Social Care Reform

Debate between Lord Bethell and Baroness Campbell of Surbiton

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are extremely respectful of the Dilnot commission report and the recommendations in it, particularly those highlighted by my noble friend on Sections 15 and 16. It is one of many proposals that we will look at very carefully. We cannot make a commitment to anyone in particular at this stage but, as I said to the noble Baroness, we will put forward a full plan by the end of the year and will remain true to that commitment.

[Baroness Campbell of Surbiton (CB) [V]]

Can the Minister assure the House that any proposals on the funding of social care will ensure that working-age disabled people who use care services can access the support that they need to live a full and independent life in the community and that the funding will be sufficient to ensure that they no longer have to pay for it, avoiding inequitable and unfair financial hardship?

[Lord Bethell (Con)]

My Lords, I hear the noble Baroness loud and clear. Indeed, the needs and priorities of those with disability and the role of care for disability and the emphasis on care in the community are things that we hear loud and clear. I am not in a position to make any commitments on finances standing at the Dispatch Box at the moment, but the noble Baroness’s points are heard loud and clearly, and I would be glad to take them back to the department.

Covid-19: Vaccination

Debate between Lord Bethell and Baroness Campbell of Surbiton

Wednesday 20th January 2021 Lords Chamber

[Lord Bethell (Con)]

I am enormously grateful for my noble friend’s important gesture and pay tribute to his generosity of spirit. However, it is absolutely essential that he gets his vaccine as soon as he can, because he is at the top of the list. Morbidity is determined by age, not proximity. Healthcare staff are of course of deep concern to all of us, but those who are in PPE and in protected conditions have no greater chance of getting the disease than members of the general public. It is essential that we put those who have the highest risk of morbidity—the oldest—at the front of the queue, which is why we have the prioritisation list that we have.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, I thank the hard-working Minister and his Government for listening to the most clinically vulnerable groups and for reprioritising vaccination for all care workers, ensuring their greater safety. However, I am concerned that people under 65 with learning disabilities who live in care homes are in group 6 rather than in group 1, when ONS data clearly shows that they have been disproportionately affected throughout the pandemic. It is illogical that they now have to wait longer than other people with learning disabilities—older ones—in residential care. What plans do the Government have to ensure consistency and fairness in vaccination allocation to all people in residential care, especially in this category of people?

[Lord Bethell (Con)]

My Lords, the noble Baroness puts her point very well. There is a huge amount of sympathy and concern for those who have underlying conditions, and she is right that ONS data on those with underlying conditions demonstrates a higher hospitalisation and mortality rate. That is why we have put all individuals between 16 and 64 with underlying health conditions that put them at a higher risk of serious disease and mortality higher up the prioritisation list than others. However, it is age more than anything else that is the greatest determinant of morbidity, and that is why the list looks the way it does.

Covid-19: Restrictions

Debate between Lord Bethell and Baroness Campbell of Surbiton

Thursday 7th January 2021 Lords Chamber

[Lord Bethell (Con)]

My noble friend puts it well. I always welcome the challenge of noble Lords on any subject whatever, but I agree that underlying many of the objections to lockdown appears to be an assumption that some lives matter less than others. Whether you are asthmatic, diabetic, infirm or just old, I think that your life is worth just as much as everybody else’s. That is why I am extremely proud of the national effort to work together to protect those who are less advantaged and to protect our health service.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, thousands of people who are currently extremely vulnerable are now in greater danger from a lack of protection against the virus. Our care workers are more likely to come into contact with coronavirus, and requests for testing have escalated. Therefore, can the Minister please tell me when I and countless others who employ personal assistants can expect them to be vaccinated? Our workforce is not currently prioritised in the same way as care home workers and registered agency carers.

Covid-19: Vaccination Prioritisation

Debate between Lord Bethell and Baroness Campbell of Surbiton

Wednesday 25th November 2020 Lords Chamber

[Baroness Campbell of Surbiton]

To ask Her Majesty’s Government what plans they have to ensure that high-risk adults under the age of 65 are prioritised for access to any Covid-19 vaccination ahead of adults less at risk who are over the age of 65.

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

My Lords, the Joint Committee on Vaccination and Immunisation has found that mortality increases exponentially with age and has published interim advice accordingly. An age-based programme captures many with underlying conditions. None the less, the sub-committee is reviewing evidence on clinical risk factors, including the clinically extremely vulnerable, and the committee will update its advice if necessary after review.

[Baroness Campbell of Surbiton (CB) [V]]

I thank the Minister for his Answer. As someone who has been shielding since early March, I celebrate those involved in producing the vaccines in such a short time. However, I am concerned to learn that those under 65 in the clinically high-risk categories have been given a lower priority for the vaccine, knowing that 59% of people who have died from the coronavirus have been high-risk disabled people. Can the Minister please provide the JCVI’s evidence that informed the Government’s decision that those in high-risk categories under 65 are less vulnerable to the virus? Disabled people tell me that they have not felt shielded or protected throughout this pandemic, and this priority decision seems to confirm that belief. I urge the Government to think again.

[Lord Bethell (Con)]

I reassure the noble Baroness that no final decisions have been made; this is only interim advice. I point out in particular that the behaviours of individual vaccines might be quite different for different groups of people. It is only when we have the final phase 3 data on the vaccines that we will be able to make the decisions that she alludes to. We are considering the extremely vulnerable carefully. As I mentioned, a review is under way to see whether clinical factors should play a greater role in prioritisation.

Covid-19 Update

Debate between Lord Bethell and Baroness Campbell of Surbiton

Thursday 10th September 2020 Lords Chamber

[Lord Bethell (Con)]

I completely recognise the problem identified by my noble friend. I reassure her that the expert sub-group NERVTAG is developing a predictive risk model to enable a more sophisticated approach to clinical risk and to identify more clearly those who need to shield. The model incorporates known relevant risk factors, such as age, sex, BMI and ethnicity. We are working at pace and will continue to engage patients, those on the shielding list, healthcare professionals and the voluntary sector as we embed this important insight into what we do.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, the Minister will be aware of the difficulties faced by disabled and older people during the first major lockdown, such as insufficient social care support services. Will the government guidance to this group now change to address those difficulties, especially if the R rate keeps rising over the coming months? Will he now consider switching off the social care coronavirus easement powers, which were meant to be only a temporary measure, especially as local authorities are now telling us that they no longer use them? These easement powers are a major cause of anxiety among older and disabled people, and it would be an easy thing to do—just switch them off. They are no longer needed, yet they cause untold anxiety.

[Lord Bethell (Con)]

My Lords, I am not sure that I have a precise answer to the noble Baroness’s question on easement powers. It was my impression that they had not been used in the vast majority of areas—only in a few areas—and that, where they had been applied, their use had been of a mainly administrative rather than practical nature. However, I am happy to look into the question that she asks and to reply to her by letter.

Covid-19: Mental Health

Debate between Lord Bethell and Baroness Campbell of Surbiton

Tuesday 16th June 2020 Lords Chamber

[Lord Bethell [V]]

My noble friend is entirely right that the fears described as mental health issues are about not only Covid itself but the economic and social consequences. The impact on mental health of the financial crisis 10 years ago was profound, and largely driven by fears of economic hardship. That is paramount. Reducing the distancing is not currently government policy, but we have that under review and news is expected.

[Baroness Campbell of Surbiton (CB) [V]]

My Lords, the CQC reports that deaths of patients detained under the Mental Health Act have doubled in one year, to 122; 56 of these patients died with either confirmed or suspected Covid-19. In the same period, we have also seen the increased use of restraints and seclusion within secure units. What plans do the Government have to address and help reduce inequalities, to prevent further tragic deaths? What steps have they taken to review these questionable restraint and seclusion practices in psychiatric hospitals?

[Lord Bethell [V]]

My Lords, the investment we are making in mental health is profound. Our commitment is to £2.3 billion of extra funding by 2023-24. This is the sort of money necessary to provide the resources that will lead to a kinder, gentler type of mental health provision. I hope it will address the issues that the noble Baroness raises.

Hospitals: Patient Safety

Debate between Lord Bethell and Baroness Campbell of Surbiton

Thursday 21st May 2020 Lords Chamber

[Lord Bethell]

The situation of cancer patients is of grave concern. We have restored all the treatments, surgery and other systems necessary for treating cancer, and we have put in place testing facilities so that those with suppressed immunity can be tested and therefore enter treatment centres with confidence. It is a situation that we maintain under review, and we are working hard to ensure that drugs and painkillers are in ready supply.

[Baroness Campbell of Surbiton (CB)]

My Lords, there are many specialist units that provide ongoing support and life-saving treatment to people with long-term, complex disabilities. Many of these units have been turned into Covid wards, for example, the National Spinal Injuries Centre at Stoke Mandeville. Will the Minister inform me when these units are likely to return to their original function? What is happening to this cohort of patients in the meantime?

[Lord Bethell]

My Lords, the NHS chief executive, Sir Simon Stevens, has written to all NHS organisations signalling a change in the phasing of our response to Covid and inviting them to return operations given over to Covid to their previous use wherever possible. I hope very much that this will lower the impact on patients that the noble Baroness described. If she has a specific example in mind, I would be glad to inquire about it.