Covid-19: One Year Report

Baroness Finlay of Llandaff Excerpts

Thursday 25th March 2021 Lords Chamber

[Baroness Finlay of Llandaff (CB) [V]]

My Lords, the National Mental Capacity Forum, which I chair, recently ran its eighth fast-track webinar during the pandemic. We called it “The good, the bad and the ugly”. I will focus on those three categories: good things we want to keep, bad things we should change and ugly things we must never see again.

The speed with which medical and public health research has been approved, instigated and reported shows that past bureaucratic systems can be abandoned. The speed of innovation has been impressive. The rapid return to clinical registers of doctors, nurses and other healthcare staff from retirement was commendable, but many were underutilised. Their knowledge and wisdom should be retained to mitigate shortages in NHS manpower by employing them to what they can do well to provide support to patients through availability for remote consultations and hundreds of other roles.

We should commend those who coped with the very difficult task of the terrible catalogue of deaths. Absolutely nobody wanted to see what we have seen. The bereaved will live with those memories for the rest of their lives. One of the greatest failings has been inappropriate rigidity and inflexibility over visiting when people were dying. We must balance risks and ensure that infection control and emotional support are achieved without compounding the anguish that so many have experienced. The inability to be with the person you love and to say goodbye has been awful. We never want to see it again. Blanket policies failed. The term DNAR, or do not resuscitate, is dangerously imprecise. The Care Quality Commission emphasises respect, open discussion and clarity over CPR.

Many of our simplest public health measures have been far too slow to roll out, compounded by mixed messaging. As a Bevan commissioner in Wales, I supervised the Distance Aware project—a simple prompt now adopted wholesale in Northern Ireland. We need to remain distance aware, probably for years to come, using the protective function of face masks and handwashing as basic infection control. Westminster must work better with the devolved Administrations for recovery.

We must also avoid vaccine complacency, maintain infection control and embrace new ways of working through the rapid rollout of technology, with working, voting, consultations and even mental capacity assessments online. But online living risks promoting loneliness, which has become an enormous problem. Safe meeting places, such as the hospitality sector, sports facilities or the myriad voluntary sector support services, are an important part of our infrastructure. In doing all this we must tackle head-on inappropriate use of alcohol and recognise the associated harms with its links to violence. Nutrition policies need to change to recognise the links between malnutrition, obesity and loss of life years.

We will never go back to where we were. In easing restrictions, consistent UK-wide messages based on evidence are essential. We face difficult decisions. We need to tackle social inequities far better, respect local and devolved services, which know their own communities, and build resilience for the next generation.