Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020 Debate
Full Debate: Read Full DebateBaroness Jolly
Main Page: Baroness Jolly (Liberal Democrat - Life peer)Department Debates - View all Baroness Jolly's debates with the Department of Health and Social Care
(4 years ago)
Lords ChamberMy Lords, this has been an excellent debate. I found myself agreeing with many noble Lords on several issues. These regulations take us out of the national lockdown and into a revised tiered system. In theory, this is something that I agree with: a targeted approach which infringes on the freedoms of only those for whom it is necessary. I have some sympathy with my noble friend Lord Greaves in his admiration for the contribution of the noble Lord, Lord Dobbs, but I do not support the amendment of the noble Lord, Lord Robathan. At times, I agreed with his assessment of the Government’s handling of this: communication was poor and the level of dither was astounding.
I also welcome many of the revisions to the previous tiers, which impose tighter restrictions on aspects of social life while extending support bubbles for some households at highest risk of isolation. However, there are some serious issues that need to be considered.
My noble friend Lady Brinton mentioned people with a learning disability. At the beginning of the virus, there was a scandal about GPs putting “DNR” on to the records of people with learning disabilities without any consultation with family or care homes. Fortunately, the CQC intervened and made it clear without any equivocation that this was not ethical, acceptable or legal.
Many concerns have been raised about the criteria for tier allocation. Of course we need a system that takes a more nuanced approach than just the number of cases in the population but, when restrictions are so damaging to the local economy and residents’ mental well-being, we need transparent data and decision-making. Last week, the transparency data was published a day late and we still do not have the full scientific evidence behind the rationale for different tier restrictions. Many noble Lords have given the impact assessment the ridicule it deserves. It is crucial that the Government engage with local authorities that know what is happening on the ground to inform decision-making. How do the Government plan to engage with local authorities to ensure they can make informed decisions that go beyond just raw data? Can we also get reassurance that political pressure is not the hidden sixth criteria for tier allocation?
There have been concerns about the size of the geographical areas that are grouped for tier allocation. Areas with low infection rates are understandably frustrated, as they are grouped with nearby areas with higher rates. Countries with robust test-and-trace systems are able to target their restrictions with far more precision; that is what this Government should be aiming for. Can the Minister please tell the House what progress was made on improving test and trace during the national lockdown? Are the Government now beginning to recognise the amazing efforts of local test-and-trace teams who use their existing expertise? How much of the £7 billion in additional funding will go to local authorities to help them trace the most difficult cases? We all know that the first 80% or so are straightforward to trace, but it is the last 20% who are the problem. Local public health teams, who know the area, can find those out-of-the-way addresses.
Now I would like to consider the rule of six. Under national lockdown rules, children under five were exempt from the rules on one-to-one meetings. Will the Government now make children exempt from the rule of six? This issue is particularly pertinent for parents of young babies who were born in lockdown and have not had access to the usual support systems. Under the rule of six, new parents can meet only in groups of three, despite these informal support networks being so important to maternal mental health. I hope that the Minister will consider this and provide a response which will make England consistent with Scotland and many of our European neighbours.
The new regulations make the new tiered system more restrictive than that which came before. Combined with some specific easing over the festive period and adjustments to policies on support bubbles, this has the potential to be confusing, to say the least. There has to be a clear communications strategy that aims to reach particularly hard-to-reach communities. As these restrictions are being brought into law with significant fines attached, the onus is on the Government to ensure that individuals know exactly what they can and cannot do—and that if they do what they want, it should be clear how much it will cost them. This is rarely mentioned at Downing Street briefings; nor does it make the front page of the dailies or the evening news.
My noble friend Lord Scriven gave us a blow-by-blow breakdown of all the recent SIs laid in your Lordships’ House for us to debate. The seeming randomness of the measures in each subsequent SI was appalling.
Christmas is an emotive issue. Many of us miss our loved ones greatly and the opportunity to meet in person at Christmas is ever so tempting. Although in-person celebrations are allowed, this should not be confused with them being encouraged. I am pleased that we have managed to obtain national consensus on Christmas bubbles. I hope that, in the new year, we will see much more of this co-ordinated approach. How are the Government going to ensure that the message is clear? Remote ways of meeting are the safest and are recommended to connect with the family.
I know that in my household, we will have a virtual Christmas this year to protect each other and show solidarity with those whose religious celebrations could not go ahead in 2020—those who did not celebrate either Diwali or Eid ul Fitr. There will be a time when it will not pose a danger to see the ones we love, but now is not it. Taking this virus seriously means recognising those who will remain isolated this Christmas: care home residents are just one example.
The winter plan outlines a significant increase in the testing occurring in care homes, with specific mention of visitor testing and testing of staff. I welcome this, but I would press the Minister on how the Government anticipate that Christmas will operate in care homes. This morning, I received an email from the chief executive of Care England, a representative body for independent care homes, who said:
“The issue about visiting in and out of care homes goes far beyond Christmas, we want to craft robust guidance that deals with the short, medium and long term. The guidance needs to recognise the intricate balance between well being and safeguarding. Although the new testing regime is extremely welcome we need to face facts that it will be a while until it is entrenched and also needs to operate as part of a raft of other infection control measures.”
No additional resources have been announced to assist with this testing. The National Care Forum estimates that an average 50-bed care home will need to administer at least an additional 1,350 tests per month, amounting to an additional 450 hours of work or an extra 15 employees. This time is taken away from caring for residents, with no replacement. Care homes need additional resources and support to have the capacity to implement the testing that we have so long called for.
The restrictions we have all been living with have had a significant impact on our economy, mental health and well-being. Every person in the country has made a huge personal sacrifice and we cannot fall at the final hurdle. We now know that there is a get-out-of-jail-free card and, within a few months, many of us will be vaccinated with one of the growing number of vaccines. I would like the Minister to put to the department that the most vulnerable adults of working age are those with a learning disability. However, they were not even on the first list that I saw for early vaccination. For nearly a year, we have suffered lockdowns and other restrictions. Living in a tier 1 area, I will resist the Boxing Day trip to Staffordshire to see my family. We will leave it to spring and rely on a video Christmas. But this means getting restrictions right and keeping them so, then regaining the public’s trust so that they can confidently follow the guidance, knowing that they are doing the right thing to protect their family, friends and neighbours.