Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020

Baroness Altmann Excerpts

Friday 25th September 2020 Lords Chamber

[Baroness Altmann (Con)]

My Lords, I too thank my noble friend for all his dedicated work.

I recognise that information about this virus is incomplete. I sympathise with the Government, who cannot be expected to get the responses right all the time. However, sitting here today, do we have sufficient evidence to justify these extraordinary ongoing— seemingly never-ending—repressive restrictions on basic freedoms, family life and our parliamentary democracy? Parliament is expected to rubber-stamp measures with comprehensive evidence and impact assessments not having been presented even weeks after the regulations have already been imposed.

My noble friend talks of a crisis level of infection. What does that mean? When will Parliament be presented with a balanced, comprehensive analysis and data to identify, for example, the most recent correlations between infection with Covid, admission to hospital due to Covid and deaths from Covid-19 relative to deaths due to the effects of lockdowns and ongoing Covid restrictions?

The Government say they hope to ease the measures when infection or transmission falls. What constitutes success here? What is the endgame? Will we continue to lock people down, rejoice at reducing infections, relax draconian restrictions and, though I can hardly believe I am saying this, allow people to see their friends and loved ones again without risking arrest? Then what? The virus will not have disappeared. Does this whack-a-mole strategy just start again?

Parliament should be able to judge the data. What is the risk to life of a Covid infection relative to the risk to life of missed cancer treatments, mental breakdown, stroke and heart failure, all of which lockdown worsens? Indeed, do we know to what extent the increased testing rates in the areas of the restrictions that we are debating today, which my noble friend mentioned, contributed to the rise in reported infection rates that led to these measures?

Health Protection (Coronavirus, Restrictions) (Leicester) (No. 2) Regulations 2020

Baroness Altmann Excerpts

Thursday 24th September 2020 Lords Chamber

[Baroness Altmann (Con)]

My Lords, I thank my noble friend for his work on these regulations and for presenting them today. I am happy to join him in congratulating the leaders, public workers and residents of Leicester on their efforts to cope with the chopping and changing of restrictions on daily and family life.

As other noble Lords have commented, I am seriously concerned about the ongoing undermining of parliamentary scrutiny and accountability for measures that have such a devastating effect on areas of our country and its citizens. The seemingly arbitrary rules are having a detrimental effect on public confidence, and even though we are debating measures that have been superseded several times, we still have no information before us that explains the rationale in any detail and no information on the cost-benefit analyses of these measures, on the impact on other health concerns and the problems they cause for family life or on the potential number of deaths from Covid-19 that may be avoided, versus the number of deaths from other causes.

Could my noble friend please explain to us—if not today, then in writing—the Government’s overall assessment of the impact of local lockdown measures on public health? For example, a study published in the Lancet Public Health reports that detection rates for type 2 diabetes, cardiovascular and circulatory diseases, mental illness and cancer have plunged, citing a diagnosis rate around 50% lower than the average of the last decade. Lockdowns may suppress Covid-19 infection rates, but that is not the same as saving lives. There will be many people in Leicester who will not have received life-saving treatment and would like to know what assessment the Government have made of the number of deaths that have been caused by other illnesses during lockdown.

Lockdowns should be a last-ditch, life-saving measure after carefully balanced consideration of all other risks, rather than a sledgehammer to beat just one illness regardless of serious side-effects. Parliament needs this information and so do the public.

Health Care: Guidance

Baroness Altmann Excerpts

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right to focus on the plight of young carers, who play an incredibly important role in society at any time, and who are under profound pressure, particularly when isolating during this epidemic. Substantial financial support has been given to local authorities to provide their social care services with the additional funds necessary to support such cases, and we continue to work through our charity partners to ensure that young carers are supported.

[Baroness Altmann (Con)]

My Lords, I congratulate the Government on avoiding the temptation to discriminate on the grounds of age in connection with this coronavirus illness. The original guidance suggested that a person was vulnerable just because they were over 70, and I welcome the clarification. Could my noble friend assure the House that the Government do not intend to introduce blanket age restrictions and that the individual medical conditions of each person will be taken into account, rather than just age?

[Lord Bethell (Con)]

My Lords, I reiterate the point I made earlier in response to my noble friend’s quite reasonable remarks on the importance of fairness when it comes to age: blanket age restrictions play no role in the NHS and are overtly against the constitution.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 2) Regulations 2020

Baroness Altmann Excerpts

Friday 18th September 2020 Lords Chamber

[Baroness Altmann (Con)]

My Lords, I regret that these regulations are necessary and urge the Government to consider their approach. In justifying emergency powers a few months ago, Parliament accepted that this was meant to be exceptional and was necessary for public health.

Subsequently, however, enforcement has been strengthened, yet it remains the case that the various iterations of the lockdown have never been in place with full parliamentary approval. Not only has Parliament not been in engaged in scrutinising these new laws, members of the public and the police have been given little chance to see and understand the new laws they are subject to. Every subsequent amendment has entailed parliamentary scrutiny being delayed and devalued. Despite repeated insistence from Ministers that this will not become routine practice, it has become precisely that.

We are supposed to be easing measures as soon as it is safe for public health to do so, but can my noble friend explain this concept of public health, which seems to have been interpreted strangely in the narrow manner of risk of catching one illness? Can he explain why the focus seems to be wholly on this one risk, when the number of deaths from other illnesses may be higher than those from Covid-19? If scientists are asked to assess the risk of this one virus, given how new it is, their risk/reward equation is bound to lead them to advise against opening up, easing restrictions or mingling. Even if they are wrong, they can claim success. It is important, therefore, to bear in mind the other elements of public health involved in these draconian measures.

Covid-19: NHS Long-term Plan

Baroness Altmann Excerpts

Tuesday 15th September 2020 Lords Chamber

[Lord Bethell (Con)]

I am grateful to the noble Baroness for raising the importance of community nursing, and all community-based healthcare, including community diagnostic hubs. The interest in nurse recruitment has risen dramatically—by 138% in recent months—partly because of our massive advertising campaign and the renewed focus of NHS trusts in community nursing, which will be matched by opportunities to provide training for those who step forward for jobs.

[Baroness Altmann (Con)]

My Lords, in light of the experiences of people relying on social care during the current pandemic, might the NHS long-term plan make some adjustments to account for the need for integration between NHS and social care? When can we look forward to the proposals for radical social care reform, to ensure parity of esteem for the NHS?

[Lord Bethell (Con)]

My noble friend is entirely right to raise the importance of social care. Undoubtably, one of the things that we have learned through Covid is that the NHS and social care sectors must work more closely together. That was always envisaged as one of the pillars of the long-term plan. It is now an increased priority. That has been witnessed through much closer collaboration in recent months between trusts and the social care industry. We continue to invest in social care, providing councils with access to £1.5 billion for adult and social care in 2020-21, as extra support during this difficult time.

Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020

Baroness Altmann Excerpts

Thursday 3rd September 2020 Lords Chamber

[Baroness Altmann (Con)]

My Lords, I congratulate the Minister on laying these regulations, his explanation for them and all his hard work in connection with the current emergency. I support the idea that the Government should not impose more nationwide controls, and the Minister’s words about people needing to get on with their lives as much as possible around the country. Targeted local measures to manage health locally are vital.

However, I echo concerns about these regulations being debated only weeks after they came into force. I am also concerned that we do not have adequate localised testing and that results from testing, where it is done, are received with such delay in too many cases. The consequence of that makes it very difficult for local authorities, or indeed the national authorities, to understand the serious and imminent threat to public health from Covid-19 and what measures are necessary and proportionate to protect public health. These very blunt instruments are all that we have at the moment. I hope that we will improve the ability to track and trace local outbreaks in the coming weeks.

The idea of using flu jab appointments as an opportunity for widespread testing is an excellent one, and freeing up local authorities to do some testing rather than being straitjacketed into a national system would encourage local authorities to use whatever local facilities are available to them to serve their local population as best they can in tracing and testing.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020

Baroness Altmann Excerpts

Friday 24th July 2020 Lords Chamber

[Baroness Altmann (Con) [V]]

My Lords, I echo other noble Lords: these regulations seem to make a mockery of parliamentary scrutiny. I also express my deep concern at the level of micromanagement of people’s everyday lives that they have represented. Can my noble friend comment on the implications for our western liberal democracies of constant government diktats about whom people can see, which family members they can hug and how they must live?

Does a plastic visor that covers the nose, mouth and eyes, while allowing the person’s face to be seen, fulfil the requirements of these regulations? Finally, will my noble friend ensure that the needs of young adults with disabilities, including autism, who live in care settings but are not especially vulnerable to Covid, are fully considered?

National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020

Baroness Altmann Excerpts

Monday 8th June 2020 Lords Chamber

[Baroness Altmann (Con) [V]]

My Lords, I welcome the opportunity to debate the social care sector, and I welcome the increase in rates that the NHS and CCG commissioning authorities will pay for nursing care. I congratulate the noble Lord, Lord Hunt, and echo some of his comments about the sector. What assessment have the Government made of the financial stability of firms promising to house the most vulnerable elderly citizens of our country for the rest of their lives? Is the department looking into the financial strength of care providers, with a view perhaps to reforming how they are funded?

The Centre for Health and the Public Interest’s 2019 study of 830 adult care homes found that 18 of the 26 biggest providers had corporate structures that separate the firm running the home from the ownership of the buildings, representing an estimated £1.5 billion of leakage in fees to pay interest, profit or rent. For the biggest five private equity-owned providers, the cost of debt per bed represented 16% of the weekly fee.

These operators are highly geared with expensive debt, following a number of corporate transactions that would not be permitted in many other areas. If you promise to pay somebody an annuity for the rest of their life, there are strict financial reserving requirements to back that, but it seems that when operating a care home, there are no such financial requirements. Indeed, there is a precarious position, particularly after the recent crisis, because care home operators were not paid enough to cover the costs of keeping people in their care home by local authorities, and therefore private payers—self-funders—had to cover the underpayments.

Is my noble friend aware of the recent study which showed that councils were paying private providers less than £500 per week, but that in the same local authority commissioning groups were paying £720 per week for a home run by councils? Therefore, there are significant differences in the amount that councils will pay for the same type of care. The regulator is supposed to ensure that council commissioning offers fair rates to care providers, but they are now struggling to make ends meet, particularly with the extra costs of PPE and so on forced on them by this crisis. Could my noble friend comment on this situation?

Covid-19: Care Homes

Baroness Altmann Excerpts

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

My Lords, this Government have already made a very clear commitment to review the social care sector; that was made before coronavirus. The experience of coronavirus will no doubt put a massive spotlight on our provision for social care. It is entirely right that we review all of our arrangements. The vacancy question that the right reverend Prelate raises is an important one, and that is why we have launched a massive recruitment campaign, and why we have brought in minimum wage legislation which has seen rises in the pay of social care workers that are historically at the high end.

[Baroness Altmann (Con)]

My Lords, care homes tell me that they are still being required to take residents from hospital who may have Covid-19. May I ask my noble friend whether scientific and medical advice supported the guidance issued in the action plan of 15 April that, prior to discharge into care homes, patients must be tested but will be discharged “pending the result”, despite spare capacity in the NHS? Will the Government urgently consider altering that guidance?

[Lord Bethell]

My Lords, the guidance has been reviewed by the CMO, and we stand by it. I can confirm that all patients leaving hospital for care homes are, as a routine, tested. When they arrive at a care home, they are treated as if they might have Covid, and they are put into an area of isolation, until either the test has come through or their diagnosis has been confirmed. This is a way of protecting care homes, and it is necessary to continue the traffic of people from hospital to care homes, in order to have the beds available for those who need them more.

Care Homes: Covid-19 Testing

Baroness Altmann Excerpts

Thursday 14th May 2020 Lords Chamber

[Lord Bethell]

No one working in the NHS should go to work if they feel ill or have a temperature. That is true for anyone working on the front line, but it is not necessarily true for people who work in normal workplaces.

[Baroness Altmann (Con)]

Is my noble friend aware of the guidance released to the NHS on 24 April announcing that all residents of care homes must be tested before admission? In paragraph 1.30, the guidance specifically states that:

“Where a test result is still awaited, the patient will be discharged and pending the result, isolated in the same way as a COVID-positive patient will be”.


Even now, this has resulted in care homes being required to take people out of hospital without knowing whether they have the virus and without necessarily having the appropriate PPE.

[Lord Bethell]

I am aware of that guidance. It is sensible guidance. It is necessary to free beds in our NHS hospitals to make them available to those who need them more. It is also necessary to isolate people when we are not sure whether they have Covid. These are 80uncomfortable truths and I do not deny that this will result in uncomfortable outcomes for some patients. One aspect of the disease is that it targets care homes and I make no apology for those arrangements.