Lord Lancaster of Kimbolton debates involving the Department of Health and Social Care during the 2019 Parliament

Children: Cancer

Lord Lancaster of Kimbolton Excerpts
Thursday 26th May 2022

(1 year, 10 months ago)

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Asked by
Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton
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To ask Her Majesty’s Government what steps they are taking to improve cancer outcomes for children.

Lord Kamall Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)
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Cancer in children is thankfully rare, accounting for less than 1% of cancer cases each year. The Government are dedicated to improving cancer outcomes and our new 10-year cancer plan will further our efforts to improve childhood cancer diagnosis rates and outcomes. We continue to invest in research, including with the paediatric experimental cancer research centres network, which is dedicated to early-phase research on childhood cancers.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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My Lords, childhood cancer is not rare; it is the biggest killer by disease of children under 14 in the United Kingdom. Sadly, it is often diagnosed late and one in five children who get it will die. The issue was highlighted in the House of Commons last month in an excellent debate led by Caroline Dinenage. There, there was a cross-party consensus that, with just 3% of funding spent on children’s cancer, there needs to be greater emphasis on research, detection and treatment. Will childhood cancer be a priority for the Government’s 10-year cancer strategy and will the requested childhood cancer mission become a reality?

Lord Kamall Portrait Lord Kamall (Con)
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I thank my noble friend for the question and for discussing the issue with me previously. As he rightly says, even though it is rare, cancer is the biggest killer of children aged up to about the age of 15. The Government’s new 10-year plan for cancer care is under development. It will address the cancer needs of the entire population, including those of children. We also recognise the severe impact that cancer has on not only the patient but their family and friends, and are focusing in particular on interventions that support patients through difficult journeys of diagnosis, treatment and aftercare.

New Hospitals

Lord Lancaster of Kimbolton Excerpts
Thursday 18th November 2021

(2 years, 4 months ago)

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Lord Kamall Portrait Lord Kamall (Con)
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One thing that is exciting about the new hospitals is that we are going to transform the way in which we deliver new healthcare infrastructure. First, it will be sustainable, with net-zero carbon across the NHS. Digital transformation is key, making use of the latest technology, so no longer will we have microscope slides couriered between sites, but we can instantly see a digital image and assess it using AI. There will be standardised design and modern methods of construction and new hospitals will be integrated with local health and care systems. This is a project for a health system that is fit for the future.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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Many of these new hospitals will be built in existing centres of population. My concern, though, is for areas of high projected population growth, such as the Oxford-Cambridge arc, where we always seem to be playing catch-up when it comes to medical facilities. Can my noble friend simply reassure me that the principles of “I before E”—infrastructure before expansion—will be applied when choosing where these hospitals will be?

Lord Kamall Portrait Lord Kamall (Con)
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I assure my noble friend that, in deciding where to build a hospital, among the things that the NHS and others look at are the needs in the community, existing infrastructure and making sure that we can build hospitals that are fit for the future, that are digital, that are transformative, but are led by clinicians as opposed to construction experts.

Covid-19: Vaccinations Administered Abroad

Lord Lancaster of Kimbolton Excerpts
Wednesday 27th October 2021

(2 years, 5 months ago)

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Lord Kamall Portrait Lord Kamall (Con)
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The Covid pass can be accessed via the NHS app, but, where that is not possible, patients are able to go to the NHS website or to call 119 to get a letter version.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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I remind the House of my interest as a member of the Army Reserve. Many serving personnel and their families have been vaccinated overseas, either by defence medical services or local practitioners, and they too have had a challenge getting their vaccines on to the NHS app. Equally, in reverse, many serving reservists here in the United Kingdom have been unable to get their vaccinations on to JPA—the MoD administration system —meaning that there is a potential delay in their deployment. Since this is not an international problem but a national one between two government departments, can my noble friend simply use his good influences to sort it out?

Lord Kamall Portrait Lord Kamall (Con)
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I thank my noble friend for making me aware of that issue; I was not aware of it. On the availability of the Covid pass, I repeat that the NHS Covid pass is available online and via NHS.UK, provided that individuals already have an NHS login. Users can then access it from anywhere in the world and download a Covid pass PDF. Individuals need to be in the UK to download the NHS app, but, once it is downloaded, it can be accessed worldwide. In terms of the conversations between the Department of Health and Social Care and the Ministry of Defence, I will make sure that I do that, and I will write to my noble friend.

Covid-19

Lord Lancaster of Kimbolton Excerpts
Thursday 15th July 2021

(2 years, 8 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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The challenge presented by workforce illness in the NHS is acute at the moment. It is one we are very conscious of, and the noble Baroness is entirely right that parents who have a sick child must stay at home. Not only is that humane; it is also infection control wisdom. That puts the pressure on. That is why we have prioritised vaccination among healthcare staff, and we are prioritising the boosters for staff.

In terms of managing emergency services, we are conducting a huge marketing campaign around the use of NHS 111 so that people can book their slot and be directed to the right kinds of services because, as the noble Baroness knows, many people who turn up in emergency departments are not necessarily in the right place for the conditions they present.

In terms of variants of concern, we are keeping an eye on lambda, beta and all those that may present a vaccine escape risk. We will take whatever steps necessary to address their threat.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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My Lords, I remind your Lordships’ House of my interest as deputy colonel commandant of the Brigade of Gurkhas. Since I last raised the plight of unvaccinated Gurkha veterans in Nepal, I am delighted that the Government have acknowledged their duty of care to them under the Armed Forces covenant. Previously my noble friend has said that our priority is to vaccinate “our people” in the United Kingdom. Now that we seem to be struggling to find people to give the first vaccination to, since there are fewer than 50,000 per day, can I simply ask him again when we will vaccinate our people —our Gurkha veterans are absolutely “our people”—in Nepal? When will they get their vaccines?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I pay tribute to my noble friend for his campaign on Nepal. His remarks are heartfelt, understood and heard clearly. We all recognise the debt we owe, not just to those from Nepal who have served in Her Majesty's Armed Forces, but their families and the entire nation for their contribution throughout Britain’s history. The PM has announced that the UK will donate 100 million doses over the next year, and the majority of those will be donated to COVAX. My honourable friend in the Foreign, Commonwealth and Development Office will be best placed to clarify the precise arrangements and where Nepal will stand in that supply chain.

Covid-19 Update

Lord Lancaster of Kimbolton Excerpts
Tuesday 29th June 2021

(2 years, 9 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the noble Baroness’s question is entirely reasonable and I wish I could be more specific on the precise timing. The honest truth is that we look at the data every day; our experience through this pandemic is that our understanding improves every day and therefore the guidance that we provide is often provided at a relatively late stage. It is an unfortunate aspect of this awful pandemic and one that I know noble Lords have commented on with vigour in the past, but it is an unavoidable fact of life. However, the comments made very thoughtfully and persuasively by noble Lords about the conditions in care homes, the restrictions that are put on residents and the pressure that that puts on them and their families have been heard loudly and clearly by all those in the department and across government, and we will seek to address those concerns when the moment is right.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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I remind the House of my interest as Deputy Colonel Commandant Brigade of Gurkhas. According to the Daily Telegraph, 63 unvaccinated Gurkha veterans have now died in Nepal. Had they lived in the UK they would have been vaccinated, but because they left the Army before the law was changed, they have no right of abode here. Under the Armed Forces covenant which we are enshrining in law, we have a duty of care to our veterans, and the differential way in which we are treating our Gurkha veterans from their UK counterparts is a clear breach of that covenant. Just 20,000 vaccines, or less than 3% of a single day’s rollout in the UK, is all that is required. When will those vaccines be made available?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I pay tribute to the points made by my noble friend and to the persuasive and energetic way in which he made them. Our thoughts go to those in Nepal, who face an awful position; the pandemic there is running extremely hot. I reassure my noble friend that colleagues at both the Department of Health and the FCDO are fully aware of the concerns of the noble Lord and the Nepalese people. We will put in place the kind of vaccination provision programme that we would like to see as soon as we can. Our priority for the moment is the UK. For all the reasons I just described, we must continue the march towards 19 July and get our own people vaccinated. However, my noble friend makes the point well; the sums involved are relatively small and we will seek to address them as soon as we reasonably can.

Covid-19 Update

Lord Lancaster of Kimbolton Excerpts
Tuesday 8th June 2021

(2 years, 9 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the noble Lord points out a dreadful dilemma that is on our minds all the time. I completely agree with his point that supporting those in the developing world is a priority and responsibility for those of us in the developed world. His son is entirely right that we should be thinking very much of those who are vulnerable or in urgent need as we consider our vaccination programme. But our responsibility as a Government is to the British people. We must look after the British people first, and there is no benefit to anywhere in the world if Britain comes close to shaking off this awful virus but falls over at the last minute because we have not seen the job through. We intend to support COVAX in the way he describes—in particular, the manufacturing of the vaccine in regional hubs. There, the AstraZeneca and Oxford vaccine has played a critical role. The profit-free availability and generous licensing arrangements being offered by AstraZeneca are having a huge impact on the global rollout of the vaccine. In the meantime, we are absolutely driving through the vaccine programme here in the UK, in the knowledge that, if Britain can emerge safely, that is of benefit not only to British taxpayers and patients but to the whole world.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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I remind your Lordships’ House of my interest as Deputy Colonel Commandant Brigade of Gurkhas. I thank my noble friend for his part in ensuring the Government’s swift response to the plea for help from Nepal in the delivery of some essential medical supplies. But there is one element missing: vaccines. Given that the Government have committed, via the COVAX consortia, to deliver 2 million vaccines to Nepal, and given that my noble friend has just said that vaccinating the developing world is a priority, I simply ask him why the UK cannot deliver those 2 million doses of vaccine bilaterally now and simply net them off our contribution to COVAX in future.

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I pay tribute to my noble friend for his advocacy on behalf of Nepal; we are all extremely moved by the stories from Nepal and the challenge that it has had from Covid. We are extremely supportive of his initiative for both medical supplies and the vaccine but, as I said, there is a sequencing challenge here. Our priority as a Government is the British people. It is important that we see the job through. As the noble Baroness, Lady Brinton, pointed out, there is a threshold to which we need to get the British public to ensure that the R rate remains below one and that the new India variant, or any other variant, does not run amok and drive up hospitalisation in the UK. Until we have reached that point, we must focus on the job at hand. In the meantime, and in parallel, we are doing absolutely everything we can to grow global manufacture of the vaccine and ensure that countries such as Nepal receive secure and reliable supply. My noble friend should be reassured that we are absolutely firm in that commitment.

Covid-19 Update

Lord Lancaster of Kimbolton Excerpts
Tuesday 18th May 2021

(2 years, 10 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the outbreak in Bolton, Bedford, London and elsewhere has demonstrated, if that were needed, the paramount importance of keeping resources for test and trace at a critical level, and that is what we have done. Since the national infection rate is lower, there is a much greater emphasis on the kind of surge activity and outbreak management that the noble Baroness describes. Sequencing has proved to be an essential part of that process, and we have brought sequencing from the back of the laboratory to the front line of test and trace operation. Every single positive case is now treated as though it were a VOC, with the same amount of tracing and sequencing that a VOC would have had a few weeks ago. We have the full operation on standby. Should another wave of infections arrive, as it may well do with the relaxing of social distancing, we have the systems in place to be able to deal with it.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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My Lords, I declare my interest as Deputy Colonel Commandant of the Brigade of Gurkhas. The Indian variant is spreading not just across the United Kingdom but across the north Indian plains and into Nepal, a country ill-equipped to deal with such a pandemic. Given the speed of response and support offered to India, I simply ask my noble friend whether the Government will respond positively to Nepal’s request for 2 million doses of vaccine.

Lord Bethell Portrait Lord Bethell (Con)
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I am grateful for the briefing on Nepal I had earlier from my noble friend. The scenes that we have seen in north-west India are heart-breaking. Nepal is such a good example of the kind of country that the global community needs to surround and support with vaccine technology that, frankly, is for G7-style countries to help to provide to developing countries. I take my noble friend’s point completely on board. I do not have immediately to hand the statistics about what Britain is doing for Nepal on the vaccine front, but I will be glad to write to him with any data that I can put together.

Hotel Quarantine for Travellers

Lord Lancaster of Kimbolton Excerpts
Wednesday 3rd February 2021

(3 years, 1 month ago)

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Lord Bethell Portrait Lord Bethell (Con)
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The noble Baroness is completely right to cite Australia, and we take our hat off to its remarkable achievement in using its island status to protect itself against the virus. We are responding to the challenge of new variants by upgrading our measures, and announcements on this will be made shortly. The CMO’s view on the variants of concern so far is that we should have a proportionate system, which means an upgrading and not necessarily an Australia-style system. But we are putting in place the kinds of measures that could be upgraded to an Australia-style system were there to be a threat of significant magnitude.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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My Lords, yesterday, the UK recorded 16,840 new Covid cases. Australia and New Zealand recorded six and one respectively. Of course, we should not be encouraging people to travel to the UK, but some people have no choice—for family reasons, for example. I encourage my noble friend, before we adopt a blanket approach to hotel quarantine, which may be appropriate for high-risk countries, to think about the cost. Can he reassure me that the Government are more than capable of adopting a dynamic, risk-based approach to hotel quarantine?

Lord Bethell Portrait Lord Bethell (Con)
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My noble friend is right that we have to be proportionate and balance risk. I flag that we are aware of the extreme measures some passengers go to in order to avoid boundary controls. Some people go to extraordinary lengths to undertake journeys that, frankly, are dangerous and irresponsible. I would normally consider travel a right of enormous value which I would fight for individuals to have. But in a pandemic, it is different. In a pandemic, travelling is dangerous. You may be taking a variant of significant danger to the country of your destination, and it cannot be regarded as something done easily and lightly, as in normal times.

Social Care Funding (EAC Report)

Lord Lancaster of Kimbolton Excerpts
Thursday 28th January 2021

(3 years, 2 months ago)

Grand Committee
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Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con) [V]
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My Lords, in recognising that the unifying message of this debate is to call on government to act, I want in the brief time I have available to comment on three areas.

The first is adult social care reform. I start by seeking reassurance from my noble friend the Minister that the Government intend to continue to work closely with local and national partners to ensure that the approach to reform is informed by diverse perspectives, but in particular from those with lived experience of the care sector, both providers and recipients. It is clear that a stable social care provider market and a qualified and committed workforce will be absolutely central to delivering the widely held ambition for raising the quality of, and access to, social care. Equally important are the recipients of care, and I hope that reform will not come at the price of the long-held desire to empower them by supporting people to live independently in their own homes and communities, for as long as possible.

My own 90 year-old father’s desire to stay in his own home comes above all else. One of the biggest challenges he faces, though, is the quality of information on offer to assess his options. I welcome the Government’s plans to tackle this issue. This is particularly important if we are to encourage recipients and their families to make decisions about their long-term care ahead of time, so they are enabled to plan for their care and make better choices rather than ending up forced into knee-jerk decisions.

The second regards the workforce. I take this opportunity to pay tribute to the social care workforce in all their forms, paid and unpaid, who have more than ever demonstrated unwavering compassion and dedication while under the most enormous pressure during this pandemic. As we have heard, one particularly irritating aspect is that they are often spoken about as being “unskilled” and paid accordingly. The reality is that few jobs require a more diverse range of skills, particularly soft skills.

It is vital that the spotlight we have seen placed on the social care workforce during the Covid-19 pandemic is transformed into a long-lasting legacy of recognition for them. This would perhaps help address the biggest single challenge facing the sector, which remains recruitment, despite two successful recent government-backed campaigns.

The Government announced a £600 million infection control fund in May 2020, now extended until March 2021 with an additional £540 million. This is most welcome, not least because it can be used for measures such as helping maintain the normal wages of staff who may need to self-isolate. Equally welcome has been the £120 million of additional funding that was announced earlier this month to help local authorities boost staffing levels in the care sector. What lessons have been learned from the use of this fund when it comes to delivering resilience to a fragile sector once the pandemic is over?

However, the vast majority of care workers are employed by private sector providers, who ultimately set their pay independently of central government. While local authorities work with care providers to determine a fair rate of pay based on local market conditions, I would be interested in my noble friend’s view as to whether the time has come for the Government to consider setting a national benchmark.

The final area concerns quality of care. We need to recognise that the vast majority of care services provide high-quality care and support. As of January 2021, 84.6% of adult social care settings are currently rated good or outstanding by the Care Quality Commission, and, for most people, the experience of adult social care and support is incredibly positive. However, one of the biggest single factors in determining the CQC rating for a care home is the quality of the management, which is why my final question for my noble friend the Minister is: should we consider, as the report highlights, a more structured approach to continual professional development for the sector?

Covid-19: Vaccinations

Lord Lancaster of Kimbolton Excerpts
Wednesday 13th January 2021

(3 years, 2 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I am not sure we are using excuses; we are observing practical matters. The priority, quite reasonably, is to get the vaccine in as many arms as possible. We are totally committed to comprehensive distribution of the vaccine that reaches into rural communities and will include working with community pharmacies as important distributors. However, be under no illusion: our priority is speed and reach, which is why the deployment has taken the shape it has.

Lord Lancaster of Kimbolton Portrait Lord Lancaster of Kimbolton (Con)
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My Lords, my noble friend Lord Blencathra hits the nail on the head. I add my thanks for the support of the military—my noble friend the Minister will forgive me if I sound like a pedant, but it is not just the Army but also the Royal Navy and the Royal Air Force. However, their support is ultimately unsustainable. Yesterday the Defence Secretary suggested that the NHS should create a reserve of its own. We are certainly not short of volunteers, given the response to the call to arms last year, so is the Minister considering it?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, my noble friend rightly picks me up on my use of words. I profoundly thank all those in the armed services who have made a contribution. They bring particular qualities to such a challenge as the deployment of the vaccine: logistical analysis and project management of the highest level, and the manpower and ability to get things done quickly on the front line. Those are extremely complementary. However, be under no illusion; there are 1.3 million employees in the NHS, and far fewer in the Armed Forces. There is no question of the Armed Forces being able either to replicate or take the role of the NHS in such a large project, though we are enormously grateful for their particular contribution. One lesson of the pandemic has been the remarkable return to work of former NHS workers and the early graduation of some trainees. We should and will look at the use of volunteers in the NHS in months to come.