Covid-19: Resuscitation Orders

Baroness Uddin Excerpts

Wednesday 24th March 2021 Lords Chamber

[Baroness Uddin (Non-Afl) [V]]

My Lords, regardless of Department of Health and Social Care policy and NHS instructions to clinicians, we know that DNACPR orders were made without adequate consultation and safeguards. Can the Minister assure this House that the Government will meet with families who have raised concerns about DNACPRs as the cause of deaths? Will he emphatically agree with this House and the families themselves that senior case reviews should be undertaken, with a panel of experts, of all cases where families have raised questions? Will he state categorically again that DNACPR without consent is—

[Baroness Evans of Bowes Park (Con)]

We will now hear from the Minister.

Health and Social Care Update

Baroness Uddin Excerpts

Monday 22nd March 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend hits the nail on the head; who could think that a return to the previous regime of turning up at a GP’s surgery or a hospital every time you feel ill could possibly be a wise way of going about your healthcare system? Professor Sir Mike Richards has done an extremely good report on community health hubs, which we are looking at very closely; it has some very wise words that we are minded to follow up.

[Baroness Uddin (Non-Afl) [V]]

My Lords, I congratulate the Government on the rollout of the vaccine programme. I have two questions. First, what steps are being taken to ensure that local authorities are making progress to resume assessments of the needs of adults with learning disabilities and autism, many of whom were forced to depend on their inadequate amount of disability benefit? Secondly, what steps have been taken to speak to family members who lost loved ones with the instruction for staff not to resuscitate? I raise this point as I have raised it before. Will the Minister assure this House that the practice is no longer applicable to residents in care homes and people with learning disabilities, unless in agreement with patients and their families?

[Lord Bethell (Con)]

My Lords, the CQC has pronounced its report on do not resuscitate orders, which is absolutely crystal clear. I wholly endorse its findings and recommendations.

Health Protection (Coronavirus, International Travel) (England) (Amendment) (No. 7) Regulations 2021

Baroness Uddin Excerpts

Monday 22nd March 2021 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, I send the noble Baroness, Lady Chapman, my warmest congratulations. She lends weight and strengthens the unacceptably low number of women in this House. I welcome her and look forward to working with her.

I echo the words of my noble friend Lord Hunt about the implementation of these regulations. The pandemic has touched all our lives in every way, with so many losing their loved ones and their livelihood. We as citizens have sacrificed many civil liberties in accepting these regulations and others in our country, where we have professed freedom. None of the progress that we have achieved so far in reducing the infection through the vaccination programme should be jeopardised in easing further lockdowns, and our population should be protected in decision-making about travel.

Travel is more than family time, togetherness and pleasure; it is also about human reasons, as suggested earlier by the noble Baroness, Lady Miller. It is also critical to our businesses in transiting to building a post-Covid world. Safe travel is part of making sure that stability is attainable but it must be measured and phased, given what the scientists have repeatedly indicated: it requires five to six weeks after lowering infections for us to know what is actually going on, and to plan ahead to reflect this when easing a lockdown.

There should be clarity in the messaging about next summer; the public deserve that. Last night I heard through the grapevine that the Brazilian variant may have been taken to Bangladesh by individuals who have travelled from our shores. Can the Minister assure the House that those who are quarantined are being monitored by our test and track system?

Covid-19: Vaccinations

Baroness Uddin Excerpts

Wednesday 13th January 2021 Lords Chamber

[Lord Bethell (Con)]

I pay tribute to colleagues in the FCDO, which has been a tremendous advocate for overseas territories. We have made considerable provisions to ensure that vaccine supplies are provided to the far-flung territories, where we have strong relationships and a duty of care. I would be glad to write to him with the details of that deployment.

[Baroness Uddin (Non-Afl)]

My Lords, anyone questioning the horror of the disease and the pressures on the NHS need look no further than outside their local hospitals, as I did, notwithstanding that questions on efficacy, information and choices are the fundamental right of every patient. The Minister will know that the Bangladeshi community has a very high vaccination compliance rate, but in this case there has been quite a lot of confusion. Can he yet again confirm that sufficient bilingual material is being made available to the community, and will he agree to meet with me and some experts on this issue?

[Lord Bethell (Con)]

My Lords, that is a very good reminder. I will be glad to return to the department and check that the bilingual material is as she asks, and I will write to her with the details.

Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020

Baroness Uddin Excerpts

Thursday 7th January 2021 Lords Chamber

[Baroness Uddin (Non-Afl) [V]]

My Lords, I agree with noble Lords that this is indeed a sombre time, with the highest rate of infection and loss of life and intense pressure on our NHS staff and services. I add my voice to the call for mandatory masking, which must be made freely available. I thank Edmund Yeo for his constant supply of masks, which I have been able to distribute among vulnerable women.

I ask the House’s indulgence to focus today specifically on people of Bangladeshi heritage, who are most excessively affected throughout this pandemic—notwithstanding my respect and concern for all those who have lost their lives or are seriously unwell and facing multiple difficulties as a result of these regulations. Consultant doctor Abdul Mabud Chowdhury was the first GP to lose his life to Covid. His family have continued a commendable campaign for safe practices in the NHS for all staff. Every day, I am notified of friends and neighbours of Bangladeshi heritage struggling with socioeconomic conditions alongside reports of Covid symptoms, self-isolation, hospital admission and, tragically, deaths.

I have spoken repeatedly to the Minister and asked him in this Chamber to explain what he and his department are doing to prevent and mitigate these untold sufferings. Noble Lords will agree that we have made colossal advances in data collection and analysis, or the vaccine simply would not have been developed so rapidly. Given that we have known for many months about the disproportionate impact on people of Bangladeshi heritage, has data has been collected on the numbers of reported Covid infections, particularly with the new variations? How many children are affected and what are their ages? How many are men and how many women, and what are their ages? What underlying conditions do they have? How many are self-isolating and how many infections and deaths are there within specific groups? I am deeply concerned not to see any adequate targeted communications under these extenuating circumstances. Will the Minister undertake to share with me and other noble Lords the Government’s strategy and implementation plan to address these issues as a matter of the gravest urgency?

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020

Baroness Uddin Excerpts

Wednesday 30th December 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, we have exponential infections and the highest number of deaths in Europe. Are the Government seriously not questioning where they have gone wrong? What must now be done to further mitigate this country’s distress? I share the many concerns raised by other noble Lords; my local hospital, the Royal London, has ambulances lined up like the lorries at Dover with patients waiting, often for urgent and emergency care.

Can the Minister say why the Excel Nightingale remains closed to patient care? If it is due to the shortage of 84,000 clinical staff, what consideration is being given to recalling early retirees and utilising the military medical corps for the Nightingales to relieve some of these extraordinary pressures?

We know that tiers are not impactful in controlling deaths and infections. Surely, given the national emergency, we must consider an immediate national lockdown. I agree wholeheartedly with the noble Baronesses, Lady Jones and Lady Watkins of Tavistock, the noble Lord, Lord Harris of Haringey, and many others. That must include schools. Our schools must also be shut down and all the necessary support put in place for schools, families and businesses. Schools have rapidly spread the infection, particularly in areas such as Tower Hamlets, Newham and Hackney.

The prevention strategy must continue, as others have argued. Face coverings must be made available free of charge in many institutions, including in shops and even on public transport. Maybe people would then begin to take their use seriously.

Testing and tracking alongside effective communication with all communities must go hand in hand with the vaccine becoming widely available for those who can and wish to take it up. I congratulate the Oxford team on this wonderful news, and long may it continue.

Covid-19 Update

Baroness Uddin Excerpts

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

The noble Lord makes his point well, but I respectfully disagree. One of the great challenges from closing schools is that young people then socialise and spread the disease much further and wider than they would if they stayed at school. This has been demonstrated time and again around the world. Also, to keep our hospitals open and our businesses and education systems going, and to stop deprivation from accelerating, it is desperately important to keep schools open. That is why, today, we announced the rollout of a much greater and enhanced asymptomatic testing regime for schools, in the new year, which will see bubble and teacher testing, so that schools can remain open.

[Baroness Uddin (Non-Afl) [V]]

My Lords, in the light of the British Medical Journal’s formal joint letter with the Health Service Journal, I hope that the Minister will reconsider the Christmas relaxation of the rules. The point I wish to make really echoes those of my noble friends Lady Verma and Lord Hunt. It is about the scepticism around medicine within some sections of the communities—in particular within Bangladeshi communities, where disproportionate numbers of deaths and infections have occurred. In the light of many noble Lords raising questions about communication issues, will the Minister urgently meet me and some of the local specialist media to consider reviewing the messaging that targets some of these communities?

[Lord Bethell (Con) [V]]

I completely accept the point made by the noble Baroness. It is incredibly frustrating that the exact communities which have often seen some of the highest mortality rates are also those which are sceptical about the vaccine. This is one of our biggest challenges; it has been for months and will continue to be so. I pay tribute to colleagues at the Department of Health and the Cabinet Office who have done a huge amount in working with specialist media—radio, magazines and online forums—to target exactly these communities. They have used advertising and direct engagement with the presenters to put the message across, often in local languages, and this has proved increasingly effective.

Ockenden Review

Baroness Uddin Excerpts

Monday 14th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I completely take on board the noble Lord’s observations. It is true that Donna Ockenden’s report alludes to the failure by senior leadership to monitor and intervene where clearly there were problems. However, let us not confuse correlation with causation. This was not caused by a failure of senior leadership, but by a breakdown in the basic management systems and culture of the maternity services within the trust. That should have been addressed by the senior leadership, but it was not necessarily caused by them. I completely endorse the observation of the noble Lord that neighbouring trusts have an important role to play in checking in and benchmarking behaviours. That is a point made very clearly in the Ockenden report, and one that I hope they will step up to.

[Baroness Uddin (Non-Afl) [V]]

I salute the courage of the parents of Kate Stanton Davies, Pippa Griffiths and so many others in their tenacious personal search for truth and justice. Donna Ockenden’s report was harrowing reading. The pain, trauma and inhuman disregard for the safety of baby and mother was palpable, profoundly damaging confidence and trust in maternity services. It made me relive my own decade-long failed attempt to seek information on whether my lengthy abandonment on a bed overnight after 48 hours of labour pain has anything to do with my now 42 year-old son’s brain damage and lifelong disabilities. I was dismissed constantly, admonished for “being an Asian mother too ashamed to have given birth to a disabled child”, which is far from the truth about a much-loved son.

Sadly, I was not alone, as the Ockenden report details. It has been repeatedly confirmed by so many others and by the first maternity advocacy scheme, which was set up in the 1980s to address the high postnatal mortality rate of mothers and babies among Bangladeshi, Pakistani, Somalian, Vietnamese and African women, whose maternity experiences, even today, remain inconsistent and patchy. Therefore, can I ask the Minister what consideration can and will be given to historic grievances in any future review of maternity services, given what the right honourable Jeremy Hunt in the other place, and Donna Ockenden, have said about the experience of mothers and babies highlighted being only the beginning of unearthing potential malpractice across England?

[Lord Bethell (Con) [V]]

I join others in paying tribute to the personal testimony of the noble Baroness. The story that she tells is extremely moving. One cannot think about the challenges and difficulties that she must have had since that awful night, which she so movingly describes. The report makes it clear that those with a BAME background have disproportionately high rates of difficulty at birth and in maternity services, something which undoubtedly we need to look at more carefully. However, the Ockenden report is not a historic grievances report, and that will not be the focus of our response.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2020

Baroness Uddin Excerpts

Thursday 10th December 2020 Grand Committee

[Baroness Uddin (Non-Afl)]

My Lords, I express my good wishes to the Minister and hope his family gets well very soon. I thank him for the precise manner in which he laid out the two SIs for our consideration.

I share the concerns expressed by the noble Baronesses, Lady Bennett and Lady Altmann, and, like others, I do not share the Minister’s confidence that adequate safeguards exist to effectively monitor private companies —some of them at least—given the fiasco that was impactfully detailed by the noble Baroness, Lady Wheatcroft.

I have a couple of general points to make. On social care for children and adults living with disabilities and autism, it is being widely reported anecdotally and in the media that families and carers are suffering an intolerable burden without adequate support from organisations and local authorities which, because of serious budget shortfalls, are failing in their statutory obligations and to safeguard their duty to protect the most vulnerable who may be experiencing abuse and neglect. Noble Lords will be equally concerned to learn that organisations such as Barnardo’s, the NSPCC and Include Me TOO, which provide specific services for ethnic-minority children, are overwhelmed with demands for services, as many families have depleted resilience to cope and to navigate the new maze of inconsistent and inadequate access to their rightful services.

The Minister speaks with confidence about the critical importance of effective testing services being available to those who require them. My inquiries in my local area, particularly among Bangladeshi communities, continue to alarm me. Many of them remain confused about at what point to trigger testing and what options might be available to them, therefore overwhelming GPs and local hospitals. I have spoken about this in the House on a number of occasions, and to the Minister personally, because there is simply not enough information being relayed to the communities in a bilingual format. I have also spoken to the Minister about re-examining the messaging and what else might need to be done to ensure that there are proper, consistent and effective messages going out about what needs to happen and where the services can be accessed.

Finally, I hope the Minister’s department is collecting adequate data on the kinds of communities—particularly their ethnicities and age ranges—where there are serious gaps in both testing and services. It is high time that we have effective equality impact assessment of all these different SIs as well as the provisions that the Government are providing.

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

My Lords, the noble Lord, Lord Wei, has withdrawn, so I now call the noble Baroness, Lady Jolly.

Coronavirus Vaccine

Baroness Uddin Excerpts

Thursday 3rd December 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord raises an important challenge there; fairness and equity are important in this important time. However, I will try to assess the situation: we have 800,000 doses of a vaccine that is incredibly difficult to transport, requires cold storage and is in vials containing more than 100 doses each. Therefore, practical considerations are pre-eminent at the moment, rather than sharp elbows.

[Baroness Uddin (Non-Afl) [V]]

My Lords, I thank the Minister for the gracious way he has introduced this discussion, and I welcome his assurance of dialogue. I hope he will agree, as he has assured us, that the vaccine will not be the only effective means of preventing infections and further deaths and that the Government will continue their heartening improvement of the test and trace programmes and ensure that those in tiers 2 and 3 have the required financial measures. Can he assure me and the House that his department will urgently scale up communication with particularly vulnerable and poorer communities, where concerns around vaccination are significant? Can he assure me that any proposed government use of the police and army will be done with consent and after consultation with local authority leadership?