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To ask Her Majesty's Government, further to the answer by Lord Kamall on 6 July (HL Deb cols 1001–2) regarding the scientific evidence available regarding folic fortification, whether they will publish the science brief referred to by Lord Kamall referencing heliocentrism versus geocentrism.
To ask Her Majesty's Government, further to the answer by Lord Kamall on 6 July (HL Deb cols 1001–2) regarding the scientific evidence available regarding folic fortification, whether they will publish the science brief referred to by Lord Kamall referencing heliocentrism versus geocentrism.
The scientific contestation referred to is summarised in the paper Folic acid and neural tube defects: Discovery, debate and the need for policy change by Professor Nicholas Wald. Professor Wald asserts that the United Kingdom should pursue a higher level of fortification than would be permitted by the UK’s Tolerable Upper Level (TUL). A copy of the paper is attached.
The Government and its independent scientific advisory bodies have agreed that fortification of non-wholemeal wheat flour with folic acid, at a level informed by the guidance for supplemental intake of folic acid intake advised by the UK Expert Group on Vitamins and Minerals, is a safe and effective measure to reduce the number of neural tube defects (NTDs).
This view is supported by the Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment (COT) and by the Scientific Advisory Committee on Nutrition (SACN). In 2018 COT published Committee on Toxicity of Chemicals in Food, Consumer Products and the Environment: COT position paper on the current upper level for folic acid intake in response to a previous paper by Professor Wald, addressing the technical points raised in objection to the TUL and continuing to recommend its use. A copy of this paper is attached.
Deaths associated with high levels of folic acid refers to potential unintended harms which may arise following the fortification of flour with folic acid, such as an increase in the potential masking of vitamin B12 deficiency or pernicious anaemia where the deficiency can cause permanent neurological damage which can lead to death if untreated.
No recent discussions have taken place with countries which have implemented folic acid fortification on unintended consequences of the policy. However, evidence from a number of countries, including those which have implemented folic acid fortification policies, was considered by the SACN and COT to establish the safety and efficacy of fortifying food with folic acid. Analysis by COT and the SACN found that there was insufficient evidence to discount a number of potential risks at very levels of fortification.
While there is no specific scientific briefing relating to the debate between heliocentrism versus geocentrism, as I stated in the debate, we will routinely review the policy post-implementation to ensure it meets the objective of reducing NTDs while avoiding any unintended consequences. The forthcoming consultation will outline the proposed fortification levels with the supporting scientific rationale.
To ask Her Majesty's Government what periodic review of literature they conduct in respect of the latest scientific evidence on foetal viability.
To ask Her Majesty's Government what periodic review of literature they conduct in respect of the latest scientific evidence on foetal viability.
Officials regularly review new evidence on foetal viability. There is currently no clear consensus from the medical profession that the age of viability has reduced below 24 weeks.
To ask Her Majesty’s Government what assessment they made of any available scientific advice when implementing or removing COVID-19 restrictions in England.
To ask Her Majesty’s Government what assessment they made of any available scientific advice when implementing or removing COVID-19 restrictions in England.
Throughout the pandemic, the Government’s approach has been informed by a wide range of scientific and medical advice and the latest data, as well as by economic, social and deliverability considerations. Ministers have always had regard to the scientific advice when taking decisions to implement or remove restrictions, but have balanced them against other considerations.
Throughout the pandemic, the Government’s approach has been informed by a wide range of scientific and medical advice and the latest data, as well as by economic, social and deliverability considerations. Ministers have always had regard to the scientific advice when taking decisions to implement or remove restrictions, but have balanced them against other considerations.
Throughout the pandemic, the Government’s approach has been informed by a wide range of scientific and medical advice and the latest data, as well as by economic, social and deliverability considerations. Ministers have always had regard to the scientific advice when taking decisions to implement or remove restrictions, but have balanced them against other considerations.
To ask Her Majesty’s Government what assessment they made of any available scientific advice when implementing or removing COVID-19 restrictions in England.
I thank my noble friend for those questions and will try to answer them as best I can. We are now transitioning to a stage where we are able to live with Covid, and we have just announced our living with Covid strategy. At the same time, we are looking at the best way to help those who are particularly vulnerable medically or economically, who should still be entitled to free tests, for example, and issues such as affordability. We continue to monitor the new variants, the BA2 and the deltacron, and we will also continue to have the ONS surveys.
I thank my noble friend for those questions and will try to answer them as best I can. We are now transitioning to a stage where we are able to live with Covid, and we have just announced our living with Covid strategy. At the same time, we are looking at the best way to help those who are particularly vulnerable medically or economically, who should still be entitled to free tests, for example, and issues such as affordability. We continue to monitor the new variants, the BA2 and the deltacron, and we will also continue to have the ONS surveys.
Given that the level of infections is now running at 220,000 new infections per day, and given the fact that the Government are planning to remove free testing from 1 April and have already removed the legal obligation to self-isolate, having already removed the support payments for self-isolation, how do the Government intend to protect the most vulnerable in society and NHS staff, given the Government’s new policy provisions of Living with Covid-19?
I thank the noble Lord for declaring an interest. We are reviewing all scientific advice and looking at the spread and potential of new variants. Advice has been given on an additional booster, particularly for those over 75. I will not ask the noble Lord his age, but I commit to write to him.
I thank the noble Lord for declaring an interest. We are reviewing all scientific advice and looking at the spread and potential of new variants. Advice has been given on an additional booster, particularly for those over 75. I will not ask the noble Lord his age, but I commit to write to him.
My Lords, given the fact referred to by the noble Baroness, Lady McIntosh, about the reversal of what was a very welcome decline in numbers, has any advice been given to the Government by the bodies to which the Minister referred about a further, fourth jab—another booster jab—for the elderly population? I suppose I should declare an interest.
The Government have reflected on that and, in line with the public sector equality duty, have considered the impact of those decisions on the wider population but also on those who were previously classified as extremely vulnerable or clinically extremely vulnerable. For example, we are looking at whether it is appropriate to continue to give them free tests, and how they can get in touch with clinicians and others to ensure that they are more protected.
The Government have reflected on that and, in line with the public sector equality duty, have considered the impact of those decisions on the wider population but also on those who were previously classified as extremely vulnerable or clinically extremely vulnerable. For example, we are looking at whether it is appropriate to continue to give them free tests, and how they can get in touch with clinicians and others to ensure that they are more protected.
My Lords, one thing that some of the most vulnerable have been able to do is make a risk assessment about going out. If testing is not happening and local scientific data on cases not available, that risk assessment cannot be made—isolating the vulnerable even more. Will the Government reflect on that?
We constantly have meetings with the UKHSA and a number of different scientists join us for the calls when we have them, but we have always balanced things up. I shall give an example of a conversation I was having just before Christmas with some of the modellers. I asked them “What is your advice?”, and they said “Minister, before we give you the advice, you have to bear in mind that we are only considering the variant at the moment. It is for you to consider the wider medical balancing issues, and also the economic and social costs as well, and we recognise that you have to balance all those up.”
We constantly have meetings with the UKHSA and a number of different scientists join us for the calls when we have them, but we have always balanced things up. I shall give an example of a conversation I was having just before Christmas with some of the modellers. I asked them “What is your advice?”, and they said “Minister, before we give you the advice, you have to bear in mind that we are only considering the variant at the moment. It is for you to consider the wider medical balancing issues, and also the economic and social costs as well, and we recognise that you have to balance all those up.”
My Lords, at the publicly streamed evidence session of the All-Party Coronavirus Group on 1 March, we asked some members of SAGE to outline SAGE modelling for the lifting of restrictions in the living with Covid plan. They replied to us that they had not been asked to model any such plans by Ministers. Given that cases, as the noble Baroness, Lady McIntosh, said, are now 221,000 a day, with active cases of more than 2 million and hospital admissions rising across England, exactly what modelling advice did the Prime Minister and Secretary of State for Health and Social Care take?
I can see that that may well be a reasonable request, so why do I not discuss what is relevant and perhaps write to all noble Lords?
I can see that that may well be a reasonable request, so why do I not discuss what is relevant and perhaps write to all noble Lords?
My Lords, further to the question asked by the noble Lord, Lord Reid, and declaring a similar interest, I ask my noble friend not just to write to the noble Lord, Lord Reid, but to make a general announcement, so that we know when these fourth jabs will be administered.
It is interesting that, when I was talking to some of the modellers and scientists about this, they said that whenever they look at models of changes in behaviour, they count in or consider that there will be some uptick because of people relaxing measures. Even though we are moving from a position where it was legal to where it is guidance, they reckon that number in, but they still felt that it was not significant enough not to go forward with the change in strategy.
It is interesting that, when I was talking to some of the modellers and scientists about this, they said that whenever they look at models of changes in behaviour, they count in or consider that there will be some uptick because of people relaxing measures. Even though we are moving from a position where it was legal to where it is guidance, they reckon that number in, but they still felt that it was not significant enough not to go forward with the change in strategy.
Does the Minister agree that there is a link between the recent upsurge in cases and the decision to stop wearing masks on 1 March?
Well, there we are: there is a result already—please never accuse me of working too slowly. In that case, it is quite clear that there is a programme, and I shall find out more details.
Well, there we are: there is a result already—please never accuse me of working too slowly. In that case, it is quite clear that there is a programme, and I shall find out more details.
My Lords, further to the question of my noble friend Lord Cormack, I have already received a summons for my fourth jab. My impression is that, in west London, the programme has been set up and will be working quite satisfactorily. I will be having my fourth jab tomorrow week.
I thank the noble Baroness for reminding noble Lords that the virus has not gone away. That is one of the reasons why we laid out the Living with Covid-19 strategy. The UKHSA, the Office for National Statistics, and a number of academics, will continue to monitor it. Noble Lords who have read all the articles during the pandemic will be aware of how many scientists are also producing data. We continue to monitor all that data and balance it up when making decisions. We are also prepared to stand up rapidly should there be any variants of concern.
I thank the noble Baroness for reminding noble Lords that the virus has not gone away. That is one of the reasons why we laid out the Living with Covid-19 strategy. The UKHSA, the Office for National Statistics, and a number of academics, will continue to monitor it. Noble Lords who have read all the articles during the pandemic will be aware of how many scientists are also producing data. We continue to monitor all that data and balance it up when making decisions. We are also prepared to stand up rapidly should there be any variants of concern.
My Lords, three matters have emerged in the past few days: first, there is a new variant; secondly, as the noble Baroness, Lady McIntosh, said, Covid cases have risen by 55% in the past week; and, thirdly, the UK Health Security Agency intends to stop funding the fantastically successful and important ZOE COVID Study app. I appreciate that this Government have an aversion to counting in general, but this app has been vital in tracking and understanding Covid-19, so how will the Government maintain their capacity to monitor this virus, which has not gone away?
If I was aware of any scientific advice that had not yet been published, I am not sure whether I would be unaware of it. I will try to find out. The Government have laid out the terms of the inquiry; only last week I sent the link to some people, which I am very happy to send to the noble Viscount, for the points that should be considered by the inquiry. During the pandemic, and even now, we continue to receive a wide range of scientific advice. The wonderful thing about scientists is that they continue to debate with and contest each other. Some say that we should never have had these measures, some that we lifted them too early, and some that you can never get the timing right, whatever you do.
If I was aware of any scientific advice that had not yet been published, I am not sure whether I would be unaware of it. I will try to find out. The Government have laid out the terms of the inquiry; only last week I sent the link to some people, which I am very happy to send to the noble Viscount, for the points that should be considered by the inquiry. During the pandemic, and even now, we continue to receive a wide range of scientific advice. The wonderful thing about scientists is that they continue to debate with and contest each other. Some say that we should never have had these measures, some that we lifted them too early, and some that you can never get the timing right, whatever you do.
My Lords, the Prime Minister has announced that at some stage there will be a major inquiry into Covid. Can the Minister assure the House that when it takes place, all scientific advice that has been received by the Government will be published? Can he also tell us whether he is aware of any scientific advice which has not yet been published?
I thank my noble friend for making that point. It is incredibly important, not only within the medical community, where we were asked, for example, to lift some restrictions so that we could start tackling the backlog. We were asked ‘by mental health experts to ensure that people were getting access to mental health care who had been unable to because of the pandemic. We have also balanced this against economic and social considerations—sometimes these things affect each other. Being unable to work and facing uncertainty can be one of the most destabilising things and can affect people’s mental health. My noble friend is right that we have had to balance a number of issues in the round.
I thank my noble friend for making that point. It is incredibly important, not only within the medical community, where we were asked, for example, to lift some restrictions so that we could start tackling the backlog. We were asked ‘by mental health experts to ensure that people were getting access to mental health care who had been unable to because of the pandemic. We have also balanced this against economic and social considerations—sometimes these things affect each other. Being unable to work and facing uncertainty can be one of the most destabilising things and can affect people’s mental health. My noble friend is right that we have had to balance a number of issues in the round.
My Lords, as we enter an economic war, are the Government not absolutely right to balance the scientific advice with the economic consequences, and that by pursuing the policies which they have since before Christmas, they have put the economy in a strong position which guarantees that we can do as much as we can to help the most vulnerable people in our country?
Lords motion to take note of the first report from the Science and Technology Committee on Ageing: Science, Technology and Healthy Living. (HL 183). Agreed to on question.
Lords motion to take note of the first report from the Science and Technology Committee on Ageing: Science, Technology and Healthy Living. (HL 183). Agreed to on question.