Covid-19 Update
Baroness Altmann Excerpts(4 years, 9 months ago)
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Lord Bethell (Con)
My Lords, the noble Lord’s testimony is very moving and I have no doubt that the red-list system has put a lot of pressure on a lot of families. I personally sign off on these exemptions, and every evening as I go through them and read about the stories people have, it breaks my heart—and I do it with huge regret indeed. However, the noble Lord needs to understand that we put the red-list system in place to protect this country. People simply cannot expect to travel in large family groups as if the pandemic had not happened, and they cannot expect the testing system to work as some kind of barrier to infection. We have tried that. It did not work. The proof is absolutely categoric.
If I may be honest with noble Lords, it is likely, unfortunately, that we will have to live with some red-list countries for some time to come. That is one aspect of the unwinding of this pandemic that is not likely to go away very quickly. I completely take on board the noble Lord’s guidance. If he would like to write to me about the specific examples, I would be happy to correspond with him. However, I would not be levelling with him if I did not make it clear that this is something that we are extremely committed to.
Baroness Altmann (Con)
My Lords, I welcome my right honourable friend Sajid Javid to his new role and also offer my public endorsement of the integrity of my noble friend the Minister. I echo the words of this Statement that we must learn to live with Covid, so that our country benefits from the fantastic vaccine success. I fear we have lost perspective on real life. Zero Covid and stopping people being ill with just one disease among the myriad diseases around us all our lives are wholly unreasonable—and indeed unattainable —aims. Can my noble friend comment on when we will take more seriously the mental health damage that lockdown and deprivation of freedom to see all our loved ones is causing, and the importance of trusting the British people to decide for themselves who they need to meet and hug and who—as the noble Earl, Lord Clancarty, and my noble friend Lord Cormack said—they feel safe to sing with?
Lord Bethell (Con)
My Lords, I hear my noble friend’s comments loud and clear, and I think that we have hit some kind of inflection point where our focus is now much more on the learning-to-live rather than the saving-life dimension. I say that with unbelievable caution, having, as noble Lords know, been through all sorts of rollercoasters of expectation over the past year. I am extremely hopeful that the vaccine has laid out a clear path out of this pandemic. It is one that is fragile, delicate and could be overturned at any point, but, so far, the vaccine has seemed to be extremely durable.
On the mental health of the nation, I completely agree with my noble friend. It has put huge pressure on families, loved ones and communities. There have been positive benefits—my honourable friend Nadine Dorries spoke movingly about that to the Health and Social Care Committee the week before last. Some families in some communities have been drawn closer together— there is good evidence for that—but, for a great many, there has been a huge amount of pressure. I, for one, look forward very much to some lessening of that burden.
Social Care and the Role of Carers
Baroness Altmann Excerpts(4 years, 9 months ago)
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Baroness Altmann (Con)
My Lords, I too congratulate the noble Baroness, Lady Jolly, and echo the thanks for the wonderful work done by carers. Our care system is broken: every part of it is in need of radical change, from the arbitrary distinction between what counts as social care and what qualifies you for NHS healthcare, the healthcare lottery; to the way in which care is provided, the postcode lottery; to the standards applied to the workforce of 1.5 million people, such as social care nurses relative to NHS nurses, an employment lottery; to the lack of funding that has increasingly rationed care; to the draconian means test and funding shortfalls, which force the entire cost of care on to the most vulnerable, who pay not only significant sums for their own care but usually a 20% or 30% surcharge to subsidise council underfunding as well, whereas those who do not need care pay nothing; to the lack of support for unpaid carers; and to the financial fragility of care home operators, who can load their business with debt, extract equity, take rental income to their offshore companies, and have provided handsome profits to hedge funds, which buy and sell their distressed debt.
Each of these parts of the system needs reform, and there is no silver bullet. Extra funding is of course needed, but system redesign is also required. Leaving social care to cash-strapped councils leaves more than 1 million people who need care. The demographics are such that, within the next 10 years, the enormous bulge of baby boomers will start to enter care needs. At the moment, the current cohort is rather small. Social care seems to have been the forgotten front line at the start of the pandemic, and it was used by the NHS as an overflow service, perhaps being considered as part of the private sector rather than part of the health service. If someone has a health problem, however, and they need social care, why should that not qualify for free basic care at the point of need? It could be modelled on the lines of our pension system.
Carers have suffered significantly; unpaid carers have often been taken for granted. They have lost, according to Carers UK, an estimated 25 hours per month of extra support that they would have had before the pandemic from support services, family and friends. I am keen to see how we can better recognise their needs. Will the Minister agree to meet Peers from across the House and Carers UK to learn from the new measures that have brought together for the first time the various parts of our service to help vaccinate carers?
Folic Acid
Baroness Altmann Excerpts(4 years, 9 months ago)
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Lord Bethell (Con)
My Lords, the noble Baroness is entirely right: medical opinion on this matter has absolutely consolidated around support for it, and the consultation in September 2019 was extremely positive indeed. I am extremely grateful to mill owners, both the large industrial ones, which make a lot of the white flour, and the artisanal mill owners, which had complexities of their own. The engagement with them has been enormously positive, and I cannot see any obstacle on that front. However, there is a machinery of government point that needs to be addressed: we have to work it through the devolved nations and other arm’s-length bodies, and we are doing that at pace.
Baroness Altmann (Con) [V]
My Lords, from my noble friend’s responses, the House will be clear that this decision is under way. Could my noble friend give some idea of whether we might expect an announcement before the Summer Recess? We know that hundreds of children being born with spina bifida and anencephaly, which can be so damaging to themselves and their families, could be avoided. The sooner we do this, the sooner we can stop such problems occurring.
Lord Bethell (Con)
I agree with my noble friend; she is right that this is a priority. However, it is not within my gift to simply grant a decision on it; it needs to be worked through both industry and government. We are making progress on this. It is a huge national undertaking for us to put substances literally in the bread of the nation. The public deserve to feel confident that that decision has been made thoughtfully and responsibly, and it is entirely right that we take care to dot the “i”s and cross the “t”s.
Covid-19: Care Homes
Baroness Altmann Excerpts(4 years, 9 months ago)
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Lord Bethell (Con)
My Lords, we were never in any doubt from the very beginning that the virus presented a huge threat to care homes. They are where the elderly and the vulnerable are housed, in conditions where it is extremely difficult to enforce infection control and where there is a large amount of intimacy between residents and staff. We knew from the experience of other countries that care homes were very likely to be an area where infection and severe illness, and potentially death, would be highly prevalent. There is no doubt that care homes suffered the brunt of this virus, and for that matter I am extremely sad indeed. Noble Lords should realise that we put every measure in place that we humanly could have done. We gave a huge amount of resources, including £2.8 billion via the NHS specifically to support enhanced discharge processes and the implementation of the discharge to assess model.
Baroness Altmann (Con)
My Lords, I apologise to my noble friend for adding to the burden that he bears in answering this question. I know he cares deeply about this situation. However, it is important for lessons to be learned, so that we have no similar experience in future. The letter sent by the NHS to care homes on 15 April 2020 states:
“Where a test result is still awaited, the patient will be discharged … pending the result ... This new testing requirement must not hold up a timely discharge”.
I do not believe any of this was a deliberate attempt to infect care homes, but I do believe that care homes need infection control and that there was a lack of follow-up for patients who were discharged positive.
Lord Bethell (Con)
My Lords, I am grateful for the tone of the question, but its assumption is, I am afraid, quite wrong. Before April 2020, there was very little evidence and no scientific consensus whatever that asymptomatic transmission posed any risk. For example, the World Health Organization said on 2 April:
“to date, there has been no documented asymptomatic transmission.”
My noble friend may remember that differently. They were very difficult times, and we made decisions on very limited information. We made the best decisions we could have done under the circumstances.
Covid-19 Update
Baroness Altmann Excerpts(4 years, 9 months ago)
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Lord Bethell (Con)
My Lords, I am extremely touched by the noble Lord’s words, and I completely endorse his meaning. It was awful last year when we saw multilateralism and global co-operation fracture and decay. We had to look to our friends and resources within our own borders to answer the pandemic. That did not work and will not work. The noble Lord is absolutely right. From a pragmatic point of view, we depend upon global supply chains for the benefit of global science. From a personal and human point of view, we depend upon the solidarity of humankind to get us through these awful moments. I completely endorse the noble Lord’s point.
Baroness Altmann (Con) [V]
My Lords, I commend my noble friend for all his work helping fight this dreadful pandemic; I know his dedication is second to none. I hope he will forgive me for asking: what is the endgame? He has said today that we must prevent people getting sick, but that seems to mean just getting sick with one illness: Covid. What about the suicides, heart attacks and cancers that are being missed because of lockdown? Covid is responsible for less than 1% of deaths right now. Can we not trust the British people to be sensible and choose the risks they are willing to take, along the lines the noble Baroness, Lady Meacher, said, using the example of the Government banning hugging for care home residents? I find this intrusion in our private everyday lives deeply frightening.
Lord Bethell (Con)
My Lords, I absolutely forgive my noble friend because that is an extremely sensible question. I take it on board completely. The endgame is to end a contagious disease that has exponential growth. As she knows, R is currently between 1.2 and 1.4. If it goes unchecked, this disease will spread pretty much through the whole population. The vaccine is excellent at keeping people out of hospital, but not everyone. It is excellent at preventing deaths, but not for everyone. It is good at stopping the disease, but only half of the disease. We must get enough vaccine out there so that the disease will not run through the entire population and lead to the deaths of thousands, tens of thousands, or more. That is the endgame of this project.
Carers: Support
Baroness Altmann Excerpts(4 years, 9 months ago)
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Lord Bethell (Con)
My Lords, the testimony from the right reverend Prelate is entirely right and is echoed in the Carers UK report. The point he makes about identification is key. One of the good things that came out of the pandemic is that we made progress on identifying and putting together registers of carers. That was seen in the delivery of the vaccination, when nearly 1.6 million of them received the vaccination early as part of priority group 6. I agree with the right reverend Prelate that more needs to be done on data collection.
Baroness Altmann (Con) [V]
My Lords, will my noble friend join me in commending the work of unpaid carers in this country who have done so much to help through the pandemic? Will he request that Her Majesty’s Treasury and the Department for Work and Pensions consider increasing the carer’s allowance, which pays anyone caring for somebody less than £2 an hour for at least 35 hours a week of care? The complexity of the current system, with overlapping benefits, would certainly be advantaged by significant simplification. At the moment, people need advice before they understand whether they can claim carers benefit.
Lord Bethell (Con)
My Lords, I completely agree with my noble friend on commending the role of unpaid carers. We could not have got through this pandemic in the way we did without them. The system is complex and work is under way at the DWP to try to simplify it. As my noble friend knows from her significant expertise, this is a difficult task but we are very focused on it.
Heathrow Airport: Border Control Passenger Safety
Baroness Altmann Excerpts(4 years, 10 months ago)
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Lord Bethell (Con)
My Lords, I completely and utterly acknowledge the concerns expressed by the noble Lord and by communities who live proximately to regional airports. As we look to the opening up of more airports, we are enthusiastically and energetically engaged with those communities. I reassure the noble Lord that the systems that we have in place around both red and amber quarantine have extremely tight restrictions on them, and there is no evidence of leakage into the local communities. We are doing our best to communicate that fact to those who are concerned.
Baroness Altmann (Con)
My Lords, Heathrow deserves credit for a number of the measures that it has been taking: dedicated channels for red-list arrivals, trialling a separate terminal for arrivals, and escorting people to separate areas. Would my noble friend agree that, if red-list arrivals are required to wait longer than others, there is justification for that? I hope that my noble friend will not consider stopping the opening up of further travel opportunities because of concerns about the spread of new variants in a population that has been so extensively vaccinated already.
Lord Bethell (Con)
My Lords, I join my noble friend in paying tribute to Heathrow, which has worked extremely hard, in a collaborative spirit, with the very difficult, challenging and often fast-changing border and quarantine arrangements. As she quite rightly says, its commitment to the red-list terminal pilot is extremely encouraging. However, I am afraid that I cannot give her the reassurance that she seeks on our mission to ensure that variants of concern that might have an impact on the vaccine will not be diligently and ruthlessly excluded from the country. It is our duty to protect the vaccine, and we will take whatever steps are necessary to do that.
Covid-19 Internal Review
Baroness Altmann Excerpts(4 years, 10 months ago)
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Lord Bethell (Con)
My Lords, the Prime Minister will define the terms of reference and the chair will define how the inquiry deports itself. On the noble Lord’s point about the rules and the suggestion of confusion, I agree that there was a lot of heat and smoke around differences but the truth is that 99% of everything that we did between the different parts of the union was exactly the same. There was a lot of focus on very small differences, but what I celebrate is how much common ground there was in our responses.
Baroness Altmann (Con)
My Lords, I echo the congratulations to my noble friend on his dedication to his role, and I welcome the noble Baroness opposite to her position. I join other colleagues in congratulating the Government on their successful rollout of the vaccine, which, from what we can see so far, deals with the variants that have arisen and allows us to open our country back up again after the extraordinary efforts that have been made in connection with the vaccine. In connection with any review, will there be an urgent announcement of an investigation into the way that social care was handled, particularly at the beginning of this, for those people who are so reliant on home care or care homes for their very survival?
Lord Bethell (Con)
My Lords, I do not think I need to speculate on this matter; of course social care will form part of the inquiry. It has been an incredibly important part of our response, and we have come a long way in the last 14 or 15 months. I pay tribute to all the people who work in social care, and their leadership, who have done an enormous amount to protect those who live in social care or are supported by it. We as a country have learned a huge amount about how to protect those who are vulnerable and those who are elderly. I also pay enormous tribute to the public, who have made huge sacrifices to protect and save the lives of those who live in social care.
Care Home Occupancy Rate
Baroness Altmann Excerpts(4 years, 11 months ago)
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Lord Bethell (Con)
The noble Baroness makes a perfectly fair point. Moving into a care home is a difficult and potentially stressful experience. Moving in at a time of Covid, when, as the noble Baroness rightly points out, there are heavy restrictions, is very difficult. Those restrictions are in place to save lives. They are under constant review, and when the infection rates warrant leaving them behind, we will make that decision.
Baroness Altmann (Con)
Will my noble friend join me in commending the excellent work of care staff during the appalling problems that have arisen over the past year during the pandemic? Will the Government urgently investigate the financial stability and debt levels of care home operators, which, too frequently, seem to have no controls on the amount of leverage, excessive debts or lack of equity in the sector?
Lord Bethell (Con)
My Lords, I absolutely join my noble friend in commending the incredible contribution of care home staff, domiciliary staff, unpaid care workers and all those who support loved ones, neighbours and residents. The Covid pandemic has shone a light on the selfless contribution of those people. The service continuity and care market review keeps a careful eye on the financial stability of the market. We are in constant contact with some of the biggest providers. The scene we see at the moment is not one that causes a huge amount of concern, but we keep close to the market.
Folic Acid
Baroness Altmann Excerpts(4 years, 11 months ago)
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Baroness Altmann (Con)
My Lords, I too congratulate the noble Lord, Lord Rooker, on his relentless campaigning on this issue and join others in encouraging my noble friend to, as soon as possible, ensure that manufacturers are mandated to add folic acid, so that we can prevent the misery and heartache of dealing with neural tube defects. I also ask my noble friend whether we can make sure that this applies to all kinds of flour, including gluten-free flour, for those mothers-to-be who are not able to have normal bread.
Lord Bethell (Con)
My Lords, I understand that considerable efforts have gone into ensuring that folic acid is put into flours of all kinds, and I pay tribute to the industry for trying to deliver a comprehensive service. I am happy to write to the noble Baroness to confirm that.