us to discuss these issues.

There is little doubt that outcomes in the NHS have been slipping. In particular, NHS England has under- performed on the four-hour accident and emergency waiting time target for some time and November saw the worst performance since records began. Some of the issues driving this are essentially secular and will not simply dissipate. This is in no way due to the NHS staff, who always impress me with their attention and care.

There is a general understanding that the greatest pressure on the NHS is the increased care burden of an ageing society. This comes across in higher numbers of operations, but nowhere more so than in adult social care. Without better social care provision, the elderly will continue to recover in hospital rather than in the community and waiting lists will increase. Adult social care has become a lingering issue that previous Governments have been unwilling or unable to address. When a new funding system was proposed in 2017, the policy had to be walked back within a few days. This underlines the weakness of creating a lasting settlement without some sense of cross-party approach. Indeed, to create institutions that last there needs to be an understanding by all parties that the need must be met, as occurred at the founding of the NHS itself.

It is for this reason that I welcome the second of the Government’s points for the forthcoming social care proposals, to

“urgently seek a cross-party consensus in order to bring forward the necessary proposals and legislation”.

I hope that all English opposition parties will recognise that this is an existential issue and play a constructive role in shaping a lasting consensus. For many in opposition, this is a real chance to leave a legacy not normally achievable for parties out of power.

The real issue to resolve will be funding a more extensive care system. The sums involved are substantial but the gains must be remembered. Shorter waiting lists, more available beds and fewer unpaid carers will make a large combined contribution and free up some capacity in the public and private sectors. The Government have committed to making sure that nobody will have to sell their home to afford care. This is a sensible first step, but there must be an equitable element to the system.

The Barker commission gave serious thought to making those above pension age pay national insurance contributions and Sir Andrew Dilnot suggested to the Economic Affairs Committee of this House that the current exemption was a “major distortion” in the tax system. The exemption should be reviewed, alongside the current range of pension benefits, which may need to be means tested to deliver additional savings, including the winter fuel allowance.

Ultimately, without increased contributions from the elderly, any new system will be doomed to unsustainability as the proportion of working-age citizens to retirees increases. Other forms of wealth taxation will also need to be explored, including higher capital gains taxes on transfers of wealth. It will not be easy, but I am convinced that with a collegiate attitude and a real effort, a path forward is possible.

Safety of Medicines and Medical Devices

Lord Suri Excerpts

Thursday 28th February 2019 Lords Chamber

[Lord Suri (Con)]

My Lords, I am very pleased to participate in today’s debate and privileged to have heard the maiden speech of the noble Lord, Lord Carrington, who brings the wealth of knowledge of senior Carringtons to this House. The debate is of great importance to all of us here, and serves as one of the most pressing cautionary tales for what might happen if the other place does not pass the withdrawal agreement that will be coming before it in due course.

The safety of medical devices and medicines is not a present issue in the minds of the electorate and does not get the attention it deserves. Part of this is down to the incredible luck we all have to live in a country with an excellent health service which guarantees consistently strong treatment across all of its hospitals and surgeries, with investment decisions taken after thorough consultation and planning. We are particularly lucky to have a national regulator with great depth of expertise in particular fields of treatment and medicines—from toothpaste to gene therapy. It is a great shame that, post-departure, the likelihood of the MHRA receiving commissions from the EMA will considerably diminish. One-third of the income of the MHRA is linked to EMA funding, and unless government support is guaranteed there is a serious and pressing risk that the MHRA will suffer a loss of income and reputation and an outflow of specialists to other European regulatory agencies, taking a sizeable proportion of the UK’s comparative advantage with them.

This is important, as it underpins investment by pharmaceutical firms in our universities and labs. It is natural that they would be keen to be close to the leading researchers and benefit from their expertise throughout the development process. I therefore ask the Minister to confirm ongoing government support for areas of specialist research traditionally funded by the EMA for the MHRA, such that the UK maintains our lead in the areas in which we excel. If this cannot be guaranteed, will the Minister commit to seeking a close continuation of the existing relationship in the next stage of Brexit talks focusing on the future relationship? I also wish to add my approval of the ongoing Cumberlege review. The NHS is funded out of general taxation to serve the population, and it is of paramount importance that the people’s voices are heard as soon as concerns are raised about medicines or medical devices.

Too often in the past we have relied on clinicians raising concerns with NICE or the MHRA and then letting action be taken, even when there has been a substantial degree of concern in the patient community. A great deal can be learned from the mechanisms enshrined in statute in Section 11 of the Enterprise Act. So-called super-complaints allow representative consumer bodies to make a well-researched complaint about some feature of the market, to which the responsible regulator or a Minister must respond within a given timeframe. The principle was extended to financial markets by the Financial Services and Markets Act 2000, and the mechanism operating via both of these statutes has been endorsed by consumers and industry alike as an effective means of ensuring accountability and maintaining high standards. I know, of course, that the yellow card scheme operates in a similar way, but there is no guarantee of a fast-track process for responsible nominated groups operating on behalf of consumers. Having had the advantage of reading some of the submissions made to the review online, I have been impressed with the quality of submissions made to the group and I therefore think that they should be given super-complaint powers.

NHS: Healthcare Data

Lord Suri Excerpts

Thursday 6th September 2018 Lords Chamber

[Lord Suri (Con)]

My Lords, this is a topic of great importance. I thank my noble colleagues who have succeeded in securing the time for this debate. I was very pleased to hear the remarkable speech by the noble Lord, Lord Kakkar. The maiden speech by my noble friend Lord Bethell was very encouraging; I am sure that he will live more than 110 years, having wished for only 100 years.

We are privileged to live in a golden age of medical innovation. New treatments are coming on to the market at an accelerating rate due to a number of new processes which are transforming surgery, pharmaceuticals, and care overall. Another area of great innovation is data. Big data has transformed the traditional working models of some industries and, when applied to datasets of sufficient scale, it can be exceedingly powerful at highlighting trends and suggesting changes. It therefore seems logical to see how the NHS could benefit.

Each year, the NHS collects terabytes of data on its patients. Those patients have a statutory opt-out, but we see that in practice most of them make the sensible decision to continue to grant access to their data so that processes can be improved going forward. This data is collected and processed, but the NHS has not started to use big data technologies on anything like the scale of other industries, such as logistics or shipping. Part of the reason for that is obvious—the NHS is not a tech company, and primarily deals with care and preventive medicine, but other barriers are more subtle. One area is privacy concerns. This data could cause great damage if it were to be stolen by the increasingly dangerous state-backed hackers of today. The solution is to invest in proper computer systems for the NHS, and to use all arms of the state to safeguard our data.

We must also make sure that important data is properly recorded. There are no reports on this, but I often see patients in hospitals filling in paper forms that are not obviously copied to an online portal. For repeated information I can see the reason why, but it would streamline processes to be able to auto-fill large parts of the form. Furthermore, that data is not easily accessible and will be expensive to find and send to patients. When new data protection laws and changing attitudes mean that people want better access to their data, this will have to change. Finally, the most recent NHS England data and datasets consultation confirmed and enhanced the recommendation of the Francis report:

“A coordinated collection of accurate information about the performance of organisations must be available to providers, commissioners, regulators and the public, in as near real time as possible”.


All nations now run their own healthcare, and increasingly city and regional mayors will have devolved health powers. This is a positive step. I have always supported devolution, for I think it leads to better decision-making, more experimentation and greater accountability. But different data collection protocols could result in incompatible datasets to which big data methods cannot be applied. Can the Minister say what plan the Department of Health has made to ensure that fragmentation of care delivery does not damage the ability of the health service to gather data at the national level?

General Practitioners: Indemnity Scheme

Lord Suri Excerpts

Monday 16th July 2018 Lords Chamber

[Lord O’Shaughnessy]

That is a very existential question. The point is that we need to introduce the scheme by April and are absolutely committed to that. There are some very big decisions to be made on the scheme design now. We have a new Secretary of State who is getting up to speed on these issues as we speak. Our intention is to make those decisions to confirm the design of the scheme and to be able to tell GPs and other stakeholders publicly as soon as possible. We are committed to the April 2019 deadline.

[Lord Suri (Con)]

My Lords, is such a scheme currently available to general practitioners in any other part of the United Kingdom?

[Lord O’Shaughnessy]

I can tell my noble friend that the scheme we are designing is for England, the jurisdiction that the department looks after. However, the Welsh Government have announced their intention to have a state-backed scheme and we are speaking to the devolved Administrations in Scotland and Northern Ireland to make sure that we act together in this regard.

The Long-term Sustainability of the NHS and Adult Social Care

Lord Suri Excerpts

Thursday 26th April 2018 Lords Chamber

[Lord Suri (Con)]

My Lords, this is a valuable and important report, which gets to the issues that we must start to grapple with if we want a decent National Health Service to hand over to future generations. The noble Lord, Lord Patel, and the committee he leads have done an excellent job and his vast experience in the NHS has clearly shaped the recommendations that it makes.

I have often been a critic of the way some departments are structured and how spending is delivered to priority areas. It often seems to me that government struggles with long-term funding for areas that are not specific projects with their own funding framework. This report picks up on an endemic culture of short-termism in the NHS. From adult social care to the public health budget, those responsible are sometimes more concerned about next year’s figures than the overall picture over the medium term. This is not to disparage the excellent and valuable work of all our NHS staff, but is rather a reflection on the current NHS structure. I am therefore heartened to read about the five-year plan proposed for NHS funding.

In any business or service, planning year-by-year would be seen as inefficient practice, especially so when the recipient is being treated over a far longer period. In my view, the greatest current failing of the entire system is in adult social care. The fact that adult social care falls to local councils is a consequence of the Poor Laws and the end of workhouses, and seems outdated in the current context. Delayed discharges are one of the most significant factors that put pressure on the health service, but a lack of joined-up thinking and planning makes it harder for an effective policy solution to be found, although I welcome the additional £2 billion earmarked in the Spring Statement. Councils are not naturally suited to managing complex residential needs, and the obvious overlap between recipients of adult social care and NHS services suggests wide scope for efficiencies to be found. If not a full merge, some sort of shared responsibility must be a top priority, and I am glad the Minister has committed to such a policy.

One area that concerns me is the lack of engagement with the public for some of the new sustainability and transformation plans. Local communities deserve and ought to receive proper consultation on transformations to services in their areas. Failing to engage meaningfully is an own goal when communities are willing to help and can provide valued input or insight. STPs have no statutory footing, which is part of the problem. A statutory duty to engage local authorities at all stages of the planning process seems a sensible update to the existing framework. Do the Government have any plans to place the STPs on a statutory footing, and if so, will there be a duty to seek engagement from local stakeholders?

Finally, I am glad that the Greater Manchester agreement will allow for some experimentation in what works in social care. Devolution allows greater flexibility and allows us to see what works best. I hope that this new partnership finds some ways to make social care more efficient, and that any lessons learned are recognised at the national level.

Hospitals: West London

Lord Suri Excerpts

Wednesday 18th October 2017 Lords Chamber

[Lord Suri (Con)]

I start by thanking my noble friend Lord Dubs, who has spoken on this topic. I have learned a great deal sitting here. I have some thoughts that I would like to share with you.

From the off, let me put on record that I have always supported cross-party collaboration on the future of the NHS. I honestly do not believe that any mainstream party seeks to undermine the future of our health service, and I have argued that it is overpoliticised and underanalysed, especially by leading spokespeople. I have supported increasing technocracy in NHS management for some time. Such enormous organisations require experts in the technicalities, not transient Governments or Ministers, whose jobs and term of office change regularly.

That is not to disparage any current or former Ministers, of course, but it must be a basic principle across government that day-to-day control of huge public services should be done by the most qualified. Oversight, yes, but not overcomplication. I note that the current principal Opposition spokesman on health has backed sustainability and transformation plans in the past, and that the Labour manifesto contained a commitment to decisions on NHS care being made locally. So did the Conservative one. In that cross-party spirit, then, let us proceed.

I am well familiar with the standards and provision of care across the north-west London region. It is not out of selfishness that I support the proposed changes to Charing Cross, but out of necessity. Increased care and support for the frailty service is of paramount importance in an ageing area of London. The cuts to the size of the hospital and provision of services are indeed wide-ranging, but they are necessary. The future of healthcare provision is in dedicated clusters. These serve best to concentrate talent and spur innovation.

In London alone, I encourage noble Lords to visit the splendid Royal National Orthopaedic Hospital or the National Hospital for Neurology and Neurosurgery. These dedicated units provide a higher standard of care, are less bureaucratic due to their specialised care, and bring down the differences between regions by aggregating treatment. Moving Charing Cross’s wide-ranging functions to those units will result in better outcomes, which I think all of us here want.

I have not said anything on funding. If additional funds are required due to the move, or to rehire or relocate professionals, I have no quibble. It is an investment and, I think, a sound one.

On another point, I feel it is necessary to widen the argument on the sale of these sites. The Government own a great deal of land in places with an intense housing shortage. I would want to consider whether the sale of more sites, especially in London, could help to alleviate the housing crisis.

Often I drive past Wormwood Scrubs. That area of land is very much prime, and a similar facility could be built closer to the edges of London. The MoD has been a trailblazer in this regard, and I think that this is one of the easier tools in the policy kit to hand if this Government really are serious about tackling the housing crisis and increasing their own funds to reinvest in core services.