(1 year, 5 months ago)
Lords ChamberMy Lords, it is a pleasure to follow the right reverend Prelate the Bishop of Durham, the noble Baronesses, Lady Lister and Lady Neuberger, and the noble and learned Lord, Lord Hope. In this group, I propose that Clauses 55 and 56 should not stand part of the Bill. I will not repeat the points or arguments made so eloquently by noble Lords, save to say to the Minister that I echo all the questions that they posed.
The noble and learned Lord, Lord Hope, referred to the errors with age assessment. Given those, for me one of the key points was made by the British Association of Social Workers, which said that social workers are currently responsible for compiling age assessments, known as Merton assessments, but they are designed to ensure that the children’s needs are met—not for immigration purposes. That raises an issue that many doctors have also raised: that these professionals are registered, and in that registration have to abide by the ethics committee of their registration body, and therefore the individual that they are serving. The problem with the proposals in Clauses 55 and 56 is that they will become the agents of the Government and will not be there to best provide for the needs of the individual concerned.
Doctors also make the point that it is absolutely unethical to expose anyone to radiation from X-rays that are not for clinical purposes. There are risks associated with overexposure, particularly for young people who are still growing. I know from my own familial experience that there is quite often a debate between doctors about the frequency of MRI scans and X-rays.
The other problem, also covered by others, is that, should a person refuse to have scientific assessments, they will automatically be deemed adults. That is balanced by the comments made by the Children’s Commissioner about Gillick competence. I have not heard anybody else ask the Minister what government body will be responsible for ensuring that anybody who is deemed an adult but in fact is not, and therefore should have been under local authority care, will be able to access medical treatment and any other care that they would have been given had they had looked-after status and been with a local authority. Perhaps the slightly shorter way of saying that is to return to the question that we have covered quite a lot of times here in Committee: what is the role of the Home Office in all this, when the status of the child—or potential child—is not understood?
At Second Reading, when I raised this issue about the technology and asked why the clauses should remain in the Bill, the Minister said that he agreed that the technology was not ready but asserted that the clauses should remain because it was quite probable that it would be ready in a fairly short space of time. All the evidence that we have had, including from the previous Home Secretary’s committee, says that it is not ready and that, although it might come, there is absolutely no clear date on the horizon.
From the perspective of these Benches, the science does not work and there is no firm data or technology to show that it will; all the professionals involved have ethical considerations about the registration bodies, and these two clauses would force them to move away from that; carrying out tests such as MRI scans and X-rays for non-clinical reasons could well damage the people undergoing them; and, finally, there is the question of whether the child can give consent, not just because of Gillick competence but because their language ability and the trauma they have been through might not allow them to do so under duress. That is why we believe the only solution is to remove Clauses 55 and 56.
My Lords, this is a very important group of amendments. I shall not speak particularly to my Amendment 127, supported by the noble Lord, Lord Alton, the noble Baroness, Lady Kennedy, and the noble Lord, Lord Carlile, because the debate has focused on some of the other amendments in the group and, given the hour, it is probably important to say a few words about those.
I start by saying to the Government that, unless they listen to some of the points that have been made by many noble Lords, children who deserve support will not receive it. That is the reality. Therefore, it is incumbent on the Government to look at what the Bill says and, at the very least, mitigate some of it and tighten up some of the various procedures.
(1 year, 12 months ago)
Lords ChamberMy Lords, we know that the Government’s asylum system is in chaos. Just 2% of last year’s small boat cases have been decided, creating a backlog of nearly 100,000 people waiting more than six months for a decision. Such is the chaos that we have seen, and are seeing, that we have the completely inappropriate last-minute use of hotels, with no proper information for local councils or public health officials. Then, of course, there is the disgrace that has been and is Manston.
We are all aware of revelation after revelation of overcrowding at Manston, of people being kept long after legal limits were passed and of poor health and hygiene. What is the latest revelation that we have from Manston? It is of 50 diphtheria cases—compared with just three last year. Was the Home Office warned four months ago, as reported in today’s media, that measures to prevent the spread of infectious diseases such as diphtheria at Manston were poor and that staff were ill prepared to deal with them? When were Ministers first told that there were diphtheria cases at Manston?
By mid-October, the Home Office had admitted that there were cases at Manston, but its officials told the Home Affairs Committee on 26 October that they had sufficient health measures in place to address diphtheria. Why, when they clearly did not? The Government kept thousands of people in overcrowded conditions at Manston, described by one as thousands of people “huddled around fan heaters” to stay warm. I am no expert but those seem like perfect conditions for infections to spread, so why on earth was it only on 11 November, weeks later, that diphtheria screening and vaccinations were recommended for everyone passing through Manston? How was it possible that, despite this, the Home Office continued to move people from Manston into hotels across the country, even as potential carriers of diphtheria? Why was this done in some cases with local public health councils or local authorities not being told or given proper information?
The Health Secretary tells us that 500 people have now been screened and vaccinated, but what about the thousands of others who have passed through Manston? Wherever they are in this country, have they been screened and vaccinated for diphtheria, or have they just been left? Have all those with possible symptoms been given antibiotics? Given that this was the recommendation of public health officials some three weeks ago, if it has not been done, why not? What liaison is taking place between the health department and the Home Office? What is the plan?
Across the country, residents and migrants from Manston have been dispersed. We were told by the Immigration Minister yesterday that asylum seekers with symptoms of diphtheria are to be isolated for a short period at Manston or in designated isolation hotels. Can the Minister say any more about the numbers of cases across the country and where they are? What is the current situation?
Of course, the Government, the Minister and the Home Office will now do all they can to protect public health, prevent infection and give healthcare to those who need it—but it should never have come to this, should it? It is time for the Government to listen, advise, act on advice and get a grip. Manston and now this associated health issue of diphtheria have been a public policy disgrace, alongside asylum backlogs and chaos in the channel. Frankly, it is shocking, and the Government need to get a grip.
My Lords, it is a pleasure to follow the noble Lord, Lord Coaker. I am afraid I will repeat not only some of his questions but the many that I have asked the Minister on this issue over the last month.
On 31 October, the Home Secretary said:
“Manston … has very good medical facilities and all protocols have been followed.”—[Official Report, Commons, 31/10/22; col. 649.]
On 27 October, Robert Jenrick, the Immigration Minister, said:
“The basic needs of arrivals are provided … including … medical care.”—[Official Report, Commons, 27/10/22; col. 401.]
When we had the Statement last Thursday, it felt like the Home Office had emptied Manston and dumped unfunded people, unscreened and unvaccinated, without access to their local NHS in their new venues.
It is good that things are starting to change, and that is why I thank the Minister. If he had anything to do with the message that came out on Friday afternoon that the spot accommodation arrangements that prevented people moving from Manston to hotels from accessing GPs have now been changed. It is a shame that it has taken repeated questions to make that happen.
On Saturday morning we heard that the man who died after staying at Manston had died from diphtheria, which was clarified by a PCR test, despite some earlier negative tests. One of the problems with diphtheria is that the symptoms are not always obvious. On 1 November, I asked the Minister whether people were being routinely screened and tested, but it appears that they are still not, let alone being vaccinated.
The spread of infectious diseases was highlighted by Charlie Taylor, Chief Inspector of Prisons, in his unannounced inspection of Manston and Jet Foil at the end of July. The report was published on 1 November, but I am sure that it is still the convention for Ministers to see a draft beforehand. It says:
“Facilities for the management of detainees with COVID or other infectious diseases were poor. Detainees were placed in a claustrophobic portacabin with no clear responsibility assigned for managing their care. Paramedic staff were unsure of any guidance, policy or procedure for the management of infectious diseases.”
What happened after the draft of this advice was seen by Ministers, prior to assurances given by Ministers, from the end of October onwards, that good healthcare and protocols were being followed?
Diphtheria is a notifiable disease because, in unvaccinated people and untreated cases, it has a fatality rate of 5% to 10%. It spreads in overcrowded communities whose health may be compromised for other reasons, which is absolutely typical for asylum seekers. What data is there for how many of the people held at Manston since the middle of October have now been screened, tested and offered vaccinations? The UNHCR, UNICEF and the American CDC all vaccinate refugees and migrant communities, and it is now compulsory if you come into America through the border with Mexico.
On Sunday, the Home Office said that infectious migrants will now be told to isolate in hotel rooms but, prior to this, the only advice about those in hotels was given to hotel staff, not local doctors and certainly not directors of public health. It is good that this is beginning to change.
Yesterday morning, the government webpage entitled “Protecting yourself against diphtheria” was updated—and that too is good. It is important to say that the wider public are not at risk; only people coming into contact with someone with diphtheria are at risk. The guidance now says:
“Everyone arriving to claim asylum in the UK is currently being offered a dose of a diphtheria containing vaccine and a course of antibiotics … to reduce the risk of diphtheria and some other infections.”
This should have been normal practice the moment the first case emerged, so why is it only starting to happen now?
The Statement says that an “enhanced diphtheria vaccination programme” will be “offered to all”. So I ask the Minister what the definition is of “those arriving”: does it cover everyone who has been at or through Manston since the numbers bloomed after Suella Braverman was appointed as Home Secretary, rising from 1,500 to 4,000 in the space of three weeks? Or is it only those currently at Manston? Or will it now be every asylum seeker in the country, as is the case with CDC in America?
I also ask whether those who come through Manston have also been screened for infectious diseases, including diphtheria and scabies? Who will be managing this; will the Home Office be funding screening and vaccinations? I hope so, because local health services should not have to pick up the tab.
The Statement says that “robust screening processes” on arrival will “identify proactively” those with symptoms. However, we know that diphtheria is asymptomatic. Two are currently hospitalised, one person is dead and there are at least 50 confirmed cases. We have had only about 50 cases in the last 10 years in the UK, but the directors of public health in local areas are still struggling to get access to information and resources, from either the Home Office or the UKHSA. When will that happen? If the Minister cannot answer all these questions, please can he write to me with some answers?
(3 years, 1 month ago)
Grand CommitteeMy Lords, I first apologise for the technical glitch. This is the first week of new remote contributions to Grand Committee. It is such a shame that we always notice the problems rather than the vast majority of smooth remote contributions. I pay credit to all the staff involved in helping those of us who are disabled Peers and can attend only remotely at present.
I commend the Minister for the principles behind the Armed Forces covenant, which are an admirable start to providing that morally binding commitment to current and past service men and women. But frankly, as these amendments seek to point out, it is somewhat patchy at the moment on the services that current and former service men and women would be able to access. Why is one function included and another excluded, when the barriers to accessing services are exactly what the covenant is trying to resolve?
Amendments 8 and 10, to which I have added my name, would add a number of functions to the relevant functions listed under proposed new Sections 343AA and 343AB. Amendment 13, to which I have also added my name, addresses how the Bill can widen the scope to other forms of potential disadvantage for service personnel under the Armed Forces covenant, including employment, pensions, compensation, social care, criminal justice and immigration. The noble Lord, Lord Coaker, has addressed very ably why this is needed, so I want to focus briefly on access to social care as one illustration.
The covenant already recognises that health is a vital service, where serving personnel and veterans can face particular problems, but social care—whether for the serving person or veteran, or for a member of their immediate family—is not. While social care is commissioned by local authorities it can, due to the circumstances of the individual, often involve a number of bodies. Some are within central government, for example on disability benefits; some are public bodies, for example health and local authorities; but some are also private, such as for those who are given a personal budget and will purchase their personal care that way. It can be very difficult and messy to navigate if you are new to it or have had to move.
Let me give an example to illustrate this point. Serving families with a severely disabled child have found it extraordinarily difficult when moving from one posting to another to transfer their child’s essential social care support, without falling off the bureaucratic cliff and having to go through reassessments in their new area, then waiting for the reports from those assessments. No services were given at all, so all help was denied them until the end of this new process. The child’s needs had not changed; their serving parent had merely been posted elsewhere. To be clear, this is not just a bit of social support every now and then. Disabled children, like the one I am describing, may have severe epilepsy or be fed with a tube, or be on ventilators some or all of the time. The help of carers at home supports the unpaid parent carer, who is already on duty pretty well 24/7.
Shockingly, the consequences of not having that help mean that a child might even be taken into care and away from their parents, not because the parents cannot cope but because one of them has been posted elsewhere. Adding social care to the covenant would protect the family and prioritise the ways of continuing the help that they are getting, when the move has made the difficulties entirely apparent.
For service men and women, and veterans, the complexities about access to services if they have mental health problems can be just as acute. Too often, we think of mental health as solely the domain of the NHS and those specialist charities such as Combat Stress, which I have been working with. The reality is that severe mental health problems disproportionately affect access to every part of the individual’s life, including discrimination in employment, access to criminal justice and compensation, and even to pensions, as well as social care. If the principles of the Armed Forces covenant are to ensure the well-being and support for current and former Armed Forces personnel, surely it cannot be possible for certain parts of the public sector to ignore it.
This amendment again applies to the covenant. I thank the noble and learned Lord, Lord Mackay, and the noble Baronesses, Lady Brinton and Lady Smith, for their support on this amendment. It seeks to extend the application of the covenant to central government. Using the test that I always use, I think people would expect that to be the case, but no doubt we will hear from the Minister why the Government seem to be resistant to it.
We all believe that the Armed Forces covenant represents a binding moral commitment between government and service communities, guaranteeing them and their families the respect and fair treatment that their service has earned. The Bill creates new responsibilities for a wide range of public bodies, from school governors to local authorities, to deliver the covenant, yet central government is not included. Amendment 9 seeks to change that. In practice, without it, we would create a situation, which I think sounds farcical, in which a chair of school governors, for example—and you can make other examples up—has a legal responsibility to have due regard to the Armed Forces covenant, but government departments, including the Ministry of Defence, do not. I find that really strange, to be frank.
As the Royal British Legion has pointed out, many of the policy areas in which members of the Armed Forces community experience difficulty are the responsibility of national government or based on national guidance. As the noble and learned Lord, Lord Mackay, said at Second Reading, it is
“questionable whether it will be successful without incorporating central government, with its policy responsibilities,”—[Official Report, 7/9/2021; col. 742.]
into the Bill. The British Medical Association has called on the Government to
“expand the ‘specified persons and bodies’ section under clause 8 of the bill to include … Her Majesty’s Government and Secretaries of State with responsibility for the functions specified within the bill.”
Giving evidence to the Bill Select Committee, General Sir John McColl of Cobseo said:
“I do think that there is a strong argument for the inclusion of central Government functions … At the moment, the central Government traction that we have is that there is a moral requirement for Government to comply with the Covenant. That is fine as long as it works, but in some cases it absolutely does not work.”
It should be a part of this Bill, in primary legislation.
The MoD has said, in defence of not including central government in the Bill, that it was already in many ways subject to a duty of regard to the covenant. Personally, I do not think that is enough; it is insufficient. Central government should be included in the Bill. The Bill Select Committee report said:
“The Committee notes that by excluding central government as a responsible public body, Service accommodation is not covered by the duty of due regard. The Government may wish to consider adding this as an area where the duty applies in the future.”
Again, that is just one example of the Bill Select Committee looking at this and giving a practical example of what happens if central government is not included in the Bill. With those remarks, I will leave it there. I look forward to the Minister’s response, and I beg to move.
My Lords, I have added my name to Amendment 9. As the noble Lord, Lord Coaker, has already said, at Second Reading a number of noble Lords, including me, raised the fundamental problem with the Armed Forces covenant. While local authorities and other public bodies offering key services are listed, there is one glaring omission: central government is not required to have due regard to the covenant, and the noble Lord has just ably explained why that is such a contradiction.
The Government need to understand that in creating the covenant they have created demand and expectation. To use the closing comments by the noble Lord, Lord Coaker, from the previous group on my Amendment 64, if you asked anyone outside the Bill they would think that the Government were already included. That service accommodation is not included is a helpful pointer to why the Government need to reconsider.
Without the same responsibilities for central government and its services to provide the covenant, frankly it is nothing more than warm words. I am sure there are plenty of arguments to say that it should, and probably will, be covered by different parts of government services, but the point is that the amendment can remedy that. The amendment would go further than the Government want to at the moment, but if the Government do not accept that they need to have the same responsibilities as other bodies, frankly they are not truly committed to delivering the covenant.
The police covenant being proposed at the moment in the Police, Crime, Sentencing and Courts Bill has this same lack of responsibility for central government while imposing it on other bodies. I have to say that it is beginning to look a bit worrying.