Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021
Lord Hunt of Kings Heath Excerpts(3 years, 6 months ago)
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Lord Hunt of Kings Heath (Lab)
My Lords, I echo the congratulations to my noble friend Lady Chapman on her excellent maiden speech. I agree that my party has hard lessons to learn.
I am going to have to agree with the noble Lord, Lord Robathan, when it comes to the issue of parliamentary scrutiny. That is twice that we have agreed with each other in the last three weeks, which is deeply worrying.
I want to reflect on the trenchant comments of the Secondary Legislation Scrutiny Committee. The SI that we are debating today has already been updated, as I understand it, by the amending Covid travel regulations Nos. 8 and 9. The Explanatory Memorandum provided with regulations No. 8, which we have yet to debate, was particularly poor, says the committee, and the DfT had to replace it immediately. As the committee says, when instruments are brought into effect immediately, it is even more important that their intent and effect be made clear to both Parliament and the public.
One would have thought that the lesson would have been learned but, according to the scrutiny committee, it has not. Regarding regulations No. 9, which we anticipate debating fairly shortly, it says:
“The Explanatory Memorandum was particularly thin … and the supplementary information provided remained opaque.”
The committee draws those regulations to the special attention of the House on the grounds that
“the explanatory material laid in support provides insufficient information to gain a clear understanding about the instrument’s policy objective and intended implementation.”
I am of course aware of the huge pressure on Ministers and their officials at the moment, and I support my noble friend in wanting a quicker and tougher approach to travel rules and quarantine. However—and this is the point that the noble Lord, Lord Robathan, was making—I also accept that we are putting severe restrictions on people’s personal liberties, and that is something that cannot be swept away. It is unacceptable if departments cannot even provide clear statements in Explanatory Memorandums of what the regulations are about.
NHS: Pay
Lord Hunt of Kings Heath Excerpts(3 years, 6 months ago)
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Lord Hunt of Kings Heath
To ask Her Majesty’s Government, further to the assumption set out in the NHS Long Term Plan Implementation Framework, published in June 2019, of a 2.1 per cent pay rise for National Health Service staff in the 2021/22 financial year, what plans they have to review their submission to the NHS Pay Review Body.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, our written evidence to the independent pay review body set out what is affordable. We have increased the size of the NHS workforce over the last decade and have committed a record-setting additional £33.9 billion by 2024-5 for the NHS to meet the rising demand for services. With strides being made in recruitment and retention, an enormous effort is under way to make the NHS a more inclusive and enjoyable place to work, with excellent well-being support for all staff.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, the Government say that they cannot afford to give nurses a decent pay rise, yet they have managed to squander billions of pounds on management consultants, fly-by-night companies and friends of Ministers. The long-term plan built in a 2.1% pay rise for NHS staff next year; it was factored into the funding settlement and enshrined in legislation. It is one thing for the PM to be filmed applauding his appreciation for NHS staff, but no amount of clapping will help pay for rising living costs. Does the Minister agree that the Government should reverse this evidence and give staff in the NHS the increase they deserve?
NHS: Staff Numbers after Covid-19
Lord Hunt of Kings Heath Excerpts(3 years, 7 months ago)
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Lord Hunt of Kings Heath (Lab) [V]
My Lords, I declare my interest as a member of the GMC board. The NHS has responded magnificently to Covid but its underlying problems still exist. As the Health Foundation’s Jennifer Dixon put it, the NHS is under-resourced, under-doctored and under-nursed. The foundation forecasts that by 2033-4, vacancies will exceed 475,000 full-time equivalent, and even more will be needed to meet rising expectations and the impact of a growing older population. Yesterday’s Budget revealed a cut in spending for the Minister’s department of £30 billion from April and social care reform has once again been kicked into the long grass, so where is the long-term approach to the NHS and social care? Where is the long-term approach to workforce planning that is so desperately needed? Where is the innovation?
The GMC has used emergency powers to grant registration to over 25,000 doctors so that they can support the pandemic response, but most of them have still not been deployed. What a missed opportunity to bring those doctors back permanently to alleviate our workforce shortages.
Independent Medicines and Medical Devices Safety Review: Sodium Valproate
Lord Hunt of Kings Heath Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
My Lords, I pay tribute to those who have put together the valproate registry scheme that became live on 11 February. My noble friend is entirely right. There are 22,095 people on the registry; 462 of them had 490 conceptions, and 180 women were prescribed in a month when they were pregnant. A redress scheme is not necessarily the correct solution to this problem. We are considering it extremely carefully, and when we publish our overall response to the Cumberlege review we will include our considered response to the redress suggestion
Lord Hunt of Kings Heath (Lab) [V]
My Lords, the noble Baroness, Lady Cumberlege, concluded in her report that the system still did not know how to minimise the risk of future babies being damaged, despite 27,000 women of childbearing age currently taking valproate in the United Kingdom. In view of that, does it not make the case for a redress scheme absolutely persuasive?
Lord Bethell (Con)
My Lords, I will leave it to the response to the Cumberlege review to make the decision on the redress scheme. In the meantime, our focus is on a regime ensuring that those who take this important drug have the right advice to prevent them becoming pregnant. I emphasise that specialists review the treatment and ensure that an annual risk acknowledgment form is signed by the prescriber and the patient. This is an important measure ensuring that all those who take this potentially life-changing drug acknowledge and understand the implications of becoming pregnant.
Covid-19: Brazilian Variant
Lord Hunt of Kings Heath Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
The noble Baroness is entirely right, which is why the Prime Minister struck such a cautious tone when he unveiled the road map. We are not through this yet. A substantial proportion of the country is vaccinated, but we have to protect the vaccine. For those who have not been vaccinated, there are risks, and that is why we still have in force a “do not travel” alert and why we are maintaining marketing and communications at every level on the restrictions that are still in place.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, to come back to my noble friend Lady Thornton’s Question, the Minister will know that, at the SAGE meeting on 21 January, there were warnings that geographically targeted bans cannot be relied upon to stop the importation of new variants, partly because of indirect travel. He has just said that he does not want a backdoor entrance through Ireland. But what are the Government going to do about indirect travel, which is a clear route into this country to avoid the current quarantine rules?
Lord Bethell (Con)
Those who travel to the UK must fill in a passenger locator form. On the PLF they have to state whether they have been in a red list country. We also share an enormous amount of information with the aviation industry to cover people’s previous travel, and therefore it is not as easy as the noble Lord might think to take a hop and a skip into Britain through a third country, as has been proved by those who have travelled from Brazil and been caught by the red list. However, his point is well made, which is I why I reinforce what I said earlier: we keep the red list under review and, if it proves necessary to extend the countries on that list, we shall do so to protect the vaccine.
Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
Lord Hunt of Kings Heath Excerpts(3 years, 7 months ago)
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Lord Hunt of Kings Heath (Lab) [V]
My Lords, the Minister has argued persuasively this afternoon that we need to ensure that infected individuals, and their close contacts, self-isolate. He was also persuasive about the need for the police to have the data necessary to strengthen the effectiveness of the current system. In principle, I support this statutory instrument. The police need more support to deter people from breaching self-isolation and increase compliance, as this is so clearly in the public interest. I wish the Government had been as vigorous when it came to quarantine arrangements at our borders.
I note that the Secondary Legislation Scrutiny Committee has welcomed this SI, having previously criticised the Government for not sharing data effectively with the authorities to enable them to enforce self-isolation. Having said that, I am, like the Minister, mindful that allowing the police access to NHS Test and Trace data does raise some uncomfortable ethical questions. Despite supporting this instrument, I think that it may cause some members of the public to be reluctant to be tested as a result. As the BMA has said:
“We are already concerned that some people are deterred from being tested because they are anxious about loss of income should they need to self-isolate—and we are worried should police involvement add to this.”
We have seen something similar with vaccines. As Nick Cohen wrote in the Observer yesterday,
“Theresa May’s ‘hostile environment’ for migrants makes them frightened of visiting vaccination centres. When the NHS shares data with the Home Office and immigration enforcement, they have every incentive to stay away.”
This is a very sensitive matter and I would like an assurance from the Minister that the SI will be rescinded as soon as possible.
Big Brother Watch has raised the issue of the memorandum of understanding with me and other noble Lords. My understanding is that this was agreed between the Department of Health and the National Police Chiefs’ Council last October but it has never been published. The Minister says that it will be published soon, but does he agree that, when it comes to the sharing of information, we are entitled to see the MoU, in the interests of transparency and speed? Can he confirm that “soon” means in a matter of days?
Covid-19
Lord Hunt of Kings Heath Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
The virus mutates all the time and minute variations have happened from the very beginning. However, this virus has been unusual in not having profound mutations; it had not changed its seriousness, its transmissibility or its escapology in a meaningful way until the end of last year. Those were not—how shall I put it?—completely unexpected, but they had not been identified before. When they were identified, we changed our tactics, our strategy and our approach. Our determination to keep out variants of concern is manifested in these proposals, and we have moved extremely swiftly to enforce border control as the threat has mounted.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, I want to follow up on that question. The SAGE minutes of 21 January make clear that
“reactive, geographically targeted travel bans cannot be relied upon to stop importation of new variants … due to the time lag between the emergence and identification of variants of concern, and the potential for indirect travel via a third country”.
By confining the quarantine measures to travel from red-list countries, are the Government not ignoring the SAGE warning about indirect travel?
Lord Bethell (Con)
My Lords, SAGE is entirely right that we have to be careful about indirect travel. That is why we have introduced a passenger form that requires people to detail all their recent travels. It is why we have attributed to the filling-in of the form very serious enforcement measures, including the potential for a large custodial sentence if it is filled in incorrectly. It is why we are using all the benefits of technology and of airline databases in order to track people’s travel and ensure that they are not in any way misleading us or skipping around borders to get here. The noble Lord is right that this is a very serious matter. This is a 21st-century pandemic and we are determined to use the techniques of the 21st century to keep out variants of concern. Countries such as Taiwan, Iceland, Australia, New Zealand and Singapore have demonstrated that if you use thoughtful 21st-century methods then you can make a big impact on transmission, and that is what we are determined to do.
Hotel Quarantine for Travellers
Lord Hunt of Kings Heath Excerpts(3 years, 8 months ago)
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Lord Hunt of Kings Heath
To ask Her Majesty’s Government what plans they have to implement a mandatory hotel quarantine for all travellers arriving in the United Kingdom.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, these new measures at the border are a necessary step to protect the public and our world-class vaccination programme. Every layer of protection we have put in place will help reduce the risk of transmission of the virus and prevent any potential new strain entering the UK. All measures will be kept under review and, if required, further action will be taken to add another layer of protection against transmission.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, given the good news on vaccines, should we not be ever more vigilant on our borders? The 22 December meeting of SAGE identified the rapid spread of a variant in South Africa, and the NERVTAG meeting of 13 January warned of the rapid growth of variant B1351 in South Africa and called for enhanced border measures. Since then, how many people have entered the UK from South Africa? Why, as Yvette Cooper said yesterday, is it still possible for people to return home to the UK from South Africa and go straight into the community with no tests on arrival, no quarantine hotels and no quarantine taxis? Scotland has announced extensive new quarantine rules today. When will the Government get a grip and bring in the much tougher quarantine measures they should have introduced weeks ago?
Lord Bethell (Con)
My Lords, I entirely agree with the noble Lord. He is right that additional vigilance is required. The advent of new variants that could have higher transmissibility or escape the vaccine is a complete game-changer, and that is why we have changed our approach to border management. We have upgraded our border control measures, and there will be further government announcements on that. We have introduced red lists of countries where there are variants of concern, and we have implemented Project Eagle, the tracing project to track down those who have tested positive in genomic sequencing for variants of concern.
Social Care Funding (EAC Report)
Lord Hunt of Kings Heath Excerpts(3 years, 8 months ago)
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Lord Hunt of Kings Heath (Lab) [V]
My Lords, this is an excellent report and its stark conclusions are as relevant today as when it was first published. Social care is severely underfunded, with the most deprived areas being the worst hit. More than a million adults who need social care are not receiving it and the system is riddled with unfairness. We are in a vicious cycle. After decades of reviews and failed reforms, the level of unmet need rises, the pressure on unpaid carers grows, the supply of care providers diminishes and the strain on the undervalued care workforce ever increases.
The core recommendation of £8 billion to be spent immediately to restore quality and access to adult social care has been widely supported. So, too, has the recommendation to introduce free personal care, such as help with washing, dressing or cooking, to be funded through general taxation over a period of five years, at a cost of £7 billion per year. The committee argues that this is simple, fair and not much more expensive than other proposals for reform. But, given the history of many reviews, we should not underestimate the barriers to its adoption, and I would like to mention five of those barriers.
First, adult social care has never commanded the priority that it deserves. The way that care homes have been dealt with over the pandemic is of course illustrative of this, with a lack of priority given to them in relation to PPE, testing and the movement of infected patients from hospitals to care homes.
Secondly, those in care homes would still pay for their accommodation and assistance with less critical needs like housework or shopping, so it is not the whole deal.
Thirdly, I am by no means certain that the costs of even limited free social care have been fully quantified. The experience of the NHS at its beginnings is instructive. Nye Bevan had assumed that, after a few years, the costs of the NHS would come down as the NHS caught up with the backlog of patients who had been unable to afford treatment before. That proved to be a trifle optimistic.
Scotland’s experience is relevant. The King’s Fund and Health Foundation 2018 report A Fork in the Road warned that the introduction of free personal care in Scotland had
“created unexpected levels of increased demand for domiciliary care which we might also expect to occur in England.”
They estimated that, with free personal care, the number of people receiving publicly funded domiciliary care in England would almost double. My concern is that free personal care would be underfunded and long waiting lists would be the result.
The fourth issue is that, in arguing for a mainly publicly funded solution, the committee’s hope for a market for private care insurance would be likely to develop in a system where personal care costs are funded by the state. This was the hope of Sir Andrew Dilnot who argued in his report, which the Government accepted, legislated for but never implemented, that limiting the risk for insurers by a cap on individual costs could help to provide a sustainable market for private social care insurance. The insurance market was unenthusiastic and I would like to hear more from the chair of the committee about how the committee thinks a more positive response would come from these proposals.
Fifthly, the committee says that cross-party co-operation will be necessary if progress is to be made on reforms to social care funding. I wish the committee well on this. Ever since Andrew Lansley’s description of Andy Burnham’s proposals in 2010 as a “death tax”, cross-party consensus has looked an ever distant dream, though I accept that it is desirable.
None the less, and despite the evident challenges, this is surely a good basis on which the Government can build their long-anticipated Green Paper.
Health: Brain Tumours
Lord Hunt of Kings Heath Excerpts(3 years, 8 months ago)
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Lord Hunt of Kings Heath
To ask Her Majesty’s Government what steps they are taking to encourage research into (1) the causes, and (2) the treatment, of brain tumours.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I am hugely grateful to noble Lords for bringing this challenge to my attention. It is House of Lords advocacy at its best. We have met interested parties and I am pleased to say that we have a plan. Workshops are being booked, more research is being funded and we are encouraging more researchers to become involved. I am hopeful that this will mean progress and I am watchful to ensure that it delivers.
Lord Hunt of Kings Heath (Lab) [V]
My Lords, I am very grateful to the Minister for that positive response. Can he assure me that, in addition to seeking ways of being able to spend up to the £40 million research money made available, he will comment on the report of the chair of the all-party group on brain tumours, which says that there is greater need because there are no researchers able to undertake much of this research? Can he consider steps to address this imbalance and attract the brightest of medical and scientific minds into this uniquely complex area?