Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020

Lord Balfe Excerpts

Wednesday 30th December 2020 Lords Chamber

[Lord Balfe (Con)]

My Lords, we keep on hearing about the end of this tunnel, at which there is some light. It is an extraordinary long tunnel, and the pinprick of light seems to be very small. In the past I have asked the Minister whether he still stands by Professor Ferguson’s prediction of 4,000 deaths a day, which has never been withdrawn and never got near, and whether he is willing to widen the pool of experts that the Government rely on. Many experts are casting doubt on the figures and their interpretation, not on a one-off basis, but very regularly. I would like to see those people inside the government tent that is producing the projections we are asked to live with.

In particular, will the department publish an updated table showing deaths by age and previous condition? Are we still dealing with people aged on average 84.4 years-old with underlying conditions, or is the disease spreading to a lower cohort? We need to know more what its impact is and a bit less about the numbers, as has been agreed. The numbers have gone up because the number of tests has gone up, among other things.

The second thing is: can we have some idea of hard plans for vaccinations, not just that they are there or that they will be used? What are the plans, and when is it expected that all the over-80s, the health staff, and the over-75s will be vaccinated? Can we have a plan for each area and something that we can hold the Government to account against?

Covid-19 Update

Lord Balfe Excerpts

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

If I have heard the question correctly, that is exactly how the test release scheme works. Travellers are invited to sign the appropriate forms and after some days they can be released from isolation early by taking tests. That scheme has been signed off by the Chief Medical Officer and data from the test is transmitted to Public Health England. We currently have a UK-only testing regime and we do not take tests from overseas, but we are keeping the scheme under review.

[Lord Balfe (Con)]

My Lords, it appears that it is among younger people where the spread is now concentrated. What is the severity of the infection? It has been put to me that it is not that severe and that, indeed, many younger people are saying that they have to learn to live with it. I do not think that things are helped by the harsh rhetoric of “4,000 deaths a day” and so on. It just goes over people’s heads. They are saying, “This is not believable. They are going on about it, but it doesn’t matter.” Instead of using punitive terms, could the Minister go for more of a nudge theory, as put forward by David Cameron, and try to persuade people that it is in the interests of everyone to do certain things, rather than terrify them all the time—because that is not working?

[Lord Bethell (Con) [V]]

My noble friend Lord Balfe is entirely right to say that the symptoms in young people are zero in many cases. There are issues of both saliency and believability among many young people who think that this is a disease that simply does not touch their lives. It is understandable that they may think it implausible that they could be carrying the disease. However, the statistics are crystal clear. When looking at the heat maps, you can see easily how infections grow among the young and then graduate through the demographics until they hit older people, and then hospital admissions rise. I am extremely sympathetic to young people and why they find this idea a challenge to believe in, but we have to hit home with this message—otherwise, we will not be able to contain the disease.

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020

Lord Balfe Excerpts

Tuesday 1st December 2020 Lords Chamber

[Lord Balfe (Con)]

This has been a fascinating evening, has it not? I wonder whether the Minister has any support. I also wonder what the Labour Party is up to, because they do not seem to be taking part at any level at all. We have had precisely two Labour speakers, and no more, one of whom is yet to speak and will undoubtedly tell us what is what.

I have a lot of sympathy for my noble friends Lord Robathan, Lady Neville-Rolfe and Lord Cormack, and I will support whichever of their proposals goes to the vote. I am sorry but this is becoming a complete shambles. We had a little family debate at the weekend about whether we should put granny by the window or whether we did not want her to get pneumonia. We decided that we wanted her not to get pneumonia, because who on earth would end up doing the washing up? When you have senior officials in the Government talking about putting granny by the window, you really know that you have lost something.

At the same time, there is a serious point here. There is a catalogue of misery within the health service of people who cannot see their relatives, of the disabled who are stranded and lonely in homes, and the NHS does not appear to care. Why do we have a Minister for vaccinating people but no Minister for sorting out the NHS—for opening hospitals, opening surgeries, and getting visitors back into homes where people have been isolated, often for months? They are not a compassionate Government; they are in the grip of a handful of so-called experts, one of whom I remember had the distinction some years ago of having half of the cattle in Britain slaughtered quite needlessly. I hope that he does not turn those latter abilities to the general population.

Last Saturday, the shroud-waver in chief, the Cabinet Minister Mr Michael Gove, told us that we would be physically overwhelmed, with

“Every bed, every ward occupied”,

and all the capacity built into the Nightingales and requisitioned from the public sector too. Let me ask this of the Minister: as of today, how many Nightingale beds are full, both as a number and as a percentage? How many of the private sector beds are full, and how many are sitting there, not taking in private sector patients because they are getting big dollops of public money—I speak from some knowledge because I have a number of friends in the medical profession—for leaving the beds empty and not taking in patients? This is the rather sad state that we are in.

What do I propose, apart from what I have said already? We need a wider view among the people who make the decisions. Why are people like Professor Heneghan and Professor Gupta voices in the wilderness? With all their scientific abilities, why are they not at least in the room where the decisions are made? They would be a small minority, but at least they would be able to put forward their views. Why are we not listening to the Chancellor and to industry? We are bankrupting the country. We are running it into debts that it will take years to pay off because we are obsessed with a handful of supposed experts—I say “supposed” because I do not think they are. I also do not think that we can continue to bankrupt the country, which is what we are doing.

I am sorry for those in the Labour Party, but their answer is always, “Give us a chequebook”, and never, “Let us sort out how to get back to normal.” That is what I want to see. I also want to see something that has been alluded to many times in the debate, which is an end to the withdrawal of civil liberties and the chip-chipping away at everything that we stand for. Let me say this: half of the people of the city I live in, which is Cambridge, do not understand the regulations. The other half who do are interpreting them in their own way—and that does not necessarily mean that they are obeying them, because many are not doing so. The Army is now involved in vaccinating people. We are beginning to look like Poland in the 1980s and we need to step back from this. Will the Minister please take tonight’s debate as a serious contribution?

Also, and finally, we must stop persecuting people. Some 45 years ago, I first met Mr Piers Corbyn. When Labour had a leader called Jeremy, people used to say, “What do you think of him?” I would always reply, “You should meet his brother.” What I will say is this: you cannot conduct society on the basis of persecuting a handful of loonies who run around demonstrating. Please stand back, think about it, calm it down, and start all over again.

[The Deputy Speaker (Baroness Garden of Frognal) (LD)]

The noble Baroness, Lady Hoey, and the noble Lords, Lord Shinkwin and Lord Moylan, have withdrawn so I now call the noble Baroness, Lady Jolly.

Face-to-Face Medical Appointments

Lord Balfe Excerpts

Thursday 19th November 2020 Lords Chamber

Asked by

[Lord Balfe]

To ask Her Majesty’s Government what progress they have made towards the return to face to face appointments on demand for medical patients.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, face-to-face GP appointments increased from 10 million in August to 15 million in September. I should like to take this moment to thank those who have worked hard to restart primary care and serve patients in difficult circumstances. But I should also flag that the proportion of consultations by phone and video is currently running at around 40% and, for many people, this represents a safe, convenient, low-stress, low-cost and hygienic way to get the clinical engagement they need.

[Lord Balfe (Con)]

My Lords, I thank the Minister for his response and note that public trust in the Government is not rising at the moment, and that many people feel that the absence of effort to get medical practice back to normal is a contributory factor in this. Will the department make it a priority to get face-to-face appointments back to the level that they were before? If it cannot, the Government will find that trust declines even further.

[Lord Bethell (Con)]

My Lords, I thank my noble friend for his comments and reassure him that the Government are absolutely focused on the restart programme. The chief executive of the NHS has written to GPs, emphasising the absolute and primary importance of face-to-face appointments, for exactly the reasons that my noble friend knows full well. I also emphasise the enormous response that we have had from the public, and that we are meeting exacting targets for those face-to-face meetings. I also emphasise that new technologies and techniques have been very much welcomed by the public. Telemedicine, and telephone and video consultations, have proved to be extremely popular and helped to increase the number of appointments last month compared with this time last year.

Personal Protective Equipment: Procurement

Lord Balfe Excerpts

Thursday 19th November 2020 Lords Chamber

[The Deputy Speaker (Lord Haskel) (Lab)]

The noble Baroness, Lady Jolly, has withdrawn, so I call the noble Lord, Lord Balfe.

[Lord Balfe (Con)]

My Lords, the report does not make for happy reading, to put it mildly. There is a perception that the reality is some way away from where the Minister thinks it is. That may be fanned by the press, but the image of a tawdry chumocracy is to the fore in many newspaper reports. There were five recommendations in this report, all of which would benefit from the disinfectant of sunlight. My question to the Minister is quite simple: will the Government accept, implement and investigate the five recommendations?

[Lord Bethell (Con)]

My Lords, I encourage my noble friend to look beyond newspaper reports. The reality is—

[Lord Balfe (Con)]

No, it is in the report.

[Lord Bethell (Con)]

I ask my noble friend to look beyond newspapers for his analysis of the report. I take the five recommendations very seriously. They are encouraging and ally absolutely with the Government’s values. We will look at how to implement them in due course.

Medicines and Medical Devices Bill

Lord Balfe Excerpts

Committee stage & Committee: 5th sitting (Hansard) & Committee: 5th sitting (Hansard): House of Lords
Wednesday 11th November 2020 Grand Committee

Further extending prescribing responsibilities could help those people better to support vulnerable groups of patients who need to minimise contact with healthcare professionals, I believe that the arguments for the new clause are overwhelming. Much of the work to achieve its aim has already been undertaken, so there should be no delay. A commitment to bring back a proposal and a timetable for implementation is completely reasonable, so I hope that the Minister will respond favourably to the amendment, which proposes to insert a new clause in the Bill.

[Lord Balfe (Con)]

It is a great pleasure to follow the four noble Lords who tabled this amendment, all of whom are working from exactly the same brief as I am—I can tell that from the quotes. First, I should declare an interest: I have not been present in Committee before, but am here as a former president of the British Dietetic Association, a TUC-affiliated union. The Bill was published during the dying days of my presidency and I undertook to speak in support of the proposed new clause.

I have nothing substantial to add to what has been already been so ably said by colleagues. I will just point out that dieticians are one of the groups seeking to extend this, and people often misunderstand what dieticians are for. The number of times I have been asked whether I am associated with Weight Watchers has rather driven me insane, but dieticians are actually more involved with undernutrition than overnutrition. Although people think of obesity and what are now the more popular things, the biggest challenge facing the average dietician is a person probably over 80 years old, almost certainly living alone and generally not caring for themselves. So the role of a dietician is often to get people to eat a balanced diet. They work in hospitals and in the community, and with other health professionals, particularly in developing clinical management plans. That effort would be reduced if this proposed clause were accepted.

Points about dieticians and others have been extensively made. I understand that

“within three months of this Act being passed”

is a big ask, but also that, unless we ask for something, we will probably not get anything at all. The noble Lord, Lord Bradley, has already quoted the Minister at Second Reading saying that they were

“considering across all non-medical groups … where there is a need to consider undertaking formal consultation on potential amendments to prescribing responsibilities”.—[Official Report, 2/9/20; col. 432.]

I realise that, at the time of Covid, there is a huge number of demands on the Minister’s department and the staff therein but, overall, if this can be made to work, it will benefit and increase the productivity of health professionals. So, in associating myself with the previous speeches, I also encourage the Minister to give as positive a response as he is able to. I am sure that, if we extend prescribing rights, we will be benefiting many patients and the medical profession. We will also be enabling many health workers to play a more effective role in the care of their patients.

[Baroness Jolly (LD) [V]]

My Lords, I support Amendment 49 in the names of the noble Baroness, Lady Thornton, and the noble Lords, Lord Hunt of Kings Heath, Lord Ramsbotham and Lord Bradley. It mandates the Secretary of State to publish proposals and a timetable for additional healthcare professionals to be given appropriately restricted prescribing rights. As other noble Lords have said, for well over 20 years, some appropriately trained nurses have been prescribing from a restricted list. I see no reason why, as the noble Baroness, Lady Thornton, described, appropriately trained allied health professionals and others, working from a list of approved medicines commensurate with their profession, should not do the same.

This is entirely appropriate at the moment, when it is not always easy to access a GP. We have seen how successful giving prescribing rights to both community and practice nurses has proven to be. Patients are becoming more willing to have appointments with AHPs and nurses, rather than GPs, which frees doctors to concentrate on patients requiring more experience, such as those with unusual or complex conditions. This is a win-win amendment and I heartily commend it.

Covid-19: Vaccine

Lord Balfe Excerpts

Wednesday 11th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have extremely detailed and thorough arrangements for our borders on 31 December. No problems are envisaged with regard to the vaccine.

[Lord Balfe (Con)]

My Lords, I draw attention to the bit of the Question that says:

“distribute approved coronavirus vaccines in the UK and internationally”.

There is a great danger in the international distribution that corruption will creep into the system. Can the Minister assure me that the Government will co-ordinate with the EU and like-minded international aid agencies to ensure that corruption is avoided and the vaccine that we donate is delivered for free to vulnerable groups in countries overseas?

[Lord Bethell (Con)]

My noble friend makes a very reasonable point. The marketplace for vaccines is extremely competitive. The British Government have been emphatic in our commitment to CEPI, Gavi and the other vaccine organisations. The COVAX advance market commitment aims to produce 1 billion doses for high-risk populations in 92 developing countries in 2021. We support that initiative enormously and work with other partners to ensure the fair and equitable distribution of vaccines around the world.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Lord Balfe Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Balfe (Con)]

My Lords, this is not the first time I have said in this Chamber that the Government need to fundamentally rethink their position. We are asked to believe that the rate can be pushed down by closing churches, John Lewis, bookshops, gyms and swimming pools but leaving open Tesco, Sainsbury’s, Marks & Spencer and the Co-op. I have very good news for the noble Baroness, Lady Smith. My wife was in the Cambridge branch of M&S yesterday to buy some tights before lockdown; they assured her that they would be packing as many clothes as possible into the grocery section so that it would still be possible to buy tights and so on. Are this Government sponsored by Amazon or by Deliveroo? Which is it, or is it both?

Some 40,000 people have died, and we are now told that another 80,000 are going to die. What have we been doing for the last six months? The Government need to go back to the drawing board and call in people such as Professor Heneghan and other scientists to look more carefully at the numbers.

I recently spent four days in Stockholm. They have the same problem as we do, but they have dealt with it very differently. Stockholm has not locked down its economy; the death rate is lower than ours and it is managing to carry on. A lot of sensible social distancing precautions are in place; most of the museums are closed, but not the economy. As you walk around, you do not get this feeling of dread, with everybody looking like frightened little mice. I ask the Government to look at resetting their strategy.

My final point is this. If there is a vaccine, the consequences will still have to be dealt with. The virus might well mutate. After all, the flu virus mutates—you need a flu jab every year. We seem to be talking about a vaccine as though it will come down from heaven like manna, we will consume it and we will be protected for ever. It will not work that way. The virus will manage to mutate, and we will have this problem with us for a very long time.

At the beginning of this debate, the noble Lord, Lord Robathan, talked about causing national self-harm. I honestly believe that we are talking ourselves into a corner because we are refusing to consider the basis on which we are working. That basis is wrong and it needs to be looked at again.

Covid-19: Intensive Care Treatment

Lord Balfe Excerpts

Thursday 29th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not know whether that specific instruction has been withdrawn; I will be glad to write to the noble Lord on that. I reassure him that, during an epidemic of a highly contagious disease, a hospital might not be the safest place for someone who is ill in a care home; nor would it necessarily be the safest place for someone who has gone to their GP and is sitting in the GP’s surgery. It is therefore absolutely essential that clinical risk management and advice is sought before referral to a hospital. There is no prejudice or unfairness here: it is simply good clinical practice.

[Lord Balfe (Con)]

My Lords, the Sunday Times has form on inaccurate stories, as does the Telegraph. Indeed, I asked the Minister a Question on 21 September about a Telegraph story about age restrictions, and he assured me that there were none. I asked him

“will he agree to place a copy of all the circulars from DHSC in the Library so that we can see what is going out?”

In reply, he said

“I will inquire as to what we can possibly share, so that these decisions are as transparent as my noble friend wishes”.—[Official Report, 21/9/20; col. 1596.]

I think it would help keep the papers on the right track if more was put into the Library. Will the Minister tell me how he is getting on with his endeavours to get this information into the public domain?

[Lord Bethell (Con)]

My noble friend is entirely right to chase me in this matter. I remember the commitment very well and I will endeavour to find out from my colleagues at the department how they are doing in getting those important papers into the Library.

Cancer Task Force

Lord Balfe Excerpts

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

The concern is serious. However, I reassure the noble Lord that although those waiting longer than 62 days for an urgent GP referral increased to about 21,000 between the end of March and the end of May this year, it now stands at about 8,000, which represents a dramatic decrease in the backlog. We have invested in the “Help Us Help You” campaign, which is directed specifically at those who are most at risk from cancer. It is a massive campaign that we are rolling out shortly, and we will continue to invest in it if that is needed.

[Lord Balfe (Con)]

My Lords, calculations by the charity Action Radiotherapy suggest that the cancer treatment backlog may cost more lives than the coronavirus itself—indeed, it estimates that it could be as high as 100,000. Can the Minister give us details—and if not, can he place them in the Library—of the investment in and expansion of radiotherapy services that is being considered and of the aim to reduce the number of machines that are beyond their 10-year lifespan?