Covid-19: Response

Baroness Hussein-Ece Excerpts

Wednesday 3rd June 2020 Lords Chamber

[Lord Bethell]

I can reassure the noble Lord, Lord Turnberg, that all people, of all ages, are currently eligible for testing. I accept that communication about this has not got through to everyone, and we are working very hard to communicate the information widely. A very large marketing campaign to make it clear began earlier today—I saw the adverts when I drove in on the M4 this morning.

I can also tell the noble Lord that because the infection and prevalence rates are so low, we have a machine with spare capacity. That is being used for surveillance and to cleanse the social care sector and the NHS sector through asymptomatic testing. The machine is on standby for the winter, and, as we lift lockdown, to protect society from any rise in the infection rate. The turnaround times are already getting much tighter and in many cases are less than 12 hours.

[Baroness Hussein-Ece (LD)]

My Lords, the Minister said that the review of disparities in Covid had revealed what we already knew: that those most at risk include minority communities, particularly BAME people. We also already knew that the guidelines for people with inequalities replicate existing inequalities. I am sure that public health directors up and down the country have known about these inequalities, and have published reports about them, for many years. The Minister says that it is a great mystery, but really the report just touches on the inequalities.

Does the Minister understand that those from BAME communities, who disproportionately work in front-line services and the jobs he mentioned, are being hit? They are extremely worried, and very angry at this response. I understand that there cannot be a huge raft of recommendations, but there needs to be more guidance on protecting people, not just in the health service but more generally for those who employ people from BAME communities.

I will give an example from my own community. The Turkish and Turkish-Cypriot communities in this country are around only half a million. We have lost somewhere in the region of 250 people; we have all been touched by this, myself and my community. In Germany, there are 3.5 million Turks, and they have had about 50 deaths. The figures are stark.

On 19 May, I asked the Minister whether he would consider meeting campaigners and health professionals to put in place a proper Covid race equality strategy, for now and beyond. Will he please take that back and agree to meet us, and others, who are determined that we will have a proper response to this terrible virus that is disproportionately impacting on our BAME communities?

[Lord Bethell]

The noble Baroness is entirely right. These diseases always hit hardest those who are most vulnerable, and the most vulnerable often include those who are poorest, who have existing morbidities and who are vulnerable in some way. She is right that this is an age-old truth; it is as old as history itself.

I was referring to the scientific links between the disease and the death rate. To clear up the point, if I may, the mystery that we do not understand is the biological explanation of why the disease appears to hit some people harder than others. That mystery is being unravelled, but I cannot pretend that we fully understand it at the moment.

As to the noble Baroness’s invitation to meet groups, I remember it well and would be very glad to take it up. I will ask my private office to be in touch to make those arrangements.

Covid-19: BAME NHS Staff

Baroness Hussein-Ece Excerpts

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

I can reassure my noble friend that action is already being taken. Individual trusts are putting in place trials and arrangements to try out different forms of amelioration, including changing staff rotas and taking vulnerable staff out of the front-line wherever possible. We will build on these pilots and trials in order to move as quickly as we can. The causes of the massive difference in the effects of the disease on different ethnic groups are not clear yet, so it is not possible to say for sure which pilots will work. However, we are moving as quickly as we can and we will build on the evidence base in order to put in effective measures.

[Baroness Hussein-Ece (LD)]

My Lords, this pandemic must be a wake-up call for us all. The Government’s review is not sufficient. BAME people make up 72% of NHS and social care staff and are 4.2 times more likely to die. Given all these separate initiatives referred to by the Minister, will he meet key leaders from BAME communities to look at establishing a Covid-19 race equality strategy, to find solutions to the current crisis based on the collective experiences of service and sacrifice from these communities?

[Lord Bethell]

My Lords, I share the noble Baroness’s tribute to BAME staff in the NHS, who, as she rightly points out, are on the front line and putting themselves at risk. We should all, as a nation, be enormously grateful for their contribution. I also salute those in the NHS moving quickly to address the concerns and evidence that the disease itself is discriminatory. I would be glad to meet representatives, but I want to be clear that the processes in place in the NHS are reasonable, proportionate and will, I believe, deliver the needed results.

National Health Service: Bullying

Baroness Hussein-Ece Excerpts

Wednesday 3rd July 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I am afraid I do not recognise the characterisation set out by the noble Lord. One of the key characteristics set out by the former Secretary of State in his leadership was that the NHS should be open and not have a culture of blame, and that people should feel free to speak up, so that when mistakes are made they should be corrected.

[Baroness Hussein-Ece (LD)]

My Lords, the NHS is the biggest employer of people from black and minority ethnic backgrounds. They face bullying and harassment from within—from co-workers—but also from members of the public and patients. There is considerable anecdotal evidence that some patients refuse to be treated by a clinician or a nurse from a minority ethnic background. What is being done to protect these workers and ensure that the NHS has a much more inclusive environment and culture?

[Baroness Blackwood of North Oxford]

The noble Baroness is quite right. Bullying faced by those in the BAME community is more significant, and data supports that. That is why the NHS is implementing the workforce race equality standard, which is a requirement for NHS commissioners and healthcare providers—including independent organisations with an NHS contract —to track and ensure that employees from BAME backgrounds have equal access to career opportunities and receive fair treatment in the workplace, and to ensure that this is properly recorded and published. This will drive through the improvements she seeks.

People with Disabilities: Reporting Abuse

Baroness Hussein-Ece Excerpts

Monday 17th June 2019 Lords Chamber

Asked by

[Baroness Hussein-Ece]

To ask Her Majesty’s Government what assessment they have made of the adequacy of the support received by people with a disability when they report any form of abuse to appropriate authorities.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, I thank the noble Baroness for her Question. Support for people who wish to make a complaint about health services is available from the independent NHS Complaints Advocacy service. The Ask, Listen, Do programme is aimed at making giving feedback and raising concerns and complaints about education, health and social care easier for children, young people and adults with a learning disability or autism, their families and carers. We will take steps to empower independent mental health advocates to raise concerns when they know that something is not right.

[Baroness Hussein-Ece (LD)]

I thank the Minister for her response, but she will be aware that, according to the Crown Prosecution Service, disabled people and those with a learning disability are at a higher risk of crime, particularly hate crime and economic fraud, than the general population. They also experience unequal access to justice and safety.

The Mental Health Foundation last autumn produced a report which highlighted the underreporting of learning disability crimes and hate crime and it made some recommendations. Have the Government taken on board any of the recommendations aimed specifically at government and police; namely, to standardise police reporting systems so as to ensure that learning disability hate crimes are correctly recorded and adjustments made to support the victims when reporting an incident?

This week, the Government launched a task force to tackle economic fraud, but vulnerable people seem not to have been included in it. When will the Government establish good practice that is standardised to include and protect disabled people?

Access to Medicinal Cannabis

Baroness Hussein-Ece Excerpts

Tuesday 9th April 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

I thank the noble Baroness for her comments, and I know that she is expert in this area. Proposals for an observational trial and the collection of observational data have been put forward. I think that the concern is that, at the moment, there is a lack of confidence in the data. What is needed is the highest quality clinical data because, while a large amount of observational data for medicinal cannabis is available, data at the level of randomised controlled trials is required so that there is confidence not only among clinicians to prescribe but also for the funding system to fund within the NHS. At this point, it is that level of data which needs to be gathered, and that is why the NIHR is bringing forward public funding for it and why the Government are encouraging the industry to fund such trials as you would expect in any other area of the pharmaceutical industry.

[Baroness Hussein-Ece (LD)]

My Lords, I declare an interest in that my grandson has intractable epilepsy, so we have been through the whole process, and I have some understanding and experience of this issue. He has recently been prescribed Epidiolex after a long struggle for him to be allowed to use it. Over the past few months, we have seen some incredible benefits from it. Does the Minister accept that rather unfair barriers have been put in place as regards access to this drug for children? I have heard of other cases where the British Paediatric Neurology Association, which she has mentioned, has said that Epidiolex, which is manufactured without THC, could be used for the treatment of childhood epilepsy as long as all other treatment avenues have been explored, including brain surgery and VNS. My grandson has had this treatment, where a device is attached to the spinal cord. These are incredibly invasive, dangerous and risky procedures. Surely it would be better to allow Epidiolex to be tried out rather than insisting on other routes? One mother told me that they are insisting that her child has brain surgery first. That cannot be right.

[Baroness Blackwood of North Oxford]

I thank the noble Baroness for her comments and for setting out her personal experience. She obviously has expertise in this area which few of us in the Chamber can claim. The reason NHS England has put forward is that individual clinical expertise relating to an individual patient is of the utmost importance, even where the guidance might seem to contradict that judgment. That is why in the autumn we will be bringing forward NICE guidance that will look at the most up-to-date evidence which should, we hope, be of assistance. It is also why we are bringing forward the NICE process review in order to understand what barriers may be in place and to encourage clinically appropriate prescribing and try to assist with cases such as these.

Cannabis: Medicinal Uses

Baroness Hussein-Ece Excerpts

Thursday 1st November 2018 Lords Chamber

[Lord O’Shaughnessy]

I absolutely acknowledge the scale of the issue. I think that the point my noble friend was getting across was that we do not want to create the next opioid addiction crisis, and I completely concur with that position. Public Health England is conducting that review and I will write to the noble Lord with specific details of what we as a Government intend to say after it has concluded.

[Baroness Hussein-Ece (LD)]

My Lords, I declare an interest, as my grandson has intractable epilepsy. He has just been assessed for medicinal cannabis and we very much welcome that. However, I am very concerned about the comments that this will be used as a last resort. My grandson has been subjected to many, many drugs and the side-effects from many of them have been horrific, so to say that those drugs are fine but that somehow medicinal cannabis oil is a problem is looking at this in the wrong way. I am worried about the restriction that has been put in place, and that many children who might benefit from this medicine will not be able to access it because of the very strict guidelines. Can the Minister give an assurance that each person will be looked at on a case-by-case basis?

[Lord O’Shaughnessy]

I absolutely acknowledge the case that the noble Baroness mentioned. She has shared it with me before and my sympathies go to her and to her family—it must be very difficult. Generally speaking, medicines in this country are licensed on the basis that they have gone through randomised control trials to make sure that they are safe and efficacious. A lot of these cannabis-based drugs have not been through that. We want to see more trials and, until we do, it is important that clinicians are able to access licensed drugs first, but with the ability to use unlicensed drugs if necessary.

NHS: Waiting Lists

Baroness Hussein-Ece Excerpts

Monday 26th February 2018 Lords Chamber

[Lord O'Shaughnessy]

I shall write to the noble Baroness on what NHS England is doing about the specific issue. I think her real point is about morale. We know that NHS staff do an incredible job under a great deal of pressure, dealing with that rising demand. We are doing two things to try to alleviate that situation. One, which we have talked about, is increased numbers coming through training so that we can increase staffing. The other is pay. Getting rid of the pay cap and allowing for an Agenda for Change pay increase is a good way of saying thank you to those staff.

[Baroness Hussein-Ece (LD)]

My Lords, in response to my noble friend Lady Jolly on child and adolescent mental health services, the Minister talked about reducing waiting times for young people and children to see a clinician as something to be addressed “in the near future”. He must appreciate that for children and young people, time is of the essence to get treatment before the situation becomes acute and they reach a crisis. Could he not give a more satisfactory answer on that question?

HIV Prevention Services: Public Health Funding

Baroness Hussein-Ece Excerpts

Thursday 30th November 2017 Lords Chamber

[Lord O'Shaughnessy]

The data that the noble Baroness refers to on spending also shows that STI testing and treatment in general has risen year on year. There is clearly still an improvement of the picture in the amount of testing and treatment. As I pointed out, the benefit of that is that fewer people are being diagnosed, which means transmission levels are falling due not just to testing but to other factors, including good treatment and preventive work. Indeed, the number of undiagnosed people is falling as well. This is all good news.

[Baroness Hussein-Ece (LD)]

My Lords, despite HIV testing being free and universally available across the United Kingdom, there are very good estimates that around 13,500 people are not aware that they are carriers and have HIV. I note what the Minister just said, but surely that figure is still unacceptable and there needs to be more testing, particularly of people living on the fringes of society or those who are not registered with a GP and do not come into contact with health services. There need to be some targeted efforts to reach those people to ensure that once they are tested they receive treatment.

[Lord O'Shaughnessy]

I quite agree with the noble Baroness. As I said, across England about 12% or 13% of gay and bisexual men and other men who have sex with men are undiagnosed. That is clearly unacceptable and means we are still not yet meeting the UNAIDS target. I will point out a couple of the interventions happening to try to address that in addition to the ones that I have already mentioned. A new contract has been awarded by Public Health England to the national HIV prevention programme for the most at-risk populations precisely to try to reach them. Another £600,000 is being given to 12 schemes under the HIV innovation fund. By definition, the people we need to reach next are the most difficult to reach because they have not come into the system.

Mental Health and NHS Performance Update

Baroness Hussein-Ece Excerpts

Monday 9th January 2017 Lords Chamber

[Lord O'Shaughnessy]

I thank my noble friend for her welcome. The global number of psychiatrists across England is increasing: I was not aware of the particular shortage in rural areas. I will certainly investigate and write to my noble friend about it. I know, from my past work in education and the example of head teachers, that the shape of the public sector workforce is now such that senior positions are weighted towards the over 55s. Although I realise that separate pension arrangements are available in the health service, now that retirement and pension ages are increasing we have a reasonable expectation that people might work longer than they did in the past. Therefore the problem described by my noble friend may not be as acute—not just in health but in other sectors as well—as she says. However, there is clearly an issue about the demography of the service and we are backing up GP recruitment with quite a big increase in extra funding for primary care over the course of this spending review period. A large part of that will go on both recruiting new staff and paying those who are in the system now.

[Baroness Hussein-Ece (LD)]

Is the Minister aware of whether GP referrals to CAMHS are now improving? Last year a number of reports highlighted the fact that in some 15 trusts up to 60% of GP referrals were not being dealt with. Only the very urgent, critical cases—those children who were self-harming or attempting suicide—were being dealt with. Has this situation improved and is there now proper access? GPs are the gateway to these services and if their referrals are not being taken seriously, these problems will mount up and we will be failing the next generation. Can the Minister give that assurance?

HIV: Barriers to Treatment

Baroness Hussein-Ece Excerpts

Thursday 1st December 2016 Lords Chamber

[Lord Prior of Brampton]

I do not like to have two questions on the trot that I cannot answer, but I do not know the answer to the noble Baroness’s question. I shall have to research it and write to her.

[Baroness Hussein-Ece (LD)]

My Lords, what steps are being taken to ensure that prisoners have access to treatment, testing and care while in prison? They are more likely to be drug users, more susceptible and more likely to be from communities that do not get themselves tested, even when they are in good health. Could the Minister say something about prison health?

[Lord Prior of Brampton]

There is a particular problem in prisons, as the noble Baroness refers to. There is a higher incidence of HIV in prisons, for all the reasons that she has alluded to. The NICE guidance and the PHE resources report that came out today echo her point. We have to reinforce and redouble our efforts in prisons to identify HIV earlier through better testing.