Adult Social Care

Lord Hamilton of Epsom Excerpts

Thursday 2nd December 2021 Lords Chamber

[Lord Kamall (Con)]

The noble Lord makes the very important point that unpaid carers save the state billions of pounds a year with all the work that they do and the love and attention that they give. Sometimes, they do have a choice, but they choose to be carers because they are worried about putting their relative into a home and are not quite sure about that—I understand that. But the fact is that, if they are unpaid, we are looking at how we can support them better. Unpaid carers are very different, and you cannot lump them all into one group: they have different needs and are at different stages of their lives. I emphasise the importance of making sure that we understand how we can personalise that journey for everyone—the cared- for person and the carer. But, if you have given up work, a range of other benefits may be available, and we want to make sure that unpaid carers are equally valued and not penalised for looking after a loved one.

[Lord Hamilton of Epsom (Con)]

My Lords, following on from my noble friend Lord Lilley’s remark, what percentage of people in need of care will be covered by the £86,000 cap?

Covid-19: Vaccination Programme

Lord Hamilton of Epsom Excerpts

Wednesday 24th February 2021 Lords Chamber

[Lord Hamilton of Epsom (Con)]

My right honourable friend the Prime Minister said in his Statement that decisions would be led by data, not dates. In the same Statement, he said that step 2 would be no earlier than 12 April, step 3 no earlier than 17 May and step 4 no earlier than 21 June. This morning, the Daily Telegraph reported that the 21 June date may be brought forward if the data continues to show that coronavirus is being well dealt with. What is leading the Government’s decisions? Is it dates or data?

[Lord Bethell (Con)]

My Lords, I recommend that my noble friend and the Daily Telegraph look at the large amount of conditional material that the Prime Minister articulated in his Statement. There were no firm dates. He made it clear that data would drive decisions and he made a lot of his indicative programme remarks reliant on passing the four key tests that he laid out very clearly in his programme.

Covid-19 Vaccines Deployment

Lord Hamilton of Epsom Excerpts

Thursday 11th February 2021 Lords Chamber

[Lord Hamilton of Epsom (Con)]

My Lords, I congratulate the Government on the vaccine programme. After a pretty disastrous war against Covid, it looks as though the Government may be winning the last battle, which is the one that counts. What happens to people who have received the jab and are registered under the test and trace system? Will they be forced to isolate, despite inoculation making it very unlikely that they will catch the disease or transmit it to others?

[Lord Bethell (Con)]

My Lords, I am afraid that is not the view of the scientists at the moment. I am extremely glad about all those who have had their first jab, but the very strong recommendation is that everyone has to abide by the lockdown rules at the moment. The transmissibility is still there: a person who has had the jab can still, and often may well, be infected by the disease, carry it and communicate it to someone who has not had the jab. They remain a danger to the community and, until a very large number of the population have had the jabs, those protocols will remain in place.

Health Protection (Coronavirus, Collection of Contact Details etc and Related Requirements) Regulations 2020

Lord Hamilton of Epsom Excerpts

Wednesday 7th October 2020 Lords Chamber

[Lord Hamilton of Epsom (Con)]

I think that my noble friend the Minister would accept that these measures being taken to combat the pandemic have to involve a trade-off with what happens in the economy. If we go back to the original decision to lock down the economy totally in March, if someone had made the point at that stage that it would result in 70% of our businesses shutting down completely for three months with the result that millions of people would lose their jobs—many for the foreseeable future—would we have reached that original decision to go for total lockdown?

I agree that most countries took the view that total lockdown was the answer, but the Swedes did not. The result is that the Swedish economy is forecast to shrink this year by something like 5.5%, while the latest figures are that our economy will shrink by between 11% and 12%—double the rate and double the impact of job losses. That is also true of this measure.

I have only one question for my noble friend. Was a cost-benefit analysis ever carried out before the original measures were taken to lock down the economy totally, and has such an analysis been made on the measures before the House today?

Covid-19 Update

Lord Hamilton of Epsom Excerpts

Tuesday 6th October 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I am touched by the testimony of the noble Baroness. I pay tribute to the work of National Voices, which has presented an extremely thoughtful and helpful guide and presented the testimony of those who have been under the extremely harsh regimes of shielding. She is entirely right that those who have had to go into the most extreme forms of lockdown depend the most on government guidelines. Those guidelines can be complex, and people can feel confused or lonely and separated because of their status. We have invested a huge amount in local authorities and in charities specifically to reach those groups. It is through that kind of civic and public service support that we can work with those people. It is not properly the role of central government to have individual communications with those who are shielding at home. We rely on our partners, and we have provided an enormous amount of resources to ensure they can do that job properly.

[Lord Hamilton of Epsom (Con)]

My Lords, if I was diagnosed with coronavirus today and subsequently recovered or showed no symptoms over the next couple of weeks, in 27 days I might get knocked over by a bus and killed, and that would be registered as a Covid-related death. My question to my noble friend is this: why are we including all these deaths that are nothing to do with Covid in the overall statistics that we publish every day?

[Lord Bethell (Con)]

My Lords, if my noble friend caught Covid today and recovered in two weeks’ time, I would personally celebrate that enormously, as I am sure would others in the Chamber. He is right that we have existing protocols for identifying cause of death, and we approach Covid in exactly the same way we do all other causes of death. This is to help our demographic analysis. Of course, the example that he gives—which is entirely correct—is an extreme example, but it is helpful for us to understand, when we are doing retrospective analysis, who has been touched by Covid in order to explain at a later date where the causes of those deaths may have come from. A death that is not apparently from Covid today may in future have a clearer connection.

Covid-19 Update

Lord Hamilton of Epsom Excerpts

Wednesday 23rd September 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Baroness asked about PPE, which is naturally a concern as we go into winter. I assure her that the NHS has 15-day, 45-day and 90-day plans for the supply of PPE to the NHS and the independent sector. Roughly half of that comes from British sources. The distribution mechanisms have been radically overhauled and tested, and have proved to be utterly modernised.

We are working extremely hard on the deployment of a Covid vaccination. She rightly mentions other vaccinations. I assure her that we have 30 million doses of the flu vaccination. As she rightly points out, there appears to be a strong link between having flu today, Covid tomorrow and problems with a combination of both at a later date.

[Lord Hamilton of Epsom (Con)]

Sweden did not go for a total lockdown, as we did in this country. Although there is some evidence that its number of infections is going up at the moment, it still has far fewer deaths from Covid per 100,000 than we do. On top of that, its economy is supposed to be declining by about 5.5%, while ours will decline by at least double that. Does my noble friend think there are any lessons to be learned from Sweden?

My second question is about herd immunity. We started this whole process of dealing with coronavirus by talking about herd immunity. We then seemed to completely desert that idea and did not think it held any promise. Where do we stand now on herd immunity?

[Lord Bethell (Con)]

My Lords, it is with sadness that I note that the infection rate in Sweden is inching up, and with regret that I note that Stockholm is bringing in many lockdown measures similar to those in the UK. The noble Lord is right that Sweden has had a distinctive approach, but it is not as distinctive as would appear. Many of the same regulations that we have had here have been applied in Sweden. One area where Sweden has shown leadership is in compliance among the public. When regulations have been brought in, there have been extremely high levels of compliance, and therefore the optics are different from the reality. This Government have never supported a herd immunity strategy.

Personal Social Care: Funding

Lord Hamilton of Epsom Excerpts

Tuesday 16th October 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Lord is right: the Dilnot commission proposed risk pooling, which we legislated for, and it was decided that it was not the right time to proceed with those proposals. However, I can tell the noble Lord that Sir Andrew Dilnot continues to be involved in the policy-making process, as does Dame Kate Barker, who chaired another review. We want to ensure that we can draw on their expertise as we put our ideas forward.

[Lord Hamilton of Epsom (Con)]

Will my noble friend correct my noble friend Lord Forsyth: there is no such thing as free social care, it is just a question of who pays for it?

[Lord O'Shaughnessy]

My noble friend is absolutely right, which is why there must be a balance between what is paid by individuals and by the taxpayer through the state.

NHS: Equitable Access

Lord Hamilton of Epsom Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord O’Shaughnessy]

The noble Lord picks a very good example of a technology that is transforming diabetic care, as he knows. A few months ago, I was pleased to be able to approve it for prescription in the NHS; it is now available across the country where clinicians think it is the appropriate course of treatment.

[Lord Hamilton of Epsom (Con)]

My Lords, is my noble friend concerned that the NHS, employing 1.3 million people, is too large to manage?

[Lord O’Shaughnessy]

On the contrary. We want it only to get bigger.

NHS and Social Care Services: Parity of Esteem

Lord Hamilton of Epsom Excerpts

Thursday 5th July 2018 Lords Chamber

[Lord O'Shaughnessy]

Well, they say that success has many parents and we should pay tribute to the Liberal MP William Beveridge, the Conservative Health Minister Henry Willink, and the Labour Health Minister Nye Bevan in the founding of the NHS. It is important to point out that the Conservative Party has been in power for 43 of the NHS’s 70 years and it has thrived under our leadership.

[Lord Hamilton of Epsom (Con)]

Will my noble friend confirm that when Nye Bevan established the NHS he said that the demand was going to be strictly limited?

[Lord O’Shaughnessy]

Limiting demand is one of the challenges that we face to make sure that we are able to deliver a health service, but the NHS has proven to be highly effective not just in dealing with acute disease but now in supporting people with chronic disease, which is the greatest health challenge that we face.

Psychiatrists: Referral Fees

Lord Hamilton of Epsom Excerpts

Thursday 7th June 2018 Lords Chamber

[Lord O'Shaughnessy]

I am as disturbed as the noble Lord is, not only by the stories we have seen in the press but by his view that this came as no surprise. If substantiated, from a professional perspective this is clearly a great cause of concern. I would be interested to meet him to talk about the overall support for the private sector. Clearly the CQC has a role in providing for patient safety and quality, but we need to make sure that publicly funded services are available for people recovering from alcohol and drug addiction.

[Lord Hamilton of Epsom (Con)]

My Lords, is it against the guidelines of the BMA for doctors to go to luxurious resorts on so-called conferences at places with plenty of golf courses, paid for by drugs companies?

[Lord O'Shaughnessy]

I do not know whether it is against the standards of the BMA. However, the General Medical Council is explicit in its guidance that doctors must not allow any financial interest—either the fact or the perception of it—to impact on the way they treat or refer patients, and they must declare any such conflicts or perceptions of conflicts to patients while treating them.