Covid-19: Aligning UK and Foreign Entry and Return Requirements

Lord McColl of Dulwich Excerpts

Monday 19th July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

[Inaudible]—are engaging with a range of international partners, including the EU and the US, on mutual recognition. Ministers have agreed to begin the formal process of reaching a technical agreement with the EU on mutual recognition of vaccine certificates. This would allow the digital verification of vaccine certificates between the UK and the EU. We believe that this process could be complete within a month, pending the Commission’s acceptance of our application.

[Lord McColl of Dulwich (Con) [V]]

My Lords, have the discussions with these countries involved the question of herd immunity, bearing in mind that countries with low levels of vaccination which have closed their borders will have fewer Covid infections? That could result in less herd immunity in the long term in countries such as New Zealand and Australia, which have closed their borders.

Organ Tourism and Cadavers on Display Bill [HL]

Lord McColl of Dulwich Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Lord McColl of Dulwich (Con) [V]]

My Lords, I also thank the noble Lord, Lord Hunt, for presenting this valuable Bill. Of all the different operations that I used to do, kidney transplantation was the most exciting. When the vein and artery were connected to the donor kidney, it would spring to life. As a contribution to good Anglo-French relations, I pay tribute to France: the French kidneys were the best of all because they would start functioning immediately by peeing on the operating table. The reason for this was said to be French wine being a good diuretic. As there was always a shortage of kidneys, there was a European system for sharing in order to have the best match for each patient. Unfortunately, this shortage led to abuses of all kinds. On many occasions, live donors were paid to give their kidneys, for a relative or a stranger. It later transpired that genuine consent was often not obtained.

Later, the horror of the Chinese practice of forcibly taking kidneys from prisoners came to light. The numbers involved have shocked the world, but is the world going to repeat its failure to take action against the Nazi atrocities, which also included horrific medical experiments on prisoners? Instead of an effective response to China, the West continues to allow it to buy up our industries, enabling the Chinese Government’s plan to dominate and control the world. When will the world wake up and take effective action?

On medical devices, it is worth saying that the medical profession has a history of reluctance to put foreign materials into bodies. The surgeon who pioneered the use of metal plates and screws to fix fractures was threatened with removal from the medical register. Another example was an eye surgeon, Harold Ridley, who was carrying out a standard operation for cataracts in 1949, simply removing the cataract and sewing up the eye. A medical student who was watching the operation suggested that perhaps the cataract should be replaced with an artificial lens. What the surgeon said at the time was not recorded, but he kept the suggestion in his mind and, the following week, he noticed a piece of plastic from a smashed windscreen in a pilot’s eye—but there had been no reaction to it. So began artificial lens implantation. In spite of great opposition, it was finally accepted 25 years later. New inventions are often opposed. Careful evaluation is essential to allow and promote good new developments as well as to stop harmful ones.

Folic Acid

Lord McColl of Dulwich Excerpts

Tuesday 13th July 2021 Lords Chamber

[Lord McColl of Dulwich (Con) [V]]

My Lords, one of the first to indicate that folic acid could prevent spina bifida was Professor Richard Smithells in 1980. That was accepted 11 years later, which is nothing compared with the present delay. Spina bifida is one of the commonest congenital defects and is easily prevented by adding folic acid to flour, which is what the Americans did 23 years ago, thus preventing 1,300 babies having that tragic condition every year. We keep hearing about consultations and meetings, which some of us regard more as group psychotherapy than as achieving anything. When will action be taken?

[Lord Bethell (Con)]

My Lords, I completely understand and appreciate the sense of frustration and urgency that my noble friend expressed, but I emphasise that this is a massive national measure. It has to be conducted in a way that takes the nations with us, that people feel confident that the right processes have been adhered to and that there is no doubt about the safety of the measure. This is not a question of foot dragging, quite the opposite. We are doing this in a thorough way that reflects the practicalities and realities of the machinery of the United Kingdom Government.

Medical Devices (Northern Ireland Protocol) Regulations 2021

Lord McColl of Dulwich Excerpts

Monday 12th July 2021 Grand Committee

[Lord McColl of Dulwich (Con) [V]]

My Lords, as there are more than half a million of these devices on the market, it is understandable that effective regulation should be in place and workable. It is also clear that most of us will need one of these devices at some time in our life. It is to be hoped that these regulations will give patients more information and choice, and that they will benefit from more up-to-date therapies. I ask the Minister this: what will be the effective way of seeking expert opinions on the wisdom of a proposed new operation that does not necessarily involve a medical device? It would be helpful to have a second opinion on whether it is likely to be feasible and safe.

As there are often notoriously long delays in obtaining answers from official bodies, and we are talking about regulations now, has any thought been given to placing a regulation to require answers within a certain time?

There has been discussion about a robust financial compensation mechanism to ensure that patients are dealt with fairly and justly for the damage caused by defective devices and by their inappropriate use in certain parts of the body. For instance, the mesh which caused so much damage in operations for incontinence is used widely and safely in hernia operations. Could the Minister tell the Committee who will operate these compensation mechanisms? Who will decide whether compensation is justified and how much to award?

Women’s Health Outcomes

Lord McColl of Dulwich Excerpts

Thursday 8th July 2021 Lords Chamber

[Lord McColl of Dulwich (Con) [V]]

My Lords, I join others in thanking the noble Baroness, Lady Jenkin, for initiating this debate. In my practice of medicine and research, mental health has always been one of my concerns, and it is obviously a very important feature in the health of women. One survey, which I think has already been mentioned, showed that 90% of people believe that mental health affects physical health and 90% believe that physical health affects mental health.

In trying to achieve better outcomes, I think it is sensible to look for cost-effective ways. For instance, the mental harm done by loneliness can be mitigated by frequent visits from friends and relatives, and this may also delay the onset of Alzheimer’s disease and help them when the condition progresses. Importantly, there are many ways to reduce stress—for instance, bringing in a four-day week. When a three-day week was introduced in 1974, there was no drop in productivity, which was interesting and surprising.

Better outcomes could be achieved by reducing violence, rape and abuse of all kinds, and alerting the public to the increased domestic violence following football matches, as the noble Baroness, Lady Jenkin, mentioned. Violence against women is also bound up with pornography and prostitution. A Swedish law making it illegal to pay for a prostitute reduces the opportunities for violence against women and could be passed here in this country. Those opposing such a law might be asked whether they have an interest to declare.

It is estimated that there are several million disabled people being cared for by women at home. For them, respite care is absolutely essential.

Lastly, a great deal of mental and physical ill health is due to the obesity epidemic, which has caused an enormous amount of ill health and is also responsible, in this country and many others, for the high mortality from Covid. There is only one way of dealing with obesity: put fewer calories into the mouth. The noble Baroness, Lady Jenkin, has done a great deal, in practical ways, to achieve this by advocating ways of finding and cooking healthy and affordable food and inviting people to these healthy and cheap lunches.

We must make a real effort to achieve better health outcomes for women in this country.

Health: Dementia

Lord McColl of Dulwich Excerpts

Monday 5th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the role of carers in the kinds of situations the noble Baroness describes. We are doing an enormous amount to supply training for carers in all facets of their delivery, including support in caring for those with dementia. I am not sure that I can make the guarantee that she seeks right now, but I reassure her that this is one area of our investment in carers that we take extremely seriously.

[Lord McColl of Dulwich (Con) [V]]

My Lords, while these patients are waiting for appointments, could some way be found to encourage relatives and close friends to help those with early dementia by having frequent conversations with them and helping them learn by heart poems they used to be able to recite in earlier years? That might also prove helpful to those relatives and friends, because loss of memory tends to affect us all as we grow older.

[Lord Bethell (Con)]

My noble friend makes a very touching and constructive point, because social engagement and involvement in the community keep older people sharp and their brains engaged and help stave off the ravages of age and the diminution of mental faculties. We all have a role to play in supporting the elderly and those with mental challenges. My noble friend is entirely right to call on the entire community to step up to that role.

Hospital Waiting Lists

Lord McColl of Dulwich Excerpts

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

I completely take on board the noble Baroness’s advice. When it comes to recruitment, it is right that local engagement with local education has to be the way forward. I can report that the recruitment efforts and marketing campaign that we have put in place to recruit 50,000 new nurses, more GPs and more staff across the healthcare system are working extremely well. There is a renewed interest in careers in health—that is one good dividend of this awful pandemic.

[Lord McColl of Dulwich (Con) [V]]

My Lords, the Government’s £1 billion elective recovery fund is most welcome. Will the Minister support this sum being made available every year until we see light at the end of the tunnel? Can he encourage health authorities to redouble their efforts to get the 40 million people in the UK who are overweight to return to a normal weight and thereby begin to release resources to treat more urgent cases, such as cancer patients?

[Lord Bethell (Con)]

On the elective recovery fund, I cannot make that commitment at the Dispatch Box but I reassure my noble friend that we are in it for the long haul and we recognise that this will be a major project needing major resources. When it comes to the health of the nation, the obesity strategy is a cross-departmental and energetic programme that tackles the issues that my noble friend is concerned about. He is entirely right that the costs of our healthcare system are predetermined by the overall health of the nation, and that is why we encourage people to eat well and lead healthy lives.

Folic Acid

Lord McColl of Dulwich Excerpts

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I understand that considerable efforts have gone into ensuring that folic acid is put into flours of all kinds, and I pay tribute to the industry for trying to deliver a comprehensive service. I am happy to write to the noble Baroness to confirm that.

[Lord McColl of Dulwich (Con)]

My Lords, as fluoride has been added to drinking water to reduce dental caries, surely the Minister agrees that preventing spina bifida is more important, as a former colleague of mine, Professor Richard Smithells, pointed out nearly 60 years ago. Is it not time to act?

[Lord Bethell (Con)]

My Lords, I take on board the point that it is time to act. That is why we are working hard on the matter. As I said, I hope to return to the House on this soon.

Covid-19: Update

Lord McColl of Dulwich Excerpts

Tuesday 20th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely recognise my noble friend’s concerns, but I reassure him that surgeries simply are not closed, and if he has any examples of those he thinks are closed, I would be grateful if he would write to me. Hospitals are not closed and if he has any examples, I would be grateful if he would write to me. In fact, the NHS has for months done a huge amount not only to be wide, wide open, but to grow in its capacity quite dramatically. It is an inevitable, predictable, sad but frustrating fact that the impact of the coronavirus pandemic, like every other pandemic, is the hit or the follow-on effect on all the other procedures that are needed from a healthcare system. We have diverted a huge amount of capacity from Covid to ordinary, business-as-usual care; we are doing a huge amount to address the backlog and we will continue to move the resources accordingly, but we have to keep provision in place for those who, I am afraid to say, are still in hospital with Covid, and we are aware that the threat remains on the horizon.

[Lord McColl of Dulwich (Con) [V]]

My Lords, in addition to the great success of the vaccination campaign, at last it is now accepted that the high mortality from Covid in the UK, and in many other countries, is due to the high prevalence of obesity. The high Covid mortality is not the fault of politicians, civil servants or scientists. Does the Minister agree that what we now need is for everyone to unite to support the Prime Minister’s campaign to reduce obesity in order to promote a healthier nation and reduce the mortality from any future pandemics?

[Lord Bethell (Con)]

My Lords, the post-mortem is not fully written. When it is, the causes of our relatively high mortality rate will undoubtedly be complex and a number of factors will have played a role, but the noble Lord is right that obesity will definitely be on the list. This country is too heavy in comparison even to our European partners. We are one of the heaviest countries in the whole of Europe and if you are overweight, I am afraid to say that the brutal truth is that your heart is having to work too hard, your lungs are having to work too hard, your immune system is run down and the ability of your organs to fight disease is greatly reduced. That is one of the reasons why a very large number of people have really struggled in hospital to fight this disease. If you are carrying an obesity-related illness, such as diabetes or some other major affliction, you really are in no shape to fight off one of the major diseases.

The resilience of this country depends on it getting fitter. That is why we have focused on the obesity strategy that we have, and we will be building on it further. The noble Lord is entirely right that this challenge is well recognised by the Prime Minister from the top, from his own personal experience and his acknowledged fight with the disease last year. It is recognised by the whole of government and by the NHS and our healthcare system.

Crohn’s Disease and Ulcerative Colitis

Lord McColl of Dulwich Excerpts

Thursday 15th April 2021 Lords Chamber

[Lord Bethell (Con)]

I am extremely grateful for the testimony of the noble Baroness. She speaks very movingly about the challenge faced by those with IBD—a challenge that we all sympathise with. We are working extremely hard with both Crohn’s & Colitis UK and IBD patient groups on this scenario. There has been disruption in the last year, but I reassure the noble Baroness that we are working extremely hard to get the scenario out as soon as possible.

[Lord McColl of Dulwich (Con)]

My Lords, does the Minister agree that, even for very experienced clinicians, diagnosis and treatment of these conditions can be very difficult indeed—as my experience over the years has taught me? Patients may present in bizarre ways—for instance, with a disease of the skin, eyes or joints. Furthermore, a patient with ulcerative colitis can almost imperceptibly become dangerously ill, requiring drastic emergency surgery. Clinicians are always trying to do better, and they need encouragement and thanks, particularly over this very difficult pandemic.

[Lord Bethell (Con)]

My noble friend is entirely right that diagnosis is key to the accurate and prompt treatment of IBD and associated conditions. That is why we have put diagnosis at the heart of our research programme. Between 2015 and 2020, we funded 20 research projects, many of them on diagnosis, with over £17 million committed. That includes a study into the overlap of IBD and magnetic resonance enterology to image Crohn’s disease patients. This approach is extremely promising.