Social Care Sector: Private Equity

Baroness Chakrabarti Excerpts

Thursday 27th January 2022 Lords Chamber

[Lord Kamall (Con)]

We value the role of independent and third sector care homes. It is important that we have that right mix. Some private companies will include private equity, and it is important not to tar all private equity with the same brush. Private equity plays a role in many companies in turning them around and retaining jobs. The important thing for us is that, if any companies are potentially in financial trouble, we have the market oversight scheme to ensure that, if they go bust, there is an ability to transfer patients elsewhere.

[Baroness Chakrabarti (Lab)]

My Lords, front-line carers often get paid around £9 or £10 an hour, and it is hard to survive on that. Yet last year, Barchester Healthcare’s CEO collected 120 times more than his care staff. What proposals does the Minister have to ensure that public moneys paid to private care homes are used to improve care and staff welfare and not siphoned off to fat cat executives?

[Lord Kamall (Con)]

The CQC has a role in making sure that the care provided to care home residents is of satisfactory quality. As I said, 84% of care providers are rated good or outstanding. The market oversight scheme examines companies that could potentially be in trouble and keeps a close eye on them. There are six stages in the market oversight scheme to make sure that we manage that.

Health and Care Bill

Baroness Chakrabarti Excerpts

2nd reading
Tuesday 7th December 2021 Lords Chamber

[Baroness Chakrabarti (Lab)]

My Lords, I join the welcome to the noble Lord, Lord Stevens of Birmingham.

The pandemic has been a magnifier of every single inequality on the planet. I hope we can all agree on our enormous good fortune to live in the land of the NHS, arguably the greatest experiment in compassionate collaboration in the history of the world. It is cause for genuine patriotism without the slightest risk of xenophobia because this service is not just envied the world over, it was built by the hard work, endeavour and innovation of people from all over the globe as well. It even has “National” in its title and mission.

While some noble Lords have spoken eloquently about the need for local flexibility and responsiveness, I fear the Minister will have to do more to convince your Lordships’ House—let alone those watching anxiously outside it—that this Bill will address widening inequalities in health, care and other outcomes, rather than baking in fragmentation and privatisation, notwithstanding his welcome opening remarks about the founding mission of a service which should be cradle to grave support, available to all and free at the point of use.

I join my noble friend Lady Bakewell in seeking greater safeguards to prevent private companies taking representation in NHS governance structures in a clear and institutional conflict of interest, inevitably necessitated by a profit motive, that will always threaten the principle of universal provision where there is limited supply and limitless demand. Similarly, public health and care professionals should be the default providers of these vital services that have proved as vital to the safety of the nation as the police and military over the last couple of years.

The complexity of this reorganisation has already been remarked upon at length, but I fear that it conceals rights of direction without corresponding overarching legal responsibility upon the Secretary of State. I would like to hear the Minister’s specific explanation of provisions to the contrary. Statutory powers and functions should not be capable of delegation to non-statutory bodies. All those working in health and care should be protected, not just with warm words and applause, but with statutory recognition of terms, conditions, pensions and collective bargaining alongside appropriate management and regulation in the public interest.

As others have said, it is high time for a national care service to dovetail with our National Health Service, giving cradle to grave security for those in need of it and a parity of respect and protection to those working within it. Likewise, lifting mental health provision from its current Cinderella status and investing in such services as lifestyle and preventive care would save billions from being wasted on substance abuse and criminal incarceration, and provide rewarding careers for young professionals in an otherwise increasingly automated world.

Finally, I will say a word on the vaccinations, to which perhaps nearly all of us in your Lordships’ House owe our lives. Those who peddle non-science about vaccines are just as dangerous and irresponsible towards their neighbours here and around the world as those who deny global warming. They of course have a right to express their views, but I suggest we have a duty to do more to correct their falsehoods.

Given that most of the initial investment in the world’s major vaccines, including here in the UK, came from public and philanthropic sources, not to allow a narrow and time-limited vaccine patent waiver at the WTO so that the poorer nations of the global south can speed up vaccination and defeat variants, is as incomprehensible a decision as any I can think of. Future generations will have little forgiveness for it, let alone respect.

HIV and AIDS

Baroness Chakrabarti Excerpts

Wednesday 1st December 2021 Lords Chamber

[Lord Kamall (Con)]

I thank my noble friend for his question. I am pretty sure that the answer is yes.

[Baroness Chakrabarti (Lab)]

My Lords, generic drugs were crucial to the global response to HIV/AIDS; I see the Minister nodding. In that case, will we learn that lesson for this pandemic and stop blocking the TRIPS waiver so that we can better vaccinate the global south and protect ourselves from new variants?

[Lord Kamall (Con)]

One of the best ways to help to vaccinate people across the world is through multilateral, bilateral and plurilateral partnerships. We will have donated 100 million coronavirus vaccine doses by next June. We are committed to working internationally. This issue comes up at the G7 where, once again, we are seen as leaders on the COVAX programme and other such programmes. It is important that we focus on what is effective and how we can get vaccines to those who really need them.

Flu Vaccination and Blood Test Cancellations

Baroness Chakrabarti Excerpts

Tuesday 14th September 2021 Lords Chamber

[Lord Bethell (Con)]

I do not quite know how to answer that question. When it comes to test tubes for blood collection and the flu vaccine, I am not sure that there is a Brexit angle and we have it covered.

[Baroness Chakrabarti (Lab)]

My Lords, I cannot be the only Member of your Lordships’ House who is slightly confused by the Minister’s answers in relation to disputes of fact about whether cancellations are even happening, and then perhaps the passing of the buck to GP surgeries. When he writes to my noble friend Lady Thornton, will he place his answer in the Library and not just address the vital issue of fact—and trust—as we head into a very difficult winter, but be clear about the priorities between routine testing and vaccination and the more acute category that he describes?

[Lord Bethell (Con)]

I would be absolutely delighted to put the letter into the Library as requested by the noble Baroness, but please do not think for a moment that I am in any way seeking to pass responsibility. I am pointing out the very clear fact that GPs are responsible for implementing the flu vaccination programme. It is something that they do brilliantly. No other country has a flu vaccination programme with the impact that ours has. GPs are taking on more responsibilities this year with secondary school children being vaccinated. The rate I am expecting for this year will be higher than we have ever seen before.

Elderly Social Care (Insurance) Bill [HL]

Baroness Chakrabarti Excerpts

2nd reading
Friday 16th July 2021 Lords Chamber

[Baroness Chakrabarti (Lab) [V]]

My Lords, I too am grateful to the noble Lord, Lord Lilley, for creating this opportunity for such an important debate this morning, but I am afraid that I cannot recommend a rather convoluted homemade attempt at a sticking plaster for the gaping wound that is our national care crisis.

The regressive conceptual contortions that some will go to to avoid the logic of paying for essential public goods by taxing the wealthiest corporations and individuals in our society are almost as ingenious as attempts to privatise such public goods—whether our health data or the desire to care for our vulnerable people—or indeed the highly successful attempts of the wealthiest 1% to avoid paying their fair share of tax.

Our National Health Service is probably the greatest communitarian experiment in world history, and it is so easy to be truly patriotic about it. Given the working people from all over the world who have contributed to it, it encapsulates a positive patriotism that is not remotely xenophobic, yet years of underfunding and its current limits have been cruelly exposed in recent times. Last year, many of our elderly were tipped out of hospitals, untested, into private care homes with inadequate PPE provision, social distancing and testing arrangements, constituting one of the biggest scandals of the Government’s pandemic management—about which the future inquiry will no doubt have much to say.

But this fault-line between health and social care is a more permanent design flaw in a model that cares for the terminal cancer patient at public expense but puts caps, charges and all sorts of constraints on our provision for the patient of identical age and means who is suffering instead from dementia. Such anomalies are only increased with the ageing profile of our population. It is simply unacceptable to leave our older people, or indeed many much younger vulnerable people, isolated, destitute or at the mercy of profiteers who pay too many carers minimum wage on zero-hours contracts.

I look forward to seeing the details of the Government’s plans suggested in the press today, but nothing short of a publicly funded national care service providing rewarding work and dignified care will fit the Bill.

Covid-19

Baroness Chakrabarti Excerpts

Thursday 15th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to my noble friend for his campaign on Nepal. His remarks are heartfelt, understood and heard clearly. We all recognise the debt we owe, not just to those from Nepal who have served in Her Majesty's Armed Forces, but their families and the entire nation for their contribution throughout Britain’s history. The PM has announced that the UK will donate 100 million doses over the next year, and the majority of those will be donated to COVAX. My honourable friend in the Foreign, Commonwealth and Development Office will be best placed to clarify the precise arrangements and where Nepal will stand in that supply chain.

[Baroness Chakrabarti (Lab) [V]]

I wonder if the Minister could help me a little with the Government’s logic. Care home workers on zero-hour contracts are to be forced to get vaccinated without even a single guaranteed paid day off to recover from side-effects. A significant step change on domestic Covid passports is to be decided on by businesses themselves and regulated by them, despite all the problems with testing and tracing. Yet something as light touch and common sense as wearing a mask in shops and on public transport is not to be a legal requirement. What is behind this mask aversion and confusion—scientific evidence or Trumpian culture wars?

[Lord Bethell (Con)]

My Lords, in terms of care home staff vaccination, we are in the midst of a consultation on the subject. The noble Baroness should not necessarily pre-empt the consultation. We take into account the views of those we are consulting with. It is a measure that has caused an enormous amount of concern both here in the Chamber and with the public. It feels right that we should be consulting on a measure that ultimately protects the elderly and vulnerable.

In terms of certification, the ultimate use of certification in domestic surroundings has not been fully decided. At this stage, with the country enjoying the benefit of the vaccine, it seems right to be leaving that to businesses to decide how they wish to use it themselves.

Women’s Health Outcomes

Baroness Chakrabarti Excerpts

Thursday 8th July 2021 Lords Chamber

[Baroness Chakrabarti (Lab) [V]]

My Lords, I thank the noble Baroness, Lady Jenkin, for leading this debate, an initiative wholly consistent, if I may say so, with her long record of campaigning on behalf of women.

Even in these days of deliberately stoked and exaggerated culture wars, there can be few who do not agree that millennia of structural inequalities have undermined women’s health worldwide. Further, it is obvious that the current devastating pandemic has magnified every such inequality on the planet. This includes the shocking, yet predictable, rise in domestic violence during necessary lockdowns, reduced access to sexual and reproductive healthcare and other vital women’s health and social services internationally.

Women are more likely to be involved in childcare, social care and cleansing, whether in the home or outside it, placing millions of them on the front line of infection. While older men seem more likely to die of Covid-19, it seems that women who survive it may be more likely to suffer from the chronic symptoms associated with long Covid. That means that every current decision in the debate about how best to either combat or live with the virus is likely to have a gendered impact.

The extent to which casting off the mask has become associated with one’s love of freedom is unfortunate indeed. I worry about the way in which some in government have become so wedded to irreversible “business as usual” from a particular date that they are risking more than necessary and perhaps forgetting that, for many, business as usual, even before the pandemic, was far from free, fair, safe or healthy.

If the Government want to honour their promise to vaccinate the planet and an earlier pledge for a new era of global Britain, they must stop siding with Germany in blocking the TRIPS waiver at the WTO and join the United States, India, South Africa and most of the Commonwealth—celebrated here earlier this afternoon—in demanding that industry shares know- how around vaccines, tests and treatment manufacture so these can be decentralised and scaled up to meet global demand.

19 July is not “freedom day”, but it could yet be solidarity day in a global race against vaccine-resistant variants and even more deaths.

Coronavirus Act 2020: Temporary Provisions

Baroness Chakrabarti Excerpts

Monday 28th September 2020 Lords Chamber

[Baroness Chakrabarti (Lab) [V]]

My Lords, what a rare pleasure it is in such dark times to be able to join the welcome and congratulations to both new Lords—my noble friend Lady Clark of Kilwinning and my older but equally dear friend, the noble and learned Lord, Lord Clarke of Nottingham.

I gave this legislation qualified and heavy-hearted support in the spring because of the urgent and drastic scale of the pandemic in which we were all engulfed. The noble and learned Lord, Lord Clarke, said that we should have locked down earlier but that everyone would have been up in arms. I disagree with him there; I and others on this side of the House called for that lockdown to come earlier and harder. However, that is not a point for today.

The Minister said at the outset that he was checking in with your Lordships’ House—it is an interesting, casual and American phrase, but he had a point. One of the flaws in this legislation is that it is seemingly unamendable by either House and not even subject to renewal by your Lordships’ House. That is at the heart of the problem and of where we need to go beyond this legislation. The Government need to come forward with amending legislation to the framework so that these provisions are not just reviewed or “checked in” on at periodic intervals. Parliamentarians, particularly elected ones, need to be able to amend this vast, draconian scheme.

I fear that the Government have squandered a great deal of not just parliamentary good will but public support over the last six months with a clumsy and asymmetric authoritarianism. Powers to ban mass gatherings and break up picnics may well have been necessary, but where were the additional powers and resources to go into unsafe workplaces or requisition manufacturing plants or private healthcare facilities and labs to crack this test and trace problem which is still such a scandal?

The Minister referred to the easing of care provisions. This may have contributed to the untimely deaths of so many of our older people, who should not have been sacrificed to the virus. He did not mention Schedule 21, a draconian set of provisions that has allowed the police to detain people for no good reason. We have learned from the Joint Committee on Human Rights and the review of the prosecutions that 100% of prosecutions brought under Schedule 21 have been found unlawful. The Minister really should have spoken to us about that.

Today’s debate will not achieve this, and neither will these Motions, but this legislation must be subject to amendment. The Government must do the decent thing, in terms of Parliament and the rule of law, and ensure without delay that this legislation is subject to amendment.