(1 month, 2 weeks ago)
Lords ChamberI assure the noble Baroness that we are more than factoring it in. We are totally committed to working to support those with sickle cell, and thalassaemia. There is ongoing work to provide the very best possible care, including boosting the number of blood donors, which is vital in improving clinical pathways and delivering treatments. There is a treatment, as I am sure the noble Baroness is aware, called Casgevy, which requires apheresis as part of the process. It is being evaluated by NICE for the treatment of thalassaemia and it is also being evaluated for sickle cell. I hope all those things will bring great benefits.
My Lords, I am grateful to the Minister for highlighting that we are a leader across Europe with our services, but only 50% of the country is covered. Can she assure us that in all reviews of the NHS, consideration will be given to centrally commissioned, highly specialised services such as this, rather than relying on local commissioning, that the workforce plan will recognise that highly skilled nurses are needed to undertake this treatment, and that that needs to be factored in? The numbers are small but the skills are enormous.
What the noble Baroness says is very true and I certainly can give the assurances she seeks.
(2 months, 2 weeks ago)
Lords ChamberI certainly hear the very welcome points that the noble Lord makes. As we progress, this will make us the first European country to mandate folic acid fortification of non-wholemeal flour. While some European countries, including Ireland, have voluntary fortification, mandatory fortification is not the case. I and my ministerial colleagues are keen to be in this position.
I am grateful to and congratulate the Minister on her perseverance on this issue and on decreasing neural tube defects. Can she also ensure that products are appropriately labelled with warnings that they are not fortified and that any woman who might become pregnant should take additional folic acid supplementation? Without that, we will not tackle the ongoing problem of neural tube defects. I do have a concern that there is inappropriate fear over toxicity, given that in 1991 there was a very good randomised controlled study. People were divided into groups, given fairly high doses, including with multiple vitamins, and compared with those on a placebo. There were no adverse neurological or other effects.
I am grateful for the noble Baroness’s contribution and can reassure your Lordships’ House, and anyone else who may be concerned, that, as noble Lords have said, this has been gone through over many decades. Safety is paramount. On products that are non-fortified, I will have to look into this, but for those that are fortified, there will be a transition period for industry because the equivalent of some 11 million loaves of bread are sold in the UK every day but only 65% of the flour used in their manufacture is produced in the UK. We have to look at this huge diversity of food products, including biscuits and cakes, and where it is a food ingredient in ready meals and soups. It is quite an undertaking, but your Lordships’ House can be assured that we are on it.
(2 months, 2 weeks ago)
Lords ChamberMy noble friend makes an important distinction, and I would certainly share that view. It is worth reminding your Lordships’ House that ministerial meetings that are attended by third parties are declared in a quarterly transparency publication in the established way. Of course, this will be done. I can tell your Lordships’ House that I had a meeting with the right honourable Alan Milburn, and it was very useful.
My Lords, I should declare an interest because I was on the Times Health Commission. We took evidence from a wide range of people, including the person mentioned. Can the Minister provide assurances that, whenever people are consulted, they are routinely asked to declare their interests; that any declaration of interest is repeated not only at the first meeting but whenever other people are present so that it is well known; that the consultation goes widely; and that there is no overreliance on a small number of people? We at the Times Health Commission found that, by consulting widely, we were able to hear very conflicting views, which was helpful and formative.
I thank the noble Baroness for sharing her experience of consulting widely. It is certainly entirely legitimate for government departments to do just that. However, those who do not have a formal role are not required to declare interests; it is different for those who have a formal role. Requiring them to do so would mean, for example, us sending forms in advance to Cancer Research UK before it comes in to talk to us about cancer and to assist us. Would we want that? We would not. Of course, where there is a formal role, we absolutely do that.
It is probably worth saying that a particularly high-profile invitation went from the Secretary of State to the noble Lord, Lord Darzi. He will report shortly on the true state of the National Health Service. He does not have a specific role in the department but he has been invited by the Secretary of State to assist; I believe that he will assist both your Lordships’ House and the other place.