Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020

Baroness Uddin Excerpts

Thursday 7th January 2021 Lords Chamber

[Baroness Uddin (Non-Afl) [V]]

My Lords, I agree with noble Lords that this is indeed a sombre time, with the highest rate of infection and loss of life and intense pressure on our NHS staff and services. I add my voice to the call for mandatory masking, which must be made freely available. I thank Edmund Yeo for his constant supply of masks, which I have been able to distribute among vulnerable women.

I ask the House’s indulgence to focus today specifically on people of Bangladeshi heritage, who are most excessively affected throughout this pandemic—notwithstanding my respect and concern for all those who have lost their lives or are seriously unwell and facing multiple difficulties as a result of these regulations. Consultant doctor Abdul Mabud Chowdhury was the first GP to lose his life to Covid. His family have continued a commendable campaign for safe practices in the NHS for all staff. Every day, I am notified of friends and neighbours of Bangladeshi heritage struggling with socioeconomic conditions alongside reports of Covid symptoms, self-isolation, hospital admission and, tragically, deaths.

I have spoken repeatedly to the Minister and asked him in this Chamber to explain what he and his department are doing to prevent and mitigate these untold sufferings. Noble Lords will agree that we have made colossal advances in data collection and analysis, or the vaccine simply would not have been developed so rapidly. Given that we have known for many months about the disproportionate impact on people of Bangladeshi heritage, has data has been collected on the numbers of reported Covid infections, particularly with the new variations? How many children are affected and what are their ages? How many are men and how many women, and what are their ages? What underlying conditions do they have? How many are self-isolating and how many infections and deaths are there within specific groups? I am deeply concerned not to see any adequate targeted communications under these extenuating circumstances. Will the Minister undertake to share with me and other noble Lords the Government’s strategy and implementation plan to address these issues as a matter of the gravest urgency?

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020

Baroness Uddin Excerpts

Wednesday 30th December 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, we have exponential infections and the highest number of deaths in Europe. Are the Government seriously not questioning where they have gone wrong? What must now be done to further mitigate this country’s distress? I share the many concerns raised by other noble Lords; my local hospital, the Royal London, has ambulances lined up like the lorries at Dover with patients waiting, often for urgent and emergency care.

Can the Minister say why the Excel Nightingale remains closed to patient care? If it is due to the shortage of 84,000 clinical staff, what consideration is being given to recalling early retirees and utilising the military medical corps for the Nightingales to relieve some of these extraordinary pressures?

We know that tiers are not impactful in controlling deaths and infections. Surely, given the national emergency, we must consider an immediate national lockdown. I agree wholeheartedly with the noble Baronesses, Lady Jones and Lady Watkins of Tavistock, the noble Lord, Lord Harris of Haringey, and many others. That must include schools. Our schools must also be shut down and all the necessary support put in place for schools, families and businesses. Schools have rapidly spread the infection, particularly in areas such as Tower Hamlets, Newham and Hackney.

The prevention strategy must continue, as others have argued. Face coverings must be made available free of charge in many institutions, including in shops and even on public transport. Maybe people would then begin to take their use seriously.

Testing and tracking alongside effective communication with all communities must go hand in hand with the vaccine becoming widely available for those who can and wish to take it up. I congratulate the Oxford team on this wonderful news, and long may it continue.

Covid-19 Update

Baroness Uddin Excerpts

Tuesday 15th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

The noble Lord makes his point well, but I respectfully disagree. One of the great challenges from closing schools is that young people then socialise and spread the disease much further and wider than they would if they stayed at school. This has been demonstrated time and again around the world. Also, to keep our hospitals open and our businesses and education systems going, and to stop deprivation from accelerating, it is desperately important to keep schools open. That is why, today, we announced the rollout of a much greater and enhanced asymptomatic testing regime for schools, in the new year, which will see bubble and teacher testing, so that schools can remain open.

[Baroness Uddin (Non-Afl) [V]]

My Lords, in the light of the British Medical Journal’s formal joint letter with the Health Service Journal, I hope that the Minister will reconsider the Christmas relaxation of the rules. The point I wish to make really echoes those of my noble friends Lady Verma and Lord Hunt. It is about the scepticism around medicine within some sections of the communities—in particular within Bangladeshi communities, where disproportionate numbers of deaths and infections have occurred. In the light of many noble Lords raising questions about communication issues, will the Minister urgently meet me and some of the local specialist media to consider reviewing the messaging that targets some of these communities?

[Lord Bethell (Con) [V]]

I completely accept the point made by the noble Baroness. It is incredibly frustrating that the exact communities which have often seen some of the highest mortality rates are also those which are sceptical about the vaccine. This is one of our biggest challenges; it has been for months and will continue to be so. I pay tribute to colleagues at the Department of Health and the Cabinet Office who have done a huge amount in working with specialist media—radio, magazines and online forums—to target exactly these communities. They have used advertising and direct engagement with the presenters to put the message across, often in local languages, and this has proved increasingly effective.

Ockenden Review

Baroness Uddin Excerpts

Monday 14th December 2020 Lords Chamber

[Lord Bethell (Con) [V]]

My Lords, I completely take on board the noble Lord’s observations. It is true that Donna Ockenden’s report alludes to the failure by senior leadership to monitor and intervene where clearly there were problems. However, let us not confuse correlation with causation. This was not caused by a failure of senior leadership, but by a breakdown in the basic management systems and culture of the maternity services within the trust. That should have been addressed by the senior leadership, but it was not necessarily caused by them. I completely endorse the observation of the noble Lord that neighbouring trusts have an important role to play in checking in and benchmarking behaviours. That is a point made very clearly in the Ockenden report, and one that I hope they will step up to.

[Baroness Uddin (Non-Afl) [V]]

I salute the courage of the parents of Kate Stanton Davies, Pippa Griffiths and so many others in their tenacious personal search for truth and justice. Donna Ockenden’s report was harrowing reading. The pain, trauma and inhuman disregard for the safety of baby and mother was palpable, profoundly damaging confidence and trust in maternity services. It made me relive my own decade-long failed attempt to seek information on whether my lengthy abandonment on a bed overnight after 48 hours of labour pain has anything to do with my now 42 year-old son’s brain damage and lifelong disabilities. I was dismissed constantly, admonished for “being an Asian mother too ashamed to have given birth to a disabled child”, which is far from the truth about a much-loved son.

Sadly, I was not alone, as the Ockenden report details. It has been repeatedly confirmed by so many others and by the first maternity advocacy scheme, which was set up in the 1980s to address the high postnatal mortality rate of mothers and babies among Bangladeshi, Pakistani, Somalian, Vietnamese and African women, whose maternity experiences, even today, remain inconsistent and patchy. Therefore, can I ask the Minister what consideration can and will be given to historic grievances in any future review of maternity services, given what the right honourable Jeremy Hunt in the other place, and Donna Ockenden, have said about the experience of mothers and babies highlighted being only the beginning of unearthing potential malpractice across England?

[Lord Bethell (Con) [V]]

I join others in paying tribute to the personal testimony of the noble Baroness. The story that she tells is extremely moving. One cannot think about the challenges and difficulties that she must have had since that awful night, which she so movingly describes. The report makes it clear that those with a BAME background have disproportionately high rates of difficulty at birth and in maternity services, something which undoubtedly we need to look at more carefully. However, the Ockenden report is not a historic grievances report, and that will not be the focus of our response.

Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2020

Baroness Uddin Excerpts

Thursday 10th December 2020 Grand Committee

[Baroness Uddin (Non-Afl)]

My Lords, I express my good wishes to the Minister and hope his family gets well very soon. I thank him for the precise manner in which he laid out the two SIs for our consideration.

I share the concerns expressed by the noble Baronesses, Lady Bennett and Lady Altmann, and, like others, I do not share the Minister’s confidence that adequate safeguards exist to effectively monitor private companies —some of them at least—given the fiasco that was impactfully detailed by the noble Baroness, Lady Wheatcroft.

I have a couple of general points to make. On social care for children and adults living with disabilities and autism, it is being widely reported anecdotally and in the media that families and carers are suffering an intolerable burden without adequate support from organisations and local authorities which, because of serious budget shortfalls, are failing in their statutory obligations and to safeguard their duty to protect the most vulnerable who may be experiencing abuse and neglect. Noble Lords will be equally concerned to learn that organisations such as Barnardo’s, the NSPCC and Include Me TOO, which provide specific services for ethnic-minority children, are overwhelmed with demands for services, as many families have depleted resilience to cope and to navigate the new maze of inconsistent and inadequate access to their rightful services.

The Minister speaks with confidence about the critical importance of effective testing services being available to those who require them. My inquiries in my local area, particularly among Bangladeshi communities, continue to alarm me. Many of them remain confused about at what point to trigger testing and what options might be available to them, therefore overwhelming GPs and local hospitals. I have spoken about this in the House on a number of occasions, and to the Minister personally, because there is simply not enough information being relayed to the communities in a bilingual format. I have also spoken to the Minister about re-examining the messaging and what else might need to be done to ensure that there are proper, consistent and effective messages going out about what needs to happen and where the services can be accessed.

Finally, I hope the Minister’s department is collecting adequate data on the kinds of communities—particularly their ethnicities and age ranges—where there are serious gaps in both testing and services. It is high time that we have effective equality impact assessment of all these different SIs as well as the provisions that the Government are providing.

[The Deputy Chairman of Committees (Baroness Pitkeathley) (Lab)]

My Lords, the noble Lord, Lord Wei, has withdrawn, so I now call the noble Baroness, Lady Jolly.

Coronavirus Vaccine

Baroness Uddin Excerpts

Thursday 3rd December 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, the noble Lord raises an important challenge there; fairness and equity are important in this important time. However, I will try to assess the situation: we have 800,000 doses of a vaccine that is incredibly difficult to transport, requires cold storage and is in vials containing more than 100 doses each. Therefore, practical considerations are pre-eminent at the moment, rather than sharp elbows.

[Baroness Uddin (Non-Afl) [V]]

My Lords, I thank the Minister for the gracious way he has introduced this discussion, and I welcome his assurance of dialogue. I hope he will agree, as he has assured us, that the vaccine will not be the only effective means of preventing infections and further deaths and that the Government will continue their heartening improvement of the test and trace programmes and ensure that those in tiers 2 and 3 have the required financial measures. Can he assure me and the House that his department will urgently scale up communication with particularly vulnerable and poorer communities, where concerns around vaccination are significant? Can he assure me that any proposed government use of the police and army will be done with consent and after consultation with local authority leadership?

Covid-19: Dental Services

Baroness Uddin Excerpts

Tuesday 10th November 2020 Lords Chamber

[Lord Bethell (Con)]

My Lords, I completely acknowledge the challenge that the noble Baroness has described. Many dentists can see only 20% of their normal cases, and around half can see about 50%. The backlog is, as she describes it, severe, and the impact, particularly on private dentists, has been very hurtful for their businesses. I cannot make a commitment to fund ventilation arrangements, but we acknowledge the scale of this challenge and are looking at ways to mitigate it, including bringing in testing, which we hope would help provide a safe environment for both staff and patients.

[Baroness Uddin (Non-Afl)]

My Lord, the Minister will be aware that people with learning disabilities and autism have suffered disproportionately in not receiving care and services. Will he undertake to ensure that they are not equally suffering by not receiving dental services, especially specialist dental provisions? I declare that I have a 41 year-old son with a learning disability and autism. I have spoken to a number of organisations that said that the pandemic exacerbated the difficulties in the process of receiving important and urgent care.

[Lord Bethell (Con)]

My Lords, the noble Baroness refers to the prioritisation of patients in the constrained appointment flow of dentists. She is entirely right that those who have vulnerabilities, disabilities or other disadvantages should be prioritised: that is the objective of the prioritisation process. She makes the point extremely well and I am happy to take on board any points on where she thinks the system is not working as well as it might do.

Health Protection (Coronavirus) (Restrictions) (England) (No. 4) Regulations 2020

Baroness Uddin Excerpts

Wednesday 4th November 2020 Lords Chamber

[Baroness Uddin (Non-Afl) [V]]

My Lords, it is a privilege to follow so many eloquent and committed speakers. I speak today with the heaviest heart. In spite of the unnecessary delays, I accept that the proposed lockdown may be necessary to prevent pressure on the NHS beyond its capacity. I extend my good wishes to all the families of those affected and pray for their speedy recovery.

I welcome some of the financial measures being extended until December. Many of the questions that I have asked the Minister on countless occasions over the past few months remain unanswered. One such question that other noble Lords and I have repeatedly asked is about a cost-benefit and risk analysis and an equality impact assessment of government policies.

I agree with the noble Lord, Lord Forsyth of Drumlean, about the unequal and unimaginable duress on the poor and low-wage families. Inevitably, this intensive period of isolation will again affect women and children, who may face further abuse and violence to comply with government regulations. Many leading civil society organisations have continuously warned that vulnerable women and their families are not accessing financial measures to which they are entitled. Will the Minister assure me that he has listened to their call, and to the many suggestions that other noble Lords and I have made to improve the Government’s communication with vulnerable groups? Will he agree to meet community experts urgently to address and improve this crucial messaging?

The Government have had months; why are there no assessments or data available to the Government on the effect of Covid on victims who have experienced exponential levels of poverty and domestic abuse, or on children and young people experiencing mental health issues? Have Public Health England and Kevin Fenton’s recommendations been understood and, if so, what action has been taken to improve financial packages and services to vulnerable groups? Are the Government mindful of the systemic inequalities which cause disproportionate numbers of deaths among minority communities? Will the Minister assure the House that lessons have been learned and actions are being taken to monitor and avoid unnecessary deaths and infections among the specified vulnerable groups as we progress through lockdown?

Locally led test, trace and isolation is crucial, as has been said by many noble Lords. It has been reported that Hammersmith and Fulham Council successfully helped the NHS reach out to its communities; its efforts and the work of housing officer Hasnat Syed were commended. Can the Government make local government their delivery partners using this model? The Government’s chaotic and inconsistent responses and delay is clearly one reason why we have the current number of in-patients.

While I give the benefit of the doubt to keeping children safe in education, I know that, in my own close and extended family, a number of children have tested positive for Covid, and I witnessed their parents’ dread of hospitalisation. I hope the Government will keep reviewing their decision based on sound evidence, and we must continue to do everything to keep the Government and Ministers answerable.

Covid-19: Intensive Care Treatment

Baroness Uddin Excerpts

Thursday 29th October 2020 Lords Chamber

[Lord Bethell (Con)]

I am not sure that I agree with the implication of the noble Lord’s question—that somehow there is a prejudice on the front line against older people and that staff take it into their own hands to make decisions that are in themselves inherently unfair. That is not my experience. Where the noble Lord absolutely has a point is that people are extremely sensitive about these kinds of issues, and, quite rightly, are deeply concerned that they are going to get the treatment and care that they deserve and will not be subject to any form of unfairness. It is imperative that the NHS builds trusts and conveys a strong communication on these issues. To push back against the noble Lord, it is not my impression that the staff at the NHS have lost sight of this important principle.

[Baroness Uddin (Non-Afl)]

My Lords, I declare an interest in that many of my family and friends work on the front line of the NHS, which I love and respect, as all other Members do. At the height of the pandemic, I watched a programme on Italian and American doctors using algorithms for vital decisions on treatment, with one being highlighted where triage tools had indicated nil chance of a patient surviving. However, their family pleaded with the doctors and convinced them to give them a few more days to see if “a miracle could happen”. In April, my close friend’s death was predicted from the use of some kind of early triage process. Sadly, my friend lost his battle. However, the miracle occurred: against all the odds, because of one decision by one team of doctors, the Italian patient survived. Given the fiasco of the use of algorithms, although I welcome the Minister’s absolute assurance, what analysis or serious case review has been undertaken of the number of treatment decisions based on early triage tools, given that extreme pressures on doctors have returned? Where deaths have occurred, can the Minister say what proportion were individuals of Bangladeshi heritage? Can any lessons be learned to improve their survival chances in the current emergency?

[Lord Bethell (Con)]

My Lords, I share my sympathies with the noble Baroness for the loss of her friend, for which we are all very sad. However, I take exception to her implication of a fiasco in the use of algorithms. I do not accept the implication that it is regular practice for clinicians somehow to give up on patients who stand a chance simply because their reading of an algorithm says that they should move on to someone else. That is not how we run the NHS; it is not how we had to run it during the first wave and it is not how we intend to run it during the second.

Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) Regulations 2020

Baroness Uddin Excerpts

Thursday 22nd October 2020 Lords Chamber

[Baroness Uddin (Non-Afl)]

My Lords, regardless of the statistics the Minister has suggested on the number of those reached for self-isolation, communities with large minority communities remain unaware of government regulations and, most importantly, the unnecessary punitive fines. Some of the latest statistics suggest that more than 60% of close contacts of those who are Covid-positive have not been reached. Are statistics available for their profile, including their ethnic backgrounds? What assessment has been made of the reasons for the evident and serious gap in trust in the Government’s management of their communications with the public? Needless to say, their resistance to engaging with the leaders of Manchester will not have filled ordinary citizens with great confidence, and any clarity is in the messaging that the Government will not accept any scrutiny or dissent.

These are emotionally testing times for us all. Problems with mental health and well-being are also at pandemic level and, regardless of government funding strategies, why are respected national and local statutory and voluntary organisations struggling to access essential funds to provide assessments, counselling and other support, while many people end up in A&E? What urgent consideration and resources have been allocated to national and local children’s organisations to support individuals and families before they reach crisis point?

Under emergency modes, we have overlooked social divisions as communities become ever more segregated, with more vulnerable families increasingly detached from those who have and those who remain at the margin of inadequate, unequal access to financial, educational, digital and emotional support. Now is the time to reach out for better management of this pandemic. The politically biased attention given to local leaders is unbecoming of this Government leading a national and global pandemic.