Covid-19 Update

Baroness Donaghy Excerpts

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the rule of six treatment of children under 12 is extremely heartbreaking. I have three children under 12 and I find it very awkward. The CMO’s view, however, is crystal clear: children, whether under 12 or not, can be vectors of infection, and if a whole generation of children is infected with the disease it will roll through the generations to those who are older or vulnerable, as sure as night follows day. For that reason, we are holding the rule as it is.

[Baroness Donaghy (Lab) [V]]

I thank the Minister for his Statement and for confirming that the alert level is now at 4. If I heard him correctly, he mentioned that COBRA would meet tomorrow. On Friday I asked why COBRA had not met for four months, and he indicated that it had given way to COVID-O and Covid Gold. I looked these up on the government website; deep into page 15 it announced the names of the operational and strategic committees and their membership. I am anxious that there should be clarity and co-ordination of decision-making, proper consideration of spending public money and accountability in contracting. Can the noble Lord give me an assurance that there will now be better co-ordination at national level and better reporting of decision-making?

[Lord Bethell (Con)]

I pay tribute to colleagues and officials at Downing Street and the Cabinet Office who have organised an extremely detailed, flexible and fast-moving decision-making arrangement through the COVID-O and Covid Gold process. That has proven, as has often been discussed in this Chamber, incredibly quick at responding to events. In terms of spending, I pay tribute to my noble friend Lord Agnew in the Cabinet Office, who is leading the fraud and financial scrutiny efforts to ensure that the money spent on taxpayers’ behalf goes to the right places.

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

Baroness Donaghy Excerpts

Friday 18th September 2020 Lords Chamber

[Baroness Donaghy (Lab)]

I thank the Minister and the noble Baroness for the statement and understand that we are playing catch-up here. We have two minutes for life and death issues. That means that I shall have to focus on two questions. First, why has COBRA not met since 10 May? Secondly, what are the Government doing to create a testing and quarantine procedure at airports that is effective and will help our economy?

The Minister said that the Government would strain every sinew to give NHS emergency wards and care homes what they need. I believe he is sincere. However, the impression given is of a Government responding to the latest daily crisis, making impossible promises and failing to deliver. Regular meetings of COBRA, where strategy and resources can be discussed, with clear decision-making and communication, might just improve government competence.

Of course, the Government have to prioritise, but the effect on travel and the failure to adopt an appropriate quarantine policy is catastrophic for the economy. Months ago, an official SAGE report showed that testing of passengers on arrival at airports and then five days later would detect 85% of those infected. We need trade deals and we need our air transport. According to IATA, we will lose our place as the third-biggest global market unless we solve the testing and quarantine issue. One journalist compared the efficiency of the system at Keflavik Airport in Iceland with that of the UK, which he said felt “haphazard, inefficient and negligent”. When will the Government save airports and promote trade?

Covid-19 Update

Baroness Donaghy Excerpts

Monday 14th September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are discussing, among other things, the very regulations we are putting in place to protect the elderly and vulnerable. The rule of six, although not part of this provision, is an emphatic commitment to protect the people whom the noble Lord cites. I add that we are concerned about not only the elderly and vulnerable; we are increasingly concerned about the phenomenon of long Covid, which hits the young. It is one of our objectives to rid this country of Covid altogether and to protect all demographics.

[Baroness Donaghy (Lab) [V]]

My Lords, in answer to my noble friend Lady Thornton’s question about the alert level, the Minister said that to his knowledge it had not changed, although it was subject to weekly review. However, these are the Government’s own levels. How can the level stay at number 3, which means “virus contained”, when number 4 means “virus not contained”? Does the Minister really think that an average travel requirement of 6.4 miles to a testing centre, with 10% of people having to travel up to 22 miles, is acceptable after all these months?

[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.

Queen’s Speech

Baroness Donaghy Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness Donaghy (Lab)]

My Lords, I want to touch on the health service staff and on universal credit. I am very grateful to the noble Baroness, Lady Finlay of Llandaff, for raising the issue of hospital doctors on the third day of debate on the gracious Speech. She warned that more legislation would not lead to better care. There might well be some improvements for the health service in the long-term plan, but it does not take away the responsibility of the Government for their top-down reorganisation, their failure to fund the service adequately and their past treatment of staff.

In 2016 there was another important event—the referendum was not the only one. It was the hospital doctors’ dispute. The Government’s treatment of the hospital doctors was shameful. They were called greedy, while what they wanted was to be able to get home occasionally and spend more time with their families. Family breakdown and suicide rates are shockingly high among doctors, and professional support is patchy at best. Staff shortages through illness and failure to recruit put extra strain on all involved. Should we really be treated by doctors who are beyond exhaustion? The failure by the Government to deal with these issues will affect our health and that of the vulnerable in the future.

Let us not forget that the shortage of GPs was exacerbated by the Government’s action on their pensions. It became fashionable to attack public service pensions, and the outcome was that GPs decided to go in their thousands. Professor Ted Baker, the CQC’s Chief Inspector of Hospitals, has linked the issue of poor community care with the 50% of A&E departments that are failing. Patients are increasingly frustrated at not being able to have an appointment, and this will eventually be reflected in people’s attitudes to GPs and the health service. The Government use the right words, but their actions need to speak louder.

I turn now to universal credit. The Prime Minister has indicated his support for the continued rollout of universal credit. This is worrying in the light of so many structural problems. The DWP has hired 1,000 extra staff to develop a specialist intelligent automation garage. A unit based in Newcastle and Manchester is developing machine learning to check claims for fraud through 100 welfare robots. The details are secret, as the DWP has refused freedom of information requests to explain how it gathers data on citizens.

There are clearly huge benefits to be claimed from automated intelligence-gathering, but if the human element of the welfare state is being diluted, and the vulnerable end up in what has been described as a “digital poorhouse”, what are the human rights implications? As Ed Pilkington said in his excellent article:

“What happens if you are one of the five million adults in the UK without regular access to the internet and with little or no computer literacy? What if the algorithm merely bakes in existing distortions of race and class?”


There is evidence of a rising error rate. Some 5,700 people a month are affected by claims of incorrect data sharing between HMRC and the DWP. I ask the noble Baroness for assurances—if not tonight then after the debate—on human rights, transparency, the objectivity of algorithms being used and on how vulnerable claimants will get to speak to a human being.

Turning to the “controversial Managed Migration pilot”—not my words but those of the Secondary Legislation Scrutiny Committee in its seven-page commentary on 5 September—there has been strong criticism of laying the replacement regulations,

“on the cusp of the summer recess”,

and three months after the High Court judgment, using the negative procedure when it was clearly a matter for the affirmative procedure. Members of the House described it as “disrespectful to Parliament”. The Secondary Legislation Scrutiny Committee described it as a “tactical ploy”. I describe it as sharp practice. It has been stated that the DWP will publish an “evaluation strategy” by the end of 2019 and publish the evaluation of the pilot before returning to Parliament with further legislation to continue migration activity. Can the Minister say when the evaluation will be available to Parliament and when there will be a debate in this House on the managed migration pilot?

Finally, I will say a brief work on universal credit and the self-employed. I have said many times that UC is not fit for purpose for the self-employed because of its clunky methodology known as the “minimum income threshold”. It is estimated that about 700,000 families with at least one self-employed earner will claim support from universal credit. A study by Policy in Practice has revealed that this figure is likely to be a significant underestimate, which makes it all the more important for the Government to look at it again, and in particular at the vulnerable self-employed. If nothing is done, they too will end up in the digital poorhouse.

Academic Health Science Centres

Baroness Donaghy Excerpts

Tuesday 2nd July 2019 Grand Committee

[Baroness Donaghy (Lab)]

My Lords, I am grateful to the noble Lord, Lord Butler of Brockwell, for initiating this important debate. As he did, I took part in the debate nearly nine years ago introduced by the noble Baroness, Lady Finlay of Llandaff. I was a non-executive director at King’s at that time and an independent panel member of the National Institute for Health Research. I was going to say a bit about King’s but I think the noble Lord has covered that, and I will spare the rest of the company. However, I chaired consultant appointment panels for a number of years, and it was clear from the calibre of applicants, all with research and international experience, that the AHSCs were expected to provide an atmosphere in which they could work and flourish.

My first question to the Minister is: given the internationalism of the best clinicians, how will the Government ensure the flow of talent needed and maintain that standard? In her speech to the Association of British HealthTech Industries last month, she said that,

“we must be relentless in our drive to ensure that the UK maintains its place at the cutting edge of health innovation”.

Only yesterday, in repeating the Statement on the NHS long-term plan, the Minister referred to,

“more investment in research and innovation”.—[Official Report, 1/7/19; col. 1270.]

Does she consider £39 million sufficient to maintain AHSCs as centres of excellence? The Government have enjoyed a lot of good will from these institutions and structures. I wonder whether it has now worn a little thin.

The noble Baroness, Lady Finlay of Llandaff, is sorry not to have been able to take part in this debate; she is on her way to Bangor—I am sure that there is a song about that somewhere. She indicated that what she regards as the jewel in the crown could be in jeopardy. Grants are so hard to come by that we are not growing our next generation of researchers. What action is being taken?

I want us to be able to compete on the world stage to attract the best consultants, researchers and innovators and, of course, to keep pharmaceutical companies here in the UK, but this is ultimately all about people. Perhaps I may give two examples from King’s. The CAR-T, or chimeric antigen receptor T-cell, to which the noble Lord, Lord Butler, has referred, is treating adult patients with lymphoma. Mike Simpson, a 62 year- old solicitor from Durham, was one of the first to receive the treatment. He said:

“I’m incredibly grateful for being given the opportunity to have this therapy … I describe it as my L’Oréal treatment… because I’m worth it”.


King’s College researchers, along with Cambridge University, have identified why arteries harden and how a medication used to treat acne could be an effective treatment for the condition. Trials are due to start shortly. I am sure that such exciting and positive developments sometimes help us forget the shortage of, and growing need for, skills in the health service, but we should feel proud of them and ensure that they continue. I hope that the Minister can answer my questions.

Social Workers: Recruitment and Retention

Baroness Donaghy Excerpts

Thursday 16th May 2019 Lords Chamber

Asked by

[Baroness Donaghy]

To ask Her Majesty’s Government what is their strategy for increasing the number of social workers and improving their retention rate.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, the Government remain committed to supporting local authorities and other social work employers to meet their duties regarding social work workforce planning and helping them to understand best practice in recruiting, retaining and developing staff. We have invested over £1.2 billion since 2010 in supporting both mainstream and fast-track qualifying routes into the profession, and our improvements to the supervision and leadership that social workers receive support people to remain and progress in social work.

[Baroness Donaghy (Lab)]

I thank the Minister for that Answer but I do not think that they can fulfil their requirements or their responsibilities. Particularly for directly employed local authority social workers, workloads must be at red on the risk register and must have been like that for some years. Stress levels, staff shortages and the inability of some areas to recruit—there is a 26% vacancy rate in London—indicate that this must have a much higher priority than this Government are prepared to give. Will she give some more practical answers on how to stop the increasing numbers of social workers leaving the profession, how to recruit more—there has been a 6% drop—and how to get some support for a very pressed service?

[Baroness Blackwood of North Oxford]

I thank the noble Baroness for what is a very important Question. She is absolutely right that we have to ensure that we recruit and retain the social work workforce: it is vital and, like any employers, local authorities are responsible for ensuring that they have the right staff with the right skills. The Government also recognise that we have a role in supporting them. That is why we provide financial support to students who qualify as social workers. We make sure that those entering social work receive the best training possible, with some new programmes to support those who are newly qualified, such as the assessed supported year in employment, so that those who come in with quite a significant workload can be supported in their first year. We understand that high caseloads can be a challenge. Local authorities are responsible for the recruitment and deployment of social workers, but we work with them to think about how they can best manage the delivery of services and make caseloads manageable so that we retain those social workers who are vital to delivering care and support for some of the most vulnerable in our society.

The NHS

Baroness Donaghy Excerpts

Thursday 5th July 2018 Lords Chamber

[Baroness Donaghy (Lab)]

I thank my noble friend Lord Darzi for initiating this debate and I thank Nye Bevan for his towering achievement in setting up the NHS against concerted opposition—a miracle for those who had no money.

We still expect the NHS to cure all our social ills while tackling permanent supply and demand challenges. Government-imposed changes in legislation, reorganisation and financial stop/start policies make it difficult to plan for the long term and apply consistent recruitment and training policies.

If there is a chronic shortage of doctors, we import them. The Royal College of Physicians says that we are currently training only half the number of doctors required by 2030 and the cap on medical school places means that we reject half of all eligible applicants— 770 of them with at least three straight grade A’s at A-level. While I am not trying to correlate the possession of three A-levels with suitability, we should be training more in the UK. Instead, 700 rejected medical student applicants a year are studying to be doctors in the eight English-language medical institutions set up in former eastern bloc countries. This is crazy, and it is the responsibility of the Government. The recent announcement of more places is too little, too late.

The NHS cannot solve all our social ills. We do not have a proper social care system, and that has an immediate impact on hospital beds. Our GP system has been weakened to the extent that many patients do not have a hope of seeing their local doctor when they need to. There were 1 million hospital visits last year because of drug or alcohol usage. The human cost of obesity is appalling, but so is the cost to the health service, which has to pay for larger stretchers, beds and mortuary places.

It is vital that we improve transparency and accountability in our NHS. The Government abolished the independent review panels in 2004 and the recently established Healthcare Safety Investigation Branch plans to cover only 30 cases a year. Will the Minister say how the Government intend to invest in independent reviews, deal with complaints and protect whistleblowers?

The advances in medicine in the past 70 years are almost beyond belief. Some of the potential breakthroughs are exciting. One drug is being made from the strain of cannabis grown legally under Home Office licence. It has a high concentration of anti-convulsant and very low content of THC, the psychoactive compound. If approved, it could help up to 5,000 people with epilepsy. Research has shown that metformin, an anti-diabetes pill, also cuts the number of heart attacks, strokes and heart failures. Researchers call that repurposing.

Finally, I thank the BBC and ITV for their coverage of the 70th birthday of the NHS and for all the programmes that have been enjoyable, historical and absorbing. They have been inspiring and have made me realise that any future attacks on the health service will be met by an army of fierce defenders, all of whom have a story to tell.

National Health Service: Assaults on Staff

Baroness Donaghy Excerpts

Wednesday 20th June 2018 Lords Chamber

[Lord O’Shaughnessy]

I agree with the noble Baroness that it is scandalous and that we therefore want to support the Bill. I believe that it will have its Second Reading here on 29 June. I can confirm that the Government will be supporting the Bill.

[Baroness Donaghy (Lab)]

I am grateful for that reply from the Minister. I have the privilege of taking the Bill through its Second Reading next week. It will create, for the first time, an aggravated offence for those who attack all emergency workers, including paramedics, nurses, doctors and all those associated with helping NHS staff in emergency work, such as St John Ambulance and other volunteers, if they are doing emergency work. So I am thankful that the Government have provided time, and I hope that we will be able to get the Bill through quickly by the summer.

[Lord O'Shaughnessy]

I salute the noble Baroness for taking it through its stages in the House of Lords. I reiterate our support for it—not just the principles behind it but the specific measures in it. Clearly it is unacceptable to assault the very people who devote their lives to serving.

Breast Cancer Screening

Baroness Donaghy Excerpts

Thursday 3rd May 2018 Lords Chamber

[Lord O’Shaughnessy]

As always, the noble Baroness makes a very incisive point. The inquiry must look at whether there were signals and whether they were missed. That may be at the macro level or the micro level, with individual women saying to their GP, “Hang on, this is odd, I haven’t got this”. The problem has arisen because of the interaction between the screening process, which is due to run until a woman’s 71st birthday, and the extension, which was meant to run from a woman’s 71st birthday to the end of her 73rd year but was taking women into this clinical trial prematurely and randomising them. Hence, women in their 70th year did not get anything. It was the interaction of the two. It is technically quite devilish. A 70 year-old woman might or might not have known that she was due to have another one. This is one of things we have to get to the bottom of because, as the noble Baroness said, although this is about technology and computers, ultimately humans are at the centre of this problem.

The inquiry is primarily focused on the incident itself, but I imagine that if, during the course of its work, it finds out or establishes that other issues need to be pursued, such as increasing screening rates variation and so on, it will have the freedom to make those recommendations.

[Baroness Donaghy (Lab)]

My Lords, this is very close to home for me—I am probably not the only one in the Chamber. It was probably the breast screening programme that saved my life. I had no symptoms and if it had not been for regular mammograms, I would not have known. I am grateful to the health service, just as the noble Baroness, Lady Maddock, is.

The worry I have is that although I had a regular mammogram directly resulting from treatment every year for eight years, I was then told last summer at the age of 73 that the following year I would not be able to have a mammogram unless I went private. This seems to rely too much on people taking individual responsibility for their own health, which I support, but does not provide sufficient back-up for those who are perhaps fearful of having a mammogram. It is extremely painful for some women. The fear of it is still there. That explains why some of the take-up is quite poor. We have a duty of care for those in that position. Those of us who are vocal will do our best to look after ourselves.

My final point is that the cut-off is arbitrary and has a sniff of age discrimination about it. I agree with the noble Baroness, Lady Masham: there is sometimes an element in hospitals whereby perhaps you are not worth it any more. I feel obliged to say that I am still very active and working, just to make sure people think I am worth saving. That should not be the case and it ought to be reviewed. There is age discrimination. It might be just a clinical thing, but I cannot help thinking that there is some self-limitation when some of these clinical groups get together and decide what is appropriate for a woman, without consulting them as individuals.

[Lord O'Shaughnessy]

I know that the whole House will join me in saying that the noble Baroness is definitely worth it. Indeed, I am pleased to hear that her care was successful and that she is with us today. It is a very interesting question about age discrimination. We have again to separate it from the clinical advice, which I am reassured, having spent time with those involved in putting it together, is based on a proper weighing of costs and benefits—of course, that is inevitably in aggregate because we are talking about whole populations. Clinicians have autonomy to do things differently. Indeed, the offer we have given to women aged over 72 is that they can refer themselves and they will have an appointment if they want one. I can provide that reassurance to the noble Baroness.

There is perhaps a separate issue. There are sometimes problems of age discrimination in society and in the national health system itself. Could that be an issue regarding why signs were missed? We know that in some instances, the National Health Service has not been very good at listening to women on some of the issues we have debated in this House and that my noble friend Baroness Cumberlege is looking at in her review. This is a very good point that needs to be investigated properly: are there cultural reasons why signs that might otherwise have been picked up during these nine years were not? I can reassure her that the inquiry will look at this.

Social Care

Baroness Donaghy Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O'Shaughnessy]

Yes, I will certainly do so.

[Baroness Donaghy (Lab)]

My Lords, in the absence of my noble friend Lady Pitkeathley and the noble Lord, Lord Warner, I feel a sense of responsibility for seeking an assurance that all the evidence and issues that have been submitted to the various reports, not least Dilnot and the carers reports, will be put together as part of the consideration and that we will not reinvent the wheel. This is a well-trodden path; some of us are quite disappointed that we have got only to Green Paper stage. As my noble friend Lady Pitkeathley said only on Monday, we know what the problem is and what the answers are, so why cannot we just get on with it? Can we have an assurance that all that work will not be wasted?