Nationality and Borders Bill

Debate between Baroness Meacher and Lord Bethell
Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, I support Amendment 64, to which I have added my name. I also strongly support Amendment 65.

The right to work—and the lack of it—for asylum seekers has concerned me for a very long time. I am rather relieved finally to be able to say so. I strongly support the comments already made in excellent speeches by other noble Lords. I shall try to avoid duplication.

First, the current law forces people to try to live on £39.62 a week. We all know that this is completely impossible. Utility bills, council tax, food, transport—you name it—cannot be paid for on this sort of money. These people are forced into something that they would never dream of doing in any other circumstances. It also prevents them from earning and paying taxes. Why would the Government force able-bodied workers to be unemployed and draw benefits at a vast cost to the taxpayer? Actually, the cost is not vast; these are trifling amounts of money, but it is a cost to the taxpayer. The cost to the community is considerable. As others have said, in many cases, these effects last for a very long time.

The Government say that they have undertaken a review of the policy. I believe they have not published the results, nor given any estimate of cost. Can the Minister inform the House whether their review considered the number of normally law-abiding asylum seekers who have been driven to crime by this policy? This is the worst possible thing a Government can do. All the asylum seekers want to do is to earn, pay taxes and lead a good life. Instead, they feel that they have to do something they have never done in their lives before and never dreamed that they would do: commit crimes. Perhaps the Minister can tell us the estimated cost in the review, and whether that includes the cost of courts, prisons and police in dealing with the crimes that these people absolutely do not want to commit.

Believe it or not, 40 years ago I wrote a book about the consequences of a similar sort of policy—a rule which deprived single people of benefits after four weeks. My research showed that the rule caused a dramatic increase in crime among that population. Government officials asked for a copy of my manuscript before I published the book. The policy was immediately scrapped. It did not help the sales of my book but, nevertheless, it was worth doing. I feel that this policy has to be scrapped for exactly the same reason. Noble Lords have pointed out all sorts of other reasons, but there cannot be a government policy which drives people into crime. Continuing it cannot be justified.

My second question concerns the basic cost to the Exchequer. The voluntary sector has come up with a figure of £194 million a year. I believe this is a massive underestimate. I am quite sure the cost is far more than that when all the unintended consequences are considered—if you want to put it that way.

The noble Lord, Lord Paddick, and others have already dealt with the pull factor. We have the evidence. Asylum seekers who are desperate to get away from persecution, rape and other ghastly things—you name it—do not even think about the detail of what there will be when they arrive at the other end. It is just a European country. If I may say so, the pull factor is rubbish, rubbish, rubbish. If it made any sense, it would be the only possible justification for this policy. I implore the Minister to go back to colleagues and see what she can do.

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, it is quite daunting to follow the noble Baroness, Lady Meacher. I very much hope that she will not be driven to writing a book about this, although if she did, maybe we would see some change.

I shall speak to Amendment 65 in the name of the noble Baroness, Lady Stroud, with the support of the noble Baronesses, Lady Lister, Lady Ludford and Lady Prashar. As has been discussed, this aims, quite rightly, to introduce the right to work for asylum seekers who have been in the UK for more than six months.

My noble friend the Minister will know the gist of my argument from my comments on Tuesday. I am grateful for her forbearance then. Suffice it to say, I believe that this amendment is a matter of complete common sense. It is exactly the sort of policy that should underpin global Britain’s new immigration system.

This is a moment when we have to decide who we are as a nation. We want an immigration system that takes back control—one where the British people can see that we are trying to manage our borders and are actually doing so. They can also see that we have compassion for those in need when we, as a nation, have so much already.

This is not a niche opinion. I note that all wings of the Conservative and Labour Parties, the Liberal Democrats, other Cross-Benchers and the Deputy Prime Minister support the extension of the right to work for asylum seekers.

The arguments for this right to work are overwhelming. I will restate a couple of them. I hope that it will be helpful to hear them from these Benches. First, as the noble Lord, Lord Alton, said, the latest figures show that 125,000 people are waiting for asylum decisions. Every study shows that the net benefit to the state would be in the tens or even hundreds of millions of pounds a year in increased tax take if this measure were enacted.

The UK economy is recovering after Covid. A lot of jobs have been created but this has, in turn, created labour shortages. It makes no sense whatever for asylum seekers who can drive HGVs or serve in the NHS to be forced to sit around doing nothing for over a year while they await a decision from the Home Office. The noble Baroness, Lady Chakrabarti, made that point very powerfully.

Secondly, there is very persuasive evidence that the right to work has a large, positive impact on the integration of asylum seekers who successfully settle. As other noble Lords have already mentioned, the Government’s Migration Advisory Committee recently underlined that shorter waiting times have a large, positive impact on long-term employment outcomes for asylum seekers.

As noble Lords have noted, these measures have overwhelming public support. I will mention one niche statistic. According to recent polling, 73% of red wall voters questioned support a right to work. As others have mentioned, business leaders back the easing of the ban on the right to work.

There is a basic human dignity argument for this policy. I believe that every individual should be able to support themselves and their family. I would go further and say that, as Conservatives, we believe that every family has a personal responsibility to do so where they can. I have often made the argument that work is the best route out of poverty. The aim and intention of this amendment are to do precisely that: let people support themselves and create their own pathway from poverty to prosperity while they wait for the decision.

The lack of the right to work leaves people vulnerable to exploitation, declining mental health, poverty and modern slavery. If the human dignity arguments do not seal the deal, the amendment could also be viewed as purely pragmatic. Reforms to the asylum system proposed through the Nationality and Borders Bill will take time to come into full effect. In the interim, while asylum cases are being processed, the asylum system continues to be under considerable strain. By offering asylum seekers the right to work, the Government would take pressure off themselves.

I anticipate that the Minister and other colleagues might be inclined to respond to this amendment using the pull factors argument, and I know others have addressed it. However, let me address those points from these Benches. First, it is push factors such as war and famine which drive refugees to these shores, not pull factors. If there are any pull factors, they are those which encourage people to come to the UK: our language, culture, rule of law, democracy, historic ties through the Commonwealth, family connections, and liberty, not the welfare payments.

It is worth noting that the UK is currently an outlier in enforcing a 12-month wait period for work and then placing long restrictions on which employment can be taken up. No other nation across Europe, USA, Australia or Canada has such stringent requirements. It is worth asking why they have not considered the right to work to be a pull factor. This view is totally backed by the experts. The Migration Advisory Committee underlined that there is no evidence in academic research that people decide to claim asylum based on these kinds of factors. The Home Office commissioned a study, which others have mentioned, that also shows that there is little evidence of this.

All of this is to say that I believe the Government could quite legitimately, without nervousness and in line with their poverty strategy for families working their way out of poverty, adopt this amendment that allows asylum seekers to work after six months of being in the UK.

Covid-19: Care Homes

Debate between Baroness Meacher and Lord Bethell
Thursday 17th June 2021

(3 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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I saw the images the noble Lord refers to and was shocked and moved by them. That is why we moved massively, including, in March, announcing £594 million in order to support care homes, and massively supporting them through the NHS. We did an enormous amount from the beginning. The effects on care homes have been profound and are extremely sad, but I am afraid to say that this presumption that we either did not enough or took the wrong advice is not supported by the facts.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, let us focus on what government can do now. My concern is that the Government are overcompensating for the very high early death rate in care homes, for whatever reason, by imposing wildly disproportionate controls over double-jabbed, tested visitors. For example, they have to wear PPE and social distance, as we know, and there is no hugging—thus wrecking the final months for these people in care homes. I ask again: will our excellent Minister—I mean that; he is an excellent Minister—put to the Prime Minister the risks and benefits of scrapping these controls?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I am extremely sympathetic to the noble Baroness’s point and conscious of her specific point that we could be in danger of over- reaching or in some way emotionally overcompensating for perceived mistakes in the past. We are conscious of that possibility, but I would like to reassure the noble Baroness that it is not the case. The decisions we have made on infection control and on visiting in care homes are tough—they are hard—but in recent weeks there have been outbreaks in care homes in London and Bolton in which vaccinated residents have caught the disease and had serious symptoms. That is something we are extremely wary of. When the vaccination has reached a higher proportion of the population and R is below 1, we will be in a position to change these policies. We will do so at pace and as quickly as we reasonably can, but until that moment arrives we have to take these tough decisions.

Covid-19 Update

Debate between Baroness Meacher and Lord Bethell
Tuesday 15th June 2021

(3 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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Yes, I entirely agree with my noble friend on this matter: we are of course only safe when we are all safe. As chair of the G7, we have done an enormous amount to try to show leadership in this area. The G7 committed to share at least 870 million doses directly over the next year and to make these doses available as soon as possible. But the numbers involved are absolutely enormous: 870 million is an astonishing figure, but it is not near to the 8 billion that we ultimately need. At the end of the day, we need manufacturing in all the regions of the world. That is why, as the supporter of the AstraZeneca vaccine, which is made on a profit-free basis and on extremely generous terms to manufacturers of the world, Britain has given an enormous benefit to the world. I very much hope that the manufacturing can ramp up to meet that need.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, I welcome the small but vitally important concession to care home residents in the Statement. However, the Prime Minister has left in place the cruel and unnecessary controls over care home visits. Even visitors who have had two vaccinations and a negative test before visiting must wear PPE and maintain social distancing—no hugging, for example. This is inhuman, particularly for people with dementia, and the risk must be close to zero. Will the Minister plead for immediate changes to those really unnecessary rules? They are well overdue.

Lord Bethell Portrait Lord Bethell (Con)
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The noble Baroness makes the case extremely well, and I agree with her sentiment that the rules are extremely tough. I have heard loud and clear the many noble Lords who have made this case, and we look at it very carefully and thoroughly. At the beginning of the pandemic, one of the most alarming images—and one that has always stuck in my mind—was that of care homes in Spain in Italy, where so many of the residents had died. What we know for sure is that, even with the vaccine, the virus can spread through a care home at great pace—typically half of residents will be infected the moment the virus arrives in a care home. Even with the vaccine, we still have to step carefully, and that is why these measures are still in place. I very much hope that they will be lifted, and I will celebrate that along with all noble Lords who have made this case to me in the past.

Covid-19: Government Handling and Preparedness

Debate between Baroness Meacher and Lord Bethell
Tuesday 8th June 2021

(3 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I completely share my noble friend’s frustration at the situation. Of course we all enormously regret the fact that our efforts to open up international travel were unfortunately reversed because of the presence of dangerous variants of concern in the Portuguese community—in this case, particularly the Nepal variant of concern. However, I cannot agree with her that quick decisions based on accurate data are not appropriate in the depths of a pandemic. It is absolutely right that we move quickly to close down a change of transmission and that we protect the vaccine from variants that may present a severe danger to this massive national project.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, this is rather relevant to the previous question: how many additional Covid cases in the UK were caused by the delay in closing our borders to travel from India after we knew about the new variant? Is the Minister making representations to the Prime Minister and appealing that no such delay should occur again as variants emerge in different countries across the world, to protect the health of the people of the UK?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I am not sure whether I have the data that the noble Baroness has asked for. I also contest the premise of her question. We have moved extremely quickly when presented with clear data, as my noble friend rightly pointed out, and I hardly need go over the timelines for the decisions around Pakistan, Bangladesh and India, which have been gone over many times indeed. I reassure the noble Baroness that we are absolutely determined, at this delicate phase of the pandemic, to ensure that our borders are extremely tough and that we do whatever we can to keep the variants out. At the same time, we are cognisant that people do have commitments overseas and we are leaning, wherever we possibly can, to opening up the borders.

Covid-19: Resuscitation Orders

Debate between Baroness Meacher and Lord Bethell
Wednesday 24th March 2021

(3 years, 8 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, yes, I do.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, I should declare my interest as chair of Dignity in Dying. What plans do the Government have to increase dramatically the numbers of people who have advanced decisions expressing their views on medical treatment? Does the Minister agree that patients’ wishes should be central to DNACPR decisions, and indeed to all significant medical decisions, particularly at the end of life?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, we absolutely agree. That is exactly how the guidelines are written and exactly the guidance sent into the system. The issue we face is much more pastoral in nature: it is one of training and creating the space and resources necessary to have extremely difficult conversations. That is the kind of front-line support we need to put in place. It is a question of patient engagement rather than a change of guidelines, but I completely take on board the noble Baroness’s recommendations.

Covid Contracts: Judicial Review

Debate between Baroness Meacher and Lord Bethell
Monday 1st March 2021

(3 years, 9 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My noble friend puts it extremely well. The judge said

“the overall picture shows the Secretary of State moving close to complete compliance. The evidence as a whole suggests that the backlog arose largely in the first few months of the pandemic and that officials began to bear down on it during the autumn of 2020”.

The judgment was entirely about the timing of the publication; it had nothing to do with the awarding of the contracts themselves. From that point of view, it is a ringing endorsement of the actions of officials in this matter.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, I strongly support the Secretary of State’s decision to prioritise saving patients’ lives, albeit that the contractual process appears to have breached the rules. Does the Minister agree that the real problem was the failure of Governments over the preceding 10 years to give proper attention to preparations for a pandemic which everybody knew could be around the corner? Can the Minister assure us that this failure will not be repeated, and systems are in place to ensure proper preparation in future?

Lord Bethell Portrait Lord Bethell (Con)
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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.

Food-related Crime

Debate between Baroness Meacher and Lord Bethell
Monday 22nd February 2021

(3 years, 9 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the NFCU’s head count is just over 80 staff in England, Wales and Northern Ireland, and its budget is £5.7 million. The NFCU has an anonymous reporting route available via the phone and the FSA website, and it welcomes contact from public-spirited people within the industry on wrongdoing. The unit also encourages engagement with industry through more overt routes, and I particularly thank the Food Industry Intelligence Network, whose members share over 50,000 anonymised authenticity sampling results with the unit each year.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, in the 1970s I wrote a book based on a survey on the consequences of benefit withdrawal and found that, typically, claimants were driven to crime. Have Her Majesty’s Government undertaken any recent research into the consequences of the very low universal credit rates, the sanctions regime and the deductions taken from benefits to repay loans early on in the claim? If not, would the Minister be good enough to ask the DWP to undertake such research into the crime effects—if you like—of the benefits system?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I bow to the noble Baroness’s great expertise on the correlation between poverty and crime. But that makes no excuse for the kind of crimes we are talking about here. Many are either brutal—as the noble Baroness, Lady Jones, referred to—or crimes of fraud, for which there is no excuse.

Mental Health Act Reform

Debate between Baroness Meacher and Lord Bethell
Monday 18th January 2021

(3 years, 10 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the noble Baroness is entirely right: the training is critical in this area; it could not be more important. We have invested £500 million in mental health services and support for the NHS workforce to address this. I cannot give her the precise number that she has asked for, but I shall write to her if I can track it down. However, we recognise the urgency of the situation and we hope that the impact of this money will be felt as quickly as possible.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, I too welcome this White Paper based on the Wessely review. However, without real increases in spending on mental health, the anticipated Bill will not be able to fulfil its potential. I was not reassured by the Minister’s comments on funding.

If we become physically ill, we can expect to be treated within a reasonable timeframe; that is not so in mental health. If the Minister agrees that that is not acceptable, will he challenge the £2.3 billion figure, which, as I am sure he knows, will do nothing to rectify the ongoing imbalance and will leave people detained in hospital because of the absence of adequate community services?

Covid-19: Vaccinations

Debate between Baroness Meacher and Lord Bethell
Wednesday 13th January 2021

(3 years, 10 months ago)

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Baroness Meacher Portrait Baroness Meacher (CB) [V]
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Sorry, I could not get myself unmuted. My Lords, as a Covid sufferer, which I am, I too applaud the Government’s amazing vaccination programme. I just have a few points of clarification. First, when the Government talk about offering a vaccination to all four top vulnerability groups by mid-February, do they mean all those groups will have a vaccination by mid-February or an invitation for one, which, of course, could be for a vaccination in March or April? Secondly, is there any progress yet on bringing forward the second vaccination—we are talking about the country here—from the 12-week point, bearing in mind the greater risk of mutations while we have this rather long wait between first and second vaccinations? Thirdly, if I may, can the Minister contradict the anti-vax story, which I regard as very dangerous, that the vaccinations contain polyethylene glycol which could be dangerous for allergic people? These stories just have to be crushed, if we can.

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the four priority groups that the noble Baroness alludes to are: care home residents; residential care workers; the 80-plus; healthcare workers; social care workers; 75 to 79 year-olds; 70 to 74 year-olds; and the clinically extremely vulnerable. It is a huge proportion of those who are most vulnerable to the disease. We can only offer people a vaccine; we cannot force them to have it. Certainly they will be offered it, but the encouraging news is that a very large proportion of people seem to be stepping forward, and attitudes towards the vaccine so far seem to be extremely positive. I reassure all those who have seen anti-vax messages that this is not something that those with allergies should be frightened of. On the second dose, the MHRA has been clear that there is no evidence that the current round of mutations we have seen has any impact on the vaccine, and that it in no way increases the need for an accelerated second dose.

Face-to-Face Medical Appointments

Debate between Baroness Meacher and Lord Bethell
Thursday 19th November 2020

(4 years ago)

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Lord Bethell Portrait Lord Bethell (Con)
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I agree with my noble friend that the terms of service should be clear, although I am not sure that we necessarily have the scope for or benefits of a legal right per se. However, perhaps I may disagree with him on one point. He said that there is a greater demand among older citizens for face-to-face contact, but that is not our experience. Older citizens are often very engaged digitally, prefer to engage with their clinicians, on occasion, from the comfort of their own homes, and can often be early adopters of such technologies.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, I agree with the Minister that, much to doctors’ surprise, many older people prefer to have virtual appointments, whether by Zoom or telephone. We can make assumptions about people, but doctors have been quite surprised by the extent to which patients prefer having an online consultation. Does the Minister agree that, in the end, this needs to be a matter for doctors to decide? Very often, they will have an initial conversation and then agree to see the patient when that is necessary. However, this is probably not a matter for government to decide on or to intervene in, and certainly not until doctors have settled down to a pattern of consultations based on their experience and understanding of their patients.

Lord Bethell Portrait Lord Bethell (Con)
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The noble Baroness makes a good point, but I would put a slightly different perspective on it. Doctors have not been the most progressive group in this area; as she says, they have been caught by surprise by patients’ views. I would actually give patients the loudest voice in this particular conversation.

Covid-19 Update

Debate between Baroness Meacher and Lord Bethell
Thursday 10th September 2020

(4 years, 2 months ago)

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Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, sadly, Professor Spiegelhalter has seriously questioned the Prime Minister’s rather splendid Moonshot mass testing proposal. I understand his concerns. Nevertheless, can the Minister assure the House that he will press for a significant investment in saliva home-testing kits, to enable families with a parent in the former shielded group and with children at school to live a reasonably normal life? Children need to be at school, but the lives of these parents are now in grave danger—I am sure the Minister appreciates this—with the R number above one and, as yet, no daily testing capacity. Can the Minister say when daily testing will be available for these families and other top-priority groups in the country?

Lord Bethell Portrait Lord Bethell (Con)
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I reassure the noble Baroness, Lady Meacher, that saliva testing is a massive priority for the Government. I reassure her and Professor Spiegelhalter that the positive error rate in the saliva test trials in Southampton has been incredibly low—virtually zero. From that, we take great reassurance that this will be an effective vector for testing.

Covid-19: Local Restrictions

Debate between Baroness Meacher and Lord Bethell
Thursday 3rd September 2020

(4 years, 2 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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The noble Baroness is entirely right that the impact of local lockdowns is far reaching. The impact is not only on families where there is domestic abuse but on children, those who are shielded, the elderly and so forth. The responsibility for caring for those vulnerable groups is with the local authorities. Central government has provided additional funding to support those interventions by local authorities; it is up to local actors to make those interventions, and we are grateful for their work.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, finally the Government are investing in preparations for widespread home testing, producing results within minutes. What priorities does the Government’s scientific advice recommend for that mass testing? Do they include avoiding local lockdowns, enabling the former shielded parents of schoolchildren to test their children daily on return from school to protect the parent, and solving the nursing-home visitor problem?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I cannot help but feel that it is not a case of “finally”. This Government could not have worked harder to push for home testing, and we are extremely grateful for the innovations in business and government that have made home testing possible and effective. When home testing is deployable on a mass scale, we will work on a prioritisation of how best to use it. But the noble Baroness is entirely right; the kinds of use cases that she articulated are the ones that we have in mind.

Covid-19: Response

Debate between Baroness Meacher and Lord Bethell
Monday 27th July 2020

(4 years, 4 months ago)

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Lord Bethell Portrait Lord Bethell [V]
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I am not quite sure of the 190 million number. I think that is possibly an aggregate number of different vaccines. However, the practicalities of vaccine research are extremely expensive, and there are eight, nine or 10 potential runners and riders in the global vaccine market. It is the practice for countries to contribute to those research costs up front in order to have access to the vaccine should it be successful. That is the practice for medical research of many kinds, and these are the practical costs of trying to break the difficult mystery of the disease and providing security for ourselves and for our children.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, I pay tribute to the Minister for the way he answers all our endless questions. I want to raise two issues of huge importance. I understand that the system of track and trace, in the absence of an app, will not be sufficient to prevent a second national wave of Covid-19. Can the Minister tell the House when we will introduce the Google/Apple app? Secondly, have the Government assessed the cost of full regular community testing, which would involve the entire population being tested weekly? This would certainly be costly, but surely it will be infinitely less costly than a second national wave of Covid-19—in terms of the demolition of the economy—particularly if we can use the Southampton saliva test.

Lord Bethell Portrait Lord Bethell [V]
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The noble Baroness is entirely right that track and trace on its own, with or without an app, is not enough to prevent a second wave. The only thing that can do that is the behaviours of the British people themselves. Commitment to hygiene, distancing and isolation is the best bulwark we have against this horrible disease. In terms of community testing, given the current level of technology, mass testing of the entire nation on a weekly basis is beyond the resources of our technology, testing capabilities and, frankly, the tolerance of the British people. However, as I said in answer to an earlier question, the technology is moving incredibly quickly. It has already moved a long way in the last few months, and I am hopeful that technologies such as—but not only—the OptiGene technology may offer new opportunities. However, they have to be validated, invested in and developed: they are not on the near-term horizon.

Medicinal Cannabis

Debate between Baroness Meacher and Lord Bethell
Monday 6th July 2020

(4 years, 4 months ago)

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Baroness Meacher Portrait Baroness Meacher
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To ask Her Majesty’s Government what action they plan to take to improve access to cannabis for medicinal purposes for (1) patients, and (2) research, in the United Kingdom.

Lord Bethell Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
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My Lords, I thank the noble Baroness, Lady Meacher, for her Question. There is no legal impediment to prescribing medicinal cannabis where clinically appropriate, and the Government are keen to make progress in this area. However, these are largely untested, unlicensed products. To support further NHS funding decisions, we have committed public funds to develop the evidence base. I thank NHS England, NHS Improvement and the National Institute for Health Research for their work to establish much-needed clinical trials and call on the industry to support clinical trials in refractory epilepsy and other treatment areas.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, from 1 November 2018 consultants have been able to prescribe medical cannabis as an unlicensed medicine, as the Minister implies, yet NHS doctors remain unwilling to prescribe, partly because medical cannabis remains on the list of controlled drugs. Hundreds of thousands of patients with severe and chronic conditions who find that cannabis is the only medicine that controls their symptoms without unpleasant side-effects continue to risk arrest every day by growing or buying their medical cannabis at exorbitant prices. Does the Minister agree that this is contrary to the patients’ human rights? How can we criminalise patients for saving the NHS huge sums of money by looking after themselves and doing harm to no one? Will the Minister appeal to Matt Hancock to write to the Home Secretary, urging her to remove medical cannabis from the list of controlled drugs?

Lord Bethell Portrait Lord Bethell
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There is a difference between the issue of controlled drugs and that of access to regulatory approved drugs. The noble Baroness is right that medicinal cannabis offers huge hope to those in pain and with severe symptoms. However, it is only through the process of regulation, clinical trials and scientific proof that we can guarantee that the benefits of this important medical opportunity are truly exploited.

Social Distancing: Two-metre Rule

Debate between Baroness Meacher and Lord Bethell
Tuesday 16th June 2020

(4 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell [V]
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My Lords, I completely and utterly share my noble friend’s frustration about the lack of clarity, but a fact of this epidemic is that the Covid germ is incredibly unpredictable. We have fought really hard to apply the best and most up-to-date science possible, which has meant that there has been a real struggle to lay out the kind of clear framework that he and the public would like to see. We remain guided by the science; we work closely with our foreign neighbours; and we are working hard to put in place a clear plan to take us out of lockdown.

Baroness Meacher Portrait Baroness Meacher (CB) [V]
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My Lords, does the Minister anticipate that the two-metre social distancing rule will in fact be reduced following the review? I might be wrong but I think that it will be, in which case access to masks on high streets and at stations will become absolutely urgent. What plans do the Government have to ensure ready access to masks across the country? Would the Minister like me to send him details of one company that provides and installs dispensers of masks and hand-sanitising gel free of charge? I declare that I have no personal interest in this company but I believe that it and others like it, if they exist, will have a vital role to play in tackling Covid-19 if the social distancing rule is in fact changed.

Lord Bethell Portrait Lord Bethell [V]
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My Lords, social distancing has without doubt been the most effective tool in the battle against Covid. That is why the Prime Minister has appointed the Permanent Secretary, Simon Case, to undertake a review, which will include the Chief Medical Officer and the Chief Scientific Adviser. The use of masks might offer some protection but in no way will it ever replicate the impact of social distancing. That is why we are not prejudging any review or making any assumptions about any changes.

Covid-19: Response

Debate between Baroness Meacher and Lord Bethell
Tuesday 19th May 2020

(4 years, 6 months ago)

Lords Chamber
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Lord Bethell Portrait Lord Bethell
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The noble Baroness is entirely right: the backlog of operations and procedures will be a daunting task for the NHS to tackle. We have prioritised it. Simon Stevens has told the NHS to throw the doors open to try to get through this backlog. As a result, we will live with the effects of Covid for months to come. I am not fully aware of the contract of which she speaks, but I will try to find out its status and will write to her with additional information.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, I thank the Minister for his helpful responses so far. The UK had just under 50,000 excess deaths in less than six weeks from 20 March. Does the Minister agree that the NHS was overrun at that time and had the unbearable choice either to let Covid-19 patients die or to deny treatment to patients with life-threatening illnesses such as cancer and kidney failure? Were we unable to make extensive use of the Nightingale hospitals to save lives due to staff shortages or for some other reason? I would be grateful for the Minister’s response.

Lord Bethell Portrait Lord Bethell
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I am extremely grateful for the noble Baroness’s comments. Since she asks for my personal opinion, I would say that, no, the NHS was not overrun. It has been a huge achievement that the NHS has stood firm on its feet. Operationally, it has been extremely sound. It was never overwhelmed, either by Covid-19 or by other operations. The Nightingale hospitals were not needed in the end because the lockdown was adopted by the British public and the infection rate was reduced. That is a huge testimony both to the British people and to the NHS.

Covid-19

Debate between Baroness Meacher and Lord Bethell
Thursday 23rd April 2020

(4 years, 7 months ago)

Lords Chamber
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Lord Bethell Portrait Lord Bethell
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I reassure my noble and learned friend that one of the most distinctive and reassuring aspects of the government response to Covid has been a very strong collaboration between the four nations. That has been epitomised by the strong relationship between the four CMOs, and operationally it has been given teeth by the presence of the devolved Administrations at COBRA meetings, which I attend.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, I thank the Ministers for all that they are doing in this very difficult situation and, of course, all our wonderful NHS and care staff for what they do every day and every night.

As the Minister knows, the countries most successful in controlling Covid-19 are those with comprehensive testing and contact-tracing systems. We are thrilled to bits that we have two leading research teams in the country—great applause to them—but, until their vaccines are available across the country, the testing regime will be the only approach that will enable a return to any kind of normality. A large-scale sample, or provision, of testing and tracing and so on for care workers will not achieve that objective. Will the Minister tell the House if or when the Government will introduce a comprehensive—I emphasise that word—scheme of testing, contact-tracing and, as has been said, isolation, of all who have symptoms of Covid-19? This means not a sample and not just people in the care sector, but the nation. That is the only way out of the tight corner we are in. If not, can the Minister explain why?

Lord Bethell Portrait Lord Bethell
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The noble Baroness, Lady Meacher, is entirely right in the way that she explains things. The driver of that decision is the need to get our prevalence rates and the velocity of the infection down to a reasonable level, so that we have reasonable resources to keep R down by track and trace. I remind her that South Korea, which has used this technique most effectively, does only 20,000 tests per day, because its prevalence levels and velocity of infection are so low.

NHS: Doctor Retention

Debate between Baroness Meacher and Lord Bethell
Wednesday 4th March 2020

(4 years, 8 months ago)

Lords Chamber
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Lord Bethell Portrait Lord Bethell
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The noble Baroness makes an important and fair point. Understanding why people depart is very important. Departure rates are too high for us to hit our objectives and raising retention rates is important. However, I emphasise that the leaver rate has not increased as she implies. In 2014 the rate was 14% and in 2018 it was 15%. That is not a huge increase but it is too high and we are finding ways to address it.

Baroness Meacher Portrait Baroness Meacher (CB)
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My Lords, in his initial response to the Question, the Minister referred to initiatives to increase the number of GPs. Does he have an estimate of how many GPs will be created through these initiatives, and by which year does he anticipate that the additional 6,000 might be achieved?

Lord Bethell Portrait Lord Bethell
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The initiatives that I described—the two-year primary care fellowship programme, the new-to-partnership payment and the locum support—are retention rather than recruitment initiatives, but an important part of our recruitment proposition is that those seeking a career in medicine think of it as a rewarding and fulfilling long-term career. As for the numbers we are seeking, we are already hitting the targets for graduate positions, and we have been encouraged by the response.