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

Baroness Wheatcroft Excerpts

Tuesday 12th May 2020 Lords Chamber

[Baroness Wheatcroft (Non-Afl)]

My Lords, we were not equipped to cope with the pandemic when Covid-19 hit. Despite the shortcomings identified in 2016 and the inevitability of such a viral attack, we had pitifully few intensive care beds and a dearth of PPE, so the lockdown was necessary to enable the NHS to gear up.

People have largely played by the rules, but the damage inflicted on people’s mental health and on the economy has been huge and should not be prolonged. The Government cannot continue prescribing people’s lifestyles as these regulations do. They must move towards trusting people’s common sense, not just talking about it. It is very clear who is most vulnerable to the virus. It is surely right to assume that a wish for self-preservation will deter those most at risk from assuming an unnecessary level of risk, but society as a whole must cope with living with the risk of Covid. We are accumulating debts, both public and private, which will affect the lives of generations. To prolong the economic misery is to make the treatment worse than the disease.

Lord Sumption has said:

“We have resorted to law, which requires exact definition, and banished common sense, which requires judgment.”


Sadly, as other noble Lords have said, exact definition is missing from much of the regulations, and it is very hard for people to apply judgment when regulations are trying to limit their behaviour. Now is the time to allow the public to exercise their judgment. If people judge it important to meet both their parents simultaneously, is it really the role of government to tell them they cannot? If young people want to go to the pub, is it really the role of government to tell them they cannot? The noble Lord, Lord Wei, suggested that perhaps the public could be told more about how the virus was behaving in their area. I agree that that would help them form their judgment.

Families must be able to resume family life. The hospitality and tourism industries must be allowed to reopen their doors. If that does not happen soon, for many of them it never will. Social distancing is a concept now well understood. The Government should trust the people to be sensible and socially distance themselves. They should concentrate their efforts on supporting our health service and care workers. This virus has highlighted the low priority given to social care for many years. Could the Minister say whether he believes that the regulations governing care homes are sufficient to ensure that they are not used as dumping grounds by the NHS?

Suicide

Baroness Wheatcroft Excerpts

Tuesday 23rd April 2013 Grand Committee

[Baroness Wheatcroft]

My Lords, every suicide is a glaring reflection of the fact that our society has failed to look after its most vulnerable. The noble Lord, Lord Roberts, has just explained how he sees failings in the community as partly responsible for that, and I can only agree. I welcome the Government’s decision to produce their new suicide prevention strategy, and congratulate my noble friend Lady Buscombe on securing this debate. At this point, I must declare an interest as a member of the Samaritans advisory board. We are well represented here this afternoon. I am in awe of the remarkable work that the Samaritans do.

The reasons why people decide to take their own lives are varied, although there are some factors that seem to be very regular occurrences, particularly financial ones. When World Suicide Prevention Day took place last year, there was a campaign under the heading “You Can Cope”, but those who kill themselves have generally decided that they cannot cope, or at least that they cannot cope alone. I agree with the noble Lord, Lord Roberts, that they feel alone. This does not necessarily mean that they are single. They may be in relationships, they may be in touch with their family, and they may apparently have a network of friends, but the person who is driven to suicide tends to feel very much alone. A problem shared is said to be a problem halved, but a problem left to grow like a malignant tutor—tumour, although there are a few malignant tutors around—inside the brain and heart of an individual is a problem multiplied. For whatever reasons, and pride may be one of them, too many people today have no one they can share their problems with.

The irony is that in an age when many people have hundreds, indeed, thousands, of what they would term friends on Facebook, there are more and more people who, when they hit the slough of despond, do not have a friend to turn to but welcome being able to turn to a stranger. A friend of mine who spent many years as a Samaritan told me that what was really wanted on the end of the phone was a friend. The main cause that really drove those people to ring was extreme loneliness. She told me that she kept one of her clients going for several days after he called to say that it was the end, there was nothing to eat in the house and he could not cope. She told him the ingredients for cauliflower cheese and sent him out to buy them, and when he came back, she talked him through the recipe. When he said, “But what about the bird? There’s nothing for the bird to eat”, she suggested that the bird should eat cauliflower cheese too. In the end, this guy went away, not happy, but feeling less alone, and over the years he called her again occasionally and they talked recipes.

For those at their wits’ end, the Samaritans enable them to phone a friend. People do that about 5 million times a year. Other charities do fantastic work in helping those who feel suicidal, and the national prevention strategy acknowledges the importance of getting all those organisations to work together and to work in tandem with social services and the National Health Service, but today I shall stress the one way in which these charities can be helped to be more effective; it is by making that life-saving phone call cheaper. The Samaritans’ national helpline number is an 0845 number, which means that landline calls are relatively inexpensive, but calls from mobiles are considerably more. Incredible although it may seem, the Samaritans’ research shows that the cost of that call will put people off making it. The aim is to have a free-to-caller national number. In 2009, Ofcom gave the Samaritans the number 116123, which is pretty easy and memorable. It has been successfully trialled, but to roll that out nationally requires about £1 million a year. It would be dreadful for somebody to pluck up the courage to phone a friend in extremis to ring that number and find it dead. Without the certainty that that £1 million will be there or that there will be some other means of achieving it, that potential lifeline is not being rolled out. Far be it from me to suggest in the current climate that the Government should dig deep, or even quite shallowly, into their pockets and find that extra money, but there has to be a way that together Ofcom, the telecoms operators and the Samaritans can get together and produce some way of doing this. Perhaps the lottery could help. It might cost a little money, but what it would save is immeasurable.

South London Healthcare NHS Trust

Baroness Wheatcroft Excerpts

Thursday 31st January 2013 Lords Chamber

[Earl Howe]

My advice is that there is no case for waiving that practice. As I said, it is a long-standing principle and indeed the practice of successive Governments that legal advice is given to Ministers in confidence. Therefore I am afraid that I cannot accommodate the noble Lord’s suggestion.

To answer the question asked by the noble Lord, Lord Kennedy, about visiting Lewisham Hospital, I have not done so personally. I try to visit as many hospitals as I can. If I am able to fit Lewisham into my programme, I would be happy to do so.

[Baroness Wheatcroft]

My Lords, I declare an interest—as so many have—in that my three children were all born in Lewisham Hospital. Thus I share the emotional feeling of many that it seems unfair that Lewisham should be penalised for the spendthrift ways of other NHS trusts. However, my understanding is that Sir Bruce was asked to look not at the financial implications but at the patient implications of restructuring. He has done that and is satisfied with the result. One thing he points out is that, in the future, not every hospital would have the capacity to offer intensive care after maternity care. One of my three children needed intensive care. If Lewisham cannot provide the highest of high-tech intensive care, then some hospitals in London will have to. The issue is that, given the high technology that is now coming in to medicine, not every hospital can be a centre of excellence. We have to spread the resource. That means some hospitals will specialise. As somebody who benefited from what was then the best of intensive care, I am very keen to see that London, and in particular south-east London, should be able to offer that. However, I accept that not every hospital that provides maternity services will be able to. Can the Minister tell me whether he can see—because I cannot—any reason why Sir Bruce would have reached the conclusions that he had, in print, if he did not actually believe them?

[Earl Howe]

I am grateful to my noble friend and agree with all that she has said. In making this very difficult decision, my right honourable friend’s primary concern has been to protect outcomes for local patients. Indeed, the logic behind these proposals comes from the clinicians themselves, who came together from across London—way before the TSA was appointed—to develop a series of standards for certain conditions. These are based on the simple principle that a critical mass of highly qualified specialist consultants in one place, on a 24/7 basis, available to see patients within one hour and backed up by the latest medical equipment, will give patients better outcomes. At present, no south-east London hospital meets all the emergency or maternity clinical quality standards. Achieving those standards will mean accommodating acute in-patient care across fewer sites. The result will be that people in south-east London will continue to have much better access to A&E and specialist maternity units than the majority of the population in England, and the prediction is that up to 100 lives a year will be saved by this rearrangement of services. My noble friend has raised a very important point because this is about better patient outcomes.

Social Care

Baroness Wheatcroft Excerpts

Thursday 29th November 2012 Lords Chamber

[Baroness Wheatcroft]

My Lords, I should like to add my thanks to the noble Baroness, Lady Pitkeathley, for securing this important debate and for her eloquent speech which showed how well she knows this important sector and the issues it faces. She also made an eloquent plea, as have others, for more money. But money is not the only answer to this problem, and that is just as well because, as we know, we are living in a time of austerity and the money to do everything we would like to do simply is not there. We have to look for more creative and collaborative solutions, as the noble Baroness, Lady Campbell, has just said. We have to look for more integration and the greater use of computer technology. We have to be inventive.

There are productivity gains to be had. A recent report from the King’s Fund pointed to the fact that there is a great search for cuts as an end in itself rather than a search for the productivity gains that could deliver cuts in spending. A recent report from the Policy Exchange, of which I am delighted to be a trustee, sets out the following sentiment:

“If we could provide integrated care bringing together primary, community, acute and social care we could provide better care for the frail elderly and save a great deal of money”.

That statement was made by David Prior, the chairman of the Norfolk and Norwich University Hospital NHS Foundation Trust—and he was talking only about integration within the NHS itself. Here we are talking about the need for integration across the NHS, social services and housing, but none of that can be done until the NHS itself manages to bring down some of the extraordinary barriers it has put up between the various parts of its own organisation. The NHS could and should be a much more integrated and efficient organisation. Experiments are being carried out in parts of the country, but nowhere near enough is being done on that front. Even the Local Government Association accepts the need for reform and that money alone will not be enough to solve the problems we now face in this area.

The state cannot do it all. Although we have already heard some appalling stories of people who are really suffering, I would maintain that that is not just because of the cuts; they are suffering because of some very severe breakdowns in our society. Those who have seen the Times today will have noted the headline on the front page about the number of people in our country who will spend Christmas alone this year—some 250,000. The Times quotes a survey which has found that one in 10 of those aged over 75 confesses to being intensely lonely all of the time. Loneliness is not just a misery in itself; it is a cause of ill health. It drives people to see their doctors. It is something that we all need to address together. Family breakdown has caused severe agony in this country. We have to look for creative solutions to help those who are growing old not to feel lonely and end up seeking medical help. They need to be integrated into communities and not to live in single-person households, as so many do, unless that is what they really want. We should be able to offer more constructive, healthy and enjoyable alternatives. While they are still fit and well, we need to get people to move into communities where they will have the sort of wonderful life that we in this House enjoy. It actually encourages life expectancy far beyond the norm. People need to be in groups. If they were living in groups, the state could provide at much less expense the sort of 24-hour care that will eventually be required.

We have heard about people who have had to give up their jobs to care for elderly members of their families, but they are rarities now. What we need is to make sure that the community as a whole takes on the responsibility of looking after its elderly. There are other constructive ways in which we can do this. Some schemes arrange for younger people with nowhere to live to be paired with elderly people who live in houses with too much space. The relationship benefits both sides. The young person agrees to do a certain amount of work helping around the house and doing the shopping, although just being there is often more than enough. That sort of help can preserve an elderly person’s sanity and keep them fit for many years.

We will hear again today about the need for more money and more spending, but I think that we could spend what we have more effectively, more efficiently and more creatively.

NHS: Private Finance Initiative Costs

Baroness Wheatcroft Excerpts

Wednesday 11th July 2012 Lords Chamber

[Earl Howe]

The noble Baroness makes an important point and it is one that I was aware of some years ago when I visited a PFI-funded hospital. She is right; it does sometimes depend on the relationship established between the contractor and the hospital management but many of these contracts do result in exactly the kind of sclerosis that she has described. It is a lesson that we need to learn for future PFI schemes.

[Baroness Wheatcroft]

Will the Minister tell the House whether the Government have investigated the possibility of clawing back fees from those private sector advisers who helped the previous Administration construct those PFI contracts?

[Earl Howe]

My Lords, I am not aware that we are doing that particular thing, although I understand my noble friend’s concern. There are contracts in place which are legally binding. Nevertheless, within the framework of those contracts there is often scope for looking creatively and flexibly at their provisions. We are endeavouring to do this in order to help the trusts work their way through their problems.