Coronavirus Act 2020: Temporary Provisions

Lord Wigley Excerpts

Monday 28th September 2020 Lords Chamber

[Lord Wigley (PC) [V]]

My Lords, I am delighted to follow the noble Lord, Lord Moynihan. On another day, I would greatly like to follow his sports-related theme, particularly the reopening of grounds, and his theme of young people.

I draw attention to my registered interest as a vice-president of Mencap. I also salute the three eloquent maiden speeches we have heard. Like the noble Baronesses, Lady Walmsley, Lady Campbell and Lady Hollins, and the noble Lord, Lord Hunt, I want to address the impact of this legislation on disabled people and their families. I will not try to address the whole spectrum of the other issues.

Most of the Coronavirus Act extends to Wales as it does to England. In Wales, it is Welsh Ministers who have responsibility for taking action under the Act, as well as under provisions of Wales-only legislation that is relevant to these matters.

I want to emphasise briefly the great significance of the Covid rules for people with learning disabilities and their families. That is relevant to Wales and England. Clearly, the regulations to protect vulnerable people from the disastrous impact that Covid can have on them are a two-edged sword when it comes to the plight of people with learning disabilities. Regulations are certainly needed to safeguard them, since many are in that category of citizens who are most open to suffering disastrous consequences from Covid. Equally, some people with learning disabilities—not all, but many—have difficulty coping with the additional safeguards they are expected to follow; for example, the wearing of face masks.

In Wales, of the 70,000 people with a learning disability, only 3,500 live in supported or residential care settings. Those who live at home are often cared for by elderly parents, who are often in a group of vulnerable people themselves, not least due to their age. The increased intensity of caring responsibilities lands on them at the very time when they themselves are most vulnerable. Additional support at home is often needed due to the closure, on account of Covid, of day centres and places of work for those who have been able to benefit from sheltered employment. The fear is that due to Covid, the support they have received may be decreased, which would be an absolute disaster.

For these reasons, as well as the vulnerability of disabled people generally, the reality is that they need a greater level of care in the present circumstances. This is where the question of allowing easements kicks in. Allowing easements of the regulations does not answer the needs of those with learning disabilities. What they need is additional help to enable them and their carers to cope with the necessary constraints imposed by coronavirus.

I am glad to say that in Wales, there is a close working relationship between the Welsh Government and the disabilities sector. Appropriate officials meet every fortnight with the Wales learning disability forum. They monitor the impact of the easements activated through our Social Services and Well-being (Wales) Act 2014, which is our relevant legislative framework.

The central message in both Wales and England is that Covid should not be used as an excuse to lower the levels of support needed by people with learning disabilities. Their needs are now even greater, and the support they get should reflect those needs.

Covid-19: Self-isolation Payment Scheme

Lord Wigley Excerpts

Wednesday 2nd September 2020 Lords Chamber

[Lord Bethell (Con)]

The noble Lord gives fascinating testimony, and I pay tribute to the council in Pendle, which is well known for its energetic approach in dealing with the epidemic. I honestly say a massive thank you to all those in Pendle who are working so hard. Despite what the noble Lord has just said, they are being successful. The strategy is working and they are fighting the disease and breaking the chains of transmission, and we are all hopeful that Pendle will be restored to normal life as soon as possible. Our approach is to give those on the ground the tools they need, exactly as the noble Lord asks. I am hopeful that that is happening. I hear reports that it is, and that is very much the emphasis of our approach.

[Lord Wigley (PC) [V]]

My Lords, will the Minister confirm that if local spikes appear around the United Kingdom, this scheme will be available to them? Will it be available in Glasgow, for example? Can he confirm that enough flexibility will be allowed to those administrating the scheme to ensure that those who need the scheme, whose circumstances will vary greatly, will be able to get it quickly and expeditiously?

[Lord Bethell (Con)]

The noble Lord asks a wide-ranging set of questions. We are looking at the effectiveness of the scheme. We are working with DAs to see whether the scheme could or should be extended in Scotland, Wales and Northern Ireland. Once that review is done and we have assessed its impact, we will be able to make decisions of the kind he describes.

Covid-19: Removal of Restrictions

Lord Wigley Excerpts

Tuesday 21st April 2020 Lords Chamber

[Lord Bethell]

Forgive me, my Lords, the beeping of my computer distracted me during my answer to the previous question. I did not want to give the impression that I was sceptical of the use of serology tests; far from it. We are investing a huge amount in research into serology tests of various kinds, both lateral flow and ELISA tests. We have been in touch with more than 180 providers of these tests. The Government recently backed a British-based consortium developing a British lateral flow test of which we have very high hopes and expectations, with a view to potentially doing a large amount of mass testing in the months to come. As the noble Lord rightly implied, you need a level of antibody prevalence for the testing to be accurate and useful. This type of test will be important to us further down the road and I will update noble Lords on the progress of our research as it develops.

[Lord Wigley (PC)]

My Lords, does the Minister agree that the best outcome by far would be for the unlocking to be simultaneous in the four nations of these islands? Does he also accept that that can happen only by the unanimous agreement of the four Governments? Will he confirm that there can be no question of areas ahead of the curve of the pandemic unlocking prematurely and putting in jeopardy the lives of citizens in other areas which are behind the curve?

Health: Learning Disability and Autism Training

Lord Wigley Excerpts

Monday 10th February 2020 Lords Chamber

[Lord Wigley (PC)]

My Lords, I am delighted to follow that moving speech. I draw attention to my registered interest in the form of my links to Mencap, and thank the noble Baroness, Lady Hollins, for facilitating this debate. I also pay tribute to her campaigning zeal on these issues over so many years; we all admire it tremendously and are indebted to her.

This is not the first time that we have addressed these issues. I spoke in a very similar debate in 2014. I served on the special investigation under the Disability Rights Commission, chaired by David Wolfe. Our 2007 report highlighted many issues to which we are returning today. It is immensely depressing that, despite warm words, so little progress of substance has been made. However, I welcome the opportunity to speak in this debate on tackling the inequalities that people with a learning disability face in relation to their healthcare services.

The noble Baroness set out clearly why all health and social care staff should receive learning disability and autism training. I, too, pay tribute to the campaigning of Paula McGowan, without whose efforts we would not be debating these matters today.

For far too long, people with a learning disability have faced inadequate healthcare and social care advice and services because of the inability of those providing the services to do so in a manner that enables the person with a learning disability to access them fully. We have heard in this House of scandal after scandal involving people with a learning disability dying avoidable deaths, often in tragic circumstances. Mencap has campaigned on this issue for many years, and I would highlight their report, Death by Indifference. Through six case studies, it revealed the reality that people with a learning disability face when receiving care in the NHS. While it led to the confidential inquiry and, subsequently, to the learning disability mortality review, things have not moved on quickly enough.

The first annual report from that review revealed that women with a learning disability are dying 29 years sooner than women in the general population, and men 23 years earlier. We can all imagine how we would feel if we were told that we might expect to live much shorter lives for reasons that could quite easily be counteracted. One can but imagine the sense of fear and anxiousness, arising from seeing shocking cases on the news, as each time you go into hospital, you think it might be the last time you do so. That is why, since 2018, Mencap has been running its Treat Me Well campaign, to transform how the NHS treats people with a learning disability and bring about equal access to healthcare.

However, equality in healthcare does not necessarily mean treating two people the same way. It is about everyone receiving the right healthcare for their needs. The NHS and social care staff are overwhelmingly dedicated to their profession and seek to provide the best possible care for every person, but they need the appropriate skills to achieve this. We must not assume that all such staff have direct personal experience of engaging with people with a learning disability or, necessarily, positive attitudes when doing so.

The Treat Me Well campaign revolves around local groups working with their NHS Trusts and healthcare professionals in a positive manner, rather than simply criticising poor practice. It is our duty to ensure that all staff, existing and new, are equipped with the essential skills and tools to provide the best possible care, regardless of a person’s disability. That is why mandatory learning disability and autism training must be part of the curriculum.

This debate is primarily about England, but health inequalities are not bound by borders so it might be helpful to share the progress made in Wales, where almost all the relevant responsibilities are devolved to the National Assembly. There may be much that we can learn from each other. Actions to reduce health inequalities have been in place in Wales since 2014, when the Welsh Government introduced the learning disability care pathway. This was a direct response to the tragic death of Paul Ridd in Morriston Hospital, Swansea, in 2009. Paul’s family have worked tirelessly in partnership with Mencap Cymru to improve awareness of the needs of patients with a learning disability. I pay tribute to Jayne Nicholls and Jonathan Ridd, Paul’s sister and brother, for their commitment over the last decade to improving health outcomes for people with a learning disability in Wales.

In November the Welsh Government announced plans to introduce mandatory learning disability awareness training for all NHS staff. This will, appropriately, be named after Paul Ridd. Such training is being designed with input from Mencap Cymru, the Paul Ridd Foundation and the University of South Wales. It is expected to be rolled out gradually and systematically, starting very shortly. I warmly welcome that move and congratulate all who helped to bring it about. I hope that NHS England engages with colleagues in Wales to share best practice in both directions and to learn from our respective experience.

A key element of the training provided in Wales is the central role that those with their own lived experience have played in its creation. I agree with the noble Baroness, Lady Hollins, that central to rolling out effective learning disability and autism training in England, and preventing it becoming a tick-box exercise, is ensuring its co-production and co-delivery by people who themselves have direct lived experience. Tick-box training simply will not stop the continuous list of scandals we have experienced. Putting those with lived experience at the heart of the training will go a long way towards breaking down negative attitudes and stereotypes and help to develop staff communication skills.

My ultimate hope is that training co-developed and co-produced by people with lived experience will help to prevent premature deaths. I hope that the Minister can give some reassurance that those with lived experience will play a central role in such training, and that she accepts that this is one vital step among many for ensuring that people with a learning disability receive the standard of healthcare that they have a right to expect.

Learning Disabilities Mortality Review

Lord Wigley Excerpts

Wednesday 15th May 2019 Lords Chamber

[Baroness Blackwood of North Oxford]

In my view, there should be no variability in the quality of care that a person with learning disabilities receives in whatever part of the country they are in. That is exactly why the LeDeR was brought in, why we have brought in a care review to understand why there is variation, why we are bringing in support through training for those delivering care and why we are bringing in measures under the long-term plan: so that individuals can be identified and flagged up to healthcare professionals who, once they have the training, can apply it and bring in proper healthcare for individuals so that they do not see the life expectancy challenges in healthcare we have been seeing until now.

[Lord Wigley (PC)]

My Lords, I draw attention to my registered interests and involvement with Mencap and Mencap Wales. A moment ago, the Minister finished her answer by referring to the need for nurses to be trained, and to have the awareness and ability to deal with people with learning disabilities so as to mainstream what is happening. Can she assure us that some priority will be given to this issue? Until we get the lack of capacity sorted, we cannot make the reasonable adjustments that will solve the problem we are addressing.

[Baroness Blackwood of North Oxford]

I can say absolutely that priority will be given to this. The mandatory training consultation, which has just been completed, was published on 13 February. The consultation lasted eight weeks but such was the volume of responses to it that it was extended by a further month; it received more than 5,000 responses, which the department is currently going through. There has been a commitment to a response within two to three months. The Government are taking this extremely seriously.

Carers: Back Pay Liability

Lord Wigley Excerpts

Wednesday 16th May 2018 Lords Chamber

[Lord O'Shaughnessy]

The noble Baroness makes an important point about the attention my right honourable friend the Secretary of State is giving this. We are taking this issue seriously, and she is quite right about the number of organisations that are affected. As I said, a scheme already exists which allows providers to defer any payments, and we are investigating whether any further interventions are necessary during that period when they can defer them.

[Lord Wigley (PC)]

My Lords, I draw attention to my entry in the register of interests as a vice-president of Mencap. Is there not a taste of retrospective legislation or at least retrospective interpretation of legislation in this, something we always try to avoid? When one hears figures, as we have, of some £400 million of liability for organisations undertaking such excellent work, does this not justify the Government intervening to ensure that no such organisations suffer unduly as a result of these changes?

[Lord O'Shaughnessy]

I agree with the noble Lord that there is a retrospective element to this, but it is around the clarification of the law. The Government have put a support scheme in place through HMRC to provide that support to resist, for example, enforcement notices on workers who ought to be paid in arrears. That is up and running and it has been open since September 2017. But clearly, as that continues we are also looking at whether other interventions might be necessary.

Social Care: Sleep-in Payments

Lord Wigley Excerpts

Thursday 7th December 2017 Lords Chamber

[Lord O’Shaughnessy]

We absolutely recognise the pressures that this has caused for providers of all kinds, whether they are large providers of social care or those with personal budgets in receipt of direct payments. I should point out that HMRC is working with local authorities where they are providing funding for direct care, so it is not just a discussion between individuals and HMRC. Local authorities are involved as well because they clearly need to look at the budgets they are providing to make sure they are adequate to pay for existing costs. We are looking at all the issues around historic liabilities, but I am afraid that I cannot give the noble Baroness the commitment she is asking for today.

[Lord Wigley (PC)]

My Lords, I declare my links with Mencap as shown in the register of interests. Will the Minister tell us what contingencies the Government have put in place to fund the services received by people with a learning disability to cover their financial difficulties arising from the Government’s decision not to fund historic liabilities on account of sleep-in shifts?

[Lord O’Shaughnessy]

It is not our position that they will not be funded. That is one of the options being explored at the moment. A huge amount of work is going on with providers and all parts of government. In the end, however, the Care Act 2014 means that local authorities have a responsibility to take on the commissioning of and, ultimately, provision for providers, if they are looking at exiting the market, to make sure there is proper and comprehensive provision in the local area.

Health and Social Care

Lord Wigley Excerpts

Thursday 24th November 2016 Lords Chamber

[Lord Wigley (PC)]

I am delighted to follow the noble Lord and the trenchant points he has made. I thank the noble Baroness, Lady Finlay of Llandaff, for initiating this timely and far-reaching debate. I also take this opportunity to thank her for her tremendous contribution to the health and social care services in Wales over many years. She spoke today from a position of immense knowledge and experience. The Government would be foolish to ignore her warnings and, indeed, the warnings of others who have brought their expertise and viewpoints to this debate.

I wish to make it clear where I am coming from on this issue. I have always been an ardent European and regard the Brexit vote as an absolute tragedy. Therefore, before I address the specific healthcare dimension, I wish to say a word about the state of play on Brexit. I accept that, regrettably, we are likely to leave the EU. The vote on 23 June in the advisory referendum asks the Government to take such a step. The referendum did not in any way advise the Government on what new alternative relationship the UK should have with our current 27 European partners. Several alternatives were mooted during the referendum campaign by the Brexit backers. Some advocated a Norwegian-type relationship, some an arrangement more similar to that of Switzerland, and some even proposed Albania, Turkey or Ukraine as possible models. Others looked to the long-negotiated deal that Canada has secured. Others on the hard Brexit extreme advocated basing new arrangements on World Trade Organization rules, and essentially walking away from our European neighbours.

Not one of these alternatives was endorsed or rejected by the referendum. The Government have no mandate from either the referendum or the 2015 general election manifesto to adopt any of these alternatives as the way forward. They have not yet even asked Parliament to endorse any preferred course of action. Unless they secure a prior mandate from Parliament laying down the negotiating objectives—not necessarily in all the intricate detail, but by way of broad strategic targets—they must face the possibility two years down the line of returning with a set of proposals that Parliament then rejects. In these circumstances, Parliament would have every entitlement to instruct—yes, instruct—the Government to withdraw their Article 50 application, which lawyers now accept is legally possible. It therefore now behoves the Government to seek a mandate from Parliament for their strategic objectives, and I approach this debate on the potential implications for the NHS from that angle.

Improving, not undermining, the NHS was a serious factor which influenced many people to back Brexit, believing that the NHS would gain £350 million a week and thereby recruit more doctors and nurses, many of them from the European Union itself. The NHS is massively dependent on staff who have been recruited from overseas. Some 20% of the entire NHS workforce is from overseas: about half from the EU and half from other overseas countries. More than 10,000 NHS doctors come from other EU countries, as do more than 20,000 nurses, and they come predominantly from Ireland, Poland, Spain, Portugal and Italy. In Wales, a staggering 30% of all doctors were trained abroad—2,687 of them.

The Brexit vote has done two things. It has raised in the minds of NHS staff from other EU countries the question of whether they will be sent home when we quit the EU. These fears were exacerbated by the Prime Minister’s ill-advised comments at the Tory Party conference and her subsequent refusal to give assurances that all EU citizens currently working in the UK will, in all circumstances, be guaranteed the right to continue to work in the UK indefinitely. The only definitive statement made by the Prime Minister on these matters has been to rule out the Australian-style immigration system. The uncertainty created by the inept way the Prime Minister has dealt with these issues has led NHS staff, particularly in specialist jobs, to start looking around for suitable vacancies in other countries. No one can blame them. If in two years they find that they have to go, they might not then easily find a job in their home country. Indeed, they might face much greater pressure as other medical specialists in the UK also turn back to look for jobs at home.

The pressure to leave the UK is not just on EU-originated NHS workers. Many from Commonwealth countries have faced the horrid racial abuse that has mushroomed as a direct result of the Brexit campaign. Racially motivated crime has escalated, as the police have told us, and many NHS staff from non-EU countries are asking themselves whether they want to remain in a narrow, inward-looking, racially prejudiced Britain—indeed, whether they want to bring up their children in such a hostile climate. It is an absolute tragedy that all the hard work that has been done to break down the barriers of prejudice and racial hatred have been so disastrously undermined by the tone of the Brexit campaign, the outcome of the referendum and the Government’s inability to handle the situation.

I ask everyone, throughout the UK, to look around when they go to their hospitals and note the number of overseas workers on whose backs all that depends, and to look at the lists of names of doctors in the departments they visit and see the many names from foreign countries. My wife recently went to an NHS hospital in Wales, and of the 14 names on the plaque by the department no fewer than 12, at least ostensibly, were from overseas. I ask people to think what they would do if such staff went home, as some are told to do on the pavements of British cities. I ask them to consider the dependency of other services, such as home helps to support disabled people, or the staff in homes for the elderly who look after their parents or grandparents.

I ask the Government, taking all these aspects into consideration, to do three things. First, they should announce forthwith that every EU national—indeed, every overseas national—working in the UK will be entitled to remain here irrespective of the Article 50 negotiations and their outcome. Secondly, such a guarantee will have no ifs, no buts and no conditions; it will be absolute and not time-limited. Thirdly, it will be in the UK’s negotiating position, if we are leaving the EU, to retain our rights vis-à-vis the single market—if necessary, specifying a customs union deal—and accept the free movement of working people throughout the EU into the UK. Anything less than this will leave a bleeding wound that will hit many sectors of the UK economy, but none worse than health and social services, from which the haemorrhaging of vital staff could lead to the end of the NHS as we know it.

Learning Disabilities: Premature Deaths

Lord Wigley Excerpts

Wednesday 30th July 2014 Lords Chamber

[Earl Howe]

My Lords, many of the issues that apply to those with learning disabilities also apply to others with different disabilities, and the work currently going on in the context of the noble Baroness’s Question will, I think, have a beneficial impact across the piece.

[Lord Wigley (PC)]

Does the Minister accept that a number of the points arising out of the confidential inquiry were touched upon by the earlier DRC report published more than six years ago, Equal Treatment: Closing the Gap, and that progress since then has been patchy? In the light of that, will he give a commitment that there will be an annual review of progress made on the confidential inquiry recommendations and a report to Parliament?

Learning Disabilities: Community-Based Support

Lord Wigley Excerpts

Tuesday 22nd July 2014 Lords Chamber

[Earl Howe]

My noble friend is absolutely right to focus on the role of commissioners. The Winterbourne View joint improvement programme has already stepped up its activity in working with local areas, including identifying 35 areas for in-depth review. NHS England is engaging with commissioners to reinforce the importance of ensuring appropriate services for people with learning disabilities close to their homes and families. That includes looking at how funding streams can be shared with local authorities so that there is no procedural blockage in the way that money moves across the system.

[Lord Wigley (PC)]

My Lords, on that very point of funding, how will the Government ensure that funding in fact follows the individual and does not, as so often currently occurs, remain locked into the funding of the wrong kind of provision? In asking this, I draw attention to my registered interest as vice-president of Mencap.