Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) (No. 2) Regulations 2020
Lord Palmer of Childs Hill Excerpts(4 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Loomba (CB) [V]
My Lords, I would like to make two points about today’s regulations. The first is regarding the wearing of face masks and the second concerns the amount of legislation being created to deal with the pandemic.
As a country, we were slow to adopt the wearing of face coverings, and there was a huge debate in the early days of the pandemic about the merits or demerits of their protective qualities. This was at a time when PPE was in short supply, and it was generally agreed that NHS and other front-line workers were left vulnerable without the correct PPE, which included wearing masks for complete protection. It is therefore a mystery as to why it did not make sense to endorse the wearing of face masks by the general public in the beginning, given that there was so much evidence of their protective benefits from their use by front-line workers. Perhaps the Minister would like to say why such an oversight took place.
My second point, which has also been noted by the Lords Secondary Legislation Scrutiny Committee, concerns the number of statutory instruments dealing with issues relating to the pandemic. For example, we had two original face covering regulations, which were subsequently amended by three further instruments. Today’s instruments add a further three amendments to the original two, making six in total.
One of today’s instruments includes taxis and private hire vehicles in the definition of public transport in order to make it compulsory for passengers to wear a face mask when using them. That it was not considered necessary to include this form of transport in the beginning means we need a further instrument to deal with the issue. Not only does that add to the legislative burden; it links to my first point about adopting the wearing of masks earlier in the pandemic: not having that regulation may have contributed to many more people being infected, as they were without face masks in a confined space. A second example is the provision that addresses the inadvertent omission from the original instrument of making it compulsory for bar staff to wear face masks.
While we are making fines for non-compliance stiffer, as here with the second regulation, we must make sure the law is accessible and easily understood by the public, or we are in danger of undermining the rule of law. I thoroughly endorse the committee’s view that the Government must take a more structured and, indeed, streamlined approach to the legislation in order to facilitate understanding and compliance, as no doubt the need for more legislation is unlikely to go away in the current situation.
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
I call the noble Baroness, Lady Uddin.
Baroness Penn (Con)
The noble Baroness might be on mute, so she could try unmuting herself.
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
I think we will go to the noble Baroness, Lady Wheatcroft.
Baroness Thornton (Lab)
My Lords, the contributors to this debate have asked the Minister pretty much all the questions that need to be asked on this issue. Perhaps I may say to my noble friend Lord Campbell-Savours that I would not have minded if he had been here doing this job, because he is definitely the expert on face masks in the House.
I want to make two procedural points. First, as we move forward to discuss face masks, I cannot see any reason why we would not be discussing them before regulations are made. If there are to be any changes to the regulatory regime around face masks, I cannot see that emergency legislation needs to be used. The House is perfectly capable now of discussing whatever needs to be changed, as the science evolves, prior to enactment rather than several weeks after. Secondly, I cannot resist teasing the Minister about the fact that the Secondary Legislation Scrutiny Committee has asked the Government if they can please take care about not publishing three amended statutory instruments to correct the mistakes that they made in the first one—and they did it within 24 hours. It said:
“The Committee has noticed a recent increase in the number of correcting instruments, with several Coronavirus instruments having to be revoked or amended immediately after laying … We therefore remind all Departments to check all instruments thoroughly before laying them before Parliament”.
I think that probably counts as a B.
The noble Baroness, Lady Finlay, was correct to say that the need to wear masks was about protecting each other. The Prime Minister said last week, concerning the sharp rise in coronavirus cases across the UK, that the country had become blasé about following restrictions designed to bring the pandemic under control, but I think a lack of enforcement is partly to blame. The Prime Minister’s father, former MEP Stanley Johnson, has been pictured three times either not wearing a mask or with one tucked under his chin, in places where face coverings are required: a London shop, a Tube station and an airport.
Therefore, it is legitimate to ask the Government not specifically about Stanley Johnson’s conduct but about what assessment they have made of the levels of compliance and of people’s reasons for not following the rules. Perhaps it is because the rules are changing so quickly and are confusing, or because people are becoming blasé. As I have said, I travel in and out of London on Tubes and buses every day; as the Minister said, the wearing of masks is significantly better than it was a month ago. There is absolutely no question of that. However, there are still people refusing to wear them.
Business enforcement is an issue here. Shops and supermarkets are required by law to inform customers to wear a face covering—unless they have an exemption—which they do through signs or by telling them when they enter the premises. This is enforced by local authorities and businesses risk a fine if they fail to do so. However, there is concern that the Government may not be following through on their own advice. Four retailers—Sainsbury’s, Lidl, Morrisons and B&M, the homeware stores—were issued with warning notices by Barking and Dagenham Council in east London, after their staff were seen failing to enforce mask-wearing and social distancing by customers. After the enforcement notices were issued under anti-social behaviour legislation, stores were understood to have complained to the Department for Business, Energy and Industrial Strategy. It has been reported that a senior official at BEIS then telephoned the council and said that it
“did not have powers to enforce these guidelines using the Government’s Covid-19 emergency powers”
and that
“the action had caused a negative reaction from the operators”,
according to a letter of complaint from the council to Alok Sharma, the Business Secretary.
This is rather important. Can the Minister confirm these reports? If so, does he share my concern that maybe his colleagues are undermining these regulations, and public health? Who will enforce these regulations, and how? As the Minister said, the British Medical Association has called for face masks to be mandatory in busy outdoor areas as well as indoors, and where there is a risk of coming within two metres of other people, including in offices. It is clear that most workplaces were never designed for people to work two metres apart. The Government need to revisit the science and enforcement of wearing face masks. It would be great to have that debate before enactment.
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
Can we try the noble Baroness, Lady Uddin, again?
Health Protection (Coronavirus, Restrictions) (No. 2) (England) (Amendment) (No. 4) Regulations 2020
Lord Palmer of Childs Hill Excerpts(4 years, 1 month ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Lord Bishop of Rochester
My Lords, like others, I tend to think that carrots are more effective than sticks. It is, therefore, vital, if people are to behave as the Government might wish, that they understand and assent to the reasons for particular restrictions.
My understanding of the rationale for the rule of six is that is about restricting the mixing of households. I understand that, and I seek, in my role and personally, to abide by that principle. But what the Minister has said notwithstanding, the anomalies do not help to gain that consent. If I have understood things correctly, I may, in a given period, be a part of more than one group of six, and thereby, I am multiplying the households with which I have contact. Yet, as many have observed—and there are other examples—a couple with three children cannot meet with two grandparents at the same time, even though that would only be two households in most instances.
I genuinely worry about the effect of these regulations, particularly the rule of six, on the long-term flourishing of family life and cohesion, if they persist for too long. My simple point is that the rule of six gives a kind of cliff edge, which could surely be graduated without compromising the principle about household mixing. I rather hope that Her Majesty’s Government will be able to think creatively about how that might be done.
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
I call the noble Lord, Lord McColl of Dulwich. He is not there. I call the noble Baroness, Lady Donaghy.
Covid-19 Update
Lord Palmer of Childs Hill Excerpts(4 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
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.
Folic Acid
Lord Palmer of Childs Hill Excerpts(4 years, 2 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Palmer of Childs Hill (LD)
My Lords, I support adding folic acid to flour and, as other noble Lords have all said, the sooner, the better. Has the Minister also considered action using Instagram influencers to encourage young women who diet to use leafy green vegetables, such as spinach, which contains B-vitamin folic acid? Would the Minster agree that, while “Eat your greens” might be a call from the past, it is cheap and still relevant today?
Lord Bethell (Con)
My Lords, I entirely endorse the noble Lord’s appeal for us to eat our greens. The concern with this specific matter is unplanned pregnancies, and the suggestion of putting folic acid into flour is to target those mothers who may need the additional supplements at a time when they do not realise they need them.
Covid-19: Masks
Lord Palmer of Childs Hill Excerpts(4 years, 5 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Palmer of Childs Hill (LD) [V]
We have compulsory mask wearing for NHS staff on 15 June at all times. At the daily rate at which the NHS uses face masks, are there enough masks? The Government announced on 28 May that all dental practices would open as normal from 8 June. They also have to source masks, competing with hospitals and care homes.
What about the general public? An article in the BMJ raises the ethical question: should the Government apply the precautionary principle and encourage the wearing of masks on the grounds that we have little to lose and maybe something to gain?
There are four key messages on Covid-19. The precautionary principle is to act without definitive evidence. It is contested that wearing masks will reduce transmission, and limited protection could prevent some transmission, but because it is such a serious threat, the wearing of masks in public should be advised under the precautionary principle.
Health Protection (Coronavirus, Restrictions) (England) Regulations 2020
Lord Palmer of Childs Hill Excerpts(4 years, 6 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Blencathra (Con)
My Lords, I pay tribute to the SLSC for its typically thorough report, which identified errors in the original regulations. But with the changes announced by the Government over the last two days, I look forward to new revised regulations, which I hope will correct one glaring anomaly in the regulations of 26 March.
Regulation 6(2), relating to restrictions on movement, states that a reasonable excuse to leave home is
“the need … to obtain basic necessities, including food”.
Leaving aside the word “need”, which is quite subjective, the term “basic necessities” has led to some police officers boasting that they were patrolling shopping aisles to make sure that consumers were purchasing what the police considered were “basic necessities.” I believe that that behaviour was quickly stamped on, but the law in this regulation still says “basic necessities”.
Schedule 2, Part 3 lists the shops that may stay open. These include supermarkets, petrol stations and hardware shops, among others. The Government have confirmed that consumers can purchase anything at all in these shops which they stock, much of which is not a basic necessity. Supermarkets selling homewares, toys, video games, clothing and compost are perfectly within the law. The term “basic necessities” is confusing and unnecessary. Regulation 6(2)(a) should therefore be changed to say: “to obtain any supplies, including food”, et cetera, “from the businesses listed in Part 3 of Schedule 2”.
Schedule 2 should also have a general provision which states that any shop or retail premises can open provided that it can maintain social distancing. If the supermarkets can limit numbers and space out customers, why not permit, say, Army & Navy Stores, Debenhams or any other retailer to open if they can set up safe systems?
Finally, I commend the statement in the Government’s plan, Our Plan to Rebuild, announced yesterday, that
“the Government will continue to recognise that not everybody’s … risk is the same; the level of threat posed by the virus varies across the population”,
and that the Government expect
“to steadily make the risk-assessment more nuanced … some … may be able to take more risk … The Government will need to consider both risk to self, and risk of transmitting to others.”
Therefore, I hope that the new regulations will make it clear that everyone over 70 is not automatically vulnerable. The same goes for those of us with “underlying health conditions.” These cover a huge range of conditions, and not all of them have equal risk. We must let people over 70 or others in perceived risk categories get out, so long as they do not pose a risk to others. If they endanger themselves, that is their decision, so long as they do not endanger anyone else. I hope that my noble friend the Minister will take those points on board.
The Deputy Speaker (Lord Palmer of Childs Hill) (LD)
Please could we all try to keep to the timings.
Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020
Lord Palmer of Childs Hill Excerpts(4 years, 6 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Deputy Speaker (Lord Palmer of Childs Hill)
My Lords, the Virtual Proceedings will now adjourn until a convenient point after 4.30 pm for the Motion in the name of the noble Lord, Lord Boswell of Aynho. The noble Baroness, Lady Henig, will be chairing the proceedings.
NHS: Specialised Services
Lord Palmer of Childs Hill Excerpts(12 years, 4 months ago)
Lords ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Lord Palmer of Childs Hill
My Lords, the noble Lord, Lord Patel, is indisposed and we wish him well.
I thank my noble friend Lady Jolly for initiating this debate and for giving a detailed introduction to the problems mentioned in its title. My concern is specifically with the treatment of Gaucher’s disease, the genetic disease mentioned by the noble Lord, Lord Turnberg. It is the most common lysosomal storage disease. It is caused by hereditary enzyme deficiency. Patients in the UK, together with patients suffering from other lysosomal storage disorders, or LSDs, are treated at nationally designated centres run by the Advisory Group for National Services and I am grateful to my noble friend Lady Jolly for reducing that to AGNSS, which saves me from repeating this long name, or the initials. There are eight nationally designated treatment centres in England serving these patients.
Since 2005, the treatment of LSDs has come under the management of AGNSS, which has allowed LSD patients to benefit from national designation with respect to assessment, diagnosis, clinical management of the disease and assessment of the therapies. The centralised management of LSDs previously mentioned by the noble Lord, Lord Turnberg, and my noble friend Lady Jolly is the creation of eight nationally designated centres and has had the following key benefits.
First, there has been provision to patients of access to experts in the management of these rare diseases. Without this access patients have suffered misdiagnosis, as the noble Lord, Lord Turnberg, said, and inappropriate treatment. Secondly, all patients in England—and it is England that we are talking about—have had equity of access to therapies. Thirdly, a nationally funded service has provided budgetary transparency for the NHS, ensuring the efficiency and effectiveness of therapies and avoiding unnecessary costs. Fourthly, the ability to launch national tenders for therapy and home care has resulted in further cost savings. Fifthly, there has been the development of national clinical guidelines defining diagnostic treatment and management criteria.
The Government have determined to disband AGNSS as part of the establishment of the NHS Commissioning Board, as has been referred to by other noble Lords. It is not yet clear how this will work and whether this service for the assessment and management of patients with LSDs will remain a distinct body. The potential disbandment of AGNSS and the subsequent division of the assessment and management of rare diseases raises significant concerns that the issues faced by many LSD patients prior to national designation will resurface. These will include delays in access to diagnosis and treatment, regional inequalities and inconsistencies, misdiagnosis and inappropriate disease management, wasted resources in the NHS, and the separation of clinical management and appraisal of therapies.
The current service is envied around the world and in its existing form is an example of the NHS at its best. In other branches of the NHS we are encouraged to create centres of excellence, in terms of heart treatment, heart attacks, strokes and the like. Many hospitals are ceasing those services—to have centres of excellence—but the rationale for them should apply to these rare diseases as well.
Can the Minister assure patients benefiting from centralised commissioning arrangements provided by AGNSS that they will continue to do so in any new arrangements and that there will not be a break-up of the existing services? Can the Minister confirm that the new NHS Commissioning Board will retain a dedicated budget appropriate to meet the needs of LSD patients currently being treated, with provision for potential additional funds for new therapies in the course of development? Can the Minister give an assurance that the new arrangements will not see a return to what is called postcode lottery for treatments of patients with rare diseases? Does the Minister agree that rare diseases requiring specialised services cannot be treated in the same way as more common conditions, and that structures such as AGNSS need to be put in place to ensure that patients continue to be properly and appropriately managed and treated by the NHS?
Finally, the chairman of the European Gaucher Alliance, which represents patients’ groups from 36 countries, tells me that the current structure for the delivery of healthcare to Gaucher’s patients is envied around the world and is the inspiration for their organisations. I hope that the Minister can provide an assurance to the House that this type of service will continue.