Covid-19 Update

Baroness Barker Excerpts

Monday 21st September 2020 Lords Chamber

[Baroness Thornton (Lab)]

Like everyone here, I watched the briefing by the Chief Scientific Officer and the Chief Medical Officer today, and very sobering it was too. It was followed by a very informed discussion on the BBC. It feels that we are playing catch-up again, although I realise that that is almost inevitable. Today we have had another Statement since this one and I gather that the Prime Minister will make a further Statement tomorrow.

Last week, when we discussed the then Statement which was already three days old, I said that I thought that we had come to a critical moment when some very serious decisions would need to be taken, and clearly that was correct. The words “tipping point” and “perilous moment” were used in the Commons today during the debate on the Statement. As we have said all along, clarity of messaging is totally vital. The country has become increasingly confused about what people should do to protect themselves and those around them, so perhaps this break point is really important.

A few weeks ago, the Prime Minister was setting out his stall to review the outstanding restrictions and allow a more significant return to normality, possibly in time for Christmas. Now the Prime Minister has admitted that we face a further six months of very difficult lockdown restrictions while the CSO, Sir Patrick Vallance, said that the UK faces 50,000 Covid cases a day by mid-October if the current infection rate is not halted. My first question for the Minister is: are we now at level 4? I ask because the Joint Biosecurity Centre has recommended that the Covid-19 alert level for the UK should be increased to level 4, meaning that transmission of the virus is high or rising exponentially. It has been at level 3, meaning that the Covid-19 epidemic is in general circulation, for several months, but the Chief Medical Officers of England, Wales, Scotland and Northern Ireland said in a joint statement this evening:

“After a period of lower Covid cases and deaths, the numbers of cases are now rising rapidly and probably exponentially in significant parts of all four nations.”


Given that, are we going to move to level 4?

Can the Minister confirm that the Government intend to bring forward further restrictions in London? What are the next steps nationally? This morning, Chris Whitty, the CMO, said that people should

“break unnecessary links between households to stop coronavirus spreading out of control.”

Has the advice about return to work changed? Can the Minister confirm whether the reported two-week circuit-breaker lockdown is indeed going to happen?

It is deeply concerning that the Statement last Thursday contained scant reference to testing. As my right honourable friend the shadow health Secretary said, under this Government test and trace is actually trace a test. When will that be resolved? Giving evidence to the Science and Technology Committee on Thursday, the noble Baroness, Lady Harding, told MPs:

“I do not think anybody expected to see the really sizeable increase in demand that we have seen over the course of the last few weeks.”


This is simply not true. Can the Minister confirm that SAGE warned the Government that the UK faced an inevitable increase in community transmission and cases after the summer and needed a fully functional and trusted test and trace system put in place?

I feel that I need to talk about the “moonshot”, because it is an emerging story on the i that the moonshot test for Covid-19 that will allow people to resume normal life will not be available on the NHS—as the Government’s testing tsar, the noble Baroness, Lady Harding, suggested. She said that individuals and companies would have to pay to access the proposed test and that it would not be part of the normal NHS test and tracing scheme that she heads, which will continue to concentrate on swab tests. So the question I need to ask the Minister is: are we now looking at an A and a B test and trace system or an A and B test system where people who can afford to pay for a test can get one immediately and those who cannot—the majority of us—will not?

Given these issues, tests now seem to be rationed, with health and social care prioritised. Could the Minister reflect on reports that care homes worst hit in the first wave could be tested for coronavirus less often, as the Government believe there will be higher levels of immunity and that they are less likely to pass on the virus? This is deeply worrying, given the high percentage of staff turnover and the vulnerability of residents.

Can the Minister confirm reports that evidence shows that 20% of people who have been told to self-isolate are still leaving their homes, and will that information be published? That is presumably what is leading to the much more aggressive fines. The Government say that the £10,000 maximum fine will act as a deterrent to testing positive and not self-isolating. Does the Minister share my concern that this actually may deter people with symptoms from getting a test at all? For many people, ignorance may also be the only legitimate option, as they are unable to get a test and self-isolation is financially non-viable.

The Minister will be aware that the Joint Committee on Human Rights said it was unacceptable that many thousands of people were receiving fixed-penalty notices despite evidence that the police do not fully understand their powers. They highlight enforcement as having a disproportionate impact on young men from black, Asian and minority ethnic backgrounds. Currently there is no way for people to challenge the fixed-penalty notices easily, so does the Minister share my concern that this will invariably lead to injustice, as members of the public who have been unfairly treated with a fixed-penalty notice have no means of redress?

It ought to be straightforward for a member of the public to find out what the current law is, nationally and in their local area, without having to trawl—as the rest of us are doing—through countless confusingly named regulations. Will the Government publish a website where people can enter their postcode and be told in plain English what restrictions currently apply where they live?

[Baroness Barker (LD)]

My Lords, I thank the Minister for dealing with this Statement, which comes hot on the news that we are at level 4 as regards the pandemic. Therefore, I want to touch on two or three points in this Statement. The first is the Government’s intention to invest £24 million in increasing call-handling capacity through NHS 111, to make it into a gateway to emergency care, providing the first port of call for patients. I must say to the Minister that it is a bit late to be doing that, and most of us should be somewhat alarmed at the news in the Statement that the Government intend to conduct pilots and will roll out NHS 111 First to all trusts from December. I understand the need to run pilots, but does he not think that time is against us?

On 17 September, six council leaders, cross-party, from across Yorkshire and Humber, wrote to the Minister. It is worth paying attention to what they said in their letter. They said: “It would be worth exploring the protocols and policies that might increase demand for what might be considered lower-value testing in a time of capacity constraint. This would include working with NHS 111 and reviewing their protocols. It seems that any childhood illness may result in a Covid test—that is what GPs are constantly telling us—while the Royal College of Paediatrics and Child Health have produced helpful guidance around that.” I ask the Minister if his department has seen that guidance and whether it will pay any attention to it.

Secondly, back to care homes and the ring of steel that never was. It is very welcome that there is going to be further investment in PPE and coverage for staff who have to take time off. However, there is a real danger in this, and there always has been, because social care is much more than care homes. Only 15% of people aged 85 or over are in a care home—most people who receive care are not. It is not uncommon for domiciliary care workers to visit 10 to 15 different homes in a shift. This Statement is silent on this matter which, given that the advisers are telling us they now know more about the transmission rate, is somewhat surprising. I wonder whether the Minister could talk about that.

The big issue in the last few days is the increasing confusion among members of the public as to who should be tested. Even in areas that are on the watchlist, people do not know whether they should be tested only if they are symptomatic or if they are asymptomatic. Some authorities have been given the power to do asymptomatic testing. Going back to that letter of 17 September, I note that the local authority says that it would be happy to have discussions locally but accepts the need for a co-ordinated approach with the Government. There needs to be a public discussion that provides urgently needed clarification from the department on how long these capacity issues are going to be around and what contingencies are going to be in place to manage them, particularly in high-risk areas.

This is not endless carping but a genuine concern for public health, and I therefore look forward to some detailed answers from the Minister.

[Lord Bethell (Con)]

My Lords, the noble Baroness, Lady Thornton, hit exactly the right note: we are at a sober moment and it is clear from the medical authorities that we are at some sort of tipping point. It is not too grand to say that the British nation faces something of a choice about how we approach the months ahead.

I confirm, as the noble Baroness, Lady Barker, has already done, that we are at level 4. The CMO has confirmed that he has taken the advice of the Joint Biosecurity Centre, and this is an indication of the seriousness of the situation. I acknowledge that there is widespread discussion of further restrictions and, as the noble Baroness, Lady Thornton, alluded to, that the Mayor of London, Sadiq Khan, has grave concerns for London. The CMO and the Chief Scientific Adviser have made their grave concerns crystal clear in their briefing this morning, and the graph showing the potential exponential growth in the case rate is extremely daunting.

I acknowledge that there are people who are concerned that we should put further restrictions in place, but I cannot confirm any of those arrangements. There will be a COBRA meeting tomorrow morning, which will be followed by a Cabinet meeting. The Prime Minister will make a Statement in the House of Commons tomorrow afternoon; how it will be repeated here is being discussed in the usual channels.

The expectations are very gruelling. The noble Baroness, Lady Thornton, queried why we did not see this coming, saying that, surely, SAGE and others had predicted this. The situation a month ago was quite different: when you looked at the dashboard, it was not clear that this sudden spike would turn up. However, the example of France—in cities like Marseilles—the hospitals in Spain and countries such as Israel has been extremely challenging and we are therefore moving quickly.

We completely acknowledge the concerns of parents and teachers in schools and the demands that they have put on the testing regime; we are absolutely determined to do whatever we can to keep schools open. We acknowledge the concerns of those with loved ones in social care, and we continue to pledge a very large amount—half of our testing capacity—to put protection in place for those in social care homes, who work with those in social care and who are in domestic care.

The noble Baroness, Lady Thornton, asked about Moonshot, and she is entirely right. The Moonshot project is adjacent to and parallel to our existing testing capacity, which uses the Rolls-Royce PCR test, which is extremely accurate in terms both of sensitivity and prevalence. Those tests take time to turn around, are costly and are best placed one after another in machines in an industrial process.

We are therefore looking at a much more flexible type of testing capacity, which may not need to be quite as scientific in its approach and may have different use cases. Principally, it would enable people to do the things they seek to do: to be in places where social distancing is more challenging, whether that is a place or work or leisure, or a family context. In answer to the noble Baroness, Lady Thornton, we absolutely apply the inclusionary principle, but there may well be a role for owners of venues such as football clubs and theatres to take advantage of these interesting, dynamic and innovative technologies in order to bring back some of the economic, social and cultural parts of the country that we all love, and that many depend on.

The noble Baroness, Lady Thornton, asked about self-isolation and quarantine. She is entirely right: these are critical components of our first-line defence against Covid. The only reason for having a test and trace programme is that people then isolate. If they do not isolate, there is no point in having that programme. We are absolutely focused on doing whatever we can to ensure that those who have been asked to isolate, because they have been in a risky situation or because they have had a positive test, do indeed do that. The fines we brought in at the weekend, or are set to bring in, are evidence of our determination to double up on the isolation principle. We have also brought in economic support for those who are isolating in certain target areas. As I have said at the Dispatch Box previously, those systems remain under review. If there is more that we can do to support those who are isolating, we will consider doing it.

The same is true of quarantine. The concerns of those in this House who would like to see our airports reopened and airlines and international travel restarted have been heard loud and clear. However, quarantining is essential to breaking the chain of transmission and to protecting this country. Until we have quarantine protocols that we can rely on, we have to live with what we have got.

The noble Baroness, Lady Thornton, also asked whether there was a better way for those in a particular place to understand what restrictions they are living under. I entirely agree. The pace at which some local lockdowns have been enforced or changed is extremely difficult to keep up with, even if you live in one area. That is why the app, which will be released on Thursday, will have a postcode checker. You can put in any post- code in the country and it will give you an indication of the lockdown principles and alert level in that area. That is a helpful device which will put many people’s minds at rest.

The noble Baroness, Lady Barker, asked about call handling and 111. I remember that, not long ago, the very existence of 111 was questioned by many. There were those who thought that closing it down might have been a good idea. During the Covid epidemic, 111 has been a phenomenal success. We have put in more resources, more call handlers, more training and more technology in order to make it more successful. It has proven its value in a massive way.

What we are doing with the trials alluded to by the noble Baroness, Lady Barker, is introducing a pilot so that those going to the emergency services in a hospital can phone 111 to check which services they should attend and, on occasion, book their slot in the emergency services. This is a system that patients have been asking for for a long time. It will help us massively with our load management as well as our Covid hygiene principles in emergency services. The pilots are starting in half a dozen locations, including Cornwall and Warrington, and we have put £24 million and a marketing campaign behind them. My expectation is that this service will prove extremely popular and will change the way in which people engage with hospitals. It will mean that the concerns and treatment of patients will be handled much more efficiently, and patients will go to the place that can best look after their treatment.

The noble Baroness asked about the protection that we are providing for care homes. The winter plan for social care, published last month, is an extremely detailed document that addresses many of the concerns that I have heard here in the Chamber. It is a thoughtful, well-financed and highly detailed plan for how we are going to protect those who are most vulnerable during the winter months. It is backed by an enormous financial commitment, a large number of tests and new guidelines to handle, for instance—as the noble Baroness rightly pointed out—the very difficult challenge of itinerant workers who may work for several different patients all at once; we are providing the financial resources and the new protocols in order to ensure that they do not become vectors of infection.

The noble Baroness, Lady Barker, asked about testing and who should be tested, and addressed in particular the question of asymptomatic testing and public discussion. We are massively engaged in a huge national conversation at the moment with local authorities, civic groups, employers, scientists and every single stakeholder that you could possibly imagine in the testing arena. Every day at the Department of Health we have round tables, webinars and all manner of engagement to understand how best we can serve schools, families, the economy and all the aspects of British life that depend on getting testing right.

One aspect of testing that is being generated by the exciting innovations that I mentioned in my answer to the noble Baroness, Lady Thornton, is the testing of asymptomatic people. That is not possible at the current levels of testing, even at 250,000 per day. We have to be extremely careful, as everyone here knows, to use every test that we have to its most effective use. When there are very large numbers of tests that can be cheaply and quickly delivered, and which are user-friendly by using things such as saliva or even breath tests, that could inaugurate a revolution in the way that we use testing and it may provide a system where those who are seeking to go outside, to go into areas where social distancing is challenging, can check whether they have the virus that morning and, at least for a day or two, have evidence that they will not be vectors of infection. That is potentially a transformative technology and it is the focus of our Moonshot ambitions. The progress that we are making is extremely encouraging and I look forward to updating the House on future days.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020

Baroness Barker Excerpts

Friday 18th September 2020 Lords Chamber

[Baroness Barker (LD)]

My Lords, regarding the Coronavirus Act passed in March, the Joint Committee on Human Rights made the following statement about the powers the Government assumed for themselves under that Act:

“Such extreme measures can only be considered lawful, justified, necessary and proportionate if (1) the threat from disease and death remains sufficiently significant to justify such extraordinary measures; (2) the measures only interfere with human rights and civil liberties to the extent necessary; (3) the measures are enforced in a clear, reasonable and balanced manner; (4) enforcement is authorised, and does not go beyond what is prohibited, by law.”


We can all agree on the first point. There is a very real threat from this virus but, six months on from the passing of that Act, we have to question the Government on the three other aspects pointed out by the Joint Committee.

On the previous set of regulations we debated this morning, the Minister said, “We now understand the nature of transmission of the virus”. If that is so, when will he publish the evidence that lies behind that statement? While the Government may understand it, individuals do not. I come from the standpoint that most people in this country want to do the right thing to protect themselves, their families, other people and their businesses, and they are genuinely confused about what to do.

Having looked at these regulations, with all the exemptions in them I do not think it would have been possible to make it much more difficult for anybody trying to enforce them if you tried. Therefore, given that we are now way behind on scrutiny as it should have been done, we are at a point where we can ask what their effect has been in practice. How many fixed penalty notices have been issued under these regulations? Who are the main recipients of FPNs, and in what areas? What information do the Government have about compliance rates in different types of venue, such as places of worship versus clinics or pubs? It is important that we get that information to inform the next set of regulations, which will inevitably follow from these.

How many court proceedings have been initiated under these regs? Again, what are the characteristics of the people who are being taken to court? How many fixed penalty notices have been given because of a failure to wear a mask on public transport? I too sat on a Tube train yesterday with two people not wearing masks. Everybody’s response was typically British; we did nothing but read the paper. The people may well have had a good reason and an exemption—I have no idea—but nobody there knew.

I want to come on to the key issue of communication. The Government have been communicating in difficult circumstances, but overall I think their communication has been extremely poor. The new regulations for the north-east came into force last night, but they were still not up on the government website this morning. They are on legislation.gov.uk—but individuals, people running businesses and local authorities would not know what they were supposed to be doing and how they were supposed to comply. Leeds asked for a limited restriction for a particular purpose, because it could see a reason for it, but that was turned down by central government for no good reason.

The Government have spent an awful lot of money; they have spent £840,000 with one company run by close associates of Dominic Cummings and Michael Gove. I have to ask on what basis its work will be evaluated, because the Government’s communication has been confused and inconsistent. If you compare it with some of the international comparators, such as Italy—not a nation generally known for a compliance with the law—it has had very clear messaging, and rates of compliance are very high.

The rule of six is a nonsense, and I think that people have worked out for themselves that it is arbitrary nonsense. Six individuals from different households meeting up every day, and six other individuals the next day—there is no way in which it makes sense, particularly in the absence of effective and timely test and trace data.

Earlier this week, on an Urgent Question, my noble friend Lord Scriven as asked why the Local Government Association did not receive local lockdown plans notice until one hour before the announcement. The Minister’s response was telling; he said

“it must have been the last one on the list”.—[Official Report, 14/9/20; col. 1000.]

That has been the fundamental problem all the way through: central Government think that they and their mates know better than the people who work in local government or the local public service agencies who are going to have to implement this.

I suggest to the Minister that, if he cannot answer my specific questions now, on this occasion can he write to me? We have to stop more daft ideas such as Covid marshals and come up with a coherent plan to work with local government in ways outlined by my noble friend Lord Greaves. This legislation is going to be reviewed, and it needs to be reviewed on the basis of evidence, not wishful thinking by government.

Covid-19 Update

Baroness Barker Excerpts

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

The change in the alert level is done in consultation with the CMO and it is his advice that the circumstances have not changed enough for us to move it. On the average travel time, most reasonable people would consider six-and-a-half miles a reasonable distance to travel for such an important test.

[Baroness Barker (LD)]

My Lords, why is it safer to allow six individuals from different households to meet together indoors, rather than limiting it to members of two families?

[Lord Bethell (Con)]

My Lords, the phenomenon we had noticed was that large groups of people, sometimes in pubs and sometimes in other congregations, would seemingly be from two households, but that the actual definition of “household” was proving to be extremely flexible in the minds of many people. Therefore, putting an integer into the formula makes it much clearer.

Covid-19 Update

Baroness Barker Excerpts

Thursday 10th September 2020 Lords Chamber

[Baroness Thornton (Lab)]

First, I place on record our thanks to the teachers, head teachers, school staff, university and FE college staff and others making it possible for our children and young people to return to their education. I hope this will remain a top priority for the Government as we move through and, we hope, out of this pandemic. It has been wonderful to see my great-nieces and nephews and granddaughter joyfully going back to school in the last week. As a non-executive director of one London’s hospitals, which is in my record, I can testify to the huge amount of work going on preparing for the winter stresses.

But here we go again. We need to start by reflecting on why we do not have before us the incredibly important new Covid restrictions announced yesterday by the Secretary of State and the Prime Minister, which aim to deal with the new surge in coronavirus infections. In fact, the Statement has been made in the Commons in the last hour or so, and I suspect we will see it in due course at the beginning of next week. I accept that the hybrid nature of the House means that we will not be able to take it today, which might have helped us all enormously. It is not the Minister’s fault; it is just one of the casualties of the situation we find ourselves in. Perhaps, the noble Lord could confirm when the new regulations will be laid.

Yesterday, Mr Speaker said quite rightly in the Commons:

“It is really not good enough for the Government to make decisions of this kind in a way that shows insufficient regard to the importance of major policy announcements being made first to this House and to Members of this House wherever possible.”—[Official Report, Commons, 9/9/20; col. 619.]


The Secretary of State made a Statement about current Covid-19 issues on Tuesday and failed to mention major policy proposals of which he must have had prior knowledge and which were already being discussed on social media. Thus, he did not allow a discussion of the current proposals, which the Prime Minister then announced in a Downing Street press conference and a letter which noble Lords will have received overnight. This suggests that the omission was deliberate and reveals yet again the disregard with which the Minister and his colleagues hold their duty to be accountable to Parliament, which is undermining our democracy. If Mr Speaker follows through on his threat to allow Covid-19 UQs at the beginning of every day to ensure that the Secretary of State can and will report new policy and be accountable to Parliament, I assure the House I will be arguing to take every single one in this House every day, so that the Minister can do his bit for accountability, too.

We have a Statement before us, press announcements made and a new law of six, but I need to return to the question I asked yesterday about what has gone wrong with the testing system. I would be grateful if the noble Lord would engage with what look like widespread problems some people are having accessing tests, rather than repeating the mantra about the high proportion of successful tests close to home, which is accurate, I am sure, but not the way to solve a clearly growing number of problems. I know the Minister will not shout at me, as his right honourable friend did to Keir Starmer yesterday, or accuse me of undermining the whole test and trace system when legitimate, evidenced problems are being articulated by many Members of Parliament and reasonable questions are being asked. The Minister needs to address the problem of the availability of tests.

Yesterday, I mentioned schools, where inevitably children will become ill. Parents are advised to keep them at home and get a test, and some are finding this impossible. Unsurprisingly, parents turn to teachers and head teachers for advice, placing even greater stress on our schools, which are working so hard to keep our children safe and educated. A reliable, rapid testing regime is vital, as we have said from the outset.

As for moonshot, which the Prime Minister mentioned in his letter, with his fondness for hyperbole, if the Government cannot even deliver testing for those ill with symptoms, how on earth are they going to deliver 10 million tests a day? I want to correct a statement the Secretary of State made in the Commons an hour or so ago, when he said to my honourable friend Jonathan Ashworth that the Labour Party was opposed to mass testing. That is absolutely not true. What we are against is incompetence. We are saying: how on earth will moonshots be delivered if basic testing is not working well?

The new regulations are meant to make it easier for people to understand. But does the noble Lord agree part of the confusion stems from the fact that some of these rules may be inconsistent with government messaging that people should return to work. Does he accept that, even where employers are taking necessary steps to facilitate social distancing, busy commuter trains, tubes and buses are not Covid-secure? On these Benches, we have said from the outset that one of the biggest barriers to self-quarantining would not be Covid fatigue but personal finances. Does the Minister accept that the Government need to go much further in helping people who need financial and housing support to self-isolate? Otherwise, how will we get on top of infections in areas characterised by low pay, child poverty and overcrowded housing?

Finally, to contact tracing: in Bolton, contacts were reached in only 57% of non-complex cases; in Oldham, 50%; in Blackburn 47%; and in Bradford, only 43%. Nationally, only 69.4% of contacts are reached and asked to self-isolate. These are Government’s latest statistics, and they make me wonder whether “world-beating” is yet another piece of hyperbole. On the effectiveness of testing, my colleague, the shadow Health Secretary, highlighted that only 69% of contacts were identified by the test and trace system, and I am afraid the noble Lord’s colleague Matt Hancock said he was wrong. He was right. I yet again have to ask the noble Lord—privately, if he wishes—to correct his boss’s record. More importantly, how can we improve on that record of testing and tracing?

[Baroness Barker (LD)]

My Lords, this is a Statement made two days ago in the other place, but it has been largely overshadowed by yesterday’s deluge of hyperbole and hokum. The Prime Minister said yesterday:

“We know, thanks to NHS Test and Trace, in granular detail, in a way that we did not earlier this year, about what is happening with this pandemic. We know the groups that are suffering, the extent of the infection rates, and we have been able, thanks to NHS Test and Trace, to do the local lockdowns that have been working.”—[Official Report, Commons, 9/9/20; col. 609.]


If that is true—and given the record of the Prime Minister and Health Secretary, one is always entitled to ask whether it is—how come local authorities and directors of public health are given only limited access to the test and trace case management system and not given full access to the contact system? Why are the Government sitting on data or passing it to companies run by their mates, instead of passing it to local authorities, which, for weeks, have been trying to predict and manage the inevitable spike in infections that follows people starting to travel and going to school and university. Why are they not getting that data in a timely manner?

From the start of this pandemic, experts advised the Secretary of State to invest in public health teams and NHS labs that are numerous and easily reached by many communities, including in rural areas. Instead, he gave the money to outsourcing firms such as Serco and G4S, which have no expertise and have not had to compete for the contracts. He could have invested in local public services; instead he has built a system on a foundation not fit for purpose. On Tuesday, in the Statement, the Secretary of State for Health said of care homes that

“we have met our target to provide testing kits to all the care homes for older people and people with dementia that have registered to get tests.”—[Official Report, Commons, 8/9/20; col. 517.]


But on Monday, the Government were forced to apologise for continuing delays to Covid-19 testing for care home bosses and GPs, who are threatening that these will lead to more infections among vulnerable people.

The Secretary of State’s own department, the Department of Health, admitted to breaking its promise to provide test outcomes within 72 hours. Care managers have described the Government’s centralised testing service as “chaotic” and “not coping”, amid reports that whole batches of tests are coming back not only late but also void. Testing officials told care homes by email on Monday morning that

“immediate action has been taken at the highest levels of the programme to bring results times back”

within 24 hours.

“We apologise unreservedly to … you … and your staff.”

The ring of steel that the Secretary of State claimed to have put around care homes never was. With upwards of 40,000 deaths, when will the Government sit down with care home providers, local authorities and CCGs to develop a comprehensive system of testing and supply of PPE? It does not have to be world beating; it just has to work.

The Prime Minister’s Statement yesterday would have been risible were the consequences not so serious. Most ludicrous of all was the announcement of a team of Covid-secure marshals to enforce the new laws on public gatherings. The Government could have done any number of things. They could have announced resources to enable the rehiring of retired public and environmental health professionals, since there is a shortage. They could have given funding to local community and voluntary groups to communicate ongoing health risks and the law to communities. They could have given additional funding for trained police officers to work with health officials and businesses to improve adherence to infection control. But, no, instead we got another vacuous attempt to steal the headlines. Maybe these marshals, with no training, no resources, no local management and no authority could join up with the 750,000 volunteers for the NHS and the trackers, and like them they could sit and twiddle their thumbs, waiting for the phone to ring.

One thing we can be sure of is that this is another stunt which will be an utter waste of time, money and resources. Local authorities, police forces, health authorities and schools are using their professional expertise and local knowledge to plan effective public health interventions. They are not only following the science but also using it to actively protect people in their authorities. In stark contrast, this Government ignore advice, misrepresent the science and carry on winging it, but the data on infections and the lack of reliable testing are evidence that the Prime Minister’s bumbling bombast and the Health Secretary’s growing litany of half-truths are indicators of world-beating incompetence and, sadly, people in black and minority ethnic communities and poor communities will suffer the consequences. It is time for the Government to change.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, I am enormously grateful for the thoughtful and informed questions from the Front Bench, and I echo the comments about teachers made by the noble Baroness, Lady Thornton. The return to school is a fundamental priority of the Government. It is a massive challenge for those involved, for governors, teachers, parents and school kids. I endorse the thanks the noble Baroness gave to teachers, who are performing incredibly well. The high return rates—percentages in the mid to high 90s—is remarkable and shows enormous confidence in the system among schoolchildren and their parents.

I also echo the noble Baroness’s thanks to NHS and social care staff who are preparing for winter. Enormous amounts of preparation are going into that. In response to the point made by the noble Baroness, Lady Barker, I reassure the Chamber that engagement with social care, local charities and local councils is incredibly intense and we are working extremely hard with local partners in all areas.

The noble Baroness, Lady Thornton, asked when the new regulations will be delivered. I am afraid that I cannot confirm the precise date, but I can reassure her that this Government are committed to being accountable to Parliament for those regulations and I look forward to that debate.

The noble Baroness also asked about the sequence of announcements. I reassure her that the Prime Minister brought his Statement to Parliament in good faith to update Parliament first. We cannot prevent leaks from happening, and leaks that get on to social media and then into the papers are something that we did not design or deliberately create. They are something that we regret. It would have been massively our preference for the Prime Minister to put Parliament first in his announcement.

The noble Baroness also asked about the testing system. The capacity of the testing system has never been higher: it has increased by 10,000 per day for the last two weeks and continues to increase dramatically. But demand has never been higher either, and there are good, laudable reasons why that demand is going up. The number of tests for supporting the vaccine programme has gone up. The number of tests to support our therapeutics programme has gone up. The surveillance of local prevalence has gone up, and the marketing around the use of tests by those who show symptoms has proved to be much more effective and the take-up among those who have Covid-19 symptoms has gone up. For those reasons we are extremely pleased by that effect.

However, there has also been a significant rise in the use of tests by asymptomatic individuals, largely tied to children returning to school. That is why we have been clarifying the guidance on the use of tests—that they should be used by those who have symptoms and not by those who are asymptomatic. One day, when the capacity is there and the system can bear it, I hope that we will move towards a system where anyone can have a test whenever they like, however they feel, but right now we must live within the system that we have. We are doing hundreds of thousands of tests per day and clarifying with teachers and parents that tests should be used by those who show symptoms and not by those who are seeking some other form of guidance.

Regarding the questions asked by the noble Baroness about the moonshot, I am a little confused. “If we cannot do millions of tests today, how can we expect to be able to do millions of tests tomorrow?” seems to be the question. I will answer it very clearly. The innovation around testing has moved much quicker than anyone could have expected in terms of scale, cost, accuracy and speed. The industry and the professionals in the NHS, academia and private business have come together in a triple helix to collaborate in a massive revolution in testing, which has changed considerably in this country from the days when we were struggling to do 2,000 or 3,000 tests per day to when we had the capacity to do 200,000 or 300,000 tests per day.

We have a clear view of how we can dramatically increase the tests. That clear view has two components: those tests that use existing technology that is purchasable in today’s world, and a clear idea of where innovation will take us in the very near future. This Government are committed to grabbing the opportunity of that innovation in order to dramatically increase the number of tests. There will be nay-sayers who will question whether that innovation will deliver, and undoubtedly there will be set-backs. Not everything will deliver as promised. However, I am extremely optimistic that we will be able to harness the power of science and innovation to invest in the backbone of our data and our delivery mechanisms, and to engage with the British public to deliver a testing system that enables us to return to the life that we love.

The noble Baroness, Lady Thornton, questioned whether the testing system could be relied on to deliver results. Let me explain: the people of Luton and Leicester have used testing and contact tracing, and infection rates are dramatically lower—less than half what they were in late July. Those are two excellent case studies of how our system of testing and contact tracing has turned around difficult situations and pushed back the spread of Covid by breaking the chain of infection. The noble Baroness also asked what we will do to improve the system as it stands. There are three areas of improvement: first, technology; secondly, infrastructure, by which I mean the data and the presence on the ground; and thirdly, engagement with the public so that they understand how to engage and we understand better how to interact with the public.

The noble Baroness, Lady Barker, asked about the contact system and gave some statistics. I reassure her that since 28 May we have rung 272,000 people who have been reached by the test and trace system. Where communication details have been provided, the service has reached 88.6% of close contacts, and 78.4% of people who have tested positive have been reached. Within the bounds of epidemiological effectiveness, these are extremely impressive statistics. Compared with those from other countries, they range among some of the highest. It is an incredibly impressive set of results for a system that was stood up in relatively recent history. Local public systems are complementing the central contact tracing hub, and I pay thanks to all those local authorities that either work with their full-time employees, or, as is often the case, have employed local businesses, to support it.

We have hit our target on care homes—the noble Baroness, Lady Barker, might like to take a moment to celebrate that. We are also trying to work with a degree of transparency in our operations. I do not regret for a moment the fact that the operational senior leadership in the track and trace team has been on the level about the present supply constraints, with social care and the general public. I reassure the noble Baroness, Lady Barker, that care homes absolutely remain top of our priorities. Many of the frustrations the public face, such as longer distances to travel, are exactly because we have put care homes first and have therefore had to dial down some of the availability of tests to the public. We sit down with care homes to discuss winter preparations. An indication of that is the 31 billion items of PPE that we have contracted to buy for this winter—an astonishing figure. That pays great tribute to the work of the noble Lord, Lord Deighton, and the PPE team, who have built up a fantastic stock.

Finally, I would like to express a small amount of confusion about the remarks from the noble Baroness, Lady Barker. On the one hand, she attacked the involvement of major private companies and central control of our track and trace system, but on the other hand, she attacked civic engagement, the volunteering of members of the public to support our track and trace system, and local initiatives whereby NHS trusts have brought back retired staff. The combination of these two themes is the heart of our success, and I celebrate both.

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

Baroness Barker Excerpts

Thursday 3rd September 2020 Lords Chamber

[Baroness Barker (LD)]

My Lords, I hope the Minister managed to get a small break over the summer. I did, and I visited Salisbury Cathedral and its most famous exhibit from 1215. The entrance to the exhibition has a copy of the emergency Coronavirus Act 2020. The display says, “Do you know that the Government has taken unto itself the following powers and taken away the following rights from citizens?”, and lists them. Looking at these regulations today, it is tempting to repeat the most famous question of all: “Magna Carta: did she die in vain?” Six months ago, when we were looking at that Act, we said to the Government that it was predicated on some wrong assumptions. One of the key assumptions that was wrong was that it did not take into account the role of locally elected officials and their accountable rule in public health.

I want to draw attention to four problems that underlie all the regulations that we are having to deal with. The first is the mistaken belief that Department of Health Ministers, their spads and their friends in tech companies know better than local government and public agencies how to handle the pandemic. With every passing week, it is more evident that what my noble friend Lord Scriven said in March, which was ignored, was absolutely right: the key to managing a pandemic is to give local authorities a general power of competence, and that is becoming more and more urgent. I ask the Minister when the Government will remedy that.

I checked throughout the summer with colleagues throughout local government and found that the same issue has arisen time and again: they are ordered by central government to take action to close down establishments and to install barriers for physical distancing, but they have no power of enforcement. They are managing at the moment on the power of their own authority negotiated with local populations, but they need the Government to understand that what is being achieved is done so despite the orders from central government, not because of them.

The second problem is the failure to understand that, while central government and the NHS can focus solely on Covid if they have to, and they have done so, others cannot. The police have to deal with the consequences of the virus at the same time as carrying out routine crime policing. Local authorities have had to reorganise social care completely, maintain sanitation services, try to support local businesses to keep open and, in one case, try to decide what the consequences were of Zippos Circus not being able to open on common land. That may seem trivial, but that is what people in local government are having to deal with as yet more “helpful” advice and guidance comes from the Government. So my next point to the Minister is this: will the Government ban officials from issuing yet more advice to local government that gets changed day by day and gets in the way of implementing things properly?

The third and most important problem is the one that we have alluded to and which we knew was coming: the failure to have an effective track and trace system. The Government have thrown millions at companies that did not have to tender or even show any competence in the area at all. Directors of public health still do not have timely household data about infections so that they can use their local intelligence to work out what the transmission patterns are and take precise precautionary action. Ministers can stand there and bluster and blame all they like, but until such time as they own up to that and work with people in local government to rectify the systems and build on local intelligence, we are not going to be able to make any of this work.

The fourth problem is that immunity from parliamentary scrutiny has clearly enabled the Government to do something that has been quite counterproductive: to pay no attention whatever to the communications strategy for what they want to do. Time and again they have announced at the last minute to professionals what they are expected to do within hours rather than days. I can tell the Minister that in Oldham, hours before the beginning of Eid, it was announced that two families from separate households could not meet in a garden but it was still all right to go to the pub. That went down very badly with everyone in Oldham because they understood entirely what its effect would be. I have to say, looking at some of the other public announcements since, it is clear that people in central government have yet to understand what people in the streets understand: that they are making this up as they go along.

The noble Baroness, Lady Jones, rightly pointed us to the really important matter: the Act has to be reviewed by the end of this month. We have a backlog of regulations that are every bit as ineffective as these are. I do not think that in all conscience this Parliament can let the Government hide as they did behind the emergency nature of the virus outbreak six months ago. The Government have to start telling us now how they intend to revise the legislation, who they intend to involve in consultation and, above all, how they will be led by local professionals who understand what is happening in their communities, so that not only do we get something that is effective but we get ourselves back on the right side of human rights and public responsibilities.

Medicines and Medical Devices Bill

Baroness Barker Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Wednesday 2nd September 2020 Lords Chamber

[Baroness Barker (LD)]

My Lords, Brexit poses many threats to the economy and well-being of UK citizens. Perhaps the greatest is the threat to our life sciences and pharmaceutical industries which, based on our scientific resources in universities and companies that have easy access to international talent and resources, have been truly world-leading. The impact of moving away from the existing collaborative approach between the UK and the EU will be substantial. The European market accounts for 25% of all world sales of medicines and has timely access to new medicines and devices. The UK, in comparison, accounts for only 3% of the total world market. It is against that backdrop that we have to consider this legislation, which is intended to mitigate threats to our industry.

We all agree that we need legislation, but not this thoroughly unsatisfactory Bill. It is a Bill that should not be accepted unless it is thoroughly revised, for three main reasons. The first is that alluded to by the Minister: it is built on the flawed assumption that the Secretary of State or an “appropriate authority” must take equal account of the safety of human medicines and medical devices, the availability of human medicines and medical devices, and the “attractiveness” of the relevant part of the UK as a place in which to conduct clinical trials, supply human medicines or develop medical devices.

The last two considerations depend on the paramountcy of the first. If we do not accept that in legislation, none of the rest will apply; we will simply be signalling to the world a willingness to move away from international standards. One of the most interesting and detailed points made in the briefings that we were given came from the Association of the British Pharmaceutical Industry, which pointed out that it wanted to encourage the UK to apply for full membership of the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use and the International Organization for Standardization. They are global organisations that produce harmonised regulatory guidance across nations. It was pointed out that previously the UK had represented the EU at meetings of those bodies and contributed to committees and regulatory thinking. Since 1 February 2020, we have had no direct recognised status as either a member or an observer. If we are willing to move away so swiftly from the international standard-setting bodies, we cannot do so on the basis of this unsatisfactory legislation.

The second reason for rejecting this Bill is that it is a Toom Tabard Bill, as we would say in Scotland; it is an empty cloak. The Minister put the best gloss possible on the reports from the Delegated Powers Committee and the Constitution Committee, whose comments were detailed, comprehensive and scathing—I have rarely seen reports of that nature.

On the delegated powers, Clauses 1, 8 and 12 allow Ministers by regulations to amend or supplement the whole regulatory regime for human medicines and clinical trials under important legislation such as the Human Medicines Regulations 2012. Those regulations alone contain 350 criminal offences which a Secretary of State could unilaterally or without any scrutiny change completely. It is something when the Constitution Committee says, as it has done:

“The delegated powers to create and adjust criminal offences in this Bill are constitutionally unacceptable.”


That is a very powerful reason.

Both the Delegated Powers Committee and the Constitution Committee were deeply critical of the way in which the Government have used this legislation, coming as it does at the time of the current pandemic, to confer emergency powers on Ministers to disapply existing health medicines regulations. They point out that there are no formal requirements to set out the form, publication or dissemination of protocols; Ministers can do that simply by publishing a document on a website. That is not taking back control; it is taking the mickey. It is time for us as a Parliament to stand up and say that this is not an acceptable way forward.

The third reason for rejecting this Bill is its potential to do harm. Many professionals in the pharmaceutical and medical devices industries have expressed the fear that by slightly and incrementally moving away from existing regulation from the EU we could very quickly put ourselves into sudden isolation. We should be fearful of that, not just because it could harm our ability to market into the European Union but because many other countries—African countries, for example— use EU approval as a short-cut mechanism for approving medicines which they do not have the capacity to trial themselves.

The report of the noble Baroness, Lady Cumberlege, is sobering. If we were to take just one thing from it, it would be the need for us to set up as soon as possible and as a matter of urgency not just databases but registries of medical devices. Those of your Lordships who have read the report will understand the difference that makes to traceability.

The Government are in trouble with the timescale that they have set for Brexit. This Bill demands detailed and lengthy scrutiny. For the health not just of our fellow citizens but of future generations, some forensic surgery needs to be done on it. It should not pass without receiving detailed attention from your Lordships’ House.

Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020

Baroness Barker Excerpts

Wednesday 29th July 2020 Lords Chamber

[Baroness Barker (LD) [V]]

My Lords, why did Public Health England take until 20 July to start supplying test data to local authorities on a daily, rather than weekly, basis? Why were local authorities told only then which households contained people who had tested positive?

On track and trace, when will the Government stop wasting resources on national call centres and—as we on the Liberal Democrat Benches have been advocating since March—put resources into local resilience forums working with directors of public health, health and safety officers and local police?

Matt Hancock stated in mid-May that he had

“tried to throw a protective ring around our care homes”

right from the start of the outbreak. Today, the Public Accounts Committee stated that discharging 25,000 patients in order to free up beds was an example of

“the Government’s slow, inconsistent and, at times, negligent approach”

to social care. The committee also said that advising hospitals to discharge thousands of patients into care homes without knowing if they had coronavirus was a “reckless” and “appalling” policy error. Will the Minister tell the House who was responsible for that decision?

There was no protection from central government. Will directors of social services now be empowered to challenge any similar decisions by NHS Providers and central government which jeopardise social care? Will local authorities currently in lockdown, such as Leicester, be resourced to share their experience and good practice with colleagues in areas at risk, such as Oldham? As the demographic profile of areas most likely to experience second waves becomes clearer, will local authorities be identified and given additional resources now to put prevention plans in place?

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

Baroness Barker Excerpts

Friday 24th July 2020 Lords Chamber

[Baroness Barker (LD) [V]]

My Lords, had these regulations been provided in April with proper consultation, they might have been credible, but today, with our “world-beating” track and trace system, which fails to notify 20% of contacts of people who have tested positive, and with Public Health England releasing data to local authorities only once a week and without patient identification, they are highly questionable. When will local authorities be given real-time data and the powers that they really need—for example, to instruct the opening of facilities such as toilets? When will the Government release the scientific basis for treating different businesses in inconsistent ways? Will they monitor the differential impact of these regulations on black and minority communities, and will they act swiftly to end such discrimination?

Pharmacies

Baroness Barker Excerpts

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

As the father of four small children, I completely endorse the noble Baroness’s point. Many a night have I been outside a hard-working pharmacist’s shop looking for advice, support and essential medicines. I pay tribute to the hard-working community pharmacy sector, whose pharmacists are often up until midnight helping their local communities and hard-hit fathers like me.

[Baroness Barker (LD) [V]]

What advice has the department had from local directors of public health about the resources that are necessary to ensure continuity for community pharmacies during local lockdowns?

[Lord Bethell [V]]

We are fully engaged with the sector. The National Pharmacy Association and the other stakeholder groups are in close communication with the department to ensure that they have the PPE, medicines and finances to keep going during the epidemic. The voice of the DPHs is involved in that stakeholder engagement.

Covid-19: Mental Health Services

Baroness Barker Excerpts

Thursday 2nd July 2020 Lords Chamber

Asked by

[Baroness Barker]

To ask Her Majesty’s Government what steps they are taking to ensure that mental health services are available in (1) acute, and (2) community, care settings (a) during, and (b) after, the COVID-19 pandemic.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, the mental health challenge of Covid is a serious matter, and I pay tribute to NHS mental health services in both acute and community care settings, which have remained opened for business throughout this time, including delivering support digitally, over the phone and, where possible, face to face. There are no plans to stand down that support after the peak of the pandemic and we remain committed to our NHS long-term plan ambitions for increasing mental health services in acute and community care settings.

[Baroness Barker (LD) [V]]

In July 2019, the Government committed £2.3 billion for services for 370,000 people with severe mental illness. Will the Minister give an undertaking that if, as expected, Covid-19 causes greater demand for mental health services, that money will be increased?

[Lord Bethell [V]]

My Lords, we are investigating the long-term implications on our services from Covid-19. We are engaging with counterparts across Whitehall and, if necessary, we will invest further money. However, the mental health impact of Covid is not clear yet, and we await the final implications of that.