Lord Bethell contributions to the Coronavirus Act 2020


Wed 25th March 2020 Coronavirus Bill (Lords Chamber)
Committee: 1st sitting (Hansard): House of Lords
15 interactions (2,292 words)
Wed 25th March 2020 Coronavirus Bill (Lords Chamber)
3rd reading (Hansard): House of Lords
4 interactions (130 words)
Tue 24th March 2020 Coronavirus Bill (Lords Chamber)
2nd reading (Hansard - continued): House of Lords
5 interactions (3,002 words)

Coronavirus Bill Debate

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Department: Leader of the House

Coronavirus Bill

(Committee: 1st sitting (Hansard): House of Lords)
Lord Bethell Excerpts
Wednesday 25th March 2020

(5 months, 3 weeks ago)

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Leader of the House
Lord Russell of Liverpool Portrait Lord Russell of Liverpool (CB) - Hansard

My Lords, first, I strongly support the very sensible amendment moved by the noble Baroness, Lady Thornton. As I think we all know, and as the noble Baroness, Lady Grey-Thompson, said so eloquently yesterday, myriad people are very worried about what is going on and are concerned that things will happen to them but their voice will not be heard. The Government have enough to worry about, so, from their point of view, it seems very sensible to have a review process in which an organisation such as the Association of Chief Executives of Voluntary Organisations acts as a sort of funnel, pulling together all the myriad concerns that many of us seek to represent today through a single forum which can communicate regularly with the Government —it would be a two-way process. It seems eminently sensible to make sure that the people who are most worried feel that they are being heard and that there is a dialogue.

Secondly, I support the amendment in the name of the noble Lord, Lord Scriven. The variety of powers that local authorities will be required to have—particularly in relation to children in care, children going through adoption or fostering, and child carers—is incredibly important. If they are worried, think what that is doing to the people they are caring for. Therefore, I feel that clarification in that respect would be enormously helpful.

Lord Bethell Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) - Hansard

My Lords, I start by welcoming this amendment, which in its spirit and intention is utterly sensible, thoughtful and right. I would like to speak on it in a way that reassures the House that the intention of the amendment and the many speeches in the Chamber today are exactly aligned with the way government is thinking and in which we have sought to build the Bill.

I also echo the many noble Lords who have mentioned the speech by the noble Baroness, Lady Grey-Thompson. Who could not have been moved by both the emotional way in which she explained herself and the very real and tangible anxiety of people—particularly in the disabled community, but anyone who depends on local authority services—who must feel incredibly vulnerable and worried that their affairs may not be given the priority they deserve, and may feel exposed and anxious about the future? That testimony was incredibly powerful and moving. It was taken to heart.

I also say a big thank you to all those who have engaged with us as we have drafted the Bill at pace, both at a senior level from major organisations such as the LGA and smaller ones and stakeholders. I assure the House that we absolutely are listening to groups that have concerns about provisions for their stakeholders. We have our ears open. The Government’s whole “protect life” strategy is shaped around an absolute priority of trying to save the lives, affairs and futures of the most vulnerable in our society. These provisions are here not because we want to leave anyone behind but because we want to enable local authorities to make the decisions they need to in order to make a fair, pragmatic and sensible distribution and prioritisation. It is our hope that these provisions will never come into play and that the commitment of resources we have made into the local authority area will see a generous and sensible provision for all those most vulnerable in society.

I will take just a moment to outline a few provisions that are in place, to reassure the House that we are not in any way removing all safeguards. For instance, I assure noble Lords that the Care Quality Commission will continue to provide independent expert regulation of health and care providers. It has already announced arrangements for a proportionate approach to ensuring standards of care over the coming period. We have published an ethical framework to provide support to ongoing response planning and decision-making. This sets out a clear set of principles and behaviours when challenging decisions on how to redirect resources where they are most needed and how to prioritise individual care.

We are working closely with the sector on additional guidance to ensure that procedures and prioritisation of needs operate in the best way possible during this period. The emergency Coronavirus Bill also contains provisions allowing the Secretary of State to direct local authorities to comply with the guidance we issue.

Legislation underpinning our crucial safeguarding arrangements to protect vulnerable people from neglect or abuse remains in place. That was a point that many noble Lords made very well yesterday. We are leaving all statutory duties relating to deprivation of liberty safeguards fully in place.

The noble Baronesses, Lady Hussein-Ece, Lady Thornton and Lady Uddin, all raised the question of carers. I assure the House that we totally agree with the intent of the amendment. We need to ensure that users and carers retain a clear voice in the coming period and are able to make their concerns known. Our guidance on the Care Act changes will cover this. A national steering group is leading the sector’s preparations for Covid-19; it includes both user and carer representatives.

The noble Lord, Lord Adonis, quite rightly raised the question of commitment to democracy and oversight. I assure the House that we absolutely embrace the ongoing functioning of Parliament. While I cannot speak for the House authorities and their arrangements for Parliament, I can speak for the health department. We are introducing technology there, such as video data and home-working, at pace. We are seeing a generational transformation in working practices in the last fortnight. These arrangements have been embraced, and I expect them to be embraced in other parts of the workings of the House.

We will also continue to report on the eight-weekly cycle. The noble Baroness, Lady Watkins, and others emphasised the importance of monitoring. We will put in place structures for providing the correct kind of monitoring.

The noble Lord, Lord Blunkett, rightly emphasised the importance of civil society, which is absolutely key, while the noble Lord, Lord Hain, emphasised the importance of volunteers. I reassure the House that the Bill contains extensive arrangements for a volunteer army to be recruited in a safe, orderly and accountable way and for funding to be put in place for volunteers. The Chancellor has announced generous and important provisions for charities; the noble Lord, Lord Hain, is entirely right that they have seen their donations dry up. They need support and provision if they are to play an important role against this contagion.

I completely understand the intent of the amendment in the name of the noble Lord, Lord Scriven. We have spoken offline about his concerns, which I have taken back. I reassure him that we have worked closely with the LGA and, in its dialogue with us, its emphasis has been on financial commitment rather than changes in the law. We have made a substantial £1.6 billion commitment but we will keep the question of legal changes under review.

The noble Baroness, Lady McDonagh, mentioned PPE, which although it lies to one side of this amendment is of concern to us all. I reassure the Chamber that a massive global procurement programme is in place. Distribution of existing PPE stocks is happening via the Army. A hotline has been issued to all front-line workers in the NHS and social care. We are moving fast and impactfully on that situation.

Lastly, we should not overlook Wales. The Welsh parliament has considered every question of this Bill and has signed off its legislative consent Motion. I am extremely grateful to Vaughan Gething, the Minister for Health and Social Services in the Welsh parliament, for his support.

For those reasons, I ask the noble Baroness to withdraw her amendment.

Baroness Thornton Portrait Baroness Thornton - Hansard

I thank the Minister for that comprehensive answer. I also thank all the House for its supportive remarks on this amendment.

I say to my noble friend Lord Adonis that the two things we are talking about—the accountability of Parliament and our need to monitor these things, and the voice of the users and people at the receiving end of care, or non-care—are not in conflict. We need to be doing both, of course.

The noble Baroness, Lady Hussein-Ece, was quite right to point to vulnerable children and their care. My noble friends Lord Hain and Lord Blunkett were also absolutely correct about the importance of civil society in getting us through this crisis.

My noble friend Lady Pitkeathley is not here, but she is listening to us. She texted me to say, “Thank you for mentioning carers”. Of course in all this, the carers —people who are at home, many of them quite elderly themselves—are caring for people who will be at the sharp end of what comes next. We should not forget that.

I found two things very useful. First, the noble Lord, Lord Russell, mentioned the NCVO’s role in this, and he is absolutely right. Secondly, and finally, the Minister mentioned that the Government will produce guidance on the enactment of these clauses. This has to be done quickly but I put in a plea: that the voices we have talked about in this short but pertinent debate should be heard in the construction of that guidance, too. On that basis, I am happy to withdraw my amendment.

Break in Debate

Baroness Thornton Portrait Baroness Thornton - Hansard

My Lords, I attempted to put my name to this amendment. For some reason, presumably because the Public Bill Office staff are all working from home, it did not quite get through. The Government need to give this very serious consideration indeed.

Lord Bethell Portrait Lord Bethell - Hansard

My Lords, I completely recognise the good intentions of this amendment and the desire to protect women in an awkward situation at a difficult time. I also recognise the strong stakeholder views given to me by the royal college, Marie Stopes and others, but it is the Government’s priority to ensure that women who require abortion services should have safe, high-quality care and that abortions should be performed under the legal framework already set out by the Abortion Act.

It is vital that everyone, regardless of their views on abortion, be assured that this Bill’s provisions work alongside existing priorities of legislation, including abortion legislation. As I have described a number of times from this Dispatch Box, the powers in this Bill are solely and entirely to meet the needs of tackling this current pandemic. It is in that spirit that the Bill has moved so quickly through the House and that we have had such strong multi-party support for it.

The safety of women remains our priority, but it is vital that appropriate checks and balances remain in place regarding abortion services, even while we are managing a very difficult situation such as Covid-19. We have worked hard with abortion providers, including the Royal College of Obstetricians, and listened to their concerns, but there are long-established arrangements in place for doctors to certify and perform abortions, and they are there for good reason. We do not think that it is right that midwives and nurses are suddenly expected to take on expanded roles without prior consultation, proper training or guidance in place.

The coronavirus outbreak is a global issue. We are not the only country having to make difficult and uncomfortable changes. All over the world, clinicians and service users are coming to terms with extremely difficult workloads and workarounds to normal procedures. We are doing an enormous amount to help the NHS cope. We are doing this to protect life and to protect the NHS, but we expect doctors to work flexibly during this time. That means that certification can still take place in a timely way. It should not delay women receiving treatment. There is no statutory requirement for either doctor to have seen or examined the woman, as I described at Second Reading yesterday. Assessment can take place via telemedicine, webcam or telephone. Guidance from my department is crystal clear about that. The doctor can also rely on information gathered from other members of their multidisciplinary team in reaching a good-faith opinion. However, we do not agree that women should be able to take both treatments for medical abortion at home. We believe that it is an essential safeguard that a woman attends a clinic, to ensure that she has an opportunity to be seen alone and to ensure that there are no issues.

Do we really want to support an amendment that could remove the only opportunity many women have, often at a most vulnerable stage, to speak confidentially and one-to-one with a doctor about their concerns on abortion and about what the alternatives might be? The bottom line is that, if there is an abusive relationship and no legal requirement for a doctor’s involvement, it is far more likely that a vulnerable woman could be pressured into have an abortion by an abusive partner.

We have been clear that measures included in this Bill should have the widespread support of the House. While I recognise that this amendment has some profound support, that the testimony of the noble Baroness, Lady Bennett, was moving and heartfelt, and that the story of her witness from Lincolnshire was an extremely moving one, there is no consensus on this amendment and the support is not widespread. Abortion is an issue on which many people have very strong beliefs. I have been petitioned heavily and persuasively on this point. This Bill is not the right vehicle for a fundamental change in the law. It is not right to rush through this type of change in a sensitive area such as abortion without adequate parliamentary scrutiny. For example, there has been widespread support for measures such as permitting cremations to proceed on the basis of only one medical certificate. We simply do not have the same widespread support to make similar recommendations on the certification of abortions. For that reason, I urge the noble Baroness to withdraw the amendment.

Baroness Barker Portrait Baroness Barker - Hansard

Can the Minister concede that we are tabling this amendment because of how the NHS and medical services are affected by the Bill. We are not asking for any change in the criteria for abortion. We are asking simply for the process of the administration of decision-making to change.

That is being done right across the whole of the health service. The Minister has explained that telemedicine is being rolled out at a surprising rate. I do not understand why an experienced clinician or a midwife cannot make the judgments that he was talking about via video. They see women all the time and they will be able to make the same judgments. I do not understand that. If the Government do not accept this proposal, I ask him to accept that they should at least be under an obligation to continue to meet very regularly with the Royal Colleges and the organisations involved in this situation day to day, and they should be willing to come back with the power to make this change under a separate piece of legislation—because if, in seven weeks’ time, there is a clear pattern of women being failed, we cannot let it continue.

Lord Bethell Portrait Lord Bethell - Hansard

I completely recognise that the noble Baroness’s intentions are totally and 100% benign. She has the interests of the women concerned at heart. That intention is completely clear to me and I utterly endorse it. Where there is a difference of opinion and where we have taken a huge amount of advice—we have worked with the scientific advice in the department —is in the fact that the changes being offered are a fundamental change to the way abortions are regulated and administered in this country. Those regulations and administration arrangements have been worked on for years and are subject to an enormous amount of consensus. Her point on monitoring the situation is exactly the one that the noble Baroness, Lady Watkins, made earlier. I commit the department to monitoring it. We will remain engaged with the Royal College of Obstetricians and Gynaecologists and other stakeholders. She is absolutely right that we can return to the subject with two-monthly reporting back, and it can be discussed in Parliament in the debates planned on a six-monthly basis.

Baroness Uddin Portrait Baroness Uddin - Hansard

I say this with the sincerest due respect. The Minister will be aware that there are huge concerns about the power to have just one doctor decide whether a body should be cremated, especially in the light of the crisis becoming more intensive and critical.

Lord Bethell Portrait Lord Bethell - Hansard

The noble Baroness’s concerns are noted.

Baroness Bennett of Manor Castle Portrait Baroness Bennett of Manor Castle - Hansard

My Lords, before I get to the procedural part I will refer the Minister to some of his own words. He referred to the Government’s desire to ensure that everyone should have safe, high-quality medical care. In this area in particular, given that the option has been given to provide alternatives, that is something that the Government will be judged against, and I hope that he will be able to live up to his promise. However, it is with a heavy heart that I beg leave to withdraw the amendment.

Break in Debate

Baroness Uddin Portrait Baroness Uddin - Hansard

My Lords, I too beg the indulgence of the Committee. I have raised this point on a number of occasions; I am raising it now with respect to the powers within the Bill relating to necessity and proportionality, particularly as regards matters of dignity in death and what may happen in the unforeseen circumstances that thousands of deaths occur among the faith communities, and cremation may be decided upon due to the lack of burial spaces and storage facilities. I am suggesting that Schedule 28 affects our human rights obligations.

I am requesting, therefore, on behalf of the many hundreds of individuals who have written to me, including faith leaders and organisations, that the Government remove from paragraphs 13(1) and (2) in Part 4 of Schedule 28 the words

“have regard to the desirability of disposing”

and replace them with “dispose”, and then delete from paragraphs 13(1)(b) and 13(2)(b) the words

“in a way that appears”

so that the necessary guarantees are provided in the legislation, which will be required to provide assurance to the relevant faith communities.

Lord Bethell Portrait Lord Bethell - Hansard

My Lords, the noble Baroness, Lady Ludford, and all those who have signed up to this amendment have made incredibly important points that the Government utterly confirms. I reassure the Committee that this Bill is very clearly focused on the present danger of SARS-CoV and the Covid-19 disease. If there is any other virus—and even if this virus mutates— we will need a new Act or at least to amend this one.

The Government are 100% committed to protecting and respecting human rights. We have a long-standing tradition of ensuring that rights and liberties are protected domestically and of fulfilling our human rights commitments. That will not change. We have strong human rights protections, with a comprehensive and well-established constitutional and legal system. The Human Rights Act 1998 gives further effect in UK law to the rights and freedoms contained in the European Convention on Human Rights. Nothing in this Bill contradicts that.

I reassure a number of speakers—including but not limited to the noble and learned Lord, Lord Falconer, the noble Lord, Lord Anderson, and the noble Baroness, Lady Kennedy—that there is nothing in this Act that allows the Government to breach or disapply the Human Rights Act or the Equality Act. The Bill itself is fully compliant with the Human Rights Act and the Government have certified this on the face of the Bill— in fact, I signed it myself in accordance with Section 19. Pursuant to Section 6 of the Human Rights Act, every exercise of power by a public authority under this Bill is already required to be compliant with the Human Rights Act. I further reassure the House that, at all times, this Government will act with proportionality.

I am advised by legal counsel that the amendment is potentially both unnecessary and unhelpful. If we accept it, it might imply that the Human Rights Act and Equality Act do not apply in this way in other Bills or Acts that do not feature this sort of provision. For that reason, I suggest that the amendment should be withdrawn.

Baroness Ludford Portrait Baroness Ludford - Hansard

My Lords, I thank the Minister for what he said, which gave considerable reassurance—up to the last sentence or two. I was permitted by the Public Bill Office to table this amendment, so I am therefore slightly surprised at his reporting of the advice he has had from legal counsel. Obviously, I have to take note of what he said. No doubt they have greater legal minds than mine, although I note that the noble Lord, Lord Anderson, co-signed my amendment. I am a little taken aback by what the Minister said, but I none the less welcome the rest of his response. I beg leave to withdraw my amendment.

Coronavirus Bill

(3rd reading (Hansard): House of Lords)
Lord Bethell Excerpts
Wednesday 25th March 2020

(5 months, 3 weeks ago)

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Department of Health and Social Care

Moved by

Lord Bethell Portrait Lord Bethell - Hansard

That the Bill do now pass.

Lord Bethell Portrait The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) - Hansard

My Lords, I offer profound thanks to all concerned. I thank the Bill team, who have put together a balanced, thoughtful Bill in an amazingly fast turnaround. I thank my own team at the Department of Health for their enormous support. I thank the team in the Leader’s office and Whips Office who have worked to manage a remarkable programme in order to pass the Bill. I thank those in other parties who have worked in a collaborative, positive and supportive way during the whole process. I thank those who work in Parliament and in the House of Lords who are here today at considerable risk to themselves; they have displayed amazing commitment to this remarkable organisation by being here. I beg to move.

Baroness Thornton Portrait Baroness Thornton (Lab) - Hansard

My Lords, on behalf of these Benches, I thank the Minister for the way he has conducted the Bill. It has been a perfect exercise in consultation and work across the House. I thank not just the parties but other noble Lords who have taken part in this Bill for co-operating and working together in a way that has allowed us to scrutinise it as best we possibly could. I think we raised every issue that we could during its passage. It is important to have those things on the record because, as we move forward, we will need to know that we have asked those questions, and the Government will need to address them.

I thank my team, particularly my noble and learned friend Lord Falconer, who got drawn into this about a week ago, and my noble friend Lady Wheeler. I also thank the people in the office, who of course do all the work. In our case, that is Rhian Copple, who has done a brilliant job in keeping us informed and on the go.

I thank all my noble friends and noble Lords who are not here, but who gave us their views and have been patient. I know that they would have wanted to be here.

Coronavirus Bill

(2nd reading (Hansard - continued): House of Lords)
Lord Bethell Excerpts
Tuesday 24th March 2020

(5 months, 4 weeks ago)

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Baroness Thornton Portrait Baroness Thornton (Lab) - Hansard

My Lords, we are living in a strange and frightening time. I congratulate all noble Lords on their speeches and questions today. I refer to my interests as listed in the register, including the fact that I am a member of a clinical commissioning group until the 31st of this month, when it will be abolished and absorbed.

As always, our thoughts have to be with those who have lost loved ones to this virus. Also, all of us would praise, as we have done today, the extraordinary efforts of our NHS staff and other dedicated public servants. We are for ever in their debt. My nephew, Oliver Carr, is a newly qualified first-year doctor at the Royal Free Hospital here in London. I cannot stress enough how proud we are of Oliver, but we are also, like thousands of families everywhere with loved ones working in our NHS today, very concerned for his safety.

Today, we are being asked to make decisions of a magnitude that we would never have dreamed of a few weeks ago. None of us came here to put on to the statute book powers that would curtail so many basic freedoms which our forebears had fought so hard to put in place and which we take for granted. As my honourable friend Jonathan Ashworth said yesterday:

“This virus spreads rapidly, exploits ambivalence, thrives on inequality”.

I shall speak about health and social care. My noble and learned friend Lord Falconer covered justice and dealt with the aspects relating to coroners—I am very pleased to say—as well as the sunset clauses. Also, I shall not refer to education, because, between them, my noble friends Lady Blackstone and Lord Watson covered the waterfront on the educational questions that need to be asked with regard to the Bill.

The reference in last night’s statement by the Prime Minister to the fact that social isolation and distancing must be enforced was welcome. It was necessary because too many people were not following the advice. I think that we all watched with incredulity and horror the pictures at the weekend of bustling markets and packed Tube trains, beaches and parks, so I am afraid that the public health message was not heard loud and clear, and we now have to see whether it will be.

Everyone who should be at home, must be, and they must work from home. I am afraid that that includes your Lordships. There are six or seven speakers in this debate, including on our Benches, who should not really be with us. They are breaking the Government’s guidelines—now, instructions—and they endanger themselves, which is really worrying. I hate to say this but I know that they are here because most of their friends, including me, would not dare tell them not to be, and they have a contribution to make. However, it does not reflect well on this House after the magnificent example that has been set by the Lord Speaker. Hundreds of our colleagues are not here and have been sending messages to us, for which we are all grateful. They have been giving us advice, as many of us have mentioned.

I happen to think that Parliament must continue to sit as best it can. We must hold the Government to account, not least because, as many noble Lords have said, inevitably this Bill will have its flaws. Normally, we would have pointed those out over a period of months. It does not adequately cover some very serious areas which we have discussed today, not least the homeless, the self-employed and renters. Therefore, although I feel that the emergency powers, while draconian, are needed, that does not mean that the Government cannot regularly be held accountable. As the Minister said, the powers should be only in the context of this virus.

Turning to the health and social care workforce, one thing that we certainly now know unambiguously, as a result of this pandemic, is that nobody can be unaware of the importance of care workers in our community. There is definitely awareness of social care. It has to be accepted and of course properly funded.

The next few months will present a different level of challenge for the NHS and anyone working in the caring professions. We know that an increasing number of people will become ill and some will require medical treatment in hospital. The additional patient volumes will place enormous pressure on all sectors of our health and social care system. There will be pressures from increased absence by staff who are unwell and self-isolating in their households, so testing is absolutely vital, as is adequate PPE.

I will divert slightly from discussing the health and social care workforce. Several noble Lords mentioned the police, including the noble Baroness, Lady Barker, and the noble Lord, Lord Adebowale. If we are putting on the statute book, as we have been and will do, things that mean that you might be breaking the law if you go out or do something you should not be doing that might involve our police, what protection are we giving them? I will read on to the record what a female police officer has said in a message I have received:

“We need masks for every officer and prisoner, at least four washable masks for police officers: one to use, one to have in the bag for three days to decontaminate before washing, and two to change during the shift. Shower facilities for police officers—there are not enough showers. Gloves. Where do we take prisoners who are symptomatic? Where do we take people in a domestic situation? What happens to child contact arrangement orders? Can a person on bail not sign for bail who is self-isolating? What’s the process for breach of bail? What about registered sex offenders? Do they have to tell us if they intend to be at a different address? They have to attend police stations and register where they are. What do they do if they are symptomatic and away from home?”

She goes on, including on serving warrants and all the issues that our police have to face on a daily basis and which will increase. The Bill does not address those issues, but the Government absolutely have to address them.

The Bill includes provisions for regulators to register suitable healthcare professionals, such as nurses, midwives and paramedics, as well as social workers, including those who have recently retired or are on career breaks. To facilitate the return of experienced staff, we understand that rules that prevent retired NHS professionals working for more than 16 hours a week and which affect their pension entitlement have been suspended. However, procedures must be in place to ensure that background checks and other measures are fast-tracked. We must ensure that the well-being of these people is prioritised.

The Government will also be registering final-year nursing and medical students who are near the end of their training. These students have to be supported, supervised and properly remunerated. I absolutely back what the noble Baroness, Lady Watkins, said about the debt that nurses face.

We recognise that it will be appropriate and necessary for doctors, nurses and other registered health professionals to work outside of the usual scope of their practice and specialisms, and that a far wider range of staff than usual will be involved in directly supporting Covid-19 patients with respiratory needs. The Bill includes indemnity provisions for those undertaking these services. However, it is vital that NHS staff working outside their usual scope of practice are trained in how to care for vulnerable patients. Can the Minister outline what training will be available, what it will entail and how many staff will need to be trained to use ventilators?

We also recognise that health staff will need to depart, possibly significantly, from established procedures to care for patients in highly challenging but timebound situations at the peak of an epidemic. Can the Minister advise what guidance will be issued to assist clinical staff to make these calls? Can he assure the House that they will be kept under constant review?

I echo and support the words of the noble Lord, Lord Adebowale, about the importance of support for social enterprises. That is based on the role and importance that they have in the delivery of social care in this country. Can the Minister commit that he and his colleagues will meet with Social Enterprise UK and its colleagues to discuss this matter urgently?

The Bill also includes provisions for drafting in volunteers, which noble Lords have discussed, but we have to recognise that people with disabilities and chronic conditions often have some of the most complex care needs. It is very unlikely that volunteers will be able to provide the care that they need. We need reassurances that these people will continue to receive the appropriate care they need from professionals.

The Bill will allow NHS providers to delay undertaking the assessment process for NHS continuing healthcare for individuals being discharged from hospital until after the outbreak has ended. We understand that this will allow hospitals to discharge all in-patients who are clinically fit to leave without delay. Sir Simon Stevens has advised that this will potentially free up 15,000 acute beds. However, it is important that these measures are brought into operation for only the shortest possible time at the peak of the outbreak. The increased burden on social care services, already creaking before the pandemic, means that they will simply not be able to cope. We are concerned that the sector will be unable to cope. It is understandably a great worry for existing service users, who will know how dependent they are on the social care they receive daily.

There is huge concern about how domiciliary social care will cope during the crisis. It really is the front line of social care, with dedicated but low-paid care workers providing vital personal care services, visiting people in their homes daily, moving from client to client and providing the link with the outside world for people who depend on them, particularly if they are without family and care support. Can the Minister reassure us, for example, that the 15-minute visits will be extended to make sure that there is adequate time for a care worker to take the effective Covid-19 precautions as well as seeing to people’s needs, reassuring them and addressing any problems? What guidance has been issued on this?

Finally on social care, the risk to care and nursing homes with older people living in them cannot be overstated. There is a huge responsibility on managers and staff to keep the virus out. Does the Minister anticipate that care workers will be required to self-isolate with residents in the event of a quarantine or lockdown? I think it is obvious: if the pandemic takes hold in a care home, that care home could account for all the acute beds in that area, so it is a very serious problem indeed.

The noble Baroness, Lady Barker, covered the waterfront on mental health issues. On the powers to detain and treat patients who need urgent treatment under the Mental Health Act, to be exercised using one doctor’s opinion rather than two if that proves impractical or would result in unhelpful delay, can the Minister just clarify for us what the thresholds are for impracticality and unhelpful delay? I think that was the only question the noble Baroness did not ask on this.

On deprivation of liberty, I echo what the noble Baroness, Lady Barker, said. Also, pressure on care homes is already significant. The legislation—which the Minister was not involved in getting through the House, but many of us here were—is being carried through now, so this really increases the pressure on care home managers.

One of the side-effects of the Government’s Bill will possibly be to reduce access to terminations. I agree with the noble Baroness, Lady Barker, that this is a problem. The Minister and the Government really need to address that.

On supporting the public over domestic violence and abuse, the evidence suggests that domestic violence may increase during this time and that children are particularly vulnerable. What are the Government doing to recognise this? Are they improving funding to this sector? Are they considering the most vulnerable, including ensuring immediate funding as well as replacement income for refuges that have already had to close?

Turning to renters, it is clear that nobody should have to lose their home because of the virus and its impact. The Government have acknowledged that with their action on mortgage holidays, yet have failed to protect those in the rented sector. Despite suggestions otherwise, we believe that the Bill fails to legislate for a ban on evictions. I hope that the Minister can confirm that the Government intend to amend the Bill to this effect or to introduce further primary legislation. There seems to be an overwhelming case here. Some 20 million people in England rent, 6 million of whom have no savings whatever, so they are particularly vulnerable if they lose their job or have their hours cut as a result of this virus. Last week, Shelter estimated that 50,000 households could face eviction through the courts in the next six months, thereby creating yet another crisis. We therefore remain extremely concerned that a three-month pause on evictions will defer this crisis only to the end of that period because landlords will then demand the total arrears of three months’ rent from many tenants who may not have been able to work at all and certainly will not be able to pay.

I turn now to the homeless. The Government need to address the specific question of people who have no recourse to public funds. As noble Lords will know, people experiencing homelessness, particularly those who are rough sleeping, are especially vulnerable in this outbreak. They are three times more likely to experience chronic health conditions, including asthma and COPD, and many are unable to access healthcare or housing because they have no recourse to public funding and benefit restrictions. These people include those on appeals whose rights are exhausted, EU and EEA migrants, people with existing visas, those whose status is not regularised, domestic workers and other migrant workers, as well as the victims of trafficking and torture, so it is critical that this is resolved. It is in everyone’s interests that it should be resolved—if we have people on our streets who are either infected or infectious, that will put yet more strain on the NHS.

On income support, we need income protection for those in precarious forms of employment. Apart from anything else, it would stop them packing Tube trains. One reason the Tube is packed is that many people in very low-paid jobs have to get to work. Like other noble Lords, we remain concerned that the Bill fails to give many people the financial support they need to get through this crisis. They should not be expected to make the choice between their health and hardship. Several noble Lords have talked about the self-employed and they are absolutely right to do so. The Government need to look at the position of the self-employed in a generous way. The Government should also act now to assist millions of people through the universal credit scheme by increasing it, suspending sanctions and scrapping the five-week wait for the first payment. We await to hear what the Chancellor will announce on this as a matter of urgency.

The issue of food is important. Stockpiling is clearly taking place and it is happening because people are not reassured that there is enough food to go around. The most vulnerable are losing out, so the Government have to take this very seriously. We understand that military personnel might be brought in to help with food chain logistics. Can the noble Lord explain what their role would be? Additionally on our food supply, by this summer we will need some 80,000 seasonal workers to pick fruit and vegetables, so we will have to train a reliable workforce for that.

The noble Baroness, Lady Grey-Thompson, covered the issues affecting the lives of disabled people. The Government’s plans in the Bill for this crisis will roll back 30 years of progress for disabled people. While we may tolerate this for a short period, we cannot tolerate it for very long. All the years that we fought for disabled people’s right to social care are being eroded and undermined, along with their civil liberties and right to support. We need to put the noble Lord on notice that, particularly in this House, we will tolerate this for as short a period as possible.

I want to say a word about food banks, which are suffering from, or are in danger of suffering from, shortages. Here I pay tribute to some of our major retailers, the Co-op in particular, for ensuring that deliveries to FareShare schemes are going through. Today I saw a message from the manager of a Boots shop, complimenting the staff on dealing with a totally unacceptable level of abuse. Apparently, it happens particularly when they run out of Calpol. Such scenes are being repeated over and again in our shops and supermarkets, so I pay tribute to all their staff and managers, who are doing very hard jobs, along with other shopkeepers and indeed our farmers.

In conclusion, as my noble and learned friend Lord Falconer said in his opening speech from these Benches, we lend our support to the Government to put this legislation on to the statute book without delay, but not without comment or scrutiny. This is just the beginning of the challenges of the crisis facing our nation and our democracy.

Lord Bethell Portrait Lord Bethell - Hansard

My Lords, I thank noble Lords enormously for their powerful contributions in this Second Reading debate on this important Bill. It is an incredibly technical Bill; it is nearly 400 pages long. It was drafted on the hoof, at pace and in quick time. Noble Lords have stored up an enormous number of extremely thoughtful and, at times, extremely technical questions; there have been literally hundreds of them in today’s proceedings. I will try my hardest to answer as many of them as I can and I will write to noble Lords where I can, but I emphasise to the Chamber that, given that we will go into recess shortly, my phone remains on for any noble Lords with questions about either the Bill or the ongoing Covid-19 arrangements. I very much want to stay in touch with noble Lords who have questions.

Despite isolation and social distancing, we embraced technological innovation and embarked on a large amount of engagement for the Bill. I thank very much all the parties who engaged on the Bill—the noble Baroness, Lady Thornton, the noble Lord, Lord Newby, the noble and learned Lord, Lord Judge, who is not here, and their various parties and conventions—all of whom engaged in an extremely positive, constructive and important way. The tone adopted was a great example of Parliament coming together. I am very grateful and hope that that will continue during the Bill’s passage.

A number of noble Lords bore testimony to the hard work of NHS staff and those who work in social care. I want to take a moment to say thanks to those who work at Public Health England, without whom we would not be in the good shape that we are in, and who continue to provide incredibly important scientific and supporting work for our healthcare system. I also want to take a moment to say a word of gratitude to every single member of the staff of the House who is here despite the circumstances, as well as to the Bill team, which has literally moved mountains to pull together an incredibly complicated and long Bill in such a short time and done so with great humour and tolerance; huge thanks to them.

I want to use this speech, first, to update the House on a Statement made in another place by the Secretary of State for Health and Social Care earlier today. Ultimately, our goal is clear: we must slow the rate of transmission to protect the NHS. Our instructions are simple: stay at home. People should leave home for one of only four reasons: first, to shop for basic necessities, for example food and medicine, which must be as infrequent as possible; secondly, to exercise once a day, for example a run, walk or cycle alone or with members of the same household; thirdly, for any medical need or to provide care or to help a vulnerable person; fourthly, to travel to and from work but only when it cannot be done from home. Employers should take every possible step to ensure that remote working can happen. These four reasons are exceptions to the rule.

A number of noble Lords, including the noble and learned Lord, Lord Falconer, asked about the powers to enforce the PM’s instructions regarding essential travel and gatherings. For England and Wales, they will be introduced by regulations under the Public Health (Control of Disease) Act 1984. The Coronavirus Bill will give Scotland and Northern Ireland similar regulation-making powers. As the Prime Minister indicated yesterday, these measures are intended to protect the NHS and our social care service, and to save lives. We have taken the right steps at the right time but the spread of coronavirus across the UK is accelerating more rapidly than was originally forecast. Therefore, it is right that this Bill gives all four UK Governments maximum legislative flexibility to reflect the unpredictable circumstances that we will face.

I was pleased to see widespread support in the Chamber from noble Lords for these measures; the measures will, first, increase the health and social care workface; secondly, they will ease the burden on front-line staff; thirdly, they will contain and slow the spread of coronavirus; fourthly, they will allow us to manage the deceased with respect and dignity; and, finally, they will support people in getting through the crisis. However, I assure all Members of this House that none of these powers is taken lightly. The powers that we take in this Bill are not powers that the Government planned to take, but they are absolutely necessary.

A number of noble Lords spoke about the “on and off” aspect of the powers. I want to reassure the Chamber that the Government will activate them only on the basis of scientific advice. Guided by the experts, we will look at the evidence and continually review the effect of these measures.

Many noble Lords pressed me on whether the necessary powers were in place to curtail the provisions in the Bill. To reiterate, such a power is already in the Bill. Most of the powers in the Bill can be suspended and revived by the Government as the science dictates. On top of this, we amended the Bill last night in the other place to allow us to terminate provisions at the six, 12 and 18-month points.

I hope that noble Lords will agree that the Bill achieves the right balance between the necessary powers alluded to by the noble Lord, Lord Newby, and the noble and learned Lord, Lord Falconer, and the proportionality referred to by the noble Lord, Lord Blunkett, and my noble friend Lord Robathan. I am grateful for the endorsement from my extremely learned friend, the noble and learned Lord, Lord Judge, who notes that the Bill is proportionate in the unparalleled circumstances that we face.

I thank those noble Lords, including the noble Lord, Lord Oates, who raised the issue of the deprivation of liberty safeguards. We recognise that we have to strike a careful balance between the need to protect some of the most vulnerable in our society with preventing the spread of the virus. Therefore, we have decided not to alter deprivation of liberty safeguards in primary legislation. However, we think that we can achieve significant improvement to the process through emergency guidance. That will include making clearer when a deprivation of liberty safeguards authorisation is necessary, and the basis on which an assessment can be made, including, for example, phone or video calling for assessment. We are especially grateful to the noble Baroness, Lady Finlay, and other experts, who have worked with us on this. On that note, I also thank the noble Lord, Lord Anderson, who has given sage advice on a number of highly technical and detailed aspects of the arrangements for lord commissioners. I cannot answer those points from the Dispatch Box right now, but I shall certainly take them home and reply to him in time.

This brings me to the Government’s ongoing work to keep the country running. My noble friends Lord Robathan and Lord Naseby spoke movingly about this, as did the noble Lord, Lord Inglewood, the noble Viscount, Lord Colville, and the noble Baronesses, Lady Ludford and Lady Bennett. They have all raised important points about how we will need to fortify our economy and ensure that it bounces back. As I explained in opening, there is a direct connection between the effectiveness of our healthcare measures and our ability to ensure that people can pay their bills and are not driven back to work. The Chancellor has outlined an unprecedented package of measures to protect millions of people’s jobs and incomes as part of the national effort in response to coronavirus. This Government’s response includes strengthening the safety net for the self-employed, who will benefit from a relaxation of the earnings rules under universal credit and deferring income tax self-assessment payments due in July 2020. We have always said that we will go further where we can, and we are actively considering further steps.

The noble Lords, Lord Adonis, Lord Low, Lord Watson and Lord Blunkett, and the noble Baroness, Lady Blackstone, among others, raised the impact of the pandemic on schools and students. As a father of four children who are being home-schooled at the moment, I feel those questions personally. This Government have confirmed that exams will not go ahead this summer and that we will not publish performance tables. These decisions were not taken lightly. There will instead be a standardised grades process set by the Office of Qualifications and Examinations Regulation which will take into account a range of evidence including, for example, non-exam assessments and mock results. Ofqual is working urgently with the exam boards to set out proposals for how this process will work. I assure noble Lords that they will talk to teachers’ representatives before finalising an approach to ensure that it is as fair to students as possible. Furthermore, the Government will issue a statement shortly on what we will do more broadly to ensure that the teaching workforce is maintained.

I turn next to social care and support for the disabled and carers, which was rightly highlighted by the noble Lord, Lord Low, the noble Baronesses, Lady Blackstone and Lady Grey-Thompson, who spoke incredibly movingly on her own behalf and that of the noble Baroness, Lady Hollins. A number of noble Lords expressed serious concerns about the state of the adult social care market to deal with these profound pressures. I assure noble Lords that these concerns are felt very meaningfully at the Department of Health. My colleague Helen Whately is a tireless champion and an effective administrator, who is bringing both money and expertise to bear on this subject.

I completely accept and take on board the testimonies we heard in the Chamber today. The challenge to social care is profound, and many of the anecdotes told and circumstances alluded to in this House are of paramount concern. The challenges we face are enormous. We know that local authorities and providers will do everything they can to continue to meet all needs. The noble Lord, Lord Scriven, spoke movingly and persuasively about that challenge. But we cannot rule out the possibility that, in the coming period, they will need to take difficult decisions and may need to be able to focus their resources on prioritising accordingly to meet the most urgent needs. The inclusion of the Human Rights Act in these provisions is intended to underscore that, where local authorities need to prioritise care during the coming period, there is an absolute and unavoidable obligation on them to meet everyone’s human rights as an absolute minimum. We are developing guidance on how councils can use these powers in the best possible way. The Secretary of State will have powers to direct councils to comply with this.

We also intend to make changes to the current rules regarding entitlement to carer’s allowance for those who have had to take a break in care, so that they can continue to receive carer’s allowance. During the period of Covid-19, emotional support can also count towards the carer’s allowance care threshold of 35 hours a week.

On protecting the most vulnerable, I want to update the House on shielding, which was introduced yesterday. We are writing to up to 1.5 million of the most vulnerable people in the UK to advise them that they will need to shield themselves from the virus in the coming months. We will provide targeted support for all those who will need it, so that they have the food, supplies and medical care to make it through.

I will say a few words about housing, which was touched on by a number of noble Lords. What we are setting out in this Bill delivers on our commitment to protect tenants during the crisis. These measures will mean that landlords cannot start possession proceedings in court for an initial period of three months, providing tenants with a clearly defined breathing space in which they will not have to leave their home because of a new eviction procedure. This is a proportionate response that mirrors the three-month mortgage relief we are giving to landlords with mortgages. We also have the power to extend both the three-month notice period and the date these powers will end, and we are clear that we will use these powers if necessary. This legislation is one part of our package of support; it should not be seen in isolation. We have sought to ensure that tenants will still have income coming in so that they can continue to pay their rent, and additional legal protections for tenants are being introduced.

However, let us not forget that the cold-weather period is a particularly tough time for those sleeping rough, as was quite rightly highlighted by the noble Lord, Lord Adebowale, and the noble and learned Lord, Lord Falconer. Given the grave situation, they quite rightly asked about the steps that the Government are taking to protect and support those who are most vulnerable and living on the streets. Some £1.6 billion of additional funding will go to local authorities to enable them to respond to Covid-19 pressures across all the services they deliver, including stepping up support for the adult social care workforce and for services helping the most vulnerable, including homeless people.

There is much more that can and will be done. Our work is continuing, our funding is increasing and our determination is unfaltering. I welcome the opportunity to meet Social Enterprise UK, an organisation that I am familiar with, and I will ask my personal office to arrange that.

Many noble Lords have asked about the justice system, including the right reverend Prelate the Bishop of Rochester, the noble and learned Lord, Lord Falconer, and the noble Lords, Lord Hastings, Lord Ramsbotham, Lord Blunkett and Lord Scriven, and rightly so; given the way that people are treated in the justice system, this experience may have a profound effect on helping them to recover. In response to why there is no mention of prisons and probation in the Bill, as the noble Lord, Lord Ramsbotham, asks, the Secretary of State has advised that powers exist that are considered sufficient for the needs in prisons and for the probation service at this time. Any decision on the release of prisoners would need to be made by the Lord Chancellor in agreement with the Prime Minister and would need to balance public protection considerations. Any decision to release individuals would also need to take into consideration the shared pressures faced by probation services.

Regarding the extremely delicate and important question of pregnant women, governors have been provided with guidance issued by the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives on supporting pregnant women, and we will continue to provide updates on this. In addition to this, the prison group director for the women’s estate has issued advice on measures that can be used to enable implementation.

I turn to the remarks of the noble Baroness, Lady Barker, who has made some important and pertinent points about abortion. We completely recognise that continued access to safe abortion services has to be a priority, and in early meetings she bore testimony to the challenge and stresses for women in that situation. That will mean that doctors have to work flexibly to ensure that certification can still take place in a timely way, and not to delay women in any way from receiving treatment. There is no statutory requirement for either doctor to have seen and examined the patient. Assessment can take place via telemedicine or webcam or over the phone; DHSC guidance is clear on this point. We are also clear that the doctors can also rely on information gathered by other members of the multidisciplinary team in reaching their good-faith opinion. For these reasons, we do not consider that changes to certification treatment for abortions should form part of the Bill.

I am sincerely grateful for the important contributions made by my noble friend Lord Sheikh and the noble and learned Lord, Lord Falconer, who asked what steps we have taken to ensure that there are no forced cremations for religious followers. This is a very delicate issue, and stakeholder engagement has been moving and persuasive. I reassure noble Lords that we are engaging with faith communities to make sure that contingency measures are designed with due consideration for different practices around managing the deceased.

Lord Sheikh Portrait Lord Sheikh - Hansard

Is my noble friend able to give me the guarantees that the community is looking for with regard to burial and cremation? They are looking for assurances and guarantees.

Lord Bethell Portrait Lord Bethell - Hansard

My noble friend Lord Sheikh spoke very movingly. The amendment agreed to in the Commons is, I believe, an extremely important step in the right direction. A huge amount of discretion is given to local councils to make arrangements with the communities that they know best. This is a set of decision-making that is best made at a local level, and for that reason I would prefer to leave it in the hands of the amendment and in the hands of the local councils. However, I want to be clear that faith communities will be involved in the drawing up of statutory guidance that will be issued before any direction affecting burial or cremation is issued. It is of the utmost importance during this difficult time that we continue to respect people of faith and their beliefs.

People across the United Kingdom have already responded heroically to this threat, as we knew they would, and it is clear from the quality of discussion that this House will do the same. I am frustrated that there are several noble Lords whose questions I have not been able to tackle; my noble friend Lord Balfe and the noble Lords, Lord Bates and Lord Watson, and the noble Baroness, Lady Bennett, are on my mind, and there are others who may also wish to stay in touch.

I want to be clear that the Bill is a necessary weapon in the fight against coronavirus. The Bill is a vital tool in our efforts to protect lives and, as this debate has shown, it commands broad support.

Bill read a second time and committed to a Committee of the Whole House.