Covid-19: Vulnerable Populations

Lord Bethell Excerpts

Tuesday 12th May 2020 Lords Chamber

The Question was considered in a Virtual Proceeding via video call.

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

My Lords, social distancing and shielding measures are in place to protect vulnerable and clinically extremely vulnerable populations. Those identified as clinically extremely vulnerable are advised to stay at home with no face-to-face contact until at least the end of June. Our approach is under continuous review. The Government’s position on shielding and social distancing reflects the latest SAGE and clinical advice from the Chief Medical Officer.

[Baroness Bull (CB)]

My Lords, every person with a learning disability has the right to be supported to live in their community, but Covid-19 is putting already-delayed in-patient transfers at risk. In March some 1,900 adults and 200 children were still locked away in in-patient units, the majority sectioned under the Mental Health Act and staying for five years in facilities intended to be short-term. Can the Minister share his department’s updated assessment of whether the Mental Health Act easements provided for in the Coronavirus Act will be required, now that the peak in infections has been passed and a plan for lifting restrictions is taking shape? Does he share concerns that these easements, if enacted, would risk the delivery of the care needed to support community living and the achievement of the goals set out in Transforming Care?

[Lord Bethell]

The noble Baroness, Lady Bull, asks a searching question. On whether the Mental Health Act easements of which she speaks have already been enacted, I will have to find out exactly what those arrangements are and write to her. However, I assure the House that the care of the most vulnerable is absolutely the Government’s number one, top priority. It is true that some of those caring and providing important pastoral care for the most vulnerable have been worst hit by Covid—the examples she gives are really good ones—but we are absolutely putting the care of the most vulnerable at the top of our priorities.

[Baroness Healy of Primrose Hill (Lab)]

Yesterday, the Prime Minister said of his road map:

“it is a plan that should give the people of the United Kingdom hope.”

But on examination of the plan, I see no hope offered to the clinically extremely vulnerable, who are just told that they must continue to shield beyond June. The Government offer only a future review into the effects on their well-being. Can the Minister say how and when this review will be conducted, and by who?

[Lord Bethell]

My Lords, the advice from the Government is that the clinically extremely vulnerable should continue to be shielded until the end of June. That is under review at the moment. We are seeking to have more refined and more targeted guidance after the end of June, and we will publish that before the end of that month.

[Lord Truscott (Ind Lab)]

My Lords, can the Minister reassure those healthy over-70s that they will not be obliged to self-isolate against their will? Will he also comment on evidence that many care homes were forced to admit Covid-19-positive patients, so causing this pandemic to spiral out of control in those homes?

[Lord Bethell]

I reassure the noble Lord that the Government are not obliging healthy over-70s to self-isolate. However, the guidance is clear: they are a vulnerable group and the disease targets those who are older. They are therefore advised to avoid all social contact, if necessary. That advice is based on the science of the disease, and we will seek ways of trying to ameliorate that once the disease has fallen back.

[Baroness McIntosh of Pickering (Con)]

My Lords, does my noble friend agree that the most vulnerable are clearly the residents of care homes and their care workers? Will he confirm the very sad figures of, as I understand it, 10,000 deaths suffered in care homes? Will he also confirm that these figures have now been added to the total? Will the Government now prioritise care home workers for the full kit of PPE, to give them the utmost safety as they look after our most vulnerable people?

--- Later in debate ---

[Lord Bethell]

I reassure the House that deaths in care homes have always been part of the official figures. It is a very sad affair, and it shows how the disease attacks those who are most vulnerable. The arrangements for PPE in social care settings have improved dramatically, and we have put in place measures so that any care home can make its own application for PPE as it needs it.

[Baroness Jolly (LD)]

Will the Minister tell the House what advice or support local authorities have been advised to give to the more than 100,000 vulnerable adults aged over 70 caring for their adult children who have a learning disability?

[Lord Bethell]

The advice given to local authorities is spelled out in guidelines. Those who are vulnerable are advised to avoid social contact. Where necessary, those whom they live with, including any children they have with learning disabilities, should also avoid the same social contact.

[Baroness Verma (Con)]

My Lords, I refer the House to my interests in the register. Will my noble friend tell me what work has been done to ensure that public health messaging and advice on access to support for mental health and anxiety issues among the BAME community is easily available to those communities, particularly where they live in densely populated home environments?

[Lord Bethell]

My Lords, mental health advice is very clearly available, most of all from GOV.UK/coronavirus, where there is a huge amount of practical and pastoral advice, and access to resources.

[Baroness Finlay of Llandaff (CB)]

My Lords, I declare that I am an honorary fellow of the Royal College of Emergency Medicine. How will the Government ensure that emergency departments never again become the crowded places that they were, which act as a source of nosocomial infection—hospital-acquired infection—for the vulnerable and those caring for them, especially child carers, who might present with acute injuries, particularly once they are out and undertaking more activities?

[Lord Bethell]

My Lords, a strange and peculiar feature of the epidemic has been that accident and emergency wards are, surprisingly, below normal capacity since people have sought to avoid them because of the obvious threat of the disease. That said, nosocomial infection is of grave concern. It is an inevitable and frequent feature of any epidemic, but we are applying new ways of working and seeking to section off those with the disease to ensure that the infection does not spread in our hospitals and from there into the community.

[Baroness Thornton (Lab)]

My Lords, I am pleased to note that today is International Nurses Day. I pay tribute from these Benches to all our nurses, at home and all over the world, for their work and courage in these dark pandemic times. I will ask the Minister about testing in our care homes. On 15 April the Government announced that they were rolling out testing to all care workers. On 28 April they extended this scheme to all staff and residents in care homes. Could the Minister explain why, then, yesterday’s strategy document set a target of 6 June? Which is it? It looks like the Government failed to meet the promise to provide the tests on time and have now moved the goalposts again.

[Lord Bethell]

I share the noble Baroness’s celebration of Florence Nightingale Day, which is an important day for the nursing profession and for all of us. We have made huge progress on testing in care homes in the last three weeks. The new portal was made live on Monday and care homes are now massively supported by satellite care home facilities manned by the Army. I am not sure about the 6 June date of which she speaks, but I reassure the House that care home testing is the number one priority of our testing facilities and is benefiting from the large increase in capacity.

[Baroness Tyler of Enfield (LD)]

My Lords, over the course of this crisis we have seen substance misuse and mental health services adapt their provision to better support homeless people facing multiple problems. Could the Minister say what the Government, in particular the new homelessness task force, will do to ensure that these flexibilities remain in place?

[Lord Bethell]

The noble Baroness is right to raise concern for the homeless—surely one of the groups suffering the most in the current epidemic. We are putting in place facilities for testing, housing and mental health support for the homeless. We envisage that these will continue for the length of the epidemic.

[The Lord Speaker (Lord Fowler)]

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