Social Care Reform

Debate between Lord Bethell and Lord Gardiner of Kimble

Tuesday 29th June 2021 Lords Chamber

[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.

[The Senior Deputy Speaker (Lord Gardiner of Kimble) (Non-Afl)]

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

Covid-19 Update

Debate between Lord Bethell and Lord Gardiner of Kimble

Tuesday 29th June 2021 Lords Chamber

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

My Lords, I am enormously grateful for those extremely thoughtful questions. As ever, I welcome the challenge and scrutiny that the House of Lords always provides on these matters.

I completely endorse what the noble Baronesses, Lady Brinton and Lady Thornton, very thoughtfully said about Chris Whitty. Chris Whitty and JVT are both complete legends, and both have been accosted in public. This is completely unacceptable. We must look at the security of those who serve us so well, and we must somehow address the disrespect that often happens when public figures walk in public. It is a great regret that this has happened.

The noble Baroness, Lady Thornton, asked about nurses’ pay. I repeat to her what my right honourable friend the Secretary of State for Health said yesterday: this absolutely remains a priority. We must have a fair pay settlement. That pay settlement is going through the pay review process at the moment, and we look forward to receiving the output on that.

Both the noble Baronesses, Lady Brinton and Lady Thornton, asked about the basis for the optimism that we have at the moment. I have stood at this Dispatch Box for 18 months as the purveyor of difficult news to the House, and have lived through some very difficult moments in that time. I am acutely aware of the concerns that noble Lords have. I think the questions put were very reasonable and deserve a clear answer, so let me explain why we are a bit more optimistic than I think we ever could have been in the recent past. The case rates are slowing down, for both over and under-60s. Hospital admissions among the over-60s have started to fall, and while there are signs in both measures that the rate of growth is slowing, there is just not enough to fundamentally change our assessment of the risk of delta. In the last two weeks, we have seen case rates fall in both Bolton and Blackburn. That is an incredibly important observation, and one that bears testimony to the effectiveness of the local authorities, test and trace, and all of those who have contributed. It is mainly driven by the under-60 group, but not wholly. Rates among older people are plateauing right across the country at a lower level, and hospitalisations and severe illness are being prevented by people being doubled vaccinated against Covid-19. There are very clear signs that the vaccine is working in lots of ways.

By 19 July, two significant things will have changed that may give us stronger confidence. First, we will have offered a first dose to all adults in the United Kingdom. The NHS states that it can do this by 19 July. We will have also given a second dose to a higher proportion of over-40s, giving them more protection against hospitalisation. Secondly, we will be very close to the school holidays, which start on 26 July, and school-aged children being out of school. This will significantly reduce transmission among the population which is unvaccinated and has driven case growth. Universities should also be out.

We are monitoring the data every day. So far, we have not seen indicators that substantially change our assessment of the four tests. I hear loud and clear what the noble Baroness, Lady Brinton, says about Andrew Marr and his experience. Vaccination is not a panacea. It does not save everyone from any illness at all, but it has a significantly strong effect for us to move on to the next stage.

In terms of the backlog, I assure the noble Baroness, Lady Thornton, that we are putting funds in place to do whatever it takes to get us back to where we began. I cannot give the specific reassurances she asked for on whether specific funds will be extended, but it is our aspiration to work as hard as we can. On GP data, I assure her that the clinical trial progress that we have made on things such as Regeneron in the last few days gives us such a clear inspiration and motivation for ensuring that we get this project right. On trusted research environments, we have demonstrated that we listen and that we will change how we implement the GP data transfer, but our objective remains resolute. We are committed to continuing with this programme of work.

I will give a very clear response to the very important question regarding emails, asked by the noble Baronesses, Lady Brinton and Lady Thornton. I am absolutely rigorous in ensuring that government business is conducted through the correct formal channels. Contracts are negotiated by officials, not by Ministers. Submissions from officials are handled through departmental digital boxes, and that is right. Official decisions are communicated through secure governmental infrastructure.

I have read the Ministerial Code; I have signed it and I will seek to uphold it in everything that I do. The guidelines are clear that it is not wrong for Ministers to have personal email addresses. I have corresponded with a very large number of noble Lords in this Chamber from both my parliamentary address and my personal address. That is right and I will continue to do so. In their enthusiasm, third parties often seek to engage Ministers through whatever means that they can find, including their personal email. That is not the same as using a personal email for formal departmental decision-making. Those who have seen material on the internet should judge it extremely sceptically, because distorted fragments of evidence do not provide sufficient grounds to rush to judgment on how Ministers do their business.

I do not recognise the substance of the comments of the Second Permanent Secretary, as referred to by the noble Baroness, Lady Brinton, and he has indicated to me that he does not recognise the substance of those comments. I completely recognise the comments that were made regarding the meetings with Abingdon Health. The meetings schedule from that week was overlooked because of an administrative oversight. It has now been uploaded to the internet. I will be glad to share a link to that register. On the complaint made by Anneliese Dodds, I have written to the Parliamentary Commissioner for Standards and would be very glad to share that letter with the noble Baronesses, Lady Thornton and Lady Brinton.

I take this post extremely seriously. During the work of the pandemic, many people—officials, Ministers and those in industry—worked extremely hard to address the severe epidemic that we face, and I am extremely proud of how that business was conducted.

[The Senior Deputy Speaker (Lord Gardiner of Kimble) (Non-Afl)]

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.

Covid-19 Update

Debate between Lord Bethell and Lord Gardiner of Kimble

Tuesday 15th June 2021 Lords Chamber

[Lord Bethell (Con)]

As ever, I am also grateful to my own Benches for their support in these difficult times.

This Statement from the House of Commons has been reflected on very thoughtfully and accurately, as shown by some of the questions. I remind noble Lords that the rollout of the vaccine is happening at pace, but it deserves to have a breath and the space to be seen through, all the way, before we make categoric steps towards opening up. I emphasise in reply to these questions that the supply of the vaccine has stepped up. Pfizer’s forecasted supply in June will be 30% more than in May; in July, it will be 80% more than in June; and we hope to have that sustained level in August. By the week commencing 19 July, we will have offered all adults a first dose, as well as a second dose to those aged over 40 who have had their first dose by mid-May.

This rollout will be absolutely transformative. It will mean that we overtake an important inflection point: the numbers of those who have had their second dose, and who are therefore, as statistics show more and more clearly, highly resistant to this virus, and certainly to severe disease and death. This variant is undoubtedly much more transmissible, by between 50% and 80%. It is therefore completely proportionate and reasonable that we take this moment to delay step 4 and give the vaccine rollout the space that it needs.

I will build on the point from the noble Baroness, Lady Thornton, about the work done by the Sanger Institute on genomic sequencing. It is only because of enormous investment, and the skills and expertise of those in genomic sequencing in the UK, that we understand as much as we do about the variant. In her comments on India, the noble Baroness, Lady Brinton, spoke about the process of analysing VOIs and VOCs. She is entirely right to allude to the fact that this is an extremely complicated matter. This analysis is down to the scientific judgment of those who have a copy of the variant. It took a very long time to get a physical copy of the variant from India, or even to have a digital sequence of it. That is why these things can take some time.

This demonstrates why we need to tidy up and invest in international systems for surveillance. An enormous amount of energy went into the G7, and I can report to noble Lords that, during the health track, we made great progress in the pandemic preparedness work stream in setting up an international scheme for exactly this kind of surveillance. It is imperative that we know what is happening in communities all the way around the world, because we are all touched by the mutations of this virus, wherever they happen. We continue to invest in the national variant assessment platform, which is our offer to the world to genomically sequence any variant sent to the Sanger, so that we can share that data with countries around the world.

We have also invested enormously in the control of our borders. Through both its red list and its amber list, the managed quarantine service has done an enormous amount to stop the transmission of new variants into this country. I pay a huge amount of tribute to Border Force and those in MQS, who have done a terrific job of bringing in this completely new infrastructure and this service that has done a huge amount to keep out variants—including the Manaus variant, the South Africa variant and others—through the red-listing process.

The noble Baroness, Lady Thornton, asked about school-age children and mask wearing. It is important that we keep a balance. Even though the infection rate is creeping up among school-age children, we need to protect the life they have in schools. In areas of enhanced response, the wearing of masks is now a recommended option for those who seek to take it up. That is a proportionate response in areas of rising infection. But across the estate, we think it is proportionate to step away from that at the moment.

On isolation payments, I can share with the noble Baroness that we are putting £2 million of funding into an agreed pilot across the Greater Manchester area, testing ways to encourage people to comply with self-isolation rules. The pilot will include support and engagement teams who will work with households within 24 hours of a positive test. The pilot is expected to reach 13,000 people over 12 weeks, and I am hopeful that it will guide the way forward in this area.

The vaccination surge is absolutely working. We saw a dramatic change in the vaccination uptake among the community in Bolton in particular. That is one area of Britain where the infection rate is coming down, which demonstrates the effectiveness of both the vaccination surge and the testing surge. We are now focused very much on accelerating second doses, particularly for over-40s. Millions of over-40s have had their first dose; some have an appointment for their second dose and some do not. It is very much the focus of our efforts to ensure that we get those people over the line and finish the job, to protect them and the ones they love.

This is an important development in our steps programme. It is frustrating, but there is an enormous amount to be optimistic about and it is in that spirit that we have made this decision.

[The Senior Deputy Speaker (Lord Gardiner of Kimble) (Non-Afl)]

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.

Covid-19 Update

Debate between Lord Bethell and Lord Gardiner of Kimble

Tuesday 8th June 2021 Lords Chamber

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

My Lords, I am thankful, as ever, to both noble Baronesses, Lady Thornton and Lady Brinton, for thoughtful and challenging questions. I will try to deal with as many as I can.

The noble Baroness, Lady Thornton, asked about the narrowing of doses. May I remind her that for those classed as vulnerable and those aged over 50, the dose period has been narrowed from 12 weeks to eight weeks. We are giving some latitude in the areas of special enforcement for the narrowing of the doses. I completely endorse her points on that and reassure her that plans are afoot. As for moving the age group to those aged over 18, our instincts are that the JCVI prioritisation process has worked extremely well. It is clear, it is fair and it has been effective. In conversation with those at the G7, I received a huge amount of admiration from other countries for how well that prioritisation process has gone. Therefore, we are reluctant, at this very late stage, to jump the gun on that, but I take her point that particularly those in areas where the infection rate is ticking up may benefit from early vaccination. Therefore, we constantly look at and review that point.

As for vaccination of children in schools, raised by the noble Baronesses, Lady Brinton and Lady Thornton, as they know, the MHRA has given its approval. The ball is now in the JCVI court. We are going to wait for it to pronounce. The state of our vaccine supplies means that we do not have a supply for children at hand right now, so there is scope for a really thoughtful conversation on that. When the JCVI has pronounced, the Government will engage on its recommendations, but I do hear, loud and clear, the obvious support that it has in this House.

As for the Nepal variant, I cannot say exactly how much of it came from Portugal, but it is true that it was present in the UK before Portugal was green-listed, so I think it is fair to say that not all of it came from there.

Moving on to NHS staff, I completely pay tribute to the contribution of NHS staff and those who work to support the NHS, social care and public health. I recognise completely the picture painted by the noble Baroness: many feel exhausted and burned out. Our focus is therefore on recruitment and the recruitment of more GPs and nurses is going extremely well. I would be happy to share updated statistics on that if it would be helpful. The work plan—the NHS People Plan—has within it a clear outline of the kind of workforce planning that we have in place. That is something that the recruitment programme has fully embraced.

I agree that the pressures on A&E, and on acute late-stage interventions from the NHS, have been rising for years—for decades. This is an unsustainable model in the long run, which is why this Government are fully committed to the prevention agenda. We have put in place plans for the Office for Health Promotion. That will be the device for using data to support our prevention agenda, and we will be working particularly with local authorities, and increasingly through the NHS, to ensure that we are putting in place measures that improve the nation’s health and that we do not just focus on those who are already extremely ill.

Moving on to data, I thank the noble Baroness for her kind comments. I completely agree that transparency is absolutely right. We want to be as transparent as possible, with both the professions and the public. These are complex issues. I accept that we could do better to improve our communications. We will be using this two-month hiatus as energetically as we can to engage the public and the professions in the changes that we are bringing about. They are changes that are absolutely essential for any modern use of data to promote resource allocation—when it comes to the workforce, as the noble Baroness rightly pointed out—and for research. I really would encourage all noble Lords who are interested in this to look at the minutes of IGARD. Noble Lords will see exactly which data uses are being sanctioned, and will be amazed by the extremely high-level, science-led research programmes that the GP data is contributing to. It will reassure noble Lords that this is an extremely well guarded and thoughtful process, and a massive asset to the nation. I agree with the noble Baroness that our data is a huge national asset; it is there to benefit patients and is mainly used for clinical trials and for planning within the NHS. That is right and I can reassure her that that is the way we intend to continue.

The noble Baroness, Lady Brinton, asked about mental health support for care workers and NHS staff. I reassure her that we have put in a huge amount of support for NHS staff: 10,300 calls have been made to the helpline, there have been 4,600 conversations on the national line and 200,000 downloads of the app, and 500,000 have engaged through the web page. The provision of mental health support for NHS staff has been extremely helpful for those stressed by the last few months, but we continue to invest in that area.

I remind the noble Baroness, Lady Brinton, that those receiving isolation payments are still eligible for their benefits. They will get support from housing benefit and other benefits if they qualify.

The noble Baroness asked about schools. The use of testing to protect schools has been one of the phenomenal success stories of this pandemic. There have been 65 million tests deployed since January, and a million tests were deployed on Sunday alone. That is both to break any chains of transmission within schools and to protect the opening of schools, which every parent in the country knows is an essential objective of our pandemic response.

On certification, we are making an enormous amount of progress. That is a Cabinet Office lead. When the plans have been crystallised, they will be published, and I am extremely hopeful that we will be able to make progress.

Lastly, the noble Baroness, Lady Thornton, mentioned the memorial wall. I am aware of it and have seen very moving pictures. I have not yet visited the wall, but I will take this prompt to go. While I am not across the future plans for the wall, I am grateful for the suggestion and will take it up.

[The Senior Deputy Speaker (Lord Gardiner of Kimble) (Non-Afl)]

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.