Covid-19: People with Learning Difficulties and Autism

Baroness Thornton Excerpts

Monday 5th October 2020 Lords Chamber

[Lord Bethell (Con)]

We are seeking to extend asymptomatic testing as widely as we possibly can and as soon as we possibly can. At the moment, our focus for testing is on residential social care, where we have committed to 100,000 tests a day. That is where the greatest threat comes from. But as the number and range of tests increase, we hope to be able to roll out asymptomatic testing to a much broader set of user cases, and the kind of care centres that she describes will surely be near the top of the list.

[Baroness Thornton (Lab) [V]]

My Lords, figures from the CQC show that there has been a 175% increase in unexpected deaths among learning disabled and autistic people during the pandemic. The Cabinet Office’s disability unit, which is charged with developing the national strategy for disabled people, has been silent so far. Does the Minister agree that, rather than Covid-19 necessitating delays for a national disability strategy, the impact of the crisis on disabled people makes its publication all the more vital? When will the national disability strategy be published?

[Lord Bethell (Con)]

My Lords, let me clarify with an update on the numbers. As of 25 September 2020, 690 deaths from Covid of people with learning disabilities have been reported to the leader programme since 16 March. We have commissioned Public Health England to carry out additional analysis of the existing data, which will be published as soon as it is completed. We are not trying to hide from this issue. Covid has raised very serious questions about the impact of a pandemic on those with learning difficulties, who are often more susceptible to disease and mortality than others. We absolutely accept the challenge of figuring out how to protect the most vulnerable in our society. Therefore, we will embrace the opportunity to take these learnings and put them into a disability report at some point in the future.

Hospitals and Nursing Homes: Do Not Resuscitate Notices

Baroness Thornton Excerpts

Thursday 1st October 2020 Lords Chamber

[Lord Bethell (Con)]

The department is aware of the Queen’s Nursing Institute report on training and, although the majority of responses were positive, it raised questions about the training of, in particular, care home staff on the instruction to change resuscitation orders for patients without discussion. We are looking at that report very carefully. We cannot comment on individual cases but the report raises important questions. In the meantime, the General Medical Council is providing additional support and guidance to clinicians and the Resuscitation Council is creating a large range of resources for clinicians to help guide them and provide training.

[Baroness Thornton (Lab) [V]]

I am pleased that the Minister has recognised that, although DNR is a medical decision and not something that requires a patient’s consent, not consulting with the patient and their family is an unlawful breach of human rights. We should be grateful that the scandal was exposed by Turning Point and other charities during the pandemic. Does the Minister have plans to review the DNR decisions that were made during the pandemic and does he know, or perhaps he can find out, how many DNRs were issued in excess of what one might have expected during the pandemic?

[Lord Bethell (Con)]

My Lords, NHSE&I is currently engaged with stakeholders, including people with lived experience, to develop better information for patients and to understand whether procedures need to be changed. I reassure the noble Baroness that DNRs are not issued, they are agreed with families and relevant loved ones. On no account should DNRs be unilaterally issued. They are for a joint decision; that kind of blanket application is something that we are extremely concerned about and seeking to avoid.

Covid-19: Tracking

Baroness Thornton Excerpts

Wednesday 30th September 2020 Lords Chamber

[Lord Bethell (Con)]

I reassure the noble Baroness that the use of non-official QR codes is rejected by the app. I have had personal experience of this. We have had downloaded 600,000 of the official QR codes—an astonishing figure. The use of those codes seems to have been embraced and adopted. I have one at my office and it works extremely well.

[Baroness Thornton (Lab)]

I confess that I am very confused by the answer given by the Minister to my noble friend Lord Foulkes about older phones. I have a friend who was excited about being able to download the app; her phone is only two or three years old but it was too old to download the app. I have to say that I am sceptical of the figures that the noble Lord has given us. Certainly, some who may or may not be in the lower income bracket, may be older, or may just be careful and have phones bought in 2015, seem unable to download the app at all. Did the noble Lord say there were two apps? This is confusing and I am not sure that it will help.

[Lord Bethell (Con)]

My Lords, I completely understand the concerns of those who may be struggling to download the app but I reassure the noble Baroness that the current app is supported by iOS versions 13.5 and higher, and by Android Marshmallow version 6.0. That covers by far the vast majority of phones. As I said, 89% of phones should support the app. They include, for instance, Apple iPhone 6S and above—a huge proportion of phones. We are debating a new initiative by Apple to bring in their own protocol that is particularly directed at developing countries which may not be able to support their own app. That initiative is not targeted at the UK. We believe that it may have some relevance in supporting downloads of the NHS app because the alerts created can perhaps be directed to the download site on the iPhone store to encourage those in the UK who have not yet downloaded the NHS app. The Apple initiative is a positive development that will be particularly well used in developing countries.

Covid-19: Medical and Funeral Expenses

Baroness Thornton Excerpts

Monday 28th September 2020 Lords Chamber

[Lord Bethell (Con)]

It is true that there is a correlation between the mortality of this disease and poverty. That is why we have enhanced the funeral expenses payments by increasing the additional costs by £300. We are also supporting public health funerals by issuing new guidance to local authorities to support this important measure which brings a degree of quiet to those who die in poverty.

[Baroness Thornton (Lab)]

Does the Minister share my concern that older people and their families are picking up the tab, with many being forced to pay a steep and unexpected coronavirus bill by their care providers? Some care home residents are being asked to pay more than £100 a week on top of their usual care home fees as PPE and the cost of covering staff absences push the finances of some care homes into the red and threaten their sustainability? What consideration have the Government given to outlawing or capping such charges, as called for by Age UK? With a second peak under way and care homes under acute financial pressure, will the Minister commit to making sure that the Government’s emergency funding is directed to them?

[Lord Bethell (Con)]

My Lords, the noble Baroness is right to say that there are costs related to PPE for social care homes. That is why we have put together a winter plan for social care that envisages a massive investment in Covid-compliant PPE for care homes providing both adult care and child care. It will be free of charge for those homes. The money that we are supporting through the DWP funeral expenses payment and through the public health funerals programme has been enhanced. In 2018, £6.3 million was spent on public health funerals by local authorities and further sums have been allocated to support this important payment.

Coronavirus Act 2020: Temporary Provisions

Baroness Thornton Excerpts

Monday 28th September 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, what great maiden speeches from the two contrasting clerks—my noble friend Lady Clark and the noble and learned Lord, Lord Clarke—and from the noble Baroness, Lady Morrissey. I congratulate all of them and join the chorus of welcome across the House. I know that all three will bring different qualities and great wealth. I am particularly pleased to see my noble friend Lady Clark here. I also say to my noble friends Lord Blunkett and Lord Hain and my noble and learned friend Lord Morris, all of whom made great, salient points, how much I value the experience and wisdom of my colleagues on this side of the House.

The debate today is significant because it is the first time this House has had the opportunity to discuss whether the emergency legislation which Parliament adopted in March has worked and is working, and to discuss how it might be allowed to roll forward and whether it should roll forward as it is for the next six months. I think the Minister will have gathered, from all parts of the House, that none of us thinks that is a good idea; all of us think that things have to change, one way or the other.

I thank the Minister for the analysis and the letter he sent us, and indeed for his speech. I have to say I agree with the noble Baroness, Lady Barker, about the analysis and the letter: it was not an analysis; it was a list. In the end, I greeted it with the same scepticism as my noble friend Lord Rooker did. The first thing that struck me when I looked at the grid that the Government have produced is how many of the powers they took that have not been used. The first thing I need to ask the Minister is whether those powers will be removed from the Act, because they have not been needed in the six months of the serious emergency we were facing in March. We are moving forward into a different place now, and I cannot see why those powers would need to be kept on the statute book.

I need to ask one question which has not been mentioned today, and I am doing it because I am a humanist. The regulations we discussed last week appear to limit humanist weddings to gatherings of just six, when religious and civil marriages can have up to 15. I ask the Minister whether that is the case or not, because that would seem to me to be absurd and very unfair for those of us who take part in these ceremonies.

In March, the Minister said:

“This is an extraordinary Bill for an extraordinary moment in the history of our country”,


and that the Bill was about “buying time”, as other noble Lords have said, to save the NHS from being overwhelmed and so that the science could be better understood. When we discussed this Act in March, my noble and learned friend Lord Falconer said:

“In normal times, it would be utterly unacceptable, but these are not normal times.”—[Official Report, 24/3/20; cols. 1652-53.]


We on these Benches supported the Bill, and the powers it gave the Government, because we recognised the need of the emergency.

The question we have before us, which—more importantly—the Commons must address later this week and which the Government must answer is whether that time was bought, and at what cost. Has the science and our understanding of the virus advanced? Is it necessary to have the full panoply of those powers still? Are the Government examining them with a view to modification, as noble Lords, and the noble and learned Lord, Lord Judge, said? It certainly is not acceptable to wait another six months to discuss these matters again.

As my noble friend Lord Hunt said—absolutely hitting the nail on the head, as he very often does—this Act and the Public Health Act are a lethal combination. Indeed, at the time, in March, we suggested that the Government already had enough powers and did not need this Act; I want to know whether that situation has been discussed at all. We know that six months is a significant time because the Prime Minister has said that it is likely we will be fighting the virus for at least another six months, and perhaps longer until we have a vaccine or cure.

The decisions which the Government have made—significant as much for the measures which have not been adopted as those which have—have been given effect by legislation, but it is all secondary legislation, adopted on the basis that there is an emergency and therefore that it does not need immediate parliamentary approval. That is the nub of the problem that many of us face and the frustration that we face.

Where the Government are taking huge coercive powers to fight the virus, it is fundamental to our constitution that Parliament must agree. In the early days of this emergency, it might have been legitimated to have no proper legislative process, but I do not think that is the case anymore—certainly not when it is painfully clear the emergency is going to last for at least another six months, maybe longer. It is an emergency, but our Parliament can surely adapt to ensure that key decisions about the increased powers the Government may well need should be taken by Parliament, not by an ever-decreasing clique of unaccountable chums within the Executive.

The requirement for Parliament to agree means that if the Government are faced with any rebellion on their own side, they must deal with it by making concessions or forming a majority which depends on the support of the Opposition. We need a dynamic, fundamental shift from the secret debate involving very few people, with most decision-makers in the group being hand-picked by the Prime Minister for their reliability and the only true outsiders being the CMO and the CSA. Civil servant advisers must be cowed by the fate of the Cabinet Secretary, the Treasury solicitor and the Permanent Secretaries at education, the Home Office, Foreign Office and justice. In other words, “If you are not one of us, you get the chop”. This must change.

It also seems that the CMO and CSA’s advice is being overridden. It is impossible to believe that the only possible response to the contents of their briefing last Monday was to require a curfew of 10 pm for the hospitality sector plus the reinforcement of existing guidance, except on work, where the message—not the law—is changed to “Go to work only if you have to”, rather than “Go to work if your place of work is Covid-secure”. Is that confusing or what? If that is the appropriate response, the country needs to see the evidence that backed it up. For very many people, a 10 pm curfew will simply mean going out earlier. As the noble Lord, Lord Patel, said, long drinking sessions into the night over the weekend, in clubs which now have to close at 10 pm, will be a casualty. Are they significant drivers of the virus? Maybe they contribute but what is the evidence?

The UK’s response to the virus is flawed, as my noble friend Lord Foulkes said. We are not handling it well and it is getting worse because decision-makers are shrinking into themselves. Parliament needs to assert its normal role. Having to explain, justify and then persuade is time-consuming for politicians, but it makes for better decision-making and will hugely improve our response. That has been repeated by noble Lords across this House.

We read that the suite of measures the Government have adopted, or more significantly not adopted, are largely driven by a pro-economy group in the Government persuading the Prime Minister to override the pressure from the public health group led by the CMO and CSA, represented by Matt Hancock. That is the widespread view in the media.

The renewal of this emergency Act requires the Government to take decisions now which will determine within the next few weeks whether people live or die, whether they get exam grades that will allow them to have the future they want, whether they will have a job, whether they can go home for Christmas, whether they will have to depend on universal credit, whether they will be evicted and whether their businesses will go bankrupt. These decisions will affect the lives of millions of people profoundly and immediately.

I turn to other important measures in the Act on its six-month review. It is now time to recognise the devastating impact the exercise of these powers has had and to restore the legal rights of disabled people, and those affected by the Mental Health Act and the Children and Families Act. We believe that amendments are necessary to remove these provisions from the Coronavirus Act 2020. Alternatively, the Government could confirm that: social care easements will be switched off by the Department of Health and Social Care; easements affecting the rights of people detained under the Mental Health Act will not be implemented by that department; and easements related to the Children and Families Act will not be implemented by the Department for Education.

Many of us were very concerned in March about the detrimental impact these easements would have. Even though only eight local authorities have officially operated the Care Act easements, many have unofficially done this. We can see that disabled children and young people’s rights to education were affected with severe detriment by the Act. The Covid-19 pandemic has had a disproportionate impact on people with learning disabilities. This is due to a combination of factors, including vulnerability to Covid-19 itself and the Government’s response. As we move into a difficult winter period, more must be done to ensure that people with learning disabilities and their loved ones receive the support they need to maintain a healthy, social and physically active life.

We on these Benches will not be supporting the noble Lord, Lord Robathan, in Motion. The noble Lord knows that the lack of accountability in the setting of restrictions in SIs has become increasingly unacceptable and I have expressed that view from these Benches on many occasions. But he has form, I am afraid. He says that because Covid-19 is not the great plague or the early 20th-century flu, these measures are disproportionate, oppressive and draconian. He said this at a time when the country was facing an NHS which might have been overwhelmed and risking huge death tolls. We on these Benches remain critical of the Government’s handling of the crisis and we believe that an earlier lockdown would have saved lives. We are bitterly disappointed by the failures of test, trace and isolate. We could do better in almost every single area. We are also very critical of the lack of scrutiny of the restrictions by this Parliament.

The Minister must have realised that there is an overwhelming feeling of dissatisfaction, but that does not mean that we wish to rescind the Act at this stage. We will leave the Minister to deal with his noble friend’s amendment, but if the noble Lord calls a Division, Members on these Benches will abstain.

Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020

Baroness Thornton Excerpts

Friday 25th September 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I first thank my noble friend Lady Donaghy for her very kind remarks to me, and indeed to the Minister. I also thank the Minister for the regrets he expressed at the beginning of his remarks when he introduced these regulations.

While we are all too familiar with the unfortunate practice of debating regulations that have already been in place for some time, and even amended by subsequent regulations, we charted new territory yesterday, it has to be said, when the House debated and approved regulations that have already been revoked. I look forward to seeing what comes in front of the Chamber in those circumstances. I felt that it was mitigated for me personally, because I am always happy to have the opportunity to talk about my beloved Bradford and discuss the steps that we have been taking in relation to the spike in infections. I am pleased to learn that we will not see redundant debates timetabled in this manner in future.

Similarly, today, we are tasked with debating and approving regulations that amend and refer to revoked instruments. Thirteen instruments have been revoked since 1 July—“convoluted” is the word that I think we can all agree on here. If the department is struggling to make sense of this system, what hope is there for the rest of us—the public health authorities, the police and the public? The Government need to take a step back and think about how to simplify this process and how to make these regulations more accessible. This is an appropriate time to do that.

My noble friend Lord Blunkett and the noble Lords, Lord Forsyth and Lord Beith, made some interesting remarks that we will probably need to address on Monday when we look at how the future will unfold in terms of regulations and so on. I thank my noble friend Lady Andrews, who was absolutely correct about the issues she raised regarding care homes and testing.

The Government first imposed lockdown measures on parts of northern England in July. All regulations in this group were laid under the affirmative procedure, so while we broadly support these measures and understand the urgency, the Minister is well aware of the concern expressed by the House on many occasions that what we are discussing now comes long after the fact, when the situation has changed considerably. Other regulations have come into force before being revoked and Parliament has therefore never had the opportunity to discuss their merits. Regulation 4 of the first set of regulations requires a review at least once every 14 days, so there must have been three since they came into effect. Can the Minister commit to routinely publishing these reviews in future for accountability and transparency? That would help us to evaluate their effectiveness.

The Minister said that the decision to act on each occasion was not driven by numbers alone, it was a judgment about the overall situation—as indeed it should be—taking into consideration not only the epidemiological evidence but local insights and views. This is perhaps a generous spin, given the well-publicised tensions between the Government and local leaders in many of these areas. For example, council leaders and the Mayor of Greater Manchester, Andy Burnham, were dismayed by the decision to lift Bolton and Trafford out of local lockdown restrictions against their and the borough councils’ wishes. They warned the Government that is was too early and urged them to wait for more evidence of a sustained downward trend in positive cases, but were overruled. My understanding is that Conservative MPs in the area were consulted on the lockdown decisions by the Health Secretary and many pushed for the restrictions to be lifted. At the time, I asked the Minister about that and expressed my concern that the process seemed to have been politicised. It was only at the 11th hour that the Government finally began to listen and made yet another U-turn—the right U-turn, as it happened.

This brings to mind what my noble friend Lady Lawrence said; she was quite correct about the need for clarity. If urgent decisions need to be taken quickly, people need to understand why and what motivates them. I hope the Minister can assure the House that the Government will now listen to local leaders and local expertise from the start. While the onus is on the Government to take these decisions, they should not be seen to be overruling councils. Does the Minister believe that the decision-making process and pandemic response would definitely be improved if there were greater regional representation at COBRA and other meetings where these decisions are being taken? It would improve dialogue with government and speed up decision-making.

I underline what a noble Lord said about these decisions not being politically driven, so let us show that they are not politically driven. Regardless of the political control of the councils involved in this, let them be involved in these decisions and bring to bear their local knowledge. It is clear to me—I agree with the Mayor of Greater Manchester, Andy Burnham—that we cannot carry on like this. He said:

“There has to be a reset moment here in the way the government is making these announcements, because the government is losing the public. We can’t afford to lose the public going into such a challenging autumn and winter.”


He is absolutely right.

The local leaders in the north of England have also called for more resource to support contact tracing, which clearly is not properly. What consideration have the Government given to utilising the police and fire services, which have indicated their willingness to put forward front-line staff to help get in touch with local people who need to isolate? We clearly need to bring to bear all the resources of these local communities where they are willing.

Health Protection (Coronavirus, Restrictions) (Leicester) (No. 2) Regulations 2020

Baroness Thornton Excerpts

Thursday 24th September 2020 Lords Chamber

[Baroness Thornton (Lab)]

My Lords, I thank the Minister for explaining the very complex statutory instruments that we have before us—although actually, we are quite clear what is before us today—which constitute the end of a long series of revocations. I was reflecting on whether I could remember if we have actually discussed any of these, but frankly, I cannot.

I start by thanking the Secondary Legislation Scrutiny Committee for all its hard work in keeping Parliament up to speed with scrutinising these regulations. It is worth reflecting on the summary of the 27th report, which arrived with us today, on the regulations in this batch and the ones we are discussing next and tomorrow. Noble Lords on that committee must be sitting in almost permanent session at the moment, and they deserve our gratitude.

In that report, the committee quoted from the Explanatory Memorandum:

“The number of positive Covid-19 cases has continued to decline in Leicester”—


and, indeed, in Blackburn, Darwen and the north of England, with the exception of Bolton.

“As a result, this instrument will apply easements made elsewhere in England on 25 July to the areas covered by the Blackburn and Bradford Regulations and Leicester Regulations. In addition, the instrument will apply the easements made elsewhere in England on 15 August to the areas covered by the Blackburn and Bradford Regulations and North of England Regulations, apart from the area of Bolton Metropolitan Borough Council.”


The point about this is that no clear reference is given to which instruments of 25 July and 15 August are intended or to what business may now operate, as different restrictions are eased in each area. The Committee said that it found the original Explanatory Memorandum vague and inadequate, and requested the Department of Health and Social Care to revise it to include a much more specific explanation of the changes to the law that it made. It went on:

“When law is imposed with immediate effect in this way it is even more important that the explanatory material provided is clear and fit for purpose.”


I hope that the Minister and his colleagues have taken that on board.

The Government were criticised for the way they introduced and subsequently made changes to the local lockdown in Leicester. During a debate in the House of Lords on the original lockdown regulations— I know that we have discussed this at least once, on 29 July, just before the recess—I pointed out that the media knew about the lockdown before the council, the local police or the NHS. I hope that is one of the lessons the Government have learned in this process.

We need to recognise that the people of Leicester have not experienced being out of lockdown since the initial measures were imposed in March. That has been taking its toll on all the communities in Leicester. It is true that the mayor, Sir Peter Soulsby, suggested that government data should have been shared much sooner. Again, I hope that is a lesson learned. Jonathan Ashworth MP, one of the local MPs, said that the lack of clarity from the Government had left the people of Leicester feeling really anxious, especially those who had been shielding. Local Leicester businesses are campaigning for judicial review of the Government’s handling of the local lockdown. The Chancellor said that he would do “whatever it takes” when the lockdown was announced, and they believe that specific economic relief should have been provided in the areas affected by local lockdown.

In recent weeks, some restrictions have been lifted, particularly those relating to the commercial sector. In spite of figures improving as a result of the local lockdown, repeated calls for the restrictions to be lifted in line with the rest of the country seem not to have been considered. Will the Minister tell us whether that is the case? My understanding is that Leicester is now 24th on the list of local authorities of interest, so unless there has been a spike that I do not know about in the last week or so, some consideration should be given to that.

We need to place on record credit for the pioneering approach in response to the local lockdown as part of the review recently carried out by Dame Mary Ney. Local interventions around targeting and testing, community engagement, the work in engaging businesses and carrying out enforcement, as well as local contact tracing, are key to the fact that, although cases in Leicester have started to rise, it has not been at the exponential rate seen elsewhere. If anything, they have stabilised around the current level.

As winter approaches, it will become more difficult for people in Leicester, as elsewhere, to meet their relatives and friends outdoors, which will impact in particular on the elderly. There is no doubt that people’s mental health will suffer—particularly that of young people, especially young women—and months will pass with grandparents being unable to play with their grandchildren in their gardens, while households in places with similar infection rates will have been able to mix. Some, of course, have had a summer in which they could mix with their families, as I did myself with my family in Bradford. I know that I can no longer see them, of course, but we will be talking about Bradford next.

The mayor has said that it does not feel fair. Does the Minister believe that Leicester is being treated fairly? I know that money has been given to the council to commission its own contact tracing, and that the local authority will have the insights, cultural connections and sensitivities for that kind of work.

I have two final questions for the Minister, about testing in care homes and schools. The Government promised weekly testing in care homes. In Leicester, where this is an absolute priority because it is a high-risk area, there are real problems about getting test results back, with some people having to wait seven days. That means that the next test happens before the previous test result is returned. Schools in Leicester are reporting serious issues with testing, particularly of children. The Minister is aware that there are no available appointments to book; pupils must remain at home in self-isolation, missing out on yet more time in the classroom. This is despite all the talk of prioritising these local areas during Covid spikes.

These are serious issues that need airing. They are probably not confined to Leicester, but because Leicester was the first, it is the most important.

Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) Regulations 2020

Baroness Thornton Excerpts

Thursday 24th September 2020 Lords Chamber

[Baroness Thornton (Lab)]

There are a couple of things that I need to say right at the beginning. First, I declare an interest as a native of Bradford, where I grew up, with a brother who is a long-standing Bradford councillor. I feel that I need to say to the Minister, who is probably from the south, that Blackburn is in Lancashire and Bradford is in Yorkshire. I have to tell him that these things are quite important up there. As we move forward, it would probably be politic to put all those councils in Yorkshire in Yorkshire and all the councils in Lancashire and the north-west in Lancashire and the north-west. It is a presentational issue, I suppose.

The Minister is aware of my views on the retrospective nature of these statutory instruments. In particular, I hope that we will be able to discuss easement of the restrictions in a normal, non-urgent and timely fashion. The noble Lord, Lord Greaves, mentioned families. I have a large family in Bradford, Kirklees and Calderdale, and my husband’s family are all from Huddersfield and Holmfirth. We are not seeing them. We managed a short break in order to see people when things were easier in the summer, but we are not sure that we will see them again until the new year. That brings its own heartbreak and distress—it really does—and the noble Lord is right to say that the Government need to think carefully about that, as I am sure they are. Everyone is affected by this.

The Minister should know that my remarks are also about what local people are saying. He and I received a comprehensive brief from Bradford City Council on what it thinks. It is helpful and definitely a model that I should like to be repeated among the other councils that we are discussing. The council is saying that it must have better test and tracing, and proper funding to do it. In a good example of community co-operation, the council leader tells us that the University of Bradford, for which I declare am a council member, has been allowing its site to be used for testing throughout. However, although it needs the site back, now that term has started, it will nevertheless continue to use the university site as part of the national programme. That is good news because the site is well established and people know its location.

Business owners have sent a letter to the council, as previous support schemes have come to an end, asking for businesses to be kept afloat. I do not know what the Chancellor has been explaining to the world while we have been here in the Chamber, but I hope that his announcement will include measures to support businesses in Bradford and those other areas.

In Blackburn, Kate Hollern MP has raised concerns that small businesses have been particularly badly impacted, which has left many families struggling who were excluded from the furlough scheme. She has asked the Government for additional financial support for those worst affected. Blackburn council has been advising people with and without coronavirus symptoms to book appointments for tests but expressed concern about the way in which national system has failed. That system must not fail in the areas that are under such stress with the infection rates.

I sat in on the Minister’s phone call with all the MPs in the Bradford area on the day before Eid, and heard some of their indignation. It was divided into two parts. There were those who were very upset because they were going to participate in the Eid celebrations and had even spent large amounts on food for celebrations in their gardens, including Bradford MP Naz Shah. There were also those such as Philip Davies MP who strongly objected that Shipley had been included in the restrictions at all because he could not believe that the infection rate merited them. However, Shipley, with Bradford, is back in from Tuesday. I hope that he has revised his view expressed in the local paper that Covid-19 is no worse than flu and that people should just have to live with it.

It is worth saying what the challenges facing Bradford are, because I do not think that they are all unique to Bradford. As I said, the report that the Minister and I received from Bradford Council was very helpful. It says that there is communication fatigue and unclear messaging, which leads to non-compliance. We know that. It says that there is a real problem with conspiracy theories about 5G masts and about the fact that the Government are tracking people, and that the lower death rate is leading to some complacency. It says that deprivation is a key challenge and that, to quote the president of Bradford Council for Mosques,

“years of underlying issues have been surfaced by Covid-19.”

It says that large families, multigenerational living, poor health, and crowded and poor-quality housing all contribute to a real challenge over adherence to Covid-19 guidance and regulation. It also says—this is very Bradford specific—that Bradford is the Asian wedding capital of the north and that there is a specific problem with large wedding venues, typically hosting 1,000 guests for a wedding, not being able to function at present. Of course, they would not be able to. There are immediate problems of financial support for those venues and businesses, and there must be a question about whether they are likely to survive.

My brother-in-law and Bradford councillors are working very hard with local communities. Community cohesion is very strong in Bradford, but there is community division and hate crime is a rising concern, not least due to the stigmatisation of Covid-19 cases along ethnic lines. Those things need to be considered when dealing with Bradford, Leicester and other places with large BME populations.

Covid-19 Update

Baroness Thornton Excerpts

Wednesday 23rd September 2020 Lords Chamber

[Baroness Thornton (Lab)]

I thank the Minister for taking questions on this Statement today. It was noticeable yesterday, and on Monday, that at no point was there any attempt to reveal any scientific basis or evidence for the impact on the spread of the virus of either a 10 pm curfew or going back to working from home if you can. A few weeks ago, we were all being urged to go to the office or workplace if we could. We have certainly not been told what SAGE’s modelling shows as the impact a ban on mixing households indoors would have.

The Government are lacking a clear Covid-management approach. We recognise that the pandemic, and its impact, are complex. The response can be no better than the best compromise, and that should be admitted. Timely policies to rejuvenate the economy will fail if policies to contain the infection fail; we recognise that. In the absence of a vaccine, testing, tracing and isolation is the only response that matters now. Covid infection data should be published, to make it clear to the public where the risks are. The Prime Minister said that more information would be made available. I would like to know that it will and when that might happen.

This leads back to testing, tracing and, importantly, isolating, as every conversation about the containment of Covid-19 does at the moment. Looking back over the last few weeks of growing disquiet, and then serious concern, about not being able to get tests, does the Minister agree that part of the problem—leaving aside the seeming failure of the noble Baroness, Lady Harding, and her operation—is the clear lack of communication about testing? I plead with the Minister not to treat the House to the mantra about the record number of tests and so on. It is completely clear, from MP’s postbags and the media, that “them out there” were under the impression that tests were more widely accessible than they in fact are. Lecturing us on how simple all this is both misses the point and is dangerous.

As far as schools are concerned, I asked a headmaster how things were going. He said: “If they ran a school the way they are running the country, what Ofsted grade would they put on their self-evaluation form?” I thought that was quite a good question. The tone of the Secretary of State and the Prime Minister in their Statements rather gave the impression that the Government were blaming people for breaking the rules and allowing the virus to grow. The reality is that people have done everything that they were asked to do. They have missed birthday celebrations, weddings and funerals; they have, quite rightly, sent their children back to school; they have gone back to their workplace. They have done what they were asked to do. In return, Ministers were supposed to fix test, trace and isolate so that we could return to something like normality.

The mayor of Tower Hamlets, John Biggs, said:

“With cases rising the government is right to bring in stricter restrictions to prevent the transmission of COVID-19. In Tower Hamlets we need to keep each other safe by following these new rules”.


He added:

“Government also needs to ensure adequate testing is available and that there’s continued support for those losing out financially due to these restrictions. The next few months will continue to be challenging—as a community we’ll remain resilient and together can get through this”.


He puts the case extremely well.

The Cabinet Office Minister, Michael Gove, said the 10 pm curfew on pubs in England has been brought in after evidence from places such as Bolton, where the curfew has already been in place for two weeks, suggested it will drive down coronavirus infection rates. However, according to the latest figures released by Public Health England, the infection rate in Bolton has risen again. Does the Minister share my concern that the new regulations may be based on poor evidence? Will the Government review this decision and immediately publish the evidence to allow it to be scrutinised in peer review?

Why is that 10 pm curfew not on all sales of alcohol? For example, you get thrown out of the pub at 10 pm with five of your mates; you go to the off-licence, buy whatever you want and go to somebody’s home. I cannot see the evidence that this will make any difference. I would really like to know.

Returning to tests, can the Minister confirm that only half of all tests have been received in less than 24 hours and will he publish the Pillar 2 data which breaks down how many people asking for those tests were symptomatic and how many were asymptomatic? Many parents report going to walk-in centres with their sick children, when they had no symptoms, and being given a test. Was that a national policy? Has it been abandoned? This is further evidence of confusion.

I welcome what the Minister said about prioritising NHS staff, care workers and teachers, but can he clarify why he has issued guidance to hospital trusts placing restrictions on the number of tests they can carry out? Also, how he will protect care homes? In a previous exchange this afternoon between the Leader of the House and the Leader of the Opposition, my noble friend asked the noble Baroness about domiciliary care. I think she maybe did not understand what was being said—it might have been after a question from the Back Benches. Will people in domiciliary care, going from one home to another doing social care, be given PPE and will the tests available in care homes be available to them? I am trying to put it as simply as I can because it is a very important question.

Will the Minister ensure that no one is discharged into a care home without a Covid test? Given where the virus is, what is his advice to the shielding community? What protections is he putting in place for those from black, Asian and minority-ethnic communities, given that there are disproportionate numbers from those communities in intensive care units even today?

None of us wants to see another lockdown or circuit-break. We will understand if one becomes necessary, but test, trace and isolate should be fixed. The failure of that has left us vulnerable and exposed. It seems to me we must now act with speed to save lives and minimise harm.

[Baroness Barker (LD)]

My Lords, three months ago the Secretary of State said that test and trace was the single most important thing that had to be done to conquer the virus. Yesterday the Prime Minister said it had “little or nothing” to do with the transmission of the virus. These two things cannot both be right. For six months, the problem has been that we have had confused messages, careless use of statistics and a persistent refusal to work with and listen to people who run local public services and know what needs to be communicated to whom and how.

All those are the fundamental reasons we find ourselves in this situation. We still lack an effective and timely track, test and isolate system. In its place and without any evidence base behind them, we have come up with messages which, quite frankly, do not make sense to the general public. The rule of six does not make any practical sense at all, as was very well evidenced today by my noble friend Lord Newby in an earlier interaction with the Leader of the House.

Yesterday, the Prime Minister said the Government now had granular data that enabled them to understand the transmission of the virus. When will that evidence be released? And when will it be released to Members of this House and the other place, who, next week, are going to be asked to renew emergency powers the like of which have never been seen before to this Government? If the Government cannot come up with that evidence—and, I have to say, over the last six months, they have persistently failed to answer any kind of detailed question from Opposition Benches in this House—why on earth should they be trusted to have those powers renewed? When are we going to get the evidence base?

It is helpful, looking at the Secretary of State’s Statement, to see that finally, after repeated questions from these Benches and the Labour Benches, we have got a clearer statement on who is being prioritised for testing and in which area. But, as the noble Baroness, Lady Thornton, said, it is remarkable that there is nothing about black and minority ethnic communities, which we know are at greater risk, and nothing about the important people who work, for example, in domiciliary care, or who work in hospitals but are not medics.

I would like to ask one final question. When will they start listening to local authorities, who are persistently asking, in helpful ways, what they can do to expand the capacity for testing and to make sure that testing is better tied into the rest of the services? We are about to have an app launched, and local authorities are already telling us that there is soft intelligence that people who think they have symptoms but are unable to get a test just give up, and that people whose children are ill give up. It is all well and good for the noble Lord to say, as he did the other day, that they are going to completely redo NHS 111 to make it a more streamlined portal into the NHS, but if people have given up looking for tests long before they should, we are never going to get the data we need to get on top of this.

So I ask, as I did the other day: when they are revamping NHS 111, will they talk to the Royal College of Paediatrics and Child Health about the NHS 111 protocols? I agree with the noble Baroness, Lady Thornton; I think the public are desperate to do the right thing. They have been extraordinarily patient and have listened throughout, giving the Government the benefit of the doubt. But they will not go on doing that indefinitely while the Government continually fail to come up with a decent evidence base for their actions.

Covid-19 Update

Baroness Thornton Excerpts

Monday 21st September 2020 Lords Chamber

[Baroness Thornton (Lab)]

Like everyone here, I watched the briefing by the Chief Scientific Officer and the Chief Medical Officer today, and very sobering it was too. It was followed by a very informed discussion on the BBC. It feels that we are playing catch-up again, although I realise that that is almost inevitable. Today we have had another Statement since this one and I gather that the Prime Minister will make a further Statement tomorrow.

Last week, when we discussed the then Statement which was already three days old, I said that I thought that we had come to a critical moment when some very serious decisions would need to be taken, and clearly that was correct. The words “tipping point” and “perilous moment” were used in the Commons today during the debate on the Statement. As we have said all along, clarity of messaging is totally vital. The country has become increasingly confused about what people should do to protect themselves and those around them, so perhaps this break point is really important.

A few weeks ago, the Prime Minister was setting out his stall to review the outstanding restrictions and allow a more significant return to normality, possibly in time for Christmas. Now the Prime Minister has admitted that we face a further six months of very difficult lockdown restrictions while the CSO, Sir Patrick Vallance, said that the UK faces 50,000 Covid cases a day by mid-October if the current infection rate is not halted. My first question for the Minister is: are we now at level 4? I ask because the Joint Biosecurity Centre has recommended that the Covid-19 alert level for the UK should be increased to level 4, meaning that transmission of the virus is high or rising exponentially. It has been at level 3, meaning that the Covid-19 epidemic is in general circulation, for several months, but the Chief Medical Officers of England, Wales, Scotland and Northern Ireland said in a joint statement this evening:

“After a period of lower Covid cases and deaths, the numbers of cases are now rising rapidly and probably exponentially in significant parts of all four nations.”


Given that, are we going to move to level 4?

Can the Minister confirm that the Government intend to bring forward further restrictions in London? What are the next steps nationally? This morning, Chris Whitty, the CMO, said that people should

“break unnecessary links between households to stop coronavirus spreading out of control.”

Has the advice about return to work changed? Can the Minister confirm whether the reported two-week circuit-breaker lockdown is indeed going to happen?

It is deeply concerning that the Statement last Thursday contained scant reference to testing. As my right honourable friend the shadow health Secretary said, under this Government test and trace is actually trace a test. When will that be resolved? Giving evidence to the Science and Technology Committee on Thursday, the noble Baroness, Lady Harding, told MPs:

“I do not think anybody expected to see the really sizeable increase in demand that we have seen over the course of the last few weeks.”


This is simply not true. Can the Minister confirm that SAGE warned the Government that the UK faced an inevitable increase in community transmission and cases after the summer and needed a fully functional and trusted test and trace system put in place?

I feel that I need to talk about the “moonshot”, because it is an emerging story on the i that the moonshot test for Covid-19 that will allow people to resume normal life will not be available on the NHS—as the Government’s testing tsar, the noble Baroness, Lady Harding, suggested. She said that individuals and companies would have to pay to access the proposed test and that it would not be part of the normal NHS test and tracing scheme that she heads, which will continue to concentrate on swab tests. So the question I need to ask the Minister is: are we now looking at an A and a B test and trace system or an A and B test system where people who can afford to pay for a test can get one immediately and those who cannot—the majority of us—will not?

Given these issues, tests now seem to be rationed, with health and social care prioritised. Could the Minister reflect on reports that care homes worst hit in the first wave could be tested for coronavirus less often, as the Government believe there will be higher levels of immunity and that they are less likely to pass on the virus? This is deeply worrying, given the high percentage of staff turnover and the vulnerability of residents.

Can the Minister confirm reports that evidence shows that 20% of people who have been told to self-isolate are still leaving their homes, and will that information be published? That is presumably what is leading to the much more aggressive fines. The Government say that the £10,000 maximum fine will act as a deterrent to testing positive and not self-isolating. Does the Minister share my concern that this actually may deter people with symptoms from getting a test at all? For many people, ignorance may also be the only legitimate option, as they are unable to get a test and self-isolation is financially non-viable.

The Minister will be aware that the Joint Committee on Human Rights said it was unacceptable that many thousands of people were receiving fixed-penalty notices despite evidence that the police do not fully understand their powers. They highlight enforcement as having a disproportionate impact on young men from black, Asian and minority ethnic backgrounds. Currently there is no way for people to challenge the fixed-penalty notices easily, so does the Minister share my concern that this will invariably lead to injustice, as members of the public who have been unfairly treated with a fixed-penalty notice have no means of redress?

It ought to be straightforward for a member of the public to find out what the current law is, nationally and in their local area, without having to trawl—as the rest of us are doing—through countless confusingly named regulations. Will the Government publish a website where people can enter their postcode and be told in plain English what restrictions currently apply where they live?

[Baroness Barker (LD)]

My Lords, I thank the Minister for dealing with this Statement, which comes hot on the news that we are at level 4 as regards the pandemic. Therefore, I want to touch on two or three points in this Statement. The first is the Government’s intention to invest £24 million in increasing call-handling capacity through NHS 111, to make it into a gateway to emergency care, providing the first port of call for patients. I must say to the Minister that it is a bit late to be doing that, and most of us should be somewhat alarmed at the news in the Statement that the Government intend to conduct pilots and will roll out NHS 111 First to all trusts from December. I understand the need to run pilots, but does he not think that time is against us?

On 17 September, six council leaders, cross-party, from across Yorkshire and Humber, wrote to the Minister. It is worth paying attention to what they said in their letter. They said: “It would be worth exploring the protocols and policies that might increase demand for what might be considered lower-value testing in a time of capacity constraint. This would include working with NHS 111 and reviewing their protocols. It seems that any childhood illness may result in a Covid test—that is what GPs are constantly telling us—while the Royal College of Paediatrics and Child Health have produced helpful guidance around that.” I ask the Minister if his department has seen that guidance and whether it will pay any attention to it.

Secondly, back to care homes and the ring of steel that never was. It is very welcome that there is going to be further investment in PPE and coverage for staff who have to take time off. However, there is a real danger in this, and there always has been, because social care is much more than care homes. Only 15% of people aged 85 or over are in a care home—most people who receive care are not. It is not uncommon for domiciliary care workers to visit 10 to 15 different homes in a shift. This Statement is silent on this matter which, given that the advisers are telling us they now know more about the transmission rate, is somewhat surprising. I wonder whether the Minister could talk about that.

The big issue in the last few days is the increasing confusion among members of the public as to who should be tested. Even in areas that are on the watchlist, people do not know whether they should be tested only if they are symptomatic or if they are asymptomatic. Some authorities have been given the power to do asymptomatic testing. Going back to that letter of 17 September, I note that the local authority says that it would be happy to have discussions locally but accepts the need for a co-ordinated approach with the Government. There needs to be a public discussion that provides urgently needed clarification from the department on how long these capacity issues are going to be around and what contingencies are going to be in place to manage them, particularly in high-risk areas.

This is not endless carping but a genuine concern for public health, and I therefore look forward to some detailed answers from the Minister.