Coronavirus Bill

Baroness Thornton Excerpts

2nd reading & 2nd reading (Hansard - continued) & 2nd reading (Hansard - continued): House of Lords
Tuesday 24th March 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, we are living in a strange and frightening time. I congratulate all noble Lords on their speeches and questions today. I refer to my interests as listed in the register, including the fact that I am a member of a clinical commissioning group until the 31st of this month, when it will be abolished and absorbed.

As always, our thoughts have to be with those who have lost loved ones to this virus. Also, all of us would praise, as we have done today, the extraordinary efforts of our NHS staff and other dedicated public servants. We are for ever in their debt. My nephew, Oliver Carr, is a newly qualified first-year doctor at the Royal Free Hospital here in London. I cannot stress enough how proud we are of Oliver, but we are also, like thousands of families everywhere with loved ones working in our NHS today, very concerned for his safety.

Today, we are being asked to make decisions of a magnitude that we would never have dreamed of a few weeks ago. None of us came here to put on to the statute book powers that would curtail so many basic freedoms which our forebears had fought so hard to put in place and which we take for granted. As my honourable friend Jonathan Ashworth said yesterday:

“This virus spreads rapidly, exploits ambivalence, thrives on inequality”.


I shall speak about health and social care. My noble and learned friend Lord Falconer covered justice and dealt with the aspects relating to coroners—I am very pleased to say—as well as the sunset clauses. Also, I shall not refer to education, because, between them, my noble friends Lady Blackstone and Lord Watson covered the waterfront on the educational questions that need to be asked with regard to the Bill.

The reference in last night’s statement by the Prime Minister to the fact that social isolation and distancing must be enforced was welcome. It was necessary because too many people were not following the advice. I think that we all watched with incredulity and horror the pictures at the weekend of bustling markets and packed Tube trains, beaches and parks, so I am afraid that the public health message was not heard loud and clear, and we now have to see whether it will be.

Everyone who should be at home, must be, and they must work from home. I am afraid that that includes your Lordships. There are six or seven speakers in this debate, including on our Benches, who should not really be with us. They are breaking the Government’s guidelines—now, instructions—and they endanger themselves, which is really worrying. I hate to say this but I know that they are here because most of their friends, including me, would not dare tell them not to be, and they have a contribution to make. However, it does not reflect well on this House after the magnificent example that has been set by the Lord Speaker. Hundreds of our colleagues are not here and have been sending messages to us, for which we are all grateful. They have been giving us advice, as many of us have mentioned.

I happen to think that Parliament must continue to sit as best it can. We must hold the Government to account, not least because, as many noble Lords have said, inevitably this Bill will have its flaws. Normally, we would have pointed those out over a period of months. It does not adequately cover some very serious areas which we have discussed today, not least the homeless, the self-employed and renters. Therefore, although I feel that the emergency powers, while draconian, are needed, that does not mean that the Government cannot regularly be held accountable. As the Minister said, the powers should be only in the context of this virus.

Turning to the health and social care workforce, one thing that we certainly now know unambiguously, as a result of this pandemic, is that nobody can be unaware of the importance of care workers in our community. There is definitely awareness of social care. It has to be accepted and of course properly funded.

The next few months will present a different level of challenge for the NHS and anyone working in the caring professions. We know that an increasing number of people will become ill and some will require medical treatment in hospital. The additional patient volumes will place enormous pressure on all sectors of our health and social care system. There will be pressures from increased absence by staff who are unwell and self-isolating in their households, so testing is absolutely vital, as is adequate PPE.

I will divert slightly from discussing the health and social care workforce. Several noble Lords mentioned the police, including the noble Baroness, Lady Barker, and the noble Lord, Lord Adebowale. If we are putting on the statute book, as we have been and will do, things that mean that you might be breaking the law if you go out or do something you should not be doing that might involve our police, what protection are we giving them? I will read on to the record what a female police officer has said in a message I have received:

“We need masks for every officer and prisoner, at least four washable masks for police officers: one to use, one to have in the bag for three days to decontaminate before washing, and two to change during the shift. Shower facilities for police officers—there are not enough showers. Gloves. Where do we take prisoners who are symptomatic? Where do we take people in a domestic situation? What happens to child contact arrangement orders? Can a person on bail not sign for bail who is self-isolating? What’s the process for breach of bail? What about registered sex offenders? Do they have to tell us if they intend to be at a different address? They have to attend police stations and register where they are. What do they do if they are symptomatic and away from home?”


She goes on, including on serving warrants and all the issues that our police have to face on a daily basis and which will increase. The Bill does not address those issues, but the Government absolutely have to address them.

The Bill includes provisions for regulators to register suitable healthcare professionals, such as nurses, midwives and paramedics, as well as social workers, including those who have recently retired or are on career breaks. To facilitate the return of experienced staff, we understand that rules that prevent retired NHS professionals working for more than 16 hours a week and which affect their pension entitlement have been suspended. However, procedures must be in place to ensure that background checks and other measures are fast-tracked. We must ensure that the well-being of these people is prioritised.

The Government will also be registering final-year nursing and medical students who are near the end of their training. These students have to be supported, supervised and properly remunerated. I absolutely back what the noble Baroness, Lady Watkins, said about the debt that nurses face.

We recognise that it will be appropriate and necessary for doctors, nurses and other registered health professionals to work outside of the usual scope of their practice and specialisms, and that a far wider range of staff than usual will be involved in directly supporting Covid-19 patients with respiratory needs. The Bill includes indemnity provisions for those undertaking these services. However, it is vital that NHS staff working outside their usual scope of practice are trained in how to care for vulnerable patients. Can the Minister outline what training will be available, what it will entail and how many staff will need to be trained to use ventilators?

We also recognise that health staff will need to depart, possibly significantly, from established procedures to care for patients in highly challenging but timebound situations at the peak of an epidemic. Can the Minister advise what guidance will be issued to assist clinical staff to make these calls? Can he assure the House that they will be kept under constant review?

I echo and support the words of the noble Lord, Lord Adebowale, about the importance of support for social enterprises. That is based on the role and importance that they have in the delivery of social care in this country. Can the Minister commit that he and his colleagues will meet with Social Enterprise UK and its colleagues to discuss this matter urgently?

The Bill also includes provisions for drafting in volunteers, which noble Lords have discussed, but we have to recognise that people with disabilities and chronic conditions often have some of the most complex care needs. It is very unlikely that volunteers will be able to provide the care that they need. We need reassurances that these people will continue to receive the appropriate care they need from professionals.

The Bill will allow NHS providers to delay undertaking the assessment process for NHS continuing healthcare for individuals being discharged from hospital until after the outbreak has ended. We understand that this will allow hospitals to discharge all in-patients who are clinically fit to leave without delay. Sir Simon Stevens has advised that this will potentially free up 15,000 acute beds. However, it is important that these measures are brought into operation for only the shortest possible time at the peak of the outbreak. The increased burden on social care services, already creaking before the pandemic, means that they will simply not be able to cope. We are concerned that the sector will be unable to cope. It is understandably a great worry for existing service users, who will know how dependent they are on the social care they receive daily.

There is huge concern about how domiciliary social care will cope during the crisis. It really is the front line of social care, with dedicated but low-paid care workers providing vital personal care services, visiting people in their homes daily, moving from client to client and providing the link with the outside world for people who depend on them, particularly if they are without family and care support. Can the Minister reassure us, for example, that the 15-minute visits will be extended to make sure that there is adequate time for a care worker to take the effective Covid-19 precautions as well as seeing to people’s needs, reassuring them and addressing any problems? What guidance has been issued on this?

Finally on social care, the risk to care and nursing homes with older people living in them cannot be overstated. There is a huge responsibility on managers and staff to keep the virus out. Does the Minister anticipate that care workers will be required to self-isolate with residents in the event of a quarantine or lockdown? I think it is obvious: if the pandemic takes hold in a care home, that care home could account for all the acute beds in that area, so it is a very serious problem indeed.

The noble Baroness, Lady Barker, covered the waterfront on mental health issues. On the powers to detain and treat patients who need urgent treatment under the Mental Health Act, to be exercised using one doctor’s opinion rather than two if that proves impractical or would result in unhelpful delay, can the Minister just clarify for us what the thresholds are for impracticality and unhelpful delay? I think that was the only question the noble Baroness did not ask on this.

On deprivation of liberty, I echo what the noble Baroness, Lady Barker, said. Also, pressure on care homes is already significant. The legislation—which the Minister was not involved in getting through the House, but many of us here were—is being carried through now, so this really increases the pressure on care home managers.

One of the side-effects of the Government’s Bill will possibly be to reduce access to terminations. I agree with the noble Baroness, Lady Barker, that this is a problem. The Minister and the Government really need to address that.

On supporting the public over domestic violence and abuse, the evidence suggests that domestic violence may increase during this time and that children are particularly vulnerable. What are the Government doing to recognise this? Are they improving funding to this sector? Are they considering the most vulnerable, including ensuring immediate funding as well as replacement income for refuges that have already had to close?

Turning to renters, it is clear that nobody should have to lose their home because of the virus and its impact. The Government have acknowledged that with their action on mortgage holidays, yet have failed to protect those in the rented sector. Despite suggestions otherwise, we believe that the Bill fails to legislate for a ban on evictions. I hope that the Minister can confirm that the Government intend to amend the Bill to this effect or to introduce further primary legislation. There seems to be an overwhelming case here. Some 20 million people in England rent, 6 million of whom have no savings whatever, so they are particularly vulnerable if they lose their job or have their hours cut as a result of this virus. Last week, Shelter estimated that 50,000 households could face eviction through the courts in the next six months, thereby creating yet another crisis. We therefore remain extremely concerned that a three-month pause on evictions will defer this crisis only to the end of that period because landlords will then demand the total arrears of three months’ rent from many tenants who may not have been able to work at all and certainly will not be able to pay.

I turn now to the homeless. The Government need to address the specific question of people who have no recourse to public funds. As noble Lords will know, people experiencing homelessness, particularly those who are rough sleeping, are especially vulnerable in this outbreak. They are three times more likely to experience chronic health conditions, including asthma and COPD, and many are unable to access healthcare or housing because they have no recourse to public funding and benefit restrictions. These people include those on appeals whose rights are exhausted, EU and EEA migrants, people with existing visas, those whose status is not regularised, domestic workers and other migrant workers, as well as the victims of trafficking and torture, so it is critical that this is resolved. It is in everyone’s interests that it should be resolved—if we have people on our streets who are either infected or infectious, that will put yet more strain on the NHS.

On income support, we need income protection for those in precarious forms of employment. Apart from anything else, it would stop them packing Tube trains. One reason the Tube is packed is that many people in very low-paid jobs have to get to work. Like other noble Lords, we remain concerned that the Bill fails to give many people the financial support they need to get through this crisis. They should not be expected to make the choice between their health and hardship. Several noble Lords have talked about the self-employed and they are absolutely right to do so. The Government need to look at the position of the self-employed in a generous way. The Government should also act now to assist millions of people through the universal credit scheme by increasing it, suspending sanctions and scrapping the five-week wait for the first payment. We await to hear what the Chancellor will announce on this as a matter of urgency.

The issue of food is important. Stockpiling is clearly taking place and it is happening because people are not reassured that there is enough food to go around. The most vulnerable are losing out, so the Government have to take this very seriously. We understand that military personnel might be brought in to help with food chain logistics. Can the noble Lord explain what their role would be? Additionally on our food supply, by this summer we will need some 80,000 seasonal workers to pick fruit and vegetables, so we will have to train a reliable workforce for that.

The noble Baroness, Lady Grey-Thompson, covered the issues affecting the lives of disabled people. The Government’s plans in the Bill for this crisis will roll back 30 years of progress for disabled people. While we may tolerate this for a short period, we cannot tolerate it for very long. All the years that we fought for disabled people’s right to social care are being eroded and undermined, along with their civil liberties and right to support. We need to put the noble Lord on notice that, particularly in this House, we will tolerate this for as short a period as possible.

I want to say a word about food banks, which are suffering from, or are in danger of suffering from, shortages. Here I pay tribute to some of our major retailers, the Co-op in particular, for ensuring that deliveries to FareShare schemes are going through. Today I saw a message from the manager of a Boots shop, complimenting the staff on dealing with a totally unacceptable level of abuse. Apparently, it happens particularly when they run out of Calpol. Such scenes are being repeated over and again in our shops and supermarkets, so I pay tribute to all their staff and managers, who are doing very hard jobs, along with other shopkeepers and indeed our farmers.

In conclusion, as my noble and learned friend Lord Falconer said in his opening speech from these Benches, we lend our support to the Government to put this legislation on to the statute book without delay, but not without comment or scrutiny. This is just the beginning of the challenges of the crisis facing our nation and our democracy.