Covid-19: Variant

Lord Farmer Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right that the EpiData showed that the figures shot up in December; that is exactly why we looked extremely carefully at the genomic data from Kent and other places. As she knows, genomic data takes time to process—the tests can take a week to turn around. Looking at all the variants and matching EpiData figures with genomic data is an enormously complicated mathematical task. We moved as swiftly as possible and far faster than in many other countries.

[Lord Farmer (Con)]

My Lords, at the Downing Street press conference of 5 January, we were told that people had protection from the new variant if they had already been infected. What is the Government’s estimate of the number of people in the UK who now have antibodies after contracting the virus and are therefore likely to be immune? What is their approach to the large population of such people, estimated by Professor Neil Ferguson to be at 25% to 30% in London, and their need for vaccination?

[Lord Bethell (Con)]

My Lords, PHE weekly seroprevalence data suggests that antibody prevalence among blood donors aged 16-plus in England is 6.9%, which is consistent with other data that we have. The MHRA has considered this and has decided that vaccinating is just as important for those who have had Covid-19 as it is for those who have not.

Covid-19 Update

Lord Farmer Excerpts

Monday 30th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am not sure that I accept the premise of the question. The scepticism that the noble Baroness describes has not stopped millions of people stepping forward to have tests. Our experience is that those who have direct experience of test and trace—whether they are people who use the app, people who turn up for testing, people who go to hospital and have tests through the NHS or people who are traced—speak of the good service and experience that they have. It is undoubtedly true that test and trace takes a hammering in the press, and its reputation has been hard hit by sceptics who talk down its performance, but, generally speaking, those who actually experience it speak highly of the service.

[Lord Farmer (Con)]

My Lords, just 10 days ago, Professor David Eyre of the University of Oxford reported that, for most people, being infected with Covid-19 protects against reinfection for at least six months. He said:

“This is really good news, because we can be confident that, at least in the short term, most people who get COVID-19 won’t get it again.”


Washington State University research found that just one case out of the multiple millions worldwide suggested that waning antibody levels or a poorly developed immune system to Covid could put people at risk of reinfection. I am aware that studies need to be replicated, but this good news seems to be a very well-kept secret, ignored on the official government web page on the relevance of antibody tests. What would give the Government confidence that potent antibodies linger beyond at least six months in the majority of cases and how small would the tiny minority of proven cases of reinfection have to be in order for them to say that this risk is a price worth paying for society to begin to get back on its feet?

[Lord Bethell (Con)]

My Lords, the Government—and I personally—are extremely interested in this area. Early findings of a study by the Coronavirus Immunology Consortium and Public Health England, which have not been peer reviewed yet, suggest that a strong cellular immune response is likely to be present in the majority of adults six months after infection. At present, there is not enough evidence to rule out people who have positive T cell responses or antibodies to Covid-19 from potentially still playing a role in transmitting the virus to others. However, further research on the level of sterilising immunity provided by natural infection should be available from the SIREN study and the Oxford healthcare workers study before the end of the year. I look forward to the results of those studies very much.

Covid-19 Update

Lord Farmer Excerpts

Tuesday 6th October 2020 Lords Chamber

[Lord Farmer (Con)]

My Lords, in the other place yesterday, the Secretary of State was very definite that the virus is transmitted from surfaces. However, this has been recently disproved, for example by Professor Gandhi of the University of California and the microbiologist Emanuel Goldman, who state that while the virus may persist on surfaces, the traces involved are not viably infectious. Will their important new research now be instilled into our response to Covid, so that we can start to move on to “project hope”?

[Lord Bethell (Con)]

My Lords, I am extremely grateful for my noble friend’s recommendation. It is a source of huge frustration, and amazement to me on some level, that the precise nature of transmission in all cases is not crystal clear. I am not sure that I would completely agree with my noble friend that it has been thoroughly disproved that the disease can never be transmitted from surfaces. In fact, there are others who think that this may actually be a very important vector of transmission. We certainly do not understand the full nature of the way in which aerosol transmission behaves, and it is likely that it is a mixture of them both. That is why we urge the country to comply with the Hands, Face, Space protocols.

Covid-19: Local Restrictions

Lord Farmer Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I have before me a large list of eight or nine public portals where exactly that information can be received. I will lodge links to those portals in the Library and on my Twitter -feed.

[Lord Farmer (Con) [V]]

My Lords, there is a marked polarisation in the country, particularly evident in attitudes towards and poor rates of return to work. Many would agree that this is not about where people can work most effectively but about unnecessary fear, given what the science says about transmission. What are the Government doing to reduce the level of polarisation in the country?

[Lord Bethell (Con)]

My Lords, we are working extremely hard to create confidence in the Test and Trace system and in the effectiveness of our two-tier system of hands, face and space combined with Test and Trace. We are appealing to the country to take necessary precautions but within those precautions to go about everyday life.

Dental Care

Lord Farmer Excerpts

Wednesday 20th May 2020 Lords Chamber

Asked by

[Lord Farmer]

To ask Her Majesty’s Government when they plan to permit the resumption of routine dental care.

The Question was considered in a Virtual Proceeding via video call.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, the NHS and the Chief Dental Officer have worked hard to reopen the dental sector, with the aim of restarting routine dental care as soon as we safely can. In the meantime, over 500 urgent dental treatment centres have been set up in each NHS region, to provide urgent face-to-face care for patients.

[Lord Farmer (Con)]

I thank the Minister for his reply. Untreated and moderate dental problems can become severe and potentially life-affecting. Infected teeth were a major cause of death in the 19th century. I note the 500 urgent dental care hubs already set up in England following strict guidelines, but can my noble friend say why the regulator cannot simply modify the existing guidelines used in the hubs to make them transferable to local dental practices?

[Lord Bethell]

The noble Lord is entirely right that poor dental care is extremely damaging to individual health. The current situation is one that we massively regret, but the safety of patients and dental professionals is paramount. The aerosols generated by dental drilling and other dental practices leave the threat of germs in the air in a dental practice for hours to come, which could be caught by staff or future patients. It is for that reason that we have focused the infection protocols in 500 special units that have the right kit, the right training and the right arrangements.

Covid-19: Social Care Services

Lord Farmer Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Farmer (Con)]

My Lords, I, too, congratulate the noble Baroness, Lady Wheeler, on initiating this important and well-timed debate. I will speak today about children’s social care and how supporting those on the edge of it can prevent this crisis from being the tipping point when they become looked after by the state. First, however, we should acknowledge the families who are flourishing now that they are no longer in the time famine of normal life, even though money and space are tight. Many children are enjoying being with their fathers, for example.

On those in social care, the Government are consulting on reforms to the use of unregulated care homes which include banning this provision for under-16s and introducing national quality standards. In these strange times, young people currently in such accommodation are out of the sight of social workers and others, who have high case loads. I have heard that these professionals are seeing only the highest-need families face to face. Some have adapted well and are catching up with young people directly, for example through WhatsApp, but such flexibility might be patchy. Can the Minister inform me whether a national assessment has been made of the welfare of those in unregulated accommodation during this crisis?

More broadly, the Government have committed to reviewing the care system. For the system to be sustainable going forwards, this review requires what I call the prevention pipeline. It should establish how we can best prevent, first, children from coming into care in the first place and, secondly, the care system from being a runway into educational underachievement, unemployment, criminality and prison, early parenthood, addiction and poor physical and mental health.

Early family support is essential to prevent children from tipping across care thresholds. Many local authorities have set up family hubs where families with children of any age can access help. I have set up the Family Hubs Network, which has held several virtual round tables with providers, who report that hubs have come into their own in this pandemic. They are offering food, maternity appointments, a rich programme of online family support and more. I understand that the DfE is leading on family hubs, but can the Minister inform me whether and how it is supporting their spread?

[The Deputy Speaker]

I call the noble Baroness, Lady Blower. She is not here. We will move on to the noble Lord, Lord Addington.

Mental Health of Children and Young Adults

Lord Farmer Excerpts

Thursday 16th May 2019 Lords Chamber

[Lord Farmer (Con)]

My Lords, I too congratulate the noble Baroness, Lady Royall, on securing this important debate. I will focus on the indispensability of family support, and particularly support for parents’ relationships with each other, if we are to address major contributing factors to children’s and young people’s poor mental health. Prevention should, whenever possible, be at the heart of any mental health strategy, whether from local or national government or from the NHS. Family relationship difficulties are also provoked by mental health problems in a child or young person. Whichever comes first, the family system, not just the person with the diagnosis, needs attention.

In a letter to the Times this week, I said that,

“The breakdown of family relationships creates a plethora of social policy challenges”.


Measures to strengthen families should be on the business plans of every department of government, as families which function well are major assets to their aims and objectives. This is particularly the case here. The NHS survey Mental Health of Children and Young People in England, 2017 found that family functioning was clearly correlated with mental health problems. Almost two-fifths of children from families functioning in the least healthy ways had a mental disorder, compared to one-12th of children in the families functioning most well. Robust surveys of mental health clinicians corroborate this. Family relationship problems were cited as the biggest presenting issue by mental health clinicians in a recent study of over 43,000 children in services.

Distressed children would agree. I commissioned research from a team led by Dr Samantha Callan, my parliamentary adviser, to inform the work of the Department for Education and the Department of Health and Social Care in developing the Green Paper on CAMHS. This included a focus group with young people with mental health problems who had experienced parental relationship breakdown. They highlighted that people in general are “not at all” aware of the effects of family breakdown on children and young people. They described teachers’ and other adults’ expectations that exposure to conflict or parental separation two or more years earlier would no longer impact them. This made it very hard to express ongoing pain from the lingering effects, including the difficulties in keeping in contact with the non-resident parent.

One participant said: “I see girls who don’t see their dads who try to get the attention and the affection from someone much older than them. It can have a bad long-term impact on you if you end up in bad relationships”. Another described their severe problems with anger management, linked to their father leaving unexpectedly more than a decade ago. Other negative effects were attributed to one parent not having recovered from the relationship breakdown. Conflict might have ceased, but children might still be coping with their parents’ depression, bitterness or other long-term ramifications of the split, which went unsupported. One said, “I have absolutely no complaints about the care I have received, but my mum didn’t get any help at all. I might not be sitting here if she had had the same level of support”.

The importance of good interparental relationships was recognised in the 2017 Green Paper, which said:

“Children who are exposed to persistent and unresolved parental conflict are at a greater risk of early emotional and behavioural problems, anti-social behaviour as an adolescent and later mental health problems as they transition into adulthood”.


To unpack the concept of persistent and unresolved conflict, this need not mean a violent home environment but one daily characterised by overt, hostile exchanges or cold, contemptuous indifference.

Apart from citing the DWP’s reducing parental conflict programme, the Government’s response to the Green Paper consultation made no proposals to support families and interparental relationships. Similarly, the NHS Long Term Plan merely acknowledges that a,

“stable and loving family life”

significantly influences young people’s health and life chances. Health services might argue that relationship and family support are someone else’s responsibility, but this ignores the fact that, in a phrase coined by researchers from UCL, good relationships are a health asset. Indeed, I cannot resist saying here that “The key to happiness”, according to today’s headlines from the Office for National Statistics, is to “Eat, drink — and be married”. Moreover, health budgets dwarf government funds earmarked for relationship support, so can my noble friend outline what the DHSC is doing to support family relationships?

I have a couple of recommendations. First, NHS organisations could invest directly in the provision of relationship support. Hackney child and adolescent mental health service employs a specialist to work directly with the couple while another member of the multidisciplinary team treats their child or young person who has been referred. The research found that this is rare, so to help build confidence that embedding couple counsellors in CAMHS teams is good use of scarce mental health funding, the DHSC should fund pilots of this model.

Secondly, early help for families is imperative to address the roots of mental illness and prevent children and young people developing such problems. Local councils, from Newcastle to the Isle of Wight, are making progress in repurposing children’s centres as “family hubs”, so that their expert early years services are preserved alongside services offering help for parents of children aged nought to 19. Health services and education, now both on the front line of help for children with mental health difficulties, are free and available to all, yet we cannot ignore any longer the uncomfortable truth that, without similarly accessible support for family relationships, they will fail to turn back the tide of mental illness in this and future generations.

Cannabis: Medicinal Uses

Lord Farmer Excerpts

Thursday 1st November 2018 Lords Chamber

Asked by

[Lord Farmer]

To ask Her Majesty’s Government whether they intend to respond to the concerns raised by the Faculty of Pain Medicine in their Faculty Position Statement on the Medicinal use of Cannabinoids in Pain Medicine, and their call for further research into the potential benefits of cannabis for medicinal uses.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord O’Shaughnessy) (Con)]

My Lords, the Government acknowledge the valid concerns raised by the Faculty of Pain Medicine. Under the new regime, only specialist doctors will be able to prescribe cannabis products. Clinical guidance published yesterday is clear that these products will be considered only in a small number of conditions and where alternative treatments have not helped or have been discounted. The National Institute for Health Research has issued a call for proposals in order to enhance knowledge in this area.

[Lord Farmer (Con)]

I thank the Minister for that Answer. Bearing in mind the faculty’s overarching cautionary position, and the fact that according to the National Health Service website,

“Regular cannabis use increases your risk of developing a psychotic illness”,


what assurances can the Minister give us that Her Majesty’s Government will not allow the changes in prescribing cannabis for medicinal use to be a Trojan horse for the legalisation of cannabis for recreational use?

[Lord O’Shaughnessy]

I can absolutely reassure my noble friend by reiterating the position outlined by my right honourable friend the Home Secretary. He has been crystal clear that the Government have no plans whatever to legalise cannabis for recreational use. Indeed, the penalties for unauthorised supply, possession and production remain unchanged.

The Long-term Sustainability of the NHS and Adult Social Care

Lord Farmer Excerpts

Thursday 26th April 2018 Lords Chamber

[Lord Farmer (Con)]

My Lords, I add my congratulations to those of others to the noble Lord, Lord Patel, and his committee on this report. I am particularly grateful that the committee took the opportunity to take a long, hard look at what the NHS is now and what we should be looking for in the future. I want to dwell on the report’s emphasis on prevention and to talk about how family breakdown and dysfunctional family relationships contribute to the long-term unsustainability of the health service and the social care system.

We must not allow nanny state concerns to perpetuate the wilful neglect of this issue by successive Governments, including the current Administration, on whose Benches I sit. We have had strategies to address disability, diabetes and dementia—all of which are laudable and necessary. After all, disability affects one in six adults; diabetes around one in 10 adults; and dementia one in six adults over 80 years old. Yet, despite almost one in two 15 year-olds having experienced the breakdown of their parents’ relationship, no UK Government have ever come close to developing a family strategy that acknowledges the repercussions of this and addresses the root causes.

The Select Committee report we are debating describes the short-sightedness of successive Governments and the culture of short-termism that seems to prevail in the NHS and adult social care. This sums up very well the policy approach over the last half century towards the growing trend of family breakdown, which drives need in both these areas. Moreover, the report highlights the false economy of neglecting public health, prevention and patient responsibility and gives short shrift to nanny state concerns.

The quality of people’s relationships, particularly in their childhood, is a significant determinant of health as studies on loneliness and the effects of adverse childhood experiences, among others, make clear. Research from the International Centre for Lifecourse Studies—the ICLS—at University College London measured cortisol levels in thousands of 60 year-old adults to see whether there are long-term effects of psychological stress in childhood. It found that people who had been separated for more than one year from their mother had higher cortisol levels, which indicates a less healthy stress response several decades later, and therefore an increased risk of disease and early death. Other ICLS research found that people who suffer stresses such as parental divorce in childhood are more likely to experience social and psychological problems later in their adult lives.

For children to flourish they need safe, stable and nurturing relationships, not just a good school place and a healthy diet. Nationwide, a million fathers have no meaningful contact with their children and, in some communities, father absence is the norm. This fuels the hunger for belonging, which leads many to join gangs and get caught up in the culture of violence, where life is cheap. Overstretched and understaffed accident and emergency departments then have to deal with high numbers of young men with stab and gunshot wounds.

Many other pressures on our health services can be traced directly back to broken and dysfunctional relationships. Prevention, in the form of family strengthening measures, should be available in every community. This and every previous Government have struggled to provide leadership in this area, yet they find themselves picking up the pieces at every turn. Curing is always more costly than preventing.

Many have gone beyond even being concerned about family breakdown. I met with a Minister this week whose official briefing included a graph showing that divorce levels had become stable and were even beginning to ease off. The implication was that “things aren’t so bad after all”. Yet this one simple set of descriptive statistics obscures the bigger picture: our high divorce rates are still almost at the top of the OECD league table and the growth area in parental splits is among those who are not married. Three-quarters of family breakdown among children under three involves unmarried parents. Three-fifths of parents who were closely involved but not living together when their children were born are no longer together by the time the children turn five, compared to fewer than one in 10 of parents who were married.

No Government have yet been courageous enough to put serious effort into communicating through policy and rhetoric that the best context for childbearing is within a committed relationship. A fear of stigmatising children born outside marriage has unintentionally penalised one generation after another by neglecting to encourage a culture where the norm is for parents, whether rich or poor, to be deeply intentional about bringing a child into the world and raising her together. Neutrality is not an option when the costs of family and relationship breakdown mount up inexorably in so many areas. These include, to touch on just a few: lower resilience among young people and greater susceptibility to them developing poor mental health; lower productivity, which leads to less cash for the NHS; fewer family members available to care for older relatives; and more people living alone in later life due to divorce, and therefore higher social care costs.

So often, and understandably, domestic abuse is a reason for reticence to talk about family stability. NHS Employers has estimated the cost to the NHS of repairing the physical damage to victims to be around £1.25 billion per annum, with the cost to mental health services related to domestic violence estimated at £176 million. A preventive approach is essential. People across the broad range of those impacted by domestic abuse need help to learn how to avoid or step out of unhealthy relationship patterns. That includes not just women victims but couples where abuse is mutual, couples who want the abuse to end but the relationship to be sustained, and male victims and female perpetrators.

On that point, I want to clarify some statistics I cited in the recent debate on domestic abuse led by the noble Baroness, Lady Lister. I mentioned SafeLives data showing that 95% of victims are women and 95% of perpetrators are men. This is based on the 4,500 people accessing independent domestic violence adviser services, and must be set alongside the Crime Survey for England and Wales. In the year to March 2017, the survey found that a little over one-third of victims of domestic abuse were men and slightly under two-thirds were women. For the purposes of this debate, health services—not the police—are often the first port of call. Indeed, the 2012-13 survey found that four out of five victims do not call the police.

The Government are beginning to take note of the damaging effect on children and young people’s mental health of frequent, intense and unresolved conflict between their parents, even when violence is not a factor. In a sample of over 42,000 children attending children and young people’s mental health services, family relationship difficulties were a presenting problem for over half—52%. Their Green Paper, Transforming Children and Young People’s Mental Health Provision, published last December, acknowledges this in its chapter on wider action to support children and young people:

“Children who are exposed to persistent and unresolved parental conflict are at a greater risk of early emotional and behavioural problems, anti-social behaviour as an adolescent and later mental health problems as they transition into adulthood”.


I have one question for the Minister, who is I know is also exercised about the negative effects of relationship breakdown on children. The consultation process asked no questions about this wider action. What is the Department of Health’s response to family breakdown?

Young Women: Self-Harm

Lord Farmer Excerpts

Thursday 16th November 2017 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness picks up on a particular interest of mine. She may know that I was involved in setting up three primary schools. It is important to start these lessons early. In the end it comes down to behaviour policies and what is expected from children. Schools with fair and robust behaviour policies do not tend to see bullying. Those which are more lax do. First, it is about making sure that teachers have training and resources and the support they need from the leadership, governors and parents to crack down on it. Bullying now has moved into different domains, particularly online. I think it is very encouraging today—the noble Baroness may have seen it—that His Royal Highness the Duke of Cambridge is launching some actions on cyberbullying. Dealing with bullying is a big part of that and I agree with the noble Baroness about the importance of starting early.

[Lord Farmer (Con)]

My Lords, the Government’s own research, most notably that commissioned by the DWP from Professor Gordon Harold, conclusively showed a causal link between young people internalising problems, such as self-harm, and conflict and breakdown in their parents’ relationships. Will this evidence be acted on in the forthcoming Green Paper on children and young people’s mental health?

[Lord O'Shaughnessy]

I know this area is of great interest to my noble friend and he has done very good research on it. He is quite right to highlight the impact that, unfortunately, parental conflict and breakdown has on children. The Department for Work and Pensions, in a cross-government approach, is doing particular work on supporting parents. I also know that the best schools and community health services work to provide that kind of parenting support. There are a number of parenting programmes out there. I assure my noble friend that that evidence takes a proper place in the mental health strategy that we will be publishing for children and young people.