Health Care: Guidance

Lord Rennard Excerpts

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is right that half of consultations have been done by telephone or on the internet. Some of those have been successful, but I agree with her that we have to keep GP surgeries open for those who either choose or need face-to-face consultations. That is why the NHS chief executive has written to CCGs and trusts urging them to be open and to have fair access to face-to-face consultations where necessary.

[Lord Rennard (LD)]

My Lords, I refer to my entry in the register of interests. Older people are more vulnerable to complications from the virus. Many more of them will have diabetes, and many more will feel that they need cancer treatment urgently. So why are so many older people still worried that they might be treated less favourably by the NHS due to their age? In particular, will the Minister explain how the backlog in treating cancer patients will be dealt with?

[Lord Bethell (Con)]

The noble Lord is entirely right that there is a large amount of concern among patients—existing patients who are on existing programmes and patients who think to go to the NHS. We are launching a “Help Us Help You” campaign at the beginning of October, which will be a substantial marketing campaign to reassure patients who might be concerned that the NHS is open and there to help them.

Anti-obesity Strategies

Lord Rennard Excerpts

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am not sure I agree with the premise of the question. It is not my belief that the anti-obesity campaign will generate massive negative repercussions. The NHS’s work in this area has developed immensely and we are putting a huge amount of money into it, including through our mental health strategy. I support the strategy we are applying.

[Lord Rennard (LD)]

My Lords, the need for psychological support for people with such eating disorders is often identified through face-to-face meetings with GPs. Is the Minister satisfied that it is possible, in safe conditions, for people to obtain such meetings at the moment and that, if such a need is identified, sufficient psychological support is available for them?

[Lord Bethell (Con)]

The noble Lord is probably aware that a letter has been sent to GPs inviting them to step up to their responsibilities for face-to-face meetings. Everyone should have a face-to-face meeting if that is what they require and need. One of the surprising and interesting outcomes of the Covid epidemic is that many mental health services have been successfully delivered through video links. It has meant that people who may feel vulnerable about attending a GP’s surgery or mental health clinic have had the opportunity for consultations. We will look at how to expand that kind of interaction.

Medicines and Medical Devices Bill

Lord Rennard Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020 Lords Chamber

[Lord Rennard (LD) [V]]

My Lords, the Bill is necessitated by Brexit but, as many noble Lords have said, it does not provide the detail required to address the concerns about protecting patient safety, promoting innovation and helping British businesses at such a difficult time.

Soon after the Brexit vote, I attended a meeting convened by the MHRA involving many of the trade associations representing businesses in the healthcare sector. There was a strong feeling that the best way of addressing some of these issues would be for transitional arrangements to continue for quite some time, if not indefinitely. This case has been strengthened by the Covid crisis.

The UK has been a powerful player within the licensing framework for European medicines and medical devices for many years. The crucial role played by our scientists has been greatly appreciated across the EU and has benefited everyone, so the principle of dividing scientific expertise into two camps, one covering the UK and one covering 27 EU member states, is not a good one.

The case for the UK becoming an independent regulator of medicines and medical devices has never really been made convincingly and we have yet to see any real evidence that the risks and difficulties are likely to be outweighed by any benefits. Patients in the UK may find themselves accessing the latest innovations significantly later than patients in the EU. Businesses are told that they may benefit from different licensing arrangements in future, but if they are different, approval may well still be needed for export to the EU or to other countries which have learned to rely on EU standards. Likewise, patients who might benefit from new products licensed by the EU may not be able to get them until the UK has also approved them.

Two sets of licensing processes will mean two sets of applications, two sets of costs and two potential sets of delays, with the consequence that businesses may be less inclined to invest in innovation than they are under present arrangements. In future, we really need closer alignment in regulation between the UK, the EU and other international standards bodies.

The government case is that the UK will now be able to give more of a lead and to deal with approval processes more expeditiously, but the Bill lacks any detail showing how this could be the case. We might hope that in future greater emphasis will be placed on regulating areas of emerging and cutting-edge science where the UK has significant expertise, such as cell and gene therapies. We may aim for the UK to be seen more widely as a destination for the regulation and trialling of innovative and advanced medicines.

We should want the UK to be an attractive place for companies to undertake research and launch new products and therapies, but we have no real evidence yet that the UK will be able to achieve any of these things alone, and everything appears to be left to government Ministers to decide how things will be done at a time when confidence in some Ministers is very low. Greater detail and greater provision for parliamentary scrutiny may provide greater hope of progress on some of the worthy aspirations that have been outlined.

Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020

Lord Rennard Excerpts

Wednesday 29th July 2020 Lords Chamber

[Lord Rennard (LD) [V]]

My Lords, I lived in the great city of Leicester for four years in the 1980s, and I am now seriously worried about the situation there, and how long these restrictions may apply without the serious risk of them being breached on a regular basis and even civil unrest breaking out. Can the Minister confirm that tomorrow’s review will provide hope and further reassurance to people there that these restrictions will not be applied for any longer than necessary?

Part of the reason why areas such as Leicester are disproportionately affected by Covid-19 is that they are areas with high BME populations and higher levels of diabetes. The issues are related. I have therefore asked a number of Written Questions today about support for people with diabetes; I will not repeat them here but I look forward to the Minister’s answers. The Prime Minister’s own Covid experience may have had a beneficial effect in persuading him of the need for proactive measures to support people struggling with obesity and those seeking to maintain good diabetic control. However, will the Minister tell us that decisions on issues such as calorie labelling will be evidence-based in the interests of public health, and not determined as a result of big business lobbying efforts?

Finally, if the lockdown continues, can I ask the Minister to help potential holidaymakers who are outside the lockdown area but have Leicester postcodes? The leader of Hinckley & Bosworth Council, Councillor Stuart Bray, tells me that some travel companies are cancelling people’s holidays because of their Leicester postcodes, even though they live outside the lockdown area. If necessary, can steps now be taken to properly advise travel companies as to exactly which postcodes are relevant for lockdown restrictions?

Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020

Lord Rennard Excerpts

Friday 24th July 2020 Lords Chamber

[Lord Rennard (LD) [V]]

My Lords, these regulations may be a sensible consolidation of previous ones, but we cannot pretend that this kind of debate subjects them to proper scrutiny. I hope that detailed questions such as those put by my friend Lord Oates will be properly answered. The process of approving new regulations that are already in place, in order to replace ones that expired before they were approved, does not inspire confidence.

So can the Minister assure us that, in the absence of Parliament meeting over the next month, the Government will make public where any of their policies on tackling the pandemic may diverge from medical advice, and for what reason? Will he agree that, in the event of the UK Covid alert level going back from 3 to 4 over the Recess, there should be a recall of Parliament, albeit virtually?

Smoking

Lord Rennard Excerpts

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness points to the knottiest and most difficult of the challenges of giving up smoking. It is extremely sad that anyone should contemplate smoking during pregnancy, but this is one of the most durable and knottiest problems. I commend the use of creative and innovative schemes such as the one in Manchester to which the noble Baroness alludes, but more needs to be done, because prevention is better than cure.

[Lord Rennard (LD) [V]]

My Lords, 1 million people have given up smoking to protect their health during lockdown and now 86% of people in the UK do not smoke. Will the Minister therefore support the amendment this afternoon, which would mean that if additional tables and chairs are put outside pubs and restaurants through pavement licences, all the new seating areas created will be smoke free and more attractive to potential customers?

[Lord Bethell [V]]

The noble Lord is right to commend those who have given up smoking during Covid. I pay tribute to anyone who has given up smoking. I struggled and found it immensely difficult, but I am glad that I did it. There is a government amendment to the Bill, which the Department for Health and Social Care supports, and we wish it every success.

Covid-19: Mental Health Services

Lord Rennard Excerpts

Thursday 2nd July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, the work on the NHS people plan continues during the epidemic and we look forward to making the first announcement on that shortly, which will cover many of the concerns of the noble Baroness. I also remind the House that, on 15 June, Public Health England unveiled its psychological first-aid training course, developed by PHE, which has proved extremely helpful, as has the confidential helpline that was unveiled on 8 April, which we continue to support.

[Lord Rennard (LD) [V]]

My Lords, people with diabetes are twice as likely to experience depression as those without, and a third of Covid-19 deaths in England are linked to people with diabetes. A survey by Diabetes UK shows that three-quarters of people with diabetes who have felt that they needed specialist mental health support cannot access it. How can the Government help to ensure that more people are tested for diabetes and that those with the condition receive comprehensive check-ups, including screening and support for mental health issues?

[Lord Bethell [V]]

My Lords, we are investing in new and additional diabetes testing arrangements. Testing is essential for the diagnosis and management of this affliction. The noble Lord is entirely right that the connection between Covid deaths and diabetes appears profound. It is a wake-up call for the whole country and puts a spotlight on the large amount of diabetes in the UK. We will unveil plans in the future for refocusing on this important public health issue.

Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020

Lord Rennard Excerpts

Thursday 25th June 2020 Lords Chamber

[Lord Rennard (LD) [V]]

My Lords, the Minister will recall that my major concern about these changing regulations is about the credibility of government advice and growing public reluctance to do what it says. Pictures of crowded beaches and incidents such as the large gathering in south London last night, which required police intervention, suggest that many people are not staying alert or staying safe, and such behaviour is putting many more people at risk. The Minister makes a valiant defence of the Government’s position, but why does he think people are increasingly using their own judgment? Has he continued listening in recent weeks to Radio 4’s “More or Less”, with its weekly demolition of government statistics, and does he still feel that he could prove the programme wrong? Does he accept that the Government have lost credibility? Why is this?

We know that the Chief Nursing Officer was excluded from a press conference when she would not toe the line about Dominic Cummings. Yesterday, the Guardian listed eight occasions on which Professor Chris Whitty’s advice has diverged from that of Boris Johnson. The Prime Minister said, for example, that judgments about what could have been done better are premature, but the Chief Medical Officer says that there is a long list of things that we should look at very seriously. He highlights the failure to speed up testing very early on. Should we not learn the lessons of what could have been done better before we face the risk of further spikes?

Social Distancing: Two-metre Rule

Lord Rennard Excerpts

Tuesday 16th June 2020 Lords Chamber

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

The noble Baroness highlights an incredibly important consideration in the review on the two-metre rule. Clearly, those who are vulnerable or in social care deserve the best protection necessary. SAGE has been extremely clear that two metres provides emphatically more protection than one metre, and the protection of our vulnerable people will be an important consideration in any review.

[Lord Rennard (LD) [V]]

My Lords, yesterday a Health Minister in the Commons repeated the mantra that advisers advise and Ministers decide. But trust in government has diminished greatly in recent weeks, so people need to know what is advised before accepting what Ministers decide. Can the Minister assure us that the advice to be provided by the Government’s scientific and medical advisers to this review will be published as it is written and submitted by them, independently of any government pressure, so that we will know whether or not any proposed change really is based on scientific and medical advice? There is a consensus that the Government were late on lockdown, late on face masks and late on testing and tracing, so we do not want to be premature in reducing the two-metre distance rule. Should we not be sure that we have a full track and trace system in place before considering easing the distance rules?

[Lord Bethell [V]]

I do not recognise the contention of the noble Lord. Having been in many meetings with our scientific advisers, I deny the suggestion that scientists are open to being pressured by politicians. The advice that they have given is clear-cut and it is for us to consider its value. The noble Lord does scientists no favours by implying that they might be changeable under pressure.

Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020

Lord Rennard Excerpts

Monday 15th June 2020 Lords Chamber

[Lord Rennard (LD)[V]]

My Lords, my main concern about these regulations is whether there can be sufficient public confidence for people to respect them. Debates such as this have shown how government advice and regulations about how we should all respond to the Covid crisis have been inconsistent: inconsistently applied and inconsistently based on scientific advice. Government statistics, on which policy is based, have been regularly challenged.

I asked the Minister some weeks ago if he listened to the excellent Radio 4 programme “More or Less”. He said that he did. If he has been listening recently, he will have heard a weekly demolition of government statistics. On Friday, we learned that England’s chief nurse was dropped from a Downing Street press conference because she would not back Dominic Cummings. Yesterday, we read in the Sunday Times that the Government’s Chief Medical Officer and Chief Scientific Adviser are both on resignation watch. Tonight, we saw the Foreign Secretary standing alone at the Downing Street press conference, without advisers.

The impression has been constantly given that political pressures to create headlines have sometimes taken precedence over protecting people’s lives. To help regulations such as these gain respect, can the Minister please tell us why the daily Downing Street press conferences should not be replaced by Statements in Parliament where they can be properly scrutinised, and by regular press conferences, at which journalists are allowed us to pursue questions where they are not answered satisfactorily and scientific advisers are able to speak freely?