Flu Vaccination and Blood Test Cancellations

Lord Brooke of Alverthorpe Excerpts

Tuesday 14th September 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I reassure the noble Lord that we have strained every sinew to deliver the most impactful flu vaccination programme in the history of the country. We have expanded the range of the flu vaccination and the number of vaccinations available. The NHS depends on us keeping people out of beds. That is why we are highly focused on this.

[Lord Brooke of Alverthorpe (Lab)]

Will the Minister answer the question asked by my noble friend Lady Thornton about the BMA’s feeling sufficiently concerned that it suggested a meeting of COBRA? COBRA could have discussions with the Armed Forces and perhaps we could use some of their drivers. There are answers to some of these problems.

[Lord Bethell (Con)]

This is not a driver problem; it is a delivery problem.

Calorie Labelling (Out of Home Sector) (England) Regulations 2021

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd July 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab) [V]]

My Lords, I am grateful to the Minister for in effect taking up much of my speech, so I will not repeat it, because I would be speaking broadly in favour of what the Government are endeavouring to do, but arguing, as I have done in my amendment, that they have not gone far enough. The Government’s Achilles heel is that they do not yet move on labelling on calories in sugar and in alcohol, and the Minister quickly skirted around that topic.

Before coming to my arguments, I want to express that I greatly sympathise with many of the arguments that the noble Baroness, Lady Bull, has advanced. I have a lot of experience in this field; I have a friend whose daughter recently committed suicide and I have another friend who presently has a granddaughter seriously ill in hospital. It is a growing problem and is not easily resolved.

On the other hand, we have this massive problem with obesity, and we cannot deny it. Covid has driven it home more forcefully than ever before. Close to 130,000 people have died from Covid, many of them with underlying conditions linked directly to obesity and, in particular, to type 2 diabetes. NHS data indicates that 26% of those who have died had type 2 diabetes.

I speak as someone with a little experience; I am on the cusp of type 2 diabetes. The NHS has put me on a nine-month course to try and get me to change my eating habits, particularly in relation to the amount of sugar I consume. Part of that has been about me checking what I am eating and drinking, what its calorific content is, and what the sugar element is. So I welcome a step that moves towards greater openness and gives me the information I need to try to avoid becoming a type 2 diabetes patient. That is possibly on the cards if I do not take the appropriate steps.

There is no simple solution to obesity; I freely concede that. A whole range of measures have to be addressed in different ways. Small steps will make up a big leap forward. Regrettably, sometimes when we are trying to find solutions and we are all working with similar problems, we end up with contradictions and conflicts. Today we have a degree of conflict arising. It is not easy to find harmony and the only way we will do it is by continuing to talk to each other and trying to move forward in a friendly and comradely way.

I believe the Minister has fallen short with the regulations that he has produced. They do not go far enough. The Government know perfectly well that, of the calories obese people consume, 10% come from alcohol, yet they consistently resist displaying sugar and calorific content on labels for drinks. When this comes into play in February next year, you will be able to go into a restaurant and see what the calorific effect will be. You will be able to see what the calories are in food and in any non-alcoholic drink you may have—a fizzy or non-fizzy drink—and how much sugar is in it, but, if you pick up a pint of lager, you will have no idea what effect it will have on your health and well-being, or whether it is contributing to obesity. That must change. The Government must break their link with the powerful drinks industry—and before long they will have to. They know in their heart that they must do it, and the sooner they address the issue, the better for the country as a whole.

--- Later in debate ---

Tabled by

[Lord Brooke of Alverthorpe]

At end insert “but that this House regrets that the Regulations do not extend to alcohol, even though mounting evidence shows that it is a significant contributor of co-morbidity and obesity, one of the major underlying causes of the nation’s 128,481 COVID-19 deaths, the highest number in Europe; and calls on Her Majesty’s Government to require the publication of the calorie content of alcohol by the end of 2021 in order to improve the people’s well-being and good health.”

Amendment to the Motion not moved.

NHS Update

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd July 2021 Lords Chamber

[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.

[Lord Brooke of Alverthorpe (Lab) [V]]

My Lords, I welcome the Minister’s offer to meet the noble Baroness, Lady Hollins, to discuss her devastating report. We should be ashamed to see the way some of our people with learning disabilities and our autistic young people have been treated. I would like to know whether the Government’s action plan can give some realistic dates on when there is likely to be proper service and support given within local communities and within homes that should be created for them.

Secondly, on Covid generally, I have been double-jabbed with Pfizer, so it is unlikely that I will go into hospital, but I have Covid. I would like to pick up on the question from the noble Baroness, Lady Brinton—what are the figures for the number of people who have had their vaccinations but are now starting to suffer from Covid? This is not flu; it is quite different from flu. You get the jab for the flu and you stay clear of it. With this, you get the jabs but you can get it just the same—and I have been suffering. Why are the Government giving mixed messages that people are now going back to normal? This is just not the case. We are sending out mixed messages and giving the impression that we have this “freedom day”. Yes, there will be freedom, but there will be freedom to spread on a scale that we have not experienced latterly. So I hope the Government will be cautious with the mixed messages they have been issuing and they will underline that having the double jab does not necessarily mean that people are clear of catching the disease.

[Lord Bethell (Con) [V]]

The noble Lord has my profound commiserations. It is an extremely tough and nasty disease, as he rightly points out. Even for those who have had two jabs, if they get the disease it can still be a really horrible experience, which he has at this moment.

He is not quite right, though, on the mixed messages. We have been crystal clear from the very beginning, even before the first vaccine arrived, that the vaccination was not going to be a panacea in itself. It will not prevent all people from getting all Covid diseases for all time, immediately. These things are incremental. The societal impact of the vaccine is to drive down the infection rate to the point that R is below one; that is the objective. But, in the meantime, those who have had the vaccine not only remain infectious but can be heavily symptomatic, and I am very sorry for the position he is in. Incidentally, that is also true of the flu vaccine; it is not a 100% vaccine, but it does an enormous amount to break the chain of transmission and to reduce the spread of flu on exactly the same basis.

Women’s Health Outcomes

Lord Brooke of Alverthorpe Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I join others in expressing my gratitude to the noble Baroness. She is a great campaigner and is prepared to reach out across all Benches. That is much required with the problems we face.

I think I am probably the first to mention football, but I mention Denmark and congratulate it on the work it does with women. Denmark ranks the highest in the whole world in presenting a community in which women have equality; it respects and does not abuse women. Women are treated as well as men at work and in health terms. It is a great country and should be proud of what it has done.

We could learn a lot from Scandinavia about how we treat each other, and in particular how we treat women. Look at what Denmark does with justice—restorative rather than punitive justice, which we engage in so much in this country. Do noble Lords know that Denmark does not fill its prisons? In fact, it invites neighbouring countries with a surplus of prisoners to send them to Denmark. That is because of the way it approaches its problems.

Similarly, we find that Denmark deals with issues we have here, where women are abused because of alcohol—that and a whole range of other topics were mentioned earlier—in a quite different way. We really ought to learn that we should visit others and invite them here to try to help us with some of our problems. Basically, I think it does so well because, as in other Scandinavian countries, the inequality in wealth is so minimal by comparison with what we experience. We cannot run away from that.

My noble friend Lord Rooker and the noble Baroness, Lady Greengross, raised Sir Michael Marmot’s continuing work on inequality and the need to get incomes and salaries closer together, in the way that we had 30 or 40 years ago. This is fundamental to health and so many aspects of what happens in society. I look to the Minister to see whether the Government are doing work on it.

This morning I listened to Nadine Dorries talk on a Zoom exercise about the coming review. There have been 112,000 responses to the strategy. Like others, I look forward to seeing whether something positive comes out of it and that we have attached to it a firm action programme.

Like others, I spoke on the great report from the noble Baroness, Lady Cumberlege, but when is the action coming? What are the Government going to do with that? When will we see the action programme presented to the House?

Social Care and the Role of Carers

Lord Brooke of Alverthorpe Excerpts

Thursday 24th June 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the noble Baroness, Lady Jolly, for giving us this debate, and for the contributions made by other noble Lords. In particular, I picked up what the noble Baroness said about care homes and the number of unfilled beds. Having watched television and seen people who have gone through the difficulties of Covid, I am not surprised that many questions are now being raised about care homes and what people should do with their loved ones. Looking to the longer term, maybe we should ask whether people working at home, being remunerated at home and, in turn, caring for loved ones there is the way forward. The best quality of care we can give anyone—young or old—is love. In the first instance, this comes primarily from family members and friends all around.

The right reverend Prelate the Bishop of Carlisle set a challenge. I was interested to hear that the Church is looking at this. I hope that it will be radical. A radical solution is available, though the Government would certainly not embrace it. Back in the 1990s, the Government would not embrace the national minimum wage. We now need to move towards a universal basic income. In due course, we shall be faced with AI and a lot more people will be unemployed. Many more will want to work from home. Many would be willing to spend their time caring for and looking after loved ones if they were remunerated, as the noble Lord, Lord Monks, has just said.

I am looking for a radical response in the longer term. If the Government do not have that within them, I would hope that my own party might start looking at something as radical as a universal basic income. We might try to start a conversation with the Lib Dems, the Greens and the SNP, as well as with Cross-Benchers. We should bring together a crowd of people who see that we need really radical and fundamental solutions that address future changes and some of the lessons that we have learned from Covid.

There needs to be a levelling up, and levelling up means a redistribution. The noble Lord, Lord Rooker, spelled out very clearly the whole range of available options. There are many more. We cannot run away from it. If we are to do the job and care for people properly, we have to pay for it. Those of us who can afford to pay should do so willingly and be prepared to see that the problems of the past are not repeated. When AI comes in the future, much money will be spent on unemployment benefit. That could be redirected into a positive return, which would be about better lives at home, people working from home and looking after their loved ones.

Office for Health Promotion

Lord Brooke of Alverthorpe Excerpts

Thursday 29th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am grateful to the Royal College of Nursing and the noble Baroness for that extremely constructive and thoughtful suggestion. That is exactly the kind of cross-government, inter- departmental suggestion that the OHP will focus on. I will be glad to take that to the OHP and make it clearly.

[Lord Brooke of Alverthorpe (Lab) [V]]

Does the Minister agree that, whichever office is in charge of it, any successful obesity strategy must engage with the so-called hard-to-reach groups in society? As many play the National Lottery, scratch cards and so on, will the Government consider how this link might be used to incentivise and reward players for moves to better and healthier eating, drinking and exercising? As the National Lottery franchise will soon come up for renewal, will the Government consider changing its remit so that it is more focused on health than at the moment, or even consider taking a stake and creating a public/private partnership with a focus on not just cash prizes but better health rewards for the nation?

[Lord Bethell (Con)]

My Lords, Covid has been an extremely important educational experience; we have backed off from using the idea of “hard to reach”. Instead, we try to be much more effective at making ourselves approachable for the kinds of people the noble Lord talks about. He is entirely right that the levelling-up agenda means nothing if it does not mean levelling up health outcomes; we are very focused on addressing the kind of health inequalities he refers to. That will be a central mission of the whole project.

Alcohol Harm Commission: Report 2020

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd April 2021 Grand Committee

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am most grateful to my noble friend Lady Finlay for her powerful introduction. I declare an interest as one of the members of her commission, which she so admirably steered to producing such a wonderful report.

In the limited time that we have, I want to focus on calories. I have been banging on about calories since the Labour Government were in power and about the need for calories to be shown on labels for alcohol. Why is the drinks industry exempt from telling people what they are consuming and what it might do to them?

I am pleased that we are starting to make some progress. There is a firm recommendation in this report and I hope that the Minister will be positive. One of the old excuses for why we could not do anything was that we were in the European Union and legislation and regulations there prevented us from acting unilaterally. We have now come out of Europe and we now have the freedom to do as we choose. I look to see whether the Minister will take sides on this issue, now that he has the freedom to do so, if required.

I had a useful conversation this morning with Sir Keith Mills, who has been appointed by the Prime Minister to review the way in which incentives might be used to encourage people to reduce their weight and exercise more. He is looking at new technologies; there are some developments taking place that are of some significance. I see that the Minister is nodding in agreement, so perhaps when he comes to respond he might say a little more about that. A change would allow an app, on our mobile or on our wrist, to tell us, for all items that have calories marked on them, just what we are purchasing. We would know what is in our shopping basket while still in the supermarket. That would be a big change. We should not permit the drinks industry to be exempt from that change.

I hope that the Minister will assure us that the consultation will be concluded soon and the Government will come out with a strong indication that, for the first time ever, we will have formal labelling on alcoholic drinks.

Body Mass Index

Lord Brooke of Alverthorpe Excerpts

Thursday 22nd April 2021 Grand Committee

[Lord Brooke of Alverthorpe (Lab)]

My Lords, I am grateful to the noble Lord for tabling the Question. We may be debating some of these broadly related issues in even greater depth in the future, because the facts of life are that we have one of the unhealthiest populations in the whole of Europe. We now have some opportunities to review what we have been doing and what we might need to do in the future to improve our health. I have been given a good briefing by Diabetes UK, and I express my gratitude to it because I am one of those on the cusp of developing type 2 diabetes. That has been identified by two factors: a blood test and a BMI measurement with my doctor.

Without any doubt there are problems for those with eating disorders, and we need to address them, but we must be careful to ensure the right balance in dealing with the country’s health problems. The reality is that we have a greater problem—the numbers are much bigger—with people with excess weight than with those with too little weight.

While we acknowledge that there can be challenges in using and interpreting BMI as a measurement, as the noble Lord pointed out, the call for it to be scrapped could negatively impact on the care of those such as myself who are at risk of diabetes. Used appropriately, BMI can provide valuable information for care focused on individuals that does not discriminate against anyone. It is important that healthcare professionals take a person-centred approach to discussing weight and health, use appropriate language and consider the use of BMI based on individual circumstances. There are instances where the use of BMI may not be appropriate, so healthcare professionals should take a person-centred approach to weight and health. We hope that the integration of care outlined in the White Paper will boost the role of personalised care.

BMI is also an important tool for monitoring the population’s overall health and informing policy decisions. If we do not have that, we have to know what the alternative is to be able to make such assessments about the state of the nation’s health. Most recently, BMI data has been fundamental in the rollout of the QCovid population risk assessment, which identified 1.7 million people at increased risk of hospitalisation and death from coronavirus and enabled them to be added to the shielding list in March 2021. Without the use of BMI, that kind of population-based intervention would not have been possible and many lives would have been put at risk. I argue that we must retain what we have at the moment until something better is found.

Covid-19: One Year Report

Lord Brooke of Alverthorpe Excerpts

Thursday 25th March 2021 Lords Chamber

[Lord Brooke of Alverthorpe (Lab)]

My Lords, it has been a while since I was last here, but I am very pleased to come in today to support my noble friend Lady Thornton. I am sorry that the Minister is not here, because I wish to thank him for the hard work he has consistently put in for so long in such difficult circumstances.

We have to recognise that no Government in the world have got this right—we have all been in an unknown area and, yes, mistakes have been made—and we need to review it. If the Minister were here, I would ask him about the width of the review, which I think is going to be very important for us. One of our big problems in this country, compared to other European countries, is that we are fatter than most of the others. That has been a big factor in the number of deaths, and it cannot be ignored. Who is responsible for that? Another factor that has emerged is that we are very short of data, and we are now finding out how important it is to have that data. Had the coalition Government—the Lib Dems and Conservatives—not abolished the work of the Labour Government on an identity being produced for each individual, we would have been in quite a different position now to cope with this disease in a better way than we have been, rather than just finding our way. Are they going to look at that and see the failings in framework, where previous policies have been abandoned by previous Governments? I hope it is going to be a wide-ranging review and that we are serious about it and not just making excuses.

Like the noble Lord, Lord Lansley, I like to look to the future rather than the past. The one thing that has changed is that, being away from here, I feel more like an ordinary citizen. I get the sense and the feeling they have—in that so much of what we talk and argue about is irrelevant to them. They are not interested. The questions I am being asked are: “Why is America now going to one-metre social distancing? It’s such a big country; is it the wisest thing to do? Are we looking at the evidence on that? Will we be following it? If so, when can we expect to move down to one-metre distancing only?”

Secondly, on face masks, there have been a variety of views held on them over the time since Covid appeared. At the start, the World Health Organization and Centers for Disease Control and Prevention said, “You don’t need them”, and then they changed their minds. Now there is further evidence coming out in other quarters that we may not necessarily need to use face masks as widely as people have been led to believe. I would like to hear from the Government on what the latest position is. There is concern and confusion about where face masks should and should not be worn. They can cause trouble between citizens, where one is taking another to task and so on. It is important that we get the rules very clear and we get some clarity for the foreseeable future, where we may be looking to relax mask wearing in certain circumstances yet continuing to require their use in others.

Thirdly, I congratulate the Government on the work they have done on vaccination. We can all come together on that and say that there have been problems in other areas, but at least in this one we have made good progress. Thank God we are not in the EU queue, waiting for our turn for vaccines to be doled out in accordance with what Brussels has decided. Some of us might have voted to put ourselves in a position where we would have been in that queue. We have to learn the lessons of what has happened.

Making sure that everybody is fully protected is very important. That leads me to illegal immigrants, of which we have a substantial number in the country according to LSE research and other organisations. Again, because we do not have very good data, we do not know the numbers, but the figures bandied around range from 400,000 to over 1 million. If these people are not vaccinated, that is a very big hole in the dam wall and a risk for others who have been vaccinated or not fully vaccinated. I would like to know from the Minister what the Government will be doing about the people below the radar who are not lined up to be vaccinated, who are not within the system for tax or registered with GPs. This is an important number, and we need to know that steps are being taken to ensure they are brought in. We could have an amnesty for them. This could be an opportunity to do that, so we can get some real data on what is happening in the country.

I have posed three questions there for the Minister. I will conclude on a positive note: I think we will have a good summer and we should make the best of it, but we may have troubles in the autumn and should learn all the lessons we can. When climate change comes, this will be seen as a dress rehearsal compared to the problems that will bring.

Future of Health and Care

Lord Brooke of Alverthorpe Excerpts

Tuesday 23rd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I start by paying an enormous tribute to the 11,251 community pharmacies for the work they do day in, day out, and in particular their contribution to the vaccine rollout. I remind my noble friend that £370 million has been made available by the Government in increased advance payments to support community pharmacies with cash-flow pressures caused by the pandemic. The community pharmacy contractual framework—the five-year deal—commits £2.5 billion annually to the sector. Non-monetary support has also been provided in recent months, such as the removal of some administrative tasks, flexibility in opening hours, support through the pharmacy quality scheme, and the delayed introduction of new services. I am afraid I do not quite recognise the figures my noble friend cited on the closure of pharmacies, but if he would like to write to me, I would be very glad to look into them more closely.

[Lord Brooke of Alverthorpe (Lab) [V]]

My Lords, the White Paper refers to the NHS problems with obesity. I make no apology for introducing this topic, because obesity is one of the major underlying causes of Covid deaths, but it is rarely raised in the direct communication between the Prime Minister and Professor Whitty and the population in the No. 10 conferences. As World Obesity Day approaches on 4 March, will the Minister speak to the Prime Minister or Professor Whitty and see if we could have this fundamental topic raised as an indicator that this is where cost savings can be achieved and we can get better health, if we work on it?

[Lord Bethell (Con)]

The noble Lord is entirely right: obesity is not only a major issue, it is specifically cited in the Bill, where we have clear measures to try to address it. I do not need to raise it with the Prime Minister or the CMO because they both take it incredibly seriously. The Prime Minister has spoken movingly about his own challenge when he caught Covid—the five stone by which he feels he was overweight, the impact that had on his life chances, and how close to death he came because of obesity when he went into hospital. That was a metaphor for the whole country, and that is why we have launched a major obesity strategy in respect of marketing and advertising. It is why we remain committed to the obesity strategy, and more measures will be rolled out during the course of the year. I am extremely grateful to the noble Lord for reminding me about World Obesity Day on 4 March, which we will be marking very seriously with a publicity campaign.