Covid-19: Social Care Services

Baroness Jolly Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Jolly (LD)]

I join other noble Lords in commending and thanking the care sector for all it does for those in its care, in care homes and in the community. I am happy to echo the opening remarks of the noble Baroness, Lady Wheeler, and thank her for instigating this debate.

The majority of care providers are private organisations, not-for-profit organisations or charities. Their income has remained pretty well constant throughout this crisis, but their costs have soared—for replacement care workers from agencies or banks to cover staff illness, and, as we heard at Questions, the new unanticipated costs of PPE. Can the Minister confirm that no provider of care will be allowed to fail in this crisis due to lack of funding to cover these and other costs?

My comments will largely be about people with learning disabilities and others who have found themselves with “DNR” on their records. We are fortunate to live in a country where life is universally valued. For the last month or so, we have seen this play out on the news, as we witness daily the efforts of our NHS and care workers struggling to save those who are in their care. Their compassion brings us to tears, and to our doorsteps on a Thursday evening. Old, young, fit or frail—it matters not. But this Covid-19 crisis has seen parents of autistic adult children receive letters from their GP practices suggesting that these children should have a “do not resuscitate” or DNR label added to their notes.

I applaud the Care Quality Commission for its condemnation of GPs across the country for categorising people who receive care in community settings as not requiring resuscitation should they fall ill with coronavirus. Let us be clear: a DNR is a clinical decision that, in perfect circumstances, involves the doctor, patient and family. NICE recommends that clinicians use the clinical frailty scale when considering patients for intensive care. It is designed to prioritise those most likely to recover from the virus, but it is not suitable for use with people who have learning disabilities, nor for people with other kinds of disabilities or conditions that affect their ability to do things independently.

Whatever the circumstances, life or death should not depend on your age, your disability, who provides your care or where you live. Does the Minister agree? Could he please persuade the department to put this message out to all care and health providers? Perhaps we can ensure that it is part of the promised Green Paper.