Questioner: Lord Rennard
Question
To ask Her Majesty's Government what plans they have to increase funding for public education campaigns about smoking in order (1) to encourage people who have quit smoking during the COVID-19 lockdown to remain smoke-free, and (2) to motivate people to quit smoking in coming months.
Answer (Lord Bethell)
The Government has committed £70,000 to support the ‘Today is the Day’ campaign which is targeted at localities with high smoking prevalence. Public Health England’s annual Stoptober campaign will be held in October 2020 and will take account of the context of the COVID-19 pandemic.
Questioner: Lord Rennard
Question
To ask Her Majesty's Government, further to the data included in Statistics on Women's Smoking Status at Time of Delivery: England Quarter 4, 2019–20, published on 7 July, what assessment they have made of Greater Manchester’s Smokefree Pregnancy programme; and what plans they have to implement a national smoke-free pregnancy incentives programme along the lines of that programme.
Answer (Lord Bethell)
The Government has a track record of reducing the harms caused by tobacco and is committed to achieving its ambition to reduce the rate of smoking in pregnancy to 6% or less by 2022.
The Government is aware of the work undertaken in Greater Manchester, although we have not made a formal assessment of it. The programme will be considered by officials when exploring further ways that we can protect babies and their parents from the consequences of smoking in pregnancy.
Questioner: Lord Storey
Question
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 July (HL6182), what is their expected timeframe for introducing the necessary legislation to extend the mandatory display of ratings to England.
Answer (Lord Bethell)
The Food Hygiene Rating Scheme is operated by the Food Standards Agency in partnership with local authorities across England, Wales and Northern Ireland.
We will consider whether mandatory display of ratings should be introduced in England in due course.
Questioner: Lord Kennedy of Southwark
Question
To ask Her Majesty's Government what steps they are taking to ensure that a nomenclature system for the genetic diversity of SARS-CoV-2 is in place.
Answer (Lord Bethell)
Public Health England is not the body that defines the nomenclature system for the genetic diversity of viruses. This is undertaken by the international scientific community.
Questioner: Lord Brooke of Alverthorpe
Question
To ask Her Majesty's Government what plans they have to implement (1) the proposals contained in Childhood obesity: a plan for action - Chapter 2, published in June 2018, and (2) the recommendations relating to childhood obesity outlined in the Green Paper Advancing our health: prevention in the 2020s, published in July 2019.
Answer (Lord Bethell)
We published Tackling obesity: empowering adults and children to live healthier lives on 27 July. The strategy demonstrates an overarching campaign to reduce obesity, takes forward actions from previous chapters of the childhood obesity plan and sets our measures to get the nation fit and healthy, protect against COVID-19 and protect the National Health Service.
In addition, Public Health England has launched the Better Health campaign, which will call on people to embrace a healthier lifestyle and to lose weight if they need to, supported by a range of evidence-based tools and apps providing advice on how to reduce the waistline.
A copy of Tackling obesity: empowering adults and children to live healthier lives is attached.
Questioner: Lord Brooke of Alverthorpe
Question
To ask Her Majesty's Government, further to reports of the disproportionate impact COVID-19 has on people living with obesity, what plans they have to develop a campaign to encourage people to make healthy choices; with whom they have engaged on the development of any such plans; and whether they intend to publish those plans.
Answer (Lord Bethell)
We published Tackling obesity: empowering adults and children to live healthier lives on 27 July. The strategy demonstrates an overarching campaign to reduce obesity, takes forward actions from previous chapters of the childhood obesity plan and sets our measures to get the nation fit and healthy, protect against COVID-19 and protect the National Health Service.
In addition, Public Health England has launched the Better Health campaign, which will call on people to embrace a healthier lifestyle and to lose weight if they need to, supported by a range of evidence-based tools and apps providing advice on how to reduce the waistline.
A copy of Tackling obesity: empowering adults and children to live healthier lives is attached.
Questioner: Lord Rennard
Question
To ask Her Majesty's Government what assessment they have made of the case for increasing public health funding in the light of the COVID-19 crisis; and whether future statements to Parliament on COVID-19 will address any such increase of that funding.
Answer (Lord Bethell)
The public health grant to local authorities is £3.279 billion in 2020-21. This is in addition to what the National Health Service spends on public health, which included over £1.3 billion in 2019-20 on national public health programmes such as immunisations and screening.
The Government has also provided £4.3 billion of additional funding for local government to help them respond to COVID-19 pressures across the services they deliver. Local authorities will take spending decisions based on local priorities, and the Government is keeping the position under review.
Funding beyond 2020-21 will be set out at the next spending review.
Questioner: Lord Strasburger
Question
To ask Her Majesty's Government, further to Question for Written Answer HL5806, tabled on 16 June and due for answer on 30 June, how many contracts they have entered into with Pestfix Ltd; on what dates those contracts were entered into; and when they will publish the contract award notices.
Answer (Lord Bethell)
The Department has awarded 11 contracts to PestFix Ltd. One Contract Award Notice has been published which shows that the contract was awarded on 13 April 2020. The other Contract Award Notices will be published shortly. These will contain the dates of the contract award which, as with all the information to be published, is subject to a validation process.
Questioner: Lord Taylor of Warwick
Question
To ask Her Majesty's Government what assessment they have made of the study by researchers from the Universities of Birmingham and Manchester on the impact of social determinants of health on patients with SARS-COV-2 infection in Birmingham, published on 19 July; in particular its finding that air pollution may have contributed to the impact of COVID-19 on BAME individuals.
Answer (Lord Bethell)
Following the publication of the Public Health England review into the risks and outcomes of COVID-19 in June, the Parliamentary Under-Secretary of State for Equalities (Kemi Badenoch MP) is leading work to better understand the key drivers of the disparities identified and the relationships between the different risk factors.
Poor air quality is the largest environmental risk to public health in the United Kingdom and the Government is taking robust action to improve air quality and minimise public health impacts, as laid out in the Clean Air Strategy.
We are committed to improving our understanding of the possible links between air quality and COVID-19, to inform policy development. This will be supported by the recent National Institute for Health Research and UK Research and Innovation call for research proposals to investigate emerging evidence of an association between ethnicity and COVID-19 incidence and adverse health outcomes. The Department of Health and Social Care continues to have extensive discussions with the Department for Environment, Food and Rural Affairs and other departments on the relationship between health and air quality.
Questioner: Baroness Gale
Question
To ask Her Majesty's Government what steps they are taking to ensure that virtual NHS continuing healthcare assessments are compliant with the Equality Act 2010 reasonable adjustments duty.
Answer (Lord Bethell)
During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. Where CHC assessments have continued during the emergency period, these must be compliant with the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) Regulations 2012 and the CHC National Framework.
CCGs may use a number of approaches to arrange Multidisciplinary Team assessments, including video conference. Preferences for how these are carried out should be indicated by the individual being assessed or their representatives.
To ensure the delivery of high-quality assessments, local assurance processes should be in place. There is also a detailed review process for eligibility decisions if an individual is dissatisfied with the outcome.
Questioner: Baroness Gale
Question
To ask Her Majesty's Government what monitoring and evaluation they have undertaken to ascertain the compliance of NHS continuing healthcare (1) virtual assessments, and (2) associated services, delivered during the COVID-19 pandemic with (a) the national framework for NHS continuing healthcare, and (b) relevant legislation.
Answer (Lord Bethell)
During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. Where CHC assessments have continued during the emergency period, these must be compliant with the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) Regulations 2012 and the CHC National Framework.
CCGs may use a number of approaches to arrange Multidisciplinary Team assessments, including video conference. Preferences for how these are carried out should be indicated by the individual being assessed or their representatives.
To ensure the delivery of high-quality assessments, local assurance processes should be in place. There is also a detailed review process for eligibility decisions if an individual is dissatisfied with the outcome.
Questioner: Baroness Gale
Question
To ask Her Majesty's Government what plans they have to produce guidance on monitoring and evaluating the quality of virtual NHS continuing healthcare assessments.
Answer (Lord Bethell)
During the COVID-19 emergency period, National Health Service Continuing Healthcare (CHC) assessments have not been required due to changes made under section 14 of the Coronavirus Act 2020. Where CHC assessments have continued during the emergency period, these must be compliant with the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) Regulations 2012 and the CHC National Framework.
CCGs may use a number of approaches to arrange Multidisciplinary Team assessments, including video conference. Preferences for how these are carried out should be indicated by the individual being assessed or their representatives.
To ensure the delivery of high-quality assessments, local assurance processes should be in place. There is also a detailed review process for eligibility decisions if an individual is dissatisfied with the outcome.
Questioner: Lord Brooke of Alverthorpe
Question
To ask Her Majesty's Government what plans they have to publish the evidence that informed their decision to include people with a BMI over 40 on the list of those most at risk of worse outcomes from COVID-19; and why people with a BMI lower than 40 who are overweight or obese were not in included in that category.
Answer (Lord Bethell)
Having a Body Mass Index (BMI) of 40 or above is not one of the specific medical conditions that expert doctors in England identified as placing someone at greatest risk of severe illness from COVID-19 (clinically extremely vulnerable) and requiring them to shield.
It is, however, one of the health conditions identified as putting someone at a higher risk of severe illness from COVID-19 (clinically vulnerable). Those with BMI over 40 were eligible for a free influenza vaccination last winter, and that is the basis for including them in the clinically vulnerable cohort.
Questioner: Lord Alton of Liverpool
Question
To ask Her Majesty's Government what assessment they have made of reports that during the peak of the COVID-19 pandemic more than 4,000 people were discharged from hospital into care homes without being tested for the virus.
Answer (Lord Bethell)
Throughout our COVID-19 response we have worked with the care sector and public health experts to put in place measures to reduce transmission and save lives. It has been our priority to ensure that everyone is discharged safely from hospital and to the most appropriate available place. Wherever possible, people who are clinically ready should be supported to return to their place of residence, where assessment of longer-term needs will take place. This approach follows the ‘Discharge to Assess’ model, to support timely and appropriate discharge from hospital.
The Hospital Discharge Service and staff should clarify with care homes the COVID-19 status of an individual and any COVID-19 symptoms, during the process of transfer from a hospital to the care home. As testing capacity was being built priority for testing was given to the most clinically vulnerable patients:
- all patients in critical care for pneumonia, acute respiratory distress syndrome (ARDS) or flu like illness;
- all other patients requiring admission to hospital for pneumonia, ARDS or flu like illness; and
- where an outbreak has occurred in a residential or care setting, for example long-term care facility or prisons.
As set out in the Adult Social Care Action Plan on 15 April, all patients are now required to be tested prior to discharge to a care home.
Questioner: Selaine Saxby
Question
To ask the Secretary of State for Health and Social Care, whether he will give care homes discretion to decide on the best use of funding allocated under the Infection Control Fund.
Answer (Helen Whately)
The £600 million Infection Control Fund was set up to reduce the rate of COVID-19 transmission in and between care homes and support wider workforce resilience. It provides funds in addition to the £3.7 billion of general funding provided to local authorities, which can be used to support adult social care. Public Health England advice is that one of the key mitigations against transmission was through restricting staff movements between care homes wherever feasible. Taking this advice and feedback from care providers regarding workforce costs into account, care home providers may use the fund to support the implementation of a new set of measures. These measures also include paying staff full pay to isolate, and other infection control matters as set out in the grant determination. Local authorities have greater discretion over the use of 25% of the funding, which may be used on other COVID-19 infection control measures.
Questioner: Lord Hay of Ballyore
Question
To ask Her Majesty's Government what steps they are taking to improve the treatment of young people with mental health conditions.
Answer (Lord Bethell)
We remain committed to investing at least £2.3 billion of extra funding a year into mental health services by 2023-24 through the NHS Long Term Plan. This funding underpins our aim for an additional 345,000 children and young people able to access support through National Health Service-funded services or school and college-based mental health support teams.
We also remain committed to delivering the core proposals of Transforming children and young people’s mental health provision: a green paper, including the introduction of senior leads in mental health and mental health support teams in schools and colleges, as well as the piloting of a four-week waiting time for specialist NHS services, so that there is swifter access for those children and young people that need it.
Questioner: Lord Hunt of Kings Heath
Question
To ask Her Majesty's Government whether they can provide the information set out in figure 5 on page 50 of the NHS Resolution annual report and accounts 2019/20, published on 16 July, in respect of clinical negligence cases only.
Answer (Lord Bethell)
NHS Resolution handles clinical negligence claims on behalf of National Health Service organisations and independent sector providers of NHS care in England.
NHS Resolution has provided information on the number of clinical negligence claims settled in 2018/19 and 2019/20 with or without damages, which is attached due to the size of the data.
Questioner: Lord Watson of Invergowrie
Question
To ask Her Majesty's Government what action they plan to take in response to the report by Aging Clinical Experimental Research The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, published on 6 May.
Answer (Lord Bethell)
Public Health England (PHE) supported the National Institute for Health and Care Excellence (NICE) to review emerging evidence on vitamin D and the prevention and treatment of COVID-19. NICE’s review, published in June 2020, concluded that there is currently no evidence to support taking vitamin D supplements to reduce the risk or severity of COVID-19.
PHE re-issued its advice on vitamin D supplementation early in April 2020; whilst stay at home measures were in place it was recommended that everyone take a daily vitamin D supplement to keep bones and muscles healthy.
A copy of the NICE evidence review Vitamin D for COVID-19 is attached.
Questioner: Lord Turnberg
Question
To ask Her Majesty's Government, further to reports of limited home testing for COVID-19, what plans they have to simplify the requirements involved in taking a test.
Answer (Lord Bethell)
Everyone with symptoms of COVID-19 is eligible for a test, but we know that certain groups or individuals may find access more difficult or be less likely to want to access a test or feel unable to self-isolate. This could be for a combination of reasons, from capability through to personal circumstance.
We are working on a number of policies to address these barriers, such as:
- the NHS 119 call centre uses the Language Line interpreter service and staff are trained to manage language barriers, including through use of this service;
- we have opened new ‘walk in’ local testing centres to make it easier for people without cars to get a test; and
- we are also conducting a targeted evaluation of asymptomatic workers in several high contact professions. In a number of these occupations such as taxi drivers, cleaners and retail assistants, there is high representation of black, Asian and minority ethnic groups. This evaluation is intended to help us learn more about who may be at higher risk from COVID-19 and how to help keep people in professions that come into greater contact with others safe.
We have also created a home testing programme that provides access to testing to anyone, anywhere in the United Kingdom. We are continuously improving the service so that testing is accessible to all. This includes working with a diverse range of organisations to help us making home as easy to access and as user friendly as possible. For example, we are currently working with the Royal National Institute of Blind People to make home testing services more accessible for the visually impaired.
Questioner: Lord Alton of Liverpool
Question
To ask Her Majesty's Government, further to the statement by Lord Bethell on 15 July (HL Deb, col 1738) that “the Primodos case is subject to legal dispute, so I cannot comment on it from the Dispatch Box”, which aspects of that legal dispute prevent an independent re-examination of the contested conclusions of the report by the Expert Working Group of the UK’s Commission on Human Medicines Report of the Commission on Human Medicines’ Expert Working Group on Hormone Pregnancy Tests, published on 15 November 2017.
Answer (Lord Bethell)
The Commission on Human Medicines Expert Working Group on Hormone Pregnancy Tests was an independent group convened to conduct a scientific review of the evidence for an association between the use of hormone pregnancy tests and adverse outcomes of pregnancy.
The report and all the evidence that was reviewed by the Group has been publicly available since November 2017. We cannot discuss specific issues regarding the litigation, but this does not prevent any re-examination of the report or evidence. Any relevant new evidence would be reviewed as it becomes available.
We are carefully considering the recommendations of the Independent Medicines and Medical Devices Safety Review and will respond in due course.
Questioner: Paul Blomfield
Question
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the compatibility of the resumption of visits to care homes in Northern Ireland and the existing guidance for England on that matter.
Answer (Helen Whately)
The resumption of visits to care homes in Northern Ireland is a devolved matter.
The Government works in close collaboration with the devolved administrations to share and stay up to date with the latest advice and policy developments.
We are aware that limiting visits in care homes is difficult for many families and residents who want to see their loved ones.
The Government published guidance for England on visiting care homes during the COVID-19 pandemic on 22 July 2020. This guidance is available on GOV.UK.
Questioner: Lord Mendelsohn
Question
To ask Her Majesty's Government what plans they have to support people who are shielding (1) who have been advised by their clinicians to continue shielding, and (2) whose workplaces are not safe to return to, after 1 August.
Answer (Lord Bethell)
All employers have been asked to work with the Government to ease the transition back to a more normal way of life for their clinically extremely vulnerable employees. Employers and employees should start having these conversations as early as possible before the guidance is changed on 1 August.
At this time, the Government does not advise clinically extremely vulnerable individuals to attend their place of work if this requires them to leave their home. From 1 August those shielding who are unable to work from home but can work on site, should do so, provided the business is COVID-safe.
Questioner: Lord Kennedy of Southwark
Question
To ask Her Majesty's Government what (1) plans, and (2) preparations, they are making for any second wave of COVID-19.
Answer (Lord Bethell)
The Government has now developed testing capacity to around 300,000 tests per day across in preparation for any second wave. We will constantly monitor demand, including anticipating winter pressures, and scale up the contact tracing workforce if needed.
We are also planning for the next phase of testing: ensuring our testing is as effective as possible in containing the virus, and building resilience for the long-term, especially ahead of winter. We plan further increases through the summer and into the autumn through a combination of improvements to existing labs and new partnerships. Increasing our testing capacity will further support the NHS Test and Trace system by allowing widespread testing of those suspected to be infected with COVID-19 and their contacts and enable the deployment of additional testing capacity to respond to local outbreaks.
Questioner: Lord Pearson of Rannoch
Question
To ask Her Majesty's Government, further to the Written Answer by Lord Bethell on 17 July (HL5874), what information they hold on (1) the number of children who have been given GnHR, or any other gender re-assignment treatment, by the NHS, (2) the amount of compensation paid to patients who received such treatments but who were subsequently deemed to have been mis-diagnosed, and (3) the number of compensation claims made following such treatments.
Answer (Lord Bethell)
The National Health Service currently offers the following medical treatments to under 18-year olds on gender dysphoria pathways: hormone blockers, cross sex hormones and psychological assessment. The service does not offer surgery to under 18-year olds.
Information on the number of children who have been prescribed GnHR is not available centrally, as information on prescribing drugs is collected locally. Further, the drugs used in gender identity pathways are not exclusively prescribed for such, meaning records do not reflect total patient numbers on these pathways.
Information on number of treatments and misdiagnosis is not available in the format requested.
Questioner: Lord Mendelsohn
Question
To ask Her Majesty's Government, further to the publication of Our Plan to Rebuild: The UK Government’s COVID-19 Recovery Strategy in May, what plans they have to introduce the “more differentiated approach to risk” for people who are shielding if the COVID-19 infection rate increases.
Answer (Lord Bethell)
We are working with a consortium of leading academics and the National Health Service to develop a new risk assessment tool that will allow us to better judge the risk that individuals face from COVID-19. This means that if the shielding policy needs to be started again in the event of an increase in the COVID-19 infection rate or in local lockdowns, we will be able to better target interventions and have a much stronger scientific basis for our approach to risk management for those most at risk.
There is no predetermined infection rate at which shielding may be reintroduced. Any decision to restart shielding would be based on clinical advice at the time taking into account the particular circumstances. We are keeping this under constant review.