(3 years, 5 months ago)
Lords ChamberMy Lords, I declare an interest as an adviser to Future Planet Capital, a sustainable investment firm that has a stake in Vaccitech, the start-up that licensed the intellectual property and original R&D relating to what is known as the AstraZeneca vaccine, of which I have received two doses. I begin by congratulating the Minister for running the marathon of this past year or so, managing the demands of the pandemic tirelessly and responding swiftly to requests, certainly from me, for information or action. For example, I remember us speaking at one point early in the pandemic about the need to restrict inbound travel from Italy. He and his colleagues at the Foreign Office ultimately took the necessary action.
I recognise the reasons behind this measure, given the high number of fatalities and infections that have taken place in care homes and facilities over the course of the pandemic and the need to ensure that those in them are protected. It is a step in the right direction proactively to seek to ensure that safeguards are in place, given that, last year, we found that the speed of events could, at times, truly overwhelm us and the system. To this end, I echo the Minister’s tribute to staff in the social care system who have tirelessly sacrificed to protect those in their care.
My main point is that, while seeking to vaccinate those working in care homes may make sense in the short term, I would love to see a more systemic approach by the Government to make our health and social care system more resilient generally, rather than reacting to events after the horse has bolted. By doing so, we would be able not only to address the problems we face in our social care system and its funding, but to deal with the long waiting lists we face and ultimately make our economy and society less of a hostage to whatever crisis next turns up to fill our hospitals with patients.
Hospitals and care homes are particularly vulnerable within our wider system right now, because they concentrate a lot of vulnerable people and thus make it easy for the virus to reach them, relatively speaking. Of course, defending them helps, but I would love to see more thinking in government to tackle root causes, such as whether we should be concentrating so many vulnerable people in one place at all and whether more diagnosis, care and treatment could be done at home, remotely, in the community or in smaller facilities. If they have to be in larger units, bubbles could be created within them, so the truly vulnerable are separated from the others. Only in that way, I believe, will we truly eliminate the likelihood of future lockdowns.
However, today we are talking not about this more holistic or comprehensive approach to preventing infection, but about the measure before us. I support it in principle, but the challenge is in the transition. Those who work in care homes today did not sign up to compulsory vaccination when they applied and accepted their job offers, so there is an ethical issue about what we do about those who choose, rightly or wrongly, to object for their own ethical and other reasons. If this were another job, for example in certain units in the Army where vaccination is the expected behaviour upon receiving an offer, this would not be an issue, but we now face having to impose it retrospectively on current workers. More thought needs to be put into how we deal with this dilemma. For example, could the Minister consult the care sector to explore what roles people who have been a front-line carer could play, which would not require vaccination, either remotely or on site, but separated from vulnerable service users? Could steps not be taken to separate different groups of patients in care homes based on the latest clinical science? This would at least reduce the risk of discrimination and the perception of rules being changed arbitrarily and after the event, rather than in a planned way.
Ultimately, we have to accept that we are still fighting this pandemic and that emergency measures like these are needed, but we also need to remember that we are in a democracy and that you cannot unvaccinate someone, so, unlike other measures, this cannot be temporary or reversible. We have to give more thought to what we do to look after those who object to being vaccinated, even if we may disagree with them, rather than casting them and their concerns aside, even if for the very worthy cause of keeping service users healthy, protected and alive. It is a very slippery slope, changing the terms of someone’s job such that they suddenly find themselves forced to do something against their conscience. Let us hope that this and future Governments will do this only very rarely and ensure that they have thought through the implications for everyone, including workers, carefully in the future.
(4 years, 4 months ago)
Lords ChamberMy Lords, I declare my interests and pay tribute to my noble friend Lord Bethell. It is not easy being a Minister in this situation, and he has been weathering it with great gravitas and perseverance.
I have just one question. Rather than arguing about masks, which are an important component in fighting this virus, what are the Government doing to fund and accelerate with industries—the beauty industry, for example—technologies and equipment that could make each space safer for the public? We will need this equipment over the winter and in future pandemics. Why do we not invest a little bit of money that might otherwise be going into bridges to help industries create screens, for example, perhaps with gloves through them? There are all kinds of ways in which, industry by industry, we can find bottom-up solutions rather than just blanket measures. We are moving away from national lockdown policy; how can we get more granular and work with industries to make the public and workers safe?
(4 years, 7 months ago)
Lords ChamberMy Lords, I want to sort of start my comments by congratulating the Government and the police on showing incredible restraint in acting under huge pressure in what has been an incredibly difficult period. The amendments to these regulations are welcome because they start to allow people to get more exercise and get the economy going. It is easy for us out here to sort of criticise, but I congratulate the Minister on what he and his team have been doing under huge pressure.
The Prime Minister has talked about the importance of common sense, and we now need to start thinking about these regulations and our whole approach to the response to Covid, using common sense, and involving other parties in this. I would be keen to hear from the Minister how we can start to involve the public in the way that these regulations evolve moving forward. For example, there is data at a local level about how many people are infected with Covid. Instead of using law and regulations all the time to shape behaviour, which can be a crude instrument, are there ways almost to gamify and allow citizens to understand the situation in their local area, understand what might be causing it locally and start to adapt their behaviour according to where they are, in the country or in a city such as London?
Secondly, understandably, we have had to bring in these regulations, but they are a huge infringement on civil liberties. So far we have had to take into account the needs of the NHS and public health in shaping these regulations, but do we also need to think about the enforceability of these regulations and laws? For example, on the new change that will allow people to meet one other person from outside the household, do we believe that the police have the resources to check every time they see people in the park whether an additional member has joined that household or whether they are part of the same family? Could we not start to work together with experts in this House, in the police and in the legal system, to shape laws based on natural law and common-law principles that are more tailored and risk-based? For example, we do not seem to have the resources to shut down large gatherings when they appear, so how will we be able to focus on policing individual families?
Moving forward, we will need to have a much wider debate to shape these laws, rather than the Government generating and issuing them and noble Lords in this House commenting around the edges. It feels as though we need to move forward and create these regulations together.
(4 years, 7 months ago)
Lords ChamberMy Lords, I thank the noble Baroness, Lady Wheeler, for tabling this very timely debate, and I declare my interests on the Lords register. I, too, echo the praise that others have expressed for the Government and our heroic NHS and care workers, especially those on the front line.
I will focus on just two issues relating to the handling of the social care crisis during this pandemic. I am concerned at how centralised an approach Public Health England has taken on a number of fronts. I fear this may have contributed to the challenges and deaths we are seeing in the care sector and non-hospital contexts generally, including in the home. It seems that at times we have let the best be the enemy of the good, alongside a narrow focus on centralised testing and healthcare rather than what can be done by the rest of society, including business and citizens. I fear that PHE maintains such a gold standard that delays and an inability to harness the energies out there can often be the result. We need to do more to loosen regulations in this emergency to allow more localised testing operated by local labs and organisations to be enabled and then shared, open-source, as well as enabling the provision of PPE. We could even have trials of new drugs made available in and near residential homes, as well as in social care contexts.
I am therefore keen to learn from the Minister whether PHE is being instructed or, if necessary, bypassed to enable more third-party innovation and involvement, and whether a Bill or instruments could be passed to relax certain rules so that local actors can be more empowered to make decisions as they see fit. Indeed, lessons need to be learned so that we can build a more agile, decentralised model of healthcare for the 21st century, delivered closer to homes generally.
Finally, I want to ask what action is being taken and what resources are being deployed to separate elderly residents of care homes who have mild symptoms, or who have been tested as asymptomatic, from other residents, without the risks associated with admitting them to hospital. Does the Minister agree that we may need to introduce a programme akin to the Nightingale one, but more like the famed little merchant navy that complemented the naval efforts to evacuate Dunkirk? That way, we can build and create facilities close to care homes for isolating elderly and vulnerable people and those of all ages who test positive but have mild symptoms, separating them from mainstream care and the general population. These individuals do not need hospital care, but they might be at risk of infecting others fatally.
(11 years, 2 months ago)
Lords ChamberMy Lords, it is a great honour and pleasure to follow my noble friend Lord Livingston of Parkhead’s insightful, witty and passionate maiden speech. We all welcome his contribution to the House, and indeed to the whole country and beyond. As a businessman, he distinguished himself when running BT, not merely by driving it forward to growth commercially inside and especially outside the UK, but also in helping to spearhead many corporate social initiatives, including those that have helped to create suitable employment for those in later life, initiatives which I know are dear to his heart.
From an early age he has shown tremendous commercial acumen and has had a stellar rise from his start as an accountant to becoming a chief accountant, then a banker and venture capitalist, before becoming the youngest ever FTSE CEO in 1991, of the Dixons Group, at the age of 32. Subsequently, he became the BT Group finance director, head of retail and group CEO. It has been an amazing rise. As a Scot from humble beginnings and originally from overseas, I am sure that he will bring additional experience to your Lordships’ House, not least from his being a non-executive director at Celtic. What better representative could we have as our soon to be installed Trade Minister, promoting the country, bringing commercial expertise to our trade promotion bodies, and insight and common sense to our deliberations in this House? I know that fellow Peers will join me in congratulating him on his appointment and once again on his wonderful maiden speech.
Turning to today’s debate, I declare an interest as co-chair of the All-Party Parliamentary Group on Life Transitions. I want to thank the Select Committee, chaired by the noble Lord, Lord Filkin, for its tremendous work and the Government for their response. It is just over a year since I had the privilege of co-authoring a report on life transitions that touches on many of the areas highlighted in the Select Committee’s report. It is encouraging to see how the report I wrote, supported by the Gulbenkian Foundation and entitled, Next Steps: Life Transitions and Retirement in the 21st Century, finds echoes in much of the tone and language of the work of the Select Committee, and indeed that we are able to think about life transitions, in this case those of ageing and retirement, in terms of presenting significant challenges and opportunities for public policy and public services. It is no longer enough to stick to our silos and care about the services on either side of a particular life transition; we now need to integrate and consider the impact of transitions both on service provision and on the individuals, families and communities who are affected by them.
I agree with many of the recommendations made in the Select Committee report. They are generally balanced, thoughtful and sensible, but I want to highlight one area where I feel that more research could be carried out, which is how the efforts of public and social entrepreneurs can contribute to enabling a smoother transition in later life, particularly when it comes to planning for retirement and ageing, and in building the support networks to cope better with and combat isolation. We tend to see retirement in the public policy arena in terms of hard fiscal, and non-fiscal, measures: pensions, saving, housing, social and healthcare implications and so on. However, in Life Transitions and Retirement in the 21st Century, we found that a major challenge for people was also the softer side and that better consideration is needed to enable people to feel positively about ageing and to see it as a journey, rather than as a disparate set of choices which can be confusing, easy to ignore when you are busy and sometimes daunting given the prospect of ill health and the end of life itself.
Specifically, we argued for a framework to provide a national retirement service that could mobilise charities, private organisations and government bodies to better signpost and draw in the ageing population. It would start when people are healthy and still in work and be designed to connect people locally and across generations, while giving them the information and training needed to make the right choices for them as they enter later life. A pilot to explore this has been initiated, which starts this weekend in Stoke with sponsorship, again, from Gulbenkian under the banner of the Retirement Transitions Initiative, using the incubation capabilities of the Shaftesbury Partnership—in which I declare a former interest as a founder. The scheme will work with employers, community organisations such as football clubs, charities, government agencies and faith groups, and local champions to encourage people to attend pre-retirement courses in a relaxed, down-to-earth and friendly local environment. By knitting people together and giving them the right information, the aim is to empower them and help them build resilience and networks of support from a cross-section of society. The aim is both to help prevent costs to the NHS and other statutory bodies further down the line and for us to learn what works and explore what blockages exist that might affect policy.
I would have liked to see a bit more in the Select Committee report about these aspects of ageing and how we can provide a cross-party consensus around significantly expanding holistic retirement planning courses under a national campaign, before it is too late. I would also have liked to see a bit more on how older people themselves can be a source of wisdom and ideas about how to improve the relationship between social care and health services and on how best to release equity and financial assets to pay for retirement or to incentivise continuing to work and a shift into portfolio part-time work. Those going through the process of retiring from the corporate world, as well as those who are unemployed or dealing with chronic illness, can often see more clearly than even some experts what the challenges are and what can be done. The APPG on Life Transitions aims to provide a forum to hear from the public and actors in the community such as social entrepreneurs about these challenges and the possible innovations in this area. I would like, in this regard, to ask the Minister whether the Chief Scientific Adviser’s research will be able to go further and gather or even crowdsource innovation and ideas from a wider audience than purely professionals and experts alone.
Clearly, the challenges and opportunities of an ageing society are mammoth and will require contributions from all quarters. How will we facilitate new kinds of start-up businesses, for example, that explicitly incorporate the wisdom and experience of part-time or non-executive semi-retirees along with young unemployed graduates and apprentices? How do we enable even more brokering of non-monetary means of bartering and support between those in later life and the wider population so that even those with limited means can still have a decent life? What role might housing design and building play in enabling young and old to live near each other and to support each other in their respective challenges, along Shared Lives and Homeshare lines, or is policy to lead inadvertently to a dangerous ghettoisation of different generations? These and many more questions and ideas need exploring if we are to have a step change in our understanding of later life and what is possible from both a wider public and public policy perspective.