Covid-19: One Year Report
Baroness Scott of Bybrook Excerpts(3 years, 8 months ago)
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Baroness Stroud (Con) [V]
My Lords, this moment in time is deeply significant and goes far beyond the immediate legislation we are debating today. Many of the actions taken by the Government and the provisions in this Coronavirus Act are welcome. The financial support for the furlough scheme, the protections against no-fault evictions during the pandemic and the rapid mobilisation of medical professionals, to name but a few, have actively protected vulnerable people. But this debate also marks one year since the Government first used the Public Health (Control of Disease) Act 1984 to enforce the first official lockdown and stay-at-home orders. As we gather here today, a year later, still living under those same restrictions, this moment acts as a milestone, a moment in time to pause and reflect on the approach we have taken.
The Government have found themselves at the helm during a rapidly evolving pandemic, bearing the responsibility of co-ordinating the nation’s response, requiring agility and dynamism to adapt to its spread, and I thank them for all their hard work and dedication. This pandemic was unprecedented in Britain’s recent history; we did not have the model of best practice in place to adopt and we knew little of this disease. My concern is not so much that we have needed to take action to find a way through this difficult time but over some of the tools that we have used to achieve the goal of public co-operation, and that the approach we have adopted over the last year could become the precedent for how we will respond to similar health crises in the future.
Rather than rely on the values that we know to be true, which define the success and prosperity of this great nation, of personal responsibility and trust, keeping calm and respect, we rather chose to follow the path of a more authoritarian regime, legislating for restrictions on our liberties and an unrelenting campaign of fear to engender compliance. At many points where we could have appealed to the British people to work with us and make responsible decisions on the basis of a health response, we chose a legislative response, and at many moments when we could have asked for responsible decision-making we drove behaviour change with fear. We are still doing it now.
When at the start of the pandemic SAGE’s SPI group on behaviours recommended the Government deliberately use psychological operations techniques to change behaviour, the use of the media and advertising was advised to “increase sense of personal threat”. SAGE thought this would be highly effective, although it warned there “could be negative” spill-over effects. Leading charities such as MIND were quick to warn the Government of the mental health pandemic that would ensue if they continued to pursue such a course of action. Experts have warned that
“the use of fear to control behaviour is dangerous and unethical, especially when combined with curbs of freedom of speech”.
There was even Ofcom guidance which cautioned its licensees against broadcasting
“statements that seek to question or undermine the advice of public health bodies on the Coronavirus, or otherwise undermine people’s trust in the advice of mainstream sources of information about the disease”,
which led to an absence of discussion and a daily broadcast diet of terrifying stories to achieve public compliance. But the public is all too aware of when there is a real threat, and they take the steps that are necessary to change their behaviour. You can see this from the mobility data, which changes as the numbers of hospitalisations and deaths gradually mount.
However, how we go through a crisis is as important as getting to the other side of a crisis. The best way to protect the public from harm is to allow scientists, experts, journalists and others to vigorously challenge the Government and public authorities, without the threat of broadcasters being sanctioned by the state regulator if those views happen not to accord with the current government position. The public are sensible.
The torrent of fear with which we have hosed the British people has been devastating for mental health, but I am most concerned about our children. The statistics here are heartbreaking. Google searches for “panic attack” in the UK have reached record highs. The NHS’s own data suggests that lockdown has led to a 50% rise in children with mental health problems—the Times reports that there has been a surge in tics and Tourette’s amongst teenage girls. Domestic violence against children has doubled, and has surged among adults.
This strategy of fear and legislative control cannot continue. Fear damages the nation’s health, and legislative control is making rule-breakers of us all. You have only to go for a walk in the park on a Sunday afternoon to see that. We must respect the British people and empower our citizens, not terrify them. As the vaccine continues its remarkably successful trajectory, we need to transition from a legislative response to a public health response as quickly as possible based on the principles of honesty and personal responsibility. If we do not do this quickly, we will find that we have eroded the bonds of trust and responsiveness.
The Deputy Speaker (Lord Lexden) (Con)
My Lords, the noble Lord, Lord Campbell-Savours, has withdrawn from the debate, so I call the noble Lord, Lord Bhatia.
Social Care Funding (EAC Report)
Baroness Scott of Bybrook Excerpts(3 years, 9 months ago)
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Baroness Kingsmill (Lab) [V]
My Lords, I am delighted that we have at last got this debate, and I share the frustration of the noble Lord, Lord Forsyth, at the time it has taken. He has been an indefatigable leader and chairman of the Economic Affairs Committee in the time that I have served on it, and I am most grateful to him and my colleagues on it for all the work and energy that have gone into not only this report but others, where we have tried to be practical and helpful and to make achievable suggestions for policy change.
I am also grateful for the passion with which the noble Lord, Lord Forsyth, has dealt with this and spoken about it today. My passion is somewhat dimmed by defeat, in a way, because it feels as if this is something that I have been banging on about for ages and we are still not really getting anywhere—but I am sure that everyone in the sector feels the same.
I will focus particularly on the plight of the care workers because that is my background and area of interest. The noble Lord, Lord Forsyth, has mentioned them, but it is worth going into some of the privations that they suffer in a little more depth. They are under- valued, underpaid and definitely undertrained; they do not have the status of nurses or even of childminders. The sector is subject to very weak regulation: we just do not know who they are or what qualifications they hold, and they are not registered with any professional body. The workforce of 1.8 million people in England is almost invisible—that is, until you need them, when they become very important.
The low status and poor treatment of care workers have led to a really vicious downward spiral in one of the most difficult sectors for workers, with a huge amount of exploitation. It is not just that they are badly paid; most of them earn less than the minimum wage, if you take into account the fact that many of them do not get paid for working in between clients. They are not paid for the journeys that they make and are often subject to very exploitative zero-hours contracts, which destabilise their lives and make it extremely difficult for them to do their work properly.
The workforce tends to be older women or migrant workers, which may very well account for the fact that they are not given much priority within the health and care service generally. They are overlooked and, as I say, we do not really know who they are. Turnover among care workers is enormous—between 30% and 40%—because they are badly paid; sometimes the supermarket down the road is offering a pound an hour more, and they have to go. They are often the main wage earner in their family, and they have to go where they can earn the most money, so there is a terrible, very rapid, turnover.
In the context of the Covid crisis that we are suffering, care workers are seven times more likely than the rest of the population to become infected with it. There is a huge amount of absenteeism at the moment because of illness or isolation, and there is a vast unmet need for care workers at the moment.
The other issue that is important when we talk about care workers is the fact that they have no career opportunities. Attracting people into the profession is very difficult: there is no progression and it is seen as unskilled work, which it most certainly is not because, so often, they need to have the skills to deal with complex feeding methods, using hoists for moving patients, dressing wounds and administering medication, as well as providing vital domestic and emotional support for the care recipients. They have to do all of this in 15-minute slots, if they are a domiciliary worker—
Baroness Scott of Bybrook (Con)
I remind the noble Baroness of the four-minute time limit.
Baroness Kingsmill (Lab) [V]
On that point, I will sum up simply by saying that I commend this report and hope that action comes as a result of it.
Lord Taylor of Holbeach (Con) [V]
My Lords, I refer to my interests as set out in the register. However, I have a personal interest in the subject of the report, as, way back in 1987, an announcement was made by the then South Lincolnshire Health Authority that it was to close Holbeach Hospital. I was active in the local community and the area generally and perceived this to be a considerable threat. The hospital provided general bed care; there were consulting rooms for out-patient clinics and a physiotherapy department. It worked with local GPs and hospital doctors to provide the substantial rural community with health and social care. To cut a long story short, with local support, we negotiated a takeover of the premises by forming a local charitable trust, which then raised the money needed to improve the building up to registration standard at nursing home level and entered into a contract with Lincolnshire County Council for the funding of 22 beds. An agreement was reached with the health authority to continue with six doctors’ beds, the out-patient clinics and the physiotherapy department. We reopened in 1989.
I chaired the Holbeach and East Elloe Hospital Trust for 18 years. When I came to your Lordships’ House, I became its patron. The trust has thrived and maintains support locally. As a result of income generated and bequests, we soon purchased the freehold and doubled the number of beds to 47, including 12 re-enablement beds under the doctors’ supervision.
I congratulate my noble friend Lord Forsyth of Drumlean on chairing the committee and producing such a full report. Reforming the sector will be one of the most challenging undertakings for our Government. With such a complex system, it is important to look at all the options on the table. Notwithstanding the challenges, putting social care on a sustainable footing, where everybody is treated with dignity and respect, is imperative.
It is not as though we need a reminder, for the past year has shown just how vital this sector is for people who rely on social care. I welcome the Government’s recognition of the challenge that this sector faces during the pandemic by providing £1.1 billion of ring-fenced funding, which is vital to help put measures in place to improve infection prevention. How much funding have the Government made available for the costs associated with increased testing in care homes?
I want also to focus on the quality of care received by those who rely on adult social care. Despite increasing challenges, it is important that we recognise that the sector continues to provide high-quality care and support. I was encouraged to read that 85% of adult social care providers are currently rated good or outstanding by the Care Quality Commission. I think that the Committee will welcome this figure and want to pay tribute to the care givers, who are doing such a fine job, as many noble Lords have said, during such difficult circumstances.
All social policy areas have been put under pressure as a result of the pandemic, for they are interrelated. Social care, healthcare, pensions policy, the benefits system and even education all play a part in a civilised approach to need, even in the best of times. We need a consensus—
Baroness Scott of Bybrook (Con)
My Lords, I remind the noble Lord that there is a four-minute speaking limit for this debate.
Queen’s Speech
Baroness Scott of Bybrook Excerpts(4 years, 10 months ago)
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Baroness Scott of Bybrook (Con)
My Lords, I welcome Her Majesty’s most gracious Speech. At last we can start to deliver on our promises to this country to honour the referendum, exit the European Union and move on. There is much to do and many issues that have not had the attention they deserve during the past three years, about which we have heard so much from noble Lords in the past three days. I wish to concentrate on issues relating to local government and at this point draw your Lordships’ attention to my interests as a vice-president of the LGA and a member of Wiltshire Council, as declared in the register.
Local government welcomes further devolution and the White Paper due later this year. It will be important however that shire counties, which serve 47% of the population and cover more than 86% of England, have equal access to levers and funding currently afforded to urban metro mayors, this being crucial to the success of the Government’s “levelling-up” agenda. Councils can and should be the building blocks of future devolution deals and any supporting structural and institutional reform. They should have the same opportunities as those enjoyed by the combined mayoral authorities, including the powers for statutory spatial plans, delivery of education and skills funding agencies, responsibility for the shared prosperity fund and powers over bus franchising.
We all welcome the uplift in NHS funding as well as the additional £1 billion a year for social care. More than 65% of county expenditure is now dedicated to that care. Health and social care are two sides of the same coin. I support the Government’s aim to find consensus on reforms and funding for care services. I urge that these discussions begin as soon as possible and that, as the largest social care providers in the country, counties are an integral part of such cross-party discussions.
To assist the levelling-up, I urge the Government to consider reintroducing strategic planning in county areas, allowing authorities to better plan and link housing and jobs with infrastructure, responding to local needs and markets. The reduction in business rates is most welcome in our market towns and on our high streets in particular, but as business rates are an integral part of local government financing, consideration needs to be given to how councils will be compensated for this loss of income.
Local government is appreciative of the settlement for this coming year. The Government have listened to us and have delivered, but we need to see real progress in the fair funding review and consideration of longer-term settlements.
Strategic county authorities are crucial to the delivery of many of this Government’s plans and priorities: on health and social care reform, knife crime, county lines and social mobility—to name a few. It is these authorities which can bring together the public, private and third sectors in a “place” to make a difference.
Finally, I hope that the local government reorganisation agenda is not lost. Both central and local government need seriously to consider whether it is sustainable financially in light of the extra responsibilities for devolved issues to continue with a two-tier system in the majority of our counties. Surely it is now time to move to a new system of local government in these areas. County unitary authorities can be both strategic and local—just look at Cornwall and Wiltshire. They can be efficient and effective, simple to navigate and easily understood by local residents, businesses and partners—just one council. I look forward to future discussions on the opportunities for a new era for local government.