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

Lord Lancaster of Kimbolton Excerpts

Thursday 7th January 2021 Lords Chamber

[Lord Lancaster of Kimbolton (Con)]

My Lords, hindsight is a wonderful thing and used wisely I am sure that, with a careful, detailed, objective review, there is much that we will learn from the Government’s handling of this crisis that will better prepare us for future pandemics. My concern, though, is that the knowledge that hindsight brings seems to be currently used only for attacks on a Government trying to deal with a pandemic in unprecedented times. I have no doubt that the Government have made their mistakes, but I do not believe that a different set of Ministers would have dealt with the situation radically differently.

The Government’s strategy of trying to keep the balance between protecting the NHS and minimising the impact on the economy and the nation’s physical and mental health is a challenge beyond all others. There are two areas where I hope we will learn specific lessons and have an agreed framework for the future. Both relate to the fact that any graduated or full lockdown will work only with the support, understanding and, crucially, consent of the population.

The first must be to get an agreed and consistent approach among the four nations of the United Kingdom. Of course I understand the principle of devolved government, but the fact is that differing rules sow confusion and ultimately a distrust of a scientific approach. That is surely to nobody’s advantage.

The second lies in the use of local authority boundaries as tier boundaries. While simple, this has caused enormous challenges in some parts of the country. I live in Gosport, where my wife Caroline Dinenage is Member of Parliament. Her constituency is part Gosport Borough, part Fareham, and was initially split in half between tier 2 and tier 4. This meant that it was fine to have social gatherings on one side of the road but literally not the other. That was impossible to explain to constituents and undermined public confidence in the system.

Boundaries must be drawn somewhere but surely not, where possible, through centres of population. I suggest to the Minister that, if preventing the NHS being overwhelmed is the main objective, perhaps a tiering system based on catchment areas to principal hospitals using postcodes would be an equally simple but more logical approach.

Covid-19: Vaccine

Lord Lancaster of Kimbolton Excerpts

Wednesday 11th November 2020 Lords Chamber

[Lord Bethell (Con)]

I am grateful for the noble Lord’s remarks. Business can play an important role. Distribution of the vaccine will employ a large workforce and the supply chain is incredibly important. There will be a dimension for business to provide thought leadership and behavioural leadership to encourage and make space for employees and to be advocates for the principle of vaccination in every way. In terms of mass testing, we have sent lateral flow devices to 67 directors of public health and we will be learning from the Liverpool experiment to see whether we can apply citywide mass testing of the kind he describes to other cities in the future.

[Lord Lancaster of Kimbolton (Con)]

My Lords, I commend the Government on the leadership they have shown in committing £548 million to the COVAX advance market commitment to which my noble friend referred a few moments ago. That is essential if we are to ensure that poorer countries are to get access to these vaccines. However, with some $2 billion of seed corn funding required by the end of this year, what are the Government doing to ensure that other first-world countries follow our lead in this area?

[Lord Bethell (Con)]

I am grateful to my noble friend for the question on international vaccines. He is right that no single country holds the keys to victory against this invisible enemy and we must work together. I point out in particular the work of the ACT Accelerator, which estimates that $38 billion is needed by the end of next year for equitable access to vaccines. This will be an important part of our chairmanship of the G7, which starts at the beginning of next year, and which will be a helpful platform for Britain’s advocacy of fair and equitable distribution of vaccines.

Oral Answers to Questions

Lord Lancaster of Kimbolton Excerpts

Tuesday 17th July 2012 Commons Chamber

[The Minister of State, Department of Health (Paul Burstow)]

I am grateful to the hon. Gentleman for that question. He has been a doughty campaigner and pursuer of this issue and I can tell him that a number of improving access to psychological therapies—IAPT—services are developing and using mindfulness-based approaches. Indeed, as the hon. Gentleman said, NICE recommends them for the treatment of recurrent depression. A number of randomised controlled trials are going on to see how it might be applied to other long-term health conditions. There is baseline allocated funding but there is no specific earmarked funding for this particular project other than in the context of the IAPT programme, in which we have invested £400 million.

[Mark Lancaster (Milton Keynes North) (Con)]

T6. Yesterday’s figures showed a 17% increase in the population of Milton Keynes over the past 10 years, the highest outside London or Manchester, and an unexpected increase of some 4,000 over the estimate in the past 12 months. May I seek the Secretary of State’s reassurance that that will be reflected in future health care budgets for the city?

[Mr Lansley]

As my hon. Friend will, I hope, have understood from previous exchanges, the focus on the delivery of care to the resident population in an area covered by a clinical commissioning group will mean that we try, as far as possible, to align resources with the needs of a whole population rather than with just the practice-registered population.

Oral Answers to Questions

Lord Lancaster of Kimbolton Excerpts

Tuesday 12th June 2012 Commons Chamber

[Paul Burstow]

There are three aspects to that question. The first is that we need to ensure that providers can purchase equipment at the lowest possible price. That is why NHS Supply Chain is making arrangements to ensure that digital mammography is available at the lowest possible price to providers through the various initiatives it is taking. The primary responsibility sits with the provider to provide the equipment against which they have been commissioned to provide services. Of course, in the specification it makes for the service, the commissioner will make it clear that digital is required.

[Mark Lancaster (Milton Keynes North) (Con)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health (Mr Andrew Lansley)]

My responsibility is to lead the NHS in delivering improved health outcomes in England, to lead a public health service that improves the health of the nation and reduces health inequalities, and to lead the reform of adult social care, which supports and protects vulnerable people.

[Mark Lancaster]

The strategic health authority has ruled out the locally preferred option for the transformation of community health services in Milton Keynes. Given the Government’s commitment to localism and their preferred approach to the integration of services, will the Secretary of State look at this matter again?

[Mr Lansley]

It is for the primary care trust to appraise the options and decide which is best for local people. The SHA has a role in providing assurance in that process, but I would urge both the PCT and the SHA to ensure that they meet the test that we are looking for, which is that any decision must be in the best clinical interests of patients and must meet the views of clinical commissioners in the future and, indeed, those of the public, not least as expressed through the local authority. I would urge the PCT and the SHA to make progress on that, and, if it would be of any assistance to my hon. Friend, I would be glad if he were able to meet me, the PCT and the local authority to help to resolve the issue.

Oral Answers to Questions

Lord Lancaster of Kimbolton Excerpts

Tuesday 12th July 2011 Commons Chamber

[Mr Burns]

The reality is that the hon. Lady does not understand, or will not accept, the figures published in the impact assessment. What she does not like is the fact that by the end of this Parliament there will be savings of about £5 billion, and thereafter of £1.7 billion until the end of the decade. That will all be reinvested in front-line services. The hon. Lady will not accept, and wishes to misrepresent to members of the public, the resulting benefits in improved and enhanced patient care.

[Mark Lancaster (Milton Keynes North) (Con)]

6. What steps he has taken to increase access to NHS dentistry since May 2010.

[The Secretary of State for Health (Mr Andrew Lansley)]

I am pleased to be able to tell my hon. Friend that the number of people with access to NHS dentistry has increased by nearly three quarters of a million over the past year.

[Mark Lancaster]

I am grateful to my right hon. Friend for that answer. In Milton Keynes in recent years we have seen greater access to dentistry. One area of particular concern is access to dentistry for children, so may I press my right hon. Friend on how exactly he will address that problem?

[Mr Lansley]

I agree with my hon. Friend. We have made it very clear that, contrary to the practice of the previous Government, we are not looking for dentists to deny access to NHS dentistry to children whose parents are not registered with them. Alongside increasing access to dentistry as a whole, we intend specifically to secure increased access for children to NHS dentistry. That will be even more the case in the pilots that we will start this month, which are specifically intended to secure a more preventive approach to dentistry, which maintains good oral health. That is especially important for children.

NHS Future Forum

Lord Lancaster of Kimbolton Excerpts

Tuesday 14th June 2011 Commons Chamber

[Mr Lansley]

If you will forgive me, Mr Speaker, I do not think that I will favour that question with an answer.

[Mark Lancaster (Milton Keynes North) (Con)]

Will the Secretary of State expand on the support that organisations such as the Spinal Injuries Association can expect through specialised commissioning?

[Mr Lansley]

I believe that as a result of our proposals the NHS commissioning board will be able to provide more consistency in much specialised commissioning, and I hope that that will apply to people with spinal injuries. I am well acquainted with the work of the Spinal Injuries Association: I think that it has done terrific work, and we have already worked closely with it in trying to ensure that we improve commissioning and services for those with spinal injuries.

Oral Answers to Questions

Lord Lancaster of Kimbolton Excerpts

Tuesday 8th March 2011 Commons Chamber

[The Minister of State, Department of Health (Paul Burstow)]

The hon. Gentleman is absolutely right to say that telephone services of the sort he describes play an invaluable role in giving people support. Again, we are at that point in the year when there are budget arguments between PCTs and hospitals, to which he refers. If he supplies me with further details on this case, I will happily write to him.

[Mark Lancaster (Milton Keynes North) (Con)]

T3. The Secretary of State has visited Milton Keynes, so he will be well aware of the historical problems at the maternity unit there and, following the intervention of his Department, of the positive outcomes that have been achieved with one-to-one supervision for all mothers. I am convinced that the increased training of midwives has contributed to those outcomes, but may I press him to reassure the House that that level of training will continue?

[Mr Lansley]

Yes, I am very grateful to my hon. Friend and I share his wish for continuing improvement in the maternity services at Milton Keynes hospital. I can tell him and the House that we are delivering on our commitment to improve maternity services, which is at the heart of that wish. The number of midwifery training places commissioned for next year—2011-12—will be no less than this year, sustaining a record number of midwives in training. That will be on top of an increase between May and November 2010—after the coalition Government came in—of 296 additional midwives employed in the NHS.

Oral Answers to Questions

Lord Lancaster of Kimbolton Excerpts

Tuesday 25th January 2011 Commons Chamber

The Secretary of State was asked—

[Mark Lancaster (Milton Keynes North) (Con)]

1. What recent progress he has made in introducing GP commissioning consortia.

[Stephen Mosley (City of Chester) (Con)]

3. What recent progress he has made in introducing GP commissioning consortia.

--- Later in debate ---

[The Secretary of State for Health (Mr Andrew Lansley)]

Last week, I announced the second wave of GP-led pathfinder consortia. There are now 141 groups of GP practices piloting the future GP commissioning arrangements. Those groups are made up of more than 4,000 GP practices, with over half the population starting to benefit from services that better meet their needs and improve outcomes for patients. The Health and Social Care Bill, which had its First Reading last week, sets out the legislative framework that supports our reforms.

[Mark Lancaster]

Consortia in Milton Keynes have been given £1 per patient as a transition fund. That money is most welcome. It will rise to £2 per head next year. The problem, however, is that the fund is proving hard to access because of the bureaucratic nature of the local primary care trust. Will the Secretary of State look into that and ensure that the money is accessible?

[Mr Lansley]

I entirely understand my hon. Friend’s point. The PCT’s role is to support the development of consortia, not inhibit it. The operating framework that was published last month sets out the range of support that PCTs should be offering emerging consortia. Milton Keynes PCT has confirmed that it will actively support Premier MK, one of two consortia in the area, with its application to become a pathfinder, and that it is actively working with another consortium in the Milton Keynes area.

Oral Answers to Questions

Lord Lancaster of Kimbolton Excerpts

Tuesday 7th December 2010 Commons Chamber

[Henry Smith (Crawley) (Con)]

3. What recent progress he has made on the introduction of GP-led commissioning consortiums.

[Mark Lancaster (Milton Keynes North) (Con)]

13. What recent progress he has made on the introduction of GP-led commissioning consortiums.

[The Secretary of State for Health (Mr Andrew Lansley)]

On 21 October, I invited general practice-led commissioning consortiums to put themselves forward as pathfinders, and I have been absolutely delighted by the response. The pathfinder consortiums will be announced shortly. They have formed in response to the needs of local communities, and there is, sensibly, variation around the country to take account of those differing needs. Some consortiums map on to local authority boundaries; others organise themselves around catchments for hospitals or smaller populations. This bottom-up, locally determined approach is exactly in line with what we envisaged in the policy framework.

[Mr Lansley]

That is exactly what our reforms will allow. We are putting not only the freedom to refer in the hands of general practices but choice in the hands of patients, and allying that to the power on the part of commissioners to commission services that meet the needs of their local community. That is precisely the change that will empower front-line clinicians and patients.

[Mark Lancaster]

Having consulted widely in Milton Keynes, I am pleased to say that the Government’s plans have been broadly welcomed. However, one area of concern that has been raised with me by patients, in particular, is the amount of time that they will get to spend face to face with their GP. Can the Secretary of State reassure my constituents and outline the administrative support that GPs will get in fulfilling their new functions?

[Mr Lansley]

I am grateful to my hon. Friend. In Milton Keynes, GP Healthcare MK and Premier MK consortiums are shaping their services in order to be able to deliver better and improved services for their patients. We do not intend that all GPs individually should become managers, by any means; there will be clinical leadership, but the consortiums should have commissioning support. The primary care trust in Milton Keynes has had some good commissioning support arrangements, as I know from having visited it in the past. It is open to the new commissioning consortiums to take teams from the primary care trust into their new consortium support arrangements, but they can go elsewhere. They can look to the local authority and to the independent sector to provide them with the commissioning support that they need so that clinicians provide leadership but continue to be responsible for clinical care.

Public Health White Paper

Lord Lancaster of Kimbolton Excerpts

Tuesday 30th November 2010 Commons Chamber

[Mr Lansley]

I am grateful to the hon. Lady. At least I know that she supports the proposal to transfer the responsibility to local government—not something I discovered from the reply of the right hon. Member for Wentworth and Dearne (John Healey). The short answer is that I have already announced that over the next four years we will double the number of family nurse partnerships, so we shall indeed support them. More than that, as Sir Michael Marmot made clear, it is vital that we combine the targeted support that the FNPs can give and a restored universal health visiting service to help every family as they start out.

[Mark Lancaster (Milton Keynes North) (Con)]

One of the clearest indicators of health inequalities is life expectancy. In two near-neighbouring wards in Milton Keynes, there is a variation of 12 years, which is a staggering figure. How can we address this problem?

[Mr Lansley]

My hon. Friend is absolutely right. The truth is that we know we have to take action nationally, and we will, not only through health protection but through much more effective health screening, immunisation programmes and an early start in the health visitor programme, for example. It will be for his local authorities and communities to get together to ask how they can address the inequalities. That will be vital to achieving health improvement in his community.