Covid-19: Testing

Baroness Thornton Excerpts

Thursday 14th May 2020 Lords Chamber

[Lord Bethell]

The noble Lord will know that we have set up one of the most ambitious surveys, conducted by the ONS, to study on a weekly basis a large number of viral and serological tests. Those are used by statisticians to understand both the prevalence and the spread of the disease. Figures for that are emerging—we now have three weeks-worth of figures. They are being published regularly and I would be glad to send the noble Lord a link to the relevant data.

[Baroness Thornton (Lab)]

My question is relevant to what has been in the news today concerning antibody testing. PCR testing is the most reliable but most resource-intensive test. Will it ever be sufficiently scalable for widespread regular testing of all key workers and to track clusters of reinfection? Are the Government investigating the potential of increasing the reliability of antibody testing by double testing? Now that a range of tests is being manufactured globally, will the Government publish their assessment of their relative efficacy in testing the two relevant antibodies?

[Lord Bethell]

The noble Baroness is entirely right. PCR testing is an important guide as to who has the virus, and we have made it available to all key workers who exhibit symptoms. However, we are sceptical of whole-population surveys. Double testing might help if there is damage to serological equipment, but the challenges of serological testing are more to do with the blood, and unfortunately people do not change their blood. We are very proud of British universities, which regularly publish assessments of the various serological approaches. That work is under way and continues, and we hope to make more progress on it in the months ahead.

Health Protection (Coronavirus, Restrictions) (England) Regulations 2020

Baroness Thornton Excerpts

Tuesday 12th May 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for his introduction and I thank all noble Lords for the many questions they have raised, which needed to be asked. We all wish these regulations were not necessary, but we also accept that they are. I think the counsel of the noble Baroness, Lady Wheatcroft, is dangerous and potentially fatal and I hope the Government will not heed it. This virus is still among us. It is not defeated, and we need to be cautious and, most of all, clear.

Before getting to the substance of these regulations and the future, it is important to remember that they represent the biggest peacetime restrictions that this country has ever seen and demand full parliamentary monitoring and scrutiny. Parliament put them through at speed, and I wonder whether the Minister agrees that a couple of hours of debate weeks after they were introduced cannot in future be sufficient to provide the level of examination and scrutiny that such sweeping laws require. The Prime Minister’s announcement, the publication of the new strategy, the subsequent debates and discussion and the statement made last night on the BBC by my right honourable friend the leader of the Labour Party, Sir Keir Starmer, all point to the need for greater clarity and significantly better communication. The main point concerns the need to come back to Parliament with yet more amendments to these regulations. Does the Minister anticipate that we will see further revisions to the regulations, and if so, when?

I would like the Minister to address some of the problems caused by the mixed messaging and to try to rectify the somewhat shambolic government communications over the past few days. For example, why have the Government called for people to return to work before the schools are open and not to go to work on public transport? To these Benches, that suggests a serious lack of understanding of ordinary people’s working lives. For the Prime Minister to say that he is sure employers will understand that some of their workforce will have childcare difficulties makes me wonder which planet he and his Ministers inhabit.

Will the Government bring forward further regulations, or even legislation, to provide protection for employees who are faced with the dilemma of employers demanding that they return to work when their children cannot go to school? Furthermore, is a grandparent allowed to look after one child but not two? Who exactly should return to work—as the Prime Minister said, “The next morning” —and how should employers keep their employees safe? The guidance on funerals also needs further clarification. It was championed by my noble friend Lord Kennedy but I feel that there is still considerable variety across the country, with some councils taking awful decisions and causing serious distress to families. Can the Minister ensure that the guidance issued is being followed? My noble friends Lord Kennedy, Lord Campbell-Savours, Lord Hunt and Lady Wilcox asked many questions, which I hope the Minister can answer.

These regulations allow officers to arrest and fine people for breaking the lockdown but, as many noble Lords have said, we know that they have been misinterpreted in some cases, with wrongful cases identified through social media and press reporting. Indeed, the Home Affairs Committee in the Commons voiced

“concern that police were enforcing government advice rather than the letter of the law”,

which is less strict. Parliament’s Joint Committee on Human Rights previously warned that the police may be punishing people “without any legal basis”, causing confusion over the extent of the law. Can the Minister confirm that all criminal charges made under the Act will be duly reviewed to ensure that they are appropriate and compliant? Given the pace at which the new regulations had to be implemented, it is not surprising that there have been early problems and errors, hence the need for a second set of amending regulations.

We all know the damage that this virus is doing to our society and we all know that these measures are needed to limit that damage, but we should not forget their impact. The physical and mental toll is huge, yet virtually everyone has been adhering to these rules in a way that is testament to the resolve and determination of the British people. Like the Minister, I congratulate everyone on their discipline, their thoughtfulness and the protection that they have afforded our NHS.

We acknowledge that this is terribly difficult. We do not want these measures to be in place for a day longer than is absolutely necessary, which is why they must be accompanied by openness, accountability and scrutiny at a greater level than we would ordinarily see. I note that the Chairman of the Secondary Legislation Scrutiny Committee considered a significant number of statutory instruments that make provision, either directly or indirectly, to deal with the coronavirus pandemic. He said:

“Some of these instruments temporarily impose significant and far-reaching restrictions on citizens and businesses, and the Committee noticed the use of a wide variety of different sunset dates and provisions.”


That is absolutely true. We face a very confusing legislative and regulatory framework.

I am also concerned about the monitoring of the Care Act and the other measures in the emergency legislation that we passed just before lockdown. When will we have the opportunity to discuss them in the House?

The three-weekly review of the regulations means that the Secretary of State is legally required to terminate any regulations that are not necessary or proportionate to control the transmission of the virus. Will a statement providing a helpful examination of that requirement follow the review, and will an Oral Statement follow each subsequent review? Can the Minister assure the House that relaxation of the measures and what will happen in the future will be discussed with opposition parties, employers, trade unions and, of course, the public?

That leads me to my next point. The current rules, sweeping as they are, are too numerous. As the Minister said, the next phase will contain a longer list of reasonable excuses to leave home; it is even more important that those rules be clear and consistent. The rules need to be harmonised with the advice, guidelines and all forms of official communication, as most noble Lords said. We do not want people to infer legal authority where there is none or to act outside the law. That is vital to preserve the rule of law. We know that the lockdown was a blunt tool—effective nevertheless—that will change by definition as restrictions ease. There will be a measure of nuance, distinction and variation that requires careful explanation and policing.

In conclusion, we on these Benches do not oppose the regulations, of course, but, given that they represent the most severe restrictions imposed on British liberty in modern history, it is critical that they be subject to continual comprehensive and transparent scrutiny.

Covid-19: Vulnerable Populations

Baroness Thornton Excerpts

Tuesday 12th May 2020 Lords Chamber

[Lord Bethell]

My Lords, a strange and peculiar feature of the epidemic has been that accident and emergency wards are, surprisingly, below normal capacity since people have sought to avoid them because of the obvious threat of the disease. That said, nosocomial infection is of grave concern. It is an inevitable and frequent feature of any epidemic, but we are applying new ways of working and seeking to section off those with the disease to ensure that the infection does not spread in our hospitals and from there into the community.

[Baroness Thornton (Lab)]

My Lords, I am pleased to note that today is International Nurses Day. I pay tribute from these Benches to all our nurses, at home and all over the world, for their work and courage in these dark pandemic times. I will ask the Minister about testing in our care homes. On 15 April the Government announced that they were rolling out testing to all care workers. On 28 April they extended this scheme to all staff and residents in care homes. Could the Minister explain why, then, yesterday’s strategy document set a target of 6 June? Which is it? It looks like the Government failed to meet the promise to provide the tests on time and have now moved the goalposts again.

[Lord Bethell]

I share the noble Baroness’s celebration of Florence Nightingale Day, which is an important day for the nursing profession and for all of us. We have made huge progress on testing in care homes in the last three weeks. The new portal was made live on Monday and care homes are now massively supported by satellite care home facilities manned by the Army. I am not sure about the 6 June date of which she speaks, but I reassure the House that care home testing is the number one priority of our testing facilities and is benefiting from the large increase in capacity.

Covid-19: Government Response

Baroness Thornton Excerpts

Wednesday 6th May 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for repeating this Statement. I point out that the Commons took an hour to receive and discuss this update; we are getting 10 minutes. It is almost two weeks since I saw the Minister across this virtual Dispatch Box, which seems a long time in a pandemic. When we went into lockdown in March, he seemed to indicate his enthusiasm for being accountable to the House in lockdown. I regret to say that I do not believe that he or his colleagues have matched that aspiration. I place on record that it is shocking that noble Lords across the House are reduced to submitting vital questions about Covid to a lottery—a ballot of topical questions. That is not serious accountability. Unprecedented times need unprecedented procedures.

I have two questions. First, will the Minister support a proposal that he and his colleagues should come to the House every day and have a Covid-related Question Time, morning or evening, which would discuss the contents of the daily press conference and other urgent matters? Secondly, how does the Minister intend to fulfil his promise to the House that there would be an eight-week review of the Covid emergency legislation? By my reckoning, those eight weeks will be up in two weeks’ time.

[Lord Bethell]

I welcome the noble Baroness’s questions on accountability. However, I remind her that not all Covid-related matters are covered by the department of health; Ministers have been in front of the House every day it has been open, answering questions on Covid, and they have given fulsome and thoughtful answers to questions and scrutiny. I welcome also her question on the eight-week review, which, as she says, is coming up in a fortnight. I will find out how the usual channels wish to mark that occasion in the House, and I would welcome the chance to submit the Government to scrutiny on the matter.

Covid-19: Contact-tracing App

Baroness Thornton Excerpts

Wednesday 6th May 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is entirely right to point to the importance of ensuring that the vulnerable are included. Of course, the app is not the only thing we are depending on. Manual track and trace in the conventional way of using a telephone and speaking to those who test positive will still be a core part of our track-and-trace arrangements. Efforts will be made to reach those who are vulnerable or digitally isolated to ensure that they have details of the provisions for these track-and-trace arrangements.

[Baroness Thornton (Lab)]

My Lords, I would like to follow up on the question asked by the noble Baroness, Lady Lane-Fox, because she has put her finger exactly on how this may not work because either our most vulnerable and poorest communities will not have the technology or there will be problems with language. I would like some more detail from the Minister about exactly how the Government intend to roll this out. Given that it took such a long time to roll out the NHS volunteers system, I feel that we might find ourselves with our most vulnerable and poorest communities disadvantaged.

[Lord Bethell]

The noble Baroness is entirely right to be concerned about the vulnerable and our approach. I completely share those concerns. It is a massive challenge, but that does not stop us embracing the advantages of technology where millions of transactions can be done in a day which could never be done by more manual processes. An enormous amount will be invested in trying to reach out to those who are isolated, vulnerable or digitally excluded to ensure that they have details of our track-and-trace arrangements. Hiring an enormous army of track-and-trace experts has already begun, and details can be seen on my Twitter feed of how volunteers who have the right qualifications can join those efforts.

Covid-19: Personal Protective Equipment

Baroness Thornton Excerpts

Thursday 23rd April 2020 Lords Chamber

[Lord Bethell]

The reference that the right reverend Prelate makes is an entirely right one. I pay tribute to the hard-working professionals in NHS and care home procurement. They have been caught in the eye of the most tremendous storm and, under extremely difficult circumstances, are working hard to meet the challenge. In particular, I pay tribute to the local procurement teams who are using their initiative to answer the challenge. Our approach to PPE procurement is one of collaboration with these sorts of local initiatives. I commend them, and they very much spell the future of PPE procurement.

[Baroness Thornton (Lab)]

I was going to ask about waiving regulatory requirements, but I will instead return to the question asked by my noble friend Lord Harris: is it the case that the Minister does not know the number of PPE required? My noble friend asked that question specifically. How much PPE is required on a daily or weekly basis? If the Minister does not know the answer, that is fine; he probably needs to find out and tell us.

[Lord Bethell]

The noble Baroness asks a perfectly reasonable question. I am afraid that I do not know the individual amount off the top of my head. I can tell her that, to date, we have delivered 135 million masks, 148 million aprons, 1.3 million gowns and 485 million gloves—more than 900 million items in total. The amount that we are providing increases every day. I will not hide from the noble Baroness or the House that this is a fast-moving situation. It is my impression that the demand for PPE will soon extend to other workplace situations and increase. It would be wrong to give the impression that this is a fixed amount that we should try to hit with short-term targets.

Covid-19

Baroness Thornton Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for repeating the Statement. I join him and the Government in saying that our thoughts are also with all those who have lost their lives to this horrible virus. I pay tribute to the NHS and social care staff who have lost their lives. I know the Minister agrees that the number of victims who appear to have come from BAME communities is very concerning. Can he confirm reports that BAME people make up 72% of all NHS and carer deaths with Covid-19?

We welcome the announcement of an inquiry. It would be great if the Minister could provide further information about the scope of the inquiry and when it will report its initial findings.

The Minister said he believes that we are now at the peak, but we are nevertheless heading for one of the worst death rates in Europe. The Government have told the public that their response to the pandemic will always be guided by science but, as the Minister will be aware, there are often different views within the scientific community, so I repeat the call that we have made from these Benches in the past that the Government should publish the evidence underpinning their decision to recommend, for example, a seven-day rule for isolation. This is important for public confidence, given that the Government’s advice appears to contradict the advice by the World Health Organization, which advocates a 14-day rule for isolation based on evidence that people can still transmit the virus after 10 days or more.

Despite many questions, it remains unclear why the UK did not participate in some of the European procurement projects. The Chancellor of the Duchy of Lancaster said this was because we missed an email, whereas a senior civil servant at the Foreign Office said in evidence to a Select Committee that it was a political decision, before retracting that comment several hours later. The lack of transparency is deeply unsatisfactory. It would help if the Government published a background briefing so that we could see exactly what happened. We believe that it is necessary to get to the bottom of this situation now to ensure that the UK takes part in any future EU schemes that may help us deliver PPE to those putting their lives at risk on the front line.

The Government have repeatedly said that they are “ramping up”—this is an expression I do not enjoy, and I certainly intend never to use it myself—testing capacity, but the latest statistics show that only 14,629 NHS tests were carried out in the last 24-hour period, eight days before the Health Secretary’s self-imposed deadline to reach 100,000 tests. This is despite testing centres having a capacity of 39,000 checks a day. Why is more than half the country’s testing capacity still going unused when tens of thousands of NHS and social care staff, along with other critical workers, are being forced to self-isolate because they have not been tested? It is very concerning that the number of tests being undertaken is not increasing. Even if the capacity does reach 100,000, that is not the same as access. The latest statistics reveal that the number of tests performed on Tuesday was two-thirds that of the previous day. The Minister needs to tell the House what on earth is going to happen and when we can see the daily increase of tests.

Earlier this week the Health Secretary pledged to test immediately anyone in the social care sector who needed it. While elderly residents can be tested in the homes they live in, staff still have to travel. I learned earlier from the Minister that there are plans in place to change that, so I would like him to explain how soon those alternatives will come on stream.

Testing and contact tracing are vital to managing the UK’s response and easing lockdown restrictions. The new NHS app mentioned is very welcome. Can the Minister set out the timeline for when that will become available?

Finally, will the Minister confirm that the combination of some spare capacity in the NHS and the Government’s view that we now have reached the peak of the virus means that postponed NHS treatments and procedures will resume imminently? Although we understand why some elective treatments were postponed, the delay for many illnesses, including cancer, involves its own risk. It is therefore important that people receive the necessary treatment as soon as possible when it is safe to do so considering the impact of the virus. What support are the Government giving to trusts to help them manage demand amid the ongoing situation and give patients confidence that they will be treated in a Covid-free hospital?

[Baroness Brinton (LD)]

I thank the Minister for repeating the Statement and for his work on testing. We may have some difficult questions for him, but I hope I have the support of the whole House in saying thank you to him and his team for the work they are doing on this difficult area.

I too thank all the staff and volunteers in the NHS and the wider social care sector and other key areas who have been working during this crisis, whether directly on the front line or in supporting families and our children in schools. We send our condolences to the families of the bereaved, and are pleased that many people are recovering, even though we know that, if they have had it badly, it takes time. From these Benches, we echo the concerns about the high percentage of BME deaths, among workers and non-workers alike.

The Statement says that there are 3,000 spare critical care beds, but ITV reports that care home residents now account for up to half of Covid deaths. However, last week the Daily Mail reported that care home residents were still being asked to sign letters to say that they would not go to hospital in the event that they had Covid-19. Will the Minister confirm that these critical care beds in hospital are not spare? There are plenty of people in care homes who could use those beds but they have been put under pressure, no matter how gently, to sign the letters.

It is good to see the Nightingale hospitals coming on board—even if they are empty, for the right reasons. One of the concerns expressed has been about the staffing and the initial request that any patient had to have staff accompanying them from their previous hospital. Can the Minister say that this has now definitely stopped and that staff with appropriate critical care experience are able to be recruited? I gather that this has also been a problem for increasing the number of beds.

There was a good message in the Statement for people to go to their GPs and to use 999 for emergencies, but today there was a report of somebody who had a severe heart attack not being picked up urgently, as heart attacks are still second-level priorities to Covid. As a result of that 20-minute target rate, sadly the patient died. Is there any rebalancing of priorities for ambulances now that we seem to be over the peak of cases?

On equipment and medicines, it is good to hear that there are now just over 10,000 ventilators. Are they full ventilators, or does that include CPAP and BiPAP machines? How many more are to come? There have been some worrying shortages of medicines for those who need to be sedated, and recently we have heard news that there is a problem with kidney dialysis and kidney medicine for people who have come out of intensive care and require long-term support. Is there a shortage of such medicines, what other medicines are at risk and what proposals are there to remedy that problem?

We have spent many hours today talking about PPE. We are still waiting for supplies for everything outside hospitals. On 6 April, Clipper was heralded as being about to solve this problem, but it is still woeful. Until the social care and community sectors get the support they need, they will continue to be worried about the spread of Covid.

The Turkish ambassador has written to various people in the APPG on Turkey, setting out the actual arrangements—as opposed to those reported by the Government—concerning the delay in the package that appeared to get stuck. Turkey actually donated 250,000 pieces of medical protection equipment to us; the rest came through privately. Can the Minister say when the remainder of the consignment due from a Turkish supplier will arrive?

It is good to hear that formal arrangements for testing, tracking and tracing are now under way, but the WHO always puts in a third word alongside “test” and “trace”: “isolate”. Any mention of isolation in the Statement is notable by its absence. Taiwan, South Korea and Hong Kong have all managed to suppress further bursts of Covid because of the arrangements for not just testing and tracing but isolating. It is good to hear that an app will be available, but the Minister will know that there are people with technical experience concerned about whether it is appropriate to use Bluetooth for it, because of security issues. Can the Minister assure the House that this is not the case and that people’s data will be used only for NHS purposes and will absolutely not be able to be used by any providers of the app or beyond? The 18,000 tracers announced by the Secretary of State just before this Statement are a good start, but we will need more for good national coverage. Worryingly, Mr Hancock said a few days ago that all this will be operated centrally. Is that still the case, or will he use the existing trained tracers that there are in local communities, whether environmental health tracers in councils or in local health teams? It seems rather bizarre to try to cover the country on that level.

On shielding, it is good that there is a request to create more volunteers and to celebrate the volunteers, but notable by their absence in the Statement are the many people who have not yet had their letters on shielding and whether any further groupings may have to consider shielding—which I understand is the case.

I congratulate the Government on their progress on test and trace, but confirm that we are extremely concerned about supplies of equipment and medicine and hope that things will be remedied speedily.

Covid-19: Social Care Services

Baroness Thornton Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, it is an honour to be winding up this historic debate on behalf of the Labour Benches. It is the first substantial debate to be held in our demi-virtual House.

For two reasons, it is completely appropriate that social and domiciliary care are the subjects of this debate. First, we could only suspect when my noble friend Lady Wheeler proposed this debate how important would be our scrutiny of the effects of Covid-19 on care homes, on domiciliary care, on the 6.5 million carers in our community, and indeed on the elderly and those living with disabilities, whether they are old or young. That has been mentioned by many of my noble friends, including my noble friend Lord Dubs, Lady Pitkeathley, Lord Hunt and Lord Turnberg. Secondly, my noble friend framed this Motion for debate in terms of both the short term and the long term.

I congratulate noble Lords on the brevity and eloquence of their contributions, which were outstanding, but also on their command of the virtual world in which we now operate. I also thank the many organisations that sent briefings to us and gently remind them that a briefing arriving yesterday will have less impact than one that we might have received a week ago.

It is right to separate the short term, where we all wish to work together to mitigate the worst of the crisis, from the long term, where we learn lessons and address with honesty the inertia, political cowardice and long-term cuts that have made it impossible to design and put in place a decent, modern, integrated care system. My noble friend Lady Wheeler and I—the Labour team—have lost count of the number of times we have raised the inadequacies of the Government’s response to the stress experienced on the front line in our social care system over the last five years, with no Green Paper, inadequate budgets and huge cuts to council infrastructure. It would be laughable were it not so awful in its consequences for the most vulnerable in our communities in this pandemic. The fact that in PMQs yesterday the First Secretary of State did not know how many social care workers had lost their lives to Covid-19 tells us all we need to know about the priority that the Government have given social care over many years. That must change.

Finding solutions means that issues are identified by good data, reported honestly and openly, and that all those involved, from care homes, trade associations, charities and trade unions, contribute to finding solutions. The employment and business solutions found by the Chancellor were a result of discussions with many different groups, including the CBI and the TUC. Why has that not been a model for social care during this pandemic? Will the Minister commit the Government to bringing together all the stakeholders in this sector to discuss the future, not just the immediate issues of survival?

Yesterday we learned that the current lockdown is unlikely to end soon. The CMO tells us that the probability of lifting social isolation in the next calendar year is incredibly small. We should be realistic about that. We will have to rely on other social measures which, of course, are very socially disruptive, as everyone is finding out right now. The Chief Medical Officer said that without a “highly effective vaccine” or “highly effective drugs” to treat coronavirus, Britain will have to get used to this new way of life. We do not know exactly what that means, partly because the Government have chosen not to have a national conversation about the best way forward, but to inform us of their decision about ending lockdown at some time—who knows when? We already know that, in the short, medium and indeed long term, the impact will be significant for the communities we are discussing.

I beg the Minister not to talk to us in lofty terms about how hard he and the Government are working—we know and appreciate that—but instead to be honest about the challenge we are facing as a nation and in this sector, and have some discourse about solutions with the communities affected. Perhaps Ministers have had incorrect or incomplete information, but time and again lofty promises and bold assertions have collided with reality. This risks undermining trust in the Government, which is so important at the moment. Levels of trust influence our behaviour. The lessons for our leaders are clear: to have humility to admit they do not know everything; to be authentic in their narrative; to have empathy and provide reassurance for the anxious; to have clarity and consistency of messaging; and above all, to have honesty.

On 9 March I asked the Minister the following question:

“My first question concerns vulnerable people in residential homes and the learning disabled who may be being supported, either by charities or at home by their parents. We need to include these people in the planning.”—[Official Report, 9/3/20; col. 849.]


Social care planning was published five or six weeks later, during which time Covid took hold in our care homes with continuing devastating effect. Only in the last few days have we seen testing offered to residents and staff in these homes, for which we are of course grateful. We are fortunate that the noble Lord, Lord Bethell, is the Minister responsible for testing, which will now be rolled out. Clearly, testing centres which are miles away and can be accessed only by car are inappropriate for residents and many staff. When will this testing, when it is accessible, kick in? What is the timeframe?

We must be honest and say that reports of serious failures have reached us all: vulnerable people denied the care they are entitled to expect, and some even denied life itself. Many with disabilities have expressed how strongly they fear the withdrawal of or reduction in services vital to their well-being, as mentioned by many noble Lords. Not enough has been done to reassure them.

In the short term, we have seen unprecedented action: the Care Act being effectively suspended, with only the protection of the HRA in place, and the injection of literally billions of pounds into the care system, although nobody seems to know exactly where it will end up or whether it is enough.

The loss of hard-won rights in the field of adult care, outlined by the noble Baroness, Lady Grey-Thompson, and others, is a major concern. Service user groups, lawyers and advocacy groups are questioning whether the powers taken are in fact disproportionate to the extent of compromising human rights and are wondering whether these rights will ever be returned after this period of emergency. These are major concerns, and the rhetorical downplaying of the value of low-skilled and low-paid workers has been replaced by treating them as heroes, as many have mentioned.

This really sets up a challenge for the future. It has proved hard in many places to set up proper systems for identifying who is vulnerable and how they can be protected and not fall through any cracks. The lack of good information and the absence of data-sharing are exposed. Market mechanisms, through contracts and regulation, failed to embrace the ability to react in a major crisis. The deep-seated organisational barriers between the different sectors of care and between local authorities and the NHS have been laid bare, despite heroic attempts in many places through local initiatives. We now see, finally, that there has been some recognition of how valuable care staff are, but this must be matched by giving them the pay, conditions, training and equipment they need.

Our current social care model does not work. Integration, despite laudable attempts in Manchester and some imaginative STPs—my own included—is not going anywhere fast. The move to a national well-being strategy avoiding all artificial barriers and tribalism in the NHS and between the NHS and social care is essential.

Labour has set out its vision for a long-term solution. Like everyone else, we will study what we can learn from the crisis and adapt our policies as required—we want to work across parties and nations, and believe that work needs to start sooner rather than later. The NHS and social care must be seen as two sides of the same coin and supported in their efforts to respond to the Covid-19 outbreak. It has never been more important to invest in this critical partnership.

Social care providers and their staff have had to adapt as the crisis evolved and new issues emerged, and are playing a key role in supporting vulnerable people at home and enabling people to return home with appropriate support. This pandemic has laid bare the challenges facing social care and highlights the urgent need for a sustainable, long-term funding solution. This must be a key priority for the Government.

In conclusion, I thank all noble Lords for their contributions to this important debate. I heard a care home manager say in despair on the television last night, “We were not prepared and we are not being led.” She is right. This must change for the short term and the long term.

Covid-19: Medically Vulnerable People

Baroness Thornton Excerpts

Wednesday 22nd April 2020 Lords Chamber

[Lord Bethell]

I completely agree with the noble Lord’s concerns, both about those who are clinically vulnerable and about the potential for a rise in non-Covid excess deaths. The second is a matter of extreme concern. The example of those with cancer who are going to hospital to have operations is a very good and clear example. These matters are very much at the highest level of the Government’s mind.

[Baroness Thornton (Lab)]

I thank the Minister. According to media reports, those who are particularly vulnerable to the virus could be advised to remain shielded for up to 18 months, or until a vaccine has been developed. Can the Minister confirm whether these reports are true? Secondly, the Government have recruited 700,000 NHS volunteers to support those who are vulnerable or shielded. Most of them seem to have been processed but many have been given nothing to do as yet, when there clearly is need. Will the Minister tell me how quickly that issue will be resolved?

[Lord Bethell]

The noble Baroness is entirely right. The prospect of long-term shielding for those most vulnerable is of deep concern. That is why we are pressing so hard on the disease, through the lockdown, to try to get R as low as possible. We will be putting in track-and-tracing measures to ensure that R can be held down and those in lockdown can be freed from their confinement. In terms of volunteers, the response has been incredible. It takes time to turn around all the offers of help that we have, but we are moving extremely quickly to do that.

Covid-19: Removal of Restrictions

Baroness Thornton Excerpts

Tuesday 21st April 2020 Lords Chamber

[Lord Bethell]

The noble Lord is right that the British public have been incredibly diligent, and I commend all those who have followed the guidelines to stay at home for the impact they have had on the infection rate and the mortality rate. However, we cannot fool ourselves into thinking that the epidemic is over. We have to be clear with, and level with, the public that any changes in the guidelines are some way off, and that they will be presented to the public when our understanding of the medium-term strategy is clear.

[Baroness Thornton (Lab)]

My Lords, I thank the noble Lord for the answer that he has just given, but it still begs the question of why the Government are treating the British public as if they were children. I am sure that it would be possible for them to share their thinking, even at this stage. My question concerns testing. Professor Paul Nurse, director of the Francis Crick Institute, said on 19 March about the way to deliver vital testing at scale:

“Institutes like ours are coming together with a Dunkirk spirit—small boats that collectively can have a huge impact on the national endeavour.”


Does the Minister agree with that approach? Can he tell the House when the Government will be able to utilise all the laboratory capacity, which will ensure mass testing and tracing, and will speed up the likelihood of an exit from the current lockdown?

[Lord Bethell]

The noble Baroness is entirely right. I have spoken to Paul Nurse and commend the Crick Institute on the work it has done to build up the remarkable capacity of 2,000 tests a day. However, there are practical issues with the “Dunkirk spirit”. There are enormous logistical challenges in getting swabs and serology to laboratories. There are logistical problems with them registering the correct patient details and then getting the responses back. We have made substantial advances—the Crick Institute has been a pioneer in this—in bringing industrial levels of organisation both to the very large number of tests done each day and to the logistical backbone necessary to process those results.