HIV: Pre-exposure Prophylaxis
Lord Fowler Excerpts(3 years, 5 months ago)
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Lord Bethell (Con)
I am afraid that I was not a Minister in the period that the noble Lord is talking about, so I cannot account for that. However, I agree with him that, on the point he raised about access to PrEP among women and the black community, we have a case to answer. I completely acknowledge that, particularly among the black community, this is one of the most difficult areas that we have to tackle in order to hit our objective of zero transmissions by 2030. We are working extremely hard to try to reassure those who are hesitant about taking on such therapies that they are safe, accessible, private and relevant. We need to win that battle in order to hit our target.
The Lord Speaker (Lord Fowler)
All supplementary questions have now been asked and we will therefore move on to the next Question.
Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020
Lord Fowler Excerpts(3 years, 5 months ago)
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Lord Robathan (Con)
My Lords, this is arguably the worst crisis—certainly the worst economic crisis—of my lifetime. Yesterday, as my noble friend referred to, we had, I am afraid, a totally inadequate government benefit analysis, belatedly produced at very short notice to persuade MPs to back these latest measures. It is a very poor document, and, if anyone does not believe me, they should read it.
However, there are some costs that we know about, and all these decisions regarding the crisis should be based on evidence and facts, not fear or conjecture. The costs were listed by the Chancellor of the Exchequer last week in an excellent speech, and I shall not repeat his detailed points. His main point was that the
“economic emergency has only just begun”
and that this will be
“the largest fall in output for more than 300 years”—[Official Report, Commons, 25/11/20; col. 827.]
since the Great Frost of 1709, which even I do not recall.
There are pubs and restaurants in particular, as well as innumerable other businesses, large and small, that are closed now and will never reopen. Unemployment will rocket and the young will find fewer vacancies and opportunities for employment. The economy may recover relatively quickly, but future generations—our children and grandchildren—will be saddled with huge debts for decades. In brief, that is the cost: billions and billions. The restrictions we are discussing today are really another lockdown in all but name, and, as Dr Nabarro of the WHO said, lockdowns make
“poor people an awful lot poorer”.
What about the benefits? On 1 October, the Health Secretary said that restrictions were necessary to prevent
“hundreds of thousands of deaths”—[Official Report, Commons, 1/10/20; col. 503.]
Some were sceptical. If it were true, it would be a ghastly scenario and a consequence of not locking down. Last year, there were 623,000 deaths in the UK—hundreds of thousands; on average, 1,700 deaths each day, each of which is tragic and causes immense pain to family and friends who remain. I suspect that most of us have suffered similar pain.
According to the NHS and ONS statistics, a total of 3,123 people under the age of 60 have died from coronavirus in English hospitals. Of these, 349 did not have known pre-existing conditions. Among the under-40s, a total of 247 people have died from the virus in English hospitals, of whom 46 had no known comorbidities. All these deaths are tragic but, every day, an average of 450 people in the UK die of cancer, approximately half of whom are under 75. Suicide is the biggest killer among men under 45. In England and Wales last year, 2,135 men of that cohort killed themselves. Admittedly, coronavirus has only been recognised for some nine months, but younger people under 40 or 45 seem more likely to die from suicide or cancer than from coronavirus. Indeed, the total deaths attributed to coronavirus are dwarfed by deaths from cancer. To make matters worse, cancer-screening and treatment have been curtailed, suicides appear to be on the rise because of isolation, and mental health problems are certainly an increasing concern. If we are destroying our economy to save lives, we should look at all these facts—not vague assertions—and note that the total deaths in England in October were only eight more than in October 2019, which statisticians would call negligible.
Do lockdowns work? Many people suggest not; I do not know. I would imagine that total isolation must surely stop the transmission of infection, but in Leicester, which has been under stringent restrictions similar to lockdown for about five months, it is only now that positive cases are dropping. Why is that? I wonder whether my noble friend the Minister can enlighten me and the House. We were told that hospitals may be overwhelmed without these restrictions. Can the Minister tell us how many hospitals are completely full, and how many beds are occupied above the seasonal norm? Also, how many beds are occupied in the excellent Nightingale hospitals? I have been told that none are.
How many people have actually been infected? I would think that that is a critical statistic in determining policy to combat the virus. The Government’s figure for those who have tested positive is just over 1.6 million, but most people would accept that it must be a lot higher—what with Prince Charles, Prince William, the Prime Minister, half the Cabinet, both my children, et cetera, having had it. Can my noble friend give us any government estimate of the real numbers?
I saw media reports that the average age for Covid deaths in the UK was higher than average life expectancy. This had to be fake news, I thought, but I checked the ONS figures and, indeed, the average age for Covid deaths is 82.4, while average life expectancy is at 81.4. Can my noble friend confirm these figures, and that those dying from coronavirus will actually have lived longer on average than those dying for other reasons?
The Government are in a very difficult position. I understand. This unpleasant virus is highly contagious and killing many people prematurely. I am sorry to hear about my noble friend’s godfather. However, we do not know enough about the virus, so we have to go on the facts. I would be grateful for clear and prompt answers to my questions so that we can see whether there has been any weighing up of costs and benefits.
In the debate on 4 November, it was said that some Peers were putting down amendments to double their speaking times, which seemed “a bit iffy”. It was suggested that some were playing games. I was accused of “having form” in that regard and of disregarding the science. Those of us who really care about our country’s future are not playing games and resent such insulting accusations. Long-standing Members of this House tell me that we should be courteous to each other even when we disagree, so I avoid personal attacks. I just counsel the Member concerned that I have experience of robust comments and can give every bit as good as I get.
The Chancellor of the Exchequer said that we must learn to live with the virus and not fear it. My young female dentist, who I saw in early November, described the second lockdown as “nuts”. I will listen to the Minister’s response, but currently I intend to divide the House, since it seems to me that there has been no adequate analysis of the costs and benefits of this policy.
The Lord Speaker (Lord Fowler)
I should inform the House that, if this amendment is agreed to, I cannot call any of the other amendments by reason of pre-emption. I call the next speaker, the noble Lord, Lord Hunt of Kings Heath.
Baroness Penn (Con)
My Lords, now is a good moment to remind speakers of the time limit for this debate, which is six minutes for Back-Bench contributions.
The Lord Speaker (Lord Fowler)
The noble Lords, Lord Forsyth of Drumlean and Lord Hutton of Furness, have withdrawn, so I call the noble Lord, Lord Cormack.
Covid-19: Vaccination Prioritisation
Lord Fowler Excerpts(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, the noble Lord tempts me to commit to schedules that I am simply not in a position to commit to, I am afraid to say. The performance of the various vaccines is extremely complex: each one of them needs a different delivery plan. In collaboration with the NHS, we are putting in place an extremely energetic and thoughtful deployment programme. Those in charge have been instructed to have that ready to start from 1 December, but I will not hide it from the House that it may well be after the new year that the very large numbers begin. I reassure the House that we are super-focused on this deployment plan, and, as soon as the vaccines become available, we will be trying to get them to the public as soon as we can.
The Lord Speaker (Lord Fowler)
My Lords, the time allowed for this Question has elapsed, and that brings us to the end of Question Time.
DHSC Answers to Written Questions
Lord Fowler Excerpts(3 years, 5 months ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the very large number of questions which have been put to the Department of Health is completely unprecedented. We had 577 in the whole of 2019. So far in 2020 we have had 1,783, of which 799 have been answered on time and the rest are late. I apologise for that; it is a matter of huge regret. I ask for the forbearance of the House, as the pandemic has put enormous pressure on the department.
The noble Baroness, Lady Thornton, quite correctly alluded to one aspect of the answering of questions: the questions themselves often address novel challenges. Traditionally, we get questions about things that the department has been doing for years and years, where it is easy to pluck out an answer from the database or from the encyclopaedia of answers. The noble Baroness gave a good example of a question where it is difficult to elicit an answer. I know the exact question she referred to, because I have sought really hard to provide an answer to the noble Lord, Lord Bassam. The question of how many swabs have not been returned by post is much more complicated than it might look. There are different types of swabs; different schemes—ONS, REACT, clinical trials—send in the swabs. Inconveniently, they do not pool all the answers. Also, some swabs may sit on a bench or in a cupboard at a house for a long time and it is not possible to know when they are, or are not, sent back.
I cite that as an example of the kind of challenge that we have faced in answering questions from noble Lords. I am not trying to detract from the inconvenience of questions not being answered on time, but I assure the House that we have put in considerably more resources. We have upgraded the quality of the people who are answering the questions and have an absolute commitment to trying to answer them on time.
The Lord Speaker (Lord Fowler)
My Lords, I remind Ministers that the instruction to be brief applies to their answers, as well as to questions from other Members.
Lord Robathan (Con)
My Lords, I do not underestimate the pressure under which the Department of Health has been put and pay tribute to my noble friend for the number of times that he comes here to answer Questions. However, the data behind this virus is hugely important. I put down a Question asking about the number of NHS workers—doctors and nurses—who have been killed by the virus. The answer that came back was: “We don’t know”. Surely, we must know this. I have also asked a question in this Chamber, not a written one, about what the strategy is without vaccinations. A vaccine has now come, but we must know what the strategy is. Are we going to go into another lockdown if the infection rate rises again? Perhaps the Minister can answer that now?
Lord Bethell (Con)
My Lords, before the pandemic the parliamentary affairs team was made up of nine people; it has grown to 15. The ministerial correspondence and public inquiries team has grown from 51 people to 111. I think the noble Lord would agree that, at a time when we are trying to deal with test and trace along with programmes on therapeutics, restart, seasonal flu, PPE and vaccines, having 111 people working on correspondence seems the outer limit of what would be proportionate.
The Lord Speaker (Lord Fowler)
My Lords, all questions in this section have now been asked. We will come to the next in a moment.
Covid-19: Vaccines and Medical Equipment
Lord Fowler Excerpts(3 years, 5 months ago)
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Lord Bethell (Con)
My Lords, the question of vaccine intellectual property is a delicate one because, as was mentioned earlier, we rely on the private sector for a lot of funding and research, and for supplying the research. So, we are respectful of intellectual property as a principle. None the less, we are also grateful to vaccine manufacturers that have taken an open-source approach to vaccine intellectual property and have made local manufacturing available, so that there can be an extremely wide distribution of vaccines, including to those in the developing world who would otherwise struggle.
The Lord Speaker (Lord Fowler)
My Lords, the time allowed for this Question has elapsed.
Covid-19: Dental Services
Lord Fowler Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, I agree with the noble Lord’s analysis, but it is too early to make commitments on funding.
The Lord Speaker (Lord Fowler)
I make the point that I say at the beginning of every Question Time that two points are the maximum that should be made.
Baroness Thornton (Lab)
In my view, the Government have offered little support to dentist practices: not exempting them from business rates, even though book- makers and vape shops are exempted, and not offering them key worker status, which has caused problems with childcare. Can the Minister commit to early access to Covid-19 vaccines for all high-street dentists who are NHS contractors, rather than employees? Can the Minister give them key worker status?
Lord Bethell (Con)
My Lords, the bottleneck around the training of new dentists, an incredibly important priority for the nation’s teeth, is one that the CDO is extremely concerned about. The question of simulation machines is not one that I was aware of but I will be happy to look into it and reply to the noble Baroness on how we can make progress.
The Lord Speaker (Lord Fowler)
My Lords, the time allowed for this Question has now elapsed.
Covid-19: Contracts and Mass Testing Programme
Lord Fowler Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
We have published 80% of the contracts to date and are working on publishing the rest. I hope that that will meet noble Lords’ expectations.
Lord Bethell (Con)
My Lords, I do not want to give the impression that absolutely everything is perfect. Those were desperate days and we had to do extraordinary things to protect our healthcare staff. I remind noble Lords that other countries were flying in their representatives with bags of cash on private jets in order to seal contracts and some of our supplies were literally taken from under our noses on the runway at Hong Kong airport. They were extremely difficult times and I do not pretend for a moment that everything was absolutely perfect, but I reassure noble Lords that the right procedures were put in place by officials, and I reassure the noble Lord that these figures are currently being validated with the National Audit Office.
The Lord Speaker (Lord Fowler)
My Lords, the time allowed for this Question has elapsed and it brings Question Time to an end.
Covid-19: Intensive Care Treatment
Lord Fowler Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, I share my sympathies with the noble Baroness for the loss of her friend, for which we are all very sad. However, I take exception to her implication of a fiasco in the use of algorithms. I do not accept the implication that it is regular practice for clinicians somehow to give up on patients who stand a chance simply because their reading of an algorithm says that they should move on to someone else. That is not how we run the NHS; it is not how we had to run it during the first wave and it is not how we intend to run it during the second.
The Lord Speaker (Lord Fowler)
My Lords, all supplementary questions have been asked and both Private Notice Questions have finished.
Covid-19: Charitably Funded Hospices
Lord Fowler Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
The issue raised by the noble Baroness is one that I am aware of. Who can think of a more moving cause than hospices for children? This will be definitely be on the agenda for 4 November and I will raise the issue with my honourable friend the Minister for Social Care.
The Lord Speaker (Lord Fowler)
My Lords, the time allowed for this Question has elapsed, which brings Question Time to an end.
Social Care
Lord Fowler Excerpts(3 years, 6 months ago)
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Lord Bethell (Con)
My Lords, we all acknowledge the power and intellectual insight of the Economic Affairs Committee report, which was welcomed on the Floor of the House and speaks for itself in terms of its authority and insight. But my noble friend is, I am afraid, not being reasonable when he says that Covid is not an excuse for inaction. There is an enormous focus on the front line and by the management of the NHS and the DHSC on preparing the winter plan, which is ambitious but also extremely stretching. There simply is not the management or political capacity to take on a major generational reform of the entire industry in the midst of this massive epidemic.
The Lord Speaker (Lord Fowler)
My Lords, the time allowed for this Question has elapsed and we now come to the fourth Oral Question.