Speeches by Dixon.

“Would you say that the emphasis for public education should be much more on infection reduction than on antibiotics?”

“I want to come back to the issue of public education. You have given examples where GPs are faced with patients and having to do that education in the moment. As part of some of the earlier plans, there were wider public education campaigns. The Keep Antibiotics Working campaign in 2017 to 2019 seemed like it was fairl…”

“You mentioned hand hygiene. During covid, there was a lot of learning and teaching us all how to make sure that we were doing that frequent handwashing, so it is possible to change human behaviour, not through education programmes but with other types of interventions. Is there anything more that the NHS could be doing…”

“Thank you for your clear answers.”

“Is there anything you would like to add, Professor Whitty, on the social determinants?”

“Given that that is clearly not in place for my constituent, what is the expectation on the NHS that it should be doing those things?”

“I would like to come now to the issue that has been highlighted about those who are more at risk of antimicrobial-resistant infections: babies, the elderly and those with compromised immune systems. We have also touched on this in terms of deprivation and ethnicity. There are various theories about why this might be an…”

“Some of that could be replaced. We have talked about other countries having e-prescribing and EPRs. We are talking about AI decision support. Are there better and more efficient ways in which we can make sure that every generalist has, at their fingertips, the right sort of decision support in terms of ensuring greater…”

“Let me flip the question. Why is a shortage of these particular specialists a threat to us achieving what we need to on AMR? Let us make it really specific.”

“I did not realise that it was necessary to declare this, but my husband works for the London School of Hygiene and Tropical Medicine, which does postgraduate training in some of these subjects, so I probably should put that on the record. I have not really thought of it being relevant, but I suppose it is. Addressing t…”

“We received evidence from the Royal College of Pathologists, and it was reiterated in our pre-panel, that there is a workforce problem here too, with a 20% shortfall in consultant medical microbiologists and a 14% shortfall in consultant virologists. Taken together with the problems that we have just talked about with …”

“Does that factor in human behaviours in terms of the basics that we were talking about, such as hand hygiene, with accessibility to sinks?”

“I am glad that you said what you said. We have an excellent primary care practice called Bevan Healthcare, which is specifically set up to provide specialised primary health and medical care both to asylum seekers in hotels and to recently arrived refugees, so that they can better help meet the needs of people coming i…”

“We will come on to inequalities, but I am guessing that you have given some of the answers there around underlying social determinants and better health. On the specifics of migration, is that an issue for broader biosecurity? Are there any measures that can be taken to mitigate our higher risk?”

“We should note that there is a risk and it is not currently being factored into some of our trade deals. I want to come back to human health and international comparisons. We have talked about animals, in which there are certain countries that are making much higher use. The league table on human use of antibiotics pro…”

“Yes, indeed. It speaks for itself. So there is a higher risk as we move outside and start to import food from places other than the European Union, where we can be confident of that type of biosecurity and standards, and from countries that have lower standards than the UK. In your view, that situation is likely to inc…”

“Would you like to add anything, Ms Seager, in relation to animals?”

“Before I move on to human health, I want to press this point. I was very taken with what you said, Sir Chris, about the fact that some of this resistance can jump from animal to human. As we have seen in some of the diagrams, one of the pathways is via food. Having left the European Union, what are we doing to ensure t…”

“That is fine. Thank you. That has been useful questioning.”

“Lord O’Neill, do you want to add anything?”