Covid-19

Debate between Lord Bethell and Baroness Wheatcroft

Wednesday 21st July 2021 Lords Chamber

[Baroness Wheatcroft (CB)]

My Lords, I too send my best wishes to the noble Baroness, Lady Penn. I echo the concerns of the noble Baronesses, Lady Thornton and Lady Brinton, over the contradictions over nightclubs and pubs and when we are going to insist on double vaccinations. Why not now? Why wait until September?

It is the contradictions in government policy that continue to cause concern. It is good to know that we are going to insist on vaccination for those working in care homes but why not across the NHS? Surely there is good sense in doing that.

We have lessons to learn from the treatment of Covid. We need to learn them as quickly as possible before the next emergency strikes. Sir Jeremy Farrar, the chief executive of Wellcome and a very eminent member of SAGE, has been coruscating about the failure to launch an inquiry now and to wait until March. Can the Minister explain why, when different people would be involved in conducting an inquiry, it cannot get under way immediately and report back as quickly as possible?

[Lord Bethell (Con) [V]]

My Lords, I have complete sympathy with the noble Baroness about the fast-changing nature of our response to this pandemic. However, as I have said from these Benches before, it is the virus that chops and changes and delivers us surprises. Who would have expected two or three months ago that the delta variant would have hit us as hard as it did?

We are trying to be agile and to adapt to changing circumstances. The guidelines on nightclubs and pubs will be published and when they are published, they will, I hope, be clear. The arrangements for September are being arranged right now. On mandatory vaccination in the NHS—which I think is what the noble Baroness inquired about—we have signalled our intention to consult on mandatory vaccination across the healthcare service. I hope that I will be able to share further details on that with the House at a future date.

In terms of an inquiry, of course I hear Sir Jeremy Farrar. However, I and many others are already working all the hours that God gives us on responding to this pandemic. There is no extra bandwidth for dealing with an inquiry. We are doing our best and we will look back and learn the lessons when the moment is right.

Covid-19

Debate between Lord Bethell and Baroness Wheatcroft

Thursday 15th July 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, in terms of care home staff vaccination, we are in the midst of a consultation on the subject. The noble Baroness should not necessarily pre-empt the consultation. We take into account the views of those we are consulting with. It is a measure that has caused an enormous amount of concern both here in the Chamber and with the public. It feels right that we should be consulting on a measure that ultimately protects the elderly and vulnerable.

In terms of certification, the ultimate use of certification in domestic surroundings has not been fully decided. At this stage, with the country enjoying the benefit of the vaccine, it seems right to be leaving that to businesses to decide how they wish to use it themselves.

[Baroness Wheatcroft (CB)]

My Lords, I want to follow on from the question from the noble Baroness, Lady Chakrabarti. The Government believe that passive smoking poses risks to individuals; hence they ban smoking in offices, pubs and other public places. The science has persuaded the Government that, during a pandemic, the wearing of masks in public places helps prevent individuals from passing on Covid to others, which even those who have been double vaccinated can do. In the Statement, the Government say that it is expected and recommended that masks will continue to be worn. Can the Minister explain why smoking should be governed by government diktat, but mask-wearing should be a matter of personal choice?

[Lord Bethell (Con)]

The noble Baroness makes her points extremely well. I support the ban on smoking in public places for exactly the reasons she describes. However, I do not support a mandatory, legal ban on sneezing, although I do not like people sneezing in my presence. We have to strike a balance between mandation and voluntary arrangements. We also have to choose the right people to make these decisions. Central Government cannot make every single decision on every single matter. I recognise the concern of both the public and of noble Lords in this Chamber about masks. It feels right to leave it to local decision-makers, politicians and companies to take the public with them and to enforce this measure which, I entirely agree, is of benefit to us all.

Covid-19 Update

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 6th July 2021 Lords Chamber

[Lord Bethell (Con)]

Yes, I can reassure the noble Lord that we have in place a strong supply chain that will meet the schedule that has been outlined by my friend the Minister for Vaccinations, Nadhim Zahawi. We are also seeking to develop new vaccines, should they prove necessary—because it has been one of the surprising but reassuring aspects of our vaccination policy that a third boost is as useful and efficacious as it is. However, should another variant emerge that somehow eludes the current suite of vaccines, we have in place arrangements to develop, manufacture and distribute more.

[Baroness Wheatcroft (CB) [V]]

My Lords, the Statement is about the need for a return to normality—[Inaudible] —businesses depend for their trade on those who go to work in offices in cities and town centres, so can the Minister—[Inaudible]—and what instructions will they get about 19 July?

[Lord Bethell (Con)]

My Lords, I did not quite catch all the details, but I got the gist of the question. I reassure the noble Baroness that the return to offices and our high streets and towns is of paramount importance, and we are working on guidelines on that matter. I cannot guarantee that absolutely everything will go back to exactly what it was: we have learned lessons from the pandemic, and we want to put this country into a shape where we are resilient should another one emerge. However, it is my hope that the economy will bounce back extremely quickly, and there is good evidence that it will.

Hospital Waiting Lists

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 29th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the publication of NHS plans around the catch-up is happening on a regular basis, and there will indeed be further communication from the NHS on this. On the use of private email, I reassure noble Lords that I have read and signed the ministerial code and I seek to uphold it in everything I do.

[Baroness Wheatcroft (CB)]

Specialist surgical hubs have been demonstrated as an effective way of dealing with surgery and would be particularly helpful in dealing with the backlog of cases. Can the Minister say what plans there are for developing specialist surgical hubs, as the Royal College of Surgeons has advocated?

Covid-19: Vaccines and Pregnancy

Debate between Lord Bethell and Baroness Wheatcroft

Monday 14th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, the up-to-date advice is this: get the vaccine. That is absolutely being promoted very widely.

[Baroness Wheatcroft (CB)]

My Lords, if the up-to-date advice is “Get the vaccine”, which is exactly what it should be, what work is being done to assess the effect on women of having Covid during their pregnancy? What is the effect on the child? Is there any research on that?

[Lord Bethell (Con)]

My Lords, the noble Baroness points to one of the challenges of longitudinal research: the babies have not been born for very long, of course. We need to do long-term studies to understand the effect. There is no evidence at all of a negative outcome but we will need to monitor that; research resources will be dedicated to looking at it.

Covid-19: Government Handling and Preparedness

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 8th June 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we will need to wait for the inquiry for a thorough post-mortem on what was or was not thoroughly prepared for. It is fair to say that the developed nations of the world had invested a huge amount in modern clinical medicine, yet that did not serve to prepare us for the precise circumstances of a respiratory pandemic. I pay tribute not only to those in the public health profession but to those in the military, who did so much and moved so quickly to deliver the kind of protection that this country has benefited from during the pandemic.

[Baroness Wheatcroft (CB)]

My Lords, when the pandemic hit this country, one of the reasons we were so badly hurt was the shortage of intensive care beds, the number of which had been run down progressively for many years, despite the World Health Organization pointing out the inherent dangers in that. So could the Minister say, without waiting for the inquiry, what our policy on intensive care beds is now?

Care Homes: Insurance Indemnity

Debate between Lord Bethell and Baroness Wheatcroft

Wednesday 19th May 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is right to point to provisions for the future and for future pandemics—or any future waves. I reassure him that arrangements are in place to ensure the safe transition of patients and residents from the NHS to care home and back again, but that is not a reason to turn the insurance arrangements of the care home industry on their head. Care homes simply cannot have the kind of risk-pooling arrangements that suit major NHS institutions.

[Baroness Wheatcroft (CB)]

My Lords, huge numbers of care homes are very dangerously financially leveraged, having been bought by private equity over the last decade, when at least £1.7 billion was ploughed into these purchases. Interest payments are heavy and insurance payments going up will add to their burden. Can the Minister assure us that before local authorities pay these privately owned, leveraged care homes, the CQC or some organisation will examine the financial stability of individual homes?

[Lord Bethell (Con)]

My Lords, the financial stability of the care home sector is, as the noble Baroness rightly pointed out, something that we monitor extremely closely. There will, of course, always been new entrants and new departures from such a rich and varied sector. That is not something to be regretted; it brings innovation and new opportunities to the sector. She is right that the potential increase in insurance payments is something that we need to factor in to the finance. That is why we have brought in the designated settlement support scheme and increased the support from local authorities for social care.

Covid-19: Resuscitation Orders

Debate between Lord Bethell and Baroness Wheatcroft

Wednesday 24th March 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we could not be moving more quickly. We got the report out before the end of the pandemic; we have acknowledged the issue and written numerous letters into the system, as I have mentioned; and we are putting in place the resources needed to support the necessary training and interactions. We are taking this extremely seriously and we are moving as quickly as we possibly can.

[Baroness Wheatcroft (CB) [V]]

As the Minister has suggested, decisions on end-of-life care are best taken long before they are necessary, so could he encourage GPs to offer all patients the opportunity to make an advanced decision to refuse treatment, properly witnessed by two individuals, if it is to become effective?

[Lord Bethell (Con)]

The noble Baroness is entirely right, and a growing number of people do take that kind of pragmatic approach. But we have to be realistic: many people are not prepared to put those sorts of arrangements in place until much later on in their lives, and it is often the family and relatives of those in care who have to be part of those important conversations.

Covid-19: Self-Isolation

Debate between Lord Bethell and Baroness Wheatcroft

Wednesday 10th February 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, we are extremely concerned about the mental health impacts of Covid on all those who are feeling the effects most harshly. A substantial amount of money has been invested by NIHR into the mental health effects of Covid, and it is up to the institute to find out the impacts to which my noble friend refers.

[Baroness Wheatcroft (CB) [V]]

My Lords, it is a legal requirement to self-isolate if you test positive or are told to self-isolate by NHS Test and Trace. However, Test and Trace counts as having been traced those who live with someone who tests positive. I believe that this is a dubious method of counting. Will the Minister tell the House whether those people who have not been contacted directly by Test and Trace can therefore be penalised if they fail to self-isolate?

[Lord Bethell (Con)]

The method of counting is done in the way that it is at the moment because we did try the way that the noble Baroness recommends and that led to all sorts of confusion. It led to people having dozens of SMSs and being called relentlessly by the same staff because other members of their household had been identified. It led to a very large number of complaints, including from noble Lords on the Opposition Benches who read to me at great length the complaints of their contacts. We rationalised the system along the lines we currently implement, and that has led to a much more effective system. The feedback from our questionnaires to households is entirely positive. Having isolated myself, with my considerable household of seven people, I can tell noble Lords that it is a huge relief that the account management system is now around households rather than individuals.

Health: Eating Disorders

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 19th January 2021 Lords Chamber

[Baroness Wheatcroft (CB) [V]]

My Lords, parents of adult children suffering from the most extreme eating disorders say they are often desperate to help but powerless because of an insistence on patient confidentiality. The desire to give autonomy to patients too often extends to those whose sickness with eating disorders makes them unable to take sensible decisions for themselves. Will the Minister agree to examine the conflict between these two wishes and how it could be resolved?

[Lord Bethell (Con)]

My Lords, the noble Baroness alludes to a conflict for which there is no easy answer. I completely sympathise with any parent whose child is exhibiting eating disorder issues. It is the most awful and frustrating situation for any parent to see their child in a self-destructive loop for which there seems to be no intervention possible, but patient safety is patient safety, and this is the conundrum that faces any mental health situation. The Mental Health Act is undergoing review at the moment—I am grateful to Sir Simon Wessely for his report, which we debated yesterday—and these are exactly the kinds of issues that we are looking at. I express profound sympathy for all those who find themselves in this awful situation.

Mental Health Act Reform

Debate between Lord Bethell and Baroness Wheatcroft

Monday 18th January 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, I confess that the noble Baroness has me on the hop there, because I had not noticed that LGBT issues are not mentioned in Sir Simon’s report. I share the noble Baroness’s surprise about that. Let me return to the document and I will address her point in correspondence.

[Baroness Wheatcroft (CB) [V]]

My Lords, Sir Simon found excessive use of restrictive practices in mental health institutions. Many of us will be familiar with the appalling case of Bethany, the autistic teenager who spent three years in what can be described only as a cell, in an appallingly inhumane regime that kept her locked up in solitary confinement and with no physical contact with other people. Only when her father went to court did she escape, and she is now living happily in an open-plan institution. Can the Minister assure us that such treatment will never be condoned again? We cannot wait for legislation on this.

[Lord Bethell (Con)]

My Lords, I certainly do not condone that treatment in any circumstances, but I acknowledge the noble Baroness’s point: there have been some instances in the past—reasonably rare but consistent—where those with autism and learning difficulties have been subject to the most inappropriate regimes and where a completely different type of support, therapy and accommodation from the kind found in mental health institutions was needed. The campaign to which the noble Baroness alluded is entirely right and we are moving quickly to address those points.

Department of Health and Social Care: Unpaid Advisers

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 17th November 2020 Lords Chamber

[Lord Bethell (Con)]

I always take the words and advice of former Attorney-General Dominic Grieve extremely seriously, and I value his opinion greatly.

[Baroness Wheatcroft (Non-Afl) [V]]

My Lords, I understand why the Government need as much help as possible in securing PPE in a time of emergency, but I struggle to understand why there still seems to be such a demand for public relations help. We recently learned that Kate Bingham, who is in charge of the vaccine programme, spent £690,000 on external PR help. Is it not the case that the Department of Health and Social Care has extensive PR expertise on its team? Is the problem that this Government is still too involved in fighting an election campaign rather than fighting Covid?

[Lord Bethell (Con)]

It is a reasonable question and let me be clear. This year, we are seeing a massive change in the behaviours of our entire population—from the big macro challenges such as the rule of six, social distancing and adherence to infection control procedures, through to different uses of NHS and medtech. This morning, I spent my time looking at the marketing for “111 First”—the important new way of using 111 that will give people guidance on using the service before they get to A&E. This has been possible only because of the change in the use of medtech and the changing attitude to telephones and the internet brought about by the pandemic. The noble Baroness is right that there is a big focus on communications right now, but that is because things are changing so quickly and we need to get the message across to the population in clear, persuasive terms, to provide the guidance they need to protect and save themselves.

Covid-19

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 20th October 2020 Lords Chamber

[Lord Bethell (Con)]

I reassure the noble Lord that his friend’s notification came from a new feature of Apple phones called “Exposure Notifications Express”. This is something that we have worked hard to incorporate in the existing app. I slightly suspect that, if she has a new version of the NHS app, she will not receive these notifications any more. We are grateful to Apple for enabling its phones to work in developing countries, but there has been some turbulence with our own app, which we think we have resolved.

On quarantines, I say that, as a follower of these debates, the noble Lord will know that the CMO’s view is that testing on arrival will capture only 7% of infections, and it is very difficult to apply quarantines to get people to commit to staying longer. However, we are committed to running pilots to try to open the kinds of schemes that he describes, and I would be happy to report back on their development.

[Baroness Wheatcroft (Non-Afl) [V]]

My Lords, at the beginning of this debate, the Minister gave a very spirited defence of the test and trace system. This morning, my daughter and her 15 month-old daughter were tested, and it was very efficiently done, but they were told that they should expect results in two to three days’ time. The Minister mentioned 24 hours; what timetable are the Government trying to operate on for test and trace because, clearly, if there are two days that are fallow, an awful lot of people risk being infected?

I will also address the issue of gyms. The noble Baroness, Lady Thornton, talked about the lack of clarity at the beginning of this debate. If people are to stick to the rules, they need clarity. I do not understand why gyms are open at all, quite honestly. It seems to me—as the Minister indicated—that they are potential hotbeds for coronavirus. However, we are told that discretion is given to local authorities to decide what they do and do not allow. I recall that Manchester was absolutely determined that it would like to stop alcohol sales at the same time that, if not sooner than, pubs were forced to close, but it was not given discretion over that. I would be grateful if the Minister could explain when local authorities do and do not have discretion.

I also wonder whether the Minister could tell the House the position on travel to work. Office workers are told to work from home if it is possible for them not to work from the office, but there does not seem to be a ruling that says, “Do not go to work in an office unless you absolutely have to”. What counts as essential? What instructions are the Government giving to civil servants about whether they should travel to work? We are told that gatherings that are “reasonably necessary” can take place in office environments with no limit on the numbers involved. In the circumstances, that seems crazy. If the Minister could clarify the position, I would be grateful.

[Lord Bethell (Con)]

I reassure the noble Baroness that 24 hours is our objective, and it is clear that a 24-hour target is right. Having swift turnaround is conducive to effectiveness, and that is what we are trying to do. There has been a very large increase in demand in the last 11 weeks, which has put pressure on our operations and pushed back some of our turnaround times. We are working extremely hard to address that; new capacity is coming on-stream all the time, and we are hopeful that that can be turned around very quickly.

The noble Baroness is entirely right to raise her point on clarity, which is very similar to those raised by others, including the right reverend Prelate. There is a really important balance that we have to get right here because to have communal buy-in to our measures, we need to somehow mobilise leaders that people trust, from their faith community, their local community or other leadership groups that they subscribe to.

However, to give people a role in the decision-making about what measures are to take place in one area or another, there will be an uneven application of regulations—what happens in one place will not be the same in another. We have made a commitment to a partnership between national and local government, and we are trying to manage that complex partnership at the moment. As noble Lords know from the discussions in the other place and our conversations with Manchester, this is an extremely bumpy affair and it does not always work out well.

However, we are committed to doing this precisely for the reasons the noble Baroness described: to have buy-in, we need to mobilise all the country and all the people who are respected by those who adhere to the rules. That is why we take the approach we do. It means that gyms will be open in Lancashire but not in Merseyside. It is argued that this is a complexity that the British public can handle. It also takes us into very public conversations about funding, the allocation of resources and the establishment of new testing facilities. We believe it is worth the administrative and political effort to try to do that. There are also delays to the implementation of some of the restrictions. The British public will form their own judgment on their politicians and whether that is worth their while. These are the prices and friction costs to the local/national partnership that we are committed to, which has been advocated on the Benches of this Chamber for many months.

Hospitals and Nursing Homes: Do Not Resuscitate Notices

Debate between Lord Bethell and Baroness Wheatcroft

Thursday 1st October 2020 Lords Chamber

[Baroness Wheatcroft (Non-Afl) [V]]

My Lords, the Minister has already said that he quite understands that there will be people, particularly the elderly, who do not wish to be resuscitated. One easy way of ensuring that resuscitation does not happen is for people to have a living will. Will the Minister undertake to try to encourage GPs to ensure that all their patients understand this and that they have the potential to have a living will?

[Lord Bethell (Con)]

My Lords, the benefits of living wills are enormous, both for those entering the last stages of their life and their loved ones. It is something that we are keen to encourage. I do not know the precise arrangements for how GPs play a role in that, but I will be glad to write to the noble Baroness and explain what provisions are in place for encouraging the use of living wills.

Covid-19 Update

Debate between Lord Bethell and Baroness Wheatcroft

Monday 21st September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I do not like telling anyone what to do. I do not like telling anyone that they should lock themselves up or stay away from the people they love—of course I do not—but in this epidemic we have learned that my health affects your health and your health affects my health. If you wander around catching the disease and giving it to other people, the impact on the whole of society is enormous. We all have to get used to this fundamental public health truism.

[Baroness Wheatcroft (Non-Afl) [V]]

My Lords, we know that Covid attacks the most vulnerable in society so, while I sympathise with the noble and gallant Lord, Lord Craig, I wonder whether the Minister sees merit in sending a clear message to those over 70 or with underlying conditions that they should consider isolating. This message would not be simply to protect them but to protect the NHS and allow the country to keep its schools and economy working.

[Lord Bethell (Con)]

My Lords, a clear message could not have been more emphatically sent to those over 70 about the dangers of this disease. The problem we have today is not one of irresponsible over-70s; it is a problem of prevalence among the young. We need to think thoroughly about how we address the issue of young people, who rarely get symptoms or even know they have the disease, transporting that disease in a dangerous way to those who are more vulnerable.

Covid-19 Update

Debate between Lord Bethell and Baroness Wheatcroft

Thursday 10th September 2020 Lords Chamber

[Lord Bethell (Con)]

I completely agree with the sentiments shared by my noble friend. Transparency has the effect of sunlight, putting a spotlight on information. It helps those who wish to contribute to make their efforts felt. We have embraced transparency: I cite the example of SAGE, where the minutes of its meetings and the data it works on are routinely published. I completely endorse my noble friend’s comments.

[Baroness Wheatcroft (Non-Afl) [V]]

My Lords, given that there have been hardly any tests available to Londoners for at least the last four days, and probably much longer, can the Minister say what belief we should have in the statistics for the prevalence of the virus in the country, and in particular in London? Furthermore, the Health Secretary—when he was not blaming the public for the shortage of available tests—did admit that there were problems with a couple of contracts. Could the Minister explain what those problems are and why, according to the Health Secretary, it will take a couple of weeks to sort them out?

[Lord Bethell (Con)]

My Lords, the statistics on prevalence are provided by the ONS. They were published yesterday and today—both the ONS and REACT figures. I would be happy to share links to those publications with my noble friend. Regarding the troubled contracts, I do not know the quotation to which she alludes but if she would like to correspond with me, I would be glad to try to figure it out.

Covid-19: Response

Debate between Lord Bethell and Baroness Wheatcroft

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

My Lords, the noble Lord is right. As a nation, we have been hit really hard by this disease and it is heart-breaking. I would have loved this country to have somehow dodged the bullet and not been the one that was hit so hard. We all feel it: we feel a great sense of responsibility and a great sense of sadness that so many lives have been lost, and that there are so many for whom the result of having had the disease and survived will be life changing. One thing that we have learned is that this disease hits you really hard and some people will never fully recover from it. However, I cannot help but pay tribute to those involved.

I do not know why we have been hit so hard. I do not know whether it is due to British behaviours and the fact that we have obesity in this country. I do not know whether it is because we are such an international country with such a large number of people coming to and fro, particularly from China. I do not know whether the Government made massive and colossal mistakes, as their critics suggest, and whether we got it all completely wrong. All I know is that the response to this disease by the British public, the NHS and the Government has not lacked energy, innovation and enthusiasm, and I stand here at this virtual Dispatch Box extremely proud of our country and of the people who have played a role in the response to this disease.

[Baroness Wheatcroft (Non-Afl)]

My Lords, the public might find it easier to stick within the rules now governing our life with coronavirus if they understood the logic. Therefore, can the Minister explain the logic or the science behind the fact that a household consisting of my son, his wife and their daughter can meet with only one member of a household consisting of his father and his mother at any one time?

[Lord Bethell]

It is very simple. If you have one person from another household meeting your household, the chances are that you will all respect the two-metre social distancing recommendation. The moment a second person is present, the proximity gauges and the way in which you all relate to each other become confused. You all start standing nearer to, and breathing all over, each other, and it becomes easier to catch the disease. That is just a simple human observation and is based on human nature and on the physical science of proximity. The example that the noble Baroness gives is a really good one, and I completely feel her frustration that her two families cannot spend time together. However, the behavioural scientists are absolutely adamant on this point, and to me at least it is common sense.