Covid Contracts: Judicial Review

Lord Alderdice Excerpts

Monday 1st March 2021 Lords Chamber

[Lord Bethell (Con)]

That is a reasonable question, and, in fact, that was our starting point: the noble Lord will remember that, at the beginning of all of this, we supplied PPE to 252 NHS trusts and no one else—everyone else sorted out their own PPE. The reason we had to change was that this was a global crisis: borders were shut, factories closed down and every country in the world was desperate for PPE. There was no facility for a procurement manager at an NHS trust, let alone a small social care home in the West Country; those avenues were all shut. That is why it took a massive national effort to secure PPE. We now have a portal that supplies more than 50,000 different NHS and social care units; as I explained earlier, we have an enormous stockpile to secure that. This has been one of the big learnings of the pandemic: in order to have resilient supply chains, there needs to be some national muscle to make sure that it works properly.

[The Deputy Speaker (Lord Alderdice) (LD)]

My Lords, the time allowed for this Question has elapsed; I regret that we were not able to reach everyone on the list.

Covid-19 Update

Lord Alderdice Excerpts

Thursday 4th February 2021 Lords Chamber

[The Deputy Speaker (Lord Alderdice) (LD)]

I regret that we have not been able to call everyone on the list but we have now come to the end of the 30 minutes allocated to Back-Bench questions. I shall give a few seconds for Members and Ministers to change around before we continue.

Medicines and Medical Devices Bill

Lord Alderdice Excerpts

Report stage & Report stage (Hansard): House of Lords & Report: 1st sitting & Report: 1st sitting: House of Lords
Tuesday 12th January 2021 Lords Chamber

Amendment 13 agreed.

[The Deputy Speaker (Lord Alderdice) (LD)]

We now come to the group consisting of Amendment 14. I remind noble Lords that Members other than the mover and the Minister may speak only once and that short questions of elucidation are discouraged. Anyone wishing to press the amendment to a Division must make that clear in the debate.

Clause 3: Falsified medicines

Amendment 14

Moved by

--- Later in debate ---

[The Deputy Speaker (Lord Alderdice) (LD)]

We now come to the group consisting of Amendment 15. I remind noble Lords that Members other than the mover and the Minister may speak only once and that short questions of elucidation are discouraged. Anyone wishing to press this amendment to a Division must make that clear in debate.

Amendment 15

Moved by

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

Lord Alderdice Excerpts

Wednesday 4th November 2020 Lords Chamber

[Lord Trevethin and Oaksey (CB) [V]]

My Lords, it is a pleasure to follow the noble Baroness. These regulations place everyone in the country under a form of qualified house arrest. The freedom to travel, to go into a friend’s house, to play sport, to go to the pub—all taken away. Lord Sumption was obviously right when he described this in his recent lecture as

“the most significant interference with personal freedom in the history of our country.”

Those who are the most affected are the young and active. The bill—billions and billions of pounds—is not an illusion. Who is going to pay that bill? Generally speaking, it will not be those who directly benefit from the lockdown. It will be paid by the economically active and the young, who for the most part are at no real risk, along with their children and perhaps their children’s children.

Is the Government’s decision a good one? I have no idea and I certainly do not envy the decision-takers. There are many unknowns. However, it seems that the country—in particular the young, who are being ordered to give up anything resembling a normal life when they themselves are not at risk—is entitled to expect certain things. The first is that decision is taken in a properly objective and rational way. There is an obvious danger in the so-called “sunk costs” fallacy which occurs when a decision to take a future course of action is justified by reference to costs already incurred rather than the merits and demerits of the possible alternatives. There is a particular danger of a sunk cost reasoning where the decision-taker is responsible for an earlier decision whose correctness may be called into question by a change of course. Is this fallacy operating here? It is troubling to hear one of the decision-takers say recently, “We have travelled too far to turn back now”. That is classic sunk costs reasoning.

Secondly, we are all entitled to expect that the adverse effects of the proposed course of action are evaluated as thoroughly as its beneficial effects. Where is that evaluation? We have heard a great deal about the deaths that will be avoided by the lockdown, but almost nothing from the Government about its effect on mental health, a subject on which the noble Baroness, Lady Meyer, spoke so powerfully, on the diagnosis of other serious diseases and on our future ability to be able to afford to care for those who fall ill.

Thirdly, we are entitled to expect that the evidence presented to us as justification for these very extreme measures has been assembled and considered in a properly objective way. Graphs, forecasts, projections and so on are guesses. The guesswork may be informed, but the utility of this spuriously precise-looking material depends entirely on the underlying assumptions. You tweak the assumptions and the figures on the bottom line jerk around wildly. Anyone who has dealt with forecasting in the commercial world knows that.

The already rather notorious 4,000-deaths-a-day graph deployed in terrorem at the weekend reminded me of a different claim about a different supposed weapon of mass destruction: chemical and biological weapons ready for use within 45 minutes of an order from Saddam Hussein—we all remember that one. That war against supposed WMD did not go well. This is a very nasty and dangerous virus but, if it proves that the cure is more damaging than the disease, we will have betrayed generations.

[The Deputy Speaker (Lord Alderdice) (LD)]

The noble Baroness, Lady Stroud, has withdrawn, so I call the noble Lord, Lord Boateng.

--- Later in debate ---

[Lord Barwell (Con)]

My Lords, I support the regulations, although it gives me no pleasure to do so. I concede that the lockdown will damage our economy and people’s mental health and will restrict our freedoms —all the arguments that my noble friend Lord Forsyth so eloquently spelled out. I do so because the lesson from the first wave is very clear: that the consequences of not acting are worse. The countries that took quick and decisive action did not see more damage to their economies and more people out of work; they saw less damage. Countries that, like us, were late to act did not better protect their economies; they saw a sharper fall in GDP and more job losses.

My noble friend Lord Robathan said that there was uncertainty about the sums. He is quite right, but at every stage during this process, we have suffered from optimism bias. Back in February and March, we believed that we were several weeks ahead of Italy, before it became apparent that that was not the case. We came out of lockdown in May and June too quickly, failing to achieve suppression of the virus—particularly in the north of the country, which is why the pandemic has recurred there first.

We did not listen to SAGE back in September, when its advice was for a short circuit-breaker lockdown. The Prime Minister clearly did not want to adopt the policy that he is now pursuing. We were told that this was all going to be over by Christmas. Even now, some noble Lords seem to believe that what is happening in Belgium, the Czech Republic and France will somehow not happen here.

I fear that we live in an age of increasing unreason, where experts are maligned. I have a lot of sympathy with those noble Lords who have asked to see the assumptions that underpin the modelling, but others go further. My noble friend Lady Noakes said that, although she could not comment on this herself, some have said that there is a deliberate plot to curtail our civil liberties. Who would benefit from such a plot? How can what the Government are recommending to the House possibly be in their interest? It will make their job over the next few years immeasurably more difficult.

I believe that a vaccine and improvements in treatment and testing are on the way. However, lest noble Lords fear that I am suffering from the optimism bias that I have criticised in others, let me say that, if we look around the world, there are countries that, even before those developments, have achieved suppression and returned life to normal.

As I come to the end of my time, I say to the Minister that the Government need to use this period to achieve proper suppression of the virus—to get the tracing system working properly and ensure better compliance—so that, if I am wrong in my optimism about vaccine treatment and testing, we do not find ourselves in January or February back debating a potential third lockdown. This measure is the right thing to do now to protect our NHS. It is better than any alternative course of action.

[The Deputy Speaker (Lord Alderdice) (LD)]

My Lords, the noble Lords, Lord McConnell of Glenscorrodale and Lord Greaves, have withdrawn so I call the noble Earl, Lord Clancarty.

[The Earl of Clancarty (CB)]

My Lords, my first question is: what is the Government’s understanding of where in the community the virus is being transmitted most? Surely this is the evidence that should be shaping the measures being taken, including this lockdown.

I welcome the Prime Minister’s intention to mass test. However, if, as the ONS has said, Covid is rising rapidly among older schoolchildren, should not a priority during this period be to test all schoolchildren and staff, and indeed university students and staff too? Will there be an advertising campaign to accompany the Liverpool testing pilot, perhaps along the lines of getting tested being a social duty, particularly as so many people might be infectious but display no symptoms? Mandatory testing, as in Slovakia, would create an undesirable precedent in the UK but Slovakia’s project to test the whole population over two weekends is nevertheless admirable.

On Friday, I was privileged to attend one of the few live performances of Sarah Kane’s play “Crave” at the Chichester Festival Theatre before it was live-streamed. Everyone was masked and socially distanced in an airy auditorium. Lockdown is another blow to the arts when they are just starting to get back on their feet, particularly because of their considerable dependence for survival on a paying public.

However, those who continue to be most affected are the self-employed. The increase in support, at least for the lockdown period, is welcome, but a majority of the self-employed in the arts and entertainment are ineligible for support. They include the newly self-employed and those paid through dividends. Freelancers who work in the arts will not be covered by the Culture Recovery Fund. In its report Jobs, Jobs, Jobs, the Resolution Foundation identified a real issue with targeting the self-employed most in need. Have the Government looked at that report? Will they address these continuing concerns?

Lastly, I ask the Minister for clarification on what the lockdown means for private music teaching. The Minister says that the Government are prioritising education. It is vital that this teaching continues through the lockdown to nurture the next generation of musicians. I sent the Minister a note on this question this morning, so he might not have had time to see it, but there is a discrepancy between the guidance and the legislation, which clearly lists education as an exception without specifying what form that may take. Can music teachers continue to teach privately from home and visit other houses to teach? Can private music schools still operate face-to-face teaching? Can peripatetic music lessons in schools take place?

Concerns about the status of extracurricular activity within Covid-safe environments extend to art, drama and sport, as we have heard, with huge implications for mental and physical well-being, which we should not neglect, even for a month.

[The Deputy Speaker (Lord Alderdice) (LD)]

The noble Lord, Lord Lamont of Lerwick, and the noble Baronesses, Lady Clark of Kilwinning and Lady Newlove, have withdrawn so I call the noble Baroness, Lady Smith of Newnham.

Covid-19: Local Restrictions

Lord Alderdice Excerpts

Friday 9th October 2020 Lords Chamber

[Lord Bethell (Con)]

I completely defer to the noble Baroness’s expertise in matters to do with the devolved Administrations, but I reassure her that there are numerous calls every day between Whitehall and the DAs on Covid. We very much celebrate the achievement of a four-nations approach. There are divergences in some procedural matters between the different countries; that is entirely to be expected—indeed, celebrated—as it enhances the effectiveness of our measures. But I completely take on board the noble Baroness’s points and we will endeavour to ensure that communication between Whitehall and the DAs remains firm and solid.

[The Deputy Speaker (Lord Alderdice) (LD)]

The noble Lord, Lord Mann, has withdrawn, so I call the next speaker, the noble Viscount, Lord Waverley.

[Viscount Waverley (CB) [V]]

My Lords, the issue is indeed about collaboration with local government. However, the Government’s decision to introduce the Coronavirus Act marred the use of secondary legislation in respect of the Civil Contingencies Act, suggesting that the Executive believe that existing legislation is not robust enough to counter the threat of pandemics. Given that we live in such a world, what plans do HMG have to review the robustness of all existing legislation? If they do, can they confirm that it will not infringe on parliamentary sovereignty?

--- Later in debate ---

[Lord Bethell (Con)]

I reassure the noble Lord that we are making progress. He is entirely right: the ventilator challenge is an inspiration, and I note that we have hit our target of 30,000 ventilators. I note that we have 300,000 tests a day at the current run rate; we have re-registered 50,000 new clinicians to return to support the NHS; we have had 16 million downloads of the NHS app; we have recruited 14,200 nurses as part of our recent recruitment; we have processed over 24 million tests in laboratories as of 8 October 2020; and the Vaccine Taskforce has secured access to six different vaccine candidates across four different vaccine prototypes. These are enormous achievements and we will continue to pursue our response with energy and vigour.

[The Deputy Speaker (Lord Alderdice) (LD)]

My Lords, the time allowed for this Private Notice Question has elapsed. I regret that we have not been able to hear all the speakers.

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

Lord Alderdice Excerpts

Wednesday 7th October 2020 Lords Chamber

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I thank my noble friend for bringing these regulations forward today and, in particular, for his admission that it would help to publish such regulations before they are laid. That would be very welcome. They should also be brought to Parliament before they are implemented in future. Those two developments would help the industry and both Houses to scrutinise them.

My noble friend is under no illusion about how great the impact of Covid has been on the hospitality sector, which reopened late in the day, only in July. I find the application of these regulations particularly helpful, as they appear to help hospitality facilities, which are their target, to remain open. The announcement over lunchtime today that Greene King may close a number of establishments, some permanently, with a mass loss of jobs, is deeply worrying and possibly the tip of an iceberg.

I will ask one question and make one comment and proposal. Could my noble friend clarify the level of fine for a first offence? It seems reasonable for £500 to be the top level for a first offence, because there could be a difficulty in understanding and adhering to the rules. An increased fine for a second or third offence would seem reasonable. However, one part of the regulations before us today says that £500 will be the first fine; in another place, I see £1,000. I make a plea for £500, which seems more reasonable.

It is not the work of his department, but my noble friend is aware of this and I have raised it in connection with other regulations. Since Covid-19 became so extensive, water companies have been regularly testing wastewater at both household and community levels. It is then sent off for analysis by the Environment Agency. The thrust of debate on these regulations, the previous Urgent Question and all comments generally is that we need lockdowns that are as localised and short as possible. The benefit of testing wastewater is that, while it cannot be limited to individual households, it can be limited to a narrow community. Could my noble friend see whether his department can liaise with the Environment Agency and Defra to see whether the information gathered could be used to target more specific, community-based, smaller lockdowns, which would last for shorter periods? That would help both the local community and the hospitality industry, which has taken the brunt of the regulations, such as those before us today.

[The Deputy Speaker (Lord Alderdice) (LD)]

We ran into some technical problems earlier, so I propose to try again to hear the last two questions of the noble Lord, Lord Naseby.

Social Care

Lord Alderdice Excerpts

Wednesday 8th July 2020 Lords Chamber

[Lord Bethell]

The noble Baroness is quite right to allude to the very large number of White Papers, think tank reports and amount of documentation in this area. All I can say is that I have never seen such acute political will and focus on social care reform. Nor have I seen a Prime Minister, a Secretary of State and a chief executive of the National Health Service to be so focused on the matter and to have raised it as a major priority in all their communications.

[The Deputy Speaker (Lord Alderdice) (LD)]

My Lords, the time allowed for this Question has elapsed.

Personal Protective Equipment

Lord Alderdice Excerpts

Wednesday 24th June 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness is entirely right to emphasise the disproportionate balance of infection among BAME people and the importance of interpreters in ensuring that they get the treatment they deserve. However, we are emphasising the use of telephone services because we want to keep people out of areas of potential infection. That remains part of the service that we deliver, and telephone arrangements are proving extremely effective. However, I take on board her point about providing PPE for those interpreters who are on site, and I will continue to press those in the department who oversee this important area of activity.

[The Deputy Speaker (Lord Alderdice) (LD)]

My Lords, the time allowed for this Question has elapsed and we come now to the third Oral Question, from the noble Lord, Lord Wallace of Saltaire.

Coronavirus Bill

Lord Alderdice Excerpts

2nd reading & 2nd reading (Hansard) & 2nd reading (Hansard): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Lord Alderdice (LD)]

My Lords, I direct the House to my medical and research interests noted in the register. The Minister, in his excellent introduction to the debate, referred to the lessons from the 1914-18 war. I understand that reference and have some sympathy for it. However, my friend the anthropologist Scott Atran has pointed out that there are certain dangers in using the terminology of war, because it tends to turn people towards various “isms”: racism, chauvinism, ethnocentrism and xenophobic nationalism—exactly the opposite of the things that we want to find in our global community at the moment.

In truth, a more accurate reflection would be to address the lessons of the 1918-20 flu pandemic, which crossed the world and led to the deaths of tens of millions of people. However, two things about that experience are different from our own. One is that people experienced it immediately after the war, when tens of millions of people had died. To some extent, they were emotionally almost numbed by the whole business of massive death. Secondly, unlike us, who are used to antibiotics, vaccination and an expectation that people will not die of infections, people at that time were very much aware that people died of infections, sometimes in large numbers.

These facts contribute to what another colleague of mine, Dr Kerry Sulkowicz, the president-elect of the American Psychoanalytic Association, has referred to as the second pandemic of the moment, which was referred to by the noble Lord, Lord Blunkett, and other noble Lords: a pandemic of anxiety. It is not that he suggests that this is an inappropriate or pathological anxiety. On the contrary, it is a very realistic anxiety, because what is ahead of us is profoundly dangerous and challenging. We do not even know how dangerous and challenging, so anxiety is not an unreasonable response; it is a natural, human response. However, it produces problems in reaction. It leads some people to be so overwhelmed that they deny the reality. Even coming through London today in my car, not by public transport for safety reasons, I still noted groups of people out on the street in much more than twos and threes, not taking seriously the very sensible advice that they have been given publicly by the Prime Minister, Ministers and other experts.

Sometimes it leads to people being paralysed by the anxiety so that they do not know how to deal with things, but it also often causes illness—not just psychiatric and emotional illnesses of various kinds, but physical illnesses. Many people will be falling ill, physically and mentally, as a result not of the coronavirus directly, but of the psychological sequelae of it. There are many sequelae, not just anxiety. Reflect, for example, on what it will mean for many people, particularly older people on their own, to face three months or more without ever having touched a person or been touched by them. As human beings, the physical dimension of life is of enormous importance. They will be losing that and undoubtedly reacting in ways we do not know, because it has never happened in this wise before.

Many years ago, I was called to do work at a hospice where the staff were finding difficulty in continuing their work. It became apparent that this was because of the repeated, incessant, unremitting experience of the deaths of those they were working with. Reflect for a second on what it will mean for health service staff, who have been relatively well used to getting people better, to find that hundreds and hundreds of their patients will die. How will they manage, psychologically as well as physically? Can the Minister say how much thought has been given to addressing these problems?

There are many other things that I could mention but I will say two. One is that there are, in the voluntary, private and community sectors, employee assistance programmes that have been relieving the health service of having to deal with many of these problems. They are not going to be able to survive financially if there is no assistance for them. The noble Baroness, Lady Hollins, who is not in her place, has asked that we also remember the problems, as have been mentioned, for those who are vulnerable because of learning disability. Finally, because there will be more people admitted on formal orders, can we monitor how many more patients come in than would normally be the case on such orders, so that we have a sense of the increased burden on the psychiatric services?

Covid-19: Helplines

Lord Alderdice Excerpts

Thursday 19th March 2020 Lords Chamber

[Lord Bethell]

The question of indemnity insurance is addressed in detail in the coronavirus emergency Bill. We are fully aware of the concerns of anyone returning to work, and indeed anyone who might have indemnity insurance in one area of practice but who will be asked to take on exceptional duties required as part of this emergency—the surgeon, for instance, who takes on respiratory support duties. Those indemnities will be thorough and will cover all work. In terms of the warehouses for PPE, it is incredibly important that there is load allocation according to the need for the PPE, not necessarily the demands of local authorities. There is therefore an active allocation of PPE to those areas that have the highest incidence of the virus. That is being managed centrally in a thoughtful and professional manner.

[Lord Alderdice (LD)]

My Lords, I direct the House to my medical and other interests in the register. I have no doubt that NHS 111 and other helpline medical professionals and health professionals will give the best advice. But Professor John Ioannidis at Stanford University has pointed out that we are making major changes in the way we run society, on necessarily limited evidence for what happens with this virus. Can those working on NHS 111 and any other advice lines also take epidemiological data on the length of time and types of symptoms and, particularly, geographical spread, and feed that data back to research institutes inside and outside the NHS, so that we can get the best handle possible, as soon as possible, on how this virus operates?

[Lord Bethell]

The noble Lord, Lord Alderdice, is entirely right: one of the features of this virus is its extremely unpredictable nature. The way in which it reacts in different people at different times is extraordinarily diverse. Some people appear to be completely knocked out by it; some have the lightest possible symptoms. There seems to be an alignment with age. We are all enormously thankful that the young and very young seem to be blessed by having the light symptoms. We are all extremely concerned about the old, but it is not even as simple or as linear as that. A huge investment is being put into understanding the virus better. I am pleased to report to the Chamber that international co-operation on that is extensive and positive, and that British researchers are at the leading edge of pulling together that data.