(3 years, 2 months ago)
Lords ChamberTo ask Her Majesty’s Government what assessment they have made of the level of cancellations of influenza vaccinations and routine blood tests.
My Lords, I regret to report that there was a shortfall in the supply of blood tubes of around 13% in the last two weeks of August, which led to some disruption. That has been mitigated through use of government stockpiles, importing tubes and changes in practice. Supply has now returned to normal. It is not true that there is a flu vaccine shortage; the delivery from one supplier was delayed by one or two weeks, but this should have no impact on the flu vaccination programme overall. I am pleased to say that we are in regular contact with doctors, and no issues of cancelled appointments have been raised.
What the Minister just said about blood tests is good news for those who have regular serious blood tests. But on the subject of flu jabs, does he recall telling me earlier this year that the flu jabs were made in the UK? They are not imported. The lorry drivers problem is a UK issue, so this is a home-grown issue. The websites this morning are saying that, up and down the country, GP after GP has been thrown into chaos because they are having to cancel appointments that were made weeks ago. I have personal experience of this, because even in Ludlow we are having appointments cancelled. The idea that this is not a problem is not the case. Why has this been allowed to happen? Everything involved is under our control in the UK.
My Lords, it is not my understanding that appointments have been cancelled. If the noble Lord has any anecdotes, reports or evidence of that, I would be very grateful if he could send me that material. Seqirus, the company concerned, brings its vaccines in from overseas.
(3 years, 4 months ago)
Lords ChamberMy Lords, I have listened very carefully to the Minister but I did not quite hear the answer to the questions asked by the noble Baronesses, Lady Tyler and Lady Finlay, about the forthcoming pressures on the NHS. The hospital I was at on Tuesday morning is, I was told, working at full stretch; it is at winter levels in July. Covid is taking up ICU beds and stopping elective surgery now, even before the pressure starts. There are constant references in the Statement about not wanting unsustainable pressures on the NHS, but we are putting such pressures on it by allowing the figures to rip without seeming to have proper back-up services and resources. Can the Minister answer the questions from the two noble Baronesses?
My Lords, I thought I had answered the questions put by the two noble Baronesses. I will seek to answer the noble Lord. He is absolutely right: our hospitals are working flat out but this is not mainly because of Covid. As of 11 July, hospital admissions in England were running at 502 a day. As of 13 July, there were 2,970 patients in hospital in England with Covid, of whom 470 were on mechanical ventilation. Catching up on all the backlog—not Covid—is what is consuming the hospitals and making them run so red hot. This is the focus of our healthcare system at the moment, and it will remain so for some time to come. We are under no illusions: there is a massive backlog which includes many people who have not come forward with symptoms of severe disease and will need to be addressed and treated. This is a huge national project that we are undertaking.
(3 years, 4 months ago)
Lords ChamberTo ask Her Majesty’s Government, further to the reply by Lord Bethell on 3 September 2020 (HL Deb, cols 444–5), whether they have yet been able to form a conclusion on the outcome of their consultation on the proposal to add folic acid to flour which closed on 9 September 2019.
My Lords, I am pleased that substantial progress has been made on this work since I spoke to the House in June, including positive dialogue with all devolved Administrations. It is right that we remain committed to proceeding on a UK-wide basis and I am grateful to colleagues in the devolved Administrations for their energy and support. I assure the House that we are progressing this as a priority, and I look forward to updating the House after the Recess.
Can I assume that the Minister is aware of the statement from the Ministry for Primary Industries in New Zealand on 8 July, five days ago, that as a result of its consultation on folic fortification in 2019 it will fortify all non-organic wheat flour from mid-2023 and therefore join Australia and more than 80 other countries in mandatory fortification? Why are we so far behind New Zealand? The women of New Zealand had the vote 30 years before British women. Can I be assured that British women will not have to wait as long to have safer, healthier pregnancies and fewer babies with a lifelong disability?
My Lords, I pay tribute to the Government of New Zealand for focusing on this important issue and to the energy and passion of the noble Lord in his advocacy in this matter. I can give him the reassurance he asked for. This is a priority for the Government. We are taking it through the machinery of the British Government to ensure that it is rolled out safely, extensively and on a nationwide basis.
(3 years, 4 months ago)
Grand CommitteeMy Lords, I do not wish to be at all critical of the figures that the Minister gave in his first few sentences regarding our capacity and what we have been able to do in our laboratories. I suspect, by the way, that he has a new speechwriter, as his speech was slightly different from what I have heard from him before. The reality is that I put my name down for this debate for one simple reason: last week’s reports that the Government intend to charge for devices that are currently free on the NHS. These regulations are about tests for sale.
The eighth report from our Secondary Legislation Scrutiny Committee is a masterclass in drafting. It clearly states that the market is “overwhelmingly dominated” by free NHS tests. Paragraph 3 states that
“the Government want to support a ‘thriving private sector market for COVID-19 detection tests’”.
Paragraph 4 says that these regulations are
“for a time when privately bought tests play a more significant role”.
Well, they certainly will be when the Government start charging for NHS tests. It is a £3 billion market, after all—at least I think so, from the figures I have seen.
In April, when the tests were first brought out, we were told that handing them out—and, indeed, encouraging people to take them—was vital to getting the country back to normal. The Secondary Legislation Scrutiny Committee has been very critical of the failure to supply documentation when the regulations were laid. In at least two paragraphs of its report, the committee makes it clear that free NHS tests must continue.
It is clear that the Government want to charge for the tests. I understand that the promise—and I have made checks—was made to supply them free only until the end of next month, August. There has been no commitment to go beyond that, hence the rush to get these regulations through. Quite clearly, that is what it is all about. It is being pushed through at this last minute, a few days before the Recess, so that the Government can abandon free tests at the end of August. I realise that the Minister has come briefed on the regulations and I am asking about something extra, but let us face it: it was predictable that this would be raised. He has not taken any opportunity to say anything about the maintenance of free tests. I think that is sad because he is going to be asked that repeatedly until the Government are clear about their intentions.
My final point is a question: why do we need to buy the NHS Test and Trace kits for the lateral flow test, the one being given out by local chemists, from one of the Chinese Communist Party-approved companies? How do we know they are not made with slave labour? What kickbacks go to that corrupt political party? What efforts are being made to get them made in the UK—dare I say Europe—or, indeed, Commonwealth countries? We now have the capacity to check the tests in laboratories. Why have we not done something about manufacturing capacity? Why are we reliant—we appear to be reliant—on the fix of the Chinese industrial structure, which is controlled by the Communist Party or it cannot operate? In winding up, the Minister has the chance to be clear. I do not expect him to answer everything, but it would be useful if he would say that the Government intend to pursue free NHS tests for a period beyond the end of August. After all, that is in Recess. We will not have time to query that, as we are not back until 6 September, so that decision would be taken outwith Parliament sitting, and I do not think that would be right.
(3 years, 4 months ago)
Lords ChamberMy Lords, as the first male Member of your Lordships’ House to speak in the debate, I welcome very much what the noble Baroness, Lady Jenkin, had to say. Her opening speech was, frankly, awesome—that is how I would describe it.
I do not apologise for returning to the Marmot review, which the Minister has heard me speak about before. Inequalities in life expectancy have increased since 2010, especially for women. Female life expectancy declined in the most deprived 10% of neighbourhoods between 2010-12 and 2016-18. Female life expectancy decreased in every region save for London, the West Midlands and the north-west. Life expectancy in England has stalled since 2010, which has not happened since 1900. When health has stopped improving, it is a sign that society has stopped improving. That is all from the Marmot Review 10 Years On, published in February 2020.
Of course, health is linked to all the other conditions in which people are born, grow, live and work, together with inequalities in power, money and resources. Frankly, the Government have not prioritised health inequalities, despite the concerning trends, and there has been no national health inequality strategy since 2010. This is a national UK issue and cannot be shoved off as a devolved matter.
I have not mentioned Northern Ireland. It has suffered the same as the other three nations but one figure, set out on page 12 of Build Back Fairer: The COVID-19 Marmot Review, is unique in respect of female health. The table is titled: “Relative cumulative age-standardised all cause mortality rates by sex, selected European countries, week ending 3 January to week ending 12 June 2020”. Of the eight countries where the situation got worse—as opposed to the 11 where it got better—the UK’s four nations were in the eight, and in only one of all the countries where it got worse, it got worse for females compared to males. That was Northern Ireland. There is quite clearly something badly wrong in health inequalities between men and women in Northern Ireland for it to stick out like that among all those countries. The recommendations for change are all well known. They are listed in both the Marmot reports I have used.
I note the BMA has highlighted more targeted issues, such as those relating to domestic abuse, pregnancy and maternity services, which male Secretaries of State keep ignoring. However, the first move has to be an acceptance that things have gone really badly since 2010, when the coalition Government imposed swingeing cuts to public expenditure without any analysis of the consequences. One consequence is the stalling of life expectancy, where women have been affected worse than men.
(3 years, 4 months ago)
Lords ChamberMy Lords, we have a prioritisation list for the booster and the third jab. It is my understanding that octogenarians are in category 1, but I am happy to write to my noble friend to confirm that point, in case I have got that wrong. I share my noble friend’s aspiration on care home workers. We are in a consultation; I cannot make the guarantee that he asks for because it is an honest consultation. We have to take people with us: this is not something that we can impose on people against their will. When the consultation has passed, I am hopeful that we will be able to take the steps that he describes.
I congratulate the Minister on his track record of appearances in the House. I will raise two brief subjects with him, both of which have been raised today, neither of which he has addressed. First, are there plans to charge for the lateral flow test? It is now being delivered to people less than 24 hours after they request it, and requests will certainly go down if there is a charge. A clear answer on that would be useful. The second issue is shielding. When the Prime Minister makes a Statement on Monday, in advance of 19 July, it is crucial that something is said about people who were shielding before; they must not be left in limbo and ignored. They could at least be given a warning that they will be given, say, a week or 10 or 14 days before they need to shield, which would remove part of the worry from the large changes due to take place on 19 July. I ask the Minister to respond on lateral flow test charging and shielding, please.
My Lords, on lateral flow tests, I said that I did not recognise the press reports that the noble Baroness mentioned, and I still do not. On shielding, I completely agree with noble Lord. Some 1.5 million patients are identified as CEV-equivalent through the new QCovid model, and they have been added to the shielding patient list, with 820,000 who had not previously been invited as part of the JCVI cohorts 1 to 4 given priority access to vaccines. Overall, 3.8 million—I think I said 3.5 million earlier—individuals are on the shielded patient list, and we continue to maintain that through the NHS. We will look at the QCovid model and see if we can apply mix-and-match vaccines, booster shots and third shots to that model, and if we can bring together a new risk assessment for those who are vulnerable. That list could therefore be applied to any future shielding or protection that may be needed.
(3 years, 5 months ago)
Lords ChamberMy Lords, I completely understand the noble Earl’s points. On WOMAD, I have a particular interest in that fine festival and I am extremely sad to hear that it has been cancelled, and to have to change my family plans accordingly. I reassure the noble Earl that we have not overlooked the arts at all. They are absolutely paramount in our thoughts. The events research programme is making progress, but it consumes a high number of tests and we simply do not have the capacity, despite the huge investment we have made, for the kinds of figures that would be needed to open up the whole of the arts world at this stage. But I am hopeful that the research we are doing will create the kind of persuasive data necessary to figure out safe ways of reopening the arts, so that we can get back to the life we had as soon as possible.
I welcome the Minister’s openness and transparency about his conduct. I also support what he said about the attacks on Dr Whitty. If there are no arrests before the end of the day, it will just show how useless the Metropolitan Police is under its current leadership. In his Statement, the Secretary of State talked about keeping the NHS safe. What I have not really connected, both from the previous Question and this Statement, is that keeping the NHS safe cannot be done in isolation. The issue of social care and its reform is inexorably linked to keeping the NHS safe, and that point does not seem to be used by Ministers as a serious connection. Finally, without abuse, if this country starts boosters or third jabs later this year when people in countries such as Nepal are still going without vaccinations, it will be a thundering international disgrace.
My Lords, I have failed in my mission, because I have sought to convey to the Chamber that we completely understand that the NHS, social care and public health—the three sectors of our healthcare system—are inextricably linked. That is why we are bringing to the House the health and social care Bill that we are. That is why we have already brought about a large number of reforms, including ICSs and the integration of various diagnostic elements, and have sought to bring more parity for social care workers and those in public health. The noble Lord absolutely hits the nail on the head. I completely agree with his point, and that is our guiding star for the future.
(3 years, 5 months ago)
Lords ChamberMy Lords, we know what the problem is. We have just heard that the Lords Economic Affairs Committee spelled it out in detail in July 2019, and the House debated it in May this year. In the meantime, of course, the Prime Minister has more than once told us that he has a plan—famous for social care plans is our Prime Minister. I will use just one speech, made in Dudley, on 30 June last year, as an example, when the Prime Minister said
“we won’t wait to fix the problem of social care that every government has flunked for the last 30 years … We are finalising our plans and we will build a cross-party consensus”.
There is another chance today to hear from a Minister the excuses for no action being taken on the plans that the Prime Minister has more than once said were finalised.
The Lords Economic Affairs Committee said that an injection of £8 billion was needed—of course, that was two years ago—just to restore the level that the coalition Government of Tories and Lib Dems inherited from the Labour Government in 2009-10. The Mencap brief for today’s debate gives one example of a £180 million gap in local authorities for people of all ages with a learning disability to be able to live a decent life.
The question is: how do we get the cash? Not from people selling their homes, as the Prime Minister is against that—but it is happening every week. It has to be a national effort, shared as we share the funding for the NHS. The Government want to be consistent with their manifesto, so here is my solution. Yes, it will involve more tax, but it will save money and misery in the end. My bid is simple: the over-40s pay an extra 2% on income tax as a social care supplement. As for national insurance, why on earth does it cease at the age of 65? I was on a salary until I was 72, and paid no national insurance after the age of 65. Today, I am an 80 year-old, 40% taxpayer, yet I pay no national insurance. You could keep the rate the same, or tweak it after 65, and stay in line with the Tory manifesto, and you could get this social care supplement from employers as well. The extras for pensioners, such as winter fuel and bus passes, are all great and convenient, but we should make them taxable. As the Minister who introduced the 75p pension increase in 2000, while ensuring that the poorest pensioners got £3, I say we need only the double lock introduced by Labour; the triple lock cannot be justified any longer.
(3 years, 5 months ago)
Lords ChamberMy Lords, this Government’s progress on this really came to a head in the consultation in September 2019, and we have been on course to implement these measures since then. It is unfortunate that the Covid pandemic intervened at that point and we had to put work on this project on hold until April of this year. Since April, we have had to deal with the elections in the devolved Administrations. That, unfortunately, creates an insuperable barrier to taking the measures through all the necessary checks and alignments. I reassure the noble Baroness that we are totally committed to this policy, we are moving at pace and I look forward to further progress shortly.
I very politely remind the Minister—and it is on the record—that the three devolved Governments were in favour of this policy before the English Government were, so there cannot really be any substance of any delay from the devolved Governments. I know this because, with scientists, I discussed it with some of the Ministers. My other point is that, given that we already fortify with three substances, there cannot be any technical difficulties whatever in the flour mills in adding folic. There should not be any long-term delay of a technical nature, should there?
My Lords, I agree with the noble Lord. Can I just take a moment to bear testimony to his patient and determined campaigning on this issue? He has held the Government’s feet to the fire on it, and I am grateful for his focus. He is right that we are hopeful that there should not be any substantive delay with the industry. A huge amount of work has gone on in the consultations and the dialogue we have had, and I am grateful for that. However, the Senedd and Scottish parliamentary elections in May meant that new personnel were at the top of government. We hope that they are as supportive as the noble Lord so rightly pointed out, but there is a process to get the official endorsement that we need to take this forward and we are waiting for that paperwork to come through.
(3 years, 5 months ago)
Lords ChamberI hope that the noble Baroness will accept my apology if I have in any way suggested that I am flippant about inconsistency—I am not. What I have in my mind is the huge amount of work that is done by policy officials in order to try to be as consistent as possible. I pay tribute to the colossal human effort that goes into trying to make sure that everything we do is aligned. It is a monumental and very difficult task.
The noble Baroness is right to say that Wimbledon is a big event pilot, quite different in its ambition and its tone to some of the other events—for instance, the care homes that the noble Baroness, Lady Meacher, referred to. What we are trying to do is to take fairy footsteps out of the pandemic. Wimbledon, for instance, will account for many hundreds of thousands of tests as we use very rigorous testing procedures to try to protect the rate of infection in that big event. If it is successful, it will help us lead our way out of this horrible arrangement.
At a personal level, I feel very sorry for the Minister. He must realise that there are considerable doubts across both Houses about the Prime Minister’s sincerity and truthfulness. Have we been told the whole truth and nothing but the truth about the delay over dealing with India?