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My Lords, given that 80% of vets in abattoirs are from the EU and that they are vital for the safety of our meat, will the Government look at the visa system prior to Brexit? I am told by scientists that the current visa system is long-winded, impenetrable and not fit for purpose. If the system cannot be understood by highly intelligent scientists, and if it takes many hours of their valuable time to bring members of their team into this country from abroad for scientific research, there is clearly a need for urgent radical improvement. Will the Minister ensure that that happens?
My Lords, given that 80% of vets in abattoirs are from the EU and that they are vital for the safety of our meat, will the Government look at the visa system prior to Brexit? I am told by scientists that the current visa system is long-winded, impenetrable and not fit for purpose. If the system cannot be understood by highly intelligent scientists, and if it takes many hours of their valuable time to bring members of their team into this country from abroad for scientific research, there is clearly a need for urgent radical improvement. Will the Minister ensure that that happens?
My Lords, I place on the record my experience of meeting many of those vets. The service provided by EU nationals in a wide range of sectors—the noble Baroness mentioned the veterinary and food safety sectors—is invaluable to us. We will want them to remain here, and indeed we will want other people to come to this country to help us in many industries. I assure the noble Baroness that we are working very closely with the British Veterinary Association and all vets to cover all contingencies, because the EU nationals working in the State Veterinary Service are invaluable to us.
My Lords, is the Minister aware that food economists have calculated that, calorie for calorie, fruit, vegetables and high-quality proteins are much more expensive than foods high in carbohydrate and fat? Is it surprising that poor parents find that they have to fill up their children with those foods that eventually often lead to obesity? The structural underpinning of this problem is poverty, which goes much wider than the Minister’s department. It should be a whole-government issue. What are the Government doing about that?
My Lords, is the Minister aware that food economists have calculated that, calorie for calorie, fruit, vegetables and high-quality proteins are much more expensive than foods high in carbohydrate and fat? Is it surprising that poor parents find that they have to fill up their children with those foods that eventually often lead to obesity? The structural underpinning of this problem is poverty, which goes much wider than the Minister’s department. It should be a whole-government issue. What are the Government doing about that?
I absolutely recognise the problem that the noble Baroness has pointed out. The prevalence of childhood obesity doubles between the least deprived and the most deprived areas. The Government are committed to reducing that deprivation gap and taking a broad range of actions to combat poverty, none more so than making sure that everybody has the chance to work, which is why we have more people in employment than has ever been the case.
My Lords, the Minister said that a majority of the electorate had voted to leave the European Union. If I recall correctly, 37% voted to leave, 33% voted to remain and 30% did not vote at all. Ministers go around saying that 52% of the British people voted to leave the European Union—I heard Jeremy Hunt say that on TV the other day. Last time I looked, the population of the UK was about 65 million, and we keep getting told that 17.4 million people voted to leave the European Union. That is about one in four. Does the Minister not agree that Ministers should be a little more precise in their language?
My Lords, the Minister said that a majority of the electorate had voted to leave the European Union. If I recall correctly, 37% voted to leave, 33% voted to remain and 30% did not vote at all. Ministers go around saying that 52% of the British people voted to leave the European Union—I heard Jeremy Hunt say that on TV the other day. Last time I looked, the population of the UK was about 65 million, and we keep getting told that 17.4 million people voted to leave the European Union. That is about one in four. Does the Minister not agree that Ministers should be a little more precise in their language?
I am happy to agree with the noble Baroness that in the referendum, of the people who voted, the majority voted to leave.
To ask Her Majesty's Government what advice the Secretary of State for Health and Social Care receives when deciding how to instruct NICE in relation to whether to use the Single Technology Appraisal route or the Highly Specialised Technology route when assessing a new medicine or treatment.
To ask Her Majesty's Government what advice the Secretary of State for Health and Social Care receives when deciding how to instruct NICE in relation to whether to use the Single Technology Appraisal route or the Highly Specialised Technology route when assessing a new medicine or treatment.
Departmental Ministers, on behalf of the Secretary of State, take decisions on the final referral of topics to the National Institute for Health and Care Excellence (NICE) technology appraisal and highly specialised technology work programmes on the basis of advice from the Department’s officials. The advice summarises the outcome of a topic selection process that is overseen by NICE and includes consideration of topics against published criteria by a group comprising representatives from the Department, NHS England and NICE and informed by public consultation.
My Lords, does the Minister accept that every week the Government delay in taking a grip on this issue means more young people having their lives destroyed? When they are considering their response, will the Government take account of the mounting evidence, added to only this week by evidence about the Catholic Church, that unless people are forced to report child abuse to external agencies, and report only within the agency concerned, very often these organisations will cover it up because they afraid of reputational damage? Will the Government take that into account?
My Lords, does the Minister accept that every week the Government delay in taking a grip on this issue means more young people having their lives destroyed? When they are considering their response, will the Government take account of the mounting evidence, added to only this week by evidence about the Catholic Church, that unless people are forced to report child abuse to external agencies, and report only within the agency concerned, very often these organisations will cover it up because they afraid of reputational damage? Will the Government take that into account?
I totally accept the noble Baroness’s point—I have just made it myself—that nobody wants to see any further delay, certainly given the age of some of these former child migrants. On reporting sexual abuse to external agencies, the noble Baroness is absolutely right: unless there is a proper system of support for these allegations, there is then further opportunity for internal cover-up.
My Lords, an important public service that has been and continues to be cut is public health. Directors of public health tell me that they can spend money extremely cost-effectively. Are the Government doing any research into the public health interventions carried out by local authorities, to let everybody know what works?
My Lords, an important public service that has been and continues to be cut is public health. Directors of public health tell me that they can spend money extremely cost-effectively. Are the Government doing any research into the public health interventions carried out by local authorities, to let everybody know what works?
My Lords, I can give the noble Baroness the assurance that the public health grant is to be incorporated into local spending by virtue of business rate retention. We are proceeding rather slowly on this because we are keen to ensure that the assurance arrangements are fully recognised to cover the points she makes.
My Lords, what will the Government do to protect whistleblowers who expose child abuse and abuse in other areas but are subsequently hounded out of their jobs, lose their careers and often go into a lot of legal debt protecting themselves? Does she agree that instead of such treatment, these people deserve a medal for service to their country?
My Lords, what will the Government do to protect whistleblowers who expose child abuse and abuse in other areas but are subsequently hounded out of their jobs, lose their careers and often go into a lot of legal debt protecting themselves? Does she agree that instead of such treatment, these people deserve a medal for service to their country?
My Lords, I entirely agree that it is very important to protect whistleblowers. They can be sources of very valid and important information where crimes have been committed. The context of this Question does not allow me to provide any further information, so I hope the noble Baroness will agree that I can write to her.
My Lords, is the Minister aware that if you have solar panels on your roof, you cannot have a smart meter? I know that because I have tried several times and have been told that I cannot have a smart meter if I have solar panels, which we are all encouraged to have. Does he agree that unless a smart meter is developed that can work with solar panels, we are never going to have smart meters in every household in the country?
My Lords, is the Minister aware that if you have solar panels on your roof, you cannot have a smart meter? I know that because I have tried several times and have been told that I cannot have a smart meter if I have solar panels, which we are all encouraged to have. Does he agree that unless a smart meter is developed that can work with solar panels, we are never going to have smart meters in every household in the country?
I am afraid that what the noble Baroness says is a myth, but I will look at her case. There is no reason why one cannot have solar panels feeding into a smart meter and being taken into account. If the noble Baroness is having problems, she can come to me and I will look at them.
My Lords, can the Minister encourage the NHS to do some proper research with the women who do not turn up for a mammogram when invited to do so and bear in mind that there is more than one reason why? In my case it is the very sharp edge of the plate that sticks under your armpit. It is really extremely painful. Will he agree that such discomfort should not discourage women from attending mammograms, which are so very important for saving thousands of lives, including my own?
My Lords, can the Minister encourage the NHS to do some proper research with the women who do not turn up for a mammogram when invited to do so and bear in mind that there is more than one reason why? In my case it is the very sharp edge of the plate that sticks under your armpit. It is really extremely painful. Will he agree that such discomfort should not discourage women from attending mammograms, which are so very important for saving thousands of lives, including my own?
Absolutely. I completely agree with the noble Baroness. Indeed, breast cancer screening saves 1,300 women’s lives every year. It is an essential part of our health system. On why women do not turn up, Professor Sir Mike Richards is reviewing all the cancer screening programmes at the moment. I will specifically put that question to him to ask him to investigate it.
My Lords, while supporting the concerns of the noble Lord, Lord Kennedy, perhaps I may point out that next week sees the International Day for the Elimination of Violence against Women. Will the Government celebrate the day and the end of austerity by funding more refuges and services for victims of domestic violence? This is necessary because during the recent years of austerity many refuges, which offered hundreds of safe places for women and their families, have been closed.
My Lords, while supporting the concerns of the noble Lord, Lord Kennedy, perhaps I may point out that next week sees the International Day for the Elimination of Violence against Women. Will the Government celebrate the day and the end of austerity by funding more refuges and services for victims of domestic violence? This is necessary because during the recent years of austerity many refuges, which offered hundreds of safe places for women and their families, have been closed.
I can reassure the noble Baroness that we will celebrate that day. I think this Prime Minister has done more than any to clamp down on domestic violence and to support victims. That was
shown in the £100 million that was set aside to support victims of domestic violence in a number of innovative ways. I can further reassure her that, as I understand it, the number of beds in refuges has increased over the past few years.
To ask Her Majesty's Government whether they have made any medium to long-term horizon scanning assessment concerning medical research advances in transplantation of material of human origin in the UK and worldwide.
To ask Her Majesty's Government whether they have made any medium to long-term horizon scanning assessment concerning medical research advances in transplantation of material of human origin in the UK and worldwide.
NHS Blood and Transplant (NHSBT) is directed by the Secretary of State for Health and Social Care to conduct or commission research into organ donation and transplantation and into the uses, or development, of stem cells and tissues.
NHSBT’s Research, Innovation and Novel Technologies Advisory Group monitors research programmes that require access to donated human material where consent has been given for research. Members of the group include leading researchers who cover all aspects of transplantation. The group also has representation from the British Transplantation Society.
The National Institute for Health Research (NIHR), funded by the Department, also has an important role. The NIHR Biomedical Research Centre has a research theme on Transplantation and Regenerative Medicine which aims to improve outcomes in solid organ transplantation and the use of clinical advances to support the development of cell based therapies. The NIHR Innovation Observatory is a national medical horizon scanning facility which identifies technologies up to 10 years from being publicly available.
My Lords, while it is true that the faculty warns against the use of dried cannabis plant of unknown composition, it accepts that there may be benefits to pain management from pharmaceutical products. Fortunately, that is exactly what patients are demanding and what the Government have just legalised. However, the faculty is also demanding that, while we wait for clinical trials, a database—which is essential to better understand these medicines—should be set up. Will the Minister support the setting up of this database and ensure that it contains the massive amount of lived evidence and experience available from patients?
My Lords, while it is true that the faculty warns against the use of dried cannabis plant of unknown composition, it accepts that there may be benefits to pain management from pharmaceutical products. Fortunately, that is exactly what patients are demanding and what the Government have just legalised. However, the faculty is also demanding that, while we wait for clinical trials, a database—which is essential to better understand these medicines—should be set up. Will the Minister support the setting up of this database and ensure that it contains the massive amount of lived evidence and experience available from patients?
I am grateful to the noble Baroness for her question. I believe that the position we have reached now is the right one, not least driven by the heart-rending stories of children who had been benefiting from these kinds of medicines but were then not able to access them. It is a very good thing that we have got to this position. However, we also have to acknowledge—as the Chief Medical Officer did—that there is a lack of evidence, particularly beyond specific conditions such as paediatric epilepsy. It is precisely to provide that evidence that we are going to do two things: first, we will fund clinical trials through the NIHR, and, secondly, we will start collecting evidence and data on usage so that we can gain the evidence base to understand whether there are other applications where these medicines could be helpful.
My Lords, I was rather surprised to learn that the Government were trying to recruit more doctors from Australia, the very country to which a great many of our newly qualified doctors go for better pay and conditions. What are the Government doing to try to recoup the taxpayers’ money spent on their training? It is surprising that they go to developed countries such as Australia, and that we get no benefit from the cost of their training.
My Lords, I was rather surprised to learn that the Government were trying to recruit more doctors from Australia, the very country to which a great many of our newly qualified doctors go for better pay and conditions. What are the Government doing to try to recoup the taxpayers’ money spent on their training? It is surprising that they go to developed countries such as Australia, and that we get no benefit from the cost of their training.
Some people will inevitably travel abroad after their training, but the vast majority of doctors who train in this country stay here. We have more GPs than ever in training. That is obviously the way to solve the long-term challenges of having the right workforce. However, the noble Baroness is absolutely right that we need to recruit from abroad in the short-to-medium term. The NHS has a recruitment target of 2,000 doctors via that route.
My Lords, is the Minister aware that the committee had evidence that one of the schools consulted its legal adviser as to whether it was legally obliged to report the abuse that it knew about. Having learned that it was not so obliged, it decided to cover it up. How much more evidence do the Government require of the need for mandatory reporting of child abuse in regulated activity? Of course, that does not include social workers, because social work is not a regulated activity. Will the Government now follow the evidence and respond with legislation?
My Lords, is the Minister aware that the committee had evidence that one of the schools consulted its legal adviser as to whether it was legally obliged to report the abuse that it knew about. Having learned that it was not so obliged, it decided to cover it up. How much more evidence do the Government require of the need for mandatory reporting of child abuse in regulated activity? Of course, that does not include social workers, because social work is not a regulated activity. Will the Government now follow the evidence and respond with legislation?
My Lords, it is absolutely unacceptable for anyone to conceal abuse. The Government are committed to ensuring that legislation can adequately deal with this. We will scope this issue fully during the current Parliament. What individuals and organisations should do is already clear in statutory guidance. The guidance also makes it clear that there is a legal duty on employers to make a referral to the Disclosure and Barring Service in certain circumstances.
To ask Her Majesty’s Government how they plan to respond to the report of the Independent Inquiry into Child Sexual Abuse regarding safeguarding failures at Downside and Ampleforth schools, published in August 2018.
To ask Her Majesty’s Government how they plan to respond to the report of the Independent Inquiry into Child Sexual Abuse regarding safeguarding failures at Downside and Ampleforth schools, published in August 2018.
My Lords, before answering the noble Baroness’s Question, I inform the House that various members of my wife’s family attended Ampleforth. I have never visited the school nor had any other connection with it.
The report of the independent inquiry into child sexual abuse regarding Downside and Ampleforth schools did not make specific recommendations to my department. However, a regulator of independent schools is carefully considering the inquiry’s findings. We have asked inspectors to pay close attention to the matters in the report at the next inspection of Downside. Ampleforth is currently under regulatory action and must improve or face further action, which could include closure.
To ask Her Majesty's Government what assessment they have made of warehousing requirements for NHS suppliers if frictionless trade with the EU is not maintained following Brexit.
To ask Her Majesty's Government what assessment they have made of warehousing requirements for NHS suppliers if frictionless trade with the EU is not maintained following Brexit.
Patient safety is paramount in our exit negotiations and maintaining continuity of supply of medical products is a key part of ensuring patients continue to receive the safe high-quality care they need on day one of the exit from the European Union exit and thereafter.
The Department is working closely with cross Government agencies to ensure that there is no disruption to the supply of medical products following the United Kingdom’s withdrawal from the EU, regardless of the terms of the withdrawal.
This includes enhancing existing supply chain resilience, scoping out alternative sources of supply and providing means to access critical medical devices at short notice. Warehousing requirements for centrally held stock of medical devices for the National Health Service is continuously reviewed against demand patterns and forecasts which incorporate consideration of external factors, such as exiting the EU, and is integral to contingency planning. Medicines suppliers will be taking a similar approach to their stocks.
To ask Her Majesty's Government what assessment they have made of NHS warehousing requirements if frictionless trade with the EU is not maintained following Brexit.
To ask Her Majesty's Government what assessment they have made of NHS warehousing requirements if frictionless trade with the EU is not maintained following Brexit.
Patient safety is paramount in our exit negotiations and maintaining continuity of supply of medical products is a key part of ensuring patients continue to receive the safe high-quality care they need on day one of the exit from the European Union exit and thereafter.
The Department is working closely with cross Government agencies to ensure that there is no disruption to the supply of medical products following the United Kingdom’s withdrawal from the EU, regardless of the terms of the withdrawal.
This includes enhancing existing supply chain resilience, scoping out alternative sources of supply and providing means to access critical medical devices at short notice. Warehousing requirements for centrally held stock of medical devices for the National Health Service is continuously reviewed against demand patterns and forecasts which incorporate consideration of external factors, such as exiting the EU, and is integral to contingency planning. Medicines suppliers will be taking a similar approach to their stocks.
To ask Her Majesty's Government whether they plan to maintain equivalence with the EU Regulation on Medical Devices 2017/745 during the planned transition period from March 2019 to March 2021.
To ask Her Majesty's Government whether they plan to maintain equivalence with the EU Regulation on Medical Devices 2017/745 during the planned transition period from March 2019 to March 2021.
The Government is committed to the safe and effective regulation of medical devices in the United Kingdom; we continue to strengthen safety while ensuring patients and the public have fast access to new, innovative devices.
The new EU Devices Regulations entered into force in May 2017. The EU Regulation on Medical Devices 2017/745 will be fully applied from May 2020, during the implementation period agreed with the European Union, and would therefore apply under the terms of the time-limited implementation period.
Under our responsibilities as a Member State, the Medicines and Healthcare products Regulatory Agency continues to work to implement the new Regulations and has met all relevant milestones set out in the legislation.
Following up on the previous question, is the Minister aware that yesterday, the All-Party Parliamentary Group for Children published a report showing that many local authorities are unable to afford the early intervention programmes that have just been mentioned and are so effective? The result is that a lot of children in some parts of the country are not getting the services that they would with the same level of need in another part of the country. Many children and families in that situation are going into a downward spiral and getting to the point where they need much more invasive intervention—even taking the child into care. It is cheaper and more effective to intervene early, so will the Minister have a look at the 12 recommendations of that report? They have the evidence, and the Government ought to act on it.
Following up on the previous question, is the Minister aware that yesterday, the All-Party Parliamentary Group for Children published a report showing that many local authorities are unable to afford the early intervention programmes that have just been mentioned and are so effective? The result is that a lot of children in some parts of the country are not getting the services that they would with the same level of need in another part of the country. Many children and families in that situation are going into a downward spiral and getting to the point where they need much more invasive intervention—even taking the child into care. It is cheaper and more effective to intervene early, so will the Minister have a look at the 12 recommendations of that report? They have the evidence, and the Government ought to act on it.
I thank the noble Baroness for bringing the report to my attention; I will certainly look at it. It is worth saying that although there has been a reduction in Sure Start centres, the proportion of centres serving the 30% most disadvantaged areas has remained constant, so the focus on disadvantaged areas has remained.
To ask Her Majesty's Government whether they have conducted an impact assessment of the draft NICE Guidelines on Abdominal Aortic Aneurysm, including the impact (1) on patients over 65 years old who may be medically unsuitable for open surgical repair, and (2) of removing certain treatment options when clinical professionals...
To ask Her Majesty's Government whether they have conducted an impact assessment of the draft NICE Guidelines on Abdominal Aortic Aneurysm, including the impact (1) on patients over 65 years old who may be medically unsuitable for open surgical repair, and (2) of removing certain treatment options when clinical professionals...
We have made no such assessments. The National Institute for Health and Care Excellence (NICE) is an independent body and has not yet published final guidance on the diagnosis and management of abdominal aortic aneurysm. NICE has recently consulted on its draft guideline and will take the comments it has received in response to the consultation fully into account in finalising its recommendations.