Covid-19: Response

Baroness Bull Excerpts

Monday 27th July 2020 Lords Chamber

[Lord Bethell [V]]

My Lords, it is put to me week in, week out that our relationship with directors of public health is in some way troubled. I reassure noble Lords that, every single day of the week, we are in contact with dozens of directors of public health in amicable, constructive dialogues that lead to concrete action, local interventions and sharing of data. These conversations happen in a cordial and friendly fashion. The message may have got through to some noble Lords that there is some huge acrimony and difficulty between us, but that is not the perspective that I have. The data has got through. It is a hell of a thing to have put up a huge track and trace system in a few months. That we can get such detailed data to a large number of people within the envelope of reasonable data security legislation is nothing short of a miracle. I am extremely proud and pay tribute to those involved.

[Baroness Bull (CB) [V]]

My Lords, I want to follow the noble Lord, Lord Reid of Cardowan, in pointing to ONS data, this time data showing that 60% of all deaths from Covid-19 have been among those living with disabilities. A recent report from Oxford University and the Bonavero Institute of Human Rights found a failure of government to embed social and human rights models of disability in its response to the pandemic, and a failure to support people with disabilities to make the adjustments required to comply with fast-changing regulations and to continue to live flourishing lives. Will the Government commit to an immediate review of the impact on disabled people of legislation passed during the coronavirus crisis, and will they put in place a disability-inclusive Covid-19 response and recovery action plan which involves people with lived experience of disabilities in decisions on economic and social recovery as well as ongoing healthcare guidance?

[Lord Bethell [V]]

My Lords, it is a horrible truth that this disease hits hardest those with vulnerabilities. We have put in place a massive national programme to seek to protect the most vulnerable, and those with disabilities have been very much the focus of our attention. I cannot make the commitments that I know the noble Baroness wants me to make, but I reassure her that those with disabilities are the focus of what we are trying to do.

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

Baroness Bull Excerpts

Friday 24th July 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, I should like to highlight the implications of these regulations for people with disabilities or impaired decision-making capacity and for those who support them. Once again, new regulations have come into effect that offer no clarity on how they should be applied when someone lacks the capacity to understand that they are in contravention of the law, or on the responsibilities of a person using these powers in regard to those with impaired decision-making capacity. The Oxford University Disability, Law and Policy Project at the Bonavero Institute of Human Rights recently reported on the impact of coronavirus-related law, policy and practice on people with disabilities. It found a failure on the part of the Government to implement properly their legal duties with respect to these people’s rights.

Last week, charities called on the Prime Minister to prioritise the national disability strategy and factor the needs of disabled people into every change in regulations going forward. Can the Minister confirm that the Government will respond positively to this plea? If they act now, there may still be time to mitigate the immediate impacts of this crisis and its long-term consequences for people living with disabilities.

Food: Fruit and Vegetables

Baroness Bull Excerpts

Monday 6th July 2020 Lords Chamber

[Lord Bethell]

My noble friend touches on an interesting area. I cannot answer it precisely. I am not sure that we have taken any assessment of the effect of eating vegetables and fruit during the lockdown, but I will find out from the department and write to the noble Lord.

[Baroness Bull (CB) [V]]

Can the Minister clarify where responsibility lies for overseeing the nutritional quality of food delivered to children eligible for free school meals? During Covid, reports have circulated on social media of packages containing crisps, chocolate biscuits and a block of fat marked “for cooking only”. In response to a letter by leading food policy experts, sent to both Defra and Public Health England, each body seemed to indicate that the other should be held responsible. Does the Minister agree that, without clarity on this, the focus on good nutrition is at risk and accountability too easily sidestepped?

[Lord Bethell]

The noble Baroness is right to cast a spotlight on an apparent area of policy confusion. Labelling is normally associated with Defra, and the provision of school meals with the Department for Education. If there is ambiguity about that, I would be happy to chase it down for the noble Baroness.

Covid-19: Response

Baroness Bull Excerpts

Tuesday 19th May 2020 Lords Chamber

[Lord Bethell]

I am afraid I did not hear the full question from the noble Baroness, but if I understood her correctly, she referred to track and trace. I reassure her that we are putting a huge amount of resources into that surveillance. It is true that surveillance does not currently exist. We do not have the facilities that some Asian countries, such as Taiwan and South Korea, had following SARS, about which we now know so much. We are putting the correct resources in place, and we hope very much to have a detailed local and demographic understanding of where and how the disease is progressing. That information is essential to beating it.

[Baroness Bull (CB)]

My Lords, many people in learning disability care services have very complex care needs that make them vulnerable to Covid-19. Indeed, recent numbers from the CQC showed that the provisional number of deaths reported across all settings where autistic people and/or people with learning disabilities may live was 175% greater than expected over the month from 10 April. When will the welcome extension of testing to all care settings announced today roll out? Can he confirm that regular testing will be available, given the potential of the virus to be spread between care homes by so-called bank staff filling temporary vacancies?

[Lord Bethell]

The noble Baroness is entirely right that the deaths of those with learning difficulties have been one of the most disturbing and sad aspects of this disease. We are focused very much on ensuring that we protect those with learning difficulties, such as those with autism, in whatever way we can. With regard to recurrent testing, the tests that we have are not a limitless resource and we have to prioritise them. Although we have massively increased the number of tests that we have, it is not possible to test millions of people on a very regular basis with hundreds of thousands of tests. However, we are using them intelligently and prioritising areas where there are infection control problems. We believe that that is the most effective way of using our resources.

Covid-19: Vulnerable Populations

Baroness Bull Excerpts

Tuesday 12th May 2020 Lords Chamber

Asked by

[Baroness Bull]

To ask Her Majesty’s Government what assessment they have made of the measures in place to protect vulnerable populations during the COVID-19 pandemic.

The Question was considered in a Virtual Proceeding via video call.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)]

My Lords, social distancing and shielding measures are in place to protect vulnerable and clinically extremely vulnerable populations. Those identified as clinically extremely vulnerable are advised to stay at home with no face-to-face contact until at least the end of June. Our approach is under continuous review. The Government’s position on shielding and social distancing reflects the latest SAGE and clinical advice from the Chief Medical Officer.

[Baroness Bull (CB)]

My Lords, every person with a learning disability has the right to be supported to live in their community, but Covid-19 is putting already-delayed in-patient transfers at risk. In March some 1,900 adults and 200 children were still locked away in in-patient units, the majority sectioned under the Mental Health Act and staying for five years in facilities intended to be short-term. Can the Minister share his department’s updated assessment of whether the Mental Health Act easements provided for in the Coronavirus Act will be required, now that the peak in infections has been passed and a plan for lifting restrictions is taking shape? Does he share concerns that these easements, if enacted, would risk the delivery of the care needed to support community living and the achievement of the goals set out in Transforming Care?

[Lord Bethell]

The noble Baroness, Lady Bull, asks a searching question. On whether the Mental Health Act easements of which she speaks have already been enacted, I will have to find out exactly what those arrangements are and write to her. However, I assure the House that the care of the most vulnerable is absolutely the Government’s number one, top priority. It is true that some of those caring and providing important pastoral care for the most vulnerable have been worst hit by Covid—the examples she gives are really good ones—but we are absolutely putting the care of the most vulnerable at the top of our priorities.

Covid-19: Social Care Services

Baroness Bull Excerpts

Thursday 23rd April 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, I join others in thanking the noble Baroness, Lady Wheeler, for introducing this important debate. I will focus my comments on the impact on the UK’s 1.5 million people who live with learning disabilities. Their challenges have been exacerbated by this pandemic. They are already seven times more likely to be socially isolated and to suffer mental health problems, and so are at particular risk from the effects of quarantine. They are challenged to understand social distancing and they are at high risk of respiratory problems, making them more vulnerable to the virus.

While the action plan for adult social care acknowledges the Covid-related challenges of this community, disability advocates have raised a number of concerns about the plan and the sector’s specific challenges. Workforce support is a key pillar of the plan but is silent on pay increases, which is a significant factor in retention and recruitment. As the workforce includes 115,000 people from the EU, staff shortages are a long-term concern.

Concerns have also been expressed that the £1.6 billion emergency funding for local authorities to support social care providers is insufficient and that distribution across different areas is uneven. The noble Baroness, Lady Jolly, articulated concerns about guidance on the assessment of people with learning disabilities who contract Covid-19, with GPs wrongly conflating support needs with frailty and telling people that they will not be prioritised for treatment.

Finally, there are concerns about flexibilities to social protection introduced by the Coronavirus Act. Can the Minister provide reassurance that people with learning disabilities will not fall through the gaps and end up locked away in in-patient units? There are already 2,000 people in these units, often far from their families and held in inappropriate environments—sometimes confined to a single room—while awaiting the completion of their care and treatment reviews. I know personally one family in the midst of such a process, with a long-awaited solution tantalisingly in sight before coronavirus put everything on the back burner. Can the Government give this family and others like them reassurance that their needs will not go to the back of a long queue, or be forgotten altogether, once this immediate crisis is under control?

The desperate need for long-term reform of social care has been highlighted yet again by the situation we now face. In 1942, while the world was at war, the British Government produced the Beveridge report, and with it the basis for the welfare state. This crisis must inspire the same sort of visionary thinking. It is not just a question of how we react to this pandemic; it is about the legacy that this generation will leave behind.

Queen’s Speech

Baroness Bull Excerpts

Thursday 9th January 2020 Lords Chamber

[Baroness Bull (CB)]

My Lords, in the days following Her Majesty’s gracious Speech, noble Lords may have missed the announcement of 0.3% as UK statistic of the decade. It represents UK productivity’s average annual growth, down over 10 years from 2%. According to the Royal Statistical Society’s Hetan Shah, it is

“the most important boring statistic that you have never heard of.”

Productivity did not feature much in election campaigns, but it should have. High productivity growth leads to higher wage growth and more money for public services. Shah is not alone in linking low productivity with social discord. The University of Sheffield’s Richard Jones suggests that it is not

“far-fetched to ascribe our current dysfunctional and bitter political environment … to a decade of stagnation in productivity growth.”

I therefore welcome the commitment to boost productivity through new investment and R&D tax incentives. As the notes on the Speech explain:

“R&D is vital to a productive economy—firms that invest in R&D have around 13 per cent higher productivity than those firms that do not”.


The Government intend to

“prioritise investment in industries of the future where the UK can take a commanding lead”—

life sciences, clean energy, space, design, computing, robotics and AI. But in focusing on the cutting edge, they need to take care not to ignore everyday and foundational areas where poor productivity is a drain on the economy: low-wage, low-skill industries such as catering and retail; the public sector, which makes up one-fifth of the economy; or health and social care, where advances in biomedical science need to be balanced with research that improves productivity in the system.

Too narrow a focus on becoming a “global science superpower” also risks excluding areas of existing dominance. This includes the creative industries, which generate 5.5% of the economy and contribute across every region of the UK. Yet they are absent from the Queen’s Speech—as they were from the last—and are seemingly excluded from any additional support for research and development. Creative businesses undertake almost as much R&D as manufacturing, but as much of it relies on arts, humanities and social science research, it does not qualify for targeted R&D tax relief. This is because in applying R&D definitions that draw on the Frascati Manual, HMRC requires that R&D relates to scientific or technological delivery, despite the manual’s wider scope. Arts, humanities and social sciences are specifically excluded, and are deemed

“not science for the purpose of these Guidelines.”

This narrow definition excludes advances in knowledge that lead to production of experiences or to enhanced understanding of human behaviour.

The benefits of a unified R&D definition across all knowledge domains go beyond the support of legitimate innovation in the creative sectors, and I am grateful to the noble Lord, Lord Duncan, for agreeing to meet on this. A unified definition would ensure that technological solutions are informed by insights into human behaviour, making adoption more likely; it would also encourage knowledge exchange across disciplines where innovation often occurs.

The correlation between creativity and scientific discovery is well understood, including, I know, by the noble Baroness, Lady Blackwood. Galileo was a poet; Newton was a painter; and Leonardo was both, and more. A 2008 study of 40 Nobel laureates in science found them three times more likely to have arts and crafts avocations than other scientists. Several observed that

“purely academic skills are not sufficient to train a person for creative scientific work.”

This makes obvious sense: it takes creative thinking to come up with new hypotheses and to imagine the experiments that will prove them.

Given this, the Government’s decision to opt out of the PISA 2021 test for creative thinking is surely a mistake. This is a unique opportunity to collect internationally comparable data and increase understanding of how education best develops creative thinking—vital for the workforce of the future and vital in solving global challenges. It is an opportunity that the Government should not turn down.

The Conservative manifesto promised to promote creativity in schools, but measures to do so are noticeably absent from the Queen’s Speech. Reversing the decision to opt out of the PISA 2021 test for creative thinking would be a first step in addressing this. I am sure noble Lords will agree that it would be unfortunate if, in our efforts for the UK to become the global science superpower, we were to lose our position as a global superstar in creativity.

Health: Eating Disorders

Baroness Bull Excerpts

Tuesday 7th January 2020 Lords Chamber

[Baroness Blackwood of North Oxford]

My noble friend is right that schools are important if we are to deliver on our commitment to the earlier diagnosis and prevention of mental ill-health, particularly in the area of eating disorders. We are introducing new school and college-based mental health support teams, the first of which are now becoming operational. We are also piloting four-week waiting times in 12 areas to improve access to children’s and young people’s specialist mental health services, which link to those schools, and we will evaluate performance on that.

[Baroness Bull (CB)]

My Lords, can the Minister confirm that in addressing the rise in eating disorders, sufficient consideration will be given to the intersection with the anti-obesity agenda? Measures to tackle child- hood obesity such as calorie counting or compensatory exercise are also symptoms of eating disorders, the very behaviours that treatment seeks to address. Many patients report that their illness started as a result of weight-related teasing, healthy eating advice or being praised for dramatic weight loss. Does the Minister agree that the solutions for eating disorders and obesity need to be considered in parallel to avoid the risk of one impacting negatively on the other?

[Baroness Blackwood of North Oxford]

Obviously we cannot ignore the obesity challenges that we face in this nation, and it is right that we take strong action to address them. But we recognise that this must be done in a sensitive way that also takes into account the potential consequences for those with eating disorders. We must strike a careful balance between informing and educating people about healthier choices and not negatively impacting on those with eating disorders, those in recovery from eating disorders or those who have the potential to develop them.