Health Protection (Coronavirus, Local COVID-19 Alert Level) (Medium) (England) Regulations 2020

Lord Dholakia Excerpts

Wednesday 14th October 2020 Lords Chamber

[Lord Dholakia (LD)]

My Lords, the reality is that the number of cases of Covid has quadrupled in the last three weeks, and there are now more people in hospitals with Covid than there were when we went into lockdown on 23 March—and deaths are already rising. All the optimism about a vaccine and winning the battle against Covid has become a distant future, and the reality has to be accepted: the virus is here to stay for a while.

I shall concentrate on some of the issues facing us. It is not to ignore the situation in very high-risk areas, but the tier system fails to address issues in other areas. There is a commonality between all three tiers. No one is immune from the spread of this virus; we cannot afford to take our eyes off the areas classified as “medium”, and great care must be taken to ensure that factors that affect the other tiers are as relevant in groups where intensity is less obvious. We do so at our own peril.

There has often been confusion in how we have handled this issue. We are told that our action relates to, and is guided by, science. That sounds hollow when we now know that scientific opinion offered a few weeks ago, including actions that should be taken, was ignored. Consultation with communities was narrowly confined, and the local population hardly featured in any outcome of the decisions taken.

I give one example. I live in a village which has no shops, no station and no post office—nothing of that sort. The nearest supermarket is about seven miles away. We have one facility, which is the local pub, the Labouring Man, and I declare an interest as I frequently visit it. It is owned by Martyn Brand, who converted his shop into a grocery shop overnight when the crisis became obvious. I hate to think what would have happened to the village had that facility not been available to local people. A number of noble Lords have talked about closing hospitality businesses at 10 pm. We have to be careful about how that affects small places in many rural areas.

At the best of times, the Government’s message is confusing. We must remember that the population has paid a very heavy price for the action taken so far. We are now expecting even more from them. They will oblige if there is absolute clarity in the message that comes from the top. This has not been the case. It is here that I want to thank local radio stations, provincial newspapers and ethnic papers, which have been at the forefront. They have probed statements for clarity and highlighted issues affecting local communities, care homes, business and the hospitality industry. Communities are better informed not because of the Government but because of how they have highlighted the fight against the virus.

In conclusion, let us not forget the plight of those at the wrong end of this issue, who fit in all three tiers that we have talked about. These include single mothers living in limited accommodation and victims of domestic violence, which is on the increase because of isolation. Unemployment is on the increase, and test and trace has been so poor—and there are many other factors. These will not go away, and action is necessary on all fronts.

We value the award of honours to those who have excelled in their contribution, and I am delighted that so many from minority communities featured on the last list. Their contribution in providing care has been unique. Many have provided food and help where appropriate. If there is one positive message from the present crisis, it is that we are more united now than we have ever been.

Prisons: Mental Health

Lord Dholakia Excerpts

Wednesday 24th June 2015 Lords Chamber

[Lord Prior of Brampton]

I thank the noble Lord for that question. I hope he will think it acceptable if I reply to him in writing after this session.

[Lord Dholakia (LD)]

My Lords, could the Minister explain why we lock up so many mentally ill offenders in prison institutions that are not fit for the purpose? Has he read yesterday’s report by the prisons inspector, which describes one prison as containing “shocking” squalor, high levels of violence and drug abuse, and high levels of staff sickness? Would the Minister explain how many mentally ill offenders are in our prison institutions and what efforts are being made to place them where proper mental health care and social care are available?

[Lord Prior of Brampton]

There are, as the noble Lord knows, some 85,000 people in prison, of whom more than 70% have two or more mental health conditions. Many of them suffer from drug or alcohol abuse, and I think it is generally accepted that a number of those people could be better treated outside a prison environment. He will also know that the liaison and diversion services that were so highly recommended by the noble Lord, Lord Bradley, now cover 40% of the prison population. There is a proposal that that should cover the whole population by the end of the year, subject to evaluation of those pilot schemes.

NHS: Global Health

Lord Dholakia Excerpts

Monday 20th December 2010 Lords Chamber

[Lord Dholakia]

My Lords, I thank the noble Lord, Lord Crisp, for securing this debate. I had a quick look at his biography, and three areas stand out: his experience of the National Health Service, his involvement as a fellow of the Institute for Healthcare Improvement and, above all, his political interest in the developing world. It should come as no surprise that he has chosen global health and medical education for this short debate. No longer can we simply concentrate on learning about what is appropriate for the health of people in the United Kingdom; we have to take into account post-war migration and our interdependency with other nations. We also have to accept that the process of globalisation crosses the geographical boundaries of all nations.

The globalising economy relies increasingly on the skills of people wherever they are available, and international migration is a key factor in ensuring that Britain benefits from this phenomenon. I shall give an analogy. Climate change is not restricted to a single nation. Last week we dealt with the outcomes of the Cancun climate conference. For the first time there is an international commitment to,

“deep cuts in global greenhouse gas emissions”.

Here is a recognition that a nation cannot act alone. The Medsin UK response on global health acknowledges that the health of people in every nation is interconnected. A global health approach seeks to understand how individuals and population health are determined by global, as well as local, factors.

I realised the need for an international dimension to training when some years ago my wife and I had returned to rural Sussex following a visit to India. After some days, despite having taken malarial precautions, my wife developed a fever. The local doctors could not make a diagnosis and her condition deteriorated. She thought that despite all the precautions she had contracted malaria, and decided to take her temperature at regular intervals. The results demonstrated that she probably had malaria. The doctors were not convinced and took her blood to look for parasites, but they did not find any as they took it at the wrong time of day. She remained undiagnosed and decided to treat herself. She obtained medication and worked out the appropriate doses and timing of the medication. I am pleased to say that, after six weeks of being ill, she made an almost instant recovery.

Let me say that many medical colleges have recognised the need for global health issues. My daughter, who qualified at St Bartholomew’s Hospital Medical College, decided to go to Brazil for her elective experience. She was fortunate during that period not only to spend time in the cities of that country but to work in the Amazon rainforest, which brought home to her the realities of a broader aspect of health, including the impact of poverty on the health of deprived communities.

There are a number of factors that we need to take into account. I urge the Minister to look at the broader determinants identified by Medsin UK: health financing, human rights, migration and environment. I am tempted to criticise the Government’s points-based system of immigration, but I shall refrain from doing so. Suffice it to say that the treatment of overseas doctors by the previous Administration was shameful; we continually moved the goalposts, and many of them suffered serious hardship when having to return to their country of origin.

The present cutbacks in university funding at about 6 per cent, which was announced today, are likely to impact on medical colleges. There is already evidence that some universities will no longer be able to afford training in certain disciplines. It is vital that knowledge is shared with countries abroad. Numerous good practices have been developed in countries such as Taiwan from which we can learn. India is making tremendous headway in providing medical tourism. It is also providing medicines at a much lower cost than we do in this country.

I am delighted that the noble Lord who is to follow me today is contributing to this debate. When I visited Ethiopia, there were those in the healthcare professions who valued his knowledge and advice. That, to my mind, is the acceptable face of our contribution to the third world.