Covid-19

Debate between Baroness Altmann and Lord Bethell

Wednesday 21st July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, this is the clinical advice given to us by clinicians. I cannot answer the whole question in the round in this brief session, but a number of considerations include not only that vaccines offer a significantly reduced rate of infection but that the level of infection is much lower, the viral load is much lower, and therefore the infectiousness is much lower. The aggregate effect is that a group of people who have been vaccinated, with a few who have the disease, is less infectious than a group of people who have been tested, however good the test.

[Baroness Altmann (Con)]

My Lords, I echo the words of appreciation for my noble friends Lady Penn and Lord Bethell and congratulate them on all the work they have been doing. I also want wholeheartedly to support the aims of the policy that we have now, with so-called freedom. Indeed, I encourage the Government to consider going even further. This is about managing risk, not just of Covid but of all other illnesses, so I have to ask, having listened to this debate, when will be the right time? If all the most vulnerable and two-thirds of all adults are vaccinated, and if the mass numbers of infections do not lead to mass hospitalisations and deaths, and if zero Covid is unachievable, when will we learn to live with the virus and stop government interference with individual citizens’ lives in the way that has been, in my view, so frightening over the last period?

[Lord Bethell (Con) [V]]

I am grateful for my noble friend’s kind remarks. Her question is extremely complex, and difficult to answer briefly but I will rest on one particular answer. As I said before, this is a question of getting the disease transmission to a point where R is below one. If that can be done on a national basis, we have contained the disease. We can then turn to local outbreak management. That is when test and trace resources will come into their own and local deployment will make a big difference. That is when we can consider the virus to have been beaten. We are not quite there yet, but vaccination rates are incredibly impressive and I am hopeful that we are near to that point.

Covid-19 Update

Debate between Baroness Altmann and Lord Bethell

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not have the figures to hand, but I reassure the noble Baroness that the policy on masks was very diligently imposed and a large number of people did get fined. We have to ask ourselves as a society whether we really want to live in a country where simple behavioural habits, such as wearing a mask or not, make you susceptible to arrest or fines. That is a very uncomfortable place for a country to find itself. The noble Baroness is right: that does introduce ambiguity, but we are sophisticated people and can live with a degree of ambiguity. We need to learn how to live not only with this disease but with each other. The dilemma that the noble Baroness points out is one that we will all have to debate, understand and learn to live with. We are not in any way letting this disease get on top of us. We are fighting it through the vaccine, we are supporting the vaccine with test and trace, and we have a tough borders measure. We are taking the battle to the virus and will continue to do so.

[Baroness Altmann (Con)]

My Lords, I welcome this Statement. As my right honourable friend Sajid Javid says, he is Health Secretary not just Covid secretary. The successful vaccine programme means that we must urgently address the shocking build-up of other health damage, physical and mental. Not opening now would cause more deaths from non-Covid causes. I have two questions for my noble friend. First, will he confirm that the Government recognise that so-called zero Covid is unachievable and we cannot stop people catching it? Secondly, will he provide details of the Government’s winter contingency plans for the NHS and Covid?

[Lord Bethell (Con)]

My Lords, I wish zero Covid was possible. I wish we had never had it at all in this country, but it is a fiendishly clever virus and it gets around the measures we put in place to try to fight it. I can, very sadly, confirm that zero Covid is not something we can plan for in this country. What we can plan for is the winter. I reassure my noble friend that the NHS has extremely thoughtful and diligent plans for the winter. It has a specific winter plan and I would be happy to write to my noble friend with a copy.

Covid-19 Update

Debate between Baroness Altmann and Lord Bethell

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord’s testimony is very moving and I have no doubt that the red-list system has put a lot of pressure on a lot of families. I personally sign off on these exemptions, and every evening as I go through them and read about the stories people have, it breaks my heart—and I do it with huge regret indeed. However, the noble Lord needs to understand that we put the red-list system in place to protect this country. People simply cannot expect to travel in large family groups as if the pandemic had not happened, and they cannot expect the testing system to work as some kind of barrier to infection. We have tried that. It did not work. The proof is absolutely categoric.

If I may be honest with noble Lords, it is likely, unfortunately, that we will have to live with some red-list countries for some time to come. That is one aspect of the unwinding of this pandemic that is not likely to go away very quickly. I completely take on board the noble Lord’s guidance. If he would like to write to me about the specific examples, I would be happy to correspond with him. However, I would not be levelling with him if I did not make it clear that this is something that we are extremely committed to.

[Baroness Altmann (Con)]

My Lords, I welcome my right honourable friend Sajid Javid to his new role and also offer my public endorsement of the integrity of my noble friend the Minister. I echo the words of this Statement that we must learn to live with Covid, so that our country benefits from the fantastic vaccine success. I fear we have lost perspective on real life. Zero Covid and stopping people being ill with just one disease among the myriad diseases around us all our lives are wholly unreasonable—and indeed unattainable —aims. Can my noble friend comment on when we will take more seriously the mental health damage that lockdown and deprivation of freedom to see all our loved ones is causing, and the importance of trusting the British people to decide for themselves who they need to meet and hug and who—as the noble Earl, Lord Clancarty, and my noble friend Lord Cormack said—they feel safe to sing with?

[Lord Bethell (Con)]

My Lords, I hear my noble friend’s comments loud and clear, and I think that we have hit some kind of inflection point where our focus is now much more on the learning-to-live rather than the saving-life dimension. I say that with unbelievable caution, having, as noble Lords know, been through all sorts of rollercoasters of expectation over the past year. I am extremely hopeful that the vaccine has laid out a clear path out of this pandemic. It is one that is fragile, delicate and could be overturned at any point, but, so far, the vaccine has seemed to be extremely durable.

On the mental health of the nation, I completely agree with my noble friend. It has put huge pressure on families, loved ones and communities. There have been positive benefits—my honourable friend Nadine Dorries spoke movingly about that to the Health and Social Care Committee the week before last. Some families in some communities have been drawn closer together— there is good evidence for that—but, for a great many, there has been a huge amount of pressure. I, for one, look forward very much to some lessening of that burden.

Folic Acid

Debate between Baroness Altmann and Lord Bethell

Wednesday 23rd June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness is entirely right: medical opinion on this matter has absolutely consolidated around support for it, and the consultation in September 2019 was extremely positive indeed. I am extremely grateful to mill owners, both the large industrial ones, which make a lot of the white flour, and the artisanal mill owners, which had complexities of their own. The engagement with them has been enormously positive, and I cannot see any obstacle on that front. However, there is a machinery of government point that needs to be addressed: we have to work it through the devolved nations and other arm’s-length bodies, and we are doing that at pace.

[Baroness Altmann (Con) [V]]

My Lords, from my noble friend’s responses, the House will be clear that this decision is under way. Could my noble friend give some idea of whether we might expect an announcement before the Summer Recess? We know that hundreds of children being born with spina bifida and anencephaly, which can be so damaging to themselves and their families, could be avoided. The sooner we do this, the sooner we can stop such problems occurring.

[Lord Bethell (Con)]

I agree with my noble friend; she is right that this is a priority. However, it is not within my gift to simply grant a decision on it; it needs to be worked through both industry and government. We are making progress on this. It is a huge national undertaking for us to put substances literally in the bread of the nation. The public deserve to feel confident that that decision has been made thoughtfully and responsibly, and it is entirely right that we take care to dot the “i”s and cross the “t”s.

Covid-19: Care Homes

Debate between Baroness Altmann and Lord Bethell

Thursday 17th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we were never in any doubt from the very beginning that the virus presented a huge threat to care homes. They are where the elderly and the vulnerable are housed, in conditions where it is extremely difficult to enforce infection control and where there is a large amount of intimacy between residents and staff. We knew from the experience of other countries that care homes were very likely to be an area where infection and severe illness, and potentially death, would be highly prevalent. There is no doubt that care homes suffered the brunt of this virus, and for that matter I am extremely sad indeed. Noble Lords should realise that we put every measure in place that we humanly could have done. We gave a huge amount of resources, including £2.8 billion via the NHS specifically to support enhanced discharge processes and the implementation of the discharge to assess model.

[Baroness Altmann (Con)]

My Lords, I apologise to my noble friend for adding to the burden that he bears in answering this question. I know he cares deeply about this situation. However, it is important for lessons to be learned, so that we have no similar experience in future. The letter sent by the NHS to care homes on 15 April 2020 states:

“Where a test result is still awaited, the patient will be discharged … pending the result ... This new testing requirement must not hold up a timely discharge”.


I do not believe any of this was a deliberate attempt to infect care homes, but I do believe that care homes need infection control and that there was a lack of follow-up for patients who were discharged positive.

[Lord Bethell (Con)]

My Lords, I am grateful for the tone of the question, but its assumption is, I am afraid, quite wrong. Before April 2020, there was very little evidence and no scientific consensus whatever that asymptomatic transmission posed any risk. For example, the World Health Organization said on 2 April:

“to date, there has been no documented asymptomatic transmission.”

My noble friend may remember that differently. They were very difficult times, and we made decisions on very limited information. We made the best decisions we could have done under the circumstances.

Covid-19 Update

Debate between Baroness Altmann and Lord Bethell

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am extremely touched by the noble Lord’s words, and I completely endorse his meaning. It was awful last year when we saw multilateralism and global co-operation fracture and decay. We had to look to our friends and resources within our own borders to answer the pandemic. That did not work and will not work. The noble Lord is absolutely right. From a pragmatic point of view, we depend upon global supply chains for the benefit of global science. From a personal and human point of view, we depend upon the solidarity of humankind to get us through these awful moments. I completely endorse the noble Lord’s point.

[Baroness Altmann (Con) [V]]

My Lords, I commend my noble friend for all his work helping fight this dreadful pandemic; I know his dedication is second to none. I hope he will forgive me for asking: what is the endgame? He has said today that we must prevent people getting sick, but that seems to mean just getting sick with one illness: Covid. What about the suicides, heart attacks and cancers that are being missed because of lockdown? Covid is responsible for less than 1% of deaths right now. Can we not trust the British people to be sensible and choose the risks they are willing to take, along the lines the noble Baroness, Lady Meacher, said, using the example of the Government banning hugging for care home residents? I find this intrusion in our private everyday lives deeply frightening.

[Lord Bethell (Con)]

My Lords, I absolutely forgive my noble friend because that is an extremely sensible question. I take it on board completely. The endgame is to end a contagious disease that has exponential growth. As she knows, R is currently between 1.2 and 1.4. If it goes unchecked, this disease will spread pretty much through the whole population. The vaccine is excellent at keeping people out of hospital, but not everyone. It is excellent at preventing deaths, but not for everyone. It is good at stopping the disease, but only half of the disease. We must get enough vaccine out there so that the disease will not run through the entire population and lead to the deaths of thousands, tens of thousands, or more. That is the endgame of this project.

Carers: Support

Debate between Baroness Altmann and Lord Bethell

Thursday 10th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the testimony from the right reverend Prelate is entirely right and is echoed in the Carers UK report. The point he makes about identification is key. One of the good things that came out of the pandemic is that we made progress on identifying and putting together registers of carers. That was seen in the delivery of the vaccination, when nearly 1.6 million of them received the vaccination early as part of priority group 6. I agree with the right reverend Prelate that more needs to be done on data collection.

[Baroness Altmann (Con) [V]]

My Lords, will my noble friend join me in commending the work of unpaid carers in this country who have done so much to help through the pandemic? Will he request that Her Majesty’s Treasury and the Department for Work and Pensions consider increasing the carer’s allowance, which pays anyone caring for somebody less than £2 an hour for at least 35 hours a week of care? The complexity of the current system, with overlapping benefits, would certainly be advantaged by significant simplification. At the moment, people need advice before they understand whether they can claim carers benefit.

[Lord Bethell (Con)]

My Lords, I completely agree with my noble friend on commending the role of unpaid carers. We could not have got through this pandemic in the way we did without them. The system is complex and work is under way at the DWP to try to simplify it. As my noble friend knows from her significant expertise, this is a difficult task but we are very focused on it.

Heathrow Airport: Border Control Passenger Safety

Debate between Baroness Altmann and Lord Bethell

Tuesday 25th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely and utterly acknowledge the concerns expressed by the noble Lord and by communities who live proximately to regional airports. As we look to the opening up of more airports, we are enthusiastically and energetically engaged with those communities. I reassure the noble Lord that the systems that we have in place around both red and amber quarantine have extremely tight restrictions on them, and there is no evidence of leakage into the local communities. We are doing our best to communicate that fact to those who are concerned.

[Baroness Altmann (Con)]

My Lords, Heathrow deserves credit for a number of the measures that it has been taking: dedicated channels for red-list arrivals, trialling a separate terminal for arrivals, and escorting people to separate areas. Would my noble friend agree that, if red-list arrivals are required to wait longer than others, there is justification for that? I hope that my noble friend will not consider stopping the opening up of further travel opportunities because of concerns about the spread of new variants in a population that has been so extensively vaccinated already.

[Lord Bethell (Con)]

My Lords, I join my noble friend in paying tribute to Heathrow, which has worked extremely hard, in a collaborative spirit, with the very difficult, challenging and often fast-changing border and quarantine arrangements. As she quite rightly says, its commitment to the red-list terminal pilot is extremely encouraging. However, I am afraid that I cannot give her the reassurance that she seeks on our mission to ensure that variants of concern that might have an impact on the vaccine will not be diligently and ruthlessly excluded from the country. It is our duty to protect the vaccine, and we will take whatever steps are necessary to do that.

Covid-19 Internal Review

Debate between Baroness Altmann and Lord Bethell

Thursday 20th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the Prime Minister will define the terms of reference and the chair will define how the inquiry deports itself. On the noble Lord’s point about the rules and the suggestion of confusion, I agree that there was a lot of heat and smoke around differences but the truth is that 99% of everything that we did between the different parts of the union was exactly the same. There was a lot of focus on very small differences, but what I celebrate is how much common ground there was in our responses.

[Baroness Altmann (Con)]

My Lords, I echo the congratulations to my noble friend on his dedication to his role, and I welcome the noble Baroness opposite to her position. I join other colleagues in congratulating the Government on their successful rollout of the vaccine, which, from what we can see so far, deals with the variants that have arisen and allows us to open our country back up again after the extraordinary efforts that have been made in connection with the vaccine. In connection with any review, will there be an urgent announcement of an investigation into the way that social care was handled, particularly at the beginning of this, for those people who are so reliant on home care or care homes for their very survival?

[Lord Bethell (Con)]

My Lords, I do not think I need to speculate on this matter; of course social care will form part of the inquiry. It has been an incredibly important part of our response, and we have come a long way in the last 14 or 15 months. I pay tribute to all the people who work in social care, and their leadership, who have done an enormous amount to protect those who live in social care or are supported by it. We as a country have learned a huge amount about how to protect those who are vulnerable and those who are elderly. I also pay enormous tribute to the public, who have made huge sacrifices to protect and save the lives of those who live in social care.

Care Home Occupancy Rate

Debate between Baroness Altmann and Lord Bethell

Wednesday 28th April 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness makes a perfectly fair point. Moving into a care home is a difficult and potentially stressful experience. Moving in at a time of Covid, when, as the noble Baroness rightly points out, there are heavy restrictions, is very difficult. Those restrictions are in place to save lives. They are under constant review, and when the infection rates warrant leaving them behind, we will make that decision.

[Baroness Altmann (Con)]

Will my noble friend join me in commending the excellent work of care staff during the appalling problems that have arisen over the past year during the pandemic? Will the Government urgently investigate the financial stability and debt levels of care home operators, which, too frequently, seem to have no controls on the amount of leverage, excessive debts or lack of equity in the sector?

[Lord Bethell (Con)]

My Lords, I absolutely join my noble friend in commending the incredible contribution of care home staff, domiciliary staff, unpaid care workers and all those who support loved ones, neighbours and residents. The Covid pandemic has shone a light on the selfless contribution of those people. The service continuity and care market review keeps a careful eye on the financial stability of the market. We are in constant contact with some of the biggest providers. The scene we see at the moment is not one that causes a huge amount of concern, but we keep close to the market.

Folic Acid

Debate between Baroness Altmann and Lord Bethell

Monday 26th April 2021 Lords Chamber

[Lord Bethell (Con)]

No.

[Baroness Altmann (Con)]

My Lords, I too congratulate the noble Lord, Lord Rooker, on his relentless campaigning on this issue and join others in encouraging my noble friend to, as soon as possible, ensure that manufacturers are mandated to add folic acid, so that we can prevent the misery and heartache of dealing with neural tube defects. I also ask my noble friend whether we can make sure that this applies to all kinds of flour, including gluten-free flour, for those mothers-to-be who are not able to have normal bread.

[Lord Bethell (Con)]

My Lords, I understand that considerable efforts have gone into ensuring that folic acid is put into flours of all kinds, and I pay tribute to the industry for trying to deliver a comprehensive service. I am happy to write to the noble Baroness to confirm that.

Folic Acid

Debate between Baroness Altmann and Lord Bethell

Tuesday 23rd March 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness puts the case well. It is an issue that I feel personally committed to; a cousin of mine was born with a neural tube defect many years ago, and the effects of that hit my family extremely hard. I recognise the problem of unplanned pregnancies and the need to find a way to get folic acid to people who were perhaps not intending to have a pregnancy. We take this matter extremely seriously, and I commit to returning to the House when we have an update on it.

[Baroness Altmann (Con)]

I encourage my noble friend to accelerate this initiative of folic acid supplementation, which the House can see clearly he would very much welcome. But can he also comment on other preventive measures to improve the nation’s wider health?

[Lord Bethell (Con)]

My Lords, I think my noble friend alludes to the rollout of the vaccine, which has been the consummate preventive medicine programme that the country has ever seen. It is, I hope, an inflection point in the whole country’s approach to its healthcare. We have for too long emphasised late-stage, heavy- duty interventions, and we have not focused enough on preventive early-stage interventions. Folic acid is a really good example, as are the vaccine and fluoridation, and the kinds of population health measures we hope to bring in will address all of those.

Covid-19: Vaccinations

Debate between Baroness Altmann and Lord Bethell

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

That is a gruesome prospect and not one that I like to see in a debate like today’s, where there is so much positivity. However, the noble Lord is entirely right that mutations may go that way. The good news is that the current round of mutations that have been seen in Kent, South Africa and Brazil seem to be about transmissibility, not escapology. It is as though the car had driven into the pits and had a turbo attached to it, but not camouflage equipment. But that could happen, and if it did, we would indeed have to look at much more emphatic and systematic long-term vaccination programme.

[Baroness Altmann (Con) [V]]

My Lords, I too congratulate the Government and the Minister on all the tremendous work that has been done, especially on the vaccine. Can he say what the hold-up would be for a 24/7 programme, what the scale of supply is, and when a supply chain might be available that could deliver 24/7 vaccination? The scale of damage to other aspects of the health of our nation as well as to the economy is unsustainable. This is like a war effort but we absolutely need to be rolling out this vaccine as quickly as we possibly can.

[Lord Bethell (Con)]

My Lords, I completely hear my noble friend’s encouragement, and her advocacy on behalf of business and a return to normal is heard loud and clear. The deployment is happening literally as quickly as we can possibly make it. I suggest to her that even NHS workers have to sleep, they have families, and it is not possible to run operations through the night on a mass scale. You cannot force people to turn up for a vaccine. I am not sure that the idea that millions of people will turn up at 4 o’clock in the morning for a vaccine is entirely realistic. However, my noble friend’s point about scale and whether we can move faster and turn around the situation more quickly is extremely well made. I reassure her that we are doing everything we possibly can.

Covid-19: Dental Services

Debate between Baroness Altmann and Lord Bethell

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness refers to the prioritisation of patients in the constrained appointment flow of dentists. She is entirely right that those who have vulnerabilities, disabilities or other disadvantages should be prioritised: that is the objective of the prioritisation process. She makes the point extremely well and I am happy to take on board any points on where she thinks the system is not working as well as it might do.

[Baroness Altmann (Con) [V]]

My Lords, will my noble friend the Minister tell us what lessons have been learned from the initial response to the Covid pandemic and the blanket closure of dental practices? Does he have any estimates of the number of cancers of the head and neck that might not have been detected because people have not had regular dental check-ups?

[Lord Bethell (Con)]

My Lords, my noble friend is right to allude to the confusion around the closure of dental practices. We have made it crystal clear that in the second lockdown all dental practices—both NHS and private—should remain open; that is part of our commitment to try to clear the backlog. I also acknowledge her concerns about the diagnosis of cancers. I do not have the figures for which she asked, but we certainly appreciate the role that the dental sector plays in detecting many cancers, including oral cancers. Dental services are open to those seeking urgent care and we hope that those urgent care clinics to which I referred earlier can provide some diagnostic analysis in urgent cases.

Food Hygiene Rating Displays

Debate between Baroness Altmann and Lord Bethell

Wednesday 7th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely acknowledge the persuasive statistics from the noble Baroness. FSA analysis suggests that food-borne illness outbreaks are twice as likely to occur in businesses with a low rating than those with a rating of three, four or five. These are very concerning figures. We completely take on board the statistics that the noble Baroness has cited, and I shall take them back to the department, as she suggests.

[Baroness Altmann (Con)]

My Lords, has the pandemic had any impact on the overall food standards and hygiene ratings of various outlets? Do local authorities need more resources to continue to carry out the checks that they are required to make?

[Lord Bethell (Con)]

My Lords, it is probably too early to make an accurate analysis, but one impact that has happened in the food industry is the move to online deliveries. That is why we are considering the application of mandatory rating for online deliveries as well as for restaurants. Online deliveries are a terrific benefit to society, but it is important that they also have regulatory scrutiny, and we will bear that in mind in any future review.

Covid-19: Adult Social Care Complaints

Debate between Baroness Altmann and Lord Bethell

Monday 5th October 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is entirely right that in April 2016 we committed, in fact sheets about the Care Act, to introduce an appeals process. That is still on the horizon, but this is best placed as an overall reform of the social care system that puts it on a sustainable footing where everyone is treated with dignity and respect. We have, therefore, delayed the implementation of this appeal system until we can make it part of a larger commitment to reforming social care.

[Baroness Altmann (Con)]

My Lords, I urge my noble friend to encourage his department to come forward with its plans for social care reform as soon as possible. How many complaints relating to Covid has the Local Government and Social Care Ombudsman received since it reopened on 29 June?

[Lord Bethell (Con)]

Last week, the Local Government and Social Care Ombudsman indicated that it had had around 100 Covid-related complaints. The department is closely monitoring the situation, including through our normal safeguarding networks. The ombudsman has confirmed that the current level of complaints is no higher than normal. We will be making sure that there is no backlog that ticks up this number.

Covid-19: NHS Application

Debate between Baroness Altmann and Lord Bethell

Thursday 1st October 2020 Lords Chamber

[Baroness Altmann (Con)]

My Lords, I too congratulate my noble friend on his birthday and I congratulate the Government on introducing this new technology. As he is aware, I am very supportive of this. I would be grateful if he could explain to the House what evidence there might already be from Scotland on the effectiveness of the Protect Scotland app in tracing contacts, ensuring isolation and reducing deaths.

[Lord Bethell (Con)]

My Lords, the Protect Scotland app has delivered huge value for the Scottish people. It has guided many to isolate and it has been downloaded a very large number of times. We seek to get the UK app and the Scottish app working together in the second version. We have learned an enormous amount by collaborating with Scottish colleagues and have gained enormous value from their learnings.

Covid-19: Tracking

Debate between Baroness Altmann and Lord Bethell

Wednesday 30th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the ultimate aim of the app is to break the chain of transmission. That is done through a number of ways. One is to provide a proximity alert for those who spend time with people who have tested positive. It also has a check-in capability to help our track and trace efforts, and we are building more applications on it all the time. One encouraging statistic is that until 10 o’clock yesterday, there were 6.5 million check-ins through the app. This is an astonishing number and it shows that those who are socialising are using the app.

[Baroness Altmann (Con)]

My Lords, I congratulate the Government on introducing this system of track and trace using apps. I encourage my noble friend to look carefully at introducing as soon as possible the express system available in the US and having it integrated into the telephones. He may not be aware that a number of people with whom I am in contact have downloaded the current app, found that it drains their batteries too quickly, and have therefore deleted it. Does he agree that if the express system were integrated into the app, it would do less damage to the battery and it would be more likely that people would stay with it?

[Lord Bethell (Con)]

My Lords, we are looking carefully at the Apple express system. It does not contain the substantial investment in the algorithm from the Alan Turing Institute that gives our own app the sensitivity and protection that phone users are seeking from such a device. We have looked carefully and worked extremely intensely with Apple on the battery and our understanding is that the app does not have a large impact on battery use.

Health Care: Guidance

Debate between Baroness Altmann and Lord Bethell

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.

Covid-19: NHS Long-term Plan

Debate between Baroness Altmann and Lord Bethell

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.

Covid-19: Care Homes

Debate between Baroness Altmann and Lord Bethell

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

Debate between Baroness Altmann and Lord Bethell

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.

Covid-19

Debate between Baroness Altmann and Lord Bethell

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

The noble Earl, Lord Clancarty, is right that our present guidelines state that those arriving in Britain should isolate if they have symptoms and seek a test from a hospital if it develops seriously. It is clear to me that the way we travel around the world is set to change dramatically in the future, but the CMO has reviewed our airport and port guidelines. He is happy with them, and the evidence suggests that this is not currently a source of new infections in the UK.

[Baroness Altmann (Con)]

My Lords, may I press my noble friend on treatment, particularly with convalescent plasma? As I understand it, other Governments are urgently looking into this. France has put its medical staff into LFB. Have we put any pressure on BPL, which is the only fractionating company available in the UK, to produce pure, hyperimmune immunoglobulins, rather than the whole plasma, so that we can start parametric testing of IVIG and injections of convalescent plasma in the pure hyperimmune form?

[Lord Bethell]

I reassure my noble friend Lady Altmann that we are making this a massive priority. It has huge advantages over other therapeutics because it is plasma and can therefore have an accelerated regulatory advance. I signed for procurement of £20 million-worth of fractionating machines last week to help the blood transplant service create the hyperplasma to which she alludes.