Down Syndrome Bill

Baroness Brinton Excerpts

3rd reading
Friday 1st April 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, we have a remote contribution from the noble Baroness, Lady Brinton.

[Baroness Brinton (LD) [V]]

My Lords, I too want to join in congratulating the noble Baroness, Lady Hollins, on the Bill reaching the end of its legislative passage today. Her expertise and commitment to people with Down syndrome and other learning disabilities is well known and much respected—and not just in your Lordships’ House.

I rise to speak on behalf of some of the Peers who raised concerns about this Bill at Second Reading, particularly the noble Baroness, Lady Neville-Jones, and the noble Lord, Lord Farmer, who cannot be in their place today. I will start by saying what is good about this Bill. It has raised the profile of Down syndrome, which, speaking as someone with a nephew with Down syndrome, I say is a good thing and long overdue.

Your Lordships’ House will remember that eight of the 12 cross-party speakers noted that, if the Bill had the powers which its promoters suggest, there risks being a hierarchy of learning disability. This has already caused a split between families with learning disability, all of whom still need to fight for the limited resources to which the law says they are entitled. I am pleased to hear the noble Baroness, Lady Hollins, expressing her desire that the objectives of this Bill are extended to other people with genetic conditions and learning disabilities. I am sure that she and I—and others —will be looking to future government Bills to make a real difference to the lives of all people with learning disabilities.

I will not go through the details of the concerns we had before, because now is not the time. One of my great concerns is that the hopes of many families of people with Down syndrome have been raised beyond the powers in this Bill. I hope that the Minister will ensure that those aspirations are met, not just for people with Down syndrome but for the wider learning-disabled community. I wish this Bill well.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Kamall) (Con)]

My Lords, I begin by extending my congratulations to the noble Baroness, Lady Hollins. I am grateful to the noble Baroness for steering the Bill to this point. I also extend a warm welcome to those who were in favour of this Bill, some of whom are in the Public Gallery. I offer my thanks to the right honourable Member for North Somerset, Dr Liam Fox, who introduced this Bill in the other place. I also want to thank everyone else who has been involved in developing this important piece of legislation.

I know that a number of concerns have been raised, and I welcomed the scrutiny of the Bill two weeks ago at Second Reading. The Government recognised some of the points that were made. Noble Lords raised important matters about the risk of discrimination and widening inequalities, as well as how the proposed guidance could be developed, scrutinised and implemented in a fair and inclusive way. We have listened closely to these concerns, and I hope to reassure noble Lords on a few points so they can be confident in their support of the Bill and the impact it will have at this stage.

The guidance is about making clearer what steps could be taken by relevant authorities to meet the unique needs of people with Down syndrome. The Bill does not remove the duties under the Equality Act 2010 for relevant authorities to assess all the needs of people to whom they provide support. Our assessment is that, to prioritise funding and resources for people with Down syndrome above other groups without proper assessment of people’s needs would be considered unlawful.

The Government will consult with a broad set of stakeholders in developing the guidance, including those with other conditions. I want to be clear that people with lived experience will be at the heart of this at each phase of its development. We will strongly encourage and support people with other genetic conditions, disabilities and protected characteristics, and their advocates, to engage with this process. It is right that we support legislation that will improve life outcomes, reduce inequalities and build a fairer society.

NHS: Pre-pandemic Facility Levels

Baroness Brinton Excerpts

Tuesday 29th March 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, we have a virtual contribution from the noble Baroness, Lady Brinton.

[Baroness Brinton (LD) [V]]

My Lords, surveys of parent carers during the pandemic by the Disabled Children’s Partnership reveal that more than 70% of disabled children were unable to access their pre-pandemic levels of therapies and health services, and many of their conditions regressed during the pandemic. How do the Government plan to use wider NHS recovery funding to meet the acute health needs of disabled children and young people?

[Lord Kamall (Con)]

I thank the noble Baroness for making me aware of this issue. We are aware of a number of front-line services where there is a backlog as a result of the pandemic and not being able to have face-to-face appointments. However, I will have to write to her on the specific case that she raised.

NHS: Gambling Treatment Services

Baroness Brinton Excerpts

Monday 28th March 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, the noble Baroness, Lady Brinton, will make a virtual contribution.

[Baroness Brinton (LD) [V]]

My Lords, Public Health England says that around 246,000 people are likely to have some form of gambling addiction, but last year, only 668 people—with the most severe addiction issues—were referred to the gambling clinics because of a lack of resources. Even with the extra clinics over the next three years, will this number of clinics be able to treat the top 10% of patients, which is 24,000 people? If not, when will the service expand to help them too?

[Lord Kamall (Con)]

The noble Baroness makes an important point and there is recognition that we must do far more on this. That is why we held a review of the Gambling Act in the first place. As noble Lords will be aware, when the work is cross-government, the Department of Health cannot lead in this area; it can contribute when it comes to the health and addiction impacts of gambling but we are doing this in a joined-up way. The White Paper will be published soon and we are continuing to have conversations with the Department for Digital, Culture, Media and Sport on this issue.

Commissioner for Patient Safety (Appointment and Operation) (England) Regulations 2022

Baroness Brinton Excerpts

Monday 21st March 2022 Grand Committee

[The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. She speaks as the Front-Bench Liberal Democrat spokesman but as there are no Back-Benchers, I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, I thank the Minister for his introduction. He will know that across the House there have been considerable discussions, not just in recent months but recent years, on the role of the commissioner for patient safety in various Questions, debates and Statements since the First Do No Harm report of the noble Baroness, Lady Cumberlege, was published in 2020. I join the Minister in paying tribute to her, not just for her report but for her absolute persistence in holding the Government to account to deliver as many of her recommendations as possible. I too am sorry that she cannot be with us today but I know that she is pleased that this SI has been published.

This SI specifically covers the appointment of the commissioner but, once again, government actions are happening before Parliament has had a chance to scrutinise this SI. This SI sets up the role of commissioner, but the Minister has just told us that not only is the advert out, but it is closed and an imminent announcement is due. I do not think that there is anyone who does not want the commissioner to be put in place, but once again, this seems to be putting the cart before the horse in that the SI is being dealt with after the advertisement has gone out.

However, for the first time there will be an independent commissioner whose role is to stand up for the rights of patients when they have suffered avoidable harm. The three main parts of the report of the noble Baroness, Lady Cumberlege, covered HPTs, sodium valproate and vaginal mesh but there are other issues as well, and unfortunately there will be more in the future. That is why the Minister is right to say that the creation of a learning and safety culture is absolutely vital, as is an environment in which people working inside the NHS and other organisations associated with delivering medicines and medical devices can speak without fear. That is why some of us had concerns over the initial period of appointment. While the possibility of a second term is welcome, the concerns related to that first period of setting up the commission. This is not just somebody who will walk into the job and everything will be ready to go. The difficulty is that, having established themselves in the post, they will then have to gain the confidence of everybody who they might be investigating, which can take a while. It will be quite difficult to judge whether it is appropriate to appoint them for a second term if they have had probably only about 18 months when they have been able to do the job properly.

Food and Feed Safety (Miscellaneous Amendments and Transitional Provisions) Regulations 2022

Baroness Brinton Excerpts

Monday 21st March 2022 Grand Committee

[The Deputy Chairman of Committees (Baroness Garden of Frognal) (LD)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. She is speaking as the Liberal Democrat Front-Bencher but, as there are no Back-Benchers to speak, I invite her to speak.

[Baroness Brinton (LD) [V]]

My Lords, I thank the Minister for his introduction to the Food and Feed Safety (Miscellaneous Amendments and Transitional Provisions) Regulations 2022, which propose three very differing amendments to existing food safety measures. He was right to start by saying that ensuring the highest levels of food safety is absolutely vital.

The Joint Committee on Statutory Instruments has pointed out that the second and third regulations come into force on the day after the day on which these amendments are made, so once again they breach the 21-day rule. It is such a shame that SIs and regulations seem always to be dealt with as emergency items, because this reduces the time available for Parliament to effectively scrutinise legislation.

The first amendment is to Article 53 of the retained general food law, to manage a problem that has arisen as a result of the Northern Ireland protocol. I note that the Explanatory Memorandum calls it a “deficiency”. It might perhaps be more honest to call it a problem of the Northern Ireland protocol and the practical effect it has had on border issues for those living in Northern Ireland—how they have to juggle the tensions of a border in the Irish Sea when third-party goods come into Great Britain via Northern Ireland and where a serious risk to human health has been identified with those goods.

It is right that the UK Government must correct regulations that are not fit for purpose, and we note that these amendments to Article 53 do not change the purpose or function of the original provision but there is now full protection for such emergency measures, regardless of where the goods have come from.

The second amendment relates to the authorisation of provisions for feed additives and for GM food and feed, which will now be through legislation, bringing them into line with other retained EU food and feed law. That is particularly welcome. There is a lot of suspicion about GM food and feed, and it is important that there is a vehicle through which it can be scrutinised carefully. Parliament is the right place for that to take place.

The third and final change is a sensible step to ensure that businesses have a slightly longer period to move from EU to UK labelling requirements, until 30 September this year. For some time, food businesses have been asking for a longer period, as well as for labelling requirements to be as close as possible to the EU requirements. The latter is not covered by this SI, but I hope that the Minister will continue to listen to UK food businesses which want to continue to sell into the EU and which must also abide by the EU labelling requirements. I thank the Government for the extension to the period during which the EU ones can be used.

The SI brings us back to the wider issues of the Northern Ireland protocol. That is obviously not on the agenda for today, but I want to say that, from these Benches, we always warned that there would be problems for goods travelling into Great Britain via Northern Ireland and for businesses there, which continue to express real concerns about the UK’s decisions and legislation between 2018 and 2020. Whether one agrees with them or not, it is good that these three corrections and amendments will at least sort out some of those minor problems.

[Baroness Merron (Lab)]

My Lords, I am grateful to the Minister for setting out the rationale behind this eminently sensible statutory instrument, which deals with a number of significant technical issues relating to the Food Standards Agency, some of which have come about because of the Northern Ireland protocol. They need to be resolved, and from these Benches we are of course happy to support this statutory instrument.

I add that the Explanatory Memorandum is very helpful in outlining the approach that the FSA is taking. I will just pick up on a few points. First, paragraph 7.7 refers to

“An analysis of the emergency powers for”


food and feed control, which revealed that these powers could not be deployed as effectively as required. I am interested in exploring the context. It would be helpful if the Minister could advise on whether this analysis was through a hypothetical desk-based exercise, or whether the situations referred to actually occurred. For example, did goods identified as presenting a serious threat to human health enter Great Britain through Northern Ireland or did that not happen in reality?

I welcome the clarification that the GM and feed additive authorisations will be dealt with through an SI. It would be helpful if the Minister could confirm whether this will be through the negative or affirmative approach. Also, are there any implications for the Government’s longer-term strategy for GM products, given the recent statutory instrument that changed some of the rules on research and gene-edited crops?

On the issue of labelling, it would also be helpful if the Minister could comment a bit on whether he feels that the date in place is the right one. I say that because the food production sector finds itself under pressure, of course, and we want to ensure that this is a practical step.

Throughout the consultation, the National Farmers’ Union has sought clarification on the UK’s relationship with the European Food Safety Authority. The NFU has stressed the importance of the UK’s close collaboration with the EFSA on equal terms. Can the Minister comment on the Government’s intentions for their relationship with the EFSA in the context of this statutory instrument, given its importance to our food industry? I would be most grateful.

I have a final point to raise. With regard to the consultations, one observation by the sector was about the expectation that these changes to the regulations could be read through in under an hour, such that businesses, regulatory agencies and councils would be able to work out in that short period how to apply the changes to their organisations. I know that this was regarded as somewhat overoptimistic, but has any further thought been given to an assessment of just how easy it will be to work with these regulations? With those comments, I offer our support for these regulations and thank the Minister in advance for the reply that I know he will give.

Down Syndrome Bill

Baroness Brinton Excerpts

2nd reading
Friday 18th March 2022 Lords Chamber

[Baroness Brinton (LD) [V]]

My Lords, I declare my interest as a vice-president of the Local Government Association. I thank the noble Baroness, Lady Hollins, and Dr Fox for their time in answering questions at yesterday’s helpful briefing, and the various people and groups who have written to me and other Peers. It was also a pleasure to support the amendments to the Health and Care Bill of the noble Baroness, Lady Hollins, on mandatory training for staff working with people with learning disabilities and autism. I am delighted that the Government agreed. I too pay credit to the noble Baroness, Lady Hollins, for her outstanding campaigning over many years for people with learning disabilities.

My Spanish nephew Alex, now in his late 30s, has Down’s syndrome. As a family we have seen this baby grow into a fine young man, hampered only by the perceptions of others. My sister has had to fight for his rights, be it for a Covid vaccine this year or for his medical needs over many years. She had to take on the education authorities because there was no integration at all in schools: “children like that” went to a special school that was, in reality, a hospital, with locked doors and staff in white coats. She won her campaign and he was the first child with Down’s syndrome to go to mainstream primary in Majorca. But the most important part of his story so far is that he is a fantastic sportsman. Twelve years ago he won a European championship in karate; he has also swum in national competitions, and I cannot tell you how proud we are of his achievements. Yet too many people do not see past the condition, nor understand that every person with Down’s syndrome is an individual and has differing needs.

Another Alex, the same age as our Alex, is the daughter of our very close friend. She went to primary school and Sunday school with our children, and now lives happily in a house near her mum, with support from carers. She is non-verbal and needs constant support when awake. She loves her house, her daily routine and her family. As with almost all people with Down’s syndrome and their families, it has not been easy, but for this Alex, it works.

So when I read this ambitious and laudable Bill, my first question was: how will this help people with Down’s syndrome and their families? Our role in the Lords is to make sure that legislation delivers the intention of a Bill and does not create unintended consequences. I share the concern of the noble Baroness, Lady Neville-Jones, that inadvertently this Bill will create a hierarchy of disability that risks doing harm to the rights of other disabled people, particularly people with learning disabilities, which may also be discriminatory.

By their very nature, the Bill and subsequent guidance will create a unique and separate focus on the needs of people with Down’s syndrome, as well as duties and rights that are exclusive to this group, which risks undermining the principles of equality and non-preferential access to resources across education, health and social care, and employment. There is also a danger that it may disadvantage individuals with other disabilities who do not have the same legal recourse if providers fail to abide by the guidance. Can the Minister tell me what work will be undertaken to ensure that the Bill does not disadvantage people with disabilities other than Down’s syndrome? If the Minister believes that no such work is required, what is the purpose of legislating to provide exclusive duties relating only to people with Down’s syndrome?

I am also concerned that the Bill lacks power to achieve its aims, which risks causing confusion among public bodies and people with Down’s syndrome and their families about their duties and their rights.

In common with people with learning disabilities generally, people with Down’s syndrome and their families face significant inequalities and discrimination in our society. The current framework of legislation that we have to address this includes the Care Act, the Children and Families Act, and the Equality Act. However, they have been systematically weakened by underfunding and by removing mechanisms through which people can secure redress.

Understandably, expectations have been raised very high by the Bill, yet I see evidence from the Minister that it and the resulting guidance have no power to address these deep-seated problems. For example, can he explain how it will ensure that people with Down’s syndrome can secure appropriate and adequate social care and that our classrooms include additional teaching assistants? The Bill does not say that. Can the Minister provide examples of the differences he believes that this Bill will make in the context of health, social care and education?

Dr Liam Fox commented that the Bill

“sets a precedent that can be followed later on in other areas.”

That has been commented on by noble Lords this morning. Will the Minister tell me whether it is the intention of the Bill to set a precedent where each diagnosis will require a new set of guidelines and, if so, what continued role the Government see for the existing legal duties which underpin disability equality? In Committee in the Commons, Gillian Keegan said at the Dispatch Box:

“We recognise that people with genetic conditions other than Down syndrome may experience problems similar to those of people with Down syndrome, so we will consider the overlaps and linkages between such conditions and Down syndrome through consultation on the development of the guidance”.—[Official Report, Commons, 26/1/22; col. 8.]


I know that by giving one group rights when resources are scarce, others will not get them. I echo the question asked by the noble Lord, Lord Farmer: what happens to those who have other genetic conditions, or none, but have learning disabilities, who must rely on the good will of Ministers in the future, and to those with learning disabilities who may not fall into this category? Here in Watford, our CCG decided some years ago to close the children’s respite centre, Nascot Lawn, because in its view respite care was not statutory. Children eligible for respite care have multiple and profound needs, and personal care for them has to be delivered by nurses or by family members trained by hospitals. Twice the Nascot Lawn families won High Court judgments against the closure and the removal of that respite care and the lack of proper provision.

The CCG repeatedly said that its resources were scarce and it had to prioritise just statutory services. It closed in 2018, and these children and their families have struggled ever since to get the support they need. It did not matter that their EHCPs said that these children and families needed respite care; it was all about resource. At least one family could not manage to look after their child without that respite care: being on duty 24 hours a day and every night had taken its toll. Will other people with high levels of need but who are not people with Down’s syndrome move even further to the back of the queue?

There is also concern that the Bill and guidance risk undermining principles concerning person-centred assessment and support, embedded in law, whether in relation to support for children and families or support for adults, by elevating the condition and suggesting that this predicts needs. That is why I gave the illustration of our two people named Alex. This not only represents a regressive step politically, by advancing a medical model of disability and elevating diagnosis over individual needs; it will also create considerable legal and regulatory complexity for local councils, the NHS and schools at a time when they are already stretched in meeting statutory duties. Will the Minister recommit to the principles of person-centred rather than diagnosis-centred assessment and support and tell me what work will be undertaken to embed this person-centred approach at every stage of the development of the guidance?

Given that it was announced in the Commons that there may be a “named person” on integrated care boards, which we have discussed at some length during the passage of the Health and Care Bill, what role will they have in ensuring the compliance of public bodies with the guidance? Will that be solely for people with Down’s syndrome, especially in the light of the past practices of CCGs, which I have outlined?

I will make a brief point on the proposed guidance. As my noble friend Lady Jolly said, will Ministers ensure that the principles of “No decision about us without us” ensures that the voice of people with Down’s syndrome is represented? Although the Commons has a mechanism to scrutinise guidance, that is not true in your Lordships’ House, so will the Minister undertake to ensure that there is time for a debate on the guidance, as it is published and debated in the Commons? As the noble Baronesses, Lady Bennett and Lady Uddin, outlined, government resources have been a real issue. The net is full of holes not through a lack of guidance, White Papers and good will but through a lack of government investment and strategic leadership for over a decade.

I think that everyone who has spoken at Second Reading today and in the Commons is passionate about ensuring that people with Down’s syndrome and their families can remove the current structural and social barriers that they face. The concerns that a number of Peers have raised today are important, and the Lords needs to be able do its job and to have responses from the Government in Committee and on Report to ensure that the Bill can deliver its aspirations and that it will not penalise others with learning disabilities because of a new hierarchy of resources. So will the Minister agree to meet those who have spoken of their concerns today prior to Committee, when it is clear we will be looking at a number of amendments?

Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022

Baroness Brinton Excerpts

Thursday 17th March 2022 Lords Chamber

Moved by

[Baroness Brinton]

As an amendment to the above motion, at the end insert “but that this House regrets that the Regulations are (1) contradictory to guidance provided by the UK Health Security Agency and NHS England on what action to take when you test positive for coronavirus, (2) an example of public health messaging that has caused confusion amongst the public, and (3) financially exclusionary to those on low incomes who cannot afford either the costs of tests or to isolate without financial support.”

[Baroness Brinton (LD) [V]]

My Lords, I want to make it clear that this amendment to the Motion is not a discussion about plunging the UK back into lockdown or imposing mass restrictions on individual liberties. I am talking here about the Government’s decision to scale back sensible public health measures—measures that would help us to continue to manage and monitor this pandemic, which is far from over.

Last week, the WHO reminded nations such as the UK that even when a virus is endemic, it needs managing, including testing, self-isolation and mask wearing. Even if not required by law and regulation, the WHO says that messaging and communications from Governments are vital in ensuring that people can take personal care. I am talking about clear and consistent messaging from our leaders about what they mean by “personal responsibility”. I am talking about support and guidance for those who still want to do the right thing and avoid spreading Covid-19. We still need to protect our NHS and ensure that those who are most likely to get severe disease, even if vaccinated, are also protected. I hope that we can all agree on these principles.

By the way, the Government keep changing the terminology for the group who have variously been called shielders, the clinically extremely vulnerable, immunocompromised and immunosuppressed. I hope the House will forgive me if I just refer to them as the CEV as a shorthand; otherwise, it becomes a real mouthful.

Time and again over the course of this pandemic, we have seen boom and bust policies relating to controlling Covid, stretching our NHS and care systems to the brink of breaking point and then introducing half-baked policies to tackle a fire that is already raging. Now we are seeing the bust again, with the withdrawal of almost all our tools to tackle this pandemic.

While we continue to allow Covid to spread through our hospitals, we cannot possibly hope to tackle the backlog of over 6 million patients waiting for treatment. The weekly average for Covid hospital admissions last week was 1,500 per day—an increase of 18% on the previous week. I am hearing that the NHS in the east of England and in London regions is already at level 4, and cases are still rising extremely quickly. Can the Minister say what plans there are if hospital admissions continue at this pace, and, given that they are a lagging indicator to cases, which have risen over 50% on the government dashboard in the last few days, how will people be protected from infection without access to test and trace from 1 April?

Sickness absences everywhere are also rapidly increasing. What are Ministers doing specifically to help keep infection levels lower among key workers, especially, but not only, in the NHS and social care sectors? Today, the Health Service Journal reports that Covid sickness absence in the NHS is up 20% in one week. What is the contingency plan if that continues to rise?

Those against any precaution say that we have to learn to live with Covid, but many people with omicron BA2 are saying that it is more like a cold at the start, and then it is like flu and worse. The problem is that it is ultra-transmissible when it is asymptomatic and in those early sneezing days. Would Ministers consider a campaign to strongly encourage wearing face masks, and at the very least try to protect key workers and the clinically extremely vulnerable?

The difference between what is being said at the Dispatch Box and in the Government’s living with Covid plan and guidance published at the end of February is most concerning. The UKHSA webpage is very clear: you must self-isolate if you have symptoms and are unwell. But this is not a clear message coming from our leaders, with statements such as “Stay at home if you can” and “Take personal responsibility”. Can people afford to? Can they manage to arrange deliveries? Can they even be bothered? Will the Minister today state in clear terms that, even though the legal requirement to self-isolate has ended, it is still absolutely expected that anyone who tests positive for Covid-19 will self-isolate? Will employers be told that they should not tell staff—as Wilko and Asda have already done—that they must work even if they test positive?

Speaking of testing, the policy document on living with Covid mentions the continued availability of

“limited symptomatic testing available for a small number of at-risk groups”.

As for who is included in these at-risk groups, yet again the public are still in the dark. We are only two weeks away from 1 April and we still do not know. We are told that information on who will have access to tests is coming. Surely this has to have been decided already. Why are we left waiting for this vital information yet again? We know already the groups that should have access to tests: the clinically extremely vulnerable and their close contacts; pregnant women; NHS staff; those working with vulnerable patients; those who attend hospitals regularly; unpaid carers; and, frankly, at the moment, our military as well. These groups will make up a sizeable proportion of the population, and I wonder how the Government are planning to identify those who will qualify for free tests.

Portsmouth City Council is so concerned at the 74% increase of positive Covid cases in just one week—to 630 cases per 100,000—and the 50% increase in cases at the Queen Alexandra Hospital to more than 150 Covid beds that it took the decision yesterday to provide free lateral flow tests to residents for three months if the Government will not. This is really tough, given that local authority public health budgets this year have not even covered inflation, and there is no extra money for any Covid mitigations such as test and trace. By the way, the Minister said on Monday that local resilience forums will now cover test and trace as the central ones are being closed down. But what are they going to do that with? No money at all. But in Portsmouth, a city full of key workers, the council feels that it has to do it.

By not providing tests for asymptomatic contacts of the clinically extremely vulnerable, we are placing them in perpetual lockdown. Not providing asymptomatic testing in hospitals also puts patients at risk. It is interesting that PPE is still going to be provided free of charge for NHS trusts until March 2023. But why has PPE been prioritised over testing? We need to know where the Covid is, and we need to protect our patients and staff. Can the Minister please confirm that this “limited free testing” will be only for people with symptoms and that the plan is to end all asymptomatic testing?

From these Benches, we have talked about the lack of financial support for those who should be self-isolating, and the revocation of that means that many people will have no choice but to go into work unwell. We ask again for this to be reinstated. By taking away the little support that was offered, the Government are clear that people’s self-isolation sacrifices are not worth anything to them—it just does not matter. Ministers talk about personal responsibility but people need to be supported financially to do the right thing, especially with reinfection rates as high as they are.

To conclude, the Government are determined to tell everyone that we have to learn to live with Covid. But by throwing away all surveillance testing and tracing, leaving individuals, employers, our NHS and even the Government completely blind about what is happening, and standing down SAGE at exactly the time that we have the highest level of infection rates, with spiralling cases and hospital admissions and, sadly, a likely increase in deaths in the next couple of weeks, how on earth is the country meant to assess and take their own responsibilities? I hope that the Government will change their mind on these epicentral precautions and mitigations. I beg to move.

[Lord Hutton of Furness (Lab)]

My Lords, I have some sympathy with the arguments that the noble Baroness has just made, but I think this is probably not the time to have a general debate about the Government’s handling of the Covid-19 pandemic.

These regulations are fairly narrowly drafted and are designed to repeal the earlier regulations that required vaccination against Covid-19 to be a condition of deployment in the NHS. I support the repeal of these regulations. The Government have made a good case for the repeal in the Explanatory Memorandum, but none the less, it represents quite a significant and dramatic U-turn in government policy.

I do not think it made a lot of sense to require compulsory vaccination; there were other ways of ensuring the protection from harm of NHS patients. Of course, the loss of critical front-line NHS staff which the earlier regulations might well have produced would itself have represented quite a significant risk of harm to NHS patients.

Today, I have only one question I want to ask the Minister. Again, it is something that is contained in the Explanatory Memorandum. Paragraph 7.29 says that the Government will engage with NHS employers to review their policies on the hiring of new staff and the deployment of existing staff to take into account their vaccination status. I ask the Minister what the Government want to see change in NHS hiring and employment practices. Will new employees in the NHS, for example, need to have been vaccinated against Covid-19? What does this paragraph in the Explanatory Memorandum actually mean?

--- Later in debate ---

[Baroness Brinton (LD)]

My Lords, I thank all noble Lords who have spoken.

The Minister said that we were saying that the pandemic is over. Not one person speaking today has said that it was over. We have all said that is has been moving to endemic and that the WHO advice was about making sure that, as formal restrictions lift, there should be continuing precautions. The Minister said that omicron BA2 is substantially weaker. Yes, it is, but the maths is also simple. He said that it is the dominant strain, but, if you have a very high level of case numbers, hospital admissions, ICU admissions and deaths will also rise. The point about testing was well made by the noble and right reverend Lord, Lord Sentamu. If local government’s public health is a vital partner, will the Government please fund this extra work?

The Minister asked us whether we only fund the very poor for lateral flow tests. The point is that the virus does not distinguish and it is really important that those on low incomes, who are facing astronomically high cost of living rises, are given some support. I thank him for his comments about the CEV forum, but just talking, without any active support for the clinically extremely vulnerable, is a chocolate teapot. The noble Lord, Lord Hutton, asked a key question on whether this is the right time to change all these mitigations and, while the Minister thanked all the doctors, scientists and other NHS key workers, I think we all agree that most of them are saying that it is too early to lose these mitigations.

I regret that the Minister has not given me reassurance. However, I withdraw my amendment.

Amendment to the Motion withdrawn.

Health and Care Bill

Baroness Brinton Excerpts

Lords Hansard - Part 2 & Report stage
Wednesday 16th March 2022 Lords Chamber

[The Deputy Speaker (Lord Russell of Liverpool) (CB)]

My Lords, the noble Baroness, Lady Brinton, is taking part remotely. I invite the noble Baroness to speak.

[Baroness Brinton (LD) [V]]

My Lords, I have put my name to Amendment 172. I thank the noble Baroness, Lady Finlay of Llandaff, for tabling this improved amendment, with important changes since Committee, as she has very helpfully explained to your Lordships’ House. I believe that this helps to find a way to balance the views of the child’s parents and the child’s doctors, and it is reassuring that many of the stakeholders from different perspectives have come to agreement on this.

The amendment also makes it clear that nothing affects the principle of the best interests of the child. This means that no medical professional could ever be forced to provide a medical treatment that they do not believe is in the best interests of the child, and that any other provider of such medical treatment would have to provide evidence during the mediation that this would benefit the child.

Another key reason for the need for this amendment is that at the moment mediation provision across England is inconsistent. While there is certainly excellence, there are also some problem areas. Having in legislation an independent mediation process made available at the earliest stage possible can help facilitate less confrontational conversations while supporting both sides in the argument.

The issue of parent-doctor conflicts will continue to persist frequently unless the Government can consider this amendment, and I strongly urge them to do so. If the noble Baroness, Lady Finlay, were to call a Division, we would support her on this, but I hope that the Minister will be able to provide some positive news.

[The Deputy Speaker (Lord Russell of Liverpool) (CB)]

My Lords, the noble Baroness, Lady Masham, is also taking part remotely. I invite the noble Baroness to speak.

--- Later in debate ---

[Baroness Brinton (LD) [V]]

My Lords, I have signed Amendment 174 in the name of the noble Baroness, Lady Chakrabarti. I thank her for introducing it and for making it clear that this aims for global pandemic preparedness. The World Health Organization set a target to vaccinate 40% of the world by the end of 2021. However, 92 countries missed this target due to a lack of access. Despite the funding from high-income countries to the WHO-run COVAX and Gavi schemes, low-income countries have remained at the back of the queue as high-income countries have been able to jump in ahead, using their money to get second and third doses for their own population.

Frankly, we need a better system for future pandemics. We need to understand that openly licensing newly developed Covid-19 technologies, waiving intellectual property rights and sharing the manufacturing know-how would allow more companies to begin producing life-saving vaccines, drugs and tests across the world. However, pharma companies have widely refused to share their technology openly. We also need to source other key critical control products, such as testing equipment, PPE and masks. Relying on too few suppliers in too few countries caused immense problems for the first six months of the pandemic, and again as subsequent waves hit those countries. In addition, the UK, the EU and Switzerland continue to block South Africa’s and India’s proposal to temporarily waive certain provisions of the Agreement on Trade-Related Aspects of Intellectual Property Rights—TRIPS—on Covid-19 tools.

Despite regular pandemic exercises in this country, and despite previous experience with vaccines for other diseases not being shared with low-income countries, we have not learned the lessons. This amendment sets out what a Secretary of State should do within three months of the WHO declaring a public health emergency. I really hope that Ministers are prepared to help make progress on this issue. If not, and if the noble Baroness, Lady Chakrabarti, calls for a Division, we will support her from these Benches.

[The Deputy Speaker (Lord Lexden) (Con)]

I now invite the noble Lord, Lord Campbell-Savours, who is taking part remotely, to speak.

Health Protection (Coronavirus, Restrictions) (Self-Isolation etc.) (Revocation) (England) Regulations 2022

Baroness Brinton Excerpts

Monday 14th March 2022 Grand Committee

[Viscount Stansgate (Lab)]

My Lords, I have another brief question for the Minister. I preface it by paying tribute to the wonderful work of the NHS, the department and the Minister, and in particular to the scientists who have been involved in producing the vaccines, on whom we all depend.

This little debate is part of the business of living with Covid. I am delighted to hear that the noble Lord, Lord Lansley, has recovered from his brief infection. That is a hopeful lesson for us all, as a number of members of my family, despite being vaccinated, have also recently got it, including my pregnant daughter-in-law, so we hope all turns out well.

As the Explanatory Memorandum to the statutory instrument says:

“The Self-Isolation Regulations played a vital and necessary role in breaking the chains of transmission.”


How will this SI be translated into the official advice on travel to and from the UK? I know that it is not his department; nevertheless, I presume that the regulations will change the nature of the advice given by the Foreign, Commonwealth and Development Office.

[Baroness Brinton (LD) [V]]

My Lords, just before the Grand Committee started, I heard a bit of a discussion about why this Motion was in Grand Committee today while I had a regret Motion tabled for the Chamber on Thursday. I had wanted to do just the regret Motion in the Chamber, but the Government Whips’ Office said that was not possible given the timing, so the only offer available was, essentially, for this statutory instrument to be heard twice. I apologise for that, but unfortunately it was the only possibility.

The lifting of the self-isolation regulations in England at the end of this month seems extraordinary and way too early. Only a couple of days ago, the World Health Organization reminded nations like the United Kingdom that, even when a virus becomes endemic, it needs managing, including by testing, self-isolation and mask wearing. Even if they are not required by regulation and law, the World Health Organization said that the message and communications from a Government are vital in ensuring that people take personal care in what they do.

We are still learning about the long-term effects of Covid. Recent research studies, published in the last two or three weeks, into long Covid are showing cardiac, respiratory and neurological problems that are already having consequences. In the future, it will be absolutely vital to watch for the currently not visible long-term consequences of Covid-19. There is an excellent book by Laura Spinney called Pale Rider: The Spanish Flu of 1918 and How it Changed the World, which has a good chapter near the end on the early deaths of Spanish flu survivors in the immediate aftermath of the pandemic. Such early deaths went on for two to three decades—interestingly, often with heart, stroke and respiratory problems. Without surveillance and self-isolation, we risk living with Covid at a very high level, and the consequences for the population may become apparent only when it is too late.

The problem with the living with Covid plan, which was announced on 24 February, was that the Prime Minister called it yet another freedom day and public behaviour has already changed. One doctor said on Twitter today that they are abused on the Tube for wearing a mask on their way to work. That is because there is not a strong clear message to people that living with Covid means that we still have to be careful about it. Can I ask the Minister—as I have asked him on many occasions before—whether the Government plan to have a strong communications message about these changes and about people taking personal care?

I would also like briefly to return to the question that I asked the Minister as a supplementary to the Question from the noble Baroness, Lady McIntosh, earlier today. Given that members of SAGE are now confirming publicly that Ministers did not ask for any modelling to be done for the living with Covid plan, how does that square with his answer to me that Ministers have to take modelling into account along with the wider needs of society? Everyone understands that dilemma for Ministers, but that was not my question. If Ministers did not ask for modelling, how on earth can they balance that risk? The Minister referred to the BA.2 variant, saying that they were watching it, but it is now the dominant variant. The one that we are watching is deltacron, and there may be others in the future.

I am grateful for the earlier comments from the noble Lord, Lord Lansley, and the noble Baroness, Lady Thornton, on the worries that those who are immunocompromised face. The Minister knows that I am one of those severely immunosuppressed people; I have had my fourth vaccination, although I have been warned that, because of my medication, it is probably already waning. There are people with blood cancer, for example, who cannot make antibodies or for whom the vaccine is contraindicated. Lifting self-isolation for them is a real risk. Under the current guidance to the clinically vulnerable—a number of people somewhere between 500,000 and 3.7 million—they will have to risk assess what they want to do. They are keen to do that, but they need the data.

The NHS daily dashboard used to be a good starting point for the public alongside the ONS data and the ZOE study, but the dashboard is now unreliable and the ZOE study is about to lose its funding along with others. That means that the vulnerable and their families, friends and work colleagues cannot see where Covid is. They will have to pay for tests—and let us be clear: offering free tests only to a small number of the most severely clinically extremely vulnerable is not helpful; it is the people who visit them and work with them who need to test before they see them. Many of the surveillance projects are, as I have said, also under risk. The REACT study is ending at the end of March and funding has been withdrawn—remarkably—from the ZOE study, the SIREN and VIVALDI studies and the CoMix social contacts survey. How do the Government plan to monitor the ongoing management of the pandemic—as WHO says they should—and assess the impact of ending restrictions with our vital surveillance systems down?

On what scientific and clinical evidence was the decision made to recommend that the CEV

“follow the same general guidance as everyone else”

in the living with covid plan? That is, frankly, a fantasy and has condemned the millions of CEV to self-imposed lockdown with no support. It is, by the way, also completely contradicted by the advice to them on the specific guidance page for the clinically extremely vulnerable and the NHS page on what to do if you have Covid, where people are told that if they have a positive test for Covid they should stay at home.

Covid-19: Restrictions

Baroness Brinton Excerpts

Monday 14th March 2022 Lords Chamber

[The Lord Speaker (Lord McFall of Alcluith)]

My Lords, we will have a virtual contribution from the noble Baroness, Lady Brinton.

[Baroness Brinton (LD) [V]]

My Lords, at the publicly streamed evidence session of the All-Party Coronavirus Group on 1 March, we asked some members of SAGE to outline SAGE modelling for the lifting of restrictions in the living with Covid plan. They replied to us that they had not been asked to model any such plans by Ministers. Given that cases, as the noble Baroness, Lady McIntosh, said, are now 221,000 a day, with active cases of more than 2 million and hospital admissions rising across England, exactly what modelling advice did the Prime Minister and Secretary of State for Health and Social Care take?

[Lord Kamall (Con)]

We constantly have meetings with the UKHSA and a number of different scientists join us for the calls when we have them, but we have always balanced things up. I shall give an example of a conversation I was having just before Christmas with some of the modellers. I asked them “What is your advice?”, and they said “Minister, before we give you the advice, you have to bear in mind that we are only considering the variant at the moment. It is for you to consider the wider medical balancing issues, and also the economic and social costs as well, and we recognise that you have to balance all those up.”