My Lords, there is an enormous amount of data published. I draw the noble Lord’s attention to table 6 in the table test conducted on 28 May 2020, which has an enormous amount of weekly collection data for schools. In that week, 1,967,904 LFTs were taken by schools, and they yielded 1,806 positive results. Those were all examples of where we have cut the chains of transmission. Tests are delivered through a variety of channels, including the community testing channel. Reports on infections in schools are analysed by the tracing programme, and they are then taken through to PHE and JCB. We are looking at ways in which we can aggregate all that schools data into more specific tables. But until we do that, there is already a very large amount of data.
My Lords, my noble friend has pointed out that cases are substantially concentrated in school-aged children and young adults, who of course have not yet been vaccinated. Does the Minister agree that it was premature to announce last week that face coverings will no longer be required in secondary school classrooms and communal areas? Does he accept that this policy could drive an increase in infections in our unvaccinated children and young people, as well as in school staff, families and wider communities?
I share the noble Baroness’s concern, but I can reassure her on a couple of things. It is, I think, a real tribute to the hard work of parents, teachers and the pupils themselves that the infection rates in schools have been relatively contained, and certainly have not shown the same kinds of behaviours that they did in September of last year. But we remain extremely vigilant, for exactly the reasons the noble Baroness explained. On the question of face coverings, it is a very difficult balance to strike—they are intrusive and disruptive but, on the other hand, they are an effective way of minimising infection. It is an area that we keep a very close watch on.
My Lords, I simply do not recognise the characterisation that the noble Baroness has just presented. The view of our treatment of the elderly and vulnerable taken by Amnesty during the pandemic is completely inappropriate and inaccurate. Huge steps have been taken to protect those who are vulnerable and elderly. I cannot think of a country that could have done more under the circumstances. I therefore reject its analysis.
My Lords, this is a Statement on health and social care. I am astonished that the Minister has confined the Government’s policy on adult social care following the pandemic to a couple of sentences. He must know that most of the adult social care in this country is provided by family carers. They are regularly ignored in such Statements, but many of the 6 million carers looking after vulnerable adults, including those with learning difficulties, have been pushed to breaking point by the pandemic. Is there nothing to say to them about access to support services or respite care and nothing on carer’s allowance? Without support for these essential carers, policies such as enhanced hospital discharge, as mentioned in the Statement, will not be feasible. What is the Government’s strategy for dealing with this crisis in care?
My Lords, I endorse completely the noble Baroness’s remarks that we depend on the generosity, public spirit and kindness of family carers who provide an enormous amount of support for their loved ones. Without them, the system could not possibly exist and the world would be a much graver place. I recognise that many carers have been pushed very hard by the pandemic. We have put a huge amount of resource into local authorities, which are responsible for providing support for those families, and that includes the kind of respite support that the noble Baroness has rightly pointed to. I am sure that more could be done and I would welcome any correspondence on this by way of follow-up that she would like to send my way.
My Lords, the noble Baroness is entirely right; ventilation is a key issue. I took my daughter to the dentist this morning, and there were indeed long gaps between each appointment. I am not aware of the ventilation system she alludes to, but if the BDA would like to write to me, I would be happy to have a closer look at it.
My Lords, can I follow up on the Minister’s point about the new activity target imposed on dentists to reduce the backlog? It seems to have had the reverse effect. It has resulted in one of the biggest dental chains in the country instructing its dentists to focus on band 1 check- ups and reduce urgent treatments to meet the targets, reducing access for those who need it most. Other practices are reported to be doing the same. What assessment have the Government made of the impact of this target on patients who need urgent and complex treatment? Dentists have continued working, like doctors, nurses and other health professionals, in a high-risk environment during the pandemic. But their contribution seems to have been ignored. Can the Minister confirm the Government’s appreciation of the commitment of dentists and their staff during this pandemic?
I join the noble Baroness in paying tribute to dentists. As of 18 December, 88% of NHS dental practices were open, and that is a huge tribute to the hard work, determination and skills of dentists. She is right that they offer a spread of services; more triaging is going on, and that has successfully made a big contribution to getting through the lists. As of 13 January, 6.9 million dental patients have been triaged on the AAA service—advice, analgesics and antibiotics—but urgent dental care centres, of which there are 695, have picked up the difficult and time-consuming work for those who have an emergency need.
My Lords, I am grateful for the noble Baroness’s kind words, and I will indeed take that patient feedback back to the department. I reassure her that this is an area where patients have undoubtedly led the way, and clinicians have to catch up. In doing so, there will need to be a meeting of minds and regulation in areas that are open to patient interpretation. In that period, there will undoubtedly need to be compromises on all sides.
My Lords, the law changed over two years ago. The then Home Secretary said:
“We have now delivered on our promises … we will work with the NHS to help support specialists in making the right prescribing decisions.”
But they have not; it has been a hollow promise for terminal brain cancer sufferers such as my nephew. NHS doctors will not prescribe medical cannabis, and the BMA advises medics not to prescribe it, yet I understand that the UK is the largest producer of medical cannabis in the world. Just how many prescriptions have been issued for unlicensed cannabis medicines, other than those subject to randomised control trials, in the last 12 months?
My Lords, the noble Baroness is being a little unfair; Health Education England published a medicinal cannabis education package on 8 August 2019. But we cannot force clinicians to make prescriptions. That is not how the health service works. We need to work on clinical trials to put in place the correct authorisations and to give marketing authorisations for these important and promising drugs. That will require collaboration between government, the regulator and industry, and I call on industry to step up to that challenge.
My Lords, the mathematics done by the noble Lord are interesting but not quite a reflection of the strategy. It is undoubtedly true that the NHS is, wisely, taking the start of the deployment with great care. This is an extremely complex vaccine to deliver, but hospital hubs, local vaccination services and vaccination centres will be rolled out around the country. The kind of ambition that the noble Lord describes—quite rightly—is exactly what we seek to deliver; we will update the House as that deployment plan rolls out.
My Lords, I want to urge early access to the vaccine for the terminally ill. On Tuesday, in response to my noble friend Lady Thornton, the Minister said that there was a powerful case but any further refinements to the priority list will “create profound operational challenges”. That is not a good enough answer for my nephew, Matthew Walton, who has stage 4 brain cancer. Surely his two young children should be able to spend their remaining time together without the additional threat of an early death, which could so easily be averted by a vaccine—unlike his cancer. Will the Minister please press this powerful case?
The noble Baroness makes the case extremely well; I pay tribute to her personal testimony. I looked into this matter after giving my answer to the question last week. I assure the noble Baroness that those who are terminally ill are, of course, clinically vulnerable by nature. We will ensure that those who are clinically vulnerable will get the vaccine when it is clinically appropriate to do so, which I hope brings her some reassurance.
My Lords, the noble Baroness puts it extremely well, and it is an area we are deeply concerned about. We have commissioned Public Health England to carry out an analysis of the existing data on those who have suffered under Covid. We will be reviewing that data extremely carefully to understand the phenomenon more deeply. In the meantime, the Chancellor has announced £750 million to support the charity sector in response to the pandemic. Some of that money has been targeted specifically at charities that are supporting those with learning difficulties to ensure that they get the support that they need.
My Lords, many families really struggled to get effective support or even to know where to go to find out what is available. I understand that evidence gathered by concerned charities like Carers UK and Carers Trust shows that many family carers have had no effective support or advice since the end of March, yet they look after some of the most vulnerable in our society. Will the Minister and his colleagues at the Department of Health and Social Care meet with these organisations to discuss what could be done to improve this very sad state of affairs?
My Lords, I would like to pay tribute to the work of the learning disability and autism advisory group for its social care task force. Its recommendations have informed the development of the social care winter plan, which provides specific provisions for those with learning disabilities and autism. I would be very glad to meet whichever groups the noble Baroness recommends, because this is an important issue that we care about immensely and are determined to get right.