82 Lord Balfe debates involving the Department of Health and Social Care

Covid-19

Lord Balfe Excerpts
Thursday 3rd September 2020

(5 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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The noble Baroness is completely talking my game here. I wish I could be 100% specific about the timeframes, but we are still going through the validation process. Personally, I am hugely optimistic. The noble Baroness, Lady Thornton, mentioned the work in this area of Yale University, which really changed our perceptions of the role that saliva testing could play. It can be used in the big PCR machines, it may be used in point-of-care machines and there is even a possibility that it could be used in the small plastic lateral-flow machines much loved by the husband of the noble Baroness, Lady Neville-Rolfe. I hope very much indeed to be able to update the House soon and to lay out a framework, but I afraid that at present the validation results have not come through and it would be premature of me to try.

Lord Balfe Portrait Lord Balfe (Con)
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Although the Minister mentioned the need to get back to face-to-face visits, it is not mentioned in the Statement. In our local hospital, Addenbrooke’s, the instruction has been that no people are to be seen unless it is absolutely necessary. Indeed, one consultant told me they had been forbidden to see a patient unless they needed to. Our local GP service provides no face-to-face meetings other than after you have been triaged and jumped through some hoops. It even had a tent outside for a time. Can the Minister assure us that some pressure will be put on local hospitals and GPs to get back to normal and start seeing people? As letters in the Times have proved, the fact that you do not see people means you miss serious diagnoses.

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, massive pressure is on the NHS from every level to get back to normal. Attendance rates are increasing dramatically in every area of the NHS. I pay tribute to those who have gone through enormous hoops to create safe and protected protocols to have people back in the system, but I cannot hide from my noble friend the fact that the health system will not be the same, going forward. We will have to change our approach to infection control and hygiene and have face-to-face contact in a completely different way. It makes no sense for lots of ill people to congregate in a GP surgery and to spread their disease among one another. We have to rethink the way we did our healthcare in the past in order to protect healthcare workers and patients from each other’s infections and to afford a sustainable healthcare system that can afford to look after everyone.

Folic Acid

Lord Balfe Excerpts
Thursday 3rd September 2020

(5 years, 5 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I pay testimony to the good work of my noble friend Lord Rooker on the campaign for mandatory fortification of flour with folic acid. He introduced a Private Member’s Bill and his work has been earnest. My personal experience is that my cousin James was born with an NTD; he survived two weeks and, sadly, passed away. Therefore, this is a matter that has my personal commitment. However, I am not in a position to give him the date he wishes, but we will come back to the House and answer his Question in due time.

Lord Balfe Portrait Lord Balfe (Con)
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I welcome the Minister to his three and a half hours at the Dispatch Box. I first raised this matter as president of the British Dietetic Association, the trade union that represents dieticians. There is overwhelming evidence in support of adding folic acid. As long ago as 1 March 2018, I was promised that the Government would be looking at a date for this to be done. I join the noble Lord, Lord Rooker, in being very disappointed about this. I ask the Minister to get on with this, please. As long ago as March 2018, we were being promised a date and we still have not got one. Please take some action.

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I completely accept the urging of my noble friend Lord Balfe on this matter. He is entirely right. There is very strong scientific evidence in this area; the Government accept that, and this is why they have launched a consultation, which was due to be published earlier this year. However, Covid has blown us away and that is why the announcement has been delayed. The Government have listened to the scientific evidence, which is very persuasive, and the decision will be made when the time is right.

Medicines and Medical Devices Bill

Lord Balfe Excerpts
2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020

(5 years, 5 months ago)

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Lord Balfe Portrait Lord Balfe (Con)
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My Lords, I too extend my congratulations to the Minister on introducing the Bill. I suspect it will be a somewhat different Bill by the time we have finished with it.

This exposes the whole nonsense of “taking back control”. We are 3% of the world drugs market; the European Medicines Agency is 25%. The way for us to gain control is to work with our colleagues in large organisations where we can have considerable impact, not to start setting up our own organisations. The impact of moving away from the European Medicines Agency is going to be a considerable extension of a centralised process of regulation and it is also going to add to the unaccountable powers of Ministers, because the EMA does have a certain amount of accountability attached to it, which I do not think will happen. Indeed, it will not be the Ministers who will be making these decisions; it will be civil servants some way down the pecking order—and many of them will in the end have to take account of what the medicines agency has to say.

One danger we face is what the British Medical Association has called the butterfly effect: we have a slight derogation from a slight position of an EMA rule, then it multiplies, because one leads to another and then to another. You have to ask yourself whether this divergence can be kept under constant evaluation, because it needs to be. I put it to the Minister—he may not like it—that in the end we are going to have to negotiate a formal agreement for continued participation in EMA assessments, because we need a common assessment. We face otherwise the danger of delay—that manufacturers will say, “Let’s be logical: 22% of the market is in Europe, 3% is in Britain, so let’s get the European agreement first, because that’s where things are based.”

As a side-effect, we will then need an agreement with Euratom for isotopes, which has not yet been mentioned but is crucial to the health service, and that will have to be a separate agreement. We will also need to maintain access to EU funding programmes; we need these joint programmes to develop to do the best job for the citizens of this country—and, of course, we need alignment with the clinical trials regulations. We cannot have a different clinical trial regulation in Britain from what is in practice in the rest of Europe. We need all those things, and we need a professional structure in Britain for advising the Minister and drawing on the advice available.

I support the idea of a commissioner for patient safety. I hope that the Minister will go away and work out how it is to be done before he gets defeated on the Floor of the House. I also believe that the proposal on the harvesting of organs will not get through this House, and there will be an amendment on that. I say to the Minister: please do your homework and bring us something that we can agree with. Otherwise, the Government are going to get defeated.

Covid-19: Response

Lord Balfe Excerpts
Monday 27th July 2020

(5 years, 6 months ago)

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Baroness Garden of Frognal Portrait The Deputy Speaker (Baroness Garden of Frognal) (LD)
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Lord Rogan? We will move quickly on to the noble Lord, Lord Balfe.

Lord Balfe Portrait Lord Balfe (Con) [V]
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My Lords, on three occasions today the Minister has said that, if you have a Covid test today, you are not guaranteed to not have the disease tomorrow. In that case, what on earth is the purpose of having the test system at all? Secondly, the NHS is not functioning properly. Bearing in mind the precedents of my noble friends Lord Deighton and Lady Harding, would it be a good idea for the Minister’s department to appoint a specific person to get the NHS up and running again, as foreseen by my noble friend Lord Ribeiro in his perceptive question?

Lord Bethell Portrait Lord Bethell [V]
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My Lords, we use the tests we have got because they are the tests we have got. The way in which the disease manifests itself is not, I am afraid, something that I can negotiate with. We do what we can, but I emphasise that an unfortunate feature of this disease—and many others—is that it harbours itself silently in our bodies and manifests itself both to infect and be diagnosed only when it is ready. That is a simple fact of life. However, the testing regime has a profound impact on the spread of the disease by identifying those who have some form of symptom, even if it is a quiet one. I pay tribute to Sir Simon Stevens, who is working hard to get the NHS back to business as usual and is having a profound impact on the issue.

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

Lord Balfe Excerpts
Friday 24th July 2020

(5 years, 6 months ago)

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Lord Balfe Portrait Lord Balfe (Con) [V]
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My Lords, I endorse everything that the noble Lord, Lord Alton, has said and the spirit of what the noble Lord, Lord Liddle, said. We really have got to get back to a system of proper parliamentary scrutiny because we are deteriorating into farce. The regulations as put forward confuse people even more. What is needed is a clear statement now that brings everything together as to what is and is not allowed.

We also need to know how the regulations are to be enforced. USDAW, the shopworkers’ union, has grave reservations about the safety of its workers if they are asked to enforce them. If they are not, how are the regulations going to be enforced? How are they going to be enforced on the railways?

My final point is that the NHS is still effectively closed down. It is the last bit of Britain that has not been opened up. Waiting lists are growing and people are suffering. We are killing people because of Covid. Can the Minister get the sclerotic NHS back into action?

Social Care

Lord Balfe Excerpts
Wednesday 8th July 2020

(5 years, 6 months ago)

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Lord Bethell Portrait Lord Bethell
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The noble Baroness is quite right to shine the spotlight on those who are in social care but not necessarily aged over 65. Half of all social care costs are now dedicated to those under 65. Housing standards is an important question. The stock of housing for social care will be considered in any forthcoming review. It is imperative that we have a modern and up-to-date industry.

Lord Balfe Portrait Lord Balfe (Con) [V]
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This policy could lead to literally unlimited costs and a bottomless pit that would make the National Health Service look like a modest outfit. When we devise this policy, we must make sure that adequate contributions are made by those affected and we do not fall into the trap of saying that inherited potential wealth is somehow to be exempted. People must pay a fair share.

Lord Bethell Portrait Lord Bethell
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My noble friend is entirely right: there is a massive potential liability. We are acutely aware of the intergenerational implications of social care reform. It is only right that we treat both those in social care and future generations fairly. Those considerations will be uppermost in our minds.

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

Lord Balfe Excerpts
Monday 15th June 2020

(5 years, 7 months ago)

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Lord Balfe Portrait Lord Balfe (Con)[V]
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My Lords, I would like to thank the Minister for his hard work. You cannot be right in a situation such as we have been facing. For a historian like me, there is something to be said for reading the accounts of the first few months of the Second World War. It began with the British people enthusiastically endorsing all the restrictions imposed by the Government of the day but then, just as with this country recently, what we call obedience fatigue set in as people started getting fed up with the regulations. That is where we are now. So I counsel the Government, “Please, ease it up as fast as you can. If you don’t, people will ease it up for you”.

The one-metre rule is already in force except where the two-metre rule is enforced. In other words, if it is left up to people, they do not obey the two-metre rule just as they do not obey the three-bubble rule, or whatever. People are increasingly doing their own thing. We have to sort out this difference between the focus groups and common-sense government. There was a man called Paul Samuelson in the 1960s who came up with the concept of the free rider. This is basically that people are always in favour of taking actions that cost them nothing, but which other people pay for and where other people suffer. When I am told that the 14-day quarantine period is very popular, I suspect that it is probably very popular with people who go on holiday once a year. It has nothing to offer people like me who go to European Union countries on a regular basis and are now having great difficulties.

I ask the Minister to try to ease things up—and that includes in hospitals. Far too many hospital beds are empty, physiotherapy has collapsed, chiropody has collapsed, and the health service is suffering from a sclerotic condition. The Minister has to get them back to work; this may well take a fair bit of toughness.

My final point is this: we need to get Parliament back to work. We are not functioning efficiently or effectively. I am sitting in my office in Millbank because I could not master the regulations for sitting in the Chamber which, I see from looking at my screen, is almost empty. The House is now running in the interests of the Government; it must be returned to the Members, and PDQ.

Covid-19: Masks

Lord Balfe Excerpts
Thursday 11th June 2020

(5 years, 7 months ago)

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Lord Balfe Portrait Lord Balfe (Con) [V]
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I think the debate is no longer about face masks. We accept that there may be shaky evidence that they are needed, but what we need to debate is when they should be worn and what sort of face mask? The overall European opinion is that they need to be worn in enclosed spaces and where people are together for a minimum of 10 minutes, because that is where the danger lies. I hope that we will look into this and not talk just about face masks. There are different types, with different levels of effectiveness. I would like the Minister to comment on what is going to be done to get them distributed. This morning, at King’s Cross station there were no face masks; at St Pancras, they were being given away free; and in Cambridge station, there were none. What do HMG have in the way of plans to distribute face masks and to look at the quality control of the types of masks that are going to be used?

Covid-19: Response

Lord Balfe Excerpts
Wednesday 3rd June 2020

(5 years, 8 months ago)

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Lord Haskel Portrait The Deputy Speaker (Lord Haskel) (Lab)
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The noble Lord, Lord Empey, has withdrawn, so I call the noble Lord, Lord Balfe.

Lord Balfe Portrait Lord Balfe (Con)
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My Lords, I want to go back to the testing centres question. I also had a test, but I had to drive to Stansted from Cambridge. Many people in our community do not have cars and do not drive. What is the Minister doing to make it possible for all major towns to have testing facilities that can be reached either by public transport or on foot?

My second point is more doubtful. Many people do not seem to realise when they should be tested, or, for that matter, how often. If you are tested at the beginning of June, when do you need to be tested again, if at all? What does the test prove, apart from the fact that you do not have the virus? It does not prove that you have had it or will not get it. Will the Minister step up the publicity campaign he just mentioned, so that people can be better informed?

Lord Bethell Portrait Lord Bethell
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I deeply regret that my noble friend had to drive from Cambridge to Stansted. We are working hard to address that and are looking at alternatives. We have now put up more than 100 sites, and I hope very much indeed that there would now be a site nearer him. We have also pioneered at-home testing, which we believe will address his key point, and we are trialling walk-in centres for city centres such as Cambridge.

My noble friend’s last point is entirely right. You should have a test when you show symptoms, but defining the symptoms of any disease, and in particular this disease, is very difficult. We do miss some people who do not show any symptoms, and some people who think that they have the symptoms actually have the symptoms of something else. It is a real dilemma and part of the battle we face against Covid.

Covid-19: Response

Lord Balfe Excerpts
Tuesday 19th May 2020

(5 years, 8 months ago)

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Lord Bethell Portrait Lord Bethell
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My Lords, as I stated this morning, I would be glad to meet with community leaders. However, I emphasise, as I said this morning, that it is the disease that is racist, and the Government and the NHS are doing an enormous amount to try to protect BAME workers, to whom we owe a huge debt of gratitude. I will do everything I can to help protect them.

Lord Balfe Portrait Lord Balfe (Con)
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My Lords, this morning, the ONS revealed that some 50,000 UK citizens are cross-border workers—in other words, English people who work part of the time outside the UK. Roughly 25,000 appear to be businessmen. There is no evidence that they are carriers; there is every evidence that when they fly back or come back on the Eurostar, they would be happy to be tested. The government proposals to suddenly clamp down on this and basically stop international business happening are not welcome and will do enormous damage to the British economy. Can the Minister try to influence his colleagues in transport to the effect that this development is not needed?

Lord Bethell Portrait Lord Bethell
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My Lords, I pay tribute to my noble friend’s commitment to freedom of travel—and he will remember my father’s own commitment to it. The sad truth, however, is that it is very difficult to prove a negative: to prove that someone does not have the disease or that they have not recently become infected and have the disease in a latent way or that they are young, fit and well. The restrictions are in place for those reasons. I advise my noble friend that we are working on finding a solution, but none is immediately available.