Covid-19: Response
Baroness Watkins of Tavistock Excerpts(4 years, 4 months ago)
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Lord Bethell [V]
My Lords, that is not in the current guidelines. The noble Lord is entirely right that it is incredibly time-consuming and not currently practicable. For the reasons I outlined in answer to an earlier question, a test today does not guarantee that someone will not be infectious either tomorrow or the next day. That is why we have not focused on testing at ports, but we remain open to suggestions. We assess a large number of options and, as evidence and trials emerge that may demonstrate the efficacy of different policies, we will of course consider them and remain open-minded.
Baroness Watkins of Tavistock (CB)
My Lords, the Statement is clear that the intention is to mass-vaccinate the population once we have a vaccine that is safe and effective. Can the Minister inform us of Her Majesty’s Government’s plans to achieve this, in the light of concerns among general practitioners that they will be overwhelmed, and given that as many as one in six people in a recent survey said that they would not take up the vaccine if it was available? Do the Government intend, for example, to deploy the many nurses and doctors who volunteered to assist earlier this year to deliver vaccinations for both flu and Covid-19? Will they engage faith leaders in encouraging the uptake of vaccinations through proper explanation of the benefits to individuals and to society as a whole of so doing?
Lord Bethell [V]
The noble Baroness raises an incredibly important issue and I pay tribute to Kate Bingham, who is running the Vaccine Taskforce. She is tackling exactly the issue that the noble Baroness raised. GPs are right to be concerned about capacity, which is why we are looking at ways of massively increasing the capacity to deliver such a vaccine. We will definitely look at resources such as returnees, pharmacists and other sources of people power to deliver the vaccine into the arms of the nation. On the anti-vaxxer groups, the fake news and wrong stories around vaccines are an area of deep concern. We are working with faith groups and other civic leaders to put right the arguments for a vaccine because, at the end of the day, any vaccine requires the participation of a large proportion of the country in order for it to be truly effective. It will cause huge disruption and personal suffering if trust is not maintained in the efficacy of such a vaccine.
Independent Medicines and Medical Devices Safety Review
Baroness Watkins of Tavistock Excerpts(4 years, 4 months ago)
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Lord Bethell
My noble friend Lady Cumberlege has put it incredibly well and I endorse her testimony about the courage and expertise of the patient groups who informed this report. I am only sad that they cannot be here to share this important moment. I pay tribute to the work of my noble friend and her team working on this. Patient safety is uppermost now in the mind of health carers. She is absolutely cutting with the groove. The words of Jeremy Hunt are very well made, and we are utterly committed to looking seriously at these recommendations.
Baroness Watkins of Tavistock (CB) [V]
My Lords, I add my apologies to the patients and their families and acknowledge the superb work done by the noble Baroness, Lady Cumberlege, and her team. The report makes very salutary reading. Are we going to make sure that we keep central records relating to any type of implant in future, including mesh used in hernias, so that we can follow up individual cases as appropriate? Will the Government consider returning to the Health Service Safety Investigations Bill, which was delayed and abandoned as a result of the recent general election?
Lord Bethell
Health records are absolutely key—that is why we have tabled an amendment on them. That amendment enjoys the support of the Government and of me personally.
Social Care
Baroness Watkins of Tavistock Excerpts(4 years, 4 months ago)
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Lord Bethell
My noble friend is entirely right: there is a massive potential liability. We are acutely aware of the intergenerational implications of social care reform. It is only right that we treat both those in social care and future generations fairly. Those considerations will be uppermost in our minds.
Baroness Watkins of Tavistock (CB) [V]
My Lords, can the Minister assure the House that any reform of the social care system will be accompanied by a comprehensive workforce strategy and fundamental improvements to employment conditions by moving away from zero-hours contracts, perhaps to an annualised hours system, to guarantee social care workers regular incomes?
Medicinal Cannabis
Baroness Watkins of Tavistock Excerpts(4 years, 4 months ago)
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Lord Bethell
The noble Baroness is very specific in her questions, and I am afraid I am not able to answer them specifically because they are subject to restrictions and confidentiality. Where I agree with the thrust of her question is that we have been in a bit of a cul-de-sac in this area, but the department is working hard to unblock the problems that have existed. Despite Covid, we appear to be making some progress on this.
Baroness Watkins of Tavistock (CB) [V]
My Lords, two cannabis medicines have MHRA approval. One of them, Sativex—prescribed within the NHS for multiple sclerosis—has a high level of the active cannabinoid THC, so we know cannabis has medical value. There is no doubt that many more cannabis medicines will be licensed in the coming years. Does the Minister therefore agree that while we are reviewing our current trials, we should evaluate whether it is justified to regard cannabis, in a medical way, as a controlled drug in the long term?
Lord Bethell
The noble Baroness will not be surprised to learn that I have just spent three and a half months looking at drugs that might make a difference to Covid, only to find that many of them are not helpful and often quite dangerous, so I do not share the optimism bias that many have towards unlicensed drugs. We remain conservative in our approach to clinical trials. I agree with the noble Baroness and others who have suggested that progress on this should be quicker, and I am leaning into the subject to try to bring that about as soon as we can.
Covid-19: Mental Health
Baroness Watkins of Tavistock Excerpts(4 years, 5 months ago)
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Lord Bethell
The area of antenatal and natal services has developed a huge amount of concern and, as my noble friend may remember, we adjusted the guidelines to give parents greater access to mother and child at an early stage. This area does concern us. However, it is a relief that, generally speaking, the disease has not hit pregnant women and early born children in the way that it has hit elderly people, and for that we are grateful.
Baroness Watkins of Tavistock (CB) [V]
My Lords, I refer to my interests in the register. As acknowledged by the Minister, the impact of nursing people with Covid-19 on the mental health of nurses is estimated to be considerable. A recent brief report from the University of Manchester into suicide by nurses identified a higher prevalence in female nurses than in women from other professions. It is vital that there is a dedicated support offer for the mental health and well-being of the NHS and social care workforce. Will the Minister ask Her Majesty’s Government to consider extending the current England-wide practitioner mental health service commissioned for doctors and dentists to include all nurses employed in the NHS, community and social care settings?
Lord Bethell
My Lords, the confidential helpline for the health and well-being of NHS staff was launched on 8 April. That remains in place and has delivered important mental health support for NHS staff. I will take away the noble Baroness’s recommendation to extend it to a wider community.
Covid-19 Update
Baroness Watkins of Tavistock Excerpts(4 years, 5 months ago)
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Lord Bethell
My noble friend points to the crux of the matter, which is that the correct response to such a local outbreak requires careful collaboration between PHE, with its expertise, insight and data, and local leaders, who have local insight, regulatory muscle and influence. Her account of talking to the mayor and raising these issues is very important and interesting. All I can say is that we are now focused on making sure that PHE and the local authorities in Leicester work together very closely. We have learned lessons in this area. Certainly, outbreaks in some other towns and cities have been handled with a higher degree of collaboration at an early stage.
Baroness Watkins of Tavistock (CB) [V]
My Lords, I declare my interests as outlined in the register. The Statement makes no mention of day centres, many of which are lifelines for carers who have had little or no respite during the UK-wide lockdown. They support people with long-term conditions, including learning disabilities, dementia and severe, enduring mental illness. In the event of local restrictions associated with Covid-19 hotspots, how will such centres be affected? With the increasing stigma associated with working in areas with high Covid-19 rates, many agency staff are refusing to work in certain care homes. Can the Minister explain what safeguards around care and treatments, including access to higher levels of healthcare and specialist services, are being planned to ensure that care home residents will not be adversely affected by further restrictions associated with high localised infection rates?
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.
Personal Protective Equipment
Baroness Watkins of Tavistock Excerpts(4 years, 5 months ago)
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Baroness Watkins of Tavistock
To ask Her Majesty’s Government what contingencies they have put in place to ensure adequate stocks of personal protective equipment for (1) a potential second wave of Covid-19, and (2) sustainable long-term infection control management in the United Kingdom.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]
My Lords, thanks to the efforts of my noble friend Lord Deighton and to brilliant British manufacturers such as Polystar, we have now massively expanded our national effort to buy PPE from around the world, to produce more PPE in the UK and to deliver PPE to the front line, where it is needed most. Despite the global challenge around PPE, we are now confident that we can meet the needs of health and social care over both the next seven and 90 days.
Baroness Watkins of Tavistock (CB)
I thank the Minister for his reply. Could he be more specific? Based on the analysis of the maximum use of PPE in the NHS and social care community recently, how many days’ worth of PPE supplies do Her Majesty’s Government plan to hold permanently as a contingency for a potential second wave in the long term? Is it the Government’s intention to work with the devolved Administrations to adopt a four-country approach to supply and distribution according to need?
Lord Bethell [V]
My Lords, we have contacted over 175 new suppliers and recently secured a further 3.7 billion gloves alone to meet demand. This approach will massively increase our stockpiling as we prepare the resources that we need for the winter ahead. We would like to have line of sight for 90 days’ worth of PPE supply, and that is what we are working against at the moment.
Nurses: Recruitment
Baroness Watkins of Tavistock Excerpts(4 years, 5 months ago)
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Lord Bethell [V]
My noble friend makes an incredibly interesting suggestion on a combined course. I am prepared to look into that and write to her about whether work has been done on such a measure.
Baroness Watkins of Tavistock (CB)
My Lords, I declare my interests as outlined in the register. Not only do we need to recruit new students this year, but we must retain those entering their second and third years of study and ensure that those in their final year, who are currently helping the NHS in a working capacity, complete their training. It is vital that we introduce universal cost of living maintenance grants that reflect students’ needs. I understand that the Prime Minister said that he will look into that further following a meeting of the Education Select Committee. Will the Minister confirm that in addition to the £5,000 maintenance grants there will be an additional £1,000 for mental health and learning disability nurses this year? Is he willing to meet me and other interested Peers to look at the long-term support for nursing students?
Lord Bethell [V]
The noble Baroness is entirely right about retention: we are battling the leakage of skills and experience from the NHS. In September 2019, the Government announced a £210 million boost for front-line NHS staff, which includes, as she referred to, funding for a £1,000 personal development budget for every nurse, midwife and allied health professional working in the NHS. I would be glad to meet her and her colleagues to discuss what more can be done.
National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020
Baroness Watkins of Tavistock Excerpts(4 years, 5 months ago)
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Baroness Watkins of Tavistock (CB) [V]
My Lords, it is a pleasure to contribute to this debate in the name of the noble Lord, Lord Hunt of Kings Heath, on amendments to the NHS commissioning rates for the provision of NHS-funded nursing care to eligible residents in nursing homes. I declare my interests as outlined in the register, in particular as a registered nurse myself.
Prior to October 2007, there were three rates for NHS-funded nursing care, which were replaced with a single band for all newly eligible residents. The small number of residents who had been in receipt of the former higher band, prior to September 2007, have been protected and will continue to receive the higher band, unless their needs reduce. Therefore, the statutory nursing care funding for the majority of those entitled has increased to £183.92. This came into force on 20 May and will be backdated to 1 April. This is welcome.
The increase reflects the recommendations of an independent study produced by LaingBuisson into the 2019-20 rate. However, the research was conducted between November 2018 and February 2019, before Covid. Therefore, the report does not appear to take into account the increased cost of PPE equipment and the nursing time associated with its use in nursing homes. However, PPE is essential to prevent the transfer of Covid-19 in nursing homes; as we know, their residents are particularly vulnerable to severe problems when infected with the virus, including in many cases, sadly, loss of life.
I understand that the proposed uplift will be dealt with by NHS England and NHS Improvement. Will the Minister clarify whether additional funds will be made available to CCGs to fund the increase in nursing care payments, or will it have to be funded from this year’s allocations to CCGs? Will the Minister also explain whether there are any plans to fund CCGs to make additional payments to nursing and care homes for the additional costs of PPE equipment and staff time associated with both the changing and using of PPE for nursing and personal care work undertaken by staff for residents—for example, to include the changing of urinary catheters and stoma bags?
I welcome the uplift in the rates for nursing care, but, in the absence of a long-term plan for funding care provision in residential homes, ask whether Her Majesty’s Government should make further extra financial provision, for at least the next year, to ensure the safe and effective use of PPE to protect residents in the light of the number of deaths in care and nursing homes attributable to Covid-19.
Covid-19: Obese and Overweight People
Baroness Watkins of Tavistock Excerpts(4 years, 6 months ago)
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Lord Bethell
My noble friend is right that personal responsibility and the leadership of those in areas of responsibility are incredibly important. Shame is not a policy that the Government particularly endorse, but I will confess to personally having a sense that I need to lose a stone in order to be match fit for the winter. I commit to my noble friend to undertake this arduous and difficult task over the next three months and will account to him on what progress I have made.
Baroness Watkins of Tavistock (CB)
My Lords, global scientific data is clear: obesity weakens immune systems, resulting in increased susceptibility to a range of diseases. Covid-19 has shone a light on the effects of being overweight, and I welcome the Government’s concern and intervention for the future. What plans do they have to work with survivors of Covid-19 who are overweight? There is a real risk that many will suffer post-viral fatigue, which will further exacerbate unhealthy lifestyles and could well result in a significant number of subsequent deaths that are in fact associated with the recovery—or non-recovery—period following Covid-19. Will the Government deliver clear and transparent guidance on healthy lifestyles and provide support to overweight people who have survived Covid-19?
Lord Bethell
The noble Baroness is entirely right: there is nothing new to the impact of Covid on those with a high BMI; it is entirely consistent with the impact of other diseases. She is also right that one of the nasty aspects of Covid is its long-term effects, which are not fully understood yet. Evidence suggests that these may be extremely damaging, and it is true that the Prime Minister has spoken about the impact of Covid on him. I have had pneumonia; I know the long-term damage of these kinds of diseases on people. We are looking very hard at offering the kind of support that she describes to those who have been hard hit by Covid.