Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020
Baroness Brinton Excerpts(5 years ago)
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Baroness Brinton (LD) [V]
My Lords, from the Liberal Democrat Benches, I start by paying our respects to the families and friends of the bereaved. I give our thanks to all those who continue to fight coronavirus on the front line and behind the scenes. The publicity may be reducing, but we know that the battle goes on.
The two regulations in front of us set the scene for the continuing slow lifting of the lockdown. I echo the points made by my noble friends Lord Scriven and Lord Purvis: having sight of regulations in advance and debating them—with clearer, smarter guidance that does not confuse—should be possible now. I want to ask the Minister two questions as we prepare for recess at the end of July. First, some regulations will expire after 28 days. What plans are there to cover such renewals, should they be necessary after we rise on 29 July?
Secondly, these regulations were designed for the short term. What arrangements will be made should there need to be a major change to regulations—for example, a second national lockdown? I hope that in those circumstances, Parliament would be recalled to debate such a serious matter. I see that Israel is already in the middle of a second wave after lifting lockdown too early. The most effective way to manage and stop any second wave, whether local or national, is to have in place a full and effective “test, trace and isolate” programme to keep people safe, as well as transparent communications with the public. Their co-operation is vital to reducing transmission.
The Minister and the noble Baroness, Lady Harding, have both said repeatedly that a full “test and trace” system will not be in place until autumn and that the app will possibly not be ready until winter. The weekly Test and Trace figures released this morning demonstrate that nationally, the Government failed to contact one in three of those who tested positive with Covid-19, down from 75% last week. For the noble Lord, Lord Naseby, who is concerned about leaving names in restaurants, only 81% of contacts were actually reached, down from 90% last week.
The BBC’s dramatisation last week of the Salisbury poisonings made clear to everyone how important local tracing is. Experienced tracers long before the pandemic, our directors of public health and their teams are our unsung heroes. There are currently some outbreaks in England, in Kirklees and Leicester, that they are dealing with. However, local authorities are still reporting that they are not being given the full data from Public Health England to do their job on the ground. I have asked the Minister on three occasions when local authorities and directors of public health will get the full data they need at a local level. I ask again: when will they get that full data? If there is no answer today, can he please write to me and other Peers taking part to explain exactly what the data issue is?
There also remains the issue of the powers of a local authority to lock down. They are currently very limited—usually up to one building or one organisation only—and the Secretary of State’s answer a few days ago at a national press conference was that he would be the person to make every single decision. If we have hundreds of localised outbreaks, which would not be unusual, surely the local team, led by the director of public health and the local authority, should have the power to make that decision—after consulting Public Health England and Ministers in the Department of Health and Social Care, obviously.
Effective lifting of lockdown remains important for our care sector. It is good that cases in care homes and among those cared for at home have now reduced but, unlike the NHS, care sector staff are still not entitled to routine weekly testing. Every time I ask the Minister this question, I am told that they can have a test if they are symptomatic—but this is not the rule for NHS staff. If the Government truly believe they have put a ring of protection around our care sector, they need to act now. When will regular testing for front-line care sector staff be made available to keep them and their patients as safe as those in hospitals?
Extra care staff, defined as those who work in patients’ homes and the non-elderly sector, are still not able to access testing through the testing portal. Can the Minister please have this error—I hope it is an error—remedied as soon as possible? Yesterday, care homes had still not received specific guidance on how they should manage the change in shielding guidance. When will that arrive?
The Chancellor of the Exchequer granted a VAT exemption on PPE to the care sector until the end of July. It is common knowledge that care homes and care companies are struggling with many extra costs. PPE is still around four times more expensive, and they have reduced income as a result of the pandemic. With many of their residents shielding, they must continue to take special care. Can the Minister ask the Chancellor for an urgent extension of this exemption for a further three months?
I recognise that I have asked a lot of questions. Will the Minister please write to me with answers to any questions he cannot answer today? I support the regulations.
Personal Protective Equipment
Baroness Brinton Excerpts(5 years ago)
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Lord Bethell [V]
My noble friend is entirely right that having adequate stocks on hand is important, but having line of sight is also important. Individual trusts are able to make their own decisions on whether they wish to have stockpiles on the premises or a flow of supplies from their suppliers. At present we are working on supporting the trusts in their decisions on this matter.
Baroness Brinton (LD) [V]
At yesterday’s Home Affairs Select Committee, Dr Jane Townson of the United Kingdom Homecare Association said that domiciliary and personal care workers are still struggling to get access to testing and PPE because the system is not designed for care at home, which means that infection control is almost impossible. Will the Minister undertake as a matter of urgency to review home care workers’ access to testing and PPE to protect them and their clients?
Lord Bethell [V]
The noble Baroness is entirely right to emphasise the importance of getting home care workers adequate supplies. The expectation is that the majority of social care providers, including home care providers, would continue to access PPE via their normal wholesale suppliers, but we are rapidly overhauling the way in which PPE is delivered to care homes and domestic care supplies, including through emergency dispatches via the pilot e-portal and the national supply disruption response.
Coronavirus
Baroness Brinton Excerpts(5 years ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I pay tribute again to those at KCL who developed the symptom-tracking app. The information from it has been enormously helpful over the last few months. In many ways we have benefited from the app’s independence as a source of important front-line intelligence. I am aware of the letter written to the Prime Minister, and I hope very much that we will be able to work more closely together. The information on asymptomatic references is very important. However, I stress that the ONS study suggests that, unfortunately, many people who declare the symptoms of coronavirus are mis-self-diagnosing, and we have to bear that factor in mind.
Baroness Brinton (LD) [V]
Following last week’s Urgent Question, the Secretary of State responded to questions about new outbreaks in local areas and local authorities not being given access to all the necessary data. He said:
“We have provided more data to them, and we will continue to do more.”—[Official Report, Commons, 17/6/20; col. 810.]
I am still hearing from local authorities that the data sent to local areas is still incomplete, which means that vital urgent local tracing teams are trying to do their job with one hand tied behind their back. This includes the outbreak at the meat-processing factory in Kirklees. When will local authorities and directors of public health get the data they need?
Lord Bethell
The noble Baroness, Lady Brinton, is right that the creation of a seamless network between the centre and local authorities is challenging. A huge amount of work has gone into refining the accuracy and speed of the exchange of data, and the joint biosecurity centre is investing a huge amount of effort in getting this right. The responses to Kirklees, Leicester and Cardiff show the progress that has been made, but also some of the shortcomings. We are fully aware of the challenge and difficulty of getting this right; we are very much focused on it and it is our top priority.
Covid-19: Mental Health
Baroness Brinton Excerpts(5 years ago)
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Lord Bethell [V]
My Lords, the noble Baroness, Lady Thornton, raises an important point on the mental health of young people. A primary concern is the effect that the epidemic has on young people, at a delicate stage of their development. However, the return to schools is a very delicate matter. It requires the confidence of both parents and young people. We do not want to create further distress or concern. Therefore, we are taking steps in a thoughtful and measured fashion, to ensure that both pupils and parents are confident about the journey back to school.
Baroness Brinton (LD) [V]
My Lords, research led by Louisa Codjoe at King’s College London on tackling mental health inequalities found that BAME people are less likely to contact their GP about their mental health, to be prescribed anti-depressants or to be referred to a specialist mental health service. Any failures by the professional health services lead to fear and mistrust among the community, perpetuating a cycle of poor access. How do the Government plan to prioritise access for BAME communities and training for GPs to overcome these barriers?
Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020
Baroness Brinton Excerpts(5 years ago)
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Baroness Brinton (LD) [V]
My Lords, I think it is fair to say that the House recognises that the Minister, and in fact not just this Minister but those throughout the Department of Health and Social Care, as well as their staff and staff throughout the NHS and social care sector, have been working incredibly hard. It is good to see the numbers of cases, hospital admissions and deaths finally beginning to decrease.
However, there are still some issues. As others have already pointed out, R remains at probably between 0.7 and 0.9, and quite possibly above 1 in some regions. The debate about moving from two metres to one does not seem to be led by expert opinion. The absence of the Chief Medical Officer and the Chief Scientific Adviser is very noticeable.
On access to PPE, I completely endorse the points made by the noble Baroness, Lady Finlay, but I would like to add that this is not just about high-level PPE. We are still hearing that there are severe shortages of PPE in care homes, and over the weekend there have been press reports about some further shortages of PPE in hospitals as well.
That brings us to these regulations, the first of a series that will start to lift lockdown. I agree with my noble friends Lord Scriven and Lord Purvis, the noble Lords, Lord Anderson and Lord Balfe, and the noble Baroness, Lady Jones, that it is very frustrating to sit here today debating something that came into force half a month ago, with two updates since. Perhaps the usual channels could start discussing emergency sessions to look at these SIs as they emerge, with a much more rapid turnaround. It rather feels as though this entire principle of debate is being abused, and, as other noble Lords have said, used solely for executive power. When the first coronavirus regulations were discussed in March, we discussed at some length how executive power would be used. The Minister assured the Moses Room that this would be done only if it was essential and there was no ability to return to the House. I urge the Minister and the usual channels to examine this again.
These regulations include increased fines for breaching restrictions on movement, and my noble friend Lady Jolly has referred to the increase in fines and their complexity. It is worth noting that in France, between mid-March and the end of April, 15.5 million people were stopped by the police, and 915,000 people received fines. Initially fines were of €38, but they have risen to €135. Spain took a much more stringent view: over a million people have received fines, which for minor infringements double each time. Seriously infringements can go straight to the highest level: €10,000. It was good last week to see Prince Joachim of Belgium being fined that amount after attending an illicit party in Andalusia, thus setting a very public example. Will the police and the courts enforce the fines here in the UK if there is substantial deliberate breaching of the rules, especially if there is an increase in cases and hospital admissions over the next few weeks?
One area that remains a worry for the millions of BAME citizens is how they will be protected as lockdown is lifted. The PHE report, Disparities in the Risk and Outcomes of Covid-19, made it plain that BAME people in the UK are more likely to fall critically ill, require respiratory support and, sadly, to die. What steps are the Government taking now to ensure that there is clear guidance for our BAME communities on how to manage those higher risks? What impact assessment will employers of key workers, especially those in health and care, have put in place for when they come into contact with coronavirus patients?
Even more worryingly, my noble friend Lord Paddick has shown me a report in today’s Guardian which says that Ken Marsh, the chair of the Police Federation, defended the police’s enforcement of the coronavirus lockdown, after Met figures showed that officers enforcing the lockdown were twice as likely to issue fines to black people as to white people. Marsh said:
“It threw crime out the window. Anyone out in the first four weeks was a drug dealer.”
Let that sink in. Any black person out in the first four weeks was a drug dealer. Most of us fear catching the virus, but if you are black, you also have the conscious bias of police officers to fear.
What advice will the Government offer to the law-abiding vast majority of black people in London when they go out? Will they undertake to talk to the Home Secretary and the Mayor of London, so that this shocking view can be challenged wherever it is found in the Metropolitan Police?
I want to end on why we must still be careful as lockdown is lifted. I have often quoted the World Health Organization. In April, as countries began considering lifting lockdown, it said that the key tests were that transmission must be controlled, there must be health system capacities for test and trace, outbreaks must be minimised and there must be preventive methods in the workplace. I am not sure that we have seen those yet. We still need to be very careful in lifting lockdown.
Exercise Cygnus
Baroness Brinton Excerpts(5 years ago)
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Lord Bethell [V]
My Lords, I admit that my briefing is not entirely specific, but it is my impression that operation Cygnus did not address the question of ventilators. One of the distinctive characteristics of Covid was the pneumonia response, which required an unanticipated and dramatic increase in our need for ventilators. That is one of the reasons why there was a global shortage of this key equipment. I have addressed this with the notes I have before me and will be happy to correct it if I have misunderstood.
Baroness Brinton (LD) [V]
The Minister has asserted that my noble friend Lady Jolly misrepresented Cygnus, but she and other noble Lords have quoted from it. The Minister said earlier that “nothing could have prepared us” for something of this severity. Surely the point of pandemic preparation is also to watch what is happening elsewhere, such as in China and Italy in January and February. Why was the government response so slow to adapt to the needs of Covid as it emerged?
Lord Bethell [V]
The noble Baroness conflates two separate matters. The National Risk Register of Civil Emergencies is updated regularly and assesses civil emergency risks with a five-year horizon. The ongoing monitoring of risks in overseas countries is done in a different manner. I was trying to convey to the House that operation Cygnus was a rehearsal for a flu pandemic, not for the kind of virus that Covid proved to be.
Covid-19: R Rate and Lockdown Measures
Baroness Brinton Excerpts(5 years ago)
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The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]
The London School of Hygiene & Tropical Medicine’s report is one model of more than a dozen that contribute to the SPI-M committee, which looks at modelling. We value it, but it is not the only model. Regarding the statistical analysis of R, I pay tribute to the Office for National Statistics, which has put in place a massive testing programme to look at prevalence across the country. Hundreds of thousands of tests are done. This is by far the gold standard in terms of understanding prevalence and it feeds in accurate, up-to-date information for the accurate assessment—not modelling—of R0. It is on that work that we depend.
Baroness Brinton (LD) [V]
On 3 June, my noble friend Lord Scriven asked the Minister which body had legal powers to implement a local lockdown. The Minister replied:
“The arrangements for local lockdowns are not fully in place. In fact, the policy around them is in development and a full decision has not been made”.—[Official Report, 3/6/20; col. 1428.]
Five days on, local authorities and directors of public health are reporting publicly that their hands are tied without the postcode data they need or the specific powers for lockdown. When will this vital decision be made so that flare-ups of Covid can be stopped?
Lord Bethell [V]
The work is being undertaken at the moment. Rather than focusing on local lockdowns, we are focusing on local action plans with a wide variety of measures, perhaps including behavioural changes as well as clinical and diagnostic interventions. It is only by working across the piece that local actors, such as local authorities, directors of public health and local infection directors, can implement the right array of measures. That holistic approach is the one we are pursuing.
National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020
Baroness Brinton Excerpts(5 years ago)
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Baroness Brinton (LD) [V]
I thank the noble Lord, Lord Hunt, for tabling this Motion. Along with other colleagues, I agree completely with the principles behind regretting these regulations.
I start by praising the care sector—all the homes and ancillary care staff, whether professional or family carers, who during the last two and a half months have done all that they could to care for the most vulnerable in our society, against all the odds. It is important this week, as Carers Week begins, to recognise the unpaid carers, especially the young ones, who have often provided support. I recognise that this is slightly off the topic of the statutory instrument, but it is important to understand the structural problems in our care systems at the moment.
Other noble Lords have outlined how the structural problems started 40 years ago. In 1979, two-thirds of care homes were run by local authorities or were not for profit—now, 84% are run for profit. The noble Baroness, Lady Bennett, outlined how in the mid-1980s things started to change. I can remember as a Cambridgeshire county councillor in the 1990s and early 2000s how the standards changed in care homes at very short notice. Many local authorities, which were not permitted to borrow any capital costs at all, had very regretfully to close down their care homes. That was when the surge started, in about 1995-96, and it continued through the next decade.
We moved as a country towards having a privatised system, but we did not fund it properly. Money for care homes certainly needs to be upgraded. One of the difficulties we face is that, even though we are approving a weekly rate—I know this from experience of my mother’s two and a half years in a care home—the CCG started from a position of arguing, either with the individual and their family or with the local authority, about what the amount should be. Almost standing over my mother’s bed, we had to try and fight back against the CCG representative who did not want to pay anything at all after her second stroke. We need to understand the pressure on families, particularly regarding the way this allowance is used, and recognise that it is not the true picture.
We need also to look at the extra costs that care homes are facing at the moment. Other noble Lords have mentioned that PPE costs have increased. They have not doubled—care homes are now paying five times the amount they were paying in February. We heard that PPE was diverted, and the noble Lord knows, as I have challenged him long enough about this, of concerns about whether Clipper Logistics were going to come on board. Can the Minister confirm the report in the Health Service Journal that the Clipper system is now to be used only for emergencies and is not to be the resource that the care home sector was led to believe it would be? If it is not, where on earth will individual care homes be able to access PPE at the price they used to pay before the pandemic?
Testing has also been a problem over the last few weeks. In order to keep people safe, it was important that everybody, in all care homes, was tested right from the start.
My noble friend Lady Barker and others have talked about that month between mid-March and mid-April, before the Secretary of State announced that care homes could have tests. We heard that last Friday was the date by which everyone in a care home for the elderly would have access to testing. It is good that today, the Government announced that those who have learning or other disabilities can now finally access testing, but care homes for the elderly still desperately need assurances that, as with the NHS, their staff and patients can access regular testing. Can the Minister confirm that this will now happen? Otherwise, there may be a local flare-up which, before we know it, is running rife through certain care homes again.
Many noble Lords have talked today about the importance of treating our care staff well. We know that they have gone way above and beyond the call of duty. Those who have given up life with their families and moved into care homes deserve special credit. I like the idea outlined by the noble Baroness, Lady Wilcox: the Welsh proposal to award £500 to care workers as a bonus for their considerable effort. For them, many of whom are on the absolute minimum wage, it is a significant amount, although it still will not reward them for everything they have done.
At the end of this, we must return to the long overdue Green Paper. I completely agree with all noble Lords who said that it must be cross-party. Dilnot was certainly a good starting point, but the problem with Theresa May’s proposals was that they were Dilnot upside down. I gently remind the Government that it was not the Liberal Democrats or the Labour Party that walked away from the last cross-party arrangements. My party is keen and eager to become involved, whatever we decide for the future. The Green Paper is very much overdue; it must come along quickly. We need to look at everything structural. This should not be just about who pays what for a bed. We need to review the entire system.
Covid-19: Obese and Overweight People
Baroness Brinton Excerpts(5 years ago)
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Baroness Brinton (LD)
Section 8.3 of yesterday’s PHE review on disparities and Covid demonstrated very clearly that Covid, obesity, hypertension and diabetes type 2 were all severely raised for the BME community. Given that the Minister said in the House yesterday that this review was just the first step in understanding Covid in our BME communities, what urgent guidance is going to our primary care sector to advise our BME communities on what they need to do?
Lord Bethell
The noble Baroness, Lady Brinton, is entirely right. The review has done an excellent job of laying a path for greater understanding of the disease and is informing the PHE response. GPs already have a very clear work plan for advising BME communities on the threat of diabetes, in particular, and on obesity and healthy living for all circumstances. This will be redoubled during the epidemic that we are experiencing.
Covid-19: Response
Baroness Brinton Excerpts(5 years, 1 month ago)
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Baroness Thornton (Lab)
Before I ask the questions we need to address, I wish to record the deep sadness felt by me and my colleagues at the death of our friend and comrade, Dr Lord Nic Rea, two days ago. Nic was much loved across the House and gave me unstinting support and health advice over many years.
In March, the medical director for England said that keeping the number of coronavirus deaths below 20,000 would be “a good result” for the UK. Therefore, I start by asking whether the Minister agrees with the Prime Minister when he says that he is proud of our efforts in the UK. They have resulted in an ONS figure of 60,000 excess deaths due to Covid-19, even if at present the Government are admitting to only almost 40,000. The UK has 2% of the world’s population and we have had 13% of the deaths from Covid. I suggest to the noble Lord that some humility is required here. We can be as proud as we all are of our NHS, support staff and all key workers but it seems inappropriate to be proud of leading us to where we are today.
I would like to ask about disparities in the risk and outcomes of Covid-19, as covered in the PHE review, which addressed the unequal nature of the risks of this virus. The review reveals that the virus poses a greater risk to those who are older, male and overweight. The risk is also described as “disproportionate” for those of Asian, Caribbean or black ethnicity. It makes no attempt to explain why the risk to BAME groups might be higher.
Yesterday, the Royal College of Nursing released data that supports PHE’s findings. The survey found that for nursing staff working in high-risk environments, including those working in intensive and critical care units, fewer than half—43%—of respondents from a BAME background said that they had enough eye and face protection equipment. This is in contrast to two-thirds—66%—of white British nursing staff who were content. Has the Minister read this report, and what is his view of its findings?
An earlier draft of the PHE review seems to have included responses from the 1,000-plus organisations and individuals that suggested that discrimination and poorer life chances were playing a part in the increased risk of Covid-19 to those with BAME backgrounds. Why was that section omitted? Why was the report published a week late? Is it true that the omitted part included recommendations like that from the Muslim Council of Britain, which stated:
“With high levels of deaths of BAME healthcare workers, and extensive research showing evidence and feelings of structural racism and discrimination in the NHS, PHE should consider exploring this in more detail, and looking into specific measures to put in place to tackle the culture of discrimination and racism”?
Apparently, these words did not survive contact with Matt Hancock’s office over the weekend. Is that true? Does the Minister agree with the Muslim council that the clear statement about the need to introduce change would surely give greater meaning to the statement by the Secretary of State that “black lives matter”?
Moving on, the Prime Minister assured us that by 1 June we would have a world-class track and trace system. I assume that he was misinformed, as crucial parts of the system do not exist and will be in place only at the end of June, which is what the noble Baroness, Lady Harding, says. Furthermore, the fragmented mess of using private contractors has been a disaster. Some recognition is finally being given to the role of expertise and knowledge at the local level and in local authorities, yet even these local experts were not consulted about the system and seem to be in the dark about just how it is supposed to work—just ask any department of public health how confident they are that we have a world-class system. Surely such a system should have the capacity to turn around tests in 24 hours, and we are nowhere near that point.
Over two weeks ago, I asked the Minister a series of simple questions. Who would call me if I tested positive? If the call is from a call centre, how will I know that it is genuine and to be trusted? The deputy at Public Health England seems to think that we would know through the expert questions that the tracer will ask. Clearly, she has never been on the receiving end of skilled online or telephone fraudsters. This is an important question. If it takes over 24 hours to get the test results and the tracing does not start within 48 hours, surely the system of protection will have broken down by then? Would the information, which is held centrally for some years, go to my GP? It is unclear where that data will be stored and what rules will apply. Can the Minister please explain?
An analysis published by Cancer Research UK has outlined that as many as 2.4 million people in the UK have been affected by a backlog in cancer care, waiting for screening, further tests or treatment. That can change only if the staff doing the cancer care, treatment and testing are being tested very frequently, even those without symptoms.
It is very concerning that the Government are refusing to publish information about the reproduction rate per region, the viability of home test kits, the number of people tested daily, and the number of people contacted under the new contact tracing system, to list a few examples. Furthermore, the data that the Government have published has been decried as highly misleading by the head of the UK Statistics Authority. Will the Minister commit to urgently publishing these figures to ensure openness, transparency and public confidence in the Government’s approach?
Does the Minister share the concerns of scientists, including members of SAGE, and public health leaders that the Government’s NHS Test and Trace system was not yet robust enough to quash any resurgence of the virus and should have been “fully working” before lockdown measures were eased? A final comment on “test, track and trace” is that the Cummings saga was bad enough, but we now have the chairman of the UK Statistics Authority making very robust suggestions that government presentation may not be what it seems. Sir David Norgrove has pulled no punches and makes it abundantly clear that he thinks the presentation of testing numbers in England is unacceptable.
On shielding, it is remarkable that the announcement to lift shielding was made during the night at the weekend. There was no notification to GPs, public health officials or those who most recently had been told to shield until the end of June. Can the Minister please tell us what the scientific justification is for that? Apparently, according to my noble friend Lady Armstrong, department officials met many organisations representing patients with long-term conditions last Thursday. There was no mention then that anything would be lifted on Saturday, even though they discussed experiences of lockdown and talked about the way forward. That suggests to me that it was a politically motivated announcement, without any involvement of the relevant clinicians or patient groups. Can the Minister say which clinical groups had supported the announcement on Saturday evening? What preparations were the NHS able to make before the announcement was made? At the beginning of lockdown, shielded people got daily emails from the NHS about how to behave but, since Saturday, I understand that they have received nothing. I think many may feel abandoned —some are our colleagues in the Commons.
We must not make the same mistakes with our shielded citizens as were made with care homes, ignoring the risks to those most vulnerable. The arguments about discharging patients into care homes without them being tested has not abated. What information does the Minister have about current and regular routine testing of care home staff, and even daily tests? There is emerging evidence of higher death rates among those with learning disabilities—yet another emerging tragedy. Does the Minister think that was avoidable? Was a strong shield wrapped around them from the start? I do not think that it was, but maybe the Minister can give us his view.
Finally, we must start thinking about what kind of NHS will emerge after the pandemic is really under control, whenever that might be. How will the system deal with the huge backlogs, such as those for cancer patients and cancelled surgery? I do not expect an answer from the Minister right now, of course, but we need a debate and a discussion. Can we expect a Statement on these matters? If we truly are now going through the worst, can we start planning for the future?
Baroness Brinton (LD)
My Lords, I too thank the Minister for the Statement. From these Benches, we send our condolences to the family of Lord Rea; he will be missed. I also repeat the support from the Liberal Democrat Benches for everyone working hard to help contain and reduce Covid-19, from the magnificent front-line staff in the NHS and the care sector to all key workers, whether visible to us or not: we know that you have given your all. We also send our condolences to all those who have seen the death of families and friends over the last four months.
The World Health Organization has insisted repeatedly that no country should start to lift lockdown until Covid-19 is no longer in the community. With the noble Baroness, Lady Harding, confirming that there are still over 8,000 new cases per day, clearly it is still in the community, and WHO also says that lockdown should not be lifted until a full test, trace and isolate process is in competent operation across the country, which it is not.
Can the Minister explain why Ministers took the decision to start the process of lifting lockdown even though the Chief Medical Officer refused to allow the threat level to reduce from four to three? Unlike other European countries, which started lifting lockdown only when the daily death rates were below 10, today the department reports a total of 359 people died in the UK in the last 24 hours. Why was the shielding advice changed over the weekend, and why was no guidance sent out to GPs, care homes and clinical groups? I can confirm, as someone who is shielding, that I still have had no advice, by text, by letter or by telephone, on what I should be doing now that the advice appears to have changed. What can the Minister do to reassure people who are shielding that this is safe advice?
What steps are the Government taking to prepare for flare-ups of cases in our communities, and, worse, an early second wave? Will the care sector be involved in that preparation, given that they appear to have been left to hang out to dry in order to protect the NHS? I understand that unlike hospitals, the care sector has not been approached at all yet.
In the Statement, the Secretary of State refers to the publication of the Public Health England report on disparities and the risks and outcomes of Covid-19. The Runnymede Trust summarised the problems with the report, saying that there were not
“any recommendations on how to save BAME lives.”
What specific guidance is being provided to the NHS and care sectors to protect BAME staff in high-risk Covid-19 areas? Can the Minister comment on the report from the Western General Hospital that BAME locums were disproportionately placed on rotas in coronavirus-intense wards, and that the hospital has experienced a recent and very large spate of cases?
Yesterday, the Office for National Statistics wrote its second letter in four weeks to the Secretary of State, challenging him in the bluntest terms and accusing him of obfuscation and confusion on the number of daily tests carried out. Can the Minister give the House a date when we will be able to see real and consistent data on testing, approved by the ONS, back- dated and adjusted, so that there is no room for any misunderstanding?
I return to the issue I have raised repeatedly with the Minister: the care sector. At the weekly APPG on Adult Social Care update today, we heard again from across the sector that it still faces a number of problems, some of which the noble Baroness, Lady Thornton, outlined. To be clear—before the Minister responds again, saying that this is just anecdotal evidence—we were told that this is happening in a large number of care homes and settings in wide areas right across England. This is not a one-off.
First, a number of CCGs are still pushing care homes to take block-bookings of patients coming out of hospital without having had Covid tests. The Prime Minister and Secretary of State have repeatedly said that this has never happened. It has happened and is still happening. When will it stop?
Secondly, on PPE, the care sector says that the Clipper system is finally starting to be rolled out across the country—a mere eight weeks after your Lordships’ House was told that it was only a handful of days away. However, care homes report that deliveries are still only a portion of their original orders, meaning homes still have to make decisions about rationing. Can the Minister provide a date by which the care sector will receive all the PPE it orders and needs?
Thirdly, the Minister told us that all care homes would be offered tests by 6 June. I repeat my question from two weeks ago as to why some homes are excluded from the portal so that they cannot access tests. These are homes for learning-disabled adults and disabled people under 65. Given the worrying comments on the inequalities data in the PHE report, when will this change?
Fourthly and finally, I echo the points made by the noble Baroness, Lady Thornton, about it being essential for all health sector staff to be able to access repeat testing to keep people safe. While it is true that it is happening for NHS staff, it is not true that our care homes or staff working in the community are able to access regular testing. Can the Minister please provide a date by which staff in care settings will have regular testing? This is vital because there are so many asymptomatic cases. They need parity with the NHS.
I recognise that I have asked a large number of specific questions and hope that, even if the Minister cannot answer them now, he will be able to write to me and others taking part in the Statement. Perhaps he could also answer any of the questions from the noble Baroness, Lady Thornton, if he cannot answer them now.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, I start by echoing the words of both noble Baronesses and give thanks for the contribution of Lord Rea to the House. I did not know him well but have read the many testaments to his work. He clearly lived a full life and made a massive contribution to the House, for which we should all be thankful.
I echo the noble Baronesses and give a moment of thought to all those who have had deaths in their family and among their friends. I have lost both an aunt and a godfather to Covid in the last few weeks; my family has not been untouched, and I think—