Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020
Baroness Tyler of Enfield Excerpts(4 years, 4 months ago)
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Baroness Tyler of Enfield (LD) [V]
My Lords, we are debating these regulations very late in the day and on the last day before Recess, although they were introduced on 4 July. We are doing this at a time of growing concern about a second wave of the pandemic, both at home and abroad, and when new measures have been introduced in Oldham, Rochdale, Blackburn and Pendle to address localised flare-ups.
The link between the prevalence of Covid infections and levels of deprivation is becoming ever clearer, as the noble Lord, Lord Ribeiro, explained so well. What systems have been put in place to ensure the sharing not just of data but of good practice, and the effectiveness or otherwise of localised measures both at national and local government level?
While I welcome today’s news that the Government will fund studies into why people from black and ethnic-minority backgrounds are more likely to die from Covid-19 than the white population—that is highly relevant to the diverse population of Leicester—why have we waited until now to do this, when the link has become increasingly clear since the early differential death rates first became apparent? I repeat my call for a full debate in this Chamber at the earliest opportunity on urgent action needed to tackle inequalities before a second wave, and before it is too late to act.
Relaxations had been made to these regulations, which came into force on 18 July—including to the areas covered—before they were even laid before Parliament. I join my noble friend Lady Jolly in asking the Minister to explain what process will be in place over the Recess to inform the House of the outcome of the review of regulations, which happens every 14 days, with the next one tomorrow.
Finally, looking ahead, what extra financial help will be given to people affected by local lockdowns such as in Leicester when the Government’s furlough scheme ends in October? Will the Government also think again about a temporary lifting of the benefit cap for the duration of the pandemic for those affected by local lockdowns or indeed any further national lockdown required?
Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020
Baroness Tyler of Enfield Excerpts(4 years, 4 months ago)
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Baroness Tyler of Enfield (LD) [V]
My Lords, I find it deeply troubling that, yet again, we are debating regulations that came into effect weeks before they received scrutiny in either Chamber. They have often been repealed or overtaken already. It makes a mockery of the parliamentary process and gives the unfortunate impression that Ministers are actively trying to avoid in-depth scrutiny. At the start of this pandemic, it was easy to understand why it was not possible to debate these regulations straightaway, but that is no longer the case. It follows a disturbing pattern of regulations and guidance coming far too late, with too little scrutiny. I cite the guidance that came out yesterday on face coverings, 12 hours before it came into effect, and to care home visiting, which caused such distress because it was so late. Like the noble Baroness, Lady Anelay, I want to know when and how this Chamber will be informed of the next review of these regulations. It is due on 30 July, when we will be in recess.
Independent Residential Care
Baroness Tyler of Enfield Excerpts(4 years, 5 months ago)
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Lord Bethell [V]
My Lords, it is not the role of a junior Minister to speak on behalf of the Prime Minister, but I can say that the Prime Minister, the Secretary of State and I are all enormously grateful for the huge amount of work that social care staff have put into this epidemic. I have seen with own eyes the commitment and expertise that they have provided during these very difficult days. We are, as a nation, enormously grateful for their hard work and skill.
Baroness Tyler of Enfield (LD) [V]
My Lords, the pandemic has placed a very harsh spotlight on the resilience of the care system, with 30,000 excess deaths in care homes in England and Wales in a three-month period. At the weekend Sir Simon Stevens made it crystal clear that we just do not have a fair or properly resourced social care system with proper workforce support. With some homes already running close to bankruptcy due to the additional costs and occupancy rates slipping below 87% when many smaller homes become financially unviable, what immediate steps are the Government taking to protect these smaller homes?
Lord Bethell [V]
The noble Baroness is entirely right that the issue of excess beds is an unfortunate and unwelcome added pressure on an already pressured system. Sir Simon Stevens was echoing the sentiments of the Government and the Secretary of State when he said that we need to move towards a long-term settlement for social care. That was very much the commitment of the Prime Minister during the election and in the manifesto. Steps have been taken towards working on that but we have been interrupted by Covid-19. It remains a number one priority for the Government. In the meantime, we will be putting in the financial resources necessary to provide the resilience for those smaller homes of which the noble Baroness speaks.
Covid-19: Mental Health
Baroness Tyler of Enfield Excerpts(4 years, 5 months ago)
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Lord Bethell
The noble Baroness is entirely right to emphasise the importance of longitudinal studies. The UK household longitudinal study data, which analyses the GHQ-12 scores, has been upgraded. We will continue to invest in that, and Public Health England has been tasked with monitoring the development of mental health issues across the country.
Baroness Tyler of Enfield (LD) [V]
My Lords, research shows that the pandemic has had a disproportionate impact on some of the most disadvantaged, particularly those from BAME communities. During this period, many mental health and community services have moved online. While that is an appropriate first response, charities are now expressing concern that it is not an effective response for many, including the elderly, those with learning disabilities and those with severe mental illnesses. Can the Minister say what urgent steps the Government are taking to restore effective treatment and care for all, including face-to-face services, with all necessary PPE and testing in place?
Lord Bethell
My Lords, we are feeling our way in this area. There have been benefits from some of the moves online. People have been able to see more of their consultants, they have found that some of the content provided has been helpful, and the reach has gone up. However, I completely agree with the noble Baroness that it will not work for everyone. I pay tribute to mental health professionals who have maintained face-to-face contact during the epidemic, with all the threats associated, and we continue to look closely at how to fit appropriate technology and digital access to the right people and in the right format.
Covid-19 Update
Baroness Tyler of Enfield Excerpts(4 years, 5 months ago)
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Lord Bethell
My Lords, I remember the incident well and I intended no discourtesy whatever. I reassure the noble Lord that I left the Chamber and instructed my officials to draft that letter; on leaving today, I will chase it down and ensure that it goes to him speedily.
Baroness Tyler of Enfield (LD) [V]
My Lords, local lockdown plans in Leicester and elsewhere are vital to ensure that a proper place-based response takes full account of existing health inequalities. At an all-party group meeting yesterday, Sir Michael Marmot explained that Covid-19 has exposed existing inequalities in society and amplified them, with Covid-19 mortality rates closely linked to health inequalities and deprivation more widely. Does the Minister agree that, before the Summer Recess, your Lordships’ House must have a full debate on tackling inequality before a second wave hits us, with a sharp focus on the disproportionate impact on specific groups, particularly the BAME community?
Lord Bethell
My Lords, it is beyond my reach to instruct the House on its debates, but I would entirely agree with the noble Baroness that one of the saddest and most challenging aspects of Covid is that it hits society where it is weakest. It has undoubtedly hit those with health issues the hardest and has exacerbated health inequalities. It is my sincere hope that this Covid epidemic will be an inflection point, when this country embraces a strong public health agenda and addresses those health inequalities with energy.
Covid-19: Mental Health
Baroness Tyler of Enfield Excerpts(4 years, 6 months ago)
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Baroness Tyler of Enfield
To ask Her Majesty’s Government what assessment they have made of the report The mental health effects of the first two months of lockdown and social distancing during the Covid-19 pandemic in the UK, published by the Institute for Fiscal Studies on 10 June; and what steps they plan to take in response.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]
My Lords, the noble Baroness raises an important issue, and I am grateful to the IFS for this thoughtful report. It is too early to know for certain the mental health consequences of Covid, but we are deeply concerned about those who suffer from isolation, young people, those who have fears of economic uncertainty, and those with existing mental health vulnerabilities. I give thanks to mental health professionals, who have worked hard during the epidemic, despite difficult circumstances.
Baroness Tyler of Enfield (LD) [V]
My Lords, last week’s report by the IFS reveals how Covid-19 and the lockdown has had a major negative impact on mental health across the population, with women and young people particularly badly hit. Pre-existing inequalities in mental health have widened yet further. The report states that the scale of deterioration in mental health is of a magnitude unlike anything seen in recent years. What immediate steps are the Government taking to prevent this looming mental health crisis turning into an epidemic in its own right?
Lord Bethell [V]
My Lords, the report is extremely helpful and throws a spotlight on an issue that we are deeply concerned about. Immediate help includes a £4.2 million support fund for mental health charities, and a £5 million fund for Mind, specifically to support charities dealing with Covid-related mental health issues. We will continue to invest in mental health in the long term, to support this important area.
Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020
Baroness Tyler of Enfield Excerpts(4 years, 6 months ago)
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Baroness Tyler of Enfield (LD) [V]
My Lords, I have no issue with the minor lifting of restrictions contained in these regulations—apart from the bizarre timing of this debate—other than to say how odd it was to prioritise being able to visit an estate agent over being able to visit family members from whom we have been separated for months.
I will focus primarily on how as a country we move out of lockdown in a way that feels fair and does not discriminate. It has been more apparent in recent weeks that we were too slow to move into lockdown and that those lost weeks in March cost precious lives. The Government have also been far too slow in getting testing, tracing and isolating up and running, as well as in providing PPE and other crucial support for care homes.
I have been particularly concerned about the impact of lockdown on the well-being of those living by themselves, for whom lockdown has been especially tough. For some living alone, there has been a limited easing of restrictions in recent weeks; they can now form a social bubble with another household. These are clearly steps in the right direction, but I am concerned about the mental health impact of long periods of isolation on both the over-70s and those of any age living alone.
Back in April, the Mental Health Foundation voiced concerns over the long-term impact of the pandemic on mental health after a quarter of adults surveyed admitted to experiencing loneliness during lockdown. Perhaps surprisingly, the most affected group was found to be young people aged 18 to 24, 44% of whom admitted to experiencing loneliness. Research has shown that loneliness has the same impact on mortality as smoking 15 cigarettes a day, making it more dangerous than obesity. More recent research from Age UK has shown that over two-fifths of people aged 70 and over say that their mental health has been affected, with those locked down alone having a particularly anxious time.
Many people over 70 who are still fit and active, contributing to the economy and society and with no underlying health conditions, are increasingly finding these blanket policies ageist and discriminatory. A growing number of over-70s are also annoyed at the implication that all their age group are equally vulnerable and have called on the Government to take a more nuanced approach. Indeed, some are starting to say that the proposed cure of a lengthy extended lockdown for older people is as bad as or worse than the disease itself.
To finish on care homes, which are never far from my mind, at the end of May social care leaders began calling on Ministers to prioritise unlocking care homes amid growing concerns that mental health problems were contributing to the deaths of residents, a call echoed by the Relatives & Residents Association. The executive director of the National Care Forum said:
“We need to put the same energy and imagination into opening up care homes as we’re putting into opening up the great British pub.”
I for one agree.
National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020
Baroness Tyler of Enfield Excerpts(4 years, 6 months ago)
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Baroness Tyler of Enfield (LD) [V]
My Lords, I too support the long-overdue pay increase for nurses working in the social care sector. I also strongly support the regret Motion tabled by the noble Lord, Lord Hunt, who is right to draw attention to the financial instability of this deeply fragmented sector.
There are approximately 15,000 care homes in the UK, with more than 400,000 beds, run by approximately 8,000 providers. Some are very small; others provide a large network of homes. It is a mixed economy: 84% of homes are owned by the private sector, including some that are owned by private equity firms, both British and offshore; 13% are owned by not-for-profit organisations; and 3% are owned by local authorities. Funding comes from a mix of private funders, local authorities and the NHS. Despite this funding mix, care homes have been hit by a decade of cuts in social care funding. An FT investigation last summer revealed:
“Britain’s four largest privately owned care home operators have racked up debts of £40,000 a bed, meaning their annual interest charges alone absorb eight weeks of average fees paid by local authorities on behalf of residents.”
Many have argued that this debt-laden model is completely inappropriate for social care, as is one that involves paying large dividends to investors.
Many homes are already running close to bankruptcy and have expressed grave concerns about the spiralling costs of PPE and extra agency staff, as well as lost income from empty beds. It has been estimated that when bed occupancy rates slip below 87%—as many have now—operating surpluses are such that many smaller care homes quickly become unviable, particularly those with greater reliance on state-funded residents.
This virus has brutally exposed systemic weaknesses in our social care sector. The latest official figures show more than 12,000 Covid-related deaths of care home residents in England and Wales, but it has been estimated that the true figure, calculated by looking at excess deaths of care home residents in the period, could be double that. According to a recent poll, one-third of people say that they are less likely to seek residential social care for their relatives or as a future option for themselves. This brings into very sharp relief the respective responsibilities of central and local government if care home owners go under financially or simply decide to shut up shop and hand back the keys. Simply put, who is the provider of last resort?
Tellingly, that poll also revealed that the vast majority of respondents want care workers to be paid above the minimum wage. If this pandemic has revealed one thing, it is that we can no longer kick the can down the road but must take advantage of the growing public and political consensus that social care should be free at the point of need, funded largely out of taxation. There are, of course, a number of ways of doing this: general taxation, hypothecated tax, or some form of social insurance. This needs to be at the nub of both the political debate and a grown-up national conversation.
Covid-19: Obese and Overweight People
Baroness Tyler of Enfield Excerpts(4 years, 6 months ago)
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Lord Bethell
The noble Baroness is entirely right that chapter 2 outlines an extremely thoughtful roadmap for how to address this issue. It is currently being reconsidered. I cannot make the guarantees she asked for from the Dispatch Box, but I can assure her that we are working hard to see how we can use the example of Covid to make progress on this important agenda.
Baroness Tyler of Enfield (LD)
My Lords, given the Prime Minister’s welcome recent statement that a more interventionist stance is needed to tackle obesity, is the Minister aware of a recent poll by the Obesity Health Alliance showing that 72% of those surveyed supported restrictions on shops promoting unhealthy foods in prominent areas, including checkout areas, and 63% wanted the sugar tax on soft drinks extended to other sugary foods? What plans do the Government have to introduce these measures, working collaboratively with supermarkets and other food retailers?
Lord Bethell
The noble Baroness is entirely right to suggest that Covid might be the infection point—the intervention necessary to wake up the nation to the dangers of obesity. We are keen to use that moment to make progress on this important issue.
Mental Health Services
Baroness Tyler of Enfield Excerpts(4 years, 6 months ago)
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Baroness Tyler of Enfield
To ask Her Majesty’s Government what steps they are taking (1) to protect, and (2) to support, mental health services (a) during, and (b) after, the COVID-19 pandemic.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the NHS has issued guidance to services to support them in managing demand and capacity across in-patient and community mental health services. Services have remained open for business as usual as a result. We remain committed to the additional investment in mental health services set out in the NHS long-term plan. We have provided an additional £5 million to mental health charities to support their work during the pandemic.
Baroness Tyler of Enfield (LD)
My Lords, the Royal College of Psychiatrists warned last week that the nation faces a mental illness “tsunami”. Those on the front lines of our health and social care services have gone above and beyond to tackle this dreadful virus, but now may themselves face significant mental health problems. Thousands have lost colleagues, endured serious illness or experienced major trauma. Will the Government commit to investing in a world-class mental health response to Covid-19, including by setting up specialist support services for those on the front line of our NHS and care services, mirroring the services available to our armed services personnel?
Lord Bethell
I join the noble Baroness in paying tribute to those working in mental health in the NHS. They have kept services running in extremely difficult circumstances and their impact has been extremely powerful. Although we are aware of the deep threat of a mental health tsunami, as was warned, the evidence to date is that these people have done an amazing job of addressing the concerns of those who are suffering under coronavirus and the lockdown.