Social Care Reform

Debate between Lord Bethell and Baroness Falkner of Margravine

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord makes an entirely fair point. The needs of those who reside in Northern Ireland are paramount in our minds. I would be very glad to meet the noble Lord and discuss how their views and needs can be best incorporated in the policies we are developing.

[Baroness Falkner of Margravine (CB) [V]]

My Lords, does the Minister accept that public opinion has shifted, and that the public are now prepared to pay more to ensure that the elderly and vulnerable are properly looked after? Will the Government look at other countries’ attempts to deal with this tricky problem in terms of financial commitment? Japan has a surcharge for people over a certain age—I believe it is between 40 and 45 —and Germany has long had a solidarity tax to pay for particular hypothecated items. Will they at least look at this before the autumn spending review?

[Lord Bethell (Con)]

My Lords, I reassure the noble Baroness that we are looking at foreign parallels. The examples she gives are extremely instructive and thoughtful. I cannot speak for certain on where the public are on this, but I share her sentiments; I think the pandemic has demonstrated that the public are more connected with and thinking more about those in care than ever before in our nation’s history. It is exactly the right moment in terms of public sentiment to address some of these issues. The generosity of spirit towards the elderly living in care could not have been higher than it was during the pandemic. In that matter, I completely agree with the noble Baroness.

Covid-19: Restrictions

Debate between Lord Bethell and Baroness Falkner of Margravine

Thursday 7th January 2021 Lords Chamber

[Lord Bethell (Con)]

The CMO has given some guidance on this matter. He has made the observation that deaths from other flus are down, partly because of the social-distancing that is part of the lockdown. He has also pointed out the very sad, but I am afraid inevitable, possibility that the large amount of infection that has grown up in the last few weeks will in time lead to further deaths. This is an uncomfortable piece of speculation but, as sure as night follows day, I am afraid that infections and hospitalisations will lead to further deaths. We are running at nearly 1,000 a day at the moment and that number is set to increase.

[Baroness Falkner of Margravine (CB)]

My Lords, I refer to my interests as set out in the register and point out that my remarks are personal. Compliance and transmission are interlinked, and transmission rates are hugely dependent on public compliance. So I echo the point made by the noble Lord, Lord Herbert, that, although senior libertarian individuals and leaders point to the fact that individuals can make their own assessments of risk, that is not the case. Does the Minister agree that complying with the rules is a public duty that we owe one another and not a matter of choice?

[Lord Bethell (Con)]

The noble Baroness makes the point well. My observation is that the British public are extremely supportive of both the lockdown and the measures involved. Of course, we all see highly visible exceptions in our travels and when we work, but by and large the British public have massively complied with the measures without any severe form of compulsion, and for that I pay an enormous amount of tribute. In the first lockdown, we had to behave as though the person we saw near us might have the disease; the suggestion now is that we should behave as though we have the disease. It is that discipline that we all need to apply.

Covid-19: Intensive Care Treatment

Debate between Lord Bethell and Baroness Falkner of Margravine

Thursday 29th October 2020 Lords Chamber

[Baroness Falkner of Margravine]

To ask Her Majesty’s Government whether any part of the NHS has operated under policy guidelines described as a “triage tool” which determine intensive care treatment for patients with Covid-19, and whether such guidelines will be used in the future.

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

My Lords, claims that frail and elderly patients were denied care in wave one of the coronavirus pandemic, in part because of the triage tool developed by the NHS in case it was overwhelmed, are categorically untrue. The Government are ultimately responsible for national policy on public access to NHS services. However, decisions on who will benefit from care are made as part of normal clinical decision-making by clinicians. Guidance to help clinicians make rational evidence-based decisions in the event of ICUs being overwhelmed was commissioned but was halted when it became clear that the NHS would not be overwhelmed.

[Baroness Falkner of Margravine (CB)]

My Lords, I think that the whole House will be grateful to the Minister for his unequivocal rebuttal of that extremely concerning story. Let me be clear that this Question is not intended to criticise the NHS, for which we all have the highest regard. However, according to that Sunday Times story, under conditions of extreme stress, consideration was given to guidance that could have amounted to age discrimination. Does he agree that there is a need for the NHS to uphold its public sector equality duty? Will he provide reassurance that these triage tools should not be used to prioritise patients on any basis other than clinical need either this winter or going forward as routine?

[Lord Bethell (Con)]

My Lords, I am grateful for the opportunity offered by the noble Baroness to reinforce the point. Age discrimination is absolutely forbidden by the NHS constitution. The CMO wrote to NHS trusts on three occasions to reiterate that point. I quote a letter published on 7 April:

“The key principle is that each person is an individual whose needs and preferences must be taken account of individually. By contrast blanket policies are inappropriate whether due to medical condition, disability, or age.”

Covid-19: Response

Debate between Lord Bethell and Baroness Falkner of Margravine

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

It may appear from the outside that there are differences between the devolved nations and England, but my experience is that the four-nations approach to combating Covid has been extremely united and effective, and that we have worked extremely well together. It is true that we move at a different pace on some subjects, but we are generally moving to the same destination and in the same direction, and for that I pay tribute to my colleagues in the devolved nations.

[Baroness Falkner of Margravine (Non-Afl) [V]]

My Lords, the United Kingdom has spent 30% more than any other EU country on PPE. Of the UK’s PPE contracts, 73% went through without any competition at all, compared with 61% in Europe. The Department of Health had 137 contracts totalling more than £1.9 billion, none of which was subject to competition, according to Spend Network. The Department of Health has told today’s Financial Times:

“We have a robust process in place to ensure that orders are of a high standard and meet commercial due diligence.”


Which of those two statements is correct—that from Spend Network, or that from the Department of Health?

[Lord Bethell [V]]

Anyone who has stood at the Dispatch Box to answer questions on PPE, as I have done, will feel extremely proud of the fact that we have managed to purchase a very large amount of it under very difficult circumstances. We have also responded well to the challenge of a global collapse in the PPE supply chain. Despite appearances, we have substantial stockpiles of both near-term seven-day and further-term 90-day PPE resources; by that, I am very pleased. Competition does not necessarily guarantee either quality or delivery. I pay tribute to colleagues in the NHS, in the Cabinet Office and at DH who have, under extremely difficult circumstances, thoroughly checked out the delivery and bona fides of the contracts we have signed while working closely with the NSA to avoid fraud. We continue to work closely with both domestic and overseas suppliers, which I would argue has delivered a valuable result for the country.

Medical Teaching and Learning: Ethnic Diversity

Debate between Lord Bethell and Baroness Falkner of Margravine

Tuesday 14th July 2020 Lords Chamber

[Lord Bethell]

I am not satisfied; the statistics are not good enough. Twenty-nine per cent of BAME staff experienced harassment. That is not good enough; we must work harder.

[Baroness Falkner of Margravine (Non-Afl) [V]]

Perhaps I might take the Minister upstream a little to the choices made by different communities about entering medical school. What work is being done at 15 and 16 year-old level in schools? Has his department had any conversations with Ofsted about the career choices that kids from diverse communities are making? Many realise that they want to go into medicine when it is too late and they have missed the appropriate A-level subjects so to do.

Independent Residential Care

Debate between Lord Bethell and Baroness Falkner of Margravine

Tuesday 7th July 2020 Lords Chamber

[Lord Bethell [V]]

The noble and right reverend Lord is entirely right: the value and contribution of care home workers to society and to the communities that they work in go way beyond the actual monetary value of their salary. We completely respect and pay tribute to the contribution that they have made, particularly during this epidemic. We have sought during the epidemic to run recruitment campaigns to bring in new workers and to help plug any skills gaps, but this is the kind of issue that needs to be addressed in a long-term plan. We have already started work on that plan and look forward to bringing it to Parliament when the kind of cross-party support that is needed is in place.

[Baroness Falkner of Margravine (Non-Afl) [V]]

My Lords, I welcome the initiation of cross-party talks. The Minister will know now that more than two-thirds of the public want to fund health and social care through higher taxation. Will he now accept that as a principle if that is the result of the cross-party talks, instead of his Government ruling out tax increases?

[Lord Bethell [V]]

The noble Baroness makes her case well. There are a large number of considerations in this matter—my noble friend Lord Forsyth has already made a strong case for the recommendations of the Economic Affairs Committee—and we need to look at all of them. It is an extremely complicated area. We need to get buy-in from cross-party support and from a wide number of stakeholders and the businesses involved. Once we are in that position, we will be able to make a plan that delivers a long-term solution to this knotty problem.

Covid-19 Update

Debate between Lord Bethell and Baroness Falkner of Margravine

Wednesday 1st July 2020 Lords Chamber

[Lord Bethell]

My Lords, we take the PHE report extremely seriously but there is still work to do in understanding how the disease affects different groups, including ethnicities. Some effects are behavioural, such as obesity; some are social, such as population density, to which my noble friend alluded; and some might be genetic. It is not clear which of those three is the main driver and what the balance is between the three. We are investing a large amount in medical and clinical research to understand that dilemma. In the meantime, we are prioritising the safeguarding of BAME workers in the NHS who might be at risk and in need of specific treatment.

[Baroness Falkner of Margravine (Non-Afl) [V]]

My Lords, what specific plans do the Government have to host people in Leicester who test positive for Covid-19 in hotels to isolate them from multigenerational households and to keep the other members of the family safe?

[Lord Bethell]

The noble Baroness asks a sensible question. It is, however, an unfortunate truth that, by the time someone tests positive, it is likely that they may have infected other members of their household. So, our current guidelines are that anyone who tests positive should isolate themselves with all other members of their household for 14 days, thereby containing the virus and breaking the chain of transmission.

Covid-19: Response

Debate between Lord Bethell and Baroness Falkner of Margravine

Wednesday 3rd June 2020 Lords Chamber

[Lord Bethell]

I completely agree with the noble Lord. The Prime Minister said that it was down to the negotiating table to sort out this important matter. I will leave it to the negotiators.

[Baroness Falkner of Margravine (Non-Afl)]

I understand that we have to wait for the data to come through that addresses what underlying health conditions and comorbidities might impact on BME critical care and death rates from Covid, but, to reassure the community while we are waiting for further information, I wonder whether the Minister’s publicity campaign could be very directly targeted at those vulnerable groups to make it very clear that they should avail themselves of the testing capacity available—indeed, that they might even get priority—so that they have some reassurance that, should they have any of the symptoms, they will be seen to as soon as possible?

[Lord Bethell]

The noble Baroness makes a powerful point. The frustrating truth is that many in the groups and communities of which she speaks take the fewest number of tests. Getting through to these groups is extremely important, so they can seek the clinical help they need if they are suffering from Covid. We have worked extremely hard with our marketing department to ensure that hard-to-reach communities get the marketing messages that will be effective. The noble Baroness provides a really reasonable reminder and I will redouble my efforts to ensure that those marketing messages are focused on the right communities.

Covid-19: NHS Contact Tracing App

Debate between Lord Bethell and Baroness Falkner of Margravine

Monday 18th May 2020 Lords Chamber

[Lord Bethell]

My noble friend is entirely right. The science on immunity is confounding and we do not fully understand it, although we are investing a huge amount of time, money and effort into understanding it better. We believe that there may be an opportunity to understand immunity better, and that will inform and make safe people’s commitment to going back to work. No decisions have been made yet, though, and we have in our minds all the reservations that my noble friend described.

[Baroness Falkner of Margravine (Non-Afl)]

Given what we know about the NHS app, I have to say that my greater concern would be about the data held by Amazon or Google, rather than by the NHS. Does the Minister accept that the countries implementing track and trace, particularly those in the EU, are all countries that have an ongoing system, decades-old, of using ID cards? Would the Government consider the fact that trust in government in those countries, even privacy-obsessed Germany, is higher due to the state having held data, not centrally but in some form, through an ID card system? Maybe they should look at that.

[Lord Bethell]

My Lords, ID cards do not form part of the British tradition. We work on a system of consent and we have a very high level of trust in the Government. The app is particularly well suited to a country that has a universal NHS system, and that is one reason why we have designed it in the way that we have.