Wuhan Coronavirus

Debate between Baroness Finlay of Llandaff and Baroness Blackwood of North Oxford

Tuesday 11th February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Lord is quite right that each of us has a role to play in preventing the spread of infection. At this point, the advice is that, if you have travelled from any of the infected areas or have been part of the contact tracing, you should self-isolate. Should you have any of the symptoms associated with coronavirus—a cough, fever or shortness of breath—you should stay indoors and call 111, even if the symptoms are mild. Outside the question of whether you have had any contact or travelled to the affected areas, the advice from the Chief Medical Officer is that effective handwashing and the “Catch It, Bin It, Kill It” concept—to use tissues when you sneeze or cough and to throw those tissues away—is the most effective way of limiting the passing on of infection, and each and every one of us has a role to play in doing that. However, I am happy to pass on to the House authorities the point the noble Lord has made and ask for communications to be sent from Public Health England with the most up-to-date information.

[Baroness Finlay of Llandaff (CB)]

My Lords, I thank the Minister for bringing the update to the House. Among all those people to whom we owe a debt, we should particularly single out the chief medical officers, led by Chris Whitty, who is an epidemiologist and therefore has an in-depth understanding of the science. We should also thank the owners and crew of, and all those on board, the “Diamond Princess”—a British-owned vessel—who are working with the Japanese authorities and doing all they can to contain the outbreak that has occurred there.

One of the difficulties—this was alluded to by the noble Baroness, Lady McIntosh, who is not in her place at the moment—is that in the early stages this is like the common manifestation of any other viral disease. Therefore, self-isolation and being responsible by staying away from people is everyone’s responsibility with all such infections. Unfortunately, some turn out to be coronavirus. Are the diagnostic kits for Covid-19, which I think is now its official name, available to adequate numbers of hospital laboratories which are under public health supervision? Are those diagnostic kits available across all four nations of the United Kingdom? Are they linked to Colindale so that there is good co-ordination of the way in which the diagnostic procedures are undertaken?

[Baroness Blackwood of North Oxford]

The noble Baroness is quite right. We are aware that there are British nationals on board the “Diamond Princess” in Japan and that six more people have tested positive for coronavirus, none of whom is a British national. We have offered consular assistance to those British nationals—we have been in touch with the “Diamond Princess”—including one who is in hospital. We obviously pay tribute to the work being done in trying to contain the situation there. I identify myself with the thanks and tribute paid to the work of the CMOs, who are doing an extraordinary job right now to make sure that the UK is prepared.

We are one of the first countries in the world to have an effective test; it is working well. Now that the protocols have been sent to the devolved Administrations, testing centres in Glasgow, Edinburgh, Cardiff and Belfast have started testing already. Labs in Cambridge, Bristol and Manchester have started testing today and Birmingham, Newcastle and Southampton will come online shortly. I hope that reassures the House about the capability already available within the NHS.

Coronavirus

Debate between Baroness Finlay of Llandaff and Baroness Blackwood of North Oxford

Monday 3rd February 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness asked that question last time and I did not forget. At the moment, Foreign Office travel advice is that anyone who has travelled to the UK from anywhere in China other than Wuhan or Hubei province, but not including Macau and Hong Kong, in the past 14 days and has developed symptoms should immediately self-isolate, even if symptoms are minor, and call NHS 111. Macau and Hong Kong are not included because those territories do not have evidence of sustained community transmission, as has been observed in mainland China, to date. They are therefore not currently included in the same travel advice as mainland China. However, the epidemiological situation in Hong Kong and Macau, as indeed in the rest of the region, is kept under constant review and will be considered in travel advice as we go forward, and reported to this House accordingly.

[Baroness Finlay of Llandaff (CB)]

My Lords, I am most grateful, as is everybody, to the Minister for updating us. She spoke about person-to-person transmission not having occurred in Hong Kong and those other areas. Will she confirm that to date there has been no evidence of person-to-person transmission outside China? That is, it has come from contact within China and people who have the virus leaving China. Do we have that information?

Also, in modelling for the worst-case scenario that might occur, how many negative pressure room beds do we have across the whole of the UK for those patients who develop severe acute respiratory infection and therefore have to be hospitalised and possibly ventilated in the event of this becoming severe? What evidence is there about the length of time that the virus survives on different surfaces outside the body? Because of the incubation and asymptomatic periods, when it appears that people are still infectious, there is a concern that the virus has quite a long survival time on surfaces, particularly those that may be warm and damp.

[Baroness Blackwood of North Oxford]

There were a few questions there. With regard to transmission, this is an evolving picture, so the best thing would be for me to send the most up-to-date information to the noble Baroness and put a copy in the Library, as I am sure it will be of interest to the whole House.

On ECMO beds, since April 2013, NHS England has commissioned a total of 15 adult respiratory ECMO beds from five providers in England. There is further provision in Scotland. But in periods of high demand, the capacity can be increased. For example, in the winter of 2018-19, when there was a significant risk associated with flu, the capacity was increased to over 30 beds and similar arrangements are in place for paediatric services. In addition, there are eight commissioned high-consequence infectious disease beds and around 500 infectious disease beds, and at the moment NHS England is confident that it has enough capacity, which I hope is reassuring for the noble Baroness. Obviously, we are keeping that under constant review as the situation evolves.

On the question about surfaces, that is one of the specific reasons why advice has been given regarding personal hygiene—washing hands and using tissues when sneezing—to avoid any forms of transmission that may create the kind of risks referred to by the noble Baroness.

NHS: A&E Waiting Time Target

Debate between Baroness Finlay of Llandaff and Baroness Blackwood of North Oxford

Tuesday 21st January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

My noble friend is absolutely right. We need to improve access to community care to make sure that people are diverted away from inappropriate visits to A&E. We have said that we will recruit over 6,000 doctors in GP practice, and we are working on that as we speak. We are also increasing the number of GP practices within A&E so that people can be diverted into appropriate care when they go to A&E inappropriately. The evidence is that already around 10% of those attending A&E are streamed into those GP practices, and we are currently trying to increase that provision.

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare my interest in relation to the Royal College of Emergency Medicine. Do the Government recognise the data from the weekly monitoring of 50 EDs that report to the Royal College of Emergency Medicine that shows that, in the first two weeks of January this year, an average of almost 6,500 people waited more than 12 hours in emergency departments, the figure having risen from just over 3,800 in October? These long waits represent risks to the health, and indeed to the very lives, of these patients. The president of the college, Dr Katherine Henderson, has urged:

“Rather than focus on ways around the target, we need to get back to the business of delivering on it.”

[Baroness Blackwood of North Oxford]

I emphasise that the review of clinical waiting times has been ongoing since 2018. The issues this winter are being addressed with urgent action in this winter. That includes: increasing the provision of same-day emergency care, so that patients can be seen as quickly as possible and are not admitted overnight, if that is inappropriate; reducing the number of patients who have unnecessarily lengthy stays, so that beds are available for those who need to be admitted; continuing to increase the number of urgent treatment centres, with a standardised level of care, so that those who do not need it can be diverted away from A&E—there are now over 140 urgent treatment centres, which can be booked from NHS 111 in most places; increasing the number of GPs in A&E, so that patients can be streamed to appropriate care; and enhancing NHS 111, so that patients can be booked into GPs locally or diverted to pharmacists.

Young Carers: Health and Well-being

Debate between Baroness Finlay of Llandaff and Baroness Blackwood of North Oxford

Monday 13th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Lord has asked a specific statistical question which I want to provide an accurate answer to, so I will write to him.

[Baroness Finlay of Llandaff (CB)]

My Lords, do the Government recognise that the shortage of beds which is being experienced across the NHS is having an adverse effect on the ability to provide respite admissions when young carers find that they are literally at breaking point? Funded beds in hospices, nursing homes and other places can be essential to maintaining the cohesiveness of a family unit that is under extreme strain.

[Baroness Blackwood of North Oxford]

Obviously, pressure on the wider NHS and on social care can have a knock-on effect on unpaid carers who provide an enormous and valuable contribution to our health system, and also on those who care for them. I think that many of us in this Chamber will have personal and direct experience of that. That is why we have provided an extra £33.9 billion of funding for the NHS to ease those pressures, why we are working hard to find a sustainable solution to social care reform, and why we want to make sure that we provide carers of all ages with the support they need, first through identification and later by making sure that they have joined-up support right through the system.

National Health Service Infrastructure

Debate between Baroness Finlay of Llandaff and Baroness Blackwood of North Oxford

Thursday 9th January 2020 Lords Chamber

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare my interests in relation to emergency medicine. Will the Government undertake to look specifically at the problem for emergency departments, given that many of them do not have enough cubicle space for the number of ambulances that arrive and the number of patients who are blue-lighted in? Staff do not have enough space to take a short break from the front line of some of the most harrowing cases that they have to deal with.

[Baroness Blackwood of North Oxford]

The noble Baroness is very expert in this area, and she is absolutely right that the NHS estate must prioritise areas of most need. This is why we have put in a serious amount of investment. NHS Improvement is also conducting a backlog review to understand where the areas of greatest need are and to assist NHS trusts in prioritising capital spending over the next few months and years.

NHS: Nurses

Debate between Baroness Finlay of Llandaff and Baroness Blackwood of North Oxford

Tuesday 7th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

The bursary will be available for new and continuing nursing, midwifery and allied health students for courses from September 2020. As I said, students will be able to access both student loan funding and this additional, non-repayable funding from the Department of Health and Social Care while studying. This means that students will have more cash in their pockets than they ever have before, which should attract them. It also means that we will be able to target funding to areas and specialisms that struggle to recruit, which we believe will definitely improve the sustainability of the nursing workforce and reduce its variability up and down the country.

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare an interest as chair of the National Mental Capacity Forum. Do the Government recognise that we need to do more than just put more money into nursing for learning difficulties, given that there are now 1,000 fewer such nurses than there were four years ago and given that the mortality and morbidity rate in the population of people with learning difficulties is alarming, in that their life expectancy can be around 10 years shorter than that of the rest of the population? This area needs to be targeted. Given the stresses involved in this type of nursing, it takes more than money to retain people.

[Baroness Blackwood of North Oxford]

As ever, the noble Baroness raises a serious issue. We have introduced a targeted initiative for students who commence loan-funded postgraduate preregistration nursing courses particularly for those going on to work in learning disability, mental health and district nursing—to give them a golden hello, as it were. We have also introduced more clinical placements, where students can gain specific professional knowledge and be attracted into those very specialised and important areas of expertise.