Covid-19: Mental Health Services
Baroness Jolly Excerpts(4 years, 4 months ago)
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Lord Bethell [V]
The noble Baroness is likely correct that the epidemic has had a particular effect on children and young people. The evidence on this is not crystal clear, but that is the strong instinct of all those in the field. I personally welcome the reopening of schools, which will have a particularly beneficial effect on those children who at present are stuck at home and do not have the support of the school system. Mental health services for young people are part of our long-term plan, with the additional £2.3 billion of spending on mental health. Our ambitions in that area remain enormous.
Baroness Jolly (LD)
My Lords, the Mental Health Act is no longer fit for purpose. With outdated legislation, both children and adults are at risk while either at home or in a care setting. In the aftermath of the Covid epidemic, there is no time for delay. When should we expect a Bill here in Parliament? If that is not in the Minister’s brief today, would he write to me?
Lord Bethell [V]
My Lords, we remain committed to publishing a White Paper that will set out the Government’s response to Sir Simon Wessely’s independent review of the Mental Health Act 1983 and pave the way for reform of that Act. We will publish it as soon as possible. The Covid epidemic does nothing but incentivise us to move as quickly as possible on this.
Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020
Baroness Jolly Excerpts(4 years, 4 months ago)
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Baroness Jolly (LD) [V]
Since we debated the previous SIs on 15 June, we have started to venture out, return cautiously to the shops, sit closer to a stranger and dare to hope that a summer holiday may be possible. These latest two SIs lift more restrictions for England. There is a balance to be struck between protection, thus preventing a second wave, and getting back to a new normal as soon as possible. For many pubs, the ability to serve takeaway meals has been an opportunity to try to keep revenue coming in. My local pub has turned into a takeaway service—with queues appropriately distanced—for older residents in the village and younger ones too, and that is much appreciated.
I am fascinated by a few of the decisions in these SIs. Why are we concerned about “elite athletes” but not young budding musicians? What made a legislator think that a place of worship would be an ideal setting for early years childcare? Does the Minister have any information about take-up, or registration to use such buildings? What consultations were held first with religious authorities?
Many will be glad that churches—and, I assume, other places of worship—can reopen for silent prayer. Usually these buildings are open but unattended. Can the Minister outline the sort of advice given about managing distance and keeping surfaces clear and behaviour appropriate?
I note that the Google Maps app has been collecting our movement data and, presumably, providing it to Public Health England to determine our behaviours out of lockdown. I do not doubt that by default we will have given our permission, but I wonder what practices were going on before Covid-19 and will continue after lockdown. Will the Minister please clarify the situation for the House and place a letter in the Library, copying in noble Lords speaking today? I am content to support these measures.
Nurses: Recruitment
Baroness Jolly Excerpts(4 years, 4 months ago)
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Lord Bethell [V]
My Lords, the Covid epidemic has thrown a spotlight on the essential role of carers, who have clearly played an enormous role in looking after those who are vulnerable. I completely support the sentiments of the noble Baroness that we should do more to help carers in their professional development so that they can convert to different secondary careers. I would be happy to look at any suggestions she has for ways in which we can do that better.
Baroness Jolly (LD) [V]
Not for a long time have nurses had such a high national profile. The career options are many and now many more men are nurses too. Will the Minister explain to the House what careers material is available to schools, what opportunities there are for potential nurses to see what the role entails, and what efforts are being made to encourage young men?
Lord Bethell [V]
My Lords, we have backed an enormous marketing campaign called “We are the NHS”, which throws a huge spotlight on the role of nurses of all genders, backgrounds and professional focus. That campaign includes a strong schools element. It seeks to attract a broad range of backgrounds of people who might think of applying to the nursing profession.
Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020
Baroness Jolly Excerpts(4 years, 4 months ago)
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Baroness Jolly (LD) [V]
My Lords, we all went into lockdown on 23 March and have largely been at home for 12 weeks, just under a quarter of a year. Recently, we have seen restrictions eased, but we all know that we are not out of the woods. We may yet have a second wave. I am sure that many noble Lords will talk about lockdown issues, but I would like to address how we can look at behaviour in lockdown. I understand the issues around paragraphs 1, 2 and 3 of Regulation 2, which amend who can be with whom, what they may or may not do and where they may or may not go.
I was surprised at how well, on the whole, the lockdown was followed by the public. It was difficult for many. Older people struggled with their shopping, as did those with a disability, but very quickly the volunteer networks kicked in for supermarket deliveries. The lockdown largely held, as people were genuinely fearful for their lives should they catch the virus; the public saw the need for a lockdown. What is remarkable is what was achieved with the first set of regulations, which are now known as the lockdown regulations.
How people behave during lockdown will be reflected in the penalty notices served, both by police force and by offence. Based on the original regulations, can the Minister outline how many people have been served with each category of the fixed penalty notices? These are listed in Schedule 2, Parts 1, 2 and 3. That could give us a clear indication of population behaviour in lockdown.
For example, here in Cornwall on the first weekend we had an invasion of second home owners and people fancying a change of scene. The police stopped the traffic on the A30 and M5 and penalty notices were issued. Similar scenes were seen in other holiday areas; cars were turned around and sent home. Were some geographic areas more inclined to break the rules than others? Were some police forces more inclined to pursue individuals than others? How much were the public inclined to report their neighbours for breaking the regulations? Can the Minister explain how this data is being analysed by local public health teams to determine the factors I have outlined? This could be helpful if we find ourselves having to return to lockdown, as I suspect further lockdowns—local or otherwise—will be less easy to enforce.
I am happy to support this SI and hope that local authorities are working with local resilience forums to determine a lockdown picture of their patch.
Covid-19: Cancelled Medical Operations
Baroness Jolly Excerpts(4 years, 4 months ago)
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Lord Bethell [V]
The noble Baroness has asked for a very specific figure, which I am afraid I do not have to hand. However, I can assure her that the private healthcare contract has provided us with incredibly valuable surge capacity and we will be looking at how to use that kind of capacity to protect the NHS from a potential surge in the wintertime.
Baroness Jolly (LD) [V]
My Lords, can the Government guarantee that there are safe spaces for all cancer services and ensure that these spaces are Covid-protected? Further, will the Minister update the House on testing numbers and the number and frequency of tests in hospitals and in cancer hubs in England? I understand that he may not have all the figures to hand, but I would be grateful if he could write to me and put a copy of the letter in the Library.
Lord Bethell [V]
The noble Baroness, Lady Jolly, is right to emphasise the importance of safe spaces. Cancer surgery requires a completely hygienic environment for those who have immune challenges. Safe spaces are found for all those who need to have cancer practices. They may not be in absolutely every hospital, but if one hospital cannot make that kind of offer, an adjacent or nearby hospital will be found to provide the kind of safe spaces that are needed to carry out the procedures she described.
Exercise Cygnus
Baroness Jolly Excerpts(4 years, 4 months ago)
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Lord Bethell [V]
My Lords, it is necessary for the preparations for such civil emergencies to be made in a confidential fashion so that the unthinkable can be thought and plans can be made in a trusted and benign environment. Publication of these reports is not in the national interest and we do not have plans to publish them in the future.
Baroness Jolly (LD) [V]
My Lords, in the Cygnus report, preparedness, response, plans and capability were found lacking. Local capacity would be outstripped in the areas of excess deaths, social care and the NHS. What findings from the Cygnus report were incorporated into the work for the current pandemic?
Lord Bethell [V]
The noble Baroness is in danger of misrepresenting the situation. The whole point of running a trial such as operation Cygnus is to probe the system and to find weaknesses. That it identified areas for improvement is entirely appropriate and is exactly why we run such projects. As I have explained, the exercise identified key areas where developments were made, and those developments helped us in our preparations for Covid.
National Health Service Commissioning Board and Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2020
Baroness Jolly Excerpts(4 years, 4 months ago)
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Baroness Jolly (LD) [V]
I too support this Motion and thank the noble Lord, Lord Hunt, for tabling it. Will the Minister explain how the 11% increase to nursing rates was determined? What consultation was held with the care sector and the NHS to determine the increase?
This SI is very straightforward and limited but, pandemic aside, it is tabled at a time of huge turmoil and instability in the sector. We all know about the issue in some care homes of private patients subsidising those supported by their local authority, either in total or in part. We know this is not fair. As my noble friend Lady Barker said, local authority funding should be adequate.
The real scandal laid bare by the Covid-19 epidemic is the delay of the care Green Paper and the lack of certainty for the sector, which was struggling financially before the pandemic. The financial model is broken. Can the Minister tell the House when this paper will be published? Its working group members are England’s experts on the subject, there have been cross-party talks about it and Prime Ministers Theresa May and Boris Johnson promised it, so when will it be published? The delay is a scandal. I feel sure the Minister will tell the House that the answer is “later”. That is always the answer.
For weeks we applauded NHS and care workers every Thursday evening to say thank you, and no one can be in any doubt about their commitment and the lengths to which many go to ensure care for those in their charge. Not many workers paid only the basic minimum wage would move into their workplace for weeks to guarantee the safety of those in their care. The professionalism shown by care workers from the UK, the EU, the Commonwealth and elsewhere is exemplary.
How would the Minister fill the places left by departing EU staff if the door to their entry were closed by the Home Office setting a salary requirement of over £30,000? The Home Secretary has suggested that we could recruit by appointing British workers, yet for the last year or so unemployment has been hovering down around the 4% mark and supermarkets pay the same sort of rate for less worry and 5% off grocery bills.
Care workers should have recognition as a profession in England. In Wales and Scotland they are regulated and professionally acknowledged. In Scotland they were given a pay rise of 3% for their work during the Covid-19 pandemic. I am sure the Minister would at least wish for parity for English care workers, as well as their recognition as professionals with their own professional body. Can he outline the Government’s thinking on care worker regulation?
Hospitals: Patient Safety
Baroness Jolly Excerpts(4 years, 5 months ago)
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Lord Bethell
The noble Baroness speaks about infection control measures regularly undertaken by trusts. Ambulances frequently take patients not to precisely the nearest hospital but to the one best suited to treating the patient. These infection control measures have been extremely effective and will continue for the foreseeable future.
Baroness Jolly (LD)
My Lords, NHS Providers has concerns about the Government’s testing strategy for Covid-19. Will the Minister tell the House when every patient and health and care staff member with suspected Covid-19 symptoms who needs a test will consistently be able to get one within an appropriate turnaround time? When will the updated strategy be published?
Lord Bethell
My Lords, every member of the NHS or social care employee can currently get a test when they present symptoms. They can do that through their employer, directly through the online service or a hotline. The turnaround time in 95% of tests is within 48 hours.
Covid-19: Response
Baroness Jolly Excerpts(4 years, 5 months ago)
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Lord Bethell
My Lords, I pay tribute to my noble friend’s commitment to freedom of travel—and he will remember my father’s own commitment to it. The sad truth, however, is that it is very difficult to prove a negative: to prove that someone does not have the disease or that they have not recently become infected and have the disease in a latent way or that they are young, fit and well. The restrictions are in place for those reasons. I advise my noble friend that we are working on finding a solution, but none is immediately available.
Baroness Jolly (LD)
My Lords, with many GP appointments now held online, the public are going to their local pharmacies for advice as never before. Pharmacies have received from the department little or no support with reconfiguring their premises, many have had no support sourcing PPE and staff are not automatically considered for routine testing. Have the Government forgotten the pharmacy profession? Will additional support be made available to our high street pharmacies as they continue to serve patients throughout the Covid-19 pandemic?
Lord Bethell
The noble Baroness is entirely right: this epidemic has demonstrated, if it needed to be demonstrated at all, the key role that pharmacists play in the health of the nation. I pay tribute to the role of pharmacists in providing support and filling the gap after GPs’ surgeries have closed. I reject, however, the idea that they have had no support. PPE has been provided, any pharmacist is prioritised as a key worker, and we will continue to offer support and to help grow this valuable sector.
Covid-19: Vulnerable Populations
Baroness Jolly Excerpts(4 years, 5 months ago)
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Lord Bethell
I reassure the House that deaths in care homes have always been part of the official figures. It is a very sad affair, and it shows how the disease attacks those who are most vulnerable. The arrangements for PPE in social care settings have improved dramatically, and we have put in place measures so that any care home can make its own application for PPE as it needs it.
Baroness Jolly (LD)
Will the Minister tell the House what advice or support local authorities have been advised to give to the more than 100,000 vulnerable adults aged over 70 caring for their adult children who have a learning disability?
Lord Bethell
The advice given to local authorities is spelled out in guidelines. Those who are vulnerable are advised to avoid social contact. Where necessary, those whom they live with, including any children they have with learning disabilities, should also avoid the same social contact.