Health Protection (Coronavirus, Restrictions) (Steps and Local Authority Enforcement Powers) (England) (Amendment) Regulations 2021

Lord Scriven Excerpts

Monday 17th May 2021 Grand Committee

[Lord Scriven (LD)]

My Lords, these regulations were laid on 7 April. It is ironic that we are discussing them today, as we start moving to step 3. If they had been discussed earlier, the facts on 9 April might have been raised to help us keep all local areas safer. On 9 April, Bangladesh had the South African variant but not the Brazilian variant but was put on the travel red list. Pakistan had neither the South African nor the Brazilian variant on that day but was put on the red list. India had both the South African and Brazilian variants and the emerging Indian variant but was not put on the red list. On 9 April, cases per 100 million on a seven-day rolling average were 21 in Pakistan, which was put on the red list, and 43 in Bangladesh, which was put on the red list. India had 84 cases per million—four times as many as Pakistan—but was not put on the travel red list.

Why, with more cases per million and with both the Brazilian and South African variants present, and the emerging Indian variant, was India left off the red list on 9 April? If the Government had followed the data, it would have been put on the red list. However, the Government were following a date—24 April—so that the Prime Minister could go on a trade mission. Dates, not data, yet again, will cause problems for individuals, families and businesses. In the period between 9 April and putting India on the red list, 900 people a day entered the country—nearly 20,000 people. They could have been carrying the South African, Brazilian or new Indian variants.

One can only assume that this was yet another abject failure of government to act with speed and good judgment to secure the nation’s borders and keep people safer. When trade deal trips trump the public health and safety of individuals and businesses, you have to ask when a government Minister will take responsibility and resign. By not putting India on the red list and by following a date and not data, the Government have put businesses and individuals at risk of illness, death and bankruptcy. It is time now for an independent inquiry to learn lessons and to put in place secure border restrictions to ensure that people stay safe and what we see in Bolton is not replicated in any other community in this country.

Office for Health Promotion

Lord Scriven Excerpts

Thursday 29th April 2021 Lords Chamber

[Lord Bethell (Con)]

My Lords, Covid has been an extremely important educational experience; we have backed off from using the idea of “hard to reach”. Instead, we try to be much more effective at making ourselves approachable for the kinds of people the noble Lord talks about. He is entirely right that the levelling-up agenda means nothing if it does not mean levelling up health outcomes; we are very focused on addressing the kind of health inequalities he refers to. That will be a central mission of the whole project.

[Lord Scriven (LD)]

My Lords, I declare my interest as a vice-president of the Local Government Association. The public health grant to local authorities is 20% lower per head in real terms than it was in 2015-16. Restoring spending per head to this level would require an extra investment of £1 billion. How can poor health prevention and promotion of well-being be achievable and sustainable with such reductions in local public health funds?

[Lord Bethell (Con)]

My Lords, local public health resources have made a huge contribution in the last year through Covid. I pay tribute to those in local public health who have contributed so much during the pandemic. The grant to local authorities is slightly beyond the scope of the Office for Health Promotion, but the noble Lord’s point is very well made.

Covid-19: Update

Lord Scriven Excerpts

Tuesday 20th April 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is right that the backlog is a grave issue, and we are fighting as hard as we can to address it. The big guns of the NHS are moving from Covid to addressing the backlog, but we should not overstate its threat either. Large parts of the NHS remained open all the way through Covid, and I pay tribute to those in the NHS who worked extremely hard to ensure that many elective procedures and much diagnosis continued. We do them and their reputations no favours if we imply that the NHS was in any way doing less than it should have done to work through Covid. But the noble Lord is right; this is a grave issue, and we take it extremely seriously.

[Lord Scriven (LD)]

My Lords, overwhelming evidence now exists that lower-paid people are less likely to take a test, self-isolate or isolate for the full period, due to not being able to afford to do so. What extra support will the Government now put in place to deal with this Achilles heel of the test, trace and isolate system?

[Lord Bethell (Con)]

My Lords, we put in place a considerable amount of support for those on low wages, including the furlough scheme, and a huge amount of economic support. It is true that those on low wages have wage pressure put on their lives, but we have statutory sick pay for those who are sick and out of work, and we have a huge amount of investment in local government and in charities, which also provide support for those who live in deprivation.

Covid-19: One Year Report

Lord Scriven Excerpts

Thursday 25th March 2021 Lords Chamber

[Lord Scriven (LD)]

My Lords, one year on, when the situation has changed, so should the response and the laws required to deal with the next phase of the pandemic. With over 126,000 people dead and many families missing loved ones this Easter, it should have been a time for the Government to seriously reflect on the approach required for the next stage of dealing with this public health challenge.

Despite some powers being dropped, the number of powers within the Act that have never been used or have hardly been used that will remain on the statute book, and the number that have been used repeatedly and incorrectly but also stay on the statute book, is telling. If the Government were committed to learning to improve the safety and resilience of the nation, they would have agreed to a public inquiry into the response to the pandemic—an independent assessment of what has gone well and what has not gone so well. That would have informed the changes that are needed in this Act and in future SIs.

The powers relating to “potentially infectious persons” under Section 51 and Schedule 21 of the Act have been used a total of 10 times by public health officers, but never by police or immigration officers, yet such powers are now also in the Health Protection (Coronavirus, International Travel) (England) Regulations, made under the Public Health Act. Why have two powers in two different Acts for the same issue?

As other noble Lords have said, the latest Crown Prosecution Service review of Covid prosecutions this week found that all six prosecutions under the Coronavirus Act in February had been incorrectly charged, bringing the total to 252 incorrectly charged, with not a single prosecution that was correctly brought. These powers are clearly not fit for purpose and are used in ways that unlawfully restrict individuals’ liberties—a good reason why nodding through these powers is not in the best interests of citizens or of improving an effective public health response. These powers within the Act should be dropped.

Talking of keeping people safe, in the last year we had the situation of care and NHS staff having at times to wear binbags rather than PPE. Some of the PPE and communications procurements have a stench of cronyism hanging over them, coming to light only when organisations such as the Good Law Project have taken the Government screaming and kicking to court—donations of over £8 million made to the Conservative Party by some of those who have contracts, and existing and established companies thrown aside in favour of those who had links to the Secretary of State’s WhatsApp messaging service or who were able to have meetings with the Minister in this House, who then had the door to the VIP channel opened and subsequently got lucrative deals. Companies with no record in health but who have run local pubs, manufactured pet food, or sold expensive jewellery, carpets and furnishing were given contracts for PPE via the VIP channel—in some cases for equipment that was not fit for purpose and did not meet UK safety standards. All those who had the golden door of the VIP channel open to them were 10 times more likely to get a contract than those established suppliers of PPE who did not get on to that channel, along with the eye-watering fact that up to three times the normal market rate was able to be claimed before serious questioning or auditing of such quotes was done.

I am sure that the Minister, as always, will gloss over this appalling cronyism. If there is nothing to hide, why do the Government still refuse to publish who nominated companies to go via the VIP channel and what recent contact they had had before companies got on the channel? It is telling that the National Audit Office report notes that, in some cases, the appropriate paperwork around those in the VIP channel was not kept. When the public inquiry comes, it will show that, at a time when we required procurement of the highest standards, some were more bothered about greed and used their contacts to pursue that. This review of the Act should have had a clause inserted promoting more open, transparent and ethical procurement.

Back in March 2020, these Benches indicated that the powers in this Act had to be proportionate to the health risk we faced, which required an equal partnership between local and national government to ensure that the response would keep people as safe as possible. On both these issues, the Government did not listen and are still not listening and acting to fully unleash the talents and skills of those in communities up and down the nation to improve the way we tackle public health issues. It is for those reasons that I will support my noble friend Lady Brinton’s regret Motion.

Covid-19: Resuscitation Orders

Lord Scriven Excerpts

Wednesday 24th March 2021 Lords Chamber

[Lord Bethell (Con)]

I will gently push back against the noble Baroness: the policy is absolutely crystal clear. Blanket DNACPR is not the policy of this Government, as was repeated time and time again in our communications, which I would list if I had more time. Training is the issue: we need to give the front-line workforce the skills it needs to apply these very delicate but critical interactions. That is the recommendation of the report, and that is where we are focused on applying the lessons.

[Lord Scriven (LD)]

My Lords, does the Minister agree with Age UK that the report is the tip of the iceberg and requires the Government to bring forward proposals as part of a complete overhaul of the advance care planning system?

[Lord Bethell (Con)]

No, my Lords, I do not accept that the report is simply the tip of the iceberg; it is very thorough and goes into the matter extremely carefully. However, there are important lessons on training to be learned and they will be driven by the ministerial oversight group.

NHS: Pay

Lord Scriven Excerpts

Tuesday 9th March 2021 Lords Chamber

[Lord Bethell (Con)]

I am grateful for the economics lesson from the noble Lord. I will take those recommendations and pass them on to colleagues at the Treasury.

[Lord Scriven (LD) [V]]

My Lords, the £37 billion found for the predominantly private sector-led test and trace system equates to spending more than £1 million every day for the next 100 years. How does the Minister reconcile that with the statement that the Government cannot find the money to fund more than a 1% pay increase for front-line NHS staff?

[Lord Bethell (Con)]

My Lords, the test and trace system is part of an essential response to a virus pandemic that has shaken the world, and the costs of that pandemic are enormous. I regret them very much and wish with all my heart that we did not have to spend this money on our pandemic response, but there is no other way of cutting the chains of transmission and responding effectively to this awful disease. The ongoing pay arrangements for nurses and doctors are commitments that we will live with for years to come, and there is a difference between the two.

Covid-19: Brazilian Variant

Lord Scriven Excerpts

Tuesday 2nd March 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right. Things are happening around the world which are causing a great deal of anxiety. Stories of possible reinfection in South Africa are extremely concerning and the huge spike in infections in South America has not been properly explained. It is possible that there are a number of mutations, and mutations of mutations, there. The truth is that we do not have the genomic or immunological data that we need to fully understand what is going on. That is why we have taken a precautionary approach, as the noble Lord recommends. We have instituted both managed quarantine and a red list which we keep under review. If we feel it necessary to extend that list, we will do so.

[Lord Scriven (LD) [V]]

My Lords, tracing new variants will be key in the next phase of this public health challenge. So why does the £22 billion test and trace system not have an individual identifier on each test posted to homes, along with an integrated database? This way, every test could be traced back to an individual, regardless of where the test was sent from, or even if a person incorrectly filled in a form.

[Lord Bethell (Con)]

I endorse the noble Lord’s observation that tracing is important. I pay tribute to the Operation Eagle team. The noble Lord will note that the South African variant, which made landfall in the UK, is currently being contained through the immense work of this team. They are throwing a blanket over communities and doing a huge amount of forensic, detective work in tracing variants. As to his specific point, it is possible for someone to walk up to a testing station, take the test, be handed a form and not fill it in. We are trying to understand if those were the circumstances in this case.

Covid Contracts: Judicial Review

Lord Scriven Excerpts

Monday 1st March 2021 Lords Chamber

[Lord Bethell (Con)]

The right honourable Secretary of State for Health and Social Care put it extremely well. For those of us who were there at the time, the priority was saving lives, not publishing contracts or focusing on anything other than the protection of those who work and live in care.

[Lord Scriven (LD) [V]]

My Lords, 25 million masks that could not be used were supplied by a pest control firm in a £59 million deal, while a Mauritius hedge fund got £252 million, and, again, the face masks could not be used. There was also a £70 million contract with a Florida jeweller for gowns that could not be used. Will the Minister commit to a judge-led public inquiry into the handling of such PPE procurement?

[Lord Bethell (Con)]

As the noble Lord knows, I cannot comment on some of those cases specifically because they are subject to legal action at the moment. However, in broad strokes, I say that there were a lot of people who stepped forward to help us in our time of need; I do not condemn them. Some of them came not from the PPE industry but from others. I am extremely grateful to all those who stepped forward to help us when we needed it.

Health Protection (Coronavirus, Restrictions) (All Tiers and Self-Isolation) (England) (Amendment) Regulations 2021

Lord Scriven Excerpts

Monday 1st March 2021 Lords Chamber

[Lord Scriven (LD) [V]]

My Lords, four months have passed since the Minister told the public that the memorandum of understanding on data sharing between the National Police Chiefs’ Council and his department was just a small administrative issue, nothing to do with health information that could undermine public health efforts. Yet four months later, the law is in place and data is being passed to the police without Parliament or the public seeing the MoU.

In answer to a Written Question from me on 17 February, the Minister stated that the MoU

“is currently being updated to reflect amendments”

to these regulations

“and feedback from the Information Commissioners Office.”

He added that,

“the MoU will be published as soon as practically possible.”

What are the issues on sharing non-sensitive health information, such as one’s name and address, that have taken four months and required the intervention of the commissioner? Did she require any changes to the original MoU, and if so, what?

As we move to the next stage of dealing with the virus and the new variants, we will still require people to self-isolate. As the noble Lord, Lord Hunt, has said, the BMA has already said that it is concerned that some people are deterred from being tested because they are anxious about loss of income if they need to self-isolate and that it is

“worried should police involvement add to this.”

Evidence has shown that most people do the correct thing and isolate if they have financial security and practical support to do so. These are the key tasks for the Government now if rates of people self-isolating are to be improved on. While some financial support is being made available, for many it is not enough. Will the Minister now commit to paying people their full wages, so that people will self-isolate for the full period without having to worry about paying bills or feeding their family?

Practical support is required too. If you live in a cramped or multigenerational household, it can be impossible to self-isolate in a separate room. Why will the Government not do what other countries have done and pay for some of the closed hotels to be used as isolation hotels? Excellent international practice has reduced the spread of the virus through supporting people to self-isolate, via community well-being and health teams. These teams support with shopping, well-being and other healthcare support. In countries where these teams are deployed, they increase self-isolation and compliance and help reduce the chain of transmission of the virus. These kinds of issues are at the root of improving self-isolation. The Government should focus on them and not four months of fruitless discussions about sharing health data with the police, fines and, potentially, criminalising people who just want the financial security and practical support to do the right thing.

Future of Health and Care

Lord Scriven Excerpts

Tuesday 23rd February 2021 Lords Chamber

[Lord Bethell (Con)]

The noble Lord is entirely right: obesity is not only a major issue, it is specifically cited in the Bill, where we have clear measures to try to address it. I do not need to raise it with the Prime Minister or the CMO because they both take it incredibly seriously. The Prime Minister has spoken movingly about his own challenge when he caught Covid—the five stone by which he feels he was overweight, the impact that had on his life chances, and how close to death he came because of obesity when he went into hospital. That was a metaphor for the whole country, and that is why we have launched a major obesity strategy in respect of marketing and advertising. It is why we remain committed to the obesity strategy, and more measures will be rolled out during the course of the year. I am extremely grateful to the noble Lord for reminding me about World Obesity Day on 4 March, which we will be marking very seriously with a publicity campaign.

[Lord Scriven (LD) [V]]

My Lords, nearly 75% of NHS expenditure goes on hospital and ambulatory care. Will the Minister explain how the proposed reforms will, in reality, lead to the redirecting of significant hospital sunk costs into ill health prevention and improving population health outcomes, as implied in the White Paper?