(3 years, 6 months ago)
Lords ChamberMy Lords, research released for Carers Week makes sobering reading. During the pandemic, 72% of carers have had no break whatever and, of those few who have had a break, many used the time for housework or their own medical appointments. With the risk of a third wave still a cause for anxiety, what plans are in place, or indeed in development, to ensure that unpaid carers can have restorative breaks and that their needs are at the heart of the Government’s plan for social care reform?
My Lords, I absolutely join the noble Baroness in paying tribute to all carers, particularly unpaid carers, who have shouldered a huge burden in the past 18 months. The role that they have played has been a real example of the sense of service and commitment that characterises the social care community in this country. We have put in place a large amount of resources through local authorities and payments to local authorities to support carers. That has helped in infection control and to reduce the itinerant nature of some social care in order to prevent the spread of the disease. But it is undoubtedly true that the burden on unpaid carers remains immense, and we continue to support, both through local authorities and through charities, the work that they do.
My Lords, in the national Carers Week, it is worth remembering that the 2017 report on Exercise Cygnus said:
“Local responders also realised concerns about the expectation that the social care system would be able to provide the level of support needed if the NHS implemented its proposed reverse triage plans.”
It also recommended that local support should be developed and planned for social care and health. Was that recommendation put into practice? Were the concerns expressed by local responders borne out last year? Will the Government now publish their internal review of pandemic preparedness to ensure that the lessons have been truly learned?
My Lords, the noble Baroness is entirely right. It was known at the very beginning and it was clearly understood that those in social care—and those who support those in social care—were in the gravest possible danger in such a pandemic, and we were focused from the beginning on giving them the right amount of support. The Cygnus report correctly identified that, and that was why we put provisions for social care into our action plan from the very beginning. It is unfortunately a truism that those who are most vulnerable are, I am afraid, at greatest risk from such a pandemic, and those who support the vulnerable will shoulder a huge burden. That is why we have put in a large amount of resources to support those people and why, when the inquiry comes, we will undoubtedly focus on how we can improve those processes.
My Lords, I will move on to another point. At the end of May, Portugal was deemed safe to host the Champions League final; five days later, it was not, despite 100,000 tests by the authorities with only six positives. This caused tens of thousands of people and businesses horrendous disruption and distress. Will my noble friend, on my behalf, kindly remind the Secretaries of State for health and transport that using emergency powers with no debate and with both Houses not sitting yet again is wholly unacceptable and can no longer be tolerated?
My Lords, I completely share my noble friend’s frustration at the situation. Of course we all enormously regret the fact that our efforts to open up international travel were unfortunately reversed because of the presence of dangerous variants of concern in the Portuguese community—in this case, particularly the Nepal variant of concern. However, I cannot agree with her that quick decisions based on accurate data are not appropriate in the depths of a pandemic. It is absolutely right that we move quickly to close down a change of transmission and that we protect the vaccine from variants that may present a severe danger to this massive national project.
My Lords, this is rather relevant to the previous question: how many additional Covid cases in the UK were caused by the delay in closing our borders to travel from India after we knew about the new variant? Is the Minister making representations to the Prime Minister and appealing that no such delay should occur again as variants emerge in different countries across the world, to protect the health of the people of the UK?
My Lords, I am not sure whether I have the data that the noble Baroness has asked for. I also contest the premise of her question. We have moved extremely quickly when presented with clear data, as my noble friend rightly pointed out, and I hardly need go over the timelines for the decisions around Pakistan, Bangladesh and India, which have been gone over many times indeed. I reassure the noble Baroness that we are absolutely determined, at this delicate phase of the pandemic, to ensure that our borders are extremely tough and that we do whatever we can to keep the variants out. At the same time, we are cognisant that people do have commitments overseas and we are leaning, wherever we possibly can, to opening up the borders.
My Lords, does the Minister recall the independent review by Dame Deirdre Hine, presented to the coalition Government in 2011, which said:
“The planning for a pandemic was well developed, the personnel involved were fully prepared, the scientific advice provided was expert, communication was excellent”?
She reported on the exceptional level of preparedness the UK had attained. Why, by 2020, had all that careful preparation by our Labour Government been so catastrophically eroded, despite the fact that the pandemic remained top of HMG’s risk register?
My Lords, I am not sure that any Government, even the Labour Government in the noble Lord’s time, could claim to have some kind of forecasting ability that could possibly have predicted the precise shape and impact of this pandemic. Even now there are things about this virus that we do not know. At the beginning, in January, February and March, the precise features of this virus were not fully understood, and it was not possible to prepare for this particular pandemic in its precise shape and nature. To pretend otherwise is doing this House a disservice.
My Lords, I will follow on from that. The Ministry of Defence and the Armed Forces are often accused of being prepared for the last war rather than the next one. In truth it is impossible to be ready for the next war unless, of course, you intend to start it. The best you can achieve within finite resources is to be ready for “a” war, not “the” war. You must then adjust what is inevitably a generic preparedness to meet a specific set of circumstances. Might the department of health’s preparedness for a global pandemic be more sympathetically viewed if this important subtlety were better explained and better understood? Might the criticisms that are made therefore be more objectively assessed as those that are fair and those that, frankly, are somewhat vacuous?
My Lords, we will need to wait for the inquiry for a thorough post-mortem on what was or was not thoroughly prepared for. It is fair to say that the developed nations of the world had invested a huge amount in modern clinical medicine, yet that did not serve to prepare us for the precise circumstances of a respiratory pandemic. I pay tribute not only to those in the public health profession but to those in the military, who did so much and moved so quickly to deliver the kind of protection that this country has benefited from during the pandemic.
My Lords, when the pandemic hit this country, one of the reasons we were so badly hurt was the shortage of intensive care beds, the number of which had been run down progressively for many years, despite the World Health Organization pointing out the inherent dangers in that. So could the Minister say, without waiting for the inquiry, what our policy on intensive care beds is now?
My Lords, as the noble Baroness probably knows, we are investing hugely in new hospital capacity, but I would question whether it was simply the lack of ICU beds that was at the heart of the challenge. The truth is that this was a virus that hit our population massively, and even if we had had double the number of ICU beds, we would have been hard hit and could not have avoided the kind of NPIs that eventually stopped the virus in its tracks. Modern medicine can do many things, but it cannot fight a virus from the wardroom.