NHS: Hospital Visiting

Debate between Lord Bethell and Lord Flight

Wednesday 15th September 2021 Lords Chamber

[Lord Flight (Con)]

My Lords, I question the wisdom of seeking to restore all visiting arrangements as soon as possible. For the time, surely visitor resource priority should go to those who are seriously ill, whether with Covid or other serious illness. Visiting should be limited, for the time being, both for the seriously ill and for limited slots of groups of limited size.

[Lord Bethell (Con)]

My Lords, it is a question of balance. We certainly have to be extremely careful about people visiting those with Covid because of the obvious contagiousness of that disease. As I said, the guidance is currently to limit the size of groups to one close family member, but we are mindful of the mental health impact of that, so trusts are trying to get the right balance between contagion control and the mental health implications of people being ill and alone in hospital.

NHS: Nursing Workforce

Debate between Lord Bethell and Lord Flight

Wednesday 8th September 2021 Lords Chamber

[Lord Bethell (Con)]

The points that the noble Baroness makes are entirely right, and we share exactly the same concerns. That is why we have put in place mental health support, enhanced occupational health support, expansion of the right to work flexibly across the NHS, and the promotion of equality. On the point about older nurses, two things particularly stand out: there is significant investment in leadership through the NHS Leadership Academy, and we have bespoke support for over-50s and newly qualified nurses, recognising that they are likely to be the biggest flight risk across the NHS.

[Lord Flight (Con)]

My Lords, might the Government consider upping NHS nurses’ pay rates but, at the same time, ending the practice of employing agency nurses? Frequently nurses work three days a week directly and two days a week on an agency basis, costing the NHS significantly more than full-time employee nurses.

Animal Diseases: Future Pandemics

Debate between Lord Bethell and Lord Flight

Wednesday 21st July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

I assure the noble Baroness that it is a massive priority. The threats from both zoonotic transmission and antimicrobial resistance are areas in which Britain has previously shown great international leadership. Through our G7 chairmanship we will continue to take up that mantle. I pay particular tribute to the work of Dame Sally Davies on antimicrobial resistance. She has done an enormous amount, particularly through the Trinity Challenge, to raise awareness and bring together Governments, industry and academia on this matter. I do not have the precise budget to hand, but I will be glad to write to the noble Baroness with any details that are available.

[Lord Flight (Con)]

What proportion of infectious diseases in people do the Government estimate to originate in animals? What should be the result of doctors and vets adopting a “one health” approach?

[Lord Bethell (Con) [V]]

It is the case that 75% of all newly infectious diseases come from animals. Diseases such as HIV began when transmitted from an animal to a person. The Ebola, Zika, SARS, MERS and SARS-CoV-2 viruses are all examples of recent zoonoses. As the noble Baroness, Lady Brinton, pointed out, the changes in human behaviour are only going to accelerate this. That is why we are so committed to the zoonotic agenda and why vets and those who work with farm animals need to have raised awareness of this threat.

Covid-19: Proof of Vaccination

Debate between Lord Bethell and Lord Flight

Monday 14th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, vaccine data is held in the vaccine database and in the patient’s record. We abide by the principle that the data is owned by the patient.

[Lord Flight (Con)]

My Lords, the Minister has really answered this question already, but may I add that it surely would be possible for vaccination units to have supplies of certificates that they could issue to people when they come to get their first or second vaccination?

[Lord Bethell (Con)]

My noble friend alludes to having pre-printed certificates. In fact, each vaccine certificate has a tailored two-dimensional QR code that is designed for each person. Therefore, it is necessary to print the certificate for the person because it has their specific details on it.

Covid-19 Internal Review

Debate between Lord Bethell and Lord Flight

Thursday 20th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am enormously grateful to my noble friend for his comments. I know he has been a vocal critic of some things, and I take his comments in very good measure. On his point on guidance, this is not how the public have presented things to us. They want clear, easy-to-understand guidance. We have learned the importance of publishing in many languages and now regularly publish in 10 spoken languages. The public are in fact hungry for detailed guidance, which is why we have published more than 400 pieces of guidance on GOV.UK, covering everything from funerals, care homes and schools right through to smokers, vapers, houseboat dwellers and singing with children. That is because the public would like to have this kind of advice and recommendation.

[Lord Flight (Con)]

My Lords, I congratulate the noble Lord, Lord Bethell, on how professionally he handles his responsibilities in the Lords. I am sure he will support the Prime Minister’s announcement that a full inquiry will be held next year, beginning in the spring, which will place the state’s actions under the microscope. The existing internal lessons-learned review was an informal exercise, not a public-facing work, which I believe will not be published. It would be wrong to publish it. While there have inevitably been some mistakes, I congratulate the Government and the noble Lord, Lord Bethell, on having got Covid-19 vaccinations moving significantly faster than the EU. I hope he will exceed the speed limit even more.

[Lord Bethell (Con)]

I am enormously grateful for my noble friend’s kind comments. On his point on vaccines, I emphasise the enormous contribution of the whole union behind the vaccine project. It has been a union project to deploy vaccines to every person in the UK at amazing speed and with consistency right across all parts of the union. For that we should be enormously grateful.

Covid-19: Resuscitation Orders

Debate between Lord Bethell and Lord Flight

Wednesday 24th March 2021 Lords Chamber

[Lord Bethell (Con)]

No, my Lords, I do not accept that the report is simply the tip of the iceberg; it is very thorough and goes into the matter extremely carefully. However, there are important lessons on training to be learned and they will be driven by the ministerial oversight group.

[Lord Flight (Con)]

My Lords, the Care Quality Commission wrote up its findings at the time of the outbreak of Covid-19, which may have made them less reliable. A number of factors have served to raise exposure to decisions on whether or not to accept DNACPRs, and these were taken for groups rather than individually. Such groups included individuals suffering with dementia and learning disabilities who needed briefings that they could understand. The Care Quality Commission report is about how hospitals, care homes and doctors should support people to make decisions properly about how to restart. Are the Government satisfied that the decisions in this territory are now being taken properly?

[Lord Bethell (Con)]

My Lords, the report is crystal clear that we accept that more training is needed. Front-line care support workers need to be given more support in their interactions, and we will be putting that in place.

Covid-19: Brazilian Variant

Debate between Lord Bethell and Lord Flight

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

I endorse the noble Lord’s observation that tracing is important. I pay tribute to the Operation Eagle team. The noble Lord will note that the South African variant, which made landfall in the UK, is currently being contained through the immense work of this team. They are throwing a blanket over communities and doing a huge amount of forensic, detective work in tracing variants. As to his specific point, it is possible for someone to walk up to a testing station, take the test, be handed a form and not fill it in. We are trying to understand if those were the circumstances in this case.

[Lord Flight (Con)]

My Lords, are there risks that the Brazilian variant may not provide adequate protection against reinfection and that vaccinations are less effective against this strain? It carries the same mutation as the Kent variation, which is rated 70% more transmissible than previous strains.

[Lord Bethell (Con)]

My noble friend is stretching my immunological skills to the limit. The Brazilian variant has a number of mutations. It is not clear to us whether those are mutations of transmissibility, vaccine-escape mutations or reinfection mutations, and therefore which we should focus on. All are possible and we are keeping a careful eye on this. An enormous amount of investment and research is going into understanding this more carefully.

Face-to-Face Medical Appointments

Debate between Lord Bethell and Lord Flight

Thursday 19th November 2020 Lords Chamber

[Lord Flight (Con)]

My Lords, my personal experience of online doctor appointments is that they are most satisfactory, efficient and time-saving, but I do understand that many older citizens may want and often need to have traditional face-to-face appointments. Appointments on demand are surely not practical, but does the Minister support citizens having the legal right to request one-to-one doctor appointments?

[Lord Bethell (Con)]

I agree with my noble friend that the terms of service should be clear, although I am not sure that we necessarily have the scope for or benefits of a legal right per se. However, perhaps I may disagree with him on one point. He said that there is a greater demand among older citizens for face-to-face contact, but that is not our experience. Older citizens are often very engaged digitally, prefer to engage with their clinicians, on occasion, from the comfort of their own homes, and can often be early adopters of such technologies.

Covid-19: Vaccine

Debate between Lord Bethell and Lord Flight

Wednesday 11th November 2020 Lords Chamber

[Lord Bethell (Con)]

I am grateful to my noble friend for the question on international vaccines. He is right that no single country holds the keys to victory against this invisible enemy and we must work together. I point out in particular the work of the ACT Accelerator, which estimates that $38 billion is needed by the end of next year for equitable access to vaccines. This will be an important part of our chairmanship of the G7, which starts at the beginning of next year, and which will be a helpful platform for Britain’s advocacy of fair and equitable distribution of vaccines.

[Lord Flight (Con) [V]]

I thank all involved for the achievement of a successful vaccine. What, if any, is the effect of the vaccine if taken when the recipient is already testing positive for coronavirus?

[Lord Bethell (Con)]

My Lords, my understanding at the moment is that it is not necessary to take a coronavirus test before having the vaccine. This has been one of the subjects of the trials that have taken place so far. I do not believe that there is any effect at all but I am happy to check that, seeing as it is a detailed clinical point that is beyond my personal experience, and revert to my noble friend with confirmation of it.

Covid-19: Dental Services

Debate between Lord Bethell and Lord Flight

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord asked for a general commitment on dentists and their staff. I reassure him that we value the dentist profession and their staff, and the Covid pandemic has only emphasised the importance of dentists in the community and to the nation’s health. He asked me a specific question about where they stand in the vaccine prioritisation list and whether they are on the healthcare list. I will write to him with a precise answer to that question.

[Lord Flight (Con) [V]]

My Lords, there are three big factors that are causing these problems. First, there is the potential patient’s caution and the worry of contracting Covid-19, which leads them to put off treatment and save the money until normal times return. Secondly, dental sessions are taking much longer, partly because of the fall in the number of patients per session and lower throughput. The principal barrier to resuming services is the issue of the fallow time required following aerosol-generating procedures. The solution is greater ventilation. The key need is to increase the patient throughput and to reduce—

[Lord Flight (Con) [V]]

Will the Government be willing to put up any funding to deal with the issue of fallow time between treatments?

[Lord Bethell (Con)]

My Lords, I agree with the noble Lord’s analysis, but it is too early to make commitments on funding.

Cancer Task Force

Debate between Lord Bethell and Lord Flight

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, during the Covid pandemic, radiotherapy services have continued. We are working to ensure that the need to travel to hospital is kept to a minimum, using drugs where they present an alternative to radiotherapy. The recovery of our radiotherapy services is massive and we are using the latest technology to ensure that this is delivered as impactfully as possible.

[Lord Flight (Con)]

My Lords, is the cancer task force, now in the fifth year of its five-year programme, to become a permanent organisation? What is the basis for allocating funding and research?

[Lord Bethell (Con)]

My Lords, the Cancer Recovery Taskforce I refer to is the group of people focused specifically on the recovery from the Covid pandemic. The overall cancer recovery programme will be published later in the autumn, and it will have budgets associated with it.

Social Care Workers

Debate between Lord Bethell and Lord Flight

Wednesday 7th October 2020 Lords Chamber

[Lord Flight (Con) [V]]

My Lords, I welcome the increase in the number of social care workers but there is more to be done not just in social care but across the wider NHS. Can my noble friend update the House on progress on wider NHS recruitment and, in particular, the manifesto commitment of 50,000 more nurses for the NHS? I hope, too, that there will be a reduction in the proportion of expensive agency-employed staff.

[Lord Bethell (Con)]

My Lords, the recruitment of nurses is extremely encouraging. We have had an enormous response, with more than 10,000 nurses already recruited and recruitment rates to universities for nursing qualifications also up. We have an enormous marketing campaign supported by broadcast and social media. However, more needs to be done and we are very focused on this area. The use of agencies provides some surge capacity for hospitals—it has a role—but I completely acknowledge my noble friend’s point that agency support needs to be used in a considered, thoughtful and commercially intelligent way.