(3 years, 10 months ago)
Lords ChamberMy Lords, engineers at the Department for Health and Social Care are undertaking an initial assessment of the Exposure Notifications Express capability in consultation with Apple. At this stage, the assessment is paper-based, as software is not available outside the United States. We anticipate ENS becoming available in European countries in one or two months. We continue to assess this capability as information becomes available.
My Lords, it is welcome that the Government have finally decided to move to a decentralised system. Apart from the number of downloads, what success criteria that can be attributable to the Covid-19 app have the Government set, how will these be measured and where will the public be able to see progress against those criteria?
My Lords, the ultimate aim of the app is to break the chain of transmission. That is done through a number of ways. One is to provide a proximity alert for those who spend time with people who have tested positive. It also has a check-in capability to help our track and trace efforts, and we are building more applications on it all the time. One encouraging statistic is that until 10 o’clock yesterday, there were 6.5 million check-ins through the app. This is an astonishing number and it shows that those who are socialising are using the app.
My Lords, I congratulate the Government on introducing this system of track and trace using apps. I encourage my noble friend to look carefully at introducing as soon as possible the express system available in the US and having it integrated into the telephones. He may not be aware that a number of people with whom I am in contact have downloaded the current app, found that it drains their batteries too quickly, and have therefore deleted it. Does he agree that if the express system were integrated into the app, it would do less damage to the battery and it would be more likely that people would stay with it?
My Lords, we are looking carefully at the Apple express system. It does not contain the substantial investment in the algorithm from the Alan Turing Institute that gives our own app the sensitivity and protection that phone users are seeking from such a device. We have looked carefully and worked extremely intensely with Apple on the battery and our understanding is that the app does not have a large impact on battery use.
When will the equality impact assessment be published for the trial in Newham of the test and trace app that uses the Google-Apple technology?
The results of the Newham trial are analytical rather than about the privacy assessment, which has already been published. What we learned from Newham was that security concerns among that community were profound and, therefore, we shaped our marketing in order to address those concerns.
My Lords, is not this new system available only on newer smartphones, which older people and poorer people are less likely to possess? They are the most vulnerable. Is there not a danger of this becoming yet another expensive and useless gimmick?
Perhaps I may reassure the noble Lord that the NHS app is usable by nine out of 10 smartphones. On average, 87% of Apple and Android phones can download the NHS app. The Apple express service uses a smaller segment of the population because it requires more modern software in the phones.
My Lords, what have the Government done to ensure that the new NHS app can read only official QR codes at venues and not scams that have the potential to corrupt a person’s phone or grab their data and cause privacy issues? How can users recognise whether a QR code is genuine and is any guidance available to help them to be cautious?
I reassure the noble Baroness that the use of non-official QR codes is rejected by the app. I have had personal experience of this. We have had downloaded 600,000 of the official QR codes—an astonishing figure. The use of those codes seems to have been embraced and adopted. I have one at my office and it works extremely well.
I confess that I am very confused by the answer given by the Minister to my noble friend Lord Foulkes about older phones. I have a friend who was excited about being able to download the app; her phone is only two or three years old but it was too old to download the app. I have to say that I am sceptical of the figures that the noble Lord has given us. Certainly, some who may or may not be in the lower income bracket, may be older, or may just be careful and have phones bought in 2015, seem unable to download the app at all. Did the noble Lord say there were two apps? This is confusing and I am not sure that it will help.
My Lords, I completely understand the concerns of those who may be struggling to download the app but I reassure the noble Baroness that the current app is supported by iOS versions 13.5 and higher, and by Android Marshmallow version 6.0. That covers by far the vast majority of phones. As I said, 89% of phones should support the app. They include, for instance, Apple iPhone 6S and above—a huge proportion of phones. We are debating a new initiative by Apple to bring in their own protocol that is particularly directed at developing countries which may not be able to support their own app. That initiative is not targeted at the UK. We believe that it may have some relevance in supporting downloads of the NHS app because the alerts created can perhaps be directed to the download site on the iPhone store to encourage those in the UK who have not yet downloaded the NHS app. The Apple initiative is a positive development that will be particularly well used in developing countries.
Have the Government set a target for the number of people who need to download the NHS Covid app for it to be an effective solution for suppressing the virus? If so, what is the target and what are they doing to reach it, should it exist? More generally, what are they doing to increase the number of people using the app?
My Lords, there is no particular target where the app becomes relevant or non-relevant. Some 14 million downloads to date is a remarkable number and the app is already proving effective, with a substantial number of people having received notifications from the proximity device and who are now abiding by isolation measures. We have a massive marketing campaign that has been seen by 97% of the population and ongoing activity, particularly among hard-to-reach communities and the young, to support the downloading and use of the app.
What is the point of the new Covid app if testing takes seven days to produce a result and, by the time the person is notified that they were in contact with someone infected, they are likely to be displaying symptoms already and will know for themselves?
My Lords, the point of the app is to support our tracing efforts and provide security among those who are in areas that are not socially distanced in order to alert them when they have been near someone who has recently had a test. The test results are not, as the noble Lord described, typically available after seven days. The figure is much lower and we have already found enormous support for the use of the app.
My Lords, all supplementary questions have been asked and we now come to the third Oral Question.
(3 years, 11 months ago)
Lords ChamberMy Lords, the circumstances of their passing and the burial of the dead has been one of the most heart-breaking aspects of the Covid epidemic. The Government have sought to soften the blow with additional payments, but nothing we do can make up for the sadness caused by this horrible disease for those who seek to mourn. As set out in the NHS constitution, access to services is based on clinical need, not on an individual’s ability to pay. To support health services through Covid, we have allocated an additional £48 billion to support this principle.
Is it not true that the places that are in the greatest need of financial support are the poorest areas? It has been confirmed again that people living in the poorer areas of our country are twice as likely to die of this virus as those in better-off areas. I know that a basic funeral will cost perhaps £1,500 which, for ordinary people in poorer areas who are in any case struggling to make ends meet, a bill of this sort—and it can often be more than that—is totally heart-breaking, with anxiety and stress resulting from it. Do the Government have any proposals to ensure that poorer folk in particular will be able to meet their needs without having to suffer the stress that they feel at the present time?
It is true that there is a correlation between the mortality of this disease and poverty. That is why we have enhanced the funeral expenses payments by increasing the additional costs by £300. We are also supporting public health funerals by issuing new guidance to local authorities to support this important measure which brings a degree of quiet to those who die in poverty.
Does the Minister share my concern that older people and their families are picking up the tab, with many being forced to pay a steep and unexpected coronavirus bill by their care providers? Some care home residents are being asked to pay more than £100 a week on top of their usual care home fees as PPE and the cost of covering staff absences push the finances of some care homes into the red and threaten their sustainability? What consideration have the Government given to outlawing or capping such charges, as called for by Age UK? With a second peak under way and care homes under acute financial pressure, will the Minister commit to making sure that the Government’s emergency funding is directed to them?
My Lords, the noble Baroness is right to say that there are costs related to PPE for social care homes. That is why we have put together a winter plan for social care that envisages a massive investment in Covid-compliant PPE for care homes providing both adult care and child care. It will be free of charge for those homes. The money that we are supporting through the DWP funeral expenses payment and through the public health funerals programme has been enhanced. In 2018, £6.3 million was spent on public health funerals by local authorities and further sums have been allocated to support this important payment.
My Lords, I am pleased to hear the Minister’s comments, but I was absolutely shocked to see that the price of a budget funeral is really quite high, at between £4,000 and £6,000, with a cremation at £3,400. Too many people are in the category where there is no way of finding that money. When the Minister answered the first Question on this, he said that the council system was still going. Could he elaborate on that, because in my council days in social services we handled a lot of funerals for people who simply had no money? This is a great anxiety for families and they need to know that they will be cared for at that stage.
My Lords, the costs of a funeral are indeed a heavy burden on families with little wealth and have to support these payments. The Cabinet Office holds weekly meetings with the funeral industry in order to ensure that measures are in place to support families of the kind my noble friend described. We have put together guidance in order to ensure Covid-compliant funerals at the lowest possible cost, and for those who cannot afford to pay, the DWP has measures in place to make a payment up front for funeral costs in order to support them.
My Lords, public health funerals cost on average about £1,500 each. Many local authorities such as Birmingham spend a significant amount on them—almost £1 million in 2019. Local authorities are reporting an increase in demand for public health funerals. Will the Government take that into account in next year’s local government settlement?
My Lords, I do take note of the point made by the noble Baroness. This is entirely on our radar screen. We are aware of these additional costs and we will take note of the point that she has made.
My Lords, will my noble friend join me in paying tribute to the tremendous community-based voluntary work of the National Burial Council, the British Islamic Medical Association, the Muslim Council of Britain and others which have co-ordinated and supported a community that has suffered a disproportionate number of deaths during this pandemic? Will he agree to receive a report on this from the All-Party Parliamentary Group on British Muslims and meet with some of the volunteers to ensure that the Government can learn lessons from the practice of faith-based initiatives in this difficult period?
My Lords, I pay tribute to those who represent faith-based funeral interests. They have been presented with a huge challenge during Covid and have worked with the Cabinet Office in order to put together the kind of measures necessary to give people of faith the respectful funerals that they deserve. I would be glad to receive the report that my noble friend described.
My Lords, I declare my interests, as set out in the register. Knowing that more men than women have sadly died from Covid-19, could the Minister tell us how many Covid-19 widows there are in the UK and what steps the Government have taken to support them financially, as well as to overcome their bereavement and grief?
My Lords, I am not sure the statistics that the noble Lord describes are at my disposal. However, the phenomenon he describes is both heart-breaking and of deep concern. Payments have been made to charities that have an interest in bereavement support to address this exact problem. Our thoughts and prayers go to all those who have lost a spouse or loved one to Covid.
My Lords, I ask about eligibility for the funeral expenses payment. It looks to be less about those who do qualify and more about those who do not. For example, somebody on benefits, who is responsible for a funeral and makes an application, will be turned down if a close member of the family is not on benefits. How many people have applied for this payment since the pandemic began and what proportion have been successful in receiving it?
My Lords, the noble Baroness is correct that the calculation is dependent on close relatives being on social benefit. It is a sliding scale, but it is applied in an open-hearted and generous-minded way, and there are relatively discretionary payments, of up to £1,000 for ancillary costs that go beyond the funeral parlour costs, to try to create the kind of funeral that marks the passing of a loved one. We are keeping this payment under very close review, given its sensitivity, and will review it if there are concerns.
My Lords, given that the number of deaths in the UK has increased by 60,000 on last year, do the Government have up-to-date figures for the number of public health funeral claims being made to local authorities?
My Lords, I do not have up-to-date figures for the claims up to this month, but the number is expected to have risen. We published refreshed non-statutory good practice guidance this month, for all local authorities, to ensure that public health funerals are delivered respectfully and with care, both for the individuals and their families.
My Lords, all supplementary questions have been asked.
(3 years, 11 months ago)
Lords ChamberThat this House takes note of the temporary provisions of the Coronavirus Act 2020 six months after the Act received Royal Assent.
My Lords, six months feels like about the right time to check in on the workings of this important piece of legislation. The check-in points on the legislation were built into the legislation itself, alongside the requirement to report every two months on the status of each provision of the Act. It is also an opportunity to remind ourselves of the work this House came together to legislate in a spirit of remarkable cross-party collaboration six months ago. It was a time of intense pressure and uncertainty, when we were just starting to understand the scale of measures needed to contain the disease and how our ways of working needed to adapt to create a Covid-secure workplace. The degree of co-operation and collegiality displayed then showed Parliament at its best, and I hope that today we can debate the future of this Act in the same spirit.
Your Lordships will recall that, during the debates on the passage of this Act in March, we devoted significant time to consideration of the necessary safeguards around the use of the powers. The Government listened to concerns and, in response, built new measures into the Act. Although we have recently been debating the local and national lockdown regulations, it is worth stating two obvious points. The Coronavirus Act is not in itself the repository of powers to tackle the actual disease—that is the role of the Public Health Act 1984. The use of the “made affirmative” procedure” is exactly what one would expect for public health legislation designed to manage a live incident. It gives us powers to vary interventions in a way that responds dynamically to the incident, but also to take account of local sensitivities of geography and local ethos and return these emergency regulations to Parliament for scrutiny within 28 days.
Secondly, we cannot use the Civil Contingencies Act, as was raised in the original debate. That Act and the emergency powers it contains are tools to prevent, control or mitigate an aspect or effect of an emergency that it has not been possible to anticipate or plan for. The triple lock of urgency, necessity and proportionality ensures that the CCA is used only when there is no other option.
So why did we need the Coronavirus Act at all? The Act provides public agencies across the UK with new powers, almost all strictly time-limited, and enables them to mount an effective response to the Covid-19 pandemic. I shall run through a few. First, on the return of public sector workers, some of the provisions in the Act ensure that there are enough workers in the health and social care sector to continue to provide key services. This includes allowing the emergency registration of certain health professionals and students and supporting recently retired NHS staff and local workers in returning to work without any negative repercussions for their pensions. These measures to support volunteers ease pressure on front-line NHS staff and social care staff. The measures had great impact. They enabled the NHS Bring Back Staff scheme, which attracted 65,000 registrations from former professionals and, as at 31 July 2020, 2,140 returning staff in England were redeployed in front-line positions or used in remote roles such as NHS 111 and test and trace.
Secondly, and very importantly, the financial support provisions provide direct support for those in economic need caused by the virus because they are shielding, isolating or otherwise prevented from working. This includes hugely important financial measures touching millions of lives called for during the Second Reading of this Act by noble Lords from all Benches. These include halting the eviction of tenants, making it easier to claim statutory sick pay and increasing working tax credits. Again, these have had great impact. To date, statutory sick pay has been extended to individuals displaying the symptoms of Covid, individuals required to shield, individuals asked to isolate following a test-and-trace notification or members of their household. A range of support is in place under the Act for those who do not receive statutory sick pay: we increased the standard rate of universal credit, meaning that claimants will be £1,040 better off each year, and we have a wide range of measures to support businesses and individuals, including the job retention scheme, the Self-employment Income Support Scheme and an enormous £330 billion worth of guaranteed loans to support businesses in accessing the finances they need.
Thirdly, there are provisions to lighten burdens on front-line staff. Some provisions enable vital services to carry on by temporarily easing some of the burdens on front-line staff. Good examples are making better use of video links in the court services; enabling the Government to order ports to close if there are insufficient customs and immigration staff; and reducing the regulatory burden in death management. These have had impact. At present 60% to 65% of hearings each day include one or two parties joining remotely. As a result, we are investing £142 million to upgrade our technology. Soon all courts will be digitally enabled, and they will never look back.
Fourthly, there are the containment provisions. Some provisions are designed to reduce the risk of spread. A couple of examples are postponing this year’s elections and taking the power to ban mass gatherings and powers for public health officers to quarantine the symptomatic and non-compliant. These provisions have been used judiciously. For instance, we have largely found that engagement is sufficiently persuasive—most people want to do the right thing—but interventions have sometimes been necessary and, as of 31 July, public health officers have used their powers fewer than 10 times.
I have heard it said that we should be using the Civil Contingencies Act instead as Ministers could have the same powers but with the additional safeguard of requiring periodic parliamentary renewal. Even if true, that simply would not do. The Civil Contingencies Act is a provision of last resort. It contains strict tests to ensure that it is used only when there are no other legislative options. In this case there were legislative options so it was not necessary or appropriate. Although the measures in the Coronavirus Act were urgent on this occasion, there was time to pass conventional legislation.
The Coronavirus Act deserves an assessment. Our assessment is that it has meant an enormous amount to the lives of people. It has meant that they have known where their next meal was coming from, thanks to the furlough scheme and the easement around the claiming of benefits that the Act has facilitated. It has encouraged a feeling of security in their own home, thanks to the additional protection from eviction that the Act has created; a feeling of more confidence that their job will exist, thanks to the support for industry and business that the Act has allowed the Government to set up; a feeling of knowing that there is access to justice, the bedrock of freedom under the law, because the Act has enabled courts to operate remotely; and a feeling of safety from harm, knowing that the NHS and social care workforce can maintain capacity thanks to the registration, indemnity and pension changes that the Act enabled the Government to put in place.
There have also been some perhaps less obvious benefits that are none the less essential to the workings of government—for example, the continuation of local democracy, allowing councils to meet virtually; the continuation of death management services by easing the burdens on providers; the continuation of judicial oversight of interception warrants; and the enabling of biometrics held for national security purposes to be retained for an additional period due to the effects of coronavirus on the police.
I do not want the current debate on lockdown legislation to distract from the achievement of the Coronavirus Act. It was a Bill born of an emergency but shaped by Parliament, and Parliament should be justifiably proud of that achievement. None the less I completely acknowledge that aspects of the Act will rightly trigger concern, and I am sure they will be raised in the debate ahead. For instance, it allows one rather than two doctors to detain a patient under the Mental Health Act. That provision has not been commenced but I recognise that it remains one of the most sensitive potential powers in the Act. The Act allows the easing of local authorities’ Care Act responsibilities. These provisions were used in some parts of the country but those eight local authorities had all ceased doing so by the end of June.
The Act allows the power to close ports, including our major airports. That power has never been used, thank goodness. The power to require non-compliant infectious people to self-isolate, or to attend for screening or assessment, has been used fewer than 10 times. Lastly, the police and crime commissioner elections, local elections and by-elections planned for this year were, sadly, postponed, but we hope for normal service to be resumed next May.
The Government have used these powers only when necessary, and we have not used them at all when we have been able to avoid doing so. We have kept Parliament and the public fully informed via our two-monthly reports. The Coronavirus Act is not directly a response to an emergency; it is instead the mechanism to support our response. For that reason, emergency powers are not suitable nor, given the necessarily temporary nature of those powers, would they give people the long-term certainty that they need.
The wording of the Motion is to encourage the continuation of the
“temporary provisions of the … Act”.
What are the non-temporary provisions? They are just ones that cannot be temporary if they are to work. For instance, the indemnity provisions cannot be temporary, although the period in which they can be incurred will be. Cremation certificates under the Act will be permanent, although disapplying the requirement for a confirmatory certificate will be temporary.
However, I cannot offer your Lordships any reliable estimate of when the crisis will be over. It will, as we recognised six months ago, ebb and flow. That is why we took the facility to spend live provisions if and when they are no longer needed and the facility to revive them as the course of the pandemic dictates. The Act will expire after two years unless renewed by Parliament. We all hope that we can dispense with it long before then, but we can be optimistic in our aspiration as long as we are realistic in our planning.
Therefore, can we permanently sunset the unused provision? No, we cannot. The response evolves over time as the course of the disease changes, but the need to be able to deploy support mechanisms remains constant. Of course, we keep the situation under review, and the built-in review mechanisms do provide opportunities to test whether any or all of the provisions are still needed. The people of this country have made great sacrifices in the struggle against this virus. They deserve the support and protection that the Coronavirus Act provides. I look forward to hearing your Lordships’ contributions in the course of this debate, and I hope to able to respond to any concerns raised. I beg to move.
My Lords, I should like to say a profound thank you to all noble Lords who have engaged in this important debate. It has been extremely thoughtful and I have a huge amount to take away with me. I express my sincere apologies for not being able to cover all the points made by every Peer in the Chamber. I start by applauding three of the most powerful maiden speeches that I have ever heard. The noble Baroness, Lady Clark of Kilwinning, laid out a really clear ground for herself, speaking on behalf of the disadvantaged, the vulnerable and those lucky enough to live in the beautiful county of Ayr, which I know and greatly admire. My noble and learned friend Lord Clarke of Nottingham gave a complete masterclass in note-free, elegantly phrased gravitas of the kind that made him envied in the other place and will, I fear, set a new bar for us here. My noble friend Lady Morrissey gave us an absolutely clear set of evidence of why she was such an illustrious figure in the City and will no doubt be an effective standard bearer for Britain’s transition from the EU.
Perhaps I may start with the Act because sometimes I think it is slightly the orphan child of this debate. But it is why we are here and I would like to reflect on the Act itself. A large number of comments, not all complimentary, have been made about it, but my ultimate reflection is that it has been a great achievement. I well remember when it was put together and I offer thanks in retrospect to the noble Baronesses, Lady Thornton and Lady Barker, my noble friend Lady Penn and the noble Lords, Lord Scriven and Lord Hunt, as well as everyone else involved in the drafting of the Bill under extremely difficult circumstances. I think we caught the spirit of the times and it has delivered a profound and positive effect on the country’s healthcare, provision for the vulnerable and the poor, and the massive provisions to support jobs and businesses. It has also contributed to the containment of the virus. I shall talk about the strategy for that in a moment.
Noble Lords have reflected on some aspects of the Act and I recognise completely the comments made about the benefits of a three-monthly review, as suggested by the noble and learned Lord, Lord Judge. I will take back to the department the value of the two-monthly reviews and how those are crafted. I note also the comments of the noble Baroness, Lady Barker, on the analysis. Comments were also made by the noble Baronesses, Lady Jones and Lady Chakrabarti, on Section 21. It is true that the CPS reviewed some of the convictions and as a result issued new guidelines. Those changes have worked to the extent that no further reviews have been necessary. I do not hide from the fact that parts of Section 21 are very severe, but they have hardly been used. I hope that reflects on the responsible and thoughtful way in which the measures of the Act have been applied.
The noble Baroness, Lady Bennett, asked about elections. They have been moved to 6 May 2021 and I would just reflect on the great efforts made by the parliamentary services to keep this Parliament open and to put those elections next May in place.
It has been suggested that it is time to change the law. On reflection, the Government consider that the Act has been of huge benefit in our fight against the virus and it is not the time to change, although that may come in the future. It is in fact a landmark and demonstrates the power of collaboration.
If I can move on, a number of noble Lords reflected on that power of collaboration, and I hear loud and clear the remarks made in the Chamber on authoritarianism, totalitarianism and the role of Parliament in the measures introduced to fight the pandemic. There is undoubtedly palpable frustration at the way in which measures are introduced, and I hear those concerns loud and clear. They largely reflect on the public health Act 1984, a piece of legislation that was deliberately put in place to address epidemics such as this one. I completely agree with the those who say that we are stronger when we work together. When measures are put in front of Parliament and communities are engaged, we end up with something much more powerful. I think we will all reflect on the importance of that message.
However, in mitigation, I will mention a few practical things. The speed of this virus has been absolutely astonishing. I could give your Lordships dozens of examples, but the July outbreaks after the lifting of the lockdown caught us all off guard and showed how violent and powerful the virus is. We have had dozens of regulations, but many of them are tweaks and have addressed small subjects such as tattoo parlours. The ability of this end of our Parliament to process legislation at a time when it is under a huge amount of pressure from the legislative agenda and from dealing with Covid-friendly processes is one of the reasons why things have been slow. I would also mention the very large number of engagements: Statements, SIs, debates, OPQs, UQs, PNQs and Bills. There have been 73 since the beginning of March, and I would be happy to run through that list with anyone who would care to reminisce with me.
I also remind noble Lords that, on the whole, despite some penalties for some things, we have applied the principle of consent in all we have done with regard to Covid, wherever possible. We have enjoyed a large amount of public support—I note the comments of my noble friend Lord Randall on that. We have also listened to these debates, whether on masks, social care, local engagement and local councils—the noble Baroness, Lady Barker, was a champion of that—and on sharing data and enforcement, which my noble friend Lord Blencathra has been a champion of. On all these measures, the debate that occurred here has been taken to the rooms where decisions have been made, the points made in this Chamber have been reflected in that decision-making process, and Parliament has played a leadership role.
The noble and learned Lord, Lord Judge, scared us all when he talked about mobilising the military and cancelling Christmas. These are headlines, not government policy. It is our intention to do everything we can to avoid exactly these kinds of measures, and we have applied the principle of consent wherever we can; whether on quarantine, isolation, masks or anything else, that has been our watchword.
I reassure my noble friend Lord Forsyth that the Civil Contingencies Act was looked at seriously. A huge amount of work went into looking at that as an alternative. I completely agree with him that there are definitely benefits to the kind of parliamentary scrutiny that the CCA offers, which have been rightly described in this Chamber as being around collaboration and people being brought into the process. My noble friend is right about that. But the government lawyers, who are the best you can get, were adamant that the threat of judicial review was considered too high and the public health Act 1984 was a much better vehicle.
By way of conclusion on this point, I completely acknowledge the strong feelings and the thoughtful arguments that have been made in this Chamber on parliamentary scrutiny and the role of Parliament. I completely acknowledge the point made by my noble friend Lord Robathan, who has articulated the case extremely forcefully and thoughtfully. We definitely need to reflect on these points. However, I note that my right honourable friend the Secretary of State for Health said earlier today in another place that the Government are looking at
“further ways to ensure that the House can be properly involved in the process—in advance, where possible.”
That commitment is felt earnestly, we are working our hardest to try to move on it, and for that reason and the reasons I gave previously, I sincerely ask my noble friend Lord Robathan to withdraw his Motion of Regret and to support the way in which we have to do things under the current framework of our legislation.
A lot of the comment today was not about the Act at all; it was about the Government’s strategy. I do not duck from discussing that. I cannot go through every aspect of the strategy, in all its detail, but will make a few comments. I start by completely sympathising with the noble Lord, Lord Blunkett, and the daughter of the noble Earl, Lord Erroll, as the science around this horrible virus is extremely frustrating and challenging. It is one of the reasons why both the public and I find it difficult. There are huge mysteries on immunity. We are confused about and collecting data on long Covid, and do not always know for sure how transmission works. The noble Lord, Lord Blunkett, said that maybe we should get rid of SAGE to try to calm the debate. I do not agree. I embrace the scientific debate. Although it is rough and tumble, and we do not always come out from it well, it is the role of scientists to probe and challenge, and that is how we have made progress.
But there are some things we know, and I say these uncomfortable things in challenge to some of the comments made in the Chamber. We know this virus kills. It is a horrible death, and those it does not kill it can maim. Those it maims can be the young or people who did not know they had the disease. The evidence emerging is that around 10% of those who had Covid will live with some kind of long-term affliction. The evidence suggests that around 10% of the country are seropositive. This is not some light flu that you will get over and walk away from. For many people, this is either a death sentence or something with which they will live for all their lives. I say this not to scare or to freak anyone out. I say it because it is the realistic assessment, and it is the story that I see, from my desk, every day at the department of health. It is as contagious as it ever was. Sometimes diseases calm down and fade away. This one may, but has not done yet.
On the positive side, the progress that the Vaccine Taskforce is making is tremendous. This is not just the Oxford vaccine, but another 10 lined up behind it. For those who are not able to take the vaccine, neutralising antibodies and other therapeutic drugs show great promise in protecting those we love.
Mass testing is not ready yet. I hardly need tell noble Lords that we are not quite there yet, but it offers hope. In the meantime, the measures that we have put in place are saving lives. It is completely illogical to condemn the measures that we have put in place as not working, because the death rate is so low. The death rate is so low because, by and large, the measures work.
That is not to say that there are no challenges. I completely recognise the points made by my noble friends Lord Lamont, Lord Bridges, Lady Stroud and Lady Noakes. The impact on the economy is absolutely horrific. At every step of taking any decision, we have that in mind. I recognise the point on impact assessments, and will take that back to quiz the department on whether we could or should be looking harder at doing that. I guess it may be one for BEIS or the Treasury.
It is unarguable that lockdowns hit jobs, but viruses hit jobs harder. If the deaths mount, we will have to hit the virus harder, for longer. That was the lesson of 1918 and of epidemics before and after, and is the lesson of today’s epidemic. We are not casual about these measures; we are absolutely serious. If public confidence goes, the social fabric cracks, supply chains break down and social trust dissipates, we will not have an economy left at all. That is why we pursue this route.
Several noble Lords talked about education and students. Can I be really clear about our approach? On testing students, we are pro spit, pro breath and pro poo. We are using every single bit of your body to test the hell out of you, and we are going to do whatever we can to test pupils and students. In terms of Christmas, we are doing everything we can to ensure that pupils and students get back from their universities and schools.
In response to my noble friend Lord Vaizey and the noble Baroness, Lady Thornton, I say that we are absolutely determined to keep the schools open. That is not just mainstream schools—it includes special schools. The role of schools in our community is not just to educate the children, although that is essential; it is to keep families going and protect vulnerable children.
A number of noble Lords mentioned health, including my noble friends Lord Lansley and Lady Manzoor. I reassure all noble Lords that the bounce-back is happening. Radiotherapies were back up to what they were in June. We have already halved the backlog. In July, there were 180,000 oncology checks, and 90% of them were within two weeks. We have a massive campaign on the blocks, and the winter plan for social care and PPE is incredibly important. I reiterate the comments made by the noble Baroness, Lady Barker, on the role of environmental health inspectors and the unsung heroes of public health.
The noble Baroness, Lady Clark, spoke very movingly about the poor and vulnerable. One of the most important aspects of the Act and our measures was to help those who were going to be hit hardest by this disease. That came out on Second Reading of the then Coronavirus Bill; it was one of the most moving and decisive parts of that process. We listened, we moved and we put in measures, which has enabled massive support for people.
By way of conclusion, I say that there are some very serious accusations on the table. The noble Lord, Lord Foulkes, spoke about failure and my noble friend Lord Naseby talked about incompetence. I completely acknowledge the frustration; not everything has run as smoothly as I would like. There have been challenges in test and trace, social care, shielding and other areas. But the House knows how I think: those frustrations and challenges are also matched by enormous achievements. We are the country that brought the first therapeutic drug to patients, in dexamethasone. We are probably the front-runner for a vaccine with the Oxford vaccine. The Nightingale hospital was put up in nine days and brought huge capacity to the NHS. Telemedicine has brought both mental health and primary care to people who would be left on their own. We have done 20 million tests until today—that was the record that we made today—and there have been 12 million app downloads.
The consequences of the regulations that we have introduced are tough—the rule of six is tough, and my noble friend Lady Neville-Rolfe spoke movingly on that—but they have worked. We are determined to use local lockdowns and the advances of technology wherever we can to fight this virus until we have a vaccine, mass testing and therapeutics to beat it.
I completely and utterly hear and understand the words on parliamentary scrutiny from my noble friends Lord Robathan and Lord Lamont as well as the noble Baroness, Lady Chakrabarti. But my noble and learned friend Lord Clarke put it very well in his grave and wise comments: we need to strike the right balance. We think that we have hit the right balance; it will not keep everyone happy, but we are determined to defeat this virus and get our lives back.
(3 years, 11 months ago)
Lords ChamberThat the Regulations laid before the House on 4 August be approved.
Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee
My Lords, we are here to debate the SIs putting restrictions on the north of England in August and September. Before we start the debate, I note that there was some confusion yesterday about a bundle of the regulations that we were debating. I express regret for this confusion and thank all noble Lords concerned for their patience. I also express reassurances the House that resources have been put in place to ensure that this does not happen again.
The regulations we are discussing today first came into force on 4 August to tackle the outbreak of coronavirus in parts of the north of England. They are therefore part of a suite of regulations that constitute a dynamic response to local outbreaks of coronavirus. They deliver on the ground a carefully targeted suite of interventions that have helped our partners in local government and in the health and care systems succeed in reducing the severity of this pandemic in each of the flare-up areas. Because of this, we developed legislative solutions as quickly as we could. A consequence of this is, of course, that the regulations are being debated long after they came into force, and it is true that they have been changed since. However, I hope that your Lordships will acknowledge that a system of local actions that is both clinically effective and sensitive to local circumstances will produce a series of regulations such as the ones we are debating today.
I apologise for taking up so much of the Order Paper with this business, but also reassure the House that I hope to mitigate this through transparency about our intentions, our actions and their results. However, I will not apologise for introducing the regulations at all because they have done so much good in supporting our colleagues in these areas in their efforts to tackle the epidemic.
I turn to a brief history of the local lockdowns in these areas. Actions had already taken place to protect the people living in the affected areas in the north of England in the weeks before these regulations came into force, such as increased testing and public health support. We also gave additional funding to all upper-tier local authorities. For example, Manchester City Council received £40,840,915 and Kirklees Metropolitan Council more than £28 million. This enabled them to enhance the various local interventions and support measures put into place.
We hoped that these interventions and the work of the local public health teams would get infection rates down without us having to take more drastic action. However, by the end of July it was clear that the rates of infection were continuing to increase to unacceptable levels. Epidemiological surveillance data had been showing high transmission rates across Greater Manchester and in areas of Lancashire and West Yorkshire. When the regulations came into force, the incidence rates in almost all these geographic areas were significantly above the national average. Pendle, for instance, had the highest incidence rate in England between 31 July and 6 August at 89.7 per 100,000 people. Oldham had the second highest rate of 82.3, and nine other local authorities in the north had rates exceeding 30 per 100,000.
The epidemiological data and local insights suggested that the most likely route for transmission of Covid-19 behind the increases was as a result of people living in different households in the areas meeting up with each other. This is a point that we discussed in the Chamber yesterday. Multi-generational households, overcrowding and social deprivation in many of those locations exacerbated the transmission risks. The Secretary of State for Health and Social Care was therefore persuaded that it would be necessary to impose restrictions to prevent further spread of the virus and keep the country safe. The cross-government Covid-19 operations committee, or Covid-O, chaired by the Prime Minister, decided on 30 July to take further measures to tackle the outbreak. The Secretary of State set out these measures in his Statement.
On 8 August, following concern about the significant increase in local incidence rates of the virus, and taking on board concerns raised by the local authority, the regulations were amended to extend their remit to include Preston. On Wednesday 15 August, a further amendment to the regulations meant that the national restrictions that were lifted across England as part of the Government’s Covid-19 strategy would not be applied to those areas covered by these regulations due to the exceptionally high incidence rates remaining across these areas. That indicates the severity of the situation in these areas.
However, by Wednesday 26 Aug, after reviewing the up-to-date epidemiological data and information from the local authorities, the local directors of public health, PHE, JBC and the contain teams, as a result of this discussion the Secretary of State removed Wigan Metropolitan Borough Council and Rossendale Borough Council from the protected area, so that the restrictions remaining in those areas aligned with the rest of England. Again, on 2 September, we were able to remove certain wards of Calderdale Metropolitan Borough Council and Kirklees Metropolitan Council. This change of strategy, moving towards hyper-localised interventions, reflects our willingness to listen to local politicians.
We sought to mitigate the impact of these measures by imposing them only where the transmission risks were highest. Concerns about the outbreak of coronavirus in the north of England have been significant, and the engagement with local leaders has been extensive, repeated and productive. I therefore thank all the local authorities and local resilience forums, Public Health England and the Joint Biosecurity Centre, as well as the local directors of public health, the Mayor of Greater Manchester, Andy Burnham, and the council leaders for all of their ongoing support.
In general, these regulations prohibited households in the relevant areas of the north of England mixing with each other in their homes or gardens, apart from those with support bubbles or in other limited circumstances on compassionate grounds. The regulations also included provisions making it a criminal offence to breach any of the restrictions or requirements. As with the national regulations, those who breach these provisions can be issued with a fixed penalty notice. Due to the increasing incidence rate in Preston as the regulations came into force, Preston was added to the protected area covered by these regulations. Subsequent amendments removed local authorities or specific wards from the regulations.
In terms of next steps, as I said earlier, we will continue to make public the outcome of any reviews. I am grateful to your Lordships for your continued engagement in this challenging process and for the scrutiny of the regulations. In particular, I thank those people in parts of Lancashire, Greater Manchester and West Yorkshire who have, in general, responded well to the measures put in place. It is thanks to their continued efforts that there were changes to the boundaries, and we hope to ease measures further if improvements continue. I beg to move.
My Lords, I too thank the noble Baroness, Lady Donaghy, for her very kind words. Let me please make it plain to the Chamber: it is an absolute honour to stand here—to have some time to consider these SIs and to do our best, as a Government, under difficult circumstances, to bring in complex regulations and laws that have a huge impact on people’s everyday lives and to try to bring the best possible parliamentary scrutiny that we can under the current rules.
I am completely aware of the concerns of my noble friends Lord Forsyth and Lord Dobbs, the noble Lord, Lord Beith, and the noble Baronesses, Lady Donaghy and Lady Thornton. They all rightly express concerns about how this could be done better. We are committed to the process that we have: we listen to these debates as they happen and I take back to the department the comments made in this Chamber.
I say to my noble friend Lord Forsyth, on the Civil Contingencies Act, the issue is that the Act is expressly concerned with threats that we could not have expected. Unfortunately, we are at a stage with this epidemic—indeed, even at the very beginning of the epidemic—where the lawyers have judged that this kind of regulation does not fit under that definition. That is why we work through the public health Act of 1984. If he has any further questions on that, I would be glad to answer them through correspondence.
The noble Lord, Lord Blunkett, asked a very important question: what have we learned? I will try to tackle people’s points through that lens as quickly as I can. In terms of the north, we learned many things but three stand out. First, this virus moves incredibly quickly through social mobility. My noble friend Lady McIntosh asked why rural areas are tied in with town areas. The truth is that people move between different areas to a much greater extent than would normally be visible. That is one of the challenges we have had to deal with. Secondly, the mixing of households has a profound effect on transmission of the disease. That is why that is a focus of these regulations. Thirdly, getting testing and tracing into hard-to-reach communities can be extremely difficult. My noble friend Lord Bourne asked what we had learned in terms of getting testing into key areas—we have learned that it is very difficult. We have put new resources into it and gathered new expertise and have sought advice from people who understand these things well.
A number of noble Lords, including the noble Lord, Lord Blunkett, asked about hospitality. If a hospitality venue, such as a pub, has good contact tracing on arrival, socially distanced seating, table service and booking, there is no reason why it should present a threat. However, not all pubs abide by those disciplines, with mass crowding either inside or outside, late-night intimacy and mixed groups. That is where the disease spreads, which is why we have cracked down—including through the 10 pm curfew, which sends a clear signal to hospitality venues that they must abide by the regulations. I make these points in answer to my noble friend Lady Wheatcroft and the noble Baroness, Lady Uddin.
We have learned four key things on the macro basis. The first and most important of them was alluded to by a number of noble Lords, including my noble friends Lady McIntosh and Lord Bourne, and the noble Baronesses, Lady Thornton, Lady Bennett and Lady Andrews: the importance of local collaboration. I was asked a large number of detailed questions about the nature of local collaboration. I assure noble Lords that it is happening on an incredibly energetic basis. New systems that completely redefine the wiring of government in this country are being put in place in response to this epidemic. People who did not have each other’s telephone number before now speak every day and collaborations are happening across party grounds. There is the occasional grinding of gears—of that I have no doubt—but the spirit of collaboration is extremely strong. I assure my noble friend Lady McIntosh that local leaders in the north-east met the CMO today and made their representations to the top of government very clearly.
A second learning has been on the sharing of granular data, which we have discussed in other debates. The third learning, in response to the right reverend Prelate the Bishop of Manchester, has been on the use of local languages and cultural sensitivity. I completely recognise his points about the impact of bringing in some of these measures around Eid. I have held round tables with community groups in the north; I heard people’s concerns loud and clear. We thought that we were leaving the time of lockdowns; it was only when the data showing that infection rates were rising emerged that we had to apply the handbrake and do a sudden turn. We learned a lot about the bruising impact of that sudden decision and its impact on trust, and we have moved on.
Fourthly, a number of noble Lords, including the noble Baroness, Lady Lawrence, and my noble friend Lord Flight, mentioned simplicity. It is key. The public’s understanding of the regulations is absolutely essential to changing their behaviours. If people do not understand it, there is no point in regulating. That has been seen through recent regulations, such as on the rule of six and the curfew, where the impact of the regulations has been well thought through.
The noble Lord, Lord Greaves, and the noble Baroness, Lady Massey, asked about money for businesses and quick money. I completely agree with their points. The money that has gone to Pendle included £1.8 million to the council and £21.8 million to Pendle businesses. That indicates both the impact and the level of money that we are distributing to make these regulations effective.
The noble Baroness, Lady Bull, my noble friend Lady Redfern and the noble Lord, Lord Loomba, all mentioned communications. I completely recognise the threat of an “infodemic”—we have one in this very Chamber—and we are working extremely hard to make interventions clearer, as the noble Baroness, Lady Walmsley, called for. The app is a really good example of that and I am extremely encouraged that the noble Baroness, Lady Massey, is able to see the status of her community and the regulations in that community through the app: that is exactly why we designed the app and I am incredibly excited that she cites that as an example. I am completely live to the threat of conspiracy theorists and those who seek to undermine the validity of our vaccine. We have a substantial rebuttal unit that crosses many departments of government. It is probably not wise for me to go into detail, but I reassure the noble Baroness, Lady Bull, that we have put the full weight of government behind that.
The noble Lord, Lord Willis, and the noble Baronesses, Lady Walmsley and Lady Andrews, raised social care. I am extremely proud of our commitment, at a time when pressure on testing capacity is extremely intense, to have 100,000 tests a day for social care. It is making an impact. A lot of people are frustrated, and I wish those testing levels were higher, but we believe that we are winning and we have capacity to bring in more.
On childcare, the noble Lords, Lord Alton and Lord Singh, and the noble Baronesses, Lady Bowles and Lady Walmsley, all gave extremely good examples of why childcare is so important. We have listened, those regulations have been changed and new statutory instruments were brought in on Tuesday that made some of those changes. I reassure the noble Lord, Lord Bilimoria, that we are looking at the Abbott test. I can tell my noble friend Lord Flight that Section 7 has been revoked.
Finally my noble friend Lord Moynihan, the noble Earl, Lord Erroll, and the noble Baroness, Lady Walmsley, and others talked about the long-term impact on young people and the country as a whole. We recognise the impact of these regulations, but it is the virus that is the cause of this; it is not the Government’s fault that we have to bring in these regulations to slow the spread of the virus. In response to my noble friend Lady Altmann, our objective is to get our lives back, and we will know we have succeeded when we get our lives back. I beg to move.
(3 years, 11 months ago)
Lords ChamberThat the Regulations laid before the House on 10 August be approved.
Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee
(3 years, 11 months ago)
Lords ChamberThat the Regulations laid before the House on 14 August be approved.
Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee
(3 years, 11 months ago)
Lords ChamberThat the Regulations laid before the House on 25 August be approved.
Relevant document: 25th Report from the Secondary Legislation Scrutiny Committee
(3 years, 11 months ago)
Lords ChamberThat the Regulations laid before the House on 2 September be approved.
Relevant document: 26th Report from the Secondary Legislation Scrutiny Committee
(3 years, 11 months ago)
Lords ChamberThat the Regulations laid before the House on 7 September be approved.
Relevant document: 27th Report from the Secondary Legislation Scrutiny Committee
(3 years, 11 months ago)
Lords ChamberTo ask Her Majesty’s Government whether mental health services for young people will be expanded to deal with concerns expressed during the COVID-19 pandemic; and if so, how.
My Lords, Covid inevitably puts pressure on young people, which is why we are increasing support through our £8 million Wellbeing for Education Return fund, which raises awareness of the tools available to support mental well-being and ensure that children and young people are directed towards the right services. That is part of our commitment to invest at least £2.3 billion of extra funding a year into mental health services by 2023, which will see 345,000 more children accessing specialist mental health support each year.
I thank the Minister for his response. Is he aware of the demands of professionals, parents and children themselves to prioritise mental health services? What he says is good, but is it enough? Some 80% of young people say that their mental health has become worse during the Covid pandemic. Will the Government urgently expand services for young people through increased counselling in schools and community services? Otherwise, the human and financial costs will be enormous.
My Lords, we are greatly concerned about the human and financial costs, as the noble Baroness rightly points out, which is why we put in place the Wellbeing for Education Return fund. It is training the trainers, working through the Anna Freud centre, the well-respected child mental health charity, and it is already having a huge impact. Some 95% of the attendees in a recent session said that they were extremely or somewhat pleased with the programme, and we are expecting it to be rolled out across schools.
My Lords, I spoke last week with a young person whose father, sadly, died recently of Covid-19, and she told me about the impact that experience has had on her own mental health. I am therefore grateful for the reassurance from the Minister that Her Majesty’s Government will be strengthening access to mental health services in our schools and, I hope, in our colleges and universities. Are there any plans for bereavement support and counselling to form part of that provision?
The right reverend Prelate the Bishop of Carlisle is right to emphasise bereavement support. We all remember well the difficulties faced by family or friends who were bereaved in the terrible circumstances that we were put under during Covid. We have put £9.2 million of additional funding into mental health charities, which includes charities that provide bereavement support. However, I will take away the well-made points of the right reverend Prelate and will look into whether more could or should be done.
My Lords, we know that a particularly risky time for children and young people is when they move across and between services, whether that is accessing CAMHS for the first time or moving on to adult services. Can the Minister reassure me that face-to-face appointments will still be made available for those important relationships to be established and embedded?
My Lords, face-to-face appointments are incredibly important for some people, which is why we have emphasised the return to work, particularly in GP surgeries. However, I would like to make the case for internet or telephone services. They have proved to be extremely popular among some mental health patients, who find the direct intimacy of face-to-face too overwhelming and prefer instead to do Zoom or telephone consultations. We are supporting analysis of where these rightfully work and in the meantime are supporting face-to-face when preferred or necessary.
My Lords, I declare my interests as in the register. Like young people, many older people have suffered a significant deterioration of their mental health during the pandemic. Due to social distancing restrictions, many counselling and other mental health services can be accessed only online. Recent research by the International Longevity Centre found that 11.9 million people in the UK lack the digital skills they need for everyday life, and ONS figures published in May show that only 47% of adults aged 75 and over use the internet. What support will the Government give vulnerable older people experiencing mental health issues, and how will they support those who are digitally excluded so that they can still have access to mental and other important health services?
My Lords, the digital gap in social care, particularly for older people, is enormous, and the noble Baroness is entirely right. NHSX has a large programme called Joined up Care, which is seeking to help bridge that gap. It includes, for instance, the provision of a large number of iPads to social care homes. However, the noble Baroness is right that that will not be enough to provide the care for those for whom digital access is simply too challenging or unavailable, which is why we will continue to support face-to-face and direct forms of care when necessary.
My Lords, it should be alarming to know that suicide rates in the UK have soared to record levels, with the highest rates over the past two decades recorded at the end of 2019. I hope the Minister will share my concern that these alarming figures will only continue to rise post lockdown and that everything needs to be done to prevent that. Can the Minister say what Her Majesty’s Government are planning to do to tackle specifically the risk of increasing suicide rates post lockdown?
We are deeply concerned about suicide; any suicide is too many. The noble Lord will be aware that the increased numbers recently are in part due to the recategorisation of suicide among the coroners’ courts. Nonetheless, we take this issue very seriously. The programme to help people identify those who show the markers of suicidal thinking has provided a very important impact on this issue. We are deeply concerned about Covid, and we continue to support suicide charities.
My Lords, calls to the eating disorder charity Beat’s helpline nearly doubled during lockdown, and at the same time fewer children and young people started treatment for eating disorders compared to the previous year. What are the Government doing to ensure sufficient funding for children and young people’s eating disorder services so that young people can access the help they need?
My Lords, provision for young people is at every level of the health service. It includes direct school interventions through the programme I discussed earlier, it is within the NHS, where we have an enormous emphasis on eating disorders, and it is in young adult care. The provision of £9.2 million to charities during Covid included charities that support young mental health and eating disorders, and it remains a major priority for the Government.
My Lords, I congratulate all those who worked so tirelessly to make sure that students have gone into higher education this autumn. However, let us be honest: a lot of young people going to these places are sitting in their rooms, lonely, having virtual lessons and very little social interaction, and that will have a huge effect on their mental health. I urge Ministers to take responsibility for the mental health of our students as they are social distancing.
My noble friend Lady Fall is right that the plight of students is tough; going to college will not be like it was in our days. That is why the DfE is putting together a Covid catch-up package of £1 billion, which will include support for universities and for the mental health of students.
My Lords, may I return to the issue of counselling? The criteria of the Children’s Commissioner, Anne Longfield, of a counsellor in every school for every child who needs one would help relieve pressure on struggling CAMHS services. Does the Minister acknowledge that the children’s mental health system will struggle to cope as long as we are failing to provide early help to tackle problems before they become crises, and will the Government commit to ring-fence funding for mental health in schools, colleges and universities to enable them to provide mental health support to all young people who need it?
My Lords, we are rolling out our response to the Green Paper on mental health for young people. That has included the implementation of mental health support teams, which will make a big impact. In addition, and in response to recent circumstances, on 8 September we launched a mental health well-being campaign specifically for children and young people through the PHE website. It encourages a personal mind plan and the use of a quick and easy interactive tool, and 2.5 million mind plans have been completed since its launch.
My Lords, the time allowed for this question has elapsed. We now come to the fourth Oral Question.