(4 years ago)
Grand CommitteeMy Lords, although I welcome the early expiry of 12 temporary provisions, it is concerning that these were the only sections removed from the Coronavirus Act. Despite the Government claiming that, as part of the one-year review of the Act in March, they had combed the legislation to ensure that what remained was necessary or proportionate, and that there was robust justification for retaining all the provisions, no details were divulged, no criteria published, and no cost-benefit analysis made available. It is worrying if this was it.
When MPs voted to extend the wide-ranging powers for another six months to the end of September, the then Health Secretary stressed that legislation had been a crucial part of the Government’s strategy. Indeed, legislation has almost become a substitute for strategy, and what the noble and learned Baroness, Lady Hale, described as a “bewildering flurry” brought in in haste. I note that it is harder to remove than install provisions. There seems no hurry to get rid of them. Matt Hancock also said that, although the Act was essential,
“we have always said that we will only retain powers as long as they are necessary.”—[Official Report, Commons, 25/3/21; col. 1115.]
Are these remaining powers necessary now? With a new Secretary of State for Health, can the Minister explain whether there is any reason why, after 19 July, any element of the Coronavirus Act will be retained? Will the new review date of 30 September be brought forward? If not, why not?
It is interesting to look at these 12 specific provisions because they tell of a mindset in drawing up the original legislation: one of a worst-case scenario, deploying the precautionary principle and therefore making laws that would perhaps have been better suited to informal arrangements. Sections 8 and 9 on emergency volunteering were intended to come into force should the delivery of health services be at risk because of the pandemic. Despite significant workforce pressure, the NHS never faced that crisis, but I know many qualified former health workers who volunteered but were never called upon. They were demoralised and felt demobilised. Maybe it is worth looking to them again for the huge backlog in the NHS. The point I am making is that the voluntary instinct was not utilised enough.
Looking at Sections 25 to 29 on food supply, it was assumed that draconian powers would be needed to force those connected with the food supply to share information, when in reality the food industry collaborated and shared data voluntarily. The law assumed the worst, and perhaps politicians should have mobilised positive solidarity rather than using the law as a coercive tool.
One reason why I mentioned the change of personnel at the Department of Health is because, despite the Minister telling me last week that the different tone and messaging on regulations has been driven by data, it feels more like a philosophical shift in emphasis from coercion to trust. The former Health Secretary spoke about the laws with a certain inflexible zealotry, once infamously responding to the Derbyshire police’s over-the-top fining of two women for merely meeting for a walk and a coffee with the quip that
“every time you try to flex the rules that could be fatal”.
This seems rather different from the new position, to quote Sajid Javid:
“We owe it to the British people … to restore their freedoms as quickly as we possibly can”.—[Official Report, Commons, 28/6/21; col. 46.]
Hear, hear to that. Indeed, the Secretary of State noted in an article this weekend not only the economic costs of continuing lockdown measures but the health costs—a helpful antidote to those who seem sometimes oblivious to the non-Covid harms caused by the virus. I accept the moving account given by the noble Lord, Lord Moynihan, of those non-measurable harms that will potentially last far longer than the virus itself.
I also note the damage that has been wreaked on democracy over the past 16 months, during which freedom has been treated as a privilege, not a right. We cannot assume that democratic norms will simply spring back to the pre-March 2020 level once 19 July happens. History tells us to be wary of the dangerous precedent set. Considering the lack of scrutiny and abuse of the legislative process, which has had enormous negative consequences for every aspect of our public and private lives, we need to avoid complacency. Following on from the comments of the noble Baroness, Lady Brinton, on civil liberties, that is why it is the responsibility of everyone in this House and in the other place to use even such rubber-stamping exercises as this in this Room to demand that every emergency measure brought in since March is expired and deemed as unnecessary as those in the regulations we are discussing. It is time to move on.
(4 years ago)
Lords ChamberI accept the noble Lord’s point. The corollary is right: there are those who have not had the engagement they once had, and it is fair to assume that that has accelerated their decline. The role of charities and communities in trying to provide that back-up support is critical. That is why we have provided £515,000 to the Alzheimer’s Society to support its Dementia Connect programme.
I am very glad to hear the response from the Minister on virtual consultations, but can I press him to urge an immediate reinstatement of face-to-face memory services and recognise that for those with cognitive and sensory impairments, Zoom is especially disorientating—it is for me, let alone anyone else? Will he also urge GP surgeries to open fully face to face—they are not at present—as doctors often spot signs of dementia when patients access services for other reasons? I think that would help.
I completely accept the noble Baroness’s point. It is clear that the benefits of digital do not play out for the elderly and those who face dementia and other similar conditions in the same way as they do for younger people and those accustomed to and familiar with Zoom and other digital services. She is entirely right that the symptoms and features of dementia, Alzheimer’s and Parkinson’s are sometimes picked up only through face-to-face engagement. That is why we are working hard to reopen GP surgeries and to ensure that such appointments can take place.
(4 years ago)
Lords ChamberMy noble friend’s comments are very much appreciated and taken on board. On his question about daily lateral flow testing, he is very perceptive and correct. This is an area that we have been exploring for some months, and we are working extremely hard to bottom it out with rigorous clinical trials—clinical trials are difficult to nail down, by their nature, but we have invested substantially in them. He is right that, for schools, for international travel and for contacts—those three things—daily testing may well offer an alternative to 10-day isolation. That would be a huge relief to many in the country, and it is something that we are very focused on delivering.
I welcome the change of tone when the new Secretary of State said that the big task ahead is to restore our freedoms—freedoms no Government should ever wish to curtail. Regime change is a bit disruptive, so I ask the Minister: are all the department behind this new approach, because it is in rather stark contrast to the Secretary of State’s predecessor’s more doom-laden, illiberal approach? As we have seen in this debate, there seems some reluctance, at least within Westminster, to allow fellow citizens to embrace freedom.
The noble Baroness is quite right to ask the question, but I would say to her that it is not actually the regime that has changed, although the regime has changed; it is that the data has changed. Last Tuesday, I sat through Covid Gold, which is our big set-piece data session—a two-hour deep dive into national and local data. Every week for the past 70 weeks, that has been a very chilling experience where we have looked at the progress of and tactics of this awful virus, and I have often left it with a very heavy heart. Last week, I genuinely felt that we had reached some kind of turning point and, on Friday, when I sat in my kitchen, I felt a great weight beginning to lift off my shoulders for the first time in a very long time. I cannot disguise from your Lordships that there may well be more surprises left in this virus. I cannot promise that I will not be standing at this Dispatch Box giving bad news at some point in future, but, right now, I am more optimistic than I have ever been, and I think that the Statement by my right honourable friend the Secretary of State reflected that.
(4 years ago)
Lords ChamberMy 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.
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?
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.
(4 years ago)
Lords ChamberThe 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?
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.
(4 years, 1 month ago)
Lords ChamberMy 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.
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.
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.
(4 years, 1 month ago)
Lords ChamberMy 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.
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?
(4 years, 1 month ago)
Lords ChamberMy 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.
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?
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.
(4 years, 2 months ago)
Lords ChamberMy 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.
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.
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.
(4 years, 2 months ago)
Grand CommitteeMy 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.