Health: Eating Disorders

Lord Winston Excerpts

Tuesday 19th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness is right: the statistics on eating disorders are shocking. The Mental Health of Children and Young People in England Survey identified 0.4% of 5 to 19-year-olds and 1.6% of girls aged 17 to 19. The NHS Digital Adult Psychiatric Morbidity Survey showed 6.4% of adults displaying signs of an eating disorder. There is the survey by Beat, and I could go on. I do not think it is an issue of surveys; we have to address the underlying statistics with measures that make a difference.

[Lord Winston (Lab) [V]]

It is very helpful that the Minister recognises the seriousness of anorexia nervosa and other conditions. It remains puzzling, and the causes are not fully understood, but the long-term risks—for example, infertility or the loss of a child during pregnancy or childbirth—are very serious. Given that some of these patients require almost forced admission to hospital, is there any scope for reviewing this issue when we come to consider the mental health provisions that are due next year?

[Lord Bethell (Con)]

The noble Lord puts it extremely well. Instances of those in pregnancy who have eating disorders are particularly heartrending and disturbing. He is right: sometimes, the condition is so extreme that it needs virtual full admission. We have put six new beds in the south-east, five in the Midlands, five in the east of England and 10 in the north-east. We are putting a massive amount into mental health budgets and this provision covers exactly this kind of disorder because we recognise that more resources are needed. I look forward to further announcements of spending in this area.

Mental Health Act Reform

Lord Winston Excerpts

Monday 18th January 2021 Lords Chamber

[Lord Bethell (Con)]

The right reverend Prelate is right to allude to the importance of culture. No amount of bureaucracy or guideline-writing can ultimately address the basic attitudes, backgrounds and mental starting point of those involved in these decisions. I reassure the House that at the moment we are processing the people plan, which addresses at a fundamental level the hierarchy, racism, homophobia and misogyny sometimes found in some parts of the NHS. We are acutely aware that culture is fundamental to the safe provision of services to patients. The framework itself is not wholly directed at culture, but it will be supplemented by these kinds of reforms.

[Lord Winston (Lab) [V]]

I congratulate the Government on getting Sir Simon Wessely to help them bring about this much-needed reform and will welcome seeing how it progresses in the next year. I want to draw attention to one of the problems about sectioning patients. Two members of my team at different times have been sectioned; both were psychotic and severely depressed at the time. One phoned me at 5 am to say that people had come for her; it was clear that this was highly scary and very damaging. The other patient was left in a police station after being found on a moor for many hours before eventually a bed could be found, miles from where she lived or where anybody could visit her. Also, the premises available for such patients when they have been sectioned seem quite inadequate. The Minister has mentioned the dormitory system, but when I visited both those women, I felt that I would be very depressed myself if I were in those circumstances. We need to do much more to make premises more homely if we are to be more successful in encouraging a return to normal health.

[Lord Bethell (Con)]

The noble Lord is entirely right: when people experience a mental health crisis, they should be treated with consideration. Unfortunately, the police are sometimes at the front line of dealing with those with mental health difficulties. It is a stretch for them, and they should have the right training to be able to deal with a situation sensitively and they should have the right premises to be able to give people safe and secure environments. It is at the outer limits of their professional responsibilities, but we are doing as much as we can to put the training in place.

I remember from my own personal experience, when my father and my mother were sectioned, the consideration and thoughtfulness of those involved in both those processes. It is not all bad, but I take the noble Lord’s point.

Covid-19: Variant

Lord Winston Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am afraid that I just do not recognise the noble Lord’s proposition. Hundreds, if not thousands, of new variants are appearing all the time. Many of them have passed through the process, but identifying those that are threatening, have more transmissibility and are significantly different is extremely complex. As I said very clearly, it was on 8 December that, after analysing all the genomes available in Kent, we showed that an important new variant was circulating.

[Lord Winston (Lab) [V]]

My Lords, clearly these variants are extremely—[Inaudible]—for all sorts of reasons. Regrettably, the Minister did not answer the question put by my noble friend Lady Thornton yesterday, when she questioned incomplete vaccination. Can the Minister give us clear figures on the risk of mutant varieties of the virus with a longer period between the two injections of the Pfizer vaccine?

Covid-19: Vaccinations

Lord Winston Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful to the noble Lord for flagging this important issue. He is entirely right that those who are sometimes overlooked by society and fall between the cracks are often those who either suffer from the disease or are vectors of infection. It is a public health priority to ensure that people such as those excluded from schools are not overlooked or in any way left behind. I would be very grateful if he could write to me with the details.

[Lord Winston (Lab) [V]]

My Lords, speaking from these Benches, I think it would be appropriate to thank the noble Lord, Lord Bethell, very much for the amazing amount of work he has been doing on this very difficult issue. I hope he will continue to take our concerns back to the Department of Health and the Government in general, because that seems very important. I join my noble friend Lady Thornton in congratulating the Government on getting vaccines out, but, with all due respect, Israel has already vaccinated over one-fifth of its population with a massive vaccine campaign. On the important issue of dividing the time of the Pfizer vaccine, many of us have given informed consent for a period of three weeks between the two injections; by extending that period, we now risk not obeying the consent issue, and therefore there is an ethical problem. Could the noble Lord address that issue, because it is of considerable importance, certainly increasing the risk of suspicion of the vaccine, already very prevalent in parts of the population?

[Lord Bethell (Con)]

I am extremely grateful for the noble Lord’s kind words. I know lawyers looked at the question he raises on informed consent; I am afraid I do not have the precise answer at the Dispatch Box right now, but I will be glad to write to him with a clarification.

Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020

Lord Winston Excerpts

Thursday 7th January 2021 Lords Chamber

[Lord Winston (Lab) [V]]

My Lords, I had the privilege of sitting on the Select Committee that looked at the virus. The committee was brilliantly chaired by the noble Lord, Lord Patel, who has already spoken. One thing we heard was that this virus occurred from a mutation and that mutations were likely to be possible in future. The fact is that the more people who are infected in a population, the greater the likelihood of mutation that may be deleterious to human health, and the more treatment that is given to people, the more likely there is to be a mutation, as the virus fights against that treatment.

Of course, people who come from outside your environment—for example, from outside the country—are more likely to bring such mutations in with them. One of the clear issues, which was not properly answered by the noble Baroness, Lady Evans of Bowes Park, earlier today, when she answered the noble Viscount, Lord Waverley, I think, is what we are doing about international travel, a point already raised very ably by my noble friend Lord Reid. It seems to me, looking at the figures for people coming through London airports, that hundreds of thousands of people are coming through on a weekly basis and we are not properly tracking or tracing them. Some of them are being asked if they might like voluntarily to be tested, and of course they have to pay for it. That is clearly nonsense. There should be much stricter controls on people coming into this country, as is happening in other countries. I ask the noble Lord, Lord Bethell, exactly what we are going to do now, because at present the Government do not seem to have a firm policy to do something to make sure that we are not bringing more viruses, which may be mutating in some cases, into this country.

Covid-19 Update

Lord Winston Excerpts

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I feel the point that my noble friend makes extremely personally. I am currently isolating with a 14 year-old; like many 14 year-olds, he and his friends never demonstrate any symptoms of Covid whatever and yet it would seem that they are carriers and vectors of the infection. The recent explosion in transmission in London and the south-east was led and probably caused by the 14 to 18-year-old age group, even though almost all of them are completely asymptomatic. We have worked with celebrities and opinion leaders in the youth groups to try to get this message across, but I point my noble friend to the announcement today of a very large increase in the use of asymptomatic testing in schools in the new year, as an indication of our commitment to ensuring that transmission among asymptomatic young people is contained.

[Lord Winston (Lab) [V]]

I thank the noble Lord for repeating the Statement. I concur with what the noble Baroness, Lady Thornton, said from the Front Bench. We know from the history of plagues that they occur through travel. This happened in the 1340s and again in the 1660s with the plague of London. Now we are seeing people travelling to London, which is a massive hub of travel; they come to the airport, they do not leave a phone number or address—they are not required to do so—and tests at the airport are voluntary. Many people go missing and are not followed up by a proper track. When they get tested, they pay for it, so it is entirely voluntary. Does the noble Lord feel that these arrangements are sufficient, given that so many people travel to London and that there is a risk of this plague continuing just as they have done historically?

[Lord Bethell (Con) [V]]

I am grateful for the noble Lord’s insight. He is right that travel is the friend of the virus. Many of the growths in transmission have been associated with it; one thinks of the ski resort holidays at the beginning, the spring break migrations in America and other examples. I reassure him that, while he is right to question the arrangements around our airports and transport hubs, we have brought in a much more strenuous test to release programme which is much more realistic than the previous isolation programme. The procedures around the passenger location ports have been tightened up and the enforcement and tracking arrangements for passengers have been supplemented. There is now a very strong body of evidence to suggest that passengers are abiding by the testing programme. As he may know, private tests were launched yesterday, and their uptake has been incredibly impressive.

Health: Sepsis

Lord Winston Excerpts

Wednesday 22nd January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

I am very happy to congratulate the BBC. I do not know that I heard “The Archers” storyline in question, but I shall make sure that I update my education in this respect. I want also to congratulate Public Health England on its national Start4Life information service for parents. It has worked with Mumsnet to make sure that awareness is spread to those most likely to need it, because those most at risk are the young, the elderly and those who have underlying conditions. Targeting the messaging at those who need it most is very important.

[Lord Winston (Lab)]

My Lords, the noble Lord, Lord Grade, raises a very important point. Can the Minister tell us what percentage of patients with sepsis have the DNA profile of the bacteria recorded?

[Baroness Blackwood of North Oxford]

The noble Lord, Lord Winston, always raises very specific questions requiring statistical answers which are not necessarily at my fingertips. I shall write to him on that point.

Health: Eating Disorders

Lord Winston Excerpts

Tuesday 7th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

Obviously we cannot ignore the obesity challenges that we face in this nation, and it is right that we take strong action to address them. But we recognise that this must be done in a sensitive way that also takes into account the potential consequences for those with eating disorders. We must strike a careful balance between informing and educating people about healthier choices and not negatively impacting on those with eating disorders, those in recovery from eating disorders or those who have the potential to develop them.

[Lord Winston (Lab)]

My Lords, the figures are, of course, of great concern but, as so often happens with many pathologies, sometimes the reasons for these sudden or increased rises are due to better diagnosis or increasing diagnosis, and, of course, greater awareness of the problem. Given that, can the noble Baroness say what plans the Government have to ensure that NHSX is fully supported in trying to help us to analyse these data to see just how important investment in this particular condition actually is, and others similarly that are on the rise?

[Baroness Blackwood of North Oxford]

The noble Lord, as ever, is quite right to delve into the detail of the 2017 survey into the mental health of children and young people in England. It found that eating disorders were identified in 0.4% of five to 19 year-olds—the spread was 0.7% of girls and 0.1% of boys—but it rose to 1.6% of girls aged seven to 19. Obviously, we want to understand what this rise in admissions means. There could be a number of reasons, which we hope are linked to earlier and better diagnosis, but of course we need to understand it better. We have a much better understanding of the data through the NHS mental health dashboard, which tracks down to CCG level what is happening with it, but we need to make sure that this work is properly funded and properly tracked in order to lead to better and more effective policies and provision of commissioned services.

Health: Tick-borne Encephalitis

Lord Winston Excerpts

Tuesday 5th November 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

The noble Baroness is absolutely right, and I am happy to recognise the organisation that she mentioned. In the first place, the tick toolkit and the work of PHE is in place to raise awareness, and work goes into providing advice to professionals so that early diagnosis is possible.

[Lord Winston (Lab)]

My Lords, one of the problems with Lyme disease is that the symptoms that it causes mimic a whole range of different viral infections, many of which are much more common. Does the Minister feel that the Government are doing enough to raise awareness of Lyme disease among general practitioners, and is she satisfied that the screening tests—I think that they cost around £60 a time—are sufficient?

[Baroness Blackwood of North Oxford]

The noble Lord is quite right, and he understands this a lot better than I do. NICE published guidelines for health professionals in 2018 in an effort to ensure prompt diagnosis of Lyme disease. Obviously if it is recognised promptly and treated with antibiotics, acute Lyme disease is usually resolved without further complications. I will take away the question about the cost of the test to consider whether that has been a barrier; we have no evidence about that at this time.

Sexually Transmitted Infections: England

Lord Winston Excerpts

Thursday 5th September 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

My noble friend is absolutely right that increases in particular STIs are worrying and we need to make sure that we drive forward our response to that. Some BAME groups are at particularly high risk of STI acquisition, particularly those from a black Caribbean background possibly due to a higher number of sexual partners. PHE’s reproductive, sexual health and HIV innovation fund is spearheading new, innovative, community-led interventions to support those at increased risk of infection and we will continue to look for new ways to respond to these challenges.

[Lord Winston (Lab)]

My Lords, it is very unwise to group all STIs together and the organism that I should like to concentrate on for the moment is chlamydia. We may not be diagnosing chlamydia in the right way. Given that the NICE guidelines now mean that we hardly ever do laparoscopies, we cannot show whether people have tubal damage, which is said to be an important part of chlamydia. In my view, that is greatly overestimated. What does the Minister think about research into whether chlamydia really does cause infertility and other problems with conception?

[Baroness Blackwood of North Oxford]

The noble Lord is of course an expert in where we should target our research. The NIHR is a £1 billion fund which is not targeted specifically. However, it is right that we should target research into STIs to ensure our response to the challenges. We know that STIs are increasing so we should include research into them.