Respiratory Syncytial Virus: Vaccination Programme

Lord Kamall Excerpts

Tuesday 9th September 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the noble Baroness, Lady Ritchie of Downpatrick, for securing this debate today on RSV, particularly on vaccines for children. I pay tribute to her for continuously raising awareness of RSV. As she reminded me, when I was a Minister she raised it a number of times and continues to raise it. That shows how important it is and the vital role she plays.

As we know, RSV, alongside flu and Covid, is a leading cause of serious respiratory illnesses. Before the rollout of the vaccination programme, it was responsible for more than 10,000 hospital admissions and 4,000 deaths each year among adults aged over 75. The noble Baroness reminded us that it poses a danger in early childhood, with, as other noble Lords have said, over 30,000 hospitalisations and up to 30 deaths each year among children under five. One of the reasons that children are especially at risk is due to their developing smaller airways, which makes them particularly susceptible to bronchiolitis, a condition in which the lungs become inflamed during the fight against infection. We also know that RSV is perhaps more widespread than is commonly known and can seriously affect the most vulnerable people in our society.

I welcome the opportunity that this debate allows us in taking the time to speak about RSV and to ask the Government about the steps they are taking to prevent it as much as possible and to treat it. The previous and current Governments and the many health professionals are to be congratulated on the fact that RSV vaccine coverage has been rising steadily. It is good news that, among eligible older adults in England, the vaccine uptake has risen from 23% in September 2024 to around 63% by the end of June 2025. Similarly, as others have said, maternal vaccination has followed a similar trajectory, so that among mothers who gave birth in March 2025, 55% have been vaccinated. I know noble Lords have given out various statistics today.

The challenge now, as the noble Baroness has identified, is how to increase this coverage further. We know that the vaccination works; a recent study, looking at data from 14 hospitals in England up to March 2025, found that vaccination reduced the chances of hospital admissions with RSV infection by 82%. It is important that we repeat some of these statistics so people recognise that vaccines work. More relevant to today’s debate is that the estimated reduction in RSV risk was 58% for infants whose mothers were vaccinated at any time before delivery. It is sometimes easy to quote statistics and figures and see who has the best or the more up-to-date statistics, but sometimes we forget the human element. It is clear that taking the RSV vaccine protects us, our friends and our loved ones from harm and hospitalisation, and we should not forget that.

Despite that good news, though, as with other conditions, there are substantial disparities in how effective these measures have been in the population data, as my noble friend Lord Mott, the noble Lord, Lord Rennard, and indeed the noble Baroness, Lady Ritchie, said. As we have seen, recent data from the UKHSA showed that the uptake of the RSV vaccine for pregnant women in London was about 44%, compared to a figure of 65% in the south-west. We have heard from other noble Lords that members of the “Black or Black British—Caribbean” ethnic community are substantially less likely to be vaccinated than the highest uptake. Interestingly, ethnically Chinese people are the most vaccinated group, but in the “Black or Black British—Caribbean” cohort the coverage reported by the UKHSA earlier this year was only 28%.

We saw that the uptake of RSV vaccine for pregnant women in some of the UK’s largest ethnic groups is also quite low, with white British people at 62% and British Indian people at 56%. This data shows that, while many people have been vaccinated against RSV and the numbers have certainly increased, there are many communities where vaccination levels remain low. Clearly more needs to be done.

When I met the Caribbean and African Health Network last week, it explained some of the factors behind vaccine hesitancy within their communities. Sometimes it stems from a lack of trust of the organisations promoting vaccines, as well as a lack of culturally and linguistically appropriate information. We also know, as other noble Lords have said, about misinformation about the harms that could be caused by vaccines, spread via social media but also by politicians in some parts of the political spectrum.

Noble Lords will recall that we had to tackle vaccine hesitancy under the Covid programme. We found that asking local community organisations—people in the communities, especially faith communities, who knew the people we were trying to reach—to take the lead helped to build trust, but it did not always solve the problem. It is very easy to point to one success story. Indeed, in at least one case, there were certain churches that were actually discouraging their congregations from being vaccinated. That just shows how granular we have to be in reaching those communities and trying to understand some of those barriers.

So, while noble Lords may extol the benefits of vaccination programmes for RSV, Covid, HPV and MMR, there is clearly more work to be done in reaching out to individuals in the communities where uptake is low. We need to understand their concerns and the barriers that they feel they face, and we need to understand how we can tap into the power of trusted local community organisations to ensure that as many people as possible benefit from RSV and other vaccines.

The noble Baroness, Lady Ritchie of Downpatrick, stressed the importance of vaccinating infants, but we need to reach the children via their parents and the communities in which they live. I am sure that noble Lords across the House share the ambition to break down barriers of access and build trust in communities, and to make sure more people are protected against RSV.

When we returned after the short break, the Minister said she missed a number of questions from noble Lords across the House, so, as in any debate, I want to make sure that I help her in that respect. I have questions but, if the Minister cannot answer now, perhaps she will write to us. What specific steps are her department and organisations such as the Office for Health Improvement and Disparities and the UKHSA taking to address these disparities in RSV vaccine uptake, not only regionally but also ethnically? What initiatives are there to increase uptake in those ethnic communities where vaccination levels are particularly low? What has worked and what has not?

Is the Minister able to share some good stories where specific programmes to tackle vaccine hesitancy have actually showed some success? How can that best practice be rolled out to other communities in other parts of the country? I think the noble Baroness, Lady Ritchie of Downpatrick, asked about disaggregated data—what disaggregated data is available on RSV vaccine uptake? If it is not yet available, will the Minister look at or perhaps commit to publishing regular disaggregated data on RSV vaccine uptake by region, ethnicity and socioeconomic group so that Parliament and the public can track progress in ensuring equity of access? I am sure the noble Baroness, Lady Ritchie of Downpatrick, would appreciate such disaggregated data, as all noble Lords would.

I once again thank the noble Baroness, Lady Ritchie of Downpatrick, for securing this debate today and for the opportunity it has afforded the full Benches to discuss this important issue. Your Lordships recognise that the Minister takes this issue seriously, so we look forward to the responses.

Suicide Reduction

Lord Kamall Excerpts

Monday 8th September 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, I thank the noble Baroness, Lady Ritchie, for raising this important issue today. The Minister will be aware that the data on suicides shows some disparities: for example, men make up three-quarters of reported suicides and the north-east of England has a suicide rate nearly twice as high as that of London. What research are the Government aware of that explains such disparities? What is being done in local communities, especially by civil society organisations, to try to reduce the rates of suicide in those communities?

[Baroness Merron (Lab)]

The noble Lord is right that there is disparity, which is often linked to priority risk factors, including, for example, financial difficulty, physical health, alcohol and drug abuse, harmful gambling, domestic abuse, social isolation and loneliness. Those priority risk factors are, sadly, more at play in the more disadvantaged areas to which the noble Lord referred. As we seek to develop further the effectiveness of the strategy—we have made great progress so far, but it is not enough—we need to ensure that the whole country is attended to and that we address the risk factors for suicide for everybody.

Prostate Cancer

Lord Kamall Excerpts

Wednesday 3rd September 2025 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend Lord Mott for securing this important debate and for sharing some of those startling statistics. I also thank other noble Lords who contributed today and shared their personal experience. Time constraints and a Paddington Bear stare from the noble Baroness, Lady Anderson, prevent me naming them all.

I hope noble Lords will forgive me if they have heard this before but, when I worked in Belgium, a urologist advised me that men over 45 should seek an annual prostate cancer test. So, when I came back to the UK, I asked my GP about this and he was dismissive, suggesting that I ask for a PSA test at my next blood test. When I did so, the nurse asked me if I was sure that I wanted one and said, “They’re not very reliable”. Given that attitude from some medical staff—not all, it has to be said—it is not surprising that the data I looked up today shows prostate cancer incidence in Belgium to be below the UK’s.

I understand concerns about overdiagnosis of what is termed slow-growing, localised, or benign prostate cancer, which, when unnecessarily treated, may lead to incontinence, erectile dysfunction or bowel issues. I also understand concerns about misinterpreting data from enlarged prostates. These are important points to bear in mind, but surely this should not be an excuse for reluctance or inaction by some clinicians, especially given the alarming racial disparities mentioned by a number of noble Lords.

I welcome the Minister back to her place after her recent absence. In doing so, I will ask her some questions. Given the emphasis on “from sickness to prevention”, how do the Government intend to raise awareness of checking for prostate cancer, particularly in those disproportionately affected communities?

Some noble Lords mentioned trials—some introduced under the last Government. There are also reports of tests. I know we have to be very careful about what we read in the media and some of the claims, but some suggest that these tests are up to 96% accurate in detecting prostate cancer. Can the Minister say any more at this stage about these trials, the ongoing evaluation, and whether there is a rough timescale for a definitive test we can all have confidence in?

Given the concerns that have been raised, what guidance is available now for medical practitioners on prostate cancer tests such as the PSA, then later the PCA and others? How do we ensure that patients can be encouraged to come forward? How can we be assured that prostate cancer is given the attention it deserves?

Care Workers: Foreign Worker Visas

Lord Kamall Excerpts

Wednesday 18th June 2025 Lords Chamber

[Baroness Merron (Lab)]

Perhaps I could assist by clarifying that the spending review, which allows for an increase of over £4 billion of funding available for social care, is by 2028-29; it is not a matter of waiting for that long. That is in comparison with 2025-26. I hope I was helpful to your Lordships’ House in identifying a number of actions we have already taken to professionalise, upskill and allow people to build careers in the social care workforce. That is absolutely crucial. That, aligned with stopping international recruitment in this area—with a period of time for transition of some years—will shift to improve and increase the adult social care workforce in this country.

[Lord Kamall (Con)]

My Lords, while there are legitimate concerns over the levels of immigration, it is important to recognise the contribution that immigrants have made to our great country, not least to recall that after the war, our public services were saved by immigrants, especially from Commonwealth countries. We should not forget that.

My question is about the NHS and Care Volunteer Responders programme, which was set up during the pandemic and extended to adult social care in 2023. Unfortunately, the Government recently closed the volunteering service without an obvious alternative. While I recognise that volunteering will not make up for workforce shortages, what action are the Government taking to ensure that those who wish to volunteer in the social care sector can make a worthwhile contribution?

[Baroness Merron (Lab)]

While I absolutely agree about the value of volunteering, as we have discussed before, I should make clear that volunteering is not a substitute for employment on the right pay, the right terms and conditions and with the right status. I also absolutely agree with the noble Lord about the contribution that has been made by those from overseas to supporting our care services, and indeed by all care workers.

As we have discussed in this Chamber, the scheme was not simply closed. It was something that was appropriate for when we were in a pandemic but not for now. In fact, we have introduced a whole range of measures which I will be very pleased to remind the noble Lord of, to ensure that we can have more volunteers who are better used and more highly regarded. They are a complement to our workforce, and very valuable they are too.

Human Medicines (Amendments Relating to Hub and Spoke Dispensing etc.) Regulations 2025

Lord Kamall Excerpts

Tuesday 17th June 2025 Grand Committee

As I say, we are generally supportive, but these regulations raise genuine concerns and questions that need to be teased out. We must ensure that, in our drive for efficiency, we do not inadvertently dismantle the very fabric of local healthcare that our local community pharmacists provide and compromise the safety interests of our citizens.

[Lord Kamall (Con)]

My Lords, I thank the Minister for introducing this statutory instrument in her usual succinct way and all noble Lords who spoke in this debate. We on these very efficient Benches—so efficient that we have only one person here today, which is very good for productivity—recognise the Government’s intention to modernise pharmacy through the introduction of hub-and-spoke arrangements and to increase efficiency and free up pharmacies to focus more on patient care, finally getting away from the 1945 model that we have been stuck with where patients try to get an appointment with their GP in the morning and, if they are fortunate enough to see them, get triaged off to a pharmacist or to secondary care. This is much more efficient, and we welcome it.

I also welcome what many other noble Lords have said about more diagnosis and testing occurring at the level of the pharmacy. As we saw, one of the silver linings of Covid was the fact that people got more used to home testing. If we can see more home testing and more pharmacy testing out in the community, maybe we can reach those communities that we have found very hard to reach until now. We thought about this lots when I was in government; all Governments think about how to reach those hard-to-reach communities.

That said, while the aim is understandable and commendable, we have some concerns. First, the Government have chosen to proceed with only one model—the patient-spoke-hub-spoke-patient model—rather than the two models proposed by the previous Conservative Government, the other of which was patient-spoke-hub-patient. We see this as a significant narrowing of options, particularly when the consultation revealed a divided response from stakeholders. As the noble Lord, Lord Scriven, said, while large pharmacies were very much in favour of the model that the Government ended up choosing, many smaller and independent pharmacies remained opposed, as well as patients and providers who may have benefited from the second model, where patients are dispensed to directly.

In the world that we live in, with Amazon, eBay and the advent of direct-to-consumer online pharmacies, which will dispense only if there is a valid prescription—they are not just selling stuff off prescription—it is really important that we encourage that innovation. It would be wonderful for patients, particularly those with limited mobility who find it difficult to get to pharmacies, to be able to order on the NHS app, have it approved and know it will be delivered to them within so many hours or days. That would be a far more efficient model. I hope that we are not inhibiting online pharmacies with all those safeguards.

I completely understand that there is always a balance between innovation and safety and precautions. Can the Government explain why they chose only one model? Was it because of concerns over safety, good lobbying or the interests of larger pharmacists being heard over the smaller pharmacists? We would be very interested in that. We are concerned about limiting it to a single model, particularly when we know that community pharmacies dispensing for GPs and distance sellers are finding innovative solutions.

Secondly, there is funding and support. The updated impact assessment openly admits that there is considerable uncertainty over the cost of establishing these hubs, their operating expenses and the level of uptake. Once again, there is an impact on smaller pharmacies. How do the Government intend to avoid the risk that smaller providers could be left behind or forced out of the market, reducing choice for patients and challenging the role of small community pharmacists? Are they concerned about this? In addressing that, have they looked at any incentives or ways to help smaller pharmacists who may not have the resources for that upfront investment?

Thirdly, the question of oversight and transparency remains. The Minister will be aware that I ask a lot of questions on patient data and accountability of data. The Government are yet to clarify who will be responsible for collecting and publishing data on the implementation and impact of these new arrangements, particularly in light of the abolition of NHS England. This oversight is crucial not only to ensure patient safety and quality of service but to understand the broader impact on costs and service delivery.

Let me be clear: we support the idea of the single patient record and the federated data platform. One of my jobs when I was a Minister was to make sure that we joined up and digitised the data as quickly as possible. We know what efficiencies that could lead to in our healthcare, but patient safety and data protection must be addressed with rigour. The framework for sharing patient information between hubs and spokes is a key feature of this reform, yet the SI and the supporting documents provide limited detail on how patient confidentiality will be maintained and how the risk inherent in multiparty data sharing will be mitigated.

We do not oppose the principle of modernising pharmacy dispensing through the hub-and-spoke model. We were disappointed that one model was chosen, as we thought we could have some innovation with the other model. Without clearer information and incentives to smaller providers, we worry about smaller community pharmacies being pushed out, particularly in the light of having only one model. How will the Government make sure that that risk is avoided? We urge them to engage more fully with all stakeholders, clarify their plans for funding and data governance, remain open to innovation and not close down other options prematurely. With that, I look forward to hearing from the Minister.

[Baroness Merron (Lab)]

My Lords, I thank noble Lords on all sides of the Committee for their helpful contributions to today’s debate. I get a sense of support for where we are going and questions about how it will happen, which I completely accept. This instrument is part of a package of measures to relieve pressure in community pharmacy and improve patient care and the ability of the NHS to serve patients, particularly in a community setting—one of the main pillars of change for our NHS fit for the future. It builds on legislation that is already in place to enable pharmacies to increase efficiency by dispensing medicines in their original packs. Pharmacy technicians are now able to act under patient group directions to supply medicines, and the Government will shortly bring forward legislation to enable them to be authorised to do more in the pharmacy.

My noble friend Lord Stansgate raised a number of issues; he asked how it has been received and raised the financial sustainability and attraction of these measures. I reiterate that the changes being introduced are enabling. They are purely voluntary. It is entirely up to pharmacists, which are independent businesses—it is important to remember that—to decide whether they feel that engaging one, two or several hubs is going to be beneficial to their business model. It is up to them to decide.

--- Later in debate ---

The noble Lord, Lord Kamall, expressed his disappointment that we are introducing model 1 only. I know that, in 2022, the previous Government ran a consultation on hub-and-spoke dispensing arrangements, which suggested for consultation two models of dispensing. On why we have gone for model 1, stakeholders raised concerns that model 2 risks undermining the important relationship between the patient and their local community pharmacy. Implementation would require additional safeguards to avoid this, which I am sure the noble Lord would describe as an unintended consequence. We took the concerns from the consultation on board, which is the reason why we decided to proceed with model 1, but I assure the noble Lord that we will of course keep this under review.

[Lord Kamall (Con)]

I appreciate the response from the Minister. She said that she will keep this under review. As part of that review, are the Government or officials looking at ways in which they could mitigate concerns about model 2 in terms of those relationship and safety concerns? That would perhaps enable investigation of a future model 2.

[Baroness Merron (Lab)]

It would be fair to say that the review will be on how well this is working rather than an attempt to move to model 2. In all the modelling, we believe this is the best way to go. Patient safety is paramount, as it always should be, as is the expansion of services to individuals, but we will keep the whole matter under review.

There were two other questions. The noble Lord, Lord Scriven, asked about the fee structure. The spoke will still receive the fee for dispensing and the paying hub for the services it provides. We are not planning to dictate how the fee structure will work between hubs and spokes, as I said in an earlier answer.

Learning Disabilities Nursing

Lord Kamall Excerpts

Tuesday 17th June 2025 Lords Chamber

[Baroness Merron (Lab)]

We are very focused on that, and NHS England is working with all areas of the country and local services to ensure that that is the case. There is a national plan for learning disability nursing that has been developed with key partners and focuses on four priorities: attracting, retaining, developing and celebrating the workforce. It is very important that we elevate the standing of learning disability nurses, to whom we are all grateful.

[Lord Kamall (Con)]

My Lords, I thank my noble friend Lady Monckton for raising the important issue of a workforce that understands how to deal with those with learning disabilities. Given the importance of this, will the Government consider committing to a targeted health promotion strategy, perhaps in partnership with local community organisations and sections of the private sector, to enable all children with a learning disability to access early promotion, intervention and prevention services to help them develop healthy habits and to improve long-life health outcomes for this vulnerable group?

[Baroness Merron (Lab)]

This is indeed a vulnerable group, as the noble Lord says, and it is probably best that I refer to the upcoming 10-year plan, which will deal with inequalities throughout a number of sectors, including the most vulnerable and including this group.

Medical Devices and Blood Safety and Quality (Fees Amendment) Regulations 2025

Lord Kamall Excerpts

Tuesday 17th June 2025 Grand Committee

[Lord Scriven (LD)]

My Lords, I thank the Minister for outlining the purpose of these regulations so eloquently and succinctly. It is clear that the change to the fee structure for regulating medical devices and medical products is part of a realm of profound importance both to public health and to the future of healthcare in the UK. As Liberal Democrats, we unequivocally support a robust, efficient and well-resourced Medicines and Healthcare products Regulatory Agency, but it is important that our regulatory bodies possess the financial stability to ensure the safety, quality and efficacy of medical products and blood safety, which touch the lives of millions throughout the year.

I am not going to speak on these regulations at great length; I just want to tease out a couple of issues about which I would like a little more information from the Minister. First, increasing the fees will mean that costs will be covered automatically. What mechanisms are in place to ensure that efficiency and effectiveness are in place, rather than just ballooning costs that it would be assumed the industry would absorb? I am not clear from reading the impact assessment or the regulations exactly how the Government will ensure that the cost really is the cost and is not excessive cost.

Secondly, it is clear in the impact assessment that most of those who gave feedback to the consultation question were against these fees. How have the Government taken into consideration the reservations, not just of the “no” element but in particular that the fees were seen in some cases to be disproportionately high and to exceed inflation? How has that developed? Why are these costs disproportionately high and why do they exceed inflation?

Finally, it is important to increase the fees to ensure the agency’s work can continue but, critically, the impact assessment demonstrates a lack of concrete detail on how these increased fees will translate into tangible improvements in these MHRA services. Although the rationale for increased fees is often framed around enhancing regulatory efficiency and speed, the document provides insufficient assurances of the measurable commitments as to how the additional revenue will be specifically utilised. There is no clear framework for accountability that demonstrates how these funds will lead to faster approvals or increased safety. How will the department measure such improvements? In particular, what improvements are expected on the back of this fee increase?

These regulations are a serious matter. They impact on the health of our nation and, to some degree, the vibrancy of our life sciences industry, but we must ensure that our regulatory framework is not only robust but forward thinking and truly serves the best interests of every patient in the UK by ensuring that the increased cost will both increase efficiency and, we hope, improve the services that the MHRA provides.

[Lord Kamall (Con)]

My Lords, I also thank the Minister for introducing these regulations succinctly, as the noble Lord, Lord Scriven, said. Perhaps in common with the Liberal Democrats, we on these Benches—the numerous people on these Benches—do not seek to oppose this statutory instrument. Rather, we just wish to reflect on its purpose and practical implications, and ask a few questions for clarification that I hope the Minister will be able to answer.

As noble Lords have said, this instrument amends three pieces of legislation. We understand that these changes are intended to enable the MHRA to increase the fees to manufacturers, suppliers and other regulated entities involved in the approval of medical devices and blood components. Noble Lords understand that the current model relies primarily on contributions from industry and that the MHRA’s fees were last comprehensively reviewed in April 2023, as the Minister said. Of course, we have seen a rise in operational costs, particularly relating to staff and overheads, so we completely understand that the intention behind these regulations is to bring the MHRA’s income more closely in line with the cost of delivering its services. It is also to place the agency on a more sustainable financial footing, thereby reducing its reliance on central government funding, which I think is something on which we all agree.

As the noble Lord, Lord Scriven, said, the impact assessment accompanying this instrument identified the primary benefit of this additional income—to enable the MHRA to continue fulfilling its responsibilities —but, as was raised by some in the industry and in the other place, it is less clear how these changes will directly benefit patients, healthcare providers or, indeed, medical innovators, in particular those operating in the small and medium-sized business sector. We understand that the Government decided to pause their proposed reforms to the medical device registration fee following concerns raised by stakeholders. That decision is welcome, and I thank the Minister and the Government for that. The paused proposals would have had a disproportionate impact on companies registering a large number of products, particularly due to the proposed fee model linked to the global medical device nomenclature codes. However, the broad uplift in the other fees will still go ahead, and it is in this wider context that we seek some reassurance about these changes.

I shall look at some of the areas on which some clarity would be welcome. First, we recognise the MHRA’s need for stable funding, but we want to make sure it does not create barriers to innovation, in particular for start-ups and SMEs, which, as we know, often operate on much narrower margins and already navigate a complex regulatory environment. What assessment has been made of the cumulative impact of these fee increases on smaller firms? Do we know how these changes compare with the regulatory costs faced by manufacturers in other major markets, such as the EU, the US or Asia? Is the Minister able to give some international context here?

Secondly, the impact assessment confirms that the staffing costs remain the largest cost driver for the MHRA and assumes a 2.2% annual pay increase through to 2027—below the current rate of inflation. Has any thought been given to whether that is a realistic assumption and basis for planning? If the actual costs prove higher than forecast, how will that impact the MHRA’s progress towards the full cost of recovery? Would the agency be forced to scale back its services, or would the taxpayer be expected to cover any shortfall?

Adult Social Care

Lord Kamall Excerpts

Monday 16th June 2025 Lords Chamber

[Baroness Merron (Lab)]

Your Lordships’ House will be aware of the financial situation that we inherited and seek to put right. The Government have made available up to £3.7 billion in additional funding for social care authorities in 2025-26, and the noble Baroness is right that just last week the spending review allowed for a further increase of over £4 billion to be made available for adult social care in 2028-29. We are taking a whole range of actions. The Employment Rights Bill, which we will come back to later today, seeks, for the first time ever, to bring in fair pay and professionalisation for those in the adult social care workforce. So it is not that nothing is happening in the meantime. We are making progress and ensuring that the funding will be available so that we have not just a decent adult social care workforce but a way of tackling what no Government have managed to tackle before.

[Lord Kamall (Con)]

My Lords, given the persistent workforce gaps in adult social care over many years, and given the concerns that there are over immigration—even though immigrants often do the work that local people do not want to do—can the Minister outline what plans the Government have, with a clear structure, to make this a more attractive career, particularly to young people in the UK? What are the Government doing in partnership with social care providers, which are stretched at the moment, to look at alternative ways of funding training and skills development and to make sure that this is an attractive career for those in the UK, rather than always having to rely on immigration?

Cardiovascular Illnesses

Lord Kamall Excerpts

Thursday 12th June 2025 Grand Committee

[Lord Kamall (Con)]

My Lords, I begin by thanking my noble friend for securing this important debate and, as other noble Lords have said, for sharing his own experience in a very moving way. It really brought home to us that this is about not just figures or statistics but the human side of this story. I thank all noble Lords who have contributed to this debate. It is not a particularly political debate; across the political spectrum, we can agree that we should work as constructively as we can together to try to address these issues.

As the noble Lord, Lord Weir, reminded us, cardiovascular disease is the cause of one in four premature deaths in England. More than 6.4 million people suffer from it and it has resulted in 1.6 million disability-adjusted life years. According to the British Heart Foundation—many noble Lords will have read the excellent briefings that we have received from many organisations, to which we are grateful for informing us—this disease may be inherited or it may develop later in life. As the noble Baroness, Lady Winterton, said, those in the most deprived 10% of the population are twice as likely to die prematurely from these diseases than those in the least deprived 10% of the population. The highest premature mortality rate is in the north-west region, and men are twice as likely as women to die prematurely from this disease.

As the noble Lord, Lord Rennard, said, the NHS has identified high blood pressure, smoking, high cholesterol, diabetes, kidney disease, inactivity—to which my noble friend Lord Moynihan referred—and obesity as risk factors. We also know that those at increased risk of developing this disease include people of south Asian and black African and Caribbean backgrounds.

The King’s Fund think tank has estimated that there are 220,000 admissions for coronary heart diseases and 100,000 admissions for stroke a year, costing the NHS an estimated £10 billion and the economy £24 billion, so the human and financial cost are alarming. We must think about how we can work on this together, across the spectrum, to improve our use of resources and to reduce the number of deaths.

As noble Lords discussed, in January 2025 the Select Committee on Health and Social Care considered the NAO’s report, alluded to by the noble Baroness, Lady Winterton, on progress in preventing cardiovascular diseases. Following this, a letter of recommendation was sent to the Parliamentary Under-Secretary of State for Public Health and Prevention on improving data collection on cardiovascular disease.

When we were in government, we set out ambitious plans in the NHS long-term plan to detect and treat people with the risk factors of developing these diseases. This is not party political; any Government would have done that, because it is important. It included the NHS health check and face-to-face check-ups for adults aged between 40 and 74 in England. It was commissioned through local authorities and delivered through GP surgeries, to help spot early signs of heart disease. Indeed, many noble Lords spoke about how we identify and diagnose, as well as how we prevent. We also introduced a digital NHS health check to operate alongside the in-person NHS health check, to reduce the pressures faced by GP surgeries, particularly as more people now are aware of digital technology and are happy using it.

These Benches also welcome the current Government’s manifesto commitment to deliver a renewed drive to tackle the biggest killers—cancer, cardiovascular disease and suicide—while ensuring that people live well for longer. I understand completely that the Government are in their early days, but, unfortunately, we are yet to see action in some of those areas. I admit that we were slightly disappointed that the new Government scrapped the major conditions strategy. I also understand, however, that we are waiting for the 10-year plan, and if these issues are integrated into the 10-year plan, as I hope they will be, that might be a better approach. As the noble Lord, Lord Weir, said, we should look at these things not in isolation but as part of an overall integrated plan. We would welcome any announcement from the Government on whether and how they would form part of the, I hope, more integrated 10-year plan. Like many other noble Lords, we eagerly await its publication.

I conclude by asking the Minister some specific questions. How do the Government plan to improve support for vulnerable communities who are at a higher risk of developing cardiovascular diseases, including men, those in more deprived areas and people of south Asian and black African or Caribbean backgrounds?

On 18 June, I will host an event with BRITE Box, a wonderful prevention charity that helps families from deprived areas to budget and to cook healthily on a budget, as a family together, to improve their health. I thank the Minister for agreeing to speak at that event. What specific programmes are the department aware of to improve this sort of prevention, including healthy diets and physical activity? How are the Government working with non-state, local community civil society organisations, such as BRITE Box, to make sure that we tackle these issues?

My noble friend Lord Moynihan spoke about the role that physical activity plays in support and prevention. What other specific steps are the Government taking to close the health inequalities of communities in the most deprived areas, especially those faced by some ethnic groups? What progress have the Government made to ensure that those commissioning and delivering health checks are obliged to collect and report on the demographic data so that we can improve the data on age, gender, ethnicity and socioeconomic status, so that we can target better?

My noble friend Lord Polak spoke about Cardiac Risk in the Young. I was slightly disappointed that when I wrote to one of the Minister’s colleagues in the department, they declined to meet with Hilary Nicholls, whom I had met to hear her daughter’s story and those of other people. I hope that the Minister and her officials will be able to accept the invitation from my noble friend Lord Polak, so that at least one person from the department can speak to Hilary Nicholls and Cardiac Risk in the Young. I hope that the Minister can confirm that this will be part of the overall 10-year plan.

I understand that I have asked lots of questions and gone over time, as usual in my typically Socratic way, like other noble Lords, but I look forward to the Minister’s answers. If she does not have them now, I know that, thanks to the wonders of technology and her wonderful officials, she will write to us.

Primary and Community Care

Lord Kamall Excerpts

Thursday 5th June 2025 Lords Chamber

[Lord Kamall (Con)]

My Lords, we on these Benches welcome the Government’s stated commitment to innovation in primary care and the commitment to continue the rollout of community diagnostic centres, which were started by the previous Government. However, unfortunately, last year the Patients Association highlighted barriers to the rollout of point-of-care diagnostics, particularly in rural areas. Is the Minister aware of those concerns, and what plans does the department have to tackle those barriers?

[Baroness Merron (Lab)]

Our commitment to moving towards a neighbourhood health service obviously allows for attention to be given to different circumstances, including in rural areas. It will mean that more care can be delivered locally and that problems can be spotted earlier, including any problems with rollout. We will shortly provide details of a national neighbourhood health implementation programme. We liaise with various groups, including the Patients Association, and I am grateful for their input and for flagging up any difficulties, which we absolutely seek to resolve.