Pharmacy First

Baroness Wyld Excerpts

Tuesday 6th February 2024 Lords Chamber

[Baroness Wyld (Con)]

My Lords, I welcome the initiative. It is very good and has been very well thought out and communicated thus far. I would like to pick up the point made by the noble Baroness, Lady Merron, about women’s health. The point about older women was very well made. Equally, for younger women, on the subject of UTIs, I understand that there have been some very successful pilots, but my noble friend will be aware that for women persistent UTIs can be a symptom of something more serious. Symptoms of more sinister diseases can also mimic UTIs. While I have every faith in pharmacists to be able to refer on where possible, it is also important that women feel empowered to go to their GP if they feel something is not right. Women’s health has too often been pushed on to the back burner or ignored. I would like a bit of reassurance on that.

[Lord Markham (Con)]

My noble friend is absolutely correct to bring that up, and that is why it is quite specific on “simple” UTIs. The devil is in the detail, but the reason behind saying simple UTIs is that so the capacity is there, and you can have a referral to a GP.

In this space I speak from personal experience with my partner. It is much harder these days to get antibiotics for UTIs. We know that this is generally a good thing in terms of antimicrobial resistance, but in many cases, as my wife often says, she knows when she has a UTI—and boy does she need those antibiotics.

Some of the things I have started to see in terms of technology, which is relevant to the question of complexity, include point-of-care devices in surgeries or pharmacies that can detect a UTI very quickly, so that you then know you can give a prescription for antibiotics. That is what we see in terms of the direction of travel.

Respiratory Syncytial Virus

Baroness Wyld Excerpts

Thursday 19th January 2023 Lords Chamber

[Lord Markham (Con)]

I thank the noble Baroness. The key risk groups in the elderly as well are, as I mentioned earlier, those with congenital lung or heart disease or spinal muscular atrophy. The problem is that the current vaccination needs monthly immunisation to be effective, and I think most people will agree that it can be used in only the most severe cases because it is not a very practical way forward and is very expensive. That is why I am really excited by the new treatments, particularly nirsevimab, which is 75% to 80% effective, versus palivizumab, which is more around 50%. I think we have a good way forward.

[Baroness Wyld (Con)]

My Lords, has the Department of Health done any assessment of how many children may have missed their routine vaccinations during the pandemic lockdown? Is the department doing anything to follow up with these children? If so, can the Minister say what?

[Lord Markham (Con)]

I know that this, like all those areas that were unfortunately missed out during the pandemic, is something the department is working on. There are catch-up activities. I have seen it personally with my four year-old, who of course was two and three during this time. I will happily provide the detail in writing.

Health and Care Bill

Baroness Wyld Excerpts

Lords Hansard - Part 1 & Report stage
Monday 7th March 2022 Lords Chamber

[Lord Mawson (CB)]

My Lords, just before the Minister stands, I rise to support Amendment 184ZA in the name of the noble Baroness, Lady Cumberlege.

Over the last 28 years, it has been my privilege to work with a fantastic team of GPs in the East End of London who are now responsible for 43,000 patients. I know what great GPs and doctors are like. If I am honest, however, I have also had to deal with a number of dodgy doctors, which is a very difficult matter to deal with. One doctor undertook female circumcision in his practice, unbeknown to the health authority for quite a period of time. He ended up marrying his practice manager and, some years later, he murdered her. Another practice, when I dug under the carpet, had bought a cheap fridge from B&Q and, over a period of three years, kept 10,000 injections at the wrong temperature and injected 10,000 patients with dead, illegal injections. Another doctor, as we learned when we took over his list, had countless ghost patients. As a result, I started to discover what ghost patients are. It took our team two years to sort out the realities of who were and were not real patients.

For the sake of GPs and patients, we need to protect them in the way the noble Baroness is suggesting. Doctors are flawed human beings like the rest of us, and we need to protect them from themselves and from us. It is really important that these things are taken seriously. This amendment puts its finger on a very important matter.

[Baroness Wyld (Con)]

My Lords, this morning, I told my three daughters that they needed to be more assertive at school, but I have completely failed to intervene tonight. I will be very quick in paying tribute to the noble Baroness, Lady Merron, and my noble friend Lord Lansley, who is not here tonight, and in thanking the Government for the amendments on cosmetic interventions. I sponsored the Botulinum Toxin and Cosmetic Fillers (Children) Bill in this House, which assisted with the regulation of non-surgical interventions for children. At the time, we said that this was only the start and that there was a lot more to do. We acknowledged that others had done a lot of spade work, and I pay tribute to all those who have done yet more spade work. I want to put on record my appreciation to the Government for listening and reacting.

[Baroness Greengross (CB)]

I will be very brief because this is a slightly different subject. I shall speak to Amendment 181, which places a duty on the Secretary of State to ensure that each hospital has sufficient accommodation for patients who are rehabilitating and no longer require a hospital bed but still have needs. Further, as part of this duty, the Secretary of State must ensure that any spare land owned by the NHS is considered for this use.

In Scandinavia, patient accommodation of this nature has been part of the state health system since the late 1980s. Having patients stay in these facilities, which are designed to cater for people still needing some medical care, has delivered considerable savings to the public health system. The savings from these facilities is significant. In the previous group, much of our discussion—as always—was about the cost of our health and care system to the taxpayer, and to those who need care. This amendment, as well as delivering better rehabilitation and care for someone recovering from being in hospital, also delivers a significant saving. As I pointed out in Committee, NHS trusts are currently spending money putting up patients in hotels, with rooms costing as much as £275 a night. One London hospital has spent over £1 million on hotel rooms in the last three years. The cost of someone staying in a hospital bed for longer than they need is even greater than that. This is something that I would very much like to take up further with the Government.

Over the last few years, I have been working with a chartered architect who has identified various sites where this could happen throughout England. One is not terribly far from here. This is a real opportunity and I hope the Government will take it to include this as part of the Bill.

Health and Care Bill

Baroness Wyld Excerpts

Lords Hansard - Part 1 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Baroness Wyld (Con)]

My Lords, I support my noble friend Lord Farmer. I declare my interest as a non-executive member of the board of Ofsted. I apologise for not being able to speak at Second Reading for my own family reasons. I echo everything that the noble Baroness, Lady Tyler, said. It was a real pleasure to serve with her on the Public Services Committee.

I will praise the Government first, which is always wise. They are showing great commitment to family hubs and I believe that they are committed to the rollout. What concerned me when the committee took evidence from certain members of the Government was a sense of a lack of urgency. Everybody agreed that this was a brilliant idea, but different people from different departments had different ideas about how they should work.

We also took evidence from families, in private and in public. The stories we heard over and again were, as others have alluded to, that, “This could have been prevented if it had been addressed in a joined-up way”. We particularly heard from young children, “I had to tell my story over and again.” Imagine the trauma. This could have been prevented under a different model. These situations did not have to happen.

We have the building blocks to make sure that these situations do not happen, but I do not think the legislative framework is in place to help us to address that. For that reason, I am persuaded by my noble friend Lord Farmer and I am happy to support his amendment.

[Lord Mawson (CB)]

My Lords, I am very supportive of what the noble Lord, Lord Farmer, said. My colleagues and I have been in this space for 37 years and we have built rather a lot of things in it. It has been very interesting to watch what happened in east London, when this new scheme from a new Government arrived in the middle of a group of communities that already had well-established relationships with very vulnerable families, with a whole range of opportunities emerging. I am sure it was unintentional—it is part of the danger of being overinfluenced by the idea that local authorities will sort this stuff out in the same old usual way that they have tried to before—but it was very disruptive for the social enterprise sector, which was already doing this stuff very effectively, with all the numbers to show it. I will not go into the detail now, but when you look at the detail of what actually happened, the present facilities cost £100,000 more than those being delivered by the social enterprise sector.

These ideas are really important. I am happy to take the noble Lord into this in a lot more detail. I encourage him to spend more time in the detail in some real places to look at the unintended consequences of what happens when new government programmes arrive in communities, with the best will in the world, with an overconfidence in what they think the state can deliver. I am very happy to have a further conversation with the noble Lord, but the detail of the long-term relationships with these families really matters.

Folic Acid

Baroness Wyld Excerpts

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I join the noble Lord in paying tribute to all those who have worked so hard, particularly the noble Lord, Lord Rooker, who has delivered a playbook campaign on this. Being on the receiving end, I pay tribute to the grace, persuasiveness and energy with which he has conducted that campaign. He is not the only one, and I pay tribute to the personal testimony of the noble Lord, Lord Dodds— what a moving story he has just told. All who have been involved in these sorts of conditions would have been touched by that. I cannot deliver the categoric guarantee that he asks for but, as I said, we are looking at it extremely carefully and I hope to return soon.

[Baroness Wyld (Con)]

I join my noble friend in paying tribute to the noble Lord, Lord Rooker, for his campaign. I urge him to keep up the pace. While the Government are looking at that, we surely need more creative public information campaigns to raise awareness of the importance of folic acid, particularly when communications around health have, under- standably, focused on the pandemic. What work have the Government done with HCPs, in practice, to make sure that women are fully informed?

[Lord Bethell (Con)]

My noble friend is right: with half of pregnancies unplanned or unexpected, it is entirely right that we should seek to raise issues such as folic acid. The Government are committed to the preventive agenda, and folic acid is just one among many examples where we hope to mobilise public interest in looking after their own health to avoid these kinds of conditions. Her point is extremely well made.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Baroness Wyld Excerpts

2nd reading
Friday 16th April 2021 Lords Chamber

Moved by

[Baroness Wyld]

That the Bill be now read a second time.

[Baroness Wyld (Con)]

My Lords, I first congratulate Laura Trott MP on her success in skilfully navigating her Bill through the other place, and in particular on its arrival in this House unamended. I am afraid the beginning of my speech may be a bit of an Oscars speech, because so many people have campaigned on this issue to date. I want to mention Alberto Costa MP, who has campaigned for so many years following the high-profile case of one of his constituents who suffered a terrible injury following a botched lip filler administered by an unregulated and unqualified beautician, and Carolyn Harris MP and Judith Cummins MP, who are co-chairs of the All-Party Group on Beauty, Aesthetics and Wellbeing. I also pay tribute to the fantastic work of Save Face, which is a national register of accredited practitioners who provide non-surgical cosmetic treatments.

I was delighted when Laura Trott approached me to sponsor this Bill in this House and I hope, with the help of noble Lords, to steer it on to the statute book in the remaining weeks of this Session. I am sure we will have a very wide-ranging discussion about children and young people; for good order, I declare my interests as a non-executive member of the boards of Ofsted and DCMS.

The purpose of the Botulinum Toxin and Cosmetic Fillers (Children) Bill—which is very hard to say—is to prohibit specific cosmetic procedures being performed on people under the age of 18 in England, except under the direction of a doctor, thus safeguarding children from the potential health risks of Botox and cosmetic fillers. The Bill has cross-party and government support; we are very grateful for the collaboration from both Opposition Benches and the time that noble Lords have given me. I hope that will help its progress.

I still find it quite shocking that this Bill is needed at all. To be clear, I have no problem whatever with an individual’s right to alter their appearance, should they so wish. However, children are still developing, physically and emotionally, and without this legislation we are leaving them exposed to completely unacceptable risk. Laura Trott commented in the other place:

“The most frequent reaction I have received in response to my Bill is, ‘Surely, that is illegal already.’”—[Official Report, Commons, 16/10/20; col. 652.]


Today we have the chance to ensure we put this right.

In recent years we have seen a growing prevalence and normalisation of non-surgical cosmetic procedures; they are increasingly accessible and affordable on the high street because technologies and products in this field have advanced. Cosmetic fillers and botulinum toxin—which I will refer to as Botox, which is actually a brand name—have been identified as the two procedures most appropriate to be brought under the scope of the Bill, as they are two of the most accessible and invasive procedures available on the high street.

For those who do not know, I will quickly say what Botox and cosmetic fillers are. Fillers are gel-like substances commonly injected into the lips or face to add volume and plump the injected area; they may also be used in the hands and feet, or for non-surgical nose jobs. There are temporary fillers and less common permanent fillers, which have an increased risk of serious complications. Although some filler products are regulated as medicines, they are usually classified as general products. As a result, there is a vast range of products available for purchase, and the specification and assurance of the product is limited.

Botulinum toxin is a medicine injected into the skin to smooth lines and wrinkles—I considered making a joke about Botox in your Lordships’ House, but I thought we ought to play it safe today. As prescription-only medicines, they are regulated by the MHRA in the UK. Regulated healthcare professionals with prescribing responsibilities, such as doctors, may delegate responsibility for the administration of the medicine to a secondary practitioner who does not have to be medically qualified.

I will now explain why children are at risk. In England, cosmetic surgery can be performed only by doctors registered with the GMC, and providers of cosmetic surgery are required to register with the Care Quality Commission. As non-surgical procedures, the administration of botulinum toxin and cosmetic fillers is not a regulated activity. The procedures can be performed by clinicians, beauty therapists or lay people in both clinical and high street venues.

Although these procedures are offered on the high street, there are risks and complications. Risks from Botox include blurred or double vision, breathing difficulties, if the neck area is injected, and infections. For fillers, complications include the substance moving away from the intended treatment area, infection, scarring and blocked blood vessels in the face, which can cause tissue death and permanent blindness. People—mainly women—have been left with rotting tissues, lip amputations and lumps.

Currently, children, in the same way as adults, may access Botox and cosmetic filler procedures on the commercial market without a medical or psychological assessment. A 2018 survey showed that 100,000 under-16s had undergone cosmetic enhancements, the most common of which were fillers.

This Bill’s focus is intentionally narrow. It will create a new offence in England of administering botulinum toxin and cosmetic fillers to persons under 18, except where their use has been approved by a medical practitioner. The procedures will still be available to under-18s from doctors and a limited range of registered health professionals—dentists, pharmacists and nurses who are acting under the direction of a doctor—as there are cases where medical conditions would require such a treatment, for example with migraines. It also places a duty on businesses to ensure that they do not arrange or perform the procedure on under-18s unless it is administered by an approved person—a doctor, nurse, pharmacist or dentist.

The Bill creates no new enforcement mechanisms. Local authorities will be able to use the powers already accorded to them under the Consumer Rights Act 2015. As they would be criminal offences, the police can use their existing powers in relation to the powers in the Bill. The legislation would bring these specific invasive cosmetic procedures in line with age restrictions on tattoos, teeth-whitening and sunbed use.

The Bill is both short and straightforward—in many ways that is its strength—but its effect in introducing an important protection for young people is crucial. It is not about attacking the cosmetic treatment industry; indeed, the industry supports the purpose of the Bill. It is about ensuring that young people cannot access cosmetic procedures until they are able to make a genuine, informed choice.

Like many others speaking today, I speak a fair bit in this House and in my other work outside it about policy affecting children and young people. I spend most of the rest of my life, when not at work, worrying about my three young daughters and whether I am being overprotective or not protective enough, given that, after all, life is full of risk and we should prepare children for that. But there are situations when we have an absolute responsibility to step in and remove danger. I strongly believe that this is one of them. I beg to move.

--- Later in debate ---

[Baroness Wyld (Con)]

My Lords, I am so grateful to everybody who spoke in the debate today. I know we are tight on time; I see the Whip looking up at me. I wish I could go name by name through everyone and respond, because so many important issues came up.

As the noble Lord, Lord Addington, so rightly said, others did all the spade-work. I must pay tribute to my noble friend Lord Lansley. I am really delighted that he was able to come in to support me today. I am very grateful to the Minister for his comprehensive response and to the Opposition Benches, as I have said, for their support thus far.

It was a very moving debate. It made me think a lot about my own daughters and the world they are growing up with, as I said. As adults, when one comes to terms with our own physical imperfections, it is easy to forget the great pain that one feels as a young person or child at being different in any way. I will be glad if we can do a little today to help.

I hope that, with such breadth of support, we ensure the Bill has a speedy passage through your Lordships’ House. I echo my noble friend the Minister’s plea that the temptation to table helpful amendments is resisted. I think and hope it is. I beg to move.

Bill read a second time and committed to a Committee of the Whole House.

NHS: Staff Numbers after Covid-19

Baroness Wyld Excerpts

Thursday 4th March 2021 Grand Committee

[Baroness Wyld (Con)]

My Lords, with my minute I would like to highlight specifically those involved in treating perinatal mental illness. As many as one in five women experience mental health difficulties during pregnancy or after childbirth. The NHS long-term plan addressed that and workforce numbers are starting to move in the right direction, although we are playing catch-up in what has been a long neglected area.

The pandemic has resulted in women missing out on vital face-to-face interactions with health workers and support groups, so it is not surprising that during my research I found that many health professionals fear an epidemic of post-natal depression in particular. I would like my noble friend to ensure that his department reviews this, recognising that it is about not just workforce numbers but adequate training to spot early signs and to give women the personalised understanding that they need. Sadly, some women may not have felt able to speak up during the pandemic, so we do not know what the long-term effects will be on the demand for services, and I urge the Government to keep that at the forefront of their mind in their workforce planning.

Independent Medicines and Medical Devices Safety Review: Sodium Valproate

Baroness Wyld Excerpts

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely acknowledge the noble Baroness’s point. Support is incredibly important and our hearts go out to all those who have been hit by any of the three conditions covered by the review. We are absolutely looking at those recommendations to see how they may be implemented to provide the support that the noble Baroness rightly points out.

[Baroness Wyld (Con)]

My Lords, could my noble friend please update the House on the timetable for the appointment of the patient safety commissioner, one of the key recommendations that I am delighted the Government accepted? I understand that that requires new regulations, and the Government have rightly said that we ought to take time to find the best and widest possible field, but surely that just underlines the urgency of the need to get going with this.

[Lord Bethell (Con)]

As my noble friend rightly acknowledges, the everyday workings of the commissioner require some work. That work is being finalised and regulations will be made setting out further details about the appointment and operation of the commissioner—for example, the terms of office, the finances and other support for the commissioner. Officials are now working with legal and appointment colleagues to firm up time- lines and begin both the regulations and the appointment process for the commissioner.

Mental Health Services: Young People

Baroness Wyld Excerpts

Thursday 24th September 2020 Lords Chamber

[Lord Bethell (Con)]

The right reverend Prelate the Bishop of Carlisle is right to emphasise bereavement support. We all remember well the difficulties faced by family or friends who were bereaved in the terrible circumstances that we were put under during Covid. We have put £9.2 million of additional funding into mental health charities, which includes charities that provide bereavement support. However, I will take away the well-made points of the right reverend Prelate and will look into whether more could or should be done.

[Baroness Wyld (Con)]

My Lords, we know that a particularly risky time for children and young people is when they move across and between services, whether that is accessing CAMHS for the first time or moving on to adult services. Can the Minister reassure me that face-to-face appointments will still be made available for those important relationships to be established and embedded?

[Lord Bethell (Con)]

My Lords, face-to-face appointments are incredibly important for some people, which is why we have emphasised the return to work, particularly in GP surgeries. However, I would like to make the case for internet or telephone services. They have proved to be extremely popular among some mental health patients, who find the direct intimacy of face-to-face too overwhelming and prefer instead to do Zoom or telephone consultations. We are supporting analysis of where these rightfully work and in the meantime are supporting face-to-face when preferred or necessary.

Childhood Obesity

Baroness Wyld Excerpts

Wednesday 2nd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, there are individual programmes specifically targeting those from deprived backgrounds. I emphasise the childhood obesity trailblazer programme, which has funding for several councils to pioneer forward-thinking ideas to address childhood obesity among those target populations.

The other area that I emphasise is exercise in school. Of course, obesity is linked to intake, not exercise, but exercise helps to get the disciplines right around looking after one’s mind and body. The £320 million going into school sports facilities is a massive bonus in this area.

[Baroness Wyld (Con)]

My Lords, could my noble friend say, a little more specifically, what training and support will be available to health visitors for the very earliest intervention? Would not the one-year and two-year checks that the majority of children go along to be an ideal opportunity to inform parents about the nutritional needs of very young children so that they can make those informed choices?

[Lord Bethell (Con)]

Health checks in the early years of childhood are an incredibly valuable opportunity to intervene in a number of health inputs. Diet and exercise are two of those. Training is in place for health visitors to provide dietary advice but, when back at the department, I will ask whether we are working on any new initiatives at the moment and write back to my noble friend.