Recovering Access to Primary Care

Baroness Young of Old Scone Excerpts

Tuesday 9th May 2023 Lords Chamber

[Lord Markham (Con)]

The noble Lord is quite correct to point out that, where you have a number of new houses in a local community, you need to make sure that there are primary care services to serve them as well. Funnily enough, just today I was having a conversation with Housing Minister Maclean on this very subject, about changing the way that we look at Section 106 payments—or CIL payments, as they are called these days—to make sure that the provision of the primary care estate is one of the key elements that can be funded through that. I know that DLUHC colleagues are very much on board with that, because absolutely fundamental to the point that the noble Lord makes is that we need to make sure that, alongside the new housing, which we all agree is very important, there are sufficient primary care services as well.

[Baroness Young of Old Scone (Lab)]

My Lords, I thank the Minister for the Statement but regret that it concentrates on more GP and other ancillary services to meet rising demand rather than focusing on the causes of that rising demand. A major source of pressure on GPs is due to the complications of diabetes, yet inadequate action is being taken on obesity, often in the face of pressures from the food lobby. Similarly, the Minister talked about the rising number of over-70s—I should declare an interest—yet much of that pressure is due to elderly people failing to get adequate social care and falling back on general practice because they have nowhere else to go. Yet, over the last 13 years, the Conservative Government have absolutely run away from any sort of reform agenda for social care. Will the Minister comment on whether new phones are going to plug even the short-term pressure, and will he tell us what sustained long-term solutions to managing down the demand for GP and other ancillary services his Government are thinking of?

[Lord Markham (Con)]

First, I completely agree with the noble Baroness’s point that prevention is better than cure—I think we would all subscribe to that—and that is what the Government’s manifesto pledge of five years’ more healthy life is all about. On how the app comes into that, it all comes down to people taking more control of their own health, such as by being able to receive reminders that it is time for their cervical smear or heart MoT, so that they can start to take ownership of their own health. Towards that, the community pharmacists have already provided 1 million blood pressure checks, through which 300,000 people were found to have high blood pressure. That is a prime example of where this expanded network really can get on to the prevention agenda, which we all agree is absolutely key to helping solve the health situation going forward.

Health and Care Bill

Baroness Young of Old Scone Excerpts

Lords Hansard - Part 1 & Report stage
Tuesday 1st March 2022 Lords Chamber

[Baroness Hayman (CB)]

My Lords, I declare my interest as co-chair of Peers for the Planet and apologise to the House that I did not declare that interest in my enthusiasm to get involved in a Question earlier today. I added my name to Amendments 7, 28, 87 and 94 and obviously welcome the way in which the Government Front Bench has responded to the debate we had and the amendments we proposed in Committee. As my noble friend Lord Stevens said, there is no point in all of us going through the arguments, although I think he added a new dimension in his remarks today; that interplay between health and climate is an important one that we should not neglect.

The Government have done very well in providing a comprehensive suite of amendments that make sure that the considerations of not just the net-zero targets but the targets in the Environment Act and the needs for adaptation, which will be extremely significant in the healthcare field, will be considered at all the correct levels within the new infrastructure that the Bill brings into place. The assurances that the Minister gave on the guidance that will be published and on making sure that procurement, which is such a large spend by the NHS, will also be governed by these considerations are extremely important.

I welcome these amendments across the board. They weave considerations of climate and the environment throughout the ecology of the NHS, and it is an excellent result. The next challenge is to persuade the Government to take the initiative on these issues and to embed these considerations throughout their policies and legislation, which would save a lot of time in the House. But I do not wish to be churlish, and I end by simply reiterating my thanks for the way in which the Government have responded to these amendments.

[Baroness Young of Old Scone (Lab)]

My Lords, the noble Baroness may wish not to be churlish, but I would regret it if I could not be a little churlish. I declare an interest as chairman of the Woodland Trust and vice-president of a range of environmental and conservation organisations. I thank the Government and the Minister for the assurances given. I also thank the noble Lord, Lord Stevens of Birmingham, for his shuttle diplomacy between the churlish and the less churlish in achieving these very welcome amendments.

I will press the Minister a little further on what she said, just to make sure that we are completely clear. The guidance will be crucial, and I am glad to see that it will be issued initially within 12 months of Royal Assent. I just want the Minister to clarify that the guidance on procurement will cover the need not just to reduce emissions through the NHS supply chain but to secure the other environmental targets, such as those set by the Environment Act. The preamble says that, but I want to make sure there is clarity in Hansard that the guidance will ask for procurement to do not just the climate change job but the other job.

Although the duties on the trusts, ICBs and NHS England include climate change, adaptation to climate change and improving the natural environment, most of the examples the Minister gave revert back just to climate change. The proposed new section in the amendment is headed up:

“Duties as to climate change etc”.


It is the “etc” that I am rather interested in. I think we should spell out more clearly what that is.

Can the Minister assure the House that the guidance will include performance in all three areas—climate change, adaptation and the wider environmental objectives set by the Environment Act and in other places? Because of the massive threat that climate change represents, it is very easy—we all fall into this trap—to squeeze out focus on the other, equally vital environmental areas. We have to remember that if we want to defeat climate change, we also have to defeat biodiversity decline and a range of other environmental factors. I hope the Minister can give these assurances to the more churlish among us.

[Baroness Bennett of Manor Castle (GP)]

My Lords, my speech follows rather neatly from that of the noble Baroness, Lady Young of Old Scone. I will begin not by being churlish but by turning this around the other way and declaring my position as a member of Peers for the Planet and paying great tribute to the noble Baroness, Lady Hayman, who has so led the Government in the right direction on this Bill—as on the Financial Services Act, to think of a recent one before this. I would like to think that maybe it has got a little easier this time than it was on the Financial Services Act, so maybe we are progressing to the point where a Bill will arrive in your Lordships’ House with climate and environment already there, and we can just focus on trying to strengthen and improve it.

Health and Care Bill

Baroness Young of Old Scone Excerpts

Lords Hansard - Part 3 & Committee stage
Wednesday 26th January 2022 Lords Chamber

[Lord Warner (CB)]

My Lords, I support the amendment in the name of the noble Lord, Lord Forsyth. This is an unusual position for me; I do not remember in 22 years ever having supported an amendment tabled by the noble Lord. I am beginning my third decade in this House supporting change in the law. Who knows? I may have reached my fourth decade before we have got there.

During this time, I have watched many parts of the English-speaking world use their Parliaments to debate these issues and change their laws. This has now happened in Canada, New Zealand, five Australian states and 10 states in America and the District of Columbia. These changes have not been rushed through; they have been measured, considered and debated, and the populations have been consulted in the way described by the noble Lord, Lord Forsyth. It cannot be said to be right, if we live in a democracy, if the only way forward on an issue that is of great personal concern to many people is having to rely on Private Members’ Bills, which can be treated to wrecking amendments which make it almost impossible to progress a discussion and debate this issue. In the statesman-like way that the noble Lord, Lord Forsyth, has set this out, we should be impressed by the need to facilitate this debate within Parliament, as other countries have managed to do both in the English-speaking world and across Europe. Even countries such as Spain, with strong religious traditions, have allowed this debate to take place and changed their law as a consequence.

At the end of the day, this issue comes down to being a matter of personal choice. It is right that Parliament should be able to debate that issue of personal choice and facilitate the exercising of it by many people who are terminally ill if they wish to do so. They are not forcing anybody else down that path—it is a personal choice; it is a personal decision. Changing the law does not mandate anybody to do this; it is left to the individual, within the safeguards provided for in the legislation, to exercise that personal choice.

I have also added my name to Amendment 203 in the name of the noble Baroness, Lady Meacher. She makes it clear in that amendment that end-of-life issues are a matter of personal choice. We make many speeches in this House about patient choice, so why is it wrong to have more patient choice at the end of life when we have a lot of patient choice during it? We need to focus much more on patient choice. I support Amendment 203 as well as Amendment 297.

[Baroness Young of Old Scone (Lab)]

My Lords, I think I am about to score a historic double whammy. I thought that I had stayed tonight to let some momentous words cross my lips that I never thought would do so—that is, I agree with everything that the noble Lord, Lord Forsyth has said—but, and I never thought I would say this, I also agree with every word that the noble Lord, Lord Warner, has said. How is that for a double whammy?

I do not want to delay the Committee, because it is late, but let me touch briefly on Amendment 203 in the name of the noble Baroness, Lady Meacher. I sat on the Commission on Assisted Dying, and we heard endlessly and quite heartrendingly from medical professionals, patients and relatives of those who had already passed away about the inadequacies of the discussion about choices at the end of life. At the moment, the legislation makes it almost impossible for healthcare professionals to open up that sort of conversation—we are not talking necessarily about assisted dying; we are talking about any sort of choices at the end of life. The amendment in the name of the noble Baroness is therefore much needed.

However, for heaven’s sake, on Amendment 297, the whole process of Private Members’ Bills is doomed to failure for something as important as this, which has been tackled by legislatures across the world. Yet we are frozen in this grand old Duke of York scenario, where we march up to the top of the hill at Second Reading on a Private Member’s Bill, then absolutely sod all happens after that and we all march back down again. We cannot continue to do that on a five-yearly basis for ever. This is not asking the Government to nail their colours to any particular side of the debate but simply to open up parliamentary time. I very much commend the noble Lord, Lord Forsyth—good grief— on his foresight in seeing this opportunity.

[Lord Mackay of Clashfern (Con)]

My Lords, your Lordships will know that I have known my noble friend Lord Forsyth as a noble friend and as a friend for many years. I know also that he is extremely good at putting forward a case—whether the case is well founded or not does not seem to matter too much.

We have a procedure in this House, which was established a long time ago, which says that government time is to be used for Bills presented by members of the Government. That is the rule generally. However, there is also a procedure for dealing with Private Members’ Bills. It has been used many times, and it has been used in connection with assisted dying during the present Session. We had a full day of discussion of the merits of that matter—exactly the merits of this matter; the arguments for and against are not for tonight. We are not here to argue for that amount of time; it took a whole day with quite brief statements being made to express different views about this matter.

The Government are a member of those procedures; they are a party to the procedures that deal with Private Members’ Bills. The Government are there so that they can be asked in the course of the proceedings to help. From time to time, they decide that what is in issue is so important generally that it should be given government time. That is the procedure that has been laid down, and as far as I know in this case so far, the Government have not been asked to give time. They said at the end of the debate just two or three weeks ago that they were neutral and waiting for a decision from Parliament. It is Parliament that takes a decision; a Private Member’s Bill is a proceeding in Parliament. It is not just Parliament dealing with government Bills—Parliament deals with Private Members’ Bills also, as well as other kinds of Bills, such as hybrid Bills.

However, this Bill was in Parliament in the Private Member’s Bill system, which is the system that exists just now. If my noble friend, with his skill, wants to suggest a different sort of procedure for Members’ Bills, he can go about it, but to try to break out of the present system a new system for this sort of Private Member’s Bill will produce a complete wreck of the present procedure when no new procedure is being introduced. The Government have from time to time given time for a Bill to be taken forward, which has reached the statute book. That is the procedure which is available now, and it is the proper procedure to ask for.

This procedure is about trying to put an amendment into a health Bill, which has no mention of this, to amend the law on assisted suicide. That is the essence of this—the heading in the amendment is “Assisted dying”—which would mean an unnecessary amendment to the law relating to assisted suicide in his country. There is no question about that. There is nothing about that in the Long Title of the Bill. This Bill is not the proper machinery for raising this matter. It is not my responsibility or an option to deal with the merits of the case. I made a speech in the debate two or three weeks ago towards the end. I think my noble friend was not able to be present, if I remember rightly.

Ageing: Science, Technology and Healthy Living (Science and Technology Committee Report)

Baroness Young of Old Scone Excerpts

Wednesday 20th October 2021 Grand Committee

[Baroness Young of Old Scone (Lab)]

My Lords, when I first came to this House, the doorkeepers told me that this was the best elderly daycare centre in London and that it would give me another 10 years of life expectancy, so this is an apt report for your Lordships’ House. I join my former colleagues on the Science and Technology Committee in thanking the noble Lord, Lord Patel, for his chairmanship of this important inquiry and echo his thanks to the staff, who supported us splendidly.

It is clear that improvements in healthy life expectancy have stalled. On average, about 20% of our lives is spent in poor health. The gap in life expectancy between the rich and the poor has widened even further.

I want to pursue three areas this afternoon. The first is to touch on technological support for older people to help to improve the quality of their lives. The second is to focus on the root causes of increases in years of ill health and disability—the root cause is indubitably poverty and deprivation—and to explore what the Government’s levelling-up agenda must do to tackle them. The third is the importance of integration of action across all policy areas nationally and locally and how the recent changes in responsibilities for prevention of ill health will work out.

I have some lasting impressions of the committee’s work. First, the foundations for healthy old age are laid down from our youth onwards. We need to focus on how people can be healthier throughout their entire life course and not try to put a sticking plaster on the situation once old age is reached. Secondly, there is a pronounced societal difference in healthy life expectancy, which is highly correlated with deprivation and ethnicity. The difference in healthy life expectation between the least and most deprived is nearly 20 years. Poverty and deprivation are the root cause of unhealthy ageing. That is totally unacceptable in a civilised society. However, perhaps my most abiding memory was that we convened a panel of elderly people to help our deliberations only to find that Select Committee members were generally older than the elderly people.

I will raise three issues directly with the Minister. The first is the role of technology in enabling healthier ageing. There are many technologies, such as digitally based products and services such as fall trackers, medication monitors and digital befrienders, and other newer technologies such as robots and digital surveillance programs, all of which could help to support older people, improve their quality of life and allow them to maintain a more independent existence. But provision is low and the poorer and more deprived simply do not get access to such help. That gradient will increase with new technologies becoming more and more available. That has to change. What plans does the Minister have to accelerate not only the pace of technological development but, more importantly, the uptake of those technologies?

Secondly and most importantly, let us not be in any doubt that the root causes of unhealthy ageing are deprivation, unemployment, poor education and housing, lack of opportunity and unhealthy diet and lifestyles, including smoking and alcohol. Tackling these root causes sounds just the thing for the Prime Minister’s levelling-up agenda. Sustained action is needed over a lengthy period, with co-ordinated efforts between national and local government.

Cutting the income of the poorest by removing the £20-a-week universal credit payment does not fit that bill, nor does a spending review and Budget in the next few weeks that has been trailed as the ultimate austerity measure by the Chancellor, who seems increasingly out of love with his boss’s objectives. We are facing another version of the TB-GBs—I will leave your Lordships to fill in whatever acronym you would like for the new Chancellor versus Prime Minister tension. We need not a focus politically on the red wall seats and town centre tart-ups but a sustained attack on inequality and lack of opportunity wherever it occurs.

It is only three years since the Government set themselves the target of five extra years of healthy life by 2035, but that target is already being airbrushed out. Its future is unclear from the Government’s response. Can the Minister confirm whether, in his view, the ageing society grand challenge will survive the proposed review that will be undertaken and whether the five extra years will still be a target? If the target has gone within three years of being established, how confident can the Minister be that the sustained approach required to tackle poverty and deprivation will not be as ephemeral? We no doubt await the White Paper on levelling up later this year, but it would be good to get a feel from the Minister now.

My third point is about the importance of integration of action to promote healthy living across all departments and many policy areas, such as work and education, transport and housing, air quality, local environment quality et cetera. Public Health England, which was responsible for co-ordination on prevention and health promotion, has gone and the Office for Health Improvement and Disparities was launched only at the beginning of this month. I understand that there is to be a cross-government ministerial board on prevention to drive forward a co-ordinated government approach on the wider determinants of health. How often has this ministerial board met and what has it done so far?

The local effort is to be driven by local directors of public health. I will pay a small tribute to those incredibly important people. They are currently up to the neck in Covid and before the pandemic were definitely below the salt for esteem and resources in local authorities. Can the Minister tell the Committee in detail how the Government will ensure that local directors of public health will be given the position, authority and resources to do this co-ordination job across many policy areas on a local level?

We hear much about the pressure on the NHS these days. Much of that pressure is due to those substantial years of poor health that, on average, many people experience. The Government need to see the challenge of healthy ageing as an issue of economics and of health service sustainability, but above all as an issue of equity.

Animal Diseases: Future Pandemics

Baroness Young of Old Scone Excerpts

Wednesday 21st July 2021 Lords Chamber

[Lord Bethell (Con) [V]]

It is the case that 75% of all newly infectious diseases come from animals. Diseases such as HIV began when transmitted from an animal to a person. The Ebola, Zika, SARS, MERS and SARS-CoV-2 viruses are all examples of recent zoonoses. As the noble Baroness, Lady Brinton, pointed out, the changes in human behaviour are only going to accelerate this. That is why we are so committed to the zoonotic agenda and why vets and those who work with farm animals need to have raised awareness of this threat.

[Baroness Young of Old Scone (Lab) [V]]

My Lords, I declare my interest as chair of the Royal Veterinary College. The Minister has stated the Government’s commitment to “one health”, but ODA cuts have slashed by two-thirds the funding of the UK’s single biggest “one health” programme, the One Health Poultry Hub led by the RVC, which tracks and fights disease emergence from poultry in Asia to combat this vector for a human health pandemic that will inevitably occur. How does the Minister intend to fulfil his commitment to “one health”, and the PM’s at the UN and G7 levels, in light of the Chancellor’s Statement last week? The criteria for restoring the ODA cut show that that will not happen for several years.

[Lord Bethell (Con) [V]]

My Lords, our contributions to “one health” are partly through our collaborations with foreign Governments, but they also include Defra’s work here in the UK and the contribution of British scientists, such as through the Trinity Challenge that I mentioned. The noble Baroness is right that this is not cost free, and we have to explain the value of this work to the taxpayer. That explanation is easier after a pandemic as massive as the one we have had, but we need to look closely at the value-for-money judgments needed before we make the necessary investments in this agenda.

COVID-19 Variant: Travel Guidance for Local Authorities

Baroness Young of Old Scone Excerpts

Wednesday 26th May 2021 Lords Chamber

[Lord Bethell (Con)]

No, the noble Baroness will be relieved to know that we are not relying on telepathy. Instead we have regional partnership teams, which include Public Health England regional directors, and Contain and JBC colleagues, working together with local authorities, and these meet on a three-times-a-week basis at the regional team updates. Attendees can include government departments, including the MHCLG, the DfE, particularly REACT, and the No. 10 Cabinet Office task force. It is through this kind of extremely regular and intense collaboration between all the different parties working on this extremely complex pandemic response that we share data, provide guidance and ensure that the communications are done to the best of our ability.

[Baroness Young of Old Scone (Lab) [V]]

I declare an interest as a resident of Bedford borough. Bedford has repeatedly been let down by the failure of government to share information. It did not get information on test results on cases that tested positive with the Indian variant returning through airports, and now there is this communication failure, which it found out about only when the Manchester press phoned it up to tell it that it was on the website. It has been starved of the Pfizer vaccine and now denied the additional boots on the ground that it needs to deal with the crisis, which apparently have all been sent to the red-wall authorities. What ill will do the Government have for Bedford and what is the Minister doing to sort out the important relationship with key local authorities without imposing top-down lockdowns, either clandestinely or publicly?

[Lord Bethell (Con)]

My Lords, I am conscious of having been asked questions about the vaccine, testing and lockdowns in Bedford before. However, I absolutely reassure the noble Baroness that we approach all areas on an absolutely equitable basis, and in fact I pay tribute to the people of Bedford and the local authorities there for their energetic response to this pandemic. We are working extremely hard with all local authorities to give them the effective powers and resources to deal with the pandemic on a local basis. That means that national co-ordination comes second to local implementation and that these communications are sometimes extremely complex. We should not be surprised if sometimes there are differences between how different areas implement those communications.

Crohn’s Disease and Ulcerative Colitis

Baroness Young of Old Scone Excerpts

Thursday 15th April 2021 Lords Chamber

[Lord Bethell (Con)]

I am not sure it is correct that it is not being adhered to widely, but there is some variation in all parts of the NHS. That is why we are developing a right-care scenario for IBD with key stakeholders. This will create a very clear template for all patients and all those involved in their care. It will, I hope, help create more consistent standards across the healthcare system.

[Baroness Young of Old Scone (Lab) [V]]

My Lords, I suffer from ulcerative colitis and understand how disabling this condition can be. Support from IBD specialist nurses is a lifeline in managing periodic flare-ups of the condition, yet the postcode lottery means that one-third of IBD patients do not have access to a specialist nurse. This is just one of the many examples of uneven standards of care. I do not know why the Minister cannot simply commit to endorsing IBD UK’s 2019 IBD standards and ensure that services are commissioned to these standards across the country. We have waited an age—at least three years—for the scenario he is talking about. Half a million patients are fed up of waiting.

[Lord Bethell (Con)]

I am extremely grateful for the testimony of the noble Baroness. She speaks very movingly about the challenge faced by those with IBD—a challenge that we all sympathise with. We are working extremely hard with both Crohn’s & Colitis UK and IBD patient groups on this scenario. There has been disruption in the last year, but I reassure the noble Baroness that we are working extremely hard to get the scenario out as soon as possible.

Social Care Funding (EAC Report)

Baroness Young of Old Scone Excerpts

Thursday 28th January 2021 Grand Committee

[Baroness Young of Old Scone (Lab) [V]]

My Lords, 12 years ago, I was the chairman of the Care Quality Commission, the regulator for the quality of health and social care. I was chilled when I saw the impact of the funding arrangements for social care on people’s access to care and the quality of care they received. Nothing much has changed in the funding system over these 12 years. In the meantime, adult social care needs are rising exponentially and funding has decreased in real terms, even with the recent additions to budgets. Local authorities are responding by raising the eligibility bar for social care, so that you have to be on your knees or virtually destitute to get funded care.

People who cannot access care are hidden at home and are a burden on unpaid carers. For those who can access it, what is the quality of that care? Much care provision at the higher end of the spectrum is fine, but it became clear to me at the CQC that care providers, funded at the very basic levels that local authorities can afford, simply cannot provide a quality service at that cost; nor can they pay the staff who deliver it more than the minimum wage. Providers either live on the edge of going bust or flee to the self-pay end of the business.

The result is that many of the less well-off in our society, who have been unable to amass savings or capital, because they have been in poorly paid jobs or unable to work due to illness or disability, are in a poor position. They are faced with a lack of access to services, poor-quality services and being looked after by staff who are often transient and paid a minimum wage, and have no qualifications and little training. I ask noble Lords: would you relish that prospect for your mum or disabled member of your family or—now that we are getting older—for you or me?

Successive Governments have failed to grasp the nettle. In 2019, the Conservative manifesto committed to building cross-party consensus and bringing forward a lasting solution, but it has not. It spoiled that assertion by continuing the old Conservative shibboleth that no one should have to sell their home. I believe that equity release schemes should not be off the table.

Three things need to happen. First, cross-party consensus talks should be set up now, be independently chaired and have a strict deadline to bring forward both proposals and implementation plans. Secondly, a progressive and pooled contributory system for pre-funding care costs should be set up, as a matter of urgency. It should be kept simple and communicated effectively to the public, in personal terms that talk about care for their family members, so that we get away from these appalling headlines of “death taxes” and “dementia taxes”. Thirdly, radical changes in social care staffing should be fast-tracked, covering qualifications, training, regulation and pay.

The Economic Affairs Committee is right: it is time to end a national scandal. The Government are politically nervous about tackling the issue, as a result of the sorts of headlines I talked about. Right now, Covid has meant that the public understand the challenges and importance of social care more than ever before. Can the Minister tell us that the Government will act now and that we will not get another Green Paper, and that we stop letting down the most vulnerable in society and the staff who are trying hard, against all the odds, to care for them?

Covid-19: Local Restrictions

Baroness Young of Old Scone Excerpts

Thursday 3rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I cannot help but feel that it is not a case of “finally”. This Government could not have worked harder to push for home testing, and we are extremely grateful for the innovations in business and government that have made home testing possible and effective. When home testing is deployable on a mass scale, we will work on a prioritisation of how best to use it. But the noble Baroness is entirely right; the kinds of use cases that she articulated are the ones that we have in mind.

[Baroness Young of Old Scone (Lab) [V]]

Could I press the Minister on the specific Question asked by the noble Baroness, Lady Thornton? The council leader of Trafford has blasted the chaotic way in which the Government have handled local lockdowns, where application and lifting of restrictions has yo-yoed sometimes daily and sometimes hourly, with inadequate consultation with local leaders. It is impossible for councils and local people to plan life on that basis, and it continues to erode trust in the Government. When will the Minister guarantee the publication of clear thresholds and criteria, backed up by published science, on which local lockdowns and their liftings will be based in future? Will he give us a date for that?

[Lord Bethell (Con)]

I apologise to the noble Baroness for disrupting the lives of local officials, but this disease is completely unpredictable. It is prevalent where we least expect it and it travels long distances very quickly. It is a fact of life—one that local authorities will have to get used to—that we cannot always predict where it is going to pop up and that fighting this epidemic is going to require fast action, which is why we have brought about the kinds of regulations that we will debate in this Chamber later this afternoon.

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

Baroness Young of Old Scone Excerpts

Wednesday 29th July 2020 Lords Chamber

[Baroness Young of Old Scone (Lab) [V]]

My Lords, in reality, it is only within the last seven days that local directors of public health, after many times of asking, were finally given access to address-level data, which is so needed for local contact tracing. This is very important to stem household transmission within vulnerable communities, particularly among those living in overcrowded housing. As yet, local public health officials and local authorities still do not routinely, in real time, get other data on those who have had negative tests; nor do they have workplace data to spot workplace clusters early and take effective action based on local knowledge. They do not have data by ethnicity, which is provided only sporadically at the time of testing and not regularly on death certificates.

Some local authorities are doing crazy things, such as scanning test results to spot likely ethnic names to help them understand the characteristics of a community spread. Information from the call centre process is not available to local authorities on who has been contact traced, where they live or whether they have undertaken to self-isolate. As well as inadequate real-time data, local authorities lack resources. The additional £300 million for Covid-19 action plans will not go far. Some local authorities have no paid or trained local contact tracers. Can the Minister clarify whether he sees local authorities, rather than the national process, as the leads in managing outbreaks; what he is doing to assure them of real-time comprehensive data of the kind that I have outlined; and how he plans to create a step change in local authority capacity? Yesterday, the noble Baroness, Lady Harding, said that local outbreaks are being managed by local authorities extremely well. This is not how local authorities feel.