Covid-19: Dental Services

Baroness Uddin Excerpts

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely acknowledge the challenge that the noble Baroness has described. Many dentists can see only 20% of their normal cases, and around half can see about 50%. The backlog is, as she describes it, severe, and the impact, particularly on private dentists, has been very hurtful for their businesses. I cannot make a commitment to fund ventilation arrangements, but we acknowledge the scale of this challenge and are looking at ways to mitigate it, including bringing in testing, which we hope would help provide a safe environment for both staff and patients.

[Baroness Uddin (Non-Afl)]

My Lord, the Minister will be aware that people with learning disabilities and autism have suffered disproportionately in not receiving care and services. Will he undertake to ensure that they are not equally suffering by not receiving dental services, especially specialist dental provisions? I declare that I have a 41 year-old son with a learning disability and autism. I have spoken to a number of organisations that said that the pandemic exacerbated the difficulties in the process of receiving important and urgent care.

[Lord Bethell (Con)]

My Lords, the noble Baroness refers to the prioritisation of patients in the constrained appointment flow of dentists. She is entirely right that those who have vulnerabilities, disabilities or other disadvantages should be prioritised: that is the objective of the prioritisation process. She makes the point extremely well and I am happy to take on board any points on where she thinks the system is not working as well as it might do.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Baroness Uddin Excerpts

Wednesday 4th November 2020 Lords Chamber

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

My Lords, it is a privilege to follow so many eloquent and committed speakers. I speak today with the heaviest heart. In spite of the unnecessary delays, I accept that the proposed lockdown may be necessary to prevent pressure on the NHS beyond its capacity. I extend my good wishes to all the families of those affected and pray for their speedy recovery.

I welcome some of the financial measures being extended until December. Many of the questions that I have asked the Minister on countless occasions over the past few months remain unanswered. One such question that other noble Lords and I have repeatedly asked is about a cost-benefit and risk analysis and an equality impact assessment of government policies.

I agree with the noble Lord, Lord Forsyth of Drumlean, about the unequal and unimaginable duress on the poor and low-wage families. Inevitably, this intensive period of isolation will again affect women and children, who may face further abuse and violence to comply with government regulations. Many leading civil society organisations have continuously warned that vulnerable women and their families are not accessing financial measures to which they are entitled. Will the Minister assure me that he has listened to their call, and to the many suggestions that other noble Lords and I have made to improve the Government’s communication with vulnerable groups? Will he agree to meet community experts urgently to address and improve this crucial messaging?

The Government have had months; why are there no assessments or data available to the Government on the effect of Covid on victims who have experienced exponential levels of poverty and domestic abuse, or on children and young people experiencing mental health issues? Have Public Health England and Kevin Fenton’s recommendations been understood and, if so, what action has been taken to improve financial packages and services to vulnerable groups? Are the Government mindful of the systemic inequalities which cause disproportionate numbers of deaths among minority communities? Will the Minister assure the House that lessons have been learned and actions are being taken to monitor and avoid unnecessary deaths and infections among the specified vulnerable groups as we progress through lockdown?

Locally led test, trace and isolation is crucial, as has been said by many noble Lords. It has been reported that Hammersmith and Fulham Council successfully helped the NHS reach out to its communities; its efforts and the work of housing officer Hasnat Syed were commended. Can the Government make local government their delivery partners using this model? The Government’s chaotic and inconsistent responses and delay is clearly one reason why we have the current number of in-patients.

While I give the benefit of the doubt to keeping children safe in education, I know that, in my own close and extended family, a number of children have tested positive for Covid, and I witnessed their parents’ dread of hospitalisation. I hope the Government will keep reviewing their decision based on sound evidence, and we must continue to do everything to keep the Government and Ministers answerable.

Covid-19: Intensive Care Treatment

Baroness Uddin Excerpts

Thursday 29th October 2020 Lords Chamber

[Lord Bethell (Con)]

I am not sure that I agree with the implication of the noble Lord’s question—that somehow there is a prejudice on the front line against older people and that staff take it into their own hands to make decisions that are in themselves inherently unfair. That is not my experience. Where the noble Lord absolutely has a point is that people are extremely sensitive about these kinds of issues, and, quite rightly, are deeply concerned that they are going to get the treatment and care that they deserve and will not be subject to any form of unfairness. It is imperative that the NHS builds trusts and conveys a strong communication on these issues. To push back against the noble Lord, it is not my impression that the staff at the NHS have lost sight of this important principle.

[Baroness Uddin (Non-Afl)]

My Lords, I declare an interest in that many of my family and friends work on the front line of the NHS, which I love and respect, as all other Members do. At the height of the pandemic, I watched a programme on Italian and American doctors using algorithms for vital decisions on treatment, with one being highlighted where triage tools had indicated nil chance of a patient surviving. However, their family pleaded with the doctors and convinced them to give them a few more days to see if “a miracle could happen”. In April, my close friend’s death was predicted from the use of some kind of early triage process. Sadly, my friend lost his battle. However, the miracle occurred: against all the odds, because of one decision by one team of doctors, the Italian patient survived. Given the fiasco of the use of algorithms, although I welcome the Minister’s absolute assurance, what analysis or serious case review has been undertaken of the number of treatment decisions based on early triage tools, given that extreme pressures on doctors have returned? Where deaths have occurred, can the Minister say what proportion were individuals of Bangladeshi heritage? Can any lessons be learned to improve their survival chances in the current emergency?

[Lord Bethell (Con)]

My Lords, I share my sympathies with the noble Baroness for the loss of her friend, for which we are all very sad. However, I take exception to her implication of a fiasco in the use of algorithms. I do not accept the implication that it is regular practice for clinicians somehow to give up on patients who stand a chance simply because their reading of an algorithm says that they should move on to someone else. That is not how we run the NHS; it is not how we had to run it during the first wave and it is not how we intend to run it during the second.

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

Baroness Uddin Excerpts

Thursday 22nd October 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, regardless of the statistics the Minister has suggested on the number of those reached for self-isolation, communities with large minority communities remain unaware of government regulations and, most importantly, the unnecessary punitive fines. Some of the latest statistics suggest that more than 60% of close contacts of those who are Covid-positive have not been reached. Are statistics available for their profile, including their ethnic backgrounds? What assessment has been made of the reasons for the evident and serious gap in trust in the Government’s management of their communications with the public? Needless to say, their resistance to engaging with the leaders of Manchester will not have filled ordinary citizens with great confidence, and any clarity is in the messaging that the Government will not accept any scrutiny or dissent.

These are emotionally testing times for us all. Problems with mental health and well-being are also at pandemic level and, regardless of government funding strategies, why are respected national and local statutory and voluntary organisations struggling to access essential funds to provide assessments, counselling and other support, while many people end up in A&E? What urgent consideration and resources have been allocated to national and local children’s organisations to support individuals and families before they reach crisis point?

Under emergency modes, we have overlooked social divisions as communities become ever more segregated, with more vulnerable families increasingly detached from those who have and those who remain at the margin of inadequate, unequal access to financial, educational, digital and emotional support. Now is the time to reach out for better management of this pandemic. The politically biased attention given to local leaders is unbecoming of this Government leading a national and global pandemic.

Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 5) Regulations 2020

Baroness Uddin Excerpts

Tuesday 20th October 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, it is a pleasure to congratulate the noble Baroness, Lady Fox. In our younger days we shared many platforms in the antiracist movement. Of course, that was before she departed completely from my political principles, but I look forward to working with her on common grounds.

The Government must lead by consensus, with clarity of messages and adequate financial support for the millions of our citizens who are experiencing such draconian measures, financial collapse, and strain on their mental and physical well-being. The spat with Mayor Burnham has certainly taken attention away from the serious impact of these regulations, including the lack of an effective test, trace and track system.

From the outset, the Government have been utterly inconsistent in their dealings with leaders of local authorities, many of which are facing massive reductions in basic services for the elderly and people with disabilities, and the decimation of voluntary organisations that have been the backbone—the bedrock, actually—of vulnerable communities. Some local authorities are facing bankruptcy, as the noble Lord is well aware. The collapse of the hospitality sector and associated businesses has had a profound impact on local authorities, as has been mentioned, and will continue to have such an impact unless the Government provide sufficient financial measures for them in their critical role in underpinning and delivering these protection measures.

[The Deputy Speaker (Baroness Fookes) (Con)]

I understand the noble Baroness, Lady Gardner of Parkes, has withdrawn, so the next speaker will be the noble Lord, Lord Bhatia.

Health Protection (Coronavirus, Local COVID-19 Alert Level) (Medium) (England) Regulations 2020

Baroness Uddin Excerpts

Wednesday 14th October 2020 Lords Chamber

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

My Lords, it is a real privilege to follow my noble friends Lord Robertson and Lord Rooker. Tiered approaches may seem fit for the purpose now, as we deal with differing rates in admissions across the country and across boroughs in London. However, it has to be said that the rapid rate of government announcements has caused manic confusion among the general public. I agree with the noble Lord, Lord Bilimoria, that clarity in message is critical. Even in areas described as medium risk, there is a deepening fear that we are about to hit a catastrophic health crisis without sufficient financial measures for significant numbers of our citizens—vulnerable citizens and communities. I have some general questions for the Minister and I look forward to his consideration and responses.

What specific measures are in place to protect front-line staff with protected characteristics? Will the Government assure this House that, unlike in the first few weeks and months, front-line staff of minority heritage will not be pushed into Covid management without safeguarding their well-being? I am citing many who lost their loved ones during the first outbreak. Given that we know people of minority heritage continue to be at risk of ending up in ICU admissions, will the Government ensure that those doing test and trace door to door have proficiency in the languages for the populations there? What additional resources will be given to areas in the middle tier to prevent them going to the more critical grade?

We also know that families with disabled children who have learning disabilities and autism, and their carers, have experienced adverse impacts in services and their mental well-being. What plans and resources are in place to meet the upcoming needs for services to ensure that we meet our obligations on human rights and equal rights? I have asked this question before and it has not been answered. What protocols exist to ensure that parents and carers of people with learning disabilities and autism can be with their loved ones, should they wish to be, when members of their families end up in hospital for treatment? I would really like to be written to if it is not possible to answer this. What protocols exist and are they being issued as guidelines to all front-line services?

Some of the exemptions are applicable to people with disabilities who are able to participate in games, outside and indoors. I understand the sentiment in ensuring that activities and provisions on playing sport are available to them. Are we not overlooking the need to safeguard the health and protection of the groups of people who have until now been shielding?

Are the criteria for shifting at-risk areas in the medium category to a higher grade being communicated to local authorities in advance so that they can prepare sufficiently, and will adequate extra resources be made available to cities and regions, whatever their political leadership?

Finally, boroughs such as Tower Hamlets and Newham have seen incredible levels of infection and admissions, which now include young people and children. What consideration is being given to ensure that we do not airbrush children out of the danger zone, as we seem to be doing?

[The Deputy Speaker (Baroness Fookes) (Con)]

As the noble Lord, Lord Berkeley, has withdrawn, I call the noble Baroness, Lady Jolly.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) (No. 2) Regulations 2020

Baroness Uddin Excerpts

Monday 12th October 2020 Lords Chamber

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

My Lords, many of us in this House have consistently called on the Government to make mask-wearing mandatory. I am relieved that they have seen the error of their ways. When masks were gold dust, my wonderful mother started making them, beautifully crafted, for all our family. I have diligently worn them since April, even when I am cooking and baking. We are at a crossroads, with increasing numbers of people being admitted to hospital across the country. No doubt we will have to examine whether mandating masks would have prevented the rising infection rate.

I take this opportunity to acknowledge the decisive action of the Lord Speaker, and the Speaker in the other place, who instructed both Houses in protecting staff. I hope that guidance will also be extended to staff at hospitality venues, including restaurants. It makes no sense for staff not to wear masks while cooking and serving.

Masks are an expensive commodity, priced well beyond the means of those on paltry state benefits and low pay. Can the Government enshrine their commitment to public health and meet the needs of those most vulnerable by making them available free in health service institutions, schools, universities, community centres and places of worship, where people are still allowed to congregate in greater numbers with social distancing?

I went to venues, as I usually do every weekend, to see what was happening and if there were any improvements among young people attending organised events. I was pleased to see increased numbers of young people wearing masks—though still not enough—but social distancing remains a huge gap in public education. The Government must address this and I am sure we will discuss it in due course.

I have just come from a Zoom briefing by the Chinese Information and Advice Centre. Its members have seen an exponential rise in hate crimes against the Chinese communities. Under the outstanding leadership of Edmond Yeo, CIAC’s endeavours have also been outstanding, ensuring that it provides thousands of masks and food parcels to vulnerable families. I have worked with CIAC since April and throughout the summer. Its work is incredible and its commitment outstanding. This community has suffered a huge rise in hate crimes. Can the Minister take this back to his and other departments, and ensure that the Chinese communities are protected on the streets of our country?

Health Protection (Coronavirus, Collection of Contact Details etc and Related Requirements) Regulations 2020

Baroness Uddin Excerpts

Wednesday 7th October 2020 Lords Chamber

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

My Lords, when the technology works, it is impactful, and therefore access to these enabling facilities is critical. Of course, we do not live in a world that is socially and economically equal by any measure. Therefore, I urge the Minister, as I have done before, that when measures such as these are presented to the House, an equality impact assessment must be embedded. That is absolutely necessary, particularly when the regulations state that there is no human rights impact but then proceed to list many possible infringements and punitive punishment measures. I therefore add my voice to those of the noble Baroness, Lady Barker, and others, who have called for the Minister to present a current analysis of what is happening on the ground, right now, when bringing forward SIs. This is important and extremely pertinent, so that we can continue to support these retrospective government measures and regulations.

The Minister listed the impressive number of people who have downloaded the apps. Indeed, as someone who is getting to be comfortable with these things, that is impressive. However, what evidence is available to the Government on the use of these apps and compliance with the test and track requirements? Are they being taken up by those in vulnerable communities where infection rates are the highest? Does the noble Lord accept that the messaging has some way to go to reach into those communities where language barriers and socio-economic disadvantages, including digital disadvantages, are so significant? These are people who remain extremely vulnerable to the upcoming surge in infection rates and admissions to hospital. If so, we will have to learn the lessons of the last deadly period.

I have spoken to the owners of a number of hospitality businesses, including to Mr Atique Choudhury, the owner of Yum Yum. Incidentally, his father, Mr Dabirul Islam Choudhury, a pioneering restaurateur and a centenarian, has raised £250,000 for the NHS and related charities. I hope that the Minister will take this opportunity to commend his incredible work. Mr Choudhury and others in the British curry industry have emphasised that they have invested significantly in keeping customers safe by ensuring effective compliance, with some using manual records to meet the requirements.

There are massive concerns about data management. Without a trustworthy track and test system in place, it feels as though we are playing Russian roulette with our populations. This has been said by one of the restaurateurs; it does not come from me.

I also reiterate points I have made before about safeguarding data, particularly when it is being calculated manually—how it is being accessed and who will have management and control responsibility. I cannot fathom the rationale of keeping classes going in some universities and schools where there have been positive Covid incidents. We know that restaurants and other businesses would be forced to close for 28 days, which may be unnecessary. Intense so-called fogging can take place, which does not require prolonged closure of businesses.

There are lots of issues and not enough time for us to express many of the frustrations we have learned. I agree with many noble Lords that these regulations should be viewed with caution and dread. I ask the Government to ensure that they speak to all our citizens with consistency and clarity.

Coronavirus Act 2020: Temporary Provisions

Baroness Uddin Excerpts

Monday 28th September 2020 Lords Chamber

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

My Lords, I congratulate our distinguished three new Members, the noble Baronesses, Lady Clark of Kilwinning and Lady Morrissey, and the noble and learned Lord, Lord Clarke of Nottingham. As quiet as the House is, we all wish them a warm welcome.

I wish to reiterate the concerns raised over the months about children and young people contracting infection having come back to education. As I speak, a member of my extended family, 15 year-old Iftekhar, is fighting for his life on a ventilator. In our family, grandchildren attending four different schools have experienced infection and consequent closure of their classes and isolation at home. Will the Minister write to me with details and any available government data if there are disproportionate rates of infection among children of minority heritage?

I wish to address specific parts of the Coronavirus Act. The Minister may recall our difficult exchanges in March over the emergency legislation on the management of death. It is worrying that Section 58 and Schedule 28, which removed the need for a second confirmatory medical certificate for cremation, remain in place. However, statutory provision preventing cremation against the deceased’s wishes in case of emergency is intact. The Act explains that the Government’s overriding objective is to protect personal choice. It imposes a duty on local and national authorities to have regard to the deceased’s wishes, religion or belief. The Government acknowledge that there are no specific national capacity issues regarding space for burial. This emergency Act of Parliament overrides any preceding duties. Given that there are no significant capacity concerns, will the Minister state the rationale for government retaining these emergency powers? Will he assure the House that, in the event of further unforeseen shortages, the Government will work with community organisations to manage death with dignity and honour? Further, will the Government review and withdraw these sections immediately to allay ongoing community fears?

I welcome bringing back staff initiatives, including social workers’ return to service. Will the Government stop the disapplication of DBS, or disclosure and barring services, which was introduced to enable speedy recruitment of social services and domiciliary care staff?

Will the Minister assure the House that the vulnerable elderly, the disabled and children’s safeguarding and safety remain paramount and will never be compromised, particularly in light of the British Institute of Human Rights report about the abject failure to provide sufficient protection for our precious elders and those with learning disabilities and autism, as testified to by the noble Baronesses, Lady Campbell and Lady Hollins?

Neither can we tolerate any tampering with civil liberties, or we will be left with no face to demand freedom and liberty elsewhere in the world. Successive Governments have failed by ignoring the dangerous impact of religious and race discrimination and the toll it takes on the social, educational, physical and emotional health of people of minority heritage. I am disheartened at the lack of evidence, strategy, action and preparedness to address these inequalities. Will the Minister and the Government publish an equality impact assessment of this and all legislation, particularly for women, minority communities and those living with disabilities and autism? I thank him for the way he has handled our relentless questioning, and look forward to his response.

Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020

Baroness Uddin Excerpts

Friday 25th September 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, there have been a staggering 6,634 cases. Will the Minister write to me with some information on the breakdown by age and ethnicity of those numbers?

The hospitality sector will once again take a massive hit, just as many, including the British curry industry, felt some hope of survival.

While I agree that we face extreme choices of balance between living safely and ensuring that families and communities do not face economic collapse, I continue to object in the strongest possible manner to the rising amount of fines. I ask the Government to review the amount of that imposition.

What strategies and action are the Government taking to protect women of minority heritage from the disproportionate disparities identified by the Public Health England report three months ago? Three months on from the publication of Beyond the Data, what progress have the Government made in implementing the seven recommendations? The review confirmed significant health inequalities and highlighted staff experiencing discrimination, although noble Lords and I have differing views on that. The review is substantiated by the many public pronouncements and statements made by professionals.

Men of Bangladeshi heritage are four times more likely to work in a sector facing restrictions and have fallen to this disease at twice the rate of others, while other minority groups are 50% more vulnerable. As pressures mount on services, can the Minister assure BAME staff and the House that doctors and nurses of minority heritage are not being “pushed” disproportionately to work on the front line of Covid management without sufficient PPE—more so than their white counterparts?

As the Minister said, overcrowding and multi- generational housing are causes of concern. Does he agree that long-term poverty and a lack of clarity and coherence in messaging may also be significant factors?