Residential Social Care: Staff

Debate between Baroness Fox of Buckley and Lord Bethell
Monday 6th September 2021

(4 months, 2 weeks ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, many young people do seek a career in social care. Many of them see it as interchangeable with work in retail and in hospitality; in fact, we have seen an enormous amount of displacement between those sectors during Covid. We have to make sure that as retail and hospitality open up, those who have moved to social care continue to stay in that setting. That is one reason we are investing in the kind of education arrangements I described.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, as the shortage of HGV drivers has led to a hike in their wages, does the inevitable increased staff crisis in care homes—effectively 40,000 to 60,000 workers will be sacked because of the illiberal mandatory vaccine for front-line workers—mean that they might get a decent amount? But seriously, does the Minister agree that any social care policy should prioritise improving working conditions and renumeration, and that this is key to the better protection of care residents and far more of a priority than obsessing about Covid at this stage in the pandemic?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the average turnover rate in social care is high, as noted by many noble Lords, as it is in some other sectors, including retail and hospitality. However, turnover rates are 8.1% lower in the past year among social care workers, down from 37.2% to 29.1%, which reassures us that many have in fact found it a fulfilling career.

Covid-19

Debate between Baroness Fox of Buckley and Lord Bethell
Wednesday 21st July 2021

(6 months ago)

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Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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Following on from the noble Lord, Lord Scriven, I want to ask specifically about the surprise in the Statement: the need for vaccination passports in nightclubs and other venues with large crowds gathering. It was a surprise because last year the Prime Minister called vaccine passports unnecessary and intrusive. More recently, the Vaccines Minister called them “discriminatory” and Matt Hancock, when in office, declared that they were a step too far and said that

“we’re not a papers-carrying country”.

It seems as though we are, because this is about making young people’s engagement in public life contingent on papers. Would the Minister comment on whether this rowing back on previous statements will fuel cynicism among the young and the conspiratorial thinking that, “You said you wouldn’t do it and now you’ve done it”? Some Conservatives told me that I am not to worry, that it will not happen and that it is just a plan to threaten the young into compliance. Can the Minister clarify that?

If nightclubs, football grounds, pubs and so on require vaccine passports, does that mean that bar staff, cleaners, bouncers, groundsmen et cetera will need proof of vaccination to keep their jobs? I am worried about another group of workers having vaccines mandated, this time in the hospitality industry.

Finally, does

“other venues where large crowds gather”

include political conferences? I am asking for a friend or two.

Lord Bethell Portrait Lord Bethell (Con) [V]
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My Lords, I make no apology for changing my mind during the pandemic. I will admit readily to the House that I have changed my mind and rowed back on all sorts of things that I thought I was certain about. It has been a learning experience, to put it politely, for all of us, and we have all had to adjust our thinking on lots of matters as the evidence and the impact of the virus have affected us greatly. So, no, I do not believe in conspiracy theories, as the noble Baroness specifically asked me.

We all have to be responsible for the fact that our health touches on those we sit next to and share air with. This is a public health truism that is self-evident and has become highly apparent. There is no way out of this pandemic other than through the vaccine; there is no other silver bullet. Therefore, we all have a personal responsibility to ensure that we are as safe as possible when we share space with other people. That is the principle with which we go into this and which we are applying when it comes to domestic certification. The guidelines and precise details have not been hammered out yet, but we will do it in a way that seeks to be as inclusive as possible and is considerate to many of the concerns that the noble Baroness quite rightly articulated.

Covid-19

Debate between Baroness Fox of Buckley and Lord Bethell
Thursday 15th July 2021

(6 months, 1 week ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My Lords, I will definitely consider the idea of a full-page advert, and I am grateful for that suggestion. I would also be very interested to receive a submission from my noble friend to the consultation, and, if he would like to copy me in on it, I would be glad to make sure that it gets through to the right people.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, I have listened carefully, and the mask obsession here seems to mask a certain reluctance to ever allow normal to return, even if it means a terrible toll on jobs, livelihoods or non-Covid health—so I am glad to hear the Minister being more balanced. However, I will bend the stick and ask him whether he will concede that many millions are demoralised that the Government’s irreversible freedom day comes with so many caveats that it feels like parole with an electronic tag and house arrest hanging over us like a sword of Damocles? Can we not get a bit more balance? On data, according to PHE on hospitalisations, of those who spent more than one night in a hospital with the delta variant at the end of June, 39% were patients who had gone to hospital with different conditions—so could the hospitalisations data perhaps be clarified, because I think that that would reduce fear and give a bit of perspective?

Lord Bethell Portrait Lord Bethell (Con)
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My Lords, the noble Baroness slightly underestimates the significant step that the Government have made in order to take advantage of the vaccine, try to get the economy moving and address the very considerable backlog that we have in the NHS. The Prime Minister deserves some praise for the way in which he has moved emphatically in this direction. Therefore, I am a little bit surprised that the noble Baroness has not done more to recognise that point. On the data, I would be glad to look at the number that she describes. It is not one that I recognise, but I would be glad to correspond with her on it.

Health: Dementia

Debate between Baroness Fox of Buckley and Lord Bethell
Monday 5th July 2021

(6 months, 2 weeks ago)

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Lord Bethell Portrait Lord Bethell (Con)
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I 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.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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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.

Lord Bethell Portrait Lord Bethell (Con)
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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.

Covid-19 Update

Debate between Baroness Fox of Buckley and Lord Bethell
Tuesday 29th June 2021

(6 months, 3 weeks ago)

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Lord Bethell Portrait Lord Bethell (Con)
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My 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.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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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.

Lord Bethell Portrait Lord Bethell (Con)
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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.

Covid-19: Care Homes

Debate between Baroness Fox of Buckley and Lord Bethell
Thursday 17th June 2021

(7 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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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 Portrait Baroness Fox of Buckley (Non-Afl)
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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 Portrait Lord Bethell (Con)
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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

Debate between Baroness Fox of Buckley and Lord Bethell
Tuesday 15th June 2021

(7 months, 1 week ago)

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Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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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 Portrait Lord Bethell (Con)
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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

Debate between Baroness Fox of Buckley and Lord Bethell
Thursday 27th May 2021

(7 months, 3 weeks ago)

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Lord Bethell Portrait Lord Bethell (Con)
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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 Portrait Baroness Fox of Buckley (Non-Afl)
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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 Portrait Lord Bethell (Con)
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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

Debate between Baroness Fox of Buckley and Lord Bethell
Wednesday 26th May 2021

(7 months, 4 weeks ago)

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Lord Bethell Portrait Lord Bethell (Con)
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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 Portrait Baroness Fox of Buckley (Non-Afl)
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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

Debate between Baroness Fox of Buckley and Lord Bethell
Monday 17th May 2021

(8 months, 1 week ago)

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Lord Bethell Portrait Lord Bethell (Con)
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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 Portrait Baroness Fox of Buckley (Non-Afl)
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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 Portrait Lord Bethell (Con)
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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

Debate between Baroness Fox of Buckley and Lord Bethell
Wednesday 28th April 2021

(8 months, 3 weeks ago)

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Lord Bethell Portrait Lord Bethell (Con)
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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 Portrait Baroness Fox of Buckley (Non-Afl)
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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 Portrait Lord Bethell (Con)
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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.

Care Homes: Guidance

Debate between Baroness Fox of Buckley and Lord Bethell
Wednesday 21st April 2021

(9 months ago)

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Lord Bethell Portrait Lord Bethell (Con)
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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 Portrait Baroness Fox of Buckley (Non-Afl)
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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 Portrait Lord Bethell (Con)
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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.

Care Quality Commission Report

Debate between Baroness Fox of Buckley and Lord Bethell
Tuesday 15th December 2020

(1 year, 1 month ago)

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Lord Bethell Portrait Lord Bethell (Con) [V]
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I completely endorse the noble Baroness’s observations. She is entirely right that the 66 case studies in the report make very harrowing reading. That is why the report was commissioned in the first place, as an acknowledgment that the current state of affairs is not acceptable and needs to improve. Overall, £4.5 billion is going to primary care and community health services, and that is additional money to be committed by 2023-24. It is part of the Government’s overall commitment in this area, and we look forward to publishing a White Paper on mental health shortly.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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I thank the noble Baroness, Lady Bull, for tabling this Question. The Care Quality Commission report is deeply shocking reading—the utter cruelty of using seclusion and segregation in care settings for people who cannot advocate for themselves. I note that the report recommends that families and advocates are involved in the development of care plans, and I fully agree with that.

Would the Minister comment on the unintentional consequences of Covid regulations in care homes, which means that there has been a huge expansion of the numbers of those who are secluded and segregated who cannot advocate for themselves? For example, there are those with dementia who have been locked away, deprived of contact with their advocates and loved ones and, equally, treated with undignified and inhumane measures. Will he look at the harrowing examples detailed by the Rights for Residents campaign, which will show him that it is not just a small number now but many more, sadly, as an unintentional consequence of government policy?

Lord Bethell Portrait Lord Bethell (Con) [V]
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My Lords, I would be grateful to hear from the Rights for Residents campaign, which sounds like an important and valuable contribution. I reassure the noble Baroness that the numbers of those who have undergone restrictive practices who have autism or learning difficulties do not appear to have risen during the pandemic. That is not to say that the current numbers are acceptable.

Puberty-blocker Drugs

Debate between Baroness Fox of Buckley and Lord Bethell
Thursday 10th December 2020

(1 year, 1 month ago)

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Lord Bethell Portrait Lord Bethell (Con) [V]
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I reassure my noble friend that people with gender dysphoria cannot access gender reassignment surgery under the age of 18, so young people are not eligible for the type of procedure that she describes. Gender identity services are clinically led and focus on enabling the young person to choose the path which suits their needs. They support children to explore their feelings, recognising that there is not a one-size-fits-all approach. This seems an appropriate approach in the circumstances.

Baroness Fox of Buckley Portrait Baroness Fox of Buckley (Non-Afl)
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My Lords, I warmly welcome the court ruling that children cannot consent to treatment to suspend puberty. Will the Minister join me in saluting the bravery of Keira Bell for taking this action and echo her message that being a tomboy or not liking stereotypically girly things does not make girls or young women any less female? Crucially, will he clarify that this ruling does not undermine the 1985 Gillick judgment giving young women the legal right to reproductive healthcare without parental consent and that the false and scaremongering misinformation circulated by certain organisations, including Amnesty International and Mermaids, is driven by a particular agenda rather than a concern for trans- gender people’s rights?

Lord Bethell Portrait Lord Bethell (Con) [V]
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My Lords, I salute the court’s thoughtful and lengthy judgment, which brought enormous clarity to an area which is very important but which has also caused concern and ambiguity. The court has made it clear that children under a certain age are not ordinarily able to make the kind of decisions that have previously been asked of them, but there are openings. No one under the age of 16 can now be referred on to puberty blockers unless a court rules that it is in the child’s best interest. These are helpful clarifications and we look forward to further work to clarify this area.