Personal Protective Equipment: Accounting
Lord Wood of Anfield Excerpts(2 years, 10 months ago)
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Lord Wood of Anfield
To ask Her Majesty’s Government what steps are being taken within both the Department of Health and the Treasury to account for the £8.7 billion spent on unusable PPE in the course of the financial years 2020-2021.
Lord Wood of Anfield (Lab)
My Lords, I beg leave to ask a Question of which I have given private notice. I remind the House of my interests as a director of the Good Law Project.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
Throughout the pandemic, our absolute priority has been saving lives; £8.7 billion of the personal protective equipment inventory has been written down, not written off. This does not mean that it is unusable. The accounts make it clear that only 3% of the items purchased were not fit for any use. The majority of the impairment reflects the fact that the Government bought in a globally inflated market. It was better to do that than risk running out of PPE and risk lives.
Lord Wood of Anfield (Lab)
My Lords, I thank the Minister for that Answer. Global inflation was clearly part of this, but of the extraordinary 72% of PPE spend that has now been written down, £670 million was on defective equipment, £750 million was on PPE that was past its expiry date and £2.6 billion was on unsuitable supplies—if you add it all up, that is enough to build more than a dozen new hospitals. Apparently, Ministers now cannot locate a further £3.6 billion in supplies, and a further £1.2 billion is again being written down on advance orders for this year. Can the Minister pledge today to have a full investigation into PPE procurement processes, particularly into how it became possible for some suppliers, funnelled through the VIP lane, to make so much money from the tax- payer for equipment that was not used or unusable?
Lord Kamall (Con)
The noble Lord asks a detailed question, so I hope noble Lords will forgive me if I try to respond in some detail. If you look at the breakdown of the writedown, you will see that, first, about £4.6 billion was attributable to changes in global prices following the point of purchase in a highly inflated market—noble Lords will remember that even toilet rolls went up at one time. As the noble Lord rightly says, the £673 million was for stuff that had failed the quality testing or technical insurance. The £2.6 billion was for stock that will not be used for its intended purposes but can be repurposed. We are also looking at stock in excess of the current forecast requirements, which can be stockpiled, and we are also introducing a tender for testing to see whether the life of some of that stock can be extended.
Social Care
Lord Wood of Anfield Excerpts(3 years, 1 month ago)
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Lord Wood of Anfield
To ask Her Majesty’s Government what proportion of the new Health and Social Care Levy will be allocated to the provision of social care.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
On 7 September, we announced £5.4 billion of new funding for adult social care over the 2022 to 2025 period. We have also announced that this includes more than £3.6 billion to reform the adult social care charging system and to help local authorities better sustain their markets by moving towards paying providers a fair rate for care. It also includes more than £1.7 billion for much-needed wider system reform. Further details will be announced in a White Paper later this year.
Lord Wood of Anfield (Lab)
My Lords, the Health Foundation has calculated that, over the next three years, the funding required just to meet current social care demand is bigger than the extra money going into social care from the levy. So this levy will not even start to address issues such as the need for better pay and conditions for social care staff, local government’s lack of resources, and the need for community care, personalisation, et cetera. Could the Minister explain how he expects the country to believe the Government’s plan that, after three years of operation, the NHS portion of the levy, which is currently the majority, will be cut and transferred to social care? Can he confirm that the plan is really to cut NHS funding in 2025 in the face of ever rising demands on its services?
Lord Kamall (Con)
The Government have always been clear that the share of the levy going towards the NHS to tackle the backlog was temporary and that, in the longer term, we would move to funding social care. As I am sure the noble Lord is aware, for decades, Governments have kicked the can down the road and have not tackled this difficult issue. The Government have been quite firm in committing money and have been learning, in our constant discussion with stakeholders, how best to reform the social care sector.
Covid Contracts: Judicial Review
Lord Wood of Anfield Excerpts(3 years, 9 months ago)
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Lord Bethell (Con)
My Lords, it is not for me to do the post-match analysis; that will be for those in the future. I reassure the noble Baroness that we have 32 billion units of PPE procured, including 19 billion purchased by the DHSC, 10 billion purchased by SSCL and 2.5 billion manufactured by our brilliant UK companies. We have 120 days of PPE ahead of us, and I can very confidently say that we are in great shape for anything the pandemic may throw at us.
Lord Wood of Anfield (Lab)
I declare an interest as director of the Good Law Project, which brought the action against the Government. Can the Minister clear up a confusion about this judicial review? In the wake of losing it, Matt Hancock, the Health Secretary, refused to apologise and said that dealing with the pandemic meant that breaching the legal obligation to publish within 30 days was “the right thing to do”. However, the case revealed emails showing that civil servants’ serious concerns that
“we are in legal breach”
were overridden in order
“to allow No.10 SpAds … enough time to be sighted and given full opportunity to comment”.
Why would the desire of No. 10 to provide comment on the mere publication of a contract legitimise a legal breach? Can the Minister explain the inconsistency between these facts and the Health Secretary’s professed explanation?
Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020
Lord Wood of Anfield Excerpts(4 years, 2 months ago)
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Lord Wood of Anfield (Lab)
My Lords, governing in these torrid, complex, challenging times is not easy. None of us should pretend that it is. I have three questions and a plea for the Minister, specifically about the rule of six.
First, given that scientific studies have shown that the risk of transmission is 20 times greater indoors than outdoors, why does the rule of six abandon that distinction? I know the answer: simplicity. I understand the force of that, as the noble Lord, Lord Lamont, said. However, if the Government want to use the authority of science to generate legitimacy for and adherence to rules, and the science suggests that a rule is not grounded in science, they must at the very least bring the public inside their reasoning for why there is an exception. You cannot simply cite science and say that it always supports your conclusions, and not mention it when it does not, and then simply keep citing the mantra: “We will always be led by science”.
Secondly, have the Government considered the unintended perverse behavioural effects of the rule abandoning this outdoor/indoor distinction? Eliminating the distinction between gathering in groups of up to six outside, where the risk is very low, and gathering in groups of up to six indoors, where it is around 20 times higher, means that people who want to break the rules, and are determined to do so, are incentivised to gather indoors and not outdoors, where the rules are more likely to be enforced. Why did the Government not follow the Welsh option of having more relaxed rules for outdoor gatherings?
Thirdly, if we look to our partners in western Europe, we see variations in rules, of course, but also some constants. Public gathering limits are considerably higher: 10 in France, 50 in Germany, and none in many countries. Private household gathering limits, apart from in Ireland, are rare, and mask wearing is considerably more compulsory in public than in the UK. Taken together, this suggests the UK is becoming an outlier: it is restriction heavy and face-mask-wearing light relative to other countries. Is this because our science knows something that they do not, or is it because the British people behave differently from those in other countries? What is the reason for the UK being an outlier in the portfolio of measures we seem to be taking?
Lastly, I make my plea. The Government rightly adopt a mixture of national rules and local variations. However, across England, local authorities have consistently complained about an absence of consultation, decision sharing and refining of rules in the light of local circumstances. Can the Government please now commit to greater responsiveness and flexibility towards local considerations, to allow a local refinement of rules that are, after all, unlikely to be equally appropriate for Camden, rural Dorset and Manchester?
Covid-19 Update
Lord Wood of Anfield Excerpts(4 years, 5 months ago)
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Lord Bethell
The noble Lord overstates his case a bit—it is 28% of Britons who are obese—but his point is very well made. We have undoubtedly been challenged as a nation because too many of us are overweight, and I say this with a degree of personal humility. As I said in my previous answer, there is a significant opportunity for this country to regard Covid as a massive warning shot and a potential inflection point where we address overeating and, as a nation, embrace the opportunity to get fit and lose some weight.
Lord Wood of Anfield (Lab) [V]
My Lords, on Monday the Mayor of Leicester said:
“It was only last Thursday that we finally got some of the data we need but we’re still not getting all of it.”
Is he mistaken, Minister?
Lord Bethell
Yes, the mayor is mistaken. He has been presented with all the data that we had. He has sat down with public health officials and been through that data, which has been re-presented to him on several occasions. I am pleased to say that he has finally come round to the lockdown measures that we have recommended.
Covid-19: Masks
Lord Wood of Anfield Excerpts(4 years, 6 months ago)
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Lord Wood of Anfield (Lab) [V]
My Lords, this is the Government’s history on the issue of face masks. On 6 March, NERVTAG expressed concern that the public did not understand why face masks were acceptable for healthcare staff but not for them. The minutes explained that, unlike the public,
“healthcare staff are trained to use the masks and know when to change the masks when they become soggy or contaminated.”
In the remainder of March, as lockdown measures were introduced, face masks were not discussed. On 7 April, NERVTAG concluded that the increased use of face masks would have minimal effect on stopping people becoming infected. SAGE agreed. There was no further mention of face masks in SAGE until 11 May, when the Prime Minister issued advice that the public should wear “face coverings” in enclosed public spaces. On 4 June, the Transport Secretary said that face coverings would be mandatory on public transport from 15 June.
I support the use of face masks, but what on earth is the scientific rationale that justifies this handbrake turn in policy? We cannot expect people to know what they are doing unless the Government explain what they are doing. Until they do so properly, people will conclude that the Government do not know what they are doing.
Covid-19: Testing
Lord Wood of Anfield Excerpts(4 years, 7 months ago)
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Lord Bethell
My Lords, I pay tribute to Public Health England, which stood up the CTAS system that provided track and trace services at the beginning of the epidemic. I pay tribute to Dido Harding, the track and trace director whose appointment was announced earlier this week. I pay tribute to Professor John Newton, who provides scientific guidance and co-ordination for the track and trace programme.
Lord Wood of Anfield (Lab)
My Lords, we have seen from the Covid outbreak at a nightclub in South Korea that speed is of the essence in ensuring an effective test, trace and isolate strategy. However, given the limited availability of test kits and the fact that it can take three to four days to process them, and in the light of the fact that what the Government called “operational issues” led last week to 50,000 tests being sent for analysis to the US, can we really be confident that the tests can produce sufficiently timely information to form the basis for a test, trace and isolate strategy?
Lord Bethell
The noble Lord is entirely right. Speed is essential and the South Korea example is a good one. More than half of our tests are turned around within 24 hours. I pay tribute to the track and trace team, who handled an extremely complex and difficult laboratory failure last weekend and used innovation to turn around 50,000 tests, the results of which were reliably given to people. However, we will continue to work on shortening the result times and getting the information back speedily so that isolation can happen in a thorough way.
Covid-19: Extent of Infection
Lord Wood of Anfield Excerpts(4 years, 7 months ago)
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Lord Bethell
The noble Baroness speaks of anecdotes of which we are very aware. We are conscious of the stories coming particularly from America about a seeming correlation, if not a causation, between obesity and Covid mortality. Clinical trials and data on this are in short supply. The CMO has not made a declaration on it. But I share her instinct that there is a strong connection. As the noble Lord, Lord Moynihan, suggested, fitness and diet will be important parts of our post-lockdown experience.
Lord Wood of Anfield (Lab)
My Lords, we can understand the epidemiological value of antibody—serology—testing. However, I am interested in the public policy uses that may come from this testing. Is it the Government’s intention to use evidence of antibodies in individuals to say that some people rather than others can return to normal life sooner—particularly people of working age and younger rather than older people?
Lord Bethell
Serology tests provide important data on the behaviours of the virus. We still do not fully understand what kind of immunity and antibody response will be long-lasting in the body. There are mysteries to this virus that are yet to be solved; serology tests are vital to that and they can play a part in the back-to-work strategy. However, I would remind him that it is a tiny proportion of the population—probably around 5%— who have antibodies. We cannot put the economy back on its feet with just 5% of the population.
Health: Cancer
Lord Wood of Anfield Excerpts(8 years, 11 months ago)
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Lord Wood of Anfield (Lab)
My Lords, I, too, thank the noble Baroness, Lady Walmsley, for securing this debate. I shall focus on childhood cancers, which present challenges that are often distinct from more common adult cancers. I declare an interest as a father of a boy who has been treated for brain cancer and take this opportunity to declare my thanks for the extraordinary joined-up care he continues to receive.
Childhood cancer is the most common cause of death in children aged one to 14 and the most common medical cause of death for 15 to 25 year-olds. Death from cancer at any age is, of course, tragic and traumatic for those left behind, but childhood deaths from cancer are especially so, and the years of life lost are considerably higher.
Paediatric cancers are rare and histologically diverse, which provides challenges for both diagnosis and attracting research funding. For many cancers, such as non-Hodgkin lymphoma and bone tumours, survival rates for 15 to 25 year-olds are worse than for adults, and childhood cancer treatments have particular hazards because they take place while bodies are still in the early stages of development and often involve lifelong consequences for those affected. But there is good news: survival rates have steadily increased for more than 20 years, from under 70% in 1990 to more than 80% in 2010. We are in the top third of high-income countries for childhood cancer survival rates, which is encouraging—but we know what more needs to be done to improve further, as the noble Baroness, Lady Walmsley, talked about.
There are four challenges in particular. The first is diagnosis. Nearly a third of teenage and young adult cancers are diagnosed through emergency presentation at A&E—much higher than the average for all other cancers in the adult population. About a third of this young age group have to visit the GP three times with symptoms before getting a referral—delays that make it more likely that a cancer will advance and that make the treatment much more complex. I know a number of parents of child cancer sufferers who very sadly feel that their GP acted as though rationing entry into the diagnostic system. I am keen to hear what more the Minister thinks can be done to raise awareness among GPs of warning symptoms.
The second challenge is education. Surveys show that teenagers have less understanding of cancer than older age groups, yet we know that many of the major risk factors for developing cancer in adulthood are initiated in adolescence. The Independent Cancer Taskforce recommended that a cancer education programme should be instituted for all secondary schools to raise awareness of healthy lifestyles and cancer symptoms. Will the Minister say whether the Government plan to endorse this proposal?
Thirdly, there is the issue of clinical trials. Half of young children with cancer enter trials for common cancer types. Among 15 to 19 year-olds just under a third do, and for 20 to 24 year-olds the figure is only 14%. That is why the Teenage Cancer Trust is calling for NHS England to set an expectation that at least half of teenagers and young adults with cancer be recruited to cancer trials over the next decade. Will the Minister comment on that ambition and say whether the Government intend to support it?
Lastly, perhaps the most important issue is funding for research. From 2010 to 2012, paediatric cancer research funding fell by 25%. What is as worrying as this dramatic fall is that it is wholly due to a reduction in government-funded research, which fell from nearly 40% of all research spend in 2011 to just 12% in 2014—so in 2014 the Government spent on paediatric cancer research one-third of what was being spent by the Government in 2009. We live in straitened times that force us to focus on priorities—we all know that—but I suggest that public funding of research into childhood cancer has to be, as for any generation, one of those priorities.