Covid-19: Response

Debate between Baroness Newlove and Lord Bethell

Wednesday 3rd June 2020 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, I start by echoing the words of both noble Baronesses and give thanks for the contribution of Lord Rea to the House. I did not know him well but have read the many testaments to his work. He clearly lived a full life and made a massive contribution to the House, for which we should all be thankful.

I echo the noble Baronesses and give a moment of thought to all those who have had deaths in their family and among their friends. I have lost both an aunt and a godfather to Covid in the last few weeks; my family has not been untouched, and I think—

[The Deputy Speaker (Baroness Newlove) (Con)]

My Lords, I think we have lost connection. Is the noble Lord, Lord Bethell, back?

[Lord Bethell]

Yes, I am back. I apologise for my broadband. I was addressing the question of the Prime Minister’s words. I have no doubt that there will be a judgment of history on whether the Government have made every decision correctly and whether every call we have made was right. There will have been mistakes, for which I am happy to put my hand up. But I am proud of the response to Covid, not just from the Government but from everyone involved.

With the leave of the House, I will single out five things. I am proud of the Lighthouse Labs. I am proud of the Nightingale hospitals. I am proud of the fact that the NHS stood up under relentless pressure when so many people thought it would fall over. I am proud of the fact that we ducked the worst effects of the epidemic, which many people forecast might lead to deaths of up to 400,000 people; everything that we know about the disease suggests that those forecasts were quite right and utterly realistic. Of course, the death rate is far too high. I have reiterated my thoughts for anyone who has lost someone and I feel very sad about the number of people who have died. And I am very proud of the scientific response, particularly by our vaccine researchers, who are world-leading in all this.

There has been an amazing collaborative effort by all parts of society, from the SAS to returning nurses, from front-line NHS workers to the private sector. It makes me profoundly sad when I hear people talk so negatively and so angrily about the way this country has responded. I totally put my hands up as a member of the Government for any mistakes that we may have made in our decision-making, but I ask noble Lords to speak a little more positively about this incredibly impressive effort and to remember that, when they speak in a negative way about the response to Covid, they are addressing not just the Government and the Government’s response. They are addressing everyone from postal workers to shop workers, the NHS and everyone who has been involved in this response. Having worked very much at the centre of things, I feel genuine pride in this effort.

The noble Baroness, Lady Thornton, asked about the PHE report. It is important, but it is preliminary research. It does not answer every single question about the complex issue of the differential rates of infection and mortality from this disease. It remains a mystery why some groups are much more profoundly hit, and it is not clear whether the differences are behavioural, social or genetic.

I say to the noble Baroness, Lady Thornton, that it appears that those areas of the NHS with the highest prevalence of infection are not those involving the front-line workers, where the use of PPE has actually protected workers from the worst effects of Covid. It has been among other parts of the hospital—in the canteens, among the porters and among back-room staff—that the prevalence has been highest. That is because infection has often happened where workers have touched each other or socialised. I mention this just to put paid to the idea that there has in any way been an irresponsible attitude, or that the NHS has in any way inadvertently put those with vulnerabilities in harm’s way.

I am not quite sure if I completely understood or heard the precise reference, but I did hear the phrase “structural racism” in the NHS. I react very sceptically towards that phrase and, to be honest, with a profound sense of anger. The NHS is not a racist organisation. This has been raised in previous debates and I reject it wholeheartedly at every level. If I have misunderstood the remarks of the noble Baroness, Lady Thornton, I hope that she will clarify them, but I want to make a clear stand on that point. There is clearly work to be done to understand better why some groups—older people, BAME groups and those who are overweight—have been hit so hard by the disease; that work is ongoing.

The noble Baroness, Lady Thornton, asked about test and trace. I want to be clear about a few things. As my noble friend Lady Harding said at its launch, this is a huge project which has been put together at pace and not every part of it is working immaculately. I admit that there are ragged edges but in essence it is working incredibly well. The people involved are working extremely hard. It is a coherent, thoughtful and, I believe, in many ways a world-beating outfit. I would like to ask anyone who is interested in finding out more about it to let me know and I will be glad to talk them through it or to invite my noble friend Lady Harding to go over the work of the test and trace programme. I genuinely believe that anyone who finds out about its workings cannot help but be impressed by it. I want to make a special testament to the private contractors who have made a contribution to it. I do not agree with people who denigrate those who work in the private sector for doing so—quite the opposite. My experience of working with private contractors who have contributed to the response to Covid has left me extremely proud of them and impressed by the results.

On local engagement, if it was the case that directors of public health, local environmental officers and local infection directors were not engaged, that is no longer true. The joint biosecurity initiative has done a fantastic job of briefing and tying in the local response. Tom Riordan from Leeds, who will be known to many noble Lords, is leading the charge on this. He is doing a fantastic job of working with local groups. Our response to Covid is now more local at every level and, as a result, is much better than it was.

The turnaround time for tests is important and is the focus of the operational priorities of the test and trace programme. Some 85% of the tests carried out through the drive-in centres are now done within 24 hours. The data is shared with GPs, although it is very hard work to tie in the test and trace computer program with the GP computer program, and more work needs to be done on this. I do not hide the fact that we are working extremely hard to bottom out and make more secure the operational arrangements of the test and trace programme. It was a huge infrastructure project which was thrown together very quickly, but I pay my thanks to those who are making extremely rapid progress on it. Perhaps I may share a point with noble Lords. Last weekend, I took a “secret shopper” test. I booked it at 6 pm on Saturday. I took the test at 11 am on Sunday at the Wroughton centre on the edge of Swindon, and I got the result at 6 pm on Monday showing that I had tested negative, of course. It was an extremely easy process. It took me 10 minutes on Saturday and 10 minutes on Sunday. The text I got was very clearly marked as being from the NHS, as it was, and it was a thoroughly professional and easy-to-handle experience. I invite all parties to try to support this important national project rather than denigrating it, because it relies on public trust and we really need the public to believe in it. They will do so only if our leaders support it.

I utterly agree with both noble Baronesses that people need to be able to understand the data—it is a really important project—but perhaps I may share a genuine and honest dilemma. We have sought to publish data as promptly and in as much quantity as we humanly can. The result of that, though, is that it is not all audited and checked and therefore it is often revised. That creates the kind of problems which David Norgrove has quite rightly identified. We are working extremely closely with David to try to close the gap. We are working closely with the Office for National Statistics to ensure that all future data is fully audited, but it is usual in peacetime to take months to iron out these processes before the publication of official data, and data is not published on a daily basis for exactly the reasons identified by both noble Baronesses. We have real and consistent data published by the ONS which is properly audited. That is completely robust data and we try our hardest to make right the data that goes into the daily updates. However, there is a tension between being prompt and being procedural, and we have sought hard to try to hit the right combination of the two.

The noble Baroness, Lady Thornton, asked about shielding. I reassure her that in no way are these announcements made for politically motivated reasons. We have been asked by many groups to address inconsistencies in the shielding arrangements. It is entirely reasonable for the Government to lift the shielding arrangements; that was done at speed and we are working extremely hard to ensure that those who were shielded are informed properly and that GPs and the NHS are part of that process.

Both noble Baronesses, Lady Thornton and Lady Brinton, asked about care homes. I reassure them both that 60,000 tests are carried out per day, and all those homes with outbreaks are being tested and retested. It is too early to tell exactly, but we are well on the way to hitting our 6 June target, and the amount of testing going on in care homes is extremely high.

As regards the anecdotes concerning CCGs being under pressure, as I understand it, to accept elderly people who are coming from hospitals into care homes, I would be very grateful if the noble Baroness, Lady Brinton, would write to me with those examples, because they are shocking, if they are true, and are completely against government policy and the agreed procedures of the NHS. I would be very happy to take up the case if she could give me chapter and verse.

On the future of the NHS, the noble Baroness, Lady Thornton, quite rightly asked what kinds of lessons we have learned. I will share two. First, one of the good things that has come out of the Covid epidemic is that the social care sector, the NHS and the public health sector have worked much more closely together than they have for a long time. We need to learn the lessons of that and figure out ways to ensure that they work even closer than they do right now. As regards the backlog, the Government completely acknowledge the challenge of catching up with the massive amount of procedures and medical work that will need to be done once Covid is under control. We have already made a full and clear commitment to funding the catch-up in that backlog, and we are putting in place the necessary preparations to staff and facilitate the catch-up process.

The noble Baroness, Lady Brinton, asked about the decision on lifting lockdown. It was the right decision and it was entirely consistent with advice from the CMO. The numerical threat level, which is organised by the CMO, is completely independently arranged, and I regard it as a testimony that it has been held at a high level, which shows the scientific independence of that process.

On preventing future flare-ups, I will flag two very important developments. First, I have already mentioned the joint biosecurity centre, which is currently being organised by Tom Hurd, and which is proving to be a really important development in arranging local responses to local flare-ups. These flare-ups may be anything from a school, a business or even, in the Weston case, a whole hospital. Being able to mobilise both the expertise and the analysis, support and data in order to jump on these flare-ups is an essential part of keeping a lid on the epidemic, and I pay tribute to the work of the biosecurity centre.

Secondly, we are working extremely hard to stockpile the necessary medicines and supplies for the winter. Our focus is very much on preparing for the winter in every possible way to prepare the NHS, social care and our public health response. We are using the summer months to mend the roof and ensure that we are in good shape. We very much hope to avoid a second spike, but we are fully aware of and preparing for the threat.

I remind both noble Baronesses that many European countries had more than 50% of their deaths in the social care sector. In fact, a low proportion of deaths in Britain have been in the social care sector, relative to other European countries. I appreciate completely that that is of no interest or value to those who have lost loved ones in the social care sector; I mention it only so that we have a sense of perspective.

On our response to and actions on the threat to BAME workers in the NHS, clear guidance has been sent from the top of the NHS to trusts, asking them to put in local measures that each trust regards as appropriate to protect BAME staff. This is entirely the right response to encourage and allow local trusts and the social care sector to make their own arrangements in their response. We continue to analyse the numbers to understand this problem more fully.

[The Deputy Speaker]

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief so that I can call the maximum number of speakers. I will now pass the chair over to the noble Lord, Lord Haskel.

Covid-19: Care Homes

Debate between Baroness Newlove and Lord Bethell

Wednesday 20th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is quite right to focus on the importance of social care, but I think she unfairly characterises the effort made to ensure that social care is protected. The social care action plan announced on 15 April has been enormously important and extremely effective. Also on 15 April, we rolled out outbreak testing for all symptomatic care home staff and residents. We brought in extra funding on 16 April, with £850 million in existing social care grants. There has been new guidance and more money for local authorities, and we have launched a workforce recruitment campaign for care home staff. An enormous amount has been done. Care homes were always vulnerable, and we have sought to put every possible measure in place to protect them.

[Baroness Newlove (Con)]

My Lords, I am grateful for the Statement. Unfortunately, I am having hearing issues, which are overriding the voices.

Can the Minister tell us what the business model is for care homes? We are seeing so many deaths in our care homes because of Covid-19 that it highlights that there may be underlying issues. We must think of the staff who are caring for the most vulnerable in our society.

[Lord Bethell]

My noble friend raises one of the key features of our social care system. It is provided by 12,000 different care home providers—or 16,000, depending on how you measure it—many of whom have very different business models. This creates a rich and diverse tapestry of provision, but it is also extremely difficult to engage with from a central campaign provision. That is one of the challenges that we have faced when rolling out support such as PPE and testing. We do not believe that the business models are inappropriate, but undoubtedly we have challenges when we are trying to reach all the care homes with an equal and central format.

Mental Health Services

Debate between Baroness Newlove and Lord Bethell

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

My Lords, I completely recognise the noble Lord’s warnings. He rightly warns about the huge pressure of lockdown on people, and rightly mentions the benefits of the arts—particularly social prescribing, of which I am particularly supportive. I pay tribute to the Permanent Secretary of the Department of Health and Social Care, who has allowed me to bring Tilly, my working cocker spaniel, into the office to provide me and my fellow workers with some kind of support from an animal. I know that canine support is valuable. We are working hard to support the kind of social prescribing of which the noble Lord speaks.

[Baroness Newlove (Con)]

My Lords, this is an interesting area which I was concerned with both in my former role as Victims’ Commissioner for England and Wales, and personally. As well as viewing mental health services through Covid, we must recognise the risks to pre-existing services, which were an underfunded postcode lottery with not enough qualified professionals. Our front-line workers are now dealing with a pandemic that none of us could envisage. Will the Minister speak to the Secretary of State for Health to ensure sustainable funding for access to mental health services, and that support is given to mental health workers, who will be the front-line workers again? We must ensure that people’s ability to access the services does not just become a tick-box system governed by an algorithm within an app. There has to be sustainable funding for a least five years to invest in the care and support needs of the most vulnerable in society.

[Lord Bethell]

I recognise the insight of my noble friend Lady Newlove, who speaks from experience of these matters. I reassure her that the funding in place from the long-term plan for mental health has been substantial and will support a dramatic change in mental health services. We will be supporting mental health workers who, as my noble friend says, have delivered under difficult circumstances. Their creativity is demonstrated by the introduction of video and other technical facilities to keep mental health services going during the lockdown. I pay tribute to their inventiveness and creativity at this time.