Hospitals: Maintenance

Baroness Foster of Oxton Excerpts

Thursday 9th February 2023 Lords Chamber

[Lord Markham (Con)]

We are assessing best practice around the world in order to design them. That is exactly the point: we are taking on board things from the Netherlands and all round the world to make them state of the art and world class.

[Baroness Foster of Oxton (Con)]

I do not know how many hospitals have been completed, and I accept that there is a huge programme. But what I do know is that, since we came into power, in Liverpool we have had the brand new, state-of-the-art Liverpool University Hospital, a multi-billion pound hospital that has opened recently; Alder Hey Children’s Hospital, a first-class, world-renowned children’s hospital which has been opened in the last few years; and a huge cancer research centre—all within three miles of each other. I am sure there must be many others around the country. Does my noble friend the Minister agree with me on this?

[Lord Markham (Con)]

Yes. Now I am no longer holding anyone up in terms of time, I welcome noble Lords to visit places like Liverpool hospital and Chase Farm Hospital, where they will see brilliant examples of state-of-the-art hospitals. There will be many more—in fact, 40—going forward.

North East Ambulance Service

Baroness Foster of Oxton Excerpts

Monday 23rd May 2022 Lords Chamber

[Lord Kamall (Con)]

I completely agree with the sentiment expressed. We should be grateful to all public service workers. They were put under immense strain during the early days of Covid and beyond, and still face some of those issues. There is no doubt that the extra pressure that people face in the workforce can have an impact on their behaviour. Going back to the point made about culture by the noble Lord, Lord Hunt, we have to look at incentives and disincentives, and why people behave in a certain way. We have to not only question that but ask what we can do better in the future. That is the point of learning. We want people to be as transparent as possible, and to feel free to come forward and explain where things have gone wrong.

[Baroness Foster of Oxton (Con)]

My Lords, this is not just about the ambulance service; it is about a culture that is endemic throughout the NHS. I have spent most of my life dealing with the aviation industry, which learned decades ago that if you cover things up, whether deliberately or not, you will never get to the source of the problem. This is why we have such high standards in that industry. Does my noble friend agree that, until and unless we take a fresh look at this and have a no-blame culture, which will then encourage people to come forward if they see things that are not working, we will not get past where we are today?

[Lord Kamall (Con)]

I begin by paying respect to my noble friend’s experience in the aviation sector. Noble Lords who took part in the debate on the Health and Care Bill will know that, when we spoke about HSSIB and safe space, that concept came from learning from the air transport industry and—I hope I get this right—the air transport accidents board, with respect to transparency. When that industry was able to have a frank, open culture and people felt free to step forward without fear of prosecution, it was found that people were frank and could learn from mistakes. This is what we are hoping to do with HSSIB, in the same way—to let people come forward, have a frank and open discussion about what went wrong, and make sure we learn from our mistakes. This is the important thing that we want to learn from the air transport industry; we hope that it will help us to improve the culture for health and care workers.

Covid-19: Lockdowns

Baroness Foster of Oxton Excerpts

Wednesday 9th February 2022 Lords Chamber

[Lord Kamall (Con)]

Once again, the noble Baroness makes the point that this paper has not been peer-reviewed. That is an important consideration. The Government were quite clear that they introduced measures including lockdown—in the face of some opposition, but with the support of the Benches opposite—because, on the balance of epidemiological and other evidence, it was important to prevent and reduce the risk of transmission of the disease.

[Baroness Foster of Oxton (Con)]

My Lords, many decisions taken during this pandemic led to unintended consequences across the board. Apart from the devastating economic impact on business and industry, the children of the United Kingdom were most badly affected. Mental health problems escalated, particularly due to lockdowns. I hope that I never live to see another lockdown in this country. Can the Minister tell the House exactly what the NHS is doing to address this particular issue?

[Lord Kamall (Con)]

My noble friend raises an important issue about the trade-offs that had to be considered when the Government announced the lockdown and plan A measures. They also announced measures to restrict the transmission of the disease. Costs and benefits had to be weighed up. It was often a nuanced decision. We are clear about the backlog in tackling mental health issues. In debates on the Health and Social Care Bill, many noble Lords across the House have expressed the importance of tackling mental health issues in this country. We hope to put that at the forefront of future health policy.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021

Baroness Foster of Oxton Excerpts

Wednesday 15th December 2021 Lords Chamber

[Lord Trefgarne (Con)]

My Lords, I have had the privilege of being a Member of your Lordships’ House for a very long time. I was sitting on the Benches opposite back in 1977, when my late noble friend Lord Carrington, then Leader of the Opposition, and the late Earl Jellicoe moved the cancellation of sanctions on Rhodesia. That was a mistake, and it would be a mistake to vote down the regulations today.

[Baroness Foster of Oxton (Con)]

My Lords, I saw a notice recently outside a restaurant. It read: “If you’d like to know how it feels to be in the hospitality sector during this Covid pandemic, just remember the ‘Titanic’ when it was sinking and the band played on.” Well, we are the band. Here we are, 21 months on, and it feels like we are going backwards.

Let us take a short trip down memory lane. Covid arrives, and it is March 2020. The Chinese authorities already knew that there was a problem several months before but did not decide to tell the WHO until the December—but there we are. So we go into lockdown. There are daily press conferences. There is new language: “Protect the NHS”, “Hands, face, space”, “Stay at home”, “We need to flatten the curve”. We needed to do that, but it would be for only a few weeks and it was for the greater good—quite right. “Go out once a day, but only for essential goods.” Spend hours queuing in Sainsbury’s car park, two metres apart, in the rain. “Close your businesses, do not travel, do not visit your neighbour, but it’s just for a short time.” “Don’t see your boyfriend—it’s for the greater good.” “We need to close all the schools.” “Teach your children from home.” “You won’t be able to see your loved ones in a care home, but that’s also for the greater good.” And we went with that, because it was for the greater good. But we are where we are now. Finally, it was: “You can’t see your GP if you’re ill. It is too dangerous.”

So what do we do next? We tried to comply. Of those who did not comply, some were arrested. They were arrested for sitting on a bench, having a cup of coffee. Perhaps they had already been out that day. But that was not the answer. Nevertheless, we looked ahead. I am nothing if not optimistic. There was a temporary release over summer, and, by autumn, it had started again. “But it’s okay; it’ll be fine for Christmas. The vaccines are coming, so please bear with us. It’s for the greater good.” And we did, and I am a huge supporter of the vaccine programme.

But families were still separated. Millions were home alone. Meanwhile, the economy went into freefall. Mental health issues have been raised. The number of suicides increased, and NHS waiting lists have grown and grown, with people becoming more and more ill. Then it arrived; it was the silver bullet, and it was such a relief. This vaccine programme has been fantastic; I am a huge supporter.

When the vaccine arrived we were told that, once we had got the over-70s jabbed, we would start to get back to normal. But then it was the over-60s. Then we had to wait for the over-50s, the over-40s and the over-20s. Then it was the 12 to 15s.

So, 21 months on, we were looking forward to Christmas again, but then the omicron variant arrived—talk about bad timing. “But don’t worry,” said the chairman of the South African Medical Association, Dr Angelique Coetzee, “you’re the most vaccinated country on the planet, the symptoms are mild and not one practitioner has prescribed oxygen.” But here we are. We feel as though we have been marched up the hill, as though we have taken one step forward and two steps back.

The headlines roared. Mainstream media have gone into overdrive. We have 10 cases and one death, but, as my noble friend asked, what were the causes? Did that person die of it, tragic though it is, or with it? We would like that information. There are approximately 10 cases a day. But we have also had the modelling figures. By April next year, we could have between 25,000 and 75,000 deaths, and 200,000 cases a day. They are the modelling figures, which sum up where we are. It is a very difficult situation. The question is: where will it end?

We cannot keep people in perpetual fear and we cannot knee-jerk from one day to the next. The hysteria is flooding the airwaves, and the consequences on the public are horrific. With a heavy heart, I find it difficult to support the Motions today, but I urge the Government to seriously rethink how we take this forward. I ask my noble friend to do that because, finally, coercion can never be the answer. Persuasion is much better. If we can have a frank and open discussion and hear arguments from both sides, that is how we will move forward.

Coronavirus Act 2020

Baroness Foster of Oxton Excerpts

Tuesday 26th October 2021 Grand Committee

[Baroness Foster of Oxton (Con)]

My Lords, I will begin by reflecting on how we arrived at this point today: a gentle reminder of the course of this pandemic might be useful. In September 2019, four months before the rest of the world was alerted to Covid-19, the Chinese authorities were temperature-testing passengers at Wuhan and other airports across China. I spent more than 20 years in the aviation sector prior to my 20 years’ travelling to Brussels and Strasbourg, so you could say that I have landed at quite a few airports. However, I had never seen, in my entire career and in my life, such a measure ever taking place. However, it was not until the end of December 2019 that they let it be known that there was a problem. In the run-up to Chinese new year, thousands of nationals and others, living and working across Italy and the rest of Europe, flew to Wuhan and elsewhere to celebrate new year—only to find that it was cancelled. So they flew back. They were none the wiser. Europe was on holiday—skiing in Italy, France, Spain and Austria—and oblivious to the situation, quite rightly. And so it unfolded.

But it was not the first time. In 2002, SARS broke out in China and, yet again, the World Health Organization was not notified for six months. Fortunately, by comparison, it was not as lethal; nevertheless, it is known that Covid-19—or SARS-CoV-2—is closely related. Sadly, this virus has killed millions. The World Health Organization has not been allowed to investigate thoroughly, but the thinking is that it must have come from a lab. So I just wonder when the Chinese authorities will be held to account, as they continue to propagate the source as a wet market—which, ironically, they are again operating across China.

As we look at the consequences, we should also put the situation in context. Fear of the unknown caused all Governments across the globe to react quickly, and the first lockdown was supported, I would say, by the vast majority of the country. We did everything that we were asked to do: hands, face, space; isolated, stayed at home, did not mix; and practically washed our hands raw to save the NHS. The silver bullet would be the vaccine—and they were right. It was a phenomenal success, which I wholly support. But these measures have continued, off and on, and the consequences have been horrific.

Under the Act, citizens were arrested for sitting on a park bench. People were followed by drones just for going for a walk. Police were going into private premises to check whether people were there. And it got worse: locking up students on campus; closing schools and businesses across the UK; the Government telling people whom they could talk to and sleep with; and locked-away, vulnerable elderly people, many of whom never recovered. Daily mainstream media, particularly the BBC and Sky News, were always frightening the life out of most of us—and the £300 million budget will continue until next year.

So the vaccine was a godsend. They said once the over-50s were vaxed, we could open up—but it did not happen. We waited, with the population becoming more anxious and ill by the day. Yet, despite the success of the vaccine programme, the sword of Damocles still hangs over our heads. Some scientists, medics and politicians want to bring back restrictions now—which I vehemently oppose, along with any imposition of a domestic vaccine passport.

That brings me to the context. In 2020, according to the ONS, 680,000 people died in the UK. Approximately 70,000 had Covid on their death certificate. The average number of deaths ran at 1,800 a day. The major causes were dementia, cancer, heart disease, strokes et cetera. About 10% of those had Covid on their death certificates, and I understand that around 5% died directly from that awful virus. That averaged about 90 people a day—and that is 90 too many, because we want to eliminate this, hopefully, at some stage in the future. But it is not easy.

Fortunately, the vaccines are effective and the medicines now available are truly ground-breaking, with the majority fully recovering. Although the elderly are still at risk, the over-65s are now back to normal for this time of year. Positive tests are predominantly among older teenagers, who are not at risk. For those keen to impose plans B, C and anything else, the fact is that 200,000 teenagers have been referred for mental health treatment in the last three months—that does not even come into the elderly and the vulnerable—alongside the millions of patients waiting for diagnosis and treatment on the NHS. Front-line medics are waiting to operate but patients are not being referred, because of Covid restrictions, by GPs and others. Along with the Nightingales, the NHS spent £400 million a month requisitioning 8,000 private beds and 20,000 staff, and managed to refer eight patients a day.

That brings us to the true cost; this is just the tip of the iceberg. The Coronavirus Act 2020 is past its sell-by date. Notwithstanding the urgency to legislate speedily, it is blindingly obvious that the Act has major flaws. There was no parliamentary scrutiny, and even now it is a take-it-or-leave-it approach every six months. This legislation affects people’s everyday lives and criminalises ordinary behaviour. It continues to use delegated rather than primary legislation to implement changes in policy. New laws come into effect at very short notice; there are no impact assessments—or very few—and little debate. They continue to portray public health advice as having the force of law, which is wrong. This is unacceptable and highly dangerous, and results in police forces acting beyond their powers by enforcing government guidance rather than law.

I have outlined my thoughts on some of the actions taken so far. As mentioned, it has been difficult to debate, as anyone challenging the status quo is seen as some sort of anti-vaxxer or troublemaker. It is about listening to all sides of opinion, so I conclude by noting that many scientists and medics do not agree with some of the decisions that have been made. As mentioned, the mainstream media is still bringing messages of doom and gloom on a daily basis, nearly two years on. The time has come to manage where we are.

Other countries have been mentioned but let us look at Scandinavia. A month ago, Denmark, Finland, Sweden and Norway lifted all restrictions. They stated that we need to get back to normal. I agree. Living in fear is not living at all. I therefore urge my noble friend to actively address the lack of scrutiny and parliamentary debate as we move forward.

--- Later in debate ---

[Lord Kamall (Con)]

Before I answer that in more detail, perhaps I may say that we are not putting SAGE into a subordinate role. It is independent and we rely on its advice. However, as I mentioned, we also rely on the Chief Scientific Adviser, the Chief Medical Officer, the UK Health Security Agency, the NHS and others, and balance up views within the scientific and medical professions. I hope I have also laid out the range of data that is examined. The decisions are data-led. We look at immunity, the ratio of cases to hospitalisations, proportional admissions and so on to see whether the data suggests that the NHS will be overwhelmed. That is what leads to the difficult decision-making and balancing up whether the time is right.

One noble Lord—I think my noble friend Lord Ridley —and many others referred to the research of the London School of Hygiene & Tropical Medicine showing the range of views. Some scientists are saying that the virus will grow while others are saying that if we keep doing what we are doing and rely on the booster vaccines, the numbers will drop off. As one can imagine, there is a range of views but I reassure the noble Lord, Lord Hunt, that we have not relegated SAGE. It is independent and we listen to its advice, as we listen to the advice of others.

On face coverings, the point made by my noble friend Lord Robathan was interesting regarding people who say they are in favour of face coverings but, as he sees when he travels on public transport, a smaller percentage wear them. That shows some of the difficulties in polling, whereby there are stated preferences but also revealed preferences. Although many people say that they will do things, one should judge them by their behaviour. I note that my noble friends Lady Foster and Lord Ridley also raised concerns about the efficacy of wearing face masks.

SAGE evidence states that face coverings, if they are worn correctly and of suitable quality, are likely to be most effective, at least in the short to medium term, in reducing transmission indoors where social distancing is not feasible. Reviews by the UK Health Security Agency in June 2020 and January 2021 found evidence that the use of face coverings in the community helped to reduce transmission. Once again, we have a range of views on the efficacy of face masks.

My noble friend Lord Robathan talked about schools, universities and transmission. In universities, there have been low case numbers among students since the end of the 2020-21 academic year, although there have been slight increases in recent weeks.

My noble friends Lady Foster and Lord Ridley asked why the Act was not being repealed. Correct me if I am wrong, but I believe the noble Baroness, Lady Fox, also asked that. Throughout the pandemic, the Government have been clear that the measures will not be in place any longer than absolutely necessary. That is why we are expiring a number of powers in the Act and intend to expire even more when, we hope, there will be a significant landmark in our progress. The two-year lifespan of the temporary provisions of the Act was chosen to ensure that powers remain available for an appropriate length of time and can be extended by the relevant national authority.

My noble friend Lord Balfe asked about test and trace, and the cost. We have released £280 million in funding thus far, which is broken down as follows: £114 million to cover the costs of the main test and trace support system, £116 million for discretionary payments, and £50 million for administrative costs.

My noble friend Lord Naseby asked about minority vaccine uptake. He asked what the Government were doing to drive uptake among ethnic minority communities. We are well aware of this issue and a lot of work is being done with a number of local community associations to work out the best way to reach them. Only yesterday, I asked the noble Baroness, Lady Benjamin, about how we could tackle particular demographics and got some very valuable advice from her on how we could focus. I fed that into the department, so hopefully that will be part of our strategy. What we have seen is pop-up temporary vaccination sites at many places of worship and community locations. One of the things we have been advised is to go to where the unvaccinated are and to see how we can pursue a targeted campaign.

The noble Baroness, Lady Brinton, asked whether there would be a charge for lateral flow tests. Anyone in England can continue to order free lateral flow tests. I am afraid that I am going to run out of time, so I will write to noble Lords.

[Baroness Foster of Oxton (Con)]

May I just make a point? My noble friend obviously spent a lot of time on certain aspects of this debate, but he tended to skip a little bit past the issue of whether plan B would be introduced. My question is—because I think it is very key—what exactly the benchmark would be to introduce something such as plan B. The NHS has been overwhelmed every year that I can remember during the winter for the last however many decades. At the moment, fewer than 5% of hospital beds are currently occupied by patients with Covid. I appreciate it is under pressure—we might have more flu cases, et cetera—but I would like a little bit of clarification on what the Government would see as that benchmark, because this is a big decision that I would not actually support.

[Lord Kamall (Con)]

I thank my noble friend for that question. One of the difficult things about answering it—believe me, it frustrates me as much as it does the noble Baroness—is that there is no set indicator, no one silver bullet or trigger point. There is a range of indicators that we will balance up to measure how they will affect the NHS and whether the NHS will be overwhelmed.

I know it has been a difficult 18 months, and people across the UK have risen to the challenge of Covid-19. We hope that the Government’s support package has helped to safeguard jobs, businesses and public services. With continued perseverance during the autumn and winter months, supported by only those essential powers remaining in place, subject to the scrutiny of noble Lords, I hope that we will get through this. I thank noble Lords for their contributions to this debate and previous debates: their expertise and the range of views expressed are hugely appreciated. I also thank everyone across the UK for the sacrifices that they have made over the period.

I end by repeating my earlier plea to everyone to do their bit. As my right honourable friend the Secretary of State for Health and Social Care made clear, quite small changes can make a big difference. Both my noble friend Lord Naseby and the noble Baroness, Lady Merron, mentioned messaging. We all have a role to play in combating this virus, especially during winter, which we know will be a challenging period. We can all do our bit by washing our hands regularly, continuing to wear masks in crowds and on public transport, testing regularly where appropriate, staying at home when we feel unwell, and, most importantly, getting fully vaccinated against both coronavirus and flu—and urging friends and family to do so. By remaining vigilant together, we can help limit the spread of the virus in the months ahead. I commend the regulations to the Committee.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021

Baroness Foster of Oxton Excerpts

Tuesday 20th July 2021 Lords Chamber

[Baroness Foster of Oxton (Con)]

My Lords, on my election to the European Parliament more than 20 years ago, it became clear early on that the Commission—or the Executive—wielded great power. There were no business impact assessments, despite our enacting primary legislation. The Commission was not keen to change the status quo, but some of us were, and eventually it gave way—albeit reluctantly. But the battles continued, as it would never admit that it was wrong. As for us, the politicians, a little courage and fortitude to hold your ground is very difficult and it is so much easier just to give in. The EU sought more and more centralising powers and aimed to micromanage every element of our lives, so we left—quite literally. When the vaccine debacle blew up last year, it summed up why we had had to go. We wanted to take back control—well, most of us did, anyway.

I do not underestimate the challenges in making the most difficult decisions that Ministers have had to make. Initially, the British people wholeheartedly supported the actions that were taken. The vaccine was and is the silver bullet, and we all bought into it. However, in my view, the hand of the state is now riding roughshod over the will of the people, still controlling everything we do and how we are allowed to think. If you question, say, a lockdown or a mask, you are accused of wanting to “let rip”—not my words. If you publicly disagree, you are normally too stupid to understand, and if you actually demonstrate then obviously you are an anarchist, which the majority plainly are not. So when Ministers turn up to the Dispatch Box, hiding behind the 2020 emergency powers Act, without a full business impact assessment and wishing to broaden the scope without consultation, that is a step too far.

I am a great supporter of the vaccines but I will not support coercion or anyone being forced to have it to keep their job or feed their family. This debate is now moving away from public health and into the realms of state control. The goalposts move daily. The public and businesses have no idea what is happening next. Contradictions abound. “Ping-gate”, as it is called, is causing chaos. It was always advisory but the public were deliberately kept in the dark. Thousands of workers and children have been self-isolating who are fit and well—500,000 last week. Test and trace is all over the place while, in my view, forcibly testing school children with no symptoms has been an outrage.

And so to holidays. The Minister decides and announces that France is now in amber plus, despite the fact that the beta variant is in Réunion, which is 6,000 miles away. It is a bit like a new “foxtrot” variant emerging in the Falklands. Portugal went back to amber—naturally, post the Champions League—and the Balearics are where all the families go, so they are in amber too, but not if it is a pilot. At concerts in Liverpool three months ago, Royal Ascot, Wimbledon and Wembley there was no distancing and no masks and there have been no spikes so they were not dangerous.

This brings me to SAGE. Some 366 members sit on 10 working groups and committees, 18 of whom remain anonymous. I do not question their integrity but they are unelected, wielding powers that affect our freedoms, movement and association with people. It beats me how they would ever agree—but they do not, really, because different medics and scientists contradict their colleagues on mainstream media every day, normally those appearing to want to wallow in bad news. The behavioural commissions admitted that they had used scare tactics and propaganda to make the public comply—terrified, more like it.

So here we are, 18 months down the line. Ministers and politicians cannot continue to hide behind the science, advisers, focus groups and opinion polls. It is about being accountable, transparent and bold. Can you imagine a Thatcher Government or the likes of my noble and learned friend Lord Clarke and my noble friends Lord Tebbit, Lord Lamont, Lord Lilley and Lord Forsyth, or many others in this House, not rigorously challenging the advice?

In conclusion, no one gave any Government the authority to take away the civil rights that we earned over centuries. We fought and died for them. No Government can demand respect; they have to earn it. We, the people, will take back control. We will get back to normal. So it behoves the Minister, along with his colleagues, to make sure that that happens. It gives me no pleasure to speak out against my own Government but, in my view, to remain silent today would have been remiss of me.

Covid-19: Government Handling and Preparedness

Baroness Foster of Oxton Excerpts

Tuesday 8th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness is entirely right. It was known at the very beginning and it was clearly understood that those in social care—and those who support those in social care—were in the gravest possible danger in such a pandemic, and we were focused from the beginning on giving them the right amount of support. The Cygnus report correctly identified that, and that was why we put provisions for social care into our action plan from the very beginning. It is unfortunately a truism that those who are most vulnerable are, I am afraid, at greatest risk from such a pandemic, and those who support the vulnerable will shoulder a huge burden. That is why we have put in a large amount of resources to support those people and why, when the inquiry comes, we will undoubtedly focus on how we can improve those processes.

[Baroness Foster of Oxton (Con)]

My Lords, I will move on to another point. At the end of May, Portugal was deemed safe to host the Champions League final; five days later, it was not, despite 100,000 tests by the authorities with only six positives. This caused tens of thousands of people and businesses horrendous disruption and distress. Will my noble friend, on my behalf, kindly remind the Secretaries of State for health and transport that using emergency powers with no debate and with both Houses not sitting yet again is wholly unacceptable and can no longer be tolerated?

[Lord Bethell (Con)]

My Lords, I completely share my noble friend’s frustration at the situation. Of course we all enormously regret the fact that our efforts to open up international travel were unfortunately reversed because of the presence of dangerous variants of concern in the Portuguese community—in this case, particularly the Nepal variant of concern. However, I cannot agree with her that quick decisions based on accurate data are not appropriate in the depths of a pandemic. It is absolutely right that we move quickly to close down a change of transmission and that we protect the vaccine from variants that may present a severe danger to this massive national project.