Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 2) Regulations 2020
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab)
My Lords, when the noble Lord, Lord Forsyth, my noble friend Lord Liddle and many other noble Lords across the House express their frustration in the trenchant way they have done today, the Government really need to listen.
I am particularly struck by the fact that the noble Lord, Lord Lamont, has in his indignation put down a negative Motion against the rule of six, which I think we will discuss in a few weeks’ time. It is in the green sheets if noble Lords want to find it—I found it this morning. That must tell the Government that this House really is very dissatisfied and very frustrated. This is not the way that Parliament should be doing its job and we need to find a better way forward.
One noble Lord said that all of these orders were not emergencies, because they were lifting emergencies, so there should have been time—I think it was the noble Baroness who said this—for these to have been discussed pre being put down and taken in an orderly fashion across both Houses of Parliament. We have many of these SIs to go before the end of September, so we are going to get used to each other.
I need to talk about things that are relevant today, before I mention any of the orders that we are actually discussing, because the whole of the UK is much more worried about what is going to happen next. Listening to the news as I was writing my speech, I heard a discussion about whether a circuit breaker will be required across the country: a two-week partial national lockdown. Local restrictions are becoming regional. Coronavirus cases have been doubling every seven to eight days in England, according to the study by Imperial College. The R rate is up, the number of people being hospitalised is growing and care homes, as we know, are in the news again because they are so concerned about what is going to happen. The Financial Times reported that one SAGE scientist said that if the R number continued at the same rate it would “break the NHS”.
We warned from these Benches months ago that unless the Government spent the summer fixing the testing regime, we would face a bleak winter. Notwithstanding the remarks of the noble Baroness, Lady Harding, at the Select Committee yesterday, that in her view the test system was not failing, it is ludicrous that a surge in demand was unexpected. The truth is that the Government ignored the advice that a robust test and tracing system was vital when our schools and universities were back and when people went back to work. So could the Minister confirm reports that a two-week national lockdown in October has been proposed by the scientists of SAGE and the Scientific Pandemic Influenza Group on Modelling? Is it true, as my noble friend Lady Donaghy said, that COBRA has not met for several months?
I suppose that we need to turn to these statutory instruments. I echo other noble Lords in asking why we are not seeing any impact assessments at all, on any of these statutory instruments. Surely that must be possible, and it is not respectful of Parliament and accountability that those have not been forthcoming. Not only has Parliament not been engaged in scrutinising these laws, but members of the public and the police forces have been given little chance to see and understand the new laws they will be subject to, and they are having to learn as they go along. It is regrettable that we are only debating these regulations weeks, and even months, after they came into effect.
Last time we discussed the issue of fines for gathering, I asked the Minister whether the legislation had been used to stop legitimate political protest, which, I said,
“this country prides itself on allowing to happen, even in its most bonkers forms”.—[Official Report, 3/9/20; col. 485.]
The Minister did not answer this, or any of the numerous questions on where the right to protest currently stands under the health protection regulations, citing a lack of time. How many demonstrations and gatherings have been refused? Who has been fined—we know certain people have been fined—and who is facing criminalisation? If the Minister does not have time to answer these questions today, perhaps he could write to me and put the answer in the Library.
Other noble Lords have very adequately covered the issues about swimming pools and the lateness of the regulations, arriving 24 hours before they were due to be enacted. I think businesses are owed an apology by the Government for being given detailed regulations 24 hours before they come into force. That is not reasonable at all. That includes ice rinks, swimming pools and so on. Now we have the regulations for the rule of six, designed to make the rules easier to understand and follow—but, as other noble Lords have said, that is simply not the case. It is particularly not the case when the four countries are operating these in different ways.
I hope that we will not continue this somewhat arid process, a mockery of the parliamentary process. I hope that when we come to review the emergency legislation, as we are due to do by the end of this month, that will change.
Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton
At end to insert “and that this House welcomes the introduction of the Regulations, but regrets the delay in bringing forward the Regulations as Her Majesty’s Government has advised the public to wear face coverings in enclosed public spaces since 11 May, announced that face coverings would be mandatory in shops from 24 July on 14 July, and laid these Regulations under the made affirmative procedure on 23 July; further regrets that this delay has caused confusion over where people will have to wear face coverings due to the absence of detailed legal requirements being available in advance; and notes the concerns of the Secondary Legislation Scrutiny Committee in its 19th Report, published on 25 June, which urged Her Majesty’s Government ‘to ensure that the legislation follows on more closely from any announcement that they have made’.”
Baroness Thornton (Lab)
My Lords, this amendment is by way of protest at how this issue has been mishandled by the Government.
I hope the House will understand that we on these Benches do not oppose the introduction of the wearing of masks, but we regret the truly incompetent way in which it is being done. We regret the delay in the regulations, as Her Majesty’s Government have been advising the public to wear face coverings in enclosed public spaces since 11 May and announced on 14 July that face coverings would be mandatory in shops from 24 July. They laid these regulations under the affirmative procedure on 23 July.
Further, we regret that this delay has caused confusion over where people have to wear face coverings, due to the absence of detailed legal requirements being made available in advance. The detailed regulations that employers, shopkeepers and others needed to know about to ensure that they complied with the law were published the day before the regulations became active, meaning that staff training, compliance and other such issues were dealt with without proper guidelines or information.
This is very serious. We want people to be safe and to follow the necessary restrictions, but they will not take the Government seriously and many will not obey the rules because of the lack of clear communication in a timely fashion. That is the cause of our regret.
In its 19th report, published on 25 June, the Secondary Legislation Scrutiny Committee urged Her Majesty’s Government
“to ensure that the legislation follows on more closely from any announcement that they have made”.
It said that
“even a short gap between regulations being laid and their coming into effect would better enable those affected to prepare, having seen the law’s actual detailed requirements (rather than just the headline announcement). While we fully understand the need for legislation to take immediate effect when imposing lockdown measures to protect public health, the justification is less strong when relaxations are being contemplated”,
as we have already said. The committee said that it was
“aware that a number of COVID-19 instruments enable powers that can be switched on or off according to current infection levels, or are subject to review every 21 or 28 days: it would assist the House and the Committee if the Explanatory Memorandum in such cases included specific information about how and where the outcome of any review is to be promulgated and how Parliament is to be informed of any change of status.”
The Minister needs to take these issues into account. The House needs to know whether any lessons have been learned; that is the point of my amendment.
Finally, I thank the Minister for calling me yesterday to explain that he was not going to be present in person today. I am sure that, wherever he is, he will be bashing those raves down. I beg to move.
Baroness Thornton (Lab)
I thank the Minister. I want to pick up on the previous debate, when the Minister was concerned to assure the House that the Government listen carefully and take account of these debates. This discussion—and that which has gone on for many months about face masks—is probably one of the very few times when we can say, particularly if I might pay credit to my noble friend Lord Campbell-Savours, that we possibly have influenced government policy. I hope that the Minister will take on board, as he said he would, the remarks of my noble friend about the types of face mask, because he is definitely an expert in these matters.
I wish this were true of all the other issues. The discussion about face masks began very early in this pandemic, in late April and early May. The statutory instrument that we are discussing today was laid in July. There seems to be no reason why we could not have taken it through the normal parliamentary process in that time and not be playing catch-up two months later. That is the reason for my amendment.
As someone who travels on public transport almost every day, I recognise that there are clear problems, as the Minister and many other noble Lords have said. We need a major public information campaign about the wearing of masks. I have seen no enforcement whatever. On saying that ONS data shows huge compliance, as the noble Lord, Lord Hayward, said, it depends when you look. On my tube this morning, there were two young men—one sitting opposite me—neither of them wearing a mask. I offered them masks, because I carry spares—I confess that I have become a bit of a mask monitor. I said, “You haven’t got your mask on. Would you like one?” One of them took a mask out of his pocket and immediately put it on. The other got off the train. I completely agree with the Minister that you have to be careful, because there are people who cannot wear masks. One way of getting around that is just to offer one to somebody who does not have one and see what happens.
It is also my observation that those not wearing their masks on the Tube are, mostly, blokes. They also do not pull them over their noses, which makes them almost completely redundant. An educational programme, and possibly the pictures on the Tube, should show that you must put your mask over your nose. This is important because, as children have gone back to school and people are returning to work, social distancing has become almost impossible on the Tube and on buses—wearing a mask is therefore much more important.
I wonder if it might be an idea for all Ministers, their advisers and special advisers to travel on public transport for a week. Perhaps then they might understand the challenge and realise that people will increasingly feel unsafe unless masks are worn regularly and there is compliance.
The Minister mentioned the exemption card template, which I think is an extremely good idea. I hope that the Government will put some resource into making sure that that happens as often as it can.
Although enforcement is a matter for the police and specified officials, the government guidance says that:
“Businesses should take reasonable steps to encourage customer compliance”.
Can the Minister explain to me in writing—since he cannot come back to me; it is not often that I get the last word, but I do today—what that means in practice?
Many people find mask wearing uncomfortable, but they are complying. The Government need to recognise that this shows that the vast majority of people in the country really are willing to do almost anything to try to deal with this pandemic. Wearing masks will be with us for a long time to come, I think. We need to recognise that this is an important part of ensuring safety for all of us and our families.
I thank noble Lords for their support for my amendment, particularly my noble friends Lord Dubs, Lord Rooker, Lady Massey and Lord Campbell-Savours, and others. My amendment to the Motion was put down as a sentiment of frustration over the way these statutory instruments are being handled. That frustration has been well expressed by noble Lords. I hope that the Minister has heard it, and I beg leave to withdraw the amendment.
Coronavirus
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab)
My Lords, the Prime Minister claimed again today that the UK does more Covid tests than anywhere else in Europe. This is not true. Denmark does almost twice as many per 1,000 people, and the UK figure includes antibody tests, which others do not do, and is based on when tests are sent out and not on results. So it is more hyperbole.
I hope today we can look at facts. There is now a backlog of 185,000 swabs and tests are being dispatched abroad. Can the Minister advise the House how many tests have been sent abroad, to which countries, the processing time and the void rates? If the Minister does not have that information at his fingertips today, can he please to write to me and put the answer in the Library?
Secondly, Coronavirus infection rates among middle-aged people have reached the same level now as rates among those in their 20s two weeks ago, and Professor Neil Ferguson has warned us that infections are back where they were in late February. So what discussions have the Government had with the Joint Biosecurity Centre and the CMO about raising the alert level from three to four?
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
I am grateful for the noble Baroness’s questions. In terms of European rates, Britain is way ahead of many of its fellow countries in Europe. On Friday last week, we did 240,312 tests. It is a massive number and, I believe, the highest we have done on any day. This is a huge achievement and I pay testimony to those in the NHS and in test and trace who have contributed to that figure.
In terms of tests being sent abroad, our testing environment and economy are part of an international system. Reagents, swabs, consumables and machines are regularly exchanged between countries and I pay tribute to the enterprise and energy of the NHS and the test and trace scheme for using whatever schemes they can find in order to process the tests accurately, efficiently and promptly. I will be glad to send the noble Baroness details of the rates which she asked for.
In terms of the increase in prevalence among the middle-aged—yes, we are deeply concerned about this. As I have said at the Dispatch Box before, as night follows day, rates progress from the young to the middle-aged and, I fear, to the elderly. We are keeping a close eye on this progress.
Covid-19: NHS Long-term Plan
Baroness Thornton Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
My noble friend is entirely right to raise the importance of social care. Undoubtably, one of the things that we have learned through Covid is that the NHS and social care sectors must work more closely together. That was always envisaged as one of the pillars of the long-term plan. It is now an increased priority. That has been witnessed through much closer collaboration in recent months between trusts and the social care industry. We continue to invest in social care, providing councils with access to £1.5 billion for adult and social care in 2020-21, as extra support during this difficult time.
Baroness Thornton (Lab)
Following on from the question asked by the noble Baroness, Lady Altmann, I must try to pin the Minister down. Can he commit to publishing a plan for the future funding and provision of social care by the end of this year, as the Prime Minister promised in January? My honourable friend Liz Kendall MP has today written to the Secretary of State about the need for a clear social care winter plan. What steps are the Government taking to ensure that no one with Covid-19 is discharged from a hospital to a care home, to prevent a repeat of the terrible impact that this had in the first months of this crisis?
Lord Bethell (Con)
My Lords, I cannot commit to a social care plan before the end of the year. It will require a huge amount of political collaboration and I suspect it will take longer than the next few months. I remind the noble Baroness that we have a £600 million infection control fund to help social care through the winter.
Covid-19 Update
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab)
My Lords, I thank the Minister for taking the Statement this afternoon. It was taken in the Commons on Thursday and enacted at one minute after midnight today. The order was laid about an hour ago, but I am not sure when we will be discussing it. Noble Lords might have noticed that we are not short of Covid-19 orders to discuss in the next two weeks. Perhaps the Minister can tell us when we might be discussing this one.
We are at a dangerous moment in the life of this horrible virus—one where we are being advised by SAGE that we need to bring down the rate of infection, which has increased alarmingly in the last week or so. Last week I asked the Minister about the R rate. I think we all understand that this has now gone up and might be as high as 1.7. Has a tipping point been reached?
Today, I want to ask about the alert level. Can the Minister confirm what assessment the Joint Biosecurity Centre has made of the risk? Have we moved to level 4? The Government have tightened restrictions on meeting in groups after a surge in infections prompted by these concerns, and we on these Benches absolutely support that. From today, it will be illegal for people in England to gather in groups of more than six.
It is the first time that the Prime Minister has imposed a nationwide lockdown measure since restrictions began to be eased in May. At a press briefing, he admitted that over time the rules “have become quite complicated and confusing”. Announcing the rule of six, he said, “We are responding, and we are simplifying and strengthening the rules, making them easier for everyone to understand.” Well, that remains to be seen.
The Chief Medical Officer has said that the number of cases has been increasing more rapidly. On 9 September, he said that, while the numbers among older people and children remained “flat”, in other age groups there were “rapid upticks”. Professor Sir Mark Walport, a member of the Government’s scientific advisory group, told BBC Radio 4’s “Today” programme that one might have to say that we are “on the edge of losing control”. He said that data suggested that, without action, Britain would be on a path “extremely similar” to that of France, where the numbers continue to rise.
Can the Minister advise the House how the Government arrived at the rule of six? Why not eight? Why not four? The Justice Secretary, Robert Buckland, said that another nationwide lockdown remains a “nuclear option”. Can the Minister outline what additional national restrictions the Government are considering to prevent a return to a full national lockdown? I have a few questions on this.
The Government say that they will “boost the local enforcement capacity of local authorities by introducing Covid-secure marshals to help ensure social distancing in town and city centres, and by setting up a register of environmental health officers that local authorities can draw upon for support.” If the new restrictions are dependent on Covid-secure marshals employed by local councils’ public health departments, how many does the Minister believe will be required, and how will they be funded?
Can the Minister confirm whether and at what age children are included in the six? It seems that different countries have different ideas about this. In England it seems that a child under 12 is included in the six, but in other countries that is not the case. Why have we taken a different line on that?
I gather that sports are exempt from this, but can the Minister confirm that that includes shooting and hunting and that they are exempt from the ban?
This morning I received a copy of a letter to the Home Secretary from the leader of Hammersmith Council. I feel that I need to raise this because it is important that the Minister is aware that there is a Covid-19 outbreak among asylum seekers placed in a hotel in Hammersmith and Fulham. The council has been misinformed by the Home Office people dealing with this and that has led to an outbreak. Last week I was talking about a dissonance between the Department for Education and the Department of Health in terms of information that has been used to try to control Covid. Today I am saying that it looks as if there is a dissonance between the Home Office and the Department of Health. In this case, that will feed directly into the spreading of the virus, so it is a matter of some urgency for the Government and I draw it to the attention of the Minister.
Bolton remains the place in England with the highest rates of coronavirus infections, with the equivalent of 192 new cases per 100,000 people. That increase comes despite the Government implementing even tougher lockdown restrictions for the town, including a strict curfew for bars and restaurants. What is the next step? Are the Government considering closing pubs and restaurants?
We have mingling on public transport and in offices and restaurants and pubs. All these are factors where infections can happen and spread, so what plans do the Government have to review the back-to-work advice?
I have to talk about the availability of tests. There is an increasing number of people reporting problems, people still being referred to Aberdeen from 400 miles away and test centres still empty or not being used because tests cannot be processed. Please can the Minister own that there is a problem here, explain what the challenges are and tell the House how and when they will be resolved?
Finally, I want to highlight that the key to preventing mass outbreaks in care homes was the availability of testing for those homes. So how many care-home tests have not been processed in the last week or so? That seems to be vital. Care home providers are reporting a slight rise in care home infections, and we cannot possibly face a repeat of what happened during the last spike of the pandemic in our care homes.
Lord Scriven (LD)
My Lords, these Benches welcome anything from the Government that is based on rational evidence and can prove to be effective in this public health crisis to keep people safe and reduce the spread of the virus. So does this Statement live up to that? Unfortunately, yet again the sales pitch from the Secretary of State last week fell short of what is required to be effective. It has to be based on fact and scientific evidence that the public have confidence in and understand.
I have some simple questions for the Minister. Now that the scientific evidence has been produced, members of the public are asking why children under 12 and 11 are included as part of the six. Why can they be in a school in a class of 30 but from 3.30 pm they cannot be in a house with seven people, including their two grandparents? What scientific evidence exists to suggest that that causes more harm than 30 children in a classroom?
There is something else that people have asked me. Why is it that I can go to the office and be there with 20 people until 4 pm, but at 4.15 pm, if I go to the pub, I have to be in a bubble of no more than six? The evidence may be there, but it has to be explained in a way that those questions can be answered and the public have confidence in those answers. Inconsistency, rather than the public not having confidence, is one of the issues that the virus breeds on.
The public health message has to be clear and consistent. The regulations do not just bring in a power of six; there are quite a number of exemptions, including a legal definition of “mingle”: for the first time since 1393 it becomes illegal to “mingle”. Can the Minister give a legal definition of “mingling”? I can go to an event with six people but I cannot mingle beyond those six if it is an event run by a charity, a public body, a philanthropic organisation or a business. If I open the door for somebody and speak to them to thank them, am I mingling? If I stop somebody who I know and speak to them, am I mingling? What is the legal definition? That is going to cause confusion and not be consistent.
These regulations and rules have to be developed in a collaborative manner with local areas to be effective. Why was the Local Government Association informed of the Covid-secure marshals only one hour before? If the rate is rising so fast and we need to be effective today to monitor six people and no more, where are those marshals’ powers as of today and in which legislation?
It is quite clear that action needs to be taken to stop this virus, but it is time for the Government to stop and be much more strategic and considered and to implement legislation and systems in a more collaborative way. People’s lives and livelihoods depend on the Government getting this right, but unfortunately this Statement is not a complete and right answer.
Anti-obesity Strategies
Baroness Thornton Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
My Lords, I entirely agree with the noble Baroness that serious eating disorders are complex, and we need to resource the medical attention required by people with serious mental health issues. However, I do not completely align with her view that all obesity is not a matter of personal responsibility, nor that the education of people about the content of their food through labelling cannot be an important part of our battle against obesity. Covid has spelt it out clearly to all of us. Some 67% of the country is overweight in some way or another. But this is a policy that we are determined to get right, and I would very much welcome the opportunity to meet with the noble Baroness and her team.
Baroness Thornton (Lab)
My Lords, following on from the noble Baroness’s question, do the Government have eating disorder experts, including those with lived experience, advising them as part of their anti-obesity strategy? It seems to me that is one way of making sure that the messages do not disadvantage those who have eating disorders. There is a reason why advocates for those with eating disorders have been very critical of the language being used. Could the Minister commit to reviewing the campaign in light of this?
Covid-19 Update
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab)
First, I place on record our thanks to the teachers, head teachers, school staff, university and FE college staff and others making it possible for our children and young people to return to their education. I hope this will remain a top priority for the Government as we move through and, we hope, out of this pandemic. It has been wonderful to see my great-nieces and nephews and granddaughter joyfully going back to school in the last week. As a non-executive director of one London’s hospitals, which is in my record, I can testify to the huge amount of work going on preparing for the winter stresses.
But here we go again. We need to start by reflecting on why we do not have before us the incredibly important new Covid restrictions announced yesterday by the Secretary of State and the Prime Minister, which aim to deal with the new surge in coronavirus infections. In fact, the Statement has been made in the Commons in the last hour or so, and I suspect we will see it in due course at the beginning of next week. I accept that the hybrid nature of the House means that we will not be able to take it today, which might have helped us all enormously. It is not the Minister’s fault; it is just one of the casualties of the situation we find ourselves in. Perhaps, the noble Lord could confirm when the new regulations will be laid.
Yesterday, Mr Speaker said quite rightly in the Commons:
“It is really not good enough for the Government to make decisions of this kind in a way that shows insufficient regard to the importance of major policy announcements being made first to this House and to Members of this House wherever possible.”—[Official Report, Commons, 9/9/20; col. 619.]
The Secretary of State made a Statement about current Covid-19 issues on Tuesday and failed to mention major policy proposals of which he must have had prior knowledge and which were already being discussed on social media. Thus, he did not allow a discussion of the current proposals, which the Prime Minister then announced in a Downing Street press conference and a letter which noble Lords will have received overnight. This suggests that the omission was deliberate and reveals yet again the disregard with which the Minister and his colleagues hold their duty to be accountable to Parliament, which is undermining our democracy. If Mr Speaker follows through on his threat to allow Covid-19 UQs at the beginning of every day to ensure that the Secretary of State can and will report new policy and be accountable to Parliament, I assure the House I will be arguing to take every single one in this House every day, so that the Minister can do his bit for accountability, too.
We have a Statement before us, press announcements made and a new law of six, but I need to return to the question I asked yesterday about what has gone wrong with the testing system. I would be grateful if the noble Lord would engage with what look like widespread problems some people are having accessing tests, rather than repeating the mantra about the high proportion of successful tests close to home, which is accurate, I am sure, but not the way to solve a clearly growing number of problems. I know the Minister will not shout at me, as his right honourable friend did to Keir Starmer yesterday, or accuse me of undermining the whole test and trace system when legitimate, evidenced problems are being articulated by many Members of Parliament and reasonable questions are being asked. The Minister needs to address the problem of the availability of tests.
Yesterday, I mentioned schools, where inevitably children will become ill. Parents are advised to keep them at home and get a test, and some are finding this impossible. Unsurprisingly, parents turn to teachers and head teachers for advice, placing even greater stress on our schools, which are working so hard to keep our children safe and educated. A reliable, rapid testing regime is vital, as we have said from the outset.
As for moonshot, which the Prime Minister mentioned in his letter, with his fondness for hyperbole, if the Government cannot even deliver testing for those ill with symptoms, how on earth are they going to deliver 10 million tests a day? I want to correct a statement the Secretary of State made in the Commons an hour or so ago, when he said to my honourable friend Jonathan Ashworth that the Labour Party was opposed to mass testing. That is absolutely not true. What we are against is incompetence. We are saying: how on earth will moonshots be delivered if basic testing is not working well?
The new regulations are meant to make it easier for people to understand. But does the noble Lord agree part of the confusion stems from the fact that some of these rules may be inconsistent with government messaging that people should return to work. Does he accept that, even where employers are taking necessary steps to facilitate social distancing, busy commuter trains, tubes and buses are not Covid-secure? On these Benches, we have said from the outset that one of the biggest barriers to self-quarantining would not be Covid fatigue but personal finances. Does the Minister accept that the Government need to go much further in helping people who need financial and housing support to self-isolate? Otherwise, how will we get on top of infections in areas characterised by low pay, child poverty and overcrowded housing?
Finally, to contact tracing: in Bolton, contacts were reached in only 57% of non-complex cases; in Oldham, 50%; in Blackburn 47%; and in Bradford, only 43%. Nationally, only 69.4% of contacts are reached and asked to self-isolate. These are Government’s latest statistics, and they make me wonder whether “world-beating” is yet another piece of hyperbole. On the effectiveness of testing, my colleague, the shadow Health Secretary, highlighted that only 69% of contacts were identified by the test and trace system, and I am afraid the noble Lord’s colleague Matt Hancock said he was wrong. He was right. I yet again have to ask the noble Lord—privately, if he wishes—to correct his boss’s record. More importantly, how can we improve on that record of testing and tracing?
Baroness Barker (LD)
My Lords, this is a Statement made two days ago in the other place, but it has been largely overshadowed by yesterday’s deluge of hyperbole and hokum. The Prime Minister said yesterday:
“We know, thanks to NHS Test and Trace, in granular detail, in a way that we did not earlier this year, about what is happening with this pandemic. We know the groups that are suffering, the extent of the infection rates, and we have been able, thanks to NHS Test and Trace, to do the local lockdowns that have been working.”—[Official Report, Commons, 9/9/20; col. 609.]
If that is true—and given the record of the Prime Minister and Health Secretary, one is always entitled to ask whether it is—how come local authorities and directors of public health are given only limited access to the test and trace case management system and not given full access to the contact system? Why are the Government sitting on data or passing it to companies run by their mates, instead of passing it to local authorities, which, for weeks, have been trying to predict and manage the inevitable spike in infections that follows people starting to travel and going to school and university. Why are they not getting that data in a timely manner?
From the start of this pandemic, experts advised the Secretary of State to invest in public health teams and NHS labs that are numerous and easily reached by many communities, including in rural areas. Instead, he gave the money to outsourcing firms such as Serco and G4S, which have no expertise and have not had to compete for the contracts. He could have invested in local public services; instead he has built a system on a foundation not fit for purpose. On Tuesday, in the Statement, the Secretary of State for Health said of care homes that
“we have met our target to provide testing kits to all the care homes for older people and people with dementia that have registered to get tests.”—[Official Report, Commons, 8/9/20; col. 517.]
But on Monday, the Government were forced to apologise for continuing delays to Covid-19 testing for care home bosses and GPs, who are threatening that these will lead to more infections among vulnerable people.
The Secretary of State’s own department, the Department of Health, admitted to breaking its promise to provide test outcomes within 72 hours. Care managers have described the Government’s centralised testing service as “chaotic” and “not coping”, amid reports that whole batches of tests are coming back not only late but also void. Testing officials told care homes by email on Monday morning that
“immediate action has been taken at the highest levels of the programme to bring results times back”
within 24 hours.
“We apologise unreservedly to … you … and your staff.”
The ring of steel that the Secretary of State claimed to have put around care homes never was. With upwards of 40,000 deaths, when will the Government sit down with care home providers, local authorities and CCGs to develop a comprehensive system of testing and supply of PPE? It does not have to be world beating; it just has to work.
The Prime Minister’s Statement yesterday would have been risible were the consequences not so serious. Most ludicrous of all was the announcement of a team of Covid-secure marshals to enforce the new laws on public gatherings. The Government could have done any number of things. They could have announced resources to enable the rehiring of retired public and environmental health professionals, since there is a shortage. They could have given funding to local community and voluntary groups to communicate ongoing health risks and the law to communities. They could have given additional funding for trained police officers to work with health officials and businesses to improve adherence to infection control. But, no, instead we got another vacuous attempt to steal the headlines. Maybe these marshals, with no training, no resources, no local management and no authority could join up with the 750,000 volunteers for the NHS and the trackers, and like them they could sit and twiddle their thumbs, waiting for the phone to ring.
One thing we can be sure of is that this is another stunt which will be an utter waste of time, money and resources. Local authorities, police forces, health authorities and schools are using their professional expertise and local knowledge to plan effective public health interventions. They are not only following the science but also using it to actively protect people in their authorities. In stark contrast, this Government ignore advice, misrepresent the science and carry on winging it, but the data on infections and the lack of reliable testing are evidence that the Prime Minister’s bumbling bombast and the Health Secretary’s growing litany of half-truths are indicators of world-beating incompetence and, sadly, people in black and minority ethnic communities and poor communities will suffer the consequences. It is time for the Government to change.
Covid-19: Rise of Positive Tests
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton
To ask Her Majesty’s Government what assessment they have made of the rise in the number of people testing positive for Covid-19.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, our assessment of the recent rise in positive tests is that we are deeply concerned, particularly about rates among young people, and particularly at a time when children are returning to schools and people are returning to the workplace. We are constantly looking at the latest data on the spread of coronavirus and have worked hard to contain outbreaks early to reduce the spread, protect the NHS and social care sectors, and save lives.
Baroness Thornton (Lab)
I thank the Minister for that Answer. I was finding it difficult to know in which direction to point myself in framing a question about our testing system, but he has given me the two issues that I want to raise. First, can he tell the House what effect the increase in Covid infections is having on R? What is SAGE advising? The second question is to do with schools. What is a head teacher to do when they have successfully got their pupils back into school and then inevitably have pupils who have symptoms, are at home and need a test—as do their families—but are unable to get one because the nearest centres are either not carrying out tests or have run out of them, the labs cannot process them, or they have been offered testing many miles away and may not even have a car? How are our schools to remain open and safe if the national testing system is not working as it should, and when will this be resolved?
Lord Bethell (Con)
My Lords, the impact on R is not entirely clear at the moment. ONS and REACT figures will be published shortly, and they will have the statistical analysis that the noble Baroness asks for. However, it is safe to say that R is up. With regard to schools, the Government have made it clear that our support for the return to schools is completely emphatic. However, I remind the noble Baroness that the average distance travelled for tests, even at this stage, remains 6.4 miles. Ninety per cent of people who book a test travel less than 23 miles, and 90% of tests undertaken in our mobile sites are still converted in 24 hours.
Suicide
Baroness Thornton Excerpts(3 years, 7 months ago)
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Lord Bethell (Con)
I remind the noble Lord that, in July 2018, the standard of proof used by coroners to determine whether a death was caused by suicide was lowered from criminal to civil. That has had a meaningful effect on the number of suicides recorded. I am afraid the numbers for Yorkshire and Humber are not available to me.
Baroness Thornton (Lab)
My Lords, we need to return to statistics. Last week, the Health Secretary Matt Hancock told the House of Commons that new figures from the ONS showed that the number of suicides in England fell during the peak of the coronavirus pandemic. Could the Minister confirm to the House that this was mistaken? While the figures cited by the Health Secretary are the latest reported by the ONS, the ONS also clearly said that those figures
“cannot be used to show the number of suicides with a date of death in 2020, including those that occurred during the COVID-19 pandemic”.
It is likely, it continues, that it
“reflects delays to inquests … due to the impact of the COVID-19 pandemic”.
As government statistics show, the last time the suicide rate was this high was 1988. I would like to know what government resources are being applied to this and that they will not be cut back.
NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) (Amendment) Order 2020
Baroness Thornton Excerpts(3 years, 7 months ago)
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Baroness Thornton (Lab)
My Lords, first, I need to declare my interests as a former member of a clinical commissioning group and a current non-executive member of a hospital trust—because, of course, we get trained in fraud when we take up these non-exec positions. So I have been diligent in doing my online training with the NHS fraud authority. It is very rigorous and it makes you think very carefully about the whole range of fraud that might occur in the NHS, including in recruitment, procurement and so on. So I will just say that it is very useful that it is so diligent in this. Of course, it is part of the whole audit process that goes on within NHS foundations and NHS bodies all the time.
I thank the Minister for introducing these provisions, which we will of course be supporting. Fraud is by definition a hidden crime and those who commit fraud are of course in a minority. But we are talking about significant sums here. The 2018-19 estimates say that fraud cost the NHS about £1.27 billion. So fraud is not and never has been victimless, and in this case it impacts directly on patient care. I commend the work of the fraud authority in uncovering scams and ghost patients, but there is still quite a long way to go.
Unfortunately, Covid-19 presents a heightened risk of fraud, and it does so across the whole of society. As someone who had to have their bank cards changed three times during lockdown, I say that unscrupulous crooks are seeking to exploit the fact that systems are not working and in particular that our health system is under unprecedented pressure—and they are doing it for their own financial gain. I think all noble Lords will agree that robust response is imperative to safeguard the reputation and resources of our health service, so we welcome these provisions and the extension of their lifespan for a further three years.
The disruption caused by Covid-19 has seen a reported spike in fraud cases across health and social care, ranging from fake PPE to recruitment, as well as cybersecurity attacks. I think noble Lords will agree that this is deeply concerning, so what assessment have the Government made of reports that levels of fraud have been increasing during the Covid-19 crisis, and is the noble Lord able to share any preliminary figures with us today?
Like my noble friend Lord Jones, I say that it is imperative that the fraud authority has the resources it needs to investigate, detect and prevent fraud. So could the Minister assure the Committee that the resources that it does need to investigate, detect and prevent fraud are there, and that there has been increased funding, commensurate with the increased risk?
An urgent concern is the relaxation of recruitment rules and practices to allow NHS bodies to hire staff working across the health and social care sector. I completely accept that this has been necessary at a time of emergency, but I wonder what assessment the Government have made of these exceptional circumstances and the unique pressures that may impact on methods of preventing fraud in recruitment. What advice and support is the fraud authority giving to NHS organisations to help them prevent fraud in these difficult times?
PPE has already been mentioned in this debate, and we have talked a lot about it in the last few months. It is of enormous concern that amounts of public money have been directly awarded outside the usual tendering process, with no competition. What steps is the authority taking to prevent fraud linked to PPE procurement? Given that PPE procurement for Covid-19 is now centrally managed, can the Minister confirm whether this falls outside or inside the remit of the authority? Who will be investigating this as we move forward? Are cases being referred to the Department of Health’s anti-fraud unit, supported by the authority? I hope that the Minister will also take the opportunity to confirm that there will be an inquiry into PPE procurement as we move forward.
The Minister has already mentioned something of vital importance: cross-working. The most recent annual report identifies a number of challenges and potential barriers that affect the ability to tackle fraud against the NHS and highlights the fact that the level of understanding of the nature of fraud in the NHS continues to be uneven across the health system. So if there is underreporting of fraud and suspicious activity, that is of continuing concern. Can the Minister expand on what the authority intends to do to improve cross-NHS working?
In June, as has been mentioned, the Cabinet Office published the Counter Fraud Functional Standard, which is intended to be introduced across the NHS by the end of the financial year. We certainly welcome this move towards a common counter approach across the public sector. But what steps is the NHS Counter Fraud Authority taking to support the NHS organisations to implement this change? Can the Minister confirm that this will be introduced across the NHS by the end of this financial year, as intended, or will it need to be delayed? Perhaps he could explain that.
So we welcome this order and I think that these are all questions that will probably need to be answered in due course.