Covid-19 Update

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Baroness is quite right to ask the question, but I would say to her that it is not actually the regime that has changed, although the regime has changed; it is that the data has changed. Last Tuesday, I sat through Covid Gold, which is our big set-piece data session—a two-hour deep dive into national and local data. Every week for the past 70 weeks, that has been a very chilling experience where we have looked at the progress of and tactics of this awful virus, and I have often left it with a very heavy heart. Last week, I genuinely felt that we had reached some kind of turning point and, on Friday, when I sat in my kitchen, I felt a great weight beginning to lift off my shoulders for the first time in a very long time. I cannot disguise from your Lordships that there may well be more surprises left in this virus. I cannot promise that I will not be standing at this Dispatch Box giving bad news at some point in future, but, right now, I am more optimistic than I have ever been, and I think that the Statement by my right honourable friend the Secretary of State reflected that.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

My Lords, the time for questions has now elapsed and, with regrets and apologies to those noble Lords whom I was unable to call, we must move to the next business.

Carers: Support

Debate between Lord Bethell and Baroness Pitkeathley

Thursday 10th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely agree with my noble friend on commending the role of unpaid carers. We could not have got through this pandemic in the way we did without them. The system is complex and work is under way at the DWP to try to simplify it. As my noble friend knows from her significant expertise, this is a difficult task but we are very focused on it.

[Baroness Pitkeathley (Lab)]

My Lords, I declare an interest as vice-president of Carers UK, and in that capacity and further to his phone call this morning, will the Minister agree to meet Carers UK and interested colleagues in the House to discuss further the contents of this important report? I know he understands the moral and ethical case for supporting carers, as he has made that very clear on many occasions, but I want to ask him about economic issues. If carers reach breaking point—this report shows that many of them are at that point—and they give up caring, any other form of care costs vastly more, so will the economic contribution of carers be taken into account when proposals for social care reform are brought forward? Might we even hope that they could influence the Treasury?

[Lord Bethell (Con)]

My Lords, I can reassure the noble Baroness that economic considerations absolutely will be borne in mind. It is a huge challenge to take on the massive economic benefits of unpaid carers, and I will be glad to meet Carers UK—I have in fact already begun scheduling a follow-up meeting to this morning’s call.

Social Care: Person-centred Dementia Care

Debate between Lord Bethell and Baroness Pitkeathley

Monday 17th May 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am extremely grateful to my noble friend for raising Dementia Action Week, a time to celebrate the contribution of those who care for people with these conditions. I know from my own experience the incredible importance of personalised care and of being able to have loved ones at home for as long as they can safely and reasonably be cared for there. My noble friend puts the experience of living with dementia for families and carers extremely well. I entirely endorse her sentiments.

[Baroness Pitkeathley (Lab) [V]]

Does the Minister agree that person-centred care for dementia sufferers must include support for those who care for them? Since today’s survey by the Alzheimer’s Society says that carers are at breaking point and 95% of carers say that their caring has affected their physical or mental health, how and when is that support to be provided? Will support for carers be an essential element in the proposals for social care reform when they eventually appear?

[Lord Bethell (Con)]

My Lords, I completely acknowledge the pressure the pandemic put on both formal and unpaid carers. That is why we put £6 billion into local authorities, to help support them in the care they gave to carers. However, I acknowledge the concerns of the noble Baroness about the pressure of the last year and reassure her that the full spectrum of social care will be considered in the forthcoming review.

Future of Health and Care

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 23rd February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the objectives outlined in the White Paper are reasonably clear. The four headline objectives are to make it easier for different people in the system to join up to find ways to address complex issues, to remove unnecessary bureaucracy, to empower local leaders to make the best decisions for the populations they serve and to facilitate a range of other improvements held back by existing legislation.

This is a large Bill with a very large number of measures. It is not, and does not pretend to be, unified by a single thought or held together by an ideology or motivation of any particular philosophy. It is the application of a very large number of recommendations that have come out of a huge engagement with the NHS family, patients and other stakeholders. As such, it is a pragmatic, thoughtful and restrained approach to an important piece of legislative housekeeping of this much-loved healthcare institution.

[Baroness Pitkeathley (Lab) [V]]

My Lords, I share the concerns of my noble friend Lady Thornton about these proposals, but I take issue tonight with one particular assertion in the Statement that health and social care are

“part of the same ecosystem.”—[Official Report, Commons, 11/2/21; col. 506.]

As far as patients are concerned, this has never been the case as healthcare is free at the point of use whereas social care is and always has been charged for. In a debate in your Lordships’ House on 28 January, to which the Minister replied, virtually every speaker from all sides of the House said that this is the anomaly which must be addressed. Will the Minister add to his previous remarks about money and charging issues and assure the House that the Government will address this issue in the long-promised reforms of social care and recognise that warm words about integration and collaboration are simply not enough?

[Lord Bethell (Con)]

The noble Baroness is right that there are distinctive qualities to social care and medical care, but the lived experience of most patients and residents is that those living in social care are very often heavy consumers of the NHS. As far as most of them are concerned, the support and treatment they are given needs to be much more closely linked. For instance, it is a strange anomaly that many living in residential social care have a completely different budget and sometimes completely different staff providing their medical treatment and their care treatment. This is not a functional distinction that we are seeking to overturn; what we are seeking is to get those teams of people and the decisions made about the care of individuals working much more closely together. We are not seeking to introduce a revolution in the funding of social care, and the financing of social care by local authorities and private individuals will continue, but we would like to see the distinction between social care and NHS medical care become more seamless, more joined up and, therefore, more effective.

Covid-19: Over-75s

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 9th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we have now reached more than 80% of over-80 year-olds. Local vaccination services, of which there are more than 1,000 in England, co-ordinate the delivery of vaccinations to people who are unable to attend a vaccination site, including visiting homes, the personal homes of housebound individuals and other settings such as residential facilities for those with learning difficulties. The rollout of the vaccine to those at home is progressing at great pace and we are getting great feedback from the front line.

[Baroness Pitkeathley (Lab) [V]]

Is the Minister aware that many people over 75, notwithstanding their age, are providing care for family members—a spouse or an adult child with special needs, for example? Research by Carers UK shows that two-thirds of these older carers are providing more than 90 hours’ care a week, having had to take on more duties during the pandemic. One-third of them say that they are reaching breaking point and that their own health, physical and mental, has been severely affected. How will the Government ensure that sufficient support is available to these older carers, on whom so many depend?

[Lord Bethell (Con)]

My Lords, I pay tribute to all those elderly carers, who, as the noble Baroness quite rightly points out, provide a huge service to society, to their loved ones and to the community. We have put in place a tremendous amount of support for carers, including PPE support. We have changed the arrangements for domiciliary care so that we can restrict the spread of the virus, and we have changed the way in which domiciliary care is paid for. The noble Baroness is entirely right: we should not forget the considerable contribution made by a large number of unpaid carers, many of whom are themselves elderly.

International Year of Health and Care Workers

Debate between Lord Bethell and Baroness Pitkeathley

Monday 1st February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I pay tribute to the work of the noble Baroness in this important area. Her implied insight is exactly correct. We cannot be healthy and safe here in Britain if there are diseases raging around the world. It is both in our pragmatic self-interest and aligned with our values of partnership with other countries that we should indeed invest in the kind of training and support to which the noble Baroness alluded. I will definitely look into how we could do this better.

[Baroness Pitkeathley (Lab) [V]]

My Lords, the WHO puts health and care workers in the same category. Does the Minister agree that we in the UK do not see them as the same, since workers in the care sector are habitually worse paid, less recognised and more poorly trained and supported than those who work in the NHS? Would not the best way to celebrate care workers be to remedy these discrepancies in the proposals for the reform of social care, which the Minister has assured the House will be brought forward this year?

[Lord Bethell (Con)]

My Lords, the noble Baroness makes a completely fair point. Her observation is entirely right and her recommendation is one that the Prime Minister has made clear is part of his thinking. Social care workers have done a phenomenal job during this pandemic. Their role in supporting the elderly and infirm is extremely valuable to the whole country. It is only right that they should be treated fairly; a review of their pay and circumstances will be part of the social care package when that is announced.

Health: Brain Tumours

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 19th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord makes an excellent suggestion. Indeed, I am pleased to report that exactly such a strategy is in place by working with the Tessa Jowell Brain Cancer Mission, to which the department, the NIHR, NHS England and NHS Improvement are all active contributors. As part of the mission the department is funding new research through NIHR, encouraging new researchers to become involved, and we will be supporting the delivery of research as a key part of the new Tessa Jowell centres of excellence.

[Baroness Pitkeathley (Lab) [V]]

My Lords, many experts conclude that without new discoveries the outlook for patients with brain tumours is bleak. Given that many sufferers are in their teens or twenties and reliant on the support of their parents or carers, do the Government see it as a priority to support families, both during treatment processes and during the all-too-frequent bereavements?

[Lord Bethell (Con)]

My Lords, the noble Baroness is right that brain tumours and brain cancer are some of the most awful situations, particularly because they so frequently affect the young. That is why infrastructure spend on brain tumour research has increased. I am pleased to say that we received 62 applications for research funding between May 2018 and 2020, 10 of which have been funded so far, but more can be done in that area. Supporting families is, of course, part of the responsibility of the charities and trusts involved, and I wish the best to all those families who have been hit by this awful condition.

Covid-19 Update

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 6th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I thank the noble Baronesses, Lady Thornton and Lady Barker, for their remarks. The noble Baroness, Lady Thornton, is entirely right about the situation that we face. The latest update, as of 4 o’clock today, is that we have 14,542 daily positives today: 2,833 are in hospital with Covid; of those, 496 are on ventilators, and I am sad to report there were 76 deaths.

These are numbers that make us extremely focused on the challenge of Covid. Earlier today we debated the rule of six, when there was a large amount of challenge about whether such rules on social distancing were really necessary. We were reminded in clear terms about the social impact of separating those who love each other. Here we are talking about the impact on the health of the nation and the threat presented to those who are vulnerable, elderly and have pre-existing conditions. Getting the balance between these two things is extremely challenging, but that is the strategy of the Government—to bear down on the virus while protecting the NHS, education and the economy until we can see a way out through the vaccine, through therapeutic drugs and through mass testing. That is our approach.

I make no bones about it; the errors made over last weekend with the data was extremely regrettable. It undoubtedly causes grave concern among those in Parliament and the general public. I cannot hide from anyone the importance, impact, and severity of the situation. However, I would like to say a few words in mitigation. First, I pay tribute to those at PHE who have pulled together a remarkable system in extremely difficult circumstances, across the length and breadth of the country, integrating many systems into one. I know that that may seem like a trivial challenge and beside the point when we are dealing with a national emergency like this, but these are incredibly complex and difficult tasks. They have involved extremely committed personnel on the technology side of things who have personally checked a huge amount of the numbers. As my noble friend Lady Harding explained, it was through the perseverance of some of those personnel that the mistake was identified.

Between 17 and 23 September, 87,000 were identified through our testing and tracing programme; that is a phenomenal number of contacts where we had the opportunity to intervene and break the chain of transmission. Some 83.7% of those were reached and asked to isolate. I completely appreciate the concerns of those speaking in the Chamber today about the test and trace programme, but those figures are remarkable. That we have set up a system that can intervene in the lives of so many who are carrying coronavirus and can bring to bear such pressure on the disease after such a start as we had at the beginning of the epidemic is a phenomenal achievement. I know that the last thing one wants to be, at this stage of things, is a hollow champion of empty achievement, but that is a hell of a thing for this country to have got to.

There have been questions about the collaboration between the centre and northern leaders, and I cannot hide the fact that there are some quite fruity discussions on the pages of the newspapers and news channels between different community leaders. However, we have to be adult about this and acknowledge that there are different roles for different parts of government. The mayor of a city simply does not have a huge laboratory in which to do tens of thousands of tests a day. The mayor of another city simply does not have a control room filled with PhD analysts who can crunch the numbers and run massive supercomputers with complex algorithms to look at millions and millions of items of data within minutes. These are not the functions of local government, nor will they ever be.

Likewise, the JBC, the Department of Health and Social Care and the Cabinet Office do not have the local knowledge of what is going on on the ground and are not expected to speak a wide range of languages. We do not know what the behaviours are of people on a street-by-street basis. That is the role of local government, and it is through the collaboration of the local and national that we will beat this disease. To try to throw up a false dichotomy and set up test and trace as a scapegoat to blame and punish for the frustrations we all feel about the disease is counter- productive and reveals a shallow understanding of a complex situation.

The noble Baroness, Lady Thornton, said that perhaps care home testing should be sent to hospitals. In many cases, hospitals are involved in care home testing and handle the staff of care homes, but hospitals have to cover their own clinical demands, and pillar 1 is stretched to do the testing of hospital staff and patients. Landing that additional burden is not something that the NHS would welcome.

With regard to the northern leaders and their running commentary on the work of test and trace, I reassure the House that the conversations held in private on a daily—and sometimes hourly—basis have an altogether more collaborative tone. I have been privy to a large number of those conversations; there is a huge amount of expertise on both sides of the conversation, and one should not take too seriously the knockabout commentary in the newspapers and on TV.

The noble Baroness, Lady Barker, asked for an update on contact tracing, and she is entirely right. To have missed a substantial number of contacts during those days was a really big disappointment, but we have moved a huge amount of resources in order to catch up. There has been a phenomenal catch-up already, and I understand that my right honourable friend the Secretary of State will be updating the other place on the progress of that shortly.

I reassure the Chamber, however, that all those who had a positive test were informed promptly. There was no omission in that respect. Therefore, the primary index case, and the person of greatest threat to community transmission, was identified and isolated, and that chain of transmission was shut down.

I will now address the questions about the CMO and the JBC and their analysis of our numbers. I reassure the noble Baroness, Lady Barker, that the integrity of the CMO is unimpeachable; if he judges that the change in numbers has not changed policy, I reassure the Chamber that that is a good judgment that is completely consistent with the way in which we have behaved over the last few weeks.

The noble Baronesses, Lady Thornton and Lady Barker, both asked about Project Orbis. This is a welcome move, enabling the UK to join an international framework to provide concurrent submissions and regulatory views of oncology products, which may allow UK patients to receive earlier access to medicines in the future. I pay tribute to colleagues at the MHRA, who I know have worked really hard on collaborating with American, Canadian and Australian regulators. I am extremely optimistic about the dividends from this collaboration. It augurs, promisingly, similar future collaborations across the health sphere.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

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.

--- Later in debate ---

[Lord Bethell (Con)]

My Lords, I will tackle those in reverse order. I would not seek to be patronising for a moment. We value the contribution of local leaders enormously, and if I hit the wrong note then I regret that. What I was trying to get across is that the rhetoric in the public media and the realities of the day-to-day conversations between government and local government are not exactly as they might appear. The roles performed by both are complementary, rather than a zero-sum game. It is worth in this Chamber remembering that.

On procurement, the noble Baroness is entirely right; there is a real tension between the absolute requirement to move quickly to meet the challenge of Covid—to stand up facilities and services that did not previously exist—and to move on a national population-wide scale in a way that is not frequently seen in the health system. I can reassure the noble Baroness that a huge amount of work is being done on the auditing, checking and supervision of these contracts. They are not entered into in either a naive or flaky way—quite the opposite. We have put a huge amount of audit and legal resources into striking the right contracts. Cabinet Office colleagues provide a huge amount of analysis and challenge to the way in which these contracts are drafted and in checking against the delivery of the products and services involved.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

The noble Lord, Lord Robathan, has scratched, so I call the noble Baroness, Lady Bennett of Manor Castle.

[Baroness Bennett of Manor Castle (GP) [V]]

My Lords, questions in your Lordships’ House on this Statement have understandably focused on Covid-19, but the Statement as delivered in the other place is a broad-ranging survey. It starts by talking about treatments for Covid and then shifts to approvals for new cancer treatments; it looks at the expansion of urgent and emergency care; and those mysterious 40 new hospitals appear yet again, as the noble Baroness, Lady Barker, alluded to. In that context, I ask the Minister whether this Statement is sufficiently balanced. If this is a survey, where is the public health element?

Covid has exposed, even more than we recognised before, a deeply unhealthy society with terrible diets, inadequate opportunities for exercise, poverty, stress, and a mental health epidemic. We know from Victorian and early 20th-century times that it is public health measures that really make the difference. In facing up to tackling Covid, surely that is the direction in which we need to be looking. For example, new research today showing the impact of air pollution includes some very stirring suggestions that childhood exposure has an impact on the rates of dementia and Alzheimer’s. My questions to the Minister are these. Are the Government paying enough attention to public health? Is their strategy sufficiently balanced? Are they funding and doing enough on the broad measures that will create the healthier society that is so clearly desperately needed in the time of Covid or at any other time?

Covid-19 Update

Debate between Lord Bethell and Baroness Pitkeathley

Wednesday 23rd September 2020 Lords Chamber

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

My Lords, I am extremely grateful to the noble Baroness, Lady Thornton, for correctly characterising our response to the epidemic as “the best compromise possible”. It is a compromise. We have competing demands on our strategy: we have to protect lives and the NHS, but we also have to be conscious of the economy and the livelihoods of people, and we have to look after our students and pupils. The package of measures being put forward by the Government is the best compromise we can make for this moment, and we are unashamed of that compromise.

But the noble Baroness is wrong when she says we do not have a strategy. The strategy is really clear; it is to suppress the virus and protect the economy and education until the vaccine and mass testing are ready. It may not feel like it now, but there are glimpses of sunlight in the distance. The vaccine and mass testing provide a strong opportunity for us to suppress the virus. The strategy that we have put in place, as the Prime Minister rightly described in his address to the nation, is a way to “get through the months” until we have those arms at our disposal.

Both the noble Baroness, Lady Thornton, and the noble Baroness, Lady Barker, talked about the publication of data. I must confess that I have a genuine sense of confusion about that point, because we publish so much data. If there is one thing that this Government have got wrong, it is that we have published too much data too early. Too much has not been audited; too much has been put out as early as possible in our efforts to be transparent. Tomorrow, we will have a REACT survey; we will have an ONS survey; we will have test-and-trace data. There are SAGE minutes; there is NIHR; there is literally data coming out of every organisation of government. It is a fantastically huge amount of data. It is, I confess, extremely difficult to process all of that data all at once. The story it tells does chop and change at an amazingly fast rate—much faster than any experience I have ever had in my life. It is a rollercoaster that the Government have to ride.

I make no apology, however, for the fact that this Government have sought to act swiftly and to bring in measures quickly when the evidence has changed. In the last few weeks we have seen the latest example of that, where the infection rates have clearly lifted quickly in a way that was not expected, and we have had a discussion about that point in previous sessions in the Chamber. We have moved promptly to address the challenge that those worrying and concerning figures have presented to us.

The noble Baroness, Lady Thornton, raised the question of testing. I completely and utterly acknowledge the frustration of anyone who has not been able to get a test for themselves, for their child or for a loved one. It is true that we have more people wanting tests today than we have supply. However, I cannot avoid pointing out that—boy oh boy—we have come a long way since February, when we were doing 2,000 tests a day, to today, when we are doing 240,000 tests a day, and we are well on the way to doing 500,000 tests a day by October. Our aspiration is to do many times that within the near future.

That is not in any way to avoid the fact that I wish that we had more tests today. I want to convey to the House that this Government are 1,000% committed to answering the needs of this country for testing and have put every resource—human, technological, administrative and financial—behind the testing programme in order to deliver that promise.

The noble Baroness, Lady Thornton, raised the question of tone. I completely accept her point that the people of Britain have made a terrific sacrifice. There is no question at all of blaming the people of Britain, but we have to acknowledge that the spread of the virus indicates as a fact within itself that some people are not respecting the principles of social distance, hygiene and isolation, and we have to move in order to shore up the basic principles of this country and, by the way, of any country that is effectively fighting the virus—because, if we do not, the virus will sweep through the country.

I thought that the Prime Minister put that challenge very well, and in a way that a large majority of this Chamber would support. He said that the choice was before us: we could ask those who are vulnerable and older and shielded to simply lock the door and we could turn our backs on them. That is not the choice that this Government have made. They have made a choice to fight the virus at every level, because we love the people whom we care about; and it is a pragmatic choice, because if we find the virus growing in one part of our society, whether that is young people, health workers or the very young, then sure as night follows day, it will sweep through the rest of society.

I turn to the evidence on the curfew. This is a moment where I do not have the science at my fingertips. However, I have been in pubs and clubs after 10 o’clock enough times to know about the proximity and intimacy of late-night drinking, and I know that what happens then is not conducive to social distancing. This is a moment when plain common sense can tell you that a curfew will help to break the chain of transmission among young people. It is, unashamedly, a signal that we cannot go on like this and, in particular, that young people have to change their behaviours because the signs of infection are crystal clear. The prevalence among young people is too high, and we have to turn that corner.

The noble Baroness, Lady Thornton, asked about symptomatic and asymptomatic testing. The honest truth is that it is very difficult to tell; if someone is standing in a testing queue, we do not turn them away. By the way, in order to get a test, people do have to fill in a form, on which they are asked if they are symptomatic. What we do know from closer analysis and questionnaires is that a proportion of testees—between 20% and 25% at current rates—do not meet the strict criteria of our testing. I am grateful to the British public for beginning to show respect for the fact that every test counts, and for helping us direct them at the most needy.

The noble Baroness, Lady Thornton, asked about domiciliary care, an issue that has been raised in this Chamber a few times. I reassure all those in the Chamber, including the noble Baroness, in answer to her specific questions: yes to PPE, yes to testing and, by the way, yes to new guidelines that help minimise contact and the number of patients seen by each itinerant domiciliary worker; and yes to substantial extra funds for the social care system, specifically to help social care avoid relying on people travelling from patient to patient.

The noble Baroness, Lady Barker, asked about our relationships with local authorities and the local teams. I reassure her that we have moved a very, very long way in the last six months and that the picture she paints is understandable but out of date. We have come a huge way to share all of our insight, data, analysis and systems with local authorities, local directors of public health and local infection teams. Decisions on lockdowns now have a protocol whereby they are led by local teams after engagement with local civic groups and brought to the Secretary of State after they have been agreed at a local level.

Substantial sums—billions of pounds—have been given to local authorities to help them afford the kinds of local intervention that they choose to make in order to support the most vulnerable and disadvantaged during the epidemic. Money is given to local authorities for PPE for the people that they decide need it. Community health is being supported within the NHS in order for communities to be given the support they need. Engagement with local civic groups and business leaders is at a level I have never seen in government before.

I will give one example in relation to contact tracing, which the noble Baroness, Lady Barker, specifically asked about. In Leicester, money has been given to the local council for it to commission its own contact tracing, because we recognise that the local authority may well have the insights, cultural connections and sensitivities, and contacts needed for this kind of work. Therefore, we have provided financial and logistical support, and professional advice on how it can fill the gaps. We recognise that a national system cannot do everything, and that we have to be both national and local at the same time.

The noble Baroness, Lady Barker, ended by talking about the public mood and her concerns that people are reaching a state of despair. I completely recognise the exhaustion that many people feel about the state of the epidemic. I particularly recognise the morale within the NHS and social care, where people have worked incredibly hard, often in circumstances and doing tasks that they did not originally sign up for, and the sacrifice that many people have made, whether they work in the healthcare system, are supporting people they love, cannot do the things they want or are isolated and on their own. Of course, lots of people have made massive sacrifices, but I do not recognise the world she describes.

I think the public largely support the steps taken by this Government to suppress the transmission of this virus. After all, it is the virus that is the enemy. In many respects, we have an incredibly united country in fighting that enemy. The way in which the British public have supported the regulations and guidelines, which have had a tough effect on many people’s lives, demonstrates a huge amount of support. No Government —and certainly not this Government—will stretch that beyond what is tolerable. I posit to the Chamber that, to date, that support is still in place, and I remain extremely grateful for it.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

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

--- Later in debate ---

[Lord Bethell (Con)]

Absolutely not, my Lords. I pay tribute to British manufacturers, which have come an enormous distance—everyone from high-end manufacturers such as Burberry to those which once made recycled bin bags and have now turned their factories over to producing aprons and other important PPE articles. I pay tribute to my noble friend Lord Deighton, who has done an enormous amount to generate interest among British manufacturers of all kinds in order to support British PPE production. However, we have to have a balance to this. Some specialist goods, such as gloves, are best made elsewhere, but having the capacity and expertise to make 50% of our PPE means that we now have a route to making it all if necessary.

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

The last question is from the noble Baroness, Lady McIntosh of Pickering.

[Baroness McIntosh of Pickering (Con) [V]]

My Lords, I am delighted to hear that there are 30 million doses of flu vaccine. I remind the House of my interest with the Dispensing Doctors’ Association. How and when will the flu vaccine reach doctors’ and GPs’ surgeries? My noble friend will be aware that PPE will presumably have to be worn for the dispensing of each dose of flu vaccine, which means that the vaccination will be administered at a loss to dispensing doctors and others. That does not seem sustainable. Is that an issue that my noble friend will be able to address?

Pharmacies

Debate between Lord Bethell and Baroness Pitkeathley

Monday 20th July 2020 Lords Chamber

[Lord Bethell [V]]

As the noble Baroness is probably aware, the Secretary of State for Health and Social Care spoke at the annual conference of the National Pharmacy Association, at which he reiterated his commitment to the sector. The noble Baroness puts it well: pharmacies have something very special and valuable because of their trusted role. We very much want to see an enhanced role for pharmacies in the delivery of healthcare.

[Baroness Pitkeathley (Lab) [V]]

Does the Minister agree that independent pharmacies are of particular importance in rural areas, where they are often the only source of advice and information, as well as prescriptions and equipment, for people with disabilities and their families? Will the Minister confirm both his support for these rural pharmacies in particular and the Government’s commitment to ensuring that they can continue to provide all these vital services?

Social Care

Debate between Lord Bethell and Baroness Pitkeathley

Wednesday 8th July 2020 Lords Chamber

[Lord Bethell]

My Lords, that is very much the policy, but I emphasise the following. No plan can succeed unless it gains the support of a wide number of stakeholders, including cross-party support. Attempts to foist a plan from one group on to another simply will not work. That is why a bridge-building exercise is needed and why the Secretary of State has invited others to cross-party talks. I invite all those players to go into that process with a spirit of collaboration.

[Baroness Pitkeathley (Lab) [V]]

It is good to hear that the Minister now accepts that piecemeal reform of social care will not do. Can he confirm that the Government will consider finally putting social care on the same level as the NHS and creating a national care service in which risks and costs are shared? Sharing costs must apply to the whole population for the whole of their lives, not just when they are in need of care—in fact, from the cradle to the grave.

[Lord Bethell]

My Lords, the Covid epidemic has been a vivid experience for me personally. I have seen how the Department of Health and Social Care prioritises the care for those in social care. I completely endorse the noble Baroness’s view: piecemeal reform is not on the cards. The Government have made it clear that a holistic solution is needed. That is what we are working to achieve.

Nurses: Recruitment

Debate between Lord Bethell and Baroness Pitkeathley

Thursday 18th June 2020 Lords Chamber

[Lord Bethell [V]]

The noble Baroness is entirely right about retention: we are battling the leakage of skills and experience from the NHS. In September 2019, the Government announced a £210 million boost for front-line NHS staff, which includes, as she referred to, funding for a £1,000 personal development budget for every nurse, midwife and allied health professional working in the NHS. I would be glad to meet her and her colleagues to discuss what more can be done.

[Baroness Pitkeathley (Lab) [V]]

Among the extra 4 million people who have become carers during the pandemic, 72,000 left the NHS to take on caring responsibilities. Many will eventually want to return to work or training. How will the Government support those who will need to combine caring with employment or training? Are there plans to enable career progression, as the noble Baroness, Lady Verma, suggested, so that skills learned in caring can be translated into professional qualifications?

[Lord Bethell [V]]

My Lords, the Covid epidemic has thrown a spotlight on the essential role of carers, who have clearly played an enormous role in looking after those who are vulnerable. I completely support the sentiments of the noble Baroness that we should do more to help carers in their professional development so that they can convert to different secondary careers. I would be happy to look at any suggestions she has for ways in which we can do that better.

Covid-19: R Rate and Lockdown Measures

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 9th June 2020 Lords Chamber

[Lord Bethell [V]]

I share my noble friend’s frustration that this disease has proved a horrid and at times confusing foe, but I testify to the strength of the scientific advice we have been given. We do not expect scientists to agree. We believe that a degree of conflict is the right approach to trying to find the right answer. The role of the CMO and the Government’s chief scientist is to distil the advice of a great many sources into the best possible advice. We expect there to be a dialectic, with some form of conflict. I do not believe that we have made profound mistakes on the science. In fact, I believe that the scientists have been wise and thoughtful in the advice and recommendations that they have given us.

[Baroness Pitkeathley (Lab) [V]]

The Minister will know from research published yesterday by Carers UK—I declare an interest as a vice-president—that more than 4 million extra people have taken on caring roles at home for family and friends during the pandemic. Following the question asked by the noble Lord, Lord Crisp, I ask: in the event of a second wave, how will the Government ensure that these carers are provided with adequate PPE and access to services?

[Lord Bethell [V]]

I share the noble Baroness’s tribute to the nation’s carers. This week is Carers Week, and it is quite right that the House pays tribute to the contribution of all those who have looked after loved ones and neighbours in the manner she described so well. Support for carers has been at the front of our minds, but she rightly reminds us that we could do more in a second wave, and we are looking hard at ways of developing that support in the months to come.

Covid-19: Government Response

Debate between Lord Bethell and Baroness Pitkeathley

Wednesday 6th May 2020 Lords Chamber

[The Deputy Speaker (Baroness Pitkeathley) (Lab)]

Good evening, my Lords. The Virtual Proceeding on the repeat of the Urgent Question will now commence. I will call the Minister, who will repeat the Statement in the usual way. There will then be 10 minutes for questions, led by the Opposition Front Bench. The Minister will respond to each question in turn. I will call each Back-Bench Member on the speakers’ list to ask a supplementary question and the Minister will answer. I ask noble Lords to ask brief questions and give brief answers. Each speaker’s microphone will be unmuted prior to them asking a supplementary question and returned to mute once their question has finished.

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

My Lords, with leave I shall repeat the Answer given to an Urgent Question asked in the other place yesterday. In the repeat, I will use the most up-to-date figures, which have changed since yesterday. The Answer is as follows:

“Mr Speaker, we have flattened the curve of this epidemic, ensured that the NHS is not overwhelmed and expanded testing capacity to over 100,000 tests a day. As a Government, we are working resolutely to defeat the coronavirus. There are two important areas where I want to update the House today.

First, on the expansion of our work to test, track and trace, we have now built a national testing infrastructure of scale. Because we have this extra capacity, we will be delivering up to 30,000 tests a day to residents and staff in elderly care homes, making sure that symptomatic and asymptomatic staff and residents can all be tested. Our care system represents the best of us, supporting our loved ones with tenderness and dedication at their time of greatest need. Through this unprecedented expansion of testing capacity, we can give them the certainty and confidence that high-quality testing can provide.

Secondly, we are working to strengthen the resilience of the NHS. We currently have 3,382 spare critical care beds in the NHS, and that does not include the capacity provided by our Nightingale hospitals, including the 460-bed Sunderland Nightingale, which opened earlier today. We should all be very proud that we have built up the NHS so fast and that our collective national effort has helped to protect the NHS and flatten the curve. As a result, not only have we been able to restore some NHS services; we are in a position to be able to place the London Nightingale on standby. This is good news, because our NHS has not been overwhelmed by this crisis and remains open to those who need care, which means that this nation’s shared sacrifice is having an impact.

Throughout its time, this Chamber has borne witness to so much, and it has borne witness to the nation’s resolve once more. I am delighted that the British people are well and truly rising to this incredibly difficult challenge.”

My Lords, that concludes the Statement.

--- Later in debate ---

[Lord Bethell]

I completely acknowledge the situation and the testimony of the noble Lord. The response by British companies to the ventilator challenge was incredible and, at times, overwhelming. No discourtesy was meant to the firm that he mentioned and I completely take on board his comments about the importance of courtesy, respect and a proper feedback mechanism in such circumstances.

[The Deputy Speaker]

Lord Dobbs. As Lord Dobbs is not responding, we will go to Lord Liddle.

--- Later in debate ---

[Lord Bethell]

I return to my comments to the noble Baroness, Lady Thornton. In the Lords at least, Ministers have been on the Front Bench answering questions on Covid every day since the Lords reopened. Subjects have ranged from social security and housing to, in my case, the Department of Health and Social Care. We remain accountable for the measures that we have put in place. The media also have a huge role in that scrutiny. We remain committed to keeping Parliament open, despite the lockdown regime, and completely respect the importance of parliamentary scrutiny.

[The Deputy Speaker]

My Lords, the time allotted for the Statement is now up. The day’s Virtual Proceedings are now complete and are adjourned. Good evening.

Coronavirus (COVID-19)

Debate between Lord Bethell and Baroness Pitkeathley

Tuesday 3rd March 2020 Lords Chamber

[Lord Bethell]

In all these matters, the Chief Medical Officer guides the Government’s decision-making. We are looking at the modelling done by SAGE—the Scientific Advisory Group for Emergencies—which guides our decision-making. It has sophisticated computer analysis, which all this information is being plugged into, and that helps inform the decisions that we make about the guidance on isolating and social distancing. It is not possible to lay out today exactly what guidance we will issue or what decisions we will make in the weeks or months to come, but when those decisions are made they will be broadcast with energy through public communications.

[Baroness Pitkeathley (Lab)]

My Lords, the Minister will know that residents of nursing homes and care homes are overwhelmingly in the high-risk category. In the containment phase, is any advice being given about restricting visitors to such homes, either family or those who provide much-needed activities? When we get to the mitigation phase, is any advice being given about how to deal with staff shortages? I remind the Minister that when we talk about volunteers going into such institutions, volunteers themselves are overwhelmingly aged, and therefore in the high-risk category.

[Lord Bethell]

The noble Baroness raises an issue that is uppermost in our minds: the care of and provision for the aged, who are clearly the most vulnerable to this virus and whose support will be most hard-hit by the virus itself. It is clearly a dilemma that the Government are struggling with. We are seeking to delay the spread of the virus as much as possible so that the peak does not knock out in one go all those who provide support, so that mitigation provisions can be put in place. I reassure the noble Baroness that when we talk about volunteers, we are not talking just about family members: we are talking about full community commitment.