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.

Queen’s Speech

Baroness Bull Excerpts

Tuesday 22nd October 2019 Lords Chamber

[Baroness Bull (CB)]

My Lords, it is a pleasure to follow the noble Baroness, who made a powerful and important speech. There are six themes on offer in today’s debate and I have chosen to speak about the one that is conspicuous by its absence from the gracious Speech, in order to fill the void where I believe that culture, creativity and the arts ought to be. I start by welcoming the announcement prior to the Queen’s Speech of a £250 million cultural investment fund for infrastructure improvements in regional museums and libraries. It is a timely response to a cri de coeur from museum leaders who have warned of a quiet crisis in infrastructure brought about by a decade of cuts to local and government funding. As welcome as this money is, though, it begs a question. In shoring up our museums, galleries, libraries and theatres for the future, are we doing enough to ensure that every citizen has an equal opportunity to access and enjoy them?

In 2015, the Warwick Commission on the Future of Cultural Value revealed a worrying lack of social, economic and cultural diversity in audiences and participants across arts and culture, with the higher social groups accounting for 87% of all museum visits. Cultural organisations up and down the country are working hard to address this imbalance through innovative programmes, marketing and the use of technology, but they do so with one hand tied behind their backs—trapped by the narrowing over the past decade of cultural education in schools. Report after report has detailed the reductions in hours and teacher numbers and the number of students taking arts subjects at GCSE and A-level, yet Ministers are still reluctant to acknowledge that there is a problem.

Like other noble Lords, I welcome the ambition to,

“ensure that all young people have access to an excellent education, unlocking their full potential and preparing them for the world of work”,

but I regret that it does not explicitly include a commitment to reversing the decline in arts provision in state schools.

This is not just about providing the encounters with arts and culture that would diversify audiences of the future, nor even ensuring equitable access for every child to the rich cultural heritage that is their birthright. No, it is about social mobility, unlocking potential and the preparedness for work to which the gracious Speech refers. Evidence shows that learning through the arts develops core personal and employability skills —confidence, collaboration, communication, problem-solving and resilience—and builds the cultural capital that is crucial in determining who gets into the elite professions and who rises to the top. Independent schools have long understood this, selling themselves to parents on the basis of high-quality arts provision. Meanwhile, art is squeezed out of education for 93% of the population.

Studying arts subjects is also one of the most effective ways of developing creativity, a skill that experts predict will be the most valuable we can offer the next generation. We miss the point if we imagine creativity to be the preserve of artists alone. Without creativity there would be no innovation, no technological breakthroughs and no scientific discoveries.

Of course, science has its place in the Queen’s Speech, with a commitment to establish the UK as,

“a world leader in scientific capability”,

to tackle some of the greatest challenges facing society. It is a laudable ambition, but it ignores the role of the arts and humanities in addressing these complex questions—the historians, anthropologists, ethnologists, philosophers, ethicists and artists who can provide the context, culture and understanding of human behaviour that will be key to driving sustainable change.

This prioritisation is not surprising. The Prime Minister’s most senior adviser has a long-held passion for science, advocating back in 2014 for,

“a civilian version of DARPA aimed at high-risk/high-impact breakthroughs in … energy science … quantum information and computing”.

The reference to this in the Queen’s Speech raises questions about the Haldane principle and the systems in place to separate government from decisions on which research gets funded. Perhaps the Minister can clarify whether this new agency is intended to sit within or outside the UKRI umbrella.

The Speech closes, as will I, with the aspiration for the UK to continue to play a leading role on the global stage. Our artists and creative organisations are among the UK’s greatest ambassadors, but their international standing has been built on the freedom to move people and equipment across borders without carnets, tariffs or visas. It is a sector dependent on importing specialist freelance talent and in which even the brightest and best can earn less than the £30,000 salary threshold proposed in the immigration White Paper. Its number one priority post Brexit is continued and reciprocal mobility to protect the sector’s success and the substantial contribution it makes to the economy, exports and employment across the UK.

Given this, perhaps the Minister might take away the suggestion that the more accessible visa system promised for scientific talent might reasonably be extended to cultural and creative talent too. As we work to rebuild our global reputation after Brexit, the soft power our artists and cultural organisations generate for the UK will be more important than ever before.

Mental Health: Weight and Shape-related Bullying

Baroness Bull Excerpts

Monday 22nd July 2019 Lords Chamber

Asked by

[Baroness Bull]

To ask Her Majesty’s Government what assessment they have made of the impact of weight- and shape-related bullying, criticism and teasing on long-term mental health.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Blackwood of North Oxford) (Con)]

My Lords, bullying in all its forms can have a serious effect on mental health. Children who are exposed to frequent, persistent bullying are at a higher risk of developing mental health problems; exposure to bullying is also associated with elevated rates of anxiety, depression, self-harm and suicidal thoughts, which can last into adulthood. The Government are providing more than £2.8 million of funding up to 2020 to support schools in tackling bullying.

[Baroness Bull (CB)]

My Lords, weight-related teasing is a form of weight bias, the consequences of which can include depression, anxiety, low self-esteem, substance abuse, eating disorders, obesity and suicidality. Weight bias is on the increase and is prevalent across the population. Research shows that even health professionals are not immune to negative stereotypes that connect character and capability with weight. Is the Minister confident that adequate social policies are in place to address and reduce the incidence of weight bias? Does she believe that there is sufficient provision in the law to protect all of us, young and old, from discrimination on the basis of size and shape?

[Baroness Blackwood of North Oxford]

The noble Baroness has a record of raising this important issue. The Government recognise that poor body image is not only a common problem but is associated with mental ill health. Approximately 70% of adolescent girls and 45% of adolescent boys want to change their body, weight or shape. As she rightly points out, in the most extreme cases, that can lead to eating disorders, depression or even feeling suicidal. The Government have delivered a broad programme of body image work over the past six years. We believe that more work can be done but we are working hard to make sure that we expand our eating disorder community care work for children and young people over the next few years. I welcome continuing the debate to see what more can be done.