Medicines and Medical Devices Bill

Baroness Wheeler Excerpts

Committee stage & Committee: 2nd sitting (Hansard) & Committee: 2nd sitting (Hansard): House of Lords
Monday 26th October 2020 Grand Committee

As other people have said in this debate, one of the biggest drags on innovation in the NHS is the way that the funding flows work, and those who do the investment very rarely see the benefits, and particularly not over time. We would like to support the noble Lord, Lord Lansley, particularly on Amendment 85, and would like to see Amendment 17 slightly adapted—and I would say improved—but I take the point that these are every bit as necessary as some of the other things here to an overall definition of attractiveness.

[Baroness Wheeler (Lab)]

My Lords, we are grateful to the noble Lord, Lord Lansley, and my noble friend Lord Hunt for amendments that would ensure that the future role and funding of NICE are placed firmly in the Bill. Amendments 17 and 79 to Clauses 1 and 13 —in the name of the noble Lord, Lord Lansley—underline for both human medicines and devices the importance for the appropriate authority making regulations under the Bill to consider the ability of the NHS to meet the needs of patients and ensure consultation in accordance with Clause 41.

Amendment 85 to Clause 13, in the name of the noble Lord, Lord Lansley, and Amendment 124 in the name of my noble friend Lord Hunt, which proposes to insert a new clause after Clause 38, deal with the funding mandate to the NHS, the availability of human medicines and medical devices, timescales, and ensuring effective monitoring and reporting arrangements by the Secretary of State to both Houses of Parliament.

Noble Lords speaking to this group, particularly those with experience as former Ministers, have made powerful arguments based on their expertise. Those speeches have been very illuminating. I hope, therefore, that the Minister will respond in a positive way that reflects these concerns and these amendments’ intentions.

My noble friend Lord Hunt’s amendment, in particular, places a duty on NICE to take account of the availability of innovative medicines and medical devices for human use on the NHS. It also requires the Secretary of State to report to Parliament on the anticipated impact of new medicines and devices on inward investment and the attractiveness of the UK life sciences sector, whose vital importance to patients and the UK economy we all recognise fully.

As we have heard, my noble friend’s Amendment 24 is very much embedded in the current review of the methods and processes of NICE, amid widespread concerns that despite its recognition as a world-class institution, there is still a major problem with the take-up of new medicines by the NHS, with many CCGs financially or structurally unable to deliver the innovation that NHS patients deserve and must have. The recent report from the cancer charities showing how UK patients are missing out on new innovative treatments that are readily available in any other comparable country shows that stark reality. The NHS’s record on implementation of technical appraisals of new drugs by NICE says it all.

We must therefore ensure that the review of NICE’s methods, which is under consultation until the end of the year, and the consultation on changes to NICE’s processes, which is due to follow early next year, deliver real and effective change, and are open and transparent. The Bill should set out clear responsibilities for both NICE and the Secretary of State on their role in funding; they will be more important than ever in getting that change and innovation.

My noble friend expressed a genuine fear, which is shared across the NHS, about the de facto rationing of innovative medicines and the role that NICE often ends up playing in this without having the clear funding mandate from the NHS that these amendments would provide. His amendment is important because it would inject some parliamentary oversight into the review of NICE’s methods and process, which many consider as having been progressing very much under wraps for a while.

I declare an interest as vice-chair of the cross-party Specialised Healthcare Alliance. We have heard worrying noises about the rarity modifier consideration on rare diseases being removed. I have heard real concerns from rare disease charities among our 100-plus members that the review could be taking a worrying turn in terms of impeding access to treatments for rare diseases. This remains to be seen but it would certainly be a retrograde step; I hope that the Minister will provide me and rare disease charities with some reassurance on it today. I hope that the Minister will at least commit to more parliamentary scrutiny of the review’s work as it reaches its conclusions over the coming months. It is crucial for NICE to be obliged to improve, rather than frustrate, access and for Parliament to be given a view on these matters.

Amendment 85 in the name of the noble Lord, Lord Lansley, would ensure that the NHS has to implement NICE’s recommendations on medical devices as swiftly as for medicines. It is squarely in line with the Government’s stated aims, in so far as the Government have promised a medtech funding mandate of the kind referred to by the noble Lord himself and the noble Lord, Lord O’Shaughnessy.

However, the reality of the Government’s limited proposals—which are now delayed until next year at the earliest—is rather different. Many of the SHCA’s charities represent patients who have already had to shield this year, and now have to do so again, and the newest medtech innovations stand to help them care for themselves at home better. Does the Minister acknowledge that the Government’s medtech funding plans need to be expanded and accelerated rather than delayed? I hope that the Minister will commit to this important issue.

Finally, the threat to the UK life sciences industry from leaving the EU, and the steps that must be taken by the Government to ensure that the NHS does not start to lose its reputation as a global leader in medical science and innovation, have been fully explored. They are a constant theme from these Benches and across the House on the Brexit legislation that we have considered so far. A statutory duty on NICE to take account of the need for improved availability of innovative medicines and medical devices for NHS patients, with a duty on it and the Secretary of State to work together to ensure that the latest medicines are able to provide the care and treatment that patients need and deserve, will be a key part of supporting a world-leading life sciences sector in future.

[Baroness Penn (Con)]

My Lords, if the noble Lord, Lord Blunkett, speaks with temerity given the other speakers on this group, I ask noble Lords to consider how it feels to be the Minister responding.

I assure the noble Lord, Lord Patel, that Health Ministers may not be completely transformed on leaving government, but discussions that may have taken place in private can become much more public once they are on the other side of the fence.

I turn to Amendment 17, with which it may be convenient to take Amendments 79, 85 and 124 in the names of my noble friend Lord Lansley and the noble Lord, Lord Hunt. On the first half of Amendments 17 and 79, my noble friend conceded that the Bill likely already delivers what is within its scope to deliver. The consideration of the availability of medicines and medical devices when making regulations is relevant. This is what sits behind the ability of the NHS to meet the needs of patients, where it relates to regulation. The Bill simply does not deal with matters related to the NHS supply chain. It supports it by ensuring that medicines and medical devices that are safe are available on the UK market. As my noble friend knows, and has referred to, these matters are set out in other pieces of legislation. NICE was established as a statutory body by the Act that he took through as Secretary of State. I know that his Amendment 85 also probes on issues to do with the NHS supply chain.

I was interested to hear my noble friend Lord Lansley’s fuller explanation of the intention behind the amendment: to enable access to innovative medicines in the NHS. I know that he has done a huge amount to improve such access in the NHS. Although the Government do not think that this amendment is necessary to achieve his goal, I hope that when we come to debate later groups of amendments, including on the Innovative Medicines Fund, I can provide him with further reassurance on this matter.

On the second parts of Amendments 17 and 79, which deal with the results of the consultation on subsequent regulations that flow from the Bill, my noble friend Lord Lansley may have noted government Amendment 126, which we shall reach in a later group. This would add to the consultation requirements in the Bill. On the result of any consultation, I assure him that there is already case law requiring that consultation responses are taken into account. This is reflected in the Cabinet Office consultation principles, which require the Government to explain the responses that have been received from consultees and how these have informed the policy. A public consultation must be formally responded to. Not only that, the Explanatory Memorandum that must accompany a statutory instrument must explain the consultation outcome. Between these various documents, the Government must not only take into account the consultation but set out what has changed as a consequence of that consultation. I therefore think that the amendment may render these changes unnecessary, as the requirement to respond and explain is already there.

My noble friend Lord Lansley also tabled Amendment 85. While I understand his interest in ensuring that we have the appropriate funding and frameworks in place so that NICE-approved devices are made available to patients—an issue already touched on in the previous discussion on attractiveness—he may have anticipated my saying to him, once again, that the Bill is not necessarily the appropriate vehicle.

None the less, my noble friend and other noble Lords have raised an incredibly important issue. I reassure him and others that the NHS medtech funding mandate will be launched in April 2021. It will get selected NICE-approved, cost-saving devices, diagnostics and digital products to patients more quickly and ensure that specified innovations are funded locally. In advance of the mandate’s launch and to support adoption of relevant technologies, the NHS standard contract has been updated to include reference to the medtech funding mandate. I hope that that provides my noble friend with the reassurances that he seeks from me. We are on the way. This Bill is not the means to the end, and I hope he feels sufficiently assured to refrain from pressing his amendment to a Division, when we reach it.

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[Baroness Barker (LD)]

It is a great pleasure to follow the noble Baroness, Lady Bennett of Manor Castle, who introduced these amendments in her customarily thorough and diligent way; I thank her for taking the time to do that. I also thank her for bringing to the Committee information about the sources from which she brings forward these amendments. They not just represent the aspirations of politicians who wish to pursue their own green agenda; they present the thinking on the part of clinicians and people in the health services about the impact of medicines and medical devices and what they do.

It is no bad thing to remind ourselves that, in the NHS long-term plan, there is a specific commitment to the sustainability of the NHS. It is perhaps no wonder that, when the NHS Sustainable Development Unit reports that the NHS is responsible for 25% of public sector CO₂ emissions, there is a recognition that large entities such as the NHS and the British Army will be crucial if the Government are to reach our carbon reduction targets within the timetables set.

As the noble Baroness, Lady Bennett of Manor Castle, said, the NHS is an organisation that British people value very highly. It is an institution that British people do their best not to demand much of—indeed, to minimise their demands on it. It is an ongoing source of frustration for many people that it is difficult for patients to assist with recycling medicines and devices. I know that I am not alone in saying this: when I came to empty the house of my mother, who not only depended on medical devices—hearing aids—but had multiple conditions for which she took medication, I could not dispose of things such as batteries or medicines in an acceptable way. I could not take them to pharmacies and get them recycled for people who needed them. I know that many people have found themselves in that position; it is a source of great frustration for people who do not want to waste precious NHS resources and for whom being in that position is offensive.

I rather suspect, as the noble Baroness, Lady Bennett of Manor Castle, suggested, that the NHS is, at a corporate level, beginning to make some progress in looking at its use of single-use plastics, its disposal mechanisms and, in particular, its use of water. I also suspect that Covid has had a huge and damaging impact on all of that. I do not expect that we will see the NHS able to prioritise this subject for the whole of next year. That is all more the reason for us to do what the noble Baroness said we should do: make sure that this remains an aspiration towards which the NHS should work and should have an obligation to work. With that in mind, I would be very pleased to support the noble Baroness’s amendments.

[Baroness Wheeler (Lab)]

My Lords, I am very grateful to the noble Baroness, Lady Bennett, for tabling these amendments so that we can discuss these important issues in the context of the Bill. Many of the broader issues she addressed will of course be under detailed scrutiny in the forthcoming Environment Bill, but it is valuable to consider them in the context of the supply of human medicines and devices. I very much value the detailed information she provided on a range of issues of concern, here in the UK and globally.

To touch on a few of the points the noble Baroness raised, Labour strongly opposes the production of single-use plastics and agrees with the Government’s policy of producer responsibility when it comes to new plastics being manufactured, but they have been slow to introduce it. As we have stressed, waste, including plastic waste, pollutes our land and seas, kills wildlife and contaminates our food. We are committed to making producers responsible for the waste they create and for the full cost of recycling or disposal. Sustainable design and manufacturing are crucial to this. Can the Minister reassure the Committee that producer responsibility will extend to the manufacture of medical devices? What incentives are being provided for hospitals to use reusable metal equipment, which can be sterilised after each use?

The Environment Agency has found examples of contaminated hospital waste being illegally exported to developing countries, such as Malaysia, for disposal. What steps are the Government taking to prevent the illegal export of such waste and ensure that we dispose of our own waste in the UK? As we know, there are also major issues about the use of incinerators for hospital waste and concerns about health impacts on those living nearby. What alternative means of secure disposal are the Government planning which will protect the environment and cut the impact of carbon emissions?

Are the Government doing enough to ensure that chemists and GP surgeries provide a secure depository for unused medicines, so they do not contaminate the water supply by being washed down the sink or end up in landfill? Is the Department of Health working with the water companies to prevent the water supply being permanently contaminated by drugs that are flushed into sewers and cannot be refined out of the clean water system? There are concerns that the contraceptive pill might be affecting male fertility through the water supply, but high levels of cocaine are also being identified. What research is taking place on the effects of residual medicine in the water supply on human health?

We also know the deep concerns about the huge expansion of single-use PPE during the Covid pandemic. What arrangements are being made for the safe disposal of this equipment and what consideration is being given as to whether these materials can be sterilised and reused? There is strong concern about the widespread distribution of single-use masks to the general public, which are now causing a huge litter problem, as we have heard, as well as being washed away into our oceans. What are the Government doing to encourage the use of cotton masks, which can be washed and worn again?

On decontamination standards, as we have heard, decontamination and sterilisation are key topics for many medical device companies, particularly those involved in reusable surgical instruments and dental and endoscopy businesses. Key issues include prion removal, healthcare-acquired infections and the logistics of moving medical devices along the contamination chain. What engagement has the DHSC had with manufacturers, medical device decontamination and sterilisation providers and medical device users? Can the Minister tell the Committee what plans the Government have to review the decontamination guidance that is currently in place?

Finally, the important issue of antimicrobial resistance was pursued by Labour in Committee in the Commons by an amendment stressing the need to recognise its importance in the development of new medicines, and which would have laid a duty on the Secretary of State to produce an updated report to Parliament, setting out progress on a UK-wide strategy for tackling AMR. The Government’s 2019 five-year plan—which is part of the 20-year strategy, as we know—has been welcomed and has been the subject of considerable discussion in your Lordships’ House. The noble Baroness, Lady Bennett, is right to underline the awareness of AMR for those participating in clinical trials. The focus must be on developing new medicines to tackle AMR and curb the spread of bacterial diseases requiring antibiotics, and on the prevention and control of infection to contain the emergence and spread of resistance to antibiotics.

Social Care Workers

Baroness Wheeler Excerpts

Wednesday 7th October 2020 Lords Chamber

[Lord Bethell (Con)]

This is a very important piece of communication. We have sought to work through the colleges and through the CQC system in order to make sure that employers make knowledge of these funds available to those in social care. I will look at the department to see what we are monitoring and what the take-up rates have been, and if I have any further information I will be glad to write to the noble Baroness with that data.

[Baroness Wheeler (Lab)]

My Lords, on agency staff, according to workforce statistics from the Department for Education in February, the number of agency social workers grew by 10% last year. Cheshire East Council, for example, spent more than £1.3 million on agency social workers last year, and these costs also include the fees that the authority has to pay to the agencies. What funding and other support has been provided to local councils specifically to enable them to reduce the reliance on agency staff and to ensure that the money spent on temporary staff in social care departments, care homes and domiciliary care can instead be used to increase the number of permanent, full-time and part-time staff in social care that are so desperately needed?

[Lord Bethell (Con)]

My Lords, the use of agency staff in itself is not something that we are fighting against. Agency staff, although often denigrated, provide an incredibly valuable contribution to the social care efforts of the country. That said, the main way in which we can address the dependence on sometimes expensive employment practices is to ensure that there is a really large pool of people taking the kinds of jobs offered in social care. That is why we are marketing those roles heavily, improving the employer brand around social care and improving the financial arrangements for those seeking training in social care.

Food Hygiene Rating Displays

Baroness Wheeler Excerpts

Wednesday 7th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, it is probably too early to make an accurate analysis, but one impact that has happened in the food industry is the move to online deliveries. That is why we are considering the application of mandatory rating for online deliveries as well as for restaurants. Online deliveries are a terrific benefit to society, but it is important that they also have regulatory scrutiny, and we will bear that in mind in any future review.

[Baroness Wheeler (Lab)]

My Lords, the consumer magazine Which? has warned that customers are at risk of being left in the dark or misled about food hygiene standards and that the regulator and local councils need to take strong action against businesses that fail to display ratings, or display incorrect ratings that mislead customers. What action are the Government taking to address this? Would he agree that England following Wales and Northern Ireland in the mandatory display of food ratings, as well as restoration after the savage cuts to local council food hygiene budgets and local environmental health services and staff, would help to tackle this problem?

[Lord Bethell (Con)]

The noble Baroness puts the case very well. I completely acknowledge that the FSA favours extending mandatory display ratings to England and that in June and November last year the National Audit Office and the Public Accounts Committee respectively recommended that the FSA pursues this ambition as soon as possible. We very much take on board the views of all these public bodies and will consider the advice given to Ministers as soon as possible.

Mental Health Services: Young People

Baroness Wheeler Excerpts

Thursday 24th September 2020 Lords Chamber

[Lord Bethell (Con)]

My noble friend Lady Fall is right that the plight of students is tough; going to college will not be like it was in our days. That is why the DfE is putting together a Covid catch-up package of £1 billion, which will include support for universities and for the mental health of students.

[Baroness Wheeler (Lab)]

My Lords, may I return to the issue of counselling? The criteria of the Children’s Commissioner, Anne Longfield, of a counsellor in every school for every child who needs one would help relieve pressure on struggling CAMHS services. Does the Minister acknowledge that the children’s mental health system will struggle to cope as long as we are failing to provide early help to tackle problems before they become crises, and will the Government commit to ring-fence funding for mental health in schools, colleges and universities to enable them to provide mental health support to all young people who need it?

[Lord Bethell (Con)]

My Lords, we are rolling out our response to the Green Paper on mental health for young people. That has included the implementation of mental health support teams, which will make a big impact. In addition, and in response to recent circumstances, on 8 September we launched a mental health well-being campaign specifically for children and young people through the PHE website. It encourages a personal mind plan and the use of a quick and easy interactive tool, and 2.5 million mind plans have been completed since its launch.

Health Care: Guidance

Baroness Wheeler Excerpts

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness puts it extremely well: all treatments should be individualised and tailored to the patient’s needs and requirements. I applaud the work of the forum. We are committed to continuing that work, and it is an important part of our correspondence with trusts that these standards are upheld and advertised.

[Baroness Wheeler (Lab)]

My Lords, the Minister will be aware of widespread concern that NHS measures introduced in response to Covid-19 are having serious consequences, with patients denied basic healthcare. Almost half of the 102 million GP consultations between March and July were delivered by phone or video, in line with government guidance to deliver a predominantly remote service. What steps are the Government taking to ensure that vulnerable people, especially the elderly, are not shut out from surgeries under measures introduced to stop the spread of the virus this winter? The reality is many are not online, they struggle with complex information systems and will face further difficulties if they are once again advised to isolate.

[Lord Bethell (Con)]

The noble Baroness is right that half of consultations have been done by telephone or on the internet. Some of those have been successful, but I agree with her that we have to keep GP surgeries open for those who either choose or need face-to-face consultations. That is why the NHS chief executive has written to CCGs and trusts urging them to be open and to have fair access to face-to-face consultations where necessary.

Folic Acid

Baroness Wheeler Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I entirely endorse the noble Lord’s appeal for us to eat our greens. The concern with this specific matter is unplanned pregnancies, and the suggestion of putting folic acid into flour is to target those mothers who may need the additional supplements at a time when they do not realise they need them.

[Baroness Wheeler (Lab)]

My Lords, we on these Benches and across the House share the deep frustration of my noble friend Lord Rooker about the delay on this vital issue. When the consultation was announced in June last year, the Government also promised that the results would be dealt with speedily and would go hand in hand with major efforts to step up awareness raising, particularly among at-risk groups, such as Afro-Caribbean women and women under 20 years old. What actions have been taken? What assessment has been made of the reason for the stubbornly low take-up of folic acid supplements? What measurable impact has awareness raising had on reaching at-risk groups or ensuring that women whose pregnancies were unplanned are not missing out on these vital nutrients in the early stages of their pregnancies?

[Lord Bethell (Con)]

My Lords, the noble Baroness did, in part, answer her own question. Work to improve the diet of pregnant mothers has progressed impressively, particularly among at-risk groups. However, it is those mothers who do not know that they are pregnant that this measure particularly targets, and that is where its inherent value is. This is why we have conducted a consultation and are looking to make a decision on it in the near future.

Pharmacies

Baroness Wheeler Excerpts

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness is right that pharmacies can play an enhanced role, particularly in providing the kinds of services that mean that people do not have to visit their GP. If we have learned one thing from Covid-19, it is that GP surgeries can be a source of infection and that GPs can sometimes be much more impactful working away from home. That is why we support exactly the kind of initiative that the noble Baroness outlines.

[Baroness Wheeler (Lab)]

My Lords, we know that the health service faces the herculean challenge of dealing with pent-up demands caused by the coronavirus pandemic, including for postponed elective surgery and delayed preventive interventions. Community pharmacists have proved themselves a key element of assistance during the crisis and should have an important role to play in future in helping to clear the backlog by bringing more care into the community. What plan do the Government have to expand the clinical role of pharmacies and what steps are they taking to ensure that pharmacies are far better integrated into the primary care system?

[Lord Bethell [V]]

The noble Baroness is entirely right. We have introduced a new framework—the community pharmacy contractual framework—which has down- played some services that were not offering value for money but has enhanced some services that have made a huge impact, many of which are of a clinical nature. The settlement also includes a transitional payment, which will help to secure the financial resilience of the pharmacy sector. We could not be more committed to the community pharmacy sector. I believe that the future of healthcare in this country will depend much more on the role of pharmacies delivering the kinds of services that the noble Baroness outlines.

Ultra-processed Foods

Baroness Wheeler Excerpts

Thursday 2nd July 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness is right to say that the consultation is an important one and we take it very seriously. Covid has been disruptive, but I reassure her that we will respond to the consultation on extending advertising restrictions as soon as we can.

[Baroness Wheeler (Lab) [V]]

My Lords, I will focus on food labelling. Does the Minister share my concern that it can be difficult to recognise ultra-processed foods in the supermarket? Even a sugary multicoloured breakfast cereal can state that it is a good source of fibre and is made with wholegrains. What consideration have the Government made of improving the food labelling process by adding the NOVA system of food classification, which divides the foods we buy into four groups ranging from unprocessed to ultra-processed? Would this not help to foster consumers’ awareness of how much processed food they and their families eat?

[Lord Bethell [V]]

My Lords, I agree completely with the noble Baroness that labelling is absolutely critical in this area. We have made huge progress already and it is eye-opening to study the labels on some foods. I agree with her that while some supermarket products can look healthy, they are often anything but. We continue to expand and improve our labelling arrangements and we are looking at the responses to the consultation and considering them carefully.

Covid-19: Test and Trace App

Baroness Wheeler Excerpts

Monday 22nd June 2020 Lords Chamber

[Lord Bethell]

My Lords, our plans for the winter are in development and I look forward to their publication. The noble Lord is entirely right to prioritise antibody screening. We have invested considerably in antibody testing from a number of suppliers, including Roche and Abbott. As he knows very well, the science remains ambiguous, but we are optimistic. That is why we are putting our best minds to understand it better, and we are world-leading in that respect.

[Baroness Wheeler (Lab) [V]]

My Lords, the PNQ refers to the lessons learned. One key one—[Inaudible]—launch of a system that was not ready and serious IT—

[The Deputy Speaker (Lord Bates) (Con)]

Order. We are having some technical difficulties hearing the noble Baroness’s question, so we will go to the next question, from the noble Lord, Lord Duncan of Springbank, and come back to her if there is time.

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[Lord Bethell]

I pay tribute to the KCL symptom tracker app. I have been a subscriber since the early days of its launch. The data it provides has been extremely useful to the Government and is used regularly. I also pay tribute to my noble friend, who has spoken before about the need for diaries. The work on diary keeping in South Korea and New Zealand has proved important.

[Baroness Wheeler [V]]

My Lords, the PNQ refers to lessons learned. A key one from the sorry story of the NHS app is that the Government should have involved local councils in the trace and contact system from the outset and used the decentralised local PHE expertise and knowledge of infection control already in place. Instead, we had a chaotic government launch of a system that was not ready, with serious IT problems experienced by many of the 25,000 new staff recruited by the NHS to carry out manual contact tracing, as well as training problems and many staff literally not having anything to do. Current figures show that they are doing just 11% of the total work while the vast majority of manual contact is being completed by trained PHE officials. Can the Minister reassure the House that the Government will make sure that councils have the necessary powers they are calling for to be able to fully respond to local outbreak hotspots, and ensure that PHE directors and local infection officials have the funding and support they need?

[Lord Bethell]

The noble Baroness is entirely right that local councils are pivotal to our response to Covid-19. I pay tribute to Tom Riordan, CEO of Leeds City Council, for the important work he is doing to stitch together the alliance of councils which is working closely with the joint biosecurity centre to organise that response. However, I do not agree with the noble Baroness on the role of the tracing teams—it has been incredibly important. There has not been the capacity in the decentralised PHE teams to provide the response necessary to this national epidemic. A central team was necessary and is proving to be effective. We have put PHE expertise at the heart of that programme.

Covid-19: Track and Trace System

Baroness Wheeler Excerpts

Thursday 18th June 2020 Lords Chamber

[Lord Bethell [V]]

I pay tribute to the perseverance of the noble Baroness on the issue of interpreters. She is entirely right that marginal communities are incredibly important in this process and can be like rockpools when the tide recedes—left as areas of infection if we do not focus on them effectively. That is why we are working extremely hard to identify those communities that might be left behind and to use resources such as interpreters to ensure that the message gets through.

[Baroness Wheeler (Lab) [V]]

My Lords, the ambition of the Minister, reported yesterday, to get a national “track and trace” system going before the winter is in marked contrast to the hype and promises of the test trial launched in May, when Matt Hancock promised that where the Isle of Wight leads, Britain follows—though obviously now not until Christmas. Does the Minister acknowledge that the failure to have an effective system up and running this summer will have a huge impact across vital services, including residential and nursing care homes? Do the Government expect care homes not to open for regular and routine visits from family, friends and others until the end of the year?

[Lord Bethell [V]]

I do not agree with that analysis. I am afraid that areas such as care homes are where the app is least effective, because the residents are static and therefore the app is not really the facility for identifying infections. This is where the manual “test and trace” process is the most effective. That is why we are super-focused on getting it right. We are working very closely with the social care community to ensure that the “test and trace” systems are working well. We are flooding social care with tests and ensuring that our tracing agents are well trained to handle local outbreaks in care homes and to deal with care home staff.