(2 years, 3 months ago)
Lords ChamberMy Lords, the recent Civitas report put the UK second from bottom in patient outcomes in key areas of cardiovascular disease, cancer and a reduction in life expectancy. Can the Minister say what role commissioning should play in improving patient outcomes?
On patient outcomes, the noble Lord is quite right: we need to look at the statistics—where we are doing well and where we are not doing so well—and then focus efforts at not only the national level but the local ICB level, to make sure there is the appropriate commissioning. Indeed, one responsibility of the local integrated care board is to look at what services are needed in the local area and make sure that they are commissioned.
(2 years, 5 months ago)
Lords ChamberMy noble friend makes a very important point, and she referred continually throughout the passage of the Health and Care Act to practices in rural areas. We have looked at the challenges and have asked GPs about this in surveys, and we know that there are problems about the reduction of working hours, administrative burdens, some stress and burnout, and some issues about equitable distribution. One thing we do have is the Targeted Enhanced Recruitment Scheme launched in 2016, which has attracted hundreds of doctors to train in hard-to-recruit areas by providing a one-off financial incentive.
My Lords, in 2017, a House of Lords report recommended that the current small business model of primary care is not fit for purpose. The same has been said by the Royal College of General Practitioners, which produced a report; the British Medical Association; two think tanks, the Nuffield Trust and the King’s Fund; and, more recently, Policy Exchange, which produced a report on the model being fit for the future. Is it not time that the Government had plans to look at future models of delivering primary care? If they do not have such an intention, does the Minister agree that the House of Lords should set up a Select Committee to follow on from the excellent report produced on the NHS in 2017?
I thank the noble Lord for that question, but I should explain to him that I have been warned for exceeding my powers, as it were, in the past. I think setting up a Select Committee is a bit beyond my powers. The noble Lord and I, and many noble Lords across the House, including previous Health Ministers of all parties, have had this conversation, and we know that the old-fashioned model of a five to 10-minute appointment with your GP, only to be referred elsewhere and into secondary care, is broken in many ways. We need a much more modern model. We have seen primary care take on some of the functions of secondary care, but we have also seen, at the GP level, that the GP does not have to do everything, and that there are other workers such as nurses, physio- therapists and pharmacists who can do more of what the GP has done in the past.
(2 years, 5 months ago)
Lords ChamberAs I said, we are keeping everything under review. We called our strategy Living with Covid-19 as opposed to “We’ve Got Over Covid-19” because we knew it could come back at any time. We have seen that, with the omicron variant, some medication is less effective. We continue to monitor that, and we are ready to stand up the measures that may be needed if the number of cases dictates that, on the advice of the JCVI and the UKHSA.
My Lords, we all agree that the numbers are increasing by the day. Can the Minister say what is driving this rise in numbers? Are particular groups driving the rise, and if so, is the policy based on that information?
(2 years, 5 months ago)
Lords ChamberI hope the noble Lord appreciates that there is debate here. He has written to me a number of times about Professor Wald’s paper, which has been put before the advisers in the department. I think what we are seeing is scientific contestation: some people say that the science is settled, but others say that you have to be very aware of the unintended consequences. The NHS website advises people with certain conditions not to take folic acid, the worry being that, for people who do have levels of folic acid, we may end up solving one problem and unintentionally creating another.
My Lords, we have now discussed the scientific validity several times. The Minister arranged a meeting, and I thought we had resolved this issue. Which scientific evidence is confusing the departmental advisers?
(2 years, 6 months ago)
Lords ChamberI am sure the noble Lord will remember from the debates on the Health and Care Bill that that Act provides for workforce plans every five years. In addition, Health Education England has been commissioned to do work on workforce needs of a much more decentralised nature, rather than top-down from Whitehall and Westminster: at the trust level and the CCG level and, in future, at the ICS level to look at needs and the mix of skills that are needed to serve local populations.
My Lords, following on from the Question asked by the noble Lord, Lord Hunt, does the Minister agree that there is a need to rethink the model of primary and community care in the light of shortages, and considering that more and more GPs are now providing only private healthcare—at the last count, there were 1,500 of them—and 57% of GPs are working three days a week or fewer?
There are indeed a number of challenges. One is that many GPs are nearing retirement age and some are worried that their pension will be affected if they carry on working. Also, as an IPPR report recently said, the nature of illness and patient expectations have changed but the model of care has remained the same throughout. We expect five-minute appointments with referrals, but what we need in primary care is a much more networked model, with GPs, nurses, mental health officials, pharmacists, link workers and charities providing a joined-up service so that it does not always have to be the GP.
(2 years, 6 months ago)
Lords ChamberI thank my noble friend for the question and for discussing the issue with me previously. As he rightly says, even though it is rare, cancer is the biggest killer of children aged up to about the age of 15. The Government’s new 10-year plan for cancer care is under development. It will address the cancer needs of the entire population, including those of children. We also recognise the severe impact that cancer has on not only the patient but their family and friends, and are focusing in particular on interventions that support patients through difficult journeys of diagnosis, treatment and aftercare.
My Lords, research for finding new treatments for cancers, particularly childhood cancers, where the numbers are small, requires international collaboration. Some 42% of current CRUK clinical trials have international partners. The Government are consulting on clinical trials regulation and we have data sharing and protection legislation going through Parliament. Does the Minister agree that it is important that neither the regulation related to clinical trials nor the legislation related to data sharing should in any way jeopardise our international role in clinical trials collaboration?
I thank the noble Lord for the question, which cuts across three of the priority areas in my ministerial portfolio: data sharing, the life sciences industry—in which clinical trials and research play a huge part—and international collaboration. It is really important that we continue international collaboration. However, one of the challenges we face is that we have to make sure that patients are comfortable with researchers having access to their data. As part of that work, we have called in civil liberties organisations to help us along that journey. So, while we encourage more people to share data, we have to make sure that they have those protections. We can have the best systems in the world, but, if people opt out, they are useless.
(2 years, 7 months ago)
Lords ChamberI will try my best. If I may, I shall use this opportunity to respond to the noble Baroness’s earlier question. We have seen horizon scanning in regulatory science, which means that ILAP is at the forefront of cutting-edge developments. It is open to commercial and non-commercial, and UK-based and global developers of medicines. As I said, I will write to the noble Baroness with more detail. On doing something about NICE and the NHS, I have constant meetings with the NHS, as do other Ministers. One of the challenges that came up during the passage of the Health and Care Bill—I know that noble Lords who have been Ministers previously made this point—was that Ministers here have to respond on issues but decisions are quite often taken at NHS level.
My Lords, I am yet another doctor. In defence of NICE, it has, despite the financial constraint, delivered 50% more appraisals in 2020-21 and is likely to do an extra 20% this year. The important point I want to make is the point made by the noble Baroness, Lady Morgan of Drefelin: patients need to have access to effective treatment sooner. If the appraisals are causing delay, for whatever reason, that is the place where NICE needs help, to get patients early access. For instance, a breast cancer drug that treats patients with triple-negative breast cancers, with a higher mortality, is available in one part of the United Kingdom now, but it is not available in England.
The noble Lord makes a very important point. One of the things we are looking at, so that we will not only be a centre for life sciences but make sure that our NHS is at the forefront of healthcare worldwide, is to make sure that we look at the different stages of medicines when they are approved, if they have conditional marketing, and the different stages of approval to see whether we can get them to patients earlier. As the noble Lord says, we should share the good news about NICE. It issued guidance within 90 days for licensing of 100% of new active substances in 2021-22 and has the highest number of technology appraisals in any year since appraisals began. There is some good news, but NICE recognises that it has to do more and we are in conversation about that.
(2 years, 7 months ago)
Lords ChamberThe noble Baroness emphasises just how wide, varying and diverse the symptoms of long Covid are. We know that children and young people can develop long Covid, just as adults can. NHS England has therefore not only established specialised paediatric services to provide care for children and young people, but is looking at providing specialist advice and support to general paediatric services as we learn more, as well as co-operating with international partners to learn from their experience.
My Lords, the Minister quite rightly referred to the correct definition for people who suffer from long Covid as having a post-Covid-19 syndrome. That implies that people may suffer from multi-organ conditions and, in that respect, training is important. Does the Minister agree that NICE should be asked to publish guidelines for all professionals to recognise this condition?
The NICE guidelines start with the definitions as I have laid out previously, and the NICE definitions are aligned with the World Health Organization. On the noble Lord’s specific question, I will have to write to him.
(2 years, 7 months ago)
Lords ChamberAs the noble Baroness will be aware, during the debates on the Health and Social Care Bill, we made quite clear the different approaches to the workforce strategy. Indeed, Health Education England has been asked to compile a strategy. The NHS has the people recovery task force, which involves health and well-being and is not only for retention. Also, in our recruitment, we are on track to meet our manifesto commitment of 50,000 nurses. We had over 30,000 more nurses by February 2022. We are looking at different areas, not only from the department but from the ground, bottom up.
My Lords, does the Minister think that the government target of diagnosing 75% of all cancers at stage 1 and 2 by 2028 needs revising?
When one looks at these reports, one sees that one area where the UK clearly needs to improve is on cancer. One of the great issues of this is diagnosis. As many noble Lords will know, when we look at the waiting lists and the backlog, we see that 80% of those people are waiting for diagnosis. It is essential that we tackle that. For children, the one-year survival rate has risen in recent years. We will continue to focus more on diagnosis, including community diagnosis centres.
(2 years, 8 months ago)
Lords ChamberMy Lords, the United Kingdom has a high incidence of babies born with neural tube defects. What evidence have the Government collected as to the decrease in the incidence of neural tube defects in babies that would occur if an appropriate daily amount of folic acid was available in the nutrition of United Kingdom citizens?
I think the noble Lord will be aware that pregnant women are advised to take 400 micrograms of folic acid. That high level cannot be put into other foods because there are some unintended consequences. For example, it disguises some other traits and conditions in the older population. Therefore, one needs to get the right balance and proportion for the wider population.
(2 years, 10 months ago)
Lords ChamberI am grateful to the noble Lord for informing me about that—it is something I have learned today. I will take it back and consider what he has said. To return to the Question, when we made this measure it was clear that it was supposed to be temporary. Will have consulted and will look at the consultation and decide what we will do. If we do go back to what it was like before, we will make sure there is a sufficient period to ensure there is no cliff edge.
My Lord, to return to the original Question asked by the noble Baroness, Lady Sugg, may I respectfully suggest that the Minister is trying to defend the indefensible? The evidence is quite clear about the safety of the procedure. We can have a debate about alternative views, but the evidence from other countries which routinely use this method of treatment is clear: it is safe and more convenient for women, and it should be implemented immediately. Will he take this back to the Department of Health?
I think the noble Lord is being slightly unfair. It is a complicated issue and not as simple as people make out. The noble Baroness said that we should be aware of dangers. These are the issues that we considered during the consultation. Whatever we do, we will be criticised— rightly so—but we want to make sure that when we make a decision it is the right decision.
(2 years, 10 months ago)
Lords ChamberMy Lords, I thank all noble Lords who took part in this debate, especially my noble friend Lady Cumberlege for her work on the independent review of medicines and medical devices, and other noble Lords who were involved in that. I know that she worked tirelessly to make sure that patients and their families have been heard and I pay tribute to her and her team. I also thank her for her lobbying—or reminding—me of the pledge that I made when I first became a Minister on championing the patient.
I welcome my noble friend’s amendment to increase transparency and promote public confidence in the healthcare system. The Government fully support the intention behind the amendment. That is why I will be moving Amendments 312B, 312C, 312D, 313B, 313C and 314ZB in my name. Before I do so, let me answer some of the questions.
All these amendments relate to the transparency of payments made to the healthcare sector. The Independent Medicines and Medical Devices Safety Review led by my noble friend Lady Cumberlege listened to the brave testimony of over 700 people to understand where improvements needed to be made to make the healthcare system safer for all patients, especially women. The Government have given the review deep consideration and accepted the majority of its nine strategic recommendations and 50 actions for improvement.
To improve transparency, the review recommended that
“there should be mandatory reporting for pharmaceutical and medical device industries of payments made to teaching hospitals, research institutions and individual clinicians”.
The amendments deliver on this recommendation by enabling the Secretary of State to make regulations requiring companies to publish or report information about their payments to the healthcare sector. The clause covers any person performing healthcare as part of their duties, benefiting patients and building on initiatives by regulators and industry. I hope that partly answers the questions raised by the noble Lord, Lord Stevens.
The amendment also allows for the Secretary of State to make regulations requiring that the information be made public and make further provision about when and how the information must be published. This could include requiring self-publication or publication in a central database. That ensures that we can adapt the system to improve reporting as necessary. To ensure that companies fulfil the obligation, requirements introduced by the regulations can be enforced using civil penalties.
There are benefits to this duty applying UK-wide, aligning with the approach taken by the pharmaceutical industry with its Disclosure UK system. As the noble Baroness, Lady Wheeler, referred to, the clause contains a statutory consent requirement, so we will work closely with the devolved Governments to develop regulations following the passage of the Bill. We will also work with patients, industry and healthcare providers to create a system that enhances patient confidence while maintaining a collaborative, world-leading UK life sciences sector.
A question was raised about the issue of “shall” versus “may”. The Government have not tabled these amendments in bad faith; we would not have tabled these amendments if we did not intend to work with them. It is the intention of my right honourable friend the Secretary of State to bring forward regulations under the clause to make sure that there is transparency. If that is not reassuring enough, perhaps between this stage and Report there can be some conversations to make sure that noble Lords are assured. It is for these reasons that I ask your Lordships’ Committee to support these amendments.
Can the Minister confirm what he just said: that it is the intention to bring regulations? How strong is that intention? The “may” creates a problem.
(2 years, 10 months ago)
Lords ChamberBefore I answer any further questions, I should draw Members’ attention to my registered interests and more specifically to the fact that, when I was the academic research director of a think tank, I invited one of the authors of the paper to speak at an academic webinar. In fact, he did not speak on this issue; he spoke on Lebanese currency—quite different issues, as noble Lords can imagine.
I say in response to my noble friend that what is important is that we look not only at the epidemiological evidence and the medical evidence but, in considering government policy, at the wider range of social, economic and other factors. For example, even within clinical decisions, there were some asking for lockdown in order to prevent hospitals from being overwhelmed, but that was counterbalanced by mental health experts who were very concerned about the impact on mental health. As my noble friend will know, there are also trade-offs with the economy and other issues.
Would the Minister agree that smoking causes cancer, that the earth is round and that, in a pandemic caused by a respiratory virus, asking people to stay at home at the height of the pandemic reduces transmission of infection? Furthermore, would he agree that meta-analysis is the right way to look at randomised control trials and how they perform but not the ideal method to look at observational studies, as referred to in the Question?
The noble Lord makes important points. If we look at the history of the debate about the world being round, at one time scientists believed that the world was flat. Because of scepticism and contestability in science, we have been able to come to the conclusion that the world is round. That shows the importance of science being contestable and of having an open debate.
(2 years, 10 months ago)
Lords ChamberWe are looking at elective recovery all the way through; some of that will be in secondary care but, clearly, some of that will be in primary care. One of the issues that we want to be sure of is that we have more and more diagnoses, which is why we have rolled out many community diagnostic centres. We are looking to tackle the complete backlog, which is why we have committed an additional £2 billion this year and £8 billion over the next three years and why we will publish the elective recovery plan very soon.
My Lords, there are 20,000 more cases of cancer in the deprived population compared to other populations. Deprived people not only get cancers at a higher incidence but have late diagnoses, find it difficult to access the services and die earlier. What plans do the Government have to address this inequality in cancer outcomes?
The noble Lord raises an important point. He may well have seen coverage last week about the cancer plan as well as the Secretary of State’s commitment to what he called a “war on cancer”, given his own experience and how many people have experience of losing a relative or loved one to cancer. That shows that diagnosis and treatment of cancer remain the top priority, and they will be prioritised with increased elective capacity. We encourage anyone with potential cancer symptoms to come forward. On health inequalities, the systems will be expected to analyse their waiting-list data by relevant characteristics, including age, deprivation and ethnicity, and by speciality. The aim is to develop a better understanding of local variations in access to and experience of treatment and to start developing detailed operational action plans to address any inequalities in treatment.
The Government clearly recognise that there is a backlog, which is why we have announced the additional funding. We hope to announce the elective recovery plan very soon. The other measure that we have taken is launching My Planned Care, which allows NHS providers to upload supportive information to the platform to help patients to manage their conditions while they wait for treatment. There will also be personalised support, including advice on prevention services et cetera. We also hope that, eventually, it will have more data on expected waiting times, for example, so there will be more information for the patient. At the same time, we hope that the additional investment that we have announced will help to tackle the backlog in elective recovery.
My Lords, the 10-year cancer plan makes no mention of what new investment the Government will make towards achieving this world-beating plan. Compare that to what President Biden had said: that he intends to invest $2 trillion to find cures for cancers in a new, DARPA-style health ARPA. What investment are we going to make?
If you look at international comparisons, the situation is clear, and my right honourable friend the Secretary of State has made it clear that he does not think it is good enough. That is why we have the cancer plan, which we will target. We understand the importance of speed and efficiency in dealing with potential cancer patients. That is why the Prime Minister announced the ambitious target to ensure that 75% of patients who have been urgently referred by their GP for suspected cancer will be diagnosed or have cancer ruled out within 28 days.
All the conversations I have had in the department about investing in research—an issue that many noble Lords have rightly raised—have been about the importance of research being not a bolt-on but integral to what clinicians do, and of it feeding in to better treatment for patients. Given that cancer is one of the Government’s priorities, I hope that far more research will feed in to better clinical outcomes.
(2 years, 10 months ago)
Lords ChamberI hope the noble Lord will forgive me if I tell him that I have not examined nurses’ garments in detail. In terms of provenance, it is important at the moment—and we are doing this on lots of equipment that comes to the UK—to ensure that it is not from regions where there is slave labour, or where the Muslim Uighurs are being persecuted by the Chinese Government. We need to do more; indeed, I have had conversations in the department to find out how we can trace the sources of the products and equipment that we buy to make sure that they are ethically sourced.
My Lords, the Minister has now said on several occasions that the Government will meet the target of 50,000 nurses. Can he tell us, if the Government do meet that target, what will the remaining deficit be?
I am afraid I do not have the answer to that question, but I can certainly look into it. I am not sure what the deficit will be but, as I said, we are on course to recruit 50,000, not just from the UK and from different pathways—not only degrees and apprenticeships—but also from all over the world and not just Europe.
(2 years, 10 months ago)
Lords ChamberMy Lords, the Minister suggested that, to have any changes in the appointment of surgeons, the department would have to consult first. I assume that the only body it would need to consult is the Royal College of Surgeons, which I understand is sympathetic to the change. If that is the case, it is a simple matter, so can it not be consulted before Report?
If it is as straightforward as the noble Lord suggests, I will see if that can be done.
(2 years, 11 months ago)
Lords ChamberOne of the issues that we need to be aware of as we look at how to tackle sugar levels is that, although we have seen a reduction in sugar in drinks and in many food products over the years, a concern that is often raised is whether the sweeteners have unintended consequences that also cause health issues. We have to consider all the evidence when we look at the measures that we introduce.
My Lords, can the Minister comment on the proposed relationship between high-carbohydrate consumption—which is what sugar is—and deprivation?
(2 years, 11 months ago)
Lords ChamberI thank the right reverend Prelate for raising this incredibly important issue. I know a number of noble Lords across the House feel very strongly about this. Indeed, many of us are part of diaspora communities and understand that many communities across the world are very concerned. From the start of the pandemic, the UK has worked to support access to Covid-19 vaccines. We helped to establish the international joint procurement initiative, COVAX. At the end of 2021, the Government confirmed that they had delivered more than 30 million Covid-19 vaccines to other countries, benefiting more than 30 countries. We have invested £71 million to help COVAX secure early supply deals. The UK is one of the largest donors to the COVAX advance market commitment, which supports access to Covid-19 vaccines for up to 92 low and middle-income countries. I have a list of a number of other initiatives that we have taken part in. In addition, in bilateral, G7 and G10 discussions, we have put this issue on the agenda, making sure that we are working in a multilateral way across the world to help those countries.
My Lords, first, in relation to the question asked by the noble Baroness, Lady Masham, very few cases of Guillain Barré syndrome have been reported following vaccination with Covid vaccines. That is not so surprising because it occurs with any vaccination, so it is not a reason at all for anybody to be denied vaccination. Secondly, and much more importantly, social media is full of worries that young women are particularly affected, because of the nonsense perpetrated that it will make them infertile. There is no scientific reason behind this. Does the Minister agree that all young women should take the vaccine? Thirdly, there are many pregnant women now in hospital because they were not vaccinated because of wrong advice that pregnant women should not be vaccinated. Again, there is no reason why pregnant women should not be vaccinated, and the recent data which suggests that mothers who breastfeed will transfer their antibodies to the newborn is good news too.
One of the wonderful things about your Lordships’ House is its range of expertise. I thank the noble Lord for enlightening us on the earlier question. However, as I committed to the noble Baroness, I will check the department’s reply and hope it corresponds with the noble Lord’s response; otherwise, I am sure we will have more discussions.
On young women, the noble Lord is absolutely right that we should be encouraging as many people as possible to take the vaccine, even—I know this is being broadcast publicly—those who have not had their first or second vaccine. It is not too late. We urge everyone to have their first and second vaccine, but also to have the booster. It is the best protection, even for those who have previously had Covid. We know that almost all pregnant women who are hospitalised or admitted to intensive care with Covid-19 are unvaccinated. The latest data from the UK Health Security Agency shows that Covid-19 vaccinations provide strong protection for pregnant women against the virus. It shows that the vaccines are safe for pregnant women, with similar birth outcomes for those who have had the vaccine and those who have not. We have launched a new campaign that urges pregnant women not to wait to take the vaccine; it highlights the risks of Covid-19 to mother and baby and the benefits of vaccination.
(2 years, 11 months ago)
Lords ChamberI thank my noble friend for that question. I am not aware of the answer, and I will commit to writing to him.
My Lords, there is good evidence through a randomised trial of 300,000 people that shows the efficacy of mask wearing, but that is not my question. We should be pleased that RSV infections in children are lower this year—I am sorry, I should have taken my mask off; surgeons are used to speaking with masks on. We should be pleased that RSV infections and bronchiolitis in children are significantly lower this year, but there are lessons to be learned both for epidemiological studies and for research. Are the Government or the Department of Health engaging in that?
I thank the noble Lord for removing his face mask; I know it is supposed to be a preventive measure, but it prevented me hearing his question. We are following the epidemiological picture for RSV and are regularly updated, both in the NHS and in the department.
(3 years ago)
Lords ChamberI thank the noble Lord; we had a conversation earlier about the importance of business and of informing businesses as quickly as possible, and the important role that they play. It is clear that the police and transport operators have fixed penalty notices. We know how sometimes it can be difficult for individuals, particularly in retail, to enforce the law—that they are worried about being seen as police officers. But we hope to make it clear that it is an offence not to wear a mask in places where you are required to do so, and we are issuing further guidance on that. I will take the matter back, as the noble Lord says, and get a cross-governmental response.
My Lords, I cannot resist this: my app did not crash because it is Scottish. Can the Minister clarify the government advice to work from home if he can? Is the advice that you should or that you could? Secondly, what advice do the Government have for people who have recovered from Covid on the risk of them spreading the virus, and for how long?
I am pleased to hear that someone’s Covid app has not crashed. I am not sure if it is due to Scotland or if that is a coincidence; some of the people in the devolved Administrations may want to raise that with me. The guidance is that you should work from home if you can, but clearly there are some issues. I know that there were mental health and other issues before, but that is the guidance. On the medical question, I hope that the noble Lord will join the all-Peers meeting with Dr Jenny Harries on Friday, when he will be able to put that question to her. If not, he should write to me and I will put that question to her.
(3 years ago)
Lords ChamberI believe all noble Lords will agree with the points made by the noble Baroness on making sure that as many people in the world as possible have access to the vaccines. Someone said to me today that we are talking about third and fourth doses in the UK, but there are people in many parts of the world who have not yet had their first dose. I am sure noble Lords are aware of that. There is an analogy with when you are on an aircraft and the oxygen masks fall; do you protect yourself before you protect others? There is clearly a debate on this.
The UK remains committed to donating 100 million doses by the middle of 2022. We will have donated more than 30 million vaccines by the end of 2021 and have announced plans for 70 million doses in total so far. We will continue to ensure that any vaccines that the UK does not need are reallocated to other nations which require them wherever possible. Having sat in one of those G7 meetings with Health Ministers and joint G7 meetings with Health and Transports Ministers, I can assure noble Lords that one of the issues that comes up constantly is how we can help the rest of the world, particularly those countries which have not had access to even first doses of the vaccine.
My Lords, on whether LFT swabs should be nasal or nasal plus throat, it is more important that the test is carried out properly; we know that LFTs have low specificity, as opposed to sensitivity, compared to PCRs. Those who test positive with the new variant and their contacts must isolate for 10 days. If a traveller arrives on these shores and tests positive for the new variant, will the whole of the aeroplane have to isolate for 10 days or only close contacts? If only close contacts, who counts as a close contact? What risk assessment have the Government made on the transmissibility of the new variant in superspreader events such as clubs and sporting events?
The noble Lord raises an important point. I will double-check the details as I do not wish to mislead him or the House. Given that this is a fast-moving situation, in which the data is very new, changing constantly and constantly being reviewed, it would be more appropriate if I double-check before I answer.
(3 years, 1 month ago)
Lords ChamberI thank my noble friend. He is indeed looking incredibly healthy and is a living advert for the path away from cigarettes to e-cigarettes. Noble Lords across the House are keen for this to happen. The MHRA has advised that it is 18 to 20 months away from approving a medicinal licence for e-cigarettes in the UK. However, I take the points of many noble Lords; I will push the MHRA, and I hope that they will too.
My Lords, it is correct that only MHRA-approved e-cigarettes should be available on prescription. The reason for that is that many e-cigarettes currently sold on the market contain dangerous products; there have been reports of deaths occurring due to lung complications. So is it not right that the sale of e-cigarettes not approved by the MHRA should be banned?
E-cigarettes are a pathway out of cigarettes; these e-cigarette products exist now, even before we have one approved via the MHRA. It is important not to ban existing products because we need to make sure that people move along that pathway. The hope is that, once there is an MHRA-licensed product, people will be encouraged to buy it, both on prescription and over the counter.
(3 years, 1 month ago)
Lords ChamberThe money that has been announced is for April 2022 onwards, for three years. In dealing with the specific issue now, believe me, we are having conversations within the department and elsewhere about how we address some of the issues that people are raising with us.
Going back to the Question on the Order Paper, can the Minister state whether it is the Government’s intention to involve the private sector in delivering some of these diagnostics? If so, will they be paying the private sector tariff or the NHS tariff?
I thank the noble Lord for that question. It is important that we recognise that this is a public/private partnership and that we make sure that we can rely on expertise and investment from the private sector. On the specific question, I will write to the noble Lord.
(3 years, 2 months ago)
Lords ChamberI thank my noble friend for that question and recognise the work she did with the Centre for Social Justice on this issue. The Government are keen to drive the NHS diabetes prevention programme, which plays a pivotal role in supporting those at risk of developing diabetes. During 2018-19, over 100,000 people took up the programme. In 2019-20, NHS England delivered the long-term-plan target, supporting around 120,000 people on the programme.
My Lords, does the Minister agree that all those over the age of 40 who are obese, and those who record a high score on the diabetes type 2 assessment, should be offered a blood glucose and haemoglobin A1c test? If he does not agree, can he say why?
The Government, in conjunction with the Department of Health and Social Care and many other partners, including Diabetes UK, are looking at the most effective way to tackle diabetes but also to understand the trade-offs that must be made and the balance of considerations. I will write to the noble Lord on the detail of his question.