Covid-19: Care Homes
Baroness Fox of Buckley Excerpts(3 years, 5 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bethell (Con)
My Lords, I do not quite understand the noble Lord’s figures. As of 14 March 2020, the seven-day rolling average showed that there were 51,741 discharges a day from hospital, of which 1,123 were from hospitals specifically to care homes. That was at a moment when our testing capacity was 3,000 a day. A month later, on 15 April, the rolling average was 22,000, of which 548 were discharges from hospitals specifically to care homes. By that date, the testing capacity was 38,766.
Baroness Fox of Buckley (Non-Afl)
My Lords, we need granular details such as dates and decision-making processes not to play the blame game but because we need to understand precisely how Covid got into care homes. In that context, can the Minister tell us when and why the policy decision was made to make vaccines mandatory for care home staff, going against the Government’s stated opposition to jabs for jobs and against the crucial ethical principle of medical consent? Does the Minister understand that for care home workers, vaccinated and non-vaccinated, this looks like decisively shifting the blame from official culpability for the scandal of how Covid got into homes on to hard-pressed front-line workers?
Lord Bethell (Con)
My Lords, we are in the middle of a consultation on mandatory vaccinations for care home staff. One thing I would remind the noble Baroness of is that the vast majority of infections in care homes last year were through staff, not through discharge.
Covid-19 Update
Baroness Fox of Buckley Excerpts(3 years, 5 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Fox of Buckley (Non-Afl)
The Minister has said several times that there are grounds for optimism. Does he not realise that this delay has caused despair? The Minister urged opponents to sit in the seats of decision-makers. Can I urge him to sit in the seats of the trashed events industry today and those likely to lose their jobs in hospitality, sport, theatre and so on? I appreciate that many people and the public remain nervous of living with the virus, despite the wonders of the vaccine. However, is it not the job of the Government to lead with courage, to reassure people not to be unduly frightened or succumb to fatalism, and to protect the unquantifiable non-Covid-related social fabric of society, which they are tearing up?
Lord Bethell (Con)
My Lords, I sympathise with those in the events and hospitality industry. As I said a moment ago, it is an industry I have a huge affection for. I worked in it for many years and I know through my friends and family who work in it how hard hit it has been, in particular for those who work on a casual basis and enjoy it from an aesthetic point of view as well as needing work of a casual nature. But these decisions are tough and hard. It would have been easier, perhaps, to have given ground in areas where we have been pressed and lobbied, but we have, where necessary, made the tough decisions based on the science and the advice that we have from clinicians in order to protect both life and the economy. At the end of the day, we do not have an economy if we have a pandemic running through our society. We do not have trust and we do not have people going out and about and enjoying normal lives if there is disease. That is one important reason why we have backed the decisions we have made.
Covid-19: Poverty
Baroness Fox of Buckley Excerpts(3 years, 6 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bethell (Con)
My Lords, the noble Baroness is entirely right that it cannot be for either the law or the Department of Health to solve a national challenge. That is why the Prime Minister has committed to appointing a cross-ministerial board. It needs the co-ordination and focus of many different departments that handle health, social welfare and the culture of the country to tackle these tricky, long-standing and difficult challenges.
Baroness Fox of Buckley (Non-Afl)
Could the Minister add the levelling-up agenda to the arguments for not delaying opening up on 21 June? Overcaution at this stage would be particularly devastating for ordinary working people. Even if the cost-benefit analysis is post hoc, I ask the Minister to start looking now at the health impacts of lockdown, not Covid as such, on the less well off. The health impacts of being confined in overcrowded houses, no gardens for kids and worries about job security are likely to have taken their toll, and we need to learn from what has happened.
Lord Bethell (Con)
My Lords, it is a difficult fact that males working in low-skilled elementary occupations, such as security guards, had rates of death more than three times higher than the general population. That illustrates that often those in the most difficult jobs face the greatest threat of infection. The best thing we can do for the economy is to get rid of this virus, for which we need vaccination and testing, and that is the Government’s focus.
COVID-19 Variant: Travel Guidance for Local Authorities
Baroness Fox of Buckley Excerpts(3 years, 6 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bethell (Con)
My Lords, I completely object to the false premise of the question. I cannot tell you how hard we are working in collaboration with local authorities, directors of public health and the incredible rhythm of regional partnership teams, regional team updates and the huge amount of data and interaction between all parts of government. It is absolutely phenomenal, and the characterisation by the noble Baroness is just not right. Where I completely agree with her is that we are working as hard as we humanly can to get the vaccine out to everyone, we are doing absolutely all we can to spread testing to all areas where there are outbreaks and we are working extremely hard to improve all those systems.
Baroness Fox of Buckley (Non-Afl)
Does the noble Lord agree that in one regard, government communication has been brilliantly successful? In Laura Dodsworth’s new book, A State of Fear, she exposes how the nudge unit, behavioural scientists and SPI-B weaponise fear. She quotes the statement:
“The perceived level of personal threat needs to be increased among those who are complacent, using hard-hitting emotional messaging.”
I genuinely want to know: can the Minister explain why the Government are so adept at deploying huge resources to communicate scary messages but seem so inept in communicating the trust and common-sense messaging he has just explained here but did not manage to explain to local people, which is why they are so confused?
Social Care: Person-centred Dementia Care
Baroness Fox of Buckley Excerpts(3 years, 6 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bethell (Con)
My Lords, according to the briefing before me, the 2020 dementia challenge commitment to spend £300 million on dementia research over five years has been delivered already, with £344 million spent over four years. However, I am happy to clarify that point with the noble Baroness, just to ensure that I have got my briefing correct.
Baroness Fox of Buckley (Non-Afl)
My Lords, one cruel aspect of dementia is how the condition gradually eats away at a sufferer’s individuality. In the context of this disorientation, with individuals forgetting who they are, one key to clinging on to personhood is family and friends. Can the Minister ensure that any Covid inquiry looks at the specific problems of those with dementia in care homes, who were deprived of any visits from relatives and forcibly isolated from familiar faces, robbing them of the resilience to fight the virus? Will he consider that, as a quarter of those who died of Covid had dementia, this one-size-fits-all approach to protecting the vulnerable did not work and makes person-centred dementia care all the more important?
Lord Bethell (Con)
My Lords, I am afraid it is beyond my reach to define the terms of the inquiry, but I entirely endorse the noble Baroness’s depiction of the very cruel dilemma we have faced over the last year: between safety—the preservation of life—and the care, love and consideration we owe to older people, particularly those with dementia. It has been a horrible and extremely uncomfortable dilemma. I pay tribute to those in social care who have sought to navigate it as thoughtfully as they could, but there is no doubt that it has been a horrible moment.
Care Home Occupancy Rate
Baroness Fox of Buckley Excerpts(3 years, 7 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bethell (Con)
My Lords, I note the intelligence from the Alzheimer’s Society, but I emphasise it is not the responsibility of central government to raise the occupancy rates of care homes. This area is supplied mainly by the private market. Players may choose to leave the market if occupancy rates fall, and local councils have been provided with more than £6 billion that should be drawn on to support the sector.
Baroness Fox of Buckley (Non-Afl)
My Lords, a number of unpaid at-home carers have told me that even though their relatives in dire need of care home residency have been offered places, they have turned them down because of heavily restricted family visits, the invidious 14-day quarantine rule and restrictions even on taking doubly vaccinated relatives for a walk in the spring sunshine. Will the Minister acknowledge that moving to a care home can be distressing, and depriving new residents of family support when settling in will inevitably impact on occupancy? When families liken taking up occupancy to sending relatives to prison, surely it is time to review guidance using today’s data, rather than as though Covid were still rampant and vaccines ineffective.
Lord Bethell (Con)
The noble Baroness makes a perfectly fair point. Moving into a care home is a difficult and potentially stressful experience. Moving in at a time of Covid, when, as the noble Baroness rightly points out, there are heavy restrictions, is very difficult. Those restrictions are in place to save lives. They are under constant review, and when the infection rates warrant leaving them behind, we will make that decision.
Alcohol Harm Commission: Report 2020
Baroness Fox of Buckley Excerpts(3 years, 7 months ago)
Grand CommitteeRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Fox of Buckley (Non-Afl)
My Lords, there is always a danger when addressing lifestyle choices that policymakers indulge in overreach. The relentless war on alcohol emanating from public health over recent years is no exemption. This can mean the state trampling on individual agency, a point well made by the noble Lord, Lord Bethell, in yesterday’s Question on obesity. There is another danger when reports are commissioned to look at harms: that they see only harms and see harms everywhere. This can mean a disproportionate focus on risk and a loss of balance.
My concern about the direction of this report is that it moves away from the sometimes exaggerated health harms of individual alcohol use into the broader social and economic realms. In doing so, it may deploy guilt by association by linking alcohol and drinkers with reprehensible behaviours such as domestic abuse, family neglect, crime and child suicide and with a financial burden on public services. There is also the danger of conflating causation with correlation. This can mean that harms associated with a small minority are projected population-wide. Indeed, the proposed illiberal solutions, such as minimum pricing, treat everyone as a potential problem drinker and alcohol per se as a harmful substance.
Surely we need balance. Alcohol is a legal and enjoyable part of human engagement and relaxed sociability for millions of people. The direction of this report could disproportionately penalise and unfairly demonise the vast majority of those who drink responsibly.
Finally, can we remember the hospitality industry? With lockdown, some 10,000 pubs, clubs and restaurants were forced out of business in 2020. That awful loss of jobs and livelihoods looks set to continue. We have seen curfews and pubs open but with alcohol banned in Scotland and Wales. This smacks of a joyless puritanism. I appreciate that I am almost a lone voice here, but there is no democratic mandate for “Temperance UK”. Policy interventions should be targeted, discreet, and aware that alcohol can be harmful but usually is not, and that grown-ups should be free to choose how they use alcohol regardless of risks.
Care Homes: Guidance
Baroness Fox of Buckley Excerpts(3 years, 7 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Bethell (Con)
I can only express complete sympathy for the noble Baroness’s points. She puts them extremely well. Undoubtedly, the pressure put on residents and their family members is profound and I regret it enormously. However, this is not an arbitrary or thoughtless measure from the Government; it is to protect residents who have shown themselves to be highly susceptible to the disease. We have instances of serious illness and death to remind us how important these measures are. The noble Baroness is entirely right that the protocols are in place in order to deter external visits. In terms of testing, the unfortunate truth is that the virus can harbour in someone’s body, undetectable, for days. We know from protocols around international travel that pre-travel testing catches only about 15% or 20% of those with the disease and it is for that reason that we cannot turn to testing as an alternative.
Baroness Fox of Buckley (Non-Afl)
My Lords, grass-roots relatives’ campaigns such as Rights for Residents, John’s Campaign and Care Unlocked describe this guidance as “false imprisonment”, “barbaric”, “cruel”, “treating residents as second-class citizens” and “more scandalous than any Greensill revelations”. I want to press the Minister. Can he really explain from a virus control point of view, as the noble Baroness asked, what the risk difference is between care home workers who leave those care homes, go about their business and then return and give personal care in the same home and a vaccinated care home resident who, after a family day out to the seaside, has to endure 14 days of solitary confinement? From a risk point of view, it makes no sense.
Lord Bethell (Con)
My Lords, there are two points of difference. One is that we can take certain measures to guide the behaviours of care home workers but we cannot mandate for every aspect of their lives. Secondly, care home workers wear PPE and that significantly reduces their infectiousness. We do not ask care home residents to wear PPE. Were we to do so, I think it would provoke suitable concern among residents and their families. As a result, we have to have these isolation protocols in place to avoid the spread of the virus.
Covid-19: One Year Report
Baroness Fox of Buckley Excerpts(3 years, 8 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Fox of Buckley (Non-Afl)
My Lords, I congratulate all those who have got us to a situation in which infections, hospitalisations, ICU admissions and deaths have tumbled, with so many millions of the vulnerable and ever-younger cohorts being vaccinated. It is an amazing achievement, but what does it mean? It effectively renders the virus endemic. It will join the range of respiratory viruses that circulate each winter and do not disrupt our lives—how brilliant. We should be celebrating today that the emergency is over—the data proves it. But the Government, bizarrely, will not admit it. I took the Prime Minister at his word when he claimed that he would follow the data not the dates, but as the data has improved, rather than a review of the road map, those dates seem fixed in aspic.
Some will say that, with only weeks or months before restrictions are lifted, it is churlish to complain about this element. But I remind noble Lords that, outside of here, each hour, each day and each week means more livelihoods destroyed, more industries being trashed and more self-employed made unemployed. It means the horrors of social isolation taking their toll on young and old, and the sheer humiliation for millions of citizens of being deprived of control over their own lives and of being condescended to with the slow drip, drip of their own freedoms dispensed from on high, for which they are expected to be grateful.
If the data shows that we have moved beyond an emergency, what possible moral or political justification can there be for prolonging draconian powers for a minute more than necessary? The Minister assured us—and it is reassuring—that the coronavirus legislation before us has retired unnecessary provisions. Good—but what is a bit worrying is that it contains some of the most extreme detention and disposal powers in British legal history even as we speak, such as the egregious Sections 21 and 22, yet this Government still think they are necessary. Does the Minister?
I am shocked and disappointed. I would have expected all politicians in a free society to be full of revulsion at the state’s acquisition of huge swathes of punitive powers. Even if you believed that over the past year they were necessary, would you not want to dump them as soon as possible? I find it cringe-worthy to hear the contortions that some are prepared to go through to excuse the extension of illiberalism well past its sell-by date.
The problem is that instead of these laws being reviled, too many seem content to normalise them as an appropriate long-term strategy to manage any ongoing public health challenges, even when there is no emergency. We have heard some brilliant speeches illustrating the dangers of that. When Dr Mary Ramsay from Public Health England said on the BBC at the weekend that we can expect restrictions on travel, laws forcing people to wear masks and social distancing to last for years, where was Matt Hancock with his “Cry freedom”?
Do noble Lords know how demoralising it is that the Government allow this dystopian future to be peddled out without contradiction? Do they realise that it leads people to ask what the point of the vaccine is? When there are knee-jerk statements and then careless talk of “jabs for jobs” or Covid certificates for pubs and pints, which are so divisive and potentially discriminatory, it all fuels fear and uncertainty about the future, as though freedom will never be restored.
What we need to do at the moment is to encourage people to be brave and resilient, so that we can energetically reopen society and reactivate the economy. Surely, if anything, it undermines the Government’s claim that the rapid rollout of the vaccine is working—and the Government told us it was the key to liberty and normal life if we roll it out successfully—if they then do not give back liberty or normal life. Will that not fuel anti-vax feeling? I worry that this refusal to repeal coronavirus legislation and to cling on to the rules dampens the mood of confidence and inadvertently fuels cynicism, because freedom is so elusive. Many people will say, “What is the point of being vaccinated?”.
Finally, many noble Lords have rightly complained about the paucity of debate and scrutiny of laws in the other place and here, but it is worse than that. Effectively, the Government suspended the public square, decommissioned the public and closed down debate. Shut down at home, the public were told to shut up and follow instructions. What a tragedy for democracy that, rather than galvanising the public and treating them as equal adults who can be trusted to take far more personal risk-based decisions, politicians on all sides agreed to use the law to change behaviour. Rather than encouraging a society-wide debate about how to balance risks and harms, or deploying creative bottom-up solutions to everything from the crisis in care homes to what is happening in schools, anyone asking questions not state-approved or rubber-stamped by SAGE was treated as a dodgy denier.
The Deputy Speaker (Lord Lexden) (Con)
The noble Lord, Lord Judd, whose name is next on the list, has withdrawn from the debate, so I call the noble Lord, Lord Farmer.
Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021
Baroness Fox of Buckley Excerpts(3 years, 9 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Baroness Fox of Buckley (Non-Afl)
My Lords, as the Minister has noted, retaining public trust is key, especially if we want people to go along with incredibly draconian and invasive tools in terms of isolation. It feels as though this is a one-way street. The Government asked the public to trust the police and the authorities rather blindly and yet, they will not trust people to make the most basic decisions, such as allowing them to assess any level of risk or threat that they might face. They then use threats of criminal conviction far too readily.
As we have heard from noble Lords, there is a lack of imagination when it comes to offering a generous settlement that would allow people to isolate without causing them and their families great hardship. I know many people who cannot afford to isolate; that is the reality and we have to face up to it.
Like the noble Baroness, Lady Neville-Rolfe, I worry about signing up to data sharing, privacy issues, a likely form of ID cards and police access to our most intimate information. These are anathema to a free society. This emergency should not blind us to the dangers of a constant expansion of police powers. Over the weekend, I noted that the Home Secretary and the Policing Minister are looking to extend some of the emergency restrictions on the right to protest. I fear that, unless there is a full public debate about the consequences for freedom of association and redrawing the relationship between the state and the individual, it will, in the end, fuel distrust.
I have one chilling piece of data, as the Government are interested in data. As of 26 February, a few days ago, 356 coronavirus-justified statutory instruments had been made law, without a draft presented in advance to Parliament, and therefore without scrutiny of their justification or proportionality. I want the Minister to understand that if he wants trust, he needs to assure us that there will be an emergency stop on the road map of this kind of democratic government as soon as possible. I am afraid that I am nervous about the rules that they keep bringing in after the effect.
The Deputy Speaker (Lord Haskel) (Lab)
As the noble Baroness, Lady Uddin, is not available, I call the noble Baroness, Lady Stroud.