(2 months ago)
Lords ChamberMy Lords, as the last speaker from the Back Benches, I do not intend to comment on everybody’s speeches, but I do hope that the noble Lord, Lord Hannan, makes his own submission to the inquiry, because it is a vital point. I would like to see how the inquiry and its advisers deal with his point. I say no more.
It is probably just as well that I do not comment widely because my own expertise in the health field is limited to virtually nil and my experience with pandemics relates to my period as a Minister dealing with the foot and mouth epidemic; in other words, in the livestock area. While there are vast differences, and the authorities in livestock epidemics have means of controlling them that would not be acceptable to the human population in any civilised society, there are also some features that are the same. Principally, those are that the authorities in the agriculture and related sectors did not have a very clear plan; there was no mutual understanding between the industry and Defra; we changed our policy several times during the period; and probably more cattle—or beasts in general—lost their lives than needed to.
There have been inquiries into that epidemic and inquiries into this pandemic. On my count, there have been—I think the noble Lord, Lord Lansley, referred to this—six key inquiries into what to do in an epidemic, beginning with the one after SARS in 2003 and going right through to the recent one in 2018. The one common feature that is clear—the noble Lord referred to this—is that there were a lot of recommendations, some of them were taken up, many of them were not, and many of those that were taken up were dropped or severely modified. I hope that this inquiry produces recommendations that can be sustained and that health practitioners, scientists and everybody is convinced at least by the main thrust of the inquiry’s recommendations. The module that we have already received will be supplemented by much more detailed ones, but it already raises a number of very serious concerns.
The fact that those inquiries have not been followed through by successive Governments is a worry, and I hope that we can have a very serious follow-through by something like a resilience structure in government, which my noble friend Lord Harris referred to, and that that will have clear backing from Parliament and the new Government.
I want to end with one final, crucial area that has not been touched on. The theme of the report is referred to in terms such as “putting into place”, “failing to put into place” and “needing to put into place” contingency plans for a surge in resources, particularly during the immediate response. My namesake Professor Chris Whitty —no relation—expresses it as a way of stopping a pandemic in its tracks. Three things have to be in place to do that during any form of pandemic or virus-based epidemic: testing; tracing; and making sure that all the equipment required, from PPE to syringes and everything else, is already in place and can be stepped up according to the severity of the epidemic.
I asked Ministers in the previous Government about the recommendation in some of these reports that we get agreements in place well in advance to sort out not only the incredibly complex governmental structure—it is reproduced in the report and involves an incredibly complicated network of bodies—but the resources in private, university and research areas. For example, there needs to be an agreement so that, as soon as a pandemic becomes evident, a system makes available laboratories in the public sector and in the rest of society, together with testing arrangements, and makes the availability, specification and distribution of PPE clear well in advance. In order to do that, public sector bodies need to have in place as soon as possible protocols on those facilities becoming available as soon as a pandemic is declared. In the private, educational and research sectors, we need to have protocols—contracts, in effect—with money paid up front so that those private facilities will be transferred into producing as soon as possible the equipment needed to test and trace, and the materials and equipment needed for combating the pandemic. They would therefore drop research work and commercial ventures, because those stand-down contracts were already available.
I asked the previous Minister—it was not the noble Baroness, Lady Neville-Rolfe—some months ago whether such contracts were already in place, but I have to say that I got a rather equivocal answer. I ask the Minister, and the previous Minister if she cares to comment, whether, if a pandemic started or was clearly threatening us tomorrow, we would have available those facilities.
I am grateful to my noble friend for giving way. This is a time-limited debate, so I shall make just one point. There was a public service laboratory that was closed down. It was a wonderful institution that many noble Lords will remember. It is something we should have not just for a pandemic, but as a continuous resource for unexpected and unusual things that affect the nation, particularly bacteriology.
I thank my noble friend for that. That shows that we are going backwards with public facilities, but private and other facilities also need to be mobilised immediately and a judgment made on how long we need to do that, according to the success or otherwise of our control of a pandemic. I put it to the Minister in the new Government that if that has not yet been put in place on a wide scale, it should be one of the priorities. I hope she can reply positively on that. I also hope that industry research labs of all sorts would respond. In the previous case, we were panicking to get them in place, and it led to some corner-cutting that in turn led to accusations of some dubious behaviour. I do not want to go into that, but if we had systems in place already, none of that would be a problem. Since nobody else has mentioned it, I hope the Minister and the ex-Minister can reply and give me some assurance on that basis.
(1 year, 9 months ago)
Lords ChamberI will write to the noble Baroness with the statistics. I can be clear that the endeavours undertaken to buy the PPE were to make sure that we did not run out. Again, there is quite a bit of hindsight going on in saying, “Ah, we bought too much of it”, when at the time everyone was scrambling to say, “You need to buy more.” That was the result of the situation, and to try to apply hindsight now is quite wrong. They did a pretty good job regarding the amount that they bought; they got 97% of it right, which I think we would agree is a pretty good result.
My Lords, the reference to hindsight is misplaced. The Minister accurately described the shambles and panic that happened at the beginning of the pandemic, but there had been several reports in the 10 years before it that indicated that one measure the Government could take for any pandemic was to have standby contracts whereby there were arrangements with companies to provide PPE and laboratory facilities. That was recommended by, among others, your Lordships’ own Science and Technology Committee. Do such contracts now exist so that, were another virus to hit us, we should not go through the same shambles and corruption that we did on that occasion?
Absolutely. As ever, we want to learn the lessons. That is why we have set up the Covid inquiry. Yes, supply arrangements are in place. At the same time, as per the answer to the previous question, holding high levels of stock does not make sense. It is cheaper in this case to dispose of it while making sure that the supply lines are in place so that we can rapidly respond to any future event.
(2 years, 1 month ago)
Lords ChamberWhen I speak to officials in the care part of my department about this issue, one of the things they say, in consultation with a number of individuals in the care sector—not only employees but owners—is that morale is clearly low, partly because of pay but also because they feel they do not have a proper vocation. It is very confusing to have all these qualifications; they are not recognised elsewhere and there is no clear career path. One reason we are putting together this register is that we want to understand the landscape out there—it is incredible that this has not yet been done—including the number of qualifications, the issues and what sort of career structure can be offered.
My Lords, several noble Lords have referred to the terrible financial situation of the whole social care sector and its employees. I recall the last Prime Minister said he was going fix social care. Nothing happened. Does the current Government recognise that a step to help out the social care sector, over and above other businesses, would be at least a first step towards fixing the sector?
One reason we brought forward the Health and Care Bill was that we wanted to make sure that social care was given proper status. Social care has been seen as the poor relation to healthcare for far too long by successive Governments. What we want is a proper health and social care system, properly integrated. Sometimes social care workers leave the social care workforce and move to the health side because they feel it is more valued as a profession. We want to make sure the same is true of social care providers.
(3 years ago)
Lords ChamberMy Lords, the noble Lords, Lord Laming and Lord Scriven, have pointed out that the loss of £1 billion over the last decade or so from the public health teams’ budgets has impaired their ability to deal with issues, including those related to Covid. Does the Minister recognise that the increase just announced goes nowhere near to closing that gap? Does he also recognise the parallel problem that the limitation on local authorities’ support for care homes is greatly impairing their ability to care for the health of elderly and other disadvantaged people resident in care homes?
As noble Lords will know, the Chancellor has confirmed additional spend for public health, and the public health grant will be maintained in real terms over the spending review period, enabling local authorities to invest in prevention and front-line services such as child health visits. There will also be continued funding of £100 million per year over the period to tackle obesity in adults and children, as well as investment in a new start for life offer for families, with an additional £66 million in 2024-25. We know and recognise the importance of public health. At the same time, the NHS is committed to rebalancing between public health, prevention and therapeutics.
(3 years, 3 months ago)
Lords ChamberWe have an established vaccine run rate and programme, and we have in place the supplies to meet those targets and to fulfil the commitment to vaccinate all those who step forward for vaccination by the end of July. My noble friend may be referring to either a third or booster shot with a variant vaccine. Negotiations and clinical studies are taking place at the moment. We are cognisant that the vulnerable, elderly and those in high priority groups may need further vaccination in the autumn. We are putting in place all the plans necessary to deliver this.
My Lords, I return to the confusing advice on masks. In the early weeks of the pandemic, some of the worst levels of deaths occurred among transport workers. They were inevitably faced with potential infection for several hours a day. It was particularly true of bus drivers, including a very good friend and neighbour of mine who died from Covid a few months before his retirement. With the advent of compulsory mask-wearing on public transport, driver hospitalisation and deaths fell dramatically. With rising infections and more unpredictable variants, what on earth is the rationale for not making masks mandatory on public transport and in other situations where staff are dealing with an increasingly maskless public?
I thank the noble Lord for that very touching personal testimony about his neighbour who passed away. It is an important account of many who have put themselves at risk. The PHE report on high mortality groups includes bus drivers, taxi drivers and many who perform an important public service that puts them in front of the general public and therefore at risk from this virus. We absolutely support the wearing of masks. Published guidance will continue to recommend that wearing a face covering will reduce the risk not only to yourself but to others, particularly in enclosed and crowded spaces. The noble Lord asked about whether mandation should be in place and for whom, and I do not wish to duck his point The mandation of masks on public transport is best left to those who run it, which is why we have moved away from legal rules to an approach that enables personal judgments and the intervention of businesses and local leaders.
(4 years, 4 months ago)
Lords ChamberMy Lords, does the Minister recognise that the key players in the food system are the large producers, the large supermarkets and the big caterers? Between them they set the prices and standards for small producers and farmers as well as spending huge amounts of money on advertising ultra-processed foods, as the noble Baronesses, Lady Boycott and Lady Bakewell, have just said—20 or 30 times as much as they spend on advertising fresh fruit and veg. Given that the Minister is reluctant to go for an advertising ban, how do the Government propose to get these large companies to help to deliver a more balanced, affordable and nutritious diet rather than, to facilitate the reverse, as they do now?
My Lords, I take some issue with the noble Lord’s demonisation of big companies and his characterisation that our food industry is dominated by a small number of them. Actually, the food industry in the UK is extremely diffuse and, when we consider regulation and advertising, we have to bear in mind that it is often the small producers, the small farmers and the small businesses which are affected by those measures. They have an effect on business, an effect on jobs and an effect on tax, so this is not a simple matter. That does not mean that we are not serious about the subject, but we have to bear in mind the effects on the entire supply chain, which includes many important British companies.
(4 years, 4 months ago)
Lords ChamberMy Lords, I can confirm that the Government have been following the code of conduct, as the noble Lord suggested. I am also hungry to publish the performance data. I can confirm that, so far, there have been 73,365 users of the Isle of Wight app, 53,490 of whom were on the Isle of Wight. The user experience has been largely benign, and we look forward to publishing fuller technical and user details shortly.
My Lords, on timing, was the analysis of the Isle of Wight results, particularly as regards privacy, available to Ministers before we started to roll out the system across England? If so, how did that influence the rollout? On the Isle of Wight, were participants told that management of their data would be contracted out to a private company, now in the national context known to be Serco? If so, what was their reaction?
My Lords, the greatest insight from the Isle of Wight experiment was that human contact tracing needed to be the first stage of our rollout of the test and trace programme and that, in the sequence of things, the app should come later, when people have got used to the principle of contact tracing. The use of private companies by the Government is commonplace, and we have had no adverse comment on or reaction to that usage.
(4 years, 5 months ago)
Lords ChamberThe noble Lord is correct: it is one test per resident for each infection. I pay tribute to the many care homes which have no infection at all, which have applied the correct disciplines and systems and for which no demand for the tests is currently present. We are prioritising homes that have infection and working through all their residents and staff, offering second and regular testing until the infection is eradicated. That logical prioritisation is exactly the right way to use the resources of both time and supplies, which are necessarily limited.
My Lords, I welcome the Minister’s reassurances, but is it not the case that this Question had to be asked because it was not clear whether the issue in care homes was a priority at the beginning of this crisis? That is shown by both the release of hospital patients into care homes and the failure to provide testing and PPE for their staff and residents. Was it true that the list of priority sectors at the beginning of this crisis did not include care homes?
My Lords, it is not true that the list of priorities did not include care homes. In every epidemic, care homes are always a priority. History has taught us that and we knew it from the beginning. We have focused on them enormously; that is why care homes are a number one priority at the moment. We are determined to reduce the rate of infection so that infection does not leak into the community.
(5 years, 10 months ago)
Lords ChamberPerhaps the noble Lord should consider attending some of these debates. We had a very good debate, attended by Front-Benchers of the Liberal Democrats and the Labour Party as well as Cross-Benchers, about these incredibly important regulations which are designed to provide continuity to people who rely on such things as blood and organs and the ability to exchange information for surrogacy purposes—which we want to encourage. While I respect the noble Lord’s right to do what he is doing, it is not a good use of time. It would have been better spent if he had engaged in our debate last week.
Would the frustration of both Ministers and the House not have been met had the Government responded to the point raised on the Statement last week by the noble Lord, Lord Wallace of Saltaire, asking the Government to set out clearly for the House what legislation is required between now and 28 March and in what order it will come in terms of both of primary legislation and SIs? We would then know what the sequence of events was and Ministers would not be faced with concern that the Government are trying to slip things through. I suggest that the Minister talks to his Chief Whip and that the usual channels produce such a schedule in time for us returning in January.
There is a schedule, which is set out in the Act, and we have good debates, as we did on these regulations. It is about making sure that we do everything that a responsible Government should do. If the noble Lord was in this position, would he be doing anything different? Of course he would not.
(7 years, 4 months ago)
Lords ChamberMy Lords, after five days of the debate on the Queen’s Speech, we have finally reached subjects which are of hourly and daily concern to millions of our fellow people—together with housing, which was briefly debated on an earlier day. These issues, from childcare to old age, concern millions of us. I do not feel that the Queen’s Speech addressed them adequately.
There is wide acknowledgement that there is a chronic crisis in the National Health Service. There is general recognition that we are suffering from a long-term affordable housing crisis, and there are serious problems of resources and teacher supply in schools. I therefore share the disappointment of the noble Lord, Lord Kirkwood, and others that in a Queen’s Speech for a two-year Session none of the legislative proposals and virtually none of the speech itself addressed fundamentally any of those interrelated social crises. The Minister was driven in his introductory speech to referring to general commitments and to relatively marginal Bills on patient safety and on money advice for pensioners. Although important in themselves, they did not address any of these fundamental issues.
It is not as if the issues were not acknowledged during the general election; indeed, many of the problems with the Conservative Party’s campaign concerned pensions and social care. It has retreated from its commitments in those areas but nothing has replaced them, and there is certainly nothing in this Queen’s Speech.
It is an indictment of this Government that they do not appear to be addressing those issues, but it is also a wider indictment of this House and the political system as a whole. Here we are on a Thursday afternoon at the end of the debate on the Queen’s Speech talking about these issues when the rest of the country has a rather different system of priorities.
The recent election and the Brexit campaign both revealed the stark divisions that exist in our country. We are not one nation, however much we may claim we are. At both ends of life, there are problems.
This Government and their programme put before the House do not address these issues. The noble Earl, Lord Kinnoull, referred to his committee’s report on social mobility. Coincidentally, a report was issued this week by the independent Commission on Social Mobility. Its conclusions are that 20 years of successive government commitments and some interventions to improve social mobility have failed and that, despite some programmes having limited success, the overall position is that we are going backwards. There is a spatial and regional divide, an income and wealth divide, an educational divide—as the noble Baroness, Lady Stowell, emphasised—and particularly a generational divide.
I shall focus briefly on the generational divide. It was evident in the general election, in the Brexit vote and in the Scottish referendum. The independent commission’s report recognised that those reaching majority in this decade are the first generation post war and probably for 100 years who will be less well-off than their parents at the same stage of their lives, with no prospect of that getting better. It is therefore not surprising that there is a generational divide. Sometimes, we do not acknowledge it. Looking around the House today, we have to recognise that our own position is not that of the country. Most of us here, being of the age that we are, probably received a free university education. Most of us could afford a mortgage in our 20s—not all of us, but most of us. Most of us had jobs or professions that yielded a steady income with reasonable prospect of job security and a fixed retirement age for which we could plan. None of that is guaranteed or even likely for the coming generation, or in many respects for people under 50.
The current generation of pensioners are envied by the young because they have decent private pensions in many cases and at least inflation-proofed state pensions. However, some of that envy is misplaced, because there is also a sting at the tail of our lives. We may enjoy our pensions and in our 60s and 70s our Saga cruises, but if we become ill and infirm the provision of social care, whether in residential homes or in our own homes, is totally inadequate. Conditions are often deplorable, with homes relying on staff who are poorly paid and under pressure to minimise any real empathetic care for those whom they are supposed to be looking after.
At both ends of life, there is a widespread feeling of betrayal, some of which came out during the general election campaign. That we are not concentrating on that cannot be blamed on our preoccupation with Brexit, nor can it all be blamed on austerity, although the end of austerity, which some Ministers have begun to proclaim, raises the possibility of some of these issues being addressed. As my noble friend Lady Sherlock said, we need to remove the ideology of those who see austerity not as a short-term necessity but as an end in itself. We do not need a further retrenchment of the state; we need the opposite: for the state to take on its responsibilities in its spending and in effective regulations and enforcement of them. If recent events show us anything, they show us that.
The yawning gap between the Government’s ambition in the Queen’s Speech and the growing divisions in our society are underlined in the report of the independent Commission on Social Mobility. It states:
“Our country has reached an inflection point. If we go on as we have been, the divisions that have opened up in British society are likely to widen not narrow … The old agenda has not delivered enough social progress. New approaches are needed if Britain is to become a fairer and more equal country. It is time for a change”.
I hope that Ministers are listening and that the legislative programme in this parliamentary Session will eventually reflect the need to address those problems.