Beyond Digital (COVID-19 Committee Report)

Debate between Baroness Fraser of Craigmaddie and Lord Hain

Wednesday 6th September 2023 Grand Committee

[Baroness Fraser of Craigmaddie (Con)]

My Lords, the Covid committee was the first committee that I sat on after entering your Lordships’ House. I have to note that I joined after this particular report was published, but I was involved with all the other reports that our wonderful chairman, the noble Baroness, has just referred to.

I commend this report to the Committee. It marks a very first step for me in learning lessons from the pandemic. I went on to serve on the Adult Social Care Committee and am now on the Communications and Digital Committee. Our report on digital exclusion, published in June, builds hugely on the work of this report. Many of its recommendations are echoed in the digital exclusion report. I want particularly to highlight the notable and distinct lack of overall responsibility for digital policies in government. Digital is an issue that cuts across the remit of all government departments. Being digitally literate and engaged is an expected skill and, as both reports make clear, digital skills are as important to everyday life as learning to read or count.

However, this report is not just about digital. Its title is Beyond Digital: it is about the world we all live in now, a hybrid world. As the report sets out, the future was always going to be a hybrid one; the pandemic just meant that the future is here now.

As the noble Baroness said and the noble Lord, Lord Hain, just mentioned, the committee exposed the huge inequalities in how people experienced life during Covid. People who had no gardens were severely restricted in their access to open spaces. People who could not afford computers or an internet connection were cut off from work, school, services and society. People, such as the disabled and the elderly, who relied on others to help them exist every day had vital services withdrawn with no notice or consultation and were basically left to get on with it. None of these inequalities is new, but they were multiplied enormously by the pandemic.

What is interesting to me is to ask: what has happened in the years since? My experience comes from the world of health and from Scotland. I need to declare various interests here: I run Cerebral Palsy Scotland and I chair the Scottish Government’s National Advisory Committee for Neurological Conditions. The Covid public inquiries are under way in Scotland and in the UK, and I am giving endless evidence to the Scottish committee at the moment. I hope that both inquiries are able to learn lessons and do not just seek to apportion blame, because I do not think that would be helpful to anybody. I particularly want to learn the lessons of what we do not want ever to happen again.

It was concerning to see the arbitrary identification of what services were deemed essential and what services were dropped. For example, carers going into people’s homes were classed as key workers, whereas support health service workers—AHPs—became online only. Disabled people were being told in all the national communications that they were more vulnerable to Covid and yet what happened was that the services that they rely on to keep them well and active were being cut. I can tell your Lordships that you can achieve only so much through an online physiotherapy appointment. However, people with long-term conditions such as cerebral palsy rely on allied health professionals such as physiotherapists to enable them to keep well and to be able to function, yet somehow these services were seen as less important and were withdrawn— I make the point again—without any consultation with the people who relied on them.

As a result of my lived experience—to coin a phrase that the Government seem to like—I know of various developments since the publication of this report. In my organisation, we have developed a “virtual first” way of triaging people who come to us to use our services. The Scottish Government have published guidance on virtual versus face-to-face acute neurology consulting and they are preparing work for neuro- psychology in this area. We have to acknowledge that for some people this is an efficient, effective and easy way to use services—I point to people who live on the Scottish islands, those who need to take time off work to attend appointments or people who have caring responsibilities. However, we have to be clear what “virtual” means. For example, an acute neurologist in Aberdeen can absolutely have a detailed virtual appointment with somebody living in Orkney but only because they might have local health professionals on site to assist with that virtual appointment. When in-person is essential—for example, making a diagnosis of such conditions or if people do not understand the terminology of what is being discussed—it is important that that is prioritised.

My experience suggests that the NHS is indeed moving in this direction and developing effective hybrid service provision, but I want to see much more movement in the digital space on data. Where is the data, how do we use data to support people moving from different services, who holds the health data and how is it safely accessed and shared? Such developments must incorporate health and social care. Although we may be seeing progress with the development of data platforms within the NHS, social care has a long way to go before the data that it needs and the data that it holds are accessed and shared with others to enable people who we, during the pandemic, labelled as vulnerable to be supported to live and thrive.

The report also touches on education in schools. We already know that many pre-existing problems were faced by children with exceptional needs. They are more likely to live in poverty and less likely to have had access to new technologies, both of which have been linked to less intensive home learning during the pandemic. The report highlights how children’s social development was compromised by the closure of schools—again, I hope that we never do that again without serious consideration. Schools are so much more than places just for academic learning. I witnessed the impact on families who were struggling with children with cerebral palsy and trying to juggle the needs of their disabled child, without support and without the respite usually provided by schools, with the needs of siblings, perhaps trying to hold down a job while working from home, all at the same time—a frankly impossible task.

Granted, evidence from Scope to our committee outlines the advantages of online learning for some disabled children who are able to learn at their own pace. However, other evidence, such as that from the Nottingham Centre for Children, Young People and Families, emphasised that it is more difficult for children without traditional literacy or verbal communication skills to sustain interaction on-screen. While we learn from the pros and cons of online learning, it is my hope that we never again leave families with disabled children to cope on their own at home without access to local, in-person support.

In the report, Scope—I come back to Scope—highlighted some of the advantages of increasing reliance on digital technology in supporting some disabled people to work from home, facilitating more flexible working patterns and reducing the issues and stresses associated with commuting, for example, all of which I support. However, in my various working environments, from Parliament to my professional interests, as laid out in the register, there is too often an either/or approach to in-person or remote working. Insisting on just going back to a pre-pandemic way of working per se flies in the face of what is happening, whether that is in the retail sector, or about the impact of travel on the climate or on the ability to attract a wider pool of talent—or, frankly, on economic efficiency measures. Is hybrid working the best of both worlds or is it a tentative middle ground in which we find ourselves at this moment? I do not believe that we know where the world of work will land. This report recommends that the Government ensure that employment legislation is fit for the digital age. For me, this is still an evolving space and employers need to be supported to implement the flexibility required for their individual business needs.

In conclusion, if this report was a useful first step in looking at the impact of the pandemic, the intervening years since the first lockdown have seen some concerning trends that suggest that we have not done enough to make things better. Enabling people to flourish in a hybrid world means tackling digital exclusion and supporting digital skills. I look forward to future debates on our report from the Communications and Digital Committee. It also requires us to tackle the systemic inequalities exposed by the pandemic. We have to understand what we mean by essential in-person services. We need to work with disabled people and the organisations that represent them to understand the impact of online versus face-to-face services on their lives and we need to reimagine how we deliver social care. I also look forward to debating the report from the Adult Social Care Committee in due course.

The pandemic reminded us what really matters in our lives: personal freedom, celebrating with our loved ones, caring for friends and family, a stable economy, a vibrant NHS and happy, healthy, well-educated children. Let us not forget that as we move into our hybrid world.

[Lord Hain (Lab)]

My Lords, I just want to notify the Committee that I am not able to speak because I cannot stay until the end. I should have been taken off the speakers’ list, as I was told had happened.