Lord Bethell debates with Department of Health and Social Care

There have been 85 exchanges between Lord Bethell and Department of Health and Social Care

Wed 16th September 2020 Coronavirus (Lords Chamber) 17 interactions (797 words)
Tue 15th September 2020 Covid-19: NHS Long-term Plan (Lords Chamber) 21 interactions (750 words)
Mon 14th September 2020 Anti-obesity Strategies (Lords Chamber) 21 interactions (810 words)
Mon 14th September 2020 Covid-19 Update (Lords Chamber) 52 interactions (3,466 words)
Thu 10th September 2020 Covid-19 Update (Lords Chamber) 49 interactions (3,392 words)
Wed 9th September 2020 Covid-19: Rise of Positive Tests (Lords Chamber) 28 interactions (918 words)
Tue 8th September 2020 Suicide (Lords Chamber) 17 interactions (533 words)
Mon 7th September 2020 NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) (Amendment) Order 2020 (Grand Committee) 6 interactions (2,138 words)
Thu 3rd September 2020 Folic Acid (Lords Chamber) 21 interactions (666 words)
Thu 3rd September 2020 Covid-19 (Lords Chamber) 34 interactions (4,308 words)
Thu 3rd September 2020 Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020 (Lords Chamber) 6 interactions (2,468 words)
Wed 2nd September 2020 Childhood Obesity (Lords Chamber) 21 interactions (699 words)
Wed 2nd September 2020 Covid-19: Self-isolation Payment Scheme (Lords Chamber) 23 interactions (737 words)
Wed 2nd September 2020 Medicines and Medical Devices Bill (Lords Chamber) 6 interactions (4,823 words)
Wed 29th July 2020 Health Protection (Coronavirus, Restrictions) (Leicester) Regulations 2020 (Lords Chamber) 6 interactions (2,302 words)
Mon 20th July 2020 Pharmacies (Lords Chamber) 19 interactions (651 words)
Mon 20th July 2020 Smoking (Lords Chamber) 23 interactions (659 words)
Thu 16th July 2020 Covid-19: Personal Protective Equipment (Lords Chamber) 19 interactions (819 words)
Wed 15th July 2020 Independent Medicines and Medical Devices Safety Review (Lords Chamber) 29 interactions (1,754 words)
Tue 14th July 2020 Medical Teaching and Learning: Ethnic Diversity (Lords Chamber) 19 interactions (694 words)
Thu 9th July 2020 Independent Medicines and Medical Devices Safety Review (Lords Chamber) 22 interactions (670 words)
Wed 8th July 2020 Social Care (Lords Chamber) 21 interactions (745 words)
Wed 8th July 2020 Covid-19 (Lords Chamber) 17 interactions (694 words)
Tue 7th July 2020 Independent Residential Care (Lords Chamber) 24 interactions (1,117 words)
Mon 6th July 2020 Medicinal Cannabis (Lords Chamber) 19 interactions (771 words)
Mon 6th July 2020 Food: Fruit and Vegetables (Lords Chamber) 19 interactions (625 words)
Thu 2nd July 2020 Covid-19: Mental Health Services (Lords Chamber) 21 interactions (757 words)
Thu 2nd July 2020 Ultra-processed Foods (Lords Chamber) 19 interactions (654 words)
Wed 1st July 2020 Covid-19: Mental Health (Lords Chamber) 19 interactions (679 words)
Wed 1st July 2020 Covid-19 Update (Lords Chamber) 51 interactions (2,840 words)
Thu 25th June 2020 Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020 (Lords Chamber) 9 interactions (2,432 words)
Wed 24th June 2020 Personal Protective Equipment (Lords Chamber) 17 interactions (627 words)
Mon 22nd June 2020 Covid-19: Test and Trace App (Lords Chamber) 31 interactions (1,034 words)
Mon 22nd June 2020 Coronavirus (Lords Chamber) 15 interactions (647 words)
Thu 18th June 2020 Covid-19: Track and Trace System (Lords Chamber) 19 interactions (758 words)
Thu 18th June 2020 Nurses: Recruitment (Lords Chamber) 21 interactions (678 words)
Tue 16th June 2020 Covid-19: Mental Health (Lords Chamber) 19 interactions (693 words)
Tue 16th June 2020 Social Distancing: Two-metre Rule (Lords Chamber) 17 interactions (624 words)
Mon 15th June 2020 Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020 (Lords Chamber) 6 interactions (2,988 words)
Thu 11th June 2020 Contact Tracing: Personal Privacy (Lords Chamber) 19 interactions (655 words)
Thu 11th June 2020 Covid-19: Masks (Lords Chamber) 2 interactions (1,796 words)
Wed 10th June 2020 Covid-19: Cancelled Medical Operations (Lords Chamber) 22 interactions (814 words)
Tue 9th June 2020 Exercise Cygnus (Lords Chamber) 21 interactions (646 words)
Tue 9th June 2020 Covid-19: R Rate and Lockdown Measures (Lords Chamber) 15 interactions (684 words)
Mon 8th June 2020 National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020 (Lords Chamber) 3 interactions (1,682 words)
Thu 4th June 2020 Covid-19: Obese and Overweight People (Lords Chamber) 18 interactions (634 words)
Wed 3rd June 2020 Covid-19: Response (Lords Chamber) 37 interactions (4,431 words)
Thu 21st May 2020 Hospitals: Patient Safety (Lords Chamber) 22 interactions (663 words)
Wed 20th May 2020 Dental Care (Lords Chamber) 22 interactions (743 words)
Wed 20th May 2020 Covid-19: Care Homes (Lords Chamber) 21 interactions (1,004 words)
Tue 19th May 2020 Covid-19: BAME NHS Staff (Lords Chamber) 20 interactions (729 words)
Tue 19th May 2020 Mental Health Services (Lords Chamber) 27 interactions (873 words)
Tue 19th May 2020 Covid-19: Response (Lords Chamber) 48 interactions (3,613 words)
Mon 18th May 2020 Covid-19: NHS Contact Tracing App (Lords Chamber) 22 interactions (765 words)
Mon 18th May 2020 Draft Human Tissue (Permitted Material: Exceptions) (England) Regulations 2020 (Lords Chamber) 7 interactions (3,161 words)
Thu 14th May 2020 Covid-19: Testing (Lords Chamber) 22 interactions (849 words)
Thu 14th May 2020 Care Homes: Covid-19 Testing (Lords Chamber) 18 interactions (723 words)
Tue 12th May 2020 Covid-19: Vulnerable Populations (Lords Chamber) 20 interactions (682 words)
Tue 12th May 2020 Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 (Lords Chamber) 7 interactions (2,929 words)
Wed 6th May 2020 Covid-19: Contact-tracing App (Lords Chamber) 20 interactions (763 words)
Wed 6th May 2020 Covid-19: Government Response (Lords Chamber) 18 interactions (978 words)
Thu 23rd April 2020 Covid-19: Personal Protective Equipment (Lords Chamber) 18 interactions (773 words)
Thu 23rd April 2020 Covid-19: Personal Protective Equipment (Lords Chamber) 17 interactions (599 words)
Thu 23rd April 2020 Covid-19: Social Care Services (Lords Chamber) 3 interactions (2,925 words)
Thu 23rd April 2020 Covid-19 (Lords Chamber) 52 interactions (4,351 words)
Wed 22nd April 2020 Covid-19: Medically Vulnerable People (Lords Chamber) 16 interactions (657 words)
Wed 22nd April 2020 Covid-19: Extent of Infection (Lords Chamber) 18 interactions (616 words)
Wed 22nd April 2020 Covid-19: Care Home Deaths (Lords Chamber) 15 interactions (678 words)
Tue 21st April 2020 Covid-19: Removal of Restrictions (Lords Chamber) 17 interactions (878 words)
Wed 25th March 2020 Coronavirus Bill (Lords Chamber) 3 interactions (130 words)
Tue 24th March 2020 Coronavirus Bill (Lords Chamber) 4 interactions (2,044 words)
Tue 24th March 2020 Coronavirus Bill (Lords Chamber) 4 interactions (3,002 words)
Mon 23rd March 2020 Covid-19: Critical Care Capacity (Lords Chamber) 14 interactions (658 words)
Thu 19th March 2020 Covid-19: Helplines (Lords Chamber) 10 interactions (719 words)
Thu 19th March 2020 Covid-19: Vaccine (Lords Chamber) 8 interactions (412 words)
Wed 18th March 2020 Contraceptives and Hormone Replacement Therapy Drugs (Lords Chamber) 10 interactions (514 words)
Mon 16th March 2020 Covid-19 Update (Lords Chamber) 51 interactions (4,136 words)
Thu 12th March 2020 Coronavirus (Lords Chamber) 31 interactions (3,545 words)
Wed 11th March 2020 Dementia: Accident and Emergency (Lords Chamber) 14 interactions (466 words)
Wed 11th March 2020 Covid-19: Deep Cleaning (Lords Chamber) 16 interactions (811 words)
Mon 9th March 2020 Coronavirus (Lords Chamber) 15 interactions (1,265 words)
Mon 9th March 2020 Health Protection (Coronavirus) Regulations 2020 (Grand Committee) 17 interactions (2,364 words)
Thu 28th February 2019 Safety of Medicines and Medical Devices (Lords Chamber) 3 interactions (964 words)
Tue 5th February 2019 Healthcare (International Arrangements) Bill (Lords Chamber) 3 interactions (904 words)
Thu 6th September 2018 NHS: Healthcare Data (Lords Chamber) 3 interactions (1,038 words)

Coronavirus

Lord Bethell Excerpts
Wednesday 16th September 2020

(2 days, 14 hours ago)

Lords Chamber
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Department of Health and Social Care
Baroness Thornton Portrait Baroness Thornton (Lab) - Hansard

My Lords, the Prime Minister claimed again today that the UK does more Covid tests than anywhere else in Europe. This is not true. Denmark does almost twice as many per 1,000 people, and the UK figure includes antibody tests, which others do not do, and is based on when tests are sent out and not on results. So it is more hyperbole.

I hope today we can look at facts. There is now a backlog of 185,000 swabs and tests are being dispatched abroad. Can the Minister advise the House how many tests have been sent abroad, to which countries, the processing time and the void rates? If the Minister does not have that information at his fingertips today, can he please to write to me and put the answer in the Library?

Secondly, Coronavirus infection rates among middle-aged people have reached the same level now as rates among those in their 20s two weeks ago, and Professor Neil Ferguson has warned us that infections are back where they were in late February. So what discussions have the Government had with the Joint Biosecurity Centre and the CMO about raising the alert level from three to four?

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

I am grateful for the noble Baroness’s questions. In terms of European rates, Britain is way ahead of many of its fellow countries in Europe. On Friday last week, we did 240,312 tests. It is a massive number and, I believe, the highest we have done on any day. This is a huge achievement and I pay testimony to those in the NHS and in test and trace who have contributed to that figure.

In terms of tests being sent abroad, our testing environment and economy are part of an international system. Reagents, swabs, consumables and machines are regularly exchanged between countries and I pay tribute to the enterprise and energy of the NHS and the test and trace scheme for using whatever schemes they can find in order to process the tests accurately, efficiently and promptly. I will be glad to send the noble Baroness details of the rates which she asked for.

In terms of the increase in prevalence among the middle-aged—yes, we are deeply concerned about this. As I have said at the Dispatch Box before, as night follows day, rates progress from the young to the middle-aged and, I fear, to the elderly. We are keeping a close eye on this progress.

Lord Scriven Portrait Lord Scriven (LD) - Hansard

My Lords, we know that the Minister is an avid listener of Radio 4’s “More or Less.” In today’s episode, Professor Alastair Grant of the University of East Anglia pointed out that 70% of coronavirus test results were completed within 48 hours at the start of August. Looking at official figures and analyses, he pointed out that by Monday, it was just 11.8%. The Minister may dispute the exact figures, but the trend clearly is down, which is worrying when we need an effective trace and isolate system to trace and isolate people as fast as possible. Can he tell the House and the country by what date all results of coronavirus testing will be turned around within a maximum of 24 hours?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I am indeed an avid listener of “More or Less,” although I have not heard the episode to which the noble Lord referred. Can I just explain that not all tests need to be done within 24 hours? There are tests that are done for surveillance, to support clinical trials and to help our investigation into vaccines and therapeutics. Those kinds of tests have a much longer turnaround time, and that is entirely appropriate and will be built into the numbers to which “More or Less” referred. Some 89.6% of in-person test results were received the next day after tests were taken; those are the ones that need fast turnaround times and the ones that will be delivered promptly.

Lord Balfe Portrait Lord Balfe (Con) - Hansard

I want to talk about care homes and hospital in-patients, many of whom have been marooned for literally months. One of the problems is the testing regime. Could I ask the Minister, first, to give priority to relatives of people in care, so that they can be tested and go in and see their loved ones? Secondly, there is clearly a problem with a lot of the staff, because they are moved around a lot. Can the Minister undertake that his department will consult UNISON, the main trade union for those staff, and see what it can do to open things up so that people in care homes and hospitals are able to be visited again?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I note my noble friend’s comments. However, I flatly deny that the social care system and social care homes have been in any way marooned. We have made a profound commitment, particularly in the testing environment, to supporting social care. One hundred thousand tests a day out of our capacity of between 200,000 and 250,000 are ring-fenced for social care and delivered to social care every day. Many of the challenges that we have for walk-in and drive-through testing centres are exactly because we are so committed to the ring-fenced testing for social care. That is a commitment that we are proud of and remain committed to.

I want to clarify with my noble friend that it is not an appropriate use of government test and trace capacity for relatives to use test and trace as a convenient method to find out whether they have the disease before they go to see relatives. That is not an appropriate use and not in the guidance.

As for UNISON, we are very much engaged with the union and are supporting staff in every way we can. However, I very much take on board my noble friend’s notes, and we will maintain that correspondence.

The Lord Bishop of St Albans - Hansard

My Lords, can the Minister clarify one or two issues? Does the rule of six mean that it will no longer be possible to have any public marking of Remembrance Sunday outdoors this year? Will he also clarify whether this effectively means that all public protests and demonstrations are now illegal?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I thank the right reverend Prelate for his question. I thank greatly those local authorities and charities that are putting in place Remembrance Day service arrangements that will abide by the new rule of six. Some of those guidelines are being written now, and I will be glad to share the guidelines with the right reverend Prelate when they are published. One thing I note is that virtual attendance at these services and the use of virtual remembrance books will be an aspect of Remembrance Day this year.

Lord Bilimoria (CB) [V] - Hansard

My Lords, Professor William Hanage of the TH Chan School of Public Health at Harvard University has said of the lack of mass testing that:

“By the time you become aware of the problem it is likely to already be much larger. You are not going to detect outbreaks if you don’t look for them.”

He also said that you need

“very good diagnostic tests as well as tests that may be less sensitive but can be used more frequently.”

I am totally with the Government in their aim for mass testing, but would the Minister agree with Professor Alan McNally of the University of Birmingham that the £500 million already announced

“could have funded around 33 million standard swab PCR tests that could have been run in well-equipped university labs”?

Why is that not happening? On rapid saliva tests, the Abbott Laboratories’ BinaxNOW $5, 20-minute test has been FDA approved, with 10 million tests produced this month and 50 million to be produced next month. Why are we not getting on with it? We need to do this really urgently. Does the Minister agree?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I completely support the noble Lord’s commitment to mass testing. We are looking at ways in which to use less sensitive machines to provide the kind of prophylactic testing to which he alludes. I thank very much indeed all universities for their contribution to our testing programme.

Lord Triesman Portrait Lord Triesman (Lab) [V] - Hansard

My Lords, in the course of the pandemic, a significant number of contracts with private companies have been signed without tender and a number of these have been in areas such as PPE and test and trace. Most appear to have failed to deliver essential services and equipment—

Break in Debate

Lord Triesman Portrait Lord Triesman (Lab) [V] - Hansard

I do not think I can get much closer to the microphone without eating it.

In the course of the pandemic, a significant number of contracts have been issued to private companies without tender. What is the value of the contracts that have been signed without competitive tender? Will the Minister place in the Library a list of all such contracts, their value, the companies involved and their ultimate beneficial owners?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

That list is already published. I would be glad to send the noble Lord a link.

Lord Lansley Portrait Lord Lansley (Con) [V] - Hansard

My Lords, one of the big risks this autumn is from students going to university and, perhaps more particularly, returning from university in the run-up to Christmas. How has the guidance been prepared with universities to try to mitigate that risk? I know that Cambridge University is looking even at the possibility of testing all its students on a weekly basis.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I thank colleagues at the DfE for their hard work in providing guidelines to universities and to vice-chancellors for implementing thoughtful arrangements for the return of students. It is very much the ambition of this Government that universities are brought back to life and that education and the impact of their work continues. None the less, it is not just the campus environment that concerns us—it is also the off-campus activities of students. For that, we look to universities to provide pastoral guidance to students to ensure that they are socially distanced and behave responsibly. We are keeping an eye on those behaviours and, should outbreaks or prevalence rise among students, we will have to review those guidelines.

Lord Duncan of Springbank Portrait The Deputy Speaker (Lord Duncan of Springbank) (Con) - Hansard

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

Covid-19: NHS Long-term Plan

Lord Bethell Excerpts
Tuesday 15th September 2020

(3 days, 14 hours ago)

Lords Chamber
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Department of Health and Social Care
Lord Hunt of Kings Heath Portrait Lord Hunt of Kings Heath - Hansard

To ask Her Majesty’s Government, in the light of the Covid-19 pandemic, what plans they have for changes to the NHS long-term plan.

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

My Lords, I pay tribute to the NHS for its remarkable achievements in response to Covid-19, from freeing up an additional 33,000 beds for Covid patients, to maintaining access to primary care by ensuring that 93% of GP surgeries offer video consultations, and swiftly mobilising an additional 65,000 former clinicians to help fight the virus. Learning from the Covid response will naturally inform future service priorities. However, at present, the Government’s focus remains on supporting system recovery and any amendments that may be needed to the NHS long-term plan will be considered in due course.

Lord Hunt of Kings Heath Portrait Lord Hunt of Kings Heath (Lab) - Hansard

My Lords, I thank the Minister and echo his tribute to the magnificent efforts of health service staff. I remind the House of my membership of the GMC board. He will know that the NHS entered this crisis underpeopled and under-resourced, and that a huge backlog of work has built up. There have been estimates that as many as 10 million people will be waiting for treatment at the end of the year. There is an issue with cancer patients waiting for tests and treatment. Can he give an indication of the work being done, despite the pandemic, to get the NHS back on track? Surely he agrees that the NHS five-year plan will have to be recalibrated to take account of this.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I thank the noble Lord for his generous comments towards the NHS. Undoubtedly it is true that, after a massive epidemic such as the one we are living through, we will have to rethink some of our priorities and learn from Covid, but I will add a few comments about the restart. The focus on getting patients back into hospital is having a huge impact on cancer waiting lists. Attendance at GP surgeries is increasing all the time, and waiting lists are coming down dramatically. I pay tribute to NHS staff for their hard work on this matter.

The Lord Bishop of Carlisle Portrait The Lord Bishop of Carlisle - Hansard

My Lords, given that the health protection remit of Public Health England is to be subsumed into the new national institute for health protection, can the Minister tell us what steps Her Majesty’s Government will take to ensure that health inequalities are robustly addressed through programmes of health education and promotion, as envisaged in chapter 2 of the NHS Long Term Plan?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, the right reverend Prelate is right; health inequalities are a massive priority for the Government. Covid has demonstrated how health inequalities play out when an epidemic such as this one hits the country. That is why we put education and levelling-up on health generally as major government priorities, why we are investing in 50,000 new nurses and 40 new hospitals, and why health remains a number one priority for this Government.

Baroness Browning Portrait Baroness Browning (Con) [V] - Hansard

My Lords, my noble friend will be aware that the long-term plan has set an ambitious target for 2028 of 75% of cancers being diagnosed at stages 1 and 2. Does he agree that this must involve GPs, and that GPs having face-to-face consultations with patients is the only way that this target will be achieved?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

We are enormously proud of the commitment to early intervention on cancer. This is the absolute core of our life science priorities. It is envisaged that we will have a revolution in the diagnostic capabilities of the NHS in order to hit these targets and, where necessary, face-to-face GP appointments will be made available. However, I am not sure that every single appointment needs to be face to face. One of the learnings of more than half of the 100 million consultations that took place between March and June was that telephone and video appointments can be extremely productive.

Baroness Masham of Ilton Portrait Baroness Masham of Ilton (CB) [V] - Hansard

My Lords, is the Minister aware that late diagnosis causes many disasters in many health specialties? Does he agree that the respiratory programme is vital and has been highlighted by Covid-19? Should we not be training and employing more doctors, nurses and physiotherapists as respiratory specialists across the country in the long-term NHS plan?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I completely agree. It is a grave shame that too many diagnoses happen late. We are proud of our acute care, but it is this Government’s mission to move to a priority around early intervention which will have a huge impact on the quality and length of people’s lives and make modern healthcare more affordable. The noble Baroness is entirely right that respiratory interventions are an important priority.

Lord Desai Portrait Lord Desai (Lab) [V] - Hansard

My Lords, it is not good enough just to praise NHS staff. Will the Government commit to spending a certain percentage of GDP on health as soon as possible? I suggest that 12% of GDP should be spent on health; then we would not have a repetition of this disaster.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

We do not just stand and praise. We are recruiting a huge number of new staff—50,000 more nurses and more GPs—and we invest in them through our people plan.

Baroness Jolly Portrait Baroness Jolly (LD) - Hansard

My Lords, the long-term plan cannot be delivered without effective community nursing support. Community nurses get people out of hospital and prevent others from being admitted. Currently, the service is short of several thousand nurses. What changes does the Minister expect to be made to get these nurses recruited, trained and operational?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I am grateful to the noble Baroness for raising the importance of community nursing, and all community-based healthcare, including community diagnostic hubs. The interest in nurse recruitment has risen dramatically—by 138% in recent months—partly because of our massive advertising campaign and the renewed focus of NHS trusts in community nursing, which will be matched by opportunities to provide training for those who step forward for jobs.

Baroness Altmann Portrait Baroness Altmann (Con) - Hansard

My Lords, in light of the experiences of people relying on social care during the current pandemic, might the NHS long-term plan make some adjustments to account for the need for integration between NHS and social care? When can we look forward to the proposals for radical social care reform, to ensure parity of esteem for the NHS?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My noble friend is entirely right to raise the importance of social care. Undoubtably, one of the things that we have learned through Covid is that the NHS and social care sectors must work more closely together. That was always envisaged as one of the pillars of the long-term plan. It is now an increased priority. That has been witnessed through much closer collaboration in recent months between trusts and the social care industry. We continue to invest in social care, providing councils with access to £1.5 billion for adult and social care in 2020-21, as extra support during this difficult time.

Baroness Thornton Portrait Baroness Thornton (Lab) - Hansard

Following on from the question asked by the noble Baroness, Lady Altmann, I must try to pin the Minister down. Can he commit to publishing a plan for the future funding and provision of social care by the end of this year, as the Prime Minister promised in January? My honourable friend Liz Kendall MP has today written to the Secretary of State about the need for a clear social care winter plan. What steps are the Government taking to ensure that no one with Covid-19 is discharged from a hospital to a care home, to prevent a repeat of the terrible impact that this had in the first months of this crisis?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I cannot commit to a social care plan before the end of the year. It will require a huge amount of political collaboration and I suspect it will take longer than the next few months. I remind the noble Baroness that we have a £600 million infection control fund to help social care through the winter.

Lord Stirrup Portrait Lord Stirrup (CB) - Hansard

My Lords, despite additional Covid funding, many NHS trusts are having to cut back on crucial capital investment programmes because of increased financial pressure. For example, some hospitals are having to replace obsolete and ineffective scanners with slightly newer but far from up-to-date models. Does the Minister agree that when the NHS long-term plan is revised, it will need to include a recovery schedule from these perhaps inevitable but nevertheless damaging short-term responses?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, the Chancellor has made it clear that catch-up support for the NHS to recover from the impact of Covid is an important part of his financial projections. However, I remind the noble and gallant Lord that we are investing in 40 new hospitals. It is a massive capital investment and the impact on our healthcare service should not be underestimated.

Lord Fowler Portrait The Lord Speaker (Lord Fowler) - Hansard

My Lords, the time allowed for this Question has elapsed. We now move to the next Question, which is from the noble Lord, Lord Storey.

Anti-obesity Strategies

Lord Bethell Excerpts
Monday 14th September 2020

(4 days, 14 hours ago)

Lords Chamber
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Department of Health and Social Care
Baroness Bull Portrait Baroness Bull - Hansard

To ask Her Majesty’s Government what assessment they have made of the impact of anti-obesity strategies on people suffering, or recovering, from eating disorders.

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

My Lords, eating disorders are serious life-threatening conditions, and it is important that people have access to the right mental health support in the right place and at the right time. We carefully consider all views on our measures to reduce obesity. This includes feedback from a wide range of experts in response to our public consultations on specific policy proposals.

Baroness Bull Portrait Baroness Bull (CB) - Hansard

My Lords, as the Minister says, eating disorders are indeed serious mental health issues, but their relationship with obesity is complex. Many obese people also live with eating disorders, which means treatment is not always as simple as rebalancing calories in and out. Does the Minister accept the expert advice that elements of the new strategy, like food labelling and calorie counting, are dangerous triggers for eating disorders, and that slogans emphasising personal responsibility stigmatise people whose obesity has more complex roots than a failure to get a grip? Will he agree to meet with me and eating disorder specialists to discuss how this important strategy can be more effective for its intended audience and avoid collateral damage for those people for whom “Eat less, exercise more” is a dangerous message?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I entirely agree with the noble Baroness that serious eating disorders are complex, and we need to resource the medical attention required by people with serious mental health issues. However, I do not completely align with her view that all obesity is not a matter of personal responsibility, nor that the education of people about the content of their food through labelling cannot be an important part of our battle against obesity. Covid has spelt it out clearly to all of us. Some 67% of the country is overweight in some way or another. But this is a policy that we are determined to get right, and I would very much welcome the opportunity to meet with the noble Baroness and her team.

Baroness Thornton Portrait Baroness Thornton (Lab) - Hansard

My Lords, following on from the noble Baroness’s question, do the Government have eating disorder experts, including those with lived experience, advising them as part of their anti-obesity strategy? It seems to me that is one way of making sure that the messages do not disadvantage those who have eating disorders. There is a reason why advocates for those with eating disorders have been very critical of the language being used. Could the Minister commit to reviewing the campaign in light of this?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

The noble Baroness is entirely right: we do rely on the advice of charities, academics and experts in eating disorders. We do not do anything without full consultation with those who have expertise in eating disorders. We review the campaign regularly, and we will be taking into account the view and feedback of those experts, charities and patient groups as a part of that review.

Lord Truscott Portrait Lord Truscott (Ind Lab) - Hansard

My Lords, what action are Her Majesty’s Government taking to tackle eating disorders, especially among the young, whose mental health may have been severely impacted by the current Covid-19 pandemic?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, the Government are committed to ensuring that everyone with an eating disorder has access to timely treatment. That is why we set up the first waiting times to improve access to eating disorder services for children and young people so that, by 2021, 95% of children with an eating disorder will receive treatment within a week. Figures show that in Q1 of 2020, 87.7% of children with an eating disorder received treatment within one week in urgent cases, and 86.8% within four weeks.

Baroness Warsi Portrait Baroness Warsi (Con) [V] - Hansard

My Lords, I welcome the Government’s recent announcement of additional funding for community-based mental health initiatives and ask my noble friend whether the Government can ensure that their latest obesity strategy is mindful of and responsive to the underlying emotional issues, as detailed by the noble Baroness, Lady Bull. The causes are often far more complex than the Government’s current approach.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I completely endorse my noble friend’s views. When it comes to mental health challenges and connections between obesity and mental health, the resources need to be put in place and the sensitivity she speaks of applied. I return to my earlier comments: 87% of the country is involved in this. Not all have mental health issues; some simply need to take responsibility for their weight.

Baroness Parminter Portrait Baroness Parminter (LD) [V] - Hansard

The National Audit Office’s report last week on tackling obesity confirmed that there is limited evidence that calorie labelling in restaurants reduces total calories consumed. How will the success or otherwise of the Government’s proposed calorie labelling in restaurants be evaluated? Will it take into account the potential harm caused, given that the ability to track calories can be highly triggering for those with or vulnerable to developing an eating disorder?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, we are tracking the success of this obesity strategy, although it should be understood that this is generations in the making and may well take a while to work through. I come back to my previous comments: calorie labelling is a very important element of people’s education about the content of their food and often their drinks, including alcoholic drinks. We support that measure as an important part of our strategy.

Baroness Verma Portrait Baroness Verma (Con) - Hansard

My Lords, will my noble friend take into account that in the south Asian community there are larger numbers of people with diabetes, heart disease and a lack of vitamin D? Through his campaigning and communications—he has been really mindful of this—will he try to ensure that we are also reaching communities in which exercise and sport do not always come as a first priority? Is he willing to meet with me and a team of people working on this?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My noble friend is right, and Covid has really spelt out the challenge in this area to the NHS and the Government. The incidence of serious Covid effects on BAME communities has been more intense because of the prevalence of diabetes and overweightness in many of those communities. We have relooked at our marketing and communications to those communities and need to redouble our efforts. That is why, as part of the obesity strategy, we are putting in serious, concentrated efforts in reaching the communities, as my noble friend advised. I would be glad to talk to her about how we can do that better.

Baroness Uddin Portrait Baroness Uddin (Non-Afl) - Hansard

My Lords, children and adolescent adults with eating disorders battle multiple debilitating physical and mental effects. Eating disorders have one of the highest morbidity rates among psychiatric conditions, causing untold helplessness and grief for families and professionals constantly struggling with a lack of adequate financial resources and services, as evidenced by Ignoring the alarms: How NHS eating disorder services are failing patients, a report by the Parliamentary and Health Service Ombudsman. In light of this report and a significant body of evidence known to health services and experts in the field, can the Minister assure the House that sufficient advice has been sought and a thorough, evidence-based risk analysis undertaken to mitigate the potential harmful, detrimental impact of the public anti-obesity campaign on those suffering and recovering from disorders?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I am not sure I agree with the premise of the question. It is not my belief that the anti-obesity campaign will generate massive negative repercussions. The NHS’s work in this area has developed immensely and we are putting a huge amount of money into it, including through our mental health strategy. I support the strategy we are applying.

Lord Rennard Portrait Lord Rennard (LD) - Hansard

My Lords, the need for psychological support for people with such eating disorders is often identified through face-to-face meetings with GPs. Is the Minister satisfied that it is possible, in safe conditions, for people to obtain such meetings at the moment and that, if such a need is identified, sufficient psychological support is available for them?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

The noble Lord is probably aware that a letter has been sent to GPs inviting them to step up to their responsibilities for face-to-face meetings. Everyone should have a face-to-face meeting if that is what they require and need. One of the surprising and interesting outcomes of the Covid epidemic is that many mental health services have been successfully delivered through video links. It has meant that people who may feel vulnerable about attending a GP’s surgery or mental health clinic have had the opportunity for consultations. We will look at how to expand that kind of interaction.

Baroness Gardner of Parkes Portrait Baroness Gardner of Parkes (Con) [V] - Hansard

My Lords, I have spoken to GPs about this issue. Particularly in cases of obesity—which they all agree is more common for people living in deprived areas—they say the difficulty now is that patients do not come in person to a surgery. Therefore, if someone tells you their obesity is still well under control, you have no way of assessing that. They suggested that I put it to the Government that there should be better liaison between schools and GPs, because schools see families all the time and become good judges of whether people are putting on weight. They can also provide exercise and advice on diet. GPs are willing to look after these people but say that if you cannot actually see them, how do you know that what they are telling you is the truth? What will the Government do to encourage liaison between schools and GPs?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My noble friend makes an incredibly thoughtful, practical point. Of course, it is easier to tell whether someone is abiding by their obesity commitments if you see them face to face. With regard to schools, I remind her about the hundreds of millions of pounds going into school exercise through the sugar tax payment. That is completely transforming exercise in schools and will have a profound effect over many generations.

Lord McFall of Alcluith Portrait The Senior Deputy Speaker (Lord McFall of Alcluith) - Hansard

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

Covid-19 Update

Lord Bethell Excerpts
Monday 14th September 2020

(4 days, 14 hours ago)

Lords Chamber
Read Full debate Read Hansard Text
Department of Health and Social Care
Lord Scriven Portrait Lord Scriven (LD) - Hansard

My Lords, these Benches welcome anything from the Government that is based on rational evidence and can prove to be effective in this public health crisis to keep people safe and reduce the spread of the virus. So does this Statement live up to that? Unfortunately, yet again the sales pitch from the Secretary of State last week fell short of what is required to be effective. It has to be based on fact and scientific evidence that the public have confidence in and understand.

I have some simple questions for the Minister. Now that the scientific evidence has been produced, members of the public are asking why children under 12 and 11 are included as part of the six. Why can they be in a school in a class of 30 but from 3.30 pm they cannot be in a house with seven people, including their two grandparents? What scientific evidence exists to suggest that that causes more harm than 30 children in a classroom?

There is something else that people have asked me. Why is it that I can go to the office and be there with 20 people until 4 pm, but at 4.15 pm, if I go to the pub, I have to be in a bubble of no more than six? The evidence may be there, but it has to be explained in a way that those questions can be answered and the public have confidence in those answers. Inconsistency, rather than the public not having confidence, is one of the issues that the virus breeds on.

The public health message has to be clear and consistent. The regulations do not just bring in a power of six; there are quite a number of exemptions, including a legal definition of “mingle”: for the first time since 1393 it becomes illegal to “mingle”. Can the Minister give a legal definition of “mingling”? I can go to an event with six people but I cannot mingle beyond those six if it is an event run by a charity, a public body, a philanthropic organisation or a business. If I open the door for somebody and speak to them to thank them, am I mingling? If I stop somebody who I know and speak to them, am I mingling? What is the legal definition? That is going to cause confusion and not be consistent.

These regulations and rules have to be developed in a collaborative manner with local areas to be effective. Why was the Local Government Association informed of the Covid-secure marshals only one hour before? If the rate is rising so fast and we need to be effective today to monitor six people and no more, where are those marshals’ powers as of today and in which legislation?

It is quite clear that action needs to be taken to stop this virus, but it is time for the Government to stop and be much more strategic and considered and to implement legislation and systems in a more collaborative way. People’s lives and livelihoods depend on the Government getting this right, but unfortunately this Statement is not a complete and right answer.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I thank the noble Baroness and the noble Lord for their perceptive and thoughtful questions. On the noble Baroness’s questions about the level of alert, to my knowledge it has not changed. It was reduced from four to three on 19 June; it remains subject to review on a weekly basis, but we are not in a position to raise it at the moment.

The noble Baroness asked about the rule of six and why we had committed to six as opposed to anything else. The short answer is that we are seeking to have rules that are simple to understand and straightforward to apply. We accept that during the last few months the guidelines have grown increasingly complex and difficult to understand in all their detail. Across the board, with “Hands, Face, Space”, the rule of six and other measures that we are seeking to publish, there is a genuine effort to engage the public in a really simple lexicon of how we can beat the coronavirus.

Sir Mark Walport, the head of UKRI, was right in his warning that the jeopardy is enormous. If we do not get this communications challenge right, and if people think they are confused and think they have a way out because it is in some way complicated, we will fail, the disease will come back and we will have tens of thousands of deaths; we will have an NHS that is challenged; we will have an economy that is shut down; and we will have a generation that is lost to education. Those are the stakes, so we are determined to get it right. I am happy to stand here for as long as it takes and be pub-quizzed on “What about this? What about that?” if it means that we get it right.

However, the public seem to understand these simpler rules. The response from the public in our planning focus groups and in the response since their publication has been extremely positive, and we think we are on the right track. This is advice that was informed by SAGE and we went through its models in great detail.

The noble Baroness and the noble Lord, Lord Scriven, asked why children are included. The bottom line is that we want to keep it simple. Children are vectors of infection; they can pass the disease from one generation to the next. Time and again, in city after city, we have seen an infection that starts with a young person, moves to mum and dad, then to grandma and grandpa. It takes weeks or sometimes months for that progress to take place but, as I have said at this Dispatch Box before, as night follows day, the infection moves through the generations unless we take steps to break the chain of transmission. The rule of six is a critical, unambiguous step in the Government’s strategy for doing just that.

The noble Baroness and the noble Lord, Lord Scriven, asked about marshalls, so let me just say a word about that. This measure came from our engagement with local authorities. Local authorities are looking for ways in which they can implement the right measures to disrupt crowds forming and, as the noble Lord, Lord Scriven, said, mingling—a concept which, frankly, I do not think needs much description and nor do members of the public. In order to break things up, they are looking for ways in which they can have both the authority and the personnel to do that, and we have responded by putting in the right regulations to do that and by providing the right resources. But it will be up to local authorities to implement that in detail.

The noble Baroness asked about shooting and hunting. My understanding is that guidelines on all sorts of sports and activities where the rule of six is in any way ambiguous will be issued in the coming days.

The noble Baroness asked about Hammersmith, and I am extremely grateful for the tip-off. I will look into it, as I have done when other noble Lords have alerted me to concerns they might have. I am extremely concerned that there might be a breakdown in the asylum centre in Hammersmith. However, I reassure the noble Baroness and the House that directors of public health are responsible for this kind of implementation, and the benefit of directors of public health is that they work across all departments. Some directors of public health have a health background, some have a police background and some come from a leisure background, but they all hold the ring when it comes to local implementation of local measures, and therefore they are the best-placed people to ensure that situations like this are not overlooked.

The noble Baroness asked whether we should be reviewing the current measures for pubs, clubs and workplaces. The simple answer to that is yes, absolutely; we should be reviewing it—and we do review it every single week. We are on tenterhooks because, if we get this wrong, the jeopardy is enormous. We are working as hard as we can, with regulatory measures such as the rule of six, marketing measures such as “Hands, Face, Space” and containment measures such as the test and trace programme, in order to keep the economy open, to keep our educational institutions open and to keep life as normal as we possibly can. If we do not—if we fail—it will go back to where we were before, and I hope memories are not so short that people do not remember quite how imposing and draconian the former lockdown was.

On test and trace, the noble Baroness quite reasonably asked about the capacity and about demand. I can reassure her that the capacity has literally never been higher. We are up 7% week on week and—if I can provide the right figures here—we will have a capacity of 500,000 by the end of October. We have 500 centres, including five major laboratories, 236 mobile testing units, 72 walk-through testing sites, and more sites opening all the time. For every 1,000 people in this country, we test 2.43 a day; that compares with Germany at 1.15, Spain at one and France at 1.15.

We are throwing everything we can at the test and trace system, but it is true that demand has gone up. Part of that demand is through children returning to school. I welcome enormously the return of children to school, but it is an un unambiguous fact that this has led to a very large increase in the number of children being sent to testing centres—often bringing their parents and other household members with them—and that has put an enormous pressure on the system.

Another feature is asymptomatic testing. Estimates are that between 20% and 25% of those turning up for a test are currently asymptomatic. If we had all the tests in the world, that would not be a problem and I would welcome it, but right now we are building the system, we are under pressure and we need to communicate more clearly to the public that asymptomatic testing is not supported by our current testing system.

The noble Baroness asked about social care—quite rightly, as this is a major feature; we are concerned about it, and I know that noble Lords are concerned about it. I reassure the noble Baroness and the House that care homes are absolutely our number one priority. This was reiterated in meetings with the Prime Minister last week. Some of the capacity challenges in places such as walk-in and drive-in centres are because we have put care homes front of the queue and because those tests are taking priority.

The noble Lord, Lord Scriven, asked a number of extremely detailed questions, some of which I have touched on. He asked why we have included children. He is entirely right that, in Scotland, they have not included all children and in some other countries they do not do so either. We have taken a different view. Partly, that is on the epidemiological advice from SAGE; partly, that is on the marketing advice from our communications department, which is insistent that we are clear and unambiguous with the population; and, partly, that is the CMO’s advice—he rightly identifies children as potential vectors of infection, particularly in intergenerational households.

The noble Lord, Lord Scriven, asked for consistency. Well, we are consistent in that we are determined to break these chains of transmission. The science is not simple; if it were, the disease would have been beaten. It bounces around, and we are doing our best to fight it. We are communicating as best we can on all the science we have.

In terms of collaboration, I pay a massive tribute to all my colleagues at the department, in other departments, in local authorities, at PHE and in the NHS. It is difficult for me to explain in great detail in a short amount of time the immense amount of cross-departmental, inter-agency collaboration that has sprung up around Covid. The amount of data that is shared, the number of Zoom calls and the working together are absolutely phenomenal. The noble Lord cited that the LGA did not know about the marshalls plan until the last minute; I am afraid to say that it must have been the last one on the list.

Baroness Finlay of Llandaff Portrait The Deputy Speaker (Baroness Finlay of Llandaff) (CB) - Hansard

My Lords, we now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can call the maximum number of speakers.

Viscount Eccles (Con) - Hansard

My Lords, last week I pursued the question as to whether there were precedents for using emergency powers under an old Act—this is an Act from 1984—and also whether the Government had any plans to change the procedure to one that is more like what we have come to expect over many years, so that we debate these regulations before they came into force. Many of the questions that are asked would be much sharper if the debate was before the regulations came into force. It would be better, because the future is more interesting than the past—and doubly so in these hybrid days, when debate is not as easy as it is in normal circumstances. Indeed, one reason for thinking that we should change is that there must be an impression that the Executive are riding roughshod over us, when what is actually needed is consensus—as has been indicated by the two Front-Bench speeches today—and I think that consensus is available. Will the Government have another think, decide it is better to be in front and implement some changes that will make Parliament’s job easier?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I thank my noble friend for his comments, but my perspective is slightly different. The fact is that this disease is incredibly aggressive and nimble; we sometimes have to turn decisions around literally within hours. I cannot think of another situation, other than war, where the decision-making has to be quite so quick. I would love to be able to bring regulations to this House for full debate in advance of their implementation, but no human institution can move at that kind of speed—it is just not possible. In answer to his question, we have no plans to switch horses at the moment. We are working as hard as we can to bring regulations here as quickly as we can, and I pay tribute to the House authorities for doing everything they can to put regulations in front of the House as quickly as they can.

Lord Patel Portrait Lord Patel (CB) [V] - Hansard

My Lords, the Office for National Statistics records over 52,000 deaths of people whose death certificates have Covid-19 as a contributory cause. More than 42,000 of these deaths were of people over the age of 65. As the numbers of infections increase, which they are, more older and vulnerable people will be infected—as has happened in France—leading to a rise in hospital admissions and deaths. What plans do the Government have as the rate of infection increases in our country to protect the elderly and more vulnerable?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, we are discussing, among other things, the very regulations we are putting in place to protect the elderly and vulnerable. The rule of six, although not part of this provision, is an emphatic commitment to protect the people whom the noble Lord cites. I add that we are concerned about not only the elderly and vulnerable; we are increasingly concerned about the phenomenon of long Covid, which hits the young. It is one of our objectives to rid this country of Covid altogether and to protect all demographics.

Baroness Donaghy Portrait Baroness Donaghy (Lab) [V] - Hansard

My Lords, in answer to my noble friend Lady Thornton’s question about the alert level, the Minister said that to his knowledge it had not changed, although it was subject to weekly review. However, these are the Government’s own levels. How can the level stay at number 3, which means “virus contained”, when number 4 means “virus not contained”? Does the Minister really think that an average travel requirement of 6.4 miles to a testing centre, with 10% of people having to travel up to 22 miles, is acceptable after all these months?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

The change in the alert level is done in consultation with the CMO and it is his advice that the circumstances have not changed enough for us to move it. On the average travel time, most reasonable people would consider six-and-a-half miles a reasonable distance to travel for such an important test.

Baroness Barker Portrait Baroness Barker (LD) - Hansard

My Lords, why is it safer to allow six individuals from different households to meet together indoors, rather than limiting it to members of two families?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, the phenomenon we had noticed was that large groups of people, sometimes in pubs and sometimes in other congregations, would seemingly be from two households, but that the actual definition of “household” was proving to be extremely flexible in the minds of many people. Therefore, putting an integer into the formula makes it much clearer.

Lord Dobbs Portrait Lord Dobbs (Con) [V] - Hansard

May I return to the issue of political gatherings, which my noble friend and I discussed last Thursday? He mentioned that protests such as those we have seen recently from Extinction Rebellion might not be outlawed quite yet, but it is not really a matter of outlawing political protest—I did not ask for that. However, can he understand how deeply outraged many would feel while spending their Christmases abiding by the very difficult rule of six if, out their window, they were watching political protesters who do not give a monkey’s about the rules? Will he confirm that political protesters are subject right now to precisely the same rules as the rest of us?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I sympathise with my noble friend’s point, but I remind him that the regulations come into force later today. It is up to the Metropolitan Police to implement crowd dispersal but the sentiments he expresses are ones that I share.

Lord Laming Portrait Lord Laming (CB) [V] - Hansard

My Lords, will the Minister please accept that while there may be good reason for the Government to ratchet up further the restrictions on social distancing, it is surely unreasonable to at the same time pressure people to return to their offices? These two objectives are incompatible, as was shown by government officers last week. Surely the Government should accept that they can press either greater social distancing or a return to offices, but not both?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I do not think that this Government are pressuring anyone into doing anything. We are keen to give those who have a reason to, whether personal or professional, the confidence to return to their workplace. I pay tribute to the very large number of employers who have invested a huge amount in making those workplaces socially distanced and safe for employees.

Lord Rooker Portrait Lord Rooker (Lab) [V] - Hansard

My Lords, the Statement makes it clear that the numbers of cases are rising. Will the Health Minister give the House his personal assurance that sufficient personal protective equipment will be available, unlike during the first wave?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I am very glad to make that assurance: 13 billion items of PPE have been procured and made available for NHS, social care and other key workers. I pay tribute to my colleague and noble friend Lord Deighton, who has led our efforts on this. The situation is completely transformed from that of earlier this year.

Baroness Hussein-Ece Portrait Baroness Hussein-Ece (LD) [V] - Hansard

My Lords, in the past week, over 700 schools have reported Covid cases among teachers and pupils, but getting a test is difficult for many. I declare an interest: my seven year-old grandson went back to school last Monday and got a high temperature. He was told to stay at home and his parents tried all week to get a test for him. They were sent to Brighton and eventually managed to get one 10 miles away, but that is because they have a car. What happens to families who do not have a car but want their children to go back to school and not lose out? Why are test kits not being made available to schools or local authorities, maybe in clusters, to enable equal access for all children and teachers to such kits so that they do not have to self-isolate unnecessarily for 14 days and can—like my grandson, whose test was thankfully negative—go back to school?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I thank the noble Baroness for her testimony, which completely resonates with me. The current national prevalence is around one in 1,500, so there is a strong likelihood that, in a school with 1,500 kids, one of them will turn up with Covid. We are aware of the challenge of febrile children who have a temperature, as children often do, and are naturally anxious to get a test. We therefore provide kits of tests to schools, but we are not able to turn schools into testing centres—I do not think that parents, teachers or schoolchildren would like us to do that. We have also prioritised social care, the protection of hospitals and the asymptomatic testing of key workers over schoolchildren for the moment. As our capacity increases, that will be reviewed.

Baroness Redfern Portrait Baroness Redfern (Con) [V] - Hansard

My Lords, this virus has shown it is extremely difficult to eradicate or keep under control until a vaccine is produced. I ask the Minister about people being asked to isolate because data has shown that some are facing real hardship. We are told that this is a central reason for people sometimes ignoring advice. Are Ministers looking at the possibility of helping with extra financial support?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

The noble Baroness is entirely right that the isolation protocol is extremely onerous for some people and has a huge impact on their life, mental health, income and social life. I completely understand the point she is making. We are keeping the question of financial support under review and will continue to look at this important subject.

Baroness Coussins Portrait Baroness Coussins (CB) [V] - Hansard

My Lords, picking up on one of the points made by the noble Baroness, Lady Thornton, what arrangements have been made to enable compliance with the rule of six for asylum seekers living in reception centres or hostels that have communal facilities for eating, sleeping, washing, cooking and leisure time? This could be a national issue, not just in Hammersmith. Also, why is there no link on the National Asylum Support Service website to any Covid information or advice in languages other than English and Welsh?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, asylum hostels are one example of a very great many that will have to put thoughtful arrangements in place in order to comply with the rule of six. I pay tribute to their efforts.

Lord Campbell-Savours Portrait Lord Campbell-Savours (Lab) [V] - Hansard

My Lords, why insist on a mask-wearing policy totally at variance with international practice? Surely, by now the Government can admit to the major benefits: they alert others to danger, signal an element of risk and, when worn without valves, protect both users and those in the immediate vicinity. Therefore, why not revisit the whole policy and promote the enforcement of wider and appropriate usage—a very, very much needed U-turn?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I pay tribute to the noble Lord’s campaigning on this issue; he has contributed to the Government changing their strategy on mask wearing. However, we are here discussing the onerous burden that these measures put on people in this country, and we have to be careful not to overburden them. The CMO’s guidance on masks is that the science remains ambiguous. I know the noble Lord does not agree with that, but that is the CMO’s advice. We have come a long way on masks in order to change policy on this and, as the scientific evidence changes, we will review that policy.

Lord Taylor of Goss Moor Portrait Lord Taylor of Goss Moor (LD) [V] - Hansard

Since the Minister wants to keep things simple, could he explain to families that are separated what the rules now are? In my case, I am a single father of three young boys who live with me every other week. They live in a household of six on the other weeks, and it includes another child who also lives in another household part of the time. Which of us are allowed to get together when?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, that is the pub-quiz question of all pub-quiz questions. There are special provisions for families that are, like the noble Lord’s, separated or complex. Those guidelines have been published, I believe, and I would be glad to send him an email with a link to them.

Lord Blencathra (Con) - Hansard

[Inaudible]—simple rule and the long overdue emphasis on better and stricter enforcement. Does my noble friend not agree that when a law is systematically and routinely broken and not enforced, it brings the rest of the law into disrepute? Therefore, will he encourage the police, in the strongest possible measures, to stop turning a blind eye to massive house parties, raves and woke demonstrations and tell them to get off their knees and enforce the law?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I completely endorse my noble friend’s comments on raves, but the effectiveness of these measures is reliant not just on police implementation but the compliance of the British public. While I understand his point on mandation and police action, it is really the personal decisions and social pressure of the British public that will make these work, and I cannot help but pay tribute to them for their sensible approach to Covid to date; that is where our trust really lies.

Lord Mackenzie of Framwellgate Portrait Lord Mackenzie of Framwellgate (Non-Afl) [V] - Hansard

My Lords, following on from the previous question, effective policing requires the consent of those being policed, and those enforcing it need good training and interpersonal skills. Covid marshals—when they are actually implemented—could well face some resistance from those who have had enough of being told what to do. Will marshals have the power to issue fixed penalties, and does the noble Lord agree that friction with them could cause breaches of the peace and place even more demands on the police themselves?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I do not know the precise legal powers of the marshals, but I remind the House that city centres and public areas frequently have civilian marshals of one kind or another to help guide public gatherings. This is a not uncommon aspect of city and public life, and I have an enormous amount of faith in the good sense of the British public to go along as requested without legal mandation.

The Earl of Clancarty Portrait The Earl of Clancarty (CB) [V] - Hansard

My Lords, the WHO’s watchword has been “test, test, test” to isolate the disease, so I am in favour of the Prime Minister’s stated ambition of mass testing. With regard to Operation Moonshot, have the Government a date in mind for testing audience members at theatres and sports venues? Secondly, does the Minister agree that we should now be testing at airports, as British Airways is asking for?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, we have embraced the “test, test, test” recommendation in a very big way, and the noble Earl is entirely right to aspire to using testing to enable a return to the economy, theatreland and all sorts of public gatherings. We are looking energetically at this, working with suppliers, academia and the NHS to figure out ways of using the new testing technologies in the way he describes.

However, we are at a relatively early stage and I am not able to make announcements on this here today. We have funded—to the tune of £500 million—a huge amount of investment in these technologies and, when they are right, we will roll them out in the theatres and airports of Britain.

Lord Hunt of Kings Heath Portrait Lord Hunt of Kings Heath (Lab) - Hansard

My Lords, we have heard a lot from the Minister today about the importance of obeying the law, yet a Bill has been introduced in the other place today that essentially sees the Government seeking to break the law. I refer him to what Geoffrey Cox, the former Attorney-General, said this morning:

“When the Queen’s minister gives his word, on her behalf, it should be axiomatic that he will keep it, even if the consequences are unpalatable. By doing so he pledges the faith, honour and credit of this nation and it diminishes the standing and reputation of Britain in the world if it should be seen to be otherwise.”

He went on to say:

“It is unconscionable that this country, justly famous for its regard for the rule of law around the world, should act in such a way”.

Does the Minister think this a good example to the public, and does he not fear that the appeal to the rule of law regarding the rule of six might just fall on rather stony ground?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I am here to support the regulations before the House, not to comment on the issues about which the noble Lord asks.

Lord Greaves Portrait Lord Greaves (LD) - Hansard

My Lords, the noble Lord has previously congratulated people in my part of Lancashire on how well we are doing, which I do not quite agree with; we are working hard. Why are people, whether in our borough or the surrounding ones, still not able to book tests locally when we usually have three testing stations going? Some are being told to ration the number of tests they do each day, which involves gaps of perhaps two hours when they will not accept any bookings, even though the testing kit and the people are there, and the tests could be carried out. However, people are not being allowed to use them.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, the amount of testing we are doing is increasing enormously. Most people who book a test do get it locally, and that test is delivered quickly and on time. The result arrives within 24 hours and we are doing a million tests a week, which is well within the bounds of our business capacity.

The noble Lord is right that the system is under scrutiny and pressure. Not everyone is getting a test where and when they want it. However, overall, it is reasonable to ask people not to make frivolous demands upon the tests, and to ask that those who are asymptomatic wait until there is further test capacity before they step forward to ask for their test.

Lord Forsyth of Drumlean (Con) [V] - Hansard

My Lords, can my noble friend tell me what the Government have identified in English children under 12, including babies, that makes them, to use his phrase, “a vector of infection and a Covid hazard”, that does not apply to children in Scotland, who have been back at school for weeks? And on the subject of making things easier to understand—simplifying matters—why is it okay in England to meet one’s grandchildren in the pub but not in their family home if the household consists of six people?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, Scottish children are just the same as English children, but the Scottish Government have decided to take a different approach; we celebrate the differences between our two nations in this. With respect to meeting in the pub, you cannot meet more than six people in the pub and you cannot meet more than six people between two households. The arithmetic is reasonably straightforward.

Viscount Waverley Portrait Viscount Waverley (CB) [V] - Hansard

My Lords, it is clear that face masks are a critical component of slowing the virus. Following on from the observations of the noble Lord, Lord Rooker, and other noble Lords, how self-sufficient is the UK expected to become in the supply of PPE, and are there targets for the supply of face masks in particular?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, we have taken huge steps in the domestic production of PPE. In some matters, where the production is relatively straightforward, such as aprons, we have taken huge steps forward and the vast majority of our production is done at home. For some products, such as gloves, that are more complex because of their shape, we are having to work harder. The progress of my noble friend Lord Deighton’s Make strategy for PPE has been profound, and we are looking at making up to half of our PPE requirements in the UK.

Baroness Blackstone Portrait Baroness Blackstone (Ind Lab) - Hansard

My Lords, given the intrusive and damaging effects, especially on family life, of the decision to limit social contacts to six people, can the Minister say why it was decided to apply this both inside and outside, rather than to follow the Welsh Government’s position of applying the new ruling only to meetings inside? Does he agree that medical evidence suggests that the chance of contracting the virus outside is tiny in comparison with inside, and that, with regard to his quest for simplicity, nobody is so simple that they cannot tell the difference between inside and outside.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I agree that everyone can tell the difference between inside and outside, but everyone also has eyes, and may have seen, as I have, how people crowd together in the forecourts and beer gardens of Britain. If they were all standing on draughty hillsides with the wind blowing the disease around, that would be one thing, but the simple fact is that our prevalence has gone up—the evidence speaks for itself—and that is why we need to be clearer about this simple measure.

Baroness Uddin Portrait Baroness Uddin (Non-Afl) - Hansard

My Lords, in the US 513,000 children have been infected as of 3 September, with 70,630 cases reported in the past two weeks. Only this morning in my locality, all reception classes bar one were shut down due to the Covid infection of a teacher. As a father, the Minister will understand that many parents remain fearful and are seeking assurance and evidence of safety. Holding the Government to account after a tragedy has occurred would be meaningless. What lessons can we learn from our friends in the US and elsewhere about minimising the spread of infection among teachers and children in the UK, with the inevitable consequence of transmission to their homes and vulnerable loved ones in their families?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, policymakers around the world are facing exactly the same dilemma. We are determined to have the schools back, because the long-term effects on young people—particularly the least advantaged—will be profound if we shut the schools. The noble Baroness is entirely right to say that parents are naturally concerned that the safety of children, and other generations that they may come into contact with, is at risk. That is why we are massively prioritising the return of schools and introducing measures such as the rule of six to break the chain of transmission and thereby protect the schools from closure.

Baroness Finlay of Llandaff Portrait The Deputy Speaker (Baroness Finlay of Llandaff) (CB) - Hansard

I apologise to the noble Baroness, Lady Verma, who I should call now.

Baroness Verma Portrait Baroness Verma (Con) [V] - Hansard

Thank you, Deputy Lord Speaker. My noble friend has talked about Covid, but I think it is important in the same debate to talk about the flu injections that are available to help people reduce their ability to catch Covid. Will my noble friend ask the pharmacies that are distributing flu injections to step up their communications, in particular to people with south Asian backgrounds, who are slightly resistant to going into pharmacies to get flu jabs? I know from my experience of having to persuade my mother that this is an issue, and it would be helpful to get the communications about getting flu injections out as quickly as possible, so that people build up their immunity as quickly as possible.

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, we are hopeful that this season the number of flu injections will be a massive increase on previous seasons. We will, therefore, be putting huge responsibility on the shoulders of pharmacies and pharmacists to deliver them. I take on board completely the very good advice from my noble friend about the reputation of pharmacists compared to GPs, particularly in certain communities. I trust that the pharmacy profession will be doing an enormous amount to promote the flu injection itself, and to reassure its customers about the efficacy of its service. It is, however, an idea that I will take back to the department.

Baroness Noakes (Con) [V] - Hansard

My Lords, when we had questions on the Statement last Thursday, I asked the Minister two questions that he did not answer. I have another opportunity now. Can the Minister say what evaluation the Government have made of the economic and societal impact of alternative responses to the spike that we are seeing in infection rates? Secondly, will they publish that evaluation?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, we have a very clear example of what will happen to the economy if the infection comes back. We will have to close down society as we did before, and the economy will suffer profoundly as a result.

Baroness Neville-Rolfe (Con) - Hansard

Most of the Covid measures made under the Public Health Act 1984 have major adverse effects on the economy and on the treatment of other fatal diseases. We cannot go on like this indefinitely until we have a vaccine. We need a new strategy that offers a degree of protection where it is needed, for example in care homes and for the very elderly, and that restores economic and social life. Are the Government now developing such a strategy, and when will we hear about it?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, my noble friend describes in the most beautiful and succinct way exactly the strategy that we are following. It balances on the one hand a fight against disease, a breaking of the chain of transmission, the protection of the NHS and the saving of lives, and on the other a measured, thoughtful and reasonable opening up of the economy, workplaces, schools, shops and other valued economic assets. We are working hard to get that balance right. I believe that we have got it right, but we are open to suggestion and we review the situation incessantly. Until we have a vaccine and other therapeutics to fight this disease, that is the life and the road that we will be walking.

Covid-19 Update

Lord Bethell Excerpts
Thursday 10th September 2020

(1 week, 1 day ago)

Lords Chamber
Read Full debate Read Hansard Text
Department of Health and Social Care
Baroness Barker Portrait Baroness Barker (LD) - Hansard

My Lords, this is a Statement made two days ago in the other place, but it has been largely overshadowed by yesterday’s deluge of hyperbole and hokum. The Prime Minister said yesterday:

“We know, thanks to NHS Test and Trace, in granular detail, in a way that we did not earlier this year, about what is happening with this pandemic. We know the groups that are suffering, the extent of the infection rates, and we have been able, thanks to NHS Test and Trace, to do the local lockdowns that have been working.”—[Official Report, Commons, 9/9/20; col. 609.]

If that is true—and given the record of the Prime Minister and Health Secretary, one is always entitled to ask whether it is—how come local authorities and directors of public health are given only limited access to the test and trace case management system and not given full access to the contact system? Why are the Government sitting on data or passing it to companies run by their mates, instead of passing it to local authorities, which, for weeks, have been trying to predict and manage the inevitable spike in infections that follows people starting to travel and going to school and university. Why are they not getting that data in a timely manner?

From the start of this pandemic, experts advised the Secretary of State to invest in public health teams and NHS labs that are numerous and easily reached by many communities, including in rural areas. Instead, he gave the money to outsourcing firms such as Serco and G4S, which have no expertise and have not had to compete for the contracts. He could have invested in local public services; instead he has built a system on a foundation not fit for purpose. On Tuesday, in the Statement, the Secretary of State for Health said of care homes that

“we have met our target to provide testing kits to all the care homes for older people and people with dementia that have registered to get tests.”—[Official Report, Commons, 8/9/20; col. 517.]

But on Monday, the Government were forced to apologise for continuing delays to Covid-19 testing for care home bosses and GPs, who are threatening that these will lead to more infections among vulnerable people.

The Secretary of State’s own department, the Department of Health, admitted to breaking its promise to provide test outcomes within 72 hours. Care managers have described the Government’s centralised testing service as “chaotic” and “not coping”, amid reports that whole batches of tests are coming back not only late but also void. Testing officials told care homes by email on Monday morning that

“immediate action has been taken at the highest levels of the programme to bring results times back”

within 24 hours.

“We apologise unreservedly to … you … and your staff.”

The ring of steel that the Secretary of State claimed to have put around care homes never was. With upwards of 40,000 deaths, when will the Government sit down with care home providers, local authorities and CCGs to develop a comprehensive system of testing and supply of PPE? It does not have to be world beating; it just has to work.

The Prime Minister’s Statement yesterday would have been risible were the consequences not so serious. Most ludicrous of all was the announcement of a team of Covid-secure marshals to enforce the new laws on public gatherings. The Government could have done any number of things. They could have announced resources to enable the rehiring of retired public and environmental health professionals, since there is a shortage. They could have given funding to local community and voluntary groups to communicate ongoing health risks and the law to communities. They could have given additional funding for trained police officers to work with health officials and businesses to improve adherence to infection control. But, no, instead we got another vacuous attempt to steal the headlines. Maybe these marshals, with no training, no resources, no local management and no authority could join up with the 750,000 volunteers for the NHS and the trackers, and like them they could sit and twiddle their thumbs, waiting for the phone to ring.

One thing we can be sure of is that this is another stunt which will be an utter waste of time, money and resources. Local authorities, police forces, health authorities and schools are using their professional expertise and local knowledge to plan effective public health interventions. They are not only following the science but also using it to actively protect people in their authorities. In stark contrast, this Government ignore advice, misrepresent the science and carry on winging it, but the data on infections and the lack of reliable testing are evidence that the Prime Minister’s bumbling bombast and the Health Secretary’s growing litany of half-truths are indicators of world-beating incompetence and, sadly, people in black and minority ethnic communities and poor communities will suffer the consequences. It is time for the Government to change.

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

My Lords, I am enormously grateful for the thoughtful and informed questions from the Front Bench, and I echo the comments about teachers made by the noble Baroness, Lady Thornton. The return to school is a fundamental priority of the Government. It is a massive challenge for those involved, for governors, teachers, parents and school kids. I endorse the thanks the noble Baroness gave to teachers, who are performing incredibly well. The high return rates—percentages in the mid to high 90s—is remarkable and shows enormous confidence in the system among schoolchildren and their parents.

I also echo the noble Baroness’s thanks to NHS and social care staff who are preparing for winter. Enormous amounts of preparation are going into that. In response to the point made by the noble Baroness, Lady Barker, I reassure the Chamber that engagement with social care, local charities and local councils is incredibly intense and we are working extremely hard with local partners in all areas.

The noble Baroness, Lady Thornton, asked when the new regulations will be delivered. I am afraid that I cannot confirm the precise date, but I can reassure her that this Government are committed to being accountable to Parliament for those regulations and I look forward to that debate.

The noble Baroness also asked about the sequence of announcements. I reassure her that the Prime Minister brought his Statement to Parliament in good faith to update Parliament first. We cannot prevent leaks from happening, and leaks that get on to social media and then into the papers are something that we did not design or deliberately create. They are something that we regret. It would have been massively our preference for the Prime Minister to put Parliament first in his announcement.

The noble Baroness also asked about the testing system. The capacity of the testing system has never been higher: it has increased by 10,000 per day for the last two weeks and continues to increase dramatically. But demand has never been higher either, and there are good, laudable reasons why that demand is going up. The number of tests for supporting the vaccine programme has gone up. The number of tests to support our therapeutics programme has gone up. The surveillance of local prevalence has gone up, and the marketing around the use of tests by those who show symptoms has proved to be much more effective and the take-up among those who have Covid-19 symptoms has gone up. For those reasons we are extremely pleased by that effect.

However, there has also been a significant rise in the use of tests by asymptomatic individuals, largely tied to children returning to school. That is why we have been clarifying the guidance on the use of tests—that they should be used by those who have symptoms and not by those who are asymptomatic. One day, when the capacity is there and the system can bear it, I hope that we will move towards a system where anyone can have a test whenever they like, however they feel, but right now we must live within the system that we have. We are doing hundreds of thousands of tests per day and clarifying with teachers and parents that tests should be used by those who show symptoms and not by those who are seeking some other form of guidance.

Regarding the questions asked by the noble Baroness about the moonshot, I am a little confused. “If we cannot do millions of tests today, how can we expect to be able to do millions of tests tomorrow?” seems to be the question. I will answer it very clearly. The innovation around testing has moved much quicker than anyone could have expected in terms of scale, cost, accuracy and speed. The industry and the professionals in the NHS, academia and private business have come together in a triple helix to collaborate in a massive revolution in testing, which has changed considerably in this country from the days when we were struggling to do 2,000 or 3,000 tests per day to when we had the capacity to do 200,000 or 300,000 tests per day.

We have a clear view of how we can dramatically increase the tests. That clear view has two components: those tests that use existing technology that is purchasable in today’s world, and a clear idea of where innovation will take us in the very near future. This Government are committed to grabbing the opportunity of that innovation in order to dramatically increase the number of tests. There will be nay-sayers who will question whether that innovation will deliver, and undoubtedly there will be set-backs. Not everything will deliver as promised. However, I am extremely optimistic that we will be able to harness the power of science and innovation to invest in the backbone of our data and our delivery mechanisms, and to engage with the British public to deliver a testing system that enables us to return to the life that we love.

The noble Baroness, Lady Thornton, questioned whether the testing system could be relied on to deliver results. Let me explain: the people of Luton and Leicester have used testing and contact tracing, and infection rates are dramatically lower—less than half what they were in late July. Those are two excellent case studies of how our system of testing and contact tracing has turned around difficult situations and pushed back the spread of Covid by breaking the chain of infection. The noble Baroness also asked what we will do to improve the system as it stands. There are three areas of improvement: first, technology; secondly, infrastructure, by which I mean the data and the presence on the ground; and thirdly, engagement with the public so that they understand how to engage and we understand better how to interact with the public.

The noble Baroness, Lady Barker, asked about the contact system and gave some statistics. I reassure her that since 28 May we have rung 272,000 people who have been reached by the test and trace system. Where communication details have been provided, the service has reached 88.6% of close contacts, and 78.4% of people who have tested positive have been reached. Within the bounds of epidemiological effectiveness, these are extremely impressive statistics. Compared with those from other countries, they range among some of the highest. It is an incredibly impressive set of results for a system that was stood up in relatively recent history. Local public systems are complementing the central contact tracing hub, and I pay thanks to all those local authorities that either work with their full-time employees, or, as is often the case, have employed local businesses, to support it.

We have hit our target on care homes—the noble Baroness, Lady Barker, might like to take a moment to celebrate that. We are also trying to work with a degree of transparency in our operations. I do not regret for a moment the fact that the operational senior leadership in the track and trace team has been on the level about the present supply constraints, with social care and the general public. I reassure the noble Baroness, Lady Barker, that care homes absolutely remain top of our priorities. Many of the frustrations the public face, such as longer distances to travel, are exactly because we have put care homes first and have therefore had to dial down some of the availability of tests to the public. We sit down with care homes to discuss winter preparations. An indication of that is the 31 billion items of PPE that we have contracted to buy for this winter—an astonishing figure. That pays great tribute to the work of the noble Lord, Lord Deighton, and the PPE team, who have built up a fantastic stock.

Finally, I would like to express a small amount of confusion about the remarks from the noble Baroness, Lady Barker. On the one hand, she attacked the involvement of major private companies and central control of our track and trace system, but on the other hand, she attacked civic engagement, the volunteering of members of the public to support our track and trace system, and local initiatives whereby NHS trusts have brought back retired staff. The combination of these two themes is the heart of our success, and I celebrate both.

Lord Rogan Portrait The Deputy Speaker (Lord Rogan) (UUP) - Hansard

We now come to the 30 minutes allocated for Back-Bench questions. I ask that questions and answers be brief, so that I can maximise the number of speakers.

Lord Lansley Portrait Lord Lansley (Con) [V] - Hansard

My Lords, the consistency of messaging over time is immensely important to secure public support and adherence. Over the last six months, we have consistently explained that indoor and outdoor gatherings are significantly different, and that the scientific evidence has clearly shown much greater risk for indoor gatherings. Can my noble friend the Minister explain to the House why the Government appear to have abandoned this important distinction in their current guidance?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My noble friend is right to point out this important change. The truth is this: from the feedback we had from the public, and from our own analysis of the facts, we see that our guidance was growing increasingly complicated and was confusing the public. While the science may suggest all sorts of clever differences between one situation and another, and between inside and outside, the guidance is effective only if it is clear, understood and obeyed. At the end of the day, what we have done is to clarify some of the more complex areas of our guidance to make it more effective.

Baroness Meacher Portrait Baroness Meacher (CB) [V] - Hansard

My Lords, sadly, Professor Spiegelhalter has seriously questioned the Prime Minister’s rather splendid Moonshot mass testing proposal. I understand his concerns. Nevertheless, can the Minister assure the House that he will press for a significant investment in saliva home-testing kits, to enable families with a parent in the former shielded group and with children at school to live a reasonably normal life? Children need to be at school, but the lives of these parents are now in grave danger—I am sure the Minister appreciates this—with the R number above one and, as yet, no daily testing capacity. Can the Minister say when daily testing will be available for these families and other top-priority groups in the country?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

I reassure the noble Baroness, Lady Meacher, that saliva testing is a massive priority for the Government. I reassure her and Professor Spiegelhalter that the positive error rate in the saliva test trials in Southampton has been incredibly low—virtually zero. From that, we take great reassurance that this will be an effective vector for testing.

Lord Hunt of Kings Heath Portrait Lord Hunt of Kings Heath (Lab) [V] - Hansard

My Lords, will the Minister accept that the reason for scepticism about the Moonshot gimmick is that the Government have a consistent record of overpromising and underdelivering? The Minister will know that the latest test and trace stats are not good: they show that 69.2% of close contacts of people who have tested positive with Covid-19 in England were reached—that is the lowest percentage since the scheme was launched. What would he say to Bridget Phillipson, the MP for Houghton and Sunderland South? Because Sunderland has a rising number of cases, she checked online this morning the availability of tests: no home tests were available and no drive-through tests could be found. Later in the morning, the only test offered was a two-hour drive away in Scotland. Why should anyone believe the ideas that the Government float from week to week?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

My Lords, I completely and utterly reject the noble Lord’s suggestions. I remember well the nay-sayers, the sofa epidemiologists and the sceptics who, when we had testing at the level of 5,000, poured cold water on the idea we would get to 100,000. We hit that target. We have made amazing progress since and we will continue to push for more testing.

Baroness Walmsley Portrait Baroness Walmsley (LD) [V] - Hansard

My Lords, the Secretary of State has blamed the recent failure of laboratories to process tests in a timely way on members of the public who are not eligible—as he calls it—seeking to take a test. Is this not another example of Ministers blaming someone else for their failures? How do people know if they are not eligible? If they are concerned about something, what system is in place to enable testing centres to know who is eligible, so that they can refuse to test those who are not?

Lord Bethell Portrait Lord Bethell (Con) - Hansard

The noble Baroness is right, but it is sometimes difficult to know whether you have the symptoms of Covid, the flu or something else. That is why it is a complicated matter. What we have seen through our engagement with the public in the last few weeks is people who show no symptoms of anything but who seek a test to provide themselves with reassurance. It is not a question of blame, but rather of clarification: we simply do not have the national resources to support that kind of activity.

Baroness Noakes (Con) [V] - Hansard

My Lords, as a Conservative, it grieves me that the Government are pursuing policies, such as the rule of six and Covid-secure marshals, which belong in a police state. The Government have chosen a highly risk-averse approach, driven by guesstimates of hospitalisation and mortality rates, and doubtless derived from mutant algorithms. In the meantime, the economy is tanking. Can the Minister say what evaluation the Government have made of the economic and societal impacts of different responses to the small spike we have seen in infection rates? Will they publish that evaluation?