Crohn’s Disease and Ulcerative Colitis

Debate between Lord Turnberg and Lord Bethell

Thursday 15th April 2021 Lords Chamber

[Lord Bethell (Con)]

I am afraid that the management of public toilets is outside the reach of the department, but I will take that idea back to the department and write to the person responsible.

[Lord Turnberg (Lab) [V]]

My Lords, when I was a gastroenterologist, I knew that patients with inflammatory bowel disease did best when managed by a team made up of a gastroenterologist, surgeon and specialist nurse. Too often now, patients are denied access to such teams. In view of what the Minister has said, will this team approach be part of how we might correct this deficiency?

[Lord Bethell (Con)]

I would like to reassure the noble Lord that the scenario I described typically includes two gastroenterology consultants, a clinical intermediate fellow, a GP partner and a patient representative. It is exactly this kind of team approach that delivers the best patient outcomes, as the noble Lord rightly outlined.

Folic Acid

Debate between Lord Turnberg and Lord Bethell

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the consultation on the proposal to fortify flour ran for 12 weeks from 13 June to 9 September 2019 and was undertaken on a UK-wide basis. The pilot ran extremely successfully; the use of the supplements by the flour manufacturers was affordable and their implementation of the pilot was achieved without much disruption, and it was an encouraging experience that gives us good evidence for taking this matter forwards.

[Lord Turnberg (Lab) [V]]

My Lords, the science is clear that folate supplementation is absolutely safe and a remarkably effective public health measure. Does the noble Lord agree that further delay would be unconscionable, especially for the children still being born with spina bifida?

[Lord Bethell (Con)]

My Lords, delay is frustrating. I completely share the noble Lord’s frustration. Unfortunately, we are handling an epidemic and, once we have got plans in place for the second wave, we will turn our attention to this important and valued matter.

Covid-19 Update

Debate between Lord Turnberg and Lord Bethell

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

It is my understanding that many day centres will be reopened, although they will have to undergo a very careful risk assessment and, depending on the physical layout, may not be able to open at full capacity. However, I am happy to check that point and reply to the noble Baroness in detail. The issue of agency staff is a big problem, particularly where the staff are itinerant, but I remind her that we are embarked on a massive recruitment programme for the social care sector, including a large recruitment marketing campaign. That is bearing fruit and we are filling spaces very quickly.

[Lord Turnberg (Lab) [V]]

My Lords, when will the Government begin to make the test available to the whole population and not just to those with symptoms, so that we can discover the 80% of asymptomatic carriers? If there is a lack of capacity, why not use private and university labs around the country, as is the case at the Francis Crick Institute in London?

[Lord Bethell]

My Lords, there is very wide access to tests. Anyone who wants a test can apply for one today and, in almost any location in the country, will get one this afternoon. Whole-population testing is not the Government’s strategy, because testing at this level of prevalence would throw up more danger of wrong results than positive results. In terms of private and university labs, I absolutely pay tribute to the Crick, the University of Birmingham, the University of Cambridge and all other university and private labs that have contributed to the test and trace programme.

Covid-19: Response

Debate between Lord Turnberg and Lord Bethell

Wednesday 3rd June 2020 Lords Chamber

[Lord Bethell]

My Lords, I bow to the experience and wisdom of the noble Lord, Lord Patel, particularly in the matter of racism in the NHS. I would not for a moment suggest that there is no racism at all in the NHS—or any large organisation—and I deeply regret any bad experiences he may have had. The accusation, however, was of structural racism in the NHS, and that is what I push back against. The NHS as an organisation is not racist, and I reject the suggestion that it is.

As for the matrix of success, that is an extremely perceptive question, and a bloody tough one—exactly the kind I would expect from the noble Lord. To summarise, it is to reduce R: if we can get a lid on R0 and stop the index case from spreading the disease to more people, then Test and Trace will have succeeded.

[Lord Turnberg (Lab)]

My Lords, like the Minister I too went to have my Covid test recently. There was hardly anyone there—lots of testing stations but no customers and no queues. I was in and out in five minutes. I was not surprised, therefore, that while 200,000 tests a day are available, many fewer are being taken up. I ask the noble Lord, therefore, whether the Government will open testing to the wider public and not restrict it to those with symptoms. There are many asymptomatic carriers and we need to know who they are and where they are.

I also reiterate the question about how soon test results will be available in hours rather than days. We can do it, but when will it be rolled out?

Covid-19: Care Homes

Debate between Lord Turnberg and Lord Bethell

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

My Lords, the guidance has been reviewed by the CMO, and we stand by it. I can confirm that all patients leaving hospital for care homes are, as a routine, tested. When they arrive at a care home, they are treated as if they might have Covid, and they are put into an area of isolation, until either the test has come through or their diagnosis has been confirmed. This is a way of protecting care homes, and it is necessary to continue the traffic of people from hospital to care homes, in order to have the beds available for those who need them more.

[Lord Turnberg (Lab)]

My Lords, among the many reasons why we have done so badly in protecting our care home residents from this dreadful illness is the almost complete lack of adequate public health services at the local level. A few years ago, when I was chairman of the then Public Health Laboratory Service, we had a robust network of public health expertise in every locality which did all the testing and tracing of infectious diseases across the country. All that has been eroded over very many years, and I fear we have lost that local expertise—the doctors and the other staff that could have done the job that we are now left struggling to fulfil far too late. I ask the noble Lord whether he will make it a priority now, as a matter of urgency, to begin to fill that huge gap in our network of local public health services.

[Lord Bethell]

The noble Lord is more expert on the history of public health than I am, but I do not doubt the story that he talked about. I reassure him that Covid has definitely made us all think again about the very clear priority that local public health provision must and will provide. I would like to pay testimony to those public health officials—public health directors, environmental health officers, infection control officers—who play, and are currently playing, a huge role in controlling the epidemic.