NHS Update

Debate between Lord Bethell and Lord McNicol of West Kilbride

Thursday 22nd July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I am enormously grateful to the noble Baroness for her hard work in this area. We are taking a range of actions to drive further, faster progress on reducing the number of autistic people and those with learning disabilities in in-patient mental health settings, including robust action by the CQC, work on our new cross-government “building the right support” delivery board, and reform of the Mental Health Act. I would be very glad to meet the noble Baroness and her colleagues to discuss these and other measures in more detail.

[Lord McNicol of West Kilbride (Lab)]

I declare my interests as set out in the register. My Lords, Ministers rightly come to these Chambers and praise NHS staff for all they have done throughout the pandemic, yet a third of NHS staff are considering leaving their job. Vacancies are endemic and, to top that, we have a looming summer crisis. For an average nurse, 3% is equivalent to £15.40 a week. Inflation removes £11.58 of that; so, for all the Minister’s kind words, in real terms that is a pay rise of £3.82 a week, or 55p a day, and less than half of that for a newly qualified nurse. Does the Minister think this is fair, and what does he think the nurses should do with their 55p a day?

[Lord Bethell (Con) [V]]

My Lords, I am also enormously grateful for the contribution of NHS staff at all levels and from all parts of the United Kingdom. This pay settlement is based on the recommendations of the pay review body. We said that that was the mechanism we would follow, and we are following it; in that respect, we are doing what we said we would. I reassure the House that recruitment to the NHS is extremely strong. We are hitting our targets on the recruitment of 50,000 nurses and our targets for GP trainees and in other parts of the NHS.

Covid-19

Debate between Lord Bethell and Lord McNicol of West Kilbride

Wednesday 21st July 2021 Lords Chamber

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

My Lords, I am enormously grateful for the thoughtful and challenging questions from the noble Baronesses, Lady Thornton and Lady Brinton. I will start by using a couple of their specific questions to illustrate, as clearly as I can, the strategy behind our approach and the challenges and limitations in what government can and cannot do.

When it comes to the app, this situation illustrates the difficulties of leaving an epidemic. I remember well the CMO talking about what happens to a country when it enters an epidemic; at the beginning of last year, he gave us an introduction and said how difficult it was when you are trying to make that transition. The challenge is of having a partially vaccinated population that has huge pressures to get on with life, while at the same this infection leaves many largely untouched by the virus—in fact, the largest proportion of people. That is exactly the kind of dilemma we are wrestling with.

With the app and the Government’s position on whether you have to isolate when you get pinged, isolation remains the most important action that people can take to stop the spread of the virus. It breaks the chain of transmission. There is no single better measure for breaking the spread of the virus than isolation, so it is argued that it is crucial for people to isolate when told to do so, either by test and trace or by the app. I can confirm that the Government’s advice is to isolate if you are pinged by the app although, as I have said previously, this is not captured in law.

Both noble Baronesses asked about policy on schools and why we emphasise Covid vaccination over LFDs for entry into venues. Those questions give me an opportunity, I hope, to be really clear about the strategy. It is to vaccinate a sufficient proportion of the country that the virus cannot spread so easily, and that R is brought below 1. When we have that moment, we can be more confident that the impact of the virus on hospitalisations, severe illness and worse will be brought under control. At the rates at which we are vaccinating, we are hopeful that we can reach that stage relatively soon.

There is no other plan; there is no way of beating the virus other than ensuring that the vaccination deployment is as effective as possible. That is why we are looking at ways to bring young people and those who are reluctant onside, by engaging them in dialogue, answering their questions and emphasising through our measures the critical importance of vaccination, particularly when sharing space with others in your community.

On vaccinating children, healthy children are at a very low risk from Covid-19, with their risk of death being around one in 2.5 million. No previously healthy child in the UK under the age of 15 has died from the pandemic in the UK, and admissions to hospitals or intensive care are very rare. That is why we are taking a cautious approach in this area. The JCVI will keep this advice under review as more safety and effectiveness information becomes available on the use of vaccines in children; for example, regarding reports of myocarditis as an adverse event following vaccination with Pfizer. However, we will be extremely energetic in looking at all avenues in this area.

We are also looking at booster shots. Following the publication of interim advice by the JCVI, the Government are preparing for a potential booster vaccination programme from September. The noble Baroness, Lady Brinton, asked what the state of the country will be in the autumn. That will in large part depend on the flu vaccine and on the Covid vaccine, which can be taken at the same time. We are working closely with GPs to ensure that that rollout is as effective as possible, because the resilience of the NHS depends enormously on the success of our dual vaccine rollout.

Lastly, the noble Baroness, Lady Thornton, spoke about the importance of keeping life moving. I do not know that phrase but I know that there is a huge backlog in the NHS. There are other profound impacts of our social restrictions and our lockdown measures on the health of the nation, the economy and our society. We cannot continue in this way for ever. There is value in trying to open up our economy and giving individuals the information to be able to make decisions for themselves. That is the inflection point we are at now. I have enormous sympathy for those looking for information on the best approach but I hope the direction of travel is crystal clear.

[Lord McNicol of West Kilbride (Lab)]

My Lords, we now come to the 30 minutes allocated for Back-Bench questions.

--- Later in debate ---

[Lord Bethell (Con) [V]]

My Lords, I make no apology for changing my mind during the pandemic. I will admit readily to the House that I have changed my mind and rowed back on all sorts of things that I thought I was certain about. It has been a learning experience, to put it politely, for all of us, and we have all had to adjust our thinking on lots of matters as the evidence and the impact of the virus have affected us greatly. So, no, I do not believe in conspiracy theories, as the noble Baroness specifically asked me.

We all have to be responsible for the fact that our health touches on those we sit next to and share air with. This is a public health truism that is self-evident and has become highly apparent. There is no way out of this pandemic other than through the vaccine; there is no other silver bullet. Therefore, we all have a personal responsibility to ensure that we are as safe as possible when we share space with other people. That is the principle with which we go into this and which we are applying when it comes to domestic certification. The guidelines and precise details have not been hammered out yet, but we will do it in a way that seeks to be as inclusive as possible and is considerate to many of the concerns that the noble Baroness quite rightly articulated.

[The Deputy Speaker (Lord McNicol of West Kilbride) (Lab)]

That brings us to the end of the Oral Statement. All questions have been asked.

Covid-19: Government’s Publication of Contracts

Debate between Lord Bethell and Lord McNicol of West Kilbride

Thursday 11th March 2021 Lords Chamber

[Lord Bethell (Con)]

We absolutely endeavour to fulfil the Cabinet Office guidelines on the publication of contracts, and I can provide that reassurance to the noble Baroness. It is my understanding that the structure of test and trace has been published. I will look into finding a link to that and would be glad to send it to her.

[Lord McNicol of West Kilbride (Lab)]

My Lords, it feels a bit like déjà vu. The Minister complained on Tuesday about my use of rhetoric. At the end of this, he might wish that I had stuck to rhetoric rather than moving on to facts, so here are some facts. Fifty million facemasks could not be used as they did not meet the specifications: fact. Britain’s safety watchdog felt political pressure to approve the use of PPE suits: fact. One million hybrid masks were withdrawn as unusable: fact. There was contract inflation of 1,392% for the same product: fact. The Government have got this wrong, and I would simply ask: if they have nothing to hide, will they put all the facts about the contracts into the public domain?

[Lord Bethell (Con)]

My Lords, there was a global epidemic: fact. There was a breakdown in the global supply chains: fact. There was a need for PPE on the front line of healthcare: fact. We were prepared to do whatever it took to make people safe: fact.

NHS: Pay

Debate between Lord Bethell and Lord McNicol of West Kilbride

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the percentages are unbelievably complicated. It is difficult to stand by one single number to represent pay that goes to hundreds of thousands of different nurses under different circumstances. However, I agree completely with my noble friend. What is at stake here is not just one pay rise in one year but the entire package of circumstances in which nurses do their job. We are determined to ensure that that workplace package is as good as it can possibly be. We acknowledge that there are cultural challenges of working in the NHS, which we are fighting hard to improve. We recognise that training opportunities for nurses should be better and we are working hard to improve those. We recognise that nurses have little capacity for holidays, which is why we are recruiting a very large number of new nurses. It is the entire package that we are focused on, which is why we have put forward the affordability argument as we have.

[Lord McNicol of West Kilbride (Lab)]

My Lords, Ministers have time and again stated that supporting our nurses is a top priority but, as unions have pointed out, an offer that amounts to £3.50 per week looks more like a kick in the teeth than a top priority. I am sure there is one thing we can all agree on: nurses and other healthcare professionals have had to work in some of the most difficult, demanding and dangerous circumstances, and they have done so with astonishing care, compassion and commitment. The Government have got this badly wrong, and I urge them to reconsider their meagre, miserly, measly 1%.

[Lord Bethell (Con)]

My Lords, I reject the rhetoric of the noble Lord. We absolutely do support nurses, which is why we are focused on recruitment, training, culture and opportunities. It is not right to think that one pay rise represents the entire and sum contribution to the welfare of nurses. That is the response we get from nurses themselves, what the public understand, and what the Government’s guidelines are about.

Mental Health Services: Young People

Debate between Lord Bethell and Lord McNicol of West Kilbride

Thursday 24th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the digital gap in social care, particularly for older people, is enormous, and the noble Baroness is entirely right. NHSX has a large programme called Joined up Care, which is seeking to help bridge that gap. It includes, for instance, the provision of a large number of iPads to social care homes. However, the noble Baroness is right that that will not be enough to provide the care for those for whom digital access is simply too challenging or unavailable, which is why we will continue to support face-to-face and direct forms of care when necessary.

[Lord McNicol of West Kilbride (Lab) [V]]

My Lords, it should be alarming to know that suicide rates in the UK have soared to record levels, with the highest rates over the past two decades recorded at the end of 2019. I hope the Minister will share my concern that these alarming figures will only continue to rise post lockdown and that everything needs to be done to prevent that. Can the Minister say what Her Majesty’s Government are planning to do to tackle specifically the risk of increasing suicide rates post lockdown?

[Lord Bethell (Con)]

We are deeply concerned about suicide; any suicide is too many. The noble Lord will be aware that the increased numbers recently are in part due to the recategorisation of suicide among the coroners’ courts. Nonetheless, we take this issue very seriously. The programme to help people identify those who show the markers of suicidal thinking has provided a very important impact on this issue. We are deeply concerned about Covid, and we continue to support suicide charities.

Covid-19: Vaccine

Debate between Lord Bethell and Lord McNicol of West Kilbride

Thursday 19th March 2020 Lords Chamber

[Lord McNicol of West Kilbride]

To ask Her Majesty’s Government what steps they are taking to ensure that UK production facilities are able to develop and produce sufficient quantities of any vaccine for COVID-19.

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

My Lords, vaccine development is moving very rapidly but is still at a very early stage. The Government are working closely with industry to assess UK manufacturing capability for a range of potential new vaccines. The type of capacity and specific route needed to take this further will be determined by the technology used to produce the vaccines and the types of vaccines produced.

[Lord McNicol of West Kilbride (Lab)]

I thank the Minister for that Answer. The Question is about not just the production of vaccines but the production facilities to mass-produce them. Understandably, the priority now must be supporting those infected and the front-line staff with the production of ventilators. However, we should be planning for what comes next, as the Minister said, and the development of vaccines is part of that. What discussions have been had, or decisions made, between the Government and UKRI about scaling up? When we get the vaccine, that will be fine, but what about the ability to scale it up? We will need to build the factory now; normally that comes after. Can we explore a little further whether the work on scaling up is happening, as well as the development of the vaccine?

[Lord Bethell]

The noble Lord, Lord McNicol, is entirely right to focus on the importance of vaccines. The Government are extremely concerned that the entire public have a clear line to having confidence that they can rid themselves of the threat of the virus so that we can all get back to work and normal life. That will not be possible until we have a vaccine. If I may digress for a moment, one consideration is that, for a vaccine to work, it will have to be taken by billions; for that, it must be as safe as houses. I contrast that with the vaccine for Ebola, where the death rate was at nearly 80% and a just-about-good-enough approach could be taken. However, the coronavirus has a relatively low mortality rate and the introduction of an added risk factor into the population is something we can avoid. For those reasons, the development of a vaccine is considered to be at least a year or 18 months off. However, the noble Lord is entirely right that planning for the production of the vaccine, when it is fully developed, is front of mind for the Government.

NHS: Data

Debate between Lord Bethell and Lord McNicol of West Kilbride

Tuesday 28th January 2020 Lords Chamber

[Lord Bethell]

The noble Lord, whose experience in this matter far outweighs mine, hits upon an incredibly important point. Public trust is essential in this area. Public awareness of the use of data remains very low and recent polling evidence suggests that engagement is not at the level that is needed. This represents a danger that the Government recognise, which is why we are doing everything we can to educate the public on the use of their data and to ensure that our partners are utterly explicit about the way in which data is used.

[Lord McNicol of West Kilbride (Lab)]

My Lords, in response to an earlier question, the Minister mentioned that income would be derived from the sharing of data. Does he have an estimate of how much of this income would be derived for the next financial year and—probably more importantly—to what use the money would be put, whether ring-fenced for the health service or put into general income?

[Lord Bethell]

The noble Lord asks an excellent question but I am afraid that those statistics are not available in my wonderful briefing. I will try to track down the numbers and write to him with whatever information is available.

European Union (Withdrawal Agreement) Bill

Debate between Lord Bethell and Lord McNicol of West Kilbride

Committee: 3rd sitting (Hansard) & Committee stage & Committee: 3rd sitting (Hansard): House of Lords
Thursday 16th January 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am enormously grateful for the opportunity to respond to the noble Baronesses, Lady Hamwee and Lady Miller, and to all noble Lords who have contributed to this debate on Amendments 37 and 44.

Amendment 37 refers to UK nationals in the EEA and Switzerland and protections to their state pensions and healthcare. I hope that the debate will provide a valuable opportunity to give some reassurances on some of the key and important points made by the noble Baronesses, Lady Hamwee and Lady Miller, and the noble Lords, Lord Shipley, Lord Steel, Lord Kerr, Lord Whitty, and other noble Lords.

The noble Baroness, Lady Hamwee, is quite right to state that confidence in the system is absolutely essential. This has been a difficult period for those who have felt, at times, that their benefits and arrangements might have been in jeopardy. The noble Lord, Lord McNicol, spoke movingly about the concerns of UK nationals in the EU, and EU citizens in the UK, who have cross-border lives and who are seeking reassurance that those healthcare and state pension rights will be protected. I reassure the House that that protection has been a high priority for the Government.

We have delivered certainty for the 1 million UK nationals that the noble Baroness, Lady Hamwee, referred to, and to the 3 million EU citizens in the UK, via the withdrawal agreement which we have reached with the EU. We have also reached a separate agreement on citizens’ rights which, in great detail, protects the rights of EEA, EFTA and Swiss nationals in the UK, and UK nationals living in those states.

Certainly, it is absolutely critical that people should feel at ease about their futures—the noble Lord, Lord Steel, touched on that point movingly. I will offer the crumb of comfort that he asked for. These agreements give citizens the certainty that they need about their rights going forward and ensure that they can continue to live their lives as they do now. That includes, importantly, the right to live, work, study and access healthcare; to receive an uprated UK state pension in the EEA and Switzerland, in line with the triple lock; and to access valued benefits.

I will tackle the question of the three-year period. I reassure the House that the uprated pension in these areas is not just for three years; that was a proposal floated under a possible no-deal arrangement. This is an uprated benefit for life. These are the key components of what I believe the noble Baroness is trying to achieve in her amendment. I make it clear to the House that these are already protected.

The Government have also gone further than the withdrawal agreement and the proposed new clause require, protecting the rights of UK nationals in the EU where it is unilaterally possible to do so. In April last year, the Government published a policy paper, Citizens’ Rights—UK Nationals in the EU, which supplemented the rights contained in the withdrawal agreement for UK nationals resident in the EU at the implementation period. I will give a few examples. In respect of family reunification when UK nationals return to the UK, there is an additional seven-year period from the end of the implementation period for UK nationals living in the EU to access higher and further education in the UK under home fee status, and with support from student finance. This offer on education has also been applied by the devolved Administrations.

I will address the proposed new clause in Amendment 37 and the specific arrangements referred to by the noble Baronesses, Lady Hamwee and Lady Miller. I reassure the House that the citizens’ rights provisions in the agreement already ensure that those who have made their lives in or plan to retire to the EU by the end of the implementation period will receive an uprated UK state pension in the EU and any associated reciprocal cover while they have the right of residence in that member state. The provisions of the agreement will protect approximately 500,000 state pensioners already in receipt of a UK state pension and approximately 190,000 UK state pensioners and their dependants for reciprocal healthcare cover across the EU, EEA, EFTA states and Switzerland.

The current arrangements go further than the amendment itself. The proposed new clause in Amendment 37 falls short of the protections offered by the agreements. That is because they ensure the protection of not only UK nationals currently in receipt of a UK state pension in the EU, but UK nationals resident in the EU who are not yet of state pension age but who might be considering retiring in the country in which they live: for example, someone who has retired early to the EU once they reach UK state pension age. I reassure those who, like the noble Lord, Lord Steel, are concerned about our EU friends. The agreements will also protect reciprocal healthcare for all those in scope of the agreements, regardless of whether they are UK nationals.

The noble Baroness, Lady Hamwee, asked about the aggregation of pensions and benefits. I reassure the House that all contributions today, made from whatever country in the EU or EFTA, and Switzerland, will be protected by the Bill. The noble Lord, Lord Kerr, referred to ongoing negotiations about those who look to make onward movements beyond the implementation period. I reassure the House that those negotiations are being carried out with energy and enthusiasm. I also reassure him that his EHIC card will be valid until the end of the year—as it will be for the Bethell family, including my four children, on our forthcoming holidays.

[Lord McNicol of West Kilbride]

The Minister said that UK pensions will be uprated “while they have the right to reside in that state”—I think I quote him correctly. But what if they move to another EU state?

[Lord Bethell]

Those parts of the pension that are already in the bag, as it were, will continue to be uprated, depending on where they move to. If they move to another area where there is a treaty arrangement, they will continue to benefit from the uprating arrangements relevant to the country to which they move. However, as my noble friend Lady Altmann referred to—a point I shall move on to—if they move to an area which does not have a treaty arrangement, their future contributions to the pot will be relevant to that country’s arrangements.